Rep. Murphy Continues To Push For Reforms In Final Hours, Emails Question NAMI’s Stance

Posted July  30, 2014

Representative Tim Murphy  (R-Pa.) is continuing to push for passage of his  Helping Families in Mental Health Crisis Act (H.R. 3717) even as the clock to the August 1st  congressional recess counts down. Meanwhile the bill’s supporters continue to ask why the National Alliance on Mental Illness has not urged its thousands of members to lobby for its passage.

On the House floor Tuesday (July 29th), Murphy described barriers that are keeping individuals with mental illnesses from getting meaningful care. As a result, some 365,000 of them are in jails and prisons. Today (July 30th), Murphy will co-host a congressional briefing where he will call for reforms  in the IMD exclusion – a tool which the federal government uses to prevent states and private mental health care providers from operating facilities with more than 16 beds. The federal government adopted the IMD rule in 1965 as part of its deinstitutionalization campaign. Its refusal to allow Medicaid dollars to be spent on patients in large hospitals is one reason why states began closing down those facilities.

At the briefing today, Murphy and Rep.  Eddie Bernice Johnson, (D-Tx.), a cosponsor of H.R. 3717, will explain how the IMD rule is unintentionally contributing to homelessness. I saw this first hand in Miami when a successful housing program called Passageways was forced to vacate 16 beds in its 32 bed housing unit because of the IMD rule. The program’s founders were hard pressed to find suitable housing for those 16 clients who had been living in clean, comfortable and safe rooms. Having half of the program’s clients booted out of their rooms also had a financial impact on the program. This incident was a perfect example of why the National Alliance on Mental Illness, the nation’s largest grassroots mental health agency, has been calling for reform of the IMD rule.

Although NAMI has called for changing the IMD rule and also is on record supporting passage of AOT laws and reforming involuntary commitment standards (changes that would be implemented in Murphy’s bill), the organization has not made an effort to rally its membership in support of Murphy’s legislation. Insiders say the national leadership is fearful that such a push would cause deep divisions in NAMI’s diverse membership, hurting the organization.  As reported last week on this blog, groups opposed to Murphy’s bill have used emails and webinars to urge their members to campaign against its passage. Opponents claim that Murphy’s bill will roll back hard-won civil rights protections, a charge Murphy says is unfair.

“Some activists are more comfortable allowing the mentally ill to live under bridges or behind dumpsters then in a psychiatric bed because they cling to their fears of the old asylum system as if medical science and our understanding of the brain had not advance over the last 60 years.”

Several organizations that oppose the bill would lose substantial funding if it passes. Murphy’s legislation would transfer millions in federal mental health dollars away from the Substance Abuse and Mental Health Services Administration. Instead those funds would be used by the National Institute of Mental Health, the government’s mental health research arm.

I received a slew of emails after I posted a blog Friday about a last minute campaign by opponents to block Murphy’s bill.  These are typical.

 There are parts of Murphy’s bill that go too far, but that shouldn’t keep NAMI from using its membership to put pressure on Democrats  to compromise with Murphy. NAMI should realize this is not an all or nothing fight and push Democrats to the negotiation table.

NAMI is afraid of losing money if Murphy’s bill is passed. It talks reforms but it’s all about keeping the status quo.

NAMI’s silence on the advocacy for this bill is extremely frustrating, but predictable.

I hold NAMI, (national) personally responsible for dragging their feet, sitting on the fence and not mobilizing advocates to be more vocal and supportive about this bill for the past year! Families like mine are drowning and our tax dollars (under SAMHSA) are being used to support this recovery nonsense that doesn’t help, (actually harms) our loved ones, who are trapped in the revolving door.
NAMI will be lobbying Congress during its national convention in September. The announcement that NAMI has distributed about its National Day of Action didn’t state whether or not Murphy’s bill will be one of the items on its list of concerns.
Join NAMI’s policy team for a briefing on legislative issues Wednesday, Sept. 3rd at 8 p.m. and then come be inspired at our Opening Legislative Plenary Thursday, Sept. 4th at 8 a.m. where former U. S. Representative Patrick Kennedy, former U. S. Senator Gordon Smith, and NAMI’s own executive director Mary Giliberti will make the rallying call to take NAMI’s message to Congress.

Rumors surfaced last week that supporters of Murphy’s bill had asked Kennedy to speak to the Democrats holding the legislation in committee but he demurred.

Murphy, a psychologist by training, began pushing for reforms shortly after the Sandy Hook Elementary School shootings.  He held repeated  hearings, inviting parents (including me) to testify about how current laws have prevented them from helping family members. His efforts have been stymed by Democrats Nancy Pelosi,  Henry Waxman, Ron Barber and Diane DeGette who have effectively kept Murphy’s bill stuck in committee.

Murphy has promised to reintroduce his bill during the next session of Congress if it doesn’t reach the house floor by July 31st. Politicians are famous for making promises, but given the determination he’s shown in writing and pushing his bill,  I’d say Murphy’s promise is one that will be kept — which means another fight between the bill’s backers and opponents will be coming.

(Immediately after posting this blog, a regular reader reminded me that NAMI did issue a statement about Murphy’s legislation in December last year. Here is what NAMI released.

To: NAMI State Organization and Affiliate Leaders
From: Ron Honberg and Andrew Sperling
Re: Mental Health Legislation in Congress
Date: December 17, 2013
We have received numerous inquiries about legislation introduced late last week by Congressman Tim Murphy (R. Pennsylvania) entitled the “Helping Families in Mental Health Crisis Act of 2013.” This memorandum is being shared with you to provide an overview of the
entire bill and to clarify NAMI’s position on it.The “Helping Families in Mental Health Crisis Act” has generated controversy and a significant
response from certain groups in the mental health field. These groups have largely focused on  provisions in the bill that they view as negative and have not discussed the many positive aspects of the bill.NAMI and a number of other organizations have avoided public criticism of the bill and have  written letters supporting specific provisions and expressing the desire to work with  Congressman Murphy to improve the bill into one that can be supported by the entire field.
What is NAMI’s Position on the Bill?

As detailed below, there are many positive provisions in the bill. Enactment of the positive  provisions would represent a significant legislative accomplishment on mental health. Because  of his personal background as a psychologist, Congressman Murphy is a key ally on mental
illness among Republicans in the House of Representatives. NAMI therefore believes that the  wisest strategy moving forward is to support the many positive provisions in the bill and to  work with Congressman Murphy and others to improve or remove the more controversial
provisions. Opportunities like this to advance meaningful legislation on serious mental illness  in Congress do not occur frequently.NAMI also recognizes that with most legislation it is very difficult to get language that everyone  stands 100 percent behind. We look forward to working through the political process to  advance the best possible bill.
Why is Congressman Murphy so concerned about serious mental illness?

Congressman Murphy is a psychologist with a background in providing community mental  health services to people living with serious mental illness. He is very concerned about the gaps  in mental health care and the fact that many individuals living with serious mental illness fall
through the cracks and experience multiple hospitalizations, homelessness, criminal justice  involvement, and other tragic circumstances. He is also aware that families frequently play an  essential caregiving and support role but also frequently encounter legal, policy and
environmental barriers in serving this role.
Congressman Murphy is Chair of the Oversight and Investigations Subcommittee of the House
Energy and Commerce Committee. With Congresswoman Diana DeGette (D. Colorado), the ranking Democratic member of the Subcommittee, he conducted three hearings on the federal  role in mental health services in the aftermath of the tragedy at Sandy Hook Elementary School
in Newtown, CT. NAMI Executive Director Mike Fitzpatrick testified at one of these hearings  and NAMI members were involved in all three of the hearings. Congressman Murphy has also  heard from many people about the tragic consequences of a failed mental health system.
Overview of the “Helping Families in Mental Health Crisis Act.”
The bill contains many provisions intended to improve the lives of people living with mental  illness, some of which reflect priorities that NAMI has worked on for years. These include:
 Improving community mental health services and integrated mental health and primary
care treatment through enactment of the Excellence in Mental Health Act;
 Expanding Medicaid reimbursement of inpatient psychiatric treatment;
 Reauthorizing the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA), an
important federal program providing resources to states, communities and tribal
governments for jail diversion, law enforcement and first responder training, and other
services to prevent unnecessary criminal justice involvement of youth and adults living with
serious mental illness;
 Improving the Health Insurance Portability and Accountability Act (HIPAA) and the Family
Educational Rights and Privacy Act (FERPA) to permit access to vital information for family
caregivers;
 Reauthorizing the Garrett Lee Smith Suicide Prevention Act, an important federal program
providing resources for suicide prevention and postvention;
 Improving access to psychiatric medication in Medicaid and Medicare;
 Enhancing federal coordination of mental health services through the creation of a federal
interagency Council on Serious Mental Illness
 Increasing resources for research at NIMH on early identification of serious mental illness in
youth;
 Authorizing a federal campaign to combat the stigma associated with mental illness;
 Reauthorizing federal programs focused on mental health services for children and youth
and
 Expanding Health Information Technology (HIT) resources for providers of mental health
services.
Certain provisions in the bill are more controversial, including:
 Transferring authority for administering the mental health and substance use Block Grants
from SAMHSA to a new Assistant Secretary for Mental Health and Substance Use Disorders
established through this bill;
 Reducing or eliminating funding for certain other SAMHSA programs;
 Eliminating the authority of state Protection and Advocacy programs to engage in lobbying
and class action lawsuits;
  Requiring some states to expand civil commitment criteria as a condition of receiving
federal block grant dollars;
Requiring some states to enact Assisted Outpatient Treatment (AOT) laws in states thatt have them (this would apply to only 5 states, since the majority of states have such  laws but rarely use them).
Process and Timetable
The Policy Committee of the NAMI Board of Directors will meet soon after the New Year to  discuss the bill and provide further guidance to staff. Staff will continue their efforts on Capitol sections. It  is likely that some of the provisions will be referred to other Committees in the House of  Representatives for consideration. While discussions about the bill will likely commence in  January when the House re-convenes, it is unlikely that serious consideration of the bill will  occur until Spring, 2014 or even later in the year.Thank you for your interest and for taking the time to read this memorandum.
Please contact
Andrew Sperling ([email protected], 703-524-7600) or Ron Honberg ([email protected], 703-
516-7972) with any questions or comments.Wishing you happy holidays and a healthy year ahead!

 

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.