A Very Long Day of Markup as Opposing Sides Argue Over Murphy’s Mental Health Bill

(Updated 11:30 am Thursday)

As expected, Democratic opponents to Rep. Tim Murphy’s Helping Families in Mental Health Crisis Act objected strongly Wednesday to the bill as written and introduced a slew of amendments in what turned into an exhausting hearing.  Those amendments were rejected. (See Shannon Muchmore’s story below)

I will post further reviews and analysis shortly. Meanwhile, you can watch the entire hearing above. Skip the first 36 minutes and 47 seconds in the first video. Yep, that’s all it takes for the  subcommittee to approve several other bills. And then the Pennsylvania Republican’s legislation  is brought before the subcommittee and the arguing starts and continues and continues and continues.

Although these two videos add up to ten hours, they are interesting to watch because viewers get to hear the differing views. From the subcommittee markup, Murphy’s bill goes to a full committee markup where attempts to change it will be made once again. Then, if it passes from the committee to the House floor, it will face more potential changes. From there, it will go to a committee to be merged with the Senate version, where it will face more potential changes.

Meaning, this is simply the first round.

Grab some popcorn,  several drinks, find a comfortable seat and watch our elected leaders all agree that our mental health system is a complete mess, but disagree completely on how to fix it.

Here is a report from Modern Healthcare reporter Shannon Muchmore.

Changes to mental health bill don’t satisfy Democrats or advocates

Rep. Tim Murphy (R-Pa.) offered changes to his mental health reform bill Wednesday, including altered language on assisted outpatient treatment, patient privacy and electronic health-record requirements. Democrats say their amendments were not being taken seriously despite Murphy’s pledge to seek bipartisan support, and advocates now say the bill has been weakened.

The Helping Families in Mental Health Crisis Act was the most discussed bill in the markup from the Energy and Commerce Committee’s Health Subcommittee. A Senate mental health bill with many of the same provisions is scheduled for markup early next year.

Murphy’s amendment requires doctors to be trained on permissible disclosure of patient information to avoid violations of the Health Insurance Portability and Accountability Act. Murphy also refined some changes to allow information to be shared with caregivers.

The amendment also clarifies that all states can receive community mental health block grants, regardless of whether they have laws allowing involuntary outpatient treatment. States with such laws will be eligible for extra funding.

In announcing his amendment, Murphy said his bill would save lives by helping prevent violent acts and deaths from mental illness. He added that most people who are mentally ill are not violent.

“For the sake of millions of suffering families, this has to end and the time is now,” he said.

Rep. Frank Pallone (D-N.J.) said the bill cuts away essential funding, stigmatizes mental illness, reduces privacy protections and doesn’t do enough to promote Medicaid expansion in all states.

“This legislation takes us back to outdated and biased treatment,” he said.

The bill has been discussed at countless meetings with legislative staff and mental health advocates, but Republicans never actually addressed Democratic concerns, he said.

Pallone has some added skin in the game: He has a substitution amendment that would use evidence-based treatment to stop crises and promote early intervention, with the hope, he says, of revamping the entire behavioral health system.

“True reform cannot occur by shifting around current resources,” he added.

Another amendment to Murphy’s bill comes from Rep. Gene Green (D-Texas), who called for an audit of the Substance Abuse and Mental Health Services Administration as a response to Republican complaints that the agency doesn’t allocate funds in the most effective manner.

Green said he did not think an audit was needed and that even with the new amendment, Murphy’s bill would cut resources for SAMHSA, which should be reformed instead.

Both the Green and Pallone amendments were voted down along party lines.

John Snook, executive director of the Treatment Advocacy Center, said any changes to the bill’s original requirements for HIPAA and court-ordered outpatient treatment would cause it to lose focus on the severely mentally ill. He remains encouraged the need for reform will win out.

“Unfortunately, what we’re seeing is more political theater than actual discussion of issues,” he said. “The bill has broad bipartisan support precisely because it deals with those sorts of issues. Stripping them out makes the bill a waste of time and effort.”

Shannon Muchmore reports from Washington on health politics and policy. Before joining Modern Healthcare in 2015, she was the health reporter at the Tulsa (Okla.) World. She has a bachelor’s degree in news editorial journalism from Oklahoma State University.


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.