Va. Senator Creigh Deeds’ Eloquent Words Capture Parents’ Frustration With System: Speaks at Capitol Summit

(5-30-16) If you wish to know why parents of adult children with mental illnesses are frustrated by today’s failing mental health system, listen to Virginia state Senator Creigh Deeds’ powerful and eloquent keynote speech that begins at 3:05:05 on the video posted above. (Don’t worry, it is only a few minutes long.)

Senator Deeds’ observations about the problems he encountered because of federal HIPAA laws, mirror comments that I receive each week from bewildered parents.

Deeds was the featured speaker at a U.S. Senate Summit on Mental Health held by Senators Bill Cassidy (R. La.) and Chris Murphy (D-Conn.) last week to whip up support for their bipartisan bill, the Mental Health Reform Act, which is making its way through the Senate. Both are hopeful that some version of it could be sent to the White House this summer to be signed into law.

Sens. Cassidy and Murphy have been working tirelessly for passage of their bill. Initially, their legislation was a companion bill to the Helping Families In Mental Health Crisis Act introduced by Rep. Tim Murphy  (R-Pa.) in the House. But that House bill drew such strong opposition from Democrats and several mental health and disability groups that it has been stymied. Insiders claim it has no chance of ever being passed as currently written.

To avoid a similar deadlock in the Senate, Cassidy and Murphy modified or dropped the most contentious changes that Rep. Murphy has requested, including major changes to HIPAA.

Senators Cassidy and Murphy were kind enough to invite me to moderate one of three panels at their day long summit that attracted a capacity crowd of more than 150 from advocacy groups, insurance companies, and mental health providers.

Hakeen Rahim gave an inspiring speech about his personal recovery. (Begins at 2:03:37)

Also worth your time is a statement by Dr. Peter Jacoby, chairman of emergency medicine at St. Mary’s Hospital in Waterbury, Conn., who warned the audience that our nation is in the midst of a crisis care bed shortage that is leading to widespread emergency room psychiatric bed boarding. (2:20:37)

Both Rahim and Jacoby strongly endorsed the senator’s bill, as did a cadre of other speakers.

Senator Lamar Alexander (R-Tenn.), the chairman of the Health, Education, Labor and Pensions Committee,  is the veteran senate power broker guiding Cassidy’s and Murphy’s bill forward, and at the summit, he complimented both, calling them “progressive, pragmatic, and effective.”  He stressed that Democrats and Republicans have to be willing to compromise and “take as much as you can get” if you wish to get a bill passed into law.  (His comments come at 15:00:01 on the tape.)

Knowing that backers of Rep. Murphy’s bill are unhappy with the Senate compromises, Sen. Alexander cited this illustration: If you live in Nashville and have been trying to get to New York City for seven years and someone offers you a ride to Philadelphia, do you say, ‘No, I’ll wait another seven years for a ride to New York or do you get to Philadelphia?’

Here is a synopsis of the Mental Health Reform Act of 2016 based on a press release issued before the summit.

Strengthens leadership and accountability for federal mental health programs:

  • Ensures the Assistant Secretary for Planning and Evaluation (ASPE) has a clear role with respect to evaluating programs and activities for mental health and substance use disorders.
  • Codifies a Chief Medical Officer at the Substance Abuse and Mental Health Services Administration (SAMHSA) to assist the Administrator and promote evidence-based and promising best practices.
  • Requires SAMHSA to develop a strategic plan with specific outcomes and goals and to review progress toward strategic priorities, and assess how programs meet established goals and performance measures.
  • Establishes an Inter-Departmental Serious Mental Illness Coordinating Committee to coordinate activities across the federal government in order to improve services for individuals with serious mental illness.Ensures programs facilitate the development of and incorporate the most up-to-date approaches to treat mental health conditions:
    • Codifies the Office of Policy, Planning, and Innovation (OPPI) within SAMHSA to provide leadership in coordinating and improving policies and programs within SAMHSA, and to support innovation in evidence-based and promising practices and programs.
    • Ensures that SAMHSA regularly evaluates and disseminates evidence-based practices and programs,collaborates with federal agencies to improve care for veterans and service members, and improves community-based and other mental health care services for individuals with serious mental illness (SMI) and children with serious emotional disturbance (SED).
    • Updates grant programs that support priority mental health and substance use disorder needs of regional and national significance.Supports flexibility for states and communities to improve mental health care:
    • Modernizes block grants for mental and substance use disorder treatment and prevention services.
    • Gives states additional flexibility to use Community Mental Health Services block grant funding to provide community mental health services for adults with SMI, and children with SED.
    • Allows states to submit a joint application for block grants to reduce redundancies and inefficiencies.
    • Replaces an outdated grant program with an Emerging Drug Issues Grant Program to support the ability of states to address emerging drug abuse issues, including opioid use disorders.Promotes increased access to mental health care and substance use disorder services:
    • Modernizes grant programs for mental health and substance use disorder services for homeless individuals.
    • Improves a current grant program related to integration of mental health and primary care with a new approach to drive significant reforms that improve care and health outcomes for patients
    • Supports the development and training of the behavioral health workforce.
    • Ensures the National Suicide Prevention Lifeline is available 24/7 to individuals seeking help, and ensures military veterans calling the hotline are connected with a veterans’ suicide prevention hotline specialist.
    • Codifies a hotline and online referral tool to ensure that patient and their families always know where to turn to find care for mental or substance use disorders.
    • Improves eating disorders awareness, supports education and training for health professionals to identify individuals with eating disorders, provide early intervention services, and refer patients to appropriate treatment.
    • Strengthens community-based crisis response systems to develop, maintain, or enhance a database of beds at inpatient psychiatric facilities, crisis stabilization units, and community treatment facilities.

Strengthens mental and substance use disorder services for women, children, and adolescents:

  • Reauthorizes Residential Treatment Programs for Pregnant and Parenting Women, including a pilot program to help states identify and address gaps in services for women.
  • Improves access to mental health care for children by providing grants to promote behavioral health integration in pediatric primary care through the development and improvement of statewide child psychiatry access programs.
  • Authorizes a grant program to help states enhance screening for maternal depression and a grant program for infant and early childhood mental health prevention, intervention, and treatment.Requires important clarifications to improve patient care:
  • Requires the Office of the Inspector General at HHS to issue a compliance program guidance to provide examples of compliance and noncompliance with existing mental health parity laws. This guidance will be based on former investigations and legal findings and will provide health plans, patients, and law enforcement with clear examples of how the law should be applied and enforced.
  • Requires HHS to issue new guidance documents to provide examples of methods health plans may use for disclosing information to patients and making coverage determinations which will bring much needed clarity to patients about how mental health coverage decision are made.
  • Requires HHS to produce an action plan for improved Federal and State coordination of enforcement of existing mental health parity laws to ensure that the right government officials share information and workin comprehensive manner to assist patients when they are seeking coverage of mental health benefits.
  • Ensures health care providers, patients, their families, and others involved with mental health or substance use disorder treatment have access to usable resources clarifying the permitted uses and disclosures of protected health information under the HIPAA Privacy Rule, including model training programs on sharing protected health information.Includes the Mental Health Awareness and Improvement Act, which passed the Senate in 2015:
  • Reauthorizes the Mental Health and Substance Use Disorder Services on Campuses grant program and the Youth Suicide Early Intervention and Prevention Strategies grant program.
  • Reauthorizes grants to train teachers, appropriate school personnel, emergency services personnel, and others, as appropriate, to recognize the signs and symptoms of mental illness, to become familiar with resources in the community for individuals with mental illnesses, and for the purpose of the safe de- escalation of crisis situations involving individuals with mental illness.
  • Reauthorizes the National Child Traumatic Stress Initiative (NCTSI), which supports a national network of child trauma centers, including university, hospital, and community-based centers and affiliate members.
  • Encourages the Director of the Centers for Disease Control and Prevention to improve, particularly through the inclusion of other states, the existing National Violent Death Reporting System.Improves the prevention and treatment of opioid use disorders:
    • In the cases of new drugs, the Commissioner of Food and Drugs shall refer to an Advisory Committee of the FDA for recommendations and a Pediatric Advisory Committee for recommendations on the inclusion of information in labeling of opioid drugs to be used in pediatric populations.
    • The Secretary of HHS shall develop recommendations for education programs for prescribers of opioids along with recommendations for which and how often prescribers should participate in such programs.
    • Requires the Department of Veterans Affairs to report information to State controlled substance monitoring programs.
    • Requires the Government Accountability Office (GAO) to conduct a study on state prescription drug monitoring programs (PDMPs).
    • Allows the National Institutes of Health to intensify and coordinate research to promote development of alternatives to opioids for effective pain treatment.
    • Requires HHS to issue best practices for prescribing opioids for treatment of acute pain, and disseminate information to prescribers on best practices of safe opioid prescribing for chronic pain.
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.