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FEDERAL LEGISLATIVE NEWS
Federation national legislative priorities for the 109th Congress will include
the following:
Mental Health Parity
The Parity bill to be introduced in this Congress will be quite different from the Wellstone Parity bills of previous Congress’ in that it will carry the language of the 1996 Act and little else. Depending on the specific language, the Federation will probably give “grudging” support and push for expansion of language to more closely reflect previous versions of the bill. More on this once a final draft is introduced.
By the way, cosponsors for last year’s legislation included 70 Senators, 22 of whom were Republicans, and 249 Representatives, 46 of whom were Republicans. Parity also has the verbal support of the President. Hard to figure why it hasn’t passed, isn’t it.
Stop Taking Our Health Privacy (STOHP)
We anticipate this bill to be reintroduced by Rep. Markey (D-MA) and to have our full support. You’ll recall this legislation was introduced to return the requirement of “informed consent” regarding the use of an individual’s private health information to the HIPPA regulations after the current administration removed it in 2002.
Skilled Nursing Facility Legislation
We also anticipate this legislation will be reintroduced. As you’ll recall, during the passage of the Balanced Budget Act of 1997, mental health workers had to be excluded from the prospective payment system in order to directly bill Medicare for services provided to patients of skilled nursing facilities. Inadvertently, Clinical Social Workers were not so excluded and lost the ability to bill Medicare directly, resulting in a loss of adequate services to those patients.
When attempts to correct the situation by regulation through the Centers for Medicare and Medicaid Services (CMS) proved fruitless, the Federation turned to the Congress. We shall do so again in this Congress.
Completion / Implementation of the Mental Health Commission’s Plan
The Administration’s Commission on Mental Health Services completed its work and issued a final report in mid-2003. Since then HHS has been charged with the task of developing and issuing an Implementation Plan for the Commission’s many recommendations.
More than a year and a half later, and failing to meet its own deadlines the Plan has yet to be completed.
The Commission’s final report stated “… the mental health delivery system is fragmented and in disarray …” and called for “… new service delivery patterns and incentives (that) must ensure that every American has easy and continuous access to the most current treatments and best support services.” How HHS intends to accomplish this transformation and reach the specific recommendations of the Commission rests within the details of the Plan under development. The impact on mental health services could be profound. The Federation will push for the completion of the Plan and review it to determine future necessary action.
Funding Mental Health Services Funding mental health services continues to remain a legislative priority, only this year the battle for dollars may prove to be more difficult than in previous years. Not only are the Administration and the Congress determined to cut spending on all programs except security and defense, but also through a little-known budget process called reconciliation, cuts that appear to be slight and acceptable in the early years become cripplingly deep in later years.
Legislation To Watch
In addition, the Federation will review the proposals to privatize Social Security, the 800-pound gorilla of federal spending, and any new attempts by the Congress to push for national identity cards, which could have privacy implications.
Michael Leavitt Nominated New HHS Secretary
Upon confirmation, Michael Leavitt will come to his new post after being named last year as Administrator of the Environmental Protection Agency. He also served as Governor of Utah for 11 years and the president and chief executive officer of the Leavitt Group, the owner of 100 insurance agencies which sell Medigap insurance policies among other products.
Leavitt has already announced some of his priorities. They include medical liability reform and reduction of health care costs. On other matters such as abortion, embryonic stem cell research, family planning, and sexual abstinence, Leavitt’s position, at this point, generally resembles the President’s. It is also likely that we will see Leavitt carrying the standard for the President’s desire to increase funding to faith-based groups, which in 2003 received $568 million.Assuming the Congress is successful in enacting the budget cuts they desire for 2006, Leavitt’s department may see billions of dollars eliminated from CMS. Speculation by the pundits, based on Leavitt’s record at the EPA, is that at HHS he will defer to industry at the expense of public health.
Leavitt’s record on Medicaid in Utah is unclear. Advocates insist he expanded access to health care for children and helped shape national Medicaid policy. Detractors argue he does not have the requisite health care background and his reforms reduced benefits and increased costs for beneficiaries. In the late 1990’s, as Governor of Utah, Leavitt lobbied the Congress to convert the Medicaid program to a block grant, an approach opposed by the Federation and other mental health organizations as it provides significantly less coverage to those in need.
Richard Yanes is the Executive Director of the Clinical Social Work Federation (CSWF).