Transcripts For CSPAN3 Mental Health Care 20171214 : compare

Reforms were included in our 21st century cures act. Senator murray is not here today and so shes asked senator murphy to fill in for her. And ive asked senator cassdy to chair most of this hearing or at least until 11 45. Ill come back to attend it but think its important they chair the hearings, especially given their leadership in enacting the legislation last year. After our witness testified, senators will have five minutes of questions. Sean lest hadder is by all akounlts a typical busy nashville young adult with a fulltime job who also attends college. Two days before his 24th birthday experienced his first schizophrenic experience and since then admitted five times, spending three weeks receiving psychiatric treatment. He recently rote me saying this may seem slightly depressing but my story does not end there. The doctors and staff i encountered there taught me to live productively again in society. Ive been free in the hospital for a whole year now. Ive returned to work and even paid off car. Im currently enrolled as a junior pursuing a degree in psychology. Sean is one out of nearly 10 million in the United States with a Serious Mental Health condition. Without this treatment his story could have had a very different outcome. About one in five adults have a Mental Illness according to the department of Mental Health and Substance Abuse. Thats more than 1 million and over 230,000 have whats considered a serious Mental Illness. Over the past few years this committee has worked in a bipartisan way to update parts, including programs at the Mental Health Services Administration we call samsa for the first time in over a decade. This effort was championed by senators cassidy and murphy as well as collins and other members of this committee they were part of the Mental Health reform act and majority leader mcconnell called the most important Legislation Congress passed last year. Today marked the third hearing on the implementation of of the cures legislation. We hope it updates will help more americans access quality based education and health care. As i said when we begin hearings on the every Student Succeeds act, its not worth the paper prinlted on unless its implemented properly and i intend to make sure it cures act is properly implemented as well. Our focus is to hear how samsa is implementing the Mental Health provisions in cures. Of the 10 million americans with a Serious Mental Health iliniln and that includes bipolar disorder, major depression. Millions go without treatment as families strug tool find care for loved ones. Most are provided by the private sector or through programs run by the states. The largest role in the federal government is the amount spent through medicaid and partnership with the states. The federal government also plays a role through samsa, which while relatively small compared to medicate and responsibility of states is quality prevention screenings and recovery services. Tennessee received over 80 million in samsa grants last year. Prior to our wurk federal Mental Health programs had not been updated in a decade and the cord nations was not as effective as it could have been. I hope well learn more about how implementations is going. How has it improved on the best way to assist those with Mental Illness. For example we hope Promising Research and earlyfort vention programs at the National Institutes of health would translate to Clinical Applications and the samsa blocks to states to insure its best meeting the needs of those suffering from Mental Illness. In addition we encourage the adoption of proven scientific treatments. And id like to hear how the agency started incorporate more evidencebased approaches in Mental Health and inhad crease integration between primary care and Mental Health care and insure its comparable for other medical conditions and strengthen Suicide Prevention efforts. Dr. Mccants cats serves as the First Assistant secretary for Mental Health and Substance Abuse. A position we created in the 21st century cures act. New authorities to work with states and federal agencies and help more americans receive the treatment they need. I look forward to hearing about the progress being made to insure more people can receive the help they need and have positive outcomes like sean. Id now like the turn it chairing of this over to senator murphy and then senator cassidy will make a statement. Thank you very much, chairman alexander to both you and Ranking Member murray for holding this important hearing and thank you to senator murray for allowing me to sit in her place and it is indeed fitting were holding this on the oneyear anniversary of president obama signing the legislation that established this new position at the department of health and human services. Dr. Cats is the first in a position long over due. It is also almost five years to the day since the terrible tragedy at Sandy Hook Elementary School when a young man with Mental Illness killed. There is no connection between Mental Illness than violence. We have no more Mental Illness than any other country and and we with people fall through the cracks of our Mental Health care system it can have a tragic impact. Republicans and democrats were able to come together to pass the reform act, it rchts the First Comprehensive authorization of our Mental Health laws. And it couldnt have happened without the bipartisanship of this committee, which is of course a testament to chairman alexander and ranking am ember murray. I think the most important provision is the part that built on the parody and equity act by strengthening enforcement of that law. And there are two recent reports that illustrate how far we need go to illustrate that vision of charity. And the first nation wide charity report which found one out of three respondents had difficulty finding a Mental Health therapy, similarly released a study that found insurers paid primary care providers 20 more for the same care they pay addiction and Mental Health specialists. In many states the disparitities in payment rates were 2 to 3 times greater for people practicing medicine below the neck than those who are practicing medicine above the neck. Fortunately the 21st sevcentury cures law allows on parody. The law also created the role of the assistant secretary to make sure theres one person who is solely focussed on these issues and we codified the role to work closely with you. Other provisions include several Grant Programs to include coordination of Mental Health treatment and the first infant and early child Mental Health grants. And after hearing from consume and we ifcluded new authorization to help patients and clinicians and family members better understand when these disclosures can take place. There are other elements of the bill that will likely come up today. We have to remember none of the programs we authorized in this bill dont matter if it we dont fund them. Congress as an awful habit of talking a really good game on Mental Health and addiction but then never being able to reach our rhetoric. The appropriations bill doesnt yet include funding for programs in the bill we passed last year and even worse the repeal bill would have cut medicaid over time by 800 billion. Medicaid is the nations primary payer for Mental Health treatment. But the legislation we passed is still Ground Breaking and properly funded it will save lives. And so im deeply thankful to the committee for their work in making this bill possible and for calling this hearing and lastly id like to ask unanimous consent that rajing member murrays statement be placed in the record. Without objection. I learned a couple lessons that one when the patient has the power, the system lines up to serve the patient. But what ive also observed is those with serious Mental Illness have no power. Their ability to act upon the resources that are available are lost by it disorder which is in their mind. Now this is not just an experience for a fellow whos worked in a Public Hospital for the uninsured. Its the experience of us all, whether its a family member, an associate. Someone we went to high school with. We all know someone who seemed to have such prommice and that promise was snuffed out by serious Mental Illness and their ability to execute power totally lost because of that. Government has a role and government has a role at its best to help those who are most vulnerable. Theres been a tangle of efforts by government to attempt to help those who have serious Mental Illness. What i was so privileged to work with senator murray and others for the Mental Health bill of 2016 and we created the position that dr. Cats is the first to hold to create the authority to untangle this mess and somehow take this whole mismash of Government Programs and line them up to help those with serious Mental Illness. Were on about it oneyear anniversary of that bill signing. And this is a hearing to look at the effectiveness of this. And let me say sometimes these committees are conon foritative. This is about cooperation. How do we Work Together with this newly created position so that we can better serve those folks who have lost their power for almost anything because of serious Mental Illness . My goal is that when that 24yearold has her first sicaughtic episode, its her last and when shes 50 years old does not look back on that as oo event leading to loss of her family and children and health but rather a distant memory from which she grew and became a better person. That is the goal of all of us. We look forward to your testimony as to how ultimately we restore wholeness and return power to that patient. Now i will make that introduction. Very pleased to welcome dr. Eleanor mccans kats to todays hearing. Shes it assistant secretary for the Mental Health and Substance Abuse administration. The 21st century cures act created the secretary, replacing the role of samsa administrator. She formally served as the chief medical officer for rhode island Behavior Health care in hospitals. Before that served as chief medical officer for samsa. You have five minutes to give your testimony and we shall hear from you now. Thank you so much, senator cassdy, murphy and members of the health education, labor and pensions committee. Thank you for inviting me to testify today. One year ago today the Substance Abuse and Mental Health Services Administration has been accurately implementing and for over 25 years ive served people with serious Mental Illness and Substance Abuse disorders. Its such a privilege for me and an honor to serve as the First Assistant secretary for Mental Health. I take my duties seriously. The cures act has asked that assistant secretary look at disseminating research findings, insure grants are subject to performance, consult with stake holders to improve Health Services for those with serious Mental Illness and children with serious emotional disturbance. Part of strengthening leadership and accountability includes a strong clinical perspective at the agency. The cures act codifies the role of chief medical officer and weve tyken that farther to ifclude two additional psychiatrists and a nurse practitioner. A new requirement is the national Mental Health and Substance Use policy laboratory. The policy lab will promote evidencebased practices through models that would benefit through expanding, replicating or scaling evidencebased practices across a wider area. The interdepartmental area was established by the cures act to establish further determination to address the needs of individuals with serious Mental Illness as well as their families. I was pleased to chair the first meeting in august which was attended by key leaders in federal government as well as 14 highly qualified nonfederal members. Its been working within five key areas of focus, strengthening coordination to improve care, strengthening the gap between what works and whats offered and improving care for those involved. Making it easier for developing finance strategies to increase aveilability and affordability of care. As required by the cares act, it will be delivered to Congress Today. We are very pleased to bring it to congress on time and i hope that you will be pleased with it. Ill scratch that question off my list. The cures act reauthorized the community Health Services block grant and the first psychosis set aside. Thats vitally important to insure individuals receiving it, rese receive timely treatment. Theyre better able to live with their illnesses, similar to other Chronic Health conditions. I strongly support assisted out patient treatment or the aot program. Samsa implemented a Grant Program and awarded 17 grants. Theyve partner would the assistant secretary of planning to implement a cross site evaluation which will assess the effectiveness and impact of this program. One very important area it addressed was Suicide Prevention. In 2015 over 44,000 americans died by suicide and there are over 1. 1 million suicide attempts annually in the United States. They activated the prevention lifeline. Its already answered over 1. 6 million calls, surpassing by 100,000 those recorded in all of 2016 and were not done with 2017 yet. Suicide remains the second leading cause of death for those 15 to 23 years old. We memorialized act to reduce Youth Suicide and suicide attempts. At the same time the highest rate is among 45 to 64 years old. Prior to that, there was no program for adults at samssa. Were grateful and for congresss funding of the program in fiscal 2017. As a result we have awarded grants for zero suicide which is a program that implements Suicide Prevention in health systems. It was a key element of the cures act. The National Child Traumatic Stress initiative was reauthorized by the cures act and provided resources to individuals impacted by natural disasters and other traumatic events impacting the health of all americans. Working collaboratively with the office of civil rights on guidance that would clarify permitted uses and disclosures to permit for care givers of adults to facilitate treatment. With the passage of the cures act we continue to recognize the Critical Role of behahiv ill healthpari health parody for all americans. Samp suhas two parody academies in the insurance market, medicaid in the health and insurance program. Its been updated to include information from a public listening system which provides information for individuals who may have experienced a parody violation. Much work has been undertaken to implement the cures act but we know this work is far from over. There are many more individuals and families suffering from substance and mental abuse disorders that need to help. I look forward to help these people and their families and to answer your questions. Thank you. Senator murphy, would you like the go first. Thank you, mr. Chairman. We are very excited you are doing fantastic work in this position. Youve got a lot on your plate but were excited about some of the early deliverables. I wanted to maybe first ask you to talk about this question of integration. Id like you to talk about it work to bring together it rest of our health care system, whether the proper ways to do that are through state governments, new payment mechanisms we could develop through cms to try to marry together these systems. The idea you have one system for your neck down and walk across town to find somebod