Mental-Health Provisions In The New Health-Care Bill
Congress passed H.R. 3590, “The Patient Protection and Affordable Care Act” on Sunday, March 21, 2010. Below, you will find information on each of the psychiatric provisions now mandated in the new law:
1. MENTAL HEALTH INSURANCE BENEFITS: “Essential Health Benefits”, as defined for the purpose of creating mandatory health insurance plans, will now include mental health and substance use disorder services.
(Page: 105—click to see details)
2. MENTAL HEALTH IN MEDICAID: The Medicaid program (health insurance for the poor) has been amended: It now MUST include mental health services.
(Page 407—click to see details)
3. MENTAL HEALTH OUTREACH: States shall establish procedures for conducting “outreach to and enrolling vulnerable and underserved populations eligible for medical assistance, including individuals with mental health or substance related disorders.”
(Page 441—click to see details)
4. MENTAL HEALTH FOR ADDICTS: The State will coordinate with the Substance Abuse and Mental Health Services Administration in “addressing issues regarding the prevention and treatment of mental illness and substance abuse among eligible individuals with chronic conditions.”
(Page 525—click to see details)
5. MENTAL HEALTH DEMONSTRATION PROJECT: Establishment of the “Medicaid Emergency Psychiatric Demonstration Project.” This provision in the bill states that the Secretary of Health and Human Services shall establish a demonstration project under which an eligible state shall provide payment under the state medicaid plan to an institution for mental diseases.
(Page 540—click to see details)
6. MENTAL HEALTH AFTER CHILDBIRTH: New support, education, and research for postpartum (after childbirth) depression. Expansion and intensification of activities. The Secretary of Health and Human services is encouraged to continue activities on postpartum depression or postpartum psychosis including research to expand the understanding of the causes of treatments for postpartum conditions.
(Page 588—click to see details)
7. MENTAL HEALTH AS NATIONAL PRIORITY: Under the “National Prevention and Health Promotion Strategy”, a new report will be generated for the President and Congress to try to handle the five leading disease killers in the country. The report will contain a list of “national priorities on health promotion and disease prevention to address lifestyle behavior modification,” including mental health, behavioral health, and substance use disorder.
(Page 1118—click to see details)
8. MENTAL HEALTH IN SCHOOLS: The law provides grants for the operation of school-based health centers. These school-based health centers are required to include: mental health and substance use disorder assessments, crisis intervention, counseling, treatment, and referral to a continuum of services including emergency psychiatric care. Grant preference will be given to communities that have “evidenced barriers to primary health care and mental health and substance use disorder prevention services for children and adolescents.”
(Page 1137—click to see details)
9. MENTAL HEALTH COMMUNITY GROUPS: Authorization of “Community-Based Prevention Health Activities.” Under this program, the government will be giving grants to state or local governmental agencies and community-based organizations for the implementation, evaluation, and dissemination of what they are calling “health activities.” Included in the things that these groups will be required to measure in the community are:
• Changes in emotional well being and overall mental health
• Other factors using community specific data from the Behavioral Risk Factor urveillance Survey.
(Page 1185—click to see details)
10. MENTAL HEALTH INTERVENTIONS: Government will give grants for the purpose of “prevention and wellness programs for Medicare beneficiaries.” This program is called “Healthy Aging, Living Well.” These health departments will carry out programs to provide “public health interventions.” Types of intervention activities may include efforts to “improve nutrition, increase physical activity, reduce tobacco use and substance abuse, improve mental health, and promote healthy lifestyles among the target population.”
(Page 1188—click to see details)
11. MENTAL HEALTH SCREENING: Under the aforementioned “Healthy Aging, Living Well” program, the health departments will be conducting ongoing health screenings to individuals 55 to 64 years of age. Types of screening activities may include “mental health/behavioral health and substance use disorders.”
(Page 1191—click to see details)
12. MENTAL HEALTH PROFESSIONALS: The bill defines the term “Mental Health Service Professional” as “an individual with a graduate or post-graduate degree from an accredited institution of higher education in psychiatry, psychology, school-psychology, behavioral pediatrics, psychiatric nursing, social work, school social work, substance abuse disorder prevention and treatment, marriage and family counseling, school counseling, or professional counseling.”
(Page 1252—click to see details)
13. MENTAL HEALTH FOR CHILDREN: In exchange for full-time employment for no less than 2 years in the field of pediatric health care (which includes child and adolescent mental health and behavioral health care), the government will enroll you in a specialty loan repayment program.
(Page 1295—click to see details)
14. MENTAL HEALTH IN HOSPITALS: Government will award grants to non-profit private hospitals, medical schools, etc., for the purpose of supporting and developing primary care. There will be a priority in awarding these grants. One of the priorities:
*”Priority will be given to a qualified applicant that ‘provides training in the care of vulnerable populations such as children, older adults, homeless individuals, victims of abuse or trauma, individuals with mental health or substance related disorders, individuals with HIV-AIDS, and individuals with disabilities.”
(Page 1319—click to see details)
15. MENTAL HEALTH FOR THE ELDERLY: Geriatric Education and Training: Grants or contracts will be awarded to entities that operate a Geriatric Education Center. Per the bill, a “Geriatric Education Center that receives an award under this subsection shall develop and include material on depression and other mental disorders common among older adults, medication safety issues for older adults, and management of the psychological and behavioral aspects of dementia, and communication techniques within individuals who have dementia in all training courses, where appropriate.”
(Page 1334—click to see details)
16. MENTAL HEALTH IN HIGHER EDUCATION: Grants will be awarded to institutions of higher education to support the recruitment of students for and to educate and give clinical experience to students in:
• providing behavioral and mental health services including substance abuse prevention and treatment services
• child and adolescent mental health in psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing, social work, school social work, substance abuse prevention and treatment, marriage and family therapy, school counseling, or professional counseling.
(Page 1344—click to see details)
17. MENTAL HEALTH FOR SOLDIERS: Priority for the Mental and Behavioral Health Education Grants:
• For a grant-recipient in graduate psychology, priority will be given to institutions in which training focuses on the needs of vulnerable groups such as older adults, children, individuals with mental health or substance related disorders, victims of abuse or trauma and of combat stress disorders such as post-traumatic stress disorder.
(Page 1347—click to see details)
18. MENTAL HEALTH GRANTS: Funding for the Mental and Behavioral Health Education Grants:
• For fiscal years 2010 through 2013, $35 million has been authorized
(Page 1348—click to see details)
19. PSYCHIATRIC RESIDENCY GRANTS: The bill includes grants for “Community Mental Health Centers.” In addition, grants would provide for a graduate residency training program in the field of psychiatry.
(Page 1459—click to see details)
20. MENTAL HEALTH IN SMALL BUSINESSES: The bill awards grants to small businesses to provide “comprehensive work-place wellness programs.” These programs would include:
• Supportive environment efforts (including workplace policies to encourage healthy lifestyles, healthy eating, increased physical activity and improved mental health).
(Page 2285—click to see details)
21. NATIONAL CENTERS OF EXCELLENCE FOR DEPRESSION: Note: This is the largest mental-health authorization in the entire bill with $1.2 billion earmarked over the next 10 years. The bill awards grants to eligible entities to establish National Centers of Excellence for Depression. Eligible entities include institutions of higher education or public or private non-profit research institutions.
The National Centers of Excellence for Depression shall engage in activities related to the treatment of depressive disorders. Priority will be given to entities that meet certain criteria. For example:
• An entity that makes use of the most up-to-date science, practices, and interventions available.
The Centers for Excellence for Depression will be carrying out certain general activities such as:
*”Educating policy makers, employers, community leaders, and the public about depressive disorders to reduce stigma and raise awareness of treatments.”
The Centers will be issued “report cards” from the Secretary of Health and Human Services. Based on these report cards, the Secretary shall make recommendations to the Centers regarding improvements such Centers shall make and make recommendations to Congress for expanding the Centers to serve individuals with other types of mental disorders.