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Legislative Update
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Congress Confronted Hard Choices at Year's End

By James K. Finley
Director of Public Policy

Divided all year on issues both large and small, legislators scurried in December to make many critical decisions to meet year-end deadlines set in law, on topics such as Medicare physician payments, expiring tax breaks, agency funding bills, and termination of unemployment insurance benefits. 

Medicare Provider Status

In spite of very aggressive efforts by AMHCA and its coalition partners, clinical mental health counselors, and marriage and family therapists, Medicare provider status legislation was not included in critical, year-end Medicare legislation introduced in December by GOP House leaders. 

The so-called Medicare physician-fee bill addresses a 27 percent physician fee cut set in statute, but the bill omits all Medicare modernization provisions. The GOP bill restores physician payments for two years at a cost $39 billion, but offsets to address the House bill costs are very controversial and said to be unacceptable to the Democrat-controlled Senate. Despite the expiring physician-fee provision in current law, it is very uncertain how Congress will reach agreement on Medicare fees in 2012. 

AMHCA and its coalition partners will keep pressing our provider-status legislation, hoping to build momentum for inclusion in revised Medicare legislation. 

Veterans’ Mental Health Services

AMHCA and its coalition partners continue to meet with various offices of the Department of Veterans Affairs (VA) to encourage hiring more clinical mental health counselors and marriage and family therapists. High-profile press criticism of VA mental health services in November has increased congressional concerns about the adequacy of mental health services for returning vets. 

Recent Veterans Affairs Committees hearings in both the House and Senate greatly criticized the VA for what they viewed as a very inadequate response to the needs of returning vets. AMHCA’s coalition hopes that congressional criticism will leverage a greater VA response to our hiring concerns. 

Agency Funding

In late December Congress passed a $1 trillion appropriations package funding many government programs through the end of the fiscal year on Sept. 30, 2012. The bill contains funding for a broad range of important mental health, education, and other programs, including the Substance Abuse and Mental Health Services Administration (SAMHSA). Fortunately, Congress rejected over $200 million in House-approved cuts to SAMHSA-funded community-based mental health programs and services appropriations. 

Acting CMHS Director Named

SAMHSA has announced a leadership shuffle of key mental health positions, which were effective Dec. 21. After eight years as director of the Center for Mental Health Services (CMHS), Kathryn Power has assumed a new position as SAMHSA administrator, Region 1 (New England). Shifting Power’s position enabled Paolo del Vecchio to become acting director of CMHS. Del Vecchio most recently served as CMHS associate director for Consumer Affairs and has worked previously for Philadelphia’s Office of Mental Health. Selection of a permanent CMHS director is planned as an open process.