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MHA Urges Lawmakers To Update Patient Consent Process

Mental Health Weekly�� October 13, 2015

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During a week laden with calls from advocates, providers and consumers on�� Capitol Hill for mental health reform and comprehensive legislation, Mental Health Association (MHA) and Netsmart officials are urging lawmakers to update and streamline the patient consent process to reflect new models of health care.

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MHA and Netsmart officials on October 6 announced support for legislation that would update 42 CFR Part 2 — federal regulations governing the confidentiality of drug and alcohol abuse treatment and prevention records.

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These regulations were enacted in 1987 by the U.S. Department of Health and Human Services and authorized by the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 and the Drug Abuse Prevention, Treatment, and Rehabilitation Act of 1972.

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Current complex patient consent requirements make it difficult or impossible for patients and providers in new integrated care settings like Health Information Exchanges, Accountable Care Organizations and Medicaid Health Homes, said officials. The regulations, they said, are a barrier in these care settings to share patient data related to substance use disorders and co-occurring physical and behavioral health conditions.

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“The federal regulation, dating back 45 years, has prevented the sharing of substance abuse diagnoses at the same time information is being shared about other health issues,” Paul Gionfriddo, president and CEO of MHA, told MHW. “Fast-forward to a reformed mental health system and the integration of behavioral health overall — an impediment has been created that doesn’t permit the widespread sharing of information on the behavioral health side.”

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Gionfriddo added, “You have to treat the whole person. Right now we’re only treating half the person [with half the data]. This is the biggest remaining obstacle.” It’s important to move treatment and services information into regular health setincluding tings, Gionfriddo said. “It’s time to repeal it [42 CFR],” he said. Gionfriddo said he has spoken to lawmakers about these concerns.

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Patient privacy protection

“Misinformation is rampant about these proposed changes,” Kevin Scalia, executive vice president of corporate development for Netsmart, said in a press release. “Patient privacy will still be protected, while consent procedures will be streamlined, enabling people to experience the full benefits of coordinated, integrated care.”

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Scalia added, “Patients will still be required to provide consent for their records to be shared with providers, and they could still opt out at any time.”

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The Mental Health Access Improvement Act of 2015 (S. 1830/H.R.2759), sponsored by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) includes a request for a Government Accountability Office report on 42 CFR Part 2 as well as requirements impacting access to mental health and substance use disorder treatment related to integration with primary care, administrative and regulatory issues, quality measurement and accountability, and data sharing.

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Rep. Tim Murphy’s (R-Pa.) bill, Helping Families in Mental Health Crisis Act of 2015 (H.R. 2646) and The Mental Health Reform Act of 2015 (S. 1945) introduced by Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-Ala.), include provisions related to the 42 CFR Part 2 consent reform.

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Letter to lawmakers

Jim Bialick, president of the Patient Safety Movement Foundation, noted in a letter to lawmakers that outdated 42 CFR Part 2 regulations are a concern for patient safety. The August 19 letter to Rep. Fred Upton (R-Mich.) and Frank Pallone (DN. J.), chairman and ranking member, respectively, of the Energy and Commerce Committee, expressed the need for 42 CFR Part 2 changes in the context of a “technology-enabled healthcare system that treats all patients equally, particularly those with substance abuse or mental health problems.”

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“By simplifying Part 2 patient/consumer consents in Health Information Exchanges, Medicare Accountable Care Organizations and Medicaid Health Homes, the sharing of addiction medical records could make an enormous contribution to the integration of addiction treatment, primary care and medical specialty services,” Bialick wrote.

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���������� Note: see the full MHA/Netsmart news release at