On December 7, the Senate followed the House of Representatives and passed the 21st Century Cures Act by an overwhelming majority. The bipartisan bill will now be sent to President Obama who has said he will sign the measure into law. The legislation will accelerate Food and Drug Administration (FDA) approved treatments, therapies, and drugs by modernizing FDA regulations considered by Congress to unnecessarily delay the approval of new drugs and devices. Additionally, the legislation provides $4.8 billion to the National Institutes of Health which covers support for the president’s Precision Medicine Initiative to drive research on the effects of genetics, lifestyle, and environment on disease, as well as support for Vice President Biden’s “Cancer Moonshot” initiative and increased research to improve understanding of diseases affecting the brain, such as Alzheimer’s. The bill also provides $1 billion in grants to states to combat opioid addiction and addresses the country’s mental health crisis.

The role of PAs in mental healthcare is acknowledged for the first time in federal mental health policy through key mental health provisions of the soon-to-be law, such as:

• Inclusion of PAs as high-need providers in mental healthcare through a required mental health strategic plan;
• Including PAs who specialize in mental healthcare as members of advisory councils authorized by the Public Health Service Act;
• Adding PAs with experience in treating serious mental illnesses or serious emotional disturbances as potential committee members to a federal Interdepartmental Serious Mental Illness Coordinating Committee;
• Strengthening the mental and substance use disorders workforce by awarding grants to eligible entities to support training for PAs and other providers to offer integrated primary care, mental health, and substance use disorder treatment services in underserved areas; and
• Requiring the Department of Health and Human Services (HHS) to identify model programs and materials for training PAs and other healthcare providers on permitted uses and disclosures of health information when caring for patients with mental illnesses.

AAPA continues to seek clarification that PAs are also included in legislative provisions on peer review, mental and behavioral health education and training grants, the minority fellowship program, and increasing access to pediatric mental healthcare.

Mental health system reforms passed by the House in July through the Helping Families in Mental Health Crisis Act were also part of the bill's package. In addition to strengthening the mental health workforce, these provisions are intended to reform the nation’s mental health delivery system by establishing a new assistant secretary for mental health within the HHS; creating a system to award grants based on evidence-based mental health and substance use treatment policy; evaluating privacy law to improve mental health treatment through increased communication among providers, families, and patients; and improving care for children and adults with serious behavioral and mental illness.

AAPA worked closely with relevant House and Senate committees and members throughout the development of the mental health provisions in the bill, educating them on the interface of PAs in primary and other medical care with patients experiencing behavioral health issues, the increasing number of PAs who provide mental healthcare , and the valuable role of PAs in building the behavioral healthcare workforce.