NYAPRS Note: Included in President Obama’s initiatives to reduce gun violence that were released yesterday (see full release at https://www.whitehouse.gov/the-press-office/2016/01/04/fact-sheet-new-executive-actions-reduce-gun-violence-and-make-our) is a proposal to allocate $500 million to “help engage individuals with serious mental illness in care, improve access to care by increasing service capacity and the behavioral health workforce, and ensure that behavioral health care systems work for everyone.” There’re no additional details at this time. The allocation would require Congressional approval.
Also included is a proposal to require the Social Security Administration to include in information provided to the national background checks system (NICS), the names of “approximately 75,000 people each year who have a documented mental health issue, receive disability benefits, and are unable to manage those benefits because of their mental impairment, or who have been found by a state or federal court to be legally incompetent.” Essentially, this means that, under this proposal, people who have a mental health diagnosis, get SSA benefits and have a rep payee will be reported to the gun database, inexplicably linking those who need help managing their mental health SSA benefits to be considered at risk for gun violence.
Third, the President announced that HHS has issued a final rule clarifying that it is not a violation of HIPAA privacy protections for clinicians and states to report information to NICS about those who are prohibited by Federal law from possessing or receiving a gun because they have previously been involuntarily committed, found incompetent to stand trial or otherwise deemed by a court to be a danger to themselves or others. See articles below for more.
The last 2 actions will dissuade some individuals from seeking or trusting care.
We have provided the relevant excerpts below from the President’s Fact Sheet.
THE WHITE HOUSE
Office of the Press Secretary
FACT SHEET: New Executive Actions to Reduce Gun Violence and Make Our Communities Safer (excerpt by NYAPRS)
?.The President and Vice President are committed to using every tool at the Administration’s disposal to reduce gun violence. Some of the gaps in our country’s gun laws can only be fixed through legislation, which is why the President continues to call on Congress to pass the kind of commonsense gun safety reforms supported by a majority of the American people. And while Congress has repeatedly failed to take action and pass laws that would expand background checks and reduce gun violence, today, building on the significant steps that have already been taken over the past several years, the Administration is announcing a series of commonsense executive actions designed to?.
“Increase mental health treatment and reporting to the background check system.
The Administration is committed to improving care for Americans experiencing mental health issues. In the last seven years, our country has made extraordinary progress in expanding mental health coverage for millions of Americans.
This includes the Affordable Care Act’s end to insurance company discrimination based on pre-existing conditions, required coverage of mental health and substance use disorder services in the individual and small group markets, and an expansion of mental health and substance use disorder parity policies, all of which are estimated to help more than 60 million Americans. About 13.5 million more Americans have gained Medicaid coverage since October 2013, significantly improving access to mental health care. And thanks to more than $100 million in funding from the Affordable Care Act, community health centers have expanded behavioral health services for nearly 900,000 people nationwide over the past two years.
We must continue to remove the stigma around mental illness and its treatment—and make sure that these individuals and their families know they are not alone.
While individuals with mental illness are more likely to be victims of violence than perpetrators, incidents of violence continue to highlight a crisis in America’s mental health system. In addition to helping people get the treatment they need, we must make sure we keep guns out of the hands of those who are prohibited by law from having them. Today, the Administration is announcing the following steps to help achieve these goals:
? Dedicate significant new resources to increase access to mental health care. Despite our recent significant gains, less than half of children and adults with diagnosable mental health problems receive the treatment they need. To address this, the Administration is proposing a new $500 million investment to help engage individuals with serious mental illness in care, improve access to care by increasing service capacity and the behavioral health workforce, and ensure that behavioral health care systems work for everyone. This effort would increase access to mental health services to protect the health of children and communities, prevent suicide, and promote mental health as a top priority.
? Include information from the Social Security Administration in the background check system about beneficiaries who are prohibited from possessing a firearm. Current law prohibits individuals from buying a gun if, because of a mental health issue, they are either a danger to themselves or others or are unable to manage their own affairs. The Social Security Administration (SSA) has indicated that it will begin the rulemaking process to ensure that appropriate information in its records is reported to NICS. The reporting that SSA, in consultation with the Department of Justice, is expected to require will cover appropriate records of the approximately 75,000 people each year who have a documented mental health issue, receive disability benefits, and are unable to manage those benefits because of their mental impairment, or who have been found by a state or federal court to be legally incompetent. The rulemaking will also provide a mechanism for people to seek relief from the federal prohibition on possessing a firearm for reasons related to mental health.
? Remove unnecessary legal barriers preventing States from reporting relevant information to the background check system. Although States generally report criminal history information to NICS, many continue to report little information about individuals who are prohibited by Federal law from possessing or receiving a gun for specific mental health reasons. Some State officials raised concerns about whether such reporting would be precluded by the Privacy Rule issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Today, the Department of Health and Human Services issued a final rule expressly permitting certain HIPAA covered entities to provide to the NICS limited demographic and other necessary information about these individuals….”
Rules eased on providing mental health records for background checks
By Sarah Ferris The Hill January 4, 2016
The Obama administration is seeking to make it easier for people to pass along mental health records for people legally banned from owning a firearm.
Some health providers, courts and state officials have been hesitant to share records because of strict privacy laws. As a result, the federal background check system, known as the NCIS, has significant gaps on people disqualified from owning guns because of mental illnesses.
New rules issued Monday by the Department of Health and Human Services (HHS) are intended to make it clear that legal authorities can pass along mental health records that could be valuable in a background check.
The rules from the Obama administration, to be published Tuesday, clarify that only limited information about the patient is shared – only a person’s name and the entity that made the ruling.
“Underlying diagnoses, treatment records, and other identifiable health information are not provided to or maintained by the NICS,” the rule reads.
Under the Health Insurance Portability and Accountability Act (HIPAA), people who have been involuntarily committed to a mental institution or found “not guilty” in court by reason of insanity cannot purchase firearms. Every licensed firearms dealer is required to perform a background check of each buyer to determine whether they’re eligible for the purchase.
Those checks are intended to keep out any person who has a history of severe mental illness as judged by a court. The system, however, has been much-criticized for its record-keeping.
Only two-thirds of states require mandatory reporting of mental health records, in part because people have raised concerns about privacy.
Doctors Can Report Some Mentally Ill Patients to FBI Under New Gun Control Rule
By David Pittman Politico January 4, 2016
Delivering on its promise to deliver "common sense" gun control, the Obama administration on Monday finalized a rule that enables health care providers to report the names of mentally ill patients to an FBI firearms background check system.
The action was one of a series of steps that President Barack Obama had called for in January 2013 in the wake of the Newtown, Conn., shootings to curb gun violence, but the rule was not published until today.
While the 1993 Brady law prohibits gun ownership by individuals who have been involuntarily committed, found incompetent to stand trial or otherwise deemed by a court to be a danger to themselves or others, federal health care privacy rules prohibited doctors and other providers from sharing information without the consent of their patients.