Key Republican blasts Trump’s mental health pick


(This story originally appeared in The Hill Extra.)

President Trump’s pick to tackle the nation’s addiction and mental health crises won praise from advocates, but a top Republican is blasting the choice.

The president on Friday tapped Elinore McCance-Katz to serve as the first assistant secretary for mental health and substance use, a job within the health department created by last year’s 21st Century Cures Act.

If the Senate confirms the post, she will take over duties as head of the Substance Abuse and Mental Health Services Administration (SAMHSA), overseeing the office and coordinating with other federal agencies.

Yet her nomination sparked harsh criticism from the Republican congressman who created the position, which could complicate he nomination.

“Dr. McCance-Katz served as Chief Medical Officer at the very time SAMHSA was under investigation for multiple failed practices and wasteful spending,” Rep. Tim Murphy (R-Pa.) said in a statement.

{mosads}“She was the key medical leader when the agency actively lobbied against any change or accountability, including when the Energy and Commerce Committee, indeed the entire Congress, was aiming to fix our nation’s broken mental health system by passing the most transformational mental health reforms in a half century.”

McCance-Katz supports medication-assisted treatment to help those with an addiction, and brings with her a background in both clinical and administrative work, advocates said.

“She is very aware that addiction is a chronic brain disease. … She is passionate about quality patient care and very knowledgeable about addiction and the health effects of addictive disease,” said Kelly Clark, American Society of Addiction Medicine’s president, noting McCance-Katz is a member.

Several advocates expressed hope the nominee would work on integrating physical and behavioral health and help increase quick intervention to ensure both disorders are caught early.

McCance-Katz is no stranger to the agency, having served as its first chief medical officer from 2013 to 2015.

She raised eyebrows after her departure by blasting the agency for not treating society’s most vulnerable, arguing it was hobbled by a “perceptible hostility toward psychiatric medicine: a resistance to addressing the treatment needs of those with serious mental illness and a questioning by some at SAMHSA as to whether mental disorders even exist.”

The comments came in an article in Psychiatric Times.

Patrick Kennedy, a former Democratic congressman from Rhode Island who is now a mental health advocate, noted that it’s likely she’ll need to repair some relationships if she returns to the agency. But said her comments probably made her stand out in the first place.

“She wrote a very harsh and critical analysis of her experience at SAMHSA,” he said. “That kind of damn the torpedoes, full-speed ahead image that she created from that story I think endeared her to the philosophy of many in the White House.”

The agency has changed since then, according to Paul Gionfriddo, president and CEO of Mental Health America, a group made up of providers, insurers and others working in the field.

He said the agency’s acting administrator — Kana Enomoto, who took over the post in 2015 — has focused on a range of evidence-based care important to McCance-Katz.  

“I think that she’ll find that the SAMHSA that she left two years ago is different from the SAMHSA of today,” he said, “and that the policy environment she left two years ago is very different from the policy environment in D.C. with respect to behavioral health policy.”  

In Congress, mental health and substance use treatment has won bipartisan support, and Republicans and Democrats came together last year to pass bills to address both.

At the same time, many advocates have warned that repealing ObamaCare could disrupt that harmony.

Some hope McCance-Katz can turn her position into a behind-the-scenes advocate for keeping some of the law’s core provisions, like Medicaid expansion and the requirement that insurers cover mental health and substance use treatment.

“More than any other disease state, Medicaid is the major payer,” Linda Rosenberg, National Council for Behavioral Health president and CEO, said. “I think protecting Medicaid as an entitlement, to ensure it is not block granted, it doesn’t go to a per capita cap, I think those are things we hope she’ll be a good spokesperson for within the administration.”

The Republican effort to replace ObamaCare moves Medicaid in the direction of block granting and per capita caps.

This story originally appeared on The Hill Extra. See more exclusive content on policy and regulatory news on our subscription-only service here.

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