On Tuesday, June 30, Governor Brown had a ceremonial signing for two bills that will help families and caregivers play a larger role in a loved one’s mental health care.
House Bill 2023 directs hospitals and acute care facilities to develop and implement comprehensive discharge planning for patients suffering from a mental health crisis. To prevent the “emergency room revolving door,” discharge planning must include a “warm hand-off” to community care and should include the patient’s support network whenever possible.
Companion House Bill 2948 clarifies conditions for disclosure under the Health Insurance Portability and Accountability Act (HIPAA). This bill clarifies when health care providers may share information about patients who are experiencing a mental health crisis. It protects health care providers from civil liability for disclosing protected health information within the parameters allowed by HIPAA. Providers are often unclear about HIPAA and err on the side of extreme caution, withholding information that could be critical.
House Bill 2948 is named the Susanna Blake Gabay Act, in honor of Jerry and Susan Gabay’s only child, who took her life within one month of being released from the hospital in 2010. Despite Susanna’s having signed a release, the hospital did not notify or engage her parents upon her release. “Even where the patient has signed a release, many providers are just not accustomed to communicating with families,” said Jerry, who brought both legislative concepts to his state representative, Alissa Keny-Guyer (D, Portland).
After his daughter’s suicide, Jerry joined the NAMI Oregon State Board of Directors and co-authored a nationally recognized suicide prevention checklist. “At a minimum, providers must be encouraged to seek authorizations to communicate with appropriate supporters of the patient and then actually communicate,” said Jerry. “There is ample literature indicating that extensive communication is a best practice for therapy and suicide prevention.”
Julie Magers, a staff member of NAMI Multnomah, testified in support of the legislation with her 20 year old daughter, Riley. Four years after Riley was hospitalized, both women say that their positive outcome was the result of discharge plans that included giving Julie the tools she needed to help her daughter.
Rep. Keny-Guyer, chief sponsor of both bills, worked closely with Jerry Gabay, Julie Magers, NAMI, and other mental health advocates and providers to shape the legislation. “Suicide is a major issue in our State; we have the second highest suicide rate in the country, and it is the second leading cause of death among Oregonians aged 10 to 24,” said Rep. Keny-Guyer when carrying the bill on the House floor.
“In 2011, Oregonians killed themselves at twice the number who died in vehicle crashes and six times the homicide rate. And the number of suicides has climbed since then,” continued Rep. Keny-Guyer. “There are many challenges in filling the gaps of the fragmented mental health system. One of them is the fear that providers have in disclosing information to those closest to patients, when it is often critical to their care.”
House Bill 2023 and 2948 received passionate testimony from several families and passed with unanimous support in both the House and Senate.
Jerry and Susan Gabay and Julie Magers were among the advocates at the ceremonial signing.