Sibylla Bostoniensis

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This is a summary report on the contents of the Murphy Bill. The Murphy Bill is a massive bill (proposed law) before the Congress of the US; it concerns mental illness and its treatment. It has 172 cosponsors, i.e. members of congress who have joined as supporters. It was introduced in June, and has been referred to various committees and subcommittees, where it presently is. If you care about mental illness and public policy in the US, you care about the Murphy Bill.

There are a lot of people debating the supposed merits of the Murphy Bill without actually knowing what is in it. All the public discussion I've found has been about AOT involuntary commitment. But here's a whole bunch of other things in this bill, too, some of which might prove just as controversial, if only people knew about them.

So this is a summary of what is in the bill, so that interested parties might know that there's something they should read further into. You may read the bill, in its entirety, for yourself here. My review is of the document at that link as it appeared Dec 18, 2015, 22:10 EST (-0400).

I have cited like whoa into the bill itself. I do not know what unsung hero of Congressional IT insisted on burying all those hidden A tags in congress.org's bills' HTML, but should they become known to you, buy them a beverage of their choice. When I cracked open the source of the page to try to find anchors to link to, I was dubious that I would find much of anything. It was faintly miraculous to find that the whole bill was shot through with anchor tags like silver through samite. Because of that excellent technical choice, I was able to provide you with links to the exact passages to which I refer.

I'm going to try to constrain myself to summarizing the content, and not editorializing. Editorializing may come later. Heaven knows I have opinions.

That said, this summary isn't complete; there was stuff I simply didn't delve into or thought was too minor to mention. I hope I didn't miss anything big.

Also, this report is not in the order of the original bill. My summary refactors the organization of the document, and I've taken the liberty of reordering topics.

Please note that while some of this bill is eminently readable, and the only challenges to parsing it are understanding the politics and pragmatics of the context in which it is functioning, other parts of this bill are basically uncompiled source code: they are lists of edits, even of single characters, of extant law, the import of which is not immediately obvious. I have striven to decode much of this, and hope I got it right. If you find an error, let me know.

The Murphy Bill: Contents of Note of H.R.2646 - Helping Families in Mental Health Crisis Act of 2015

Organizations Come, Organizations Go

Various organizations are founded, expanded, or eradicated by this bill:

• The Substance Abuse and Mental Health Services Administration (SAMHSA) would be eliminated, and replaced by an office reporting to the Secretary of Health and Human Services. This officer would be the Assistant Secretary for Mental Health and Substance Use Disorders. (Title 1, Sections 101 and 102.)


• A National Mental Health Policy Laboratory would be established (Title 2, Section 201). Its Director is to have authority over standards for grant programs run by the Assistant Secretary (Title 2, Section 201 (b)) and the standards for other things.


• A Interagency Serious Mental Illness Coordinating Committee would be established. Much of the language of this part of the bill is delineating at length who would be on this committee. (Title 3)


• A Minority Fellowship Program would be founded to fund postbaccalaureate training, explicitly including master's and doctoral degrees, to increase the ethnic minority cultural competence of the mental healthcare workforce. (Title 2, Section 207 (c))


• The extant National Child Traumatic Stress Initiative would be written into 42 USC 290hh-1, the Federal law which funds programs concerning psychological trauma in children. Also, this bill would change that law from merely "developing" (new) programs to continuing to fund extant programs. Also, this bill explicitly charters the NCTSI with a bunch of activities including conducting outcome studies, training, and disseminating information. (Title 2, Section 208 (a))


• A grant is authorized for the founding of a Suicide Prevention Technical Assistance Center. (Title 2, Section 208 (c)(1))


• The National Suicide Prevention Lifeline program is funded (Title 2, Section 208 (5))


• A new national awareness campaign to target the stigma of mental illness in students This bill would require the Secretary of Education to conduct a nationwide program to attempt to reduce the stigma of serious mental illness among secondary and post-secondary students, educate about how to assist the apparently mentally ill, and promote presenting voluntarily for treatment if one experiences mental illness. They would also be required to evaluate the efficacy of this program. Despite this item being included under "Authorized Grants and Programs", it is apparently unfunded, making no mention of money. (Title 2, Section 208 (b))

The Legal Rights of the Mentally Ill

This bill would modify a number of extant laws about protecting the rights of patients, students, and the mentally ill:

• A controversial new form of involuntary commitment. This bill would promote Assisted Outpatient Treatment (AOT). This is a form of involuntary commitment of the mentally ill that is an alternative to hospitalization: a patient commited to AOT is legally required to take the medication prescribed them as a condition of being at liberty. States would be required to have AOT in their State laws to be eligible for Medicaid funding. Furthermore, this bill specifes that said State AOT laws, to qualify for Medicaid funding, must require State court judges to involuntarily commit a person (either inpatient or AOT) when "a State court finds by clear and convincing evidence that an individual, as a result of mental illness, is a danger to self, is a danger to others, is persistently or acutely disabled, or is gravely disabled and in need of treatment, and is either unwilling or unable to accept voluntary treatment" (Title 2, Section 206 (c)(4))



• HIPAA and FERPA Confidentiality Exceptions for Caregivers of the Mentally Ill. This bill would open explicit exceptions to HIPAA and FERPA confidentiality rules for disclosure of some otherwise confidential information to "caregivers".

  
  

  HIPAA, the law that delineates the privacy rights of patients, would be amended to have:

  
  
  • Provision for some protected health information to be disclosed to a "identified responsible caregiver" of a severely mentally ill person if a six point test is passed. Psychotherapy notes remain privileged and are never disclosed under any circumstances. (Title 4, Section 401 (a))
  
  
  • Provision for mental health professionals to receive information from family members or other caregivers at all times. (Title 4, Section 401 (d)))
  
  
  • A definition of "Caregiver" that is someone who meets one of four conditions and doesn't have a documented history of abuse: immediate family members, "an individual who assumes primary responsibility for providing a basic need of such individual", "a personal representative of the individual as determined by the law of the State in which such individual resides", or someone who "can establish a longstanding involvement and is responsible with the individual". (Title 4, Section 40)
  
  
  • A definition of "individual with serious mental illness" which entails meeting the criteria for a DSM diagnosis and either "results in functional impairment of the individual that substantially interferes with or limits one or more major life activities of the individual" (Title 4, Section 404 (e)(4)(b)) or is any mental illness at all if it co-occurs with autism or other developmental disability. (Title 4, Section 404 (e)(4)).

  
  
  

  FERPA, the law that delineates the privacy rights of students (including college students), would be amened to have:

  
  
  • Permission for educational institutions to have their mental health professionals release "the education record" of students 18 and older, even without consent of the student, to "the caregiver of the student", if the mental health professional thinks it is "necessary to protect the health, safety, or welfare" of the student, or the safety of others. Having a "serious mental illness" is not a requirement. (Title 4, Section 402)
  
  
  • A definition of "Caregiver" that is

    a family member or immediate past legal guardian who assumes a primary responsibility for providing a basic need of such student (such as a family member or past legal guardian of the student who has assumed the responsibility of co-signing a loan with the student)

    (Title 4, Section 402)

  
  Additionally, the part of Federal law that funds State organizations to advocate for the rights of the mentally ill would be amended to charge those organizations with ensuring that caregivers "have access to the protected health information of such individuals consistent with such section 201". (Title 8 Subtitle 2, Section 812)



• New exception to substance abuse treatment confidentiality. Right now, records concerning substance abuse treatment are held confidential by federal law 42 USC 290dd-2 "Miscellaneous Provisions Relating to Substance Abuse and Mental Health". This bill would add an exception to the law, permitting certain kinds of medical institution to share substance abuse treatment information with themselves (yes): health information exchanges, health homes, or other integrated care arrangements. This would make it such that substance abuse treatment records would not need to be segregated from other (electronic) health records. (Title 4, Section 403)


• Limiting the speech, activities of rights advocacy orgs. Right now, there is a Federal law titled "the Protection and Advocacy for Individuals with Mental Illness Act"; it has/is a provision for funding organizations within the States to "protect and advocate the rights of individuals with mental illness". (42 USC 10805 "System requirements") This bill would amend that law to change the purpose and activity of State organizations funded by this law:
  
  
  • Any rights-protecting organization receiving that money would be forbidden from lobbying the government and forbidden from

    counseling an individual with a serious mental illness who lacks insight into their condition on refusing medical treatment or acting against the wishes of such individual’s caregiver.

    (Title 8 Subtitle B, Section 811).
  
  
  • All parts of the "Protection and Advocacy for Individuals with Mental Illness Act" (see 42 USC 10801: Congressional findings and statement of purpose, 42 USC 10803: Allotments, 42 USC 10804: Use of allotments, 42 USC 10805: System requirements, 42 USC 10821: Applications, 42 USC 10824: Reports by Secretary) that refer to "protecting the rights of individuals with mental illness" are to be amended to say "protecting the rights of individuals with mental illness to be free from abuse and neglect" instead (italics for the inserted language). For instance, in the prefatory material of the Act, it lists the purposes of this law, and two of those purposes would be changed by this bill. Where it currently says that a purpose of this law is

    to ensure that the rights of individuals with mental illness are protected

    it would be changed to say a purpose of this law is

    to ensure that the rights of individuals with mental illness to be free from abuse and neglect are protected

    Where it currently says that a purpose of this law is to help the States set up systems to

    protect and advocate the rights of such individuals through activities to ensure the enforcement of the Constitution and Federal and State statutes

    it would be changed to say that those State systems are to

    protect and advocate the rights of such individuals to be free from abuse and neglect through activities to ensure the enforcement of the Constitution and Federal and State statutes

    (Title 8 Subtitle B, Section 813 (a) through (f))
  
  
  • Similarly, this bill adds clauses requiring of such organizations that:

    the protection and advocacy activities of such an agency or organization shall be exclusively focused on safeguarding the rights of individuals with mental illness to be free from abuse and neglect

    (Title 8 Subtitle B, Section 813 (c)(3)) and that they

    be exclusively focused on safeguarding the rights of individuals with mental illness to be free from abuse and neglect

    (Title 8 Subtitle B, Section 813 (d)(1)) and requires of them for payment

    assurances that such system, and any State agency or nonprofit organization with which such system may enter into a contract under section 10804(a), will be exclusively focused on safeguarding the rights of individuals with mental illness to be free from abuse and neglect

    (Title 8 Subtitle B, Section (e)(4))

Darning Holes in the Safety Net

There are a variety of places where the severely mentally ill can fall into cracks in the system, or have their care undermined by things their mental healthcare providers have to deal with. This bill aims to rectify a whole bunch of these:

• Limiting liability of professional volunteers. Right now, there are certain limitations on the legal liability of employees of certain mental health facilities. This bill will extend those same limitations of legal liability to mental health professionals practicing pro bono (for free) at those facilities, by statutorily defining them as employees for the purpose of liability. (Title 2, Section 207 (b))


• Unlimited coverage of psych hospitalizations under Medicare. Right now, there is a 190 day lifetime limit on psychiatric hospitalizations for Medicare patients. After a total of 190 days hospitalized, Medicare won't cover the cost of you going to hospital for a psychiatric condition any more. This bill would strike that limit, and make it that Medicare will cover unlimited psychiatric hospitalizations for its members. (Title 5, Section 503) But! There's a catch. This provision shall not go into effect if it results "in any increase in net Federal expenditures under title XVIII of the Social Security Act." (Title 5, Section 503 (b))


• Same-day health services: payment for. Right now, it is the practice of many Medicaid programs (run by the States) to refuse to pay for two different kinds of medical care on the same day. (Medicare may also do this; not sure.) Under such plans, if you see a psychiatrist and a PCP on the same day, one of them will not get paid. For this reason, psychiatrists and PCP will often refuse to book or see patients on the same day. This bill would make it illegal for States to have their Medicaid programs refuse to pay for a psychiatric service that is provided on the same day as a a primary care service, or vice versa – so long as the services were provided at certain limited kinds of facilities, and the programs would have paid for the services if only they hadn't been on the same day. (Title 5, Section 501 (a))


• Expanding Medicaid's coverage of inpatient care to adults. Right now, Medicaid programs (run by the States, funded by the Feds) are allowed to cover inpatient (hospital) psychiatric care for children and for the elderly. This bill will give permission for States to expand the coverage of inpatient psychiatric services to all adults who are qualified for Medicaid, so long as the inpatient psychiatric services are provided at a facility has a length of stay of less than 30 days. It also gives permission for States to expand Medicaid program coverage to care provided in residential psychiatric facilities. (Title 5, Section 501 (b)) But there is a catch. "The amendments made by this section shall not be effective unless the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that [...] this would not result in any increase in net program spending under title XIX of such Act." (Title 5, Section 501 (d)(2))


• Mandating coverage of certain medications for mental illness, under goverment plans. Right now, if you are on government-subsidized/provided third-party health insurance, the health insurance plan you are on can refuse cover certain medications in certain circumstances. This bill would restrict or eliminate some of that, and require coverage of some/all psych meds in government plans:
  
  
  • Right now, the law for Medicare/Medicaid Part D – the prescription medication coverage part of Medicare and Medicaid – has some rules about how companies that sponsor Prescription Drug Plans (PDPs) for Medicare/Medicaid must include certain types of medications under their coverage, unless the Secretary makes an exception. This bill would make it such that "Antidepressants" and "Antipsychotics" must all be covered by Medicare/Medicaid PDPs, no matter what. It would revoke the Secretary's discretion in making exceptions for PDPs where those classes of medication are concerned. [NB: I may have this wrong. This chunk was far and away the worst to decode, being like a comp sci problem set in pointer referencing, only written by lawyers.] (Title 5, Section 502 (a))
  
  
  • This bill would require States' Medicaid plans to cover "covered outpatient drugs used for the treatment of a mental health disorder". (I don't know what "covered" means here. The bill literally says covered drugs must be covered.) But! It explicitly permits prior authorization programs. (Title 5, Section 502 (b)(1))
  
  
  • This bill would also require managed care entities contracting with States under Medicaid to cover "all covered outpatient drugs used for the treatment of a mental health disorder". (Title 5, Section 502 (b)(2))


• More discharge planning by hospitals. Right now, hospitals that accept Medicare/Medicaid are required to make certain plans, on patient discharge, for the patient's follow-up care. This bill will add further requirements for the discharge planning of psychiatric patients (those being discharged from psychiatric facilities), including requiring hospitals to transmit "in a timely manner" relevant medical information to the receiving treater, if referred out. (Title 5, Section 504)


• Funding mental healthcare at universities, for real this time Right now, federal law provides for giving grants to universities for "enhancing" mental health care services for students under 42 USC 290bb-36b: "Mental and behavioral health services on campus", however it forbids using those funds for provision of actual direct mental health or substance abuse care, such as running clinics for students. This bill would completely rewrite that law, to fund direct mental health and substance abuse treatment services on campuses. (Title 2, Section 208 (4).)

States Being Held More Accountable, Stricter Standards

Right now, the Feds provide the States with money for the care of the mentally ill, through funding Medicaid (42 USC 300x-1: State plan for comprehensive community mental health services for certain individuals). This bill would make the requirements of getting that money more strict in a bunch of ways, including:

• It would tightly constrain the use of these funds to only the most severely mentally ill patients ETA: I now believe my initial reading of this is incorrect, and that this doesn't constrain the use of funds, but mandates reporting on utilization of services for the limited subset of patients specified. (Title 2, Section 206 (c)(3)(b))


• Recipient States would be required to have outreach programs for actively engaging treatment-shy severely mentally ill people, "who are substantially unlikely to voluntarily seek treatment". (Title 2, Section 206 (e))


• Right now recipient States are required to provide for the severely mentally ill case management services distict from treatment services, but only to the end of reducing hospitalization. This would be amended to be concerned not solely with reducing hospitalization but:

  reduction of rates of suicides, suicide attempts, substance abuse, overdose deaths, emergency hospitalizations, incarceration, crimes, arrest, victimization, homelessness, joblessness, medication nonadherence, and education and vocational programs drop outs

  (Title 2, Section 206 (c)(1)(d))


• Recipient States would have to do more thorough reporting on outcomes of their expenditures on the, including in terms of

  rates of suicides, suicide attempts, substance abuse, overdose deaths, emergency hospitalizations, incarceration, crimes, arrest, victimization, homelessness, joblessness, medication non-adherence, and education and vocational programs drop outs

  among the severely mentally ill. (Title 2, Section 206 (c)(2)(d) and Section 206 (c)(3)(a))


• The aforementioned AOT law requirement.

All About the Benjamins

There's various bits about money:

• Innovation Grants for further applied research into treatment or service integration. (Title 2, Section 202)


• Demonstration Grants for scaling up extant programs of a wide variety of sorts (Title 2, Section 203) and a bunch of specific rules for Certified Community Behavioral Health Clinics to get demonstration grants, and also planning grants for getting the demonstration grants. (Title 5, Section 505)


• Grants for Early Childhood Treatment. (Title 2, Section 204)


• AOT Program Grants to extend AOT Program. (Title 2, Section 205)


• Just more money all over if the the Assistant Secretary and the Director of the NIMH think it's a good and evidence-based idea, (Title 2, Section 206 (5))


• Telepsychiatry and PCP Training Grants and provisions for Primary Care Physicians (i.e. "regular doctors", general practitioners) who get this psychiatric training to get paid for doing psychiatry, and also for psychiatrists who consult to them via internet (said telepsychiatry) to get paid for doing so. (Title 2, Section 207 (a))


• Grants for training police how not to shoot the mentally ill; also for training all LEO, corrections officers, paramedics and other first responders on dealing with the mental health and substance abuse issues of the "individuals encountered in the line of duty. (Title 2, Section 207 (e))


• Suicide prevention activities under the rubric of something called the "Garrett Lee Smith", especially prevention among minors (Title 2, Section 208 (c)(2)) and requiring grant recipients dedicate 85% of the money for direct service (i.e. prevention and treatment.). (Title 2, Section 208 (c)(2))


• Funding NIMH research into "self- and other directed-violence in mental illness", (Title 6, Section 601)


• The extant incentives for adoption of "Health Information Technology" are expanded in terms of who qualifies to get them, such as to include, for instance, clinical psychologists and private mental hospitals that serve at least 10% Medicaid patients. (Title 7, Sections 701 and 702)

Investigations and Reports

A bunch of investigations are ordered to be conducted by various parties into various things and reports issued on them:

• Compliance with parity law (Admin of CMS, annually) (Title 1, Section 103 (a))


• Peer-support specialists (Assistant Secretary, biannually) (Title 1, Section 103 (b))


• "The state of the States in mental health and substance use treatment" (Assistant Secretary, biannually) (Title 1, Section 103 (c))


• The coordinative communication costs of regulation compliance on certain types of mental healthcare facilities (Assistant Secretary + another institute, once) (Title 1, Section 103 (d))


• Quality of care in Assistant Secretary's grant programs (Director of the NMHPL (founded below), biannually) (Title 2, Section 201 (d))


• Evaluating the PCP training and telepsychiatry grant program (Assistant Secretary + NMHPL, annually, plus a big wrap up once in 2018) (Title 2, Section 207 (10))


• Financial consequences of the expansion of Medicaid coverage for inpatient and residential psychiatric care as per Section 501(b) if passed (Assistant Secretary, once, no later than 2 years post enactment) (Title 5, Section 501 (c))


• Discriminatory insurance coverage limitations in violation of the Federal parity law (GAO, once, no later than 1 year post enactment) (Title 9, Section 901)

Moar Science, Moar Medical

In various places in extant Federal law, this bill changes language or adds clauses concerning "evidenced-based" treatment, scientific research, and the participation of medical or other licensed clinical professionals.

• The Assistant Secretary is charged with endeavoring "to ensure access to effective, evidence-based treatment for individuals with mental illnesses and individuals with a substance use disorder". (Title 1, Section 101 (b)(2)(c))


• The Assistant Secretary is tasked with reviewing all programs concerning mental illness, to "identify any such programs and activities that are not evidence-based, effective, or efficient" (Title 1 Section 101 (b)(6)(c)) and those that are evidence-based "best practices" (Title 1, Section 101 (b)(7))


• The Assistant Secretary is to "promote" "greater research-oriented psychiatrist residency training on evidence-based service delivery models" (Title 1, Section 101 (c)(2)) and "evidence-based collaborative care models" (Title 1, Section 101 (c)(3)(a))


• The Assistant Secretary's peer-review boards reviewing mental health things would have to be 50% doctors (but not specifically psychiatrists) or experienced clinical psychologists (Title 8 Subtitle A, Section 801).


• The Assistant Secretary is only allowed to fund grants to programs and activities that shall use "evidence-based best practices or emerging evidence-based best practices that are translational and can be expanded or replicated to other States, local communities, agencies, or through the Medicaid program under title XIX of the Social Security Act." (Title 1, Section 101 (e)(3))


• The Assistant Secretary's peer-review boards (presumably not reviewing mental health things) would have to be 50% doctors (though not necessarily psychiatrists), psychologists (though not necessarily clinical psychologists?), or a licensed mental health professional. (Title 8 Subtitle A, Section 803)


• The Assistant Secretary's peer-review boards would be required to use science. (Title 8 Subtitle A, Section 803 (2))


• The Assistant Secretary's advisory councils must be 50% mental health treaters, none of whom are recipients of the grants being advised about (i.e. no conflicts of interest) (Title 8 Subtitle A, Section 802).


• The Assistant Secretary is ordered to develop "a list of such evidence-based [...] assertive outreach and engagement services". (Title 2, Section 206 (e))


• The Director of the NMHPL is tasked to "evaluate and disseminate to such [States] evidence-based practices and services delivery models using the best available science shown to be cost-effective while enhancing the quality of care furnished to individuals" (Title 2, Section 201 (c)) and to "establish standards for the appointment of scientific peer-review panels to evaluate grant applications" (Title 2, Section 201 (a)(2)(d)) and to set standards for "the extent to which [grantees] must submit statements on the extent to which the grantee is meeting annual program priorities with quantifiable, objective, and scientific targets, measures, and outcomes", "the extent to which [grantees] must use evidence-based practices and the extent to which those evidence-based practices must be used with respect to a population similar to the population for which the evidence-based practices were shown to be effective" and "the extent to which [grantees], when possible, must have a control group" (Title 2, Section 201 (b)(1)(d, g, and h))


• The NMHPL's staff must be 20% psychiatrists, 20% clinical or research psychologists (doctoral), 20% substance abuse specialists, and 20% "professionals or academics with expertise in research design and methodologies". (Title 2, Section 201 (c)(1)(a through d))


• Under the Demonstration Grants program, "no amounts shall be made available for any program or project that is not evidence-based". (Title 2, Section 203 (c)(2)) and the Director of the NMHPL will "ensure that programs and activities funded through grants under [the Early Childhood Intervention and Treatment Grants] subsection are based on a sound scientific model that shows evidence and promise and can be replicated in other settings." (Title 2, Section 204 (a)(3)) And such grant recipients must include an analysis of "any evidence-based best practices generally applicable as a result of such treatment and educational techniques used with such children" (Title 2, Section 204 (e)(3))


• Five percent of block grant funding already appropriated by Federal law (42 U.S.C. 300x–9) "shall [be obligated] [...] for translating evidence-based [...] interventions and best available science into systems of care" (Title 2, Section 206 (a))


• "The Protection and Advocacy for Individuals with Mental Illness Act" (much more on which elsewhere in this post) would be amended to include that Federally funded State organizations for protecting the rights of the mentally ill are charged with "[ensuring] that individuals with serious mental illness have access to and can obtain evidence-based treatment for their serious mental illness". (Title 8 Subtitle B, Section 816)


• Etc.

This bill defines "evidence-based" to mean:

the conscientious, systematic, explicit, and judicious appraisal and use of external, current, reliable, and valid research findings as the basis for making decisions about the effectiveness and efficacy of a program, intervention, or treatment.

Miscellaneous interesting tidbits

• Under the bit about reporting on the state of the States (Title 1, Section 103 (c)), is a definition (Title 1 Section 103 (c)(2)):

  In this subsection, the term “emergency room boarding” means the practice of admitting patients to an emergency department and holding them in the department until inpatient psychiatric beds become available.

  This is one of the adverse outcomes to be measured in the reports, above.


• Added into the extant law for "Block Grants Regarding Mental Health and Substance Abuse" (US Code Title 42, Chapter 6A, Subchapter XVII) will be an additional clause which requires 5% of the money authorized in that subchapter to be dedicated to "for translating evidence-based [...] interventions and best available science into systems of care". (Title 2, Section 206 (a))


• The National Health Service Corps law, which provides for student loan repayment of healthcare professionals practicing in underserved areas, is tweaked to extend it (more explicitly?) to pediatric care. (Title 2, Section 207 (d))


• For some reason, the demonstration grant program for Certified Community Behavioral Health Clinics expressly forbids that grant money from being used to pay for outpatient care delivered at satellite sites. (Title 5, Section 505).

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ETA: WARNING. STRICT MODERATION AHEAD WITH ATYPICAL RULES. ALL COMMENTS SCREENED. THIS IS NOT, I REPEAT, NOT THE PLACE FOR YOU TO SHARE YOUR OPINION OF THE MURPHY BILL. This post is for factual discussion of the Murphy Bill. You are welcome to share your opinions of what I wrote, for instance, whether you feel I have accurate represented an aspect of the bill or not. You are welcome to ask questions of fact about the Murphy Bill or matters it concerns. You are welcome to answer other people's questions of fact about the Murphy Bill or matters it concerns. DO NOT POST POSITIONS ON THE MURPHY BILL HERE. DO NOT POST YOUR SPECULATIONS ABOUT THE MURPHY BILL, OR RUMORS ABOUT OR THIRD PARTY CHARACTERIZATIONS OF THE MURPHY BILL HERE, EITHER.