State Senate unanimously passes mental health bill

  • HINDS

Staff Writer
Published: 2/18/2020 9:06:13 PM

A bill that would reform the state’s mental health care system by expanding access, boosting the workforce and strengthening coverage has unanimously passed in the state Senate and is on its way to the House.

The bill would create a pilot program through the state Department of Higher Education aimed at creating a “workforce pipeline” to encourage and support individuals from diverse backgrounds to work toward careers in mental health. The legislation would invest in the mental and behavior health workforce, provide the state with more effective tools to enforce existing mental health parity laws and remove barriers.

“Mental health touches every issue we are confronting as a society, and we are just now making strides to address the mental health needs of our community,” said Sen. Adam Hinds, D-Pittsfield. “This legislation is an important step in breaking down barriers to mental health care, and stripping the stigma that surrounds mental health by creating parity with other medical conditions”

The comprehensive legislation, S 2519, called “An Act Addressing Barriers to Care for Mental Health (ABC),” serves as a first step toward developing more integrated systems of mental health care.

Hinds said Massachusetts residents have historically experienced difficulty accessing health services, many times due to health inequities and persistent barriers, leaving many without the treatment they need. A 2018 report by the Blue Cross Blue Shield Foundation of Massachusetts showed that more than half of a “representative sample” of fully insured adults who sought mental health care found services.

Mental health is just as important as physical health, and Hinds said the vote reflects the Senate’s goal of improving mental health care for all.

Prioritized efforts

The Senate prioritized efforts in the 2019 to 2020 legislative session to improve the delivery of mental health services throughout the state by appropriating record funding levels for mental health services this year, creating and funding a $10 million Behavioral Health Outreach, Access and Support Trust Fund; and ensuring that health insurers’ provider network directories are accurate and up-to-date by eliminating so-called ‘ghost networks.’ It also protects clinicians from unreasonable retroactive claims, denials or “clawbacks” of payments for services from insurance providers.

Despite all of the achievements, Hinds said there’s a lot more to do, and the recent legislation is a good start, but inequities still persist and patients are often denied coverage for mental health treatment that is just as critical to managing their health as treatment for conditions such as diabetes or heart disease.

He said the legislation includes quicker evaluation and resolution of parity complaints, greater reporting and oversight of insurance carriers’ processes and policies related to mental health care coverage, and penalties and alternative remedies for when an insurance company does not comply with the law.

Every day throughout the state, adults and children arrive in emergency departments in the throes of acute mental health crises that require immediate treatment, but because of complex and restrictive medical necessity and prior authorization review processes imposed by insurance companies, many experience barriers and delays in treatment, Hinds said.

Senate Bill 2519

The bill mandates coverage and eliminates prior authorization for mental health acute treatment for children and adults, placing care with the clinician, rather than the insurance company. It also creates an interim licensure program for licensed mental health counselors so they can be reimbursed by insurance for services they provide, as well as be eligible for state and federal grant and loan forgiveness programs.

If passed by the House and signed by Gov. Charlie Baker, the bill would also request an academic study conducted by the Office of Health Equity to review the availability of culturally competent mental health care providers within networks of both public and private health care payers. It would also identify potential barriers to care for the underserved populations.

Hinds said the bill would direct an interagency health equity team to improve access to and quality of culturally competent mental health services to serve those underserved populations, and would create a Psychiatric Mental Health Nurse Practitioner Fellowship Pilot Program in community health centers to offer additional support and training to psychiatric nurse practitioners who agree to work in community settings with the underserved.

Currently, Hinds said mental health and primary care providers are reimbursed at different rates for the same service. The bill seeks to “level the playing field” for reimbursement by requiring an equitable rate floor for evaluation and management services consistent with primary care.

Hinds said the bill would improve access to care by prohibiting insurers from denying coverage for mental health services and primary care services solely because they were delivered on the same day in the same facility, which would remove a significant financial barrier to the integration of the two. It would also require emergency departments to have the capacity to evaluate and stabilize a person admitted with a mental health problem, and then refer them to appropriate treatment.

The bill would authorize the state Department of Public Health and Department of Elementary and Secondary Education to collaborate on three pilot programs for tele-behavioral health services in public high schools. There are already several successful hospital and school districts in Western Massachusetts doing this, and others would be based on those models.

The bill would also direct the Department of Public Health to consider factors that may present barriers to care, including travel distance and access to transportation, when contracting for services in geographically isolated and rural communities.

The Senate added some amendments to the bill, including a pediatric mental health care task force be formed; inclusion of veterans and aging populations be considered in the study; a comprehensive behavioral workforce commission be created; and expedited admission for those under the age of 22 who present in an emergency room with mental health needs.

The bill now goes to the House for its consideration. If the House makes any changes, the bill will go to a joint committee to be reconciled. Then, the bill will be sent to Baker for his signature.

Reach Anita Fritz at
413-772-0261, ext. 269 or afritz@recorder.com.




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