Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts

Friday, October 7, 2022

Senator Becca Rausch and I had a wide ranging conversation on education, health care, elections & voting, and more (audio)

FM #857 = This is the Franklin Matters radio show, number 857 in the series. 


This session of the radio show shares my conversation with Senator Becca Rausch. We had our conversation via conference bridge to adhere to the ‘social distancing’ requirements of this post pandemic period.


We have a wide ranging conversation on education, health care, elections & voting, and of course climate. Links to the Senator’s pages as mentioned during our conversation are provided in the show notes.  


Our recording runs about 41 minutes, so let’s listen to my conversation with Senator Becca Rausch.

Audio file -> https://franklin-ma-matters.captivate.fm/episode/fm-857-state-senator-becca-rausch-10-03-22


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Senator Becca Rausch home page:   https://www.beccarauschma.com/ 


Her issues page:  https://www.beccarausch.com/issues    


Constituent engagement opportunities


Newsletter archive  https://us20.campaign-archive.com/home/?u=09452b4d597ce95fe20563af4&id=c427233b9b  


Hey Sam - support line -> https://samaritanshope.org/our-services/24-7-helpline/ 


From the audio archives: 

The conversation recorded in March 2021

https://www.franklinmatters.org/2021/03/fm-492-senator-becca-rausch-031121-audio.html 

The conversation recorded in August 2020

https://www.franklinmatters.org/2020/08/fm-331-senator-becca-rausch-81420-audio.html 


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We are now producing this in collaboration with Franklin.TV and Franklin Public Radio (wfpr.fm) or 102.9 on the Franklin area radio dial.  


This podcast is my public service effort for Franklin but we can't do it alone. We can always use your help.

 

How can you help?

  • If you can use the information that you find here, please tell your friends and neighbors

  • If you don't like something here, please let me know


Through this feedback loop we can continue to make improvements. I thank you for listening.


For additional information, please visit Franklinmatters.org/ or www.franklin.news/


If you have questions or comments you can reach me directly at shersteve @ gmail dot com


The music for the intro and exit was provided by Michael Clark and the group "East of Shirley". The piece is titled "Ernesto, manana"  c. Michael Clark & Tintype Tunes, 2008 and used with their permission.


I hope you enjoy!

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You can also subscribe and listen to Franklin Matters audio on iTunes or your favorite podcast app; search in "podcasts" for "Franklin Matters"

 

what is your voting plan?
what is your voting plan?

Wednesday, August 17, 2022

Governor Baker Signs Legislature’s Expansive Mental Health Bill

Law will further equitable access to mental health care for residents

Today (08/16/2022), legislative leaders and advocates joined Governor Baker for the ceremonial bill signing of the Mental Health ABC Act: Addressing Barriers to Care, comprehensive legislation to continue the process of reforming the way mental health care is delivered in Massachusetts, with the goal of ensuring that people get the mental health care they need when they need it.  The Governor officially signed this legislation into law on August 10, 2022.

The Mental Health ABC Act is driven by the recognition that mental health is as important as physical health for every resident of the Commonwealth and should be treated as such. The legislation includes a wide variety of reforms to ensure equitable access to mental health care and remove barriers to care by supporting the behavioral health workforce.  

"One moment, many years ago, I made the split-second decision to share the story of my family's struggle with mental illness—a moment of vulnerability and honesty that has become a movement, as more and more people stand up and speak up for accessible, high quality mental health care," stated Senate President Karen E. Spilka (D-Ashland). "We all deserve to have access to the mental health care we need, when we need it, and I am thrilled to see comprehensive mental and behavioral health care reform signed into law. I'd like to thank my colleagues in the Senate—especially Senators Cyr and Friedman—Speaker Mariano and our partners in the House, and Governor Baker, as well as the countless individuals, families, advocates, providers and others who have stood up for the idea that mental health is just as important as physical health, and to everyone who has fought for mental health care reform in Massachusetts and never gave up."

"Simply put, this legislation will move us closer to treating mental and physical health equally, as it builds upon our long-standing efforts to improve our behavioral health care delivery system," said House Speaker Ronald J. Mariano (D-Quincy). "I'm incredibly proud of the fact that this legislation will help to address the behavioral health crisis that so many of our residents are currently experiencing, especially young people. I want to thank my colleagues in the House, Senate President Spilka and our partners in the Senate, and Governor Baker for prioritizing increased support for the Commonwealth's mental health infrastructure."

"Today's ceremonial bill signing signifies a vital stride toward transforming mental health care in Massachusetts," said Senator Julian Cyr (D-Truro), Senate of the Joint Committee on Mental Health, Substance Use and Recovery. "By signing the Mental Health ABC Act into law, we codify and affirm that mental health is just as essential as physical health and take a leap forward to ensure that all people in Massachusetts can access the mental health care they need and deserve. I am deeply grateful to Senate President Karen Spilka for her leadership and example, to Senators Friedman, Rodrigues, and Tarr for their efforts in this most urgent endeavor, and to Representative Madaro for his partnership."

"Too many people in communities across the Commonwealth struggle to get the mental, emotional and behavioral health care they deserve," said Representative Adrian C. Madaro (D-Boston), House Chair of the Joint Committee on Mental Health, Substance Use and Recovery. "This legislation helps reduce barriers to resources, support, and treatment residents need for their overall wellbeing. It enables enforcement of existing parity laws, enhances emergency response services and acute psychiatric care, develops programs to strengthen the workforce, and invests in mental health. Importantly, our legislation also creates initiatives to address the unique mental health needs of young people. This legislation is the first step in addressing the structural deficits in our mental health care delivery system by prioritizing the people it serves and the people who make it work."

"The health care system in Massachusetts is only as strong as its weakest link, and for far too long, mental health care has been overlooked and underfunded," stated Senator Cindy F. Friedman (D-Arlington), Senate Chair of the Joint Committee on Health Care Financing. "This law confronts this reality with the most comprehensive mental health care action the Commonwealth has seen in recent years, and it builds off of the historic investments we made in this care system over this past two-year legislative session. Of particular importance to me, this bill will finally provide the state the tools it needs to enforce existing mental health parity laws and it will address the emergency department boarding crisis that is impacting too many of our children and their families. I have long believed that Massachusetts should deliver affordable, high quality, and accessible care to its residents, and this includes mental health care."

"With this legislation, the House and Senate make an important investment in mental health care—and in the mental and behavioral health workforce," said Representative Denise C. Garlick (D-Needham), Chair of the House Committee on Bills in the Third Reading. "Every aspect of this bill is rooted in the fact that we support and strengthen health care workers through a focus on health equity, equitable reimbursement, and supporting those who support providers. Every resident will benefit from a stronger workforce providing care."

"This bill takes major and necessary steps to advance and strengthen the delivery of mental health care in our Commonwealth, by securing parity with physical health care, moving pediatric mental health patients expeditiously from emergency departments to more appropriate treatment settings. I am pleased that amendments that I offered to address mental health needs of police, firefighters, EMTs, and other first-responders are included as well as the requirement that online portals with updated information and resource will be available in real-time," said Senate Minority Leader Bruce Tarr (R- Gloucester), a member of the conference committee. "These and other components of the bill make the identification and treatment of mental health in our Commonwealth stronger, better, and more effective so that people in need of care can better access essential resources in the right place and provided by the right people."

"This legislation is a sea-change, greatly improving access to mental and behavioral health services and addressing some of the most challenging aspects of delivering this critical health care to all," stated Representative Hannah Kane (R-Shrewsbury). "Far too many families have seen loved ones suffering and unable to access the short and long term care they need to get well and be well, my family included. I am grateful for the work of the conferees and the leadership of the Legislature." 

The following are features of The Mental Health ABC Act:

  • Guaranteeing Annual Mental Health Wellness Exams. This law mandates insurance coverage for an annual mental health wellness exam, comparable to an annual physical. 
  • Enforcing Mental Health Parity Laws. This law provides the state with better tools to implement and enforce parity laws by creating a clear structure for state agencies to receive and investigate parity complaints and ensure their timely resolution.
  • Initiatives to Address Emergency Department Boarding. This law creates online portals that provide access to real-time data on youth and adults seeking mental health and substance use services and includes a search function that allows health care providers to easily search and find open beds using several criteria; requires the Health Policy Commission (HPC) to prepare and publish a report every three years on the status of pediatric behavioral health as the youth boarding crisis is particularly acute; requires the Center for Health Information and Analysis (CHIA) to report on behavioral health needs; updates the expedited psychiatric inpatient admissions (EPIA) protocol and creates an expedited evaluation and stabilization process for patients under 18.
  • 988 Implementation and 911 Expansion. This law increases access to on-demand behavioral health care through the implementation of the nationwide 988 hotline that will provide 24/7 suicide prevention and behavioral health crisis services and expands 911 to bridge the gap until 988 is implemented.
  • Red Flag Laws and Extreme Risk Protection Orders. This law initiates a public awareness campaign on red flag laws and extreme risk protection orders (ERPOs) that limit access to guns for people at risk of hurting themselves or others. 
  • Reimbursing Mental Health Providers Equitably. The law requires an equitable rate floor for evaluation and management services that is consistent with primary care. 
  • Reforming Medical Necessity and Prior Authorization Requirements. This law mandates coverage and eliminates prior authorization for mental health acute treatment and stabilization services for adults and children and ensures that if a health insurance company intends to change its medical necessity guidelines, the new guidelines must be easily accessible by consumers on the health insurance company's website. 
  • Creating a Standard Release Form. This law directs the development of a standard release form for exchanging confidential mental health and substance use disorder information to facilitate access to treatment by patients with multiple health care providers. 
  • Increasing Access to Emergency Service Programs. The law requires health insurance companies to cover Emergency Service Programs (ESPs), community-based and recovery-oriented programs that provide behavioral health crisis assessment, intervention, and stabilization services for people with behavioral health needs. 
  • Expanding Access to the Evidence-Based Collaborative Care Model. The law expands access to psychiatric care by requiring the state-contracted and commercial health plans to cover mental health and substance use disorder benefits offered through the psychiatric collaborative care model. 
  • Reviewing the Role of Behavioral Health Managers. The law directs the Health Policy Commission (HPC), in consultation with the Division of Insurance (DOI), to study and provide updated data on the use of contracted behavioral health benefit managers by insurance carriers, often referred to as 'carve-outs.'
  • Tracking and Analyzing Behavioral Health Expenditures. The law directs the Center for Health Information and Analysis (CHIA) to define and collect data on the delivery of behavioral health services to establish a baseline of current spending and directs the Health Policy Commission (HPC) to begin tracking behavioral health care expenditures as part of its annual cost trends hearings. 
  • Establishing an Office of Behavioral Health Promotion. The law establishes an Office of Behavioral Health Promotion within the Executive Office of Health and Human Services (EOHHS) to coordinate all state initiatives that promote mental, emotional, and behavioral health and wellness for residents. 
  • Increasing Access to Care in Geographically Isolated Areas. This law directs the Department of Mental Health (DMH) to consider factors that may present barriers to care—such as travel distance and access to transportation—when contracting for services in geographically isolated and rural communities. 
  • Enhancing School-based Behavioral Health Services and Programming. This law enhances school-based behavioral health supports, increases access points for effective behavioral health treatment by limiting the use of suspension and expulsion in all licensed early education and care programs and public schools, and creates a statewide technical assistance program to help schools implement school-based behavioral health services.
  • Increasing Access Points for Youth for Effective Behavioral Health Treatment. The law requires behavioral health assessments and referrals for children entering the foster care system and establishes an interagency review team to ensure young people with complex behavioral health needs are assisted quickly and with cross-agency support and coordination.
  • Expanding Insurance Coverage for Vulnerable Populations. This law ensures individuals over 26 years old who live with disabilities can remain on their parents' health insurance.
  • Creating a Roadmap on Access to Culturally Competent Care. Under this provision, an interagency health equity team under the Office of Health Equity, working with an advisory council, will make annual recommendations for the next three years to improve access to, and the quality of, culturally competent mental health services. Paired with the Legislature's ARPA investment of $122 million in the behavioral health workforce through loan repayment assistance programs, this roadmap will make great strides toward building a robust workforce reflective of communities' needs. 
  • Allows for an Interim Licensure for Licensed Mental Health Counselors. The law creates an interim licensure level for Licensed Mental Health Counselors (LMHCs) so that they can be reimbursed by insurance for their services while obtaining supervised practice hours towards full licensure and be eligible for state and federal grant and loan forgiveness programs.
  • Expanding Mental Health Billing. This law allows clinicians practicing under the supervision of a licensed professional and working towards independent licensure to practice in a clinic setting.
  • Updating the Board of Registration of Social Workers. The law updates the membership of the Board of Registration of Social Workers to clarify that designees from the Department of Children and Families (DCF) and Department of Public Health (DPH) be licensed social workers. 

"During a national mental health emergency, Massachusetts leaders in the Legislature, Administration, and healthcare community joined to craft, pass, and sign landmark legislation to address equitable access to behavioral health care in the Commonwealth," said Danna Mauch, President and CEO of the Massachusetts Association for Mental Health (MAMH). "MAMH applauds the pacesetting institution of universal payor participation in and coverage for annual mental wellness exams, 24/7 telephonic behavioral health help line, comprehensive crisis services, behavioral health urgent care, and collaborative care as part of roadmap for reform."

"The passage of An Act addressing barriers to care for mental health signals the Commonwealth's ongoing commitment to improving mental health care access and quality for Massachusetts residents," said Lydia Conley, President/CEO of the Association for Behavioral Healthcare (ABH). "This landmark law will help individuals experiencing a mental health crisis, reduce emergency eepartment boarding, and ensure that parity laws are followed and enforced. ABH is grateful for the continued leadership of the Senate, House, and Governor in driving forward important reforms with the urgency these issues demand." 

"The collaboration between the Administration and the Legislature to pass the 2022 Mental Health law has been extraordinary," said Mary McGeown, Executive Director of the Massachusetts Society for the Prevention of Cruelty to Children (MSPCC). "This landmark law creates vital tools and strategies to help families, schools and communities respond to the current child mental health crisis and to address long standing gaps in access to care. As part of the leadership team of the Children's Mental Health Campaign, we are thrilled to see these meaningful reforms signed into law today." 

"On behalf of the National Association of Social Workers - MA Chapter, we are thrilled this landmark mental health legislation has been signed into law," said Rebekah Gewirtz, Executive Director of NASW-MA. "We are especially encouraged that the new interagency health equity team will work to support a more diverse behavioral health workforce that represents communities served and that will better ensure culturally competent care. Passage of this law will go a long way to improving the quality of life for all Massachusetts residents at a time of such acute and pressing need for critical behavioral healthcare services." 

"This is a groundbreaking day for mental healthcare in the Commonwealth," said Steve Walsh, President and CEO of the Massachusetts Health and Hospital Association. "Our hospitals and health systems applaud leaders in the Senate, House, and Baker Administration for making it possible. This law is grounded in systemic changes to guarantee long-promised parity, bolster the behavioral health workforce and—perhaps most critically—better address the mental health needs of children. Behavioral health has been a top priority of every healthcare organization in Massachusetts since before the pandemic began, and they remain deeply committed to ensuring that every community member has access to the resources and care they need." 

"Access to quality mental health care has never been more important," said Dr. Sandhya Roa, Chief Medical Officer of Blue Cross Blue Shield of Massachusetts. "This legislation is the culmination of years of work by policymakers and stakeholders to reform the mental health delivery system across the Commonwealth. Blue Cross Blue Shield of Massachusetts applauds this thoughtful, evidence-based approach to increasing capacity, improving integration with physical care, and making targeted investments to better serve our residents." 

"MAHP applauds the House and Senate for their collaboration and leadership in seeking to improve access to behavioral health care services and treatment. We thank bill sponsor Senate President Spilka for her dedication and leadership," said a statement from the Massachusetts Association of Health Plans (MAHP). "MAHP and our member health plans are pleased to see that the mental health ABC legislation includes important policy solutions to reduce emergency department boarding of patients seeking mental health and substance use disorder services, including codifying the expedited psychiatric inpatient admission process, and ensuring patients have timely access to the behavioral health care they need in the emergency department while in crisis. Our health plans are committed to providing high quality and comprehensive behavioral health benefits, in compliance with state and federal mental health parity laws. We look forward to working with the legislature next session to ensure that the entire health care system treats physical and behavioral health the same." 

"On behalf of our patients, the physicians of the Massachusetts Medical Society extend our gratitude to Governor Baker, and we thank Senator Cyr and our legislators for their leadership in recognizing the importance and urgency surrounding this bill," said Dr. Theodore Calianos, President of the Massachusetts Medical Society. "The COVID-19 public health crisis amplified myriad challenges our patients face in accessing timely, high-quality, comprehensive mental health care, challenges that can be especially insurmountable for the most vulnerable residents of the Commonwealth. Provisions in this bill will empower patients and physicians to make decisions that will more often lead to optimal outcomes for those who need and seek mental health care." 

"With the passage of the Mental Health ABC Act, we are at the dawn of a new day for mental health treatment in the Commonwealth," said Dr. Grace Chang, President of the Massachusetts Psychiatric Society. "We are now leading the nation in parity for mental health care just when it is most needed.  MPS congratulates the Massachusetts legislature on its visionary measure and looks forward to assisting in its implementation." 

Having been officially signed by the Governor on August 10, 2022 the Mental Health ABC Act is now law. 

Thursday, August 4, 2022

Please welcome Sam DuBois to the Franklin Police Department

Please welcome Sam DuBois to the Franklin Police Department. Sam has been with us for a few months now and is our new Mental Health Clinician through the Jail Diversion Program (JDP). The JDP is a grant-funded program through the Department of Mental Health. It pairs clinicians with local police departments through a co-response model. Sam rides with our officers each night and responds to calls as they come in. 

In addition to the FPD, Sam also works as the clinician for the Medway Police Department. Sam has a Masters's Degree from Anna Maria College in Social Work and he previously worked for Riverside Community Care as an adult clinical community services clinician. 

Sam is a GREAT resource within our department, please don’t hesitate to reach out to him for services.

Or reach him by email  SaDubois@advocates.org or sdubois@franklinma.gov.

Shared from Instagram https://www.instagram.com/p/Cgz7qnIP3mB/?utm_source=ig_web_copy_link

For more about the Jail Diversion Program, visit the Town of Franklin Police Dept page   https://www.franklinma.gov/police-department/pages/jail-diversion-program

Sam DuBois
Please welcome Sam DuBois to the Franklin Police Department

Tuesday, August 2, 2022

Legislature Passes Landmark Mental Health Reform

The Massachusetts Senate and House passed the Mental Health ABC Act: Addressing Barriers to Care (ABC), comprehensive legislation to continue the process of reforming the way mental health care is delivered in Massachusetts, with the goal of ensuring that people get the mental health care they need when they need it. 

The Mental Health ABC Act is driven by the recognition that mental health is as important as physical health for every resident of the Commonwealth and should be treated as such. The final conference report proposes a wide variety of reforms to ensure equitable access to mental health care and remove barriers to care by supporting the behavioral health workforce.  

"One moment, many years ago, I made the split-second decision to share the story of my family's struggle with mental illness—a moment of vulnerability and honesty that has become a movement, as more and more people stand up and speak up for accessible, high quality mental health care," stated Senate President Karen E. Spilka (D-Ashland). "We all deserve to have access to the mental health care we need, when we need it, and today we are on the brink to seeing comprehensive mental and behavioral health care reform signed into law. Thank you Senator Julian Cyr and Senator Cindy Friedman for their tireless work on this bill, to Senator Tarr for his work on the conference committee, and to our partners in the House for seeing this through. I'd also like to thank the countless individuals, families, advocates, providers and others who stood up for the common-sense idea that mental health is just as important as physical health, and to everyone who has fought for mental health care reform in Massachusetts and never gave up."

"I'm incredibly proud of the mental health legislation passed today that will help to address the behavioral health crisis that so many of our residents are currently experiencing, and that will move us closer to treating mental and physical health equally," said House Speaker Ronald J. Mariano (D-Quincy). "This legislation builds upon our long-standing efforts to advance important reforms that are aimed at improving our behavioral health care delivery system. I want to thank Chairman Madaro and the conferees, my colleagues in the House, as well as Senate President Spilka and our partners in the Senate for prioritizing increased support for the Commonwealth's mental health infrastructure."

"Today, the Massachusetts Legislature took vital strides toward transforming mental health care in Massachusetts," said Senator Julian Cyr (D-Truro), Senate of the Joint Committee on Mental Health, Substance Use and Recovery. "By unanimously passing the Mental Health ABC Act, we affirm that mental health is just as essential as physical health and take a leap forward to ensure that all people in Massachusetts can access the mental health care they need and deserve. I am deeply grateful to Senate President Karen Spilka for her leadership and example, to Senators Friedman, Rodrigues, and Tarr for their efforts in this most urgent endeavor, and to Representative Madaro for his partnership." 

"Too many people in communities across the Commonwealth struggle to get the mental, emotional and behavioral health care they deserve," said Representative Adrian C. Madaro (D-Boston), House Chair of the Joint Committee on Mental Health, Substance Use and Recovery. "This legislation helps reduce barriers to resources, support, and treatment residents need for their overall wellbeing. It enables enforcement of existing parity laws, enhances emergency response services and acute psychiatric care, develops programs to strengthen the workforce, and invests in mental health. Importantly, our legislation also creates initiatives to address the unique mental health needs of young people. This legislation is the first step in addressing the structural deficits in our mental health care delivery system by prioritizing the people it serves and the people who make it work."

"The health care system in Massachusetts is only as strong as its weakest link, and for far too long, mental health care has been overlooked and underfunded," stated Senator Cindy F. Friedman (D-Arlington), Senate Chair of the Joint Committee on Health Care Financing. "This legislation confronts this reality with the most comprehensive mental health care legislation the Commonwealth has seen in recent years, and it builds off of the historic investments we made in this care system over this past two-year legislative session. Of particular importance to me, this bill will finally provide the state the tools it needs to enforce existing mental health parity laws and it will address the emergency department boarding crisis that's impacting too many of our children and their families. I have long believed that Massachusetts should deliver affordable, high quality, and accessible care to its residents, and this includes mental health care."

"With this legislation, the House and Senate make an important investment in mental health care – and in the mental and behavioral health workforce," said Representative Denise C. Garlick (D-Needham), Chair of the House Committee on Bills in the Third Reading. "Every aspect of this bill is rooted in the fact that we support and strengthen health care workers through a focus on health equity, equitable reimbursement, and supporting those who support providers. Every resident will benefit from a stronger workforce providing care."

"This bill takes major and necessary steps to advance and strengthen the delivery of mental health care in our Commonwealth, by securing parity with physical health care, moving pediatric mental health patients expeditiously from emergency departments to more appropriate treatment settings. I am pleased that amendments that I offered to address mental health needs of police, firefighters, EMTs, and other first-responders are included as well as the requirement that online portals with updated information and resource will be available in real-time," said Senate Minority Leader Bruce Tarr (R- Gloucester), a member of the conference committee. "These and other components of the bill make the identification and treatment of mental health in our Commonwealth stronger, better, and more effective so that people in need of care can better access essential resources in the right place and provided by the right people."

"This legislation is a sea-change, greatly improving access to mental and behavioral health services and addressing some of the most challenging aspects of delivering this critical health care to all," stated Representative Hannah Kane (R-Shrewsbury). "Far too many families have seen loved ones suffering and unable to access the short and long term care they need to get well and be well, my family included. I am grateful for the work of the conferees and the leadership of the Legislature."

The following is an overview of The Mental Health ABC Act:

Guaranteeing Annual Mental Health Wellness Exams. A cornerstone of this reform is the idea that a person's mental health is just as important as a person's physical health. This bill would codify this principle by mandating coverage for an annual mental health wellness exam, comparable to an annual physical. 

Enforcing Mental Health Parity Laws. This bill provides the state with better tools to implement and enforce parity laws by creating a clear structure for the Division of Insurance to receive and investigate parity complaints and ensure their timely resolution. Other tools include parity enforcement for commercial, state-contracted and student health insurance plans, increased reporting and oversight of insurance carriers' mental health care coverage processes and policies, and reasonable penalties and alternative remedies for when an insurance company does not comply with the law. 

Initiatives to Address Emergency Department Boarding. For many people with acute mental health needs, the only place to get help is an emergency department (ED). Unfortunately, these patients may wait days, weeks, and even months for more appropriate admission to an inpatient psychiatric unit or less acute level of care. This is referred to as 'boarding,' which continues to rise dramatically. This legislation tackles this by creating online portals that provide access to real-time data on youth and adults seeking mental health and substance use services and includes a search function that allows health care providers to easily search and find open beds using several criteria; requiring the Health Policy Commission (HPC) to prepare and publish a report every three years on the status of pediatric behavioral health as the youth boarding crisis is particularly acute; requiring the Center for Health Information and Analysis (CHIA) to report on behavioral health needs; updating the expedited psychiatric inpatient admissions (EPIA) protocol and creating an expedited evaluation and stabilization process for patients under 18; codifying in statute the working group tasked with implementing the EPIA in law. 

988 Implementation and 911 Expansion. This legislation increases access to immediate behavioral health care through the implementation of the nationwide 988 hotline to access 24/7 suicide prevention and behavioral health crisis services. This legislation also expands 911 to bridge the gap until 988 is implemented by increasing training, funding, and capacity for regional emergency responses to behavioral health crises.

Red Flag Laws and Extreme Risk Protection Orders. This bill initiates a public awareness campaign on the Commonwealth's red flag laws and extreme risk protection orders (ERPOs) that limit access to guns for people at risk of hurting themselves or others. 

Reimbursing Mental Health Providers Equitably. 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 to mental health providers by requiring an equitable rate floor for evaluation and management services that is consistent with primary care. 

Reforming Medical Necessity and Prior Authorization Requirements. This bill mandates coverage and eliminates prior authorization for mental health acute treatment and stabilization services for adults and children. It also establishes a special commission to bring all stakeholders to the table to study and make recommendations on the creation of a common set of medical necessity criteria to be used by health care providers and insurance carriers for mental health services. 

Creating a Standard Release Form. Behavioral health providers struggle in the era of electronic health records and care coordination to create systems that simultaneously protect an individual's right to consent to share sensitive health information and allow practitioners to access the information they need to treat the individual and coordinate care. This bill directs the development of a standard release form for exchanging confidential mental health and substance use disorder information to facilitate access to treatment by patients with multiple health care providers. 

Increasing Access to Emergency Service Programs. Emergency Service Programs (ESPs), which are community-based and recovery-oriented programs that provide behavioral health crisis assessment, intervention, and stabilization services for people with psychiatric illness, are currently covered by MassHealth. The bill would require commercial insurance companies to cover ESPs as well. 

Expanding Access to the Evidence-Based Collaborative Care Model. The collaborative care model delivers mental health care in primary care through a team of health care professionals, including the primary care provider, a behavioral health care manager, and a consulting psychiatrist. This evidence-based access to mental health care has proven effective, less costly, and less stigmatizing. The bill would expand access to psychiatric care by requiring the state-contracted and commercial health plans to cover mental health and substance use disorder benefits offered through the psychiatric collaborative care model. 

Reviewing the Role of Behavioral Health Managers. Some insurance companies have subcontracted mental health benefits to specialty utilization management companies for years with mixed results. The bill directs the Health Policy Commission, in consultation with the Division of Insurance, to study and provide updated data on the use of contracted mental health benefit managers by insurance carriers, often referred to as 'carve-outs.'

Tracking and Analyzing Behavioral Health Expenditures. This bill includes a critical first steps toward incentivizing greater investments in mental health care within the analysis of statewide health care cost growth. Specifically, the bill directs the Center for Health Information and Analysis (CHIA) to define and collect data on the delivery of mental health services to establish a baseline of current spending.

Establishing an Office of Behavioral Health Promotion. Current behavioral health promotion activities are spread across state agencies. This dilutes the responsibility for mental health promotion and focus on the issues and undermines the important work being done. The bill establishes an Office of Behavioral Health Promotion within the Executive Office of Health and Human Services (EOHHS) to coordinate all state initiatives that promote mental, emotional, and behavioral health and wellness for residents. The new office is tasked with tailoring mental health messaging and intervention to veterans and first responders. It also creates a student advisory council to guide the office on meeting the mental health needs of the Commonwealth's students.

Increasing Access to Care in Geographically Isolated Areas. This bill directs the Department of Mental Health (DMH) to consider factors that may present barriers to care—such as travel distance and access to transportation—when contracting for services in geographically isolated and rural communities. 

Enhancing School-based Behavioral Health Services and Programming. This bill improves the wellness of young people by enhancing school-based behavioral health supports and increasing access points for effective behavioral health treatment by limiting the use of suspension and expulsion in all licensed early education and care programs and creating a statewide program to help schools implement school-based behavioral health services.

Increasing Access Points for Youth for Effective Behavioral Health Treatment. To support treatment accessibility for young people, this bill requires behavioral health assessments and referrals for children entering the foster care system.

Expanding Insurance Coverage for Vulnerable Populations. Critically, this legislation implements a technical fix to ensure individuals over 26 years old who live with disabilities can remain on their parents' health insurance.

Creating a Roadmap on Access to Culturally Competent Care. Under this provision, an interagency health equity team under the Office of Health Equity, working with an advisory council, will make annual recommendations for the next three years to improve access to, and the quality of, culturally competent mental health services. Paired with the Legislature's ARPA investment of $122 million in the behavioral health workforce through loan repayment assistance programs, this roadmap will make great strides toward building a robust workforce reflective of communities' needs. 

Allows for an Interim Licensure for Licensed Mental Health Counselors. The bill creates an interim licensure level for Licensed Mental Health Counselors (LMHCs) so that they can be reimbursed by insurance for their services and be eligible for state and federal grant and loan forgiveness programs, further increasing the number of licensed providers able to serve patients. 

Expanding Mental Health Billing. This bill allows clinicians practicing under the supervision of a licensed professional and working towards independent licensure to practice in a clinic setting. This will help to ensure quality training and supervision and encourage clinicians to stay practicing in community-based settings. 

Updating the Board of Registration of Social Workers. The bill updates the membership of the Board of Registration of Social Workers to clarify that designees from the Department of Children and Families (DCF) and Department of Public Health (DPH) be licensed social workers. 

Having passed both Senate and the House of Representatives, this legislation will be laid before the Governor for his consideration.  

Legislation text can be found -> https://malegislature.gov/Bills/192/S3097

Legislature Passes Landmark Mental Health Reform
Legislature Passes Landmark Mental Health Reform

Saturday, July 16, 2022

Call 988 - Mental Health Emergency Line activates on July 16, 2022

"The National Suicide & Crisis Lifeline activates their new Mental Health Emergency Line tomorrow. If you or someone you know is suicidal or struggling with a mental health crisis, you can dial 988 to be connected to immediate support. There is Hope.

Just call or text 988"

Shared from Twitter -> https://twitter.com/DSpencerFSC/status/1548091265941614597


Call 988 - Mental Health Emergency Line activates on July 16, 2022
Call 988 - Mental Health Emergency Line activates on July 16, 2022

Wednesday, June 22, 2022

Senate President Spilka's Boston Chamber Remarks as Prepared for Delivery - June 21, 2022

It is a great honor to speak with you today. As the Senate heads into the final month of formal sessions, we are poised to try to tackle some of the big issues facing the people of the Commonwealth, and I am feeling optimistic about what we have accomplished and what I believe we can accomplish by working with our partners in the House and the Baker Administration.

Just last week, the Legislature sent the Governor a conference committee VOTES Act, designed to increase voting access by enacting vote-by-mail and expanded early-voting options, widely used in the 2020 election, on a permanent basis. It was my hope that this legislation would include same-day voter registration. Although we couldn’t reach a compromise on this provision, I will continue to advocate for its adoption, as so many Senators remain in favor of this provision.

We also recently passed our Fiscal Year 2023 budget, in which the Senate prioritized workforce development so that employers have access to a larger pool of local talent to hire and partner with. Together with our first ARPA allocation, we have made historic investments in the Workforce Competitiveness Trust Fund, Adult Basic Education, our cybersecurity workforce in partnership with our public community colleges and universities, as we in the Legislature believe the Commonwealth can and should be a leader in cybersecurity, because we see it as a natural priority, and organizations working with people displaced from jobs during the pandemic, historically underserved populations, and individuals reentering their communities from the corrections system.

Finally, despite our current economic uncertainty and all our recent investments in our people, the Commonwealth’s Rainy Day Fund has never been higher. As Ways & Means Chair and now as Senate President, it has been my priority to grow our rainy day fund, and I’m proud to say that it’s now over $6 billion. So when we need it next, we’ll be prepared.

As for the Student Opportunity Act, many of you know that I ran for the Legislature on this issue, because I wanted to achieve real transformative change for all of our students. That’s why I’m proud that, in our recent budget, we invest a record $6 billion in Massachusetts public K-12 schools, thereby providing students with high quality educational opportunities while addressing pandemic costs—and keeping us on track to fulfill the promise of the Student Opportunity Act in seven years.

We also doubled the increase in the amount of local aid to cities and towns, to $1.2 billion, and invested over $900 million in increased funding towards housing stability and assistance to those living with homelessness. The measures we’re taking, including subsidizing rents and the cost of moving, provide concrete help to individuals and families experiencing housing instability while preventing costs from being passed on to local landlords.

As we continue to emerge from the COVID-19 pandemic, it is more important than ever that we ensure that the Commonwealth not only maintains but grows its economic vitality while ensuring the wonderful quality of life we aspire to here. And as we rethink the way that we work, our priorities in a post-COVID world, and grapple with economic realities in an inflationary environment, it’s clear that there are aspects of our economy and our society that just aren’t serving us well anymore.

When it comes to both early education and care, and mental and behavioral health, it seems as if we are still trying to exist in a post World War II structure, where men were assumed to be the primary breadwinners and no one talks about their feelings. But think of everything we have achieved since then—not only have we put a man on the moon, we now carry tiny powerful computers in our pockets. We’ve passed marriage equality, and we’ve made great strides in rights for women, our trans brothers and sisters, and immigrants—and we continue to work towards a more just and equitable Commonwealth for all.

Much of the technology used to propel our world forward—and the groundbreaking social policy used to propel our society forward—was invented right here in Massachusetts. Yet our antiquated beliefs about child care and mental health—and the systems we’ve built to support them—are dragging us down, and need to be urgently addressed if we are to remain economically competitive.

Take early education and care. Before the pandemic, women in Massachusetts were participating in the workforce at increasing rates, surpassing the national rate by 2019—but the pandemic has brought women back to where they were after the 2009 recession. In fact, the percentage of women participating in the U.S. labor market in October 2020 was the lowest since 1988. And while a February 2022 Bureau of Labor Statistics report shows that men have now recouped all their labor force losses since February 2020, over 1 million fewer women were in the labor force in January 2022 as compared to February 2020. Given how many women either need to work or prefer to work, this reflects an unsustainable trend.

But a lack of affordable early education and care options dampens the economy in other ways too.

According to a recent news article, parents of a four-year-old in Massachusetts can expect to pay 27 per cent of a typical family’s wages on child care—the highest percentage of any state in the U.S. except for Hawaii. In fact, the Economic Policy institute has pointed out that childcare workers themselves cannot afford childcare – because the cost of childcare in Massachusetts is more than 75 percent of the wages earned by a typical childcare worker, which is truly outrageous.

And so I’m proud to report that the Senate is tackling this issue from many different angles—and I’m also excited that there is action in the Legislature to address this important issue this session.

In our Fiscal Year 2021 budget, we created a Special Legislative Early Education and Care Economic Review Commission. That commission submitted its final report in March 2022, and included some pragmatic recommendations for the Legislature in the areas of stabilization, family affordability and access; and workforce compensation.

I’m excited to announce that the Senate will be releasing a bill shortly. This legislation, if and when it is fully implemented, will be transformative in expanding access to high quality, sustainable, and affordable early education and care for young children and families in Massachusetts. It also recognizes that our workforce needs significant supports, through salary, and education and training.

To provide a crucial down payment on our efforts to shore up childcare and early education, the Fiscal Year 2023 Senate budget invests a record $1.13B to transform the childcare system, an increase of $309.6M over FY 2022. The Senate budget also formalizes the practice of reimbursing providers based on enrollment rather than attendance, which will provide more stable payments for our early educators. We also dedicate a new $250M to continue the Commonwealth Cares for Children (C3) Stabilization Grant Program through at least the end of the calendar year. We believe that the C3 grants provide the bedrock funding necessary for the continued development of this sector. And, in recognizing that we need to do more for all our providers, particularly subsidized providers, we are putting this provision in our budget to demonstrate the Senate’s commitment to funding this year after year.

I’m optimistic our House colleagues will support these critical infrastructure investments.

With implementation of the SOA well underway, I believe that it’s time to turn our attention to early ed and care—and pursue the same type of transformational change in a multi-year process. The business community has been at the table on the early education and childcare issue – and we need you to stay. With your support, we can continue to shore up our childcare and early education infrastructure to better serve our businesses, our communities, our families, and most importantly, our children.

Another area where we can’t let the systems of the past impinge on our future is mental health.

I’d like to start by saying how grateful I am to Speaker Ron Mariano, Chair Adrian Madaro, and the entire House for passing their version of the Mental Health ABC Act 2.0 last week. I am extremely hopeful that we will finally get a comprehensive reform bill done this session, and it can’t come soon enough.
 
In this post-pandemic, inflationary environment, the stress of finding childcare, putting food on the table, and keeping a roof over your head is detrimental to our overall wellbeing, and yet our mental health care system remains broken, disrupting both people’s lives and our economy.

According to the Lancet, poor mental health was estimated to cost the world economy approximately $2.5 trillion per year in poor health and reduced productivity in 2010, and—in part due to the effects of the pandemic—that cost is projected to more than double to $6 trillion by 2030.

So, investing in mental and behavioral health makes good sense all around. In fact, according to the World Health Organization, for every $1 put into scaled up treatment for common mental disorders, there is a return of $4 in improved health and productivity.

That’s why, for Fiscal Year 2023, the Senate budget includes over $1B for mental health supports. These investments are paired with $400M from the American Rescue Plan Act legislation, primarily focused on building and sustaining this much- needed workforce.

Just two weeks ago, I attended the commencement ceremony at William James College, where they are intentionally working to foster a new generation of diverse mental and behavioral health professionals who can help us build the future when it comes to mental health access and care.

The Senate also included funding for a mental health clinician loan forgiveness program, a student telebehavioral health program and a public awareness campaign, and $15M in capacity-building initiatives to tackle the heartbreaking reality of emergency department boarding, along with an additional $100M plus to provide tools to sustain momentum around increased SEL supports, children mental health supports, and to Family Resource Centers.

And because substance use disorder is so often the result of unmet mental health needs, the Senate also dedicates significant funding in this area, including $209.3 million for a complete range of substance use disorder treatment and intervention services to support individuals and their families.

It’s clear that the need for mental health care has risen to the top of the agenda for many, and that may be one of the very few silver linings of the pandemic. I’m proud of all the work the Senate has done to advance this critical issue—and I hope you will all join us in getting this over the finish line—and then let your employees take the time they need to access mental health care! It will truly benefit us all.

Another area where our past threatens our future is our transportation system. By now, we’ve all read about the damning Federal Transportation Authority report. If Jim were here, I know he’d have something to say about this.

As he stated in the Globe, safety concerns are a top reason why employees are hesitant to return to work—and you have to wonder, what is stopping them from looking for work elsewhere? And we all know that when employees leave, employers are often forced to follow.

It’s high time that Massachusetts has the public transportation system to match the values and aspirations of its residents, not just here in Boston but throughout the entire state. As a Commonwealth, we need to take a comprehensive look at what we have, what we want, where we're going and how we pay for it—statewide.

This is important not only to provide a top-notch transportation system, but to reach our climate goals as well. In the climate bill now in conference committee, the Senate focused on electrifying our public transportation and cars, which is essential to reaching the future we envision.

Just this morning, the Speaker and I are announcing our support for continued discussions on East-West rail, including the $50 million we included in the last transportation bond bill, with the intent to include significantly more in the upcoming one. I’m hoping that the creation of this new transportation system will open up opportunities for economic development, just as the South Coast rail and the Green Line extension have done.

But we can’t just focus on these large-scale projects at the expense of the Regional Transit Authorities that service our local communities, and that’s why the Senate added $2.5 million in our budget for RTAs for the first time to explore opportunities for means-tested, discounted or fare-free pilot programs. And although I am disappointed the Governor vetoed the Senate’s attempt to move forward on a low-income fare program at the T and the Commuter Rail last session, I am looking forward to continuing that conversation with my colleagues in the upcoming transportation bond bill currently moving through the legislature. As that bill moves, we will continue to have these important discussions on the future of transportation in our state, and I look forward to the Boston Chamber continuing to be a partner in those talks.

Finally, the Speaker and I have also announced this morning that the Joint Committee on Transportation will hold an oversight hearing on the MBTA. The Federal Transit Administration’s findings and the MBTA’s subsequent service cuts don’t inspire public confidence in our transit system. Given the FTA’s interim findings and alarming directives there is an increased need to better understand the agency’s shortcomings and help restore public confidence, and so we need to learn more so that the Legislature can help ensure the T returns to safe and reliable service.

Finally, I believe our state’s strong financial position means that the Legislature can safely balance targeted spending, in areas like housing, childcare and higher education, with tax relief for individuals and families, and other ways to put money back in people’s pocket.

Last year, the Senate converted tax deductions for young children, elderly or disabled dependents and business-related dependent care expenses into refundable tax credits. This meant an additional $16 million to 86,000 low-income working parents and caregivers, thereby helping to lift families out of poverty, and we were happy to see the Governor expand this Senate initiative in his tax relief proposal, as these are dollars that go directly back into the economy.

In addition, the very first commitment we made with funds from the American Rescue Plan was a billion-dollar investment. We put $500 million towards businesses, in the form of unemployment insurance relief, giving them more resources to hire, innovate and invest back into the economy, and $500 million to frontline workers who couldn’t telecommute and who put themselves at risk, providing $500 checks for those who can use it the most.

$500 payments were delivered to nearly 240,000 people in March in the first round of the program, and the second round is distributing $500 checks to approximately 300,000 additional workers this month—a phenomenal number.

We are currently in discussions about a tax relief proposal, which may include changes to the Earned Income Tax Credit and the estate tax, among others. We will continue to ensure that Massachusetts is open, competitive, and inclusive, and that these same values guide our tax relief proposal.

As I conclude, it is clear that we have a lot of work ahead of us. But I am, as I said, I am hopeful about the future. Everywhere I go, I see people of all backgrounds and experiences wanting to row in the same direction when it comes to what is best for our children and families, our mental health, and our economy.

And it is indeed an honor to be in a leadership position in this time, even if it is a time of unprecedented change and uncertainty.

I’d like to thank all of you for your leadership in the business community, and for caring so very much about our Commonwealth. I look forward to our continued partnership.