F. Hearings |
F. Hearings - FY 2019 Budget Hearing - 7:10 PM
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- don't accept the patient
- get lift assistance tools or hire those who can
- pay me $900+ when I come in the door
Providing accurate and timely information about what matters in Franklin, MA since 2007. * Working in collaboration with Franklin TV and Radio (wfpr.fm) since October 2019 *
F. Hearings |
F. Hearings - FY 2019 Budget Hearing - 7:10 PM
|
"Arguing the state has been too hands-off in quelling the latest COVID-19 surge, Democratic state lawmakers on Tuesday pressed Governor Charlie Baker to take a more aggressive posture on testing in schools, masking rules, and public messaging.
The leaders of a legislative committee peppered Baker and his health secretary, Marylou Sudders, with questions over a combined 75 minutes, at times engaging in testy exchanges about the governor’s turbulent distribution of masks to educators and his administration’s resistance to a universal mask mandate.
A through-line of their requests: more."
"GOV. CHARLIE BAKER often says he and his political opponents will “agree to disagree.” That could have been the mantra of Tuesday’s oversight hearing of the Legislature’s Joint Committee on COVID-19 and Emergency Preparedness and Management.As the Omicron variant of COVID-19 surges through Massachusetts, overwhelming hospitals, lawmakers monitoring the state’s response questioned Baker and Secretary of Health and Human Services Marylou Sudders in a 1 1/2-hour virtual hearing. They pressed the officials on vaccination outreach, education policy, and how to help the state’s struggling health care system. "
JONATHAN WIGGS/GLOBE STAFF |
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 |
Quick Recap:
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School Committee Budget Workshop - Recap - Dec 1, 2020 |
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.
"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:
"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.