Massachusetts Senate approves sweeping mental health bill
Steve LeBlanc | AP | November 17, 2021
The Massachusetts Senate unanimously approved a bill Wednesday that would guarantee Massachusetts residents are eligible for annual mental health wellness exams at no cost — akin to annual physical exams.
The sweeping bill, which passed on a 39-0 vote, would also create an online portal to help smooth the transition from emergency to longer-term care; establish a panel to help resolve barriers to care for children with complex behavioral health needs who find themselves in an emergency room; and dedicate $122 million to support nearly 2,000 behavioral professionals.
“This investment is absolutely critical. It’s a game-changer. It includes the retention and recruitment we need to get the workforce we need, where we need it,” Democratic Sen. Julian Cyr said during the debate.
The legislation would enforce existing mental health parity laws, which are intended to ensure that insurance coverage for mental health care is equal to insurance coverage for other medical conditions.
The goal of the bill is to create a more functional, transformed mental health care system, Cyr said.
“This legislation builds more robust mental health care by advancing parity implementation and other insurance reforms, supporting our mental health workforce and doing everything we can to bring down barriers to care and make mental health care more accessible,” he added.
The bill would rely in part on $400 million in federal American Rescue Plan Act funds.
Although the concept of mental health parity has been codified in federal and state law for decades, enforcement has been spotty, with patients often denied coverage for mental health treatment, advocates say.
“It’s a sad pathetic myth to say that we have parity” in Massachusetts, Democratic state Sen. Mark Montigny, said during the debate.
The proposal would address the enforcement issue in part by allowing the Division of Insurance to more swiftly receive and investigate parity complaints.
The bill is an updated version of legislation approved by the Senate last year. It now heads to the Massachusetts House for consideration.
Another problem the bill would address is what’s known as emergency department boarding or “ED boarding.” That’s what happens when adults or children in the throes of a mental health crisis seek help in a hospital emergency department.
If they ultimately need to be admitted to an inpatient psychiatric unit, the wait can last days or weeks. In the interim, the individual seeking help must often wait in the emergency department, receiving little or no psychiatric care.
The bill would address the issue by creating an online portal with real-time data to help health care providers more easily search for open beds, requiring hospital emergency departments to have a qualified behavioral health clinician to evaluate patients seeking mental health care during all operating hours, and directing the state Office of the Child Advocate to produce an annual report on child ED boarding.
The legislation would also reimburse mental health providers more equitably, create a standard release form, eliminate requirements for prior authorization from insurance providers for acute mental health treatment, encourage health care facilities to develop more emergency psychiatric services, and increase access to mental health care in more geographically isolated areas.
During the debate senators adopted an amendment that would create a state 988 crisis hotline center to provide intervention services and crisis care coordination to individuals calling into the federally designated 988 suicide prevention and behavioral health crisis hotline.