Bill signing signals importance of mental health in Massachusetts

It's a nuts-and-bolts bill addressing the structure and delivery of mental health services to Massachusetts residents, dealing mostly with insurance company issues: from compensation for providers, standardization of paperwork, expenditure tracking, to creating a statewide office to promote mental wellness.

While mandating insurance coverage for an annual mental health wellness screening, it establishes that, in Massachusetts at least, mental health is just as important as physical health.

Signed by Gov. Charlie Baker on Aug. 16 in a post-legislative session ceremony, the Mental Health ABC Act: Addressing Barriers to Care (ABC) puts in place, Baker said, "the pieces necessary to get to a place of true parity" in mental and behavioral health services.

It takes a big step toward de-stigmatizing mental illness and substance abuse.

The bill was hammered out in the post-final hours of the 192nd Legislative Session by both the Senate and the House last month. It came to fruition after decades of work, according to Senate President Karen A. Spilka (D-Ashland), and "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. " She thanked "everyone who has fought for mental health care reform in Massachusetts and never gave up."

In announcing the bill's passage, Spilka was candid about her family's own struggles with mental health.

"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," Spilka said. "We all deserve to have access to the mental health care we need, when we need it."

The comprehensive mental and behavioral health reform bill breaks down barriers to access in different ways:

For consumers: It mandates insurers pay for yearly mental and behavioral health screenings and care.

It expands supports for behavioral health in school settings. It provides screening and referrals for children entering the foster care system. It expands care for vulnerable populations: extending parental insurance coverage to disabled adults over the age of 26. And it creates a team in the Office of Health Equity to improve access to, and the quality of, culturally competent mental health services.

For practitioners: It ensures providers are paid on par with primary care physicians, as well as providing tools needed to enforce the provision for commercial, state-contracted and student-health insurance plans.

It addresses the problem of boarding patients in crisis in hospital emergency rooms while providers seek, sometimes for weeks, a psychiatric bed, for an individual. The bill fosters the creation of a portal allowing immediate access to the availability of beds.

Removes the need for prior-authorizations particularly for acute treatments and stabilization services for both adults and children.

Mandates all insurance carriers cover mental health services and substance abuse disorders and supports the collaborative care model of a team of health care professionals that include a patient's primary care physician, psychiatrist and behavioral health care manager. This collaborative care has proven effective, less costly, and less stigmatizing.

Increases access to Emergency Service Programs (ESPs).

Promotes the creation of a set of medical necessity criteria for mental health providers and insurance companies.

Creates standardized release forms that allow practitioners to exchange confidential medical information.

Mandates that the Center for Health Information and Analysis (CHIA) track the delivery of services to establish a baseline of current spending.

The bill also mandates a review of subcontractors and behavioral health managers, delegated in many circumstances to provide coverage for mental health services by commercial insurance companies.

"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.