Deal reached to improve children’s health care access

BOSTON - MassHealth would be required to cover young adults previously in state custody until they turn 26, health insurers would need to maintain accurate provider directories and a host of commissions would be created under compromise children's health legislation filed Monday afternoon.

The conference committee reconciling the different House and Senate bills filed its report with the House clerk at 4:17 p.m., less than a half hour after wrapping up a press conference called to announce a deal agreed to by five of the panel's six members. The sixth member, Senate Minority Leader Bruce Tarr, ultimately signed on as well before the bill (H 4210) was filed.

"Parents that are dealing with children with mental health, I think there's going to be somewhat of a sigh of relief that the state is finally listening and finally doing something about children's mental health," Rep. Mathew Muratore said.

The conference committee was led by Rep. Jennifer Benson and Sen. Cindy Friedman, the co-chairs of the Health Care Financing Committee. Its other members were Mental Health, Substance Use and Recovery Committee chairs Rep. Marjorie Decker and Sen. Julian Cyr, and Republicans Tarr and Muratore.

Conferees did not indicate a timeline for votes on their bill in the House or Senate, but it's likely one would take place by Wednesday, the last day of formal legislative business for 2019. Lawmakers will continue holding informal sessions throughout the rest of the year and resume formal sessions in January.

The House already plans to vote Tuesday on a separate conference report that would ban handheld cellphone use by drivers.

"We were very motivated to get this done before we break at Thanksgiving to keep the public aware of the importance that we've been putting on this issue, but also to keep the conversation moving," Benson said. "It became very much a priority for us, I think, to make sure that this was ready and ready to be voted on prior to the break."

The conference committee's bill calls for an analysis of insurance coverage and access to services for children with medical complexities, and for a pilot program of three "regional childhood behavioral centers of excellence" to provide information on behavioral health resources available in a particular area.

According to a summary, the bill also requires MassHealth to cover individuals under age 26 who were previously in Department of Children and Families custody, and requires health insurers to post online and regularly update their provider directories, a measure aimed at making it easier for patients to access needed mental and physical health care.

It creates special commissions on the pediatric provider workforce; school-based health centers; and mandated reporter laws, along with a task force on pediatric behavioral health screening.

"In no way, shape or form do we believe that this is the end of the work that we need to do," Friedman said, adding that some Senate approved measures relating to DCF were omitted from the final bill "in deference to" the House's ongoing effort to pull together legislation addressing the department.

The conferees also dropped a commission Tarr had proposed on children's behavioral health, though Friedman said the chairs had "made a commitment to ensure that that gets looked at" and "attached to some very direct actions."

At a 3:30 p.m. press conference, Tarr said he had not agreed to the compromise bill because it was "still concerning" to him to move forward "without addressing what is clearly something that is at a crisis state, if not close to a crisis state, with regard to pediatric mental and behavioral health."

Conferees said their conversations would continue during the afternoon. At 4:10 p.m., a staffer said Tarr had signed on, and the bill was filed at 4:17 p.m. with all six conferees' signatures.

Tarr told the News Service later that he had "deep reservations about signing the jacket" and was concerned about leaving "one of the most important child wellness issues in the commonwealth" to be discussed next year, when formal sessions run from January through July.

"However, I had extensive conversations with the two chairs, and we have agreed that we will make it a priority in January to put out a substantive bill, and while there are no guarantees, I am satisfied with their commitment to work with me and others on addressing the issue," Tarr said.

Decker said during the press conference that she and Cyr are working on a children's mental health bill that will come out of their committee.

"There's a lot of strong interest and I think there's a sense of urgency that is very much tied into understanding some of the obstacles that face us," she said. "One of the themes that I've continued to hear...is that what we really do, our system right now is set up to pathologize children until they're in crisis, and only when they're in crisis are we willing to address and acknowledge their needs for behavioral health, and even then, that's when we find out it's even more complicated to address their needs."

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