The sweeping bill, which supporters say could lead to historic changes in the mental and behavioral health care landscape, aims to guarantee that patients have the same access to mental health care as they do to physical health care.
To accomplish that goal, the bill creates new enforcement mechanisms for the state, calls for an expanded and more diverse practitioner workforce, seeks a rate floor to pay mental health clinicians the same as primary care providers for similar services, and more.
"This is a really big first step. I'd call it landmark. This is so many years, decades in the making,"
While the legislation focuses on mental health, its mechanisms are wide-ranging and varied.
Insurers would no longer be able to require prior authorization for patients who need acute psychiatric inpatient care, placing those treatments on the same level as emergency physical treatment. The bill also calls for a commission to study medical necessity criteria, a provision designed to ensure that patients are not improperly deemed not to require vital mental health services.
"What we try to do in this bill which may be unique among states, is to do this in such a comprehensive way," said Sen.
The legislation passed 38-0 and now goes to the House, whose leaders have not indicated their plans. Senate Minority Leader
A 2000 state law and a 2008 federal law both require insurers to provide mental health benefits comparable to those offered for physical health, but advocates and legislators say those standards have never fully been met.
"There was a real lack of specificity around what the expectation and requirements were around parity," she said. "For a long time, while these laws have been on the books, it's really been about self-reporting, so insurers and people who are responsible for parity were allowed to self-report."
Senators cited examples of gaps in coverage during Thursday's debate: roughly 50 percent of mental health care providers in
Senators also rejected an amendment offered by Veteran Affairs Committee Co-chair Sen.
Those with acute or co-occurring conditions often face the largest challenges. Sen.
Before a single amendment was considered Thursday, more than 20 senators from both parties -- a majority of the chamber -- rallied with health care providers and mental health experts to tout the importance of the bill.
More than a dozen speakers at the event, including leaders of industry organizations, labor organizations and hospitals, voiced their support for the legislation at the event, calling it "historic."
"Discrimination has for too long driven disparities in insurance coverage and health care access for children, adults and their families," said
Some of those, she said, were from desperate residents who had been searching for help without success for weeks or months straight.
"The crisis of access to mental health services is real," Gerwitz said.
One amendment the
"We would never tolerate that for a heart attack. We wouldn't tolerate that for a broken leg. We wouldn't tolerate that for a gunshot. We wouldn't tolerate that for a car accident victim," Lesser said on the floor. "These are kids sitting in emergency rooms without proper staffing, without proper protections, for days and days and weeks and weeks. Shame on us if we cannot deliver a way to help them and their families get the treatment and support they need."
While the bill includes several other pilots and studies at a total projected cost of roughly
Both before and during Thursday's debate, senators shared their own stories of mental health challenges.
Spilka said during unveiling of the bill that her father suffered from significant mental health issues after his service in World War II but never sought help because of stigma.
Cyr said on the
"I've gotten dozens, probably hundreds of messages from people saying, 'thank you for talking about mental health in a personal way,' " Cyr said. "Our broken mental health system is something that, I think, a lot of people have been dealing with quietly and have really felt in isolation."
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