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Bill would guarantee annual mental health wellness exams

Steve LeBlanc
Associated Press

Boston — Massachusetts residents would be eligible for annual mental health wellness exams — akin to annual physical exams — at no cost under a sweeping mental health bill set to be debated by the state Senate next week.

The bill would also create an online portal to help smooth the transition from emergency to longer-tern care; dedicate $122 million to recruit and retain nearly 2,000 behavioral professionals; and establish a panel to help resolve barriers to care for children with complex behavioral health needs who find themselves in an emergency room.

The goal of the bill is to create a more robust mental health care system on par with the state’s existing health care system, according to advocates such as Democratic Senate President Karen Spilka.

Massachusetts Senate President Karen Spilka, D-Ashland, stands in the Senate Chamber at the Massachusetts Statehouse in Boston. Supporters such as Spilka say the goal of the bill is to create a robust mental health care system on par with the state's existing health care system.

For Spilka, the question of expanding access to mental health care is personal as well as political. She has spoken about the undiagnosed and untreated post-traumatic stress disorder and mental health problems her father, a WWII veteran, suffered for much of his life.

“I know first-hand how mental health conditions can affect the entire family, not only the person that might be experiencing mental health issues, but the entire family,” Spilka said when she unveiled the bill earlier this week.

The bill would rely in part on $400 million in federal American Rescue Plan Act funds.

The proposal would also enforce existing mental health parity laws intended to ensure that insurance coverage for mental health care should be equal to insurance coverage for other medical conditions.

Although the concept of mental health parity has been codified in federal and state law for decades, enforcement has been spotty as patients are often denied coverage for mental health treatment, advocates said.

The bill would address the enforcement issue in part by allowing the Division of Insurance to more swiftly receive and investigate parity complaints.

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, weeks or even months. Often in the interim, the individual seeking help must wait in the emergency department receiving little or no psychiatric care.

The bill seeks to address the issue by creating an online portal with real-time data to help health care providers more easily search for open beds, requiring all hospital emergency departments to have a qualified behavioral health clinician to evaluate patients in need of 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.

While Massachusetts has made strides in expanding health coverage, many residents still face barriers to accessing the care they need, particularly behavioral health care, according to Amy Rosenthal, executive director of the advocacy group Health Care for All.

Rosenthal said the Senate bill “seeks to address these barriers through several levers, including enhancing health insurance coverage and parity provisions, building and diversifying the workforce, addressing the emergency department boarding crisis, and increasing access for especially underserved populations.”

The bill is an updated version of legislation approved by the Senate last year.

If again approved by the Senate next week, the bill would go to the Massachusetts House for consideration.