Human Services Committee

JOINT FAVORABLE REPORT

Bill No.:

SB-322

Title:

AN ACT CONCERNING A BEHAVIORAL HEALTH CLEARINGHOUSE.

Vote Date:

3/20/2014

Vote Action:

Joint Favorable Substitute

PH Date:

3/6/2014

File No.:

SPONSORS OF BILL:

Human Services Committee

REASONS FOR BILL:

To provide a central resource for information and referrals for behavioral health services.

The original bill set up information clearinghouse on behavioral health care to be run by Office of Health Care Advocate. The substitute bill removes "clearinghouse" language and establishes an information and referral service with primary objective of providing privately insured residents and providers with more timely access to behavioral health care. Title changed to "AAC Connecting the Public to Behavioral Health Care Services" to reflect changes.

RESPONSE FROM ADMINISTRATION/AGENCY:

RODERICK L. BREMBY, Commissioner, Connecticut Department of Social Services (DSS), testified on this bill and expressed some concerns. “This proposal seeks to create a centralized repository for available behavioral health services to be located within the Office of the Healthcare Advocate. If the goal of the bill is to create a comprehensive clearinghouse of publicly funded and privately funded behavioral health services, we feel that this has merit and should be explored.”

“While we do not object to this legislation in principle, we would recommend that our sister agencies, the Department of Mental Health and Addiction Services, as the lead agency for adult behavioral health, and the Department of Children and Families, as the lead agency for children's behavioral health, be included in any discussions about where the clearinghouse should reside. In addition, it is our hope that this initiative would not be redundant of or impact any services already being done by 2-1-1 Infoline, the state's contracted informational and referral partner.”

PATRICIA REHMER, MSN, Commissioner of the Department of Mental Health and Addiction Services, testified on the bill. “DMHAS currently funds two programs that would meet most of the criteria laid out in this bill. The Connecticut Clearinghouse is a library and resource center for information on substance use and mental health disorders, prevention and health promotion, treatment and recovery, wellness, and other related topics.  A program of the Wheeler Clinic, Connecticut Clearinghouse is funded by the Connecticut Department of Mental Health and Addiction Services. From July 1, 2012 through June 30, 2013 the Connecticut Clearinghouse logged 422,526 website visits. Onsite, telephone, and written requests for information, materials, and other services totaled 5,031.”

“In addition, in 2005 the legislature enacted PA 05-80 which provided DMHAS with funding to develop a web site to provide behavioral health care information and assistance. This web site is called the 'Network of Care' and it is a single resource web site that provides timely access to behavioral health care information and assistance for children, adolescents and adults. The website includes (1) directory information on available federal, state, regional and community assistance, programs, services and providers; (2) current mental health diagnoses and treatment options; (3) links to national and state advocacy organizations, including legal assistance; and (4) summary information on federal and state mental health law, including private insurance coverage. The website also has an optional, secure personal folder for web site users to manage information concerning their individual mental health care and assistance. The Network of Care site is updated on a regular basis by information provided by 211. We contract with 211 to provide change files to Network of Care on a monthly basis. DMHAS spends approximately $130,000 a year for the Network of Care and approximately $11,000 a year for 211, and ensures that there is coordination between the two programs.”

VICTORIA VELTRI, Office of the Healthcare Advocate, State of Connecticut, testified in support of this bill. “OHA advocates for people with public and private coverage, including those enrolled in self-funded plans that include most large employer plans, many mid-size employer plans, municipal plans and the state employee plan, among others. Several meetings with a range of advocacy community organization representatives and 2-1-1 led to this proposal.”

“The Network of Care provides valuable resources, including types of services available and a list of non-profit or other public providers. However, with respect to private healthcare coverage, it does not provide detail on the many types of private coverage offered or the private providers participating in private health plans, particularly for individuals enrolled in self-funded healthcare coverage, which represents the majority of privately covered people in the state.”

“The Connecticut Clearinghouse also provides many valuable services, including links to locators of services and other very important information for consumers. 2-1-1 also provides tremendous benefit to CT residents by directly assisting individuals with crisis services, as detailed in its testimony, among its many other duties. 2-1-1 also acknowledges in its testimony the gaps with private provider monitoring and access to care for those with private coverage and longer-term needs.”

“Importantly, no site and no entity provides real-time measurement of the availability of providers for privately covered individuals, something that has been repeatedly identified as a barrier to access to care for those with private healthcare coverage.”

“As OHA understands the intent behind this bill, it was to complement the assistance already offered by existing resources, assessing caller's needs and providing appropriate guidance, information, advocacy or referral as indicated, including to 2-1-1, state agencies and our community partners, while collecting data on gaps in access that can then be addressed by OHA's mission to monitor existing laws and make recommendations for improvement in private coverage. This bill does not seek to replicate or replace the already well-established and excellent existing services, such as those offered by 2-1-1, DMHAS and DCF, but build upon OHA's already existing partnerships with them to promote greater consumer access to assistance.”

STATE OF CONNECTICUT, INSURANCE DEPARTMENT, submitted testimony. “The Insurance Department does support the underlying intent of the bill. However, should the bill move forward, the Department respectfully requests it does so with joint favorable substitute language.”

“As currently written, Section 1(g)(5) of this bill would instruct the OHA to identify gaps in services and barriers specifically associated with “private insurers”. This provision would be duplicative with regard to fully insured plans. The Insurance Department in collaboration with the Department of Mental Health and Addiction Services (DHMAS) is currently engaged in just such an activity. As such, the Department would suggest the Committee amend (g)(5) of bill to state that this effort will remain solely under the auspices of the Insurance Department with assistance from DHMAS. Additionally, OHA appears to already have the statutory authority under 38a-1041 (e) and (f) to create a clearinghouse (see 38a-1041(e)(f) below).”

NATURE AND SOURCES OF SUPPORT:

RICHARD PORTH, CEO of United Way of Connecticut, submitted testimony on this bill. “We applaud state leaders in DMHAS, DCF, and The Office of the Healthcare Advocate, and the legislature for the ongoing efforts to strengthen and improve access to behavioral health services. Connecticut residents in the thousands have turned to 2-1-1 for years now, for crisis intervention and to learn about and access a multitude of behavioral health and substance abuse services provided by government agencies and non-profits. The demand for assistance is great; last year over 450,000 callers contacted 2-1-1 for help finding and accessing needed services.”

“The Office of the Health Care Advocate has done an excellent job advocating on behalf of Connecticut's privately insured residents having trouble accessing health care services and/or getting their insurers to pay for health care services. The state can build on this OHA role and complement the existing mental health service infrastructure by authorizing OHA to develop a comprehensive, searchable directory of private sector behavioral health providers that could include up to date information on provider practice type and specialty, insurances that are accepted, level of care, service availability, contact information and so forth.”

“A focus on behavioral health services offered by private providers along with guidance and assistance for those who are privately insured and having trouble getting their insurance to cover behavioral health services would address a real need in the current behavioral health services delivery system.”

CONNECTICUT PSYCHOLOGICAL ASSOCIATION, submitted testimony in support of this bill. “[A] central information and referral clearinghouse to increase public access to information regarding behavioral health services and offer referrals to residents to appropriate services is an important service for Connecticut residents. Such a clearinghouse would serve to centralize fragmented information, help residents identify and understand their treatment options, and allow residents take control of their mental health needs by seeking appropriate treatment. Importantly, the proposed legislation also provides for mechanisms to identify gaps in the mental health system, which will be informative and allow for the most efficient allocation of resources in the future. The provision for quality review of the effectiveness of the clearinghouse overall is also important, facilitating change and adaption of the clearinghouse as needed.”

NATURE AND SOURCES OF OPPOSITION:

None expressed.

Reported by: Dionne Abrams

Date: March 27, 2014