2013 AND 2014 LEGISLATION AFFECTING ACCESS TO MENTAL HEALTH SERVICES
By: James Orlando, Associate Attorney
What significant legislation was enacted this year and last year concerning access to mental health services?
The legislature passed several bills during the 2013 and 2014 sessions affecting access to mental health services. Below we briefly summarize relevant provisions of some of them. Please note that not all provisions of the acts are included. Complete summaries of 2013 Public Acts are available on OLR's webpage. Complete summaries of 2014 acts will be available in the coming weeks.
REGIONAL BEHAVIORAL HEALTH CONSULTATION SYSTEM FOR PEDIATRICIANS
PA 13-3 (§ 69) requires the Department of Children and Families (DCF) commissioner, by January 1, 2014, to establish and implement a regional behavioral health consultation and care coordination program for primary care providers who serve children. The program must provide these providers with:
1. timely access to a consultation team that includes a child psychiatrist, social worker, and care coordinator;
2. patient care coordination and transitional services for behavioral health care; and
3. training and education on patient access to behavioral health services.
EFFECTIVE DATE: Upon passage
ADVERSE DETERMINATIONS AND MENTAL HEALTH INSURANCE COVERAGE
PA 13-3 (§§ 70-79) makes various changes to the process for grieving adverse determinations (e.g., claims denials) by health insurers. Among other things, it reduces the time health insurers have to (1) make initial determinations on requests for treatments for certain mental or substance use disorders and (2) review claim denials and other adverse determinations of such requests.
EFFECTIVE DATE: Most provisions effective October 1, 2013
(PA 14-40 makes certain changes affecting these provisions of PA 13-3, such as changes to the qualifications for psychologists acting as clinical peers to evaluate certain adverse determinations.)
ASSERTIVE COMMUNITY TREATMENT (ACT)
PA 13-3 (§ 67) requires the Department of Mental Health and Addiction Services commissioner to implement an ACT program in three cities that, on June 30, 2013, did not have such a program. The program must use a person-centered, recovery-based approach that provides people diagnosed with a severe and persistent mental illness with specified services in community settings.
EFFECTIVE DATE: July 1, 2013
COMPREHENSIVE PLAN FOR CHILDREN'S SERVICES
PA 13-178 requires DCF and the Office of Early Childhood (OEC), in consultation and collaboration with various individuals and agencies, to take several steps to address Connecticut children's mental, emotional, and behavioral health needs. For example, it requires DCF to develop a comprehensive plan to (1) meet these needs and (2) prevent or reduce the long-term negative impact of mental, emotional, and behavioral health issues on children.
EFFECTIVE DATE: July 1, 2013, except for the OEC provisions, which take effect October 1, 2013.
INFORMATION AND REFERRAL SERVICE
PA 14-115 requires the Office of the Healthcare Advocate, by January 1, 2015, to establish an information and referral service to help residents and providers get information, timely referrals, and access to behavioral health care providers.
The act requires the office, by February 1, 2016, and annually thereafter, to report to the Committee on Children and the Human Services, Insurance, and Public Health committees. The report must identify gaps in services and the resources needed to improve behavioral health care options for state residents.
EFFECTIVE DATE: July 1, 2014
ADVANCED PRACTICE REGISTERED NURSE (APRN) INDEPENDENT PRACTICE
PA 14-12, as amended by sHB 5537 and HB 5597, allows APRNs to practice independently if they have been licensed and practicing in collaboration with a physician for at least three years and 2,000 hours. This may increase access to mental health services offered by APRNs.
Under prior law, APRNs had to work in collaboration with a physician, and had to have a written agreement regarding their prescriptive authority.
EFFECTIVE DATE: July 1, 2014
OFF-SITE SERVICES BY MULTI-CARE INSTITUTIONS
PA 14-211 allows a multi-care institution to provide behavioral health services or substance use disorder treatment services on the premises of more than one facility, at a satellite unit, or at another location outside of its facilities or satellite units that is acceptable to the patient and consistent with his or her treatment plan.
EFFECTIVE DATE: October 1, 2014