House Bill 1174
An Act Requiring Mental Health Parity For Disability Policies
January 24, 2012
Testimony of Laurie Martinelli, Executive Director
National Alliance on Mental Illness of Massachusetts (NAMI Massachusetts)
Honorable Chairs and Members of the Committee:
My name is Laurie Martinelli, and I am the Executive Director of the National Alliance on Mental Illness of Massachusetts (NAMI Massachusetts).
NAMI is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI advocates for access to services and treatment, and is steadfast in its commitment to raising awareness for all of those in need. Since our inception in 1979, NAMI has been dedicated to improving the quality of life of individuals and families affected by mental illness.
We are here today to advocate for a health care system that ensures equal access to treatment for those with mental illness, and specifically I am here today in support of House Bill 1174, an act which would require parity for both mental health and physical health in disability insurance.
Today, we have a system where physical health coverage is not equal to mental health coverage in disability insurance. The disability insurance system that exists covers physical disabilities for life, and only covers mental disabilities for two years. This difference is called discrimination and is patently unfair.
The Legislature has redressed this inequity in the Parity legislation that it passed in 2000 and again in 2009 – parity created fundamental fairness between mental illness and physical illness by requiring health insurance for “biologically based” illnesses. NAMI is asking for this same equal coverage by disability policies for both mental and physical health.
Our state’s mental health care crisis is everyone’s problem and its solution is everyone’s responsibility.
Passing this H. 1174 would not require an outlay of any taxpayer money, a resource we know is in short supply these days.
It would require companies that provide short and long term disability insurance to cover physical disabilities and mental disabilities for the same length of time, and it would require these companies to not have any different limitations for behavioral health coverage than those than exist for physical health.
We know that there are costs involved in funding shelters, hospital emergency departments, and the criminal justice system – costs that are increased as programs for people with mental illness are decreased. This bill would ensure that people with mental illness that are not able to work for a period of time would receive the coverage afforded by their disability policies. Otherwise, they are forced to access and rely upon state funded safety net services.
Many people who go on disability insurance can, with treatment and time, return to work and again be productive members of society. This bill would help ensure that the insurance coverage they have would cover some of the costs associated with their recovery from mental illness.
NAMI has brought both consumers (and peers) and experts here today to testify on the impact this has on the community, and also to discuss the underlying assumptions behind excluding mental health issues, that mental illness is not malingering or the idea that mental illness is not a real illness in the same way that diabetes is an illness.
NAMI urges the committee to issue a favorable report on House Bill 1174.
Thank you for the opportunity to testify.
KNOW YOUR DISCHARGE PLANNING RIGHTS FROM MASSACHUSETTS LICENSED PSYCHIATRIC UNITS!
Every patient of a locked psychiatric unit, regardless of coverage, has a right to effective and proper discharge planning. Depending on insurance coverage, some patients may have additional discharge planning protections. Below please find a listing of your rights pertaining to hospital discharge planning.
FOR MASSHEALTH RECIPIENTS:
FOR MEDICARE RECIPIENTS:
FOR THOSE PATIENTS WHO ARE PRIVATELY INSURED:
FOR ALL PATIENTS REGARDLESS OF INSURANCE COVERAGE:
WHAT TO DO IF A MEDICAL FACILITY HAS VIOLATED THESE RIGHTS:
Division of Health Care Quality
99 Chauncy Street, 11th Floor
Boston, MA 02111
File your complaints in writing if possible. Keep a copy of your complaint for yourself. Keep also the name of the staff you filed the complaint with and the date you filed it.
Other individuals, such as family members, may file any of these types of complaints on your behalf.
IF YOU PREFER, YOU CAN ALWAYS CONTACT NAMI MASSACHUSETTS AND WE WILL HELP YOU WRITE AND SEND THE APPROPRIATE COMPLAINT LETTERS.
400 West Cummings Park, Suite 6650
Woburn, MA 01801
 130 C.M.R. 415.419(B)(3)
 42 C.F.R. § 412.27(d)
 42 C.F.R. § 412.27(d)
 Department of Mental Health Discharge Procedures read: “A facility shall make every effort to avoid discharge to a shelter or the street. The facility shall take steps to identify and offer alternative options by a patient, document such measures, including the competent refusal of alternative options by a patient in the medical record. In the case of such discharge, the facility shall nonetheless arrange for or, in the case of a competent refusal, identify post-discharge support and clinical services. The facility shall keep a record of all discharges to a shelter or the street in a form approved by the Department and submit such information to the Department on a quarterly basis.” (104 C.M.R. § 27:09(1) (b))
 AHA Bill of Rights, http://www.patienttalk.info/AHA-Patient_Bill_of_Rights.htm
MassHealth has been working for over one year to develop a Demonstration Project that it will send to the federal government (Centers for Medicare and Medicaid Services) on a proposal to integrate Medicaid and Medicare for the 110,000 people who are called “dually eligible” because they have MassHealth and Medicare. Two out of three people who are “dually eligible” in the state have a mental health diagnosis so this is a BIG issue for NAMI Massachusetts.
This Demonstration Project came about because of President’s Obama Health Reform Law (the Affordable Care Act of 2009) and his efforts to achieve cost savings in both Medicare and Medicaid programs by having a major realignment in how health care is delivered to the “dually eligible.” Massachusetts was one of 15 states chosen by the feds to receive a grant that allowed MassHealth to develop this Demonstration Project.
NAMI Massassachusetts has been following this effort for over year and final comments on the proposal are due today, Jan. 10th at 5pm. Massachusetts is encouraged to combine MassHealth and Medicare into contracts administered by a Third Party, known as Integrated Care Organizations (ICO). MassHealth will take the comments it receives and use them to finalize its proposal to the federal government (Center for Medicare and Medicaid).
While NAMI Massachusetts thinks the proposal to integrate Medicare and Masshealth is generally a good idea and will improve care for people with mental illness, we have many concerns about the Demonstration Project that the State recently unveiled.
Please read a copy of NAMI Massachusetts’s comments as this is a huge issue for many people with mental illness.