Bill works in tandem with landmark investments in mental and behavioral health
to transform mental health care delivery
BOSTON (11/09/2021) – Today, Senator Cindy F. Friedman (D-Arlington) helped the Massachusetts Senate unveil the Mental Health ABC Act 2.0: Addressing Barriers to Care (ABC) (S2572), comprehensive legislation to continue the process of reforming the way mental health care is delivered in Massachusetts, with the goal of ensuring that people get the mental health care they need when they need it. This legislation comes at a time when the Massachusetts State Senate is making landmark investments in mental and behavioral health, including $400 million in American Rescue Plan Act (ARPA) funds to transform the behavioral health sector, with $122 million dedicated to recruiting and retaining nearly 2,000 behavioral professionals.
The Mental Health ABC Act 2.0 is driven by the recognition that mental health is as important as physical health for every resident of the Commonwealth and should be treated as such. The bill proposes a wide variety of reforms to ensure equitable access to mental health care and remove barriers to care by supporting the behavioral health workforce.
“For far too long, mental health has been a forgotten component of our healthcare system, and we must address the persisting inequities—made painfully clear in the wake of the COVID-19 pandemic—in our delivery of mental health care,” said Senator Friedman, co-chair of the Joint Committee on Health Care Financing. “This bill builds on the work the Senate has done over the last several years to improve our mental health system and takes a comprehensive approach to tackle our most pressing issues, such as expanding services to all corners of the Commonwealth, enforcing existing parity laws, and addressing the boarding crisis in our Emergency Departments that is impacting too many of our children and families. I want to sincerely thank Senate President Spilka, Chair Rodrigues, and Senator Cyr for their thoughtful collaboration on this legislation and for continuing to prioritize reforming our mental health care system this session so it is accessible, affordable, and equitable for all.”
Additions and extensions to the original version of the Mental Health ABC Act – which Senator Friedman championed last session –include: guaranteeing an annual mental health wellness exam at no cost to the patient; creating an online portal that enables access to real-time data to move patients from the emergency department to appropriate inpatient care; establishing a complex case resolution panel to help resolve barriers to care for children with complex behavioral health needs who find themselves in the emergency department; requiring the Office of the Child Advocate and the Health Policy Commission to issue reports on child emergency department boarding; creating a standard release form; expanding access to psychiatric care by requiring the state-contracted and commercial health plans to cover mental health and substance use disorder benefits offered through the psychiatric collaborative care model; incentivizing investments in acute psychiatric services; and establishing an Office of Behavioral Health Promotion.
To ensure equitable access to mental health care, the bill:
- Guarantees annual mental health wellness exams are covered by insurance;
- Provides the state with better tools to implement and enforce our parity laws by creating a clear structure for the Division of Insurance (DOI) to receive and investigate parity complaints to ensure their timely resolution;
- Tackles the state’s Emergency Department (ED) boarding crisis by creating an online portal that allows health care providers to easily search and find open beds, establishes a complex case resolution panel to help resolve barriers to care for children with complex behavioral health needs, and requires all hospital EDs to have a qualified behavioral health clinician available to evaluate and stabilize a person admitted to a hospital ED with a behavioral health presentation during all operating hours;
- Requires an equitable rate floor for mental health providers that is consistent with primary care providers;
- Mandates coverage and eliminates prior authorization for mental health acute treatment and stabilization services;
- Creates a standard release form for exchanging confidential mental health and substance use disorder information;
- Requires commercial insurance companies to cover Emergency Services Programs (ESPs);
- Mandates that state-contracted and commercial health plans cover mental health and substance use disorder benefits offered through the psychiatric collaborative care model;
- Directs the Health Policy Commission (HPC) and the DOI to study and provide updated data on the use of contracted mental health benefit managers by insurance carriers, often referred to as “carve-outs;”
- Creates an exemption from the Department of Public Health’s (DPH) determination of need process to incentivize health care facilities to invest in and develop more acute psychiatric services across the Commonwealth;
- Establishes an Office of Behavioral Health Promotion within the Executive Office of Health and Human Services (EOHHS) to coordinate all state initiatives that promote mental, emotional, and behavioral health and wellness for residents; and
- Directs the Department of Mental Health (DMH) to consider factors that may present barriers to care—such as travel distance and access to transportation—when contracting for services in geographically isolated and rural communities.
It’s also essential to support the workforce to remove barriers to care. In pursuit of this, the bill:
- Creates a roadmap on access to culturally competent care;
- Allows for an interim licensure for licensed mental health counselors (LMHCs);
- Allows clinicians practicing under the supervision of a licensed professional and working towards independent licensure to practice in a clinical setting; and
- Updates the Board of Registration of Social Workers.
For a more comprehensive overview of the bill, visit the factsheet.
This legislation builds upon the original Mental Health ABC Act, passed by the Senate in 2020, important provisions of which have been signed into law, including:
- Standardizing credentialing forms, which shortens the amount of time it takes for newly hired mental and behavioral health professionals to be approved for inclusion in an insurance network, increasing access to care.
- Requiring coverage for same day care, removing a significant financial barrier to the integration of primary care and mental health.
- Creating a tele-behavioral health pilot program, which authorized three pilots for tele-behavioral health services in public high schools in the Commonwealth.
- Creating a psychiatric mental health nurse practitioner fellowship pilot program, which offers additional support and training to psychiatric nurse practitioners who agree to work in community settings with underserved populations.
- Creating a mental health workforce pipeline to encourage and support individuals from diverse backgrounds to choose careers in mental health by emphasizing that it is valued and important work.
- Studying access to culturally competent care to review the availability of culturally competent mental health care providers, as well as to identify potential barriers to care for underserved cultural, ethnic and linguistic populations, the LGBTQ+ community, and others.
This legislation also comes at a time when the Massachusetts State Senate is making transformative investments in mental and behavioral health, including:
- $400 million in American Rescue Plan Act (ARPA) funds to transform the behavioral health sector, with $122 million dedicated to recruiting and retaining nearly 2,000 behavioral professionals.
- $10 million annually for the newly-created Behavioral Health Outreach, Access and Support Trust Fund, which funded the highly successful More to the Story public awareness campaign.
- $10 million for the rapid creation of new inpatient mental health acute care beds, particularly new beds for children, adolescents and underserved communities.
- $15 million for Programs of Assertive Community Treatment (PACT) for children who exhibit symptoms of serious emotional disturbance; PACT uses a multidisciplinary team approach to provide acute and long term supports for individuals in the community.
- $3 million for a loan repayment assistance program to recruit and retain child and adolescent psychiatrists at community mental health and health centers.
The Senate is scheduled to debate the Mental Health ABC 2.0 Act next week.