Children’s Mental Health Legislation Heard

When the omnibus Act Relative To Children’s Mental Health (Chapter 321 of the Acts of 2008) was signed into law last year, there was one provision that was not included: reimbursement for collateral contacts by commercial insurance.

Collateral contacts can be more accurately referred to as coordination of care. When an adult is working with a mental health professional, the adult can typically express what is going on in his or her life directly to the clinician in such a way as to make treatment effective. When it is a seven year old, it’s not so simple.

Children are not little adults. To have treatment of mental health needs be effective, it is vital that the treating clinician speak to other people in the child’s life – parents, teachers, pediatrician, etc. Only through this coordination will the child have the best chance to have his or her mental health needs addressed properly.

Of course, to protect the privacy of the young people involved, this type of coordination would only be done with parental consent.

In Massachusetts, the state already reimburses mental health clinicians for collateral contacts when children are covered under MassHealth. Commercial insurance, on the other hand, does not provide this benefit. Mandating reimbursement for collateral contacts will ensure that care coordination is the standard practice rather than an exception to the rule.

The collateral contacts piece of Chapter 321 was not included in the final version of the law because a cost analysis had not been completed by the Division of Health Care Financing and Policy. The cost review was completed late last year and it found that collateral contacts are extremely inexpensive – 5.5 cents per member per month or 0.01% of total premium costs.

This piece of the original omnibus bill was refiled for the current legislative session as H. 3586 / S. 757, An Act Relative To Coordination of Children’s Mental Health Care, and was heard yesterday by the Joint Committee on Mental Health and Substance Abuse.

Testimony was given in support of the legislation by two panels.

On the first panel, Dr. David DeMaso, Psychiatrist in Chief at Children’s Hospital Boston and Professor of Psychiatry and Pediatrics at Harvard Medical School, illustrated the importance of coordination of care by asking Senate Chair Jen Flanagan to imagine herself as a third grade teacher with a student displaying mood swings and classroom outbursts. In an effort to more effectively attend to the behaviors while also teaching the other students, isn’t it a good idea to talk with the child’s psychiatrist, Dr. DeMaso asked.

Similarly, Dr. DeMaso asked House Chair Liz Malia to put herself in the shoes of a pediatrician treating a young woman with severe asthma. Before changing her patient’s medication to address her asthma, wouldn’t it be responsible for her to speak to her patient’s mental health clinician to avoid a potentially dangerous interaction with her antidepressant medication?

The second panel featured testimony from Central Massachusetts: Cathy Apostolaris from the Winchendon Project, Tony Poti from the Choices Program, and Dr. David Keller, a pediatrician from Webster. For all three of these individuals, care coordination has been vital to the success of their work.

Passage and enactment of An Act Relative To Coordination of Children’s Mental Health Care is the top legislative priority of the Children’s Mental Health Care. More effective coordination of care is an important step in addressing the mental health needs of Massachusetts’ children.

Matt Noyes
Children’s Health Coordinator

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This entry was posted in Children's Health, Children's Mental Health. Bookmark the permalink.

4 Responses to Children’s Mental Health Legislation Heard

  1. Parfume says:

    I recall looking through a thing about this past month saying that this had not been the truth, merely can not seem to locate the website.

  2. Ken O'Tole says:

    This is a blog paid for by the psychotropic drug industry and you should know that. Do you really want your children on the same drugs that kill over 42,000 Americans a year, over 3,000 a month, men, women, and children die each month due to the effects of these drugs. Wake up America please. Why would someone take anything that kills on average over 3,000 Americans a month? Seven people died last year in the US with swine flu, people are going around with masks on, and taking vaccines, psychotropic drugs is something we are voluntary ingesting that is killing 42,000 a year, all in the guise that it’s helping someone..

  3. James Beglin says:

    I certainly support this legislation. it seems that the mental health of the young has been less than priority status when we all know they are this country’s future. I do not see this as an expense but rather an investment in a better future.

  4. Neal Biron says:

    From Mr. Noyes’s comments, it seems that “collateral contacts” is a normal and necessary part of doing the proper job in treating child mental health issues. I do not understand why the cost of this is not just part of the normal negotiated fee the Dr. is being paid per patient. If his costs projection is correct, then the increase in the negotiated fee scheduled payments form the insurance comnpany would be pretty minimal. This eliminates all of the unnecessary adiministraive expenses of filing cordination of benefits claims.
    All of the proponants of a single payor system keep pointing to the duplication of functions by many payors as a contributor to the high cost of health care. We need to provide the services for these children, so increase the fee the Dr. is getting to cover them, lets not add seperate charges and billings to do it.

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