Earlier this year, Assemblywoman Janet L. Duprey (R,I,C-Peru) supported “Timothy’s Law,” which requires almost all insurance companies to cover most mental illnesses and requires coverage for a broad range of mental illnesses and conditions specifically related to children. Earlier this week, the assemblywoman worked to pass “Jonathan’s Law,” which ensures that parents and guardians have access to records pertaining to allegations and investigations into the mistreatment of children at mental health care facilities.
“Families with special needs children face unique challenges and rewards that cannot readily be put into words. It’s gratifying to see that my hard work and support for these changes in the law are actually helping clients, families, and providers better cope and meet these challenges,” Duprey said.
“Jonathan's Law” recently passed the Assembly, and is expected to be signed into law. This new measure:
- Ensures that parents or guardians have access to records concerning alleged abuse or investigations of abuse when it concerns their children. Upon written request, records must be released within 21 days of the conclusion of an investigation;
- Mandates telephone notification to the parent or guardian of a patient when an incident occurs involving that patient, and upon request, a written incident report must be provided to the parent or guardian;
- Directs the Commission on Quality Care and Advocacy for Persons with Disabilities (CQCAPD) to prepare and disseminate a pamphlet on the right to access records relating to patient care and treatment;
- Requires that parents or guardians be notified when there is credible evidence of alleged abuse or mistreatment; and
- Establishes a Task Force on Mental Hygiene Records to study and make recommendations on additional legislation regarding access to patient records and reports.
“Timothy’s Law” provides for mental health parity. This law is applicable to group policies issued by commercial insurers and group contracts issued by non-profit health insurers (i.e., Blue Cross plans) and HMOs. The requirements are as follows:
- Changes the existing “make available,” broad-based mental health benefit to a mandatory requirement.
- Adds school blanket policies to the requirement.
- Requires coverage for broad-based mental illness, as defined in the policy, at least equal to coverage provided for other health conditions. The coverage may be limited to not less than 30 days of inpatient and 20 days of outpatient coverage. The added cost of this coverage to small group contract holders will be paid for by the State through general fund appropriations.
- Requires policies covering inpatient hospital care to include coverage of adults and children for biologically-based mental illness* and of children with serious emotional disturbances**.
- The provisions requiring biologically-based mental health parity benefits and coverage of children with severe emotional disturbances only apply to small group policies (50 or fewer employees) on a make available (optional coverage) basis.
- Authorizes comparable co-payments, deductibles, utilization review, network providers, etc.
- Not applicable to persons presently incarcerated; because the services are court-ordered; or deemed cosmetic.
The Superintendent of Insurance must monitor the law’s implementation to ensure that insurers’ contracts do not contain unreasonable definitions of mental disorders. The Superintendent must ensure benefits are consistent with those available to State employees. In conjunction with the Commissioner of Mental Health, the Superintendent must produce a study, by April 1, 2009, on the effectiveness of mental health parity.
The bill does not require coverage of alcoholism/substance abuse treatment.
The bill’s effective date is January 1, 2007 and its provisions will be applicable to policies and contracts issued, renewed, modified, altered or amended on or after this date. The bill sunsets on December 31, 2009. “Timothy’s Law” (S.8482) was signed into law and is Chapter 748, Laws of 2006.
* Biologically based mental illness is defined as a mental, nervous, or emotional condition that is caused by a biological disorder of the brain and results in a clinically significant, psychological syndrome or pattern that substantially limits the functioning of the person with the illness. Such biologically based mental illnesses are defined as schizophrenia/psychotic disorders, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorder, bulimia, and anorexia.
** Children with serious emotional disturbances means persons under the age of eighteen years who have diagnoses of attention deficit disorders, disruptive behavior disorders, or pervasive development disorders, and where there are one or more of the following:
- serious suicidal symptoms or other life-threatening self-destructive behaviors;
- significant psychotic symptoms (hallucinations, delusion, bizarre behaviors);
- behavior caused by emotional disturbances that placed the child at risk of causing personal injury or significant property damage; or
- behavior caused by emotional disturbances that placed the child at substantial risk of removal from the household.