BOSTON (SHNS) – A suite of measures aimed at making mental health care more accessible in Massachusetts earned unanimous approval from the state Senate Wednesday evening.
The Senate’s vote sends the bill to the House where the legislation’s consideration will likely have to wait until 2022 as lawmakers on Wednesday night started a roughly seven-week recess from formal legislative sessions.
A similar bill passed the Senate last year, before COVID-19 took hold in Massachusetts, and as senators discussed the updated version they said that the pandemic has driven home the importance of mental health care and highlighted the challenges people can face in seeking to access services.
The bill (S 2572) mandates insurance coverage for an annual mental health exam, similar to an annual physical, and the Massachusetts Association of Health Plans has expressed support for that measure.
It also includes policies aimed at preventing long stays in emergency rooms for patients waiting for a psychiatric bed, and would eliminate insurers’ prior authorization for patients who need acute mental health treatment and set a rate floor to reimburse mental health clinicians at the same level as primary care providers for evaluation and management services.
When they rolled out the bill last week, a trio of top Senate Democrats described the issue of mental health access as personal to them. Senate President Karen Spilka described herself as “the daughter of a World War II veteran who suffered from undiagnosed and untreated PTSD and other mental health concerns,” Sen. Julian Cyr said he has struggled with anxiety and depression, especially in his adolescence, and Health Care Financing Committee co-chair Sen. Cindy Friedman said she is the “parent of a child that has serious and persistent mental illness.”
They credited people who have shared their personal stories around mental health with helping break down stigma and compel action.
At home recovering from an illness, Spilka was not present in the chamber when the Senate took up the bill, a priority on her fall legislative agenda, but participated in votes remotely.
Cyr, who co-chairs the Mental Health, Substance Use and Recovery Committee, said Wednesday that therapy helped him manage his anxiety and do things he’d never dreamed of, but he could not get insurance coverage for outpatient mental health care for a long time and his coverage now involves a “very complicated reimbursement process.”
“Now, I consider myself a pretty savvy consumer,” Cyr said. “I’m a 35-year-old health policy wonk. And if I can’t navigate this system — and what is for relatively routine care, I’m getting pretty routine outpatient care — imagine how many people in Massachusetts cannot access the mental health care they need.”
In hopes of tackling what is known as emergency department boarding — when patients wait hours, days or longer in the ER for an inpatient psychiatric bed — the bill would create an online portal to allow health care providers to search for and find open beds and would require emergency departments to have a qualified behavioral health clinician available to evaluate and stabilize patients.
As of Nov. 8, 564 patients were boarding at 53 hospitals across the state, according to a Massachusetts Health and Hospital Association report, including 335 adults between 18 and 64 years old, 167 pediatric patients and 62 geriatric patients. The association’s weekly report says that boarding was a “major issue” in the state before the pandemic, but “the effects of COVID-19 have worsened the situation and created a behavioral health crisis.”
After Sen. Nick Collins withdrew an amendment dealing with public hearings for recovery homes, Cyr said the Senate was “committed to taking up substance use disorder legislation to address recovery homes and a myriad of issues” that are before his committee.