Health Association in New York State, Inc.
Friday Fax from Albany
Senate Amends Parity Bill: The Senate, just a week after introducing their new mental health parity legislation (S.7296), have amended their bill, now S.7296-A. The amended bill differs from the previous version in minor ways, maintaining many of the core elements contained in the original version: exempting employers with 50 or fewer employees, covering only 10 mental health diagnoses, eliminating parity-based coverage for chemical dependency services, and exempting any employers that can demonstrate a 2% or more premium increase.
MHANYS’ Message Remains the Same – “Please Don’t Abandon Timothy’s Law - S.5329”: Please contact your Senator to urge them not to abandon Timothy’s Law (S.5329). You may do so by calling your Senator, using the Senate switchboard phone number – (518) 455-2800. Or, you can use MHANYS’ online advocacy tool, at http://www.mhanys.org/policy/advtlc.php to send your Senator an e-mail.
In the News: The first of the three articles that follow outlines the various positions regarding parity and the present dynamic regarding mental health parity here in Albany. If you are looking for some coverage of Timothy’s Law in your newspaper, you can write a letter to the editor, urging the Senate to pass the bill. MHANYS’ would be happy to help you craft a letter to the editor – just contact Michael Seereiter at email@example.com or (518) 434-0439 ext. 21.
Senate Parity Proposal Includes Some Limits.
While some New York state mental health advocates are somewhat encouraged by the state Senate's move to introduce mental health parity legislation, they say the bill's small-business exemption and limited coverage provisions would reduce the number of New Yorkers with behavioral illness who could access coverage.
Advocates say the legislation doesn't measure up to Timothy's Law, the state Assembly parity bill that passed in March and covers a broader range of mental illnesses as well as chemical dependency (which is omitted from the Senate proposal).
Officials and advocates said last week that the Senate was working on possible changes to the bill in advance of its formal introduction.
During a press conference held May 11, Senate Majority Leader Joseph L. Bruno and Sen. Thomas Libous unveiled the details of legislation that would require insurance companies to cover most mental illnesses and would require coverage for a broad range of conditions specifically related to children.
The state Assembly last year passed Timothy's Law, a broader approach requiring New York health insurers to provide coverage for mental health and chemical dependency treatment on par with coverage for general health conditions (see MHW, June 9, 2003). The legislation passed the Assembly again this March 3.
Some New York advocates are encouraged by the legislative attention from both the Assembly and the Senate. We consider the Senate bill to be the floor of the [parity] negotiation and the Assembly bill to be the ceiling," Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services (NYAPRS), told MHW. "It is a goal, a blueprint for where we want to be."
However, in a May 12 fax memorandum from the Mental Health Association in New York State, Inc., the association's president and chief executive, Joseph A. Glazer, called the planned Senate bill a "(dis)parity proposal."
He said that based on the materials issued by the two senators, such a bill "would give New Yorkers the weakest law in the nation."
Under the Senate version, insurance companies would be required to cover most biologically based mental illnesses, including schizophrenia, schizoaffective disorder, major depression, bipolar disorder, obsessivecompulsive disorder, paranoid delusional disorders, bulimia, anorexia and binge eating.
Organizations with 50 or fewer employees would be exempt from the mandate, and the Senate bill would exempt any company that can prove to the state Superintendent of Insurance that it has experienced an insurance rate increase of 2 percent or more as a result of having to provide mental health coverage.
The parity legislation passed by the Assembly stems from intense advocacy efforts last year involving the Timothy Law's Campaign Coalition of mental health and addiction advocates. They urged state legislators to end discriminatory behavioral health coverage by adopting a law in memory of Timothy O'Clair, a Schenectady resident who committed suicide at age 12 in 2001.
Advocates are concerned by the Senate's approach of creating "limitations by diagnoses and by the size of the company for which you work," said Rosenthal. "Only specific diagnoses would get unlimited mental health care."
Asked about the status of the Senate bill, Libous's deputy director of public affairs said the Senate is continuing work on the legislation.
"It's a real sticky point & the Senate and Assembly legislation don't match," Bijoy Datta told MHW. Legislators will negotiate between the two Houses and "offer some sort of compromise bill," Datta indicated.
The overall goal of the legislation "is to achieve mental health parity without compromising small businesses, so they can provide coverage that New Yorkers with mental illness deserve, just like people with cancer or diabetes get coverage," said Datta.
"The concern is small businesses wouldn't be able to afford any coverage for their employees if insurance costs went too far with Timothy's Law."
"Last year the Senate introduced its version of Timothy's Law and got 37 Republicans to sponsor it," J. David Seay, executive director of the National Alliance for the Mentally Ill (NAMI) in New York State, told MHW. "The new version is a step back from that. It's not Timothy's Law."
But Seay added that the importance of a bill being introduced in the Senate should not be underestimated.
"It means some commitment to movement on these issues," he said. "To their credit, they're going back and fixing it," he said.
New York advocates still consider Timothy's Law to be the standard for the protections they seek. "We've gone through the bill, and it is far from Timothy's Law," Glazer told MHW.
"Sen. Bruno said during the press conference that his bill will help tens of thousands of New Yorkers with mental health needs," Glazer said. "I agree his bill will help tens of thousands. [But] Timothy's Law will serve millions of New Yorkers with mental illness."
"We are really looking forward to having equal and fair coverage for our families and children," Paige Macdonald, executive director of Families Together in New York State, Inc. and co-chair of the Timothy's Law Campaign Coalition, told MHW.
"We hope it's sooner rather than later and is consistent with the spirit of Timothy's Law."
Meanwhile, officials are hoping to come to a consensus on the parity bills soon. "I think the public and the community deserve to have a public discourse on the differences, build consensus, move forward and put an end to [and] instill hope in people that can embrace the advances in medical treatment growing by the day," said Assemblyman Paul D. Tonko, lead sponsor of Timothy's Law who represents the O'Clair family's district.
"We're best served by a straightforward bill," Tonko told MHW. "Timothy's Law really speaks to assisting with access and availability of mental health services. This is the mental health community's bill."
Tonko is encouraged that Bruno and Libous have both indicated a willingness to sit at the conference committee table and resolve both bills, "which is great news for the residents of the state," he said.
What's significant is that the legislative developments represent state lawmakers' overall commitment to the issue, said Rosenthal. "This is the furthest they ever moved forward on passing a mental health parity bill," he said. "We appreciate the fact that the Senate has come forward and said [they] should be doing a parity bill."
He added, "We're working vigorously with both the Senate and Assembly to give us a broad and comprehensive parity bill and one [the O'Clairs] would be willing to call Timothy's Law."
"Historically, we're farther along in this process than we've ever been," added Seay. "The Senate and the House have said, "This is a must do bill."
Mental Illness Awareness. by Denise M. Champagne
WATERLOO- Awareness of mental health is being celebrated nationally this month, but Seneca County Mental Health Director Dave Hekel thinks the issue should be prominent throughout the year.
In a recent interview, Hekel noted mental health issues affect everyone. He is particularly concerned about children, for whom the first week of the month was dedicated in honor of Timothy O'Clair of Schenectady. O'Clair was born May 5, 1988, and suffered from a variety of mental illnesses. He committed suicide seven weeks before his 13th birthday.
Hekel said there are 520,000 children statewide with serious emotional disturbances but only one in five receives treatment. Common disturbances include bipolar disorder, attention deficit disorder, oppositional defiant disorder and obsessive compulsive disorder.
Hekel said depression is another major mental health problem affecting people of all ages, though depressed children are more likely to commit suicide, the third leading cause of death in teens ages 15 to 19 and the sixth leading cause of death for children under 15.
Symptoms of depression include a decline in school performance, poor grades despite strong efforts, regular worry or anxiety, rapidly changing mood swings, a change in sleeping habits, feelings of worthlessness, recurring nightmares, thoughts of suicide, frequent temper tantrums and hyperactivity. Many of the same symptoms are present in adults.
"Ninety percent of children and teens who commit suicide have some type of mental health issue," Hekel said, noting someone under 18 commits suicide every two hours in the United States.
He said he knows of no child suicides in Seneca County in the five years he has been with the health department, but he added some accident victims' deaths could be seen as questionable.
"It doesn't mean the risk isn't masked," Hekel said. "What we're trying to accomplish during Mental Health Month is to increase awareness in the county and the fact that millions of people with mental health issues don t receive services."
Hekel supports the passage of Timothy's Law, also known as the Mental Health Parity Law, because it seeks to force insurance companies to provide the same services for mental illnesses that are provided for physical illnesses.
In Timothy's case, his parents, Tom and Donna O'Clair, put him in foster care to have the state pay for the residential treatment he needed and that Tom O'Clair's insurance coverage would not provide. The coverage, like that with most carriers, was limited to 20 outpatient and 30 inpatient visits a year. Supporters of the bill, which include 30 statewide organizations, estimate individual employee insurance premiums would increase $1.26 per month, a cost they say many are willing to pay.
The proposed law also hopes to eliminate the stigma attached to mental illness in which patients, including chemical dependents, are discriminated against.
"People who are experiencing severe and persistent mental illness; those are individuals who have longer-term mental health issues who feel the stigma of the community," Hekel said. "They're treated differently and not respected."
Hekel said respect is what mental health patients want most, according to a 10-year study.
"They don't feel they have respect. We wanted to emphasize that and highlight it. The most effective ways are public education awareness raising and people feeling free to ask questions.
"It's 100 things you always wanted to know about mental health issues but were afraid to ask. Ask us. Sometimes all a person needs is a soft and gentle voice."
Hekel thinks awareness is slowly improving with people being more respectful. He attributes some of that to activist groups such as the National Alliance for the Mentally Ill, which is hoping for the passage of Timothy's Law this year. The bill has been approved by the Assembly the last few years but has not gotten through the Senate. Supporters are hopeful it can be made law this year with a recent endorsement from Senate Majority Leader Joseph Bruno following an overnight candlelight vigil in Albany.
Hekel said the causes for many mental illnesses are unknown, but the latest theory is a link between biological and environmental factors. He said the environmental piece is the level of nurturing and caring support a child receives.
Treatment consists of medication, verbal therapy or a combination of the two. Long-term treatment is necessary for more severe cases, which is why mental health care workers believe insurance reform is needed.
Hekel said the success rate for treating mental illness is 70 percent in adults and 80 percent in children.
Senior citizens present a different challenge in that no viable support systems are in place to help them and many need outreach services because they are reluctant or unable to travel to a central location for treatment. Hekel said seniors are isolated and often an invisible sector of the population.
"I cannot share with you how significant the prevalence of mental health issues among the senior population is because we don't know," he said. "It's a growing need and one that needs to be addressed."
He said his department would like to work with the Office for the Aging in identifying the mental health needs of seniors and how to meet them.
Hekel said men also are more reluctant to seek treatment. He said they're perceived as being strong and taking care of everybody, so they're unwilling to admit they may have a problem.
The Seneca County Mental Health Department offers a variety of services. For more information, call 539-1980. Residents in the southern part of the county can call (607) 869-5575. All emergencies should be directed to (800) 310-1160.
"I want to emphasize we don't turn anyone away based on their ability to pay," Hekel said.
words from beauty queen. by Catherine Wilde
Beauty queen Jessica Lynch enchanted families and friends of people with mental illness at Rockland Psychiatric Center's ninth annual Family Day yesterday.
Lynch, 24, who was crowned The Miss America Organization's Miss New York in 2003, shared with the audience her own 15-year battle with depression and anorexia, recalling a poignant time in her life at age 9 when she awoke one morning unable to stop crying.
"My parents thought it was something that would pass, but for me it wasn't," Lynch told the audience.
When switching to an all-girls private school didn't work, her parents sent her to a psychologist, which helped with the depression but not her anorexia.
Lynch said that at one point, her father told her she had to start taking care of herself or she was going to die.
Lynch said she was "petrified" when her father explained that she would be forced into foster care because the family could no longer afford treatment. She had been taken out of a children's psychiatric hospital because her insurance had ended.
After this, Lynch decided to make an effort to get better, but still suffered bullying and trauma throughout her high school years, and felt compelled to deny that she had a problem to her peers.
However, through treatment and family support she managed to get her life in order enough to graduate 4th out of 425 students and get accepted into the University of Virginia, ultimately graduating in three years, while battling her illness throughout.
"People always ask, 'What does depression feel like?' " Lynch said, "and I always tell them, 'You really can't understand unless you've been there, but to me it feels like being in a fog. I can't see or think clearly, and I feel so hopeless and tired I just want to sleep.' "
After graduation, Lynch moved to New York with aspirations of becoming an actress. She has danced in the "Radio City Christmas Spectacular" and won the title of Miss Manhattan and Miss New York City before being crowned Miss New York in June 2003.
Lynch decided to make mental illness her platform, speaking at schools to raise awareness and fight discrimination against people with mental illness.
"I want to give hope and show that treatment can work and that being mentally ill does not mean you can't lead a productive and fulfilling life," Lynch said before yesterday's program.
She added that the important thing is finding what treatment works best for each individual, in her case a combination of medication and discussing the problem with an objective person.
The presentation hit home for one member of the co-sponsor, NAMI-Familya, an advocacy group for people with family members who are mentally ill.
Peggy Moran's son has suffered from schizophrenia for more than 20 years. Moran, of New City, describes her son as having led a "revolving-door existence," in and out of institutions until 1990, when medication became available to him.
Moran described schizophrenia as a "family disease" because the whole family is affected, but considers herself very fortunate that her son had a support system from her three other children.
"There is a silver lining in every cloud, and that was it," she said, adding that now her son is driving, working and doing very well.
"Absolutely incredible," Moran said of the presentation. "Everything she said was to-the-point and true, about the stigma and how families help. Her Miss New York state label meant nothing in there, she was just someone giving a message that needs to be given."
Lynch also is an advocate for Timothy's Law, a bill now before the state Assembly and Senate that pushes for adequate insurance coverage for individuals with mental disorders.
next time, we remain,