Mental Health Association in New York State, Inc.
(Publication Archives)

Friday Fax from Albany

TIMOTHY’S LAW CAMPAIGN RELEASES UPDATED VERSION OF TIMOTHY’S LAW: On Monday, Timothy’s Law advocates unveiled an updated of version of Timothy’s Law specifically designed to address the concerns regarding small businesses that has blocked Timothy’s Law from becoming a reality in past years. It is our hope that this updated bill, which carves out small businesses from the mandate, but does not leave the employees of those small businesses without adequate mental health coverage, will quickly be enacted into law by the Legislature. All Capital region television news outlets covered the press conference, helping to raise the visibility of Timothy’s Law in Albany even further.

All Timothy’s Law supporters are encouraged to call their elected representatives early and often these next two weeks to encourage them to pass Timothy’s Law before the Session ends on June 23rd. Following below is the Timothy’s Law Campaign press release that details Monday’s event and includes the details of the new bill.

Timothy’s Law Campaign
Working for health insurance parity for mental health
and chemical dependency coverage
15 Elk Street
Albany, New York 12207
518-432-0333 fax 518-434-6478
www.TimothysLaw.org

PRESS RELEASE

Timothy’s Law Campaign Unveils Updated Bill
that Addresses Small Business Concerns

Group Also Unveils Timothy’s Law Ad set to Air on Stations Throughout New York

For over a decade, advocates have been working to secure passage of legislation that would end discriminatory insurance practices levied against individuals suffering from mental illness. Three years ago, a name and a face were given to those efforts and most unfortunately it was the face of a twelve-year old boy named Timothy O’Clair, who, after struggling with mental illness for five of his twelve short years, took his own life in March of 2001.

While struggling with his illness, Timothy’s parents, Tom and Donna O’Clair found themselves to be in a battle for their son’s life on two levels; stabilizing Timothy’s condition and securing the treatment necessary to accomplish this. As they attempted to maneuver through the mental health system, Timothy’s parents were astonished to discover that, unlike treatment for physical health care, health insurers and HMO’s in New York State are allowed to restrict treatment for mental illness however they see fit. The result of these practices forced the O’Clair family down a road of rationing Timothy’s treatment. Eventually, as a result of these limitations, and as a last ditch effort to obtain care for Timothy, the O’Clairs were forced to relinquish custody of him to the state. Unfortunately, in the end, the family’s efforts were in vain, as Timothy completed his suicide at the tender age of twelve. However, the O’Clairs' war was far from over as they joined in the crusade to end discriminatory insurance practices and lent the movement Timothy’s name.

Opposition to Timothy’s Law has long since revolved around the belief that passing such a measure will negatively impact small businesses in New York State, citing that increasing access to mental health benefits will also increase premiums, causing small businesses to drop insurance all together. Legislators have heard this message and as a result, New Yorkers with mental illness are still struggling to access treatment. The Timothy’s Law Campaign (TLC) has heard this message as well and as a result, the have come up with a solution. After many months of work, TLC has updated their version of Timothy’s Law to address the concerns of the small business community. This updated version of Timothy’s Law will provide New Yorkers in need of mental health and addiction treatment access to services without placing an undue burden on small employers. The bill represents a significant compromise on the part of the Timothy’s Law supporters to address the concerns of small employers. “Our intention is not, and has never been to create a burden on the small business community in New York State. Our goal is to prevent families from experiencing the additional pain and suffering that our family has undergone. While the bill doesn’t go quite as far as we would like in completely eliminating discriminatory health insurance policies, I think it represents a fair compromise to those who have expressed concern while at the same time sparing other families from unnecessary anguish, hence, I am proud to lend my son’s name to this bill” stated Tom O’Clair.

Paige Macdonald, Executive Director of Families Together in New York State and Co-chair of the TLC, called it, “a good faith effort on our part to genuinely address the concerns that many have had regarding the impact of Timothy’s Law on small businesses.”

The Coalition for the Homeless’ Shelly Nortz, a key contributor to the creation of the updated bill, explained how it would work. “First, we believe that the current benefit structure provided by most health plans must be codified to establish a base benefit - a floor, if you will, to even the playing field. With this cornerstone, no plan could provide less than the base benefit - the practice of charging exponentially higher co-payments for mental health and addiction services would finally come to an end. Building on this universal foundation, employers with more than 50 employees would be required to provide complete parity-based benefits, and employers with 50 or fewer employees would be provided with the option to purchase the same benefits that larger employers would be required to provide. For those small employers that choose not to subscribe to the additional coverage, a financial safety net would be in place should any of their employees need more than the base amount of inpatient care provided by their insurance plan. Such employees facing a catastrophic situation such as foreclosure, bankruptcy, eviction, or child custody relinquishment would qualify for help in covering extraordinary costs for inpatient care. We think this package is a prescription for success.”

The press conference concluded with the unveiling of a 30-second television spot, featuring images from Timothy O’Clair’s childhood and a voice over by Timothy’s father, Tom O’Clair. The TV spot, viewable at www.timothyslaw.org, explains what happened to the O’Clair family, the barriers they faced in trying to get Timothy the mental health services he needed, and urges people to call Governor Pataki, Senate Majority Leader Bruno and Speaker Silver to call for passage of Timothy’s Law this year.

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IN THE NEWS:

Insurance should cover mental health, as other ailments. Letter to the Editor
Schenectady Daily Gazette, May 29, 2005

In a May 5 article, the Gazette reported that some business owners – particularly those who operate small businesses – oppose legislation that would require insurers to provide coverage for mental health and addiction services in the same manner they provide for other physical illnesses.

It is true that some mandates can be costly, but mental health parity is not a costly mandage. Real-life experience and numerous actuarial studies have demonstrated that mental health parity is affordable and good for business.

Untreated mental illness is very costly to the business sector. Serious depression is the third-leading cause of poor performace and absenteeism in the workplace. Fortune magazine reported that the annual cost of mental illness in business is estimated to be $148 billion. Utilization of mental health and addiction services can help a person recover from these debilitating illnesses and thus result in a reduction in absenteeism and overall health insurance costs.

Unfortunately, most insurance plans require higher out-of-pocket payments for outpatient and inpatient mental health and addiction services than for other covered services. In addition, many plans arbitrarily cap coverage at 20 outpatient visits and 30 days of inpatient care, obliging a person to pay out-of-pocket for any additional care needed. These practices are discriminatory and often prohibitively expernsive to individuals who are allegedly “covered” by insurance.

When people are unable to obtain treatment for illnesses for themselves or their children, their condition worsens until they are unable to work and are forced to use Medicaid or other public sector programs to get needed care. This leads to increased expenditures in the public sector, and results in “job-killing taxes.”

I hope that New York will soon join other states that have passed legislation to improve coverage of mental health and addiction services, and assure that small business owners are not prohibited from taking advantage of insurance coverage that will improve their bottom line. Former U.S. Surgeon General David Satcher was right when he said, “There is no health without mental health.”

Davin Robinson
Albany

The writer is an employee of Schuyler Center for Analysis and Advocacy in Albany. Visit the Web site at www.scaany.org

Timothy’s Law
Crain’s Health Pulse, June 7, 2005

Advocates of “Timothy’s Law” are promoting what they call a compromise mental health insurance parity bill. The proposal requires full parity for mental health treatment under health insurance policies provided by large employers, but allows businesses with fewer than 50 workers to offer insurance with lesser benefits. It also envisions a pool, launched with $1 million in state money and sustained through a surcharge on premiums. The conference of Blue Cross insurers says it opposes any additional mandates, and the National Federation of Independent Business says it’s skeptical of the advocates’ projection that the surcharge will cost only a half-cent per month per premium.

Study: New York economy loses billions to depression, suicide. By Joel Stashenko
The Business Review (Capital Region), June 3, 2005

Suicide and the depression that usually accompanies it costs New York state's economy between $3.4 billion and $4 billion a year, a new state study estimates.

The state Office of Mental Health report, "The Challenge of Suicide Prevention," found that employers can play a crucial role in reducing suicides by identifying at-risk employees and having programs available to them to help.

The study said the vast majority of people who attempt suicide are depressed, have a more serious psychiatric illness or an alcohol- or drug-abuse problem. In each case, the problems usually manifest themselves in lack of productivity at the workplace before they escalate to where workers are thinking of taking their own lives, mental health experts said.

The state report urged close study of a program started in 1996 by the U.S. Air Force that has been credited with cutting suicide among Air Force personnel by 80 percent.

The program stresses the recognition of early warning signs of workers' behavior--domestic violence is also a frequent indicator of future suicidal behavior, experts say--and of intervening forcefully with employees to make sure they get help.

The Office of Mental Health report was released as the state Legislature in Albany was urged to act on legislation dubbed "Timothy's Law," which would mandate group mental health insurance coverage in New York on par with requirements for coverage for physical injuries.

Harvey Rosenthal of the New York State Association of Psychiatric Rehabilitation Services argued that employers are losing billions of dollars in lost productivity due to workers' mental illnesses. The total is probably far more than it would cost most of them to buy mental health care riders on employees' policies, Rosenthal contended.

"You can find reams and reams of studies about the cost to companies in terms of lost business, pressure on employees, limits to their ability to show up at work, to concentrate or to work at optimum speed and competence," Rosenthal said. "I think is a hugely underestimated problem."

With the Legislature set to conclude its regular 2005 session on June 23, "Timothy's Law" was again stalled this week.

The Assembly favors the bill. Senate Republicans say they are sympathetic to the emotionally and mentally ill, but they argue "Timothy's Law" would increase companies' insurance premium costs by at least 3 percent or $200 million a year.

The Business Council of New York State remains opposed to the legislation and critical of what it said are the liberal definitions the bill gives to emotional or mental conditions.

Aging and mental health. Editorial
The Journal News, May 31, 2005

If Americans were to be honest about it, the current obsession, if not hysteria, over the solvency of pensions, Social Security and the Medicare system reflects more than mere financial concern about the future. It's the sound of personal reckoning on a massive scale: We are going to get older, and we are going to die. In between, we likely will get ill. Our faculties will wane or even fail. We are going to need care. And we are terrified.

Every individual, and generation, confronts such issues, of course, but the volume of today's angst is easily explained: There are more of us. Baby boomers are aging and, as it tends to be with any baby-boomer concern, woe to those not doing something about it.

True, nobody can do much about death and taxes. Yet there is a large alliance of individuals and organizations that is advocating for New Yorkers to pro-actively address those fears about aging, including the specter of mental illness, now — to begin benefitting today's elderly and the coming elder boom.

The Geriatric Mental Health Alliance of New York was established less than two years ago by the Center for Policy and Advocacy, part of The Mental Health Associations of New York City and of Westchester. Under the chairmanship of Michael B. Friedman of White Plains, the alliance has become an advocacy group of more than 600 individual and organizational members.

Last week, the alliance unveiled what it and legislative sponsors call "landmark legislation" in Albany. "The Geriatric Mental Health Act . . . will position New York as the nation's first state to begin to comprehensively address the mental-health needs of the dramatically increasing number of older Americans,'' the alliance announced in a press release Tuesday.

The sweeping bill would affect all the state's mental-health, aging and health-care systems. It calls for public education, structural changes and interagency collaboration, quality improvement measures, a services demonstration program and workforce development.

Most of all, it calls for long-term planning, something neither New York nor most individuals do well.

The bill — A4742 in the Assembly and S7672 in the Senate — has numerous high-ranking sponsors, including Sen. Nicholas Spano, R-Yonkers, and endorsements by chairs of key committees. Local lawmakers who have signed on include Sen. Vincent Leibell III, R-Patterson, and Adam Bradley of White Plains and Sandra Galef of Ossining, Assembly Democrats.

The challenges of properly serving older adults with mental and emotional disorders are great. Among the needs that the alliance identifies

Few would argue against realizing such goals, as the Geriatric Mental Health Act attempts. Even the price is right: a requested appropriation of $5 million to fund its first year.

Given that, and last week's enthusiasm of lawmakers and policy-makers to climb aboard, what's the problem? Answer: New York's notorious inability to make massive change systematically. The arena of mental health especially struggles. Insurance "parity" with physical illness, remember, remains elusive after years of advocacy, a victim of both stigma and short-sighted financial fears.

Nevertheless, New York's opportunity to do something about geriatric mental health — in fact, provide a role model for the rest of aging America — could, and should, have a better shot than usual: Baby boomers after all are growing up, awakening to the reality of aging and the need for a plan.

Bill would create new agency to help mentally ill seniors. By Paul Esmond
Legislative Gazette, May 31, 2005

Ranking legislators from both houses said they hope that the Senate and Assembly pass a broad bill they say will help address mental illness among the state’s senior citizens.

Democrats and Republicans held a press conference last week to announce their legislation, which would combine efforts between the state Office of Mental Health and Department for the Aging to deal with senior citizen mental health problems, including dementia, depression and late onset schizophrenia.

The bill, sponsored by Assembly mental health chairman Peter Rivera, D-Bronx, and his Senate counterpart Thomas P. Morahan, R-New City, would create a department within OMH and the Department of Aging with direct oversight of mental health coverage and services for senior citizens. The legislation would also require OMH to develop a specific operating plan for geriatric mental illness each year.

Mental illness is common among senior citizens and could become an increasingly burdensome problem for the state as baby boomers age in coming decades, Morahan said when introducing the bill.

“We need to make sure we don’t have a second class of citizens vis-à-vis mental health coverage,” Morahan said, adding that it was important for OMH-sanctioned providers to employ social workers, psychiatrists and other mental health professionals who are better trained in recognizing and treating geriatric mental illnesses.

The nation needs more than 32, 000 geriatric social workers to handle cases of mentally ill senior citizens, according to statistics provided by the Geriatric Mental Health Alliance of New York. Social workers do the bulk of counseling nationwide.

According to the Geriatric Mental Health Foundation, pinpointing mental illness in senior citizens is often harder than in younger adults because symptoms can be mistaken as the outgrowth of physical illness.

Michael Freidman, GMHNY chairman, said that when senior citizens approach under-trained clinicians complaining of psychological problems, it is easy to confuse their ailments as pain associated with the aging process.

“(Doctors may say) Oh, you’re just getting older,” Friedman said.

Friedman said there is currently a shortage of mental health clinicians, particularly those licensed to deal with mental illness.

Assemblyman Steven Englebright, D-Setauket, chairman of the Assembly aging committee, said the suicide rate for people over 65 is 50 percent high than it is for younger adults.

“We can’t abandon them,” Englebright said.

The bill would allow the newly established geriatric mental health office to issue grants to non-profits to prevent mentally ill senior citizens from going into institutional care, committing suicide and address substance abuse problems.

Grants also would be issues to organizations to provide housing and in-home care.

New York State’s senior citizen population will increase dramatically in coming decades, according projections the legislators provided.

According to their statistics, by 2030 the population of New Yorkers 65 and older will nearly double from the current level of 2.4 million. Legislators said New Yorkers 65 and older with mental illnesses will increase as well from nearly 500,000 people to 740,000 in the next 25 years.

During his years as a New York City police officer, Sen. Martin Golden, R-Brooklyn, said he had occasion to see the destruction mental illness could create in the lives of senior citizens.

During the press conference, Golden recalled an instance in the 1980s when on a patrol, he was called to the dirty and disorganized apartment of an older man who had just died. He said he was surprised at how quickly a medical examiner determined the cause of the man’s death.

“He wasn’t there more than two minutes and he signed ‘alcoholism,’” Golden said. “He did this in two minutes looking at this individual’s surroundings.”

The initial program to create grants for service providers working with senior citizens would cost the state $5 million, Morahan said, adding that some of the money earmarked for the program was fixed into this year’s OMH budget.

“Will it cost more?” Morahan said. “Probably. Should we not move forward with it if it costs more? No.”

Coalition wants protection from unsafe adult homes. By Etanjalie Narraph
Legislative Gazette, May 31, 2005

A week after the death of an adult home resident, the New York State Adult Home Reform Coalition was in Albany to ask legislators to pass adult home reform.

Charles Dunbar died on May 8 at Brooklyn Manor, which he was referred to in July 2004 by a homeless shelter in Manhattan, despite the fact that the home was on the “do not refer” list because of violations.

The coalition wants reform that would protect adult home residents from building owners who create unsafe conditions and help those with psychiatric disabilities find living assistance outside the homes.

“Adult homes are ghettos within the ghettos,” said Davin Robinson, policy director for the Schuyler Center for Analysis and Advocacy.

In addition, “Adult homes were never designed for people with mental health disabilities,” she said.

One of the three bills the group wants passed would develop a community housing waiting list that would provide data as to how many community housing needs to be built for people with mental health disorders.

“Unless the state begins to collect information and invest in alternative forms of housing, thousands of people with psychiatric disabilities will continue to wait for relief that will never come,” said Harvey Rosenthal, executive director of the New York State Association of

Psychiatric Rehabilitation Services.

Assemblyman Peter M. Rivera, D-Bronx, and state Sen. Thomas P. Morahan, R,C-Clarkstown, who both chair the mental health committee, are sponsoring this bill.

In addition, they are sponsoring a bill that would give adult home residents the right to go to court when the conditions in their home becomes dangerous to their health and safety.

“Every person living in an adult home should have the ability to contact a group like the Coalition of Institutionalized Aged and Disabled or speak with a lawyer so they know and understand their rights,” said Irene Kaplan, vice president of Surf Manor resident council and CIAD member. “These services should not just be available to a few lucky people the way they are now.”

Assemblyman Richard N. Gottfried, D-Manhattan, chair of the health committee, has also sponsored adult home reform legislation.

“While the state has made some improvement in oversight and inspections, much more needs to be done to protect vulnerable people form unscrupulous or incompetent operators,” said Karen Schimke, president and CEO of SCAA.

Among the items on the bill, the legislation would enact an emergency investigation of the adult home industry and require the homes to report all important incidents to the department of health.

“Please pass this legislation,” said Gary Levin, a resident at Ocean House in Far Rockaway and a CIAD policy committee member. “Gov. George Pataki, give the people living in adult homes relief today.”

Brooklyn Manor was taken off the “do not refer” list recently after the courts decided the inspection reports were not valid since they did not propose remedies.

Until next time, we remain,
Working to ensure available and accessible
mental health services for all New Yorkers