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

Friday Fax from Albany

ANOTHER SAD YEAR FOR TIMOTHY’S LAW: As the Senate and Assembly are feverishly wrapping up the loose ends on a variety of issues before they leave Albany for the summer (possibly to return at some later date in the year), Timothy’s Law supporters are disappointed that our bill, that would prevent tragedies like Timothy’s from happening to others, is not amongst those issues being ironed out. While there was a valiant effort put forth by members of the Timothy’s Law Campaign and supporters from throughout the state in the last few days of session, our goal was not realized, leaving millions of New Yorkers without the mental health and addiction coverage they deserve.

This last week of the Legislative Session proved to be quite a roller coaster of progress and emotions for those present at the Capitol.. There were extreme highs when it looked as though some version of parity legislation would become a reality and other times when that reality stung us. The last minute rush all began late Friday when Assemblymember Paul Tonko made a phone call to Senator Tom Libous. Assemblymember Tonko’s phone call prompted a visit to the Assembly chamber by Senator Libous, which resulted in a productive conversation between the two legislators where both expressed their desire to get something done for individuals living with mental health and addiction disorders.

As Monday became Tuesday, and Tuesday became Wednesday, members of the Timothy’s Law Campaign, under the leadership of the NYS Psychiatric Association’s representatives, Richard Gallo and Karin Moran, entered into intense negotiations with Senator Libous and members of the Senate Majority Leader’s staff. The efforts on the part of all of these parties to reach some sort of agreement that would be worthy of bearing Timothy’s name was impressive and noteworthy. Significant chunks of 14+ hour days were dedicated to this effort, but unfortunately met with no success.

In the Assembly, there were no discussions or negotiations in an effort to find common ground with the Senate. On Monday, the bill that the Assembly has passed for a number of years, and that the Senate has refused to pass, A.2912, passed the Assembly once again, by a vote of 130-10 (Bacalles, Barclay, Barraga, Crouch, Fitzpatrick, Kolb, Nesbitt, Oaks, O’Mara, Schimminger voted ‘no’). Knowing how strongly Assemblymember Tonko and other members of the Assembly believe in the concept behind Timothy’s Law, we look forward to working with both sides later this year (if the Legislature returns) to negotiate a bill worthy of bearing Timothy’s name.

WHAT’S THIS ALL ABOUT?
The dynamic at hand that has delayed the passage of Timothy’s Law for the past several years is in the fact that there are two diametrical philosophical beliefs held by the respective Majority parties in each house of the NYS Legislature with regard to insurance coverage as it relates to small businesses.

In the Assembly, there is a deeply rooted belief that benefits or enhancement should be available and cover everyone, and should not be made available exclusively to one subset of people. With Timothy’s Law, the Assembly’s Democratic Majority holds firm to a belief that providing the employees of larger employers (50+ employees) with enhanced mental health and addiction benefits without providing the same benefit to the employees of large employers is simply discrimination. So far, they have been unwilling to pass a version of Timothy’s Law that does not cover the employees of small employers equally to the employees of large employers.

In the Senate, the Republican Majority in that house believes just as strongly that small employers (less than 50 employees) are not capable of absorbing the cost increase associated with any additional mental health and addiction benefit. Their concerns lie with the impact that an onerous cost associated with a mental health and addiction benefit enhancement could have on the ability of those business owners to continue to afford health insurance for their employees. So far, they have been unwilling to pass legislation that they believe will negatively impact small businesses and their ability to continue to provide health insurance to their employees.

Who’s right? The truth is that there are legitimate concerns and points that both parties hold.

In the mean time, as the politicking and posturing continues, there is a little girl in Western New York who recently ran out of inpatient benefits and a man here in the Capital District who took his own life on Tuesday. Could they have been helped if insurance restrictions on mental health and addiction services had been lifted? The answer is a resounding ‘YES’, but still we have no law.

GERIATRIC MENTAL HEALTH ACT PASSES LEGISLATURE – ON TO GOVERNOR: Under the stewardship of the Geriatric Mental Health Alliance’s Michael Friedman and Kimberly Steinhagen, the Geriatric Mental Health Act has passed both the Assembly and Senate – an impressive feat for a bill that was introduced for the first time this year. Some compromises were made in negotiations with the two houses and the Governor’s office, giving the bill very good prospects to be signed into law by the Governor when it is delivered to his desk.

According to Michael and Kim, “The modified Act provides for a services demonstrations grants program very similar to the one included in the original bill. It also provides for the establishment of an Interagency Geriatric Mental Health Planning Council. Although the Geriatric Mental Health Act does not include all the elements of the original bill, it will enable NYS to take significant steps towards the development of the kinds of services needed to meet the mental health needs of older New Yorkers. We are very grateful to Senators Spano, Morahan, and Golden and to Assemblymen Rivera and Englebright, who joined together in a great bi-partisan effort to win passage of this legislation.”

Congratulations and great work!!

LEGISLATION TO ‘BOOT THE SHU’ PASSES ASSEMBLY: This year’s effort to enact legislation to ban the use of solitary confinement for inmates with mental illness has been quite a success. Working as a coalition, the Mental Health Alternatives to Solitary Confinement (MHASC) Campaign worked to get this legislation, which has passed the Assembly last year, introduced in the Senate by working with the New York State Correctional Officers Police Benevolent Association (NYSCOPBA). While the legislation did not make it through to passage in the Senate this year, the work done this year will hopefully lead to movement on the bill in future years.

In the meantime, congratulations are due to the Assembly, in particular to Assemblymember Jeff Aubry and the Assembly Speaker’s staff, for their efforts in seeing this legislation through to passage.

A WISE HIRE (pun courtesy of NYAPRS’ Harvey Rosenthal): MHANYS would like to join NYAPRS and others in recognizing the great work of Jeff Wise on issues such as Timothy’s Law and others as he takes a new position as the CEO of the New York State Rehabilitation Association (NYSRA). Jeff has been an outstanding partner to work with and was instrumental in crafting the compromise legislation the Timothy’s Law Campaign offered recently in an effort to see parity become a reality. We will miss working with Jeff in his capacity with the Coalition for the Homeless, but look forward to working with him as he takes the reins at NYSRA. New York State Rehabilitation Association (NYSRA) press release follows.

State Rehabilitation Association appoints new
Chief Executive Officer, Jeff Wise

The New York State Rehabilitation Association (NYSRA) and its affiliated corporation the Rehabilitation Research and Training Institute (RRTI) is pleased to announce the appointment of its new Chief Executive Officer, Jeff Wise.

Wise brings over 18 years of experience in the public policy and legislative areas to NYSRA/RRTI. As a member of the New York State Law Revision Commission, he was the principal attorney on a project to study and recommend changes to the various elements of the State's Criminal Procedure Law affecting criminal defendants with developmental disabilities, as well as studies regarding tort issues and areas involving surrogate decisionmaking.

While a legislative liaison and, later, executive director of a state association of community health centers, Wise worked on matters of health care policy and health care financing affecting New York's most vulnerable populations.

"We are delighted to have Jeff as our new Executive of NYSRA and RRTI," said James DeStefano, Chair, NYSRA Board of Directors. "His proven leadership skills and legislative experience in the human service field, coupled with his pure drive and dedication uniquely qualifies him to lead NYSRA and RRTI."

Since 2000, he has been an Albany policy analyst and legislative representative for the Manhattan-based Coalition for the Homeless. Wise said he looks forward to "the opportunity to lead NYSRA/RRTI into the future and build upon its rich history in the disability field."

Wise earned his bachelor's degree in philosophy from the State University College at Potsdam. He was awarded a Juris Doctor degree from the Albany Law School in 1987. He currently resides in Saratoga Springs. NYSRA, a statewide association represents over 130 organizations and individuals that provide services to individuals with disabilities.

IN THE NEWS:

Similar articles to this were also published in Long Island’s Newsday, Syracuse Post-Standard, and Ithaca Journal.

Supporters of Timothy's Law offering new compromise bill. By Mark Johnson, Associated Press
Albany Times Union, June 20, 2005

ALBANY -- Tom O'Clair says he's not giving up hope that lawmakers will pass a bill requiring insurance coverage for mental illness even as a last-minute compromise apparently failed to improve the proposal's chances.

O'Clair, whose 12-year-old son Timothy killed himself in 2001 after his parents had to give up custody of him so he could get public-funded treatment for emotional problems, remains committed to seeing "Timothy's Law" passed by the state Assembly and Senate.

"We spent months of late nights trying to come up with something both sides would be happy to work with," he said Monday, with four days left in the scheduled legislative session. "It seems to be an ever-elusive goal. I'm extremely frustrated, but I'll be here until New York state has an acceptable mental health parity law, one I'm comfortable putting Timothy's name on."

O'Clair and other supporters of the bill have offered a compromise proposal they hope will pass the Legislature this year after more than a decade of frustrating efforts to equalize the coverage of emotional or substance abuse problems with that given for physical injuries or illnesses like cancer or diabetes.

Three years ago, the bill became known as "Timothy's Law." So far the Legislature has not been able to reach an agreement on the measure. The bill has been held up mostly because of concerns in the Republican-led Senate over the potential costs to small businesses. Those concerns remain, even with the compromise plan.

The Senate last year passed a version of a bill that exempted businesses with less than 50 workers from providing mental health coverage. That bill also excluded coverage for alcohol and substance abuse therapy because other state programs are already available to provide treatment, Senate Majority Leader Joseph Bruno said.

"Timothy's Law is an ongoing discussion," Bruno said Monday. "We had a bill we passed that addresses about 80 percent of the public out there. We were hoping the Assembly would be realistic in compromising to get that done."

The new proposal still exempts businesses with fewer than 50 employees from being covered, but gives those businesses the option of buying the coverage at the same cost as larger businesses. Michael Seereiter, the legislative director for the Mental Health Association in New York State, said the cost would amount to around $1.25 a month per employee.

The updated bill also creates a $1 million safety net to pay for treatment beyond the standard length of inpatient and outpatient treatment covered by most insurance companies, Seereiter said. The provision would be paid for by a small fee on each health insurance policy.

The new proposal is "part of negotiations that are taking place and that's one of the key issues we'd like to get done," Bruno said.

But Assemblyman Paul Tonko, sponsor of the bill in his house, said he has heard little from his colleagues in the Senate. Tonko said he expects the Assembly this year to pass the same bill it did last year.

"The time has long passed for the Senate to come to the table," said Tonko, a Montgomery County Democrat. "We want an inclusive bill that provides for benefit and savings for employer and employees across the state. We're not looking to create new discrimination."

A recent study done for the National Institutes of Mental Health found that a quarter of Americans suffered some form of mental illness in the past year, from depression and anxiety to schizophrenia and anorexia.

Mills discusses proposed legislation with supporters of Timothy’s Law.
Mid-Hudson News, June 22, 2005

A handful of sign carrying area residents met state Insurance Superintendent Howard Mills outside the Ramada Inn in the Town of Newburgh yesterday morning as he was on his way in to discuss insurance issues with members of the Orange County Chamber of Commerce.

The picketers were calling for resolution to the legislative stalemate over Timothy’s Law, a proposal that would provide insurance coverage parity for persons with mental disorders.

Alexandra Zimmerman of Middletown is disappointed that the Assembly and Senate have their own versions of the measure with no apparent compromise in sight. “Right now New Yorkers with mental health care are not allotted the same as with physical disability,” she said. “They don‘t have the same number of visits. They are discriminated in that regards as well as they do visit; their co-pays are normally much higher. Our children are suffering because they do not get the care that they need.”

Mills, who voted for the legislation when he was an assemblyman, did not give up hope even though the legislature is to adjourn this week. “There are only days in the legislative session scheduled. The Assembly and Senate can always be called back into session, as you know,” he said. “So, there still is time.”

The proposed law is named after a teenaged boy, Timothy O’Clair, who took his own life after suffering with mental illness.

Mental health care needs coverage parity. Letter to the Editor
Albany Times Union, June 20, 2005

I am writing about Cathy Woodruff's June 7 article, "Depression concerns cloud HMOs' shine." It did not surprise me that enrolled HMO patients rated coverage benefits for mental health as falling short. As a licensed clinical social worker, I share their concern.

Conditions such as depression, anxiety, phobias, post-traumatic stress disorder and attention deficit disorder are often substantially treatable with psychotherapy, medication or a combination in the hands of competent practitioners.

Unfortunately, many HMO plans have a maximum cap of 20 mental health sessions per year, and have raised their co-payment fees to $50 per session. High co-payments are difficult for many and serve as a disincentive to seek mental health care. The 20-session cap is often insufficient to treat more serious conditions. If a patient has used 20 sessions by October, and continues to have serious mental health problems, there are no more outpatient mental health benefits available for that year.

Physicians do not face a limitation on the number of appointments per year to treat a medical condition, such as diabetes. Mental health conditions profoundly affect all of us either directly or indirectly. Studies have demonstrated that money spent on mental health treatment saves dollars in the long run, which would otherwise be spent on other medical complaints, and on the social costs and lost productivity associated with untreated emotional problems.

I am in favor of mental health parity in health benefits, something that federal employees already have, thanks to President Bill Clinton. The proposed Timothy's Law, which has been before the state Legislature for several years, would put mental health on a par with physical health. The facts demonstrate that minimal cost would be added to health care plans, with great long-term benefit.

DEBRA NOZIK
Licensed Clinical Social Worker, Albany

HMOs need to improve treatment of depression. Letter to the Editor
Albany Times Union, June 21, 2005

This letter is in response to the June 7 article, "Depression concerns cloud HMOs' shine." Based on the New York State Health Accountability Foundation annual report card, most area HMOs scored well except in areas regarding treatment of depression.

This was true statewide as well. Unfortunately, I am not surprised by this finding. Despite the fact that more than 19 million Americans suffer from depression, there is still great confusion regarding treatment. Fewer than half of those 19 million individuals come forward and seek treatment largely because of the stigma associated with depression.

Yet, the rate of recovery from depression is at an all-time high. More than 80 percent of individuals who seek treatment for depression do improve. Treatment, whether through medication, psychotherapy, or a combination, does indeed work.

How do we best ensure that treatment for depression by HMOs improves in future years?

The answer is several fold: 1. The state Legislature must pass Timothy's Law to ensure the ending of the discriminatory and artificial caps currently in place for coverage of mental health care in insurance plans. 2. HMOs must provide educational and training materials to their members to educate them about the symptoms of depression and to show how treatable depression is. By talking factually about depression and recovery, HMOs can help break down the barriers to treatment created by stigma. Resources such as the Mental Health Association in New York State Web page, http://www.mhanys.org would be very helpful. 3. HMOs must put in place a strong reporting and monitoring mechanism to ensure their members are receiving adequate treatment for depression. As detailed in this article and in the report, there is a demonstrated need for quality assurance improvements regarding treatment for depression in HMOs.

These measures will help to ensure greater treatment and recovery for the millions of New Yorkers who suffer from depression.

GLENN LIEBMAN
CEO, Mental Health Association in New York State, Albany