Timothy’s Law - The issue which has, by far, gotten the most amount of press coverage, is Timothy’s Law, as is evidenced by the news coverage which follows. As was reported in the most recent edition of the Update, the Assembly and Senate reached an agreement late Friday night, June 23rd, after both houses had adjourned.

Essentially, the agreement would require all health insurance policies in NYS to include “broad based coverage for the diagnosis and treatment of mental, nervous or emotional disorders or ailments,” consisting of at least 30 inpatient days and 20 outpatient visits. Most importantly is the fact that insurers would no longer be able to charge significantly larger co-payments for accessing such services compared to the other health services they provide. This portion of the agreement applies to employers of all sizes, and would ensure that smaller employers (50 or fewer employees) are held harmless from any cost increases associated with this mandate, via some form of financial assistance from the state.

For larger employers (more than 50 employees), the policies they provide to their employees would not only have to cover the services mentioned above, but they would also have to provide coverage without arbitrary limits (30/20, etc.) for a limited list of diagnoses, consisting of schizophrenia/psychotic disorders, major depression, bipolar disorder, panic disorder, obsessive compulsive disorder, bulimia and anorexia. For children, this coverage above and beyond the 30/20 benefit would extend to those with attention deficit disorders, disruptive behavior disorders and pervasive development disorders. Such diagnosis would have to be accompanied by one or more of the following: “(i) serious suicidal symptoms or other life-threatening self-destructive behaviors; (ii) significant psychotic symptoms (hallucinations, delusion, bizarre behaviors); (iii) behavior caused by emotional disturbances that places the child at risk of causing personal injury or significant property damage; or (iv) behavior caused by emotional disturbances that placed the child at substantial risk of removal from the household.” Smaller employers will have the option to purchase the enhanced mental health benefit that larger employers would be required to provide.

A major disappointment to advocates was that the agreement fails to address the discriminatory health insurance policies that restrict access to services for those with addiction needs. However, advocates are determined to continue this fight on behalf of those with addiction disorders next year and hope to expand upon the advances provided in this agreement when the law would need renewal in 2009.

However, a great deal of work is necessary to see this legislation through to enactment into law. Timothy’s Law advocates are working to ensure that both houses do indeed pass this agreed upon bill when the Legislature is expected to return in September. In addition, efforts to demonstrate the support Timothy’s Law enjoys in an effort to get the Governor to sign the bill into law are also underway. While it appears we have been successful in this leg of the Timothy’s Law Campaign, we will need your help in seeing it through to completion before the year ends.

‘Boot the SHU’ – Pleased by the progress that the effort to ban the use of solitary confinement (special housing units) for prisoners with psychiatric disabilities has made in passing both houses, advocates looking to ‘Boot the SHU’ are now focusing in on how to convince Governor Pataki to sign the legislation. As the editorial from the Albany Times Union states, nearly everyone, including the correctional officers (who were instrumental in getting this legislation passed), has come to the realization that the time has come to end this deplorable practice and redirect efforts to provide treatment to inmates with mental health needs rather than placing them in an environment that perpetuates, and may even cause, psychiatric issues. Your continued calls and contact with elected leaders will continue to be necessary if this legislation is to become law. Stay tuned for additional information on how you can help ‘Boot the SHU.’

Mental Health Housing Waiting List – As was mentioned in the most recent edition of the Update, your assistance will also be necessary in convincing the Governor that the state should establish a housing waiting list for people with psychiatric disabilities. This model has been successfully used in addressing the housing need for New Yorkers served by the NYS Office of Mental Retardation and Developmental Disabilities and its success should be replicated for those served by OMH. Again, we will have additional information coming shortly on how you can help make this legislation become a legal reality.

Medicare Part D Medicaid Wrap Around Extended To January – An additional victory in the 2006 legislative session was the extension of the Medicaid wrap-around benefit for dual eligible New Yorkers who have recently transitioned from Medicaid to Medicare as the primary provider of medications as part of the Medicare Prescription Drug Benefit Program.

 

Following is a letter from the NYS Department of Health to all dual eligibles on the extension of this wrap-around benefit from its original expiration date 10 days ago to January 1, 2007.

STATE OF NEW YORK
DEPARTMENT OF HEALTH

June 30, 2006

Our files show that you have both Medicare and Medicaid. If you think this is wrong, call your Medicaid eligibility worker right away.
In New York City, call (877) 472-8411.

Important Information About Your Drug Coverage

FOR INDIVIDUALS WHO RECEIVE BOTH MEDICARE AND MEDICAID

You were recently sent a notice that beginning July 1, 2006, New York State Medicaid would reduce the pharmacy benefit to cover only certain drugs for people who have both Medicare and Medicaid. Due to a recent change in New York State law, this reduction in benefits will not occur until January 1, 2007. We are sending you this letter to let you know that until January 1, 2007, Medicaid will continue to pay for covered drugs when your Medicare prescription drug plan will not pay for them. However, the pharmacist must first request that your Medicare prescription drug plan pay for the medications. If the plan refuses, then Medicaid may be able to pay for your medication. Please remember to show both your Medicare prescription drug card, and your Medicaid card, when purchasing prescription drugs.

Because you have both Medicare and Medicaid, you may need to be enrolled in a Medicare prescription drug plan to receive prescription coverage. If you need help choosing the plan that covers your medications, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. Or, you can call New York’s Health Insurance Information Counseling & Assistance program (HIICAP) at 1-800-701-0501 for assistance.

If you are not required to join a Medicare prescription drug plan because you have an employer/union retiree health plan, and you have received a letter that told you that you will lose your health insurance coverage if you enroll in a Medicare prescription drug plan, these changes in Medicaid coverage may not apply to you. If you have not already done so, you must provide a copy of that letter to your local Medicaid office.

MHANYS ESTABLISHES MEDICARE PART D HELP LINE: As many people knew in advance of the implementation of Medicare Part D, dual eligible individuals, including those with psychiatric disabilities, would experience difficulty in accessing the medications that keep them healthy and stable in the new environment of the Medicare Prescription Drug Benefit program. In an effort to assist those experiencing difficulty, MHANYS has established an 888 number to assist individuals in navigating the complexities of Medicare Part D and getting the medications they need.

Individuals experiencing difficulty accessing medications should call MHANYS’ Medicare Part D Help Line at 1-888-341-8324.

NYAPRS’ ENEWS SPECIAL ALERT ON PROS:
S P E C I A L A L E R T

To: NYAPRS Members and Friends July 7, 2006
From: Harvey Rosenthal, Executive Director
________________________________________
Yesterday, the NYS Office of Mental Health announced that it was resuming efforts to implement its new Medicaid outpatient rehabilitation license, PROS (Personalized Recovery Oriented Services) and increasing the PROS rates.

The announcement confirmed that OMH'S efforts over the past 6 months to "further clarify the record keeping standards to document medical necessity and support Medicaid billing for PROS services" have been approved by the Department of Health as meeting appropriate standards under the federal Medicaid Rehabilitation Option.

An accompanying letter from DOH Medicaid chief Brian Wing gave approval of OMH's new modifications in documentation of medical necessity and a system of progress notes that clearly track the delivery of services necessary to support progress towards specific goals identified in the treatment plan. DOH has also approved OMH's new "modified threshold (reimbursement) methodology."

The announcement goes on to say that,

IN THE NEWS: An impressive number of articles relating to the accomplishments and progress on mental health issues have been published in newspapers throughout the state over the last two weeks.

Loose Ends Await at Capitol
Legislators likely to wait until after Sept. 12 primaries to return to deal with Pataki veto of union bill, other issues. By James M. Odato.
Albany Times Union, July 11, 2006

ALBANY -- Assembly Speaker Sheldon Silver says he will return to the Capitol -- when, he isn't saying -- to give poor people more money.

Senate Republicans plan to return after the summer to give mentally ill patients health insurance.

But none of the state business lawmakers say they want to finish is compelling enough to rearrange their vacation calendars anytime soon, according to legislative leaders. Even Gov. George Pataki, who in mid-June said he'd call a special session to get his all-crimes DNA databank bill acted on, has backed away from the threat, content with the compromise version the Legislature passed.

Nevertheless, lawmakers, who left after the session concluded June 23, will be back to take up some odds and ends, probably after the Sept. 12 primaries in New York, several officials said.

Among those loose ends is Pataki's veto of a bill to allow home day-care workers to organize and be represented by unions. Advocates say it would allow day-care providers to negotiate such issues as pay and regulation with government agencies.

Several lawmakers want to return as soon as possible to override the governor's veto.

The Senate overrode the bill, sponsored by Sen. Nicholas Spano, R-Yonkers, just before the Republican-led chamber broke for the summer at 9 p.m. that final Friday night.

Assemblyman Adriano Espaillat, D-Manhattan, said overriding the veto is his biggest priority for 2006. He said he will push Silver to lead the override, even though Attorney General Eliot Spitzer, the Democratic designee for governor, has urged Silver to let the bill die.

"For me, it's going to be a bare-knuckles fight," Espaillat said.

The legislation would allow 50,000 to 60,000 low-wage employees, many of them from New York City, to become state employees and join unions such as the United Federation of Teachers. The eligible workers must provide in-home child day-care and be paid directly or indirectly from funds administered by New York City or any county.

Espaillat said the override didn't happen in his chamber because Silver, an Orthodox Jew, had departed before sundown that Friday for Sabbath observances.

Before he left, Silver, in an interview, did not reveal his plans for the measure.

He did, however, say Pataki was "holding hostage poor people" by putting $101 million for programs for people on welfare in a bill with two bills the Assembly opposes: a targeted early retirement incentive program unions don't like, and an increase in the number of charter schools allowed in New York from 100 to 250.

Silver said his chamber would have to introduce an alternative bill later this year without the poison pills.

Also on tap later this year could be a breakthrough in the long fight for Timothy's Law, which would mandate mental health insurance coverage.

Sen. Thomas Libous, R-Binghamton, and Assemblyman Paul Tonko, D-Amsterdam, came to an agreement just before the break on Timothy's Law, and Libous said his chamber will return in September to pass it. Advocates say both chambers were ready to pass the bill before leaving Albany, but they could not get a message of necessity from Pataki allowing them to skip the three-day aging requirement after bills are introduced.

The compromise bill, hailed by advocates of mentally ill people and acceptable to the small business lobby, requires employer insurance policies to cover treatments for mental illness. It eliminates coverage of substance abuse patients, which the Assembly wanted. The mental health lobby plans to try to get that included next year.

The mental health parity legislation calls for the state to pick up the extra cost for businesses with up to 50 employees. Estimates range from tens of millions of dollars to up to $200 million. Larger businesses would pay for the mandate on their own.

Lawmakers could return with other overrides to consider. Potential vetoes by Pataki include the early retirement bill, several union-friendly measures, a ban on solitary confinement of mentally ill prisoners in prisons and legislation to effectively force collection of taxes by Indian retailers by requiring manufacturers to sell tobacco products only to wholesalers who put tax stamps on packs of cigarettes.

Michael Marr, a Pataki spokesman, said most of the bills are still under review. However, he said a measure to change the budgeting process, tipping more power to the Legislature while moving the fiscal year's start to May 1, will be vetoed as it mirrors the proposed constitutional change rejected by voters last fall.

To-do list:

New York Debates Parity, SHU Bill, Community Housing Waiting List
Mental Health Weekly, June 26, 2006

Perhaps one of the most watched parity bills in recent years has been the legislation in New York State known as 'Timothy's Law,' which would require that health insurance companies treat mental illness and chemical dependency equal to physical health needs.

As Mental Health Weekly went to press, state lawmakers had not finalized their business and were still undecided on whether to add one more day to its session. As the eleventh hour approaches, advocates, meanwhile, continue to seek Senate passage on key mental health issues.

New York mental health advocates have kept up the momentum on mental health parity, the SHU bill, which would end solitary confinement of prisoners with mental illness, and a waiting list for community housing, for several years.

The passage of Timothy's Law, in particular, has for many years remained at the top of mental health advocates' wish list. Advocates are encouraged by the state Assembly's ongoing support of Timothy's Law and the passage of the parity bill earlier this year (see MHW, March 20).

Timothy's Law is aimed at ending insurance discrimination against individuals with mental health and addiction issues. The parity legislation is named after Timothy O' Clair who committed suicide five years ago just shy of his 13th birthday.

The legislative session last week involved intense discussion between the House and Senate on those issues. As New York legislators approached an end to their current session, advocates remained hopeful that all of their key issues would get passed.

However as Mental Health Weekly went to press, advocates had learned that lawmakers had so far only approved a bill allowing people with psychiatric disabilities to be in their most integrated community setting. Discussions involving Timothy's Law and the SHU bill continue, they say.

'Timothy's Law is the most pressing issue at the moment,' J. David Seay, executive director of the National Alliance on Mental Illness' New York State (NAMI-NYS), told MHW. 'We've become very encouraged. The Senate has been talking to the Assembly and vice versa.' At press time, they had not yet reached an agreement, he said.

Advocates are concerned that the Senate version of the parity bill does not include a provision to address addiction services, something that has always been included in the Assembly version, noted Seay.

'Substance abuse is part and parcel,' said Seay. 'It doesn't make sense to treat one-half of the problem,' he said. 'Fifty percent of those with mental illness have a co-occurring disorder and vice versa.' The addiction issue is one of the areas that pose a stumbling block, he said.

Seay added, 'It will be tragic if they don't pass this bill. As a member of Timothy's Law campaign, we're holding together with all the other advocates. We're willing to concede an awful lot to get a bill.'

Advocates are certainly encouraged by the increased interest by lawmakers on mental health issues. 'The good news is that mental health is high on the agenda here in the capital, Timothy's Law most of all.' Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services (NYAPRS), told MHW.

'Timothy's Law is casting a very giant shadow over the mental health bills in session,' he said. 'It's getting most of the attention. All of these issues are well understood and well known,' said Rosenthal.

'We're working very hard to try and get Timothy's law done,' said Glenn Liebman, chief executive of the Mental Health Association of New York State. 'We think the state Assembly has been very responsive. The Senate has been much more engaged than in the past. We're hoping it will translate into some kind of bill.'

A lot of the legislative attention to the parity bill is credited to the intense grassroots efforts among advocates, said Liebman. 'It has a lot to do with our strategy, and more grassroots pressure in the community. We've conducted rallies all around the state.'

Multicultural Centers
Another important issue closely watched by advocates are the Multicultural Centers of Excellence, which is awaiting Senate action. The legislation sponsored by Assembly M. Rivera, directs the Office of Mental Health to establish two centers of excellence for culturally and linguistically competent mental health.

According to the bill, the purpose is to improve the quality and availability of mental health services in the diverse population of New York State through the development of best practices by designated centers of excellence in culturally competent mental health.

The legislation is designed to improve mental health service and access and quality to people of color, said Rosenthal. It also creates an office of Minority affairs within the Office of Mental Health to ensure cultural competency issues are prioritized, he said. An advisory body to advise both the OMH Commissioner Sharon E. Carpinello, R.N., Ph.D., and Gov. George Pataki would also be established, he added.

Housing Waiting List
The New York Assembly and the Senate have passed legislation that would create a New York State housing waiting list for individuals with mental illness.

Advocates indicate that New York has developed additional units of housing for people with mental illness, especially with the recent New York housing agreement Gov. Pataki announced last year, which creates new supportive housing for individuals with mental illness at risk of homelessness in New York City. They say, however, that there is still a large need for additional housing for people with mental illness in New York City and the rest of the state.

'We commend the administration for putting up more housing than they have in the past,' said Liebman. 'It's not always done in a planful way. It's important to quantify the numbers so that key agencies in the state can participate in meeting the goals of the housing waiting list,' he said.

A waiting list would help address the housing needs of individuals with mental illness being discharged from psychiatric facilities and nursing homes as well as jails and prisons. Individuals living in adult homes would like more independent settings. Officials need to know how many people will require housing throughout different parts of the state, he said.

'If a 'planful process' were in place you could bring in more agencies in to work together toward fulfilling those numbers,' he added.

Advocates Support SHU Bill
Mental heath advocates are also encouraged that the Senate may approve the passage of the SHU bill, legislation that would end solitary confinement of prisoners with psychiatric disabilities in New York State special housing units (SHUs), often referred to as 'the box.'

They are bolstered that legislation passed the Assembly earlier this year to ensure that the practice of placing prisoners with psychiatric disabilities into solitary is abolished and that there are sufficient beds and mental health staff to address the needs of inmates with mental illness (see MHW, April 8).

'While the legislation has made a lot of progress it may not be enough to pass the entire Senate,' said Rosenthal. 'On the positive side, the Senate leadership is very aware of and supportive of the bill.'

'We're still cautiously optimistic,' added Seay. 'It's too early to tell whether it can actually go.'

Mental Health Legislation in Albany Became Personal for One Father. By Jennifer Medina.
The New York Times, July 4, 2006

ALBANY — Night after night, Tom O'Clair watched the clock tick past midnight in the halls of the Capitol. He buttonholed all the lawmakers he saw, reminding them about his son, Timothy, who killed himself in 2001 at age 12.

More times than he can recall, Mr. O'Clair, who has an image of Timothy tattooed on his arm, drove about 20 miles to Albany from his home in Schenectady to explain to strangers that he gave up custody of his son to the state, essentially making the boy an orphan so that he could qualify for treatment for his emotional problems under Medicaid. The benefits under Mr. O'Clair's health insurance had run out.

It was nearly midnight on June 23, after the Legislature's last regular session for the year had ended and most lawmakers had gone home, when Mr. O'Clair learned of his success. After years of wrangling, the State Senate and Assembly reached an agreement that would require health insurance companies to cover treatment for mental illness.

Under the pact, which must still be voted on when legislators reconvene later this year, insurance policies would have to cover hospitalization for mental illness for up to 30 days each year, and up to 20 visits annually with a psychotherapist. About 35 other states have similar laws, according to legislative staff members.

The Democratic-controlled Assembly had passed a similar bill in each of the last four years. But critics of the measure, including business groups and many Republican lawmakers, said that the mandate would drive up the price of health insurance — by as much as 3.5 percent, according to some estimates.

The Republicans who control the State Senate had been particularly worried about the cost to small businesses. Several Republican senators, including the majority leader, Joseph L. Bruno, also opposed including coverage for alcohol and drug abuse treatment in the legislation, a demand first made by the Assembly.

The two houses reached a compromise that would allocate $50 million from the state to subsidize the cost of mental health coverage for businesses with fewer than 50 employees and would drop a requirement to cover substance abuse treatment. The legislation must still be signed by Gov. George E. Pataki. Michael Marr, a spokesman for the governor, would say only that the bill would be reviewed once it was passed by the Legislature.

But for Mr. O'Clair and other advocates, the legislative agreement was tantamount to a victory.

"We feel like there is no way at this point to go back," said Glenn D. Liebman, the chief executive of the Mental Health Association of New York State. "Nobody wanted to go home until we got something done. Maybe they just got tired of seeing us."

While the deal was a result of the work of dozens of people, it also reflected one man's determination to turn his deepest loss into something good. And it showed that sometimes in politics, the most effective advocates are not the professional lobbyists, but the persistent amateurs with wrenching tales to tell.

For days on end this year, Mr. O'Clair and dozens of mental health advocates stood just outside Mr. Bruno's office. In the final days of session, they stood with quilts bearing photographs of young children, arriving about 8 a.m. and staying until midnight. On June 20, they went to a minor-league baseball stadium where Mr. Bruno was throwing out the ceremonial opening pitch.

Mr. O'Clair, 46, who works as a mechanic for the New York State Thruway Authority, said that Mr. Bruno then made it clear that "something" would get done.

"I was just listening to the rhetoric and didn't put a lot of weight into it — people tend to protect themselves," Mr. O'Clair said last week. "All these politics are so confusing, but the advocacy had reached a fevered pitch."

Senator Thomas W. Libous, a Republican from Binghamton who helped broker the deal, said: "Everyone had a willingness to come to the compromise. The plight of people with mental illness is something we all understand, and we all wanted to get this done."

Just before midnight on June 23, Mr. Libous stood in a hallway, working out the final details of the deal with a lobbyist for the advocates.

Mr. O'Clair sat a few feet away, on one of the plush green chairs outside the Senate chambers. As a passer-by offered congratulations, Mr. O'Clair gave a weary smile. He noted that the next morning he planned to attend what would have been his son's high school graduation.

"It's a kind of bittersweet victory," he said. "We didn't have the money to get my son help. I had to make it so that could change for other families."

Mental-Health Insurance
The Journal News Editorial, June 27, 2006

A celebration would be premature, but an end-of-session agreement between the state Senate and Assembly has brought New York an important step closer to requiring that mental illness get the same insurance protection afforded physical illnesses.

For more than four years, advocates have pushed for passage of Timothy's Law, insurance-parity legislation named for 12-year-old Timothy O'Clair, a Schenectady boy who committed suicide in 2001 after his parents were forced to give up custody so he could qualify for state-paid mental-health treatment. The family's insurance coverage did not cover his needs.

The boy's father, Tom O'Clair, heralded the agreement reached late Friday by the two houses of the state Legislature. The legislation requires health-insurance policies to provide at least 30 inpatient and 20 outpatient visits for all mental-health treatment, lowering co-pays that can now be excessive for mental-health treatment. The bill lists specific adult and childhood disorders that would receive unlimited benefits.

The measure has consistently gotten strong support in the Assembly. What has stopped it has been the Senate's concern that the extra insurance cost would put an unacceptable burden on small businesses. The agreement calls for the state to cover the extra cost for businesses with 50 or fewer employees.

The reasons why it is not yet time for outright cheering

Deal on Mental Health Coverage Could Kick in Jan. 1. By Cara Matthews
Ithaca Journal, June 27, 2006

ALBANY — If the Senate and Assembly follow through on their promises, insurance companies will start paying for mental illness treatment on a par with physical ailments beginning Jan. 1.

Legislative leaders reached a last-minute agreement late Friday on a landmark bill — known as Timothy's Law — that would put New York in line with about three dozen other states. It is named for Timothy O'Clair, a Schenectady boy who committed suicide in 2001.

The O'Clair family's health insurance for Timothy's mental illnesses had run out, and his parents gave up custody of him so he could get treatment he needed.

Timothy's death led Tom O'Clair, his father, to become an vocal leader for what activists call mental-health parity. Proponents of Timothy's Law have been a constant presence at the state Capitol the last four sessions. Lawmakers, working with advocates like O'Clair and lobbyists for the insurance and business industries, forged a compromise this year.

“It's a good thing. It's extremely important,” O'Clair, 46, said Monday, two days after he attended what would have been his son's graduation ceremony at a Schenectady County high school. “This will provide care for millions of people.”

The Senate has not scheduled a date for a vote to follow up on the agreement, but it is expected to be sometime in September, said Mark Hansen, a spokesman for Senate Majority Leader Joseph Bruno, R-Brunswick, Rensselaer County. The Assembly could return later this year, subject to the call of Speaker Sheldon Silver, D-Manhattan, spokesman Bryan Franke said. Members would likely take up and pass Timothy's Law at that time, he said.

It was unclear Monday whether outgoing Gov. George Pataki would sign the legislation. Pataki's office would not comment on the legislation before it was passed, spokesman Jason Brown said.

The bill calls for a baseline of coverage that would apply to insurance policies for all employers. Every insured person would have a minimum of 20 outpatient visits for mental illness and 30 inpatient days annually.

For small businesses with 50 employees or fewer, whose financial health has been a primary concern for the Senate, the state would have a safeguard to pick up any additional cost in premiums. That could run $60 million a year for the state, according to one estimate.

For larger businesses, there is an additional echelon of coverage. The mandate calls for unlimited treatment for adults with schizophrenia/psychotic disorders, major depression, bipolar disorder, obsessive-compulsive disorder, delusional disorders, panic disorder, bulimia, anorexia and binge eating.

Children under 18 will be covered for those ailments as well as attention deficit/hyperactivity disorders, disruptive behavior disorder and pervasive developmental disorders. Smaller employers could opt into this coverage.

The compromise bill does not include requirements for drug and alcohol addictions, something the advocates had sought.

“Mental illness can result in tragedy if it is not properly treated. However, many families do not have access to proper treatment,” Bruno said in a statement.

Bruno's support was considered crucial in leading to an agreement. In the days before the session ended Friday, O'Clair and other advocates lined the halls outside Bruno's office. They held quilts whose panels depicted people who had taken their own lives and held blown-up editorials from newspapers urging passage of Timothy's Law.

Under the bill, a patient would not have to pay more for mental health treatment than physical illnesses, said Assemblyman Paul Tonko, D-Amsterdam, Montgomery County, who sponsored the legislation in his house. For example, insurance companies could not require higher co-payments for mental-health visits.

“It's a wiping out of a discriminatory approach,” Tonko said.

The Assembly has passed Timothy's Law for several years, but the Senate had not.

The law would expire after three years and could be amended later. In the meantime, the state Insurance Department and Office of Mental Health would be required to study the effectiveness and cost of mental-health parity.

The Business Council of New York State, which has opposed previous versions of Timothy's Law, is reviewing the new bill and did not have a position on it as of Monday, spokesman Matthew Maguire said.

Leslie Moran of the New York Health Plan Association said the most important part of the compromise is that insurance plans would manage the benefits and make sure treatments met standards for medical necessity versus having a totally open-ended benefit with no restrictions.

“With a three-year sunset we can go back and fight for what we didn't get this time,” O'Clair said.

-- -- -- -- --

Timothy's Law — who and would be covered:

(A similar editorial was also published in Saratoga’s newspaper, The Saratogian.)
They Did Right Thing with Timothy's Law
Troy Record Editorial, July 2, 2006

State lawmakers finished their session with a flurry of activity, and took an important, long-overdue step forward in treatment for the mentally ill by coming to an agreement on Timothy's Law.

Named for Timothy O'Clair, a Schenectady County boy who committed suicide in 2001 shortly before he turned 13, the law requires insurance companies to cover mental illness, especially for children. Simply put, it makes sure they do the right thing.

The agreement surely comes as a bittersweet victory for O'Clair's parents, who have lobbied for years to help make sure no other family goes without help because of lack of adequate insurance coverage.

The agreement requires insurance companies to cover 30 inpatient days of treatment and 20 outpatient days for all mental illnesses.

Companies will have to fully cover biologically based illnesses such as major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorder, bulimia, anorexia and binge eating.

It also requires insurance coverage for children under the age of 18 who suffer from a range of disorders that could put them at risk of suicide or violence to others.

While mental illness is not as obvious as, say, a broken leg or heart attack, it is just as real and can be as fatal. Mental illness won't go away if you ignore it, and it's no one's fault for having mental illness.

Like any medical condition, treatment doesn't come cheaply - not for the insurance company and not for the person paying the premium.

That's a problem with the health care system in this country, but it's not an excuse to withhold necessary treatment.

Bearing in mind the concerns of small business, the Legislature's agreement protects businesses with 50 fewer employees from any insurance in premiums that might result from this measure.

Timothy's Law won't solve all mental health or insurance issues, but it's a step forward in the right direction.

It allows equal measures of logic and compassion to get help to those who need it.

Our lawmakers did the right thing.

Mental Illness Parity Needed
Poughkeepsie Journal Editorial, July 2, 2006

A crucial law that would provide insurance coverage for mental illnesses was not passed this legislative session. However, a compromise plan is slated to be on the agenda when the Senate and Assembly reconvene, possibly in September. This legislation must be approved then and passed to Gov. George Pataki for his signature. New Yorkers cannot afford to be without this coverage.

The disparity in insurance plans for mental illness has left far too many people grappling for services. Their stories are heartbreaking. In some instances desperate parents have gone so far as sign their children over as wards of the state in order to get the medical care they need.

This compromise legislation, known as Timothy's Law, would require that companies offering health insurance in New York must include 30 inpatient visits and 20 outpatient visits for mental health care. Copayments must be kept in line with the rest of the plan. Currently, some mental health care carries a copay in excess of $50 each visit, while traditional doctor copays average $15 a visit.

In addition, companies with more than 50 employees also would cover necessary treatment of major disorders above and beyond the 30/20 option. These illnesses include bipolar, major depression, panic disorders and various other ailments. Small-business employers would have the option to purchase this enhanced coverage.

There are additional protections for small-business owners in the compromise that was reached on the last day of the legislative session, with the state absorbing any increases in premiums.

The plan expires three years after it's enacted and also requires a cost analysis by the state's insurance department. Most advocates expect the insurance will more than pay for itself as it offsets lost productivity and expensive crisis care.

Adequate care can save lives.

The goal is to get New Yorkers the medical care they need to be healthy. Mental illness takes both a financial and emotional toll on people. Struggling to get adequate coverage should not be part of the problem.

It has taken four years for Timothy's Law to be accepted. The compromise agreement was reached on what would have been the high school graduation of Timothy O'Clair, who hanged himself at age 12 after suffering for years, trying to get the proper treatment for his mental illness. His father, Tom, has steadfastly insisted that other families should not go through the anguish and financial burden his family suffered.

He has tirelessly fought to bring mental health parity to the forefront of legislative action.

In his honor, in memory of Timothy and for the good of all the people of New York, legislators must pass this vital law when they reconvene.

Parity for the Mentally Ill
Binghamton Press & Sun Bulletin Letter to the Editor, June 28, 2006

I support Timothy's Law. It equalizes insurance coverage for mental illnesses with physical ailments.

In a June 21 article, an insurance representative stated that physical illness was more likely to be diagnosed, treated and cleared according to evidence-based practice (EBP). This means that treatment is based on research that proves better outcomes. He said mental disorders could need lifelong treatment.

I disagree. Many physical ailments that are chronic, with no possible cure, are better covered by health insurance than are psychological disorders. They will require lifelong treatment.

Mental health organizations in New York have embraced EBP. This practice improves the treatment, diagnosis, prognosis, education and economic evaluations of mental health issues.

People with mental disorders should not be punished for having a more subjective, ambiguous ailment. They suffer, too. These people may pay the same monthly insurance premium as everyone else, but get less coverage.

Marlene Living
Binghamton

Step Toward Ending Private Hell in Prison
Bill's passage leaves one hurdle to stopping solitary imprisonment of mentally ill in New York . By Paul Grondahl.
Albany Times Union June 28, 2006

ALBANY -- By passing a bill to prohibit placing mentally ill inmates in solitary confinement, the state Legislature took the lead nationally on an issue prison reformers consider a breakthrough.

It took more than six years of dogged advocacy to earn passage in the Republican-controlled Senate at the end of the session. The bill previously passed overwhelmingly in the Democratic-led Assembly. It now goes to Gov. George Pataki.

"I hate to speculate, but I'm hopeful it will be signed by the governor," said state Sen. Michael Nozzolio, R-Seneca Falls, chairman of the Committee on Crime Victims, Crime and Corrections and sponsor of the bill.

Nozzolio said the bill's unanimous passage in the Senate came about because it not only would offer more humane treatment for mentally ill prisoners placed in Special Housing Units (SHUs), also known as The Box, but would make prisons safer for correction officers, too. Support from the correction officer union and others representing prison employees was crucial, Nozzolio said.

Currently, about 8,000 prisoners, roughly 12 percent of the total inmate population, have been diagnosed with serious mental illness.

Confined to SHUs for months or years at a time, these inmates purposely injure themselves and commit suicide at a rate three times higher than the general prisoner population. Mentally ill inmates also face exceptionally high rates of recidivism because they commonly are released straight from solitary confinement into the community with little preparation.

In addition to prohibiting the mentally ill from being put in solitary confinement in the first place, the legislation would establish new treatment alternatives in the prisons, expand mental health training for correction officers and create an oversight body. The law would be phased in after 18 months.

Molly Fullington, a spokeswoman for Pataki, declined to speculate on the bill's chances.

"We don't comment on bills," said Linda Foglia, a state Department of Correctional Services spokeswoman.

But advocates were already celebrating.

"We were just ecstatic that it passed. It's landmark legislation," said Robert Corliss, associate director for criminal justice at the National Alliance on Mental Illness of New York State.

"No other state has passed this sort of legislation," said Corliss, who was among the lead lobbyists for the bill for more than six years. Efforts included rallies at the state Capitol, letter-writing campaigns and public hearings where former inmates with mental health problems who had been confined to The Box spoke.

"The passage of this bill represents a major step forward in terms of appropriate and humane treatment of people with mental illness in our prison system," said Robert Gangi, executive director of the Correctional Association of New York, a watchdog group.

Advocates doubted this day would ever come.

"We never stopped thinking about the suffering of mentally ill prisoners in The Box, and we refused to give up," said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services.

Two dozen women who are wives, sisters and mothers of prisoners praised passage of the bill at the fourth annual retreat of Prison Families of New York, held last week in Lake George, the group's director said.

"Their loved ones with mental illness were being criminalized, and they had no business being in the SHUs," Alison Coleman said.

"This is a huge issue for our prisoner families," she said. "We feel if we can accomplish this victory, we can accomplish other things."

End the Torture
Gov. Pataki should sign legislation banning solitary confinement for mentally ill inmates.
Albany Times Union Editorial, June 30, 2006

Is anyone left in New York so stubborn and unenlightened as to continue to embrace the barbaric practice of placing mentally ill inmates in solitary confinement? Anyone, that is, outside of the upper levels of the prison establishment?

Even the rank and file prison guards have come to oppose the brutal and ineffective treatment of relegating prisoners who already are mentally disturbed to the further horrors of 23 hours a day in what's known as The Box. It was their support for a bill to stop the banishment of such vulnerable inmates that got it through the state Senate after six years of relentless lobbying by prisoners' rights advocates, especially Assemblyman Jeffrion Aubry, D-Queens, along with reporting and editorials in this newspaper, including a 2002 series by staff writer Paul Grondahl.

For that, thank Sen. Michael Nozzolio, R-Seneca Falls, chairman of the Committee on Crime Victims, Crime and Corrections. He was the one who kept driving home the point that mentally ill inmates, treated this way, pose an unnecessary and unacceptable danger to the people responsible for keeping order in what are dangerous environments under the best of circumstances.

How could it be otherwise? The Box is, as an inmate who survived it and went on to work for the New York Association of Psychiatric Rehabilitation Services can attest, torture -- not treatment. Prisons that are more humane for some of their most potentially violent inmates are safer for correction officers, too.

That will be the case in New York, if only Governor Pataki signs a bill that has been passed by both houses of the Legislature.

Just whom will the governor listen to, then? An ever wider consensus of conservatives as well as liberals, his fellow Republicans as well as Democrats, determined to spare the 8,000 mentally ill inmates in New York from mistreatment that leads to self-inflicted injuries and even suicides at three times the rate of other prisoners?

Or will the governor defer to a Department of Correctional Services that has maintained for so long that confinement in The Box is an effective way of changing the behavior of inmates who in many cases can't help themselves?

"We don't comment on bills," comes the word from a Department of Correctional Services spokeswoman.

Loosely translated, that means they don't like this nonetheless long overdue legislation.

This bill offers an intriguing glimpse at the legacy of a governor who's about to leave office. No one has ever had reason to challenge Mr. Pataki's credentials as a hard-liner on criminal behavior. But no one has questioned his very sense of humanity, either.

Sign that bill, governor.

End Isolation
State must treat mentally ill inmates
Newsday Editorial, July 10, 2006

Prisons have become the state's psychiatric facilities of last resort. That has created problems for prisoners with severe mental disorders and for prison officials struggling to keep order. Too many inmates whose illnesses make it hard for them to follow the rules land in punitive, segregated units where they are locked in isolation 23 hours a day, sometimes for years. That's no way to treat mental illness.

The State Legislature passed a bill in the waning hours of the recent session that would end the use of solitary confinement for mentally ill prisoners. It would require more appropriate in-prison housing units and psychiatric treatment for those inmates, along with training for correction officers who deal with them. The bill is on its way to Gov. George Pataki's desk. He should sign it.

It would give officials 18 months to develop the alternative units. The cost is uncertain, but the bill could save money by reducing the time mentally ill prisoners spend behind bars and the number who return to prison after failed attempts to live in the community. That would be a win-win-win for the inmates, correction officials and the public.

Putnam Mental Health Advocates Seek Improved Services. By Susan Elan.
The Journal News, July 7, 2006

CARMEL — Mental-health patients, family members and professionals want Putnam to restore the county's 24-hour mental health hotline and a crisis team that responded to psychiatric emergencies.

The 25 participants at a hearing Wednesday at Putnam's Department of Social Services building in Carmel said the county also needs more therapists to treat patients regardless of ability to pay, and residential and employment support services to help people live on their own and lead productive lives.

"When a crisis occurs, most families never thought they would need these services," said Jeanne Toovell of Mahopac, co-chair of the National Alliance for the Mentally ill in Putnam County.

Toovell and co-chairman Edward Murphy of Carmel say a crisis team would help save money in the long run by decreasing the number of people hospitalized.

Murphy said his 29-year old son has bipolar disorder has ended up in the hospital as a last resort.

"We did not know what to do and we didn't have time to ask questions," Murphy said. "He has several social phobias and being hospitalized was very difficult for him."

Alliance members have collected 200 signatures on a petition they plan to deliver to county officials requesting the reinstatement of Putnam's crisis hotline. A year ago, Putnam cut off its hotline and disbanded its crisis team based at the Putnam Community Services state clinic in Southeast after the state eliminated funding.

Michael Piazza, mental-health commissioner, said yesterday those requests will be included on a "wish list" Putnam submits to the state and county as part of its annual mental-health planning process.

It would cost $700,000 to run a 24-hour mobile crisis team, Piazza estimated. He said he does not know what it would cost to set up the 24-hour hotline.

"We didn't talk too much about money because there is no pool of funds," Piazza said.

Edythe Schwartz, executive director of Putnam Family and Community Services Inc., the agency that treats residents in need of mental-health care, said adults and children in Putnam may wait for months to see a therapist because there is no money to hire additional staff. Last year, the agency treated 9,700 people, about 10 percent of the county's population.

Waiting lists would be eliminated if Putnam paid its portion of salary and benefits for county employees that remain on staff following an arbitration arrangement made in 1997 when the county privatized its mental-health services, Schwartz said.

County Executive Robert Bondi could not be reached. Deputy County Executive John Tully said the agency will have surplus county funding next year because two of the five remaining county employees plan to retire.

"Making people wait for mental-health services is unconscionable," said Toovell, whose son first exhibited irrational behavior about a decade ago when he was an honors student in college. "If someone had diabetes or another physical illness, they wouldn't be told in Putnam County to wait for a month. This is critical care that needs to be addressed immediately."

Megan Castellano, executive director of the Mental Health Association in Putnam County, said the absence of services to prepare people with mental illness to work and live independently often ends up costing society money.

Mother Wrestles with Needs of Her Son
A mother pleads for society to embrace children with mental illness. By Lisa Selim
Syracuse Post-Standard July 9, 2006

I am the mother of a soon-to-be 9-year-old son, and am looking to help raise awareness into the disability that he has. I hope to try and erase the stigma against families that suffer from bipolar disorder and many other mental health illnesses.

No one can understand what it is like to question your every move as a parent unless you have a child like mine. He is brilliant and funny, yet there are days, even weeks, when his sickness can mask these wonderful attributes.

His illness can cause rages and extreme behaviors that are difficult for even me to understand. His words - even I have a hard time remembering that he does not mean them.

His rages can be tear-jerking, physically exhausting and mentally draining. To know that his moan can quickly turn into a rage at the blink of an eye can leave me asking myself: What else can I do?

I spend many sleepless nights on my knees, asking for forgiveness for what I lack as a parent. I have tried almost every punishment and reward, yet I am constantly asking if I have done enough. I am constantly thinking I am either too lenient or too strict, failing to remember that there will be days no punishment or reward will change the behavior, because he has an illness.

From infancy, my son cried constantly. The crying soon turned into rages, that at times would wear out both him and me. I remember times I would feel like a failure. I would question whether I had enough patience to parent this very special child. It took time for me to relax and learn to enjoy the smallest smile, the smallest touches, and even one minute of sitting through dinner together in peace.

If only I had known what was to come, maybe I could have better prepared myself for what I face every day now.

Soon I found myself in search of services to better help my son and my family, but due to the lack of awareness of mental illness, we almost always hit a dead end. I cannot count the times I have had to hear that he and I would receive help if it were only "developmental" instead of "mental"! It is heart-wrenching to experience the lack of services available to children and families who suffer from mental illness.

Many have suggested that placement might be better for my son. It was not until I let go of the guilt, stopped blaming myself and became my child's voice that I began to change the mind of many of these individuals. I had to stand up for my child and what he deserves. I had to start trusting my heart.

I knew that with adequate support and services, he could be managed in the home and in the community. I also knew that I could be taught to parent such a special and deserving child. No child deserves to be neglected!

It is sad that because my child has a mental illness, I must take so much precious time away from him and his siblings to fight for what he needs and deserves. Only recently, though, has bipolar disorder in children even begun to be acknowledged.

We must come together in society to begin to erase the stigma associated with families and children affected by mental illness. I hope that can start by conveying my personal experience, as well as my family's.

How can I convey to you the obstacles we face and the energy it takes to constantly fight for an adequate education for your child because he is affected by a mental illness?

How do I convey the numbing feeling of holding your child while you are drenched in tears, sweat and fear as he rages for an hour or more for no particular rhyme or reason?

How do I convey a child's confusion, seeing things that are only real to him - and a parent's heart bleeding the bleeding as she tries to hug and comfort her child ever so gently while he runs from what is only real to him?

How do I convey the most wonderful feeling of seeing your child warmly smile - for the first time in months?

If only I could convey to you what it is like to try and find just the right "cocktail" of medications, and to know that once this "cocktail" is achieved, it will most likely need to be adjusted and readjusted as his body grows and develops; what it is like to know that most of the medications used to treat childhood mood disorders have never been tested in children.

How can I convey the stress a family goes through as a child is hospitalized for weeks and even months, time and time again?

How can I better help you understand the feelings of a sibling locking herself in a room as her brother rages? How in a futile attempt to understand the confusion he feels, he thrashes about, screaming, "It feels as if my brain is going to explode!"

How do I convey the rage a parent feels when a child is once again unstable, and instead of riding in an ambulance, her 8-year-old is handcuffed and given a ride in a police car to the hospital, all because he is hallucinating and needs to be treated? He has not committed a crime - he is ill; yet due to the lack of education in mental illness, he is treated as a criminal.

These are innocent children and families, often shunned by friends, family and society due to the stigma associated with mental illness. These children, siblings and parents did nothing to deserve the horrible stares, snickers and remarks passed toward them on a daily basis.

It must stop! Our communities, schools and government leaders must educate themselves. More support and services must be offered and provided to these children and families. Funding must be approved at the state and federal levels to provide studies in the medications we use to treat our ill children. We need funding to educate our teachers on mental illness in children and the impact it has on their families.

As parents we must stop blaming ourselves and let go of the guilt. We must educate ourselves and become a part of our child's voice. Our children deserve respect, an equal and adequate education, and to have their needs met. This cannot happen until we stand united as parents and speak against the stigma that our children and families face every day.

Lisa Selim lives in Syracuse.

How One Woman Moved the Assembly. By Yancy Roy
Binghamton Press & Sun Bulletin, July 2, 2006

ALBANY -- It was around 7 p.m. on the final day of the legislative session. The sun was fading outside the Capitol and so were the politicians inside.

Talked out, no one wanted to debate a bill or hear a speech. They wanted to leave for the summer. It was clock-watching time.

When Amy Paulin rose, she felt numb. She didn't know was she was about to do.

She thought she was merely going to thank her colleagues who were about to vote on a bill to end the statute of limitations for prosecuting rape.

Then she stepped out of herself, she figures.

"I want to tell you a story ... about a 14-year-old," the Scarsdale Democrat began.

When she was done, the assemblywoman produced one of the few authentic moments at the Capitol. A moment that made people stop and listen, give her a standing ovation afterward and flock to her to tell their tales.

A lot of times when a legislator rises to make a point at the State Capitol, it's to repeat some well-rehearsed argument about some bill that's been debated ad nauseum. Or to ask question they already know the answer to. Or to posture.

Paulin talked of herself, but in the third person:

This 14-year-old Brooklyn girl was already a political junkie and frequently attended party meetings at the Madison Club in East Flatbush. One night after a meeting, a man offered her a ride home.

He took her to a dark alley and sexually assaulted her. She didn't tell anyone for years, especially not the police.

Then she told another story. About a 17-year-old. Her sister, who said she was sexually assaulted at high school. But a jury acquitted the accused. Paulin, 24 at the time, said she "felt victimized all over again."

Paulin had told these tales to her Democratic colleagues a few weeks ago behind closed doors and later disclosed it to reporters. But that wasn't the same as rising in formal proceeding of the Legislature.

Paulin's decision to come forward had convinced colleagues to bring the bill to the floor for a vote, where its passage was assured. Gathering confidence in her voice, Paulin moved to a close.

"We are giving a message to that 14-year-old, to that 24-year-old, to this 50-year-old that we won't take it any more. We have zero tolerance for that power and control in this state. We will forever be grateful and the young people in this state will forever be grateful when they read about what we have done."

After it was over, she started shaking just a bit. She sat. She just wanted to "press my little ('yes') button" to record her vote. Then she looked directly across to Assemblywoman Patricia Eddington who stood to applaud. Soon everyone joined.

A number of legislators, Republicans and Democrats, approached her afterward. Some told her she was brave. Some said they were worried about their daughters. Some confessed to being assaulted themselves.

"Some even asked about my sister. That brought tears to my eyes," Paulin recalled. "All these years, I thought I'd be criticized."