State Senate Passes Mental Health ABC Act 2.0

Special To The Journal

Senator Brendan P. Crighton voted along with the entire Massachusetts State Senate to pass the Mental Health ABC Act 2.0: Addressing Barriers to Care (ABC) to further prioritize mental health care reform in Massachusetts and ensure that people get the mental health care they need, when they need it.  

With the passage of the Mental Health ABC Act 2.0, the Massachusetts State Senate reaffirms that mental health is as important as physical health and should be treated as such. The bill proposes numerous reforms to ensure equitable access to mental health care and remove barriers to care by supporting the behavioral health workforce. It also provides the state with better tools to implement and enforce parity laws by creating a clear structure for the Division of Insurance to receive, investigate, and resolve parity complaints in a timely manner. By expanding and strengthening our mental and behavioral health workforce, ensuring parity between coverage for mental and physical health care, and establishing equitable reimbursement rates, we will expand access to quality care.   

“As we emerge from the pandemic, it is more important than ever that all Massachusetts residents have easy and equitable access to care for mental health,” said Senator Crighton. “The Mental Health ABC Act 2.0 will improve accessibility and make care more equitable by giving individuals more control over decisions that affect them, and by providing behavioral care workers with the tools and support needed to allow them to focus on their patients. I am proud that the Senate voted unanimously to pass this legislation, and grateful to Senate President Karen Spilka for continuing to prioritize mental health policy.”

Senator Crighton introduced two amendments that the Senate passed, both of which will help ensure access to quality mental health care. The first will help ensure a continued focus on overcoming barriers to access mental health care after these improvements are made to our healthcare system. This amendment convenes a diverse group of stakeholders—government leaders, patients, providers, and insurance companies—to study and make recommendations on how to address barriers to accessing high-quality mental health care. This group will focus on how to overcome barriers so that more mental health care providers accept public and private health insurance.  

The Mental Health ABC Act 2.0 would require the development of a standard release form for exchanging confidential mental health and substance use disorder information to facilitate access to treatment by patients with multiple health care providers. Behavioral health providers struggle in the era of electronic health records and care coordination to create systems that simultaneously protect an individual’s right to consent to share sensitive health information and allow practitioners to access the information they need to treat the individual and coordinate care. Navigating the multitude of behavioral health consent forms presents a barrier to patients attempting to obtain their own medical records and share information with providers. 

Senator Crighton offered an amendment, which the Senate passed, to help ensure individuals with mental health or substance use disorder diagnoses have meaningful input in decisions that directly impact care and services they receive. This amendment added two additional members to the advisory group that will inform the creation of this form: one with lived experience of mental health or substance use treatment, and the other a family member of such an individual. 

To further support behavioral health professionals, the bill creates an interim licensure level for Licensed Mental Health Counselors (LMHCs) so that they can be reimbursed by insurance for their services and be eligible for state and federal grant and loan forgiveness programs, further increasing the number of licensed providers able to serve patients. It also allows clinicians practicing under the supervision of a licensed professional and working towards independent licensure to practice in a clinical setting. This will help to ensure quality training and supervision and encourage clinicians to stay practicing in community-based settings.  

“The need and demand for mental health services has soared as a result of the pandemic, and anyone who has tried to find help for mental health concerns will vouch for the many barriers that still exist,” stated Danna E. Mauch, President and CEO of the Massachusetts Association for Mental Health (MAMH). “This bill tackles some of our most difficult challenges. These challenges include insurance company policies that make it hard to pay for care, a lack of providers across the Commonwealth but especially in communities of color, and care that too often is fragmented and siloed. The bill’s provisions provide creative, practical steps toward addressing these issues and it looks ahead to creation of a comprehensive system of effective crisis services. We thank the Senate, and especially President Spilka and Senators Cyr, Friedman, and Creem for their leadership, deploying their commitment, insights, and authority to protect and promote mental health and well being.” 

Additionally, the final bill establishes a suicide postvention task force dedicated to addressing the after-effects of a confirmed suicide and requires the Department of Public Health (DPH) to collect certain relevant data. It also directs the state 911 department to integrate training on identification of and response to callers experiencing behavioral health crises into the certification standards for 911 workers, and, in preparation of the establishment of a new national ‘988’ hotline in July, designates one or more ‘988’ crisis hotline centers to provide crisis intervention services and crisis care coordination to individuals accessing the suicide prevention and behavioral health crisis hotline 24/7. 

The Mental Health ABC Act 2.0 also takes steps to address the emergency department (ED) boarding crisis that is ongoing across the Commonwealth. Waiting times to be admitted to an inpatient psychiatric unit after going to an ED can extend from days into months, leaving the individual in crisis essentially boarding in an ED while they wait, with little to no psychiatric care. This legislation tackles this issue by using ARPA funds to create an online portal for health care providers to access real-time data and search for open beds for their patients, establishing a complex case resolution panel that includes representatives from state and local health and education agencies to resolve barriers to care to ensure that children’s behavioral health needs are met in a timely manner, and requiring all hospital EDs to have a qualified behavioral health clinician available to evaluate and stabilize anyone admitted to a hospital ED with behavioral health concerns during all operating hours.  

This legislation also comes at a time when the Massachusetts State Senate is making transformative investments in mental and behavioral health, including: 

• $400 million in American Rescue Plan Act (ARPA) funds to transform the behavioral health sector, with $122 million dedicated to recruiting and retaining nearly 2,000 behavioral professionals. 

• $10 million annually for the newly-created Behavioral Health Outreach, Access and Support Trust Fund, which funded the highly successful More to the Story public awareness campaign. 

• $10 million for the rapid creation of new inpatient mental health acute care beds, particularly new beds for children, adolescents and underserved communities. 

• $15 million for Programs of Assertive Community Treatment (PACT) for children who exhibit symptoms of serious emotional disturbance; PACT uses a multidisciplinary team approach to provide acute and long term supports for individuals in the community. 

• $3 million for a loan repayment assistance program to recruit and retain child and adolescent psychiatrists at community mental health and health centers.  

This legislation now goes to the House of Representatives for consideration. 

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