Establishes the child psychiatry access project; provides that the office of mental hygiene shall establish regional child psychiatry access projects across the state to provide primary care providers with timely access to child psychiatry consultations they treat in order to assist such primary care providers in meeting the mental health needs of the children and adolescents and their families; establishes a gift for the child psychiatry access project on state personal income tax forms, the proceeds from which shall be deposited into a child psychiatry access fund for the funding of such projects.
TITLE OF BILL: An act to amend the mental hygiene law, in relation to establishing the child psychiatry access project; to amend the tax law, in relation to establishing a gift for the child psychiatry access project; and to amend the state finance law, in relation to establishing the child psychiatry access fund
PURPOSE OR GENERAL IDEA OF BILL: This legislation would enhance access to mental health services for children and adolescents by creating regional teams specializing in behavioral health to consult with and provide support to primary care providers caring for children and families dealing with mental health issues.
SUMMARY OF SPECIFIC PROVISIONS: Sections one of the bill creates a new section 7.42 of the mental hygiene law directing the office of mental health, within amounts appropriated therefore, to establish regional child psychiatry access projects across the state designed to provide primary care providers with timely access to child psychiatry consultations regarding the children and adolescents they treat. The teams would consist of a child psychiatrist and appropriate support staff who would support primary health care providers in their region regardless of the patient's insurance status. The teams would answer questions, provide consultations, make referrals and in some cases provide transitional support to the child and family until the family can access local behavioral health services. They may also provide educational and advocacy services to providers and the mental health community. Section two provides for an effective date on the 90th day after it shall have become law.
JUSTIFICATION: According to a 1999 report of the Surgeon General "About 20% of children are estimated to have mental disorders with at least mild functional impairment." The number of children reported to have "serious emotional disturbance" are reportedly 59% of children ages 9 to 17. Indications are that these numbers have not changed much over the last decade and, unfortunately, the vast majority of these children receive little or no treatment.
A recent report to the Senate Mental Health and Developmental Disabilities Committee from the NYS Department of Health and Office of Mental Health on psychiatric drugs for Medicaid beneficiaries age eighteen and under concluded that "the greatest problem in children's mental health is that most children needing help get too little, too late." At the same time as children are suffering untreated, many are also being treated with medications some of which have not been approved by the FDA for use in children and adolescents. While these medications may provide great benefit there is the potential for serious adverse side effects. There is growing concern about appropriate and safe prescribing of medication to children and adolescents with a mental illness. Part of the reason that children are not getting the mental health help they need is that there are significant barriers to referral to behavioral health providers. The President's New Freedom Commission on Mental Health
reported in 2003 that these barriers included "lack of available specialists, insurance restrictions, appointment delays and stigma." The lack of child psychiatrists is a well documented national problem. In New York State there are many counties without a single child psychiatrist. Efforts have been made to pilot telepsychiatry as a way to provide at least some access to rural areas of the state for consultations and assessments by child psychiatrists. However, more needs to be done.
Because of the inadequate numbers of child psychiatrists, primary care practitioners for children and adolescents are often the ones who care for young people with behavioral and emotional problems. Providing primary care providers and families with timely access to expert guidance is essential in helping to make informed decisions about psychopharmacology and other treatments. This bill aims to provide that resource through regional child psychiatry access teams.
The bill will address the problems of access, inappropriate medication, and insurance barriers by establishing regional teams specialized in child and adolescent behavioral health who will be available to primary care practitioners to consult, answer questions and provide support and referrals for their patients. It is a model that began in Massachusetts in 2004-05 and has proven very successful. In Massachusetts there are six regional teams covering the entire state who are able to respond to the primary care providers in their region, at no cost to the provider or patient, within about 30 minutes of a call. The program is not meant to replace emergency services or on going behavioral health care. This bill will provide support and information to primary care providers and timely access to mental health services for children and adolescents.
With such legislation, "too little, too late," could become a description of the past for the children of New York State.
PRIOR LEGISLATIVE HISTORY: Same as S.7033A of 2007 Veto # 122
FISCAL IMPLICATIONS: To be determined.
EFFECTIVE DATE: 90 days after enactment.
STATE OF NEW YORK ________________________________________________________________________ 4577--B 2009-2010 Regular Sessions IN ASSEMBLY February 5, 2009 ___________Introduced by M. of A. P. RIVERA, ALFANO, LUPARDO, WEISENBERG, SCHROEDER -- read once and referred to the Committee on Mental Health, Mental Retardation and Developmental Disabilities -- reported and referred to the Committee on Ways and Means -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- committed to Mental Health, Mental Retardation and Developmental Disa- bilities -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the mental hygiene law, in relation to establishing the child psychiatry access project; to amend the tax law, in relation to establishing a gift for the child psychiatry access project; and to amend the state finance law, in relation to establishing the child psychiatry access fund THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. The mental hygiene law is amended by adding a new section 7.42 to read as follows: S 7.42 CHILD PSYCHIATRY ACCESS PROJECT. (A) THE OFFICE SHALL, WITHIN AMOUNTS APPROPRIATED THEREFOR, ESTABLISH OR MAY CONTRACT FOR THE ESTABLISHMENT OF REGIONAL CHILD PSYCHIATRY ACCESS PROJECTS ACROSS THE STATE TO PROVIDE PRIMARY CARE PROVIDERS WITH TIMELY ACCESS TO CHILD PSYCHIATRY CONSULTATIONS IN ORDER TO ASSIST SUCH PRIMARY CARE PROVIDERS IN MEETING THE MENTAL HEALTH NEEDS OF THE CHIL- DREN AND ADOLESCENTS AND THEIR FAMILIES. (B) REGIONAL TEAMS SHALL CONSIST OF A CHILD PSYCHIATRIST WITH APPRO- PRIATE SUPPORT STAFF, AND BE ESTABLISHED TO PROVIDE CHILD PSYCHIATRIC TELEPHONE CONSULTATIONS TO PRIMARY CARE PROVIDERS WITHIN THE DESIGNATED REGION RESULTING IN ONE OF THE FOLLOWING, DEPENDING UPON THE NEEDS OF THE CHILD PATIENT AND/OR FAMILY: 1. RESPONDING TO THE PRIMARY CARE PHYSICIAN'S PATIENT SPECIFIC QUES- TIONS ABOUT BEHAVIORAL HEALTH;EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00731-06-0 A. 4577--B 2
2. ASSISTING THE FAMILY IN ACCESSING ROUTINE, LOCAL BEHAVIORAL HEALTH SERVICES, WITH THE UNDERSTANDING THERE MAY BE A WAITING PERIOD; 3. PROVIDING TRANSITIONAL SUPPORT TO THE CHILD PATIENT AND FAMILY UNTIL THE FAMILY CAN ACCESS ROUTINE, LOCAL BEHAVIORAL HEALTH SERVICES; 4. MAKING REFERRAL TO A TEAM CHILD PSYCHIATRIST FOR AN ACUTE PSYCHO- PHARMACOLOGIC OR DIAGNOSTIC CONSULTATION. (C) REGIONAL TEAMS MAY ALSO PROVIDE MENTAL HEALTH RESOURCE SERVICES, EDUCATIONAL SERVICES, MENTAL HEALTH ADVOCACY AND OTHER RELATED SERVICES TO THE PROVIDER AND MENTAL HEALTH COMMUNITY. (D) CHILD PSYCHIATRY ACCESS SERVICES PROVIDED UNDER THIS SECTION SHALL NOT DISCRIMINATE AGAINST CHILDREN AND FAMILIES, BASED UPON THEIR INSUR- ANCE STATUS, WHEN SUCH SERVICES ARE ACCESSED THROUGH THEIR PRIMARY CARE PROVIDER PRACTICING IN THE REGION. S 2. The tax law is amended by adding a new section 628-a to read as follows: S 628-A. GIFT FOR THE CHILD PSYCHIATRY ACCESS PROJECT. EFFECTIVE FOR ANY TAX YEAR COMMENCING ON OR AFTER JANUARY FIRST, TWO THOUSAND TEN, AN INDIVIDUAL IN ANY TAXABLE YEAR MAY ELECT TO CONTRIBUTE TO THE CHILD PSYCHIATRY ACCESS FUND. SUCH CONTRIBUTION SHALL BE IN ANY WHOLE DOLLAR AMOUNT AND SHALL NOT REDUCE THE AMOUNT OF STATE TAX OWED BY SUCH INDI- VIDUAL. THE COMMISSIONER SHALL INCLUDE SPACE ON THE PERSONAL INCOME TAX RETURN FORM TO ENABLE A TAXPAYER TO MAKE SUCH CONTRIBUTION. NOTWITH- STANDING ANY OTHER PROVISION OF LAW, ALL REVENUES COLLECTED PURSUANT TO THIS SECTION SHALL BE PAID TO THE CHILD PSYCHIATRY ACCESS FUND ESTAB- LISHED PURSUANT TO AND USED ONLY FOR THOSE PURPOSES ENUMERATED IN SECTION EIGHTY-NINE-H OF THE STATE FINANCE LAW. S 3. The state finance law is amended by adding a new section 89-h to read as follows: S 89-H. CHILD PSYCHIATRY ACCESS FUND. 1. A SPECIAL FUND TO BE KNOWN AS THE "CHILD PSYCHIATRY ACCESS FUND" IS HEREBY ESTABLISHED IN THE JOINT CUSTODY OF THE STATE COMPTROLLER AND THE COMMISSIONER OF TAXATION AND FINANCE. 2. THE FUND SHALL CONSIST OF ALL MONEYS TRANSFERRED TO SUCH FUND PURSUANT TO LAW, ALL MONEYS REQUIRED BY ANY PROVISION OF LAW TO BE PAID INTO OR CREDITED TO THE FUND, ALL MONEYS FROM GIFTS PURSUANT TO SECTION SIX HUNDRED TWENTY-EIGHT-A OF THE TAX LAW AND ANY INTEREST EARNINGS WHICH MAY ACCRUE FROM THE INVESTMENT OF MONEYS IN THE FUND. NOTHING CONTAINED IN THIS SECTION SHALL PREVENT THE STATE FROM RECEIVING GRANTS, GIFTS OR BEQUESTS FOR THE PURPOSES OF THE FUND AS DEFINED IN THIS SECTION AND DEPOSITING THEM INTO THE FUND ACCORDING TO LAW. 3. MONEYS OF THE FUND, WHEN ALLOCATED, SHALL BE MADE AVAILABLE TO THE OFFICE OF MENTAL HEALTH SOLELY FOR THE PURPOSE OF ESTABLISHING CHILD PSYCHIATRY PROJECTS PURSUANT TO SECTION 7.42 OF THE MENTAL HYGIENE LAW. 4. MONEYS SHALL BE PAYABLE FROM THE FUND ON THE AUDIT AND WARRANT OF THE COMPTROLLER ON VOUCHERS APPROVED AND CERTIFIED BY THE COMMISSIONER OF MENTAL HEALTH. S 4. This act shall take effect on the ninetieth day after it shall have become a law.