BILL NUMBER:  S2639A

 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 :

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 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 of the bill adds a new Section 628-a to the Tax Law to
provide for a tax check off for contributions to the child psychiatry
access fund to be included on personal income tax returns beginning in
tax year 2010.

Section three of the bill adds a new section 89-i to establish a child
psychiatry access fund and direct funds to be made available to the
Office of Mental Health to establish child psychiatry projects.

Section four 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 tele-psychiatry 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 arc 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
psycho- pharmacology 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
ongoing 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.

 LEGISLATIVE HISTORY :

2013-14: S.3202 - Referred to mental health and developmental
disabilities
2011-12: S.3434 - Referred to mental health and developmental
disabilities
2009-10: S.187A/A.4577B - Held in Finance, Passed Assembly
2007-08: S.7033A - Veto 0122

 FISCAL IMPLICATIONS :

Self supporting as the bill establishes a tax check off to allow state
income tax filers to donate to the child psychiatry access project
fund.

 EFFECTIVE DATE :
90 days after enactment.