From mseereiter at mhanys.org Tue Jul 11 14:49:49 2006 From: mseereiter at mhanys.org (Michael Seereiter) Date: Tue, 11 Jul 2006 14:49:49 -0400 Subject: [Timothy's Team] Timothy's Team Update - Sampling of News Articles Message-ID: <006d01c6a51a$ca332500$3f01a8c0@MHA> Dear Timothy's Law Supporters, While things have been relatively quiet in Albany over the past two weeks, as people try to recuperate from the Legislative Session, preparations are underway to ensure that the Assembly and Senate do pass the legislation they agreed to when they return to Albany, which is expected in September. While this agreement is a huge step forward in the fight to end discrimination in health insurance, there is still much to do. In the coming weeks, we will provide you with information on how you can help convince Governor Pataki to sign this agreement into law. Stay tuned! In the meantime, following are a few articles, editorials, and letters to the editor concerning Timothy's Law. Let's keep the public discussion about Timothy's Law going until its finally signed into law by Governor Pataki. Mental Health Legislation in Albany Became Personal for One Father The New York Times July 4, 2006 By JENNIFER MEDINA 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 . Neither house has actually voted on the legislation, the agreement coming late Friday as the Legislature was adjourning. But Assembly and Senate leaders - including Sen. Thomas Morahan, R-New City, chairman of the Senate Mental Health and Developmental Disabilities Committee - pledge passsage when legislators return to Albany. . The bill will require the signature of Gov. George Pataki, who has not yet reacted to the agreement. . The legislation directs the state Insurance Department "to develop a methodology" to cover small-businesses' costs. That means legislators didn't figure out how to pay for it. . And, most disappointing for the advocates, the legislation does not cover addictions. The agreement puts a two-year time limit on the legislation, requiring the Insurance Department and Office of Mental Health to study its impact. Should the study disprove the sky-is-falling financial implications critics have cited, while demonstrating the life-saving benefits that advocates predict, there will be a chance for improvements. Deal on mental health coverage could kick in Jan. 1 Ithaca Journal June 27, 2006 By Cara Matthews 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: - Insurance companies would have to cover 30 inpatient days and 20 outpatient days of treatment a year for all mental illnesses. - The state would cover the additional cost of premiums for small businesses with 50 or fewer employees. - For larger businesses, there would be unlimited coverage for adults and children with schizophrenia/psychotic disorders, major depression, bipolar disorder, obsessive-compulsive disorder, delusional disorders, panic disorder, bulimia, anorexia and binge eating. - For children under 18, policies would have to cover attention deficit/hyperactivity disorders, disruptive behavior disorder and pervasive developmental disorders. To be eligible, the child would have to be at risk for suicide, serious self-destructive behavior, significant property damage, removal from the home and other problems. - The law would take effect Jan. 1, 2007 and last for three years. - The state would have to analyze the cost and effect of the law. (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 HAVE A FRIEND WHO YOU THINK MIGHT WANT TO JOIN TIMOTHY'S TEAM? Refer A Friend Friend's Name: Friend's Email: Your Name: Your Email: -------------- next part -------------- An HTML attachment was scrubbed... URL: