[Timothy's Team] Timothy's Team Update - Sampling of News Articles

[Michael Seereiter]

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

 

 

 

 

 
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