Mental Health Parity Task Force
Wednesday, January 13, 1999
Meeting Agenda
Legislative Information Office
716 W. 4th Avenue, Room 220
Anchorage, Alaska
8:00 – 9:30 am Task Force Discussions/Business
10:00am – Noon Testimony – Priority given to telephone testimony
Noon – 1:30 pm Lunch
1:30 – 3:30 pm Testimony – Priority given to in-person testimony
3:45 – 5:00 pm Task Force Discussions/Business
5:00 pm Adjourn
General. The Task Force, having studied the various issues
and elements of mental health parity, developed a set of three different
models for initial consideration. All three models have some common
features:
Model 2: Catastrophic Model. The next model would add, in addition to the elements of MHTA noted above, parity with regard to days and visit limits and maximum out-of-pocket expenses.
Model 3: Financial Parity. This model would add, in addition to the elements of the two models noted above, parity with regard to co-insurance, co-payments, and deductibles.
1/13/99, Wednesday In Person Meeting and Public Comment Time included, at the Legislative Information Office in Anchorage for more info, call 272-8216
2/1/99, Monday (tentative) The Task Force Last Meeting
The Task Force terminated on 2/28/99
Alaska Psychiatric Institute, Room 3123
2900 Providence Drive
Anchorage, Alaska
9:30 am – 4:30 pm
Morning Agenda Items
I. Call to OrderII. Review of Data
III. Report Format/Contents Proposal and Discussion
- Alaska Employer/Employee Data
- Insurance Coverage/Number of Lives Covered
- Cost Information – General
VI. Draft Report – Instructions to the Contractor/Distribution
VII. The Next Step/Timetables
VIII. Adjournment
Respectfully Submitted,
Steven Hamilton
C & S Management Associates
9:30 am – 2:45 pm Task Force Meeting
Call to Order
Introductions
Approval of Agenda
Presentation of Work Plan – C & S Management Associates
Information needed by National Contractor
Discussion of Issues
? Definitions used: Mental Disorders versus Seriously Mentally
Ill (SMI)
? Services Covered: Experiences of Other States
? Needed Data (lives covered, description of plans, utilization)
– Approach/Problems
? Mandatory versus Optional Coverage; relationship to parity
Next Steps; agenda items for next meeting
Note: Lunch will be ordered in
In-Person Public Testimony: 3:00 – 5:00 pm
Call-in and In-Person Public Testimony: 7:00 – 9:00 pm
Walter Majoros
Executive Director
Time: 9:30 am. to 2:45 pm Task Force Meeting with Working Lunch
3:00 pm. to
5:00 pm. In-person Public Testimony
7:00 pm. to
9:00 pm. Call-in and In-person Testimony
Mental Health Parity Task Force
Thursday, October 1, 1998
Teleconference Meeting
Minutes
1. Call to Order. The teleconference meeting of the Mental Health
Parity Task Force was called to order at 11:09 am by Representative Gary
Davis, Co-Chair.
2. Attendance. Attending the teleconference were:
Representative Gary Davis, Co-Chair Senator Johnny Ellis
Representative Tom Brice Dr. Cynthia Dodge – Provider
Joe Heueisen – Insurance Industry Pat Murphy – AMHB
Elmer Lindstrom – DHSS Walter Majoros – AMHB
Katsumi Kenaston – Consumer Banarsi Lal – ABADA
Steven Hamilton – C & S Management Associates Sharon Macklin –
Bridges Campaign
Julie Tauriainen – Rep Davis Staff Pat Ryan Clasby – ASHNA
Matt Felix – C & S Management Associates
3. Introductions. Members of the task force, staff, and contractors
introduced themselves briefly before taking up items on the agenda.
4. Review of Services. Steven Hamilton, owner and principal
of C & S Management Associates, reviewed the scope of work and services
to be provided under the contract. Several points of direction were
given by the Task Force:
? Avoid duplication and reinventing; there are many studies that can
provide excellent information and insight. Use existing studies and
verify the experiences of other states to the extent possible.
? Once the Task Force has arrived at a recommendation or series of
recommendations from which legislation can be developed, the contractor
will be expected to support those positions through testimony before legislative
committees.
? In addition to gathering data, special effort should be made by the
contractor to contact providers, consumers, and advocates to obtain qualitative
information regarding the impacts of mental illness and insurance limitations
on people’s lives.
? The contractor will examine the issue of inclusion or exclusion of
substance abuse in any parity recommendations and present information and
data to address parity both with and without substance abuse.
? Coordination with PricewaterhouseCoopers, who are conducting the
national actuarial study, should begin as early as possible to ensure that
the Alaska-specific information and assumptions are conveyed in time for
a meaningful analysis to take place.
? In addition to public comments on the draft report, public testimony
will take place at the first face-to-face meeting, following the completion
of business. This will allow interested members of the public, consumers,
providers, and other stakeholders to comment at the earliest stages of
the project. During this public meeting, priority will be given to
those individuals who have not been contacted and interviewed as key informants.
5. Communications with Contractor. Walter Majoros agreed to act
as primary liaison to the contractors, C & S Management Associates.
Walter will provide contact information for other key individuals, such
as legislative aides, to the contractor. Steve will distribute both
meeting minutes (target 7 days following meetings) and meeting packets
(7 to 10 days prior to meetings) by mail.
6. Verification of Key Policy Issues. Based on the prior two
Task Force Meetings, a set of key policy issues has been developed and
was included as part of the issues to be addressed by the contractor.
The Task Force again reviewed and, in some cases amplified, these issues
during the teleconference:
(a) Definition of Mental Illness – Pat Murphy expressed the hope that
the group not get bogged down in the details of mental illness definitions;
the true issue is parity.
(b) Inclusion or Exclusion of Substance Abuse – Banarsi Lal reiterated
the expectation that the contractor would examine the issue of parity both
with and without substance abuse included and present information to cover
both possibilities to the Task Force.
(c) Definition of Eligible Expenses – Representative Brice asked for
amplification on this issue. Does this define who is a provider?
What services are provided?
(d) Definition of Existing Employer Pool – Considerable discussion
took place regarding potential employers who may or may not be covered
under any proposed parity legislation in Alaska. Examples of such
organizations include State of Alaska employees or municipalities who are
self-insured. Steve indicated that his first step would be to begin
to identify and categorize employers and try to identify insurance coverage
for the various groups.
(e) Mandatory versus Voluntary Coverage
(f) Continuum of Options from Partial to Comprehensive Parity
(g) Analysis of Actuarial Data, including Alaska-specific Information
(h) Consideration of Public Input
(i) Review/Approval of Final Report – Steve recommended a time line
that calls for completion of a draft report by December 31. The working
draft would be distributed to Task Force members during the third week
of December. Upon their direction, the contractor would then distribute
the draft for public comment. The Committee would receive such comment
in written, oral, or testimony format (mid-January meeting). Comments
from the all of the relevant groups and the Task Force would then be integrated
into the report and the final edition distributed.
(j) Development of any Proposed Legislation
(k) Others – Walter indicated that he had added this to ensure that
there were no other major issues not included. With the short time
available for the completion of work, it will be critical to have the relevant
issues identified at the beginning.
7. Options for Public Input. The concept of public testimony
at the next face-to-face meeting was approved. Walter and Steve will
make arrangements.
8. Determination of Future Meetings:
(a) October 26, 1998, 9:30 am(Business Meeting and Public Testimony)
(b) November 24, 1998, Time TBA
(c) January 13, 1999, Time TBA
(d) Teleconference late December; date to be announced
9. Next Meeting Agenda; Details. Walter suggested that he and
Steve work on meeting details and agenda. The Task Force agreed with
this approach.
10. Adjournment. The meeting was adjourned at 12:50 pm.
Respectfully Submitted
Legislative members include Senators John Torgerson and Johnny Ellis, and Representatives Gary Davis and Tom Brice. Co-Chairs of the task force are Representative Gary Davis and Senator John Togerson.
Public sector members are Cynthia Dodge ( Anchorage Psychologist ), Jo Heusisen ( Insurance Broker ), Katsumi Kenaston ( Consumer ), Marianne Burke ( Director of Division of Insurance )
The Mental Health Board rep. Pat Murphy
The Alcoholism and Drug Abuse Board. Loren Jones
Commissioner's designee Elmer A. Lindstrom
Special Assistant to the Commissioner
Note: Walter Majoros is preparing to hire an office staff person
and the location of the office and other details are unknown yet.
By Tanya Iden, Legilslative Assistant to Representative Allen Kemplen
The bill was first referred to two Senate Committees - the Senate Health,
Education and Social Service Committee and the Senate Finance Committee.
On
February 17, 1998 SCR 14 passed the Senate HESS Committee and passed
the Finance
Committee on March 20, 1998. On March 23, 1998 the Senate voted
unanimously in
favor of the Resolution. SCR 14 was then transferred to the House
of
Representatives where it was referred to the House Rules Committee.
On April 8,
1998 the Resolution passed out of the House Rules Committee.
The House of
Representatives voted unanimously in favor of SCR 14 on April 24, 1998
and the
Senate concurred with the bill on April 27, 1998.
SCR 14 was permanently filed as a legislative resolve on May 8, 1998.
Now the task at hand is for the President of the Senate and the Speaker
of the
House to appoint members to the board. Senate President Miller
must appoint two
members of the Senate and Speaker Phillips must appoint two members
of the House
of Representatives. Together they also appoint two members representing
the
insurance industry and two members representing mental health consumers
and
community-based mental health providers. In addition, the Alaska
Mental Health
Board appoints a member to represent them, the Commissioner of the
Department of
Health and Social Services must have a designee, and a representative
of the
state Advisory Board on Alcoholism and Drug Abuse must be chosen.
The Task Force's first job is to define the following terms: mental
disorders,
mental illness, serious mental illness, mental injury, and mental health
consumers. Once this duty is completed the members will study:
1. Differential tretament in health insurance coverage
between a person with
a mental disorder and a person with a physical disorder.
2. Costs of mental health coverage in relation to
other health care
insurance, with special emphasis on parity, and the extent of such
coverage,
including deductables and co-payments, disorders and conditions to
be covered,
and other pertinent issues.
3. Ways to define and quantify unmet mental health
needs in the state and
recommending meaningful ways to measure th efficacy of treatment of
mental
health needs by analyzing possible outcome data collection measures.
4. The positive and negative effects on metal health
consumers if parity for
mental health coverage is mandated in Alaska.
5. The feasibility fo implementing any recommendations
of the task force
through legislation.
6. The effect of the September 30, 2001, sunset
date for the Mental Health
Parity Act of 1996 on the above mentioned issues.
The Alaska Task Force on parity for Mental Health shall provide a report
to the
Legislature and the Governor by January 1, 1999 and the Task Force
is terminated
on February 28, 1999.
Fifteen other states have established laws addressing mental health
parity in
insurance practices. The Task Force is the first step to enacting
permanent
legislation concerning mental health parity. Mental health consumers
should
follow the activities of the Task Force by requesting agendas and minutes
from
meetings. The Task Force may conduct public hearings to
receive testimony
about issues relative to parity for mental health.
A staff person has not been hired yet, but once the Task Force is up
and running
the staff person for the task force would be the appropriate person
to contact
regarding information on meetings and any plans of action. I'll
keep you
posted.