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Proposed Gun Changes Could Boost Mental Health Care Access in Maine
01/17/2013   Reported By: Jay Field

As part of his gun violence initiative, President Obama wants to speed up final implementation of a law, requiring insurers to cover mental health and regular medical services the same way. Under the 2008 Mental Health Parity and Addiction Equity Act, group insurers would be forbidden from charging higher co-payments, deductibles and out-of-pocket expenses for services like therapy or substance abuse treatment. Under the Affordable Care Act, the parity law will now apply to everyone. Jay Field has this look at how these coming changes will effect mental health care in Maine.

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Originally Aired: 1/17/2013 5:30 PM
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Tri-County Mental Health Services is the oldest community mental health center in the state. Having the words "Tri-County" in its name has become something of a misnomer - the Lewiston-based organization, founded more than 60 years ago, now serves clients in seven counties with a staff of around 500 psychiatrists, therapists, nurses, nurses practioners, and others.

Catherine Ryder is Tri-County's executive director. "We see over 10,000 people per year and we have about 500 crisis contacts a month. So it's a fairly large agency," she says.

Ryder says patients span the full spectrum, from people with persistent mental illness, to alcoholics and drug addicts, to children and adults in need of outpatient treatment for issues of abuse and neglect. Ryder says it can be a struggle for the staff to get services approved for clients with employer-based or private health insurance plans.

"You know, we work really hard with the individual's insurance provider, sometimes brokering individual contracts for folks, if it's not covered under they're existing plan, based on the need and the fact that we could prevent, for example, a hospitalization with an outpatient intervention," Ryder says. "And many insurance companies have been very responsive to chat. Others not as much."

But in the near future, Ryder's staff may not have to fight quite as hard with the health insurers that cover these kinds of patients.

"As soon as I'm finished speaking here, I'm going to sit at that desk and I will sign a directive giving law enforcement, schools, mental health professionals and the public health community some of the tools they need to help reduce gun violence," President Obama said Wednesday, as he signed a total of 23 Executive Orders at the White House.

Back in 2008, Congress passed a law called the Mental Health and Addiction Equity Act. It requires group health plans to cover mental health benefits the same way they provide coverage for regular medical and surgical care. One order, signed by the president, calls on the administration to finalize the rules needed to implement the mental health parity law.

Mitchell Stein says that's important because of the way the measure works hand in hand with the Affordable Care Act. Stein is policy director for the group Consumers for Affordable Health Care. "What the Affordable Care Act says is that the 2008 law, the federal Mental
Health Parity Act, now applies, basically, to everyone."

Under the Affordable Care Act, mental health and substance services become so-called essential health services. Stein says more people in Maine and across the nation will have access to care, starting in 2014 "when the essential health benefits is required of all insured plans, specifically the individual and small group market."

And it's those plans, says Stein, that have not typically provided benefits for mental health and substance abuse disorders. 





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