Delaware’s First Mental Health Parity Examinations Complete

Regulated health insurers found to be in violation laws of that prohibit discrimination in mental healthcare, $597K in fees assessed

Insurance Commissioner Trinidad Navarro has announced the completion of the first in a series of Mental Health Parity examinations on health insurers in Delaware. Investigations conducted by the Delaware Department of Insurance uncovered thousands of mental health parity violations, resulting in $597,000 in fines thus far. The exams are ongoing and include each of the four major insurers. The department works with each insurer to correct issues and create a less discriminatory environment in the future. The 2018 passage of SB 230 required companies to submit an initial analysis of mental and behavioral health coverage to the department in 2019, after which the department would include compliance reviews in their annual market conduct exams. A high number of violations was expected due to this being the first assessment by the department.

“After an incredibly thorough review, our team identified many changes that needed to be made to improve parity. Today’s announcement shows that there is more work to do to ensure those seeking mental health care can do so without undue expense or difficulty. I will continue to hold insurers accountable to meet our state’s standards,” said Commissioner Navarro. “Each violation incurred a fine, but it also brought about important conversations that will result in action, and insurers have been cooperative throughout the process and are already making improvements. We will be following up with insurers frequently and expecting substantial progress.”

Mental Health Parity laws, which exist both at the state and federal levels, aim to eliminate coverage discrimination between policyholders seeking mental illness or substance abuse care and those seeking physical care. A lack of parity can prevent a person from pursuing needed care due to cost or limited access, or otherwise make it more expensive or more time intensive than medical visits. Department examinations are critical to uncovering parity issues as consumers may not be aware if they are experiencing disparate treatment when seeking substance abuse or mental health care.

“Everyone deserves equal access to equal treatment. Mental Health Parity has been a priority of mine and the Behavioral Health Consortium. I want to thank Commissioner Navarro and his department for conducting these examinations and advocating for persons suffering with mental health and substance use disorder,” said Lt. Governor Bethany Hall-Long. “Everyone should be able to access the level of care required for the duration and intensity of their behavioral health needs. Persons should be able to access treatment based on the acuity and severity of their health condition or recovery needs and should never be denied treatment due to insurance practices driven by cost and quotas. This practice has adversely impacted outcomes for persons suffering with mental health and addiction.”

“Making progress on mental health parity has been a priority for our office for several years,” said Navarro, “but this year has emphasized the importance of this task. COVID-19, and all the stress, isolation, anxiety, and grief that has come with it has amplified the need for mental health care access, while also in many ways destigmatizing utilization of services.”

In general, the violations found in policies and practices revolved around a lack of parity between mental health and medical/surgical procedures, medications and procedure preauthorization requirements. Mental health patients often had to meet higher standards for Non-Quantitative Treatment Limitation (limits on the scope or duration of benefits) than other patients, and pharmacy requirements appeared to differ as well. The companies are working to resolve these differences.


DHSS Sponsors Recovery Events to Raise Awareness of Support for People Living with Mental, Substance Use Disorders

NEW CASTLE (Sept. 2, 2020) – Recognizing September as National Recovery Month, Department of Health and Social Services (DHSS) Secretary Molly Magarik acknowledged the importance of meeting the needs of Delawareans with mental and substance use disorders, especially during the COVID-19 pandemic.

“The pandemic is difficult for all of us emotionally, but none more so than Delawareans struggling with addiction, mental illness or both,” Magarik said. “And with such public health measures as social distancing in place to reduce the spread of COVID-19, we know treatment referrals for individuals with behavioral health issues can be more difficult to access, their recovery plans can be altered, and the actual treatment and recovery supports can look very different than what people are used to receiving. Still, we know that prevention works, treatment is effective, and people do live a long, quality life in recovery. DHSS can provide Delawareans with the resources they need.”

Recovery Month is a national observance sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services. The celebration raises awareness of mental and substance use disorders, celebrates individuals in long-term recovery, and acknowledges the work of prevention, treatment, and recovery support services.

To promote the widespread national observance, DHSS’s Division of Substance Abuse and Mental Health (DSAMH) is sponsoring Recovery Month events. These events support people in recovery and draw attention to critical prevention, treatment, and recovery support services in Delaware. The events, when scheduled, will be added to an online calendar here: https://bit.ly/3fiMnaI

Recognizing the benefit of having trained professionals available to listen and connect Delawareans to care, DSAMH is also promoting the new Delaware Hope Line. The Hope Line is a confidential phone line staffed by a diverse group of professionals dedicated to helping Delawareans cope with stress and meet their behavioral health needs during the coronavirus pandemic. Delawareans can call 1-833-9-HOPEDE (1-833-946-7333). This service is available 24 hours a day, seven days a week. Hope Line specialists provide a variety of resources and information, including behavioral health treatment options available, regardless of insurance or ability to pay.

“DSAMH is here to help Delawareans with behavioral health needs during these extraordinary times,” said Alexis Teitelbaum, DSAMH’s acting director. “Recovery Month offers a chance to celebrate with those in recovery and recognize the dedicated work of our behavioral health care providers throughout the state. There are resources available, and we want to ensure those who are suffering know that help is here.”

For more information, visit, www.HelpIsHereDE.com.


Commissioner Navarro Partners with Aquila to Distribute Overdose Medication

Will provide Naloxone kits and training at Seaford event

Insurance Commissioner Trinidad Navarro, the Town of Seaford, and Aquila Behavioral Health of Delaware have joined forces to deliver life-saving overdose reversal medication to residents on July 27 from 4:00 to 6:00PM at Williams Pond Park. Free opioid rescue kits provided by the Division of Public Health, will be distributed car-side to attendees along with trainings of how the product should be used. Each kit has two doses of Naloxone.

“I am proud to join Aquila in offering life-saving overdose reversal kits to residents. For individuals who are facing the struggle of addiction, or those who have family members or friends in this fight, a naloxone kit is a must-have. For those in this situation, having naloxone on hand is like having an airbag in your vehicle – we hope that you won’t need to use it, but it is important to have one because it could save a life” said Commissioner Navarro.

Coverage for mental health has been a priority of the Commissioner. Efforts include working with the General Assembly and insurers to require coverage for serious mental illnesses including addiction, creating Mental Health Parity and Addiction Equity Act reporting requirements, and ensuring that medication-assisted treatment for those with drug and alcohol dependencies can be accessible.

The event comes as the Delaware is seeing increased overdose rates during the coronavirus pandemic, with 39 suspected overdose deaths in May, tying the highest monthly total. As of the end of May, 160 suspected overdose deaths have occurred in Delaware, a 60% increase over a similar period of 2019.

“Aquila is pleased to partner with the Insurance Commissioner and the Town of Seaford to ensure Naloxone gets into the hands and homes of all individuals who may need it to keep their loved ones safe – we know that nobody chooses addiction, and by making this opioid reversal drug available, we can give individuals another chance to get treatment. Thank you to Public Health for continuing to provide these kits to the community,” said Amy Kevis, Director of Development for Aquila Behavioral Health of Delaware. Aquila provides comprehensive psychiatric and substance abuse treatment statewide. Learn more by calling (302) 999-1106.

The Division of Substance Abuse and Mental Health launched the 24/7 Hope line to serve as a single point of contact for resources, info, clinical and peer support, and crisis assistance. If you or a loved one are struggling with substance abuse, do not wait, find help today. Call 1-833-9-HOPEDE or visit HelpisHereDE.com.

Any residents having problems obtaining insurance approval for treatment or prescriptions related to substance abuse or mental health needs, contact the Delaware Department of Insurance’s Consumer Services Division by emailing consumer@delaware.gov or calling (302) 674-7300.

Event attendees and media representatives must observe social distancing and wear a face covering.


Sussex County Bridge Clinic to Help Individuals, Families Impacted by Mental Illness, Opioid Use Disorder

NEW CASTLE (July 11, 2019) – As a new support for individuals and families impacted by the effects of mental health and substance use issues, the Division of Substance Abuse and Mental Health (DSAMH) officially will open the Sussex County Bridge Clinic on July 15 at the Promise Access Center in Georgetown, providing screening and referrals to treatment, as well as additional services. The Sussex County clinic joins a similar clinic in New Castle County, which opened in March near New Castle.

The Sussex County Bridge Clinic, which is open from 8:30 a.m. to 4 p.m. Monday through Friday, is available to all Delaware residents at the Thurman Adams State Service Center, 546 S. Bedford St., Georgetown. The clinic’s services, which do not require an appointment, include:

  • Screening and referrals to treatment.
  • Evaluations conducted by qualified, licensed clinicians.
  • Guidance navigating the care network.
  • Training for administering naloxone, an overdose-reversal medication.
  • Transportation to and from the facility may be available.
  • All services made available regardless of ability to pay.

“In opening this Sussex County Bridge Clinic, we are providing rapid access to qualified clinicians who can help individuals and their families to understand what type of treatment is needed for loved ones and how to engage with the treatment system,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a practicing family physician. “For too many Delaware families in the throes of a behavioral health crisis, they can be overwhelmed simply by trying to navigate the system. The Bridge Clinic provides an in-person starting point.”

Secretary Walker said the opening of the new clinic helps to engage high-risk populations in treatment, one of four main recommendations from a team of researchers and clinicians at the Johns Hopkins Bloomberg School of Public Health. In April 2017, Secretary Walker asked Johns Hopkins to conduct a review of Delaware’s addiction treatment system. In July 2018, the Johns Hopkins team issued a 33-page report that proposed four main strategies:

  • Increase the capacity of the treatment system.
  • Engage high-risk populations in treatment.
  • Create incentives for quality care.
  • Use data to guide reform and monitor progress.

“Our bridge team leads with care and commitment,” said DSAMH Director Elizabeth Romero. “Persistence is a core principle, and they will never give up helping a client along their journey to recovery.”

For more information, call the Sussex County Bridge Clinic at 302-515-3310.

To reach the New Castle County Bridge Clinic at 14 Central Ave., New Castle (just off U.S. 13), call 302-255-1650.


Governor Carney signs “Mental Health Parity” Legislation

Senate Bill 230 addresses first recommendation of Behavioral Health Consortium’s Action Plan

WILMINGTON, Del. – Governor John Carney on Wednesday signed Senate Bill 230 beside members of the General Assembly, Lieutenant Governor Bethany Hall-Long and the Behavioral Health Consortium, and other mental health and addiction advocates.

“I am proud to sign this bill into law, a concrete step to assist Delawareans dealing every day with mental illness and drug and alcohol dependency,” said Governor John Carney. “This legislation recognizes that mental health and drug or alcohol dependency benefits should be treated the same as medical benefits. Thank you to Lieutenant Governor Bethany Hall-Long for her leadership on this issue with the Behavioral Health Consortium, and to all of the advocates who helped with this legislation.”

Senate Bill 230, also known as Mental Health Parity, is a critical step to eliminating coverage discrimination in Delaware and mandating certain reporting requirements that will allow the state to determine if health insurance carriers and Medicaid managed care organizations are applying treatment limitations which may prevent someone from accessing care for their addiction or mental illness. The legislation will help ensure compliance with the Mental Health Parity and Addiction Equity Act, passed by United States Congress in 2008, in order to ensure fair access to behavioral health treatment and making sure that those who need help can receive it.

“For far too long, people struggling with addiction and mental illness have not been treated fairly when it comes to getting the quality health care they need and deserve,” said Lt. Governor Hall-Long. “That ends now. This legislation is an important step to knocking down the barriers to treatment and eliminating stigma. I am thrilled we are enacting the first recommendation of the Behavioral Health Consortium’s Three Year Action Plan today.”

Lt. Governor Hall-Long, and members of the consortium, worked closely with former U.S. Representative Patrick Kennedy on this legislation.

“I applaud Governor Carney for signing Senate Bill 230, which represents a major step forward in ending coverage discrimination against those with mental health and addiction challenges in Delaware,” said Patrick Kennedy, Founder of the Kennedy Forum. “Make no mistake: This new law will save lives. By forcing health plans to submit proof of their compliance with parity laws, Senate Bill 230 shifts the burden back to insurance companies and away from families in crisis. I would particularly like to thank Lieutenant Governor Hall-Long, whom I worked closely with on this bill, for her outstanding leadership, as well as Representative Bentz, Senator Townsend, and Senator Henry for helping to expand access to treatment.”

Senate Bill 230 requires health insurance issuers to complete an initial analysis, and submit a report to the Department of Insurance and the Delaware Health Information Network.

“Mental health and substance abuse disorders are among the greatest public health challenges that our country and our state face,” said Senator Bryan Townsend, prime sponsor of Senate Bill 230. “It’s important for our entire health care system, from public policy to commercial insurance, to respond to that challenge by demonstrating that we value mental health just as much as physical health and that parity is a standard we take seriously in Delaware. I’m thankful to the Lt. Governor for her advocacy on this issue and to Gov. Carney for signing this bill into law.”

“The Behavioral Health Consortium gives us the opportunity to take a deep dive into Delaware’s challenges as they relate to behavioral and mental health. I thank Lt. Gov Hall-Long for her leadership on these issues,” said Representative David Bentz. “Senate Bill 230 was a collaborative effort that increases reporting of insurance coverage for mental and behavioral health in an effort to help us get a clear picture of the care in our state. Addiction is a disease – like cancer or heart disease – and we should be doing what we can to combat it and help those who struggle.”

Stakeholders, such as the Ability Network of Delaware and NAMI Delaware, were also heavily involved in the passage of this legislation.

“Ultimately, real parity breaks down the final barrier to stigma,” said Carolyn Petrak, Associate Executive Director of the Ability Network of Delaware.  “When insurers cover mental health and substance use disorders in an unbiased measure and those seeking treatment need not weigh the cost maybe then, the barriers that stigma creates start to crumble.”

“Already there is significant stigma about mental health conditions. Only about half of the 1 in 5 Americans affected by mental illness seek treatment each year,” said Anne Slease, Director of Advocacy & Education for the National Alliance on Mental Illness (NAMI) in Delaware. “Overcoming the stigma is a big obstacle. Paying the bill shouldn’t have to be.”

Click HERE for photos from the bill signing.

 

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