A mental and behavioral health care access bill cleared the Massachusetts House on unanimous vote Thursday, and representatives will now have a little over six weeks to reconcile their plan with its Senate counterpart if they hope to get a final version to Gov. Charlie Baker's desk by the July 31 end of formal legislative sessions.
Rep. Adrian Madaro, the House chair of the Mental Health, Substance Use and Recovery Committee, said communities across Massachusetts "are facing a behavioral health crisis" and the situation has been exacerbated by the COVID-19 pandemic.
"These are issues that affect our families, our loved ones, our neighbors, our friends and disproportionately our youth," Madaro, an East Boston Democrat, said. "We've seen alarming rises in emergency department boarding for mental health concerns, and increasing demand for services without a sufficient workforce to address the need. The situation is compounded by continued disparities and how behavioral health and physical health treatment services are covered."
The bill cleared the House following emotional remarks from Rep. Michael Kushmerek of Fitchburg, who recounted his parents' struggles with mental health and addiction, and the lack of resources available to them.
"Through decades of societal inaction, we have fundamentally failed to address and destigmatize behavioral health," Kushmerek said. "All the while insurance companies have reaped massive profits and while funding behavioral health as if it were a summer camp extracurricular activity."
Nearly one in five Americans has a mental health condition, Kushmerek said, and one in 13 individuals over age 12 experiences a substance use disorder.
The House's vote Thursday comes after the Senate unanimously passed a bill last November aimed at knocking down barriers to mental health care.
The two bills (H 4879, S 2584) share many features in common, which could become the building blocks for a final piece of consensus legislation.
Both would require insurers to cover an annual mental health wellness exam. They each include measures aimed at ensuring compliance with existing mental health parity laws, though the bills differ in their approaches to doing so.
The House and Senate both seek to combat what's known as emergency department boarding, a longstanding problem that reached crisis levels during the COVID-19 pandemic. Patients who are boarding in an emergency room spend hours, days or longer there waiting for a behavioral health bed where they can receive needed care.
Both branches propose creating an online portal that would give providers access to data on patients who are boarding and available psychiatric or substance-use treatment beds.
Madaro said the House bill also aims to focus on addressing youth behavioral health needs. He said it includes workforce recruitment and retention policies, language around implementation of the new national 988 behavioral health hotline and a public awareness campaign around the state's "red flag" law that allows family or household members to request the courts temporarily rescind gun ownership rights of someone believed to be a danger.
The House adopted several amendments before passing its bill, including Rep. Carole Fiola's proposal requiring MassHealth to cover postpartum depression screenings by pediatricians up to a year after a child's birth and Minority Leader Brad Jones' amendment establishing a student stakeholder advisory commission on mental health.
Different House and Senate versions of legislation are often viewed as "competing" bills, and the two branches can at times be far apart on their priorities or approaches. On mental health, leaders in both branches appear to be framing the forthcoming decisions over what makes it into final legislation in a collegial way rather than a competitive one.
Before the House bill emerged, Speaker Ronald Mariano had said that its aim would be to "complement" the Senate's bill and create "a complete mental health program for our citizens in the Commonwealth."
Senate President Karen Spilka on Wednesday said she was "grateful" to the House for advancing a version of the bill and said its release moves the state "one step closer to transforming" its mental health care delivery system.
