Mental Health Parity Task Force
Wednesday, January 13, 1999
Legislative Information Office
716 W. 4th Avenue, Room 220
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
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
9:30 am – 4:30 pm
Morning Agenda Items
I. Call to Order
II. 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
C & S Management Associates
9:30 am – 2:45 pm Task Force Meeting
Call to Order
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
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
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.
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
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
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
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
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
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
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