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Post Session Legislative
Up-date:
Virginia General Assembly 2004 Regular Session
The 2004 regular session of the Virginia General Assembly adjourned on
Saturday, March 13, 2004. The General Assembly held a so-called VETO
session on April 14, 2004. Several items of legislation of interest to
clinical social workers was signed into law by the Governor. A summary of
each bill signed into law by the Governor appears in an Appendix.
INSURANCE LEGISLATION
Mental Health Parity Reauthorization
SB-44 introduced by Sen. Steve Martin (R-Chesterfield) passed the House and Senate. SB 44 has been signed by the Governor. This measure removes the sunset clause from the mental health parity law that would have caused it to expire this June 30.
For the purposed of this law, “biologically-based mental illnesses” are defined as “disorders of the brain that result in a clinically significant syndrome that substantially limits the person’s functioning.” The specific illnesses defined as biologically-based in the law are: schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, panic disorder, obsessive-compulsive disorder, attention deficit hyperactivity disorder, autism and drug and alcoholism addiction.
This law requires that the limitations on coverage, deductibles, co-payments, and all other provisions of coverage need to be the same for these illnesses as they are for cancer, heart disease or any other illness or condition.
Insurance Legislation Affecting Mental Health and Substance Abuse Coverage
- Del. Lee Ware (R-Powhatan) introduced HB-294 designed to have anorexia and bulimia included in parity insurance coverage because it, also, has a scientifically-proven biological basis. The House Commerce and Labor Committee carried over this measure to the 2005 session so it could be examined and studied by the Special Advisory Commission on Mandated Health Insurance Benefits.
The Special Advisory Commission on Mandated Health Insurance Benefits was created to review any proposed new insurance mandated benefits and make a recommendation to the General Assembly on whether they should be adopted. Membership of the Special Commission includes some legislators, and representatives from the insurance industry, businesses, and health care professionals.
The Commission will consider HB-294 during the spring or summer of 2004 and make a recommendation to the 2005 General Assembly about it. We will keep you informed of when any meetings or hearings on the bill are scheduled.
- HB-322 introduced by Del. Morgan Griffith (R-Roanoke) passed the House and Senate and has been signed by the Governor. This measure would prohibit a health insurer from imposing any retroactive denial of payment or seeking recovery or refund of a previously paid claim unless the carrier specifies in writing the specific claim for which the retroactive denial is to be imposed or the recovery or refund is sought. The insurer would also be required to explain why the claim is being retroactively adjusted.
- Two bills were introduced to allow insurers and HMOs to sell health care policies and plans without all the benefits currently required by law. They were characterized as creating the Consumer Choice Benefits Act to reduce the cost of health insurance. Neither bill passed, although one was carried over to the 2005 session and will be considered in the Senate Commerce and Labor Committee late next fall.
These bills were HB-935 introduced by Del. Danny Marshall (R-Danville) and SB-679 introduced by Sen. Steve Martin (R-Chesterfield). Sen. Martin’s bill was stricken at his request in the Senate Commerce and Labor Committee. Del. Marshall’s bill passed the House 97 – 2, with Del Bob Brink (D-Arlington) and Del. Chris Amundsen (D-Fairfax County) voting against it because they believe mandated benefits are valuable. By the time the bill got to the Senate, more legislators agreed with Dels. Brink and Amundsen, and decided that this bill needed more study.
As introduced, both bills would have included coverage for both the basic mental health and substance abuse benefits, as well as parity coverage. Since there are a number of advocacy groups attempting to have additional currently mandated benefits included in these Consumer Choice proposals, it will be worth our while to watch this bill to ensure that both mental health and substance abuse mandated benefits are preserved if the bill is to progress.
- If HB-1362 were to pass, it would effectively preclude any amendments to expand parity coverage to other illnesses that are determined to be biologically-based until expiration of the moratorium. Thus, the Clinical Society need to decide their level of involved as the Commission considers this measure, also.
Currently, and health care plan that includes a list of approved or preferred providers is required to provide a list of those providers to each insured. SB-618 introduced by Sen. Frank Wagner (R-Virginia Beach) will allow those lists to be transmitted electronically.Mental Health Legislation
- HB-381 was introduced by Del. Scott Lingamfelter (R-Prince William). This measure failed in the House Health, Welfare and Institutions Committee but a vote of 16 – 6. Currently, minors can consent to mental health and substance abuse treatment, as well as some other health care services, as an adult. This means that parental consent is not required for these services. Del. Lingamfelter’s bill would have required public employees (i.e. school, community services boards, health department) to notify parents when they provided these services to a minor. Mental health and substance abuse advocates, as well as advocacy organizations for children, opposed this measure because parental notification will create a barrier to a minor asking for help.
- Del. Vivian Watts (D-Annandale) introduced HB-424 to require the State Board of Social Services to develop special regulations for assisted living facilities that serve people with mental illness or mental retardation. This measure was carried over to the 2005 session in the House Health, Welfare and Institutions Committee.
- Several bills were introduced to clarify how transportation is provided to a person with a mental illness who is in emergency custody and has been temporarily detained for hospitalization to ensure his safety or the safety of others. These bills were HB-570 (Del. Phil Hamilton, R-Newport News); HB-588 and HB-589 (Del. Bill Janis, R-Goochland) and SB-604 (Sen. Bill Bolling, R-Hanover). Since all the bills were designed to achieve the same result, HB-589 is the only one that the General Assembly passed. As passed, this measure provides parameters for specifying which law-enforcement agency must execute emergency custody orders or temporary detention orders and provide transportation of the subjects of such orders. It is the General Assembly’s hope that this bill will resolve disputes and ensure timely transportation.
- A total of four bills were introduced to place additional criteria on methadone clinics that apply for state licensure. Two of the bills merely would have required the state to notify a locality when a new license application was received for that area. These measures were HB-745 introduced by Del. Onzlee Ware (D-Roanoke) and SB-134 introduced by Sen. John Edwards (D-Roanoke). The other two measures proposed restrictions on siting such a clinic near a school or licensed day care center. These bills were SB-607 introduced by Sen. William Wampler (R-Bristol) and SB-312 introduced by Sen. Brandon Bell (R-Roanoke).
Strong advocacy by Sen. Wampler persuaded the General Assembly to adopt both approaches, combine them in his SB-607, and pass the bill. It is interesting to note that northern Virginia is exempted from the provisions of the bill because population density and the resulting many schools would virtually prevent any methadone clinic from locating in Northern Virginia, and the localities in this area want to maintain this as a treatment option for opiate addiction. While other urban areas shared the concerns of northern Virginia, the General Assembly declined to exempt any other areas of the Commonwealth from the restrictive provisions of this bill.
- There were a number of measures introduced that would have amended the state Constitution to make it more predictable for people who committed crimes to have their civil rights restored. All these measures failed in the House of Delegates. These bills were HB-1104 and HJR-204 introduced by Del. Brian Moran (D-Alexandria) and SB-17 and SJR-4 introduced by Sen. Yvonne Miller (D-Norfolk).
SB-93 introduced by Sen. Jeannemarie Devolites (R-McLean) also failed in the House by a vote of 41 – 55 on the floor. This measure would have allowed employers in adult substance abuse treatment programs to hire people convicted of a crime if they were licensed or certified by one of the health regulatory boards.
- Sen. Henry Marsh (D-Richmond) offered legislation (SJR 25) requesting the General Assembly Joint Commission on Health Care to study the mental health needs and treatment of minority young adults. One focus of this study is the assessment of whether mental health treatment is culturally competent in Virginia. If you are interested in following the progress of this study, you can do so through the Joint Commission on Health Care website at http://legis.state.va.us/jchc/jchchome.htm.
Public Mental Health and Substance Abuse Issues
The General Assembly has not reported a budget bill as of Saturday, April 24, 2004. At this time we do not know what initiative the General Assembly and the Governor will approve and fund for community and facility mental health services.
Medicaid Policy and Reimbursement
We have been successful in seeing no reduction in Virginia’s Medicaid rate structure for reimbursement to licensed clinical social workers and other mental health providers. We have had to put off our efforts to seek an increase in Medicaid rates of reimbursement for mental health services due to the Commonwealth’s until the January 2006 legislative session.
Note: The sources of material for this document are: the General
Assembly Legislative Information Internet site; Division of Legislative
Services publications; House of Delegates, Committee on Appropriations;
state Senate Committee on Finance; publications of the Virginian’s for
Mental Health Equity.
Prepared by: Christopher J. Spanos
Government and Public Affairs Counselor for the Greater Washington and
Virginia Societies for Clinical Social Work
SPANOS Consulting Group LLC
For GSCSW Legislative
Information contact:
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Oakton VA 22124
202-537-0007
Fax: 703-938-8389
email: gwscsw@gmail.com
Website http://www.gwscsw.org