The long road to achieving better access to behavioral health care
June 10, 2021
By: Anusha Roy
HB21-1068’s goal is to expand beyond a crisis response model for behavioral health, incorporating more wellness and preventative care.
DENVER — A Colorado bill, HB21-1068, has a goal of expanding beyond a crisis response model for behavioral health care to incorporating more wellness and preventative care.
The bill, now headed to the office of Gov. Jared Polis, aims to change the overall approach to mental health.
Democratic Rep. Dafna Michaelson Jenet is a sponsor of this legislation. In part, she hopes mental check-ups can become routine for Coloradans.
When you go every year for your physical, the same time you schedule your annual mental health wellness exam,” she said.
“We think about physical and mental health very separately,” said Michaelson Jenet. “They are considered opposite sciences. I can pull myself up by my bootstraps, I don’t need to get mental health care. [But] oh, I broke my leg — I have to go the doctor and get a cast.”
The idea would also help people know who to call if they experience depression, stress or anxiety, just like you could call a professional for help with a cough. This would be available to people with insurance, ranging from children to older citizens for a variety of reasons, including marriage counseling, addiction, and therapists.
The conversation about leveling the playing field for physical and mental health care goes back decades.
There are several state laws on the books going as far back as the 1990s, that were then reinforced by the federal government in 2008. More laws were passed at a federal and state level, and a bill passed in 2019 in Colorado to reinforce the laws in existence to make sure state law was aligned with federal law.
So what’s been holding Colorado back from achieving more equality between medical and mental health care?
Vincent Atchity with Mental Health Colorado said simply passing a law doesn’t wave a magic wand and change things.
“Parity is very similar,” he said. “A lot of disparity in the way we manage mental health is associated with historical, traditional discrimination.”
There is also making sure there are enough behavioral health providers and sorting out reimbursements, coupled with a system that’s often set up to intervene during emergencies, not before.
“We have in our society, especially in Colorado, a crisis response model for mental health,” said Michaelson Jenet. “For many kids, the first entry into interaction with a mental health care provider is a suicide attempt and the Children’s emergency room. That’s [a] crisis.”
The hope is the new bill will start to flip that by integrating more preventative and wellness care.
The idea is, for those with insurance, this should be free. So if there is no co-pay with a person’s insurance for a physical, the same should go for the wellness exam.
Because of past laws, follow-up visits should cost the same as physical medical appointments.
“If you have Medicaid it’s important to note you can do this now,” said Michaelson Jenet, “Medicaid says is you have six visits for no reason at all. You don’t need any sort of pre-existing anything. So if you want to call up and say I want to establish care with a mental health care provider you can use one of your visits for that. Start this routine of annual mental health maintenance.”
Also because of past laws, the state division of insurance started looking into four carrier groups last year to review how mental health, behavioral health and substance use disorder care compares to medical and surgical health care, when it comes to network adequacy and development standards; reimbursement rates and policies: pharmacy benefit designs; and financial requirements.
They’ve also received 28 complaints from people when it comes to mental health, behavioral health, and substance abuse disorder care since June of 2020.
The state said the number of complaints is less than on the physical medical side, but believes that’s because not everyone knows their rights and protections when it comes to accessing behavioral health care.