Under New Law, Self-Advocates To Train Police - Disability Scoop
Self-advocates will take a role in training police on interacting
with people who have developmental disabilities under a
first-of-its-kind law.
Maryland Gov. Larry Hogan signed the law Tuesday establishing the Ethan Saylor Alliance for Self-Advocates as Educators.
The new effort, which will operate out of the state’s Department of
Disabilities, will bring together people with intellectual and
developmental disabilities to teach law enforcement officers about the
unique needs of this population.
The legislation is named for Robert Ethan Saylor, a 26-year-old with Down syndrome who died
at the hands of law enforcement in 2013 after being restrained by three
off-duty sheriff’s deputies when he refused to leave a Frederick, Md.
movie theater. Saylor’s death garnered national headlines and sparked calls for better police training.
The new law takes effect July 1. Advocates say they hope other states will enact similar legislation.
“Self-advocates have a voice and we need to listen to them. It’s their life,” Saylor’s mother, Patti Saylor, told WUSA.
Friday, May 15, 2015
Thursday, May 14, 2015
Jeff Grisamore's Lobbying
| LOBID:L003693 | Received Date:1/27/2015 | |||
| Lobbyist's Name | Jeff Grisamore | Registered Through: 12/31/2015 | ||
| Lobbyist's Address | PO Box 800 | Termination Date: | ||
| Lobbyist's Address2 | ||||
| Lobbyist's C/S/Z | Lees Summit, MO 64063 | |||
| Telephone: | (816) 225-5695 | |||
| Telephone (2): | None |
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Cashing in on termed out: Ron Richards’ non-reform bill - St. Louis Business Journal
Cashing in on termed out: Ron Richards’ non-reform bill - St. Louis Business Journal
to be a lobbyist in Jefferson City. Weeks earlier, Grisamore was a state
representative. But as the new legislators were sworn in, Grisamore was
termed limited out, so he decided to lobby. Grisamore isn't alone. He
was the sixth member of his class to register to lobby.
This is known as the
"revolving door." The public frowns on the practice because it appears
that the legislators are cashing in on their public service as they
pursue a potentially lucrative career lobbying. There are bills in both
the House and the Senate aiming to change the laws with regard to
legislative ethics. Floor Leader Ron Richard sponsored the first ethics
bill. It was passed out of the Senate earlier this week. It is an
embarrassingly weak bill. With regard to the revolving door, it would
create a two-year waiting period during which legislators couldn't
lobby. But inexplicably the law would only affect legislators who are
sworn in after January 2017. In other words, none of the current
legislators would have to play by this rule. It's an ethical concern for
those who come after them, not for themselves.
That's just one
aspect of the non-reformism of Richard's bill. Currently, Missouri has
no campaign contribution limits. The voters passed limits in 1994, but
the Legislature quickly overruled that vote. The no-limits system once
seemed excessive, but has now veered into the absurd. Earlier this year,
Rex Sinquefield wrote a $1 million check to Bev Randles for her
lieutenant governor campaign's exploratory committee. Democrats have
insisted that campaign contributions should be part of any ethics reform
package. But Republicans note that when there were limits, it didn't
stop the huge checks. It just split them into pieces and re-routed them.
Sinquefield, for example, started scores of different PACs when there
were campaign limits to accommodate his giving. The Republican solution
has been transparency. As long as voters can find out who is giving and
receiving, they can judge for themselves if they want to re-elect those
politicians.
Cashing in on termed out: Ron Richards’ non-reform bill
Last month Jeff Grisamore registeredto be a lobbyist in Jefferson City. Weeks earlier, Grisamore was a state
representative. But as the new legislators were sworn in, Grisamore was
termed limited out, so he decided to lobby. Grisamore isn't alone. He
was the sixth member of his class to register to lobby.
This is known as the
"revolving door." The public frowns on the practice because it appears
that the legislators are cashing in on their public service as they
pursue a potentially lucrative career lobbying. There are bills in both
the House and the Senate aiming to change the laws with regard to
legislative ethics. Floor Leader Ron Richard sponsored the first ethics
bill. It was passed out of the Senate earlier this week. It is an
embarrassingly weak bill. With regard to the revolving door, it would
create a two-year waiting period during which legislators couldn't
lobby. But inexplicably the law would only affect legislators who are
sworn in after January 2017. In other words, none of the current
legislators would have to play by this rule. It's an ethical concern for
those who come after them, not for themselves.
That's just one
aspect of the non-reformism of Richard's bill. Currently, Missouri has
no campaign contribution limits. The voters passed limits in 1994, but
the Legislature quickly overruled that vote. The no-limits system once
seemed excessive, but has now veered into the absurd. Earlier this year,
Rex Sinquefield wrote a $1 million check to Bev Randles for her
lieutenant governor campaign's exploratory committee. Democrats have
insisted that campaign contributions should be part of any ethics reform
package. But Republicans note that when there were limits, it didn't
stop the huge checks. It just split them into pieces and re-routed them.
Sinquefield, for example, started scores of different PACs when there
were campaign limits to accommodate his giving. The Republican solution
has been transparency. As long as voters can find out who is giving and
receiving, they can judge for themselves if they want to re-elect those
politicians.
Wednesday, May 13, 2015
Are You Shocked That He Is Now A Lobbyist?
Missouri House Speaker Fingered In Sexting Scandal With Intern | Crooks and Liars
Missouri House Speaker Fingered In Sexting Scandal With Intern | Crooks and Liars
I always enjoy stories like this, because the Republicans
are so very hypocritical and don't mind doing really terrible things to
people in the name of Jesus. Via The Kansas City Star:
I always enjoy stories like this, because the Republicans
are so very hypocritical and don't mind doing really terrible things to
people in the name of Jesus. Via The Kansas City Star:
Text messages obtained by The Star reveal a sexually
charged relationship between House Speaker John Diehl and a college
freshman in a Missouri Capitol internship program that shut down
abruptly last month.
The conversations unveil a flirty rapport and suggest an intimacy
between arguably the state’s most influential lawmaker and a young woman
taking some pleasure in a secret association.
The texts show occasional efforts by Diehl and the intern to meet in
person. They range from mundane chatter, about boring meetings and
dreading speeches, to the more sexually suggestive.
Diehl declined to comment. The intern, who has hired an attorney specializing in employment matters, told The Star that the text messages were not real. Meantime, she has told confidants that she had an ongoing relationship with Diehl.
Multiple sources helped The Star confirm that the screenshots of the
texts, which show Diehl’s business cellphone number, originated from the
intern’s smartphone. The text conversations also included photographs
of each of them. And others who know Diehl well said they recognized the
language and tone of the conversations from their own text exchanges
with him.
The discovery of the text messages between Diehl and the intern
follows a decision by Missouri Southern State University to end its
Capitol internship program more than a month prematurely.
Richard Miller, dean of the School of Arts and Sciences at Missouri
Southern, told The Star that the school pulled its four interns out of
the state Capitol this spring after an unspecified incident. Yet Miller,
citing student privacy laws, declined to be more specific about what
led the university to end the internships.
Missouri Southern has held a legislative internship program for the
past 20 years, sending students to the United Nations in New York City
and Washington, D.C.
“This is the first time we have pulled all the interns,” Miller said.
“Usually, when something happens, it is a problem with the interns
themselves, but that was not the situation this year.”
Tuesday, May 12, 2015
Right to record an issue at Missouri hearing on “right-to-work” | PoliticMo
Right to record an issue at Missouri hearing on “right-to-work” | PoliticMo
JEFFERSON CITY, Mo. – As the Missouri Senate prepared for a showdown
on “right-to-work,” people attending a hearing on the bill Monday
engaged in a showdown over another “right”: the right to film.
When reporters and the public arrived at a hearing of the Senate
Small Business, Insurance and Industry Committee, they were told they
could neither film nor record the proceedings. A Senate camera, they
were told, would be recording the hearing “gavel to gavel,” and the
public could obtain a tape of the hearing from them after it was over.
The option to obtain the video later was not enough for a number of
radio journalists who hoped to record audio from the meeting in time to
use it in their broadcast reports. “It’s like standoff at the OK Corral
here right now, press aren’t backing down from access to audio
recording,” said Alexandra Townsend, an organized labor activist who works for AFSCME.
When state Sen. Mike Parson, the committee chairman who has said he
is also seeking the Republican nomination for governor, arrived, he
reneged on the ban on audio recording, but kept in place a policy
banning anyone from filming the hearing or taking a photo.
The Missouri Sunshine Law states that, “a public body shall allow for
the recording by audiotape, videotape, or other electronic means of any
open meeting.” But, Senate rules require anyone wanting to film to
receive permission first, citing a provision in the Sunshine Law that
allows public bodies to “establish guidelines regarding the manner in
which such recording is conducted so as to minimize disruption to the
meeting.”
The Senate rule states that, “persons with cameras, flash cameras,
lights, or other paraphernalia may be allowed to use such devices at
committee meetings with the permission of the Chairman as long as they
do not prove disruptive to the decorum of the committee.”
Parson, in an interview after the hearing, said he has followed the
same camera policy all year: If someone wants footage of his hearing,
they can get it from the Senate.
“As long as the public is aware of everything that goes on, I think
you’re satisfying the right to know what’s going on there,” he said. “As
long as you’re filming it from beginning to end, I’m not sure you’re
taking away anyone’s ability to record — well, you are, but I’m saying
it’s there and anyone can get it.”
In some cases, however, it is not. Last month, the liberal advocacy group Progress Missouri filed a lawsuit against the Senate
in which they claimed the Senate did not provide “gavel to gavel”
footage of committee hearings and had blocked its staffers from filming
the hearings themselves.
Parson said, “if you were cutting out part of it, I’d see more of an
issue,” but said he had no problem barring cameras from the public
meetings if the Senate filmed them entirely. “You can still always come
in as a reporter and write or record — we never stopped any of that,” he
said.
They did, however, stop people from taking photos. At least one person, Grace Haun, another Progress Missouri staff member, had her phone taken away when she refused to stop taking photos of the hearing.
Typically, Senate doormen cite a committee chairman’s discretion when
enforcing rules at hearings. But, Parson said he did not care much
about the cameras.
“There was no phones I asked to be taken today, period. I had no idea
of that,” he said. “We’re in a world of cell phones today, and everyone
probably knows if you’re out somewhere, someone is probably going to
snap a shot of you.”
Amid the controversy Monday and the pending lawsuit, Parson said he would be open to revisiting the issue next year.
JEFFERSON CITY, Mo. – As the Missouri Senate prepared for a showdown
on “right-to-work,” people attending a hearing on the bill Monday
engaged in a showdown over another “right”: the right to film.
When reporters and the public arrived at a hearing of the Senate
Small Business, Insurance and Industry Committee, they were told they
could neither film nor record the proceedings. A Senate camera, they
were told, would be recording the hearing “gavel to gavel,” and the
public could obtain a tape of the hearing from them after it was over.
The option to obtain the video later was not enough for a number of
radio journalists who hoped to record audio from the meeting in time to
use it in their broadcast reports. “It’s like standoff at the OK Corral
here right now, press aren’t backing down from access to audio
recording,” said Alexandra Townsend, an organized labor activist who works for AFSCME.
When state Sen. Mike Parson, the committee chairman who has said he
is also seeking the Republican nomination for governor, arrived, he
reneged on the ban on audio recording, but kept in place a policy
banning anyone from filming the hearing or taking a photo.
The Missouri Sunshine Law states that, “a public body shall allow for
the recording by audiotape, videotape, or other electronic means of any
open meeting.” But, Senate rules require anyone wanting to film to
receive permission first, citing a provision in the Sunshine Law that
allows public bodies to “establish guidelines regarding the manner in
which such recording is conducted so as to minimize disruption to the
meeting.”
The Senate rule states that, “persons with cameras, flash cameras,
lights, or other paraphernalia may be allowed to use such devices at
committee meetings with the permission of the Chairman as long as they
do not prove disruptive to the decorum of the committee.”
Parson, in an interview after the hearing, said he has followed the
same camera policy all year: If someone wants footage of his hearing,
they can get it from the Senate.
“As long as the public is aware of everything that goes on, I think
you’re satisfying the right to know what’s going on there,” he said. “As
long as you’re filming it from beginning to end, I’m not sure you’re
taking away anyone’s ability to record — well, you are, but I’m saying
it’s there and anyone can get it.”
In some cases, however, it is not. Last month, the liberal advocacy group Progress Missouri filed a lawsuit against the Senate
in which they claimed the Senate did not provide “gavel to gavel”
footage of committee hearings and had blocked its staffers from filming
the hearings themselves.
Parson said, “if you were cutting out part of it, I’d see more of an
issue,” but said he had no problem barring cameras from the public
meetings if the Senate filmed them entirely. “You can still always come
in as a reporter and write or record — we never stopped any of that,” he
said.
They did, however, stop people from taking photos. At least one person, Grace Haun, another Progress Missouri staff member, had her phone taken away when she refused to stop taking photos of the hearing.
Typically, Senate doormen cite a committee chairman’s discretion when
enforcing rules at hearings. But, Parson said he did not care much
about the cameras.
“There was no phones I asked to be taken today, period. I had no idea
of that,” he said. “We’re in a world of cell phones today, and everyone
probably knows if you’re out somewhere, someone is probably going to
snap a shot of you.”
Amid the controversy Monday and the pending lawsuit, Parson said he would be open to revisiting the issue next year.
Why is Progress Missouri suing the Missouri Senate? A chat with executive director Sean Nicholson | The Fast Pitch | The Pitch
Why is Progress Missouri suing the Missouri Senate? A chat with executive director Sean Nicholson | The Fast Pitch | The Pitch
Earlier this year, the liberal advocacy group Progress Missouri — we're fans
— provided a noble and important public service that also happened to
be hilarious, when one of its staffers attended a lobbyist-funded dinner
for lawmakers at a Jefferson City country club and photographed and live-streamed House
members cramming saffron sea bass and honey miso chicken into their
jowly faces. It was an illuminating look at how political business is
done in Missouri, a state with some of the loosest ethics laws in the
nation.
The country club dinner was technically a public meeting, which is why
Progress Missouri was allowed in — all public meetings can be filmed and
otherwise documented under Missouri's Sunshine Laws.
But lately, some Missouri state senators have been disregarding these
laws and forbidding Progress Missouri from filming its meetings. This
has been going on since at least the 2014 legislative session, but it
came to a boil last week when Progress Missouri filed a lawsuit against
the Missouri Senate asserting that such restrictions on filming are in
violation of the state's laws. Named in the suit are three state
senators: Sen. Mike Kehoe (R-Jefferson City), Sen. David Sater
(R-Cassville) and Sen. Mike Parson (R-Bolivar).
We recently caught up with Progress Missouri executive director Sean Nicholson to get his side of the story.
The Pitch: So, what ultimately precipitated the lawsuit? Was
it just one instance or the combination of several times being
prohibited from videotaping hearings?
Nicholson: We think our live streams and videos of House and
Senate hearings are really useful public services, because their
proceedings aren’t recorded like floor debate. There’s so much that
happens in these hearings — some of it is great, some of it is
horrifying — but all of it has a bigger impact on our lives than many
Missourians might assume.
Sadly, Missouri senators have been ignoring the Sunshine Law for a few
years now by denying members of the public and the press the simple
ability to film what they’re doing in public meetings. The Missouri
Sunshine Law plainly states
that public bodies, including legislative bodies, “shall allow for the
recording by audiotape, videotape, or other electronic means of any open
meeting.” But some of them really, really, really don’t want the public
to know what they’re doing.
You guys haven't been disruptive in these meetings, correct? You just sit and film?
We sit quietly with a laptop and a webcam or camcorder. Senators
haven’t suggested that we’re disrupting their proceedings — they’ve just
issued blanket statements before or during public hearings.
You name Kehoe, Sater and Parson in the suit. Are they the only
three who have prevented you from filming or are there others? What do
the other legislators in the room do when these guys are trying to boot
Progress Missouri from the room?
Progress Missouri has been denied access to film hearings in the past
by Ron Richard, Scott Rupp and Will Kraus. Last year, former Sen. Nieves
ordered all video and TV cameras out of a public hearing. A few weeks
ago, PoliticMO reported that KRCG reporter Kermit Miller was denied the ability to film a public meeting.
At the same time, some senators, like Kurt Schaefer and Bob Dixon, have
been welcoming, knowing that they have no business restricting public
access to public meetings. We have a lot of concerns about the policies
pushed by Sens. Schaefer and Dixon, but they’ve both been great about
letting the sun shine into their hearings.
Is there a specific topic in these hearings where you get/got most
resistance to videotaping them? In other words, is there a connection
between the idiocy/odiousness of certain bills and the Senate's
heightened desire for privacy in these hearings, in your view?
I don’t get the sense that the denials are related to specific policy
matters. Some of these senators just don’t think the Sunshine Law
applies to them or their committees.
Do you think you guys being booted from these hearings is in any way
retaliation for your shaming many lawmakers at that surf-and-turf
lobbyist dinner earlier this year?
I’m sure a lot politicians in Jefferson City wish we didn’t shine a
light on the ridiculous things they do and say. But the great thing
about the Sunshine Law is that it protects the rights of everyone,
regardless of political persuasion, to know what their government is
doing and to be a part of their government.
Have you communicated with people in other states who have had to
deal with lawmakers banning them from filming open hearings? Is this an
issue in other states or just Missouri, in your experience?
We haven’t heard of any state legislature anywhere trying this hard to keep its public proceedings secret.
Do you think their defense will be that Progress is not a
credentialed member of the media and thus shouldn't be allowed to film?
And what do you think of that defense?
The Sunshine Law is for everyone — you, me and every other Missourian.
There’s nothing in the law (passed by the very same Missouri Senate that
is now blocking public access) that allows for a club membership or
test to be a part of government.
Are there any lawmakers from the KC area who have tried to boot you guys out?
Sen. Will Kraus has denied access in the past, but he allowed cameras in his hearings this year.
Why is Progress Missouri suing the Missouri Senate? A chat with executive director Sean Nicholson
Posted
By David Hudnall
on Mon, Apr 20, 2015 at 10:53 AM
Earlier this year, the liberal advocacy group Progress Missouri — we're fans
— provided a noble and important public service that also happened to
be hilarious, when one of its staffers attended a lobbyist-funded dinner
for lawmakers at a Jefferson City country club and photographed and live-streamed House
members cramming saffron sea bass and honey miso chicken into their
jowly faces. It was an illuminating look at how political business is
done in Missouri, a state with some of the loosest ethics laws in the
nation.
The country club dinner was technically a public meeting, which is why
Progress Missouri was allowed in — all public meetings can be filmed and
otherwise documented under Missouri's Sunshine Laws.
But lately, some Missouri state senators have been disregarding these
laws and forbidding Progress Missouri from filming its meetings. This
has been going on since at least the 2014 legislative session, but it
came to a boil last week when Progress Missouri filed a lawsuit against
the Missouri Senate asserting that such restrictions on filming are in
violation of the state's laws. Named in the suit are three state
senators: Sen. Mike Kehoe (R-Jefferson City), Sen. David Sater
(R-Cassville) and Sen. Mike Parson (R-Bolivar).
We recently caught up with Progress Missouri executive director Sean Nicholson to get his side of the story.
The Pitch: So, what ultimately precipitated the lawsuit? Was
it just one instance or the combination of several times being
prohibited from videotaping hearings?
Nicholson: We think our live streams and videos of House and
Senate hearings are really useful public services, because their
proceedings aren’t recorded like floor debate. There’s so much that
happens in these hearings — some of it is great, some of it is
horrifying — but all of it has a bigger impact on our lives than many
Missourians might assume.
Sadly, Missouri senators have been ignoring the Sunshine Law for a few
years now by denying members of the public and the press the simple
ability to film what they’re doing in public meetings. The Missouri
Sunshine Law plainly states
that public bodies, including legislative bodies, “shall allow for the
recording by audiotape, videotape, or other electronic means of any open
meeting.” But some of them really, really, really don’t want the public
to know what they’re doing.
You guys haven't been disruptive in these meetings, correct? You just sit and film?
We sit quietly with a laptop and a webcam or camcorder. Senators
haven’t suggested that we’re disrupting their proceedings — they’ve just
issued blanket statements before or during public hearings.
You name Kehoe, Sater and Parson in the suit. Are they the only
three who have prevented you from filming or are there others? What do
the other legislators in the room do when these guys are trying to boot
Progress Missouri from the room?
Progress Missouri has been denied access to film hearings in the past
by Ron Richard, Scott Rupp and Will Kraus. Last year, former Sen. Nieves
ordered all video and TV cameras out of a public hearing. A few weeks
ago, PoliticMO reported that KRCG reporter Kermit Miller was denied the ability to film a public meeting.
At the same time, some senators, like Kurt Schaefer and Bob Dixon, have
been welcoming, knowing that they have no business restricting public
access to public meetings. We have a lot of concerns about the policies
pushed by Sens. Schaefer and Dixon, but they’ve both been great about
letting the sun shine into their hearings.
Is there a specific topic in these hearings where you get/got most
resistance to videotaping them? In other words, is there a connection
between the idiocy/odiousness of certain bills and the Senate's
heightened desire for privacy in these hearings, in your view?
I don’t get the sense that the denials are related to specific policy
matters. Some of these senators just don’t think the Sunshine Law
applies to them or their committees.
Do you think you guys being booted from these hearings is in any way
retaliation for your shaming many lawmakers at that surf-and-turf
lobbyist dinner earlier this year?
I’m sure a lot politicians in Jefferson City wish we didn’t shine a
light on the ridiculous things they do and say. But the great thing
about the Sunshine Law is that it protects the rights of everyone,
regardless of political persuasion, to know what their government is
doing and to be a part of their government.
Have you communicated with people in other states who have had to
deal with lawmakers banning them from filming open hearings? Is this an
issue in other states or just Missouri, in your experience?
We haven’t heard of any state legislature anywhere trying this hard to keep its public proceedings secret.
Do you think their defense will be that Progress is not a
credentialed member of the media and thus shouldn't be allowed to film?
And what do you think of that defense?
The Sunshine Law is for everyone — you, me and every other Missourian.
There’s nothing in the law (passed by the very same Missouri Senate that
is now blocking public access) that allows for a club membership or
test to be a part of government.
Are there any lawmakers from the KC area who have tried to boot you guys out?
Sen. Will Kraus has denied access in the past, but he allowed cameras in his hearings this year.
Despite Laws, Mental Health Coverage Often Falls Short - Disability Scoop
Despite Laws, Mental Health Coverage Often Falls Short - Disability Scoop
Under federal law, insurance plans that cover mental health must
offer benefits that are on par with medical and surgical benefits.
Twenty-three states also require some level of parity.
The federal law, approved in 2008, and most of the state ones bar
insurers from charging higher copayments and deductibles for mental
health services. Insurers must pay for mental health treatment of the
same scope and duration as other covered treatments; they can’t require
people to get additional authorizations for mental health services; and
they must offer an equally extensive selection of mental health
providers and approved drugs.
Federal and state regulators have an easy time keeping track of
copayments and deductibles, and insurers typically follow those rules.
Compliance with parity requirements for the actual delivery of medical
services is another story.
The responsibility for enforcing parity laws is divided between the
federal government and the states. Under the federal parity law, states
are supposed to police commercial insurance plans and Medicaid, although
the federal government can step in if it determines states aren’t doing
enough. The federal government is responsible for overseeing
self-insured plans.
But among states, only California and New York consistently enforce
the rules, mental health experts say. As a result, Americans with mental
illness and addictions “don’t have a right to mental health and
addiction treatment that the law promises,” said Emily Feinstein of
CASAColumbia, a nonprofit organization focused on drug addiction.
In a report released last month, the National Alliance on Mental
Illness found that patients seeking mental health services from private
insurers were denied coverage at a rate double that of those seeking
medical services. The report also found that patients encountered more
barriers in getting psychiatric and substance use medications.
One major roadblock is that health insurers usually do not disclose
policies for determining if a treatment is medically necessary. Without
that information, it is difficult for regulators and consumers to
determine whether the denial of coverage is warranted. Although the
federal parity law requires insurers to divulge that information to
patients and doctors upon request, critics and plaintiff attorneys say
insurers are still keeping too much hidden and states aren’t diligent in
forcing disclosure.
“The fact that health plans have not been transparent about approving
or denying care means that providers are flying blind and consumers are
losing out,” said Sita Diehl, director of state policy and advocacy for
the National Alliance on Mental Illness.
Another problem has been the federal government’s long delay in
coming up with regulations to implement the 2008 parity law. The U.S.
Department of Health and Human Services finally issued rules for most
commercial insurance plans at the end of 2013, and they took effect last
July. The final rules for Medicaid managed care plans won’t be in place
before the end of 2016—at the earliest. (Medicaid fee-for-service plans
and Medicare remain exempt from the federal parity law.)
Mental health advocates are hopeful that as the federal rules take
effect for insurance plans issued after July 1, 2014, they will give
regulators a stronger hand in enforcing parity.
The Affordable Care Act also has complicated matters, according to
advocates. Implementing the extensive new health care law so overwhelmed
the states and federal government that ensuring compliance with parity
laws simply got pushed aside.
But some believe the main barrier to enforcement is the same one that
led to inferior mental health benefits in the first place: the stigma
associated with mental illness and addictions.
“I can’t help but feel that the stigma associated with having a
mental health or developmental disability impacts the zeal with which
regulators want to get in on this issue,” said Ele Hamburger, a Seattle
attorney who said she has won more than a half-dozen settlements against
insurers on parity grounds. “That stigma is so widespread.”
New York and California Lead the Way
Two months ago, New York state Attorney General Eric Schneiderman
announced that Beacon Health Options had agreed to a $900,000 settlement
after a state investigation revealed that the company denied coverage
for mental health and substance use services at twice the rate its
affiliated insurers had rejected claims for medical and surgical
services. Beacon administers behavioral health benefits for 2.7 million
New Yorkers.
Schneiderman, a Democrat, has reached settlements in five cases
involving health plans covering a total of 4 million New Yorkers. He is
the exception: No other state attorney general has sought sanctions
against insurers for violating state or federal laws requiring mental
health parity, according to New York officials.
“Obviously, Attorney General Schneiderman is really a hero in terms
of this movement,” said Patrick Kennedy, a former Democratic congressman
from Rhode Island. The Kennedy Forum, which he founded after leaving
Congress in 2011, promotes mental health parity. “If he’s found a
consistent pattern and practice of discrimination in his state, it’s
only logical that there are similar practices in other states in the
country. They can’t just be picking on New Yorkers.”
Other mental health experts agree. “I haven’t seen a lot of evidence of states enforcing parity,” Feinstein said.
According to Kennedy, California and New York are the only states
that consistently enforce mental health parity. Before it authorizes a
health insurance plan to operate in the state, California scrutinizes it
to determine whether its coverage meets parity requirements. Once an
insurer is cleared, state regulators closely monitor it and can impose a
financial penalty if it doesn’t live up to its promises.
Hamburger, the Seattle attorney, said that some of her clients whose
insurance companies denied their mental health or substance use claims
appealed to the state of Washington for help, but did not receive any.
Stephanie Marquis, a spokesman for the Washington insurance
commissioner, said the state was still working on regulations to support
the state parity law in 2014 when the state Supreme Court ruled in
favor of some of Hamburger’s clients. Marquis said the court gave the
state guidance on how it should enforce parity. Now that the state has
its own rules along with the federal ones, Marquis said her office “will
be using the new parity analysis tools we have in place” to evaluate
2016 insurance plans.
Government Advantages
With their superior resources and investigative powers, state
regulators and law enforcement agencies are able to review claims
records and internal company policies in a way that consumers or private
lawyers cannot. Hamburger said that private lawyers can force insurers
to disclose the information through discovery, but that requires a
lawsuit and perhaps months or years of delays for a person who may need
help immediately.
“These laws need to be enforced by government entities because it’s
all about doing comparisons between data sets,” said Lisa Landau, chief
of the New York attorney general’s health care bureau, which brought the
cases against the insurers in New York.
New York passed its state parity law in 2006. By 2011, Landau said,
officials began to notice an alarmingly high number of complaints to the
attorney general’s health hotline regarding the denial of claims by
health insurers for mental health addiction treatments.
Investigators found that some insurers were denying nearly half of
all claims for substance abuse treatment, Landau said. They also
discovered exclusions for some types of treatment for certain mental
illnesses, such as eating disorders. And patients with mental illnesses
were often forced to make a certain number of outpatient visits before
gaining approval to enter a residential facility. That so-called “fail
first” process is nearly unheard of on the medical and surgical side.
Landau said that when her office began its investigations, it looked
around the country to review other states’ enforcement actions. “We
didn’t see any,” she said.
Aside from Beacon Health Options (formerly known as ValueOptions),
Schneiderman has reached settlements with four other health plans:
EmblemHealth and MVP Health Care, both of which subcontracted
administration of mental health and substance use claims to Beacon;
Cigna; and Excellus Blue Cross Blue Shield. Since the settlements,
Landau said, 45 percent of previously rejected mental health and
substance abuse claims have been overturned on appeal.
Under federal law, insurance plans that cover mental health must
offer benefits that are on par with medical and surgical benefits.
Twenty-three states also require some level of parity.
The federal law, approved in 2008, and most of the state ones bar
insurers from charging higher copayments and deductibles for mental
health services. Insurers must pay for mental health treatment of the
same scope and duration as other covered treatments; they can’t require
people to get additional authorizations for mental health services; and
they must offer an equally extensive selection of mental health
providers and approved drugs.
Federal and state regulators have an easy time keeping track of
copayments and deductibles, and insurers typically follow those rules.
Compliance with parity requirements for the actual delivery of medical
services is another story.
The responsibility for enforcing parity laws is divided between the
federal government and the states. Under the federal parity law, states
are supposed to police commercial insurance plans and Medicaid, although
the federal government can step in if it determines states aren’t doing
enough. The federal government is responsible for overseeing
self-insured plans.
But among states, only California and New York consistently enforce
the rules, mental health experts say. As a result, Americans with mental
illness and addictions “don’t have a right to mental health and
addiction treatment that the law promises,” said Emily Feinstein of
CASAColumbia, a nonprofit organization focused on drug addiction.
In a report released last month, the National Alliance on Mental
Illness found that patients seeking mental health services from private
insurers were denied coverage at a rate double that of those seeking
medical services. The report also found that patients encountered more
barriers in getting psychiatric and substance use medications.
One major roadblock is that health insurers usually do not disclose
policies for determining if a treatment is medically necessary. Without
that information, it is difficult for regulators and consumers to
determine whether the denial of coverage is warranted. Although the
federal parity law requires insurers to divulge that information to
patients and doctors upon request, critics and plaintiff attorneys say
insurers are still keeping too much hidden and states aren’t diligent in
forcing disclosure.
“The fact that health plans have not been transparent about approving
or denying care means that providers are flying blind and consumers are
losing out,” said Sita Diehl, director of state policy and advocacy for
the National Alliance on Mental Illness.
Another problem has been the federal government’s long delay in
coming up with regulations to implement the 2008 parity law. The U.S.
Department of Health and Human Services finally issued rules for most
commercial insurance plans at the end of 2013, and they took effect last
July. The final rules for Medicaid managed care plans won’t be in place
before the end of 2016—at the earliest. (Medicaid fee-for-service plans
and Medicare remain exempt from the federal parity law.)
Mental health advocates are hopeful that as the federal rules take
effect for insurance plans issued after July 1, 2014, they will give
regulators a stronger hand in enforcing parity.
The Affordable Care Act also has complicated matters, according to
advocates. Implementing the extensive new health care law so overwhelmed
the states and federal government that ensuring compliance with parity
laws simply got pushed aside.
But some believe the main barrier to enforcement is the same one that
led to inferior mental health benefits in the first place: the stigma
associated with mental illness and addictions.
“I can’t help but feel that the stigma associated with having a
mental health or developmental disability impacts the zeal with which
regulators want to get in on this issue,” said Ele Hamburger, a Seattle
attorney who said she has won more than a half-dozen settlements against
insurers on parity grounds. “That stigma is so widespread.”
New York and California Lead the Way
Two months ago, New York state Attorney General Eric Schneiderman
announced that Beacon Health Options had agreed to a $900,000 settlement
after a state investigation revealed that the company denied coverage
for mental health and substance use services at twice the rate its
affiliated insurers had rejected claims for medical and surgical
services. Beacon administers behavioral health benefits for 2.7 million
New Yorkers.
Schneiderman, a Democrat, has reached settlements in five cases
involving health plans covering a total of 4 million New Yorkers. He is
the exception: No other state attorney general has sought sanctions
against insurers for violating state or federal laws requiring mental
health parity, according to New York officials.
“Obviously, Attorney General Schneiderman is really a hero in terms
of this movement,” said Patrick Kennedy, a former Democratic congressman
from Rhode Island. The Kennedy Forum, which he founded after leaving
Congress in 2011, promotes mental health parity. “If he’s found a
consistent pattern and practice of discrimination in his state, it’s
only logical that there are similar practices in other states in the
country. They can’t just be picking on New Yorkers.”
Other mental health experts agree. “I haven’t seen a lot of evidence of states enforcing parity,” Feinstein said.
According to Kennedy, California and New York are the only states
that consistently enforce mental health parity. Before it authorizes a
health insurance plan to operate in the state, California scrutinizes it
to determine whether its coverage meets parity requirements. Once an
insurer is cleared, state regulators closely monitor it and can impose a
financial penalty if it doesn’t live up to its promises.
Hamburger, the Seattle attorney, said that some of her clients whose
insurance companies denied their mental health or substance use claims
appealed to the state of Washington for help, but did not receive any.
Stephanie Marquis, a spokesman for the Washington insurance
commissioner, said the state was still working on regulations to support
the state parity law in 2014 when the state Supreme Court ruled in
favor of some of Hamburger’s clients. Marquis said the court gave the
state guidance on how it should enforce parity. Now that the state has
its own rules along with the federal ones, Marquis said her office “will
be using the new parity analysis tools we have in place” to evaluate
2016 insurance plans.
Government Advantages
With their superior resources and investigative powers, state
regulators and law enforcement agencies are able to review claims
records and internal company policies in a way that consumers or private
lawyers cannot. Hamburger said that private lawyers can force insurers
to disclose the information through discovery, but that requires a
lawsuit and perhaps months or years of delays for a person who may need
help immediately.
“These laws need to be enforced by government entities because it’s
all about doing comparisons between data sets,” said Lisa Landau, chief
of the New York attorney general’s health care bureau, which brought the
cases against the insurers in New York.
New York passed its state parity law in 2006. By 2011, Landau said,
officials began to notice an alarmingly high number of complaints to the
attorney general’s health hotline regarding the denial of claims by
health insurers for mental health addiction treatments.
Investigators found that some insurers were denying nearly half of
all claims for substance abuse treatment, Landau said. They also
discovered exclusions for some types of treatment for certain mental
illnesses, such as eating disorders. And patients with mental illnesses
were often forced to make a certain number of outpatient visits before
gaining approval to enter a residential facility. That so-called “fail
first” process is nearly unheard of on the medical and surgical side.
Landau said that when her office began its investigations, it looked
around the country to review other states’ enforcement actions. “We
didn’t see any,” she said.
Aside from Beacon Health Options (formerly known as ValueOptions),
Schneiderman has reached settlements with four other health plans:
EmblemHealth and MVP Health Care, both of which subcontracted
administration of mental health and substance use claims to Beacon;
Cigna; and Excellus Blue Cross Blue Shield. Since the settlements,
Landau said, 45 percent of previously rejected mental health and
substance abuse claims have been overturned on appeal.
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