Fact Sheet - Children`s League of Massachusetts

HD 826 – An Act to Increase Access to
Children’s Mental Health Services
in the Community
What is the purpose of the bill?
This bill requires coverage for community and home-based behavioral health care services
(“Wraparound care”) for children and adolescents with mental health disorders who are covered by
commercial insurance. Currently, these services are only available to children with MassHealth and
their families, through the Children’s Behavioral Health Initiative (CBHI). Families with commercial
insurance either go without these services, or use “secondary MassHealth” to obtain the services.
Why is this bill important?
Approximately one in five children and adolescents experiences symptoms of a diagnosable
mental health disorder each year.
Among children ages 9 to 17, 11 percent experience “significant impairment” and 5 percent
experience “extreme functional impairment.”
Half of all lifetime mental illnesses begin by age 14; three quarters by age 24.
In 2008, the implementation of the Children’s Behavioral Health Initiative (also known as the
Rosie D. Remediation) reflected the recognition that children and adolescents in the
Commonwealth who suffer from mental health disorders needed access to community-based
services to minimize the need for out-of-home placements.
Families who pay for commercial insurance should not need MassHealth in order to get
services for their child. Many families must pay premiums for MassHealth in order to access
CBHI services.
Community-based care can prevent costly out-of-home placements. Commercial insurers
should welcome the opportunity to decrease the need for costly hospitalizations.
The Commonwealth is currently paying for services that could be covered by children’s
commercial insurance plans.
Who would be affected by the change?
This bill would affect private insurers, employees and retirees under the state plan, hospital service
plans and HMOs. Because self-funded plans are regulated by ERISA, they would not be affected by this
new requirement.
335 Chandler Street, Worcester, MA 01602 [email protected]  www.childrensmentalhealthcampaign.org