Timothy's Law - for Parity-based Mental Health & Chemical Dependency insurance coverage
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December 2006



New Law Requires Health Insurance Policy to Provide
Coverage to Adults and Children with Mental Illness

For Release:
December 22, 2006

Governor George E. Pataki today signed legislation to enact Timothy’s Law, which will require insurance companies to provide coverage for individuals with mental illnesses.

The new law is named after Timothy O’Clair, a 12-year old boy from Schenectady County who had an emotional disorder, but was unable to obtain mental health services under his parent’s health insurance coverage. Timothy completed suicide in March 2001.

“It is vital that our society take care of those in need, especially our most vulnerable children,” Governor Pataki said. “Timothy’s Law is an important step to ensure that mental health services are accessible to all individuals and families, so that they can receive beneficial assistance and treatment for mental illnesses. Insurance coverage serves as a safety net and with this new law, we have extended this protection to children and families across the State.

“I commend the efforts of Tom and Donna O’Clair in helping to get this law enacted. Sharing their experiences and sense of loss was no doubt a difficult task, but through their tireless work and the support of numerous groups and individuals, individuals with mental illnesses will benefit,” the Governor added.

Tom O’Clair, Timothy’s father, said, “On behalf of my family and myself I wish to thank the Governor, the Leaders, and the entire Legislature and staff for their efforts that have made this day possible. I have maintained throughout this effort that this is Timothy’s work. With the timeless efforts of the advocates and supporters, and in Timothy’s name, New York can join some 39 other states in ending the discrimination facing mental illness. What a wonderful way for New Yorkers to celebrate the holidays.”

Senate Majority Leader Joseph L. Bruno said, “Today is a dramatic step forward for those who suffer from mental illness, and a tremendous victory for families throughout New York. I applaud Tom and Donna O’Clair, who have courageously advocated on behalf of this legislation since the loss of their son over five years ago. I thank Governor Pataki for signing this bill today and also Senators Tom Libous and Tom Morahan for their hard work on behalf of Timothy’s Law in the Senate.”

Senator Thomas W. Libous said, “We’ve worked for years to help provide needed insurance coverage to families to prevent future tragedies like Timothy O’Clair’s. I applaud Governor Pataki, Assemblyman Tonko, the O’Clair Family and the many other advocates who fought to get this important compromise bill done.”

Assemblyman Paul D. Tonko, who was the lead sponsor of the legislation in the Assembly, said, “The Governor’s approval formally brings to an end a long fought battle to end discrimination. Timothy’s Law is a victory for working families who require access to and affordability of mental health services. The determination and perseverance of the O’Clair family and their colleagues of the Timothy’s Law Coalition are proof positive that grassroots efforts can inspire fair and just public policy.”

Senator Thomas P. Morahan said, “I am delighted that the Governor is signing Timothy’s Law. This landmark legislation will put mental health treatment on parity with other physical illnesses. As Chairman of the Mental Health Committee and on behalf of the mental health community, I congratulate and thank Governor Pataki.”

Under this new law, which takes effect January 1, 2007, health insurance providers are required to provide comparable insurance coverage for mental illnesses (“parity”) as the policies provide for other medical care. This will allow adults and children with biologically-based mental illnesses to receive the same health care coverage benefits as those provided for other physical ailments.

In a calendar year, the coverage must include at least 30 days of active inpatient (hospital) care, and at least 20 days of active treatment in a facility operated by the State Office of Mental Health (OMH), a psychiatrist or psychologist licensed to practice in New York, or a university faculty practice corporation. The cost of any premiums and deductibles must be consistent with those imposed for other benefits available under the insurance policy.

Insurance coverage for businesses with 50 or more employees must include treatment for schizophrenia/psychotic disorders, major depression, obsessive compulsive disorders, bulimia, anorexia, serious cases of attention deficit disorders in children, disruptive disorders, or pervasive development disorders. In addition, children under 18 years of age are eligible for coverage if they have serious suicidal symptoms or other life-threatening self-destructive behaviors, significant psychotic symptoms, behavior causes by emotional disturbance that place the child at risk of causing personal injury or significant property damage, or behavior caused by emotional disturbances that place the child at substantial risk of removal from the household.

A group insurance purchaser with 50 or fewer employees, such as a small business, will be required to make the parity benefits coverage for mental health services available for purchase upon request. In addition, the law seeks to offset the additional costs that may be placed on such groups by directing the Superintendent of the State Insurance Department to develop and implement a plan to fully cover the costs for these small group insurance purchasers, which will be financed through the State General Fund.

Richard M. Peer, MD, President of the Medical Society of the State of New York, said, “Together Governor Pataki, Senator Bruno, and Speaker Silver have established protections which will ensure that New Yorker’s living with mental illness will receive the care and treatment necessary to address the needs of their medical condition, regardless of whether an insurer considers that condition to be ‘physical’ or ‘mental.’”

OMH Commissioner Sharon E. Carpinello, RN, PhD, said, “Today, we celebrate the life of Timothy O’Clair with the enactment of Timothy’s Law. Building on the unprecedented ‘Achieving the Promise for New York’s Children and Families,’ mental health parity promotes wellness for all New Yorkers. Early intervention and treatment are critical in reducing the disabling and costly effects of serious mental illness for individuals and families. Mental health parity is a significant step in ensuring that children and adults with mental illness have access to the services and supports they need. Recovery from mental illness is possible and does occur. This legislation is another important step forward in helping reduce the stigma and discrimination associated with mental illness.”

Insurance Superintendent Howard Mills said, “This is another in a series of far-reaching steps by Governor Pataki and the legislature to ensure all New Yorkers, and most especially children, have the security of knowing they have health insurance on which they can always depend. The Insurance Department will immediately begin work to fulfill the Governor’s mandate to eliminate any financial impact on small groups.”

The $62 million “Achieving the Promise for New York’s Children and Families” initiative is the single largest investment in new children’s mental health services in New York State history. The initiative consists of a highly interrelated series of fundamental changes in the ways that services are provided, the means through which services are accessed, and profound improvements in clinical quality. Among the programs being funded are: $33 million for the Child and Family Clinic-Plus program, which provides screening and early intervention services for nearly 400,000 children each year; $21.5 million to create 450 new opportunities in the Home and Community-Based Waiver Program, which allows children to be served each year in their homes and with their families; and $450,000 for rural telepsychiatry, expanding access to comprehensive evaluations and consultations in rural health areas.

Timothy’s law would sunset on January 31, 2009.