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Mental Health Parity-State of Ohio

OPA supports comprehensive mental health parity.

Insurance plans that are regulated by our state must now provide equal care for physical health problems and a short list of serious mental illness. Other equally significant mental illnesses, such as post traumatic stress disorder (PTSD), alcohol and substance abuse, and autism are not covered under our current state law. The lack of comprehensive parity in our current health care plans reinforces the stigma that has unnecessarily demeaned people with mental health problems for generations.

Forty-two other states have passed mental health parity legislation. Their experience shows that premium costs have not gone up by more than .05-1.9%, and the rate of the uninsured in those states has not been affected either.

OPA supports a comprehensive parity bill because we believe that “medical necessity” determined by a doctor should be the test of whether a diagnosis is covered or not. OPA supports covering alcohol and substance abuse because many addicts became ill after self-medicating for untreated mental illness. Treatment works to bring about recovery and puts people back to work. ( Kentucky and Indiana have this type of parity legislation.)

State Funding for Mental Health Care
OPA supports increased funding for mental health care for children and adults.

Ohio is in a silent crisis with respect to providing adequate mental health treatment for its citizens. County community mental health centers are losing staff, and are overwhelmed with patients. Psychological research indicates that “a stitch in time, saves nine.” Early and consistent psychological treatment prevents problems in the home, school and workplace. Untreated trauma and mental illness leads to increases in criminal and suicidal behavior. The police, prisons, and homeless shelters are left to cope with untreated Ohioans, many of them undereducated and unemployed or veterans who have served our country in wars. By providing adequate mental health services at each step of the life stage, Ohio can support a well-adjusted, well-educated, active workforce.

Prescriptive Authority for Advanced Practice Psychologists
OPA supports prescriptive authority for psychologists with adequate postdoctoral training in psychopharmacology.

In response to serious problems accessing psychiatric services, particularly in rural areas and for minority populations, New Mexico and Louisiana recently passed legislation to allow specially trained medical psychologists to prescribe psychotropic medications (medicines to treat mental illness). In Ohio, adults wait weeks and children wait months to see a psychiatrist for medication, prompting growing interest in similar legislation here. Increasing evidence proves that specially trained psychologists can safely prescribe medication and play a vital role in solving this health care problem. The U.S. Department of Defense conducted successful demonstration programs in which psychologists received significant post-doctoral training and effectively managed patient medication and psychotherapy. These specially trained psychologists actually cut pharmaceutical costs because they balanced medication with psychotherapy. Psychologists with specialized training now prescribe in the Army, AirForce, and Navy as well as the U.S. Public Health and Indian Health Services. Two years masters programs in psychopharmocology are nationally certified and a national exam assures professional standards are met.

Insurance Regulation & Patient Access
OPA supports out of network providers and “any willing provider” legislation.

HMOs (Health Maintenance Organizations) typically restrict the ability of patients to see health care providers by only reimbursing for services of a “network provider.” Most surveys indicate that patients want to choose their own psychologist or other health care professional. With employers shifting from one health plan to another with greater frequency, patients are forced to find new providers and abandon successful treatment programs and providers with whom they have built a trusting relationship. HMOs tout the high quality of providers on their panels, but in truth, they frequently include deceased or retired providers, providers who are not taking new patients, and providers who practice in a given geographic area on a part time basis. HMOs generally determine the proximity of a provider to a geographic area “as the crow flies” and in many areas of Ohio this may mean that providers on a given panel may be a significant distance from patients. Patient access legislation would permit patients to use an out-of-network provider of their choice if the provider is willing to provide service in manner consistent with HMO requirements. The patient would pay an appropriate administrative fee for using a non-network provider.

Another option is “any willing provider” legislation, now enacted in 34 states. Generally, “any willing provider” laws require managed care plans to accept onto it’s provider network any appropriate licensed provider who is willing to accept the plan’s contract terms.