Kids First: Every fight needs a voice

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When tragedy strikes, the grief can be overwhelming. One way that some people choose to deal with their pain is to try to make something good come out of a horrible situation. That’s what the parents of Timothy O’Clair did when their 12-year-old son died by suicide on March 6, 2001 after mental health benefits provided by their insurance company ran out.

The O’Clair family fought tirelessly for years for New York State to pass a law requiring health insurance policies to provide access to timely and affordable mental health care in the same way they cover physical illness. The legislation, called Timothy’s Law in honor of their son, was finally signed in December 2006.

Timothy’s Law helped to blaze the trail for a much broader federal law that passed two years later which requires health insurers to provide access to mental health care on par with medical and surgical care.

Now, what would you think if I told you that despite these hard-fought state and federal laws, in New York State national insurance companies are continuing to prevent children like Timmy O’Clair from accessing care and that New York State regulators are assisting them in doing so?

This is precisely the case. As health law expert Brian Hufford stated, “Timothy’s Law appears effective. In 2009, the state reported an increase of 4.5 million people with plans promising comprehensive mental health coverage. But that number is almost certainly a mirage.” Hufford goes on to say that New York’s insurance regulator, the Department of Financial Services, has a shallow history of enforcement that suggests it lacks the interest or resources to adequately protect New Yorkers.

One year ago North Shore Child & Family Guidance Center issued the results of a groundbreaking study known as Project Access, which surveyed 650 people across Nassau and Suffolk Counties.

The results revealed conditions similar to what the O’Clair family fought against in the early 2000s and showed that discrimination against people living with mental illness and substance use disorders persist.

An immediate follow-up to the Project Access study exposed the reality: the New York State Department of Financial Service is stonewalling demands to further investigate this civil rights issue.

In a letter to DFS Commissioner Mary Vullo citing the Project Access study, state Senators Todd Kaminsky and Elaine Phillips requested a thorough investigation into the persistent problem New Yorkers were experiencing when trying to access timely and affordable mental health care.

Almost five months later Scott Fischer, executive deputy superintendent for Insurance, a division of DFS, responded in writing to the senators.

Fischer wrote: “DFS’s review of the various networks has confirmed that each of the insurance companies in Long Island exceeds the standards for mental health and substance use providers, for the purpose of the commercial products sold outside of the New York State of Health,” the official health plan marketplace.

In other words, this DFS official is stating that there is no problem and nothing more to do, which is contrary to the evidence.

Fischer’s response belies the reality that DFS does little if anything to verify reports from health insurers indicating that they have adequate networks of providers available to their beneficiaries.

I had the privilege of meeting Timothy O’Clair’s dad Tom at a National Alliance on Mental Illness event in Albany in October.

Tom was the driving force behind the passage of Timothy’s Law. We shared a stage in recognition of our mutual efforts to advocate for effective and enforceable parity laws so insurers do, in fact, cover mental health care the same way they do physical illness.

We spoke briefly. I told him that although I never met his son, I keep Timothy close to my heart in the continued fight. He responded, “Keep doing what you’re doing.”

Although it was only the two of us in this fleeting interchange, I’m sure that Tom’s entreaty was meant for all people of good will that know firsthand the devastating impact of untreated mental illness and addiction. We all must keep fighting so Timothy’s Law is a reality and not just mere words on paper.

To find out how you can join this effort, contact Andrew Malekoff at (516) 626-1971, ext. 302, or email amalekoff@northshorechildguidance.org.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org

 

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