Legislature(1997 - 1998)
02/11/1998 09:00 AM Senate HES
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
SCR 14 - PARITY FOR MENTAL HEALTH TASK FORCE
CHAIRMAN WILKEN announced there were five amendments to SCR 14, and
that version H was adopted by the committee at a previous meeting.
SENATOR LEMAN moved to adopt amendment #1. SENATOR ELLIS objected
and asked for an explanation.
TAPE 98-10, SIDE B
SENATOR LEMAN explained amendment #1 splits the tasks to be studied
by the task force into a more understandable order, and more
importantly it requires the task force to identify and define the
unmet mental health needs and then recommend ways to measure the
effectiveness of treatment.
CHAIRMAN WILKEN announced the objection was not maintained,
therefore amendment #1 was adopted.
SENATOR GREEN moved to adopt amendment #2 (labeled H.1). SENATOR
ELLIS objected.
SENATOR GREEN explained that amendment #2 requires the task force
to determine and define the terms "mental disorders," "mental
illness," "serious mental illness," and "mental health consumers"
before undertaking its study. Those phrases are not defined in the
resolution and can be very broad.
SENATOR ELLIS said amendment #2 presumes that those terms are
currently undefined yet they may be in the field, in statute, or in
regulation. SENATOR GREEN said and if that is the case, those
definitions could be used. SENATOR ELLIS clarified that Senator
Green was not asking the task force to redefine those terms.
SENATOR GREEN emphasized the amendment would require the task force
to define those terms for purposes of the work on the report they
produce.
SENATOR ELLIS removed his objection, therefore amendment #2 was
adopted.
SENATOR GREEN moved to adopt amendment #3 (labeled H.2). There
being no objection to the adoption of amendment #3, the motion
carried.
SENATOR LEMAN noted he had no objection to amendment #3, but noted
the number "5" on line 3 should be number "6." SENATOR GREEN
agreed.
SENATOR GREEN moved to adopt amendment #4. SENATOR ELLIS objected.
SENATOR GREEN explained the Mental Health Parity Act of 1996 did
not include chemical dependency disorders. Amendment #4 would
delete the inclusion of chemical dependency disorders from the task
force's study on discrimination in health insurance policies. The
remainder of amendment #4 pertains to the makeup of the task force,
because by narrowing the study, a net of three task force members
would not be necessary. However, to retain an odd number of task
force members, one of the three positions was restored, and she
arbitrarily chose one member who is employed as staff to a member
of Congress simply to have connection with, and access to
information about, mental health parity on the congressional level.
SENATOR GREEN repeated she does not think the task force needs to
go beyond the boundaries of the Mental Health Parity Act by
including chemical dependency disorders.
CHAIRMAN WILKEN commented that amendment #4 eliminates the
inclusion of tasks related to chemical dependency disorders and by
doing so changes the make-up of the task force.
Number 448
DON DAPCEVICH, Executive Director for the State Advisory Board on
Alcoholism and Drug Abuse, testified against Amendment #4. He
stated SCR 14 provides an opportunity to take a look at how
chemical dependency is affecting Alaskans, and to do so at no cost
to the state. The task force will determine whether there is a
cost benefit to including chemical dependency in any changes
considered in the future. If there is no cost benefit, the task
force's recommendations will reflect that. The Mental Health Trust
Authority has offered to share its resources so that the
Legislature will examine their beneficiaries, both mental health
and chemical dependency beneficiaries. Amendment #4 will prevent
any discussion on the issue. Mr. Dapcevich agreed chemical
dependency disorders are not included in the Mental Health Parity
Act of 1996, but an amendment to include it is being introduced
before Congress. Each state taking up the issue of parity is
studying whether chemical dependency disorders should be included.
Mr. Dapcevich emphasized the Alaska Advisory Board on Alcoholism
and Drug Abuse will not know whether to support the issue of parity
unless the task force studies the issue. He strongly encouraged
committee members to reject amendment #4.
SENATOR LEMAN questioned whether there is a way to reword that
section by taking the phrase "chemical dependency disorders" out of
subsection (1), and creating a separate subsection that identifies
the study of the cost benefit relationship of chemical dependency
disorders. He believed it will not hurt to look at the issue and
identify whether there is a cost benefit.
MR. DAPCEVICH thought it would be wise to separate, in the report,
chemical dependency issues from mental health issues. He cautioned
that excluding task force participation of professionals from the
chemical dependency field will provide less than a perfect product
in terms of participants and expertise.
CHAIRMAN WILKEN said his sense is that although there is some
relationship between the two, the issues are different and should
be studied separately. He stated he supports the amendment for
that reason. He asked Mr. Dapcevich why the relationships between
the two cannot be separated.
MR. DAPCEVICH thought the two issues can be separated for
expediency sake, but the Trust Authority does not distinguish
between the beneficiaries, and the parity issues for both groups
are the same. Both have artificial caps on insurance, and the
rationale for exclusion is the same in many cases.
SENATOR GREEN mentioned that the original resolution pertained only
to mental illness. She said she is opposed to summarily saying, by
implication, that substance abuse is mental illness. If substance
abuse leads to mental illness, that needs to be defined in the
definition of mental illness.
SENATOR ELLIS maintained his objection to the adoption of amendment
Ward, Wilken, and Leman voting "yea," and Senator Ellis voting
"nay."
SENATOR LEMAN said that although he voted for the amendment, he
believes Mr. Dapcevich's point is valid. He thought it would be
more useful to have people serve on the task force with expertise
in chemical dependency disorders, than to create two task forces.
CHAIRMAN WILKEN noted SCR 14 has another referral to the Senate
Finance Committee. He asked Senator Leman if he would like to
offer another amendment at the next meeting. SENATOR LEMAN asked
Mr. Dapcevich to provide the committee with a subsection to add
that specifically addresses the cost benefit of parity for chemical
dependency disorders.
Number 398
CHAIRMAN WILKEN said he is very reluctant to include chemical
dependency disorders because he thought it would be more beneficial
to both issues to keep them separate. He announced SCR 14 will be
held until the next meeting on Monday.
CHAIRMAN WILKEN offered amendment #5. SENATOR ELLIS objected.
CHAIRMAN WILKEN explained the prior amendment eliminated chemical
dependency disorders, therefore the annual cost to the state should
be $187,272,000 rather than $432,072,000; and the phrase "annually
costs the state at least" was changed to specify the actual cost in
1996, to be more specific.
SENATOR ELLIS felt the committee's discussion was ironic given the
Senate's strong bipartisan support for Sobriety Awareness Month.
He agreed with Senator Leman's conclusion that the creation of a
second task force to study chemical dependency disorders is
unlikely to occur.
SENATOR LEMAN questioned how Chairman Wilken obtained the 1996
costs. CHAIRMAN WILKEN said he relied on an estimate from the
professionals.
There being no further objection, amendment #5 was adopted.
CHAIRMAN WILKEN announced SCR 14 will be heard again on Monday,
February 16. He adjourned the meeting at 10:18 a.m.
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