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.