RESOLUTION

WHEREAS, chapter 431M, Hawaii Revised Statutes (HRS), currently requires health insurance policies in the State, with certain exceptions, to include mental health and substance abuse treatment services within their hospital and medical coverage; and

WHEREAS, the specific requirements for mental illness and alcohol and drug abuse treatment benefits are covered in section 431M-4, HRS; and

WHEREAS, consideration should be given to providing coverage for the treatment of mental illness and substance abuse under health care insurance plans, to the same extent that these plans cover treatment for physical illness; and

WHEREAS, ideally, mental health and substance abuse treatment benefits would be determined by medical necessity and standardized criteria for patient placement, admission, discharge, and continuing care, which reflect best practices for mental health and substance abuse treatment, with cost controls achieved as insurers exercise oversight of utilization and the authorization of payment for treatment; and

WHEREAS, section 431M-1, HRS, currently defines "serious mental illness" to mean schizophrenia, schizoaffective disorder, and bipolar mood disorder; and

WHEREAS, S.B. No. 1321, H.D. 1, introduced in the Regular Session of 2003, proposes to amend the definition of "serious mental illness" to also mean delusional disorder, major depression, obsessive compulsive disorder, and dissociative disorder, and to replace "bipolar mood disorder" with "bipolar types I and II"; and

WHEREAS, the proposed amendment in S.B. No. 1321, H.D. 1, may add to the social and financial impacts of chapter 431M with regard to health insurance coverage for mental illness benefits; and

WHEREAS, if S.B. No. 1321, H.D. 1, is enacted, coverage for the treatment of the specified serious mental illnesses under group and government employee health plans will be permanently on par with coverage for the treatment of other covered medical or surgical conditions; and

WHEREAS, parity in coverage for the treatment of alcohol dependency and drug dependency should also be considered; and

WHEREAS, if an analysis of mental health and substance abuse treatment benefits is to be useful, findings must:

WHEREAS, section 23-51, HRS, requires the Legislature to pass a concurrent resolution requesting the Auditor to assess both the social and financial effects of proposed mandated health insurance coverage for specific diseases; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-Second Legislature of the State of Hawaii, Regular Session of 2003, the Senate concurring, that the Auditor is respectfully requested to assess both the social and financial effects of:

BE IT FURTHER RESOLVED that prior to complying with this concurrent resolution that the Auditor clarify insufficient detail which may preclude an accurate assessment of social and financial impacts of proposed mandated coverage for mental health and substance abuse; and

BE IT FURTHER RESOLVED that data collection and analysis include but is not be limited to the Hawaii Medical Service Association and the Kaiser Permanente Medical Care Program; and

BE IT FURTHER RESOLVED that insurers shall separate data according to mental health and substance abuse utilization, and according to treatment utilization by children, adolescents, and adults; and

BE IT FURTHER RESOLVED that data submitted include an analysis of those who have exhausted their mental health or substance abuse treatment benefits, including their two episodes per lifetime treatment limit for substance abuse; and

BE IT FURTHER RESOLVED that the Auditor consult with the Insurance Commissioner, Department of Health, and all interested parties including the Board of Medical Examiners, Board of Psychology, and representatives of insurance carriers, nonprofit mutual benefit associations, health maintenance organizations, public and private providers, consumers, employers, labor organizations, and state agencies that implement policies under chapter 431M, HRS; and

BE IT FURTHER RESOLVED that the Auditor is requested to submit a report of the findings and recommendations to the Legislature no later than 20 days prior to the convening of the Regular Session of 2004; and

BE IT FURTHER RESOLVED that a certified copy of this Concurrent Resolution be transmitted to the Auditor and Director of Health.

Report Title:

Mandatory Coverage for Mental Health and Substance Abuse; Study