In New Hampshire, with its 424-person legislative body (the fourth largest in the world behind the British and Indian Parliaments and the U.S. Congress), there are always a number of bills introduced each year that would affect the delivery of mental health care in the state. Bills are introduced for any number of reasons by legislators – from responses to angry constituents to bills they feel would smooth the way for first-responders to do their jobs – and each must be looked at closely by those who would be affected.
Currently, the New Hampshire legislature is looking at a number of bills relevant to mental health professionals. From a bill to limit restraints used on children to another offering guidance on how psychotropic drugs are administered, there is much for the New Hampshire Psychological Association (NHPA) and for individual psychologists to address with local legislators.
When asked to choose the top three issues they felt should concern the state’s mental health professionals, NHPA’s executive director and lobbyist Kathryn Saylor, PsyD, chose the following:
Mental Health Parity
House Bill 1493 is an “act to establish a committee to study comprehensive mental health parity.” The bill is currently in the Commerce and Consumer Affairs committee and is not yet scheduled for a public hearing or floor vote.
This bill is designed to take a closer look at other state parity laws to “determine the best comprehensive coverage for New Hampshire.” The committee would also look at a review of costs and benefits, whether the law should include all clinical diagnoses and include self-funded health plans, mandate plans to have mental health coverage or require companies with more than 25 employees to provide mental health coverage.
“Right now we have parity in New Hampshire,” said Saylor, “but it is fairly limited at this point. We are looking to craft something similar to what Vermont has, a fully comprehensive parity package.”
Mental Health and Disabilities Database
House Bill 1599 is an act to establish a database of mentally ill or developmentally disabled people for the state police to access in an emergency. The bill has been labeled as “inexpedient to legislate,” meaning that it was not recommended to go forward to a vote.
The bill was created to “better protect persons with certain mental illnesses and developmental disabilities by providing law enforcement officers … with immediate access to information that will assist them in recognizing and assisting such individuals in times of crisis.”
Although this bill is basically dead, Saylor felt that it is important to be aware that this is the type of thing that can be introduced.
“That was something we took a look at and took a hard stand on,” Saylor said. “It is dead, but it is an important one.”
Insurance issues for Small Businesses
Although it’s not strictly within the realm of mental illness care, the issue of health insurance for small businesses was one that both Saylor and NHPA President Steven Atkins, Psy.D., agreed should be considered top priority on any story about New Hampshire legislative issues. The three bills in question would have large ramifications for many N.H. psychologists, who basically run small businesses.
The first bill, House Bill 1431, was deemed “inexpedient to legislate” in committee but would have allowed individuals to purchase insurance over state lines. The second, HB 1545, concerns the deletion of the use of group size by insurance companies when they set premiums for small employer health care coverage. This bill is currently listed as “in committee” with the House Commerce and Consumer Affairs committee.
The third bill, SB 408, is in the Senate Commerce, Labor and Consumer Protection Committee. It would establish a law to govern “alliances… for the purposes of purchasing health insurance.” The bill was designed to make it easier and more affordable for employers to reduce costs by joining forces with other, similar, businesses to purchase insurance as a larger group.
For the New Hampshire Psychological Association, whose legislative arm is charged with keeping track of the various bills introduced throughout the year, advocacy can be a daunting job. Some bills might have good intentions, but be poorly designed to work in the real world. Others may benefit one area of the mental health profession but end up being detrimental to others.
With such a large task at hand, it makes sense to mobilize the immense, grass-roots power of the voices of psychologists across the state. The NHPA has received a grant from the American Psychological Association to offer advocacy trainings at the NHPA Spring Convention, scheduled for April 30/May 1. Another training session will take place in Oct. at its Fall Conference.
“We believe that we know more about social policy and so it is time we showed up for the dance,” said Atkins. “We need to be able to talk to these legislators who make a big $100 a year for all they do. They do not need to be abused or attacked but instead we can say, ‘here’s what we know about our profession.’ We need to move towards a civil discussion of what New Hampshire needs to do to protect those who can’t advocate for themselves.”
For more information on getting involved in advocacy, contact the NHPA at 603-225-9925 or nhpaonline.org.