2022 -- H 7801 | |
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LC004978 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2022 | |
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A N A C T | |
RELATING TO INSURANCE -- INSURANCE COVERAGE FOR MENTAL ILLNESS AND | |
SUBSTANCE ABUSE | |
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Introduced By: Representatives Cassar, McGaw, Kislak, Ranglin-Vassell, Diaz, | |
Date Introduced: March 03, 2022 | |
Referred To: House Health & Human Services | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Chapter 27-38.2 of the General Laws entitled "Insurance Coverage for Mental |
2 | Illness and Substance Abuse" is hereby amended by adding thereto the following section: |
3 | 27-38.2-6. Infant and early childhood mental wellness. |
4 | (a) The general assembly hereby finds that: |
5 | (1) Infant and early childhood mental health is defined by zero to three as “the developing |
6 | capacity of the child from birth to five (5) years of age to: form close and secure adult and peer |
7 | relationships, experience, manage and express a full range of emotions, and explore the |
8 | environment and learn -- all in the context of family, community and culture.” |
9 | (2) Significant mental health challenges can and do occur in babies and young children. |
10 | Epidemiological studies show a sixteen percent (16%) to eighteen percent (18%) prevalence rate |
11 | of mental health disorders in children between age one and age six (6). Evidence shows that many |
12 | mental health challenges occurring in the first years of life persist and increase the risk of problems |
13 | related to early learning and development in all areas, and to serious long-term health and mental |
14 | health challenges and poor educational and economic outcomes. |
15 | (3) Young children respond to and process emotional experiences and traumatic events in |
16 | ways that are very different from adults and older children. Consequently, identifying and |
17 | addressing mental health challenges in early childhood requires special skills and knowledge. |
18 | Promoting responsive and nurturing parent/caregiver-child relationships is particularly important |
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1 | for babies and young children. |
2 | (4) It is essential to treat young children’s mental health challenges in the context of their |
3 | relationships within families, homes, and communities. The emotional well-being of young |
4 | children is directly tied to the functioning of their parents/caregivers and the families in which they |
5 | live. Thus, successful mental health treatment for young children involves working to build and |
6 | strengthen consistent, supportive relationships within their families and community. Identifying |
7 | and treating mental health challenges of parents and caregivers, especially maternal depression |
8 | which is a common condition and can negatively impact child development, is also needed. When |
9 | relationships are reliably responsive and supportive and stress is reduced, young children can thrive. |
10 | (5) Diagnostic Classification of Mental Health and Developmental Disorders of Infancy |
11 | and Early Childhood (DC: 0-5) is the only recommended diagnosis system for children under age |
12 | six (6). DC: 0-5 is a system of classification of mental health and developmental disorders for |
13 | infants and toddlers. |
14 | (6) Evidence-based and evidence-informed parent-child dyadic therapies exist that focus |
15 | on the powerful influence of the parent/caregiver-child relationship to positively impact a child’s |
16 | trajectory. Evidence-based interventions aimed at mental health challenges are more effective when |
17 | implemented during early childhood rather than school age. It is a misconception that young |
18 | children will grow out of their difficulties or simply forget early traumatic experiences. |
19 | (7) In Rhode Island, approximately fifty percent (50%) of infants and young children have |
20 | Medicaid health coverage which covers screening, evaluation, diagnosis, and treatment for |
21 | children’s mental health needs starting at birth. Data from 2018 indicate that less than eight percent |
22 | (8%) of the Medicaid population under age six (6) received any mental health services. |
23 | (8) According to the National Center for Children in Poverty, at least twenty-one (21) states |
24 | have adopted research-informed infant/early childhood mental health state policies and scaled |
25 | initiatives. Medicaid policy in at least thirteen (13) states and the District of Columbia recommends |
26 | or requires the use of the developmentally-appropriate DC: 0-5 system for the diagnosis of children |
27 | under age six (6), and at least twelve (12) states require providers to use an evidence-based dyadic |
28 | treatment model for children under age six (6). |
29 | (b) The executive office of health and human services shall establish a task force to develop |
30 | a plan to improve promotion of social and emotional well-being of young children as well as |
31 | screening, assessment, diagnosis, and treatment of mental health challenges for children from birth |
32 | through age five (5) with Medicaid coverage. |
33 | (c) The planning task force shall include representation from the RI Association for Infant |
34 | Mental Health and representatives from pediatric health care, mental health care, child psychiatry, |
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1 | child welfare, Early Intervention, Family Home Visiting, early care and education, advocacy |
2 | organizations, Medicaid Managed Care Organizations, Medicaid Accountable Entities, families |
3 | with young children, and other stakeholders as needed. |
4 | (d) The plan established in accordance with this section shall include strategies to: |
5 | (1) Promote use of developmentally appropriate screening, assessment, diagnosis, and |
6 | evidence-based and evidence-informed parent-child dyadic therapies for children from birth |
7 | through age five (5). |
8 | (2) Identify mental health promotion and prevention-related parenting support programs, |
9 | particularly evidence-based or evidence-informed parent-child programs supporting social and |
10 | emotional well-being. |
11 | (3) Allow for effective screening, evaluation, and treatment over multiple visits with a |
12 | qualified practitioner in a variety of settings, including in children’s homes, at childcare and early |
13 | learning programs, in schools, and in clinical and other professional settings. |
14 | (4) Establish a registry of trained infant/early childhood mental health professionals that |
15 | can be a resource across health care, education, and human service settings. |
16 | (5) Strengthen infant and early childhood mental health skills, knowledge, and practices of |
17 | all providers who work with young children (birth through age five (5)) in health care, mental health |
18 | care, early childhood, and child welfare service sectors. |
19 | (6) Address and respond to the intergenerational effects of racism, economic insecurity, |
20 | and toxic stress that influence the health and mental health of parents/caregivers, babies, and young |
21 | children. |
22 | (e) The task force shall submit a plan to the governor and general assembly on or before |
23 | June 30, 2023. |
24 | SECTION 2. This act shall take effect upon passage. |
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EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO INSURANCE -- INSURANCE COVERAGE FOR MENTAL ILLNESS AND | |
SUBSTANCE ABUSE | |
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1 | This act would establish a state plan to improve the promotion of social and emotional |
2 | well-being of young children as well as screening, assessment, diagnosis and treatment of mental |
3 | health challenges in currently covered Medicaid mental health services for infants and young |
4 | children under the age of six (6). |
5 | This act would take effect upon passage. |
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