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

     

     Introduced By: Representatives Cassar, McGaw, Kislak, Ranglin-Vassell, Diaz,
Donovan, Cortvriend, Williams, Solomon, and Vella-Wilkinson

     Date Introduced: March 03, 2022

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Chapter 27-38.2 of the General Laws entitled "Insurance Coverage for Mental

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Illness and Substance Abuse" is hereby amended by adding thereto the following section:

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     27-38.2-6. Infant and early childhood mental wellness.

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     (a) The general assembly hereby finds that:

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     (1) Infant and early childhood mental health is defined by zero to three as “the developing

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capacity of the child from birth to five (5) years of age to: form close and secure adult and peer

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relationships, experience, manage and express a full range of emotions, and explore the

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environment and learn -- all in the context of family, community and culture.”

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     (2) Significant mental health challenges can and do occur in babies and young children.

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Epidemiological studies show a sixteen percent (16%) to eighteen percent (18%) prevalence rate

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of mental health disorders in children between age one and age six (6). Evidence shows that many

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mental health challenges occurring in the first years of life persist and increase the risk of problems

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related to early learning and development in all areas, and to serious long-term health and mental

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health challenges and poor educational and economic outcomes.

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     (3) Young children respond to and process emotional experiences and traumatic events in

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ways that are very different from adults and older children. Consequently, identifying and

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addressing mental health challenges in early childhood requires special skills and knowledge.

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Promoting responsive and nurturing parent/caregiver-child relationships is particularly important

 

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for babies and young children.

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     (4) It is essential to treat young children’s mental health challenges in the context of their

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relationships within families, homes, and communities. The emotional well-being of young

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children is directly tied to the functioning of their parents/caregivers and the families in which they

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live. Thus, successful mental health treatment for young children involves working to build and

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strengthen consistent, supportive relationships within their families and community. Identifying

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and treating mental health challenges of parents and caregivers, especially maternal depression

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which is a common condition and can negatively impact child development, is also needed. When

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relationships are reliably responsive and supportive and stress is reduced, young children can thrive.

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     (5) Diagnostic Classification of Mental Health and Developmental Disorders of Infancy

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and Early Childhood (DC: 0-5) is the only recommended diagnosis system for children under age

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six (6). DC: 0-5 is a system of classification of mental health and developmental disorders for

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infants and toddlers.

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     (6) Evidence-based and evidence-informed parent-child dyadic therapies exist that focus

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on the powerful influence of the parent/caregiver-child relationship to positively impact a child’s

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trajectory. Evidence-based interventions aimed at mental health challenges are more effective when

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implemented during early childhood rather than school age. It is a misconception that young

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children will grow out of their difficulties or simply forget early traumatic experiences.

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     (7) In Rhode Island, approximately fifty percent (50%) of infants and young children have

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Medicaid health coverage which covers screening, evaluation, diagnosis, and treatment for

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children’s mental health needs starting at birth. Data from 2018 indicate that less than eight percent

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(8%) of the Medicaid population under age six (6) received any mental health services.

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     (8) According to the National Center for Children in Poverty, at least twenty-one (21) states

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have adopted research-informed infant/early childhood mental health state policies and scaled

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initiatives. Medicaid policy in at least thirteen (13) states and the District of Columbia recommends

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or requires the use of the developmentally-appropriate DC: 0-5 system for the diagnosis of children

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under age six (6), and at least twelve (12) states require providers to use an evidence-based dyadic

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treatment model for children under age six (6).

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     (b) The executive office of health and human services shall establish a task force to develop

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a plan to improve promotion of social and emotional well-being of young children as well as

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screening, assessment, diagnosis, and treatment of mental health challenges for children from birth

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through age five (5) with Medicaid coverage.

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     (c) The planning task force shall include representation from the RI Association for Infant

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Mental Health and representatives from pediatric health care, mental health care, child psychiatry,

 

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child welfare, Early Intervention, Family Home Visiting, early care and education, advocacy

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organizations, Medicaid Managed Care Organizations, Medicaid Accountable Entities, families

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with young children, and other stakeholders as needed.

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     (d) The plan established in accordance with this section shall include strategies to:

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     (1) Promote use of developmentally appropriate screening, assessment, diagnosis, and

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evidence-based and evidence-informed parent-child dyadic therapies for children from birth

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through age five (5).

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     (2) Identify mental health promotion and prevention-related parenting support programs,

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particularly evidence-based or evidence-informed parent-child programs supporting social and

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emotional well-being.

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     (3) Allow for effective screening, evaluation, and treatment over multiple visits with a

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qualified practitioner in a variety of settings, including in children’s homes, at childcare and early

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learning programs, in schools, and in clinical and other professional settings.

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     (4) Establish a registry of trained infant/early childhood mental health professionals that

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can be a resource across health care, education, and human service settings.

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     (5) Strengthen infant and early childhood mental health skills, knowledge, and practices of

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all providers who work with young children (birth through age five (5)) in health care, mental health

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care, early childhood, and child welfare service sectors.

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     (6) Address and respond to the intergenerational effects of racism, economic insecurity,

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and toxic stress that influence the health and mental health of parents/caregivers, babies, and young

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children.

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     (e) The task force shall submit a plan to the governor and general assembly on or before

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June 30, 2023.

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     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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     This act would establish a state plan to improve the promotion of social and emotional

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well-being of young children as well as screening, assessment, diagnosis and treatment of mental

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health challenges in currently covered Medicaid mental health services for infants and young

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children under the age of six (6).

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     This act would take effect upon passage.

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