November 19, 2021
The Massachusetts Senate passed the Mental Health ABC Act 2.0: Addressing Barriers to Care (ABC), comprehensive legislation to continue the process of reforming the way mental health care is delivered in Massachusetts, with the goal of ensuring that people get the mental health care they need when they need it. This legislation comes at a time when the Massachusetts State Senate is making landmark investments in mental and behavioral health, including $400 million in American Rescue Plan Act (ARPA) funds to transform the behavioral health sector, with $122 million dedicated to recruiting and retaining nearly 2,000 behavioral professionals.
The Mental Health ABC Act 2.0 is driven by the recognition that mental health is as important as physical health for every resident of the Commonwealth and should be treated as such.
State Senator Susan Moran filed an amendment to operationalize a 988 hotline for mental health crises in the Commonwealth. The federal government created a 988 hotline through the National Suicide Hotline Designation Act of 2020, which allows states to establish a sustainable funding mechanism for 988 crisis response. States are then required to pair the hotline with sustainable crisis response. The Commonwealth has not yet established sustained funding or designated a crisis hotline to provide local response when individuals in crisis call. The amendment will require hotline centers that are linguistically and culturally competent, provide sustainable financing, and creates a commission to review best practices and make recommendations.
“Although we have made great strides in mental health access in Massachusetts, we have to continue driving towards greater access, visibility, and standards of care for mental health in our state. This bill is an incredible effort to address many of the inequities and the amendment will provide crisis intervention services and crisis care coordination to individuals accessing the suicide prevention and behavioral health crisis hotline 24 hours a day, seven days a week. Because reaching out and being able to connect with someone can save a life,” said State Senator Susan L. Moran.
Other provisions in the bill:
Establishes a suicide postvention task force dedicated to addressing the after-effects of a confirmed suicide and requires the Department of Public Health (DPH) to collect data on the physical location of suicides and the number of known attempts made by any person at the same location.
Establishes a special commission to review and make recommendations to remedy administrative burdens to accessing mental health care and behavioral health care services and requires the Office of Behavioral Health Promotion to ascertain the mental health needs of veterans.
Mandates coverage for an annual mental health wellness exam, comparable to an annual physical.
Provides the state with better tools to implement and enforce our parity laws by creating a clear structure for the Division of Insurance to receive and investigate parity complaints to ensure their timely resolution. Other tools include parity enforcement for commercial, state-contracted, and student health insurance plans, greater reporting and oversight of insurance carriers’ mental health care coverage processes and policies, and reasonable penalties and alternative remedies for when an insurance company does not comply with the law.
Senator Moran’s support of ABC 2.0 and filing of the 988-hotline amendment reflect a longstanding prioritization of mental health. Moran hosted a roundtable discussion over the summer, on the boarding crisis with Beth-Israel Deaconess (BID) Plymouth Hospital and Cape Cod Healthcare The forum consisted of medical professionals, public safety, and government officials as well as individuals that have been affected by this inadequacy. Commissioner Brooke Doyle of the Department of Mental Health (DMH) who attended virtually noted the shared concern with the problems and affirmed the commitment of the DMH to working towards providing solutions to the shortages faced by patients. For many adults and children in the grips of a mental health crisis, the fastest way to get help is to go to a hospital emergency department (ED). When they need to be admitted to an inpatient psychiatric unit, it can be days, weeks, or even months before they’re admitted. Meanwhile, the person must often wait in the Emergency Department (ED), receiving little to no psychiatric care. This is referred to as ‘ED boarding’ and it has increased up to 400% since the COVID-19 pandemic began.
“The increasing pressure placed on the mental health system has resulted in over-filled emergency rooms and left those in need of treatment without options. Right now, there is a critical need to immediately expand bedding availability and improve preventative care models,” said Moran.
The bill addresses some of the concerns that were raised at that forum in July by:
Creating an ARPA-funded online portal that enables access to real-time data on and includes a search function that allows health care providers to easily search and find open beds using a number of criteria.
Establishing a complex case resolution panel to help resolve barriers to care for children with complex behavioral health needs and would include representatives from several state and local health and education agencies working together to ensure a child’s behavioral health needs are met in a timely manner.
Requiring all hospital EDs to have a qualified behavioral health clinician available to evaluate and stabilize a person admitted to a hospital ED with a behavioral health presentation during all operating hours.
Directing the Office of the Child Advocate (OCA) to produce an annual report on child ED boarding.
Tasking the Health Policy Commission (HPC) with conducting a statewide pediatric behavioral health assessment every five years to inform future policymaking.
Leveling the playing field for reimbursement to mental health providers by requiring an equitable rate floor for evaluation and management services that is consistent with primary care.
In addition to the mental health forum, Senator Moran secured $10,000 for peer support training and programming at Sandwich Fire Department in the Senate ARPA bill. In the FY 2021 budget, Senator Moran worked to increase spending by $500,000 on supporting mental health for children in childcare settings and $100,000 for clinical support for law enforcement responding to mental health calls.
The bill would create an interim licensure level for Licensed Mental Health Counselors (LMHCs) so that they can be reimbursed by insurance for their services and be eligible for state and federal grant and loan forgiveness programs, further increasing the number of licensed providers able to serve patients. It would also allow clinicians practicing under the supervision of a licensed professional and working towards independent licensure to practice in a clinic setting. This will help to ensure quality training and supervision and encourage clinicians to stay practicing in community-based settings.
Having passed the Senate, the Mental Health ABC 2.0 Act now goes to the House of Representatives for consideration.