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General Assembly Raised Bill No. 6461
January Session, 2021
LCO No. 2848
Referred to Committee on HIGHER EDUCATION AND
EMPLOYMENT ADVANCEMENT
Introduced by:
(HED)
AN ACT IMPLEMENTING THE RECOMMENDATIONS OF THE TASK
FORCE REGARDING THE PREVENTION AND TREAT MENT OF
MENTAL ILLNESS AT INSTITUTIONS OF HIGHER EDUCATION.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective July 1, 2021) (a) As used in this section and 1
sections 2 to 5, inclusive, of this act: 2
(1) "Services" or "mental health services" means counseling, therapy, 3
rehabilitation, crisis intervention or emergency services for the 4
screening, diagnosis or treatment of mental illness; 5
(2) "Programs" or "mental health programming" means education, 6
outreach, research or training initiatives aimed at students for the 7
prevention of mental illness, including, but not limited to, poster and 8
flyer campaigns, electronic communications, films, guest speakers, 9
conferences or other campus events; 10
(3) "Institution of higher education" means any institution of higher 11
education in the state, but does not include Charter Oak State College 12 Raised Bill No. 6461
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or any institution of higher education that solely provides programs of 13
higher learning through its Internet web site; and 14
(4) "Mental health crisis" means a condition in which a person 15
requires immediate intervention or medical attention without which 16
such person would present a danger to himself or herself or to others or 17
which renders such person incapable of controlling, knowing or 18
understanding the consequences of his or her actions. 19
(b) Not later than January 1, 2022, each institution of higher education 20
shall establish a campus mental health coalition with representatives 21
from each of its campuses. The campus mental health coalition shall 22
consist of individuals appointed by the president of each institution of 23
higher education who are reflective of the demographics of the student 24
body at such institution, including, but not limited to, at least one 25
member from such institution's (1) administration, (2) counseling 26
services office, if any, (3) health services office, if any, (4) senior and mid-27
level staff, (5) student body, (6) residential life office, if any, (7) faculty, 28
and (8) any other individuals designated by the president. 29
(c) Each institution of higher education shall ensure that every 30
member of the campus mental health coalition is educated about the (1) 31
mental health services and programs offered at each campus by such 32
institution, (2) role and function of the campus mental health coalition 33
at such institution, and (3) protocols and techniques to respond to 34
student mental illness that are receptive to students of diverse race, 35
cultural backgrounds, sexual orientation or gender identity or status as 36
a veteran or service member of the armed forces of the United States. 37
(d) Each campus mental health coalition shall (1) conduct an 38
evaluation every four years of the effectiveness of the mental health 39
services and programs offered by the institution of higher education in 40
accordance with section 2 of this act, (2) review the results of such 41
evaluation and develop a plan to address any weaknesses in such 42
services and programs offered by the institution, and (3) review and 43
recommend improvements to (A) institutional polices regarding 44 Raised Bill No. 6461
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student mental health, (B) the variety of mental health services available 45
to students at the institution, including on-campus services, telehealth 46
services provided in accordance with section 19a-906 of the general 47
statutes or services offered through community-based mental health 48
care providers or emergency mobile psychiatric service providers in 49
accordance with any memorandum of understanding entered into 50
pursuant to section 3 of this act, (C) the quality of mental health services 51
available to students, including recommendations for obtaining 52
accreditation from the International Accreditation of Counseling 53
Services or another nationally or regionally recognized accrediting body 54
for mental health services, and (D) the crisis intervention and 55
management plan established pursuant to section 4 of this act. 56
Sec. 2. (NEW) (Effective July 1, 2021) (a) Not later than January 1, 2022, 57
and every four years thereafter, the executive director of the Office of 58
Higher Education and the Commissioner of M ental Health and 59
Addiction Services, in consultation with an epidemiologist or other 60
specialist with expertise in the study of student mental health, shall 61
jointly (1) develop or approve, and update as necessary, an assessment 62
tool for use by each institution of higher education in evaluating the 63
effectiveness of the mental health services and programs offered at each 64
of the institution's campuses, (2) develop, and update as necessary, 65
guidelines for the implementation of the assessment tool, including a 66
timeline for its completion, and (3) conduct training workshops for the 67
campus mental health coalitions established pursuant to section 1 of this 68
act regarding best practices for the use and completion of the assessment 69
tool. 70
(b) Not later than October 1, 2022, and every four years thereafter, 71
each campus mental health coalition established at each institution of 72
higher education pursuant to section 1 of this act shall (1) conduct an 73
evaluation of the effectiveness of the mental health services and 74
programs offered at each campus by such institution using the 75
assessment tool developed or approved pursuant to subsection (a) of 76
this section, in accordance with the guidelines and training provided by 77
the executive director of the Office of Higher Education and the 78 Raised Bill No. 6461
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Commissioner of Mental Health and Addiction Services, and (2) submit 79
the results of such evaluation to the Office of Higher Education. 80
(c) Not later than thirty days after the receipt of the results of the 81
evaluation conducted pursuant to subsection (b) of this section from 82
each campus mental health coalition, the executive director of the Office 83
of Higher Education shall post such results on the Internet web site of 84
said office and submit a report, in accordance with the provisions of 85
section 11-4a of the general statutes, to the joint standing committee of 86
the General Assembly having cognizance of matters relating to higher 87
education on such results from each institution of higher education. 88
Sec. 3. (NEW) (Effective July 1, 2021) Not later than January 1, 2022, 89
any institution of higher education that lacks resources on campus for 90
the provision of mental health services to students shall enter into and 91
maintain a memorandum of understanding with at least one 92
community-based mental health care provider or, in consultation with 93
the Department of Mental Health and Addiction Services, with an 94
emergency mobile psychiatric service provider for the purpose of 95
providing students access to mental health services on or off campus 96
and assistance to institutions in developing mental health 97
programming. 98
Sec. 4. (NEW) (Effective July 1, 2021) (a) Not later than January 1, 2022, 99
and annually thereafter, each institution of higher education shall 100
establish and update a crisis intervention and management plan for each 101
campus of such institution. Such plan shall include, but not be limited 102
to, (1) a detailed description of the campus-wide response to a mental 103
health crisis, (2) an environmental review of each campus to identify 104
areas that may be improved for the benefit of student mental health, and 105
(3) protocols to ensure campus safety. 106
(b) Not later than January 1, 2022, the governing board of each 107
institution of higher education shall adopt, and update as necessary, a 108
policy regarding student mental health. Such policy shall include, but 109
not be limited to, (1) the types of mental health services and mental 110 Raised Bill No. 6461
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health programming provided to students each academic year, and (2) 111
the availability of and eligibility requirements for mental health leave 112
available to students. 113
(c) Not later than February 1, 2022, and not more than thirty days 114
after the adoption of an updated policy, the governing board of each 115
institution of higher education shall submit, in accordance with the 116
provisions of section 11-4a of the general statutes, to the joint standing 117
committee of the General Assembly having cognizance of matters 118
relating to higher education, the policy adopted pursuant to subsection 119
(b) of this section. 120
Sec. 5. (Effective July 1, 2021) Not later than January 1, 2022, the Board 121
of Regents for Higher Education shall employ a grant writer to identify 122
and apply for available grant funding to implement or improve mental 123
health services and programs offered by the regional community-124
technical colleges to address student mental illness. 125
Sec. 6. Section 38a-477d of the general statutes is repealed and the 126
following is substituted in lieu thereof (Effective January 1, 2023): 127
(a) Each insurer, health care center, hospital service corporation, 128
medical service corporation, fraternal benefit society or other entity that 129
delivers, issues for delivery, renews, amends or continues a health 130
insurance policy providing coverage of the type specified in 131
subdivisions (1), (2), (4), (11) and (12) of section 38a-469 in this state, 132
shall: 133
(1) Make available to consumers, in an easily readable, accessible and 134
understandable format: [, the] 135
(A) The following information for each such policy: 136
[(A)] (i) Any coverage exclusions; 137
[(B) any] (ii) Any restrictions on the use or quantity of a covered 138
benefit, including on prescription drugs or drugs administered in a 139
physician's office or a clinic; 140 Raised Bill No. 6461
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[(C) a] (iii) A specific description of how prescription drugs are 141
included or excluded from any applicable deductible, including a 142
description of other out-of-pocket expenses that apply to such drugs; 143
[(D) the] (iv) The specific dollar amount of any copayment and the 144
percentage of any coinsurance imposed on each covered benefit, 145
including each covered prescription drug; and 146
[(E) information] (v) Information regarding any process available to 147
consumers, and all documents necessary, to seek coverage of a 148
noncovered outpatient prescription drug; and 149
(B) With respect to explanations of benefits issued pursuant to 150
subsection (d) of this section, a statement disclosing that each consumer 151
who is a covered individual and legally capable of consenting to the 152
provision of covered benefits under such policy may specify that such 153
insurer, center, corporation, society or entity, and each third-party 154
administrator, as defined in section 38a-720, providing services to such 155
insurer, center, corporation, society or entity, shall: 156
(i) Not issue explanations of benefits concerning covered benefits 157
provided to such consumer; or 158
(ii) (I) Issue explanations of benefits concerning covered benefits 159
provided to such consumer solely to such consumer; and 160
(II) Use a method specified by such consumer to issue such 161
explanations of benefits solely to such consumer, and provide sufficient 162
space in the statement for such consumer to specify a mailing address 163
or an electronic mail address for such insurer, center, corporation, 164
society, entity or third-party administrator to use to contact such 165
consumer concerning covered benefits provided to such consumer. 166
(2) Make available to consumers a way to determine accurately: 167
(A) [whether] Whether a specific prescription drug is available under 168
such policy's drug formulary; 169 Raised Bill No. 6461
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(B) [the] The coinsurance, copayment, deductible or other out-of-170
pocket expense applicable to such drug; 171
(C) [whether] Whether such drug is covered when dispensed by a 172
physician or a clinic; 173
(D) [whether] Whether such drug requires prior authorization or the 174
use of step therapy; 175
(E) [whether] Whether specific types of health care specialists are in-176
network; and 177
(F) [whether] Whether a specific health care provider or hospital is 178
in-network. 179
(b) (1) Each insurer, health care center, hospital service corporation, 180
medical service corporation, fraternal benefit society or other entity 181
shall make the information and statement required under subsection (a) 182
of this section available to consumers at the time of enrollment and shall 183
post such information and statement on its Internet web site. 184
(2) The Connecticut Health Insurance Exchange, established 185
pursuant to section 38a-1081, shall post links on its Internet web site to 186
such information and statement for each qualified health plan that is 187
offered or sold through the exchange. 188
(c) The Insurance Commissioner shall post links on the Insurance 189
Department's Internet web site to any on-line tools or calculators to help 190
consumers compare and evaluate health insurance policies and plans. 191
(d) (1) Except as provided in subdivision (2) of this subsection, each 192
insurer, health care center, hospital service corporation, medical service 193
corporation, fraternal benefit society or other entity that delivers, issues 194
for delivery, renews, amends or continues a health insurance policy 195
described in subsection (a) of this section, and each third-party 196
administrator, as defined in section 38a-720, providing services to such 197
an insurer, center, corporation, society or entity, shall: 198 Raised Bill No. 6461
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(A) Issue explanations of benefits to consumers who are covered 199
individuals under the policy; and 200
(B) (i) Permit each consumer who is a covered individual under the 201
policy and legally capable of consenting to the provision of covered 202
benefits to specify, in writing, that such insurer, center, corporation, 203
society, entity or third-party administrator issue explanations of 204
benefits concerning covered benefits provided to such consumer solely 205
to such consumer, and specify, in writing, which of the following 206
methods such insurer, center, corporation, society, entity or third-party 207
administrator shall use to issue such explanations of benefits solely to 208
such consumer: 209
(I) Mailing such explanations of benefits to such consumer's mailing 210
address or another mailing address specified by such consumer; 211
(II) Sending such explanations of benefits to such consumer by 212
electronic means, including, but not limited to, electronic mail; or 213
(III) Making such explanations of benefits available to such consumer 214
by electronic means, provided making such explanations of benefits 215
available solely to such consumer by electronic means complies with all 216
applicable federal and state laws and regulations concerning data 217
security, including, but not limited to, 45 CFR Part 160, as amended from 218
time to time, and 45 CFR Part 164, Subparts A and C, as amended from 219
time to time. 220
(ii) Each method specified by a consumer, in writing, pursuant to 221
subparagraph (B)(i) of this subdivision shall be valid until the consumer 222
submits a written specification to the insurer, center, corporation, 223
society, entity or third-party administrator for a different method. Such 224
insurer, center, corporation, society, entity or third-party administrator 225
shall comply with a written specification under this clause or 226
subparagraph (B)(i) of this subdivision, as applicable, not later than 227
three business days after such insurer, center, corporation, society, 228
entity or third-party administrator receives such specification. 229 Raised Bill No. 6461
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(iii) Each insurer, center, corporation, society, entity or third-party 230
administrator that receives a written specification from a consumer 231
pursuant to subparagraph (B)(i) or (B)(ii) of this subdivision, as 232
applicable, shall provide the consumer who made such specification 233
with written confirmation that such insurer, center, corporation, society, 234
entity or third-party administrator received such specification, and 235
advise such consumer, in writing, regarding the status of such 236
specification if such consumer contacts such insurer, center, 237
corporation, society, entity or third-party administrator, in writing, 238
regarding such specification. 239
(2) Each consumer who is a covered individual under a policy 240
described in subsection (a) of this section and is legally capable of 241
consenting to the provision of covered benefits may specify, in writing, 242
that the insurer, center, corporation, society or entity that delivered, 243
issued for delivery, renewed, amended or continued the policy, or a 244
third-party administrator providing services to such insurer, center, 245
corporation, society or entity, not issue explanations of benefits 246
pursuant to subdivision (1) of this subsection if such explanations of 247
benefits concern covered benefits that were provided to such consumer. 248
Such insurer, center, corporation, society, entity or third-party 249
administrator shall not require such consumer to provide any 250
explanation regarding the basis for such consumer's specification, 251
unless such explanation is required by applicable law or pursuant to an 252
order issued by a court of competent jurisdiction. 253
(3) Each insurer, center, corporation, society or entity that delivers, 254
issues for delivery, renews, amends or continues a policy described in 255
subsection (a) of this section, and each third-party administrator 256
providing services to such insurer, center, corporation, society or entity, 257
shall disclose to each consumer who is a covered individual under the 258
policy such consumer's ability to submit specifications pursuant to 259
subdivisions (1) and (2) of this subsection. Such disclosure shall be in 260
plain language and displayed or printed, as applicable, clearly and 261
conspicuously in all evidence of coverage documents, privacy 262
communications, explanations of benefits and Internet web sites that are 263 Raised Bill No. 6461
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maintained by such insurer, center, corporation, society, entity or third-264
party administrator and accessible to consumers in this state. 265
(4) No insurer, center, corporation, society or entity that is subject to 266
this subsection shall require a consumer or policyholder to waive any 267
right to limit disclosure under this subsection as a precondition to 268
delivering, issuing for delivery, renewing, amending or continuing a 269
policy described in subsection (a) of this section to the consumer or 270
policyholder. Nothing in this subsection shall be construed to limit a 271
consumer's or policyholder's ability to request review of an adverse 272
determination. 273
Sec. 7. Section 19a-14c of the general statutes is repealed and the 274
following is substituted in lieu thereof (Effective July 1, 2021): 275
(a) For the purposes of this section, "outpatient mental health 276
treatment" means the treatment of mental disorders, emotional 277
problems or maladjustments with the object of (1) removing, modifying 278
or retarding existing symptoms; (2) improving disturbed patterns of 279
behavior; and (3) promoting positive personality growth and 280
development. Treatment shall not include prescribing or otherwise 281
dispensing any medication which is a legend drug as defined in section 282
20-571. 283
(b) A psychiatrist licensed pursuant to chapter 370, a psychologist 284
licensed pursuant to chapter 383, an independent social worker certified 285
pursuant to chapter 383b or a marital and family therapist licensed 286
pursuant to chapter 383a may provide outpatient mental health 287
treatment to a minor without the consent or notification of a parent or 288
guardian at the request of the minor if (1) requiring the consent or 289
notification of a parent or guardian would cause the minor to reject such 290
treatment; (2) the provision of such treatment is clinically indicated; (3) 291
the failure to provide such treatment would be seriously detrimental to 292
the minor's well-being; (4) the minor has knowingly and voluntarily 293
sought such treatment; and (5) in the opinion of the provider of 294
treatment, the minor is mature enough to participate in treatment 295 Raised Bill No. 6461
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productively. The provider of such treatment shall document the 296
reasons for any determination made to treat a minor without the consent 297
or notification of a parent or guardian and shall include such 298
documentation in the minor's clinical record, along with a written 299
statement signed by the minor stating that (A) [he] the minor is 300
voluntarily seeking such treatment; (B) [he] the minor has discussed 301
with the provider the possibility of involving his or her parent or 302
guardian in the decision to pursue such treatment; (C) [he] the minor 303
has determined it is not in his or her best interest to involve his or her 304
parent or guardian in such decision; and (D) [he] the minor has been 305
given adequate opportunity to ask the provider questions about the 306
course of his or her treatment. 307
(c) [After the sixth session of outpatient mental health treatment 308
provided to a minor pursuant to this section, the provider of such 309
treatment shall notify the minor that the consent, notification or 310
involvement of a parent or guardian is required to continue treatment, 311
unless such a requirement would be seriously detrimental to the minor's 312
well-being. If the provider determines such a requirement would be 313
seriously detrimental to the minor's well-being, he shall document such 314
determination in the minor's clinical record, review such determination 315
every sixth session thereafter and document each such review. If the 316
provider determines such a requirement would no longer be seriously 317
detrimental to the minor's well-being, he shall require the consent, 318
notification or involvement of a parent or guardian as a condition of 319
continuing treatment.] (1) Except as otherwise provided in subdivision 320
(2) of this subsection, a minor may request and receive as many 321
outpatient mental health treatment sessions as necessary without the 322
consent or notification of a parent or guardian. No provider shall notify 323
a parent or guardian of treatment provided pursuant to this section or 324
disclose any information concerning such treatment to a parent or 325
guardian without the consent of the minor. 326
(2) A provider may notify a parent or guardian of treatment provided 327
pursuant to this section or disclose certain information concerning such 328
treatment without the consent of the minor who receives such treatment 329 Raised Bill No. 6461
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provided (A) such provider determines such notification or disclosure 330
is necessary to the minor's well-being, -(B) the treatment provided to the 331
minor is solely for mental health and not for a substance use disorder, 332
and (C) the minor is provided an opportunity to express any objection 333
to such notification or disclosure. The provider shall document his or 334
her determination concerning such notification or disclosure and any 335
objections expressed by the minor in the minor's clinical record. A 336
provider may disclose to a minor's parent or guardian the following 337
information concerning such minor's outpatient mental health 338
treatment: (i) Diagnosis; (ii) treatment plan and progress in treatment; 339
(iii) recommended medications, including risks, benefits, side effects, 340
typical efficacy, dose and schedule; (iv) psychoeducation about the 341
minor's mental health; (v) referrals to community resources; (vi) 342
coaching on parenting or behavioral management strategies; and (vii) 343
crisis prevention planning and safety planning. A provider shall release 344
a minor's entire clinical record to another provider upon the request of 345
the minor or such minor's parent or guardian. 346
(d) A parent or guardian who is not informed of the provision of 347
outpatient mental health treatment for his or her minor child pursuant 348
to this section shall not be liable for the costs of the treatment provided. 349
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2021 New section
Sec. 2 July 1, 2021 New section
Sec. 3 July 1, 2021 New section
Sec. 4 July 1, 2021 New section
Sec. 5 July 1, 2021 New section
Sec. 6 January 1, 2023 38a-477d
Sec. 7 July 1, 2021 19a-14c
Statement of Purpose:
To (1) implement the recommendations of the task force regarding the
prevention and treatment of mental illness at institutions of higher
education, (2) require health insurers to maintain explanations of
benefits as confidential in certain circumstances, and (3) allow minors to Raised Bill No. 6461
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receive more than six outpatient mental health treatment sessions
without the consent of a parent or guardian.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]