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General Assembly Substitute Bill No. 6461
January Session, 2021
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
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 Substitute Bill No. 6461
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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 have been developed with consideration 35
given to the students' race, cultural background, sexual orientation or 36
gender identity or status as a veteran or service member of the armed 37
forces of the United States. 38
(d) Each campus mental health coalition shall (1) conduct an 39
evaluation every four years of the effectiveness of the mental health 40
services and programs offered by the institution of higher education in 41
accordance with section 2 of this act, (2) review the results of such 42
evaluation and develop a plan to address any weaknesses in such 43
services and programs offered by the institution, and (3) review and 44
recommend improvements to (A) institutional polices regarding 45
student mental health, (B) the variety of mental health services available 46
to students at the institution, including on-campus services, telehealth 47
services provided in accordance with section 19a-906 of the general 48 Substitute Bill No. 6461
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statutes, or services offered through community-based mental health 49
care providers or emergency mobile psychiatric service providers in 50
accordance with any memorandum of understanding entered into 51
pursuant to section 3 of this act, (C) the quality of mental health services 52
available to students, including recommendations for obtaining 53
accreditation from the International Accreditation of Counseling 54
Services or another nationally or regionally recognized accrediting body 55
for mental health services, and (D) the crisis intervention and 56
management plan established pursuant to section 4 of this act. 57
Sec. 2. (NEW) (Effective July 1, 2021) (a) Not later than January 1, 2022, 58
and every four years thereafter, the executive director of the Office of 59
Higher Education and the Commissioner of Mental Health and 60
Addiction Services, in consultation with an epidemiologist or other 61
specialist with expertise in the study of student mental health, shall 62
jointly (1) develop or approve, and update as necessary, an assessment 63
tool for use by each institution of higher education in evaluating the 64
effectiveness of the mental health services and programs offered at each 65
of the institution's campuses, (2) develop, and update as necessary, 66
guidelines for the implementation of the assessment tool, including a 67
timeline for its completion, and (3) conduct training workshops for the 68
campus mental health coalitions established pursuant to section 1 of this 69
act regarding best practices for the use and completion of the assessment 70
tool. 71
(b) Not later than October 1, 2022, and every four years thereafter, 72
each campus mental health coalition established at each institution of 73
higher education pursuant to section 1 of this act shall (1) conduct an 74
evaluation of the effectiveness of the mental health services and 75
programs offered at each campus by such institution using the 76
assessment tool developed or approved pursuant to subsection (a) of 77
this section, in accordance with the guidelines and training provided by 78
the executive director of the Office of Higher Education and the 79
Commissioner of Mental Health and Addiction Services, and (2) submit 80
the results of such evaluation to the Office of Higher Education. 81 Substitute Bill No. 6461
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(c) Not later than thirty days after the receipt of the results of the 82
evaluation conducted pursuant to subsection (b) of this section from 83
each campus mental health coalition, the executive director of the Office 84
of Higher Education shall post such results on the Internet web site of 85
said office and submit a report, in accordance with the provisions of 86
section 11-4a of the general statutes, to the joint standing committee of 87
the General Assembly having cognizance of matters relating to higher 88
education on such results from each institution of higher education. 89
Sec. 3. (NEW) (Effective July 1, 2021) Not later than January 1, 2022, 90
any institution of higher education that lacks resources on campus for 91
the provision of mental health services to students shall enter into and 92
maintain a memorandum of understanding with at least one 93
community-based mental health care provider or, in consultation with 94
the Department of Mental Health and Addiction Services, with an 95
emergency mobile psychiatric service provider for the purpose of 96
providing students access to mental health services on or off campus 97
and assistance to institutions in developing mental health 98
programming. 99
Sec. 4. (NEW) (Effective July 1, 2021) (a) Not later than January 1, 2022, 100
and every four years thereafter, each institution of higher education 101
shall establish or update a crisis intervention and management plan for 102
each campus of such institution. Such plan shall include, but not be 103
limited to, (1) a detailed description of the campus-wide response to a 104
mental health crisis, (2) an environmental review of each campus to 105
identify areas that may be improved for the benefit of student mental 106
health, and (3) protocols to ensure campus safety. 107
(b) Not later than January 1, 2022, the governing board of each 108
institution of higher education shall adopt, and update as necessary, a 109
policy regarding student mental health. Such policy shall include, but 110
not be limited to, (1) the types of mental health services and mental 111
health programming provided to students each academic year, and (2) 112
the availability of and eligibility requirements for mental health leave 113
available to students. 114 Substitute Bill No. 6461
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(c) Not later than February 1, 2022, and not more than thirty days 115
after the adoption of an updated policy, the governing board of each 116
institution of higher education shall submit, in accordance with the 117
provisions of section 11-4a of the general statutes, to the joint standing 118
committee of the General Assembly having cognizance of matters 119
relating to higher education, the policy adopted pursuant to subsection 120
(b) of this section. 121
Sec. 5. (Effective July 1, 2021) Not later than January 1, 2022, the Board 122
of Regents for Higher Education shall employ a grant writer to identify 123
and apply for available grant funding to implement or improve mental 124
health services and programs offered by the regional community-125
technical colleges to address student mental illness. 126
Sec. 6. Section 38a-477d of the general statutes is repealed and the 127
following is substituted in lieu thereof (Effective January 1, 2023): 128
(a) Each insurer, health care center, hospital service corporation, 129
medical service corporation, fraternal benefit society or other entity that 130
delivers, issues for delivery, renews, amends or continues a health 131
insurance policy providing coverage of the type specified in 132
subdivisions (1), (2), (4), (11) and (12) of section 38a-469 in this state, 133
shall: 134
(1) Make available to consumers, in an easily readable, accessible and 135
understandable format: [, the] 136
(A) The following information for each such policy: 137
[(A)] (i) Any coverage exclusions; 138
[(B) any] (ii) Any restrictions on the use or quantity of a covered 139
benefit, including on prescription drugs or drugs administered in a 140
physician's office or a clinic; 141
[(C) a] (iii) A specific description of how prescription drugs are 142
included or excluded from any applicable deductible, including a 143 Substitute Bill No. 6461
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description of other out-of-pocket expenses that apply to such drugs; 144
[(D) the] (iv) The specific dollar amount of any copayment and the 145
percentage of any coinsurance imposed on each covered benefit, 146
including each covered prescription drug; and 147
[(E) information] (v) Information regarding any process available to 148
consumers, and all documents necessary, to seek coverage of a 149
noncovered outpatient prescription drug; and 150
(B) With respect to explanations of benefits issued pursuant to 151
subsection (d) of this section, a statement disclosing that each consumer 152
who is a covered individual and legally capable of consenting to the 153
provision of covered benefits under such policy may specify that such 154
insurer, center, corporation, society or entity, and each third-party 155
administrator, as defined in section 38a-720, providing services to such 156
insurer, center, corporation, society or entity, shall: 157
(i) Not issue explanations of benefits concerning covered benefits 158
provided to such consumer; or 159
(ii) (I) Issue explanations of benefits concerning covered benefits 160
provided to such consumer solely to such consumer; and 161
(II) Use a method specified by such consumer to issue such 162
explanations of benefits solely to such consumer, and provide sufficient 163
space in the statement for such consumer to specify a mailing address 164
or an electronic mail address for such insurer, center, corporation, 165
society, entity or third-party administrator to use to contact such 166
consumer concerning covered benefits provided to such consumer. 167
(2) Make available to consumers a way to determine accurately: 168
(A) [whether] Whether a specific prescription drug is available under 169
such policy's drug formulary; 170
(B) [the] The coinsurance, copayment, deductible or other out-of-171 Substitute Bill No. 6461
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pocket expense applicable to such drug; 172
(C) [whether] Whether such drug is covered when dispensed by a 173
physician or a clinic; 174
(D) [whether] Whether such drug requires prior authorization or the 175
use of step therapy; 176
(E) [whether] Whether specific types of health care specialists are in-177
network; and 178
(F) [whether] Whether a specific health care provider or hospital is 179
in-network. 180
(b) (1) Each insurer, health care center, hospital service corporation, 181
medical service corporation, fraternal benefit society or other entity 182
shall make the information and statement required under subsection (a) 183
of this section available to consumers at the time of enrollment and shall 184
post such information and statement on its Internet web site. 185
(2) The Connecticut Health Insurance Exchange, established 186
pursuant to section 38a-1081, shall post links on its Internet web site to 187
such information and statement for each qualified health plan that is 188
offered or sold through the exchange. 189
(c) The Insurance Commissioner shall post links on the Insurance 190
Department's Internet web site to any on-line tools or calculators to help 191
consumers compare and evaluate health insurance policies and plans. 192
(d) (1) Except as provided in subdivision (2) of this subsection, each 193
insurer, health care center, hospital service corporation, medical service 194
corporation, fraternal benefit society or other entity that delivers, issues 195
for delivery, renews, amends or continues a health insurance policy 196
described in subsection (a) of this section, and each third-party 197
administrator, as defined in section 38a-720, providing services to such 198
an insurer, center, corporation, society or entity, shall: 199 Substitute Bill No. 6461
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(A) Issue explanations of benefits to consumers who are covered 200
individuals under the policy; and 201
(B) (i) Permit each consumer who is a covered individual under the 202
policy and legally capable of consenting to the provision of covered 203
benefits to specify, in writing, that such insurer, center, corporation, 204
society, entity or third-party administrator issue explanations of 205
benefits concerning covered benefits provided to such consumer solely 206
to such consumer, and specify, in writing, which of the following 207
methods such insurer, center, corporation, society, entity or third-party 208
administrator shall use to issue such explanations of benefits solely to 209
such consumer: 210
(I) Mailing such explanations of benefits to such consumer's mailing 211
address or another mailing address specified by such consumer; 212
(II) Sending such explanations of benefits to such consumer by 213
electronic means, including, but not limited to, electronic mail; or 214
(III) Making such explanations of benefits available to such consumer 215
by electronic means, provided making such explanations of benefits 216
available solely to such consumer by electronic means complies with all 217
applicable federal and state laws and regulations concerning data 218
security, including, but not limited to, 45 CFR Part 160, as amended from 219
time to time, and 45 CFR Part 164, Subparts A and C, as amended from 220
time to time. 221
(ii) Each method specified by a consumer, in writing, pursuant to 222
subparagraph (B)(i) of this subdivision shall be valid until the consumer 223
submits a written specification to the insurer, center, corporation, 224
society, entity or third-party administrator for a different method. Such 225
insurer, center, corporation, society, entity or third-party administrator 226
shall comply with a written specification under this clause or 227
subparagraph (B)(i) of this subdivision, as applicable, not later than 228
three business days after such insurer, center, corporation, society, 229
entity or third-party administrator receives such specification. 230 Substitute Bill No. 6461
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(iii) Each insurer, center, corporation, society, entity or third-party 231
administrator that receives a written specification from a consumer 232
pursuant to subparagraph (B)(i) or (B)(ii) of this subdivision, as 233
applicable, shall provide the consumer who made such specification 234
with written confirmation that such insurer, center, corporation, society, 235
entity or third-party administrator received such specification, and 236
advise such consumer, in writing, regarding the status of such 237
specification if such consumer contacts such insurer, center, 238
corporation, society, entity or third-party administrator, in writing, 239
regarding such specification. 240
(2) Each consumer who is a covered individual under a policy 241
described in subsection (a) of this section and is legally capable of 242
consenting to the provision of covered benefits may specify, in writing, 243
that the insurer, center, corporation, society or entity that delivered, 244
issued for delivery, renewed, amended or continued the policy, or a 245
third-party administrator providing services to such insurer, center, 246
corporation, society or entity, not issue explanations of benefits 247
pursuant to subdivision (1) of this subsection if such explanations of 248
benefits concern covered benefits that were provided to such consumer. 249
Such insurer, center, corporation, society, entity or third-party 250
administrator shall not require such consumer to provide any 251
explanation regarding the basis for such consumer's specification, 252
unless such explanation is required by applicable law or pursuant to an 253
order issued by a court of competent jurisdiction. 254
(3) Each insurer, center, corporation, society or entity that delivers, 255
issues for delivery, renews, amends or continues a policy described in 256
subsection (a) of this section, and each third-party administrator 257
providing services to such insurer, center, corporation, society or entity, 258
shall disclose to each consumer who is a covered individual under the 259
policy such consumer's ability to submit specifications pursuant to 260
subdivisions (1) and (2) of this subsection. Such disclosure shall be in 261
plain language and displayed or printed, as applicable, clearly and 262
conspicuously in all evidence of coverage documents, privacy 263 Substitute Bill No. 6461
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communications, explanations of benefits and Internet web sites that are 264
maintained by such insurer, center, corporation, society, entity or third-265
party administrator and accessible to consumers in this state. 266
(4) No insurer, center, corporation, society or entity that is subject to 267
this subsection shall require a consumer or policyholder to waive any 268
right to limit disclosure under this subsection as a precondition to 269
delivering, issuing for delivery, renewing, amending or continuing a 270
policy described in subsection (a) of this section to the consumer or 271
policyholder. Nothing in this subsection shall be construed to limit a 272
consumer's or policyholder's ability to request review of an adverse 273
determination. 274
Sec. 7. Section 19a-14c of the general statutes is repealed and the 275
following is substituted in lieu thereof (Effective July 1, 2021): 276
(a) For the purposes of this section, "outpatient mental health 277
treatment" means the treatment of mental disorders, emotional 278
problems or maladjustments with the object of (1) removing, modifying 279
or retarding existing symptoms; (2) improving disturbed patterns of 280
behavior; and (3) promoting positive personality growth and 281
development. Treatment shall not include prescribing or otherwise 282
dispensing any medication which is a legend drug as defined in section 283
20-571. 284
(b) A psychiatrist licensed pursuant to chapter 370, a psychologist 285
licensed pursuant to chapter 383, an independent social worker certified 286
pursuant to chapter 383b or a marital and family therapist licensed 287
pursuant to chapter 383a may provide outpatient mental health 288
treatment to a minor without the consent or notification of a parent or 289
guardian at the request of the minor if (1) requiring the consent or 290
notification of a parent or guardian would cause the minor to reject such 291
treatment; (2) the provision of such treatment is clinically indicated; (3) 292
the failure to provide such treatment would be seriously detrimental to 293
the minor's well-being; (4) the minor has knowingly and voluntarily 294
sought such treatment; and (5) in the opinion of the provider of 295 Substitute Bill No. 6461
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treatment, the minor is mature enough to participate in treatment 296
productively. The provider of such treatment shall document the 297
reasons for any determination made to treat a minor without the consent 298
or notification of a parent or guardian and shall include such 299
documentation in the minor's clinical record, along with a written 300
statement signed by the minor stating that (A) [he] the minor is 301
voluntarily seeking such treatment; (B) [he] the minor has discussed 302
with the provider the possibility of involving his or her parent or 303
guardian in the decision to pursue such treatment; (C) [he] the minor 304
has determined it is not in his or her best interest to involve his or her 305
parent or guardian in such decision; and (D) [he] the minor has been 306
given adequate opportunity to ask the provider questions about the 307
course of his or her treatment. 308
(c) [After the sixth session of outpatient mental health treatment 309
provided to a minor pursuant to this section, the provider of such 310
treatment shall notify the minor that the consent, notification or 311
involvement of a parent or guardian is required to continue treatment, 312
unless such a requirement would be seriously detrimental to the minor's 313
well-being. If the provider determines such a requirement would be 314
seriously detrimental to the minor's well-being, he shall document such 315
determination in the minor's clinical record, review such determination 316
every sixth session thereafter and document each such review. If the 317
provider determines such a requirement would no longer be seriously 318
detrimental to the minor's well-being, he shall require the consent, 319
notification or involvement of a parent or guardian as a condition of 320
continuing treatment.] (1) Except as otherwise provided in subdivision 321
(2) of this subsection, a minor may request and receive as many 322
outpatient mental health treatment sessions as necessary without the 323
consent or notification of a parent or guardian. No provider shall notify 324
a parent or guardian of treatment provided pursuant to this section or 325
disclose any information concerning such treatment to a parent or 326
guardian without the consent of the minor. 327
(2) A provider may notify a parent or guardian of treatment provided 328 Substitute Bill No. 6461
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pursuant to this section or disclose certain information concerning such 329
treatment without the consent of the minor who receives such treatment 330
provided (A) such provider determines such notification or disclosure 331
is necessary to the minor's well-being, (B) the treatment provided to the 332
minor is solely for mental health and not for a substance use disorder, 333
and (C) the minor is provided an opportunity to express any objection 334
to such notification or disclosure. The provider shall document his or 335
her determination concerning such notification or disclosure and any 336
objections expressed by the minor in the minor's clinical record. A 337
provider may disclose to a minor's parent or guardian the following 338
information concerning such minor's outpatient mental health 339
treatment: (i) Diagnosis; (ii) treatment plan and progress in treatment; 340
(iii) recommended medications, including risks, benefits, side effects, 341
typical efficacy, dose and schedule; (iv) psychoeducation about the 342
minor's mental health; (v) referrals to community resources; (vi) 343
coaching on parenting or behavioral management strategies; and (vii) 344
crisis prevention planning and safety planning. A provider shall release 345
a minor's entire clinical record to another provider upon the request of 346
the minor or such minor's parent or guardian. 347
(d) A parent or guardian who is not informed of the provision of 348
outpatient mental health treatment for his or her minor child pursuant 349
to this section shall not be liable for the costs of the treatment provided.350
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
HED Joint Favorable Subst. Substitute Bill No. 6461
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