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OLR Bill Analysis
sHB 6461
AN ACT IMPLEMENTING THE RECOMMENDATIONS OF THE
TASK FORCE REGARDING THE PREVENTION AND TREATMENT
OF MENTAL ILLNESS AT INSTITUTIONS OF HIGHER EDUCATION.
SUMMARY
This bill requires the Office of Higher Education (OHE) and higher
education institutions to evaluate and improve mental health services.
It must do so by requiring:
1. higher education institutions, excluding Charter Oak State
College or any institution that solely provides online
programming, to establish, by January 1, 2022, (a) a campus
mental health coalition to evaluate the effectiveness of their
mental health services (§ 1) and (b) a crisis intervention and
management plan for each campus (§ 4);
2. OHE and the Department of Mental Health and Addiction
Services (DMHAS) to consult with a mental health specialist for
students to develop or approve, by January 1, 2022, an
assessment tool to evaluate institutions' mental health services
and programs (§ 2); and
3. the Board of Regents for Higher Education to employ a grant
writer to identify and apply for available grant funding to
implement or improve mental health services and programs
offered by the regional community-technical colleges to address
student mental illness (§ 5).
The bill requires certain health insurance carriers and their third-
party administrators (TPAs) to (1) provide explanation of benefits
(EOBs) to covered individuals for benefits they receive and (2) allow
covered individuals, who can legally consent to receive covered
medical services, to make a specific written selection about whether 2021HB-06461-R000264-BA.DOCX
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and how to receive these EOBs. The bill requires health insurance
carriers and TPAs to disclose EOB delivery options to covered
individuals (§ 6).
The bill applies to insurers, health care centers (i.e., HMOs), hospital
and medical service corporations, fraternal benefit societies, and any
other entity that delivers, issues, renews, amends, or continues a health
insurance policy in Connecticut (i.e., “health insurance carriers”) that
cover (1) basic hospital expenses; (2) basic medical-surgical expenses;
(3) major medical expenses; or (4) hospital or medical services,
including those provided under an HMO plan. It also applies to TPAs
providing services to these health insurance carriers.
Additionally, the bill eliminates a provision requiring a mental
health provider to notify a minor that the consent, notification, or
involvement of a parent or guardian is required to provide more than
six outpatient mental health sessions. It instead allows minors to
request and receive as many sessions as necessary without this consent
or notification. Under the bill, the provider may inform the parent or
guardian under certain circumstances (§ 7).
EFFECTIVE DATE: July 1, 2021, except the provision on EOBs is
effective on January 1, 2023.
§ 1 — MENTAL HEALTH COALIT ION
Membership
The bill requires each higher education institution, excluding
Charter Oak State College or online institutions, by January 1, 2022, to
establish a mental health coalition to evaluate the effectiveness of their
mental health services and programs.
Under the bill, the president of each institution must appoint
individuals to the coalition that reflect their institution’s student body
demographics, including, at least one member from their institution’s
(1) administration; (2) counseling services office, if any; (3) health
services office, if any; (4) senior and mid-level staff; (5) student body;
(6) residential life office, if any; (7) faculty; and (8) any other 2021HB-06461-R000264-BA.DOCX
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individuals the president designates.
Duties
The bill requires each higher education institution to ensure that
coalition members are educated on the (1) mental health services and
programs offered at each institution’s campus; (2) the coalition’s role
and function at the institution; and (3) protocols and techniques to
respond to student mental illness that have been developed with
consideration given to the students’ race, cultural background, sexual
orientation or gender identity, or status as a veteran or service member
of the U.S. armed forces.
The bill requires each mental health coalition to do the following:
1. evaluate the effectiveness of the institution’s mental health
services and programs every four years using the assessment
tool required by the bill (see § 2);
2. review the evaluation results and develop a plan to address
weaknesses in the institution’s services and programs; and
3. review and recommend improvements to (a) institutional
student mental health policies; (b) the variety of mental health
services available to the institution’s students, including on-
campus services, telehealth services, or a community-based
provider arranged through an agreement (see § 3); (c) the
quality of mental health services available to students, including
recommendations for obtaining accreditation from a nationally
or regionally recognized accrediting body for mental health
services; and (d) the crisis intervention and management plan
established under this bill (see § 4).
The bill defines (1) mental health services as counseling, therapy,
rehabilitation, crisis intervention, or emergency services for the
screening, diagnosis, or treatment of mental illness and (2) mental
health programs such as education, outreach, research or training
initiatives aimed at students for the prevention of mental illness.
Examples of programs include poster and flyer campaigns, electronic 2021HB-06461-R000264-BA.DOCX
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communications, films, guest speakers, conferences, or other campus
events.
§ 2 — EVALUATION OF THE EF FECTIVENESS OF HIGHE R
EDUCATION INSTITUTIO N MENTAL HEALTH SERV ICES AND
PROGRAMS
Assessment Tool Development and Implementation
The bill requires, by January 1, 2022, and every four years thereafter,
the OHE executive director and DMHAS commissioner, in
consultation with an epidemiologist or other specialist with expertise
in the study of student mental health, to jointly develop or approve,
and update as necessary, an assessment tool for each higher education
institution to evaluate the effectiveness of mental health services and
programs offered at each of its campuses.
The bill requires OHE and DMHAS to (1) develop, and update as
necessary, guidelines for assessment tool implementation, including a
timeline for completion, and (2) conduct training workshops for the
established mental health coalitions regarding best practices for
assessment tool use and completion.
Under the bill, by October 1, 2022, and every four years thereafter,
each established campus mental health coalition must evaluate the
effectiveness of the mental health services and programs offered at
each institution’s campus using the developed assessment tool in
accordance with the guidelines and training provided by OHE and the
DMHAS executive directors. Each coalition must submit the
evaluation results to OHE.
Reporting Requirements
The bill requires the OHE director, within 30 days after receiving
the evaluation results, to post them on the OHE website and submit a
report to the Higher Education and Employment Advancement
committee.
§ 3 — PROVIDER PARTNERSHIP S
The bill requires, by January 1, 2022, a higher education institution
that lacks campus resources for providing mental health services to 2021HB-06461-R000264-BA.DOCX
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students to enter into and maintain a memorandum of understanding
with at least one community-based mental health care provider or, in
consultation with DMHAS, with an emergency mobile psychiatric
service provider to (1) provide students access to mental health
services on or off campus and (2) assist institutions in developing
mental health programming.
§ 4 — CRISIS INTERVENTION AND MANAGEMENT PLAN
The bill requires each higher education institution to establish or
update a crisis intervention and management plan for its campus by
January 1, 2022. The plan must include (1) a detailed description of the
campus-wide response to a mental health crisis, (2) an environmental
review of each campus to identify areas that may be improved to
benefit student mental health, and (3) protocols to ensure campus
safety. The bill defines “mental health crisis” as a condition (1) in
which a person requires immediate intervention or medical attention
without which the person would present a danger to himself or herself
or to others or (2) that renders a person incapable of controlling,
knowing, or understanding the consequences of their actions.
Student Mental Health Policies
The bill requires each higher education institution’s governing
board to adopt, and update as necessary, a student mental health
policy by January 1, 2021. The policy must include (1) the mental
health services and programming provided to students each academic
year and (2) the availability of, and eligibility requirements for, student
mental health leave.
Under the bill, by February 1, 2022, and within 30 days after
adopting an updated student mental health policy, the governing
board of each institution must submit the policy to the Higher
Education and Employment Advancement Committee.
§ 6 — EXPLANATION OF BENEF ITS (EOBs)
Delivery Method
The bill requires health insurance carriers and TPAs to issue EOBs
to consumers, but also allows covered individuals who can legally 2021HB-06461-R000264-BA.DOCX
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consent to receiving covered services to (1) specify how EOBs are
delivered or (2) opt out of receiving them entirely.
Health insurance carriers and TPAs must allow legally consenting
consumers who are covered individuals to specify in writing that
EOBs must be delivered solely to him or her by:
1. mail to his or her address or any other specified address;
2. e-mail or other electronic means; or
3. making the EOB available solely to him or her electronically, in
compliance with certain federal privacy laws (e.g., through a
patient portal).
Under the bill, the consumer’s choice remains valid until he or she
specifies another method in writing to the carrier. The health insurance
carrier or TPA must comply with a consumer’s written request for a
specific delivery method within three business days after receiving it.
Additionally, they must provide written confirmation of receipt and, if
contacted by the consumer, advise them on the status of his or her
selection.
Opting Out
Covered individuals who can legally consent to benefits may
specify, in writing, that the health insurance carrier or TPA not issue
an EOB. In such a case, the carrier or TPA cannot require the covered
individual to explain this decision unless required by law or pursuant
to a court order.
Disclosures
Additionally, the bill requires health insurance carriers and TPAs to
make available to consumers a statement disclosing that any covered
individual who can legally consent to receiving covered benefits may
specify that the carrier:
1. not issue EOBs concerning him or her or
2. issue them only to the consumer using the method he or she 2021HB-06461-R000264-BA.DOCX
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chooses.
The statement must (1) be in an easily readable, accessible, and
understandable format and (2) include a space for the consumer to
provide a mailing or email address.
Under the bill, the disclosure statement described above must be
included in the benefits information that carriers must provide upon
enrollment, and that both carriers and the Connecticut Health
Insurance Exchange (Access Health CT) must make available on their
websites.
The bill also requires health carriers and TPAs to disclose to
insureds that they may (1) submit EOB delivery method requests or (2)
request that EOBs not be delivered at all. This disclosure must be in
plain language and displayed or printed clearly and conspicuously in
all coverage documents, privacy communications, EOBs, and Internet
websites the health carrier makes available to Connecticut consumers.
The bill prohibits a health insurance carrier from requiring a
covered individual to waive his or her right to limit disclosure under
the bill as a precondition to issuing, delivering, renewing, amending,
or continuing a policy. The bill specifies that it does not limit a covered
individual’s or policy holder’s ability to request an adverse
determination review.
§ 7 — OUTPATIENT MENTAL HE ALTH TREATMENT FOR M INORS
By law, a psychiatrist, psychologist, independent social worker, or
marital and family therapist may provide outpatient mental health
treatment to a minor without the consent or notification of a parent or
guardian at the minor’s request under certain conditions. Current law
requires a mental health provider to notify the minor that the consent,
notification, or involvement of a parent or guardian is required to
continue treatment after the sixth session, unless it would be seriously
detrimental to the minor’s well-being. The bill eliminates this
requirement and instead allows minors to request and receive as many
outpatient mental health treatment sessions as necessary without the 2021HB-06461-R000264-BA.DOCX
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consent or notification of a parent or guardian. However, the bill also
creates an option where the provider may inform the parent or
guardian.
Under the bill, a provider may notify a parent or guardian about
treatment provided without the parent or guardian’s consent or
notification, if (1) the provider determines that notification or
disclosure is necessary for the minor’s well-being, (2) the treatment
provided to the minor is solely for mental health and not for a
substance use disorder, and (3) the minor is provided an opportunity
to express any objection to the notification or disclosure.
The bill requires the provider to document his or her determination
regarding the notification or disclosure and any objections expressed
by the minor in the minor’s clinical record. The provider may disclose
to a minor’s parent or guardian the following information regarding
the minor’s outpatient mental health treatment:
1. diagnosis;
2. treatment plan and progress;
3. recommended medications, including risks, benefits, side
effects, typical efficacy, dose, and schedule;
4. psychoeducation about the minor’s mental health;
5. referrals to community resources;
6. coaching on parenting or behavioral management strategies;
and
7. crisis prevention planning and safety planning.
It also requires a provider to release a minor’s entire clinical record
to another provider upon the request of the minor or the minor’s
parent or guardian.
Existing law, unchanged by the bill, shields a parent or guardian
from liability for treatment costs if he or she is not informed of the 2021HB-06461-R000264-BA.DOCX
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minor child’s outpatient mental health treatment.
BACKGROUND
Related Bills
SB 1086, reported favorably by the Public Health Committee, allows
minors to request and receive as many outpatient mental health
treatment sessions as necessary without the consent or notification of a
parent or guardian.
HB 6389, reported favorably by the Insurance and Real Estate
Committee, requires certain health insurance entities to (1) provide an
EOB to covered individuals for benefits they receive and (2) allow
certain individuals who can legally consent to receive services to select
how and if they receive EOBs.
COMMITTEE ACTION
Higher Education and Employment Advancement Committee
Joint Favorable Substitute
Yea 20 Nay 2 (03/18/2021)