Connecticut 2021 Regular Session

Connecticut House Bill HB06461 Compare Versions

Version 1 (Old)

Version 2 (New)

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7		-	General Assembly Substitute Bill No. 6461
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	5	+	LCO No. 2848 1 of 13
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	7	+	General Assembly Raised Bill No. 6461
8	8		January Session, 2021
	9	+	LCO No. 2848
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	11	+
	12	+	Referred to Committee on HIGHER EDUCATION AND
	13	+	EMPLOYMENT ADVANCEMENT
	14	+
	15	+
	16	+	Introduced by:
	17	+	(HED)
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13	21
14	22		AN ACT IMPLEMENTING THE RECOMMENDATIONS OF THE TASK
15	23		FORCE REGARDING THE PREVENTION AND TREAT MENT OF
16	24		MENTAL ILLNESS AT INSTITUTIONS OF HIGHER EDUCATION.
17	25		Be it enacted by the Senate and House of Representatives in General
18	26		Assembly convened:
19	27
20	28		Section 1. (NEW) (Effective July 1, 2021) (a) As used in this section and 1
21	29		sections 2 to 5, inclusive, of this act: 2
22	30		(1) "Services" or "mental health services" means counseling, therapy, 3
23	31		rehabilitation, crisis intervention or emergency services for the 4
24	32		screening, diagnosis or treatment of mental illness; 5
25	33		(2) "Programs" or "mental health programming" means education, 6
26	34		outreach, research or training initiatives aimed at students for the 7
27	35		prevention of mental illness, including, but not limited to, poster and 8
28	36		flyer campaigns, electronic communications, films, guest speakers, 9
29	37		conferences or other campus events; 10
30	38		(3) "Institution of higher education" means any institution of higher 11
31		-	education in the state, but does not include Charter Oak State College 12
	39	+	education in the state, but does not include Charter Oak State College 12 Raised Bill No. 6461
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	41	+
	42	+
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32	45		or any institution of higher education that solely provides programs of 13
33	46		higher learning through its Internet web site; and 14
34		-	(4) "Mental health crisis" means a condition in which a person 15 Substitute Bill No. 6461
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	47	+	(4) "Mental health crisis" means a condition in which a person 15
41	48		requires immediate intervention or medical attention without which 16
42	49		such person would present a danger to himself or herself or to others or 17
43	50		which renders such person incapable of controlling, knowing or 18
44	51		understanding the consequences of his or her actions. 19
45	52		(b) Not later than January 1, 2022, each institution of higher education 20
46	53		shall establish a campus mental health coalition with representatives 21
47	54		from each of its campuses. The campus mental health coalition shall 22
48	55		consist of individuals appointed by the president of each institution of 23
49	56		higher education who are reflective of the demographics of the student 24
50	57		body at such institution, including, but not limited to, at least one 25
51	58		member from such institution's (1) administration, (2) counseling 26
52	59		services office, if any, (3) health services office, if any, (4) senior and mid-27
53	60		level staff, (5) student body, (6) residential life office, if any, (7) faculty, 28
54	61		and (8) any other individuals designated by the president. 29
55	62		(c) Each institution of higher education shall ensure that every 30
56	63		member of the campus mental health coalition is educated about the (1) 31
57	64		mental health services and programs offered at each campus by such 32
58	65		institution, (2) role and function of the campus mental health coalition 33
59	66		at such institution, and (3) protocols and techniques to respond to 34
60		-	student mental illness that have been developed with consideration 35
61		-	given to the students' race, cultural background, sexual orientation or 36
62		-	gender identity or status as a veteran or service member of the armed 37
63		-	forces of the United States. 38
64		-	(d) Each campus mental health coalition shall (1) conduct an 39
65		-	evaluation every four years of the effectiveness of the mental health 40
66		-	services and programs offered by the institution of higher education in 41
67		-	accordance with section 2 of this act, (2) review the results of such 42
68		-	evaluation and develop a plan to address any weaknesses in such 43
69		-	services and programs offered by the institution, and (3) review and 44
70		-	recommend improvements to (A) institutional polices regarding 45
71		-	student mental health, (B) the variety of mental health services available 46
72		-	to students at the institution, including on-campus services, telehealth 47
73		-	services provided in accordance with section 19a-906 of the general 48 Substitute Bill No. 6461
	67	+	student mental illness that are receptive to students of diverse race, 35
	68	+	cultural backgrounds, sexual orientation or gender identity or status as 36
	69	+	a veteran or service member of the armed forces of the United States. 37
	70	+	(d) Each campus mental health coalition shall (1) conduct an 38
	71	+	evaluation every four years of the effectiveness of the mental health 39
	72	+	services and programs offered by the institution of higher education in 40
	73	+	accordance with section 2 of this act, (2) review the results of such 41
	74	+	evaluation and develop a plan to address any weaknesses in such 42
	75	+	services and programs offered by the institution, and (3) review and 43
	76	+	recommend improvements to (A) institutional polices regarding 44 Raised Bill No. 6461
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80		-	statutes, or services offered through community-based mental health 49
81		-	care providers or emergency mobile psychiatric service providers in 50
82		-	accordance with any memorandum of understanding entered into 51
83		-	pursuant to section 3 of this act, (C) the quality of mental health services 52
84		-	available to students, including recommendations for obtaining 53
85		-	accreditation from the International Accreditation of Counseling 54
86		-	Services or another nationally or regionally recognized accrediting body 55
87		-	for mental health services, and (D) the crisis intervention and 56
88		-	management plan established pursuant to section 4 of this act. 57
89		-	Sec. 2. (NEW) (Effective July 1, 2021) (a) Not later than January 1, 2022, 58
90		-	and every four years thereafter, the executive director of the Office of 59
91		-	Higher Education and the Commissioner of Mental Health and 60
92		-	Addiction Services, in consultation with an epidemiologist or other 61
93		-	specialist with expertise in the study of student mental health, shall 62
94		-	jointly (1) develop or approve, and update as necessary, an assessment 63
95		-	tool for use by each institution of higher education in evaluating the 64
96		-	effectiveness of the mental health services and programs offered at each 65
97		-	of the institution's campuses, (2) develop, and update as necessary, 66
98		-	guidelines for the implementation of the assessment tool, including a 67
99		-	timeline for its completion, and (3) conduct training workshops for the 68
100		-	campus mental health coalitions established pursuant to section 1 of this 69
101		-	act regarding best practices for the use and completion of the assessment 70
102		-	tool. 71
103		-	(b) Not later than October 1, 2022, and every four years thereafter, 72
104		-	each campus mental health coalition established at each institution of 73
105		-	higher education pursuant to section 1 of this act shall (1) conduct an 74
106		-	evaluation of the effectiveness of the mental health services and 75
107		-	programs offered at each campus by such institution using the 76
108		-	assessment tool developed or approved pursuant to subsection (a) of 77
109		-	this section, in accordance with the guidelines and training provided by 78
110		-	the executive director of the Office of Higher Education and the 79
111		-	Commissioner of Mental Health and Addiction Services, and (2) submit 80
112		-	the results of such evaluation to the Office of Higher Education. 81 Substitute Bill No. 6461
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	81	+
	82	+	student mental health, (B) the variety of mental health services available 45
	83	+	to students at the institution, including on-campus services, telehealth 46
	84	+	services provided in accordance with section 19a-906 of the general 47
	85	+	statutes or services offered through community-based mental health 48
	86	+	care providers or emergency mobile psychiatric service providers in 49
	87	+	accordance with any memorandum of understanding entered into 50
	88	+	pursuant to section 3 of this act, (C) the quality of mental health services 51
	89	+	available to students, including recommendations for obtaining 52
	90	+	accreditation from the International Accreditation of Counseling 53
	91	+	Services or another nationally or regionally recognized accrediting body 54
	92	+	for mental health services, and (D) the crisis intervention and 55
	93	+	management plan established pursuant to section 4 of this act. 56
	94	+	Sec. 2. (NEW) (Effective July 1, 2021) (a) Not later than January 1, 2022, 57
	95	+	and every four years thereafter, the executive director of the Office of 58
	96	+	Higher Education and the Commissioner of M ental Health and 59
	97	+	Addiction Services, in consultation with an epidemiologist or other 60
	98	+	specialist with expertise in the study of student mental health, shall 61
	99	+	jointly (1) develop or approve, and update as necessary, an assessment 62
	100	+	tool for use by each institution of higher education in evaluating the 63
	101	+	effectiveness of the mental health services and programs offered at each 64
	102	+	of the institution's campuses, (2) develop, and update as necessary, 65
	103	+	guidelines for the implementation of the assessment tool, including a 66
	104	+	timeline for its completion, and (3) conduct training workshops for the 67
	105	+	campus mental health coalitions established pursuant to section 1 of this 68
	106	+	act regarding best practices for the use and completion of the assessment 69
	107	+	tool. 70
	108	+	(b) Not later than October 1, 2022, and every four years thereafter, 71
	109	+	each campus mental health coalition established at each institution of 72
	110	+	higher education pursuant to section 1 of this act shall (1) conduct an 73
	111	+	evaluation of the effectiveness of the mental health services and 74
	112	+	programs offered at each campus by such institution using the 75
	113	+	assessment tool developed or approved pursuant to subsection (a) of 76
	114	+	this section, in accordance with the guidelines and training provided by 77
	115	+	the executive director of the Office of Higher Education and the 78 Raised Bill No. 6461
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119		-	(c) Not later than thirty days after the receipt of the results of the 82
120		-	evaluation conducted pursuant to subsection (b) of this section from 83
121		-	each campus mental health coalition, the executive director of the Office 84
122		-	of Higher Education shall post such results on the Internet web site of 85
123		-	said office and submit a report, in accordance with the provisions of 86
124		-	section 11-4a of the general statutes, to the joint standing committee of 87
125		-	the General Assembly having cognizance of matters relating to higher 88
126		-	education on such results from each institution of higher education. 89
127		-	Sec. 3. (NEW) (Effective July 1, 2021) Not later than January 1, 2022, 90
128		-	any institution of higher education that lacks resources on campus for 91
129		-	the provision of mental health services to students shall enter into and 92
130		-	maintain a memorandum of understanding with at least one 93
131		-	community-based mental health care provider or, in consultation with 94
132		-	the Department of Mental Health and Addiction Services, with an 95
133		-	emergency mobile psychiatric service provider for the purpose of 96
134		-	providing students access to mental health services on or off campus 97
135		-	and assistance to institutions in developing mental health 98
136		-	programming. 99
137		-	Sec. 4. (NEW) (Effective July 1, 2021) (a) Not later than January 1, 2022, 100
138		-	and every four years thereafter, each institution of higher education 101
139		-	shall establish or update a crisis intervention and management plan for 102
140		-	each campus of such institution. Such plan shall include, but not be 103
141		-	limited to, (1) a detailed description of the campus-wide response to a 104
142		-	mental health crisis, (2) an environmental review of each campus to 105
143		-	identify areas that may be improved for the benefit of student mental 106
144		-	health, and (3) protocols to ensure campus safety. 107
145		-	(b) Not later than January 1, 2022, the governing board of each 108
146		-	institution of higher education shall adopt, and update as necessary, a 109
147		-	policy regarding student mental health. Such policy shall include, but 110
148		-	not be limited to, (1) the types of mental health services and mental 111
149		-	health programming provided to students each academic year, and (2) 112
150		-	the availability of and eligibility requirements for mental health leave 113
151		-	available to students. 114 Substitute Bill No. 6461
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	120	+
	121	+	Commissioner of Mental Health and Addiction Services, and (2) submit 79
	122	+	the results of such evaluation to the Office of Higher Education. 80
	123	+	(c) Not later than thirty days after the receipt of the results of the 81
	124	+	evaluation conducted pursuant to subsection (b) of this section from 82
	125	+	each campus mental health coalition, the executive director of the Office 83
	126	+	of Higher Education shall post such results on the Internet web site of 84
	127	+	said office and submit a report, in accordance with the provisions of 85
	128	+	section 11-4a of the general statutes, to the joint standing committee of 86
	129	+	the General Assembly having cognizance of matters relating to higher 87
	130	+	education on such results from each institution of higher education. 88
	131	+	Sec. 3. (NEW) (Effective July 1, 2021) Not later than January 1, 2022, 89
	132	+	any institution of higher education that lacks resources on campus for 90
	133	+	the provision of mental health services to students shall enter into and 91
	134	+	maintain a memorandum of understanding with at least one 92
	135	+	community-based mental health care provider or, in consultation with 93
	136	+	the Department of Mental Health and Addiction Services, with an 94
	137	+	emergency mobile psychiatric service provider for the purpose of 95
	138	+	providing students access to mental health services on or off campus 96
	139	+	and assistance to institutions in developing mental health 97
	140	+	programming. 98
	141	+	Sec. 4. (NEW) (Effective July 1, 2021) (a) Not later than January 1, 2022, 99
	142	+	and annually thereafter, each institution of higher education shall 100
	143	+	establish and update a crisis intervention and management plan for each 101
	144	+	campus of such institution. Such plan shall include, but not be limited 102
	145	+	to, (1) a detailed description of the campus-wide response to a mental 103
	146	+	health crisis, (2) an environmental review of each campus to identify 104
	147	+	areas that may be improved for the benefit of student mental health, and 105
	148	+	(3) protocols to ensure campus safety. 106
	149	+	(b) Not later than January 1, 2022, the governing board of each 107
	150	+	institution of higher education shall adopt, and update as necessary, a 108
	151	+	policy regarding student mental health. Such policy shall include, but 109
	152	+	not be limited to, (1) the types of mental health services and mental 110 Raised Bill No. 6461
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158		-	(c) Not later than February 1, 2022, and not more than thirty days 115
159		-	after the adoption of an updated policy, the governing board of each 116
160		-	institution of higher education shall submit, in accordance with the 117
161		-	provisions of section 11-4a of the general statutes, to the joint standing 118
162		-	committee of the General Assembly having cognizance of matters 119
163		-	relating to higher education, the policy adopted pursuant to subsection 120
164		-	(b) of this section. 121
165		-	Sec. 5. (Effective July 1, 2021) Not later than January 1, 2022, the Board 122
166		-	of Regents for Higher Education shall employ a grant writer to identify 123
167		-	and apply for available grant funding to implement or improve mental 124
168		-	health services and programs offered by the regional community-125
169		-	technical colleges to address student mental illness. 126
170		-	Sec. 6. Section 38a-477d of the general statutes is repealed and the 127
171		-	following is substituted in lieu thereof (Effective January 1, 2023): 128
172		-	(a) Each insurer, health care center, hospital service corporation, 129
173		-	medical service corporation, fraternal benefit society or other entity that 130
174		-	delivers, issues for delivery, renews, amends or continues a health 131
175		-	insurance policy providing coverage of the type specified in 132
176		-	subdivisions (1), (2), (4), (11) and (12) of section 38a-469 in this state, 133
177		-	shall: 134
178		-	(1) Make available to consumers, in an easily readable, accessible and 135
179		-	understandable format: [, the] 136
180		-	(A) The following information for each such policy: 137
181		-	[(A)] (i) Any coverage exclusions; 138
182		-	[(B) any] (ii) Any restrictions on the use or quantity of a covered 139
183		-	benefit, including on prescription drugs or drugs administered in a 140
184		-	physician's office or a clinic; 141
185		-	[(C) a] (iii) A specific description of how prescription drugs are 142
186		-	included or excluded from any applicable deductible, including a 143 Substitute Bill No. 6461
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	158	+	health programming provided to students each academic year, and (2) 111
	159	+	the availability of and eligibility requirements for mental health leave 112
	160	+	available to students. 113
	161	+	(c) Not later than February 1, 2022, and not more than thirty days 114
	162	+	after the adoption of an updated policy, the governing board of each 115
	163	+	institution of higher education shall submit, in accordance with the 116
	164	+	provisions of section 11-4a of the general statutes, to the joint standing 117
	165	+	committee of the General Assembly having cognizance of matters 118
	166	+	relating to higher education, the policy adopted pursuant to subsection 119
	167	+	(b) of this section. 120
	168	+	Sec. 5. (Effective July 1, 2021) Not later than January 1, 2022, the Board 121
	169	+	of Regents for Higher Education shall employ a grant writer to identify 122
	170	+	and apply for available grant funding to implement or improve mental 123
	171	+	health services and programs offered by the regional community-124
	172	+	technical colleges to address student mental illness. 125
	173	+	Sec. 6. Section 38a-477d of the general statutes is repealed and the 126
	174	+	following is substituted in lieu thereof (Effective January 1, 2023): 127
	175	+	(a) Each insurer, health care center, hospital service corporation, 128
	176	+	medical service corporation, fraternal benefit society or other entity that 129
	177	+	delivers, issues for delivery, renews, amends or continues a health 130
	178	+	insurance policy providing coverage of the type specified in 131
	179	+	subdivisions (1), (2), (4), (11) and (12) of section 38a-469 in this state, 132
	180	+	shall: 133
	181	+	(1) Make available to consumers, in an easily readable, accessible and 134
	182	+	understandable format: [, the] 135
	183	+	(A) The following information for each such policy: 136
	184	+	[(A)] (i) Any coverage exclusions; 137
	185	+	[(B) any] (ii) Any restrictions on the use or quantity of a covered 138
	186	+	benefit, including on prescription drugs or drugs administered in a 139
	187	+	physician's office or a clinic; 140 Raised Bill No. 6461
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193		-	description of other out-of-pocket expenses that apply to such drugs; 144
194		-	[(D) the] (iv) The specific dollar amount of any copayment and the 145
195		-	percentage of any coinsurance imposed on each covered benefit, 146
196		-	including each covered prescription drug; and 147
197		-	[(E) information] (v) Information regarding any process available to 148
198		-	consumers, and all documents necessary, to seek coverage of a 149
199		-	noncovered outpatient prescription drug; and 150
200		-	(B) With respect to explanations of benefits issued pursuant to 151
201		-	subsection (d) of this section, a statement disclosing that each consumer 152
202		-	who is a covered individual and legally capable of consenting to the 153
203		-	provision of covered benefits under such policy may specify that such 154
204		-	insurer, center, corporation, society or entity, and each third-party 155
205		-	administrator, as defined in section 38a-720, providing services to such 156
206		-	insurer, center, corporation, society or entity, shall: 157
207		-	(i) Not issue explanations of benefits concerning covered benefits 158
208		-	provided to such consumer; or 159
209		-	(ii) (I) Issue explanations of benefits concerning covered benefits 160
210		-	provided to such consumer solely to such consumer; and 161
211		-	(II) Use a method specified by such consumer to issue such 162
212		-	explanations of benefits solely to such consumer, and provide sufficient 163
213		-	space in the statement for such consumer to specify a mailing address 164
214		-	or an electronic mail address for such insurer, center, corporation, 165
215		-	society, entity or third-party administrator to use to contact such 166
216		-	consumer concerning covered benefits provided to such consumer. 167
217		-	(2) Make available to consumers a way to determine accurately: 168
218		-	(A) [whether] Whether a specific prescription drug is available under 169
219		-	such policy's drug formulary; 170
220		-	(B) [the] The coinsurance, copayment, deductible or other out-of-171 Substitute Bill No. 6461
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	193	+	[(C) a] (iii) A specific description of how prescription drugs are 141
	194	+	included or excluded from any applicable deductible, including a 142
	195	+	description of other out-of-pocket expenses that apply to such drugs; 143
	196	+	[(D) the] (iv) The specific dollar amount of any copayment and the 144
	197	+	percentage of any coinsurance imposed on each covered benefit, 145
	198	+	including each covered prescription drug; and 146
	199	+	[(E) information] (v) Information regarding any process available to 147
	200	+	consumers, and all documents necessary, to seek coverage of a 148
	201	+	noncovered outpatient prescription drug; and 149
	202	+	(B) With respect to explanations of benefits issued pursuant to 150
	203	+	subsection (d) of this section, a statement disclosing that each consumer 151
	204	+	who is a covered individual and legally capable of consenting to the 152
	205	+	provision of covered benefits under such policy may specify that such 153
	206	+	insurer, center, corporation, society or entity, and each third-party 154
	207	+	administrator, as defined in section 38a-720, providing services to such 155
	208	+	insurer, center, corporation, society or entity, shall: 156
	209	+	(i) Not issue explanations of benefits concerning covered benefits 157
	210	+	provided to such consumer; or 158
	211	+	(ii) (I) Issue explanations of benefits concerning covered benefits 159
	212	+	provided to such consumer solely to such consumer; and 160
	213	+	(II) Use a method specified by such consumer to issue such 161
	214	+	explanations of benefits solely to such consumer, and provide sufficient 162
	215	+	space in the statement for such consumer to specify a mailing address 163
	216	+	or an electronic mail address for such insurer, center, corporation, 164
	217	+	society, entity or third-party administrator to use to contact such 165
	218	+	consumer concerning covered benefits provided to such consumer. 166
	219	+	(2) Make available to consumers a way to determine accurately: 167
	220	+	(A) [whether] Whether a specific prescription drug is available under 168
	221	+	such policy's drug formulary; 169 Raised Bill No. 6461
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227		-	pocket expense applicable to such drug; 172
228		-	(C) [whether] Whether such drug is covered when dispensed by a 173
229		-	physician or a clinic; 174
230		-	(D) [whether] Whether such drug requires prior authorization or the 175
231		-	use of step therapy; 176
232		-	(E) [whether] Whether specific types of health care specialists are in-177
233		-	network; and 178
234		-	(F) [whether] Whether a specific health care provider or hospital is 179
235		-	in-network. 180
236		-	(b) (1) Each insurer, health care center, hospital service corporation, 181
237		-	medical service corporation, fraternal benefit society or other entity 182
238		-	shall make the information and statement required under subsection (a) 183
239		-	of this section available to consumers at the time of enrollment and shall 184
240		-	post such information and statement on its Internet web site. 185
241		-	(2) The Connecticut Health Insurance Exchange, established 186
242		-	pursuant to section 38a-1081, shall post links on its Internet web site to 187
243		-	such information and statement for each qualified health plan that is 188
244		-	offered or sold through the exchange. 189
245		-	(c) The Insurance Commissioner shall post links on the Insurance 190
246		-	Department's Internet web site to any on-line tools or calculators to help 191
247		-	consumers compare and evaluate health insurance policies and plans. 192
248		-	(d) (1) Except as provided in subdivision (2) of this subsection, each 193
249		-	insurer, health care center, hospital service corporation, medical service 194
250		-	corporation, fraternal benefit society or other entity that delivers, issues 195
251		-	for delivery, renews, amends or continues a health insurance policy 196
252		-	described in subsection (a) of this section, and each third-party 197
253		-	administrator, as defined in section 38a-720, providing services to such 198
254		-	an insurer, center, corporation, society or entity, shall: 199 Substitute Bill No. 6461
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	226	+
	227	+	(B) [the] The coinsurance, copayment, deductible or other out-of-170
	228	+	pocket expense applicable to such drug; 171
	229	+	(C) [whether] Whether such drug is covered when dispensed by a 172
	230	+	physician or a clinic; 173
	231	+	(D) [whether] Whether such drug requires prior authorization or the 174
	232	+	use of step therapy; 175
	233	+	(E) [whether] Whether specific types of health care specialists are in-176
	234	+	network; and 177
	235	+	(F) [whether] Whether a specific health care provider or hospital is 178
	236	+	in-network. 179
	237	+	(b) (1) Each insurer, health care center, hospital service corporation, 180
	238	+	medical service corporation, fraternal benefit society or other entity 181
	239	+	shall make the information and statement required under subsection (a) 182
	240	+	of this section available to consumers at the time of enrollment and shall 183
	241	+	post such information and statement on its Internet web site. 184
	242	+	(2) The Connecticut Health Insurance Exchange, established 185
	243	+	pursuant to section 38a-1081, shall post links on its Internet web site to 186
	244	+	such information and statement for each qualified health plan that is 187
	245	+	offered or sold through the exchange. 188
	246	+	(c) The Insurance Commissioner shall post links on the Insurance 189
	247	+	Department's Internet web site to any on-line tools or calculators to help 190
	248	+	consumers compare and evaluate health insurance policies and plans. 191
	249	+	(d) (1) Except as provided in subdivision (2) of this subsection, each 192
	250	+	insurer, health care center, hospital service corporation, medical service 193
	251	+	corporation, fraternal benefit society or other entity that delivers, issues 194
	252	+	for delivery, renews, amends or continues a health insurance policy 195
	253	+	described in subsection (a) of this section, and each third-party 196
	254	+	administrator, as defined in section 38a-720, providing services to such 197
	255	+	an insurer, center, corporation, society or entity, shall: 198 Raised Bill No. 6461
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261		-	(A) Issue explanations of benefits to consumers who are covered 200
262		-	individuals under the policy; and 201
263		-	(B) (i) Permit each consumer who is a covered individual under the 202
264		-	policy and legally capable of consenting to the provision of covered 203
265		-	benefits to specify, in writing, that such insurer, center, corporation, 204
266		-	society, entity or third-party administrator issue explanations of 205
267		-	benefits concerning covered benefits provided to such consumer solely 206
268		-	to such consumer, and specify, in writing, which of the following 207
269		-	methods such insurer, center, corporation, society, entity or third-party 208
270		-	administrator shall use to issue such explanations of benefits solely to 209
271		-	such consumer: 210
272		-	(I) Mailing such explanations of benefits to such consumer's mailing 211
273		-	address or another mailing address specified by such consumer; 212
274		-	(II) Sending such explanations of benefits to such consumer by 213
275		-	electronic means, including, but not limited to, electronic mail; or 214
276		-	(III) Making such explanations of benefits available to such consumer 215
277		-	by electronic means, provided making such explanations of benefits 216
278		-	available solely to such consumer by electronic means complies with all 217
279		-	applicable federal and state laws and regulations concerning data 218
280		-	security, including, but not limited to, 45 CFR Part 160, as amended from 219
281		-	time to time, and 45 CFR Part 164, Subparts A and C, as amended from 220
282		-	time to time. 221
283		-	(ii) Each method specified by a consumer, in writing, pursuant to 222
284		-	subparagraph (B)(i) of this subdivision shall be valid until the consumer 223
285		-	submits a written specification to the insurer, center, corporation, 224
286		-	society, entity or third-party administrator for a different method. Such 225
287		-	insurer, center, corporation, society, entity or third-party administrator 226
288		-	shall comply with a written specification under this clause or 227
289		-	subparagraph (B)(i) of this subdivision, as applicable, not later than 228
290		-	three business days after such insurer, center, corporation, society, 229
291		-	entity or third-party administrator receives such specification. 230 Substitute Bill No. 6461
	259	+	LCO No. 2848 8 of 13
	260	+
	261	+	(A) Issue explanations of benefits to consumers who are covered 199
	262	+	individuals under the policy; and 200
	263	+	(B) (i) Permit each consumer who is a covered individual under the 201
	264	+	policy and legally capable of consenting to the provision of covered 202
	265	+	benefits to specify, in writing, that such insurer, center, corporation, 203
	266	+	society, entity or third-party administrator issue explanations of 204
	267	+	benefits concerning covered benefits provided to such consumer solely 205
	268	+	to such consumer, and specify, in writing, which of the following 206
	269	+	methods such insurer, center, corporation, society, entity or third-party 207
	270	+	administrator shall use to issue such explanations of benefits solely to 208
	271	+	such consumer: 209
	272	+	(I) Mailing such explanations of benefits to such consumer's mailing 210
	273	+	address or another mailing address specified by such consumer; 211
	274	+	(II) Sending such explanations of benefits to such consumer by 212
	275	+	electronic means, including, but not limited to, electronic mail; or 213
	276	+	(III) Making such explanations of benefits available to such consumer 214
	277	+	by electronic means, provided making such explanations of benefits 215
	278	+	available solely to such consumer by electronic means complies with all 216
	279	+	applicable federal and state laws and regulations concerning data 217
	280	+	security, including, but not limited to, 45 CFR Part 160, as amended from 218
	281	+	time to time, and 45 CFR Part 164, Subparts A and C, as amended from 219
	282	+	time to time. 220
	283	+	(ii) Each method specified by a consumer, in writing, pursuant to 221
	284	+	subparagraph (B)(i) of this subdivision shall be valid until the consumer 222
	285	+	submits a written specification to the insurer, center, corporation, 223
	286	+	society, entity or third-party administrator for a different method. Such 224
	287	+	insurer, center, corporation, society, entity or third-party administrator 225
	288	+	shall comply with a written specification under this clause or 226
	289	+	subparagraph (B)(i) of this subdivision, as applicable, not later than 227
	290	+	three business days after such insurer, center, corporation, society, 228
	291	+	entity or third-party administrator receives such specification. 229 Raised Bill No. 6461
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298		-	(iii) Each insurer, center, corporation, society, entity or third-party 231
299		-	administrator that receives a written specification from a consumer 232
300		-	pursuant to subparagraph (B)(i) or (B)(ii) of this subdivision, as 233
301		-	applicable, shall provide the consumer who made such specification 234
302		-	with written confirmation that such insurer, center, corporation, society, 235
303		-	entity or third-party administrator received such specification, and 236
304		-	advise such consumer, in writing, regarding the status of such 237
305		-	specification if such consumer contacts such insurer, center, 238
306		-	corporation, society, entity or third-party administrator, in writing, 239
307		-	regarding such specification. 240
308		-	(2) Each consumer who is a covered individual under a policy 241
309		-	described in subsection (a) of this section and is legally capable of 242
310		-	consenting to the provision of covered benefits may specify, in writing, 243
311		-	that the insurer, center, corporation, society or entity that delivered, 244
312		-	issued for delivery, renewed, amended or continued the policy, or a 245
313		-	third-party administrator providing services to such insurer, center, 246
314		-	corporation, society or entity, not issue explanations of benefits 247
315		-	pursuant to subdivision (1) of this subsection if such explanations of 248
316		-	benefits concern covered benefits that were provided to such consumer. 249
317		-	Such insurer, center, corporation, society, entity or third-party 250
318		-	administrator shall not require such consumer to provide any 251
319		-	explanation regarding the basis for such consumer's specification, 252
320		-	unless such explanation is required by applicable law or pursuant to an 253
321		-	order issued by a court of competent jurisdiction. 254
322		-	(3) Each insurer, center, corporation, society or entity that delivers, 255
323		-	issues for delivery, renews, amends or continues a policy described in 256
324		-	subsection (a) of this section, and each third-party administrator 257
325		-	providing services to such insurer, center, corporation, society or entity, 258
326		-	shall disclose to each consumer who is a covered individual under the 259
327		-	policy such consumer's ability to submit specifications pursuant to 260
328		-	subdivisions (1) and (2) of this subsection. Such disclosure shall be in 261
329		-	plain language and displayed or printed, as applicable, clearly and 262
330		-	conspicuously in all evidence of coverage documents, privacy 263 Substitute Bill No. 6461
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	296	+
	297	+	(iii) Each insurer, center, corporation, society, entity or third-party 230
	298	+	administrator that receives a written specification from a consumer 231
	299	+	pursuant to subparagraph (B)(i) or (B)(ii) of this subdivision, as 232
	300	+	applicable, shall provide the consumer who made such specification 233
	301	+	with written confirmation that such insurer, center, corporation, society, 234
	302	+	entity or third-party administrator received such specification, and 235
	303	+	advise such consumer, in writing, regarding the status of such 236
	304	+	specification if such consumer contacts such insurer, center, 237
	305	+	corporation, society, entity or third-party administrator, in writing, 238
	306	+	regarding such specification. 239
	307	+	(2) Each consumer who is a covered individual under a policy 240
	308	+	described in subsection (a) of this section and is legally capable of 241
	309	+	consenting to the provision of covered benefits may specify, in writing, 242
	310	+	that the insurer, center, corporation, society or entity that delivered, 243
	311	+	issued for delivery, renewed, amended or continued the policy, or a 244
	312	+	third-party administrator providing services to such insurer, center, 245
	313	+	corporation, society or entity, not issue explanations of benefits 246
	314	+	pursuant to subdivision (1) of this subsection if such explanations of 247
	315	+	benefits concern covered benefits that were provided to such consumer. 248
	316	+	Such insurer, center, corporation, society, entity or third-party 249
	317	+	administrator shall not require such consumer to provide any 250
	318	+	explanation regarding the basis for such consumer's specification, 251
	319	+	unless such explanation is required by applicable law or pursuant to an 252
	320	+	order issued by a court of competent jurisdiction. 253
	321	+	(3) Each insurer, center, corporation, society or entity that delivers, 254
	322	+	issues for delivery, renews, amends or continues a policy described in 255
	323	+	subsection (a) of this section, and each third-party administrator 256
	324	+	providing services to such insurer, center, corporation, society or entity, 257
	325	+	shall disclose to each consumer who is a covered individual under the 258
	326	+	policy such consumer's ability to submit specifications pursuant to 259
	327	+	subdivisions (1) and (2) of this subsection. Such disclosure shall be in 260
	328	+	plain language and displayed or printed, as applicable, clearly and 261
	329	+	conspicuously in all evidence of coverage documents, privacy 262
	330	+	communications, explanations of benefits and Internet web sites that are 263 Raised Bill No. 6461
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337		-	communications, explanations of benefits and Internet web sites that are 264
338		-	maintained by such insurer, center, corporation, society, entity or third-265
339		-	party administrator and accessible to consumers in this state. 266
340		-	(4) No insurer, center, corporation, society or entity that is subject to 267
341		-	this subsection shall require a consumer or policyholder to waive any 268
342		-	right to limit disclosure under this subsection as a precondition to 269
343		-	delivering, issuing for delivery, renewing, amending or continuing a 270
344		-	policy described in subsection (a) of this section to the consumer or 271
345		-	policyholder. Nothing in this subsection shall be construed to limit a 272
346		-	consumer's or policyholder's ability to request review of an adverse 273
347		-	determination. 274
348		-	Sec. 7. Section 19a-14c of the general statutes is repealed and the 275
349		-	following is substituted in lieu thereof (Effective July 1, 2021): 276
350		-	(a) For the purposes of this section, "outpatient mental health 277
351		-	treatment" means the treatment of mental disorders, emotional 278
352		-	problems or maladjustments with the object of (1) removing, modifying 279
353		-	or retarding existing symptoms; (2) improving disturbed patterns of 280
354		-	behavior; and (3) promoting positive personality growth and 281
355		-	development. Treatment shall not include prescribing or otherwise 282
356		-	dispensing any medication which is a legend drug as defined in section 283
357		-	20-571. 284
358		-	(b) A psychiatrist licensed pursuant to chapter 370, a psychologist 285
359		-	licensed pursuant to chapter 383, an independent social worker certified 286
360		-	pursuant to chapter 383b or a marital and family therapist licensed 287
361		-	pursuant to chapter 383a may provide outpatient mental health 288
362		-	treatment to a minor without the consent or notification of a parent or 289
363		-	guardian at the request of the minor if (1) requiring the consent or 290
364		-	notification of a parent or guardian would cause the minor to reject such 291
365		-	treatment; (2) the provision of such treatment is clinically indicated; (3) 292
366		-	the failure to provide such treatment would be seriously detrimental to 293
367		-	the minor's well-being; (4) the minor has knowingly and voluntarily 294
368		-	sought such treatment; and (5) in the opinion of the provider of 295 Substitute Bill No. 6461
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	335	+
	336	+	maintained by such insurer, center, corporation, society, entity or third-264
	337	+	party administrator and accessible to consumers in this state. 265
	338	+	(4) No insurer, center, corporation, society or entity that is subject to 266
	339	+	this subsection shall require a consumer or policyholder to waive any 267
	340	+	right to limit disclosure under this subsection as a precondition to 268
	341	+	delivering, issuing for delivery, renewing, amending or continuing a 269
	342	+	policy described in subsection (a) of this section to the consumer or 270
	343	+	policyholder. Nothing in this subsection shall be construed to limit a 271
	344	+	consumer's or policyholder's ability to request review of an adverse 272
	345	+	determination. 273
	346	+	Sec. 7. Section 19a-14c of the general statutes is repealed and the 274
	347	+	following is substituted in lieu thereof (Effective July 1, 2021): 275
	348	+	(a) For the purposes of this section, "outpatient mental health 276
	349	+	treatment" means the treatment of mental disorders, emotional 277
	350	+	problems or maladjustments with the object of (1) removing, modifying 278
	351	+	or retarding existing symptoms; (2) improving disturbed patterns of 279
	352	+	behavior; and (3) promoting positive personality growth and 280
	353	+	development. Treatment shall not include prescribing or otherwise 281
	354	+	dispensing any medication which is a legend drug as defined in section 282
	355	+	20-571. 283
	356	+	(b) A psychiatrist licensed pursuant to chapter 370, a psychologist 284
	357	+	licensed pursuant to chapter 383, an independent social worker certified 285
	358	+	pursuant to chapter 383b or a marital and family therapist licensed 286
	359	+	pursuant to chapter 383a may provide outpatient mental health 287
	360	+	treatment to a minor without the consent or notification of a parent or 288
	361	+	guardian at the request of the minor if (1) requiring the consent or 289
	362	+	notification of a parent or guardian would cause the minor to reject such 290
	363	+	treatment; (2) the provision of such treatment is clinically indicated; (3) 291
	364	+	the failure to provide such treatment would be seriously detrimental to 292
	365	+	the minor's well-being; (4) the minor has knowingly and voluntarily 293
	366	+	sought such treatment; and (5) in the opinion of the provider of 294
	367	+	treatment, the minor is mature enough to participate in treatment 295 Raised Bill No. 6461
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375		-	treatment, the minor is mature enough to participate in treatment 296
376		-	productively. The provider of such treatment shall document the 297
377		-	reasons for any determination made to treat a minor without the consent 298
378		-	or notification of a parent or guardian and shall include such 299
379		-	documentation in the minor's clinical record, along with a written 300
380		-	statement signed by the minor stating that (A) [he] the minor is 301
381		-	voluntarily seeking such treatment; (B) [he] the minor has discussed 302
382		-	with the provider the possibility of involving his or her parent or 303
383		-	guardian in the decision to pursue such treatment; (C) [he] the minor 304
384		-	has determined it is not in his or her best interest to involve his or her 305
385		-	parent or guardian in such decision; and (D) [he] the minor has been 306
386		-	given adequate opportunity to ask the provider questions about the 307
387		-	course of his or her treatment. 308
388		-	(c) [After the sixth session of outpatient mental health treatment 309
389		-	provided to a minor pursuant to this section, the provider of such 310
390		-	treatment shall notify the minor that the consent, notification or 311
391		-	involvement of a parent or guardian is required to continue treatment, 312
392		-	unless such a requirement would be seriously detrimental to the minor's 313
393		-	well-being. If the provider determines such a requirement would be 314
394		-	seriously detrimental to the minor's well-being, he shall document such 315
395		-	determination in the minor's clinical record, review such determination 316
396		-	every sixth session thereafter and document each such review. If the 317
397		-	provider determines such a requirement would no longer be seriously 318
398		-	detrimental to the minor's well-being, he shall require the consent, 319
399		-	notification or involvement of a parent or guardian as a condition of 320
400		-	continuing treatment.] (1) Except as otherwise provided in subdivision 321
401		-	(2) of this subsection, a minor may request and receive as many 322
402		-	outpatient mental health treatment sessions as necessary without the 323
403		-	consent or notification of a parent or guardian. No provider shall notify 324
404		-	a parent or guardian of treatment provided pursuant to this section or 325
405		-	disclose any information concerning such treatment to a parent or 326
406		-	guardian without the consent of the minor. 327
407		-	(2) A provider may notify a parent or guardian of treatment provided 328 Substitute Bill No. 6461
	371	+	LCO No. 2848 11 of 13
	372	+
	373	+	productively. The provider of such treatment shall document the 296
	374	+	reasons for any determination made to treat a minor without the consent 297
	375	+	or notification of a parent or guardian and shall include such 298
	376	+	documentation in the minor's clinical record, along with a written 299
	377	+	statement signed by the minor stating that (A) [he] the minor is 300
	378	+	voluntarily seeking such treatment; (B) [he] the minor has discussed 301
	379	+	with the provider the possibility of involving his or her parent or 302
	380	+	guardian in the decision to pursue such treatment; (C) [he] the minor 303
	381	+	has determined it is not in his or her best interest to involve his or her 304
	382	+	parent or guardian in such decision; and (D) [he] the minor has been 305
	383	+	given adequate opportunity to ask the provider questions about the 306
	384	+	course of his or her treatment. 307
	385	+	(c) [After the sixth session of outpatient mental health treatment 308
	386	+	provided to a minor pursuant to this section, the provider of such 309
	387	+	treatment shall notify the minor that the consent, notification or 310
	388	+	involvement of a parent or guardian is required to continue treatment, 311
	389	+	unless such a requirement would be seriously detrimental to the minor's 312
	390	+	well-being. If the provider determines such a requirement would be 313
	391	+	seriously detrimental to the minor's well-being, he shall document such 314
	392	+	determination in the minor's clinical record, review such determination 315
	393	+	every sixth session thereafter and document each such review. If the 316
	394	+	provider determines such a requirement would no longer be seriously 317
	395	+	detrimental to the minor's well-being, he shall require the consent, 318
	396	+	notification or involvement of a parent or guardian as a condition of 319
	397	+	continuing treatment.] (1) Except as otherwise provided in subdivision 320
	398	+	(2) of this subsection, a minor may request and receive as many 321
	399	+	outpatient mental health treatment sessions as necessary without the 322
	400	+	consent or notification of a parent or guardian. No provider shall notify 323
	401	+	a parent or guardian of treatment provided pursuant to this section or 324
	402	+	disclose any information concerning such treatment to a parent or 325
	403	+	guardian without the consent of the minor. 326
	404	+	(2) A provider may notify a parent or guardian of treatment provided 327
	405	+	pursuant to this section or disclose certain information concerning such 328
	406	+	treatment without the consent of the minor who receives such treatment 329 Raised Bill No. 6461
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414		-	~~pursuant to this section or disclose certain information concerning such 329~~
415		-	~~treatment without the consent of the minor who receives such treatment 330~~
416		-	provided (A) such provider determines such notification or disclosure ~~331~~
417		-	is necessary to the minor's well-being, (B) the treatment provided to the ~~332~~
418		-	minor is solely for mental health and not for a substance use disorder, ~~333~~
419		-	and (C) the minor is provided an opportunity to express any objection ~~334~~
420		-	to such notification or disclosure. The provider shall document his or ~~335~~
421		-	her determination concerning such notification or disclosure and any ~~336~~
422		-	objections expressed by the minor in the minor's clinical record. A ~~337~~
423		-	provider may disclose to a minor's parent or guardian the following ~~338~~
424		-	information concerning such minor's outpatient mental health ~~339~~
425		-	treatment: (i) Diagnosis; (ii) treatment plan and progress in treatment; ~~340~~
426		-	(iii) recommended medications, including risks, benefits, side effects, ~~341~~
427		-	typical efficacy, dose and schedule; (iv) psychoeducation about the ~~342~~
428		-	minor's mental health; (v) referrals to community resources; (vi) ~~343~~
429		-	coaching on parenting or behavioral management strategies; and (vii) ~~344~~
430		-	crisis prevention planning and safety planning. A provider shall release ~~345~~
431		-	a minor's entire clinical record to another provider upon the request of ~~346~~
432		-	the minor or such minor's parent or guardian. ~~347~~
433		-	(d) A parent or guardian who is not informed of the provision of ~~348~~
434		-	outpatient mental health treatment for his or her minor child pursuant ~~349~~
435		-	to this section shall not be liable for the costs of the treatment provided.~~350~~
	410	+	LCO No. 2848 12 of 13
	411	+
	412	+	provided (A) such provider determines such notification or disclosure 330
	413	+	is necessary to the minor's well-being, -(B) the treatment provided to the 331
	414	+	minor is solely for mental health and not for a substance use disorder, 332
	415	+	and (C) the minor is provided an opportunity to express any objection 333
	416	+	to such notification or disclosure. The provider shall document his or 334
	417	+	her determination concerning such notification or disclosure and any 335
	418	+	objections expressed by the minor in the minor's clinical record. A 336
	419	+	provider may disclose to a minor's parent or guardian the following 337
	420	+	information concerning such minor's outpatient mental health 338
	421	+	treatment: (i) Diagnosis; (ii) treatment plan and progress in treatment; 339
	422	+	(iii) recommended medications, including risks, benefits, side effects, 340
	423	+	typical efficacy, dose and schedule; (iv) psychoeducation about the 341
	424	+	minor's mental health; (v) referrals to community resources; (vi) 342
	425	+	coaching on parenting or behavioral management strategies; and (vii) 343
	426	+	crisis prevention planning and safety planning. A provider shall release 344
	427	+	a minor's entire clinical record to another provider upon the request of 345
	428	+	the minor or such minor's parent or guardian. 346
	429	+	(d) A parent or guardian who is not informed of the provision of 347
	430	+	outpatient mental health treatment for his or her minor child pursuant 348
	431	+	to this section shall not be liable for the costs of the treatment provided. 349
436	432		This act shall take effect as follows and shall amend the following
437	433		sections:
438	434
439	435		Section 1 July 1, 2021 New section
440	436		Sec. 2 July 1, 2021 New section
441	437		Sec. 3 July 1, 2021 New section
442	438		Sec. 4 July 1, 2021 New section
443	439		Sec. 5 July 1, 2021 New section
444	440		Sec. 6 January 1, 2023 38a-477d
445	441		Sec. 7 July 1, 2021 19a-14c
446	442
447		-	HED Joint Favorable Subst. Substitute Bill No. 6461
	443	+	Statement of Purpose:
	444	+	To (1) implement the recommendations of the task force regarding the
	445	+	prevention and treatment of mental illness at institutions of higher
	446	+	education, (2) require health insurers to maintain explanations of
	447	+	benefits as confidential in certain circumstances, and (3) allow minors to Raised Bill No. 6461
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	452	+
	453	+	receive more than six outpatient mental health treatment sessions
	454	+	without the consent of a parent or guardian.
	455	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	456	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	457	+	underlined.]
454	458