Paying for 'wraparound' mental health for kids divides advocates, business leaders
Cheryl Guerin of Enfield said her son, suffering from a chronic mental illness, would have been unable to survive without the 'wraparound' services provided through the state's FAST Forward program.
'We spent four years navigating the system and these services, once we got them, made all the difference,' Guerin said.
A group of mental health advocates joined Guerin for a press conference urging House budget writers to agree with the Senate's spending plan that would create a permanent way to finance these benefits through an increase in the state's premium tax on commercial insurance companies.
But several business and taxpayer organizations have mounted a late offensive against the measure, branding it a 'new tax' that would only lead to higher health insurance rates.
Natch Greyes is a lobbyist for the Business & Industry Association and recently wrote House Majority Leader Jason Osborne, R-Auburn, to urge the House to block the program from becoming law.
'As the high cost of employee health care coverage reduces employers' ability to grow and makes it more difficult for workers to afford health insurance, the BIA has a standing policy position to oppose new or expanded health insurance mandates,' Greyes wrote.
The Senate budget's trailer bill includes legislation (SB 128) that has never faced scrutiny before the House this year.
Wraparound services are a family-centered program that identifies youth behavioral health problems at an early stage and through intervention provides support services that allow the family to keep the child at home and not need psychiatric inpatient care.
The Fast (Families and Systems Together) Forward program is for those aged 5-21 years old.
Denis Calcutt is the director of Connected Families Inc., one of the two case management programs offering these services; NFI North Inc. is the other.
About 20% of the children in the program are covered under commercial insurance.
'We aren't talking about kids who need care once a week. We have known for some time the continuum for mental health is therapy at one end and the psychiatric hospital at the other,' Calcutt said.
Advocates say earlier services have lowered costs
The two providers reported to the state that the program has led to a 25% decline in systems costs because more expensive inpatient services have been avoided.
Michele Merritt, president of New Futures, a public health advocacy group, said there's a perverse incentive for insurers not to cover this level of care because it means many families end up on the government-run, Medicaid health insurance program that does reimburse for this treatment.
'The system rewards commercial carriers for providing the least amount of care possible for these patients,' Merritt said. 'For five years we have tried to resolve this matter without legislation…this legislation is not about expanding government, it is above providing care through insurance. This restores basic fairness to a system that is basically not working.'
Merritt said taxpayers currently are subsidizing up to $2 million a year for these services once some of the clients end up on Medicaid.
John Reynolds, state director for the National Federation of Independent Business, said it's not right to charge employers through higher insurance premiums for the service.
'While increasing access to and compensation for children's mental health services is laudable, the assessment in SB 128 on fully insured and self-funded health plans is misplaced," Reynolds said. "Rather than assess health plans bought by individuals and small businesses, those known to be responsible for the surge in youth mental health issues, like social media companies, should pay for it.'
Susan Stearns, executive director of the National Alliance for Mental Illness – N.H., said estimates are this tax would have very little impact on insurance rates and the more cost-effective care could end up making the program 'cost neutral' for employers.
'I would like to have a conversation with these employers' who oppose the change, Stearns said. 'Are they getting their money's worth (from health insurers) when it comes to behavioral health care for children?'
The Granite State Taxpayers Association last week began its own lobbying campaign to try and sink the proposal that will be part of the give-and-take between House and Senate negotiators as they work toward a compromise state budget.
'GST opposes SB 128 as it stands or it being placed in HB 2 since this is an annual $2.5 million tax on all commercial insurance premium holders, most of which will never gain any benefit from the program it will be funding,' said former state Rep. Patrick Abrami, vice chairman of the taxpayers group.
What's Next: House and Senate budget conferees are expected to begin their negotiations at the end of this week.
Prospects: The changes for this becoming a reality are good especially because the bill's prime sponsor, Senate Majority Leader Regina Birdsell, R-Hampstead, is one of four senators who will be negotiating with the House towards a state budget compromise.
klandrigan@unionleader.com
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