MENTAL HEALTH PARITY
OPA supports comprehensive mental health parity.

Insurance plans that are regulated by our state must now provide equal care for physical health problems and a short list of serious mental illness. Other equally significant mental illnesses, such as post traumatic stress disorder (PTSD), alcohol and substance abuse, and generalized anxiety disorder are not covered under our current state law. The lack of comprehensive parity in our current health care plans reinforces the stigma that has unnecessarily demeaned people with mental health problems for generations.

Forty-two other states have passed mental health parity legislation.Their experience shows that premium costs have not gone up by more than .05-1.9%, and the rate of the uninsured in those states has not been affected either.

OPA supports a comprehensive parity bill because we believe that “medical necessity” determined by a doctor should be the test of whether a diagnosis is covered or not. OPA supports covering alcohol and substance abuse because many addicts became ill after self-medicating for untreated mental illness. Treatment works to bring about recovery and puts people back to work. ( Kentucky and Indiana have this type of parity legislation)

STATE FUNDING FOR MENTAL HEALTH CARE
OPA supports increased funding for mental health care for children and adults.

Ohio is in a crisis with respect to providing adequate mental health treatment for its citizens. In 2001, Ohio ranked 33rd in funding for mental health, a rating reflective of this crisis. Ohio’s ranking for mental health funding has been on a steady downward trend for several years (Rank #17 in 1981; #25 in 1990; #29 in 1997).

PRESCRIPTIVE AUTHORITY FOR ADVANCED PRACTICE PSYCHOLOGISTS
OPA supports prescriptive authority for psychologists with adequate postdoctoral training in psychopharmacology.

In response to serious problems accessing psychiatric services, particularly in rural areas and for minority populations, New Mexico and Louisiana recently passed legislation to allow specially trained medical psychologists to prescribe psychotropic medications (medicines to treat mental illness). In Ohio, adults wait weeks and children wait months to see a psychiatrist for medication, prompting growing interest in similar legislation here. Increasing evidence proves that specially trained psychologists can safely prescribe medication and play a vital role in solving this health care problem. For example, the U.S. Department of Defense has conducted successful pilot programs in which psychologists received significant post-doctoral training and effectively managed patient medication and psychotherapy. These specially trained psychologists actually cut pharmaceutical costs because they balanced medication with psychotherapy.

INSURANCE REGULATION, & PATIENT ACCESS
OPA supports patient access legislation and “any willing provider” legislation.

HMOs (Health Maintenance Organizations) typically restrict the ability of patients to see health care providers by only reimbursing for services of a “network provider.” Most surveys indicate that patients want to choose their own psychologist or other health care professional. With employers shifting from one health plan to another with greater frequency, patients are forced to find new providers and abandon successful treatment programs and providers with whom they have built a trusting relationship. HMOs tout the high quality of providers on their panels, but in truth, they frequently include deceased or retired providers, providers who are not taking new patients, and providers who practice in a given geographic area on a part time basis. HMOs generally determine the proximity of a provider to a geographic area “as the crow flies” and in many areas of Ohiothis may mean that providers on a given panel may be a significant distance from patients. Patient access legislation would permit patients to use an out-of-network provider of their choice if the provider is willing to provide service in manner consistent with HMO requirements. The patient would pay an appropriate administrative fee for using a non-network provider.

Another option is “any willing provider” legislation, now enacted in 34 states. Generally, “any willing provider” laws require managed care plans using a provider network to accept any appropriate licensed provider who is willing to accept the plan’s contract terms.