| Chapter 303 |
| 2022 -- S 2614 Enacted 06/29/2022 |
| A N A C T |
| RELATING TO INSURANCE -- INSURANCE COVERAGE FOR MENTAL ILLNESS AND SUBSTANCE ABUSE |
Introduced By: Senators DiMario, Valverde, Miller, Burke, Lawson, DiPalma, Seveney, and Euer |
| Date Introduced: March 10, 2022 |
| It is enacted by the General Assembly as follows: |
| SECTION 1. Chapter 27-38.2 of the General Laws entitled "Insurance Coverage for Mental |
| Illness and Substance Abuse" is hereby amended by adding thereto the following section: |
| 27-38.2-6. Infant and early childhood mental wellness task force. |
| (a) The general assembly hereby finds that: |
| (1) Infant and early childhood mental health is defined by zero Zero to three Three as “the |
| developing capacity of the child from birth to five (5) years of age to: form close and secure adult |
| and peer relationships, experience, manage and express a full range of emotions, and explore the |
| environment and learn -- all in the context of family, community and culture.” |
| (2) Significant mental health challenges can and do occur in babies and young children. |
| Epidemiological studies show a sixteen percent (16%) to eighteen percent (18%) prevalence rate |
| of mental health disorders in children between age one and age six (6). Evidence shows that many |
| mental health challenges occurring in the first years of life persist and increase the risk of problems |
| related to early learning and development in all areas, and to serious long-term health and mental |
| health challenges and poor educational and economic outcomes. |
| (3) Young children respond to and process emotional experiences and traumatic events in |
| ways that are very different from adults and older children. Consequently, identifying and |
| addressing mental health challenges in early childhood requires special skills and knowledge. |
| Promoting responsive and nurturing parent/caregiver-child relationships is particularly important |
| for babies and young children. |
| (4) It is essential to treat young children’s mental health challenges in the context of their |
| relationships within families, homes, and communities. The emotional well-being of young |
| children is directly tied to the functioning of their parents/caregivers and the families in which they |
| live. Thus, successful mental health treatment for young children involves working to build and |
| strengthen consistent, supportive relationships within their families and community. Identifying |
| and treating mental health challenges of parents and caregivers, especially maternal depression |
| which is a common condition and can negatively impact child development, is also needed. When |
| relationships are reliably responsive and supportive and stress is reduced, young children can thrive. |
| (5) Diagnostic Classification of Mental Health and Developmental Disorders of Infancy |
| and Early Childhood (DC: 0-5) is the only recommended diagnosis system for children under age |
| six (6). DC: 0-5 is a system of classification of mental health and developmental disorders for |
| infants and toddlers. |
| (6) Evidence-based and evidence-informed parent-child dyadic therapies exist that focus |
| on the powerful influence of the parent/caregiver-child relationship to positively impact a child’s |
| trajectory. Evidence-based interventions aimed at mental health challenges are more effective when |
| implemented during early childhood rather than school age. It is a misconception that young |
| children will grow out of their difficulties or simply forget early traumatic experiences. |
| (7) In Rhode Island, approximately fifty percent (50%) of infants and young children have |
| Medicaid health coverage which covers screening, evaluation, diagnosis, and treatment for |
| children’s mental health needs starting at birth. Data from 2018 indicate that less than eight percent |
| (8%) of the Medicaid population under age six (6) received any mental health services. |
| (8) According to the National Center for Children in Poverty, at least twenty-one (21) states |
| have adopted research-informed infant/early childhood mental health state policies and scaled |
| initiatives. Medicaid policy in at least thirteen (13) states and the District of Columbia recommends |
| or requires the use of the developmentally-appropriate DC: 0-5 system for the diagnosis of children |
| under age six (6), and at least twelve (12) states require providers to use an evidence-based dyadic |
| treatment model for children under age six (6). |
| (b) The executive office of health and human services shall establish a task force to develop |
| a plan to improve promotion of social and emotional well-being of young children as well as |
| screening, assessment, diagnosis, and treatment of mental health challenges for children from birth |
| through age five (5) with Medicaid coverage. |
| (c) The planning task force shall include representation from the RI Association for Infant |
| Mental Health and representatives from pediatric health care, mental health care, child psychiatry, |
| child welfare, Early Intervention early intervention, Family Home Visiting family home visiting, |
| early care and education, advocacy organizations, Medicaid Managed Care Organizations |
| managed care organizations, Medicaid Accountable Entities accountable entities, families with |
| young children, and other stakeholders as needed. |
| (d) The plan established in accordance with this section shall include strategies to: |
| (1) Promote use of developmentally appropriate screening, assessment, diagnosis, and |
| evidence-based and evidence-informed parent-child dyadic therapies for children from birth |
| through age five (5). |
| (2) Identify mental health promotion and prevention-related parenting support programs, |
| particularly evidence-based or evidence-informed parent-child programs supporting social and |
| emotional well-being. |
| (3) Allow for effective screening, evaluation, and treatment over multiple visits with a |
| qualified practitioner in a variety of settings, including in children’s homes, at childcare and early |
| learning programs, in schools, and in clinical and other professional settings. |
| (4) Establish a registry of trained infant/early childhood mental health professionals that |
| can be a resource across health care, education, and human service settings. |
| (5) Strengthen infant and early childhood mental health skills, knowledge, and practices of |
| all providers who work with young children (birth through age five (5)) in health care, mental health |
| care, early childhood, and child welfare service sectors. |
| (6) Address and respond to the intergenerational effects of racism, economic insecurity, |
| and toxic stress that influence the health and mental health of parents/caregivers, babies, and young |
| children. |
| (e) The task force shall submit a plan to the governor and general assembly on or before |
| June 30, 2023. |
| SECTION 2. This act shall take effect upon passage. |
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| LC004994 |
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