For the past 15 years, the Washington State Coalition of Mental Health Professionals and Consumers  (the Coalition) has worked to maintain access to ethical mental health treatment; prevent insurers from intruding into the treatment process or unfairly restricting mental health treatment; elect legislators who support access to ethical mental health treatment; and keep clinical mental health judgment in the hands of clinicians.  This summary will outline the activity and successes of the Coalition over the past 15 years.

Beginnings of the Coalition

In 1994, several mental health practitioners became very concerned about the evolution of Managed Care and formed two groups, one the precursor to the Coalition, led by Dick Miller, Sue Wiedenfeld, and Mel Knight, and the other, founded by Ken King and Laura Groshong, the Consortium of mental health practitioners.  Both were multidisciplinary efforts to make a difference in protecting the values that underlie effective psychotherapy.

The Coalition and Consortium merged and began the advocacy work on behalf of all mental health clinicians and consumers that continues today.  That year there were testimonials all over the state on the need for adequate protection of client rights and the elements of effective psychotherapy.  Coalition meetings were well attended as people looked for ways to cope and survive in an evolving managed care environment.

1999

The work with Commissioner Senn became the Insurance Commissioner’s Mental Health Task Force.  The Coalition played a major role in passing SB 5587, the Patient Bill of Rights, protecting insurance enrollees’ access to benefits.  The Coalition became actively involved with the Washington Coalition for Insurance Parity, with Laura Groshong as a WCIP Board member.

2000-2001

A big step for the Coalition—joining forces with seven other mental health groups to form MH-PAC, a mental health political action committee.  We held a Patients’ Rights Conference in association with the Washington State Labor Council and Commissioner Senn. 

2002

Coalition Board member Jane Palmer created a Provider Satisfaction Survey, identifying which insurers were the easiest for clinicians to work with.  Laura Groshong and Sue Wiedenfeld were appointed to the Regence Behavioral Health Advisory Panel with 8 other clinicians.  The MH-PAC took in $4,000 and endorsed 35 candidates, 90% of whom won their races. 

2003-2004

The Coalition Board expanded talks with Rotary Clubs.  In defensive mode, we worked with other groups to prevent the Department of Health from seizing clinical records without due process.  We continued to work with the WCIP to pass mental health parity.  HB 1828, our mental health parity bill, passed the House for the first time.  

2005

Success! The first part of mental health parity, HB 1828, a mandated benefit for companies with more than 50 employees, passed the legislature.  The Coalition had been a member of the Washington Coalition for Insurance Parity since its inception in 1998.

Rep. Eileen Cody created the Joint Executive Legislative Task Force to review our state’s public mental health systems, and the Coalition was one of only five groups asked to submit recommendations. 

2006

The Coalition met with Regence executives to discuss their intent to cover only “evidence-based practice.”  We began discussions with Regence on the problems inherent in requiring all treatment meet this limited standard.  MH-PAC continued to win, with 98% of endorsed candidates successful.

2007

Expanded parity success!  HB 1460 was signed into law in March, giving mental health parity to all non-ERISA plans (the small business and individual market) for the first time.  A monumental legislative year for mental health, SB 1088, the Children’s Mental Health bill, provided $12 million in new funding for children in Medicaid programs and foster care.

2008

The Coalition worked diligently to elect candidates who supported the right to ethical mental health services.  MH-PAC had seven members who sent questionnaires to all 250 candidates.  Of the 75 candidates who were endorsed, 90% were elected.

Additionally, the Coalition carefully tracked the reorganization of the Registered Counselors, a category with more than 19,000 members who were not required to have any clinical degree or training.  This contentious process led to higher standards for mental health clinicians and better protection of Washington citizens who needed mental health treatment. 

2009

The Coalition began working with the Health Care Authority on the Uniform Medical Plan administration.  This plan had one of the best mental health benefits in the state but, as our state revenue decreased sharply, it was clear that the benefits and reimbursement rates would need to be lowered.  The Coalition met with Aetna executives when the contract was awarded to this insurer.  Shortly after this, the contract was revoked for failure to follow state laws on contract procedures, and a new round of contract proposals had to be started.

The Coalition also tracked the national changes to health care through the Affordable Care Act, which would begin to change the way that health care was delivered.

2010

The Coalition continued to work on the way that the Uniform Medical Plan would be administered, meeting with Director Steve Hill of the Health Care Authority to discuss the way that mental health should be included in a balanced plan.  The contract was awarded to Regence BlueShield and the Coalition, which had already been meeting with Regence regularly, increased our contact with Regence to discuss the way that the UMP mental health benefit would be implemented.  Regence planned to cover the UMP the same way that other mental health benefits were covered, resulting in hardships for clinicians and their patients.

2011

The Coalition tracked the way that the Uniform Medical Plan was implemented and began receiving complaints from members in April that payments were not being made.  The monthly conference calls that the Coalition had with Regence administrators became increasingly difficult as the number of unpaid mental health claims climbed to 7,000.  Finally, Regence was able to resolve the problem with its computer system that prevented claims from being paid when Regence was a secondary insurer to Medicare, and most claims were paid by November.

A new problem arose in the form of the Regence decision to begin using Milliman Guidelines as the basis for mental health treatment coverage.  The Coalition investigated the way that these Guidelines were constructed by an actuarial firm and mobilized the mental health community to confront the lack of sound clinical judgment behind the way that the Guidelines viewed mental health treatment.  The Coalition was a leader in forming the Washington Mental Health Treatment Task Force, a group that intends to create a clinical alternative to the Milliman Guidelines in discussions with insurers and legislators.  The target date for this alternative is February 2012.