HOUSE OF REPRESENTATIVES
TWENTY-NINTH LEGISLATURE, 2017
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO VICTIMS OF SEXUAL VIOLENCE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that sexual violence is extremely prevalent. In the United States, one in six women and one in thirty-three men have experienced an attempted or completed rape in their lifetime, while one in four girls and one in six boys will be sexually abused before they turn eighteen.
The legislature further finds that sexual violence can have severe and lasting emotional and mental health impacts on victims. Victims of sexual assault during adulthood suffer post-traumatic stress disorder at a rate between thirty to sixty-five per cent and also experience elevated rates of depressive disorders, parasuicidal behaviors, and substance use disorders. Victims of sexual abuse during childhood are diagnosed with post-traumatic stress disorder at a rate three to five times greater than that of people who have not experienced sexual abuse, have a rate of lifetime depression of fifty-two per cent, and experience increased rates of suicide and other self-harming behaviors, problems with alcohol use, eating disorders, and disruptions to developmental processes that lead to personality disorders. Consequently, many victims of sexual violence experience complex mental health issues and require clinical case management services by licensed mental health providers in addition to psychotherapy to effectively manage mental illness related to sexual violence.
The legislature additionally finds that it can be difficult for victims of sexual violence to obtain appropriate mental health services due to the limited availability of qualified service providers who are able to take on complex cases. Clinical case management services are not generally covered by health insurers. This creates a barrier to accessing needed services since providers may be unwilling or unable to provide clinical case management services, which are often an unreimbursed expense, or to take on patients who require these services.
The purpose of this Act is to improve mental health service availability for victims of sexual violence by requiring that health insurance cover appropriate, related case management services by licensed mental health providers for victims of sexual violence who suffer from mental illness.
SECTION 2. Section 431M-1, Hawaii Revised Statutes, is amended by adding three new definitions to be appropriately inserted and to read as follows:
""Case management" means professional intervention conducted by a licensed mental health provider that identifies needs and assists in obtaining coordinated, appropriate services and resources for a victim of sexual violence. "Case management" includes:
(1) Coordinating with other health care providers, including behavioral and mental health care providers; and
(2) Assisting victims of sexual violence to obtain appropriate government program entitlements, access insurance coverage, and obtain other appropriate programs and services offered by government agencies and community organizations.
"Licensed mental health provider" means a:
(2) Licensed mental health counselor;
(3) Licensed marriage and family therapist;
(4) Licensed clinical social worker;
(5) Psychologist; or
(6) Licensed dietician treating eating disorders,
who holds a current and unencumbered license to practice or is exempt from licensure requirements in this State.
"Victim of sexual violence" means an individual who suffers from mental illness caused, in whole or in part, by sexual violence."
SECTION 3. Section 431M-2, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
All individual and group accident and health or sickness insurance policies
issued in this State, individual or group hospital or medical service plan
contracts, and nonprofit mutual benefit society, fraternal benefit society, and health
maintenance organization health plan contracts shall include within their
hospital and medical coverage the benefits of alcohol use disorder, substance
use disorder, and mental health treatment services, including services for
alcohol dependence and drug dependence[
,] and case management
services for victims of sexual
violence, except that this section shall not apply to insurance
policies that are issued solely for single diseases, or otherwise limited,
SECTION 4. Section 431M-4, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:
"(b) Mental illness benefits.
(1) Covered benefits for mental health services set forth in this subsection shall be limited to coverage for diagnosis and treatment of mental disorders. All mental health services shall be provided under an individualized treatment plan approved by a physician, psychologist, licensed clinical social worker, licensed marriage and family therapist, licensed mental health counselor, advanced practice registered nurse, or licensed dietitian treating eating disorders, and must be reasonably expected to improve the patient's condition. An individualized treatment plan approved by a licensed clinical social worker, licensed marriage and family therapist, licensed mental health counselor, advanced practice registered nurse, or a licensed dietitian treating eating disorders, for a patient already under the care or treatment of a physician or psychologist shall be done in consultation with the physician or psychologist;
(2) In-hospital and nonhospital residential mental health services as a covered benefit under this chapter shall be provided in a hospital or a nonhospital residential facility. The services to be covered shall include those services required for licensure and accreditation;
(3) Mental health partial hospitalization as a covered benefit under
this chapter shall be provided by a hospital or a mental health outpatient facility.
The services to be covered under this paragraph shall include those services required
for licensure and accreditation; [
(4) Mental health outpatient services shall be a covered benefit
under this chapter[
(5) Case management services by licensed mental health providers for victims of sexual violence shall be a reimbursable covered benefit under this chapter."
SECTION 5. Notwithstanding any other law to the contrary, the coverage and reimbursement for case management services for victims of sexual violence required under this Act shall apply to all health benefits plans under chapter 87A, Hawaii Revised Statutes, issued, renewed, modified, altered, or amended on or after January 1, 2018.
SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 7. This Act shall take effect upon its approval and shall apply to all policies, contracts, plans, or agreements issued or renewed in the State on or after January 1, 2018.
Health Insurance; Mental Illness Benefits; Covered Services; Case Management Services; Victims of Sexual Violence
Requires health insurance coverage for case management services by licensed mental health providers for victims of sexual violence. (HB665 HD2)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.