Appropriations Committee
JOINT FAVORABLE REPORT
Bill No.: HB-5433
AN ACT ESTABLISHING A COUNCIL ON MENTAL AND BEHAVIORAL
Title: HEALTH PROGRAM OVERSIGHT.
Vote Date: 4/7/2022
Vote Action: Joint Favorable Substitute
PH Date: 3/18/2022
File No.:
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
Appropriations Committee
REASONS FOR BILL:
This bill establishes a Behavioral and Mental Health Policy and Oversight Committee to evaluate the
availability and efficacy of prevention, early intervention, and mental health treatment services and
options for children under the age of 18, and make recommendations regarding the governance and
administration of the mental health care system for children. The committee would seek to coordinate
services and evaluate existing programing pertinent to children's mental health as the current services
provided have been found incomplete, especially given the increased demand for behavioral and
mental health services amid the fallout of the COVID-19 pandemic.
Substitute Language
The substitute language eliminates the Department of Mental Health and Addiction Services
(DMHAS) as the agency to which the committee will advise. It also limits the number of appointees
allotted from the Speaker of the House of Representatives, President Pro Tempore of the Senate,
House and Senate Majority Leaders, House and Senate Minority Leaders and eliminates a designee
from the Office of the State Comptroller. Alternatively, it adds appointed members from DMHAS, the
Office of Health Strategies, the Child Advocate, the Healthcare Advocate, the executive director of the
Commission on Women, Children, Seniors, Equity and Opportunity (CWCSEO), and one
representative from each administrative services organization under contract with the Department of
Social Services to provide such services for recipients of assistance under the HUSKY Health
program, who shall be ex-officio nonvoting members.
RESPONSE FROM ADMINISTRATION/AGENCY:
Nancy Navarretta, Commissioner, DMHAS - Commissioner Navarretta testified in opposition of the
bill. She explained that while DMHAS supports collaborative efforts of multiple stakeholders in
committees and councils, however, the Department does not have the resources to assist in
implementation of this bill. She continues that the activities of the proposed council in relation to
behavioral health, are already performed by several other councils mandated by the legislature.
Additionally, the Commissioner referred the committee to the Committee on Children's mental health
bill, SB 2, as section 24 of their bill proposes a Cabinet that will accomplish the tasks outlined in
Section 2 of this bill pertinent to creating a standing subcommittee related to the needs of children's
mental health.
Vanessa Dorantes, Commissioner, Department of Children and Families (DCF) Commissioner
Dorantes submitted testimony on behalf of DCF explaining that if this bill were to move forward, they
respectfully request that the bill be amended that the council focuses its efforts on adult mental and
behavioral health needs, as those fall under DMHAS' purview and DCF is statutorily mandated as the
lead agency for behavioral services for children. The Commissioner explained that the Department
already provides coordination, oversight, and funding for a broad array of community-based mental
health services designed to assist children, youth, and their families with a range of psychiatric and
substance use disorders. She continued that the administration of these programs and support
services have been guided by the Connecticut Childrens Behavioral Health Plan, developed in 2014,
in consultation with providers, advocates, and families with lived expertise. Implementation of the plan
is overseen by the Children's Behavioral Health Plan Implementation Advisory Board, with members
appointed by DCF, which provides annual progress reports to the Connecticut General Assembly.
Additionally, DCF is currently working with legislative leadership on comprehensive children's
behavioral health legislation which will include a governance structure a Children's Behavioral
Health Cabinet - that the agency believes will be most effective for improving the delivery of statewide
services.
Deidre Gifford, Commissioner, Department of Social Services (DSS) - DSS testified that while
they appreciate the intent of this bill, they find it unnecessary as it would be duplicative in nature. DSS
suggests that the work of a council that advises DMHAS on the planning and implementation of
behavioral health services and programs, is currently being done by the legislatures Behavioral
Health Partnership Oversight Council (BHPOC). There are also several subcommittees that meet
regularly and are charged with more precise issues surrounding behavioral health, such as
coordination of care, child/adolescent quality and access, and diversity, inclusion and equity. While
the Department is not opposed to the concept, it is their suggestion to seek to consolidate and focus
on expanding the reach and work of the BHPOC rather than creating duplicative efforts with an
additional council.
Sarah Eagan, Child Advocate, State of CT Office of Child Advocate (OCA) Ms. Eagan
submitted testimony on behalf of OCA stating the agency deeply appreciates the bipartisan
commitment to transformation of our childrens mental health delivery system. OCA explains that
several state agencies currently play important roles in the childrens behavioral health system and
there are many areas of high quality and innovative initiatives and programming. However, OCA
expresses that there is not a robust oversight and coordination infrastructure to bring information
together across systems to inform regarding the efficacy and needs of the current behavioral health
system. The agency highlighted a few areas that need the robust, data-driving, and accountable
coordination and oversight including payment reform as it relates to the inadequate reimbursement
rates for key services and levels of care, bolstering existing service array, strengthening services for
children with developmental disabilities, continuing to develop the workforce essential to supporting
mental health service delivery to children and families, analyze and improve the service array gaps for
justice involved/as-risk children, supporting school-based mental health initiatives.
The Commission on Women, Children, Seniors, Equity and Opportunity (CWCSEO)- CWCSEO
testified in support of HB 5433 and expressed that they would be honored to serve in some capacity
on the oversight council. They went on to explain that this legislation is necessary referencing that in
2019, in children between the ages of 12 and 17, suicide was the second leading cause of death.
Page 2 of 3 HB-5433
COVID-19 has only exacerbated this need, with over 20% of school-aged children reporting that their
mental health has worsened since its start. CWCSEO continued that along with increasing demand
there are increasing disparities in access for children of color, with the burden falling largely on Black
and Hispanic adolescents and that 65% of Black children and 62% of Latinx children with depression
do not receive any treatment. Additionally, The Commission supports this attention to increasing
awareness to available services and how to access them as it recognizes the increasing need in this
state; the persistence of the pandemic and its impact on people's overall quality of life "has translated
into a 20% increase in calls to 2-1-1 from people seeking mental health treatment and more trips to
the emergency department for children and adults who are in a mental health crisis". Despite the
increase in mental health service needs, about 30% of adults in Connecticut suffering from anxiety
and depression have not had their treatment needs met". The Commission also supports the notion of
having the council make recommendations regarding the sufficiency of providers and provider rates.
Furthermore, the Commission supports the explicit inclusion of council recommendations concerning
the linguistic and cultural competency of providers within the bill text.
NATURE AND SOURCES OF SUPPORT:
Fran Rabinowitz, Connecticut Association of Public School Superintendents (CAPSS) - CAPSS
supports this bill and welcomes the opportunity to participate in this subcommittee; however, CAPSS
suggests it might be prudent to extend the deadline for the subcommittee to complete its
comprehensive review of this critically important and complicated subject.
NATURE AND SOURCES OF OPPOSITION:
Howard Sovronsky, Chief Behavioral Officer, CT Children's Medical Center (CCMC) Mr.
Sovronsky submitted testimony on behalf of CCMC stating while they are pleased with the
membership from many state agencies, they are concerned that the council, as proposed, may not be
as effective as intended, as the official charge of this council seems narrow in scope and not specific
to the needs of children. They also disagree with DMHAS being the point of referral for the council as
DCF is the agency with cognizance over children's mental health issues.
Reported by: Taylor Hyde Date: April 19, 2022
Page 3 of 3 HB-5433