Legislative Information & Advocacy


Certified peers are considered mental health / addiction recovery professionals in the state of Connecticut. They are held to professional standards and demonstrate their value at every point of a persons recovery journey. Trained peers can work in environments ranging from mental health treatment centers to hospital emergency rooms. In 2017 a question was raised, should insurance companies cover the cost of services provided by these peers? This led to the creation of several bills brought before the state legislature. This page will serve as a reference starting from the first proposed bill in 2017 and all bills that could effect peers in the workforce in the future.

Peer Reimbursement

HB-6887: AN ACT CONCERNING MENTAL HEALTH CARE SERVICES AND SUBSTANCE ABUSE
SERVICES PROVIDED BY CERTIFIED PEER COUNSELORS.

Statement of Purpose: To require that certain health insurance policies cover nonmedical mental health care and substance abuse services provided by certified peer counselors.

Introducer(s):
Insurance and Real Estate Committee


Bill History

01-25-2017 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
02-02-2017 RESERVED FOR SUBJECT MATTER PUBLIC HEARING
02-09-2017 PUBLIC HEARING 02/16
02-23-2017 VOTE TO DRAFT
03-03-2017 DRAFTED BY COMMITTEE
03-06-2017 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
03-15-2017 JOINT FAVORABLE SUBSTITUTE CHANGE OF REFERENCE Public Health Committee
03-16-2017 FILED WITH LEGISLATIVE COMMISSIONERS’ OFFICE
03-21-2017 REPORTED OUT OF LEGISLATIVE COMMISSIONERS’ OFFICE
03-21-2017 FAVORABLE CHANGE OF REFERENCE, HOUSE TO COMMITTEE ON Public Health
Committee
03-22-2017 FAVORABLE CHANGE OF REFERENCE, SENATE TO COMMITTEE ON Public Health
Committee

Co-sponsor(s):
Rep. Cristin McCarthy Vahey, 133rd Dist. Rep. Dorinda Borer, 115th Dist


Bill Language

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. (NEW) (Effective January 1, 2018) (a) For the purposes of this section: (1) “Certified peer counselor” means an individual certified by the Insurance Commissioner to provide peer support services; and (2) “peer support services” means such nonmedical mental health care services and substance abuse services, as designated by the commissioner, that a certified peer counselor may provide to a person insured under a policy of the type specified in subsection (b) of this section.

(b) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, amended, renewed or continued in this state shall provide coverage for peer support services provided by a certified peer counselor.

(c) The Insurance Commissioner shall adopt regulations, in accordance with chapter 54 of the general statutes, to implement the purposes of this section, including, but not limited to, regulations concerning the: (1) Education and certification of certified peer counselors; (2) peer support services a certified peer counselor may provide; (3) peer support services eligible for reimbursement under subsection (b) of this section; and (4) method and amount of such reimbursement.

Sec. 2. (NEW) (Effective January 1, 2018) (a) For the purposes of this section: (1) “Certified peer counselor” means an individual certified by the Insurance Commissioner to provide peer support services; and (2) “peer support services” means such nonmedical mental health care services and substance abuse services, as designated by the commissioner, that a certified peer counselor may provide to a person insured under a policy of the type specified in subsection (b) of this section.

(b) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, amended, renewed or continued in this state shall provide coverage for peer support services provided by a certified peer counselor.

(c) The Insurance Commissioner shall adopt regulations, in accordance with chapter 54 of the general statutes, to implement the purposes of this section, including, but not limited to, regulations concerning the: (1) Education and certification of certified peer counselors; (2) peer support services a certified peer counselor may provide; (3) peer support services eligible for reimbursement under subsection (b) of this section; and (4) method and amount of such reimbursement.


Joint Favorable Report

Bill No.: HB-6887
Title: AN ACT CONCERNING MENTAL HEALTH CARE SERVICES AND SUBSTANCE ABUSE SERVICES PROVIDED BY CERTIFIED PEER COUNSELORS.
Vote Date: 3/15/2017
Vote Action: Joint Favorable Change of Reference to Public Health
PH Date: 2/16/2017
File No.:

SPONSORS OF BILL:

Insurance and Real Estate Committee

Rep. Cristin McCarthy Vahey, 133rd Dist.

REASONS FOR BILL:

Currently, private insurance coverage does not always cover certified peer counselors and only does so in public insurance through a grant to the Department of Mental Health and Addiction Services. This bill would change that and make it so that private insurance companies need to develop plans that would reimburse peer support specialists and case managers for their work in mental health and substance abuse services.

Substitute Language

Changes the language in the bill from “shall” to “may” under section 2 and section 3 dealing with how the Insurance Commissioner may adopt regulations to implement each respective section regarding individual and group health insurance covering peer support services.

RESPONSE FROM ADMINISTRATION/AGENCY:

State of Connecticut Insurance Department opposed the bill as unnecessary due to existing laws that require carriers to provide medically necessary coverage for mental or nervous conditions. They stated that this coverage includes treatment for mental and nervous conditions which also includes substance use disorder. They also noted the Department’s Consumer Affairs Division is always ready to assist consumers who believe the mental health or substance abuse treatment received was not covered adequately.

Rep. Cristin McCarthy Vahey, 133rd Dist. Supported the bill and testified that individuals accompanied by a team of at least a peer support specialist and a case manager, have a better chance for long term recovery.

NATURE AND SOURCES OF SUPPORT:

Chelsea Boska (McIntosh), Psychiatrist testified that a lot of work she does for her clients involves case management outside of her work sessions and that with this bill, she can refer her clients to a case manager who can then bill for services rendered. She stated that this would free her work schedule in a manner that would allow for more focused care for her clients.

Vered Brandman testified that the bill would allow for peer support services to bill their clients and therefore receive reimbursements from the insurance companies. He also testified that Peer Support Specialists are here to compliment the system and not to take jobs away from other professionals.

Tina M. Corlett supported the bill and stated that this will help individuals navigate the already complex system by granting reimbursements for those who understand the system from firsthand experience.

Marcia DuFore, Executive Director, North Central Regional Mental Health Board

Testified the bill provides reimbursements for peer support counselors and that they have personal experience with the system to help others as they navigate the system. She went on to say that this bill is especially important because DMHAS grant funded services are slated to be cut by $4.7 million by the Governor’s budget proposal. Lastly, she noted that roughly $500,000 was cut last year for peer services.

Dianela Giordana, MSW, Public Policy Director, NAMI Connecticut supported the legislation and noted that there are two certifications for two kinds of peer supports. The first one is an 80 hour certifications through Advocacy Unlimited for those who have experienced mental health matters to become a Recovery Support Specialist. The other one is offered by the CT Community for Addiction Recovery for those who have experienced addiction issues and become certified Recovery Coaches.

Michael Mackniak, Chief Operating Officer, Guardian Ad Litem Services, Inc. testified that by expanding what defines case management and including care coordination as covered services, the quality of life would increase for many throughout the state.

Kati Mapa, Interim Executive Director, Eastern Regional Mental Health Board testified that those with private insurance should have the same access to supports that are available to those with public insurance.

Northwest Regional Health Board, Inc. testified in support of the bill by stating that coverage for peer support specialist are available to those with public coverage under DMHAS funded programs and that those with private insurance should have the same options as well.

Jeanne Proctor supported the bill and noted their son has schizophrenia and the help from peer support specialists and peer groups have been significant in their son’s life.

Marc Rabinowitz testified that peer support services are currently available in every state and Medicaid reimbursable in 35 states. He stated that these services can lead to a decrease in length of hospital stays, reduce symptoms and hospitalizations, and encourage longer-lasting recoveries.

Marisa Rambush, Peer Support Specialist, Milford Division of the CT Strong Grant testified that bill is an important step in addressing mental health and addiction in the state. She went on to say that currently there is no definition of what a peer support specialist is and that with the introduction of insurance companies; a clearer job description and insurance coverage would both work to legitimize the work of a peer support.

Valerie Sacco testified that the cost of insurance to cover these services are less expensive than hospital stays and many other health services.

Michael Scanlon

Susan Buchsbaum

Both submitted similar testimony supported peer support specialists and indicated they wanted to see insurance coverage expanded to cover these costs listed throughout the bill’s language. They stated the peer support specialists are a great community resource and play an important role for those working through recovery.

Elsa Ward, Assistant Director, South Central Peer Services, Continuum of Care, New Haven supported peer support specialists and wanted to see insurance coverage expanded to cover these costs. She stated that she would like to see peer support specialists go through an intensive training program and certification and also that case managers have a Bachelor’s degree.

Margaret Watt, Executive Director, Southwest Regional Mental Health Board, Norwalk

supported peer support specialists and wanted to see insurance coverage expanded to cover these costs. Testified that the cost of insurance to cover these services are less expensive than hospital stays and many other health services. She stated that many people in Connecticut rarely see the benefits from peer support specialists because many insurance companies do not cover the peer support specialists.

Mary Jane Williams Ph.D., RN, Chairperson, Government Relations Committee, Connecticut Nurses Association supported peer support specialists and wanted to see insurance coverage expanded to cover these costs. He also cited a number of statistics that detailed the lack of services available for mental health patients have available in the state. He noted that an avenue to deal with this is to increase the amount of work peer special supports can provide by requiring insurance coverage for their work so they can be reimbursed.

NATURE AND SOURCES OF OPPOSITION:

Greg Benson, Director of Policy, Advocacy Unlimited, Inc.

Paul D. Acker, Director of Recovery University

Both expressed concern over the bill and the language used to define “peer support” and how much latitude it gives to insurance companies to determine what actually counts as “peer support”. He testified that this bill does not protect peer support from co-option and would like to see matters worked out in the bills language before supporting it.

Anthem Blue Cross and Blue Shield in Connecticut expressed concern regarding all bills, this one included, that pertain to health insurance and asked that the committee refrain from passing any legislation until the Congress has acted on the Affordable Care Act in Washington D.C.

Cheri Bragg expressed dissatisfaction with the bill and in particular how it uses the term “case management”. He went on to say that traditional “case management” has not been effective for individuals with mental health and substance abuse for wellness or recovery. He testified that “case management” tends to advocate a dependency on the system and the case managers instead of promoting self-empowerment.

Connecticut Association of Health Plans objected to the bill by how it issues an additional mandate on private insurance companies. They went on to say that this would limit the flexibility an insurance company has in terms of how it constructs benefit packages for consumers.

Michaela I. Fissel

Latosha Taylor

Both testified that by requiring insurance companies, provider networks, and hospital associations to define peer support service, it will become another business transaction. They went on to say that when this becomes purely a business transaction, the effectiveness of this particular support service will be diminished.

Daniel C. Giungi, Senior Legislative Associate, Connecticut Conference of Municipalities (CCM) wanted the committee to hold all proposals until a detailed fiscal analyses was done to see the implications the bill would have on towns and cities as this is an additional mandate on increased insurance coverage.

Natacha Kereljza liked the intent of the bill and peer support services but expressed concern over expanding this service through insurance coverage.

Joanie Masot, Certified Recovery Support Specialist, Advocacy Unlimited Inc. expressed concern over the language in the bill and asked the committee to not permit the peer support’s value to be diminished by allowing the services to become entwined in the insurance infrastructure.

Celeste Mattingly, LCSW testified the training peer support advocacy groups receive cannot compare to what professional counselors have to do in order to become licensed. She stated that this is undervaluing the licensed professional community and urged the committee to oppose the bill.

Reported by: Stephen Sanabria, Assistant Clerk Date: March 29, 2017

HB-5270: AN ACT CONCERNING PEER SUPPORT SPECIALISTS AND REQUIRING HEALTH INSURANCE COVERAGE FOR OUTPATIENT PEER SUPPORT SERVICES PROVIDED BY CERTIFIED PEER SUPPORT SPECIALISTS.

Statement of Purpose: To require (1) the Commissioner of Public Health to adopt regulations (A) providing for the certification and education of peer support specialists, and (B) specifying the peer support services that a certified peer support specialist may provide to another individual in this state, and (2) health insurance coverage for peer support services provided by certified peer support specialists on an outpatient basis.

Introducer(s):
Insurance and Real Estate Committee


Bill History

01-14-2019 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
01-31-2019 VOTE TO DRAFT
02-27-2019 DRAFTED BY COMMITTEE
02-28-2019 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
03-01-2019 PUBLIC HEARING 03/05
03-14-2019 JOINT FAVORABLE SUBSTITUTE
03-18-2019 FILED WITH LEGISLATIVE COMMISSIONERS’ OFFICE
03-27-2019 REFERRED TO OFFICE OF LEGISLATIVE RESEARCH AND OFFICE OF FISCAL
ANALYSIS 04/01/19-5:00 PM
04-02-2019 REPORTED OUT OF LEGISLATIVE COMMISSIONERS’ OFFICE
04-02-2019 FAVORABLE REPORT, TABLED FOR THE CALENDAR, HOUSE
04-02-2019 HOUSE CALENDAR NUMBER 176
04-02-2019 FILE NUMBER 270

Co-sponsor(s):
Rep. David Michel, 146th Dist. Rep. Josh Elliott, 88th Dist.
Rep. Cristin McCarthy Vahey, 133rd Dist. Rep. Jeff Currey, 11th Dist.
Rep. Kevin Ryan, 139th Dist. Rep. Peter A. Tercyak, 26th Dist.


Bill Language

AN ACT CONCERNING PEER SUPPORT SPECIALISTS AND
REQUIRING HEALTH INSURANCE COVERAGE FOR OUTPATIENT
PEER SUPPORT SERVICES PROVIDED BY CERTIFIED PEER
SUPPORT SPECIALISTS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
1 Section 1. (NEW) (Effective October 1, 2019) (a) For the purposes of
2 this section:
3 (1) “Certified peer support specialist” means a peer support
4 specialist certified by the Commissioner of Public Health to provide
5 peer support services to another individual in this state;
6 (2) “Peer support services” means all nonmedical mental health care
7 services and substance abuse services provided by peer support
8 specialists; and
9 (3) “Peer support specialist” means an individual providing peer
10 support services to another individual in this state.
11 (b) The Commissioner of Public Health shall adopt regulations, in
12 accordance with chapter 54 of the general statutes, to provide for the
13 certification and education of peer support specialists and specify the
14 peer support services that a certified peer support specialist may
15 provide to another individual in this state.
16 Sec. 2. (NEW) (Effective January 1, 2020) Each individual health
17 insurance policy providing coverage of the type specified in
18 subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general
19 statutes delivered, issued for delivery, amended, renewed or
20 continued in this state shall provide coverage for peer support services
21 provided by certified peer support specialists, as such terms are
22 defined in section 1 of this act, on an outpatient basis. The Insurance
23 Commissioner may adopt regulations, in accordance with chapter 54
24 of the general statutes, to implement the provisions of this section.
25 Sec. 3. (NEW) (Effective January 1, 2020) Each group health insurance
26 policy providing coverage of the type specified in subdivisions (1), (2),
27 (4), (11) and (12) of section 38a-469 of the general statutes delivered,
28 issued for delivery, amended, renewed or continued in this state shall
29 provide coverage for peer support services provided by certified peer
30 support specialists, as such terms are defined in section 1 of this act, on
31 an outpatient basis. The Insurance Commissioner may adopt
32 regulations, in accordance with chapter 54 of the general statutes, to
33 implement the provisions of this section.


Joint Favorable Report

Bill No.: HB-5270
Title:
AN ACT CONCERNING PEER SUPPORT SPECIALISTS AND REQUIRING
HEALTH INSURANCE COVERAGE FOR OUTPATIENT PEER SUPPORT
SERVICES PROVIDED BY CERTIFIED PEER SUPPORT SPECIALISTS.
Vote Date: 3/14/2019
Vote Action: Joint Favorable Substitute
PH Date: 3/5/2019
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:
Insurance and Real Estate Committee
Rep. David Michel, 146th Dist.
Rep. Cristin McCarthy Vahey, 133rd Dist.
Rep. Josh Elliott, 88th Dist.
Rep. Jeff Currey, 11th Dist.
REASONS FOR BILL:
To adopt insurance coverage for outpatient care provided by certified peer support
specialists, while also outlining the licensing procedure to make it legally official.
SUBSTITUTE LANGUAGE:
LCO #5841 which removed Section 1 from the original bill, added the parameters in place of
“peer support services” in Sections 2 & 3, and renamed the sections accordingly. Also,
included the date of enactment in each section.
RESPONSE FROM ADMINISTRATION/AGENCY:
Connecticut Conference of Municipalities testified in opposition, stating “state-mandated
expansions of health insurance coverage would increase insurance costs for towns and
cities.”
Raul Pino, M.D., M.P.H., Commissioner, Department of Public Health wrote testimony in
opposition to the bill because it creates requirements for the department to establish a scope
of services that peer support specialists are to provide, and regulate certification—something
Page 2 of 3 HB-5270
they say many associations already do, and that the Department does not have existing
resources to accomodate. The Department recommends that should the legislation move
forward that there be language outlining parameters for the title of Certified Peer Support
Specialist.
NATURE AND SOURCES OF SUPPORT:
Susan Kelley, Director of Advocacy and Policy, NAMI cited the federal Substance Abuse
and Mental Health Services Administration which recognizes peer support as one of the ten
components to recovery.
Representative David Michel, 146th District wrote in testimony that DMHAS consolidated
mental health and addiction boards into Behavioral Health Boards reinforcing the need to
assure those needing the support get it effectively and at an optimal cost. Also, Rep. Michel
offers a potential language change in line 6 of possibly changing “mental health” to
“behavioral health”, but also sees potential negative consequences of that change.
Suzi Craig, Senior Director of Policy, Mental Health Connecticut supports this bill
because peer support specialists operate well in addition to a therapist or other members of a
treatment plan. She states that the data on these specialists significantly reduce care costs
for patients while lowering hospitalization rates, length of stay, and rehospitalization by
improving care quality and offering health alternatives. “Mental Health CT is the New England
testing site for Mental Health America’s National Certified Peer Specialist certification.”
Thomas Burr, Community and Affiliate Relations Manager, NAMI testified in support
because these specialists provide more real experience and perspective than most clinical
staff.
Susan Kelley, Director of Advocacy and Policy, NAMI cited the federal Substance Abuse
and Mental Health Services Administration which recognizes peer support as one of the ten
components to recovery. She states that reimbursement for peer support should be passed
for insurers, particularly Medicaid, because as of now much of the funding for the services
comes from Department of Mental Health and Addiction services through grants.
Marcia DuFore, North Central Regional Mental Health Board testified in support by
sharing a story of a person close to her who struggled with opioid addiction, and how Marcia
was able to connect her with a solid network of people who were able to help her beat the
addiction. She states that this would not be possible without her or peer support, and that
when hospitalized for addiction, many times you simply wait for release with no guidance of
what is next.
Kathleen Flaherty, Esq., Executive Director, CT Legal Rights Project, INC. testified in
support of this bill because it creates a new type of parity between services provided in the
public and private insurance plans. She states that if both markets were to cover certified
peer support services, availability would be extended to the 80% of the state with private
insurance. Also, she states it provides employment opportunities for people in recovery.
The following people wrote about their support for this bill due to personal experiences which
have lead them to consult with or become a peer support specialist—usually after consulting
Page 3 of 3 HB-5270
clinical care for years and getting a feeling that something was missing—which has aided
both parties immensely in their recovery.
Matthew Reilly wrote that “sometimes traditional care is not enough to feel connected”, and
elaborates on how finding a peer support specialist has helped him in an understanding,
empathetic, non-clinical manner.
David Woodworth
Melissa Thomas
Jeffrey Santo, RSS, RIPPLE
NATURE AND SOURCES OF OPPOSITION:
None Expressed.
Reported by: Logan Cotter Date: 03/28/19

HB-5248: AN ACT ESTABLISHING A TASK FORCE TO STUDY HEALTH INSURANCE COVERAGE FOR PEER SUPPORT SERVICES IN THIS STATE.

Statement of Purpose: To establish a task force to study health insurance coverage for peer support services in this state.

Introducer(s):
Insurance and Real Estate Committee


Bill History

Bill History:
02-20-2020 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
02-21-2020 PUBLIC HEARING 02/27
03-10-2020 JOINT FAVORABLE

Co-sponsor(s):
Rep. Lucy Dathan, 142nd Dist. Rep. Tom Delnicki, 14th Dist.
Rep. Cristin McCarthy Vahey, 133rd Dist. Rep. Kenneth M Gucker, 138th Dist.
Rep. David Michel, 146th Dist. Rep. Bill Buckbee, 67th Dist.
Rep. Raghib Allie-Brennan, 2nd Dist. Rep. Jillian Gilchrest, 18th Dist.


Bill Language

Be it enacted by the Senate and House of Representatives in General
Assembly convened:
1 Section 1. (Effective from passage) (a) There is established a task force
2 to study health insurance coverage for peer support services in this
3 state. Such study shall include, but need not be limited to, an
4 examination of any means available to increase health insurance
5 coverage for peer support services in this state.
6 (b) The task force shall consist of the following members:
7 (1) Two appointed by the speaker of the House of Representatives;
8 (2) Two appointed by the president pro tempore of the Senate;
9 (3) One appointed by the majority leader of the House of
10 Representatives;
11 (4) One appointed by the majority leader of the Senate;
12 (5) One appointed by the minority leader of the House of
13 Representatives;
14 (6) One appointed by the minority leader of the Senate;
15 (7) The Insurance Commissioner, or the commissioner’s designee;
16 and
17 (8) Two persons appointed by the Governor.
18 (c) Any member of the task force appointed under subdivision (1),
19 (2), (3), (4), (5) or (6) of subsection (b) of this section may be a member
20 of the General Assembly.
21 (d) All initial appointments to the task force shall be made not later
22 than thirty days after the effective date of this section. Any vacancy shall
23 be filled by the appointing authority.
24 (e) The speaker of the House of Representatives and the president pro
25 tempore of the Senate shall select the chairpersons of the task force from
26 among the members of the task force. Such chairpersons shall schedule
27 the first meeting of the task force, which shall be held not later than sixty
28 days after the effective date of this section.
29 (f) The administrative staff of the joint standing committee of the
30 General Assembly having cognizance of matters relating to insurance
31 shall serve as administrative staff of the task force.
32 (g) Not later than January 1, 2021, the task force shall submit a report
33 on its findings and recommendations to the joint standing committee of
34 the General Assembly having cognizance of matters relating to
35 insurance, in accordance with the provisions of section 11-4a of the
36 general statutes. The task force shall terminate on the date that it
37 submits such report or January 1, 2021, whichever is later.


Joint Favorable Report

Bill No.: HB-5248
Title:
AN ACT ESTABLISHING A TASK FORCE TO STUDY HEALTH INSURANCE
COVERAGE FOR PEER SUPPORT SERVICES IN THIS STATE.
Vote Date: 3/10/2020
Vote Action: Joint Favorable
PH Date: 2/27/2020
File No.:
Disclaimer: The following HOUSE 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:
Insurance and Real Estate Committee
REASONS FOR BILL:
This bill will establish a task force to study health insurance coverage for peer support services in
this state.
RESPONSE FROM ADMINISTRATION/AGENCY:
None Expressed
NATURE AND SOURCES OF SUPPORT:
Paul Acker, Senior Policy Advisor, Advocacy Unlimited supports the passage of HB5248. We ask that two of the ten seats on the task force be for persons with direct lived
experience providing peer support in mental health and/or addition services and that two
additional seats be offered to Advocacy Unlimited and CCAR (Connecticut Community for
Addiction Recovery) who train people to provide professional peer support. Without the vast
expertise and knowledge of people directly involved in peer support, any task force will fail to
capture the core essence of the profession. As many say in our movement, “Nothing about us
without us.” Peer support professionals must be involved in the design, implementation and
evaluation of such a huge shift in the system, as this directly affects their craft and the people
who choose to utilize their support.
Marcia DuFore, Executive Director, Amplify, Inc this is a topic of great concern to me and
one that our members identify as a top priority in all our needs assessments. But the opiate
epidemic has reached such proportions of late, that is hard for any of us to view the problem
Page 2 of 3 HB-5248
from a distance – a problem that does not touch someone we hold dear. That happened for
me several years ago. She explained in detail the hardship of a close family.
People lose out on recovery every day because they lack support at critical junctures for
treating this illness and moving on toward long term sustained recovery. We lose out because
some of these people die and those who love them suffer immensely. We lose out because
of the economic cost of repeated crisis care and the number of people who don’t find
recovery and become productive citizens. We have a crisis. Please move this bill forward and
help us ensure that insurance coverage for mental health and addiction includes critically
needed peer support services.
Kathy Flaherty, Esq., Executive Director, CT Legal Rights Project, Inc. support HB 5248
and establish a task force to study health insurance coverage for peer support services in this
state. Peer-delivered services promote recovery. I would suggest that the task force also
examine coverage for peer support services under Medicaid. It is very important that the Task
Force include people from the various organizations who have been involved in training peer
providers of support services, including recovery support specialists and recovery coaches,
so my suggestion would be that the committee consider amending the bill to name specific
organizations to be included at the table.
Patricia Rehmer, Senior Vice President, Behavioral Health Network, Hartford
Healthcare We would encourage the committee to expand the charge of the group to look at
coverage under Medicaid and to ensure that peer support specialists are included in this
conversation. Should this bill move forward, we would welcome the opportunity to participate.
According to the U.S. Substance Abuse and Mental Health Services Administration
(SAMHSA), peer support workers are people who have been successful in the recovery
process who help others experiencing similar situations. Through shared understanding,
respect, and mutual empowerment, peer support workers help people become and stay
engaged in the recovery process and reduce the likelihood of relapse. Peer support services
can effectively extend the reach of treatment beyond the clinical setting into the everyday
environment of those seeking a successful, sustained recovery process. Peer support is an
evidence-based practice and is cost effective. HHC uses peer support specialists for a variety
of purposes, including long term follow up after discharge. Our peer support specialists must
complete a rigorous 80-hour course and pass a certification exam. Currently we are not
reimbursed for these services either under Medicaid or commercial insurance in Connecticut.
While these services should be available to more patients, we are concerned that if peer
support specialist services are covered by Medicaid or private insurance, they will be limited
to patients who meet their health plan’s medical necessity standards. Right now, providers
who offer this service may do so in cases where Medicaid or insurance is unlikely to
reimburse. This topic certainly merits further study and discussion and we agree with the task
force.
Ben Shaiken, Manager of Advocacy & Public Policy, CT Community Nonprofit Alliance
supports H.B. 5248, which would establish a task force to study health insurance coverage
for peer support services in Connecticut. Peer Support services are recovery-focused
services provided by specialists who have experience recovering from mental health or
substance abuse conditions. They are a crucial part of behavioral health treatment, and a
growing body of evidence and experience shows that peer support services are effective at
treating mental health conditions and helping people recover from addiction. Connecticut
does not require commercial insurance companies cover peer support services, even though
Page 3 of 3 HB-5248
they have been proven effective to help people recover from mental health and substance
abuse conditions. Connecticut also does now allow peer support services to be billed through
Medicaid, even though many other states do. While this important service should be available
to all Connecticut’s residences, we acknowledge that there are several outstanding issues,
including how to certify Peer Support Specialists, that require more in-depth discussion and
analysis. That is why we support H.B. 5248, which would create a task force to determine the
best course of action.
The following individuals submitted testimony in support of this bill:
Ronald Abell Sally Arbott Anna Assad Annie Atwood Nicole Baier Aleska Bembnista
Rhiannon Benedetto Tammy Binnette Linda Bishop Michele Brabant Jennifer Bradshaw
Juliana Bregler Deborah Brown Colleen Buckle y Jennifer Cederberg Shah Chirayu Aprille
Coutss Sharon Dean Terri -Lynne DeFino Matt DeSimone Emily Dionne Traci Eburg Emily
Elander Melissa Florio Anna Marie Fraioli Allie Franco Donald Franco Heather Franklin
Cynthia Fusco Mihirkumar Gosrani Melissa Grandinetti Michael Grube Morgan Grube
Brianna Herbest DelVina Herbest Thomas Herr Cheryl Hill Julie Hulse Leah Hulse Alyssa
Kassimis Christopher Keller Jennifer Kelley Jennifer Kocenko Lynn Kovack Tracey Kurjiaka
Patrice Lago, RN EMT Sandra Lasher -Pelton Susan Leonard Tiffani Little Strongbow Lone
Eagle Mandi MacDonald Frank Manni Cassandra Marden Scott Martin Mariah Martirano Erin
Mccauley Ann Metzger Rebecca Miller Patrick Mitchell Anthony Morrissey Maddy Morrissey,
Heidi Norcross Michelle Palerno Amy Plude Elizabeth Poller Sachs Randi Hailey Ranson
Cathy Renzulli-Valente Ted Roman Terry Sachs Joy Scozzafava Alison Sherman Makayla
Showalter Melissa Silva Lone Eagle Sonny Melissa Storms Leanne Swanson Pinedo Nadine
Tannous Amanda Tarallo Tyler Ulisse Austin Ulisse Naomi Ulisse Casey Villa Miranda Villa
Sharon Villa Brittany Waldron Danielle Walker Donovan Ward Margaret Watt Lisa Winjum
Patricia Zelno
NATURE AND SOURCES OF OPPOSITION:
None Expressed
Reported by: Diane Kubeck Date: April 14, 2020

HB-5550: AN ACT ESTABLISHING A TASK FORCE CONCERNING PEER SUPPORT SPECIALISTS.

Statement of Purpose: To establish a task force to study the possible certification and education of peer support specialists in this state, the peer support services that would be delivered by such certified peer support specialists and possible health insurance coverage for such services.

Introducer(s):
REP. LUCY DATHAN, 142nd DIST.


Bill History

Bill History:
01-26-2021 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee


Bill Language

Be it enacted by the Senate and House of Representatives in General
Assembly convened:
1 That a task force be established to study the possible certification and
2 education of peer support specialists in this state, the peer support
3 services that would be delivered by such certified peer support
4 specialists and possible health insurance coverage for such services.


NOTE: During the 2021 legislative session this bill was merged into HB-6588 which addressed multiple mental health and addiction service topics, at that point HB-5550 was no longer relevant.

HB-6588: AN ACT CONCERNING MENTAL HEALTH CARE AND SUBSTANCE ABUSE SERVICES

Statement of Purpose: To: (1) Provide that no individual or group health insurance policy providing coverage for outpatient prescription drugs shall (A) require a prescribing health care provider to prescribe a supply of a covered outpatient psychotropic drug that is larger than the supply of such drug that such provider deems clinically appropriate, or (B) if a prescribing health care provider deems a ninety-day supply of a covered outpatient psychotropic drug to be clinically inappropriate and prescribes less than a ninety-day supply of such drug, impose a coinsurance, copayment, deductible or other out-of-pocket expense for the prescribed supply of such drug in an amount that exceeds the amount of the coinsurance, copayment, deductible or other out of pocket expense for a ninety-day supply of such drug reduced pro rata in proportion to such prescribed supply of such drug; (2) provide that no mental health care benefits provided under state law, with state funds or to state employees shall require a prescribing health care provider to prescribe a supply of an outpatient psychotropic drug that is larger than the supply of such drug that such provider deems clinically appropriate; (3) establish a task force to study methods available to this state, and health carriers doing business in this state, to encourage health care providers providing mental health services to participate in provider networks; and (4) establish a task force to study health insurance coverage for peer support services.

Introducer(s):
Insurance and Real Estate Committee


Bill History

03-04-2021 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
03-05-2021 PUBLIC HEARING 03/09
03-22-2021 JOINT FAVORABLE
03-23-2021 FILED WITH LEGISLATIVE COMMISSIONERS’ OFFICE
04-01-2021 REFERRED TO OFFICE OF LEGISLATIVE RESEARCH AND OFFICE OF FISCAL
ANALYSIS 04/07/21-5:00 PM
04-08-2021 REPORTED OUT OF LEGISLATIVE COMMISSIONERS’ OFFICE
04-08-2021 FAVORABLE REPORT, TABLED FOR THE CALENDAR, HOUSE
04-08-2021 HOUSE CALENDAR NUMBER 260
04-08-2021 FILE NUMBER 344
05-12-2021 HOUSE ADOPTED HOUSE AMENDMENT SCHEDULE A:LCO-8402
05-12-2021 HOUSE PASSED AS AMENDED BY HOUSE AMENDMENT SCHEDULE A
05-14-2021 FAVORABLE REPORT, TABLED FOR THE CALENDAR, SENATE
05-14-2021 SENATE CALENDAR NUMBER 436
05-14-2021 FILE NUMBER 691

Co-sponsor(s):
Rep. Tammy Nuccio, 53rd Dist. Rep. Holly H. Cheeseman, 37th Dist.
Rep. Tom Delnicki, 14th Dist. Rep. Kenneth M Gucker, 138th Dist.
Rep. Whit Betts, 78th Dist.


Bill Language

Be it enacted by the Senate and House of Representatives in General
Assembly convened:
1 Section 1. (NEW) (Effective January 1, 2022) Notwithstanding any
2 provision of the general statutes, no individual health insurance policy
3 providing coverage of the type specified in subdivisions (1), (2), (4), (11),
4 (12) and (16) of section 38a-469 of the general statutes delivered, issued
5 for delivery, renewed, amended or continued in this state on or after
6 January 1, 2022, that provides coverage for outpatient prescription
7 drugs shall: (1) Require a prescribing health care provider to prescribe a
8 supply of a covered outpatient psychotropic drug that is larger than the
9 supply of such drug that such provider deems clinically appropriate; or
10 (2) if a prescribing health care provider deems a ninety-day supply of a
11 covered outpatient psychotropic drug to be clinically inappropriate and
12 prescribes less than a ninety-day supply of such drug, impose a
13 coinsurance, copayment, deductible or other out-of-pocket expense for
14 the prescribed supply of such drug in an amount that exceeds the
15 amount of the coinsurance, copayment, deductible or other out-of
16 pocket expense for a ninety-day supply of such drug reduced pro rata
17 in proportion to such prescribed supply of such drug.
18 Sec. 2. (NEW) (Effective January 1, 2022) Notwithstanding any
19 provision of the general statutes, no group health insurance policy
20 providing coverage of the type specified in subdivisions (1), (2), (4), (11),
21 (12) and (16) of section 38a-469 of the general statutes delivered, issued
22 for delivery, renewed, amended or continued in this state on or after
23 January 1, 2022, that provides coverage for outpatient prescription
24 drugs shall: (1) Require a prescribing health care provider to prescribe a
25 supply of a covered outpatient psychotropic drug that is larger than the
26 supply of such drug that such provider deems clinically appropriate; or
27 (2) if a prescribing health care provider deems a ninety-day supply of a
28 covered outpatient psychotropic drug to be clinically inappropriate and
29 prescribes less than a ninety-day supply of such drug, impose a
30 coinsurance, copayment, deductible or other out-of-pocket expense for
31 the prescribed supply of such drug in an amount that exceeds the
32 amount of the coinsurance, copayment, deductible or other out-of
33 pocket expense for a ninety-day supply of such drug reduced pro rata
34 in proportion to such prescribed supply of such drug.
35 Sec. 3. Section 38a-476b of the general statutes is repealed and the
36 following is substituted in lieu thereof (Effective January 1, 2022):
37 Notwithstanding any provision of the general statutes or the
38 regulations of Connecticut state agencies, no mental health care benefit
39 provided under state law, or with state funds or to state employees may,
40 through the use of a drug formulary, list of covered drugs or any other
41 means: (1) Limit the availability of psychotropic drugs that are the most
42 effective therapeutically indicated pharmaceutical treatment with the
43 least probability of adverse side effects; [or] (2) require utilization of
44 psychotropic drugs that are not the most effective therapeutically
45 indicated pharmaceutical treatment with the least probability of adverse
46 side effects; or (3) require a prescribing health care provider to prescribe
47 a supply of an outpatient psychotropic drug that is larger than the
48 supply of such drug that such provider deems clinically appropriate.
49 Nothing in this section shall be construed to limit the authority of a
50 physician to prescribe a drug that is not the most recent pharmaceutical
51 treatment. Nothing in this section shall be construed to prohibit
52 differential copays among pharmaceutical treatments or to prohibit
53 utilization review.
54 Sec. 4. (Effective from passage) (a) There is established a task force to
55 study methods available to this state, and health carriers doing business
56 in this state, to encourage health care providers providing mental health
57 services to participate in provider networks.
58 (b) The task force shall consist of the following members:
59 (1) Two appointed by the speaker of the House of Representatives;
60 (2) Two appointed by the president pro tempore of the Senate;
61 (3) One appointed by the majority leader of the House of
62 Representatives;
63 (4) One appointed by the majority leader of the Senate;
64 (5) One appointed by the minority leader of the House of
65 Representatives;
66 (6) One appointed by the minority leader of the Senate;
67 (7) The Insurance Commissioner, or the commissioner’s designee;
68 and
69 (8) Two appointed by the Governor.
70 (c) Any member of the task force appointed under subdivision (1),
71 (2), (3), (4), (5) or (6) of subsection (b) of this section may be a member
72 of the General Assembly.
73 (d) All initial appointments to the task force shall be made not later
74 than thirty days after the effective date of this section. Any vacancy shall
75 be filled by the appointing authority.
76 (e) The speaker of the House of Representatives and the president pro
77 tempore of the Senate shall select the chairpersons of the task force from
78 among the members of the task force. Such chairpersons shall schedule
79 the first meeting of the task force, which shall be held not later than sixty
80 days after the effective date of this section.
81 (f) The administrative staff of the joint standing committee of the
82 General Assembly having cognizance of matters relating to insurance
83 shall serve as administrative staff of the task force.
84 (g) Not later than January 1, 2022, the task force shall submit a report
85 on its findings and recommendations to the joint standing committee of
86 the General Assembly having cognizance of matters relating to
87 insurance, in accordance with the provisions of section 11-4a of the
88 general statutes. The task force shall terminate on the date that it
89 submits such report or January 1, 2022, whichever is later.
90 Sec. 5. (Effective from passage) (a) There is established a task force to
91 study health insurance coverage for peer support services in this state.
92 Such study shall include, but need not be limited to, an examination of
93 any means available to increase health insurance coverage for peer
94 support services provided to individuals in this state.
95 (b) The task force shall consist of the following members:
96 (1) Two appointed by the speaker of the House of Representatives,
97 one of whom is a recovery support specialist and one of whom is a
98 member of the Connecticut Certification Board;
99 (2) Two appointed by the president pro tempore of the Senate, one of
100 whom is a recovery coach and one of whom is a representative of the
101 Connecticut Hospital Association;
102 (3) One appointed by the majority leader of the House of
103 Representatives, who is a representative of a program overseen by the
104 Department of Children and Families;
105 (4) One appointed by the majority leader of the Senate, who is a
106 representative of an organization that trains recovery coaches or
107 recovery support specialists;
108 (5) One appointed by the minority leader of the House of
109 Representatives, who is a supervisor of peers from a provider agency
110 that employs peers;
111 (6) One appointed by the minority leader of the Senate, who is a
112 representative of an organization that provides services to Medicaid
113 beneficiaries;
114 (7) One appointed by the Insurance Commissioner, who is a
115 representative of a health carrier; and
116 (8) Two appointed by the Governor, one of whom is a young adult
117 with experience in various forms of peer support and one of whom has
118 perspective concerning community reentry.
119 (c) Any member of the task force appointed under subdivision (1),
120 (2), (3), (4), (5) or (6) of subsection (b) of this section may be a member
121 of the General Assembly.
122 (d) All initial appointments to the task force shall be made not later
123 than thirty days after the effective date of this section. Any vacancy shall
124 be filled by the appointing authority.
125 (e) The speaker of the House of Representatives and the president pro
126 tempore of the Senate shall select the chairpersons of the task force from
127 among the members of the task force. Such chairpersons shall schedule
128 the first meeting of the task force, which shall be held not later than sixty
129 days after the effective date of this section.
130 (f) The administrative staff of the joint standing committee of the
131 General Assembly having cognizance of matters relating to insurance
132 shall serve as administrative staff of the task force.
133 (g) Not later than December 31, 2021, the task force shall submit a
134 report on its findings and recommendations to the joint standing
135 committee of the General Assembly having cognizance of matters
136 relating to insurance, in accordance with the provisions of section 11-4a
137 of the general statutes. The task force shall terminate on the date that it
138 submits such report or December 31, 2021, whichever is later.


Joint Favorable Report

Bill No.: HB-6588
Title:
AN ACT CONCERNING MENTAL HEALTH CARE AND SUBSTANCE ABUSE
SERVICES.
Vote Date: 3/22/2021
Vote Action: Joint Favorable
PH Date: 3/9/2021
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:
Insurance and Real Estate Committee
REASONS FOR BILL:
The bill seeks to prevent the abuse and misuse, or prescriptive medication practices as 90-day
dispensing has been a harmful practice for consumers. The bill also establishes two tasks force
to understand the role of provider networks and peer support services in Connecticut.
RESPONSE FROM ADMINISTRATION/AGENCY:
None expressed.
NATURE AND SOURCES OF SUPPORT:
Claire Bien, Hamden, CT supports the bill regarding forming a task force on peer support.
Having a support group to openly discuss mental health has had a great impact on her life.
Thomas Burr, Community & Affiliates Relations Manager, NAMI Connecticut supports
the bill. He firmly believes that if his son had peer services in his life his path to recovery
would have been shorter and less expensive to the State of Connecticut. Peer support is an
essential role in a health care team and if CT wants to make that happen it needs to make
Certifies Peer Recovery Specialists reimbursable.
Suzi Craig, Registered Lobbyist, Chief Strategy Officer, Mental Health Connecticut
supports the bill as peer support is an essential role on health care teams to support the
recovery process.
Page 2 of 3 HB-6588
Carol Cruz, Milford, CT supports the bill as peer support is an essential role on health care
teams to support the recovery process.
Connecticut Hospital Association supports the establishment of a task force to study
health insurance coverage for peer support services. The bill provides for the appointment of
a representative of CHA to serve on the task force and they welcome the opportunity to
engage in this work as drug overdose continues to endanger the lives of many citizens.
Marcia DuFore, Amplify Inc. supports the bill as peer support is an essential role on health
care teams to support the recovery process. In an experience with a close friend she explains
the lack of resources and support there was and how lives are lost without it.
Hilary Felton-Reid, Connecticut Association of Health Plans offered comments on the
bill. CTAHP supports efforts to minimize and prevent medication misuse and abuse however
each patient responds to treatment differently. Prescriptive treatment and coverage
requirements laid out in statute impeded the ability of carriers and clinicians to adapt
treatment protocols in line with clinical appropriateness. Urged caution in adopting a one-size
fits all policy. With costs of pharmaceuticals rising, it is irresponsible and not in the interest of
the consumer to prohibit the ability of carriers to manage cost. Lastly should the legislature
choose to move forward with the task’s forces, CTAHP request a seat at the table.
Michaela L. Fissel, Executive Director, Advocacy Unlimited supports the bill and offered
some suggestions. She asked for a seat for Advocacy Unlimited and one for the Connecticut
Community for Addiction Recovery. These organizations have had the longest standing
experience with training and educating peer specialists. She also asked for an additional seat
for a person who is working in peer services as a Certified Peer Recovery Specialist and to
replace the representative of the Department of Children and Families with a representative
of the Department of Mental Health and Addiction Services.
Diane Frost, RSS, MSW, Stamford, CT supports the bill and from her experience as a
mental health professional she acknowledged the importance of the bill.
Robert Goethals, New Haven, CT supports the bill as peer support is an essential role on
health care teams to support the recovery process.
Nicole Hampton, Certified Peer Recovery Specialist, Recovery Coach Professional
supports the bill as establishing a task force would elevate and formalized the discussion at a
state level. If we are to increase pathways to peer workforce Certified Peer Recover
Specialists need to be reimbursable.
Danielle Morgan, MSN, CNS, Family PMHNP, APRN-BC, supports the bill as it provides
support for the prescribing providers’ medical decision making while outweighing the 90-day
convenience of health insurers. The appreciation for the complexity of psychiatric care is lost
with patients when inappropriate 90-day dispensing is encouraged. This can lead to noncompliance, treatment failure, poor outcomes and illness that never reaches remission.
Gisela Pena, Hamden, CT supports the bill from personal experience in her own recovery
process, she has had much success with her Certified Peer Recover coach. She urged that
health insurance be inclusive of certified peer support services.
Page 3 of 3 HB-6588
Theo Pinnow, RSS, Naugatuck, CT supports the bill as peer support services is an
essential role in the mental healthcare system. As a recovery support specialist himself he
has witnessed the importance of the role on the individuals.
Jeffrey Santo, Norwalk, CT supports the bill as it is necessary for the future of CT residents.
It will not only help fill the gaps in current mental health and addiction services but allow for
new ideas and practices to be brought to the table.
Ben Shaiken, Manager of Advocacy & Public Policy, CT Community Nonprofit Alliance
supports the bill as research shows that peer support services are effective at treating mental
health conditions and helping people recover from addiction.
David Watson, Monroe, CT supports the bill as it will be a powerful too and resource for
communities. He recommends that there should be strong representation of the peer support
community on the task force to mitigate any misinformation.
Margaret Watt, Norwalk, CT supports the bill as peer support specialists can bridge the
gaps in mental health in an effective manner. Peer Support specialists are important and
have made a big contribution to individuals’ recovery.
NATURE AND SOURCES OF OPPOSITION:
None Expressed.
Reported by: Christina Cruz Date: 04/05/2021

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