How a need to make something better Became a Law - Jake's Law
Jake’s Law has 2 main parts that Denise and Ben Denslow made happen:
Insurance – Rep. Mitzi Epstein worked with stakeholders to develop the complex insurance requirements that help people to use their insurance to get mental healthcare. This came from the many stakeholder meetings that the Denslows and I co-chaired in 2019.
Schools – Sen. Kate Brophy McGee did good work with stakeholders on improving mental healthcare for students via school referrals
Denise and Ben Denslow were determined to make a difference to help others.
As their State Representative, I did everything I could to bring people together to achieve their goal. March 3, 2020 Jake's Law was signed.
Jacob Edward Machovsky was lost to suicide on January 11, 2016. His parents, Ben and Denise Denslow established the JEM Foundation to honor him by helping others. JEM’s purpose is ending youth suicide.
Denise and Ben describe, "You would have liked Jake, everyone did. He had a passion for airplanes and protecting other kids...
He was hospitalized twice in under 2 months for suicidal ideation. Both times, Jake was released in only 5 days. The doctor and parents knew Jake wasn’t ready to be released, but the insurance company refused to pay for the needed care. ..."
I met Denise and Ben in late 2018 when I convened a gathering of people working for suicide prevention.
I introduced them to Bahney Dedolph with the Arizona Council for Human Service Providers who suggested to them that Jake's situation may have been a violation of the federal insurance parity law.
That information from Bahney helped a lot! But we did not know yet what would really make a difference. We didn't just want to pass a law, we wanted to be sure that people got the help they needed. We formed a broad coalition to define the problems and find solutions.
Throughout 2019, we met roughly twice per month for a couple hours with experts in mental health, insurance, lobbyists, parents and survivors of suicide and many others. We reached out to people for their stories as patients trying to use their mental health care insurance and 125 answered our survey.
Denise and Ben were the best advocates I had ever met. They did the research and never stopped connecting people to help.
We developed a list of solutions including state laws to require insurance companies to cover mental health care in parity with physical healthcare. It's a lot of reporting and enforcement of compliance and the bottom line is this:
You should get what you pay for in your insurance policy.
We had a good list of solutions that would work and would make life better for people seeking mental health care. It could prevent suicides.
At that point, the Denslows brought the work results of this coalition to Republican Senator Kate Brophy McGee.
Our list from our 2019 meetings included many improvements and and some from our list made it into the bill that became Jake's Law:
Give the Division of Insurance the clear authority to enforce MHPAEA (the federal mental health parity law) and ensure that insurance companies are complying with parity requirements. We worked through many kinds of reports that could or should be made between DIFI and insurance companies. We used research from many authorities on the topic to make the reports impactful, but not onerous.
Require reports about the follow-up services for patients who visit a hospital and are at risk for suicide. CMS (US Center for Medicare and Medicaid) was a good resource for standards and now the law includes HEDIS (Healthcare Effectiveness Data and Information Set ) measures must be reported, so people can understand more about their insurance policies.
Establish an Advisory Council to continue to work through the details of assuring MPHEA compliance in Arizona.
- Give patients, providers and insurers an opportunity to be part of policy planning and decisions. That became the Mental Health Parity Advisory Committee in the law.
Evaluate customer service requests in DIFI to determine if and how the department can improve their attention to complaints and get better results for Arizonans.
Require DIFI to create a website to educate residents about what insurers should be offering and how to file insurance complaints.
Require state-regulated insurers to provide a customer service line on insurance cards.
- In one of our meetings we all suddenly took out our insurance cards and started looking at them to see if there was room for a phone number or website.
- We brainstormed practical solutions for the problems patients faced in dealing with their health insurance companies.
- You're welcome for all the research and work we did, Kate. Thanks for sponsoring the bill.
- Thanks to Carly Fleege, who volunteered her time as a professional lobbyist to bring in Republican elected officials.
Sponsoring the Bill is Different from Developing the Bill.
Then-Senator Kate Brophy McGee sponsored the bill, SB1523. She also worked with stakeholders to develop the school referrals parts.
I worked with stakeholders to develop the parts that help patients to use their healthcare insurance. I developed that part of the bill. I always indicate that I collaborate and develop bills that pass. I do not say that I sponsored a bill, unless I did sponsor it.
Nobody makes a law all by themselves. Laws do not belong to legislators; they belong to the people of Arizona. I offered repeatedly to sign on as a co-sponsor of the bill, but Senator McGee "fast-tracked the bill" and did not notify me when it was ready for co-sponsor signings. By the time I heard about the House and the Senate bills, they were dropped in the hopper and not available to add co-sponsors.
Senator Brophy-McGee and I did our part as legislators in convening people to write the bill well, and to develop and brainstorm for ideas that would really help people.
Denise and Ben Denslow are the heroes for their persistent, intelligent pursuit of changes to insurance laws to help people get better mental health care. They deserve the credit for this great achievement.
Side notes about politics:
The Republican leadership in the AZ legislature quells Democrats from being prime-sponsors of bills that will pass.
This bill was a big deal. It will help people a lot! The work we did in 2019 helped a lot of powerful people at the Capitol to realize: This is a big deal!
So the Republican powers-that-be wanted the credit for the bill to go to Republicans Kate Brophy McGee and Jeff Weninger. McGee and Weninger were in tough election contests against fantastic Democratic candidates in 2020.
Also see here the photo of the pen from that bill-signing ceremony that Gov. Ducey handed to me. Several important stakeholders in the room literally pushed me forward to get one of 5 signing pens.
I just wanted the bill to pass so it will help people.
Hurray for everybody who helped it along the way!
Rep. Jennifer Jermaine made made a good suggestion to cover special needs students for their full school careers. Others made practical suggestions. Lobbyist Carly Fleege was very dedicated to getting this bill signed into law.
I do not need credit for this good bill. It will help people and that is enough for me. The credit really goes to Denise and Ben!
I Do want the voters in my district to know about the kind of work I do.
I listen. I work to define the problems so that we can find a solution that works.
I bring lots of people together to solve big, complex problems. Then the stakeholders and I find a Republican legislator to sponsor the solution as a bill, because that helps the Republican Caucus to vote Yes on the bill.