Lupardo Calls for PTSD to be Included in Timothy’s Law

Guaranteed coverage would benefit veterans and victims of sexual abuse and assault

Assemblywoman Donna Lupardo (D-Endwell) today called for an expansion of Timothy’s Law to include Post-Traumatic Stress Disorder (PTSD). She is co-sponsoring legislation that would include post traumatic stress disorder (PTSD) among the list of biologically based mental illnesses that would be covered under Timothy's Law.

“Unlike other serious physical and mental illnesses that are covered in full by insurers, health plans in New York State presently limit access to treatment for PTSD,” said Assemblywoman Lupardo. “The plans arbitrarily limit individuals to only 30 days of inpatient care and 20 outpatient visits per year, even for those who have a medically verified need for more treatment above the minimum amounts mandated by law.”

The legislation would include PTSD as a “biologically based” mental illness in Timothy’s Law, therefore removing unnecessary and arbitrary limits on treatment for those patients that require more than the minimum 20 outpatient visits per year. A recent study by the RAND Corporation found that failure to treat PTSD for a single veteran leads to work productivity loss and unnecessary hospitalizations estimated to cost as much as $10,298 over a two-year period. By contrast, adding PTSD to Timothy’s Law would cost mere pennies per person per year (at most) as a component of health premiums for large employers in New York State.

While a sizeable number of veterans access mental health care within the Veterans Administration (VA), only half of the soldiers returning to New York State turn to the VA for care. Many others, particularly National Guard and Reservists (who make up the majority of New Yorkers deployed to Operation Enduring Freedom and Operation Iraqi Freedom) return to their communities and jobs, and seek mental health care through their employer-based private health plans. In some cases, they have been deemed ineligible for VA mental health services, and in others, the stigma associated with mental illness leads these men and women to seek treatment at venues that have no military association. The wounds of war profoundly affect the lives of returning soldiers, their families and communities.

The number of women deployed by the military has grown significantly since earlier conflicts: 10 percent of all service-members deployed to Afghanistan and Iraq are women, compared with only 0.01 percent deployed during the Vietnam War. According to a recent RAND study, women facing combat are more susceptible to PTSD, and less likely to seek care through the VA.

“We have an obligation to assure access to quality care for the physical and psychological combat injuries sustained by veterans,” said Assemblywoman Lupardo. “Veterans who rely upon our state licensed and regulated systems of care, including those who use their employee health plans or those of their spouses, deserve comprehensive care for their injuries.”

Over 900 rape victims assaulted in 2007 alone have or will develop PTSD as a result of the trauma they have experienced and countless other victims of assault and even serious accidents need treatment for PTSD as well. “This legislation will also assure proper access to mental health care for thousands victims of child abuse, domestic violence and rape who suffer PTSD each year,” said Assemblywoman Lupardo. “We cannot in good conscience allow health plans to continue to turn these people away from treatment.”

While the prevalence of PTSD in the general population is small, it is relatively high when you look at certain subgroups of the population that are affected by it. Veterans who have been in combat, victims of violent crimes such as rape, survivors of childhood abuse, and persons exposed to catastrophic events such as natural disasters or terrorism all suffer from much higher rates of PTSD. Additionally the symptoms are very real and debilitating.

Left untreated, PTSD is highly associated with serious medical ailments leading to significant physical debilitation and even premature death. Further, suicide risk for PTSD patients is considerably higher than among unaffected populations.

New York State adopted mental health parity under Timothy's Law in 2006. The law, named for 12-year-old Timothy O’Clair, who took his life after battling mental illness, requires insurance coverage for biologically-based mental illnesses.

Assemblywoman Lupardo is the Chair of the Subcommittee on Women Veterans. She is also a member of the Mental Health and Veterans Affairs committees in the Assembly.