Amendment ID: S2519-33-R1

Redraft Amendment 33

Screening for Adverse Childhood Experiences

Ms. Creem, Messrs. Feeney and O'Connor and Ms. Chang-Diaz move that the proposed new draft be amended by inserting after section 57 the following section:-

“SECTION 57A. For the purposes of this section, the following terms shall have the following meanings unless the context clearly requires otherwise:-

“Adverse childhood experience”, a potentially traumatic event that occurs in childhood, including, but not limited to: (i) experiencing violence or abuse; (ii) witnessing violence in the home or community; (iii) having a close family member die or attempt or die by suicide; (iv) living with close family member or caregiver with substance use disorder or presenting with behavioral health needs; or (v) experiencing separation from a parent due to divorce, incarceration or child welfare intervention.

“Trauma”, the result of an event, series of events or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional or spiritual well-being.

There shall be an advisory working group to update, amend or select, as appropriate, tools and protocols for the screening of children for trauma and adverse childhood experiences within the developmental and mental health screening protocols applicable to the Early and Periodic Screening, Diagnosis and Treatment benefit. The advisory working group shall be comprised of the following members or their designee: the assistant secretary of MassHealth and the commissioner of insurance, who shall serve as co-chairs; the commissioner of public health; the commissioner of mental health; and the following members to be appointed by the co-chairs, at least 2 of whom shall represent commercial health insurance carriers, at least 2 of whom shall be behavioral health experts, at least 2 of whom shall be developmental pediatric experts, at least 2 of whom shall be child welfare experts and at least 2 of whom shall be child and adolescent stakeholders.

The advisory working group shall consider: (i) existing screening tools used in the MassHealth program, including, but not limited to, those outlined in the MassHealth All Provider Manual Appendix W - Early and Periodic Screening, Diagnosis and Treatment Program Services Medical and Dental Protocols and Periodicity Schedules; (ii) other validated and reliable screening tools with empirical support for reliability, validity, standardization of norms, specificity and sensitivity of measures that assess abuse, neglect, household dysfunction and related indicators, including parental trauma and toxic stress; (iii) validated and reliable screening instruments that meet criteria set forth by the American Academy of Pediatrics and the federal Centers for Medicare and Medicaid Services; (iv) the efficacy and appropriateness of the types of providers authorized to administer screenings; (v) the training required to support authorized providers in the sound and efficient administration of adverse childhood events and trauma screening; (vi) ways to ensure regular periodic review of protocols for the screening of trauma in children; and (vii) ways to ensure adequate reimbursement for screening children for adverse childhood experiences.

The advisory working group shall hold the first meeting not later than April 1, 2020 and report its findings and recommendations to the clerks of the senate and house or representatives, the joint committee on mental health, substance use and recovery and the joint committee on health care financing not later than December 31, 2020.”.