A waiting area in the emergency department of Connecticut Children's Medical Center in Hartford.
A waiting area in the emergency department of Connecticut Children's Medical Center in Hartford. During the pandemic, the number of children and teens waiting in emergency departments for inpatient psychiatric beds increased. Yehyun Kim / ctmirror.org

More than a year after lawmakers passed broad legislation meant to expand access and boost resources for children’s mental health in Connecticut, a group of health care providers, advocates, legislators and residents affected by the issue convened to begin examining the availability and efficacy of services.

The panel was formed as part of the legislation passed in 2022 but only began its work on Monday. Rep. Tammy Exum, a co-chair of the group, said organizers used the intervening months to fine-tune membership and the role the committee will play, and to appoint members.

The group, called the Transforming Children’s Behavioral Health Policy and Planning Committee, is expected to meet monthly for at least three years and issue recommendations to the General Assembly and some state agencies by December.

It will explore gaps in the system, the sustainability of funding for programs, access to services, disparities, utilization of services and best practices. The committee will also research what programs have worked well in other states and make suggestions for Connecticut, as well as perform checks and balances on initiatives related to the 2022 bills, ensuring reform efforts are carried out.

The measures covered a wide range of priorities, from enabling license reciprocity for out-of-state providers to setting up a grant program for local boards of education so they can hire additional behavioral health specialists and requiring certain insurance plans to cover mental health wellness examinations.

“I, personally, am so invested in this issue,” said Exum, a West Hartford Democrat who co-chairs the committee with Sen. Ceci Maher, D-Wilton, and Claudio Gualtieri, senior policy advisor for the state Office of Policy and Management. “When the organizations we partner with are saying they have what they need for funding … and people are seeing a turnaround — a turnaround in our emergency rooms — and we start to see the impact on our children and families, I will know we’re doing the right thing and heading in the right direction.

“What this committee wants to do is identify goals and measurable outcomes we can use to improve the system,” she said. “That requires us to really take a holistic look with lots of stakeholders and people personally impacted and try to ensure systems are working together to address the needs.”

The panel will also form subgroups to take a deeper look at certain topics. Issues may include recruitment and retention of providers, delivery of services, data sharing, acute care and the effectiveness of school-based programs.

Nonprofit leaders and advocates have raised concerns about budget cuts this year that mean some mental and behavioral health programs will be forced to scale back or eliminate services. In some cases, initiatives created in connection with the 2022 bills are having trouble getting off the ground due to uncertainty around funding, CTInsider reported.

Several of the programs established or supported through those measures were backed by funds from the American Rescue Plan Act, and with the money running out, there is not yet a long-term plan for maintaining the services.

Exum said the committee will look at the problem and recommend solutions.

“I can’t stress how important this is for me,” she said. “It’s a tremendous concern, because this crisis is still underway. We can’t manage a full crisis with temporary funding. I share the concerns of these organizations, and it is a high priority of mine to look closely at the funding.”

Advocates and providers called on the panel to make sustainability of funding a top priority.

“That’s, ultimately, one of the key things,” said Thomas Burr, public policy and affiliates relations manager with the National Alliance on Mental Health in Connecticut. “If you can’t sustainably fund these things, you can’t expect the provider community to leap in, setting themselves up for failure. I was disappointed at the lack of interest in funding the nonprofit world this session.

“At the end of the day, we’re not where we need to be. This is a big problem,” he said. “You don’t want to short-sheet this bed. The moral thing to do to is to make sure people can get the help they need. It’s clear to us as an organization that when people can get the help they need by intervening early, it can literally change the trajectory of a person’s life.”

Alice Forrester, CEO of Clifford Beers in New Haven, which provides mental health and support services for children, teens and young adults, said funding hasn’t kept up with demand for services.

The state budget this year included $53 million to provide a 2.5% rate increase in the first year of the new biennium for nonprofits that provide the bulk of state-sponsored social services. The industry, however, had asked for more — a 9% bump starting July 1 and then a 7% hike on top of that in July 2024. The CT Community Nonprofit Alliance estimated that minimal or no state funding hikes for the past two decades have forced many agencies to cut staff and shrink programs.

Forrester said the less-than-hoped-for rate increase this year meant her organization had to lay off four workers, including care coordinators, and eliminate several vacant positions. She hopes the committee will consider the issue of funding.

“If you’re going to look at the systems that care for our children, you have to look at how they’re financed,” she said. “And if you’re going to change a system, you have to understand how that is going to be sustained. It’s not easy; it’s like turning a ship around. But I think if this committee is seriously looking at a system change, it’s going to have to really look at structural financing.”

“We were really disappointed to see that some of the landmark investments like the urgent crisis centers and the sub-acute crisis stabilization beds … were not included in the state budget and did not have the continued funding,” added Tammy Freeberg, vice president of strategy and planning for The Village for Families & Children in Hartford. “I think continuity around investments that are decided through the legislative process is something this committee can absolutely address, and I think they will.”

At its first meeting Monday, committee members introduced themselves and laid out goals and next steps. The panel will next meet in September.

Once the first batch of recommendations is presented to the legislature, state officials and advocates say lawmakers must consider and act on them.

“Is anyone going to act on what they come up with? That’s always the thing,” Burr said. “That’s always my biggest fear when the legislature does these sorts of things — is anyone going to take what they say seriously? Or are they just going to throw it on a shelf and say thank you to the committee and move on.”

House Speaker Matthew Ritter, D-Hartford, pointed out that the panel will have staff and resources supported by state funding. He likened it to the Juvenile Justice Policy and Oversight Committee, launched in 2014, which has assessed the impact of juvenile justice legislation and the quality of education across the system, analyzed disparities and recommended changes, among other things.

“I think when you have a more formal committee like this, for which there’s money appropriated in the budget, you have the staying power of constantly being ahead with the most updated information and the most current communication with providers,” he said. “That’s the goal, that this doesn’t get washed aside with the inevitability of other issues that will rise to the forefront next year.”

Jenna is CT Mirror’s Health Reporter, focusing on health access, affordability, quality, equity and disparities, social determinants of health, health system planning, infrastructure, processes, information systems, and other health policy. Before joining CT Mirror Jenna was a reporter at The Hartford Courant for 10 years, where she consistently won statewide and regional awards. Jenna has a Master of Science degree in Interactive Media from Quinnipiac University and a Bachelor or Arts degree in Journalism from Grand Valley State University.