HOUSE OF REPRESENTATIVES	H.B. NO.	615
TWENTY-SIXTH LEGISLATURE, 2011		H.D. 1
STATE OF HAWAII

A BILL FOR AN ACT

 

 

RELATING TO MENTAL HEALTH.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  Chapter 334, Hawaii Revised Statutes, is amended by adding three new sections to be appropriately designated and to read as follows:

     "§334‑    Adult mental health services; time with patients.  The department shall limit the number of hours devoted to individual patients to thirty units per month and shall assign case managers to patients based upon the Diagnostic and Statistical Manual of Mental Health Disorders, DSM-IV, of the American Psychiatric Association.

     §334‑    Crisis intervention services; staff requirements.  The department shall employ appropriately trained professionals and paraprofessionals, including social workers licensed under chapter 467E,  who are certified in suicide prevention and substance and alcohol abuse to determine the proper referral of patients, to provide emergency crisis intervention services through its crisis hotline.

     §334‑    Assertive community treatment program.  (a)  There is established under the department of health an assertive community treatment program that includes teams that are staffed with trained professionals, paraprofessionals, and specialists to provide individualized counseling and treatment to the patient.

     (b)  The mission of the assertive community treatment program shall be to provide comprehensive case management and treatment services according to the program for assertive community treatment model which manages the symptoms of mental illness by focusing on the establishment and linkage of a supportive services network in a cultural context that promotes community integration and allows for family and social understanding of mental illness."

     SECTION 2.  Section 431M-1, Hawaii Revised Statutes, is amended by amending the definition of "serious mental illness" to read as follows:

     "["Serious] "Severe mental illness" means a mental disorder consisting of at least one of the following:  schizophrenia, schizo-affective disorder, bipolar types I and II, obsessive compulsive disorder, dissociative disorder, delusional disorder, [and] major depression, major depressive disorder, anxiety disorder, and borderline personality disorder, as defined in the most recent version of the Diagnostic and Statistical Manual of the American Psychiatric Association and which is of sufficient severity to result in substantial interference with the activities of daily living."

     SECTION 3.  Section 431M-4, Hawaii Revised Statutes, is amended by amending subsections (a) and (b) to read as follows:

     "(a)  The covered benefit under this chapter shall not be less than thirty days of in-hospital services per year.  Each day of in-hospital services may be exchanged for two days of nonhospital residential services, two days of partial hospitalization services, or two days of day treatment services.  Visits to a physician, psychologist, licensed [clinical] social worker, marriage and family therapist, licensed mental health counselor, or advanced practice registered nurse shall not be less than thirty visits per year to hospital or nonhospital facilities or to mental health outpatient facilities for day treatment or partial hospitalization services.  Each day of in‑hospital services may also be exchanged for two outpatient visits under this chapter; provided that the patient's condition is such that the outpatient services would reasonably preclude hospitalization.  The total covered benefit for outpatient services in subsections (b) and (c) shall not be less than twenty-four visits per year; provided that coverage of twelve of the twenty-four outpatient visits shall apply only to the services under subsection (c).  The other covered benefits under this chapter shall apply to any of the services in subsection (b) or (c).  In the case of alcohol and drug dependence benefits, the insurance policy may limit the number of treatment episodes but may not limit the number to less than two acute treatment episodes per lifetime.  Nothing in this section shall be construed to limit [serious] severe mental illness benefits.

     (b)  Alcohol and drug dependence benefits shall be as follows:

     (1)  Detoxification services as a covered benefit under this chapter shall be provided either in a hospital or in a nonhospital facility that has a written affiliation agreement with a hospital for emergency, medical, and mental health support services.  The following services shall be covered under detoxification services:

         (A)  Room and board;

         (B)  Diagnostic x-rays;

         (C)  Laboratory testing; and

         (D)  Drugs, equipment use, special therapies, and supplies.

          Detoxification services shall be included as part of the covered in-hospital services, but shall not be included in the acute treatment episode limitation, as specified in subsection (a);

     (2)  Alcohol or drug dependence treatment through in‑hospital, nonhospital residential, or day treatment substance abuse services as a covered benefit under this chapter shall be provided in a hospital or nonhospital facility.  Before a person qualifies to receive benefits under this subsection, a qualified physician, psychologist, licensed [clinical] social worker, marriage and family therapist, licensed mental health counselor, or advanced practice registered nurse shall determine that the person suffers from alcohol or drug dependence, or both; provided that the substance abuse services covered under this paragraph shall include those services that are required for licensure and accreditation and shall be included as part of the covered in-hospital services as specified in subsection (a).  Excluded from alcohol or drug dependence treatment under this subsection are detoxification services and educational programs to which drinking or drugged drivers are referred by the judicial system and services performed by mutual self‑help groups;

     (3)  Alcohol or drug dependence outpatient services as a covered benefit under this chapter, in addition to acute substance abuse and alcohol treatment episodes requiring hospitalization, shall be provided under an individualized treatment plan approved by a qualified physician, psychologist, licensed [clinical] social worker, marriage and family therapist, licensed mental health counselor, or advanced practice registered nurse and shall be services reasonably expected to produce remission of the patient's condition.  An individualized treatment plan approved by a marriage and family therapist, licensed mental health counselor, licensed [clinical] social worker, or an advanced practice registered nurse for a patient already under the care or treatment of a physician or psychologist shall be done in consultation with the physician or psychologist.  Services covered under this paragraph shall be included as part of the covered outpatient services as specified in subsection (a)[; and].  The crisis substance abuse and alcohol treatment program shall extend for a period of thirty to sixty days for patients known to abuse substances, including individual and group counseling; and

     (4)  Substance abuse assessments for alcohol or drug dependence as a covered benefit under this section for a child facing disciplinary action under section 302A‑1134.6 shall be provided by a qualified physician, psychologist, licensed [clinical] social worker, advanced practice registered nurse, or certified substance abuse counselor.  The certified substance abuse counselor shall be employed by a hospital or nonhospital facility providing substance abuse services.  The substance abuse assessment shall evaluate the suitability for substance abuse treatment and placement in an appropriate treatment setting."

     SECTION 4.  Section 431M-5, Hawaii Revised Statutes, is amended by amending subsection (c) to read as follows:

     "(c) A health insurance plan shall not impose increased rates, terms, or conditions including service limits and financial requirements, on [serious] severe mental illness benefits, if similar rates, terms, or conditions are not applied to services for other medical or surgical conditions.  This chapter shall not apply to individual contracts; provided further that this chapter shall not apply to QUEST medical plans under the department of human services until July 1, 2002."  SECTION 5.  There is appropriated out of the general revenues of the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2011-2012 to establish a community care crisis center to assist with day programs for designated patients who are discharged from inpatient care.

     The sums appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 6.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 7.  This Act shall take effect upon its approval; provided that section 5 shall take effect on July 1, 2011.

 

Report Title:

Mental Health; Appropriation

 

Description:

Adds crisis substance abuse and alcohol treatment as a covered benefit.  Changes the term "serious mental illness" to "severe mental illness" and amends the definition to include additional disorders.  Requires the Department of Health (DOH) employ trained professionals, paraprofessionals, and social workers to provide certain services through its crisis hotline. Limits the number of hours of adult mental health services treatment per patient. Establishes an assertive community treatment program under DOH.  Appropriates funds to establish a community care crisis center.  (HB615 HD1)

 

 

 

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