Bill Text: NJ A5600 | 2022-2023 | Regular Session | Introduced
Bill Title: "Right to Mental Health for Individuals who are Deaf or Hard of Hearing Act"; establishes certain requirements concerning provision of mental health services to individuals who are deaf or hard of hearing.
Spectrum: Moderate Partisan Bill (Democrat 7-2)
Status: (Introduced - Dead) 2023-06-15 - Introduced, Referred to Assembly Human Services Committee [A5600 Detail]
Download: New_Jersey-2022-A5600-Introduced.html
Sponsored by:
Assemblywoman PAMELA R. LAMPITT
District 6 (Burlington and Camden)
Assemblywoman CAROL A. MURPHY
District 7 (Burlington)
Assemblywoman ANGELA V. MCKNIGHT
District 31 (Hudson)
Co-Sponsored by:
Assemblymen Benson, Giblin, DePhillips and Umba
SYNOPSIS
"Right to Mental Health for Individuals who are Deaf or Hard of Hearing Act"; establishes certain requirements concerning provision of mental health services to individuals who are deaf or hard of hearing.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning access to mental health services for people who are deaf and hard of hearing and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. This act shall be known and may be cited as the "Right to Mental Health for Individuals who are Deaf or Hard of Hearing Act."
2. The Legislature finds and declares that:
a. Individuals who are deaf or hard of hearing, as a group, represent an underserved population in many respects, particularly with regard to access to mental health services.
b. Individuals who are deaf or hard of hearing often require highly specialized mental health services because of communication barriers and other complex needs.
c. Research shows that individuals who are deaf or hard of hearing are subject to significantly more risks to their mental health than are individuals who are able to hear, for reasons that include, but are not limited to, issues involving communication access in general, deficient communication with family members, educators, and treating healthcare professionals, and access to appropriate educational services and culturally affirmative and linguistically appropriate physical and mental health services.
d. Some individuals who are deaf or hard of hearing may have secondary disabilities that affect the type and manner of the mental health services the individual needs. For example, individuals who are deaf and blind often have diverse ways of communicating, such as through the use of tactile sign language.
e. Being deaf or hard of hearing affects the most basic human needs, including the ability to communicate with other human beings. Many individuals who are deaf or hard of hearing use sign language, which may be their primary method of communication, while other individuals who are deaf or hard of hearing receive language orally and aurally, with or without visual signs or cues. However, some individuals who are deaf or hard of hearing lack any significant language skills, may experience language deprivation, or both.
f. Individuals who are deaf or hard of hearing frequently possess highly diverse communication skills and experience highly diverse communication challenges. The nature and timing of a hearing loss, the success of medical or therapeutic remediation efforts, and the accessibility of sign language or spoken language at home, school, and in other settings, each shape the way that hearing loss affects an individual who is deaf or hard of hearing.
g. The communication ability of an individual who is deaf or hard of hearing can vary widely, and can be affected by factors such as the individual's innate abilities and the degree to which the individual has been supported in language acquisition. Some individuals who are deaf or hard of hearing are multilingual, with fluency in more than one communication method, while others are alingual, with fluency in no communication methods. However, it is not uncommon for individuals who are deaf or hard of hearing to have poorly developed language skills in both sign language and spoken language.
h. It is essential that individuals who are deaf or hard of hearing:
(1) have access to appropriate mental health services that are provided in the primary communication method used by the individual, as determined by the individual's preference, by the results of an appropriate communication assessment, or both;
(2) have access to services provided by mental health professionals who are fluent in the individual's primary method of communication, understand the unique nature of being deaf or hard of hearing, possess the knowledge and training to work effectively with individuals who are deaf or hard of hearing to provide culturally affirmative and linguistically appropriate mental health services, and who can collaborate skillfully with interpreters;
(3) have access to mental health professionals who are familiar with the unique culture and needs of individuals who are deaf or hard of hearing, as a lack of awareness of the special needs of individuals who are deaf or hard of hearing or a lack training in working with individuals who are deaf or hard of hearing can result in misdiagnosis of a mental health issue;
(4) are involved in determining the scope, content, and purpose of the mental health services they are provided, which services should be tailored for delivery to the individual who is deaf or hard of hearing; and
(5) have access to mental health services that provide appropriate one-on-one access to a full continuum of mental health services, including all modes of therapy and evaluation, as well as access to specialized mental health services that are consistent with best practices and use appropriate curricula, staff, and outreach to support the unique mental health needs of individuals who are deaf or hard of hearing.
i. Individuals who are deaf or hard of hearing should have access to a resource guide listing the mental health services in this State that offer the best access and provide the most specialized mental health services for clients.
j. Individuals who are
deaf or hard of hearing will benefit from the development and implementation of
State and regional services designed to address their unique and specialized mental
health needs.
3. As used in this act:
"Certified mental health professional" means a psychiatrist, psychologist, advanced practice nurse, therapist, counselor, or social worker licensed or certified to practice under Title 45 of the Revised Statutes who is certified by the Division of the Deaf and Hard of Hearing in the Department of Human Services as: fluent in one or more primary communication methods; a specialist who is trained and experienced in working skillfully with interpreters; and knowledgeable of the cultural needs of clients.
"Client" means an individual who is deaf or hard of hearing and who is in need of mental health services.
"Communication skills assessment" means the Sign Language Proficiency Interview assessment and any other communication skills assessment approved by the Division of the Deaf and Hard of Hearing in the Department of Human Services.
"Culturally affirmative mental health services" means mental health services provided by certified mental health professionals and support staff, which services are sensitive to, and in support of, the diverse cultural affiliations and needs of clients, including affiliation with the deaf community and culture.
"Deaf" means the condition of having sustained a hearing loss that is so severe that the individual has difficulty in processing linguistic information through hearing, regardless of amplification or other assistive technology, as well as the unique culture, community, and identity of an individual who is deaf.
"English-based manual or sign system" means a sign system that uses manual signs in English word order, which may include the use of added affixes that are not present in American Sign Language.
"Fluent" means a sign language communication skills assessment score of "Advanced," in the case of a certified mental health professional, and a sign language communication skills assessment score of "Intermediate Plus," in the case of other licensed and nonlicensed support staff working in a mental health setting.
"Hard of hearing" means the condition of having sustained a hearing loss, whether permanent or fluctuating, which hearing loss may be corrected by amplification or other hearing assistive technology, but which, regardless of correction, presents challenges in processing linguistic information through hearing.
"Interpreter" means an interpreter certified by the New Jersey Registry of Interpreters for the Deaf.
"Linguistically appropriate mental health services" means the full continuum of mental health services that are made available in the method of communication preferred by the client or in the method of communication that is determined to be most effective for the individual, based on the results of a communication assessment.
"Method of communication" means any of the following systems of communication used by clients: American Sign Language; an English-based manual or sign system; a highly visually oriented and minimal sign language system to communicate, including, but not limited to, a home-sign-based system, idiosyncratic signs, a sign system or language of another country, or non-linguistic or semi-linguistic communication systems designed to meet the needs of language-deprived or dysfluent individuals; or an oral, aural, or speech-based sign system.
"Oral, aural, or speech-based system" means a communication system that uses the speech or residual hearing, or both, of an individual who is deaf or hard of hearing, regardless of technology or cued assistance.
"Primary method of communication" means the method of communication preferred by an individual who is deaf or hard of hearing that will be most effective, as determined by the preference of the individual who is deaf or hard of hearing, by the results of an appropriate communication assessment, or both.
"Telemedicine and telehealth" means the provision of services using telemedicine and telehealth in accordance with the provisions of P.L.2017, c.117 (C.45:1-61 et al.).
4. a. Each certified mental health professional providing mental health services to a client shall:
(1) offer culturally affirmative mental health services and linguistically appropriate mental health services to clients in the client's primary method of communication; and
(2) not deny a client access to culturally affirmative mental health services or linguistically appropriate mental health services using the client's primary method of communication due to the client's having:
(a) residual hearing ability, whether or not supported by amplification or other hearing assistive technology; or
(b) previous experience with another method of communication.
b. Nothing in this section shall be construed to:
(1) prevent a client from receiving mental health services in more than one method of communication; or
(2) require a client to receive culturally affirmative mental health services or linguistically appropriate mental health services.
5. The Division of Mental Health and Addiction Services in the Department of Human Services, in consultation with the Division of the Deaf and Hard of Hearing in the Department of Human Services, shall:
a. implement and maintain culturally affirmative mental health services and linguistically appropriate mental health services for any client using the client's primary method of communication;
b. recruit, develop, and maintain an adequate number of certified mental health professionals and other licensed and non-licensed support staff qualified to work in settings where mental health services are provided to clients to ensure the delivery of culturally affirmative mental health services and linguistically appropriate mental health services one-on-one to any client in the client's primary method of communication;
c. monitor all culturally affirmative mental health services and linguistically appropriate mental health services to ensure that clients of all ages are adequately served;
d. provide adequate supplemental funding to all culturally affirmative mental health services and linguistically appropriate mental health services, as well as incentives to promote recruitment and retention of certified mental health professionals;
e. establish a certification process for mental health professionals who meet all standards and guidelines, as determined by the Division of the Deaf and Hard of Hearing, to provide culturally affirmative mental health services and linguistically appropriate mental health services to clients; and
f. develop and implement strategies for ensuring access to culturally affirmative mental health services and linguistically appropriate mental health services by clients in geographic areas where there is a lack or shortage of certified mental health professionals, including, but not limited to, the authorization of treatment:
(1) provided by certified mental health professionals in alternative or non-traditional locations; or
(2) using telemedicine and telehealth or other approved remote technologies that allow certified mental health professionals to provide clients with culturally affirmative mental health services and linguistically appropriate mental health services.
6. a. In order to provide culturally affirmative mental health services and linguistically appropriate mental health services to clients, the Division of Mental Health and Addiction Services in the Department of Human Services, in consultation with the Division of the Deaf and Hard of Hearing in the Department of Human Services, shall employ a deaf services coordinator, who shall be responsible for coordinating and overseeing the implementation of culturally affirmative mental health services and linguistically appropriate mental health services Statewide.
b. At a minimum, the deaf services coordinator employed pursuant to subsection a. of this section shall:
(1) be competent and have extensive experience in providing mental health services to clients;
(2) be fluent in American Sign Language and possess a thorough understanding of the deaf community and culture;
(3) have at least three years of experience providing one-on-one services to clients;
(4) possess a master's degree or higher in a behavioral health or clinical field, as well as the skill, knowledge, and experience in adapting and developing policies and procedures based on the actual service needs of individuals who are deaf or hard of hearing; and
(5) know and understand applicable State and federal laws governing the rights of, and services provided to, individuals who are deaf or hard of hearing.
c. The deaf services coordinator employed pursuant to subsection a. of this section shall:
(1) ensure that culturally affirmative mental health services and linguistically appropriate mental health services are accessible Statewide and that the provision of appropriate consultation, training, and technical assistance is accessible to mental health professionals in various settings, including, but not limited to, inpatient, outpatient, and residential programs;
(2) serve as a professional liaison to other State departments, divisions, offices, agencies, and boards for the collaboration needed to maximize the use of State resources and engage in joint planning;
(3) develop a model for a Statewide system of care for culturally affirmative mental health services and linguistically appropriate mental health services for clients that includes, at a minimum:
(a) standards of care for individuals who are deaf or hard of hearing, including standards for the level of American Sign Language fluency required to provide care in mental health settings;
(b) guidelines to measure the proficiency of a mental health professional in the methods of communication used by clients; and
(c) a partnership with the New Jersey Registry of Interpreters for the Deaf;
(4) collaborate with State and private mental health professionals throughout the State to assist and ensure compliance with State and federal laws relating to mental health services for clients;
(5) collect and evaluate clinical and programmatic outcome data from mental health professionals serving individuals who are deaf or hard of hearing;
(6) distribute funds or grants to public and private mental health professionals to achieve optimum service delivery within the system of care;
(7) prepare and submit such reports as shall be required by the Division of Mental Health and Addiction Services and the Division for the Deaf and Hard of Hearing; and
(8) provide clinical and administrative case consultations to mental health professionals, when appropriate, regarding the provision of culturally affirmative mental health services and linguistically appropriate mental health services to clients.
d. (1) The deaf services coordinator employed pursuant to subsection a. of this section shall establish an advisory committee to make recommendations and provide advice and assistance concerning the implementation of this section.
(2) The advisory committee established pursuant to paragraph (1) of this subsection shall comprise 10 members appointed by the Commissioner of Human Services. The membership of the advisory committee shall include at least six individuals who are deaf or hard or hearing, at least one parent or legal guardian of an individual who is deaf or hard of hearing, at least one certified mental health professional, at least one interpreter, and at least one educator who is licensed in New Jersey to teach individuals who are deaf or hard of hearing. The members of the advisory committee shall serve for a term of two years and shall be eligible for reappointment to the advisory committee.
(3) The deaf services coordinator shall call the first meeting of the advisory committee no later than 30 days after all 10 members are appointed to the advisory committee. Thereafter, the advisory committee shall meet at least quarterly and at the call of the deaf services coordinator.
(4) Members of the advisory committee shall serve without compensation, but may be reimbursed for travel and other reasonable expenses incurred in the performance of their duties as members of the advisory committee, within the limits of funds made available to the advisory committee for that purpose. To the extent possible, the deaf services coordinator shall seek to use technology and other available resources to limit the travel and related expenses incurred by the members of the advisory committee.
7. a. Each client who is admitted for mental health treatment shall have access to culturally affirmative mental health services and linguistically appropriate mental health services.
b. (1) Each mental health professional who provides mental health services to clients shall work with the deaf services coordinator employed pursuant to subsection a. of section 6 of this act, as appropriate, to ensure that culturally affirmative mental health services and linguistically appropriate mental health services are made accessible to clients.
(2) Each client shall have access to one-on-one culturally affirmative mental health services and linguistically appropriate mental health services from a certified mental health professional who is fluent in the client's primary method of communication, as determined by the preference of the client, by the results of an appropriate communication assessment, or both. If one-on-one culturally affirmative mental health services and linguistically appropriate mental health services by a certified mental health professional are not available within a reasonable geographical area for a client, as determined by the deaf services coordinator, the client shall be offered:
(a) an appropriate referral to a certified mental health professional who can provide culturally affirmative mental health services and linguistically appropriate mental health services through telemedicine and telehealth or other approved remote technologies; or
(b) at no cost to the client, culturally affirmative mental health services and linguistically appropriate mental health services through the use of an interpreter. If an interpreter cannot be physically present in a timely manner, the services of an interpreter may be offered to the client through telemedicine and telehealth or other approved remote technologies.
(3) If an interpreter is offered to a client, the client may voluntarily decline to accept or use the mental health services through the interpreter, without a penalty to the client, and shall be offered any other assistance and services as are required by State and federal law, including, but not limited to, the use of a different interpreter or hearing assistive technology.
(4) If a client refuses all culturally affirmative mental health services and linguistically appropriate mental health services that are offered, the mental health professional shall:
(a) secure from the client a signed waiver of the right to receive culturally affirmative mental health services and linguistically appropriate mental health services and include the signed waiver in the client's records;
(b) notify the deaf services coordinator of the client's refusal of culturally affirmative mental health services and linguistically appropriate mental health services; and
(c) allow the deaf services coordinator to review the culturally affirmative mental health services and linguistically appropriate mental health services offered to ensure that the services were appropriate.
8. The Assistant Commissioner of the Division of Mental Health and Addiction Services in the Department of Human Services and the Executive Director of the Division of the Deaf and Hard of Hearing in the Department of Human Services may adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as necessary to implement the provisions of this act.
9. This act shall take
effect 180 days after the date of enactment, except that the Assistant
Commissioner of the Division of Mental Health and Addiction Services in the
Department of Human Services and the Executive Director of the Division of the
Deaf and Hard of Hearing in the Department of Human Services may take any
administrative action in advance thereof as may be necessary to implement the
provisions of this act.
STATEMENT
This bill, which is designated as the "Right to Mental Health Care for Individuals who are Deaf or Hard of Hearing Act," establishes certain requirements concerning the provision of mental health services to individuals who are deaf or hard of hearing, who are referred to in the bill as "clients."
Specifically, the bill requires that mental health services be provided in a manner that is culturally affirmative and linguistically appropriate, using the client's primary method of communication. Clients may receive services using more than one method of communication, and will retain the right to refuse services.
The Division of Mental Health and Addiction Services (DMHAS) in the Department of Human Services (DHS), in consultation with the Division of the Deaf and Hard of Hearing (DDHH) in the DHS, will be required to: implement and maintain culturally affirmative and linguistically appropriate mental health services; recruit, develop, and maintain an adequate number of certified mental health professionals and support staff to meet the demand for culturally affirmative and linguistically appropriate mental health services; monitor the services provided to ensure that clients are adequately served; provide adequate funding for services; develop certification criteria for mental health professionals to provide services to clients, as well as incentives to promote professional recruitment and retention; and develop and implement strategies to ensure access to mental health services regardless of geography, which may include the use of telemedicine and other approved remote technologies.
The DMHAS, in consultation with the DDHH, will be required to employ a deaf services coordinator, who will be responsible for coordinating and overseeing the implementation of culturally affirmative and linguistically appropriate mental health services Statewide. Among other things, the coordinator will be required to ensure appropriate mental health services for clients are accessible Statewide in all treatment settings; serve as a liaison throughout State government to maximize the use of State resources and engage in joint planning; develop a model for a Statewide system of care; collaborate with mental health professionals throughout the State to assist and ensure compliance with State and federal laws relating to mental health services for clients; collect and evaluate clinical and programmatic outcome data; distribute funds or grants to achieve optimum service delivery; prepare and submit reports as required by the DMHAS and DDHH; and provide clinical and administrative case consultations support the provision of mental health services to clients.
The deaf services coordinator will be required to establish an advisory committee to make recommendations and provide advice and assistance concerning the implementation of the bill.
