HB 1541-FN - AS INTRODUCED
2016 SESSION
\t16-2203
\t01/04
HOUSE BILL\t1541-FN
AN ACT\tprohibiting placement of certain persons with a mental illness in the secure psychiatric unit, and authorizing the commissioner of the department of corrections to seek therapeutic alternatives.
SPONSORS:\tRep. Cushing, Rock. 21; Rep. Mangipudi, Hills. 35; Rep. MacKay, Merr. 14; Rep. Sherman, Rock. 24; Rep. Berrien, Rock. 18; Rep. Danielson, Hills. 7; Rep. Pantelakos, Rock. 25; Sen. Stiles, Dist 24; Sen. Lasky, Dist 13; Sen. Fuller Clark, Dist 21
COMMITTEE:\tHealth, Human Services and Elderly Affairs
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ANALYSIS
\tThis bill prohibits persons who are involuntarily admitted to the mental health services system pursuant to RSA 135-C who have never been charged with a crime or convicted of a crime to be placed in the secure psychiatric unit. Under this bill, such persons shall be placed in a therapeutic institution in this state or in another state.
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Explanation:\tMatter added to current law appears in bold italics.
\t\tMatter removed from current law appears [in brackets and struckthrough.]
\t\tMatter which is either (a) all new or (b) repealed and reenacted appears in regular type.
\t16-2203
\t01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Sixteen
AN ACT\tprohibiting placement of certain persons with a mental illness in the secure psychiatric unit, and authorizing the commissioner of the department of corrections to seek therapeutic alternatives.
Be it Enacted by the Senate and House of Representatives in General Court convened:
\t1 New Paragraph; Involuntary Admission; Secure Psychiatric Unit. Amend RSA 622:45 by inserting after paragraph I the following new paragraph:
\t\tI-a. Notwithstanding paragraph I, no person subject to an involuntary admission to the state mental health services system pursuant to RSA 135-C upon a determination that such person would present a serious likelihood of danger to himself or herself or to others if admitted to or retained in a receiving facility in the state mental health services system and who has never been charged with a crime or convicted of a crime shall be placed in the unit. The commissioner, in consultation and collaboration with the commissioner of the department of health and human services, shall enter into agreements with the equivalent commissioner of corrections or mental health agency in any other state for the placement of such person in a therapeutic forensic hospital. Such person may also be placed in a therapeutic institution in this state.
\t2 Report Required. The commissioner of the department of corrections shall submit a report relative to the status of securing placement for persons currently in custody in other psychiatric hospital facilities in other states pursuant to RSA 622:45, I-a on or before December 1, 2016 to the speaker of the house of representatives, the president of the senate, and the governor.
\t3 Effective Date. This act shall take effect January 1, 2017.
\t\t\t\t\t\t\t\t\t\t\t16-2203
\t\t\t\t\t\t\t\t\t\t\t11/24/15
HB 1541-FN- FISCAL NOTE
AN ACT\tprohibiting placement of certain persons with a mental illness in the secure psychiatric unit, and authorizing the commissioner of the department of corrections to seek therapeutic alternatives.
FISCAL IMPACT:
The Departments of Health and Human Services and Corrections state this bill, as introduced, will increase state general fund expenditures by an indeterminable amount in FY 2017 and each year thereafter. There will be no impact on state, county and local revenue or on county and local expenditures.
METHODOLOGY:
The Department of Health and Human Services states this bill would prohibit admission to the Secure Psychiatric Unit (SPU) of any person committed to the state mental health system who has never been charged with or convicted of a crime, even where the person has been determined to present a serious likelihood of danger to themselves or others if admitted to, or retained in, a receiving facility. The bill would require the commissioners of Health and Human Services and Corrections to consult and collaborate regarding agreements with out-of-state therapeutic forensic hospitals to provide care for these individuals. The bill permits placement in a therapeutic institution in New Hampshire, however the Department states no such forensic institution currently exists. The Department indicates the bill would significantly impact New Hampshire Hospital (NHH) and the Developmental Services Designated Receiving Unit (DRF). Presently the NHH and the DRF may transfer certain patients to the SPU in accordance with administrative rules if there has been a determination there is a serious likelihood of danger based on behaviors of a person that create a strong probability the NHH of DRF cannot reasonably provide the degree of safety or security necessary to prevent harm. The Department indicates there were 51 such transfers between 2012 and 2015 and 50 transfers were done on an emergency basis. The Department is not able to compute the fiscal impact but provides the following information on likely costs:
•\tThe daily rate for services in a New York therapeutic forensic hospital in 2013 was $859 per day or $313,535 annually. The source of funds for payment of these services would be general funds as such facilities are likely to be Institutions for Mental Diseases and not eligible for Medicaid under federal regulations.
•\tNHH transfers an average of 13 persons to the SPU each year. The average length of stay is not known.
•\tTransfer to out-of-state institutions will result in transportation costs and involve at least two staff members, and in some cases three, to accompany the individual resulting in increased staff costs.
•\tSome individuals transferred to the SPU have committed serious assaults on NHH staff. Without the ability to make emergency transfers, NHH may need extra staff and may incur additional workers’ compensation costs.
The Department of Corrections states the transfer of applicable clients to an appropriate out-of- state forensic hospital would cost the Department of Corrections a per diem rate that would be funded 100% with general funds. The Department indicates the population of the SPU would not decrease as bed space would be filled by clients from other settings awaiting admission. When the Department of Corrections is not the institution to which the client was committed, but a receiving facility as the result of a transfer, the burden to find alternative placement would fall on the Department of Health and Human Services. The Department states the fiscal impact cannot be determined.