SB590 (2018) Detail

(Second New Title) relative to the state loan repayment program, the developmental disabilities wait list, involuntary admissions procedures, and the mental health system.


CHAPTER 343

SB 590-FN-A - FINAL VERSION

 

03/14/2018   0991s

03/14/2018   1061s

3May2018... 1705h

05/23/2018   2098EBA

 

2018 SESSION

18-2835

01/05

 

SENATE BILL 590-FN-A

 

AN ACT relative to the state loan repayment program, the developmental disabilities wait list, involuntary admissions procedures, and the mental health system.

 

SPONSORS: Sen. Bradley, Dist 3; Sen. Carson, Dist 14; Sen. Avard, Dist 12; Sen. Gray, Dist 6; Sen. Fuller Clark, Dist 21; Sen. Watters, Dist 4; Sen. Feltes, Dist 15; Rep. Danielson, Hills. 7; Rep. Rosenwald, Hills. 30; Rep. M. MacKay, Hills. 30

 

COMMITTEE: Health and Human Services

 

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AMENDED ANALYSIS

 

This bill:

 

I.  Establishes an excess appropriation allocation account in the department of health and human services for the biennium ending June 30, 2019, and authorizes the department to use a portion of the account for the state loan repayment program.

 

II.  Designates funding for the developmental disabilities wait list from federal funds and the excess appropriation allocation account.

 

III.  Clarifies admission to receiving facilities and other services for people who are involuntarily committed under RSA 135-C.

 

IV.  Extends the reporting date for the 10-year plan for mental health services to October 15, 2018.

 

V.  Directs the department of health and human services to increase behavioral health services by establishing either a behavioral health crisis treatment center or a mobile crisis team and related apartments.

 

VI.  Directs the department of health and human services to use a portion of the agency's current appropriation to fund supported housing for individuals with serious mental illness.

 

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/14/2018   0991s

03/14/2018   1061s

3May2018... 1705h

05/23/2018   2098EBA 18-2835

01/05

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Eighteen

 

AN ACT relative to the state loan repayment program, the developmental disabilities wait list, involuntary admissions procedures, and the mental health system.

 

Be it Enacted by the Senate and House of Representatives in General Court convened:

 

343:1  New Section; Department of Health and Human Services; Account Established.  Amend RSA 126-A by inserting after section 74 the following new section:

126-A:75  Excess Appropriation Allocation Account.  There is hereby established under the department of health and human services an excess appropriation allocation account.  For the biennium ending June 30, 2019, immediately upon acceptance by the fiscal committee of any federal funds attributable to the 38 percentage point enhanced federal match for the children’s health insurance program, the commissioner of administrative services shall transfer general funds of an equal amount from account 05-95-47-470010-7948, Medicaid Care Management, into the excess appropriation allocation account.  Any funds remaining unspent in the excess appropriation allocation account at the end of each fiscal year shall lapse to the state general fund.

343:2  Department of Health and Human Services; State Loan Repayment Program; Funding Source.  The department of health and human services is authorized to utilize up to $410,000 in the fiscal year ending June 30, 2019, for the purpose of providing additional funding to the state loan repayment program.  This amount shall be a charge against the department of health and human services excess appropriation allocation account established in RSA 126-A:75.  If new federal funds become available to the program, the department is authorized to accept and expend such funds without prior approval of the fiscal committee of the general court.  Participants in the state loan repayment program shall agree to work or practice in the state for a total of 3 years.

343:3  Department of Health and Human Services; Developmental Disabilities Wait List; Funding Source.  The department of health and human services is authorized to utilize up to $5,400,000 in the fiscal year ending June 30, 2019, for the purpose of funding the developmental disabilities wait list.  Of this amount, $2,700,000 shall be a charge against the department of health and human services excess appropriation allocation account established in RSA 126-A:75 and $2,700,000 shall be federal funds.  Fiscal committee of the general court approval shall not be required for the acceptance and expenditure of federal funds authorized under this section.

343:4  New Paragraph; Mental Health Services System; Definitions.  Amend RSA 135-C:2 by inserting after paragraph XV the following new paragraph:

XV-a.  "Transitional housing program services'' means a residential program that provides housing and support services to persons with serious and persistent mental illness through a contract with the department of health and human services.

343:5  Involuntary Emergency Admissions; Examination.  Amend RSA 135-C:28, I to read as follows:

I.  The involuntary emergency admission of a person shall be to the state mental health services system under the supervision of the commissioner.  The admission may be ordered upon the certificate of a physician or APRN, as defined in RSA 135-C:2, II-a, who is approved by either a designated receiving facility or a community mental health program approved by the commissioner, provided that within 3 days of the completion of the petition the physician or APRN has conducted, or has caused to be conducted, a physical examination if indicated and circumstances permit, and a mental examination.  The physician or APRN must find that the person to be admitted meets the criteria of RSA 135-C:27.  The certificate shall state the time and, in detail, the nature of the examinations conducted.  The certificate shall also state a specific act or actions the physician or APRN has actually observed or which have been reported to him or her by the petitioner or a reliable witness who shall be identified in the certificate, and which in the physician's or APRN's or designee's opinion satisfy the criteria set forth in RSA 135-C:27.  The physician or APRN shall [identify in the certificate the facility in the state mental health services system to which the person shall be admitted] inform the person of the designated receiving facility in the mental health services system that he or she will be transported to upon the facility location being identified. The admission shall be made to the facility which can best provide the degree of security and treatment required by the person and shall be consistent with the placement principles set forth in RSA 135-C:15.  As used in RSA 135-C:27-33, "petitioner'' means any individual, including a physician or APRN completing a certificate, who has requested that a physician or APRN conduct or who has conducted an examination for purposes of involuntary emergency admission.  Every certificate shall be accompanied by a written petition signed by a petitioner.

343:6  Nonemergency Involuntary Admissions; Conditions of Conditional Discharge.  Amend RSA 135-C:50, III to read as follows:

III.  During the term of conditional discharge, the person conditionally discharged shall be provided with continuing treatment on an out-patient basis by a community mental health program approved by the commissioner or by transitional housing program services.

343:7  Nonemergency Involuntary Admissions; Revocation of Conditional Discharge.  Amend the introductory paragraph of RSA 135-C:51, I to read as follows:

I.  If a psychiatrist or APRN, as defined in RSA 135-C:2, II-a, at a community mental health program or transitional housing program services providing continuing treatment on an outpatient basis to a person conditionally discharged pursuant to RSA 135-C:50, reasonably believes that:

343:8  Nonemergency Involuntary Admissions; Revocation of Conditional Discharge.  Amend RSA 135-C:51, III to read as follows:

III.  If the psychiatrist or APRN, following the examination the psychiatrist or APRN conducted or caused to be conducted of the person, finds that the person either has violated a condition of the discharge or is in such a mental condition as a result of mental illness as to create a potentially serious likelihood of danger to himself or herself or to others, he or she may temporarily revoke the conditional discharge.  If the conditional discharge is temporarily revoked, the psychiatrist, or APRN, or designee, shall prepare, offer to and explain to the person a written notice, if it can be done safely without significant possibility of bodily harm, giving the reasons for the revocation and to [identify the receiving facility to which the person is to be delivered] inform the person of the designated receiving facility in the mental health services system that he or she will be transported to upon the facility location being identified.  If this cannot be done safely, a description of the circumstances indicating such risk shall be placed in the file.

343:9  Guardians and Conservators; General Powers and Duties of Guardian of the Person.  Amend RSA 464-A:25, I(a) to read as follows:

(a)  To the extent that it is consistent with the terms of any order by a court of competent jurisdiction relating to detention or commitment of the ward, the guardian shall be entitled to custody of the ward and may establish the ward's place of abode within or without this state.  Admission to a state institution or other designated receiving facility shall be in accordance with the following:

(1)  A guardian may admit a ward to a state institution or other designated receiving facility with prior approval of the probate court if, following notice and hearing, the court finds beyond a reasonable doubt that the placement is in the ward's best interest and is the least restrictive placement available.  Authorization for such admission shall not be time limited unless the court so orders.  Authority to admit a ward to a state institution or other designated receiving facility with prior approval under this subparagraph shall not be subject to the limitations contained in RSA 464-A:25, I(a)(2) through (7).

(2)  A guardian may admit a ward to a state institution or other designated receiving facility without prior approval of the probate court upon written certification by a physician licensed in the state of New Hampshire, or, in the case of placement in New Hampshire hospital or other designated receiving facility, by a psychiatrist licensed in the state of New Hampshire, or an advanced practice registered nurse, as defined in RSA 135-C:2, II-a, that the placement is in the ward's best interest and is the least restrictive placement available.  Within 36 hours, excluding days when the court is closed, of such an admission of a ward to a state institution or other designated receiving facility, the guardian shall submit to the Merrimack county probate court notice of the admission and the reasons therefor, together with a copy of the certificate by the physician, psychiatrist, or advanced practice registered nurse.

(3)  The Merrimack county probate court shall review the guardian's notice within 48 hours of the filing of the notice, excluding days when the court is closed, to determine whether the notice on its face appears to establish that the placement is in the ward's best interest and is the least restrictive placement available.  If the court concludes that the notice is insufficient, the court shall order the immediate release of the ward from the state institution or other designated receiving facility.  If the court concludes that the notice is sufficient, counsel for the ward shall be appointed no later than 48 hours following the court's review of the guardian's notice, excluding days when the court is closed.  Notice of the appointment shall be transmitted to the ward, to the guardian, and to counsel.  Counsel's notice shall be transmitted in writing and electronically or in another manner which is likely to give actual notice of the appointment to counsel at the earliest practicable time.  For purposes of proceedings regarding admissions to state institutions or other designated receiving facilities without prior court approval, the ward shall have the right to legal counsel in the same manner as provided in RSA 464-A:6.  The court shall also provide the ward a notice stating that the ward has the right to appointed counsel, the right to oppose the admission by the guardian, and the right to a hearing and to present evidence at that hearing.

(4)  Counsel for a ward admitted to a state institution or other designated receiving facility who has been appointed pursuant to subparagraph (3) shall deliver a written report to the court within 5 days of his or her appointment which shall declare whether the ward requests a hearing on the propriety of the admission.  Unless the ward waives a hearing, counsel's report shall include a request for a hearing on behalf of the ward.  A copy of counsel's report shall be sent to the ward and to the guardian.  If the court does not receive a written report from counsel within 5 days of counsel's appointment, the court shall order appropriate relief, including but not limited to substitution of counsel, an order to show cause, or scheduling of a hearing on the propriety of the admission without awaiting a report from counsel.

(5)  Upon receipt of a request for a hearing, the court shall schedule a hearing on the admission to a state institution or other designated receiving facility without prior approval of the probate court, at which the guardian shall have the burden of proving, beyond a reasonable doubt, that the placement is in the ward's best interest and is the least restrictive placement available.  The hearing shall be held within 10 days, excluding days when the court is closed, from the date that the request is received.

(6)  A guardian may not admit a ward to a state institution or other designated receiving facility for more than 60 days for any single admission or more than 90 days in any 12- month period upon certification of a physician or psychiatrist, or an advanced practice registered nurse, as defined in RSA 135-C:2, II-a, without filing a petition requesting approval of the probate court.

(7)  At any time, the ward or counsel for the ward may request a hearing on the admission to a state institution or other designated receiving facility without prior approval of the probate court, at which the guardian shall have the burden of proving, beyond a reasonable doubt, that the placement is in the ward's best interest and is the least restrictive placement available.  The hearing shall be held within 15 days, excluding days when the court is closed, from the date that the hearing is requested.

343:10  New Section; Rescission of Involuntary Admission.  Amend RSA 135-C by inserting after section 29 the following new section:

135-C:29-a  Rescission of Involuntary Admission.

I.  Following completion of an involuntary emergency admission certificate under RSA 135- C:28 and before custody of the person is accepted by a law enforcement officer pursuant to RSA 135- C:29, the certificate may be rescinded and the person who is the subject of the certificate released in any of the following circumstances:

(a)  A mobile crisis team under contract with the department of health and human services accepts transfer of the person's care.

(b)  An assertive community treatment team operated by a community mental health program accepts transfer of the person's care.

(c)  A community-based provider accepts transfer of the person's care.

II.  Following completion of an involuntary emergency admission certificate under RSA 135- C:28 and before custody of the person is accepted by a law enforcement officer pursuant to RSA 135- C:29, the certificate shall be rescinded and the person who is the subject of the certificate released if the physician or APRN who completed the certificate, or any other physician or APRN authorized to complete such certificates, finds that the person no longer meets the criteria of RSA 135-C:27.

III.  No civil action shall be maintained against a person who rescinds an involuntary admission pursuant to paragraph I or II, provided that the person is acting in good faith within the limits of his or her authority.

343:11  Ten-Year Plan for Mental Health Services.  Amend 2017, 112:2, III to read as follows:

III.  The commissioner of the department of health and human services shall submit the plan to the speaker of the house of representatives, the president of the senate, and the governor on or before [July 1, 2018] October 15, 2018.  The department shall provide interim reports to the oversight committee on health and human services, established under RSA 126-A:13, on or before October 1, 2017 and on or before March 1, 2018.  Thereafter, the department shall report quarterly to the health and human services oversight committee providing an update on the progress of the development and implementation of the plan.

343:12  Repeal; Department of Health and Human Services; Mobile Crisis Teams and Apartments.  2017, 156:188, relative to mobile crisis teams and apartments, is repealed.

343:13  Department of Health and Human Services; Behavioral Health Policy Options.  For the fiscal year ending June 30, 2019, the department of health and human services is authorized to use up to $3,421,696 of existing appropriations for one of the 2 purposes specified in paragraph I or II of this section.  Of this amount, $2,360,848 shall be state general funds and $1,060,848 shall be federal funds.  The department is authorized to choose from one of the following 2 options, based upon a determination by the commissioner, as to which option will more readily address the state’s behavioral health needs:

I.  Establish one behavioral health crisis treatment center in a geographic location that has high rates of admissions to and discharges from New Hampshire hospital.  

II.  Establish one mobile crisis team and related apartments.

343:14  Designated Receiving Facilities; Residential Beds.  The section heading and paragraph I of 2017, 156:186 are repealed and reenacted to read as follows:

156:186  Supported Housing; Residential Beds.

I.  The commissioner of the department of health and human services shall contract with programs that enable individuals with serious mental illness to attain and maintain integrated, affordable, supported housing.  The department shall use funding not to exceed $500,000 from existing appropriations for the biennium ending June 30, 2019.  Eligibility for such funding shall include persons who are not eligible for existing housing subsidy programs.  The department shall submit a monthly report to the fiscal committee of the general court regarding implementation of this section.

343:15  Repeal.  RSA 126-A:75, relative to the excess appropriation allocation account, is repealed.

343:16  Effective Date.

I.  Sections 1 and 15 of this act shall not take effect.

II.  The remainder of this act shall take effect July 1, 2018.

 

Approved: June 28, 2018

Effective Date:

I. Sections 1 and 15 shall not take effect.

II. Remainder shall take effect July 1, 2018.

 

 

Links

SB590 at GenCourtMobile

Action Dates

Date Body Type
Feb. 8, 2018 Senate Hearing
March 8, 2018 Senate Floor Vote
March 8, 2018 Senate Floor Vote
March 14, 2018 Senate Floor Vote
March 22, 2018 Senate Floor Vote
April 3, 2018 House Hearing
April 17, 2018 House Hearing
April 18, 2018 House Exec Session
April 25, 2018 House Exec Session
April 25, 2018 House Exec Session
House Floor Vote
May 2, 2018 House Floor Vote

Bill Text Revisions

SB590 Revision: 4270 Date: July 2, 2018, 11:34 a.m.
SB590 Revision: 3867 Date: May 29, 2018, 12:32 p.m.
SB590 Revision: 3725 Date: May 3, 2018, 3:57 p.m.
SB590 Revision: 3263 Date: April 3, 2018, 11:16 a.m.
SB590 Revision: 2982 Date: Jan. 25, 2018, 10:27 a.m.

Docket


July 1, 2018: II. Remainder Effective 07/01/2018


: I. Section 1 & 15 shall not take effect


June 28, 2018: Signed by the Governor on 06/28/2018; Chapter 0343


May 23, 2018: Enrolled (In recess 05/23/2018); SJ 18


May 23, 2018: Enrolled 05/23/2018


May 23, 2018: Enrolled Bill Amendment # 2018-2098e Adopted, VV, (In recess of 05/23/2018); SJ 18


May 23, 2018: Enrolled Bill Amendment # 2018-2098e: AA VV 05/23/2018


May 10, 2018: Sen. Bradley Moved to Concur with the House Amendment, MA, VV; 05/10/2018; SJ 17


May 3, 2018: Ought to Pass with Amendment 1705h: MA RC 315-14 05/03/2018


May 3, 2018: Amendment # 2018-1705h: AA VV 05/03/2018


: Committee Report: Ought to Pass with Amendment # 2018-1705h (NT) (Vote 22-4; RC)


May 2, 2018: Committee Report: Ought to Pass with Amendment # 2018-1705h (NT) for 05/02/2018 (Vote 22-0; RC) HC 17 P. 22


April 25, 2018: Executive Session: 04/25/2018 10:00 AM LOB 210-211


April 25, 2018: Executive Session: 04/25/2018 10:00 AM LOB 210-211


April 24, 2018: Division III Work Session: 04/24/2018 10:00 AM LOB 210-211


April 24, 2018: Division III Work Session: 04/24/2018 10:00 AM LOB 210-211


April 20, 2018: Division III Work Session: 04/20/2018 02:00 PM LOB 210-211


April 18, 2018: ==RECESSED== Executive Session: 04/18/2018 01:00 PM LOB 210-211


April 17, 2018: Public Hearing on non-germane Amendment # 2018-1487h: 04/17/2018 11:00 AM LOB 210-211


April 16, 2018: Division III Work Session: 04/16/2018 11:00 AM LOB 210-211


April 10, 2018: Division III Work Session: 04/10/2018 09:00 AM LOB 210-211


April 9, 2018: Division III Work Session: 04/09/2018 09:00 AM LOB 210-211


April 3, 2018: Public Hearing: 04/03/2018 02:00 PM LOB 210-211


March 22, 2018: Introduced 03/22/2018 and referred to Finance HJ 10 P. 53


March 22, 2018: Ought to Pass: RC 23Y-0N, MA; OT3rdg; 03/22/2018; SJ 10


March 22, 2018: Without Objection, Sen. Birdsell Moved the Question, MA; 03/22/2018; SJ 10


March 22, 2018: Sen. Fuller Clark Floor Amendment # 2018-1197s, RC 9Y-14N, AF; 03/22/2018; SJ 10


March 22, 2018: Committee Report: Ought to Pass, 03/22/2018; SC 13A


March 14, 2018: Ought to Pass with Amendments 2018-0991s, and 2018-1061s, MA, VV; Refer to Finance Rule 4-5; 03/14/2018; SJ 7


March 14, 2018: Sen. Reagan Floor Amendment # 2018-1061s, AA, VV; 03/14/2018; SJ 7


March 14, 2018: Committee Amendment # 2018-0991s, RC 24Y-0N, AA; 03/14/2018; SJ 7


March 14, 2018: Committee Report: Ought to Pass with Amendment # 2018-0991s, 03/14/2018; SC 11


March 8, 2018: Special Order to the next session, Without Objection, MA; 03/08/2018; SJ 6


March 8, 2018: Committee Report: Ought to Pass with Amendment # 2018-0991s, 03/08/2018; SC 10A


Feb. 8, 2018: ===ROOM CHANGE=== Hearing: 02/08/2018, Room 100, SH, 01:30 pm; SC 6


Jan. 18, 2018: Introduced 01/18/2018 and Referred to Health and Human Services; SJ 3