Bill Text - SB11 (2019)

Relative to mental health services and making appropriations therefor.


Revision: Jan. 17, 2019, 4:10 p.m.

SB 11-FN-A - AS INTRODUCED

 

 

2019 SESSION

19-1053

01/10

 

SENATE BILL 11-FN-A

 

AN ACT relative to mental health services and making appropriations therefor.

 

SPONSORS: Sen. Sherman, Dist 24; Sen. Rosenwald, Dist 13; Sen. Chandley, Dist 11; Sen. Levesque, Dist 12; Sen. Cavanaugh, Dist 16; Sen. Dietsch, Dist 9; Sen. Morgan, Dist 23; Sen. Kahn, Dist 10; Sen. Watters, Dist 4; Sen. Fuller Clark, Dist 21; Sen. Soucy, Dist 18; Sen. Feltes, Dist 15; Sen. Hennessey, Dist 5

 

COMMITTEE: Health and Human Services

 

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ANALYSIS

 

This bill:

 

I.  Authorizes the department of health and human services to use general surplus funds for designated receiving facilities and for voluntary inpatient psychiatric admissions.

 

II.  Makes an appropriation to the department of health and human services for the purpose of renovating certain existing facilities.

 

III.  Provides for rulemaking for involuntary admission hearing requirements.

 

IV.  Makes an appropriation to the affordable housing fund, established in RSA 204-C:5, for transitional housing for persons leaving mental health treatment facilities.

 

V.  Requires insurers to reimburse certain facilities for emergency room boarding.

 

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

19-1053

01/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Nineteen

 

AN ACT relative to mental health services and making appropriations therefor.

 

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

 

1  Department of Health and Human Services; Designated Receiving Facilities; Residential Beds.  There is hereby appropriated to the department of health and human services an amount up to $2,000,000 in existing surplus general funds for the fiscal year ending June 30, 2019 for the purpose of increasing diagnosis-related group (DRG) rates for designated receiving facilities (DRF) beds, as set forth in RSA 135-C:26, for the remainder of the fiscal year ending June 30, 2019.  The commissioner shall submit a report on proposed DRG rates for the purpose of establishing additional community-based DRF beds to the president of the senate, the speaker of the house of representatives, and the governor no later warrant laws than November 1, 2019.  The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.

2  Department of Health and Human Services; Voluntary Inpatient Psychiatric Admissions; Rates.  There is hereby appropriated to the department of health and human services an amount up to $1,000,000 from existing surplus general funds to establish an atypical rate for voluntary inpatient psychiatric admission for the remainder of the fiscal year ending June 30, 2019.  The commissioner shall submit a report on proposed atypical voluntary inpatient psychiatric admission rates for the purpose of establishing additional community-based voluntary inpatient psychiatric bed capacity to the president of the senate, the speaker of the house of representatives, and the governor no later than November 1, 2019.  The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.

3  Department of Health and Human Services; Designated Receiving Facilities; Residential Beds; Hospital Renovations.

I.  The sum of $3,000,000 is hereby appropriated to the department of health and human services for the fiscal year ending June 30, 2019, for the purpose of renovating existing hospital facilities for up to 3 new or expanded designated receiving facilities (DRF), as set forth in RSA 135-C:26, of no fewer than 10 beds for a new DRF.  Such funds shall be nonlapsing.  The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.

II.  The commissioner of the department of health and human services shall allocate and disburse such funds through a request for applications (RFA) and shall prioritize the use of the funds to areas within the state of New Hampshire that are underserved for inpatient psychiatric treatment.  Any hospital receiving such funding shall operate the new or expanded DRF beds for no less than 5 years.  The RFA shall be issued no later than December 1, 2019 and the new or expanded DRF beds shall be operational by January 1, 2020.

4  New Section; Residential Care and Health Facility Licensure; Compliance with Involuntary Admission Hearing Requirement.  Amend RSA 151 by inserting after section 2-g the following new section:

151-2-h  Compliance With Involuntary Admission Hearing Requirement.  No later than 30 days following the first decision on the merits in Doe v. NH Department of Health and Human Services, et al. #1:18-cv-01039, or a court-approved agreement of all parties in the case, the commissioner of the department of health and human services shall initiate emergency rulemaking consistent with either the first decision on the merits or the court-approved agreement.  The commissioner shall adopt such rules within 90 days of initiating rulemaking.

5  Appropriation.  The sum of $500,000 is hereby appropriated to the department of health and human services for the fiscal year ending June 30, 2019, for the purpose of grants to modify or outlays to implement the first decision on the merits, or the court approved agreement, in Doe v. NH Department of Health and Human Services, et al. #1:18-cv-01039.  The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.

6  Appropriation; Housing Finance Authority; Affordable Housing Fund.  The sum of $3,000,000 is hereby appropriated to the housing finance authority for deposit in the affordable housing fund, established in RSA 204-C:57, to provide safe, affordable, and stable transitional housing opportunities to those leaving mental health treatment facilities.  The housing finance authority and the commissioner of the department of health and human services shall jointly issue a request for applications (RFA) no later than December 1, 2019.  In the event there are insufficient responses to the RFA, the housing finance authority and the commissioner of the department of health and human services shall jointly submit a report on the reasons for the insufficiency of responses no later than November 1, 2019 to the president of the senate, the speaker of the house of representatives, and the governor.  The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.

7  New Section; Coverage for Emergency Services.  Amend RSA 417-F by inserting after section 3 the following new section:

417-F:4  Reimbursement for Emergency Room Boarding.  Without prior authorization for up to 30 days or to discharge, whichever is sooner, an insurer shall reimburse a licensed hospital emergency facility, at a rate comparable to those for an insured or enrollee admitted for medical surgical reasons, for services rendered to and the cost of maintaining an enrollee or insured in an emergency room who is being seen for symptoms related to a mental illness, as defined by RSA 417-E:1, III.  An insurer shall also credential any mental health emergency services provider employed by a community mental health center or affiliate in the hospital service area to provide mental health services and supports to an enrollee or insured in an emergency room who is being seen for symptoms related to a mental illness and reimburse the community mental health center for such services.

8  Effective Date.

I.  Section 7 of this act shall take effect July 1, 2019.

II.  The remainder of this act shall take effect upon its passage.

 

LBAO

19-1053

Revised 1/17/19

 

SB 11-FN-A- FISCAL NOTE

AS INTRODUCED

 

AN ACT relative to mental health services and making appropriations therefor.

 

FISCAL IMPACT:      [ X ] State              [    ] County               [    ] Local              [    ] None

 

 

 

Estimated Increase / (Decrease)

STATE:

FY 2020*

FY 2021

FY 2022

FY 2023

   Appropriation

$0

$0

$0

$0

   Revenue

Indeterminable

Indeterminable

Indeterminable

Indeterminable

   Expenditures

$0

$0

$0

$0

Funding Source:

  [ X ] General            [    ] Education            [    ] Highway           [    ] Other

 

* This bill appropriates $9,500,000 of General Funds in FY 2019 and it is assumed all these funds will be expended FY 2019.

 

METHODOLOGY:

This bill makes general fund appropriations to the Department of Health and Human Services and the Housing Finance Authority for the following purposes:

 

Agency

Purpose

Amount

DHHS

Designated Receiving Facility (DRF) Rate Increases

$2,000,000

DHHS

Voluntary Inpatient Psychiatric Admission Rates

$1,000,000

DHHS

New or Expanded DRFs

$3,000,000

DHHS

Grants to Implement Doe vs DHHS

$500,000

HFA

Transitional Housing for Individuals Leaving Mental Health Facilities

$3,000,000

 

     Total:

$9,500,000

 

The bill does not specify the fiscal year in which the appropriation for the Housing Finance Authority is to be made, but for the purposes of this fiscal note, it is assumed to be FY 2019.  The remaining appropriations identified above are made in FY 2019, with nonlapsing language for the new or expanded DRFs appropriation.  For the purposes of this fiscal note, the expenditures are assumed to occur exclusively in FY 2019.

 

In addition to the above expenditures, the bill requires insurers to reimburse licensed hospital emergency facilities for individuals being seen for mental health reasons at rates comparable to services provided to those admitted for medical or surgical reasons.  The Insurance Department states that to the extent this provision impacts insurance premium costs, it may have a related impact on insurance premium tax revenue.  

 

AGENCIES CONTACTED:

Department of Health and Human Services, Housing Finance Authority, and Insurance Department