SB684 (2020) Detail

Relative to Medicaid to schools.


SB 684-FN - AS AMENDED BY THE SENATE

 

01/30/2020   0269s

2020 SESSION

20-2909

06/05

 

SENATE BILL 684-FN

 

AN ACT relative to Medicaid to schools.

 

SPONSORS: Sen. Kahn, Dist 10; Sen. Levesque, Dist 12; Sen. Rosenwald, Dist 13; Sen. Fuller Clark, Dist 21; Sen. Chandley, Dist 11; Sen. Watters, Dist 4; Sen. Cavanaugh, Dist 16; Sen. Morgan, Dist 23; Sen. Carson, Dist 14; Sen. Gray, Dist 6; Sen. Starr, Dist 1; Sen. Sherman, Dist 24; Sen. Hennessey, Dist 5; Sen. Soucy, Dist 18; Rep. W. Thomas, Hills. 21; Rep. Luneau, Merr. 10

 

COMMITTEE: Education and Workforce Development

 

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ANALYSIS

 

This bill:

 

I.  Authorizes the department of education to adopt rules relative to federal funding available to schools under New Hampshire's Medicaid program.

 

II.  Permits professionals certified by the department of education who are providing medical services in public schools to be licensed by medical and health care boards.

 

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

01/30/2020   0269s 20-2909

06/05

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty

 

AN ACT relative to Medicaid to schools.

 

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

 

1  Statement of Purpose and Intent.  The general court acknowledges the critical importance of ensuring the quality, accessibility, and sustainability of Medicaid services provided in the school setting, as well as ensuring that billing under the program meets all state and federal requirements.  The purpose of this act is to strengthen the state's Medicaid to schools and Medicaid to schools for Medical services programs consistent with the Social Security Act.  Accordingly, this act shall provide the department of health and human services with the additional authority to adopt administrative rules that maximize the availability of federal financial aid to schools under New Hampshire's Medicaid program.  This act also provides a more efficient pathway to allow qualified professionals certified and credentialed by the department of education who are currently providing medical services in public schools to be licensed by medical and health care boards.  Finally, this act further facilitates the provision of medical services in the school setting to students who are enrolled in participating public schools and Medicaid, thereby furthering the education and health of New Hampshire's students.

2  Medicaid to Schools Program.  RSA 186-C:25, III-b are repealed and reenacted to read as follows:

I.  The department of health and human services Medicaid reimbursement program shall be known as the "Medicaid to schools" program, providing medical assistance for covered services furnished to children with disabilities who are enrolled in Medicaid.  The purpose of the program is to seek any and all Medicaid reimbursement for medical and health related services provided by local school districts and school administrative units to children with disabilities which are reimbursable under federal law but which were previously fully funded by such districts or administrative units.  The program shall be voluntary and is designed to assist children with disabilities by maintaining them in their own homes and communities.  The program shall be administered in the same, or similar, manner as the Medicaid to schools for medical services program established in RSA 167:3-k.  This subdivision is intended to provide Medicaid funding for services which, in the absence of such funding, nevertheless qualify as special education or related services under this chapter.  It is not the intention of this subdivision to increase school district responsibility or liability beyond what is required by other sections of this chapter.

II.  A reimbursable service under this section shall be:

(a)  A covered New Hampshire Medicaid state plan service, or a service not covered under the state's Medicaid state plan, but coverable pursuant to 1905(a) of the Social Security Act through the Early and Periodic Screening Diagnosis and Treatment (EPSDT) benefit;

(b)  Provided to a Medicaid enrolled child after obtaining parental consent;

(c)  Provided by a Medicaid qualified provider;

(d)  Medically necessary; and

(e)  Provided in compliance with applicable state and federal law and rules.

III.  Services provided under this subdivision shall:

(a)  Offer the least restrictive setting for children receiving the services.

(b)  Be in addition to any special education program as defined in the New Hampshire rules for the education of children with disabilities.

III-a.  Any provider who orders, refers, prescribes, renders, or provides services under this section shall do so in accordance with the relevant health professional practice act and regulations including, but not limited to, RSA 137-F, RSA 317-A, RSA 326-B, RSA 326-C, RSA 326-E, RSA 326-F, RSA 326-H, RSA 327, RSA 328-A, RSA 328-D, RSA 328-F, RSA 329, RSA 329-B, RSA 330-A, and RSA 330-C.

III-b.  For purposes of this section, “medically necessary” means a service that has been determined by a qualified professional, licensed by medical or health care boards, to meet accepted standards of medical practice and that is needed to diagnose or treat an illness, injury, condition, disease, or its symptoms.

3  Medicaid to Schools for Medical Services Program.  RSA 167:3-k is repealed and reenacted to read as follows:

167:3-k  Medicaid to Schools For Medical Services Program.  

I.  The department of health and human services Medicaid reimbursement program shall be known as the "Medicaid to schools for medical services" program, providing medical assistance for covered services furnished to children in public schools who are enrolled in Medicaid.  The purpose of the program is to seek any and all Medicaid reimbursement for medical or health related services provided by local school districts and school administrative units to children which are reimbursable under federal law.  General fund dollars allocated to the department of health and human services shall not be used for matching the federal financial participation for Medicaid reimbursement.  All matching dollars for Medicaid to schools medical services shall come from the local school districts or school administrative units.  The program shall be voluntary and administered by the department in the same, or similar, manner as the Medicaid to schools program established in RSA 186-C:25.  This section shall not be construed to increase school district responsibility or liability beyond what is required by other state or federal law.  

II.  A reimbursable service under this section the service shall be:

(a)  A covered New Hampshire Medicaid state plan service, or a service not covered under the state's Medicaid state plan, but coverable pursuant to 1905(a) of the Social Security Act through the Early and Periodic Screening Diagnosis and Treatment (EPSDT) benefit;

(b)  Provided to a Medicaid enrolled child after obtaining parental consent;

(c)  Provided by a Medicaid qualified provider;

(d)  Medically necessary; and

(e)  Provided in compliance with applicable state and federal law and rules.

III.  Any provider who orders, refers, prescribes, renders, or provides services under this section shall do so in accordance with the relevant health professional practice act and regulations, including, but not limited to, RSA 137-F, 317-A, 326-B, 326-C, 326-E, 326-F, 326-H, 327, 328-A, 328-D, 328-F, 329, 329-B, 330-A, and 330-C.

IV.  For purposes of this section, “medically necessary” means a service that has been determined by a qualified professional, licensed by medical or health care boards, to meet accepted standards of medical practice and that is needed to diagnose or treat an illness, injury, condition, disease, or its symptoms.

V.  The commissioner of the department of health and human services, after consultation with the commissioner of the department of education, shall adopt rules, pursuant to RSA 541-A, relative to:

(a)  Further defining services eligible for Medicaid reimbursement under this section.  In defining such services, the commissioner shall, to the extent practicable, seek to maximize the availability of federal financial assistance to local school districts and school administrative units.

(b)  State plans and reimbursement procedures necessary for local school districts or school administrative units to receive appropriate Medicaid reimbursement for eligible services under paragraph II that are provided or paid for by school districts or school administrative units.

(c)  Monitoring mechanisms to ensure that services provided under this section meet the requirements of paragraph II.  Monitoring responsibilities shall be consistent with the jurisdiction of the different departments.

(d)  A financial mechanism by which the federal mandatory matching requirement is met through collection, or other means, of 50 percent of the cost of allowable services from local school districts and/or school administrative units.

VI.  New Hampshire local school districts or school administrative units shall be the enrolled Medicaid providers for the purpose of administration and billing.

4  Nurse Practice Act; Scope of Practice; Licensed Nursing Assistant.  Amend RSA 326-B:14, II-a(b) to read as follows:

(b)  A licensed nurse delegates the task of medication administration to the LNA who is employed in the home care, hospice, residential care, public school, or adult day care setting.  The board, in consultation with the commissioner of health and human services or a designee, shall adopt rules under RSA 541-A establishing standards for such delegation of medication administration which include, but are not limited to, limitations on the number of delegations per assistive personnel, training and competency requirements, documentation requirements, and medication administration error reporting requirements.

5  New Section; Licensed School Psychologist-Doctoral and Licensed School Psychologist-Specialist.  Amend RSA 329-B by inserting after section 15 the following new section:

329-B:15-a  Licensed School Psychologist-Doctoral and Licensed School Psychologist-Specialist.

I.  The board shall issue a license for the title of licensed school psychologist-doctoral to any person who has a doctoral degree in psychology and:

(a)  Is certified as a school psychologist by the New Hampshire department of education, bureau of credentialing; and

(b)  Has completed all of the following requirements:

(1)  Has passed a satisfactory examination in psychology as determined by the board including a national school psychologists’ examination.

(2)  Has met education and other requirements determined by the board.

(3)  Is of good professional character.

(4)  Has submitted a complete set of fingerprints and a criminal history records release form in accordance with RSA 329-B:14-a.

(5)  Has paid all fees established by the office of professional licensure and certification established under RSA 310-A:1-a and collected by the board.

II.  The board shall issue a license for the title of licensed school psychologist-specialist to any person who does not have a doctoral degree and:

(a)  Is certified as a school psychologist by the New Hampshire department of education, bureau of credentialing; and

(b)  Has completed all of the following requirements:

(1)  Has passed a satisfactory examination in psychology as determined by the board including a national school psychologists’ examination.

(2)  Has met education and other requirements determined by the board.

(3)  Is of good professional character.

(4)  Has submitted a complete set of fingerprints and a criminal history records release form in accordance with RSA 329-B:14-a.

(5)  Has paid all fees established by the office of professional licensure and certification established under RSA 310-A:1-a and collected by the board.

III.  The following shall apply to those school psychologists who are certified by the department of education on the effective date of this section:

(a)  Each certified school psychologist in good standing who holds a doctoral degree in psychology shall be licensed as licensed school psychologist-doctoral.

(b)  Each certified school psychologist in good standing who does not hold a doctoral degree in psychology shall be licensed as licensed school psychologist-specialist.

(c)  Those certified school psychologists who are subject to discipline or are under review, or who are under investigation shall be reviewed by the board which shall grant, deny, or issue a license with conditions as determined by the board.

(d)  Those school psychologists granted licenses under this paragraph shall be exempt from fees for the initial license period which shall extend beyond that individual’s certification in school psychology by 3 months and shall include an additional year for those whose certifications from the department of education would expire in June of 2020.  Following that time, such individual shall be eligible for renewal under the rules established by the board and upon payment of the applicable fee.

IV.  Examinations for applicants under this section shall be held by the board at least once each year.  The board shall determine the subject and scope of the examination, which may be written, oral, or both.  If an applicant fails the examination, the board shall deny the license or specify conditions under which the applicant may be admitted to a future examination according to board rules.

V.  Unless otherwise licensed under another provision, a licensed school psychologist-doctoral or licensed school psychologist-specialist licensure is for services provided in those settings that are provided in an educational institution.  No persons licensed under this section may provide services outside such settings if the services are directly related to the client’s improvement of school functioning including but not limited to learning, development, social and emotional functioning, and behavior, but any services provided outside of the school shall relate to such person's students and his or her employment in a school.  No persons licensed under this section shall hold themselves out as psychologists, psychological examiners, or by any business name incorporating variations of those titles other than school psychologists or nationally certified school psychologists unless they are otherwise licensed under another provision.

VI. The board shall provide materials and information concerning licensed school psychologists-doctoral and licensed school psychologists-specialist to the department of education bureau of credentialing that will further the proper administration of the credentials of each department.

6  New Paragraphs; Psychologists; Definitions; Licensed School Psychologist-Doctoral and Licensed School Psychologist-Specialist.  Amend RSA 329-B:2 by inserting after paragraph IV the following new paragraphs:

IV-a.  "Licensed School Psychologist-Doctoral" means any person licensed as a licensed school psychologist-doctoral under RSA 329-B:15-a.

IV-b.  "Licensed School Psychologist-Specialist" means any person licensed as a licensed school psychologist-specialist under RSA 329-B:15-a.

7  Psychologists; Board; Definitions.  Amend RSA 329-B:2, VI-XI to read as follows:

VI.  "Professional conduct investigator" means a trained psychologist, licensed school psychologist-doctoral, or licensed school psychologist-specialist licensed by the board who acts as the agent of the board under the guidance of the board investigator and is authorized to discover facts and make reports to the board.

VII.  "Psychology practice by a licensed psychologist" means:

(a)  The observation, description, evaluation, interpretation, prediction, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purposes of:

(1)  Preventing, eliminating, evaluating, assessing, or predicting symptomatic, maladaptive, or undesired behavior;

(2)  Evaluating, assessing, or facilitating the enhancement of individual, group, or organizational effectiveness, including personal effectiveness, adaptive behavior, interpersonal relationships, work and life adjustment, health, and individual, group, or organizational performance; or

(3)  Assisting in legal decision-making.

(b)  Psychological testing and the evaluation or assessment of personal characteristics, such as intelligence; personality; cognitive, physical, and emotional abilities; skills; interests; aptitudes; and neuropsychological functioning;

(c)  Counseling, consultation, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy;

(d)  Diagnosis, treatment, and management of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, and the psychological and behavioral aspects of medical/physical illness, accident, injury, or disability;

(e)  Psycho-educational evaluation, therapy, and remediation;

(f)  Consultation and coordination with other psychologists, physicians, other health care professionals, and patients regarding all available treatment options, including medication, with respect to provision of care for a specific client or patient or group;

(g)  Provision of direct services to individuals or groups for the purpose of enhancing individual and organizational effectiveness, or using psychological principles, methods, or procedures to assess and evaluate individuals on personal characteristics for individual development or behavior change, or for making decisions about the individual, such as selection;

(h)  Provision of any of these services or activities by any means, including electronic or telephonic; and

(i)  The supervision, ordering, referring, and prescribing of any of these services or activities;

The practice of psychology shall be construed within the meaning of this definition without regard to whether payment is received for services rendered.

VIII.  "Psychology services by a licensed psychologist" means the observation, description, evaluation, interpretation, diagnosis, and modification of human behavior by the application of psychological and systems principles, methods, and procedures for the purpose of preventing or eliminating symptomatic, maladapted, or undesirable behavior and of enhancing interpersonal relationships, work and life adjustments, personal effectiveness, behavioral health, and mental health, as well as the diagnosis and treatment of the psychological and social aspects of physical illness, accident, injury, or disability.  Psychology services may include, but shall not be limited to, those services based on diagnosis and treatment of mental and emotional disorders and psycho-educational or consultative techniques integral to the treatment of such disorders when diagnosis is specified in the most current edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, The International Classification of Disease Manual (ICD), or an equivalent of such manual as determined by the board.  Psychological services may be rendered to individuals, families, groups, systems, or organizations.

IX.  "Psychologist" means any person licensed as a psychologist under RSA 329-B:15.

X.  "Psychology intern, resident, or fellow" means a person in training as a psychologist, subject to the provisions of this chapter and regulation by the board.

XI.  "Psychotherapist" means a psychologist, licensed school psychologist-doctoral, or licensed school psychologist-specialist licensed under this chapter who performs or purports to perform psychotherapy.

8  New Paragraphs; Psychologists; Board; Definitions.  Amend RSA 329-B:2 by inserting after paragraph XII the following new paragraphs:

XII-a.  “School psychology practice" by a licensed school psychologist-doctoral or licensed school psychologist-specialist” means:

(a)  Practices that permeate all aspects of service delivery through:

(1)  Data-based decision making and accountability; and

(2)  Consultation, coordination, and collaboration;

(b)  Direct and indirect services for children, families, and schools which include:

(1)  Student-level services including;

(A)  Conducting, interpreting, and communicating the findings of assessments of students, including but not limited to their:

(i)  Intellectual ability.

(ii)  Cognitive processing.

(iii)  Academic achievement.

(iv)  Behavior.

(v)  Social and emotional functioning.

(vi)  Learning environments.

(vii)  Adaptive functioning.

(B)  Designing, implementing, monitoring, and adapting instructional and behavioral supports and interventions;

(C)  Creating, implementing, evaluating, ordering, referring, and prescribing mental health interventions and direct services to develop social/emotional and life skills;

(2)  Systems-level services including:

(A)  Interacting effectively in a school setting by understanding systems, roles, curriculum, instruction, and assessment to promote socialization, learning, and mental health; and

(B)  Implementing and evaluating school wide practices that promote learning; and

(3)  Preventative and responsive services including:

(A)  Applying principles of resilience and risk factors in learning and mental health;

(B)  Promoting multi-tiered systems of support; and

(C)  Formulating evidence-based strategies for effective crisis preparation, response, and recovery; and

(4)  Foundations of professional school psychological services which include:

(A)  Understanding and analyzing the diversity in human development and learning including culture, context and individual differences;

(B)  Explaining typical and atypical psychological and educational development in children and youth;

(C)  Synthesizing, evaluating and applying theories and models of research, empirical findings, and techniques related to student learning;

(D)  Utilizing research design, statistics, measurement, and varied data collection and analysis techniques;

(E)  Designing and implementing program evaluation to support evidence-based practices at the individual, group, and/or systems levels;

(F)  Integrating the history and foundations of psychology into a professional identity and practice as a school psychologist; and

(G)  Adhering to ethical, legal and professional standards including:

(i)  Ethical and professional decision making; and

(ii)  Professional work characteristics and disposition that reflect personal integrity.

XII-b.  “School psychology services" by a licensed school psychologist-doctoral or licensed psychologist-specialist” means the provision of services related only to functioning at school and transition to post-secondary goals, including: the observation, description, evaluation, interpretation, diagnosis, and modification of human behavior by the application of psychological and systems principles, methods, and procedures for the purpose of preventing or eliminating symptomatic, maladapted, or undesirable behavior and of enhancing interpersonal relationships, school and life adjustments, personal effectiveness, behavioral health, and mental health, as well as the diagnosis and treatment of the psychological and social aspects of physical illness, accident, injury, or disability.  School psychology services may include, but shall not be limited to, those services based on diagnosis and treatment of mental and emotional disorders and psycho-educational or consultative techniques integral to the treatment of such disorders when diagnosis is specified in the most current edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, The International Classification of Disease Manual (ICD), or an equivalent of such manual as determined by the board.  School psychological services may be rendered to individuals, families, groups, systems, or organizations within school settings and other locations as provided in RSA 329-B:15-a V.

9  Board of Psychologists.  Amend RSA 329-B:3, I to read as follows:

I.  There shall be a board of psychologists composed of 5 licensed psychologists, one licensed school psychologist-doctoral or licensed school psychologist-specialist, and 3 public members.  The members shall be appointed to a term of 3 years by the governor with the approval of the council.  The members of the board shall elect a chairperson on an annual basis.  Chairperson terms shall alternate between [psychologist] licensees and public members.

10  New Paragraph; Board of Psychologists.  Amend RSA 329-B:3 by inserting after paragraph III the following new paragraph:

IV.  On occasions when the licensed school psychologist board member is recused on a matter, inquiry, or case concerning a licensed school psychologist-doctoral, licensed school psychologist-specialist, or application for such before the board, then a licensed school psychologist-doctoral or licensed school psychologist-specialist from the school psychologist advisory committee shall be allowed to stand in to address the board business for the licensed school psychologist-doctoral or licensed school psychologist-specialist board member for that matter only.

11  Psychologists; Board; Committees Established, Duties.  RSA 329-B:4, I-III are repealed and reenacted to read as follows:

I.  The board shall create 2 advisory committees for the purpose of assisting the board in its responsibilities under this chapter, including rulemaking under RSA 329-B:10.

(a)  The psychologists advisory committee shall be chaired by a psychologist board member appointed by the board which shall have a maximum of 12 members, including up to 9 psychologists and up to 3 consumers appointed by the board.

(b)  Members of the licensed school psychology advisory committee shall be appointed by the board and shall include: A licensed school psychologist-doctoral board member who shall be the chairperson of the committee, up to 9 licensed school psychologist-doctoral or licensed school psychologist-specialist members, and up to 3 consumer members who shall be school administrative personnel and/or parents of students, and one representative from the department of education bureau of credentialing.  There shall be a maximum of 13 members.

II.  The board shall create 2 committees for professional conduct investigations, one for licensed psychologists, and one for licensed school psychologist-doctoral and licensed school psychologist-specialists, for the purpose of assisting the board in its responsibilities under RSA 329-B:22 and RSA 329-B:23.  A board investigator, appointed by the chairperson of the board with the advice and consent of the board, shall chair the professional conduct investigation committees.  The balance of the membership of the professional conduct investigation committees shall be composed of persons licensed by the board for the committee’s respective profession to a maximum of 12 members.

III.  The board shall create a professional's health committee to administer the professional's health program which shall address issues that may impinge on a practitioner's ability to practice.  A board member, appointed by the chairperson of the board with the advice and consent of the board, shall chair the professional's health committee.  The balance of the membership of the professional's health committee shall be composed of persons licensed by the board to a maximum of 12 members.

12  New Paragraph; Board of Psychologists; Qualifications; Administrative Members.  Amend RSA 329-B:6 by inserting after paragraph III the following new paragraph:

IV.  Each public member of the board and the advisory committees shall be a resident of this state.

13  Psychologists; Board; Organization and Meetings.  Amend RSA 329-B:9, I-II to read as follows:

I.  The board shall hold regular annual meetings.  Other meetings of the board shall be held at such times and upon such notice as the rules of the board provide.  [Five members] A majority of the members of the board who have been approved by the governor and council shall constitute a quorum.

II.  When a quorum is not available for just and timely resolution of a specific matter, former board members or members of the advisory committees may be appointed by the board to serve as acting board members for purposes of obtaining the minimum quorum in the resolution of that specific matter or in an adjudicatory hearing.  Advisory committee members shall have the same qualification as the missing or recused board member.

14  Psychologists; Board; Responsibilities and Rulemaking Authority.  Amend RSA 329-B:10, VII to read as follows:

VII.(a)  Ethical standards, as promulgated by the American Psychological Association, required to be met by each psychologist licensed under this chapter, and how a psychologist license may be revoked for violation of these standards.

(b)  Ethical standards, as promulgated by the National Association of School Psychologists, required to be met by each licensed school psychologist-doctoral and licensed school psychologist-specialist licensed under this chapter, and how a licensed school psychologist-doctoral or licensed school psychologist-specialist license may be revoked for violation of these standards.

(c)  Competence standards for licensees under this chapter.

15  Psychologists; Board; Responsibilities and Rulemaking Authority.  Amend RSA RSA 329-B:10, IX-X to read as follows:

IX.  Establishment of the scope of practice for psychologists, licensed school psychologist-doctoral, and licensed school psychologist-specialist.

X.  Procedures for assuring the continuing competence of psychologists, licensed school psychologists-doctoral, and licensed school psychologists-specialist licensed under this chapter including, but not limited to, continuing education requirements, and the professional's health program.

16  Psychologists; Board; Responsibilities and Rulemaking Authority.  Amend RSA 329-B:10, XIV to read as follows:

XIV.  Requirements to be met by licensees relative to the disclosure of information to clients, patients and the general public concerning the nature of psychological and school psychological services and the responsibilities of psychologists, licensed school psychologists-doctoral, and licensed school psychologists-specialist to clients or patients in RSA 329-B:32.

17  Psychologists; Board; Unlawful Practice; Penalty.  Amend RSA 329-B:17 to read as follows:

329-B:17  Unlawful Practice; Penalty.

I.  Except as provided in RSA 329-B:20 and RSA 329-B:28, it shall be unlawful for any person to be engaged in psychology, licensed school psychology-doctoral, or licensed school psychology-specialist practice unless that person is licensed by the board or working under the direct supervision of a person licensed by the board.  The license of such person shall be current and valid.  It shall be unlawful for any person to practice as or to refer to oneself as a psychologist, licensed school psychology-doctoral, or licensed school psychology-specialist or use the word "psychology" or "psychological" in such person's title or in the title of such person's work products unless that person is licensed by the board or working under the direct supervision of a person licensed by the board.

II.  Except as otherwise provided in this chapter, any person who violates paragraph I or paragraph III of this section or who violates any of the other provisions of this chapter relating to psychology, or, having had his or her license suspended or revoked, shall continue to represent himself or herself as a licensed psychologist, licensed school psychology-doctoral, or licensed school psychology-specialist, shall be guilty of a class A misdemeanor if a natural person, and a felony if any other person, and each violation shall be deemed a separate offense.

III.  Any person whose license under this chapter has been suspended or revoked by the board for disciplinary action under RSA 329-B:21 or sexual misconduct under RSA 329-B:30 shall not engage in psychology, licensed school psychology-doctoral, or licensed school psychology-specialist practice as defined in RSA 329-B:2, VII and VIII unless and until the suspension or revocation of the license has been lifted.

18  Psychologists; Board; Definitions.  Amend RSA 329-B:18 to read as follows:  329-B:18 Injunction.  The board may request the attorney general to commence an action to enjoin the operation of any person engaged in practicing unlicensed psychology, licensed school psychology-doctoral, or licensed school psychology-specialist in violation of this chapter.  Said action shall be filed in the superior court.

19  Psychologists; Board; Civil Claims.  Amend RSA 329-B:19 to read as follows:

329-B:19  Civil Claims.  Any person injured by the actions of a person engaged in the practice of unlicensed psychology, licensed school psychology-doctoral, or licensed school psychology-specialist in violation of any of the provisions of this chapter may bring a civil action to recover damages suffered by reason of the violations.

20  Psychologists; Board; Temporary and Emergency Applicants from Other States.  Amend RSA 329-B:20 to read as follows:

329-B:20  Temporary and Emergency Applicants From Other States.

Any psychologist, licensed school psychologist-doctoral, or licensed school psychologist-specialist practicing pursuant to this section shall conform his or her practice to the mandates of this chapter and the rules of the board.  Any psychologist, licensed school psychologist-doctoral, or licensed school psychologist-specialist seeking to practice under this section shall register with the board in a manner determined by the board.

I.  An individual licensed to practice psychology or school psychology in another jurisdiction may practice psychology, licensed school psychology-doctoral, or licensed school psychology-specialist in accordance with this chapter in New Hampshire [without] by applying for a license, if:

(a)  The psychologist, licensed school psychologist-doctoral, or licensed school psychologist-specialist limits her or his practice in New Hampshire to no more than 30 days per year; and

(b)  The psychologist, licensed school psychologist-doctoral, or licensed school psychologist-specialist is not the subject of a past or pending disciplinary action in another jurisdiction; and

(c)  At least one of the following is true:

(1)  [The requirements for a license in the former jurisdiction are equal to, or exceed, the requirements for licensure in New Hampshire; or

(2)]  The psychologist is the holder of one of the following credentials:

(A)  The Association of State and Provincial Psychology Boards (ASPPB) Certificate of Professional Qualification in Psychology (CPQ);

(B)  The ASPPB Interjurisdictional Practice Certificate (IPC);

(C)  The American Board of Professional Psychology (ABPP) certification;

(D)  The National Register of Health Providers in Psychology certification; or

(E)  Other equivalent qualifications determined by the board.

(2)  The school psychologist is:

(A)  The holder of the Nationally Certified School Psychologist (NCSP), credentialed by the National Association of School Psychologists, or other equivalent qualifications determined by the board; and

(B)  Approved by the board to be knowledgeable in state practice as determined by the board.

(d)  An individual licensed to practice psychology in another jurisdiction seeking to perform an evaluation under a court order may be allowed a temporary license for no more than 30 days which may be non-consecutive during a 12 month period, providing he or she qualifies under subparagraphs (b) and (c)(1).

(e)  An individual seeking temporary licensure shall submit the application and pay the fee determined by the office of professional licensure and certification.

II.  An individual licensed to practice psychology or school psychology in another jurisdiction who is providing services in response to a declared disaster, under the American Red Cross or the American Psychological Association's Disaster Response Network, or other such agency so designated by the board, may practice psychology in New Hampshire for no more than 60 days per year without applying for a state license.  Any psychologist practicing pursuant to this paragraph shall conform his or her practice to the mandates of this chapter and rules of the board.  Any psychologist seeking to practice under this paragraph shall register with the board or cause said organization to make such registration in a manner determined by the board.

III.  The board may issue a temporary license to practice for not more than 90 days in a 12-month period to a psychologist who is licensed in another jurisdiction and who has applied for a temporary license to practice psychology in New Hampshire, provided that:

(a)  The requirements for licensure in the licensing jurisdiction are equal to or exceed the requirements for licensure in New Hampshire; [and]

(b)  The applying psychologist meets the requirements for admission to the examination process in New Hampshire; [and]

(c)  The psychologist is not the subject of a past or pending disciplinary action in another jurisdiction[.] and

(d)  The individual submits an application and pays the fee determined by the office of professional licensure and certification.

21  Psychologists; Board; Investigations and Complaints.  Amend RSA 329-B:22, III to read as follows:

III.  After determining the nature and scope of an investigation or hearing, the board may employ or retain hearing officers, legal counsel, medical advisors, psychologist or school psychology advisors, or investigators through the office of professional licensure and certification to assist with that investigation or hearing.  Members of the board are not eligible for retention.

22  Psychologists; Board; Expirations, Renewals, Reinstatements, and Inactive Status.  RSA 329-B:25 is repealed and reenacted to read as follows:

I.  It shall be the duty of the board to notify every person licensed by the board under this chapter of the date of expiration of the license and the amount of the fee that shall be required for its renewal period.  Such notice shall be mailed at least 2 months in advance of the date of expiration of such license.  Renewal shall be conditional upon filing a timely and complete renewal application and payment of the renewal fee.

(a)  Psychologist licenses shall be valid for a period of 2 years and shall become invalid on the expiration date unless renewed or reinstated, which shall be for a 2 year period.

(b)  Licensed school psychologist-doctoral and licensed school psychologist-specialist licenses shall be valid for a period of 3 years and shall become invalid on the expiration date unless renewed or reinstated, which shall be for a 3 year period.

II.  If a license is not renewed it may be reinstated not later than 6 months after the date of license expiration upon compliance with rules adopted by the board and payment of the reinstatement fee.  A license may be placed on inactive status pursuant to rules adopted by the board.

III.  Upon the request of a person licensed by the board who is a member of any reserve component of the armed forces of the United States or the national guard and is called to active duty, the board shall place such person's license on inactive status.  The license may be reactivated, after notification to the board, within one year of the person's release from active duty by application to the board of psychologists providing that no more than 4 years has passed since the change to inactive status.

23  Psychologists; Board; Expirations, Renewals, Reinstatements, and Inactive Status.  Amend RSA 329-B:27, IV to read as follows:

IV.  Except for administrative rules relating to establishing and collecting fees for psychologists, administrative rules pertaining to psychologists adopted under RSA 330-A that are in effect on June 30, 2012, shall remain in effect and be administered by the board of psychologists under RSA 329-B until such rules are amended, repealed, superseded, or expired.  [The board of mental health practice shall continue to have responsibility to establish and collect fees for psychologists.]  

24  New Paragraphs; Psychologists; Board; Expirations, Renewals, Reinstatements, and Inactive Status.  Amend RSA 329-B:27 by inserting after paragraph V the following new paragraphs:

VI.  All complaints in process pertaining to school psychologists or their trainees under certificate consideration, investigation, supervision, discipline, settlement, consent decree, and all other like matters under RSA 21-N on the effective date of this paragraph shall be communicated to the board under this chapter.

VII.  All corrective supervision agreements pertaining to school psychologists, associate school psychologists, and school psychology students in effect or under consideration under RSA 21-N on effective date of this paragraph shall be communicated to the board under this chapter.

VIII.  Any doctoral level school psychologist who served on the board established under RSA 21-N prior to the effective date of this paragraph shall be considered a former member of the board established under this chapter.

25  Psychologists; Board; Persons Exempted.  Amend RSA 329-B:28, II to read as follows:

II.  Nothing in this chapter shall be construed to prevent the New Hampshire department of education from credentialing individuals with the title certified school psychologist or certified associate school psychologists to provide school psychological services in those settings that are under the purview of the New Hampshire department of education.  In addition, nothing in this chapter shall be construed to limit the ability of an educator in the field of psychology in a duly chartered educational institution to use his or her appropriate title.

26  Psychologists; Board; Psychology Client-Patient Bill of Rights.  Amend RSA 329-B:32 to read as follows:

329-B:32  Psychology Client-Patient Bill of Rights.  The board shall provide guidance for the provision of informed consent for client or patient rights, based on the professional codes of ethics as they apply in the variety of settings in which psychologists, licensed school psychologist-doctoral, or licensed school psychologist-specialists practice.  When addressing the patient or client rights, reasonable accommodations shall be made for those persons who cannot read or who have communication impairments and those who do not understand English.

27  New Subparagraph; Department of Education; Division of Educator Support and Higher Education.  Amend RSA 21-N:8-a, I by inserting after subparagraph (c) the following new subparagraph:

(d)  Provide materials and information concerning certificate holders to boards providing licenses relative to Medicaid to schools.

28  New Section; School Social Workers.  Amend RSA 330-A by inserting after section 18 the following new section:

330-A:18-a  School Social Workers.  

I.  The board shall issue a school social worker license to any person who meets the following requirements:

(a)  Is currently certified as a school social worker by the department of education, bureau of credentialing and was certified as of December 31, 2019; or

(b)  Has completed all of the following requirements or their equivalent:

(1)  Has received a college undergraduate degree.

(2)  Has received a 2-year master's degree or doctorate degree in social work from a school approved by the Council on Social Work Education.

(3)  Has completed a minimum of 2 years of post-masters experience including completion of a minimum of 3,000 hours of post-masters, supervised school social work experience by a board approved licensed independent school social worker or licensed clinical mental health counselor supervisor, or any other supervisor based on reasonable and specific criteria established in rules adopted under RSA 330-A:10.

(4)  Has passed a national proctored examination approved by the board.

II.  Any school social worker who chooses to seek licensure under RSA 330-A:18-a, I, shall notify the office of licensure and certification in writing of his or her intent to be licensed.  The office of licensure and certification shall grant licenses under RSA 330-A:18-a, I, within 10 days of receipt of notification.  

III.  The office of licensure and certification shall exempt licensees licensed in accordance with paragraph II from fees for the initial license period which shall extend beyond that individual’s certification as a school social worker by 3 months and shall include an additional year for those whose certifications from the department of education would expire prior to July 1, 2020.  Following that time, that individual shall be eligible for renewal under the rules established by the board and upon payment of the applicable fee.

29  Mental Health Practice; Board; Responsibilities and Rulemaking Authority.  Amend RSA 330-A:10, II to read as follows:

II.  The qualifications of applicants in addition to those requirements set by statute. This provision shall not apply to applicants under RSA 330-A:18-a, I.

30  Mental Health Practice; Definitions; Mental Health Discipline.  Amend RSA 330-A:2, V to read as follows:

V.  "Mental health discipline" means the disciplines of those licensed as pastoral psychotherapists, clinical social workers, school social workers, clinical mental health counselors, and marriage and family therapists.

31  Mental Health Practice; Definitions; Mental Health Practitioner.  Amend RSA 330-A:2, VII to read as follows:

VII.  "Mental health practitioner" means persons licensed under this chapter as pastoral psychotherapists, clinical social workers, school social workers, clinical mental health counselors, or marriage and family therapists.  For purposes of this chapter, the term clinical social worker shall include independent clinical social worker.

32  Mental Health Practice; Definitions; Psychotherapist.  Amend RSA 330-A:2, VIII to read as follows:

VIII.  "Psychotherapist" means a clinical social worker, school social worker, pastoral psychotherapist, clinical mental health counselor, or marriage and family therapist licensed under this chapter who performs or purports to perform psychotherapy.  This definition shall include psychiatrists licensed as physicians under RSA 329 and advanced registered nurse practitioners licensed under RSA 326-B:18 as psychiatric nurse practitioners.

33  Mental Health Practice; Board.  Amend RSA 330-A:3, I to read as follows:

I.  There shall be a board of mental health practice composed of the following members: one licensed pastoral psychotherapist, one licensed clinical social worker, one licensed school social worker, one licensed marriage and family therapist, one licensed clinical mental health counselor, one member from a community mental health center, one member from a community health center, and 3 public members.  The members shall be appointed to a term of 3 years by the governor with the approval of the council.  The members of the board shall elect a chairperson on an annual basis.  No discipline's representative and no individual public member shall serve as chairperson for more than 2 years consecutively.

34  New Paragraph; Mental Health Practice; Board; Responsibilities and Rulemaking Authority.  Amend RSA 330-A:10 by inserting after paragraph X the following new paragraph:

X-a.  Ethical standards, as promulgated by the School Social Work Association of America, required to be met by each licensed school social worker, and how a license may be revoked for violation of these standards.

35  Mental Health Practice; Fees.  Amend RSA 330-A:12, I to read as follows:

I.  The board shall establish fees pursuant to RSA 541-A for [review of applicants for licensure;] supervisory agreements; applications for licensed pastoral psychotherapist, independent clinical social worker, school social worker, clinical mental health counselor, and marriage and family therapist; renewal of license; renewal of dual license; reinstatement of license; inactive license status; reactivation of an inactive license; examination of applicants; transcribing and transferring records; and other services, including investigations and hearings conducted under this chapter.

36  New Section; Speech Language Specialist Eligibility for Licensure.  Amend RSA 326-F by inserting after section 3 the following new section:

326-F:3-a  Speech Language Specialist Eligibility for Initial Licensure.

I.  The board shall issue a speech-language pathologist license to any person who:

(a)  Is currently certified as a speech-language specialist by the department of education, bureau of credentialing and was certified as of December 31, 2019; and

(b)  Possesses a master's degree or higher academic degree in speech-language pathology, communications sciences and disorders, or communications disorders.

II.  Any speech-language pathologist who chooses to seek licensure under RSA 326-F:3-a, shall notify the office of professional licensure in writing of his or her intent to be licensed.  The office of professional licensure and certification shall grant licenses under RSA 326-F:3-a within 10 days of receipt of notification.  

III.  The office of licensure and certification shall exempt licensees licensed in accordance with paragraph II from fees for the initial license period which shall extend beyond that individual’s certification as a speech-language pathologist by 3 months and shall include an additional year for those whose certifications from the department of education would expire prior to July 1, 2020.  Following that time, that individual shall be eligible for renewal under the rules established by the board and upon payment of the applicable fee.

37  Effective Date.  This act shall take effect upon its passage.

 

LBAO

20-2909

1/7/20

 

SB 684-FN- FISCAL NOTE

AS INTRODUCED

 

AN ACT relative to Medicaid to schools.

 

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

 

 

 

Estimated Increase / (Decrease)

LOCAL:

FY 2020

FY 2021

FY 2022

FY 2023

   Revenue

$0

$0

$0

$0

   Expenditures

$0

Indeterminable Decrease

Indeterminable Decrease

Indeterminable Decrease

 

METHODOLOGY:

This bill repeals and reenacts RSA 186-C:25 (the "Medicaid to Schools Program") and RSA 167:3-k, (the "Medicaid to Schools for Medical Services Program") in order to bring the programs into compliance with federal regulations.  Specific changes when compared to the existing statutes are as follows:

 

RSA 186-C:25, Medicaid to Schools.  Compared to existing law, the bill:

  • Adds a requirement that the program be administered in the same, or similar, manner as the Medicaid to Schools for Medical Services Program.
  • Replaces the statute's itemization of eligible services with a list of requirements for eligible services.
  • Adds a new paragraph requiring providers to provide services in accordance with the relevant health professional practice and regulations.
  • Revises the rulemaking authority of the Department of Health and Human Services, and removes the requirement that the Department file an annual report regarding the cost of the program and number of students served.

 

RSA 167:3-k, Medicaid to Schools for Medical Services Program.  Compared to existing law, the bill:

  • Replaces existing RSA 167:3-k, II with a list of requirements for reimbursable services that are the same as those in the proposed RSA 186-C:25.
  • Replaces existing RSA 167:3-k, III with a requirement that providers provide services in accordance with the relevant health professional practice and regulations.
  • Removes RSA 167:3-k, V, which prohibits billing until after administrative rules have been adopted.

 

In addition, the bill amends and/or adds provisions to various health professional practice act requirements related to nursing practice, psychologists, school social workers, mental health practice, and speech language specialists.

 

Neither the Department of Health and Human Services nor the Department of Education expect the bill to have an impact on state expenditures or revenue.  Nor does the proposed rule create any obligation for schools to provide services that they are not otherwise legally obligated to provide.  By bringing state statute into compliance with federal regulations governing the Medicaid to Schools program, the bill may result in school districts receiving federal reimbursement for services that are not currently reimbursable.  As a result, to the extent that school districts offer those services, local expenditures will decrease as costs will be partially covered by federal Medicaid funds.  For illustrative purposes, in FY 2018, school districts were reimbursed $27.3 million for 11,218 students.  Total reimbursement may be higher during the FY 2020/21 biennium, as SB 235 in 2017 authorized the expansion of coverage from only those children with Individualized Education Plans (IEP) to all Medicaid-eligible students attending public schools.   

 

It is assumed any fiscal impact from this bill will not occur until FY 2021.

 

AGENCIES CONTACTED:

Department of Education and Department of Health and Human Services

 

Links

SB684 at GenCourtMobile
SB684 Discussion

Action Dates

Date Body Type
Jan. 23, 2020 Senate Hearing
Jan. 30, 2020 Senate Floor Vote
Feb. 12, 2020 House Hearing
Feb. 12, 2020 House Exec Session
House Floor Vote
Feb. 19, 2020 House Floor Vote

Bill Text Revisions

SB684 Revision: 8078 Date: Jan. 30, 2020, 1:29 p.m.
SB684 Revision: 8013 Date: Jan. 14, 2020, 4:12 p.m.

Docket

Date Status
Jan. 8, 2020 Introduced 01/08/2020 and Referred to Education and Workforce Development; SJ 2
Jan. 23, 2020 Hearing: 01/23/2020, Room 103, SH, 09:00 am; SC 3
Jan. 30, 2020 Committee Report: Ought to Pass with Amendment # 2020-0269s, 01/30/2020; SC 4A
Jan. 30, 2020 Committee Amendment # 2020-0269s, AA, VV; 01/30/2020; SJ 2
Jan. 30, 2020 Ought to Pass with Amendment 2020-0269s, MA, VV; OT3rdg; 01/30/2020; SJ 2
Jan. 9, 2020 Introduced 01/09/2020 and referred to Education
Feb. 12, 2020 Public Hearing: 02/12/2020 10:00 am LOB 207
Feb. 12, 2020 Executive Session: 02/12/2020 11:00 am LOB 207
Feb. 19, 2020 Committee Report: Ought to Pass with Amendment # 2020-0581h for 02/19/2020 (Vote 19-1; CC) HC 7 P. 5
Committee Report: Ought to Pass with Amendment # 2020-0581h (Vote 19-1; CC)