Revision: Jan. 12, 2024, 4:01 p.m.
SB 495-FN - AS INTRODUCED
2024 SESSION
24-2878
05/08
SENATE BILL 495-FN
AN ACT relative to certification of alcohol and other drug use treatment facilities.
SPONSORS: Sen. Carson, Dist 14; Sen. Avard, Dist 12; Sen. Altschiller, Dist 24; Sen. Whitley, Dist 15; Sen. Birdsell, Dist 19; Sen. Bradley, Dist 3; Rep. Nagel, Belk. 6; Rep. Schapiro, Ches. 16
COMMITTEE: Health and Human Services
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ANALYSIS
This bill provides for certification of substance use treatment programs by the department of health and human services and establishes an office of the behavioral health ombudsman in the department.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
24-2878
05/08
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Four
AN ACT relative to certification of alcohol and other drug use treatment facilities.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Hampshire Substance Use Disorder Services System. Amend RSA 172:2-a to read as follows:
172:2-a State Substance Use Disorder Services System Established.
I. The commissioner shall provide for the scientific care, treatment, and rehabilitation of individuals with substance use disorders and their families, and work towards the prevention of, and assist in the control of, alcohol and drug misuse within the state through education, treatment, community organization, and research. The department shall establish, maintain, implement, and coordinate a system of substance use disorder treatment services under this chapter. This system shall be supervised by the commissioner. [With the exception of a youth drug treatment center required to be operated by a non-governmental entity at the Sununu youth services center, at the discretion of the commissioner,] The department may directly operate and administer any program or facility which provides, or which may be established to provide, services to persons with substance use disorders or may enter into a contract with any individual, partnership, association, public or private, for profit or nonprofit, agency or corporation for the operation and administration of any such program or facility.
II. The commissioner shall establish, pursuant to rules adopted under RSA 541-A, a certification process for substance use treatment programs and facilities operating in the state of New Hampshire. Programs and facilities required to be certified shall include, but not be limited to those providing early intervention treatment, outpatient treatment, intensive outpatient and partial hospitalization treatment, residential treatment, and medically managed intensive treatment. Independent providers, the programs and facilities in the system of mental health services established by RSA 135-C:3, and other providers identified by the commissioner shall be exempt from certification.
III. The commissioner shall adopt rules under RSA 541-A, relative to:
(a) Certification procedures, requirements, and exemptions for substance use treatment programs and facilities.
(b) Certification and renewal fees.
(c) The nature and content of training requirements for substance use treatment programs and providers.
IV. All fees received from certification under this section shall be kept by the state treasurer in a separate fund known as the substance use treatment certification fund, which shall be kept separate and distinct from all other funds. The nonlapsing fund shall be continually appropriated to the department of health and human services for the purposes of this chapter.
V. The department shall maintain and regularly update on its website a publicly available listing of all programs and facilities certified under this chapter and all investigatory and monitoring reports, and final decisions made relative to certification.
2 New Subparagraph; Dedicated Funds; Substance Use Treatment Certification Fund. Amend RSA 6:12, I by inserting after subparagraph (394) the following new subparagraph:
(395) Moneys deposited in the substance use treatment certification fund under RSA 172:2-a.
3 New Hampshire Substance Use Disorder Services System. Amend RSA 172:2-c to read as follows:
172:2-c Community Substance Use Disorder Treatment Programs.
I. Any city, county, town, or any individual, partnership, association, public or private, for profit or nonprofit, agency or corporation may establish and administer a community substance use disorder treatment program for the purpose of providing substance use disorder treatment services to individuals, families, and organizations in the area. Every program shall, at a minimum, provide substance use disorder screening and evaluation, case management, and outpatient counseling services. The department may contract with a community substance use disorder treatment program, pursuant to RSA 172:2-a, for the operation and administration of any services that are part of the state substance use disorder treatment system. In the event that the commissioner decides to enter into a contract for the operation and administration of any services which are part of the state substance use disorder treatment system, the contract shall contain standards designed to measure the performance of the contractor in achieving positive consumer outcomes, maintaining fiscal integrity, and providing quality services. The commissioner shall adopt rules, pursuant to RSA 172:8-b, to establish criteria for designating substance use disorder treatment programs under this chapter.
II. No person may establish, maintain, operate, or conduct any program or facility for substance use treatment without certification by the department under RSA 172:2-a.
III. Every facility or program certified under RSA 172:2-a shall pay a certification fee to the commissioner for deposit in the fund established under RSA 172:2-a.
4 New Section: New Hampshire Substance Use Disorder Services System; Behavioral Health Ombudsman. Amend RSA 172 by inserting after section 15 the following new section:
172:16 Behavioral Health Ombudsman; Office Established.
I. The commissioner, in consultation with the attorney general, shall designate a person as the administrator and chief executive officer of the office of the behavioral health ombudsman. The behavioral health ombudsman shall be a person with expertise and experience in the field of behavioral health advocacy. The person serving in the position of behavioral health ombudsman shall designate such other qualified persons needed to perform the functions of this office. The behavioral health ombudsman shall devote his or her entire time to the duties of the position. The behavioral health ombudsman shall receive such salary as shall be provided in a classified position as determined by the division of personnel, unless administered on a contract basis.
II. The behavioral health ombudsman shall:
(a) Investigate any act, omission, practice, policy or procedure of any individual, facility, or government agency that may adversely effect the health, safety, welfare, or civil or human right of any patient of a substance use treatment or mental health treatment facility;
(b) Represent the interests of residents before governmental agencies and seek administrative, legal, and other remedies to protect the health, safety, welfare, and rights of patients;
(c) Represent the interests of staff members of organizations providing substance use or mental health treatment who report or cause to be reported, verbally or in writing, what the employee has reasonable cause to believe is a violation of any law or rule adopted under the laws of this state;
(d) Establish an advisory committee, which shall include patients and their legal representatives, providers of services, representatives of government agencies and representatives of community organizations serving individuals with substance use disorder or individuals with mental illness, which shall meet quarterly in order to provide consultation to the behavioral health ombudsman in planning and operating this subdivision;
(e) Provide information as appropriate to facilities, other agencies, and the public regarding the problems and concerns of patients of facilities.
(f) Inform patients, family members, staff members of organization providing substance use or mental health treatment, and others acting on behalf of patients how to access the assistance and services of the office and the services and assistance of other providers or agencies, including legal services.
(g) Ensure regular and timely access to and response from the office.
(h) Comment on, facilitate public comment on, and recommend changes to existing or proposed laws, rules, regulations and other governmental policies and actions that affect the health, safety, welfare, and rights of patients.
(i) Provide technical support for the development of resident and family councils to protect the well-being and rights of patients.
(j) Provide for education and training of the behavioral health ombudsman office staff and volunteers.
(k) Educate facilities, agencies, and staff members concerning the rights and welfare of patients.
(l) Promote and support development of citizen organizations to participate in the ombudsman program.
III. The files maintained by the office shall be confidential and shall not be disclosed unless such disclosure is authorized by law or required by court order. Nothing in this section shall be construed to prohibit the disclosure of information gathered in any investigation to any interested party as may be necessary to resolve the complaint.
IV. The commissioner of the department of health and human services shall adopt rules, pursuant to RSA 541-A, relative to the responsibilities, duties, and general administration of the office of the behavioral health ombudsman and to assure compliance with the Confidentiality of Substance Use Disorder Patient Records, as set forth in 42 C.F.R Part II.
5 Effective Date. This act shall take effect 60 days after its passage.
24-2878
Revised 1/12/24
SB 495-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to certification of alcohol and other drug use treatment facilities.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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Estimated State Impact - Increase / (Decrease) | ||||||
| FY 2024 | FY 2025 | FY 2026 | FY 2027 | ||
Revenue | $0 | Indeterminable | $342,000 | $351,000 | ||
Revenue Fund(s) | Substance use center certification fees | |||||
Expenditures | $0 | $333,000+ | $342,000+ | $351,000+ | ||
Funding Source(s) | General Fund Substance Use Treatment and Certification Fund | |||||
Appropriations | $0 | $0 | $0 | $0 | ||
Funding Source(s) | None | |||||
• Does this bill provide sufficient funding to cover estimated expenditures? [X] See Below • Does this bill authorize new positions to implement this bill? [X] Yes | ||||||
METHODOLOGY:
This bill establishes a certification process for substance use treatment programs and facilities operating in the state of New Hampshire. The Department of Health and Human Services would be required to maintain a publicly available listing of all certified programs and facilities, as well as all investigatory reports, monitoring reports, and final decisions made relative to certification. In addition, the bill establishes a new substance use treatment certification fund. All fees received from certification will be kept in the separate fund. The Department assumes that certification rates will be based on the revenue needed to support operation of the program. Finally, the bill establishes a behavioral health ombudsman within the Department.
The Department states that although the total number of substance use treatment agencies is unknown, there are 65 individual organizations enrolled with Medicaid as substance use disorder outpatient groups or programs, with a total of 106 separate sites. There are also agencies that are not enrolled with Medicaid, as well as fluctuation in agencies opening and closing over time. In addition, the bill includes residential facilities within its definition of treatment programs and facilities. The Department estimates a total of 50-150 agencies in need of certification, requiring four additional staff: three Licensing and Evaluation Coordinators and one Supervisor IV, at a total cost of $333,000 in FY25, $342,000 in FY26, and $351,000 in FY27. The Department notes that although the program is intended to be self-funded through the substance use treatment and certification fund, the positions will need to be filled before any revenues are received, resulting in a general fund cost in the first year of implementation.
With respect to the establishment of a behavioral health ombudsman, the Department did not provide an estimated cost. Instead, the Department stated that it would be able to handle the new responsibilities within the existing Department-wide ombudsman's office, at a cost of $50,000 to provide training to ombudsman personnel.
AGENCIES CONTACTED:
Department of Health and Human Services