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Regular Session, 2010
HOUSE BILL NO. 1263
BY REPRESENTATIVE CARMODY
MENTAL HEALTH: Creates the Child and Adolescent Psychiatric Care Reform Act
AN ACT1
To enact Part III of Chapter 8 of Title 46 of the Louisiana Revised Statutes of 1950, to be2
comprised of R.S. 46:977.21 through 977.22, relative to psychiatric care for children3
and adolescents; to create the Child and Adolescent Psychiatric Care Reform Act;4
to provide for legislative findings; to provide for certain duties of the Department of5
Health and Hospitals relating to psychiatric care for children and adolescents; and6
to provide for related matters.7
Be it enacted by the Legislature of Louisiana:8
Section 1. Part III of Chapter 8 of Title 46 of the Louisiana Revised Statutes of 1950,9
comprised of R.S. 46:977.21 through 977.22, is hereby enacted to read as follows: 10
PART III. CHILD AND ADOLESCENT PSYCHIATRIC CARE11
§977.21. Short title; legislative findings12
A. This Part shall be known and may be cited as the "Child and Adolescent13
Psychiatric Care Reform Act".14
B. The legislature finds and declares all of the following:15
(1) The Louisiana Medicaid State Plan provides for coverage of inpatient16
psychiatric care for children and adolescents.17
(2) Hurricanes Katrina, Rita, Gustav, and Ike disrupted access to inpatient18
psychiatric care throughout south Louisiana.19 HLS 10RS-1870 ORIGINAL
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(3) Louisiana's budget crisis has resulted in several reductions in Medicaid1
payment rates for inpatient psychiatric services.2
(4) Federal and state regulatory changes have resulted in increased denials3
for admissions and inappropriate lengths of stay resulting in Medicaid eligible4
children and adolescents receiving fewer services than children and adolescents5
covered by other insurers.6
(5) Certificate of need requirements to qualify for admission are driving up7
costs to both Medicaid and the providers of services.8
(6) Out-of-area placement has made family involvement in the treatment of9
children and adolescents difficult and costly.10
(7) Out-of-area placement has made assurance of appropriate outpatient11
follow-ups and medication compliance increasingly difficult.12
(8) Private hospitals are discontinuing the provisions of inpatient psychiatric13
care to children and adolescents at the same time that capacity in state-operated14
psychiatric facilities is shrinking.15
(9) Decreased capacity in state-operated psychiatric facilities is driving up16
uncompensated costs in private psychiatric hospitals and nonstate hospital17
psychiatric units.18
§977.22. Medical assistance program; rulemaking and state plan19
On or before January 1, 2011, the Department of Health and Hospitals,20
hereafter referred to as the "department", shall promulgate rules and regulations in21
accordance with the Administrative Procedure Act and shall file Medicaid state plan22
amendments with the Centers for Medicare and Medicaid Services as may be23
necessary to provide for the following:24
(1) The implementation of length of stay criteria for inpatient psychiatric25
care of children and adolescents that is consistent with the criteria used by other26
payors in the state.27
(2) The implementation of organizational units in the office of mental health28
in each region of the department for the purpose of:29 HLS 10RS-1870 ORIGINAL
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(a) Facilitating family involvement in the treatment and aftercare of children1
and adolescents in need of psychiatric care.2
(b) Facilitating twenty-four hour, seven day per week access to physicians3
who may issue a certificate of need for inpatient psychiatric admission for a child or4
adolescent when the primary care physician of the child or adolescent is not known5
or not available.6
(c) Establishing and funding twenty bed inpatient psychiatric units in each7
region of the department to serve indigent patients.8
(3) The creation of an uncompensated care pool equal to at least ten percent9
of the annual uncompensated care appropriation to Public Psychiatric Free Standing10
Units, the purpose of which shall be to cover the uncompensated costs incurred by11
nonstate operated inpatient psychiatric units.12
(4) The creation of a Medicaid reimbursement rate for nonstate inpatient13
psychiatric services for children and adolescents equal to the average payment14
received from non-Medicaid payors for such services.15
Section 2. This Act shall become effective upon signature by the governor or, if not16
signed by the governor, upon expiration of the time for bills to become law without signature17
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If18
vetoed by the governor and subsequently approved by the legislature, this Act shall become19
effective on the day following such approval.20
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Carmody HB No. 1263
Abstract: Provides for certain duties of the Dept. of Health and Hospitals relating to
psychiatric care for children and adolescents.
Proposed law creates the Child and Adolescent Psychiatric Care Reform Act.
Proposed law provides legislative findings. HLS 10RS-1870 ORIGINAL
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Proposed law requires the Dept. of Health and Hospitals to:
(1)Implement length of stay criteria for inpatient psychiatric care of children and
adolescents that is consistent with the criteria used by other payors in the state.
(2)Develop organizational units in the office of mental health in each region of the
department for the purpose of improving child and adolescent access to psychiatric
care.
(3)Create an uncompensated care pool to cover the uncompensated costs incurred by
nonstate operated inpatient psychiatric units.
(4)Create a Medicaid reimbursement rate for nonstate inpatient psychiatric services for
children and adolescents equal to the average payment received from non-Medicaid
payors for such services.
Proposed law requires the department to carry out the necessary rulemaking and Medicaid
state plan amendments to provide for the functions.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 46:977.21-977.22)