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are additions.
Regular Session, 2012
HOUSE BILL NO. 952
BY REPRESENTATIVES BROSSETT AND WILLMOTT
MENTAL HEALTH: Establishes the Mental and Behavioral Health Services Preservation
Act
AN ACT1
To enact Part I-A of Chapter 1 of Title 28 of the Louisiana Revised Statutes of 1950, to be2
comprised of R.S. 28:26.10.1 through 26.10.5, relative to mental and behavioral3
health services; to provide a short title; to a provide a statement of legislative intent;4
to provide for management of mental and behavioral health resources; to provide for5
funding priorities; to provide for innovative mental and behavioral health services;6
and to provide for related matters.7
Be it enacted by the Legislature of Louisiana:8
Section 1. Part I-A of Chapter 1 of Title 28 of the Louisiana Revised Statutes of9
1950, comprised of R.S. 28:26.10.1 through 26.10.5, is hereby enacted to read as follows:10
PART I-A. MENTAL AND BEHAVIORAL HEALTH SERVICES 11
PRESERVATION ACT12
§26.10.1. Short title13
This Chapter shall be known and may be cited as the "Mental and Behavioral14
Health Services Preservation Act".15
§26.10.2. Legislative declaration of intent16
It is the intent of the legislature to preserve vital state funding for mental17
health services to ensure delivery of and access to quality care for those in desperate18
need of such services throughout the state. Many citizens in the state have limited19
access to mental and behavioral health services because of the massive cuts, both20 HLS 12RS-1333 ENGROSSED
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federal and state, in mental and behavioral health funding. The legislature also finds1
that the provision of high-quality mental and behavioral health services, regardless2
of setting, is of overriding importance. The state wholly supports efforts to assist3
individuals suffering from serious and persistent mental illness in their efforts to4
participate fully in society. As such, the department should streamline the delivery5
of mental and behavioral health services through the prudent allocation of existing6
resources. The Department of Health and Hospitals will improve the safety and7
health of individuals, families, and communities by providing leadership and8
establishing and participating in partnerships for the continuation of mental and9
behavioral health services throughout the state, including cooperative agreements,10
mergers, joint ventures, and consolidations among mental and behavioral health care11
facilities. Consumer and advocate participation in the process can only aid in the12
delivery of services to those most in need. To improve the quality of services13
available and promote treatment, which often involves the rehabilitation, recovery,14
and reintegration of persons suffering from mental illness, the state must secure15
adequate funding for mental and behavioral health services and require state16
departments to exercise fiscal responsibility in the allocation of these resources.17
§26.10.3. Management of mental and behavioral health resources18
In the operational management of the office of behavioral health, the19
department shall guarantee, to the maximum extent practicable, the efficient and20
effective use and retention of the state's scarce mental and behavioral health21
resources to adequately provide for the peace, health, safety, and general welfare of22
the public, by ensuring the following:23
(1) Accountability of efficient and effective services through state-of-the-art24
quality and performance measures and statewide standards for monitoring quality of25
service and performance and reporting of quality of service and performance26
information. These processes shall be designed so as to maximize the use of27
available resources for direct care of people with a mental illness and to assure28
uniform data collection across the state. 29 HLS 12RS-1333 ENGROSSED
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are additions.
(2) Minimum service delivery standards.1
(3) Coordination of integration of services offered by department and mental2
and behavioral health communities, including the office of behavioral health and3
their respective contract providers, involved in the delivery of mental and behavioral4
health treatment, along with local systems and groups, public and private, such as5
state mental hospitals, public health organizations, parish authorities, child6
protection, and regional support networks, aimed at reducing duplication in service7
delivery and promoting complementary services among all entities that provide8
mental and behavioral health services to adults and children throughout the state, 9
(4) Implementation of a system of reimbursement by the Medical Assistance10
Program to private hospitals and to state hospitals for covered Medicaid services11
that, to the extent possible, allocates funding in the areas of the state based on needs,12
population, and acuity level as determined by the Department of Health and13
Hospitals. The above-mentioned system of reimbursement shall be subject to14
approval by the Centers for Medicare and Medicaid Services.15
(5) The respective regions of the department are the focal point of all mental16
and behavioral health planning activities, including budget submissions, grant17
applications, contracts, and other arrangements that can be effected at the state and18
regional levels.19
(6) State agencies licensing and monitoring contracted providers perform in20
the most cost-efficient and effective manner with limited duplication and disruption21
to organizations providing services.22
(7) Adequate research and evaluation regarding the effectiveness of services23
being provided and achievement of outcome measures.24
§26.10.4. Funding priorities; cost-effectiveness25
A. The department shall ensure that all current and future funds are expended26
in the most cost-effective manner and services are provided in accordance with27
recommended best practices subject to state oversight to ensure accountability to28
taxpayers and the public. The department shall evaluate existing proposed29 HLS 12RS-1333 ENGROSSED
HB NO. 952
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expenditure plans for mental and behavioral health services and determine the best1
use of such funds to achieve positive policy outcomes in the mental and behavioral2
health communities. This effort shall involve the use of innovative methods of3
expanding the reach of current funding and securing increased local, regional, state,4
federal, or private source funding in the future. The department shall develop5
methods for estimating the need for mental and behavioral health services in certain6
regions of the state, with special attention to underfunded and inaccessible programs,7
and allocate state funds or resources according to that need. 8
B. The state, to the extent practicable, shall continue to provide funding for9
mental and behavioral health services that are not less than the existing allocations10
from the state general fund. 11
§26.10.5. Innovative mental and behavioral health services; programs12
A. The department shall develop goals, objectives, and priorities for the13
creation of innovative programs which promote and improve the mental and14
behavioral health of the citizens of the state by making treatment and support15
services available to those persons who are most in need and least able to pay. These16
programs shall achieve the following:17
(1) Increase access to underserved groups.18
(2) Increase the quality of services, including better outcomes.19
(3) Promote interagency collaboration by improving the integration and20
effectiveness of state agencies responsible for mental and behavioral health care.21
(4) Increase access to services.22
(5) Ensure cost-effectiveness of services.23
(6) Encourage delivery of services more efficiently and effectively.24
(7) Mitigate the cost of the delivery of services. 25
(8) Increase effectiveness of treatment and management strategies.26
(9) Promote emerging best practices and increased quality of care in the27
delivery of mental and behavioral health services.28 HLS 12RS-1333 ENGROSSED
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are additions.
B. The department shall collaborate with mental and behavioral health1
advocates, clinicians, physicians, professional organizations, parish human service2
authorities, local citizens, consumers, and family members in the planning,3
designing, and implementation of innovative mental and behavioral health service4
programs and priorities in their respective regions throughout the state.5
Section 2. The department shall promulgate rules and regulations necessary for the6
implementation of the provisions of this Act in furtherance of the preservation of mental and7
behavioral health services. 8
Section 3. Nothing in this Act shall be construed to reduce the existing authority or9
responsibility of the office of behavioral health within the Department of Health and10
Hospitals or negatively impact the existing funding of mental and behavioral health services11
in the state.12
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)]
Brossett HB No. 952
Abstract: Provides relative to the preservation of state funded mental and behavioral health
services.
Proposed law (R.S. 28:26.10.1) specifies that the provisions within proposed law will be
known and may be cited as the "Mental and Behavioral Health Services Preservation Act".
Proposed law (R.S. 28:26.10.2) provides a statement of legislative intent. Provides that it is
the intent of the legislature to preserve vital state funding for mental and behavioral health
services to ensure delivery of and access to quality care for those in desperate need of such
services throughout the state. Also, specifies that many citizens in the state have limited
access to mental and behavioral health services because of the massive cuts, both federal and
state, in mental and behavioral health funding. Specifies that the legislature acknowledges
the need of high-quality mental and behavioral health care services, regardless of setting, is
of overriding importance. Specifies that the state supports efforts to assist individuals
suffering from serious and persistent mental illness in their efforts to participate fully in
society. Provides that the Dept. of Health and Hospitals (DHH) should streamline the
delivery of mental and behavioral health services through the prudent allocation of existing
resources. Provides that DHH will improve the safety and health of individuals, families,
and communities by providing leadership and establishing and participating in partnerships
for the continuation of mental and behavioral health services throughout the state, including
cooperative agreements, mergers, joint ventures, and consolidations among mental and
behavioral health care facilities. Specifies that consumer and advocate participation in the
process can only aid in the delivery of services to those most in need. Specifies that to
improve the quality of services available and promote treatment, which often involves the
rehabilitation, recovery, and reintegration of persons suffering from mental illness, the state HLS 12RS-1333 ENGROSSED
HB NO. 952
Page 6 of 8
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
must secure adequate funding for mental and behavioral health services and require state
departments to exercise fiscal responsibility in the allocation of these resources.
Proposed law (R.S. 28:26.10.3) provides relative to the management of mental and
behavioral health resources. Provides that in the operational management of the office of
behavioral health, DHH must guarantee, to the maximum extent practicable, the efficient and
effective use and retention of the state's scarce mental and behavioral health resources to
adequately provide for the peace, health, safety, and general welfare of the public, by
ensuring the following:
(1)Accountability of efficient and effective services through state-of-the-art quality and
performance measures and statewide standards for monitoring quality of service and
performance and reporting of quality of service and performance information. These
processes shall be designed so as to maximize the use of available resources for
direct care of people with a mental illness and to assure uniform data collection
across the state.
(2)Minimum service delivery standards.
(3)Coordination of integration of services offered by DHH and the mental and
behavioral health community, including the office of behavioral health and their
respective contract providers, involved in the delivery of mental and behavioral
health treatment, along with local systems and groups, public and private, such as
state mental hospitals, public health organizations, parish authorities, child
protection, and regional support networks, aimed at reducing duplication in service
delivery and promoting complementary services among all entities that provide
mental and behavioral health services to adults and children throughout the state.
(4)Implementation of a system of reimbursement by the Medical Assistance Program
to private hospitals and to state hospitals for covered Medicaid services that, to the
extent possible, allocates funding in the areas of the state based on needs, population,
and acuity level as determined by DHH. The above-mentioned system of
reimbursement shall be subject to approval by the Centers for Medicare and
Medicaid Services.
(5)The respective regions of DHH are the focal point of all mental and behavioral health
planning activities, including budget submissions, grant applications, contracts, and
other arrangements that can be effected at the state and regional levels.
(6)State agencies licensing and monitoring contracted providers perform in the most
cost-efficient and effective manner with limited duplication and disruption to
organizations providing services.
(7)Adequate research and evaluation regarding the effectiveness of services being
provided and achievement of outcome measures.
Proposed law (R.S. 28:26.10.4) establishes DHH funding priorities. Requires DHH to
ensure that all current and future funds are expended in the most cost-effective manner and
services are provided in accordance with recommended best practices, subject to state
oversight, to ensure accountability to taxpayers and the public. Requires DHH to evaluate
existing proposed expenditure plans for mental and behavioral health services and determine
the best use of such funds to achieve positive policy outcomes within the mental and
behavioral health community. Specifies that this effort must involve the use of innovative
methods of expanding the reach of current funding and securing increased local, regional,
state, federal, or private source funding in the future. Requires DHH to develop methods for
estimating the need for mental and behavioral health services in certain regions of the state,
with special attention to underfunded and inaccessible programs, and allocate state funds or
resources according to that need. Specifies that the state, to the extent practicable, shall HLS 12RS-1333 ENGROSSED
HB NO. 952
Page 7 of 8
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
continue to provide funding for mental and behavioral health services that are not less than
the existing allocations from the state general fund.
Proposed law (R.S. 28:26.10.5) provides for innovative mental and behavioral health
services. Requires DHH to develop goals, objectives, and priorities for the creation of
innovative programs which promote and improve the mental and behavioral health of the
citizens of the state by making treatment and support services available to those persons who
are most in need and least able to pay. Specifies that these programs shall achieve the
following:
(1)Increase access to underserved groups.
(2)Increase the quality of services, including better outcomes.
(3)Promote interagency collaboration by improving the integration and effectiveness
of state agencies responsible for mental and behavioral health care.
(4)Increase access to services.
(5)Ensure cost-effectiveness of services.
(6)Encourage delivery of services more efficiently and effectively.
(7)Mitigate the cost of the delivery of services.
(8)Increase effectiveness of treatment and management strategies.
(9)Promote emerging best practices and increased quality of care in the delivery of
mental and behavioral health services.
Requires a collaboration between DHH and mental and behavioral health advocates,
clinicians, physicians, professional organizations, parish human service authorities, local
citizens, consumers, and family members in the planning, designing, and implementation of
innovative mental and behavioral health service programs and priorities in their respective
regions throughout the state.
Proposed law authorizes DHH to promulgate rules and regulations necessary for the
implementation of the provisions of proposed law in furtherance of the preservation of
mental and behavioral health services.
Proposed law specifies that nothing in proposed law can be construed to reduce the existing
authority or responsibility of the office of behavioral health within DHH or negatively
impact the existing funding of mental and behavioral health services in the state.
(Adds R.S. 28:26.10.1-26.10.5)
Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Health and Welfare to the
original bill.
1. Made technical changes.
2. Extended the application of the bill, which is designed to preserve certain
services, to behavioral health services. HLS 12RS-1333 ENGROSSED
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3. Deleted a provision which encouraged DHH to implement an equitable system
of total annual reimbursement by the Medical Assistance Program to private
hospitals and to state hospitals for covered services delivered to program clients
at those two categories of facilities.
4. Added a provision which encourages implementation of a system of
reimbursement by the Medical Assistance Program to private hospitals and to
state hospitals for covered Medicaid services that allocates funding in the areas
of the state based on needs, population, and acuity level as determined by DHH.
5. Added a provision that specifies that system of Medicaid reimbursement will be
subject to approval by the Centers for Medicare and Medicaid Services.