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Regular Session, 2012
HOUSE BILL NO. 952
BY REPRESENTATIVES BROSSETT, ARNOLD, BADON, BARROW, BERTHELOT,
BILLIOT, WESLEY BISHOP, HENRY BURNS, BURRELL, CARMODY, COX,
DOVE, EDWARDS, GAROFALO, HARRIS, HUNTER, KATRINA JACKSON,
JAMES, JEFFERSON, JONES, LEGER, LIGI, MORENO, PIERRE,
SCHEXNAYDER, SMITH, 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 SERVICES11
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 HLS 12RS-1333 REENGROSSED
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need of such services throughout the state. Many citizens in the state have limited1
access to mental and behavioral health services because of the massive cuts, both2
federal and state, in mental and behavioral health funding. The legislature also finds3
that the provision of high-quality mental and behavioral health services, regardless4
of setting, is of overriding importance. The state wholly supports efforts to assist5
individuals suffering from serious and persistent mental illness in their efforts to6
participate fully in society. As such, the department should streamline the delivery7
of mental and behavioral health services through the prudent allocation of existing8
resources. The Department of Health and Hospitals will improve the safety and9
health of individuals, families, and communities by providing leadership and10
establishing and participating in partnerships for the continuation of mental and11
behavioral health services throughout the state, including cooperative agreements,12
mergers, joint ventures, and consolidations among mental and behavioral health care13
facilities. Consumer and advocate participation in the process can only aid in the14
delivery of services to those most in need. To improve the quality of services15
available and promote treatment, which often involves the rehabilitation, recovery,16
and reintegration of persons suffering from mental illness, the state should secure17
adequate funding for mental and behavioral health services and require state18
departments to exercise fiscal responsibility in the allocation of these resources.19
§26.10.3. Management of mental and behavioral health resources20
In the operational management of the office of behavioral health, the21
department may guarantee the efficient and effective use and retention of the state's22
scarce mental and behavioral health resources to adequately provide for the peace,23
health, safety, and general welfare of the public, by ensuring the following:24
(1) Accountability of efficient and effective services through state-of-the-art25
quality and performance measures and statewide standards for monitoring quality of26
service and performance and reporting of quality of service and performance27
information. These processes may be designed so as to maximize the use of28 HLS 12RS-1333 REENGROSSED
HB NO. 952
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available resources for direct care of people with a mental illness and to assure1
uniform data collection across the state. 2
(2) Minimum service delivery standards.3
(3) Coordination of integration of services offered by department and mental4
and behavioral health communities, including the office of behavioral health and5
their respective contract providers, involved in the delivery of mental and behavioral6
health treatment, along with local systems and groups, public and private, such as7
state mental hospitals, public health organizations, parish authorities, child8
protection, and regional support networks, aimed at reducing duplication in service9
delivery and promoting complementary services among all entities that provide10
mental and behavioral health services to adults and children throughout the state, 11
(4) Implementation of a system of reimbursement by the Medical Assistance12
Program to private hospitals and to state hospitals for covered Medicaid services13
that, to the extent possible, allocates funding in the areas of the state based on needs,14
population, and acuity level as determined by the Department of Health and15
Hospitals. The above-mentioned system of reimbursement may be subject to16
approval by the Centers for Medicare and Medicaid Services.17
(5) The respective regions of the department are the focal point of all mental18
and behavioral health planning activities, including budget submissions, grant19
applications, contracts, and other arrangements that can be effected at the state and20
regional levels.21
(6) State agencies licensing and monitoring contracted providers perform in22
the most cost-efficient and effective manner with limited duplication and disruption23
to organizations providing services.24
(7) Adequate research and evaluation regarding the effectiveness of services25
being provided and achievement of outcome measures.26
§26.10.4. Funding priorities; cost-effectiveness27
A. The department may ensure that all current and future funds are expended28
in the most cost-effective manner and services are provided in accordance with29 HLS 12RS-1333 REENGROSSED
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recommended best practices subject to state oversight to ensure accountability to1
taxpayers and the public. The department may evaluate existing proposed2
expenditure plans for mental and behavioral health services and determine the best3
use of such funds to achieve positive policy outcomes in the mental and behavioral4
health communities. This effort may involve the use of innovative methods of5
expanding the reach of current funding and securing increased local, regional, state,6
federal, or private source funding in the future. The department may develop7
methods for estimating the need for mental and behavioral health services in certain8
regions of the state, with special attention to underfunded and inaccessible programs,9
and allocate state funds or resources according to that need.10
B. The state may continue to provide funding for mental and behavioral11
health services that are not less than the existing allocations from the state general12
fund. 13
§26.10.5. Innovative mental and behavioral health services; programs14
A. The department may develop goals, objectives, and priorities for the15
creation of innovative programs which promote and improve the mental and16
behavioral health of the citizens of the state by making treatment and support17
services available to those persons who are most in need and least able to pay. These18
programs may achieve the following:19
(1) Increase access to underserved groups.20
(2) Increase the quality of services, including better outcomes.21
(3) Promote interagency collaboration by improving the integration and22
effectiveness of state agencies responsible for mental and behavioral health care.23
(4) Increase access to services.24
(5) Ensure cost-effectiveness of services.25
(6) Encourage delivery of services more efficiently and effectively.26
(7) Mitigate the cost of the delivery of services. 27
(8) Increase effectiveness of treatment and management strategies.28 HLS 12RS-1333 REENGROSSED
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(9) Promote emerging best practices and increased quality of care in the1
delivery of mental and behavioral health services.2
B. The department may collaborate with mental and behavioral health3
advocates, clinicians, physicians, professional organizations, parish human service4
authorities, local citizens, consumers, and family members in the planning,5
designing, and implementation of innovative mental and behavioral health service6
programs and priorities in their respective regions throughout the state.7
Section 2. The department may promulgate rules and regulations necessary for the8
implementation of the provisions of this Act in furtherance of the preservation of mental and9
behavioral health services.10
Section 3. Nothing in this Act may be construed to reduce the existing authority or11
responsibility of the office of behavioral health within the Department of Health and12
Hospitals or negatively impact the existing funding of mental and behavioral health services13
in the state.14
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 HLS 12RS-1333 REENGROSSED
HB NO. 952
Page 6 of 8
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
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
should 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 may guarantee 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 may 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 may 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. Authorizes 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. Authorizes 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 may 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. Authorizes DHH to develop methods HLS 12RS-1333 REENGROSSED
HB NO. 952
Page 7 of 8
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
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 may 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. Authorizes 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 may 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.
Authorizes 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 may 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 REENGROSSED
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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.
House Floor Amendments to the engrossed bill.
1. Modified provisions of law relative to legislative intent, the management of
mental and behavioral health services, funding priorities, innovative mental and
behavioral health programs, and the promulgation of rules by changing them
from mandatory to permissive.