Louisiana 2013 2013 Regular Session

Louisiana House Bill HB281 Chaptered / Bill

                    ENROLLED
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ACT No. 308
Regular Session, 2013
HOUSE BILL NO. 281
BY REPRESENTATIVE SIMON
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
AN ACT1
To amend and reenact R.S. 40:2006(A)(2)(b), (B)(2)(e), and (E)(2)(b), to enact Part IV-A2
of Chapter 11 of Title 40 of the Louisiana Revised Statutes of 1950, to be comprised3
of R.S. 40:2151 through 2161, and to repeal R.S. 28:567 through 573 and Part XIII4
of Chapter 4 of Title 40 of the Louisiana Revised Statutes of 1950, comprised of R.S.5
40:1058.1 through 1058.10, relative to behavioral health services providers; to6
provide for definitions; to provide for applicability; to establish a behavioral health7
services providers license; to provide rulemaking authority; to provide for license8
issuance and renewal; to require a licensing fee; to prohibit operating without a9
license; to provide for penalties and remedies; to provide for opioid treatment10
programs; to provide for right of inspection; to provide for drug-free zones; to repeal11
provisions relative to the licensing of mental health clinics; to repeal provisions12
relative to the licensing of substance abuse/addiction treatment facilities; to provide13
for effective dates; and to provide for related matters.14
Be it enacted by the Legislature of Louisiana:15
Section 1. R.S. 40:2006(A)(2)(b), (B)(2)(e), and (E)(2)(b) are hereby amended and16
reenacted and Part IV-A of Chapter 11 of Title 40 of the Louisiana Revised Statutes of 1950,17
comprised of R.S. 40:2151 through 2161, is hereby enacted to read as follows:18
§2006.  Fees; licenses; penalties19
A.20
*          *          *21
(2)  This Subsection shall apply to any licensed:22
*          *          *23 ENROLLEDHB NO. 281
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(b)  Substance abuse/addiction treatment facility.  Behavioral health services1
provider.2
*          *          *3
B.4
*          *          *5
(2)  This Subsection shall apply to any licensed:6
*          *          *7
(e)  Substance abuse/addiction treatment facility.  Behavioral health services8
provider.9
*          *          *10
E.11
*          *          *12
(2)  This Subsection shall apply to any licensed:13
*          *          *14
(b)  Substance abuse/addiction treatment facility.  Behavioral health services15
provider.16
*          *          *17
PART IV-A.   LICENSING OF BEHAVIORAL HEALTH SERVICES PROVIDERS18
§2151.  Short title19
This Part may be cited as the "Behavioral Health Services Provider Licensing20
Law". 21
§2152.  Purpose22
The purpose of this Part is to authorize the Department of Health and23
Hospitals to promulgate and publish rules and regulations to provide for integrated24
behavioral health services under one license, to provide for the health, safety, and25
welfare of persons receiving behavioral health services, and to provide for the safe26
operation and maintenance of providers and facilities providing such care.27 ENROLLEDHB NO. 281
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§2153.  Definitions1
For the purposes of this Part, and subject to the provisions of R.S. 40:2154,2
unless the context otherwise clearly indicates, the following terms shall have the3
following meanings:4
(1) "Behavioral health services" means mental health services, substance5
abuse/addiction treatment services, or a combination of such services, for adults and6
children.  Behavioral health services may be provided in a residential setting, in a7
clinic setting on an outpatient basis, or in a home or community setting. 8
(2) "Behavioral health services provider" means a facility, agency,9
institution, person, society, corporation, partnership, unincorporated association,10
group, or other legal entity that provides behavioral health services and that presents11
itself to the public as a provider of behavioral health services.12
(3) "Client" means any person who has been accepted for treatment or13
services, including rehabilitation services, furnished by a provider licensed pursuant14
to this Part.15
(4)  "Department" means the Department of Health and Hospitals or any16
office or agency thereof designated by the secretary to administer the provisions of17
this Part. 18
(5) "Financial viability" means the provider or facility seeking licensure is19
able to provide verification and continuous maintenance of all of the following:20
(a) A line of credit issued from a federally insured, licensed lending21
institution in the amount of at least fifty thousand dollars.22
(b) General and professional liability insurance of at least five hundred23
thousand dollars.24
(c)  Workers' compensation insurance. 25
(6) "License" means a license issued by the department to a behavioral26
health services provider. 27
(7) "Licensed Mental Health Professional (LMHP)" means an individual28
who is currently licensed and in good standing in the state of Louisiana to practice29 ENROLLEDHB NO. 281
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within the scope of all applicable state laws, practice acts, and the individual's1
professional license, as one of the following:2
(a)  Medical psychologist.3
(b)  Licensed psychologist.4
(c)  Licensed clinical social worker (LCSW).5
(d)  Licensed professional counselor (LPC).6
(e)  Licensed marriage and family therapist (LMFT).7
(f)  Licensed addiction counselor (LAC).8
(g)  Licensed Advanced Practice Registered Nurse (APRN).9
(h)  Licensed rehabilitation counselor (LRC).10
(8) "Mental health service" means a service related to the screening,11
diagnosis, management, or treatment of a mental disorder, mental illness, or other12
psychological or psychiatric condition or problem. 13
(9) "Outpatient services" means behavioral health services offered in an14
accessible nonresidential setting to clients whose physical and emotional status15
allows them to function in their usual environment. 16
(10) "Physician" means an individual who is currently licensed and in good17
standing in the state of Louisiana to practice medicine in Louisiana and who is acting18
within the scope of all applicable state laws and the individual's professional license.19
(11) "Physician assistant" means an individual who is currently approved and20
licensed by and in good standing with the Louisiana State Board of Medical21
Examiners to perform medical services under the supervision of a physician or group22
of physicians who are licensed by and registered with the Louisiana State Board of23
Medical Examiners to supervise a physician assistant, and who is acting within the24
scope of all applicable state laws and the individual's professional license.25
(12) "Secretary" means the secretary of the Department of Health and26
Hospitals or his designee.27
(13) "Standards" means policies, procedures, rules, and other guidelines or28
standards of current practice contained in this Part, in addition to those rules and29 ENROLLEDHB NO. 281
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standards promulgated by the department for the licensing and operation of1
behavioral health service providers. 2
(14) "Substance abuse/addiction treatment service" means a service related3
to the screening, diagnosis, management, or treatment for the abuse of or addiction4
to controlled dangerous substances, drugs or inhalants, alcohol, problem gambling,5
or a combination thereof.6
§2154.  Applicability7
The provisions of this Part shall not apply to the licensing of any of the8
following facilities or persons and shall not be construed as requiring any of the9
following facilities or persons to seek licensure as a behavioral health services10
provider:11
(1)  Hospitals licensed under R.S. 40:2100 et seq.12
(2)  Crisis receiving centers licensed under R.S.  40:2180.11 et seq. 13
(3)  Nursing homes licensed under R.S. 40:2009.3 et seq.14
(4) Psychiatric residential treatment facilities or therapeutic group homes15
licensed under R.S. 40:2009.16
(5)  Facilities or services operated by the federal government.17
(6) Federally qualified health care centers certified by the federal18
government. 19
(7)  Community mental health centers certified by the federal government.20
(8)  Home- and community-based service providers licensed under R.S.21
40:2120.1 et seq.22
(9)  An individual Licensed Mental Health Professional (LMHP), whether23
incorporated or unincorporated, or a group practice of LMHPs, providing services24
under the auspices of and pursuant to the scope of the individual's license or group's25
licenses.26
(10) An individual licensed physician, or a group of licensed physicians,27
providing services under the auspices of and pursuant to the scope of the individual's28
license or group's licenses.29 ENROLLEDHB NO. 281
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(11) An individual licensed physician assistant, or a group practice of1
licensed physician assistants, providing services under the auspices of and pursuant2
to the scope of the individual's license or group's licenses.3
(12) School-based health clinics/centers that are certified by the Department4
of Health and Hospitals, office of public health, and enrolled in the Louisiana5
Medicaid Program.6
(13) A health care provider or entity solely providing case management or7
peer support services, or a combination thereof.8
(14)  A health care provider that meets all of the following criteria:9
(a) Was an accredited mental health rehabilitation provider enrolled in the10
Louisiana Medicaid Program as of February 28, 2012.11
(b) Was enrolled with the statewide management organization for the12
Louisiana Behavioral Health Partnership as of March 1, 2012.13
(c) Maintains continuous, uninterrupted accreditation through an approved14
accreditation organization.15
(d)  Maintains continuous, uninterrupted enrollment with the statewide16
management organization for the Louisiana Behavioral Health Partnership.17
(15) An individual licensed advanced practice registered nurse, or a group18
practice of licensed advanced practice registered nurses, providing services under the19
auspices of and pursuant to the scope of the individual's license or group's licenses.20
(16)  Rural health clinics licensed under R.S. 40:2197. 21
(17)  Facilities or services operated by the Department of Public Safety and22
Corrections, corrections services.23
§2155.  Licensure of behavioral health services providers24
A. All behavioral health services providers shall be licensed.  No facility,25
agency, institution, person, society, corporation, partnership, unincorporated26
association, group, or other legal entity providing behavioral health services may be27
established, operated, or reimbursed under the Medicaid program unless licensed as28
a behavioral health services provider to perform such care by the department.29 ENROLLEDHB NO. 281
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B. A license issued to a behavioral health services provider shall be valid for1
only one geographic location and shall be issued only for the person and premises2
named in the license application.3
C. A license pursuant to this Part shall be valid for twelve months, beginning4
the month of issuance, unless revoked or otherwise suspended prior to that date. 5
D. A license issued pursuant to this Part shall be on a form prescribed by the6
department. 7
E. A license pursuant to this Part shall not be transferrable or assignable.8
F.  A license issued to a behavioral health services provider shall be posted9
in a conspicuous place on the licensed premises. 10
G. A license issued to a behavioral health services provider shall list the11
types or modules of behavioral health services that the provider is licensed to12
provide. 13
§2156.  Rules and regulations; licensing standards; fees14
A. The department shall promulgate and publish rules, regulations, and15
licensing standards, in accordance with the Administrative Procedure Act, to provide16
for the licensure of behavioral health services providers, to provide for the health,17
safety, and welfare of persons receiving care and services from providers, and to18
provide for the safe operation and maintenance of providers. The rules, regulations,19
and licensing standards shall become effective upon approval of the secretary of the20
department in accordance with the Administrative Procedure Act.  The rules,21
regulations, and licensing standards shall have the effect of law. 22
B. The department shall prescribe, promulgate, and publish rules,23
regulations, and licensing standards. The rules, regulations, and licensing standards24
shall include but are not limited to the following:25
(1) Licensure application and renewal application forms, procedures, and26
requirements.27
(2)  Operational and personnel requirements.28
(3)  Practice standards to assure quality of care.29 ENROLLEDHB NO. 281
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(4) Practice standards to assure the health, safety, welfare, and comfort of1
persons receiving care and services.2
(5)  Confidentiality of clients' records.3
(6)  Treatment priorities, as well as residential and outpatient criteria.4
(7) Criteria and protocols to assure uniform and quality assessment,5
diagnosis, evaluation, and referral to appropriate level of care. 6
(8) Survey and complaint investigations, including investigations into7
allegations that a provider is operating without a license.8
(9) Initial and annual renewal of license, including the requirement of9
providing verification and continuous maintenance of financial viability for all10
behavioral health services providers other than those owned by governmental11
entities.12
(10)  Provisional licenses.13
(11) Denial, revocation, suspension, and nonrenewal of licenses, and the14
appeals therefrom.15
(12) Planning, construction, and design of the facility or provider to ensure16
the health, safety, welfare, and comfort of persons receiving care and services. 17
(13) Modules of behavioral health services providers with varying levels or18
types of services.   The modules for behavioral health services providers shall19
include at a minimum: 20
(a)  Mental Health Services Module.21
(b)  Substance Abuse/Addiction Treatment Module.22
(14)  Requirements for offsite or branch locations.23
(15) Other regulations or standards as will ensure proper care and treatment24
of persons receiving care and services, including provisions relative to civil25
monetary penalties, as may be deemed necessary for an effective administration of26
this Part. 27
C. The department shall have the authority to monitor, survey, and regulate28
mental health clinics and substance abuse/addiction treatment facilities under the29
existing licensing regulations for the programs until the department publishes30 ENROLLEDHB NO. 281
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minimum licensing standards for behavioral health services providers and the time1
for all existing licensed mental health clinics and substance abuse/addiction2
treatment facilities to apply for the behavioral health services provider license has3
expired. 4
§2157.  License issuance; application; onsite inspection5
A. Each application for licensure of a behavioral health services provider6
shall be submitted to the department on forms prescribed by the department and shall7
contain such information as the department may require.  Additional information8
required by the department shall be provided by the applicant as requested.9
B. Each application for licensure and each license renewal application shall10
be accompanied by a nonrefundable license fee in the amount required pursuant to11
R.S. 40:2006.12
C. Following receipt of the completed initial licensing application and13
licensing fee, the department shall perform an onsite survey and inspection.  If, after14
the onsite survey and inspection, the department finds that the provider meets the15
requirements established under this Part and under the licensing standards adopted16
pursuant to this Part, a license shall be issued. 17
D. As a condition for renewal of license, the licensee shall submit to the18
department a completed annual renewal application on the forms prescribed by the19
department, which shall contain all information required by the department.20
Additionally, the annual renewal licensing fee shall be submitted with the annual21
renewal application. Upon receipt of the completed annual renewal application and22
the annual renewal licensing fee, the department shall determine if the facility23
continues to meet the requirements established under this Part and under the24
licensing standards adopted pursuant to this Part. The department may perform an25
onsite survey and inspection upon annual renewal.  If the provider continues to meet26
the requirements established under this Part and under the licensing standards27
adopted pursuant to this Part, a license shall be issued which shall be valid for up to28
one year, unless otherwise revoked or suspended. 29 ENROLLEDHB NO. 281
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E. The department may perform an onsite inspection at reasonable times as1
necessary to ensure compliance with this Part. 2
§2158.  Operation without license; penalty3
A. A behavioral health services provider shall not operate without a license4
issued by the department.  Any provider or facility operating without a license shall5
be guilty of a misdemeanor and upon conviction shall be fined no less than two6
hundred fifty dollars nor more than one thousand dollars. Each day of violation shall7
constitute a separate offense.  It shall be the responsibility of the department to8
inform the appropriate district attorney of the alleged violation to assure9
enforcement.10
B. If a behavioral health services provider is operating without a license11
issued by the department, the department shall have the authority to issue an12
immediate cease and desist order to that provider.  Any such provider receiving such13
a cease and desist order from the department shall immediately cease operations until14
such time as that provider is issued a license by the department.15
C. The department shall seek an injunction in the Nineteenth Judicial District16
Court against any provider who receives a cease and desist order from the17
department under Subsection B of this Section and who does not cease operations18
immediately.  Any provider against whom an injunction is granted shall be liable to19
the department for attorney fees, costs, and damages. 20
§2159.  Opioid treatment programs 21
The department shall not license any opioid treatment programs under the22
behavioral health services provider license unless the department, in its discretion,23
determines that there is a need for another opioid treatment program in a certain24
geographic location.  The department has promulgated and adopted rules and25
regulations in accordance with the Administrative Procedure Act to provide for the26
criteria and processes for determining whether such a need exists and the procedures27
for selecting an opioid treatment program to be licensed once a need has been28
determined.29 ENROLLEDHB NO. 281
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§2160.  Right of inspection by department; records; reports1
A. Every behavioral health services provider that has applied for a license2
or that is licensed pursuant to this Part shall be open at all reasonable times for3
inspection by the department, the state fire marshal, municipal boards of health, and4
any other authorized governmental entity. 5
B. Every licensee shall keep all records and make all reports as the6
department shall prescribe, and all records shall be open to inspection by the7
department or other authorized governmental entity. 8
§2161. Drug free zone; notice, signs9
A. A drug free zone is an area inclusive of any property used as a behavioral10
health services provider that has a substance abuse/addiction treatment module, or11
within two thousand feet of such property.  12
B. The local governing authority which has jurisdiction over zoning matters13
in which each drug free zone is located shall publish a map clearly indicating the14
boundaries of each drug free zone in accordance with the specifications in15
Subsection A of this Section.  The drug free zone map shall be made on an official16
public document and placed with the clerk of court for the parish or parishes in17
which the drug free zone is located.18
C.(1) The secretary of the Department of Health and Hospitals shall develop19
a method by which to mark drug free zones, including the use of signs or other20
markings suitable to the situation.  Signs or other markings shall be located in a21
visible manner on or near each behavioral health services provider that has a22
substance abuse/addiction treatment module, indicating that the area is a drug free23
zone, that the zone extends for a distance of two thousand feet, and that a felony24
violation of the Uniform Controlled Dangerous Substances Law will subject the25
offender to severe penalties under law.  The posting required in this Subsection is26
the responsibility and at the expense of the licensed provider. 27
(2) The Department of Public Safety and Corrections shall coordinate and28
provide rules for the establishment of toll free telephone numbers for use in29
submitting anonymous information regarding drug activity to local law enforcement30 ENROLLEDHB NO. 281
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agencies. The telephone numbers shall be displayed on the drug free zone signs that1
shall be manufactured in correctional institutions subject to the office of corrections2
in the Department of Public Safety and Corrections. 3
D.(1)  It shall be unlawful for any person to cover, remove, deface, alter, or4
destroy any sign or other marking identifying a drug free zone as provided in this5
Section.6
(2) Any violation of this Subsection shall be punishable by a fine of not more7
than one thousand dollars or by a jail sentence of not more than six months, or both.8
Section 2. R.S. 28:567 through 573 and Part XIII of Chapter 4 of Title 40 of the9
Louisiana Revised Statutes of 1950, comprised of R.S. 40:1058.1 through 1058.10, are10
hereby repealed in their entirety.11
Section 3. The provisions of R.S. 40:2006(A)(2)(b), (B)(2)(e), and (E)(2)(b) as12
enacted under the provisions of this Act and Section 2 of this Act shall become effective13
upon promulgation and publication by the Department of Health and Hospitals of the final14
rules for the Behavioral Health Services Provider license.  15
Section 4. The provisions of R.S. 40:2151 through 2161 as enacted under the16
provisions of this Act and Sections 3 and 4 of this Act shall become effective upon signature17
by the governor or, if not signed by the governor, upon expiration of the time for bills to18
become law without signature by the governor, as provided by Article III, Section 18 of the19
Constitution of Louisiana. If vetoed by the governor and subsequently approved by the20
legislature, this Act shall become effective on the day following such approval.21
SPEAKER OF THE HOUSE OF REPRESENTATI VES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED: