HLS 18RS-205 ORIGINAL 2018 Regular Session HOUSE BILL NO. 148 BY REPRESENTATIVE FALCONER HEALTH/BEHAVIORAL: Provides for implementation of the zero suicide initiative and a state suicide prevention plan 1 AN ACT 2To enact Chapter 12 of Title 28 of the Louisiana Revised Statutes of 1950, to be comprised 3 of R.S. 28:801 through 813, relative to suicide prevention; to create and provide for 4 a program to be known as the zero suicide initiative; to provide for administration 5 of the program by the office of behavioral health of the Louisiana Department of 6 Health; to provide for creation of the Louisiana suicide prevention plan; to provide 7 for legislative findings and intent; to provide for promulgation of administrative 8 rules; and to provide for related matters. 9Be it enacted by the Legislature of Louisiana: 10 Section 1. Chapter 12 of Title 28 of the Louisiana Revised Statutes of 1950, 11comprised of R.S. 28:801 through 813, is hereby enacted to read as follows: 12 CHAPTER 12. SUICIDE PREVENTION 13 PART I. GENERAL PROVISIONS 14 §801. Short title 15 This Chapter shall be known and may be cited as the "Louisiana Suicide 16 Prevention Act". 17 §802. Definitions 18 For purposes of this Chapter, the following terms have the meaning ascribed 19 to them in this Section: Page 1 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 18RS-205 ORIGINAL HB NO. 148 1 (1) "America's Health Rankings report" means the annual report of that name 2 published by the United Health Foundation. 3 (2) "Department" means the Louisiana Department of Health. 4 (3) "Office of behavioral health" means the office of behavioral health of the 5 Louisiana Department of Health. 6 (4) "State suicide prevention plan" means the Louisiana suicide prevention 7 plan required by and provided for more specifically in Part III of this Chapter. 8 (5) "Suicide Prevention Resource Center" means the resource center of that 9 name operated by the Education Development Center, Incorporated, which is 10 devoted to advancing the National Strategy for Suicide Prevention. 11 (6) "Zero suicide initiative" means the program for suicide prevention 12 created by the provisions of Part II of this Chapter. 13 §803. Legislative findings and declaration; purpose 14 A. The legislature hereby finds and declares all of the following: 15 (1) An individual suicide is a tragic event, and suicide generally is now 16 recognized as a serious public health concern. 17 (2) According to the 2016 America's Health Rankings report, the number of 18 deaths due to suicide per one hundred thousand population in the United States rose 19 steadily from 2012 through 2016, and Louisiana's rate of deaths from suicide is 20 nearly ten percent higher than the national average. 21 (3) While suicide occurs among persons of all ages, ethnic backgrounds, and 22 income levels, it is an especially troubling problem among youth in Louisiana, with 23 suicide ranking as the second-leading cause of death in this state for persons between 24 the ages of ten and twenty-four in 2014, the most recent year for which complete 25 data is available. 26 (4) Suicide is a pronounced public health concern among military veterans 27 nationwide and in Louisiana particularly, as Louisiana's veteran suicide rate is over 28 ten percent higher than that of the nation and of the southern region. Page 2 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 18RS-205 ORIGINAL HB NO. 148 1 (5) Enhancing suicide awareness and prevention has been a priority of the 2 Legislature of Louisiana as evidenced by the final passage, or final adoption and 3 concurrence, of all of the following bills and concurrent resolutions: 4 (a) House Bill No. 452 of the 2017 Regular Session, providing for in-service 5 training on suicide prevention for teachers and other employees of nonpublic and 6 charter schools, as had previously been provided in law for teachers and other 7 employees of traditional public schools. 8 (b) Senate Bill No. 539 of the 2014 Regular Session, providing relative to 9 suicide assessment, intervention, treatment, and management training for several 10 health professions. 11 (c) House Concurrent Resolution No. 152 of the 2016 Regular Session, 12 recognizing the month of September as suicide prevention awareness month in this 13 state and urging greater awareness of the problem of suicide, particularly among 14 military veterans. 15 (d) Senate Concurrent Resolution No. 75 of the 2014 Regular Session, 16 requesting that the department develop a list of best-practice suicide prevention 17 training programs to make available for groups of professionals and citizens to take 18 voluntarily. 19 (e) House Concurrent Resolution No. 15 of the 2013 Regular Session, 20 requesting the department to study the most effective means by which to reduce the 21 rate of suicide in this state and report its findings to the legislative committees on 22 health and welfare. 23 (6) Healthcare settings, including mental and behavioral health systems, 24 primary care clinics, physical and mental health clinics in educational institutions, 25 and hospitals are valuable access points to reach those at risk for suicide. 26 (7) National data indicate all of the following: 27 (a) Over thirty percent of individuals are receiving mental health care at the 28 time of their deaths by suicide. Page 3 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 18RS-205 ORIGINAL HB NO. 148 1 (b) Approximately forty-five percent of persons who die by suicide have 2 seen a primary care physician within one month of their deaths, illustrating that 3 primary care is often the entry point into the health system for individuals who are 4 less likely to seek out mental health services. 5 (c) Approximately twenty-five percent of those who die of suicide visited an 6 emergency department in the month prior to their deaths. 7 (8) Healthcare facilities and providers including but not limited to mental 8 health professionals, behavioral health services providers, primary care providers, 9 and hospitals that have implemented a suicide prevention model such as that 10 provided for in Part II of this Chapter have noted significant reductions in suicide 11 deaths among patients within their care. 12 (9) Identifying and putting into practice an effective means of suicide 13 prevention such as that provided for in this Chapter is a vital public health priority 14 for this state. 15 B. The legislature hereby declares that the purpose of this Chapter is to 16 combat a dire public problem in this state by creating and providing for the zero 17 suicide initiative, a systems approach and national best practice for addressing 18 suicide as a public health issue. 19 §804. Sources of funding authorized 20 The office of behavioral health may receive and expend funds as may be 21 necessary to carry out the requirements of this Chapter, including but not limited to 22 funds appropriated by the legislature, including any appropriation of federal funds; 23 and any public or private donations, gifts, or grants from governmental sources, 24 individuals, corporations, nonprofit organizations, business entities, and any other 25 lawful source. Page 4 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 18RS-205 ORIGINAL HB NO. 148 1 PART II. ZERO SUICIDE INITIATIVE 2 §807. Zero suicide initiative; creation 3 A. The legislature hereby creates the zero suicide initiative, which shall be 4 administered by the office of behavioral health in accordance with the provisions of 5 this Part. 6 B. The legislature hereby declares that the zero suicide initiative embodies 7 the foundational belief and aspirational goal that suicide deaths of individuals who 8 are under the care of any part of the health system in this state, including providers 9 of mental health and behavioral health services, are frequently preventable. 10 C. The zero suicide initiative of this state shall be based upon the model set 11 forth in the National Strategy for Suicide Prevention published in 2012 by the United 12 States Surgeon General and further developed, refined, and promoted by the Suicide 13 Prevention Resource Center or its successor. 14 §808. Zero suicide initiative; administration; duties of the office of behavioral 15 health 16 A. In administering the zero suicide initiative, the office of behavioral health 17 shall ensure that the initiative incorporates, at minimum, all of the following 18 components as set forth by the zero suicide model of the Suicide Prevention 19 Resource Center: 20 (1) Leadership development. 21 (2) Healthcare provider training. 22 (3) Identification of suicide risk factors. 23 (4) Patient engagement. 24 (5) Treatment. 25 (6) Health system transition. 26 (7) Health system quality improvement. 27 B. The office of behavioral health shall ensure that administrators of all 28 healthcare facilities licensed by the department and that all healthcare professionals 29 licensed by any board or commission of the department have ready access to Page 5 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 18RS-205 ORIGINAL HB NO. 148 1 informational resources and technical assistance necessary for implementation of the 2 zero suicide initiative. 3 C.(1) Subject to the limitations of Paragraph (2) of this Subsection, the office 4 of behavioral health shall examine and coordinate the use of existing data to identify 5 priority groups of patients, improve the quality of care for persons who are suicidal, 6 and provide a basis for measuring progress in the ongoing operation of the zero 7 suicide initiative. 8 (2) The office of behavioral health shall carry out the requirements of 9 Paragraph (1) of this Subsection in a manner that protects the privacy of individuals, 10 and shall comply with all applicable state and federal laws and regulations relative 11 to privacy of health information. 12 D. The department shall promulgate all rules and regulations in accordance 13 with the Administrative Procedure Act as may be necessary to implement the 14 provisions of this Part. 15 §809. Legislative intent; stakeholder collaboration and coordination in the zero 16 suicide initiative 17 Because suicide in Louisiana is a primary public health concern, the 18 legislature intends that the office of behavioral health, state and local criminal justice 19 systems, healthcare facilities and providers including but not limited to mental health 20 professionals, behavioral health services providers, primary care providers, hospitals, 21 and physical and mental health clinics in educational institutions throughout this 22 state do all of the following: 23 (1) Work in collaboration to adopt and operate the zero suicide initiative as 24 promulgated in administrative rules of the department. 25 (2) Work with advocacy groups, faith-based organizations, and any other 26 entities with an interest in suicide prevention to support the adoption by health 27 systems in Louisiana of the suicide prevention plan provided for in Part III of this 28 Chapter. Page 6 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 18RS-205 ORIGINAL HB NO. 148 1 (3) Make efforts to connect persons and groups who are at higher risk for 2 suicide with services provided under the suicide prevention plan provided for in Part 3 III of this Chapter. 4 PART III. STATE SUICIDE PREVENTION PLAN 5 §811. State suicide prevention plan; creation; goals; publication; report to governor 6 and legislature 7 A. The Louisiana suicide prevention plan, referred to in this section as the 8 "state suicide prevention plan", is hereby created as an initiative of the office of 9 behavioral health, which shall lead the development of and publish the plan. The 10 goal and purpose of the state suicide prevention plan is to reduce the incidence of 11 suicide in Louisiana through system-level implementation of the plan in criminal 12 justice and health systems statewide, including mental health and behavioral health 13 systems. 14 B.(1) The office of behavioral health shall collaborate with criminal justice 15 and health systems, including mental health and behavioral health systems, primary 16 care providers, physical and mental health clinics in educational institutions, colleges 17 and universities, community mental health centers, advocacy groups, emergency 18 medical services professionals, public and private insurers, hospital chaplains, and 19 faith-based organizations to develop and implement all of the following: 20 (a) A plan to improve training on means by which to identify a person with 21 trends, attributes, and indicators of suicidal thoughts and behavior across criminal 22 justice and health systems. 23 (b) A plan to improve training on the provisions of the Health Insurance 24 Portability and Accountability Act (42 U.S.C. 1320d et seq.) and regulations issued 25 pursuant thereto; and on other applicable federal and state laws and regulations 26 concerning privacy of health information. 27 (c) Professional development resources and training opportunities regarding 28 indicators of suicidal thoughts and behavior, risk assessment, treatment, and 29 management. Page 7 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 18RS-205 ORIGINAL HB NO. 148 1 (2) The office of behavioral health shall include as elements within the state 2 suicide prevention plan the items required by Paragraph (1) of this Subsection. 3 C. As a demonstration of commitment to patient safety, criminal justice and 4 health systems, including mental and behavioral health systems, primary care 5 providers, and hospitals throughout the state are encouraged to contribute to and 6 implement the state suicide prevention plan. 7 D.(1) The office of behavioral health shall publish the state suicide 8 prevention plan on or before December 31, 2020. 9 (2) At the time of publication of the state suicide prevention plan, the office 10 of behavioral health shall transmit a summary of the plan in a report to the governor 11 and to the legislature. 12 §812. Stakeholder collaboration and coordination in suicide prevention plan 13 The legislature intends that the following systems and organizations 14 contribute to the development and implementation of the state suicide prevention 15 plan: 16 (1) Community mental health centers. 17 (2) Behavioral health services providers. 18 (3) Hospitals. 19 (4) Emergency medical services professionals and responders. 20 (5) Regional health systems. 21 (6) Physical and mental health clinics in educational institutions. 22 (7) State and local criminal justice systems. 23 (8) Advocacy groups with an interest in suicide prevention. 24 (9) Faith-based organizations. 25 (10) Colleges and universities. 26 §813. Administrative rulemaking 27 The department shall promulgate all rules and regulations in accordance with 28 the Administrative Procedure Act as may be necessary to implement the provisions 29 of this Part. Page 8 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 18RS-205 ORIGINAL HB NO. 148 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)] HB 148 Original 2018 Regular Session Falconer Abstract: Provides for implementation of the "zero suicide initiative", a state suicide prevention plan, and duties of the office of behavioral health of the La. Department of Health with respect to suicide prevention. General Provisions Proposed law provides legislative findings concerning suicide prevention, noting especially the problem of suicide among young people and military veterans, and provides the following declaration: The purpose of proposed law is to combat a dire public problem by creating and providing for the zero suicide initiative, a systems approach and national best practice for addressing suicide as a public health issue. Proposed law provides that it shall be known and may be cited as the "Louisiana Suicide Prevention Act". Zero Suicide Initiative Proposed law creates the zero suicide initiative to be administered by the office of behavioral health of the La. Department of Health (LDH) in accordance with the provisions of proposed law. Proposed law provides that the zero suicide initiative shall be based upon the model set forth in the National Strategy for Suicide Prevention published in 2012 by the U.S. Surgeon General and further developed by the Suicide Prevention Resource Center. Proposed law stipulates that in administering the zero suicide initiative, the office of behavioral health shall ensure that the initiative incorporates, at minimum, all of the following components as set forth by the zero suicide model of the Suicide Prevention Resource Center: (1)Leadership development. (2)Healthcare provider training. (3)Identification of suicide risk factors. (4)Patient engagement. (5)Treatment. (6)Health system transition. (7)Health system quality improvement. Proposed law requires the office of behavioral health to ensure that administrators of all healthcare facilities licensed by LDH and that all healthcare professionals licensed by any Page 9 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 18RS-205 ORIGINAL HB NO. 148 La. board or commission have ready access to informational resources and technical assistance necessary for implementation of the zero suicide initiative. Proposed law requires the office of behavioral health to examine and coordinate the use of existing data to identify priority groups of patients, improve the quality of care for persons who are suicidal, and provide a basis for measuring progress in the ongoing operation of the zero suicide initiative. Proposed law expresses the intent that La. healthcare providers do the following: (1)Work in collaboration to adopt and operate the zero suicide initiative as promulgated in administrative rules by LDH. (2)Work with advocacy groups, faith-based organizations, and any other entities with an interest in suicide prevention to support the adoption by health systems in La. of the suicide prevention plan provided for in proposed law. (3)Make efforts to connect persons and groups who are at higher risk for suicide with services provided under the suicide prevention plan established by proposed law . State Suicide Prevention Plan Proposed law requires the creation of the La. suicide prevention plan by the office of behavioral health. Proposed law provides that the goal and purpose of the La. suicide prevention plan is to reduce the incidence of suicide through system-level implementation of the plan in criminal justice and health systems statewide, including mental health and behavioral health systems. Proposed law provides that the office of behavioral health shall collaborate with criminal justice and health systems, including mental health and behavioral health systems, primary care providers, physical and mental health clinics in educational institutions, colleges and universities, community mental health centers, advocacy groups, emergency medical services professionals, public and private insurers, hospital chaplains, and faith-based organizations to develop and implement all of the following, which shall be included as elements within the state suicide prevention plan: (1)A plan to improve training on means by which to identify a person with trends, attributes, and indicators of suicidal thoughts and behavior across criminal justice and health systems. (2)A plan to improve training on the provisions of the federal Health Insurance Portability and Accountability Act and regulations issued pursuant thereto; and on other applicable federal and state laws and regulations concerning privacy of health information. (3)Professional development resources and training opportunities regarding indicators of suicidal thoughts and behavior, risk assessment, treatment, and management. Proposed law encourages criminal justice and health systems, including mental and behavioral health systems, primary care providers, and hospitals throughout the state to contribute to and implement the state suicide prevention plan. Proposed law requires the office of behavioral health to publish the state suicide prevention plan on or before Dec. 31, 2020. Provides that at the time of publication of the plan, the office shall transmit a summary of the plan in a report to the governor and to the legislature. Page 10 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 18RS-205 ORIGINAL HB NO. 148 Proposed law expresses the intent of the legislature that the following systems and organizations contribute to the development and implementation of the state suicide prevention plan: (1)Community mental health centers. (2)Behavioral health services providers. (3)Hospitals. (4)Emergency medical services professionals and responders. (5)Regional health systems. (6)Physical and mental health clinics in educational institutions. (7)State and local criminal justice systems. (8)Advocacy groups with an interest in suicide prevention. (9)Faith-based organizations. (10)Colleges and universities. (Adds R.S. 28:801-813) Page 11 of 11 CODING: Words in struck through type are deletions from existing law; words underscored are additions.