Louisiana 2018 2018 Regular Session

Louisiana House Bill HB148 Engrossed / Bill

                    HLS 18RS-205	REENGROSSED
2018 Regular Session
HOUSE BILL NO. 148
BY REPRESENTATIVES FALCONER, ANDERS, BACALA, BAGLEY, BAGNERIS,
BILLIOT, BRASS, TERRY BROWN, CARMODY, GARY CARTER, CHANEY,
COX, DEVILLIER, EDMONDS, EMERSON, FOIL, GISCLAIR, HENRY,
HODGES, HORTON, JACKSON, LEGER, LYONS, MCFARLAND, GREGORY
MILLER, POPE, REYNOLDS, RICHARD, SIMON, AND STAGNI
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".
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1 §802.  Definitions
2	For purposes of this Chapter, the following terms have the meaning ascribed
3 to them in this Section:
4	(1)  "America's Health Rankings report" means the annual report of that name
5 published by the United Health Foundation.
6	(2)  "Department" means the Louisiana Department of Health.
7	(3)  "Office of behavioral health" means the office of behavioral health of the
8 Louisiana Department of Health.
9	(4)  "State suicide prevention plan" means the Louisiana suicide prevention
10 plan required by and provided for more specifically in Part III of this Chapter.
11	(5)  "Suicide Prevention Resource Center" means the resource center of that
12 name operated by the Education Development Center, Incorporated, which is
13 devoted to advancing the National Strategy for Suicide Prevention.
14	(6)  "Zero suicide initiative" means the program for suicide prevention
15 created by the provisions of Part II of this Chapter.
16 §803.  Legislative findings and declaration; purpose
17	A.  The legislature hereby finds and declares all of the following:
18	(1)  An individual suicide is a tragic event, and suicide generally is now
19 recognized as a serious public health concern.
20	(2)  According to the 2016 America's Health Rankings report, the number of
21 deaths due to suicide per one hundred thousand population in the United States rose
22 steadily from 2012 through 2016, and Louisiana's rate of deaths from suicide is
23 nearly ten percent higher than the national average.
24	(3)  While suicide occurs among persons of all ages, ethnic backgrounds, and
25 income levels, it is an especially troubling problem among youth in Louisiana, with
26 suicide ranking as the second-leading cause of death in this state for persons between
27 the ages of ten and twenty-four in 2014, the most recent year for which complete
28 data is available.
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1	(4)  Suicide is a pronounced public health concern among military veterans
2 nationwide and in Louisiana particularly, as Louisiana's veteran suicide rate is over
3 ten percent higher than that of the nation and of the southern region.
4	(5)  Enhancing suicide awareness and prevention has been a priority of the
5 Legislature of Louisiana as evidenced by the final passage, or final adoption and
6 concurrence, of all of the following bills and concurrent resolutions:
7	(a)  House Bill No. 452 of the 2017 Regular Session, providing for in-service
8 training on suicide prevention for teachers and other employees of nonpublic and
9 charter schools, as had previously been provided in law for teachers and other
10 employees of traditional public schools.
11	(b)  Senate Bill No. 539 of the 2014 Regular Session, providing relative to
12 suicide assessment, intervention, treatment, and management training for several
13 health professions.
14	(c)  House Concurrent Resolution No. 152 of the 2016 Regular Session,
15 recognizing the month of September as suicide prevention awareness month in this
16 state and urging greater awareness of the problem of suicide, particularly among
17 military veterans.
18	(d)  Senate Concurrent Resolution No. 75 of the 2014 Regular Session,
19 requesting that the department develop a list of best practice suicide prevention
20 training programs to make available for groups of professionals and citizens to take
21 voluntarily.
22	(e)  House Concurrent Resolution No. 15 of the 2013 Regular Session,
23 requesting the department to study the most effective means by which to reduce the
24 rate of suicide in this state and report its findings to the legislative committees on
25 health and welfare.
26	(6)  Healthcare settings, including mental and behavioral health systems,
27 primary care clinics, physical and mental health clinics in educational institutions,
28 and hospitals are valuable access points to reach those at risk for suicide.
29	(7)  National data indicate all of the following:
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1	(a)  Over thirty percent of individuals are receiving mental health care at the
2 time of their deaths by suicide.
3	(b)  Approximately forty-five percent of persons who die by suicide have
4 seen a primary care physician within one month of their deaths, illustrating that
5 primary care is often the entry point into the health system for individuals who are
6 less likely to seek out mental health services.
7	(c)  Approximately twenty-five percent of those who die by suicide visited
8 an emergency department in the month prior to their deaths.
9	(8)  Healthcare facilities and providers including but not limited to mental
10 health professionals, behavioral health services providers, primary care providers,
11 and hospitals that have implemented a suicide prevention model such as that
12 provided for in Part II of this Chapter have noted significant reductions in suicide
13 deaths among patients within their care.
14	(9)  Identifying and putting into practice an effective means of suicide
15 prevention such as that provided for in this Chapter is a vital public health priority
16 for this state.
17	B.  The legislature hereby declares that the purpose of this Chapter is to
18 combat a dire public problem in this state by creating and providing for the zero
19 suicide initiative, a systems approach and national best practice for addressing
20 suicide as a public health issue.
21 §804.  Sources of funding authorized
22	The office of behavioral health may receive and expend funds as may be
23 necessary to carry out the requirements of this Chapter, including but not limited to
24 funds appropriated by the legislature, including any appropriation of federal funds;
25 and any public or private donations, gifts, or grants from governmental sources,
26 individuals, corporations, nonprofit organizations, business entities, and any other
27 lawful source.
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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
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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.
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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.
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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.
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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 Reengrossed 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
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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.
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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)
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