Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S72 Compare Versions

Only one version of the bill is available at this time.

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2	2	SENATE DOCKET, NO. 965 FILED ON: 1/18/2023
3	3	SENATE . . . . . . . . . . . . . . No. 72
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Brendan P. Crighton
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act ensuring access to behavioral health services for children involved with state agencies.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Brendan P. CrightonThird Essex 1 of 9
16	16	SENATE DOCKET, NO. 965 FILED ON: 1/18/2023
17	17	SENATE . . . . . . . . . . . . . . No. 72
18	18	By Mr. Crighton, a petition (accompanied by bill, Senate, No. 72) of Brendan P. Crighton for
19	19	legislation to ensure access to behavioral health services for children involved with state
20	20	agencies. Children, Families and Persons with Disabilities.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Third General Court
24	24	(2023-2024)
25	25	_______________
26	26	An Act ensuring access to behavioral health services for children involved with state agencies.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Section 21 of chapter 19 of the General Laws, as appearing in the 2020
30	30	2Official Edition, is hereby amended by striking out the fifth sentence and inserting in place
31	31	3thereof the following two sentences:-
32	32	4 Pursuant to such agreements the department of mental health shall assume responsibility
33	33	5for individuals requiring specialized mental health services, including, but not limited to,
34	34	6inpatient mental health services, community-based acute treatment, intensive community-based
35	35	7acute treatment, mobile crisis intervention, intensive residential treatment programs, and crisis
36	36	8stabilization services. Pursuant to such agreements the department of mental health may assume
37	37	9responsibility for the provision of other non-mental health services to the department of
38	38	10developmental services.
39	39	11 SECTION 2. Section 33C of chapter 119 of the General Laws, as so appearing, is hereby
40	40	12amended by inserting after subsection (b) the following four new subsections: - 2 of 9
41	41	13 (c) The department, in consultation with the department of public health and the
42	42	14department of mental health, shall develop a model emergency response plan that includes both
43	43	15medical and behavioral health crisis response in order to promote best practices for congregate
44	44	16care settings, including clear guidelines for the roles and responsibilities of staff in congregate
45	45	17care settings, including but not limited to, protocols to access mobile crisis intervention, and,
46	46	18where applicable, youth crisis stabilization services, and community-based mental health
47	47	19providers; provided, however, that such model plan shall be designed to limit referrals to law
48	48	20enforcement in congregate care settings to cases in which an imminent risk of death or serious
49	49	21physical, emotional, or mental harm to individuals or damage to congregate care property
50	50	22necessitates such referral.
51	51	23 The model plan shall be made available to all congregate care settings, provided the
52	52	24department shall support the congregate care setting in adapting said plan for implementation. In
53	53	25developing the model plan, the department shall consult with the department of mental health,
54	54	26the department of public health, the executive office of health and human services, the office of
55	55	27the child advocate, and other relevant organizations that identify the essential components of an
56	56	28emergency response plan. The department shall biennially review and update the model plan,
57	57	29publicly post the model plan on its website, and provide technical assistance to congregate care
58	58	30settings to review and implement changes to model emergency response plan. The model plan
59	59	31shall include, but not be limited to, required access to training in behavioral health for staff in
60	60	32behavioral and mental health competencies, including, but not limited to, de-escalation
61	61	33strategies, trauma-informed, culturally, and linguistically congruent care, suicide prevention,
62	62	34peer support, and available resources and methods of outreach to non-clinical and clinical
63	63	35services related to behavioral and mental health. 3 of 9
64	64	36 (d) A congregate care program under contract to provide foster care to children in the
65	65	37care or custody of the department, in consultation with the department, shall ensure the
66	66	38implementation of an emergency response plan for said setting; provided the congregate care
67	67	39program may adapt the department’s model emergency response plan to fit the needs of the
68	68	40setting; provided further, the congregate care program shall biennially review the plan. The plan
69	69	41shall be made available to the department upon request.
70	70	42 (e) A child in the care or custody of the department has the right to return to their
71	71	43congregate care program under contract to provide foster care to children in the care or custody
72	72	44of the department following a medical or non-medical leave of absence if it is determined
73	73	45appropriate for the child to return to the congregate care setting. The department shall reimburse,
74	74	46at the prevailing rate of reimbursement, the congregate care program to hold the bed of a child
75	75	47for each day of their hospitalization or other leave of absence from the program.
76	76	48 (f) If a child requires care in another setting, including, but not limited to an emergency
77	77	49department visit or a stay in an inpatient setting, community behavioral health center, intensive
78	78	50community based acute treatment, community based acute treatment, or community crisis
79	79	51stabilization, a congregate care program, under contract to provide foster care to children in the
80	80	52care or custody of the department, shall not refuse to readmit a child living in that congregate
81	81	53care program after a medical or non-medical leave of absence, including an emergency or acute
82	82	54behavioral or psychiatric circumstance, provided that the child has been determined medically
83	83	55and psychiatrically stable and provided further, it is appropriate for the child to be discharged to
84	84	56return to their congregate care program. A congregate care program may deny readmission to a
85	85	57child whose needs have been determined by the program’s director or clinical director to exceed
86	86	58the program’s capability at the time readmission is sought; provided the program reports the 4 of 9
87	87	59denial of readmission of the child to said program to the department of children and families
88	88	60pursuant to section 33D. The determination shall be recorded in writing and shall include the
89	89	61factors justifying the denial and why mitigating efforts would have been inadequate to address
90	90	62the care needs of the child.
91	91	63 The congregate care program shall participate in the emergency team pursuant to section
92	92	6433D; provided further the department shall assume responsibility to coordinate care for the child.
93	93	65 SECTION 3. Chapter 119, as so appearing, is hereby amended by inserting after section
94	94	6633C, the following new section: -
95	95	67 33D. (a) The department of children and families shall collect data on the instances when
96	96	68a congregate care program, under contract to provide foster care to children in the care or
97	97	69custody of the department, denies to readmit a child after a circumstance requiring care in
98	98	70another setting, including, but not limited to an emergency department visit or a stay in an
99	99	71inpatient setting, community behavioral health center, intensive community based acute
100	100	72treatment, community based acute treatment, or community crisis stabilization. A congregate
101	101	73care program shall report to the department when it denies readmission to a child after a medical
102	102	74or non-medical leave of absence, including an emergency or acute behavioral or psychiatric
103	103	75circumstance. Such report shall include, but not be limited to, i) instances when a congregate
104	104	76care program denies readmission of a child following a medical or non-medical leave of absence,
105	105	77(ii) the underlying factors justifying denial of readmission of the child to a congregate care
106	106	78program, and (iii) why mitigating efforts would have been insufficient.
107	107	79 The department shall post to the department’s website, on a quarterly basis, a report on
108	108	80the data collected in this section. To the extent feasible, all data shall be disaggregated by race, 5 of 9
109	109	81ethnicity, gender identity, age and other demographic information. The department shall provide
110	110	82a copy of the report to the executive office of health and human services; the joint committee on
111	111	83mental health, substance use and recovery; and the joint committee on children, families and
112	112	84persons with disabilities.
113	113	85 (b) At the request of the congregate care program or the setting where the child is
114	114	86awaiting discharge from, the department shall convene an emergency team within two business
115	115	87days to conduct planning discussions to facilitate child placement in an appropriate setting. The
116	116	88emergency team shall include, but not be limited to, a representative from the child’s clinical
117	117	89care team, including, but not limited to, the team currently caring for the child; the child’s
118	118	90current behavioral health provider and primary care provider, as applicable; a representative of
119	119	91the relevant congregate care program; a representative of the department; and the child’s legal
120	120	92guardian, if applicable. If the team does not determine an appropriate placement within 7 days of
121	121	93convening, or earlier if the department deems additional state-agency involvement is necessary,
122	122	94the department may refer the child to the complex case resolution panel pursuant to section 16R
123	123	95of chapter 6A, as inserted by chapter 177 of the Acts of 2022, provided the department report to
124	124	96the panel a written summary of the team’s determination to refer the case to the complex case
125	125	97resolution panel.
126	126	98 SECTION 4. Notwithstanding any general or special law to the contrary, the department
127	127	99of children and families shall prepare a comprehensive plan to address access to behavioral and
128	128	100mental health services for individuals in their custody or care. The plan shall include, but not be
129	129	101limited to: (i) strategies to expand access to post-hospitalization settings, including but not
130	130	102limited to, services for transitional age youth, youth with complex behavioral health needs, youth
131	131	103with autism spectrum disorders, youth with intellectual or developmental disabilities, youth with 6 of 9
132	132	104co-occurring behavioral and substance use disorders, youth with co-occurring behavioral and
133	133	105medical needs, school-based services, and respite services; (ii) strategies to reduce the wait times
134	134	106for patients awaiting discharge so that the patients determined appropriate for congregate care,
135	135	107intensive residential treatment programs, community-based programs or other appropriate
136	136	108settings would be admitted to the appropriate setting within fourteen days of their application;
137	137	109and iii) strategies to facilitate care coordination between the department and local education
138	138	110agencies including, but not limited to, recommendations for streamlined communications
139	139	111between local and out-of-district schools, community partners, and other residential-educational
140	140	112settings. The department of children and families shall submit a copy of the plan, including any
141	141	113budgetary needs, to the executive office of health and human services; the clerks of the senate
142	142	114and house of representatives; the joint committee on mental health, substance use, and recovery,
143	143	115and; the joint committee on children, families, and persons with disabilities within 60 days of the
144	144	116effective date of this act.
145	145	117 SECTION 5. Notwithstanding any general or special law to the contrary, the department
146	146	118of developmental services shall prepare a comprehensive plan to address access to behavioral
147	147	119and mental health services for individuals in their custody or care. The plan shall include, but not
148	148	120be limited to: (i) strategies to expand access to post-hospitalization settings, including but not
149	149	121limited to, services for transitional age youth, youth with complex behavioral health needs, youth
150	150	122with autism spectrum disorders, youth with intellectual or developmental disabilities, youth with
151	151	123co-occurring behavioral and substance use disorders, youth with co-occurring behavioral and
152	152	124medical needs, school-based services, and respite services; (ii) strategies to reduce the wait times
153	153	125for patients awaiting discharge so that the patients determined appropriate for congregate care,
154	154	126intensive residential treatment programs, community-based programs or other appropriate 7 of 9
155	155	127settings would be admitted to the appropriate setting within fourteen days of their application;
156	156	128and iii) strategies to facilitate care coordination between the department and local education
157	157	129agencies including, but not limited to, recommendations for streamlined communications
158	158	130between local and out-of-district schools, community partners, and other residential-educational
159	159	131settings. The department of developmental services shall submit a copy of the plan, including
160	160	132any budgetary needs, to the executive office of health and human services; the clerks of the
161	161	133senate and house of representatives; the joint committee on mental health, substance use, and
162	162	134recovery, and; the joint committee on children, families, and persons with disabilities within 60
163	163	135days of the effective date of this act.
164	164	136 SECTION 6. There shall be a special commission established for the purposes of making
165	165	137an investigation and study relative to children and adolescents with intensive behavioral health
166	166	138needs whose behavioral health needs, such as acute aggressive, assaultive or otherwise unsafe
167	167	139behaviors, are not adequately addressed through inpatient psychiatric hospitalizations,
168	168	140community based acute treatment (CBAT) services, or existing residential or community
169	169	141treatment models contracted by the Department of Children and Families.
170	170	142 The Commission shall consist of 25 members or their designees: the Secretary of Health
171	171	143and Human Services or a designee, who shall serve as chair; the Commissioner of Public Health
172	172	144or a designee; the Commissioner of the Department of Children and Families or a designee; the
173	173	145Commissioner of the Department of Youth Services or a designee; the Commissioner of the
174	174	146Department of Developmental Service or a designee; the Commissioner of the Department of
175	175	147Early Education and Care or a designee; Chief Justice of the Juvenile Court Department or a
176	176	148designee; the Chairs of the Joint Committee on Mental Health, Substance Use and Recovery or
177	177	149their designees; the Chairs of the Joint Committee on Children, Families and Persons with 8 of 9
178	178	150Disabilities or their designees; a representative from the Office of the Child Advocate; a
179	179	151representative from the Association for Behavioral Healthcare, Inc.; a representative from the
180	180	152Massachusetts Health & Hospital Association; a representative from the Massachusetts
181	181	153Association of Behavioral Health Systems; a representative from the Children’s Mental Health
182	182	154Campaign; a representative from the Children’s League of Massachusetts; a representative from
183	183	155the Parent/Professional Advocacy League; a representative from the Massachusetts Behavioral
184	184	156Health Partnership; 6 members to be appointed by the chair, 2 of whom shall be a family
185	185	157member of a child or adolescent with behavioral health needs or who has been involved in the
186	186	158juvenile court system; 3 of whom shall be a behavioral health provider specializing in serving
187	187	159children and adolescents with intensive behavioral health needs; and 1 of whom shall be a
188	188	160clinician or researcher with expertise related to children and adolescents with intensive
189	189	161behavioral health needs. In making appointments, the Secretary shall, to the maximum extent
190	190	162feasible, ensure that the Commission represents a broad distribution of diverse perspectives and
191	191	163geographic regions.
192	192	164 The Commission shall: (i) create aggregate demographic and geographic profiles of
193	193	165children and adolescents with intensive behavioral health needs; (ii) examine the current
194	194	166availability of, and barriers to providing, behavioral health services and treatment to children and
195	195	167adolescents with intensive behavioral health needs; (iii) examine existing efforts undertaken by
196	196	168healthcare providers and the existing body of research around best practices for treating children
197	197	169and adolescents with intensive behavioral health needs; including, but not limited to models that
198	198	170promote community involvement and diversion from the juvenile court system; and (iv) examine
199	199	171other matters deemed appropriate by the Commission.
200	200	172 All appointments shall be made not later than 30 days after the effective date of this act. 9 of 9
201	201	173 The Commission shall submit its findings and recommendations to the Clerks of the
202	202	174Senate and the House of Representatives, the Joint Committee on Mental Health, Substance Use
203	203	175and Recovery, the Joint Committee on Children, Families and Persons with Disabilities and the
204	204	176Senate and House Committees on Ways and Means not later than January 1, 2024. The Secretary
205	205	177of Health and Human Services shall make the report publicly available on the website of the
206	206	178Executive Office of Health and Human Services.