Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H213 Compare Versions

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

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2	2	HOUSE DOCKET, NO. 1297 FILED ON: 1/14/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 213
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Marjorie C. Decker
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 :DATE ADDED:Marjorie C. Decker25th Middlesex1/14/2025 1 of 9
16	16	HOUSE DOCKET, NO. 1297 FILED ON: 1/14/2025
17	17	HOUSE . . . . . . . . . . . . . . . No. 213
18	18	By Representative Decker of Cambridge, a petition (accompanied by bill, House, No. 213) of
19	19	Marjorie C. Decker relative to ensuring access to behavioral health services for children involved
20	20	with state agencies. Children, Families and Persons with Disabilities.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Fourth General Court
24	24	(2025-2026)
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 youth
36	36	8crisis stabilization services. Pursuant to such agreements the department of mental health may
37	37	9assume responsibility 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) Following a medical or non-medical leave of absence from a congregate care program
71	71	43under contract to provide foster care to children in the care or custody of the department, there
72	72	44shall be a presumption that the child will return to the congregate care program if it is determined
73	73	45that the program is appropriate to meet the needs of the child. The department shall reimburse, at
74	74	46the prevailing rate of reimbursement, the congregate care program to hold the bed of a child for
75	75	47each 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 youth 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 who has been determined appropriate for the
98	98	70program after a circumstance requiring care in another setting, including, but not limited to an
99	99	71emergency department visit or a stay in an inpatient setting, community behavioral health center,
100	100	72intensive community based acute treatment, community based acute treatment, or youth
101	101	73community crisis stabilization. A congregate care program shall report to the department when it
102	102	74denies readmission to a child after a medical or non-medical leave of absence, including an
103	103	75emergency or acute behavioral or psychiatric circumstance when the child has been determined
104	104	76appropriate for the program. Such report shall include, but not be limited to, i) instances when a
105	105	77congregate care program denies readmission of a child following a medical or non-medical leave
106	106	78of absence, (ii) the underlying factors justifying denial of readmission of the child to a
107	107	79congregate care program, and (iii) why mitigating efforts would have been insufficient. 5 of 9
108	108	80 The department shall post to the department’s website, on a quarterly basis, a report on
109	109	81the data collected in this section. To the extent feasible, all data shall be disaggregated by race,
110	110	82ethnicity, gender identity, age and other demographic information. The department shall provide
111	111	83a copy of the report to the executive office of health and human services; the joint committee on
112	112	84mental health, substance use and recovery; and the joint committee on children, families and
113	113	85persons with disabilities.
114	114	86 (b) At the request of the congregate care program or the setting where the child is
115	115	87awaiting discharge from, the department shall convene an emergency team within two business
116	116	88days to conduct planning discussions to facilitate child placement in an appropriate setting. The
117	117	89emergency team shall include, but not be limited to, a representative from the child’s clinical
118	118	90care team, including, but not limited to, the team currently caring for the child; the child’s
119	119	91current behavioral health provider and primary care provider, as applicable; a representative of
120	120	92the relevant congregate care program; a representative of the department; and the child’s legal
121	121	93guardian, if applicable. If the team does not determine an appropriate placement within 7 days of
122	122	94convening, or earlier if the department deems additional state-agency involvement is necessary,
123	123	95the department may refer the child to the complex case resolution panel pursuant to section 16R
124	124	96of chapter 6A, as inserted by chapter 177 of the Acts of 2022, provided the department report to
125	125	97the panel a written summary of the team’s determination to refer the case to the complex case
126	126	98resolution panel.
127	127	99 SECTION 4. Notwithstanding any general or special law to the contrary, the department
128	128	100of children and families shall prepare a comprehensive plan to address access to behavioral and
129	129	101mental health services for individuals in their custody or care. The plan shall include, but not be
130	130	102limited to: (i) strategies to expand access to post-hospitalization settings, including but not 6 of 9
131	131	103limited to, services for transitional age youth, youth with complex behavioral health needs, youth
132	132	104with autism spectrum disorders, youth with intellectual or developmental disabilities, youth with
133	133	105co-occurring behavioral and substance use disorders, youth with co-occurring behavioral and
134	134	106medical needs, school-based services, and respite services; (ii) strategies to reduce the wait times
135	135	107for patients awaiting discharge so that the patients determined appropriate for congregate care,
136	136	108intensive residential treatment programs, community-based programs or other appropriate
137	137	109settings would be admitted to the appropriate setting within fourteen days of their application;
138	138	110and iii) strategies to facilitate care coordination between the department and local education
139	139	111agencies including, but not limited to, recommendations for streamlined communications
140	140	112between local and out-of-district schools, community partners, and other residential-educational
141	141	113settings. The department of children and families shall submit a copy of the plan, including any
142	142	114budgetary needs, to the executive office of health and human services; the clerks of the senate
143	143	115and house of representatives; the joint committee on mental health, substance use, and recovery,
144	144	116and; the joint committee on children, families, and persons with disabilities within 60 days of the
145	145	117effective date of this act.
146	146	118 SECTION 5. Notwithstanding any general or special law to the contrary, the department
147	147	119of developmental services shall prepare a comprehensive plan to address access to behavioral
148	148	120and mental health services for individuals in their custody or care. The plan shall include, but not
149	149	121be limited to: (i) strategies to expand access to post-hospitalization settings, including but not
150	150	122limited to, services for transitional age youth, youth with complex behavioral health needs, youth
151	151	123with autism spectrum disorders, youth with intellectual or developmental disabilities, youth with
152	152	124co-occurring behavioral and substance use disorders, youth with co-occurring behavioral and
153	153	125medical needs, school-based services, and respite services; (ii) strategies to reduce the wait times 7 of 9
154	154	126for patients awaiting discharge so that the patients determined appropriate for congregate care,
155	155	127intensive residential treatment programs, community-based programs or other appropriate
156	156	128settings would be admitted to the appropriate setting within fourteen days of their application;
157	157	129and iii) strategies to facilitate care coordination between the department and local education
158	158	130agencies including, but not limited to, recommendations for streamlined communications
159	159	131between local and out-of-district schools, community partners, and other residential-educational
160	160	132settings. The department of developmental services shall submit a copy of the plan, including
161	161	133any budgetary needs, to the executive office of health and human services; the clerks of the
162	162	134senate and house of representatives; the joint committee on mental health, substance use, and
163	163	135recovery, and; the joint committee on children, families, and persons with disabilities within 60
164	164	136days of the effective date of this act.
165	165	137 SECTION 6. There shall be a special commission established for the purposes of making
166	166	138an investigation and study relative to children and adolescents with intensive behavioral health
167	167	139needs whose behavioral health needs, such as acute aggressive, assaultive or otherwise unsafe
168	168	140behaviors, are not adequately addressed through inpatient psychiatric hospitalizations,
169	169	141community based acute treatment (CBAT) services, youth crisis stabilization, or existing
170	170	142residential or community treatment models contracted by the Department of Children and
171	171	143Families.
172	172	144 The Commission shall consist of 25 members or their designees: the Secretary of Health
173	173	145and Human Services or a designee, who shall serve as chair; the Commissioner of Public Health
174	174	146or a designee; the Commissioner of the Department of Children and Families or a designee; the
175	175	147Commissioner of the Department of Youth Services or a designee; the Commissioner of the
176	176	148Department of Developmental Service or a designee; the Commissioner of the Department of 8 of 9
177	177	149Early Education and Care or a designee; Chief Justice of the Juvenile Court Department or a
178	178	150designee; the Chairs of the Joint Committee on Mental Health, Substance Use and Recovery or
179	179	151their designees; the Chairs of the Joint Committee on Children, Families and Persons with
180	180	152Disabilities or their designees; a representative from the Office of the Child Advocate; a
181	181	153representative from the Association for Behavioral Healthcare, Inc.; a representative from the
182	182	154Massachusetts Health & Hospital Association; a representative from the Massachusetts
183	183	155Association of Behavioral Health Systems; a representative from the Children’s Mental Health
184	184	156Campaign; a representative from the Children’s League of Massachusetts; a representative from
185	185	157the Parent/Professional Advocacy League; a representative from the Massachusetts Behavioral
186	186	158Health Partnership; 6 members to be appointed by the chair, 2 of whom shall be a family
187	187	159member of a child or adolescent with behavioral health needs or who has been involved in the
188	188	160juvenile court system; 3 of whom shall be a behavioral health provider specializing in serving
189	189	161children and adolescents with intensive behavioral health needs; and 1 of whom shall be a
190	190	162clinician or researcher with expertise related to children and adolescents with intensive
191	191	163behavioral health needs. In making appointments, the Secretary shall, to the maximum extent
192	192	164feasible, ensure that the Commission represents a broad distribution of diverse perspectives and
193	193	165geographic regions.
194	194	166 The Commission shall: (i) create aggregate demographic and geographic profiles of
195	195	167children and adolescents with intensive behavioral health needs; (ii) examine the current
196	196	168availability of, and barriers to providing, behavioral health services and treatment to children and
197	197	169adolescents with intensive behavioral health needs; (iii) examine existing efforts undertaken by
198	198	170healthcare providers and the existing body of research around best practices for treating children
199	199	171and adolescents with intensive behavioral health needs; including, but not limited to models that 9 of 9
200	200	172promote community involvement and diversion from the juvenile court system; and (iv) examine
201	201	173other matters deemed appropriate by the Commission.
202	202	174 All appointments shall be made not later than 30 days after the effective date of this act.
203	203	175 The Commission shall submit its findings and recommendations to the Clerks of the
204	204	176Senate and the House of Representatives, the Joint Committee on Mental Health, Substance Use
205	205	177and Recovery, the Joint Committee on Children, Families and Persons with Disabilities and the
206	206	178Senate and House Committees on Ways and Means not later than January 1, 2026. The Secretary
207	207	179of Health and Human Services shall make the report publicly available on the website of the
208	208	180Executive Office of Health and Human Services.