Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S111 Compare Versions

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

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1	1	1 of 1
2	2	SENATE DOCKET, NO. 1716 FILED ON: 1/16/2025
3	3	SENATE . . . . . . . . . . . . . . No. 111
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. 1716 FILED ON: 1/16/2025
17	17	SENATE . . . . . . . . . . . . . . No. 111
18	18	By Mr. Crighton, a petition (accompanied by bill, Senate, No. 111) 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	[SIMILAR MATTER FILED IN PREVIOUS SESSION
22	22	SEE SENATE, NO. 72 OF 2023-2024.]
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Fourth General Court
26	26	(2025-2026)
27	27	_______________
28	28	An Act ensuring access to behavioral health services for children involved with state agencies.
29	29	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
30	30	of the same, as follows:
31	31	1 SECTION 1. Section 21 of chapter 19 of the General Laws, as appearing in the 2020
32	32	2Official Edition, is hereby amended by striking out the fifth sentence and inserting in place
33	33	3thereof the following two sentences:-
34	34	4 Pursuant to such agreements the department of mental health shall assume responsibility
35	35	5for individuals requiring specialized mental health services, including, but not limited to,
36	36	6inpatient mental health services, community-based acute treatment, intensive community-based
37	37	7acute treatment, mobile crisis intervention, intensive residential treatment programs, and youth
38	38	8crisis stabilization services. Pursuant to such agreements the department of mental health may
39	39	9assume responsibility for the provision of other non-mental health services to the department of
40	40	10developmental services. 2 of 9
41	41	11 SECTION 2. Section 33C of chapter 119 of the General Laws, as so appearing, is hereby
42	42	12amended by inserting after subsection (b) the following four new subsections:-
43	43	13 (c) The department, in consultation with the department of public health and the
44	44	14department of mental health, shall develop a model emergency response plan that includes both
45	45	15medical and behavioral health crisis response in order to promote best practices for congregate
46	46	16care settings, including clear guidelines for the roles and responsibilities of staff in congregate
47	47	17care settings, including but not limited to, protocols to access mobile crisis intervention, and,
48	48	18where applicable, youth crisis stabilization services, and community-based mental health
49	49	19providers; provided, however, that such model plan shall be designed to limit referrals to law
50	50	20enforcement in congregate care settings to cases in which an imminent risk of death or serious
51	51	21physical, emotional, or mental harm to individuals or damage to congregate care property
52	52	22necessitates such referral.
53	53	23 The model plan shall be made available to all congregate care settings, provided the
54	54	24department shall support the congregate care setting in adapting said plan for implementation. In
55	55	25developing the model plan, the department shall consult with the department of mental health,
56	56	26the department of public health, the executive office of health and human services, the office of
57	57	27the child advocate, and other relevant organizations that identify the essential components of an
58	58	28emergency response plan. The department shall biennially review and update the model plan,
59	59	29publicly post the model plan on its website, and provide technical assistance to congregate care
60	60	30settings to review and implement changes to model emergency response plan. The model plan
61	61	31shall include, but not be limited to, required access to training in behavioral health for staff in
62	62	32behavioral and mental health competencies, including, but not limited to, de-escalation
63	63	33strategies, trauma-informed, culturally, and linguistically congruent care, suicide prevention, 3 of 9
64	64	34peer support, and available resources and methods of outreach to non-clinical and clinical
65	65	35services related to behavioral and mental health.
66	66	36 (d) A congregate care program under contract to provide foster care to children in the
67	67	37care or custody of the department, in consultation with the department, shall ensure the
68	68	38implementation of an emergency response plan for said setting; provided the congregate care
69	69	39program may adapt the department’s model emergency response plan to fit the needs of the
70	70	40setting; provided further, the congregate care program shall biennially review the plan. The plan
71	71	41shall be made available to the department upon request.
72	72	42 (e) Following a medical or non-medical leave of absence from a congregate care program
73	73	43under contract to provide foster care to children in the care or custody of the department, there
74	74	44shall be a presumption that the child will return to the congregate care program if it is determined
75	75	45that the program is appropriate to meet the needs of the child. The department shall reimburse, at
76	76	46the prevailing rate of reimbursement, the congregate care program to hold the bed of a child for
77	77	47each day of their hospitalization or other leave of absence from the program.
78	78	48 (f) If a child requires care in another setting, including, but not limited to an emergency
79	79	49department visit or a stay in an inpatient setting, community behavioral health center, intensive
80	80	50community based acute treatment, community based acute treatment, or youth community crisis
81	81	51stabilization, a congregate care program, under contract to provide foster care to children in the
82	82	52care or custody of the department, shall not refuse to readmit a child living in that congregate
83	83	53care program after a medical or non-medical leave of absence, including an emergency or acute
84	84	54behavioral or psychiatric circumstance, provided that the child has been determined medically
85	85	55and psychiatrically stable and provided further, it is appropriate for the child to be discharged to 4 of 9
86	86	56return to their congregate care program. A congregate care program may deny readmission to a
87	87	57child whose needs have been determined by the program’s director or clinical director to exceed
88	88	58the program’s capability at the time readmission is sought; provided the program reports the
89	89	59denial of readmission of the child to said program to the department of children and families
90	90	60pursuant to section 33D. The determination shall be recorded in writing and shall include the
91	91	61factors justifying the denial and why mitigating efforts would have been inadequate to address
92	92	62the care needs of the child.
93	93	63 The congregate care program shall participate in the emergency team pursuant to section
94	94	6433D; provided further the department shall assume responsibility to coordinate care for the child.
95	95	65 SECTION 3. Chapter 119, as so appearing, is hereby amended by inserting after section
96	96	6633C, the following new section:-
97	97	67 33D. (a) The department of children and families shall collect data on the instances when
98	98	68a congregate care program, under contract to provide foster care to children in the care or
99	99	69custody of the department, denies to readmit a child who has been determined appropriate for the
100	100	70program after a circumstance requiring care in another setting, including, but not limited to an
101	101	71emergency department visit or a stay in an inpatient setting, community behavioral health center,
102	102	72intensive community based acute treatment, community based acute treatment, or youth
103	103	73community crisis stabilization. A congregate care program shall report to the department when it
104	104	74denies readmission to a child after a medical or non-medical leave of absence, including an
105	105	75emergency or acute behavioral or psychiatric circumstance when the child has been determined
106	106	76appropriate for the program. Such report shall include, but not be limited to, i) instances when a
107	107	77congregate care program denies readmission of a child following a medical or non-medical leave 5 of 9
108	108	78of absence, (ii) the underlying factors justifying denial of readmission of the child to a
109	109	79congregate care program, and (iii) why mitigating efforts would have been insufficient.
110	110	80 The department shall post to the department’s website, on a quarterly basis, a report on
111	111	81the data collected in this section. To the extent feasible, all data shall be disaggregated by race,
112	112	82ethnicity, gender identity, age and other demographic information. The department shall provide
113	113	83a copy of the report to the executive office of health and human services; the joint committee on
114	114	84mental health, substance use and recovery; and the joint committee on children, families and
115	115	85persons with disabilities.
116	116	86 (b) At the request of the congregate care program or the setting where the child is
117	117	87awaiting discharge from, the department shall convene an emergency team within two business
118	118	88days to conduct planning discussions to facilitate child placement in an appropriate setting. The
119	119	89emergency team shall include, but not be limited to, a representative from the child’s clinical
120	120	90care team, including, but not limited to, the team currently caring for the child; the child’s
121	121	91current behavioral health provider and primary care provider, as applicable; a representative of
122	122	92the relevant congregate care program; a representative of the department; and the child’s legal
123	123	93guardian, if applicable. If the team does not determine an appropriate placement within 7 days of
124	124	94convening, or earlier if the department deems additional state-agency involvement is necessary,
125	125	95the department may refer the child to the complex case resolution panel pursuant to section 16R
126	126	96of chapter 6A, as inserted by chapter 177 of the Acts of 2022, provided the department report to
127	127	97the panel a written summary of the team’s determination to refer the case to the complex case
128	128	98resolution panel. 6 of 9
129	129	99 SECTION 4. Notwithstanding any general or special law to the contrary, the department
130	130	100of children and families shall prepare a comprehensive plan to address access to behavioral and
131	131	101mental health services for individuals in their custody or care. The plan shall include, but not be
132	132	102limited to: (i) strategies to expand access to post-hospitalization settings, including but not
133	133	103limited to, services for transitional age youth, youth with complex behavioral health needs, youth
134	134	104with autism spectrum disorders, youth with intellectual or developmental disabilities, youth with
135	135	105co-occurring behavioral and substance use disorders, youth with co-occurring behavioral and
136	136	106medical needs, school-based services, and respite services; (ii) strategies to reduce the wait times
137	137	107for patients awaiting discharge so that the patients determined appropriate for congregate care,
138	138	108intensive residential treatment programs, community-based programs or other appropriate
139	139	109settings would be admitted to the appropriate setting within fourteen days of their application;
140	140	110and iii) strategies to facilitate care coordination between the department and local education
141	141	111agencies including, but not limited to, recommendations for streamlined communications
142	142	112between local and out-of-district schools, community partners, and other residential-educational
143	143	113settings. The department of children and families shall submit a copy of the plan, including any
144	144	114budgetary needs, to the executive office of health and human services; the clerks of the senate
145	145	115and house of representatives; the joint committee on mental health, substance use, and recovery,
146	146	116and; the joint committee on children, families, and persons with disabilities within 60 days of the
147	147	117effective date of this act.
148	148	118 SECTION 5. Notwithstanding any general or special law to the contrary, the department
149	149	119of developmental services shall prepare a comprehensive plan to address access to behavioral
150	150	120and mental health services for individuals in their custody or care. The plan shall include, but not
151	151	121be limited to: (i) strategies to expand access to post-hospitalization settings, including but not 7 of 9
152	152	122limited to, services for transitional age youth, youth with complex behavioral health needs, youth
153	153	123with autism spectrum disorders, youth with intellectual or developmental disabilities, youth with
154	154	124co-occurring behavioral and substance use disorders, youth with co-occurring behavioral and
155	155	125medical needs, school-based services, and respite services; (ii) strategies to reduce the wait times
156	156	126for patients awaiting discharge so that the patients determined appropriate for congregate care,
157	157	127intensive residential treatment programs, community-based programs or other appropriate
158	158	128settings would be admitted to the appropriate setting within fourteen days of their application;
159	159	129and iii) strategies to facilitate care coordination between the department and local education
160	160	130agencies including, but not limited to, recommendations for streamlined communications
161	161	131between local and out-of-district schools, community partners, and other residential-educational
162	162	132settings. The department of developmental services shall submit a copy of the plan, including
163	163	133any budgetary needs, to the executive office of health and human services; the clerks of the
164	164	134senate and house of representatives; the joint committee on mental health, substance use, and
165	165	135recovery, and; the joint committee on children, families, and persons with disabilities within 60
166	166	136days of the effective date of this act.
167	167	137 SECTION 6. There shall be a special commission established for the purposes of making
168	168	138an investigation and study relative to children and adolescents with intensive behavioral health
169	169	139needs whose behavioral health needs, such as acute aggressive, assaultive or otherwise unsafe
170	170	140behaviors, are not adequately addressed through inpatient psychiatric hospitalizations,
171	171	141community based acute treatment (CBAT) services, youth crisis stabilization, or existing
172	172	142residential or community treatment models contracted by the Department of Children and
173	173	143Families. 8 of 9
174	174	144 The Commission shall consist of 25 members or their designees: the Secretary of Health
175	175	145and Human Services or a designee, who shall serve as chair; the Commissioner of Public Health
176	176	146or a designee; the Commissioner of the Department of Children and Families or a designee; the
177	177	147Commissioner of the Department of Youth Services or a designee; the Commissioner of the
178	178	148Department of Developmental Service or a designee; the Commissioner of the Department of
179	179	149Early Education and Care or a designee; Chief Justice of the Juvenile Court Department or a
180	180	150designee; the Chairs of the Joint Committee on Mental Health, Substance Use and Recovery or
181	181	151their designees; the Chairs of the Joint Committee on Children, Families and Persons with
182	182	152Disabilities or their designees; a representative from the Office of the Child Advocate; a
183	183	153representative from the Association for Behavioral Healthcare, Inc.; a representative from the
184	184	154Massachusetts Health & Hospital Association; a representative from the Massachusetts
185	185	155Association of Behavioral Health Systems; a representative from the Children’s Mental Health
186	186	156Campaign; a representative from the Children’s League of Massachusetts; a representative from
187	187	157the Parent/Professional Advocacy League; a representative from the Massachusetts Behavioral
188	188	158Health Partnership; 6 members to be appointed by the chair, 2 of whom shall be a family
189	189	159member of a child or adolescent with behavioral health needs or who has been involved in the
190	190	160juvenile court system; 3 of whom shall be a behavioral health provider specializing in serving
191	191	161children and adolescents with intensive behavioral health needs; and 1 of whom shall be a
192	192	162clinician or researcher with expertise related to children and adolescents with intensive
193	193	163behavioral health needs. In making appointments, the Secretary shall, to the maximum extent
194	194	164feasible, ensure that the Commission represents a broad distribution of diverse perspectives and
195	195	165geographic regions. 9 of 9
196	196	166 The Commission shall: (i) create aggregate demographic and geographic profiles of
197	197	167children and adolescents with intensive behavioral health needs; (ii) examine the current
198	198	168availability of, and barriers to providing, behavioral health services and treatment to children and
199	199	169adolescents with intensive behavioral health needs; (iii) examine existing efforts undertaken by
200	200	170healthcare providers and the existing body of research around best practices for treating children
201	201	171and adolescents with intensive behavioral health needs; including, but not limited to models that
202	202	172promote community involvement and diversion from the juvenile court system; and (iv) examine
203	203	173other matters deemed appropriate by the Commission.
204	204	174 All appointments shall be made not later than 30 days after the effective date of this act.
205	205	175 The Commission shall submit its findings and recommendations to the clerks of the
206	206	176senate and the house of representatives, the joint committee on mental health, substance use and
207	207	177recovery, the joint committee on children, families and persons with disabilities and the senate
208	208	178and house committees on ways and means not later than January 1, 2026. The secretary of health
209	209	179and human services shall make the report publicly available on the website of the executive
210	210	180office of health and human services.