THE SENATE

S.B. NO.

1465

THIRTIETH LEGISLATURE, 2019

S.D. 2

STATE OF HAWAII

H.D. 1

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO TREATMENT INSURANCE BENEFITS.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


SECTION 1. Section 431M-4, Hawaii Revised Statutes, is amended to read as follows:

"431M-4 Mental illness, alcohol and drug dependence, and assisted community treatment benefits. (a) Alcohol and drug dependence benefits shall be as follows:

(1) Detoxification services as a covered benefit under this chapter shall be provided either in a hospital or in a nonhospital facility that has a written affiliation agreement with a hospital for emergency, medical, and mental health support services. The following services shall be covered under detoxification services:

(A) Room and board;

(B) Diagnostic x-rays;

(C) Laboratory testing; and

(D) Drugs, equipment use, special therapies, and supplies.

Detoxification services shall be included as part of the covered in-hospital services;

(2) Alcohol or drug dependence treatment through in-hospital, nonhospital residential, or day treatment substance abuse services as a covered benefit under this chapter shall be provided in a hospital or nonhospital facility. Before a person qualifies to receive benefits under this subsection, a qualified physician, psychologist, licensed clinical social worker, licensed marriage and family therapist, licensed mental health counselor, or advanced practice registered nurse shall determine that the person suffers from alcohol or drug dependence, or both; provided that the substance abuse services covered under this paragraph shall include those services that are required for licensure and accreditation. Excluded from alcohol or drug dependence treatment under this subsection are detoxification services and educational programs to which drinking or drugged drivers are referred by the judicial system and services performed by mutual self-help groups;

(3) Alcohol or drug dependence outpatient services as a covered benefit under this chapter shall be provided under an individualized treatment plan approved by a qualified physician, psychologist, licensed clinical social worker, licensed marriage and family therapist, licensed mental health counselor, or advanced practice registered nurse and shall be services reasonably expected to produce remission of the patient's condition. An individualized treatment plan approved by a licensed marriage and family therapist, licensed mental health counselor, licensed clinical social worker, or an advanced practice registered nurse for a patient already under the care or treatment of a physician or psychologist shall be done in consultation with the physician or psychologist; and

(4) Substance abuse assessments for alcohol or drug dependence as a covered benefit under this section for a child facing disciplinary action under section 302A‑1134.6 shall be provided by a qualified physician, psychologist, licensed clinical social worker, advanced practice registered nurse, or certified substance abuse counselor. The certified substance abuse counselor shall be employed by a hospital or nonhospital facility providing substance abuse services. The substance abuse assessment shall evaluate the suitability for substance abuse treatment and placement in an appropriate treatment setting.

(b) Mental illness benefits.

(1) Covered benefits for mental health services set forth in this subsection shall be limited to coverage for diagnosis and treatment of mental disorders. All mental health services shall be provided under an individualized treatment plan approved by a physician, psychologist, licensed clinical social worker, licensed marriage and family therapist, licensed mental health counselor, advanced practice registered nurse, or licensed dietitian treating eating disorders, and must be reasonably expected to improve the patient's condition. An individualized treatment plan approved by a licensed clinical social worker, licensed marriage and family therapist, licensed mental health counselor, advanced practice registered nurse, or a licensed dietitian treating eating disorders, for a patient already under the care or treatment of a physician or psychologist shall be done in consultation with the physician or psychologist;

(2) In-hospital and nonhospital residential mental health services as a covered benefit under this chapter shall be provided in a hospital or a nonhospital residential facility. The services to be covered shall include those services required for licensure and accreditation;

(3) Mental health partial hospitalization as a covered benefit under this chapter shall be provided by a hospital or a mental health outpatient facility. The services to be covered under this paragraph shall include those services required for licensure and accreditation; and

(4) Mental health outpatient services shall be a covered benefit under this chapter.

(c) Covered benefits for assisted community treatment benefits set forth in this subsection shall cover the costs incurred by:

(1) A licensed psychiatrist or other mental health professional, including an advanced practice registered nurse, in preparing a certificate of examination to accompany a petition for a hearing for assisted community treatment pursuant to section 334‑123(b); and

(2) A licensed psychiatrist in conducting a psychiatric examination or presenting the findings of the examination at a hearing for assisted community treatment pursuant to section 334-126(h)."

SECTION 2. (a) There is established an assisted community treatment benefits task force within the department of health for administrative purposes to consist of the following members:

(1) The director of the department of health or the director's designee, who shall serve as the co-chair of the task force;

(2) The director of the department of human services or the director's designee, who shall serve as the co-chair of the task force;

(3) A representative from a homelessness advocacy group, to be nominated jointly by the co-chairs of the task force;

(4) A representative from a mental health advocacy group, to be nominated jointly by the co-chairs of the task force; and

(5) A representative from a substance abuse treatment advocacy group, to be nominated jointly by the co-chairs of the task force.

(b) The task force shall investigate the payment and costs for assisted community treatment. The investigation shall include, but not be limited to:

(1) The cost of obtaining a licensed psychiatrist or other mental health professional to prepare a certificate of examination to accompany a petition for a hearing for assisted community treatment;

(2) The cost of conducting a psychiatric examination or presenting of the findings of the examination at a hearing for assisted community treatment;

(3) The delivery mechanisms for assisted community treatment, including mechanisms for petitioning for assisted community treatment for indigent or homeless populations; and

(4) Possible grant mechanisms to ensure the needs of individuals and families are adequately met.

(c) The task force shall submit a report of its findings and recommendations, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2020.

(d) The task force shall serve until it has accomplished the purpose of this Act or twenty days prior to the convening of the regular session of 2020, whichever occurs first.

(e) The members of the task force shall serve without compensation, but shall be reimbursed by the department of health for necessary expenses, including travel expenses, incurred for service on the task force. No member of the task force shall be made subject to section 84-17, Hawaii Revised Statutes, solely because of that member's participation on the task force. The task force shall be exempt from chapter 92, Hawaii Revised Statutes.

SECTION 3. Section 23-51, Hawaii Revised Statutes, shall not apply to this Act.

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect on July 1, 2050.



 

Report Title:

Mental Health and Alcohol and Substance Use Disorder Treatment Insurance Benefits; Assisted Community Treatment

 

Description:

Requires health insurance policies and plan contracts to cover certain expenses related to petitions and hearings for persons obtaining assisted community treatment. Establishes task force to study assisted community treatment benefit costs. (SB1465 HD1)

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.