THE SENATE

S.B. NO.

2019

THIRTY-FIRST LEGISLATURE, 2022

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

relating to behavioral health services.

 

 

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

 


     SECTION 1.  The purpose of this Act is to:

     (1)  Require the department of health to establish 9-8-8 call centers that meet certain minimum requirements and to adopt administrative rules;

     (2)  Require the department of health to establish crisis response teams that meet certain requirements;

     (3)  Create funding mechanisms for crisis and intervention services;

     (4)  Establish a 9-8-8 fee to fund the services created by this Act;

     (5)  Establish a board to oversee and implement the services created by this Act;

     (6)  Require the department of health to set a timeline to accomplish the services created by this Act; and

     (7)  Establish the 9-8-8 special fund.

     SECTION 2.  As used in this Act, unless the context requires otherwise:

     "9-8-8 administrator" means the administrator of the 9-8-8 suicide prevention and mental health crisis hotline.

     "9-8-8 crisis hotline center" means a state-identified center participating in the National Suicide Prevention Lifeline network to respond to statewide or regional 9-8-8 contacts.

     "9-8-8 suicide prevention and mental health crisis hotline" means the National Suicide Prevention Lifeline or its successor maintained by the Assistant Secretary for Mental Health and Substance Use pursuant to section 520E–3 of the Public Health Service Act, P.L. 78-410.

     "Community mental health centers" or "certified community behavioral health centers" means facilities as defined under section 1913(c) of the Public Health Services Act, P.L. 78-410 or section 223(d) of the Protecting Access to Medicare Act of 2014, P.L. 113-93.

     "Crisis receiving and stabilization services" means facilities providing less than twenty-four hours of service with capacity for diagnosis, initial management, observation, crisis stabilization, and follow up referral services to all persons in a home-like environment.

     "Mobile crisis teams" means behavioral health professionals and peers that provide professional onsite community-based intervention such as de-escalation, and stabilization for individuals who are experiencing a behavioral health crisis.

     "Peer" means an individual employed on the basis of the individual's personal lived experience of mental illness or addiction and recovery who meet the State's peer certification requirements, where applicable.

     SECTION 3.  (a)  Before July 1, 2023, the department of health shall designate at least one 9-8-8 crisis hotline center  located in the State to provide crisis intervention services and crisis care coordination to individuals accessing the 9-8-8 suicide prevention and behavioral health crisis hotline, twenty-four hours a day, seven days a week.

     (b)  Any designated 9-8-8 crisis hotline center shall:

     (1)  Have an active agreement with the 9-8-8 administrator for participation within the network;

     (2)  Meet National Suicide Prevention Lifeline requirements and best practices guidelines for operational and clinical standards;

     (3)  Participate in evaluations and related quality improvement activities, and report and provide data as required by the 9-8-8 administrator;

     (4)  Utilize technology, including chat and text, that is interoperable between and across crisis and emergency response systems used throughout the State and with the 9-8-8 administrator;

     (5)  Have the authority to deploy crisis and outgoing services, including mobile crisis teams, and coordinate access to crisis receiving and stabilization services or other local resources as appropriate and according to guidelines and best practices established by the National Suicide Prevention Lifeline;

     (6)  Collaborate with mental health and substance use disorder treatment providers, including hospital emergency departments and inpatient psychiatric settings; local community mental health centers, including certified community behavioral health clinics and community behavioral health centers; crisis receiving and stabilization centers; and mobile crisis teams throughout the State to coordinate linkages for persons contacting 9-8-8 with ongoing care needs, and establishing formal agreements where appropriate;

     (7)  Coordinate access to crisis receiving and stabilization services for individuals accessing the 9-8-8 suicide prevention and behavioral health crisis hotline through appropriate information sharing regarding availability of services;

     (8)  Meet the requirements set forth by National Suicide Prevention Lifeline for serving high risk and specialized populations as identified by the federal Substance Abuse and Mental Health Services Administration, including training requirements and policies for transferring callers to an appropriate specialized center or subnetworks within or external to the National Suicide Prevention Lifeline network, including LGBTQ youth, minorities, rural individuals, and other high-risk populations well as those with co‑occurring substance use, and for providing linguistically and culturally competent care; and

     (9)  Provide follow-up services to individuals accessing the 9-8-8 suicide prevention and behavioral health crisis hotline consistent with guidance and policies established by the National Suicide Prevention Lifeline.

     (c)  The department of health shall adopt rules, pursuant to chapter 91, Hawaii Revised Statutes, to allow appropriate information sharing and communication between and across crisis and emergency response systems for the purpose of real-time crisis care coordination, including deployment of crisis and outgoing services and linked, flexible services specific to crisis response.

     (d)  The department of health shall work in concert with the National Suicide Prevention Lifeline and the Veterans Crisis Line to ensure consistent public messaging about 9-8-8 services.

     (e)  The department of health shall submit an annual report to the legislature and the federal Substance Abuse and Mental Health Services Administration no later than twenty days prior to the convening of each regular session regarding the 9-8-8 suicide prevention and behavioral health crisis hotline's usage and services provided.

     SECTION 4.  The department of health shall provide onsite response services to crisis calls utilizing state or locally funded mobile crisis teams.  The mobile crisis teams shall:

     (1)  Include at least one peer and either a licensed behavioral health professional or a behavioral health team embedded in emergency medical services;

     (2)  Collaborate with local law enforcement agencies and include police as co-responders in behavioral health teams only as needed to respond in high-risk situations that cannot be managed without law enforcement;

     (3)  Be designed in partnership with community members, including people with lived experience utilizing crisis services;

     (4)  Be staffed by personnel that reflect the demographics of the community served; and

     (5)  Collect customer service data from individuals served by demographic requirements, including race and ethnicity, as set forth by the federal Substance Abuse and Mental Health Services Administration and consistent with the state block grant requirements for continuous evaluation and quality improvement.

     SECTION 5.  The department of health shall fund treatment for crisis receiving and stabilization services as follows:

     (1)  Crisis receiving and stabilization services as related to the call shall be funded by the State if the individual meets the State’s definition of uninsured or if the crisis stabilization service is not a covered service by the individual's health coverage;

     (2)  For Medicaid recipients, the state Medicaid office shall work with the entity responsible for the development of crisis receiving and stabilization services to explore options for appropriate coding of and payment for crisis management services; and

     (3)  The State shall determine how payment will be made to the provider of service.

     SECTION 6.  The department of health, in compliance with the National Suicide Hotline Designation Act of 2020, P.L. 116-172, shall establish a monthly statewide 9-8-8 fee on each resident that is a subscriber of commercial landline telephone, mobile telephone, or internet protocol-enabled voice services at a rate that provides for the creation, operation, and maintenance of a statewide 9-8-8 suicide prevention and behavioral health crisis system and the continuum of services provided pursuant to national guidelines for crisis services.  The fee may be adjusted as needed to provide for continuous operation, volume increases and maintenance.  The revenue generated by a 9-8-8 fee shall be deposited into the 9-8-8 special fund established pursuant to section 334-  , Hawaii Revised Statutes, to be obligated or expended only in support of 9–8–8 services, or enhancements of such services.

     SECTION 7.  The department of health shall create boards or committees or assign tasks to existing agencies, boards, or committees to accomplish the planning required for the implementation or ongoing oversight of this Act in coordination with any designated 9-8-8 crisis hotline center, 9-1-1 center, law enforcement, hospital emergency departments, the National Suicide Prevention Lifeline, and the department's alcohol and drug abuse and adult mental health divisions.

     SECTION 8.  The department of health shall establish timeframes to accomplish the provisions of this Act that are consistent with the timeframes required by the National Suicide Hotline Designation Act of 2020 and the Federal Communication Commission’s rules adopted on July 16, 2020.

     SECTION 9.  Chapter 334, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§334-    9-8-8 special fund.  (a)  There is established the 9-8-8 special fund into which shall be deposited:

     (1)  Fees derived from the statewide 9-8-8 assessment on subscribers of commercial landline telephone, mobile telephone, or internet protocol-enabled voice services;

     (2)  Appropriations made by the legislature;

     (3)  Grants and gifts intended for deposit in the fund;

     (4)  Interest, premiums, gains, or other earnings on the fund; and

     (5)  Moneys from any other source that is deposited in or transferred to the fund.

     (b)  All moneys deposited into the special fund shall be expended by the department of health to be used exclusively to offset costs that are reasonably attributed to:

     (1)  Ensuring the efficient and effective routing of calls made to the 9-8-8 suicide prevention and behavioral health crisis hotline to any designated 9-8-8 crisis hotline center, including staffing and technological infrastructure enhancements necessary to achieve operational and clinical standards and best practices set forth by the National Suicide Prevention Lifeline;

     (2)  Personnel, including recruitment of personnel that reflect the demographics of the community served; specialized training of staff to serve at-risk communities, including culturally and linguistically competent services for LGBTQ+, racially, ethnically, and linguistically diverse communities; and the provision of acute behavioral health and crisis outreach and stabilization services by directly responding to the 9–8–8 suicide prevention and mental health crisis hotline;

     (3)  Provision of data, reporting, participation in evaluations, and related quality improvement activities as required by the 9-8-8 administrator; and

     (4)  Administration, oversight and evaluation of the fund."

     SECTION 10.  New statutory material is underscored.

     SECTION 11.  This Act shall take effect upon its approval.

 

INTRODUCED BY:

_____________________________

 

 


 


 

Report Title:

Behavioral Health; Crisis Services; Mental Health; 9-8-8 Hotline

 

Description:

Requires the Department of Health to establish 9-8-8 call centers that meet certain minimum requirements and to adopt administrative rules.  Requires the Department of Health to establish crisis response teams that meet certain requirements.  Creates funding mechanisms for crisis and intervention services.  Establishes a 9-8-8 fee to fund the services created by this Act.  Establishes a board to oversee and implement the services created by this Act.  Requires the Department of Health to set a timeline to accomplish the services created by this Act.  Establishes the 9-8-8 special fund.

 

 

 

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