HP0975
LD 1367
Session - 126th Maine Legislature
C "A", Filing Number H-717, Sponsored by
LR 1550
Item 2
Bill Tracking, Additional Documents Chamber Status

Amend the bill by striking out the title and substituting the following:

‘An Act To Decrease Costs and Disability Due to Mental Illness in Children, Adolescents and Young Adults’

Amend the bill by striking out everything after the enacting clause and before the summary and inserting the following:

Sec. 1. 22 MRSA §3174-XX  is enacted to read:

§ 3174-XX Mental and behavioral health services for children, adolescents and young adults

The department shall provide reimbursement under the MaineCare program for care coordination and assertive community treatment services for eligible persons who are 26 years of age or under who meet the criteria for a psychiatric diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, published by the American Psychiatric Association and experience significant impairment in function as determined by a licensed mental health provider. For the purposes of this section, "assertive community treatment services" means self-contained services with a fixed point of responsibility for providing treatment, counseling, vocational and educational rehabilitation and support services to eligible persons who are 26 years of age or under and their families for whom other community-based treatment approaches have been unsuccessful. In accordance with the assertive community treatment scale developed by Dartmouth College, assertive community treatment uses principles of care coordination, chronic illness management and evidence-based therapies to minimize fragmentation of care and maximize care coordination for persons whose symptoms of mental illness result in serious functioning difficulties in multiple areas of life, including family relationships, social relationships, education, employment, residential independence, medical health, substance abuse and psychotropic medication management. Assertive community treatment is provided by multidisciplinary teams who are on duty 24 hours per day, 7 days per week; a team includes a psychiatrist, a registered psychiatric nurse, licensed clinical social workers, community support workers and vocational and educational specialists and may include a peer recovery specialist or a substance abuse counselor.

Sec. 2. 24-A MRSA §4320-I  is enacted to read:

§ 4320-I Mental and behavioral health services for children, adolescents and young adults

A carrier shall provide coverage for care coordination and assertive community treatment services for eligible persons who are 26 years of age or under who meet the criteria for a psychiatric diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, published by the American Psychiatric Association and experience significant impairment in function as determined by a licensed mental health provider. For the purposes of this section, "assertive community treatment services" means self-contained services with a fixed point of responsibility for providing treatment, counseling, vocational and educational rehabilitation and support services to eligible persons who are 26 years of age or under and their families for whom other community-based treatment approaches have been unsuccessful. In accordance with the assertive community treatment scale developed by Dartmouth College, assertive community treatment uses principles of care coordination, chronic illness management and evidence-based therapies to minimize fragmentation of care and maximize care coordination for persons whose symptoms of mental illness result in serious functioning difficulties in multiple areas of life, including family relationships, social relationships, education, employment, residential independence, medical health, substance abuse and psychotropic medication management. Assertive community treatment is provided by multidisciplinary teams who are on duty 24 hours per day, 7 days per week; a team includes a psychiatrist, a registered psychiatric nurse, licensed clinical social workers, community support workers and vocational and educational specialists and may include a peer recovery specialist or a substance abuse counselor.

Sec. 3. Transition services. The Department of Health and Human Services shall require each provider of mental and behavioral health services for children to establish or participate in so-called bridge teams for the purpose of ensuring continuity of care for students receiving mental and behavioral health services who graduate from high school. The bridge teams shall conduct outreach and identify students prior to graduation who are likely to be in need of mental and behavioral health services after graduation, develop plans to meet those students' needs after graduation, facilitate access to services and coordinate the continuance of care for those students after graduation. When developing plans for students, the bridge teams shall focus on prevention, continuity of treatment and avoidance of hospitalization.

Sec. 4. Application. That section of this Act that enacts the Maine Revised Statutes, Title 24-A, section 4320-I applies to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2015. For the purposes of Title 24-A, section 4320-I, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.’

summary

This amendment is the majority report of the committee and replaces the bill and changes the title. The amendment requires the MaineCare program and health insurance carriers to provide coverage for care coordination and assertive community treatment services for eligible persons who are 26 years of age or under who meet the criteria for a psychiatric diagnosis and experience significant impairment in function as determined by a licensed mental health provider. The amendment adds a definition of "assertive community treatment services." The requirements imposed on health insurance carriers apply to individual, group health and group health maintenance organization insurance policies, contracts and certificates issued or renewed on or after January 1, 2015. The amendment specifies the scope and length of coverage for eligible persons based on age rather than referring to persons who have graduated from high school as in the bill. The amendment also more specifically describes the types of services required to be covered.

The amendment also requires the Department of Health and Human Services to require providers of mental and behavioral health services for children to establish or participate in so-called bridge teams for the purpose of ensuring continuity of care for students receiving mental and behavioral health services who graduate from high school and are likely to be in need of such services following graduation.

FISCAL NOTE REQUIRED
(See attached)


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