An Act To Strengthen Supports for Adults with Intellectual Disabilities or Autism in Crisis
Sec. 1. 34-B MRSA §5201, sub-§7, as amended by PL 2011, c. 542, Pt. A, §92, is further amended to read:
Sec. 2. 34-B MRSA §5206, as amended by PL 2011, c. 542, Pt. A, §93, is repealed.
Sec. 3. 34-B MRSA c. 5, sub-c. 5 is enacted to read:
§ 5701. Definitions
As used in this subchapter, unless the context otherwise indicates, the following terms have the following meanings.
§ 5702. Crisis services objectives
Crisis services must be delivered to a person with an intellectual disability or autism as a protective and supportive service with the following objectives:
§ 5703. Crisis and respite services system established
The department shall establish a system to provide crisis and respite services throughout the State as part of the system of care required by section 5003-A in accordance with this subchapter.
§ 5704. Pre-crisis planning
A personal planning team in accordance with section 5470-B shall consider the potential for crisis as a component of personal planning. This consideration must include, but is not limited to, review of historical data and behavioral trends and consideration of past trauma and potential triggers; pain and how it presents; past and current medical conditions; and the extent to which unmet needs and lack of or limitations on access to services may contribute to risk of crisis.
§ 5705. Crisis assessment team
The department shall maintain a crisis assessment team to provide comprehensive clinical assessments for persons who have required emergency hospital services, resided in a crisis stabilization unit or required regional crisis services on at least 3 occasions within a 2-week period.
§ 5706. Crisis central intake service
The department shall maintain a crisis central intake service to receive notification of a crisis and need for crisis services. The crisis central intake service shall provide remote crisis services in accordance with this section and connect a user of the service with the appropriate regional crisis services when in-person assistance is requested or necessary to support a person with an intellectual disability or autism in crisis. The crisis central intake service must:
§ 5707. Regional crisis services
The department shall maintain an adequate capacity to maintain mobile, in-person regional crisis services where crisis services can be provided on scene. Regional crisis services must be coordinated with the crisis central intake service to locate persons with intellectual disabilities or autism in need of regional crisis services and meet the persons in settings most conducive to meeting the persons' needs. Regional crisis services must:
The department may not routinely use law enforcement entities to transport persons in crisis. Transportation of persons in crisis by law enforcement personnel may occur only if the transportation has been specifically authorized by the person's guardian or personal planning team or when determined by law enforcement personnel to be necessary to provide for the safety of the person or others.
§ 5708. Residential crisis services
The department shall maintain the capacity to provide out-of-home safety and support by trained staff with appropriate professional backup resources for persons with intellectual disabilities or autism experiencing crises that cannot be safely managed at the persons' homes. Residential crisis services must:
§ 5709. Least restrictive environment
Crisis services and respite services must be provided in the least restrictive environment with both a short-term goal of stabilization and a long-term goal of as much independence as possible. Home-based and community-based services must be maintained and funded to support persons with intellectual disabilities or autism that have high behavioral needs and are at risk for out-of-home placement. The department shall maintain and fund, at minimum:
§ 5710. Post-crisis review and assessment
A crisis assessment team shall perform a post-crisis review and assessment no more than 10 business days after any out-of-home placement, such as a hospitalization or placement in a crisis stabilization unit, of a person with an intellectual disability or autism who experiences a crisis. The review must include service providers and appropriate members of the person's personal planning team. The review must identify possible causes of the person's crisis and must recommend for the personal planning team changes in the person's environment, services and supports to prevent crises in the future.
§ 5711. Data collection and reporting
The department shall collect and report information in accordance with this section.
(1) Persons who were referred to regional crisis services;
(2) Persons who were referred to residential crisis services; and
(3) Persons who were referred to emergency hospital services;
(3) Current level of MaineCare services; and
(4) Unstaffed hours of authorized MaineCare services identified prior to accessing crisis services;
(1) Average time to access the crisis central intake service;
(2) Average time between referral and arrival of regional crisis services;
(3) Average time between referral and arrival at a crisis stabilization unit;
(4) Average length of time using regional crisis services;
(5) Average length of time using residential crisis services at a crisis stabilization unit;
(6) Any referrals made to a higher level of care while waiting to access crisis services; and
(7) Any referrals made to a higher level of care due to unstaffed hours of authorized MaineCare services;
(1) Percentage of crisis assessments completed within 10 business days as required by section 5710; and
(2) Percentage of individual support teams that met within the required time frame; and
§ 5712. Training
The department shall offer regular and ongoing information, consultation and training on crisis prevention and intervention and respite services to its own staff and to service providers, persons with intellectual disabilities or autism and their families or friends.
§ 5713. Rulemaking
The department shall adopt rules necessary to implement this subchapter no later than January 1, 2020. Rules adopted pursuant to this paragraph are major substantive rules as defined in Title 5, chapter 375, subchapter 2-A.
This bill requires the Department of Health and Human Services to provide a system of crisis and respite services specific to persons with intellectual disabilities or autism and their families. It requires the department to adopt rules by January 1, 2020. The rules are major substantive rules.