HOUSE OF REPRESENTATIVES
TWENTY-SEVENTH LEGISLATURE, 2013
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO HEALTH.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that the department of health implemented administrative rules narrowing the scope of individuals eligible to receive continuing services from the adult mental health division. The legislature further finds that these restrictive rules leave many individuals with mental health needs without access to mental health services.
The purpose of this part is to add a definition of "qualifying diagnosis" to the Hawaii Revised Statutes and require the adult mental health division of the department of health to provide services to individuals with a qualifying diagnosis.
SECTION 2. Section 334-1, Hawaii Revised Statutes, is amended by adding two new definitions to be appropriately inserted and to read as follows:
""Qualifying diagnosis" means one of the following diagnoses:
(1) Schizophrenia and other psychotic disorders;
(2) Mood disorders, including recurrent major depressive disorder and bipolar disorders;
(3) Anxiety disorders, including panic disorder with agoraphobia, obsessive-compulsive disorder, and post‑traumatic stress disorder;
(4) Borderline personality disorder;
(5) Substance-related disorders that do not resolve in thirty days, including alcohol-induced psychotic disorder; amphetamine-induced psychotic disorder; cannabis-induced psychotic disorder; cocaine-induced psychotic disorder; hallucinogen-induced psychotic disorder; inhalant-induced psychotic disorder; opioid‑induced psychotic disorder; phencyclidine‑induced psychotic disorder; sedative-, hypnotic-, or anxiolytic-induced psychotic disorder; and other- or unknown-substance-induced psychotic disorders; and
(6) Co-occurring disorders, including persons with severe and persistent mental illness and a substance abuse disorder, and persons with severe and persistent mental illness and diagnosis of mild mental retardation.
"Severe and persistent mental illness" means a qualified diagnosis, as defined in this section, that results in emotional, cognitive, or behavioral functioning which is so impaired as to substantially interfere with a person's capacity to remain in the community without treatment, and which results in a long-term limitation in a person's functional capacities for the primary activities of daily living."
SECTION 3. Section 334-3, Hawaii Revised Statutes, is amended by amending subsection (c) to read as follows:
"(c) The department shall specifically:
(1) Perform statewide assessments of the need for prevention, treatment, and rehabilitation services in the areas of mental or emotional disorders and substance abuse;
(2) Adopt rules pursuant to chapter 91 for establishing the number and boundaries of the geographical service areas for the delivery of services in the areas of mental or emotional disorders and substance abuse. The department shall periodically review the effectiveness of the geographical service areas in promoting accessibility and continuity of appropriate care to all residents of that geographical area;
(3) Appoint a service area administrator in each county who shall be responsible for the development, delivery, and coordination of services in that area;
(4) Ensure statewide and community-based planning for the ongoing development and coordination of the service delivery system as guided by needs assessment data and performance related information;
(5) Establish standards and rules for psychiatric facilities and their licensing, where applicable;
(6) Establish standards and rules for services in
the areas of mental health and substance abuse treatment, [
including] the core services of which are based upon evidence-based
practices for substance use disorder treatment, including assurances of the provision of minimum levels
of accessible service to persons of all ages, ethnic groups, and geographical
areas in the State;
(7) Ensure community involvement in determining the service delivery arrangements appropriate to each community of the State;
(8) Cooperate with public and private health, education, and human service groups, agencies, and institutions in establishing a coordinated system to meet the needs of persons with mental or emotional disorders and substance abuse difficulties;
(9) Evaluate and monitor all services in the fields of mental health and substance abuse where such services are supported fully or in part by state resources;
(10) Promote and conduct research, demonstration projects, and studies concerned with the nature, prevention, intervention, and consequences of mental or emotional disorders and substance abuse;
(11) Keep records, statistical data, and other information as may be necessary in carrying out the functions of the mental health system and this chapter;
(12) Advocate patients' rights in all psychiatric facilities in the State and investigate any grievances submitted to the department by any patient in a psychiatric facility, except as provided in section 334E-2(d). The department shall establish rules and procedures for the purpose of this paragraph within one year after January 1, 1985, and post the rules in a conspicuous manner and accessible place;
(13) Promote and conduct a systematic program of accountability for all services provided, funds expended, and activities carried out under its direction or support in accordance with sound business, management, and scientific principles;
(14) Coordinate mental health resources in each county of the State by the development and presentation of a comprehensive integrated service area plan developed by the service area administrator in conjunction with the service area board. The service area administrator and the service area board, in collaboration with private and public agencies serving their population, shall submit recommendations for the statewide comprehensive integrated service plan, including needs assessment, program planning, resource development, priorities for funding, monitoring, and accountability activities;
(15) Oversee and coordinate service area
programs and provide necessary administrative and technical assistance to
assist service area programs in meeting their program objectives; [
(16) Provide staffing to the state council and
service area boards to assist in the performance of their functions[
(17) Provide services to persons who have a qualifying diagnosis; provided that notwithstanding any law or rules adopted by the department to the contrary, any person who has a qualifying diagnosis shall be eligible to receive services that are offered by the department of health's adult mental health division and are not covered by any insurance policy held by or for the benefit of that person."
SECTION 4. The legislature finds that budgetary reductions forced cuts to state mental health services, reducing access to needed medication, treatment, and other services and causing harm to thousands of mentally ill persons. This reduction in mental health services may run afoul of the United States Supreme Court holding in Olmstead v. L. C., 527 U.S. 581 (1999). This holding gave persons with disabilities the right to live in the community, if they desire, rather than being institutionalized, and the failure to provide necessary supports to these persons may constitute a denial of that right.
The department of health adult mental health division changed its eligibility rules in July 2010 to end services it provided to patients other than those with severe and persistent mental illness. This change left thousands of persons searching for help from private providers already in short supply. The adult mental health division also eliminated or reduced support for residential facilities, parent education, support groups, and clubhouses that have been important resources for the mentally ill. Cuts have also been made to area-service administrator positions for the adult mental health division, adversely affecting the availability and coordination of mental health resources on the neighbor islands. In the wake of these steep cuts and intense government-wide budget pressures, it is also questionable whether the State has the means to adequately monitor and treat former criminal defendants who are on conditional release.
The purpose of this part is to make an appropriation for the restoration of mental health services.
SECTION 5. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2013-2014 and the same sum or so much thereof as may be necessary for fiscal year 2014-2015 for restoration of funding for mental health services for adults, adolescents, and children that have been eliminated or reduced in the past two years.
The sums appropriated shall be expended by the department of health for the purposes of this part.
SECTION 6. The legislature finds that homelessness continues to be one of the State's most significant and challenging social problems. The legislature further finds that according to a recent report, fourteen thousand two hundred homeless individuals were served through shelter and outreach programs in fiscal year 2011. Of these individuals, 9,781 resided in the city and county of Honolulu. The legislature also finds that homeless service providers estimate that six thousand homeless persons in the State need shelter each night.
The legislature additionally finds that homelessness is a complex issue that requires continuous resources and coordinated efforts at all levels. The legislature also finds that homeless persons face a myriad of issues, including mental illness, substance abuse, loss of employment and income, and lack of affordable housing. Appropriate funding for programs and services tailored to address these issues is essential.
The purpose of this part is to make an appropriation
for substance abuse treatment and mental health support services for individuals who are homeless or at risk of becoming homeless.
SECTION 7. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2013-2014 and the same sum or so much thereof as may be necessary for fiscal year 2014-2015 for substance abuse treatment and mental health support services for individuals who are homeless or at risk of becoming homeless.
The sums appropriated shall be expended by the department of health for the purposes of this part.
SECTION 8. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 9. This Act shall take effect on July 1, 2050.
Mental Health; Adult Mental Health; Homeless Services; Appropriation
Adds definitions for "qualifying diagnosis" and "severe and persistent mental illness." Requires the provision of services to individuals with a qualifying diagnosis. Appropriates funds for mental health services previously eliminated or reduced, and for substance abuse treatment and mental health support services for individuals who are homeless or at risk of becoming homeless. Effective July 1, 2050. (HB649 HD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.