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An Act To Address Maine's Shortage of Behavioral Health Services for Minors
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §7708  is enacted to read:
§ 7708. Behavioral health resource for minors website
 
1.  Definitions.     As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
 
A.  "Behavioral health needs" means a wide range of mental health disorders and illnesses, substance use disorder, developmental disabilities and autism spectrum disorder.
 
B.  "Community service provider" has the same meaning as in Title 5, section 20003, subsection 4.
 
C.  "Extended stay" means a stay of a patient in a health care facility that is longer than required to stabilize immediate threats to the life and safety of the patient for the purpose of a longer term treatment of a health care issue.
 
D.  "Hospital emergency department" means the department of a hospital responsible for the provision of medical and surgical care to patients arriving at the hospital with health conditions, including illnesses and trauma, requiring immediate care.
 
E.  "Mental health disorders and illness" means certain mental and emotional disorders including depression, anxiety, bipolar disorder, schizophrenia, post-traumatic stress disorder, conduct disorder, attention deficit disorder and attention deficit hyperactivity disorder and aggressive behavior, risk of harm to self or others and difficulty with anger control.
 
F.  "Substance use disorder" means a significant functional impairment of a person, including a health problem or a disability, caused by the misuse of alcohol or another drug as addressed by Title 5, chapter 521.
 
2.  Website.     The department shall maintain:
 
A.  A daily updated statewide list on a publicly accessible website accessible by hospital emergency departments that displays available placements to assist hospital emergency departments to locate potential openings in mental health facilities or programs and with community service providers for minors with behavioral health needs for the purpose of referring the persons to the facilities or programs for residential placement or care; and
 
B.  A quarterly updated resource list for hospital emergency departments on a publicly accessible website that includes mental health facilities or programs and community service providers for minors with behavioral health needs with descriptions of the admissions and exclusions criteria of the programs, facilities and providers, including age, gender and populations served, such as individuals with physical or developmental disabilities or autism or other behavioral health needs.
 
3.  Data collection and analysis.     The department shall collect and analyze data on the issue of minors with behavioral health needs being held in hospital emergency departments for extended stays, including:
 
A.   Collecting on a monthly basis data regarding:
 
(1) Admissions to all hospital emergency departments of minors with behavioral health needs, including length of stay and criteria for admission and discharge;
 
(2) Programs available to minors with behavioral health needs, including the number and type of programs and the number of beds, slots or placements of the programs available to the minors; and
 
(3) Minors with behavioral health needs sent to a facility or program outside the State for treatment, including the type of program and length of stay for each minor; and
 
B.  Analyzing the data in paragraph A, including identifying:
 
(1) Reasons for extended stays, including lack of beds, slots or placements in other facilities or programs, refusal of admission to other facilities or programs due to behavioral concerns or lack of community-based programs such as home-based support, step-down programs providing partial hospitalization or outpatient treatment providers or programs;
 
(2) Specific behavioral health needs treatment programs and the waiting list for admission to each program; and
 
(3) Funding mechanisms for appropriate service delivery and programming to provide short-term, transitional assistance, such as temporary staff increases, one-on-one staffing or staff training to address specific areas of behavioral health needs, to minors with behavioral health needs who are discharged to residential placements, partial hospitalization or home-based programs.
 
The department shall study the data collected and analyzed to determine the extent of the issue of minors with behavioral health needs being held in hospital emergency departments, the characteristics of the minors and any progress made on efforts to address the issue. By January 1st of each year, the department shall submit a summary of the study along with conclusions and any recommendations to the joint standing committee of the Legislature having jurisdiction over health and human services matters. The committee may report out legislation based upon the study and recommendations to the Legislature by February 1st of that year.
Sec. 2. Department of Health and Human Services to study behavioral health needs advocate. In conjunction with the report required under the Maine Revised Statutes, Title 22, section 7708, subsection 3, for the report due January 1, 2020, the Department of Health and Human Services shall study the feasibility of adding a child behavioral health needs advocate within the department to ensure best practices among behavioral health needs providers and to coordinate the department's activities regarding addressing the behavioral health needs of minors with activities by hospital emergency departments and behavioral health treatment providers such as hospitals, step-down programs providing partial hospitalization, contracted behavioral health residential programs and the Department of Corrections. For purposes of this section, "behavioral health needs" has the same meaning as in Title 22, section 7708, subsection 1, paragraph A.
 
SUMMARY
This bill:
1. Defines "behavioral health needs" to mean a wide range of mental health disorders and illnesses, substance use disorder, developmental disabilities and autism spectrum disorder;
2. Directs the Department of Health and Human Services to take measures to address the issue of extended stays in hospital emergency departments by minors with behavioral health needs by:
A. Maintaining a daily updated online statewide list of available mental health facility or program and community service provider placements for referral purposes by hospital emergency departments;
B. Maintaining a quarterly updated online resource list of mental health programs or facilities and community service providers that treat behavioral health needs; and
C. Collecting monthly data on and study the issue of extended stays of minors with behavioral health needs in hospital emergency departments and annually submitting a report with a summary of the study along with any recommendations to the joint standing committee of the Legislature having jurisdiction over health and human services matters;
3. Directs the department to study the data and analysis on extended stays in hospital emergency departments by minors with behavioral health needs and submit an annual report to the Legislature that identifies:
A. Reasons for the extended stays;
B. Specific behavioral health needs treatment programs and the waiting list for admission to each program; and
C. Funding mechanisms to provide short-term transitional assistance to minors with behavioral health needs discharged from a hospital emergency department to residential placements, partial hospitalizations or home-based programs; and
4. Directs the department to study the feasibility of adding a child behavioral needs advocate within the department to coordinate the department's activities with those of various agencies and programs that provide behavioral health needs services to minors and to submit a report to the Legislature by January 1, 2020.