2010 Legislative Update

1. 2010 Legislative Update Indiana Council of Community Mental Health Centers2010 Winter Quarterly Meeting University Place Conference Center & Hotel – IUPUIFebruary 11th, 2010

2. Major Issues of 2010 Session Overview of Legislation Three hundred and ninety (390) bills filed active in House 105 total House bills passed out of committee (27%) Four Hundred and nineteen (419) bills filed in Senate 128 total Senate bills passed out of committee (32%) Major Legislative Issues: HB 1001 - Ethics Reform SB 114 – Government Ethics Property Tax Caps under: HJR 0001 SJR 0001 Both allow for constitutional vote on caps for homesteads at 1%, other residential at 2%, and commercial at 3%.

3. Bills Impacting Mental Health & Healthcare • SB 62 – FSSA Expiration Date • Repeals the current statutorily established expiration date for FSSA. • Eliminates the need for FSSA to “renew” every few years. • Created due to initial concerns over establishment of FSSA.

4. Bills Impacting Mental Health & Healthcare • SB 079 – Mental Health Quality Advisory Committee • Adds a new section under Medicaid prescription drug statute. • Defines “waste” for the such things as “overprescribing” and “overutilization”. • Allows the OMPP to restrict access to certain mental health prescription drugs for individuals under eighteen (18) years of age. • OMPP has indicated this change is needed to ensure federal compliance.

5. Bills Impacting Mental Health & Healthcare • SB 149 – Department of Child Services • The “Christmas tree” bill for DCS. • Includes a provision for Group Homes related to child abuse reporting. • Removes FSSA from child investigation cases. • SB 175 – Various Health Matters • Includes a provision related to lead paint in child based facilities. • Possible Vehicle Bill for House action.

6. Bills Impacting Mental Health & Healthcare • SB 254 – Voluntary Audits by Health Facilities • Applies to health facilities licensed under I.C. 16-28-2 • Changes the exemptions related to privileged and confidential status of health facility audit reports • A health facility audit report is not considered privileged in certain circumstances such as; criminal proceedings and certain civil proceedings.

7. Bills Impacting Mental Health & Healthcare • SB 294 – DSH Providers • Bill is dead. Attempted to change DSH distribution formula. • SB 295 – • FSSA general administrative bill. • Allows for disclosure of social security number for state funded health plans. • Amends the definition of case management under I.C. 12-7-2-25. • Continuum of care would be redefined as; “based on current practice and recovery focused models of care and that are intended to meet the individual treatment needs of the consumer.”

8. Bills Impacting Mental Health & Healthcare • SB 295 Continued: • The bill would remove the continuum of care from state statute and allow the FSSA/DMHA Director to promulgate rules concerning its definition. • Bill was amended to ensure that DMHA shall consider reimbursement related to the promulgated services delineated under the continuum. • The bill changes the statute related to the DMHA requirement that one-third (1/3) “stand alone” addictions providers are entitled to funding. • The bill requires that 1/3 of the funds go to “specialty addiction providers” based on outcomes developed by DMHA. • Funding is for; • primary diagnosis of chronic substance abuse and dependence; and are without significant or immediate treatment needs for mental illness or serious emotional disturbance.

9. Bills Impacting Mental Health & Healthcare • SB 295 Continued: • Questions remain over the definition of “specialty addiction provider” on whether or not a CMHC qualifies. • The bill also changes state restrictions over the use of the Evansville State Hospital and Evansville State Psychiatric Treatment Center for Children. • The bill allows removes limitations on the ability of the FSSA to modify or close services at either facility. • Establishes a local council that can recommend the viability and use of the facilities. • Allows the release of mental health records without patient consent for certain court matters.

10. Bills Impacting Mental Health & Healthcare • SB 298 – State Administration • This bill also contains language on the Evansville facilities, however, it is expected to be finalized under SB 295. • SB 356 – Professional Licensing • Establishes a “mental health counselor associate license”. • The license shall mean the following:

11. Bills Impacting Mental Health & Healthcare Sec. 1.5. An individual who applies for a license as a mental health counselor associate must meet the following requirements: Furnish satisfactory evidence to the board that the individual has: (A) received a master's or doctor's degree in mental health counseling therapy or in a related area as determined by the board from an institution of higher education that meets the requirements under section 2 of this chapter or from a foreign school that has a program of study that meets the requirements under section 2(3)(A) or 2(3)(B) of this chapter; and (B) completed the educational requirements under section 3 of this chapter. Furnish satisfactory evidence to the board that the individual does not have a conviction for a crime that has a direct bearing on the individual's ability to practice competently. Furnish satisfactory evidence to the board that the individual has not been the subject of a disciplinary action by a licensing or certification agency of another state or jurisdiction on the grounds that the individual was not able to practice as a mental health counselor associate without endangering the public. Pay the fee established by the board. Pass an examination provided by the board.

12. Bills Impacting Mental Health & Healthcare • SB 356 will allow for the expansion of licensed mental health professionals. • Whether or not this licensure will be accepted for billing under MRO, other Medicaid services, Medicare or commercial insurance is yet to be determined. • Bill may dilute the professional licensure of mental health professionals with work experience or clinical training. • Individuals representing this class of employees assume this bill will incentivize employment in CMHCs and other mental health providers.

13. Bills Impacting Mental Health & Healthcare • HB 1003 - Public assistance matters • This bill was withdrawn on 3rd reading. A version of this bill expected to “reappear”. • Requires FSSA to establish an independent monitoring system to evaluate the quality of the eligibility determinations for public assistance services. • Requires FSSA to attempt to resolve any issues with an application for public assistance in the office's initial contact with the applicant. • Specifies actions to be taken by the office if an unfavorable evaluation is received or if a majority of the committee votes to terminate a contract for eligibility determinations for public assistance services

14. Bills Impacting Mental Health & Healthcare • HB 1065 – Firearms • Prohibits a person, including an individual, a corporation, and a governmental entity, from adopting or enforcing a policy or rule that prohibits or has the effect of prohibiting an individual from legally possessing a firearm that is locked in the individual's vehicle while the vehicle is in or on the person's property. • Exempts “Group Homes”, however, CMHCs are not yet exempt. • Clients we serve may require a push to exempt all CMHC properties from enforcement of this proposal.

15. Bills Impacting Mental Health & Healthcare • HB 1157- Select Joint Commission on Child Welfare Services Oversight • Establishes the select joint commission on child welfare services. • HB 1169 - Volunteer advocates programs for incapacitated adults and seniors • Courts with probate jurisdiction may contract with an Indiana nonprofit corporation to provide volunteer advocates for seniors programs or volunteer advocates for incapacitated adults programs. • The progress report shall include current physical and mental condition, residential placement, property, and any property related issues of the senior or the incapacitated adult.

16. Bills Impacting Mental Health & Healthcare • HB 1226 - Health and Medicaid Fraud Matters • Established procedures for the Attorney General to seize medical records. • Allows certain providers to be excluded in cases of Medicaid fraud. • Contains provisions regarding pharmacist and the dispensing of controlled substances. • Originally required providers to submit $50,000 bond, which the Council and others providers worked to amend out of bill. • HB 1277 – Health Disparities in Medicaid • Requires the MCOs to provide and report on appropriate cultural services. • Requires MCOs to measure health disparities.

17. Bills Impacting Mental Health & Healthcare • HB 1271 - Problem solving courts • Provides that certain courts may establish a problem solving court for alternative treatment and rehabilitation. • Requires the board of directors of the judicial center to adopt rules for the certification and operation of problem solving courts. • A city court or county court may establish a problem solving court. A problem solving court established under this section may be a:        (1) drug court;        (2) mental health court;        (3) family dependency drug court;        (4) community court;        (5) reentry court;        (6) domestic violence court;        (7) veteran's court; or        (8) any other court certified as a problem court by the Indiana judicial center under section 17 of this chapter.

18. Resolutions Impacting Mental Health & Healthcare • SCR 0002 – Mental Health Advisory Commission • SCR 0003 – Mental Health Commission Topics • Impact of MRO Changes • SCR 0006 – Clubhouse Funding • Urges DMHA to seek funding to support Clubhouses • SCR 0007 – Mental Illness and Tobacco • Urges DMHA to develop tobacco programs aimed at the mentally ill

19. Final Session Considerations • Bills have now moved to the opposing House requiring identical action in terms of committees, 2nd Reading Amendment, 3rd Reading and finally conference committee. • Determine final issues and concerns this week in order for bills to be amended if needed following the membership meeting. • Work with appropriate legislators, if needed, to ensure our needs are met and negotiate with impacted parties during conference committee.