MISSISSIPPI LEGISLATURE
2005 Regular Session
To: Public Health and Welfare; Appropriations
By: Senator(s) Dawkins, Williamson
AN ACT TO ESTABLISH THE MISSISSIPPI COMMISSION ON SERVICES AND SUPPORTS FOR INDIVIDUALS WITH MENTAL ILLNESS, ALCOHOL AND OTHER DRUG ABUSE DISORDERS AND DUAL DIAGNOSES TO DEVELOP AN INTEGRATED STATE PLAN FOR TREATMENT AND SUPPORT FOR INDIVIDUALS WITH MENTAL ILLNESSES, SUBSTANCE ADDICTIONS AND CO-OCCURRING DISORDERS; TO PROVIDE THAT SUCH COMMISSION SHALL SERVE IN AN ADVISORY CAPACITY TO THE MISSISSIPPI BOARD OF MENTAL HEALTH IN COMPLIANCE WITH FEDERAL INITIATIVES; TO SPECIFY THE MEMBERSHIP OF THE COMMISSION; TO REQUIRE REPORTS; TO CREATE REGIONAL PLANNING COUNCILS THROUGH THE REGIONAL MENTAL HEALTH AND MENTAL RETARDATION COMMISSIONS; TO AMEND SECTION 41-19-33, MISSISSIPPI CODE OF 1972, IN CONFORMITY THERETO; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. (1) The Legislature hereby finds and declares that:
(a) National initiatives, including the 1999 White House Conference on Mental Health and the 1999 United States Surgeon General's Report on Mental Health, have promoted the concept that mental health is fundamental to health care.
(b) It has been found that:
(i) The leading causes of disability for individuals age five (5) and older are mental disorders;
(ii) The current mental health and substance abuse system is lacking a comprehensive state plan that would improve the mental health status of the citizens of Mississippi; and
(iii) It is necessary to require long-range planning for mental health and substance abuse services.
(2) There is created the Mississippi Commission on Services and Supports for Individuals with Mental Illness, Alcohol and Other Drug Abuse Disorders and Dual Diagnoses. The "commission" shall consist of:
(a) The Executive Director of the Mississippi Department for Mental Health, or his designee;
(b) The State Health Officer, or his designee;
(c) The Attorney General, or his designee;
(d) The Executive Director of Medicaid, or his designee;
(e) The Commissioner of the Department of Corrections, or his designee;
(f) The Executive Director of the Mississippi Department of Human Services, or his designee;
(g) The State Superintendent of Education; or his designee;
(h) The Executive Director of the Mississippi Department of Rehabilitation Services, or his designee;
(i) An appointee of the Governor, who shall be a person familiar with the issues of mental illness, mental retardation and substance abuse, who shall serve a term concurrent with that of the Governor;
(j) The Chairman of the Senate Committee on Public Health and Welfare and the House Committee on Health and Human Services.
(3) The Executive Director of the Mississippi Department of Mental Health shall serve as chair of the commission. Members shall serve during their terms of office.
(4) The commission created in Section 1 of this act shall meet as often as necessary to accomplish its purpose but shall meet at least quarterly during the 2005-2006 fiscal year, and the first meeting shall be held within six (6) months of the effective date of this act. The commission shall meet at least annually thereafter, or upon the call of the chair, the request of four (4) or more members, or the request of the Governor.
(5) The commission shall receive, integrate and report, as required by this section, the findings and recommendations of the regional planning councils established under Section 2 of this act. The commission shall serve in an advisory capacity to accomplish the following:
(a) Assess the needs statewide of individuals with mental illness, alcohol and other drug abuse disorders and dual diagnoses;
(b) Assess the capabilities of the existing statewide treatment delivery system including gaps in services and the adequacy of a safety net system;
(c) Assess the coordination and collaboration of efforts between public and private facilities and entities, and the roles of the Mississippi Department of Mental Health and the regional community mental health centers, state hospitals and other providers;
(d) Identify funding needs and related fiscal impact, including Medicaid reimbursement, limitations under government programs and private insurance and adequacy of indigent care;
(e) Recommend comprehensive and integrated programs for providing mental health and substance abuse services and preventive education to children and youth utilizing community resources;
(f) Develop recommendations to decrease the incidence of multiple hospitalizations of individuals with mental illness, alcohol and other drug abuse disorders, and dual diagnoses; and
(g) Recommend an effective quality assurance and consumer satisfaction monitoring program that includes recommendations as to the appropriate role of persons with mental illness, alcohol and other drug abuse disorders, and dual diagnoses, family members, providers and advocates in quality assurance efforts.
(6) The commission shall develop a comprehensive state plan that will provide a template for the decision making regarding program development, funding and the use of state resources for delivery of the most effective continuum of services in integrated statewide settings appropriate to the needs of the individual with mental illness, alcohol and other drug abuse disorders, and dual diagnoses.
(7) The commission may apply for and expend federal funds made available under the federal New Freedom Commission on Mental Health for State Implementation activities. The Mississippi Department of Mental Health shall provide necessary administrative and fiscal support for the commission.
(8) Within six (6) months after receiving reports and recommendations from the regional planning councils established under Section 2 of this act, the chair of the commission shall present the plan to the Governor and the members of the Legislature. The state plans shall:
(a) Advise the Governor and the Legislature concerning the needs statewide of individuals with mental illness, alcohol and other drug disorders, and dual diagnoses; and
(b) Advise the Governor and the Legislature on whether the recommendations should be implemented by administrative regulations or proposed legislation for the 2006 Regular Session.
(9) The commission shall review the plan annually and shall submit annual updates no later than October 1 to the Governor and the Legislature.
SECTION 2. (1) The regional community mental health/mental retardation commissions established under Section 41-19-33 shall institute regional planning councils for the purpose of conducting assessment and strategic planning. The councils shall be attached to the community mental health/mental retardation commissions for administrative purposes.
(2) A member of the regional community mental health/mental retardation commission shall serve as chair of the regional planning council.
(3) The commission shall issue invitations to join the council to no less than two (2) representatives from each of the following groups:
(a) Family members of adults and children with mental illness, alcohol and other drug abuse disorders and dual diagnoses;
(b) Consumers of mental health and substance abuse services;
(c) County officials and business leaders;
(d) Health departments and primary care physicians;
(e) Advocates and community organizations;
(f) Educators and school personnel;
(g) Regional interagency councils;
(h) Law enforcement and court personnel;
(i) Public and private facilities that provide services for mental health and substance abuse in the region representing inpatient services, outpatient services, residential service and community-based supportive housing programs; and
(j) Individuals who provide mental health and substance abuse services in the region.
(4) The regional planning councils shall meet as often as necessary to accomplish their purpose.
(5) The regional planning councils shall:
(a) Assess in the region the needs of individuals with mental illness, alcohol and other drug abuse disorders, and dual diagnoses;
(b) (i) Study the regional mental health and substance abuse treatment delivery system.
(ii) Assess the capacity of and gaps in the existing system, including the adequacy of a safety net system; and
(iii) Assess the coordination and collaboration of efforts between public and private facilities and entities;
(c) Develop a regional strategy to increase access to community-based services and supports for individuals with mental illness, alcohol and other drug abuse disorders and dual diagnoses. The strategies may include:
(i) Exploration of the use of community-based treatment programs;
(ii) Access to funding for the most effective medications;
(iii) Promotion of family and consumer support groups statewide; and
(iv) Reduction of instances of criminalization of individuals with mental illness, alcohol and other drug abuse disorders and dual diagnoses;
(d) Identify funding needs;
(e) Evaluate the access of children and youth to mental health and substance abuse services and preventive programs within the region, including, but not limited to, those provided by schools, family resource and youth services centers, public and private mental health and substance abuse providers and facilities, physical health care providers and facilities, the faith community and community agencies;
(f) Collect and evaluate data regarding individuals with mental illness, alcohol and other drug abuse disorders and dual diagnoses who experience repeated hospital admissions, involvement with law enforcement, courts, and the judicial system, and
repeated referrals from hospitals to community-based services;
(g) Recommend an effective quality assurance and consumer satisfaction monitoring program; and
(h) Make recommendations on each subsection of this section to the commission established under Section 1 of the act within eight (8) months of the effective date of this act. These recommendations may be incorporated into the regional annual plans.
SECTION 3. Section 41-19-33, Mississippi Code of 1972, is amended as follows:
41-19-33. (1) Each region so designated or established under Section 41-19-31 shall establish a regional commission to be composed of members appointed by the boards of supervisors of the various counties in said region. It shall be the duty of such regional commission to administer mental health/retardation programs certified by the State Board of Mental Health. In addition, once designated and established as provided hereinabove, a regional commission shall have the following authority and shall pursue and promote the following general purposes:
(a) To establish, own, lease, acquire, construct, build, operate and maintain mental illness, mental health, mental retardation, alcoholism and general rehabilitative facilities and services designed to serve the needs of the people of the region so designated; provided that the services supplied by said regional commissions shall include those services determined by the Department of Mental Health to be necessary and may include, in addition to the above, services for persons with developmental and learning disabilities; for persons suffering from narcotic addiction and problems of drug abuse and drug dependence; and for the aging as designated and certified by the Department of Mental Health.
(b) To provide facilities and services for the prevention of mental illness, mental disorders, developmental and learning disabilities, alcoholism, narcotic addiction, drug abuse, drug dependence and other related handicaps or problems (including the problems of the aging) among the people of the region so designated, and for the rehabilitation of persons suffering from such illnesses, disorders, handicaps or problems as designated and certified by the Department of Mental Health.
(c) To promote increased understanding of the problems of mental illness, mental retardation, alcoholism, developmental and learning disabilities, narcotic addiction, drug abuse and drug dependence and other related problems (including the problems of the aging) by the people of the region, and also to promote increased understanding of the purposes and methods of the rehabilitation of persons suffering from such illnesses, disorders, handicaps or problems as designated and certified by the Department of Mental Health.
(d) To enter into contracts and to make such other arrangements as may be necessary, from time to time, with the United States government, the government of the State of Mississippi and such other agencies or governmental bodies as may be approved by and acceptable to the regional commission for the purpose of establishing, funding, constructing, operating and maintaining facilities and services for the care, treatment and rehabilitation of persons suffering from mental illness, mental retardation, alcoholism, developmental and learning disabilities, narcotic addiction, drug abuse, drug dependence and other illnesses, disorders, handicaps and problems (including the problems of the aging) as designated and certified by the Department of Mental Health.
(e) To enter into contracts and make such other arrangements as may be necessary with any and all private businesses, corporations, partnerships, proprietorships or other private agencies, whether organized for profit or otherwise, as may be approved by and acceptable to the regional commission for the purpose of establishing, funding, constructing, operating and maintaining facilities and services for the care, treatment and rehabilitation of persons suffering from mental illness, mental retardation, alcoholism, developmental and learning disabilities, narcotic addiction, drug abuse, drug dependence and other illnesses, disorders, handicaps and problems (including the problems of the aging) relating to minimum services established by the Department of Mental Health.
(f) To promote the general mental health of the people of the region.
(g) To pay the administrative costs of the operation of said regional commissions, including per diem for the members of said commission and its employees, attorney's fees, if and when such are required in the opinion of said commission, and such other expenses of the commission as may be necessary. The Department of Mental Health standards and audit rules shall determine what administrative cost figures shall consist of for the purposes of this paragraph. Each regional commission shall submit a cost report annually to the Department of Mental Health in accordance with guidelines promulgated by the department.
(h) To employ and compensate any personnel that may be necessary to effectively carry out the programs and services established pursuant to the provisions of the aforesaid act, provided such person meets the standards established by the Department of Mental Health.
(i) To acquire whatever hazard, casualty or workers' compensation insurance that may be necessary for any property, real or personal, owned, leased or rented by said commissions, or any employees or personnel hired by the said commissions.
(j) To acquire professional liability insurance on all employees as may be deemed necessary and proper by the commission, and to pay, out of the funds of the commission, all premiums due and payable on account thereof.
(k) To provide and finance within their own facilities, or through agreements or contracts with other local, state or federal agencies or institutions, nonprofit corporations, or political subdivisions or representatives thereof, programs and services for the mentally ill, including treatment for alcoholics and promulgating and administering of programs to combat drug abuse and the mentally retarded.
(l) To borrow money from private lending institutions in order to promote any of the foregoing purposes. A commission may pledge collateral, including real estate, to secure the repayment of money borrowed under the authority of this paragraph. Any such borrowing undertaken by a commission shall be on terms and conditions that are prudent in the sound judgment of the members of the commission, and the interest on any such loan shall not exceed the amount specified in Section 75-17-105. Any money borrowed, debts incurred or other obligations undertaken by a commission, regardless of whether borrowed, incurred or undertaken before or after the effective date of this act, shall be valid, binding and enforceable if it or they are borrowed, incurred or undertaken for any purpose specified in this section and otherwise conform to the requirements of this paragraph.
(m) To acquire, own and dispose of real and personal property. Any real and personal property paid for with state and/or county appropriated funds must have the written approval of the Department of Mental Health and/or the county board of supervisors, depending on the original source of funding, before being disposed of under this paragraph.
(n) To enter into managed care contracts and make such other arrangements as may be deemed necessary or appropriate by the regional commission in order to participate in any managed care program. Any such contract or arrangement affecting more than one (1) region must have prior written approval of the Department of Mental Health before being initiated and annually thereafter.
(o) To provide facilities and services on a discounted or capitated basis. Any such action when affecting more than one (1) region must have prior written approval of the Department of Mental Health before being initiated and annually thereafter.
(p) To enter into contracts, agreements or other arrangements with any person, payor, provider or other entity, pursuant to which the regional commission assumes financial risk for the provision or delivery of any services, when deemed to be necessary or appropriate by the regional commission. Any action under this paragraph affecting more than one (1) region must have prior written approval of the Department of Mental Health before being initiated and annually thereafter.
(q) To provide direct or indirect funding, grants, financial support and assistance for any health maintenance organization, preferred provider organization or other managed care entity or contractor, where such organization, entity or contractor is operated on a nonprofit basis. Any action under this paragraph affecting more than one (1) region must have prior written approval of the Department of Mental Health before being initiated and annually thereafter.
(r) To form, establish, operate, and/or be a member of or participant in, either individually or with one or more other regional commissions, any managed care entity as defined in Section 83-41-403(c). Any action under this paragraph affecting more than one (1) region must have prior written approval of the Department of Mental Health before being initiated and annually thereafter.
(s) To meet at least annually with the board of supervisors of each county in its region for the purpose of presenting its total annual budget and total mental health/retardation services system.
(t) To provide alternative living arrangements for persons with serious mental illness, including, but not limited to, group homes for the chronically mentally ill.
(u) To make purchases and enter into contracts for purchasing in compliance with the public purchasing law, Sections 31-7-12 and 31-7-13, with compliance with the public purchasing law subject to audit by the State Department of Audit.
(v) To insure that all available funds are used for the benefit of the mentally ill, mentally retarded, substance abusers and developmentally disabled with maximum efficiency and minimum administrative cost. At any time a regional commission, and/or other related organization whatever it may be, accumulates surplus funds in excess of one-half (1/2) of its annual operating budget, the entity must submit a plan to the Department of Mental Health stating the capital improvements or other projects that require such surplus accumulation. If the required plan is not submitted within forty-five (45) days of the end of the applicable fiscal year, the Department of Mental Health shall withhold all state appropriated funds from such regional commission until such time as the capital improvement plan is submitted. If the submitted capital improvement plan is not accepted by the department, the said surplus funds shall be expended by the regional commission in the local mental health region on group homes for the mentally ill, mentally retarded, substance abusers, children or other mental health/retardation services approved by the Department of Mental Health.
(w) Notwithstanding any other provision of law, to fingerprint and perform a criminal history record check on every employee or volunteer. Every employee or volunteer shall provide a valid current social security number and/or driver's license number that will be furnished to conduct the criminal history record check. If no disqualifying record is identified at the state level, fingerprints shall be forwarded to the Federal Bureau of Investigation for a national criminal history record check.
(x) In general to take any action which will promote, either directly or indirectly, any and all of the foregoing purposes.
(y) To appoint regional community mental health/retardation planning councils for the purpose of conducting assessment and strategic planning pursuant to the provisions of Section 2 of Senate Bill No. 2821, 2005 Regular Session, and in compliance with federal initiatives.
(2) The types of services established by the State Department of Mental Health that must be provided by the regional mental health/retardation centers for certification by the department, and the minimum levels and standards for those services established by the department, shall be provided by the regional mental health/retardation centers to children when such services are appropriate for children, in the determination of the department.
SECTION 4. This act shall take effect and be in force from and after July 1, 2005, and shall stand repealed from and after July 1 2009.