MISSISSIPPI LEGISLATURE

2000 Regular Session

To: Public Health and Welfare; Appropriations

By: Senator(s) Thames

AN ACT TO AMEND SECTIONS 43-14-1, 43-14-3, 43-14-5 AND 43-14-7, MISSISSIPPI CODE OF 1972, TO RECONSTITUTE THE CHILDREN'S ADVISORY COUNCIL INTO AN INTERAGENCY COORDINATING COUNCIL FOR CHILDREN AND YOUTH, TO EMPOWER THE INTERAGENCY COUNCIL TO IMPLEMENT A PLANNING PROCESS FOR EACH CHILD SERVICE AGENCY TO UTILIZE FEDERAL AND STATE FUNDS, TO DEFINE CHILDREN ELIGIBLE FOR SERVICES WHICH ARE TO BE COORDINATED UNDER THIS ACT, AUTHORIZE THE INTERAGENCY COUNCIL TO DIRECT THE STATE DEPARTMENT OF EDUCATION TO INCREASE THE NUMBER OF CHILDREN IDENTIFIED AND SERVED AS HAVING SERIOUS EMOTIONAL DISORDERS PURSUANT TO FEDERAL LAW AND TO REQUEST ADDITIONAL EDUCABLE CHILD FUNDS, TO AUTHORIZE THE INTERAGENCY COUNCIL TO DIRECT THE DIVISION OF MEDICAID TO APPLY FOR NECESSARY WAIVERS FOR THIS POPULATION OF CHILDREN, TO EMPOWER THE ADVISORY COUNCIL TO COORDINATE A POOL OF FUNDS FROM THESE STATE AGENCIES TO SERVE THIS POPULATION OF CHILDREN THROUGH LOCAL COORDINATING CARE ENTITIES DESIGNATED BY THE INTERAGENCY COUNCIL, TO CHARGE THE LOCAL COORDINATING CARE ENTITIES WITH CERTAIN RESPONSIBILITIES, TO PROVIDE CERTAIN PENALTIES FOR STATE AGENCIES WHICH DO NOT CONTRIBUTE OR PARTICIPATE IN THIS COORDINATED PROGRAM AND TO SPECIFY THE DUTIES AND RESPONSIBILITIES OF THE INTERAGENCY COUNCIL; TO REPEAL SECTION 43-14-9, MISSISSIPPI CODE OF 1972, WHICH IS THE AUTOMATIC REPEALER ON SECTIONS 43-14-1 THROUGH 43-14-7, MISSISSIPPI CODE OF 1972; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. Section 43-14-1, Mississippi Code of 1972, is amended as follows:

43-14-1. (1) The purpose of this chapter is to expand the development of a coordinated interagency system of necessary services and care beyond the two (2) existing pilots, designated by the Children's Advisory Council established in 1993, for (a) children and youth up to age twenty-one (21) with serious emotional/behavioral disturbance or mental illness who require services from a multiple services and multiple programs system; (b) children suspended or expelled from a local school district for serious and chronic misconduct; (c) children with alcohol and drug abuse problems; (d) children with co-occurring disorders (mental illness and alcohol and drug abuse problems); (e) neglected, abused or delinquent children with serious emotional or behavioral problems that would be subject to the jurisdiction of the Department of Human Services or the youth court; and (f) those children with special mental health needs for whom the necessary array of specialized services and supports is not available in the state, in the most fiscally responsible (cost efficient) manner possible, based on an individualized plan of care which takes into account other available interagency programs, including, but not limited to, Early Intervention Act of Infants and Toddlers, Section 41-87-1 et seq., Early Periodic Screening Diagnosis and Treatment, Section 43-13-117(5), * * * and waivered program for targeted case management services for children with special needs, Section 43-13-117(31), and is tied to clinically appropriate outcomes. Some of the outcomes are to reduce the number of inappropriate out-of-home placements inclusive of those out-of-state and to reduce the number of inappropriate school suspensions and expulsions for this population of children. From and after July 1, 2000, this coordinated interagency system of necessary services and care shall be named the System of Care program.

(2) There is established a reconstituted Children's Advisory Council which shall be known as the Interagency Coordinating Council for Children and Youth comprised of one (1) member from each of the appropriate child-serving divisions or sections of the State Department of Health, the Department of Human Services, the State Department of Mental Health, the State Department of Education, the Division of Medicaid of the Governor's Office, the Department of Rehabilitation Services, the Attorney General's office, the Executive Director of the Mississippi Association of School Superintendents, the Executive Director of the Public Education Forum of Mississippi, a pediatric specialist representative from the University of Mississippi Medical Center, the public Policy Chair, Mississippi Early Childhood Association, a representative from the Mississippi Economic Council, a representative from the Mississippi Association of Child-Caring Agencies, a representative from the Council of Administrators for Special Education/Mississippi Organization of Special Education Supervisors (CASE/MOSES), a family member designated by Mississippi Families as Allies for Children's Mental Health, Inc., a family member designated by the Foster Family Association of Mississippi, and a representative from the Mississippi Council of Youth Court Judges, a representative from the Governor's Office, and up to six (6) persons appointed by the chairman, of whom not less than three (3) shall have special expertise in working with children and youth with special mental health needs. Appointments to the ICCCY shall be made within sixty (60) days after the effective date of this act. The council shall organize by selecting a chairman from its membership to serve on an annual basis, and the chairman may be re-elected.

(3) The Interagency Coordinating Council for Children and Youth, (hereafter referred to as the ICCCY) is so authorized and shall oversee a planning process that mandates that each child and/or youth-serving state agency define in writing how each agency utilizes its federal and state statutes, policy requirements and funding streams to identify and/or serve children and youth with emotional disabilities or disorders; and mandate further that each define any additional federal statutes, state statutes, and/or other agency regulations, processes, or guidelines that are now being or could be used to identify and serve this population of children and youth. The ICCCY shall coordinate with, and may conduct concurrent meetings with, the Juvenile Health Recovery Board established under Section 43-27-303, Mississippi Code of 1972.

(4) The ICCCY is so authorized and shall direct the State Department of Education to use whatever means necessary to work with local public school districts to ensure appropriate identification, evaluation and services for children with serious emotional disorders in order that they shall be appropriately identified as having the eligibility category of emotional mental disorder (EMD) as defined under the federal Individuals with Disabilities Education Act of 1997, as amended.

(5) The ICCCY is so authorized and shall direct the State Department of Education and the Department of Mental Health to seek additional funds from the Mississippi Legislature for community-based coordinated services for children and youth with serious emotional disorders and children and youth with the ruling of EMD under the federal Individuals with Disabilities Education Act of 1997 (IDEA). The ICCCY is also authorized and shall direct the State Department of Education to seek from the Mississippi Legislature an increased amount of Educable Child Funds to serve children with serious emotional disorders in the custody of the Department of Human Services and to serve those children with serious emotional disorders for whom the local school district is unable to provide an appropriate public education.

(6) The ICCCY is so authorized and shall direct the Division of Medicaid to apply for necessary waivers and investigate and develop all options to increase the efficiency and flexibility of Medicaid mental health services for this population of children including, but not limited to, making changes in the Medicaid State Health Plan to ensure full implementation of Early Periodic Screening, Diagnostic and Treatment Services (EPSDT) to identify and serve children with mental health diagnoses to provide a full array of services and options for the population of children named in subsection (1).

(7) The ICCCY shall oversee a pool of state funds contributed by each participating state agency and additional funds from the Mississippi Tobacco Health Care Expenditure Fund, subject to specific appropriation therefor by the Legislature. Part of this pool of funds shall be available for increasing the present funding levels by matching Medicaid funds in order to increase the existing resources available for necessary community-based services for Medicaid beneficiaries. The monetary contribution of each participating agency shall be determined as fair and equitable by the governing board or other duly authorized state level oversight authority for such agency by July 1 of each fiscal year, to begin July 1, 2000. The amount of the monetary contribution necessary for each agency shall be determined through the compilation of agency data, historical expenditure rates and/or actuarial studies of each agency's expenditures and funds available for those children and youth. In lieu of contributing funds, the State Department of Health shall contribute to the * * * System of Care program described in this section in-kind health/medical services through the department to all the children and youth to be served by this chapter. The ICCCY shall evaluate the effectiveness of the State Department of Health's in-kind contributions and shall make recommendations for adjustment on an annual basis. The State Fiscal Officer is hereby authorized and directed to withhold quarterly allocations of funds to any state agency which is a member of the ICCCY and fails to make the monetary contributions required.

(8) The local coordinating care entities to administer the System of Care programs * * * shall be designated by the ICCCY using an RFP process. Each local coordinating care entity shall be an administrative body capable of securing and insuring the delivery of services and care across all necessary agencies and/or any other appropriate service provider(s) to meet each child or youth's authorized plan of care. After June 30, 2000, the Children's Advisory Council will add * * * additional coordinating care entities in each congressional district of the state so that all of the children in the State of Mississippi served by this chapter will be covered by June 30, 2010. Those local coordinating care entities designated by the ICCCY shall be those that clearly reflect their capability to select and secure appropriate services and care in the most cost-efficient and timely manner for the children and youth who are to be served by this chapter.

(9) Each local coordinating care entity shall work with or help establish a local Multidisciplinary Assessment and Planning Team (MAP) which shall be made up of local interagency administrators and others who have special interest and expertise with the population of children named in subsection (1) who shall provide policy oversight and community commitment to the local System of Care programs. Each local MAP team shall serve as the single point of entry and the coordinating group to ensure that comprehensive diagnosis and assessment occurs for the children named in subsection (1). Local children in crisis shall have first priority for access to the MAP team processes and local System of Care programs.

(10) Each state agency named in subsection (2) of this section shall enter into a binding interagency agreement to participate in the oversight of the statewide System of Care programs for the children and youth described in this section. The agreement shall be signed and in effect by July 1 of each year * * *.

SECTION 2. Section 43-14-3, Mississippi Code of 1972, is amended as follows:

43-14-3. The powers and responsibilities of the Interagency Coordinating Council for Children and Youth shall be as follows:

(a) To expand * * * the System of Care programs into each congressional district from a minimum of one (1) per congressional district up to not more than twenty-five (25) statewide;

(b) To implement a Request for Proposal process through which a local coordinating care entities will be selected in each congressional district to perform the functions provided in Section 43-14-7;

(c) To serve in an advisory capacity and to provide state level leadership and oversight to the development of the * * * System of Care programs;

(d) To insure the creation and availability of an annual pool of funds from each participating agency member of the ICCCY that includes the amount to be contributed by each agency that is based on the funding formula developed through the original pilot projects designated by the Children's Advisory Council established in 1993, and a process for utilization of those funds;

(e) To contract and expend funds for any contractual technical assistance and consultation necessary to the System of Care programs.

SECTION 3. Section 43-14-5, Mississippi Code of 1972, is amended as follows:

43-14-5. There is created in the State Treasury a special fund into which shall be deposited all funds contributed by the Department of Human Services, State Department of Health, Department of Mental Health and State Department of Education for the operation of the * * * System of Care programs. By the first quarter of each state fiscal year, each agency named in this section shall pay into the special fund out of its annual appropriation a sum equal to the amount determined by the board or other duly authorized state level oversight authority for that agency and accepted by the board or other duly authorized state level oversight authority for each other agency on the ICCCY. Additionally, the Division of Medicaid shall use all unmatched funds not committed for another purpose to match federal Medicaid funds for any Medicaid approved services that will be used in the System of Care programs for Medicaid eligible children and youth to be served by this chapter.

SECTION 4. Section 43-14-7, Mississippi Code of 1972, is amended as follows:

43-14-7. (1) The Interagency Coordinating Council for Children and Youth shall contract with the selected local coordinating care entity in the additional designated System of Care regions, and these entities shall administer the program according to the terms of the contract with the ICCCY.

(2) Persons eligible for services provided through the * * * System of Care programs are (a) * * * under the age of twenty-one (21) with serious emotional or behavioral disorders or mental illnesses who require services from a multiple services and multiple programs system; (b) children suspended or expelled from a local school district for serious and chronic misconduct; (c) children with alcohol and drug abuse problems; (d) children with co-occurring disorders (mental illness and alcohol and drug abuse problems); (e) neglected, abused or delinquent children with serious emotional or behavioral problems that would be subject to the jurisdiction of the Department of Human Services or the youth court; and (f) those children with special mental health needs for whom the necessary array of specialized services and supports is not available in the state, including other interagency programs which serve the children and youth to be served by this chapter including, but not limited to, Early Intervention Act of Infants and Toddlers, Section 41-87-1 et seq., Early Periodic Screening Diagnosis and Treatment, Section 43-13-117(5), waivered program for home- and community-based services for developmentally disabled people, Section 43-13-117(29), and waivered program for targeted case management services for children with special needs, Section 43-13-117(31) and those identified through the federal Individuals with Disabilities Education Act of 1997 as having a serious emotional disorder (EMD) and through the implementation of the Mississippi Children's Health Insurance program Phase I and Phase II. Those children and youth to be served by this chapter who are eligible for Medicaid shall be screened through the Medicaid Early Periodic Screening Diagnosis and Treatment (EPSDT) and their needs for medically necessary services shall be certified through the EPSDT process. Children who are not Medicaid eligible * * * shall have access to their necessary services in the * * * System of Care programs through a funding formula determined by the ICCCY based on the implementation of the original pilot projects and funded through the operating fund provided in Section 43-14-5.

(3) Services that shall be provided through the * * * System of Care programs shall include, but not be limited to, intensive home-based intervention, respite, therapeutic recreational services, emergency and crisis management, care management, day treatment, diagnosis and therapy. Services provided through the * * * System of Care programs shall be provided in the home setting of the recipient whenever feasible, rather than in a clinical setting. Services in the community of the recipient shall be considered and implemented before authorizing a more restrictive, out-of-home community setting. Where appropriate, other interagency programs which serve the children and youth to be served by this chapter, including, but not limited to, Early Intervention Act of Infants and Toddlers, Section 41-87-1 et seq., Early Periodic Screening Diagnosis and Treatment, Section 43-13-117(5), waivered program for home- and community-based services for developmentally disabled people, Section 43-13-117(29), and waivered program for targeted case management services for children with special needs, Section 43-13-117(31), and those children identified through federal Individuals with Disabilities Education Act of 1997 as having serious emotional disorder (EMD) and those children identified through the implementation of the Mississippi Children Health Insurance program, Phase I and Phase II, shall be utilized. Additional services that shall be provided for the children in this chapter in each System of Care program shall be behavioral aides for the local school districts in each System of Care program region; Service Access and Coordination Specialists for local MAP teams; and Intensive WRAP-Around Services. In addition, there shall be established in one (1) of the selected regions a pilot Family Outreach and Support Center which shall provide family support/psychoeducation groups, respite services and therapeutic recreational services.

(4) Payment for services dictated by the plan of care shall be made to the providers of the services by the selected local coordinating care entity in each of the designated System of Care regions utilizing the blended fund pool established for the * * * programs.

SECTION 5. Section 43-14-9, Mississippi Code of 1972, which is the automatic repealer on Sections 43-14-1 through 43-14-7, is hereby repealed.

SECTION 6. This act shall take effect and be in force from and after June 30, 2000.