Bill H.1199

HOUSE DOCKET, NO. 2549 FILED ON: 1/19/2023

HOUSE . . . . . . . . . . . . . . . No. 1199

By Representative Hendricks of New Bedford, a petition (accompanied by bill, House, No. 1199) of Christopher Hendricks, William M. Straus and Lindsay N. Sabadosa relative to hospital-based violence intervention and prevention services. Health Care Financing.

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Third General Court
(2023-2024)

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An Act relative to using Medicaid for violence prevention and intervention.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. (a) As used in this section:

(1)"Community violence" means intentional acts of interpersonal violence committed in public areas by individuals who are not family members or intimate partners of the victim;

(2)"Community violence prevention and intervention services" means evidence- based and/or evidence-informed, trauma-informed, supportive and psychotherapeutic services provided by a prevention professional and/or a certified violence prevention professional, within or outside of a clinical setting, for the purpose of promoting improved health outcomes and positive behavioral change, preventing injury recidivism and reducing the likelihood that individuals who are victims of community violence will commit or promote violence themselves. "Community violence prevention services" may include, but are not limited to, the provision of a community-based mobile team, outreach by violence prevention professionals who are certified or seeking certification as defined in subsection (c) serving as primary case manager or other team member outreach, comprehensive assessment and treatment planning, in-home or community-based trauma-specific therapy, specifically cognitive behavior strategies, integrated access to educational, employment and housing services, integrated access to MAT and psychopharmacology, stakeholder engagement and education. Community violence prevention and intervention services are person-centered, team-based interventions that may also include peer support and counseling, mentorship, conflict mediation, crisis intervention, targeted case management, referrals to certified or licensed health care professionals or social services providers, patient education or screening services to victims of community violence, and collaboration or integration with transitional employment, housing or other rehabilitative services. “Community violence prevention and intervention services” are intensive, longitudinal interventions responsive to individual risks and needs. “Community violence prevention and intervention services” are not care navigation, case management, or bridging services.

(3)"Interpersonal violence" means the intentional use of physical force or power against other persons by an individual or small group of individuals;

(4)"Prevention professional" has the same meaning as described by the National Uniform Claim Committee (NUCC), or its successor, under NUCC Code Number 405300000X; and

(5)"Certified violence prevention professional" means a prevention professional who meets all of the conditions specified in subsection (c) of this section.

(b)(1) On or before passage, the Secretary of the Executive Office of Health and Human Services, shall amend the Medicaid state plan to make community violence prevention services available, to the extent permitted by federal law, to any Medicaid beneficiary who has: (A) Received medical treatment for an injury sustained as a result of an act of community violence, or (B) been referred by local and/or state police as being at proven risk for engagement in violence or to be a victim of violence; and (C) been referred by a certified or licensed health care provider, correctional institution, school or school officer, social services provider or state agency to receive community violence prevention services from a certified violence prevention professional, after such provider determines such beneficiary to be at elevated risk of a violent injury or retaliation resulting from another act of community violence.

(2)Secretary of the Executive Office of Health and Human Services shall seek any federal approvals necessary to implement this section, including, but not limited to, state plan amendment by the federal Centers for Medicare and Medicaid Services. This subsection shall be implemented only to the extent that federal financial participation is available, and any necessary federal approvals have been obtained.

(3)The Secretary of the Executive Office of Health and Human Services shall utilize the Violence Prevention Federal Reinvestment Trust Fund to expand the purchase of community violence and intervention services, as defined above.

(4)The Secretary of the Executive Office of Health and Human Services shall treat existing violence prevention expenditures, including, but not limited to, expenditures for the Safe and Successful Youth Initiative, as certified public expenditures and ensure that all federal matching reserves are directed into the Violence Prevention Federal Reinvestment Trust.

(5)Massachusetts Medicaid will claim Federal Financial Participation on all annual expenditures from the Violence Prevention Federal Reinvestment Trust and will ensure that all federal revenues are directed into the Trust.

(6)The provisions of this subsection shall be implemented only to the extent permitted by federal law.

(c)Any prevention professional seeking certification as a certified violence prevention professional shall complete six months of full-time experience in community violence prevention, complete a training and certification program for certified violence prevention professionals, approved in accordance with subsection (d) of this section and maintain such certification, and annually complete at least six hours of continuing education.

(d)On or before passage, the Executive Office of Health and Human Services shall approve at least three training and certification programs for certified violence prevention professionals. Such programs shall be aligned with national best practices regarding violence prevention and intervention work including but not exclusive to outreach practices, tools to support long term behavior change and tools to address and manage trauma, including but not limited to cognitive behavioral interventions. Training should include at least thirty-five hours of initial training and at least six hours of continuing education every two years.

(1)Any entity that employs or contracts with a certified violence prevention professional to provide community violence prevention services shall:

(a) Maintain documentation that each certified violence prevention professional has met all of the conditions described in subsection (c) of this section; and

(b) Ensure that each certified violence prevention professional is providing community violence prevention services in compliance with any applicable standards of care, rules, regulations and governing law of the state or federal government.

(2)No person, unless certified as a violence prevention professional pursuant to this section, may use the title "certified violence prevention professional" or make use of any title, words, letters, abbreviations or insignia indicating or implying that he or she is a certified violence prevention professional.

(3)Nothing in this section shall alter the scope of practice for any health care professional.

SECTION 2. (a) As used in this section:

(1)"Community violence" means intentional acts of interpersonal violence committed in public areas by individuals who are not family members or intimate partners of the victim;

(2)"Hospital-based violence prevention and intervention services" are multidisciplinary programs that combine the efforts of medical staff with trusted community-based partners to provide safety planning, services, and trauma-informed care to violently injured people. Hospital-based violence prevention and intervention services means evidence- based and/or evidence-informed, trauma-informed, supportive and psychotherapeutic services provided by a prevention professional and/or a certified violence prevention professional in a hospital setting for the purpose of reducing the likelihood that individuals who are victims of community violence will be reinjured, commit, or promote violence themselves. "Hospital-based violence intervention and prevention services" may include, but are not limited to, crisis evaluation and stabilization, brief intervention in the hospital setting, including at the bedside, by a violence prevention professional who is certified or seeking certification as defined in subsection (c), safety planning, referral and transition to a community-based violence prevention and intervention services provider prior to leaving the hospital setting. Hospital-based violence intervention and prevention services may be delivered directly by hospital-employed staff or through partnership with community-based violence prevention and intervention service providers. Hospital-based violence intervention and prevention services must establish formal documented referral relationships with community-based violence prevention and intervention services to ensure longitudinal intervention in the community following the hospital encounter.

(3)"Interpersonal violence" means the intentional use of physical force or power against other persons by an individual or small group of individuals;

(4)"Prevention professional" has the same meaning as described by the National Uniform Claim Committee (NUCC), or its successor, under NUCC Code Number 405300000X; and

(5)"Certified violence prevention professional" means a prevention professional who meets all of the conditions specified in subsection (c) of Section 1.

(b)(1) On or before passage, the Secretary of the Executive Office of Health and Human Services shall amend Department of Public Health (DPH) hospital licensure regulations for Trauma Center Designation (105 CMR 130.850-.854) to include the requirement that hospitals provide access to hospital-based violence prevention and intervention services on premises to be designated and approved as a Level One Trauma Center by DPH. The regulatory requirement shall stipulate that the hospital-based violence prevention and intervention services operated by the Level One Trauma Center must include formal, documented referral partnership with community-based violence prevention and intervention services as defined in Section 1 (2) to ensure continuity of violence intervention and prevention outside of the hospital-based setting.

(c)(1) On or before passage, the Secretary of the Executive Office of Health and Human Services, shall amend the Medicaid state plan to make hospital-based violence prevention and intervention services available, to the extent permitted by federal law, to any Medicaid beneficiary who is receiving medical treatment for an injury sustained as a result of an act of community violence, is seen in a hospital based emergency department or admitted to acute hospital setting following an act of community violence, or presents for care at a hospital-based outpatient hospital clinic, and is determined upon evaluation by a qualified healthcare professional to be in need of hospital-based violence intervention and prevention services.

(7)Secretary of the Executive Office of Health and Human Services shall seek any federal approvals necessary to implement this section, including, but not limited to, state plan amendment by the federal Centers for Medicare and Medicaid Services. This subsection shall be implemented only to the extent that federal financial participation is available, and any necessary federal approvals have been obtained.

(8)The Secretary of the Executive Office of Health and Human Services shall utilize the Violence Prevention Federal Reinvestment Trust Fund to expand the purchase of hospital-based violence prevention and intervention services, as defined above.

(9)The Secretary of the Executive Office of Health and Human Services shall establish rates of payment for hospital-based violence prevention and intervention services and shall ensure that Managed Care Entities contracted to provide covered services to Medicaid beneficiaries reimburse for hospital-based violence prevention and intervention services at rates of payment no less than those established by the secretary.

(10)The Secretary of the Executive Office of Health and Human Services shall ensure that all funds appropriated for the purposes of funding hospital-based violence prevention and intervention services, including funds passed to Managed Care Entities, will be fully expended each year. The secretary shall provide a report accounting for the expenditure of funds for hospital-based violence prevention and intervention services to the legislature on or before [set date] of each year.

(11)The Secretary of the Executive Office of Health and Human services shall ensure that all federal matching reserves associated with expenditures on hospital-based violence intervention and prevention services are directed into the Violence Prevention Federal Reinvestment Trust.

(12)Massachusetts Medicaid will claim Federal Financial Participation on all annual expenditures from the Violence Prevention Federal Reinvestment Trust and will ensure that all federal revenues are directed into the Trust.

(13)The provisions of this subsection shall be implemented only to the extent permitted by federal law.

Name:	District/Address:	Date Added:
Christopher Hendricks	11th Bristol	1/19/2023
William M. Straus	10th Bristol	2/1/2023
Lindsay N. Sabadosa	1st Hampshire	2/8/2023
William J. Driscoll, Jr.	7th Norfolk	6/14/2023