Amendment #352 to H4000

Addressing Continuing Care Transparency and Capacity

Ms. Decker of Cambridge moves to amend the bill by inserting the following section:-

SECTION XX. Chapter 19 of the General Laws, as appearing in the 2018 Official Edition, is hereby amended by adding the following section:-

Section 26.

(a) The department shall publicly report data on the availability of adult and pediatric beds at inpatient continuing care facilities that are operated by or contracted by the department.  On a monthly basis, the department shall report: i) number of operational beds, per continuing care facility, and ii) the number of beds that have been taken out of operation, per continuing care facility.  On a weekly basis, the department shall report: i) inpatient census, per continuing care facility; ii) number of patients that have been admitted off of the waitlist for continuing care placement, disaggregated by the continuing care facility that accepted the patient and by the inpatient facility the patient was accepted from; iii) the number of forensic patients admitted per continuing care facility; iv) the number of patients discharged per continuing care facility; v) the number of patients who cannot be discharged from the continuing care facility to the community due to the acuity of their behavioral health diagnosis or forensic status, per continuing care facility; and vi) the number of patients appropriate for discharge from continuing care but who are awaiting an available community placement, per continuing care facility.  In its first monthly report detailing the operational status of beds at each continuing care facility operated or contracted by the department, the department shall provide historic data on the previous 15 years of operational continuing care beds, per continuing care facility.  To the extent feasible, data in the weekly reports shall be disaggregated by race, ethnicity, gender identity, age and other demographic information deemed relevant.

(b) The department’s continuing care referral list, known as the inpatient referral summary, shall include data on patients in acute psychiatric facilities waiting for acceptance to continuing care facilities.  The inpatient referral summary shall indicate the length of time a patient has awaited a continuing care placement, and shall indicate by each inpatient psychiatric facility the number of patients that have been awaiting placement for: i) 0 to 7 days; ii) 8 to 30 days; iii) 31 days to 3 months; iv) more than 3 months to 6 months; v) more than 6 months to 9 months; vi) more than 9 months to 12 months; and vii) more than 12 months.  In calculating the amount of time a patient has been awaiting a continuing care placement, the department shall include the time the patient waited between the submission of an application and eventual acceptance to a continuing care facility in addition to the time the patient awaited transfer after acceptance for admission. Said report shall be distributed to all licensed psychiatric hospitals and units on a weekly basis.

(c) If continuing care beds are taken out of operation, either by the department or by a contractor of the department, the department shall immediately report to the clerks of the senate and house of representatives, the senate and house committees on ways and means, the joint committee on health care financing, and the joint committee on mental health, substance use and recovery: i) the number of beds taken out of operation and facility where the beds taken offline are located; and ii) the rationale for taking the beds offline.

and further moves to amend the bill in section 2, in item 5095-0015, by striking out the figure “$5,000,000” and inserting in place thereof the figure:- “$10,00,000”;

and further moves to amend said item by inserting after “more beds at Taunton State Hospital;” the following:-

“provided further, that the department shall expend $13,000,000 to expand inpatient continuing care facilities so that the total number of continuing care beds exceed the number of operational beds prior to March 10, 2020;”;

and further moves to amend said item by striking the figure “255,779,455” and inserting in place thereof the figure “267,379,455”.;

and further moves to amend the bill in section 2, in item 5046-0000, by striking the figure “$5,000,000” and inserting in place thereof the figure: “$10,000,000”;

and further moves to amend the bill in section 2, in item 5055-0000, by inserting after “juvenile court clinics” the following:-

“;provided further, than not less than $200,000 be expended for a study conducted by the department of mental health to assess: (i) the feasibility of the state establishing a forensic psychiatric treatment setting that does not use continuing care inpatient beds maintained by the department and is not located at Bridgewater State Hospital, provided that the department may operate or contract with providers to operate said forensic psychiatric treatment setting; (ii) in conjunction with the trial courts, the feasibility of establishing community forensic evaluation programs geographically equitably across the commonwealth, the establishment of a step down pathway for forensic patients to community-based psychiatric treatment services that does not first require treatment for said patients in an inpatient facility operated by or contracted with the department, and the development of any necessary additional and appropriate settings of psychiatric care for forensic patients that are not operated by the department ”;

and further amend said item by striking out the figures “11,094,542” and inserting in place thereof the figures “11,294,542”.

and further moves to amend the bill in section 2, in item 4000-0300, by inserting after “the subsequent month” the following:-

“; provided further, that in calculating rates of payment for high acuity adult and pediatric psychiatric patients enrolled in MassHealth receiving intensive inpatient psychiatric services at acute care hospitals and freestanding psychiatric hospitals, the executive office, in conjunction with providers who operate or have current plans to operate specialized inpatient psychiatric units for adults and youth, shall develop, and MassHealth shall make enhanced payments at a rate sufficient to ensure the viability of intensive acute psychiatric treatment for the duration of a patient’s course of treatment, including the cost of providing intensive services, augmented staff, blocked beds, the continued maintenance of available beds including within intensive units, the preservation of a patient’s care team for the duration of treatment and specialized training for staff; provided further, that MassHealth shall conduct an analysis in consultation with the Massachusetts Health and Hospital Association, Conference of Boston Teaching Hospitals and Massachusetts Association of Behavioral Health Systems regarding the need for additional intensive inpatient psychiatric units for high acuity psychiatric patients beyond those units currently proposed”.

Additional co-sponsor(s) added to Amendment #352 to H4000

Addressing Continuing Care Transparency and Capacity