SB295 FULLPCS1 Doug Cox-AM 4/1/2013 4:30:37 pm COMMITTEE AMENDMENT HOUSE OF REPRESENTATIVES State of Oklahoma SPEAKER: CHAIR: I move to amend SB295 Of the printed Bill Page Section Lines Of the Engrossed Bill By striking the Title, the Enacting Clause, the entire bill, and by inserting in lieu thereof the following language: AMEND TITLE TO CONFORM TO AMENDMENTS Amendment submitted by: Doug Cox Adopted: _____________________________ ______________________________________ Reading Clerk 1 STATE OF OKLAHOMA 2 1st Session of the 54th Legislature (2013) 3 4 PROPOSED COMMITTEE SUBSTITUTE FOR ENGROSSED SENATE BILL NO. 295 By: Ivester of the Senate 5 and 6 Murphey of the House 7 8 9 10 PROPOSED COMMITTEE SUBSTITUTE 11 An Act relating to mental health; amending 43A O.S. 2011, Section 1-103, which relates to definitions; adding certain term; amending 43A O.S. 2011, Section 3-317, which relates to community-based structured crisis centers; requiring centers to comply with certain standards; amending 43A O.S. 2011, Section 3403, which relates to definitions; adding certain term; amending 43A O.S. 2011, Section 3-415, which relates to certified services for alcohol- and drugdependent persons; adding certain exemptions; and providing an effective date. 12 13 14 15 16 17 18 19 20 21 22 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: SECTION 1. AMENDATORY 43A O.S. 2011, Section 1-103, is amended to read as follows: Section 1-103. When used in this title, unless otherwise 23 expressly stated, or unless the context or subject matter otherwise 24 requires: Req. No. 7705 Page 1 1 2 3 4 5 1. "Department" means the Department of Mental Health and Substance Abuse Services; 2. "Chair" means the chair of the Board of Mental Health and Substance Abuse Services; 3. "Mental illness" means a substantial disorder of thought, 6 mood, perception, psychological orientation or memory that 7 significantly impairs judgment, behavior, capacity to recognize 8 reality or ability to meet the ordinary demands of life; 9 10 11 4. "Board" means the "Board of Mental Health and Substance Abuse Services" as established by this law; 5. "Commissioner" means the individual selected and appointed 12 by the Board to serve as Commissioner of Mental Health and Substance 13 Abuse Services; 14 6. "Indigent person" means a person who has not sufficient 15 assets or resources to support the person and to support members of 16 the family of the person lawfully dependent on the person for 17 support; 18 7. "Facility" means any hospital, school, building, house or 19 retreat, authorized by law to have the care, treatment or custody of 20 an individual with mental illness, or drug or alcohol dependency, 21 gambling addiction, eating disorders, an opioid substitution 22 treatment program, including, but not limited to, public or private 23 hospitals, community mental health centers, clinics, satellites or 24 Req. No. 7705 Page 2 1 facilities; provided that facility shall not mean a child guidance 2 center operated by the State Department of Health; 3 8. "Consumer" means a person under care or treatment in a 4 facility pursuant to the Mental Health Law, or in an outpatient 5 status; 6 9. "Care and treatment" means medical care and behavioral 7 health services, as well as food, clothing and maintenance, 8 furnished to a person; 9 10. Whenever in this law or in any other law, or in any rule or 10 order made or promulgated pursuant to this law or to any other law, 11 or in the printed forms prepared for the admission of consumers or 12 for statistical reports, the words "insane", "insanity", "lunacy", 13 "mentally sick", "mental disease" or "mental disorder" are used, 14 such terms shall have equal significance to the words "mental 15 illness"; 16 17 11. "Licensed mental health professional" means: a. 18 19 a psychiatrist who is a diplomate of the American Board of Psychiatry and Neurology, b. a physician licensed pursuant to Section 480 et seq. 20 or Section 620 et seq. of Title 59 of the Oklahoma 21 Statutes, 22 c. a clinical psychologist who is duly licensed to 23 practice by the State Board of Examiners of 24 Psychologists, Req. No. 7705 Page 3 1 d. 2 a professional counselor licensed pursuant to Section 1901 et seq. of Title 59 of the Oklahoma Statutes, 3 e. a person licensed as a clinical social worker pursuant 4 to the provisions of the Social Worker’s Licensing 5 Act, 6 f. a licensed marital and family therapist as defined in 7 Section 1925.1 et seq. of Title 59 of the Oklahoma 8 Statutes, 9 g. a licensed behavioral practitioner as defined in 10 Section 1930 et seq. of Title 59 of the Oklahoma 11 Statutes, 12 h. an advanced practice nurse as defined in Section 567.1 13 et seq. of Title 59 of the Oklahoma Statutes 14 specializing in mental health, or 15 i. a physician’s assistant who is licensed in good 16 standing in this state and has received specific 17 training for and is experienced in performing mental 18 health therapeutic, diagnostic, or counseling 19 functions; 20 12. "Mentally incompetent person" means any person who has been 21 adjudicated mentally or legally incompetent by an appropriate 22 district court; 23 24 Req. No. 7705 Page 4 1 13. a. "Person requiring treatment" means a person who 2 because of his or her mental illness or drug or 3 alcohol dependency: 4 (1) poses a substantial risk of immediate physical 5 harm to self as manifested by evidence or serious 6 threats of or attempts at suicide or other 7 significant self-inflicted bodily harm, 8 (2) poses a substantial risk of immediate physical 9 harm to another person or persons as manifested 10 by evidence of violent behavior directed toward 11 another person or persons, 12 (3) has placed another person or persons in a 13 reasonable fear of violent behavior directed 14 towards such person or persons or serious 15 physical harm to them as manifested by serious 16 and immediate threats, 17 (4) is in a condition of severe deterioration such 18 that, without immediate intervention, there 19 exists a substantial risk that severe impairment 20 or injury will result to the person, or 21 (5) poses a substantial risk of immediate serious 22 physical injury to self or death as manifested by 23 evidence that the person is unable to provide for 24 Req. No. 7705 Page 5 1 and is not providing for his or her basic 2 physical needs. 3 b. The mental health or substance abuse history of the 4 person may be used as part of the evidence to 5 determine whether the person is a person requiring 6 treatment. 7 history of the person shall not be the sole basis for 8 this determination. 9 c. The mental health or substance abuse Unless a person also meets the criteria established in 10 subparagraph a of this paragraph, person requiring 11 treatment shall not mean: 12 (1) a person whose mental processes have been 13 weakened or impaired by reason of advanced years, 14 dementia, or Alzheimer’s disease, 15 (2) a mentally retarded or developmentally disabled 16 person as defined in Title 10 of the Oklahoma 17 Statutes, 18 (3) a person with seizure disorder, 19 (4) a person with a traumatic brain injury, or 20 (5) a person who is homeless. 21 d. A person who meets the criteria established in this 22 section, but who is medically unstable, or the 23 facility holding the person is unable to treat the 24 additional medical conditions of that person should be Req. No. 7705 Page 6 1 discharged and transported in accordance with Section 2 1-110 of this title; 3 4 5 6 7 14. "Petitioner" means a person who files a petition alleging that an individual is a person requiring treatment; 15. "Executive director" means the person in charge of a facility as defined in this section; 16. "Private hospital or facility" means any general hospital 8 maintaining a neuro-psychiatric unit or ward, or any private 9 hospital or facility for care and treatment of a person having a 10 mental illness, which is not supported by the state or federal 11 government. 12 include nursing homes or other facilities maintained primarily for 13 the care of elderly and disabled persons; 14 17. The term “private hospital” or “facility” shall not "Individualized treatment plan" means a proposal developed 15 during the stay of an individual in a facility, under the provisions 16 of this title, which is specifically tailored to the treatment needs 17 of the individual. 18 a. Each plan shall clearly include the following: a statement of treatment goals or objectives, based 19 upon and related to a clinical evaluation, which can 20 be reasonably achieved within a designated time 21 interval, 22 b. 23 treatment methods and procedures to be used to obtain these goals, which methods and procedures are related 24 Req. No. 7705 Page 7 1 to each of these goals and which include specific 2 prognosis for achieving each of these goals, 3 c. identification of the types of professional personnel 4 who will carry out the treatment procedures, including 5 appropriate medical or other professional involvement 6 by a physician or other health professional properly 7 qualified to fulfill legal requirements mandated under 8 state and federal law, 9 d. documentation of involvement by the individual 10 receiving treatment and, if applicable, the accordance 11 of the individual with the treatment plan, and 12 e. a statement attesting that the executive director of 13 the facility or clinical director has made a 14 reasonable effort to meet the plan's individualized 15 treatment goals in the least restrictive environment 16 possible closest to the home community of the 17 individual; and 18 18. “Telemedicine” means the practice of health care delivery, 19 diagnosis, consultation, evaluation, treatment, transfer of medical 20 data, or exchange of medical education information by means of 21 audio, video, or data communications. 22 video multimedia telecommunication equipment which permits two-way 23 real-time communication between a health care practitioner and a 24 patient who are not in the same physical location. Req. No. 7705 Telemedicine uses audio and Telemedicine Page 8 1 shall not include consultation provided by telephone or facsimile 2 machine; and 3 19. “Recovery and recovery support” means nonclinical services 4 that assist individuals and families to recover from alcohol or drug 5 problems. 6 among allied service providers, including but not limited to 7 transportation to and from treatment or employment, employment 8 services and job training, case management and individual services 9 coordination, life skills education, relapse prevention, housing 10 11 12 13 They include social support, linkage to and coordination assistance, child care, and substance abuse education. SECTION 2. AMENDATORY 43A O.S. 2011, Section 3-317, is amended to read as follows: Section 3-317. A. The Board of Mental Health and Substance 14 Abuse Services, or the Commissioner of Mental Health and Substance 15 Abuse Services upon delegation by the Board, shall certify 16 community-based structured crisis centers for the provision of 17 nonhospital emergency services for mental health and substance abuse 18 crisis intervention. 19 certification of community-based structured crisis centers. 20 B. The Board shall promulgate rules for the No community-based structured crisis center shall operate or 21 continue to operate unless the facility complies with the rules 22 promulgated by the Board and is certified as required by this 23 section. 24 Req. No. 7705 Page 9 1 C. For the purposes of this section, "community-based 2 structured crisis center" means any certified community mental 3 health center, comprehensive community addiction recovery center, or 4 facility operated by the Department which is established and 5 maintained for the purpose of providing community-based mental 6 health and substance abuse crisis stabilization services including, 7 but not limited to, observation, evaluation, emergency treatment and 8 referral, when necessary, for inpatient psychiatric or substance 9 abuse treatment services. 10 D. The Department of Mental Health and Substance Abuse Services 11 is authorized to establish and collect certification and renewal 12 fees for certification of community-based structured crisis centers 13 as provided in Section 3-324 of this title. 14 E. Failure to comply with rules and standards promulgated by 15 the Board shall be grounds for revocation, suspension or nonrenewal 16 of certification Certified community-based structured crisis centers 17 shall comply with standards adopted by the Board. 18 shall be in compliance with: 19 20 1. Such standards The Joint Commission on Accreditation of Healthcare Organizations; 21 2. 22 Facilities; 23 3. The Commission on Accreditation of Rehabilitation The Council on Accreditation (COA); or 24 Req. No. 7705 Page 10 1 4. 2 the Board. 3 4 5 6 7 Approved medical and professional standards as determined by SECTION 3. 43A O.S. 2011, Section 3-403, is amended to read as follows: Section 3-403. As used in the Oklahoma Alcohol and Drug Abuse Services Act: 1. 8 "Approved treatment facility" means any facility which: a. 9 offers either inpatient, intermediate or outpatient treatment to any person suffering from alcohol or drug 10 abuse, or alcohol- or drug-related problems, and 11 b. 12 13 AMENDATORY is certified by the Board of Mental Health and Substance Abuse Services; 2. An "alcohol-dependent person" is one who uses alcoholic 14 beverages to such an extent that it impairs the health, family life, 15 or occupation of the person and compromises the health and safety of 16 the community; 17 3. A "drug-dependent person" means a person who is using a 18 controlled substance as presently defined in Section 102 of the 19 Federal Controlled Substances Act and who is in a state of psychic 20 or physical dependence, or both, arising from administration of that 21 controlled substance on an intermittent or continuous basis. 22 dependence is characterized by behavioral and other responses which 23 include a strong compulsion to take the substance on a continuous Drug 24 Req. No. 7705 Page 11 1 basis in order to experience its psychic effects, or to avoid the 2 discomfort of its absence; 3 4. "Intoxicated person" means a person whose mental or physical 4 functioning is substantially impaired as the direct result of the 5 consumption of alcohol or drugs; 6 5. "Medical detoxification" means diagnostic and treatment 7 services performed by licensed facilities for acute alcohol 8 intoxication, delirium tremens and physical and neurological 9 complications resulting from acute intoxication. Medical 10 detoxification includes the services of a physician and attendant 11 medical personnel including nurses, interns and emergency room 12 personnel, the administration of a medical examination and a medical 13 history, the use of an emergency room and emergency medical 14 equipment if warranted, a general diet of three meals each day, the 15 administration of appropriate laboratory tests, and supervision by 16 properly trained personnel until the person is no longer medically 17 incapacitated by the effects of alcohol; 18 6. "Nonmedical detoxification" means detoxification services 19 for intoxicated clients with no apparent physical or neurological 20 symptoms requiring medical treatment as a result of their 21 intoxication. 22 oral administration of fluids, three meals a day and the taking of 23 the client's temperature, blood pressure and pulse at least once Nonmedical detoxification includes providing a bed, 24 Req. No. 7705 Page 12 1 every six (6) hours for the duration of the client's stay in the 2 nonmedical detoxification service; 3 4 5 7. "Inpatient treatment" means the process of providing residential diagnostic and treatment services on a scheduled basis; 8. "Intermediate care" means an organized therapeutic 6 environment in which a client may receive diagnostic services, 7 counseling, vocational rehabilitation and/or work therapy while 8 benefiting from the support which a full or partial residential 9 setting can provide. Intermediate care should provide a transition 10 between the inpatient detoxification facility and reintegration into 11 community life. 12 three meals a day and medical support if needed; 13 9. Intermediate care must include provision for a bed, "Transitional living facility" and "halfway house" means an 14 approved treatment facility which offers or provides temporary 15 residential accommodations, meals, supervision at all times 16 residents are in the facility or on facility premises, and services, 17 including counseling, short-term supportive care, case management, 18 mental health services or treatment services; 19 10. "Short-term supportive care" means a service rendered to 20 any person residing in a halfway house or transitional living 21 facility which is sufficient to assist the person to meet or achieve 22 an adequate level of daily living and to learn or develop adequate 23 daily living skills. 24 limited to, resident participation in meal preparation and routine Req. No. 7705 Daily living skills shall include, but not be Page 13 1 housekeeping and laundry tasks. 2 includes, but is not limited to, assistance in the preparation of 3 meals, housekeeping, laundry tasks and personal hygiene. 4 supportive assistance shall not include medical services or personal 5 care as defined in Section 1-820 of Title 63 of the Oklahoma 6 Statutes; and 7 11. Short-term supportive assistance Short-term "Treatment" means the broad range of emergency, inpatient, 8 intermediate and outpatient services and care, including diagnostic 9 evaluation, medical, psychiatric, psychological and social service 10 care, vocational rehabilitation and career counseling, which may be 11 extended to alcohol-dependent, intoxicated and drug-dependent 12 persons; and 13 12. “Faith-based” means an organization, association, facility 14 or program that offers services within a context of religious 15 beliefs that are articulated by the organization’s, association’s, 16 facility’s or program’s mission statement, affiliations, or 17 sponsoring entities. 18 19 20 SECTION 4. AMENDATORY 43A O.S. 2011, Section 3-415, is amended to read as follows: Section 3-415. A. 1. The Board of Mental Health and Substance 21 Abuse Services shall promulgate rules and standards for 22 certification for private facilities and organizations which provide 23 treatment, counseling, recovery and rehabilitation services directed 24 toward alcohol- and drug-dependent persons. Req. No. 7705 These facilities and Page 14 1 organizations shall be known as “Certified Services for the Alcohol- 2 and Drug-Dependent”. 3 assist alcohol- and drug-dependent persons by providing treatment, 4 recovery support and rehabilitation. 5 2. Only certified facilities may receive and Any person violating the requirement that only certified 6 facilities may receive and assist alcohol- and drug-dependent 7 persons by providing treatment to alcohol- and drug-dependent 8 persons, upon conviction, shall be guilty of a misdemeanor. 9 as otherwise provided in this section, no substance abuse treatment Except 10 program shall operate or continue to operate unless the facility 11 complies with the rules promulgated by the Board and is certified as 12 required by this section. 13 B. Applications for certification as a certified service for 14 the alcohol- and drug-dependent person pursuant to the provisions of 15 this section shall be made to the Department of Mental Health and 16 Substance Abuse Services on prescribed forms. 17 C. The Board, or the Commissioner of Mental Health and 18 Substance Abuse Services upon delegation by the Board, may certify 19 the facility for a period of thirty-six (36) months subject to 20 renewal as provided. 21 D. The Board or the Commissioner of Mental Health and Substance 22 Abuse Services upon delegation by the Board, may postpone, deny 23 renewal of, revoke, or suspend the certification of the facility for 24 failure to comply with rules and standards promulgated by the Board. Req. No. 7705 Page 15 1 2 3 E. The following are exempt from the provisions of the Oklahoma Alcohol and Drug Abuse Services Act: 1. Individual persons in private practice as licensed 4 physicians, licensed psychologists, licensed social workers, 5 registered nurses, licensed professional counselors, licensed 6 marriage and family therapists, licensed behavioral practitioners, 7 individual members of the clergy, and certified alcohol or drug 8 abuse counselors. 9 professional persons in their private practice and not to any 10 11 12 The exemption shall apply only to individual treatment facility operated by the person; 2. Properly licensed hospitals, psychiatric and medical surgical facilities; 13 3. Programs or facilities operated by a state agency; 14 4. Programs conducted and facilities operated by Alcoholics 15 16 17 Anonymous; or 5. Programs conducted and facilities operated by the Salvation Army; 18 6. Faith-based, nonresidential recovery programs; 19 7. Residential recovery-based programs with a resident capacity 20 21 of less than twelve; or 8. Residential recovery and recovery support programs that are 22 not collocated with certified treatment programs. 23 Department of Mental Health and Substance Abuse Services shall offer 24 voluntary certification for those resident recovery and recovery Req. No. 7705 However, the Page 16 1 support programs that are not collocated with certified treatment 2 programs that desire Department certification. 3 F. Certified services for the alcohol- or drug-dependent person 4 shall comply with standards adopted by the Board. 5 shall require that treatment and therapeutic methods shall be in 6 compliance with: 7 8 1. Such standards The Joint Commission on Accreditation of Healthcare Organizations; 9 2. 10 Facilities; 11 3. The Council on Accreditation (COA); or 12 4. Approved medical and professional standards as determined by 13 the Board. 14 G. The Commission on Accreditation of Rehabilitation Any facility or organization certified to provide certified 15 services shall cooperate with inspection personnel of the state and 16 shall promptly file all reports required by the Board. 17 H. All claims by and accomplishments publicized by any 18 applicant for certification or any certified alcohol- or drug- 19 dependent organization, including but not limited to consumer count 20 and success rates, shall be documented and verifiable by the Board. 21 I. The Department of Mental Health and Substance Abuse Services 22 is authorized to establish and collect certification and renewal 23 fees for certification of private facilities and organizations which 24 provide treatment, counseling and rehabilitation services directed Req. No. 7705 Page 17 1 toward alcohol- and drug-dependent persons, as provided in Section 2 3-324 of this title. 3 J. Any materials or information received by the Department from 4 an applicant regarding the applicant’s financial status shall not be 5 construed to be open records pursuant to the Oklahoma Open Records 6 Act. 7 SECTION 5. This act shall become effective November 1, 2013. 8 9 54-1-7705 AM 04/02/13 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Req. No. 7705 Page 18