Bill Text: HI HB484 | 2019 | Regular Session | Amended

Hawaii House Bill 484 (Prior Session Legislation)

Bill Title: Relating To Clinical Victim Support Services.

Spectrum: Moderate Partisan Bill (Democrat 15-3)

Status: (Introduced - Dead) 2019-02-13 - Report adopted. referred to the committee(s) on FIN as amended in HD 2 with none voting aye with reservations; none voting no (0) and Representative(s) Holt, McDermott, Nakamura, Ward excused (4). [HB484 Detail]

Download: Hawaii-2019-HB484-Amended.html

HOUSE OF REPRESENTATIVES	H.B. NO.	484
THIRTIETH LEGISLATURE, 2019		H.D. 2
STATE OF HAWAII

A BILL FOR AN ACT

RELATING TO CLINICAL VICTIM SUPPORT SERVICES.

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

PART I

SECTION 1. The legislature finds that sexual violence and abuse are extremely prevalent in the United States. One in six women and one in thirty-three men have experienced an attempted or completed rape in their lifetimes, while one in four girls and one in six boys will be sexually abused before they turn eighteen. According to the federal Centers for Disease Control and Prevention, an estimated 43.9 per cent of women and 23.4 per cent of men have experienced forms of sexual violence other than rape within their lifetimes.

The legislature further finds that sexual violence and abuse can have severe and lasting emotional and mental health impacts on victims. Victims of sexual assault during adulthood suffer post-traumatic stress disorder at a rate between thirty to sixty-five per cent, as well as elevated rates of depressive disorders, parasuicidal behaviors, and substance use disorders. Victims of sexual abuse during childhood face numerous psychological challenges at rates higher than people who have not experienced sexual abuse, including being three to five times more likely to be diagnosed with post-traumatic stress disorder; having fifty-two per cent higher rates of lifetime depression; and experiencing increased rates of suicide, self-harming behaviors, alcohol use, eating disorders, and disruptions to developmental processes that lead to personality disorders. Consequently, many victims of sexual violence and abuse represent mental health cases that require clinical victim support services by licensed mental health providers, in addition to psychotherapy, to effectively manage mental disorders related to sexual violence and abuse.

The legislature also finds that it can be difficult for victims of sexual violence and abuse to obtain appropriate mental health services due to the limited availability of licensed mental health providers who are able to take on potentially complex mental health cases. Clinical victim support services, which are required for treatment of mental disorders caused, in whole or in part, by sexual violence and abuse, are not generally covered by health insurers. This is a barrier to sufficient provider availability, as clinical victim support services are often an unreimbursed expense that discourages providers from accepting potentially complex cases.

The purpose of this Act is to improve mental health service availability for victims of sexual violence and abuse by clarifying that clinical victim support services for victims of sexual violence and abuse are a mental health outpatient services benefit required to be covered under health insurance policies offered by health insurers, mutual benefit societies, fraternal benefit societies, and health maintenance organizations.

SECTION 2. Section 431M-1, Hawaii Revised Statutes, is amended by adding two new definitions to be appropriately inserted and to read as follows:

""Clinical victim support services" means a professional intervention conducted by a licensed mental health provider to identify needs and assist in obtaining coordinated, appropriate services and resources for a victim of sexual violence and abuse to curtail or prevent the progression and worsening of mental disorders and associated functional impairments caused, in whole or in part, by the sexual violence and abuse. "Clinical victim support services" include:

(1) Coordinating with other health care providers, such as primary care physicians, behavioral and mental health care providers, and hospitals;

(2) Assisting victims of sexual violence and abuse in obtaining appropriate government entitlements, access to insurance coverage, and other appropriate programs and services offered by government agencies and community organizations; and

(3) Coordinating with schools, employers, and other individuals and entities concerning a victim of sexual violence and abuse.

"Victim of sexual violence and abuse" means an individual who suffers from one or more mental disorders caused, in whole or in part, by sexual violence and abuse."

SECTION 3. Section 431M-2, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) All individual and group policies of accident and health or sickness insurance [~~policies~~] issued in this State, individual or group hospital or medical service plan contracts, and nonprofit mutual benefit society, fraternal benefit society, and health maintenance organization health plan contracts shall include within their hospital and medical coverage the benefits of alcohol use disorder, substance use disorder, and mental health treatment services, including services for alcohol dependence and drug dependence[,] and clinical victim support services for victims of sexual violence and abuse, except that this section shall not apply to insurance policies that are issued solely for single diseases, or otherwise limited, specialized coverage."

SECTION 4. Section 431M-4, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

"(b) Mental illness benefits.

(1) Covered benefits for mental health services set forth in this subsection shall be limited to coverage for diagnosis and treatment of mental disorders. All mental health services shall be provided under an individualized treatment plan approved by a physician, psychologist, licensed clinical social worker, licensed marriage and family therapist, licensed mental health counselor, advanced practice registered nurse, or licensed dietitian treating eating disorders, and must be reasonably expected to improve the patient's condition. An individualized treatment plan approved by a licensed clinical social worker, licensed marriage and family therapist, licensed mental health counselor, advanced practice registered nurse, or a licensed dietitian treating eating disorders, for a patient already under the care or treatment of a physician or psychologist shall be done in consultation with the physician or psychologist;

(2) In-hospital and nonhospital residential mental health services as a covered benefit under this chapter shall be provided in a hospital or a nonhospital residential facility. The services to be covered shall include those services required for licensure and accreditation;

(3) Mental health partial hospitalization as a covered benefit under this chapter shall be provided by a hospital or a mental health outpatient facility. The services to be covered under this paragraph shall include those services required for licensure and accreditation; and

(4) Mental health outpatient services, including clinical victim support services, shall be a covered benefit under this chapter."

SECTION 5. Notwithstanding any other law to the contrary, the coverage and reimbursement for clinical victim support services for victims of sexual violence and abuse required under sections 2, 3, and 4 of this Act shall also apply to all health benefit plans under chapter 87A, Hawaii Revised Statutes, issued, renewed, modified, altered, or amended on or after the effective date of this Act.

PART II

SECTION 6. (a) The state auditor shall conduct an impact assessment report pursuant to section 23-51, Hawaii Revised Statutes, to assess the social and financial effects of the mandate specified in part I of this Act.

(b) This part shall satisfy the procedural requirements, in lieu of a concurrent resolution, of section 23-51, Hawaii Revised Statutes.

(c) The state auditor shall submit a report of its findings and recommendations, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2020.

PART III

SECTION 7. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 8. This Act shall take effect on July 1, 2050; provided that part I of this Act shall take effect January 1, 2021.

Report Title:

Insurance; Benefits; Clinical Victim Support Services; Victims of Sexual Violence and Abuse

Description:

Clarifies that clinical victim support services for victims of sexual violence and abuse are a mental health outpatient services benefit required to be covered under health insurance policies. Requires the State Auditor to conduct an impact assessment and to report any findings prior to the Regular Session of 2020. (HB484 HD2)

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.