Bill Text: NJ A5715 | 2018-2019 | Regular Session | Introduced


Bill Title: Provides for establishment of internal Statewide discharge planning list to facilitate prompt and efficient discharge and transfer of patients with mental health or substance use disorders from hospitals to community-based residential facilities.

Spectrum: Slight Partisan Bill (Democrat 2-1)

Status: (Introduced - Dead) 2019-08-23 - Introduced, Referred to Assembly Human Services Committee [A5715 Detail]

Download: New_Jersey-2018-A5715-Introduced.html

ASSEMBLY, No. 5715

STATE OF NEW JERSEY

218th LEGISLATURE

 

INTRODUCED AUGUST 23, 2019

 


 

Sponsored by:

Assemblywoman  VALERIE VAINIERI HUTTLE

District 37 (Bergen)

 

 

 

 

SYNOPSIS

     Provides for establishment of internal Statewide discharge planning list to facilitate prompt and efficient discharge and transfer of patients with mental health or substance use disorders from hospitals to community-based residential facilities.

 

CURRENT VERSION OF TEXT

     As introduced.

  


An Act concerning the discharge and transfer of certain patients from hospitals to community-based residential facilities that provide mental health or substance use disorder treatment or recovery services, and supplementing Title 26 of the Revised Statutes.

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

     1.    a.  The Division of Mental Health and Addiction Services in the Department of Human Services shall develop and maintain an internal Statewide discharge planning list, as provided by this section, to facilitate the prompt and efficient discharge and transfer of patients with a mental health or substance use disorder from a hospital, following the completion of treatment therein, to a community-based residential facility that is appropriate for the patient's ongoing mental health and substance use disorder treatment or recovery needs.  

     b.    The discharge planning list established pursuant to this section shall: 

     (1)   identify the names and current treatment locations of all patients with a mental health or substance use disorder who are undergoing, or who have completed, medical treatment at a hospital for such disorder, and who have been determined by the attending physician to be in need of, and likely to benefit from, the continued receipt of community-based residential treatment or recovery services for the patient's mental health or substance use disorder, following the patient's discharge from the hospital; and

     (2)   be used by hospital staff, and by other persons and entities, as deemed by the division to be appropriate, to facilitate the prompt and efficient discharge and transfer of each such patient from the hospital to an appropriate community-based residential facility, as soon as a residential bed becomes available therein. 

     c.     A patient shall only be included on the discharge planning list maintained pursuant to this section, if the patient, or the patient's legal guardian, has consented to the patient's admission to, and ongoing receipt of treatment or recovery services from, a community-based residential facility.

     d.    Patient names included on the discharge planning list shall be listed in the order in which they were added to the list, and those at the top of the list shall receive priority for available residential beds.  

     e.     The Commissioner of Human Services, in consultation with the Assistant Commissioner of the division, the New Jersey Hospital Association, the Hospital Alliance of New Jersey, the New Jersey Council of Teaching Hospitals, the New Jersey Chapter of the American College of Emergency Physicians, the New Jersey Psychiatric Association, the Olmstead Advisory Committee, the Olmstead Oversight Committee, Hospital-based Olmstead Committees, and local Olmstead Residential Planning Committees, shall develop standardized medical clearance and other criteria, and uniform protocols and procedures, that are to be used by hospitals and practitioners when: 

     (1)   assessing a patient's ongoing mental health and substance use disorder treatment needs for the purposes of discharge planning;

     (2)   obtaining consent from the patient, or the patient's guardian, regarding the patient's admission to, and continued receipt of mental health or substance use disorder treatment or recovery services from, a community-based residential facility, following the conclusion of hospital-based treatment;

     (3)   adding the patient's name to the discharge planning list; and

     (4)   effectuating the patient's discharge and transfer from the hospital, and the patient's admission to a community-based residential facility appropriate to the patient's needs, in cases where the patient's name reaches the top of the list and a residential bed becomes available. 

     f.     The protocols and procedures established under subsection e. of this section shall, at a minimum, require hospital staff to:

     (1)   conduct an individualized assessment of each patient who is receiving hospital-based treatment for a mental health or substance use disorder, in order to determine the patient's individual needs and preferences with respect to the ongoing receipt of mental health and substance use disorder treatment or recovery services from a community-based residential facility;

     (2)   develop an individualized discharge plan for each patient who is receiving hospital-based treatment for a mental health or substance use disorder, which plan shall identify the patient's needs for specialized community-based services and particular types of community-based residential housing;

     (3)   make use of the LOCUS for Psychiatric and Addiction Services, or another similar clinical decision-making instrument, in order to ensure a high level of reliability in determining appropriate levels of continuing residential care for hospital patients with mental health or substance use disorders; and

     (4)   utilize the residential beds database established pursuant to section 1 of P.L.2015, c.293 (C.26:2G-25.1), and the data dashboard report prepared pursuant to section 1 of P.L.2017, c.115 (C.30:4-177.66), as well as any other information on available residential bed space, when determining appropriate community-based residential placements.

     g.    The division shall take appropriate action to ensure: 

     (1)   that the discharge planning list maintained pursuant to this section reflects current information, and is updated on a daily basis, to the extent practicable; and

     (2)   that all hospitals and other appropriate facilities and practitioners in the State have access to the discharge planning list, as well as access to updated information on available residential bed space, as may be necessary to effectuate the prompt discharge and transfer of patients on the list to residential placements, as provided in this section.

     h.    To the extent practicable, the protocols and procedures developed under this section shall be consistent with, or shall mirror, the existing protocols and procedures that are applicable to the residential placement of psychiatric hospital patients who are designated as having a Conditional Extension Pending Placement (CEPP), under Olmstead v. L.C., 527 U.S. 581 (1999).  The discharge planning list established pursuant to this section may be linked to, or combined with, the existing planning list that is used for the residential placement of CEPP patients, or any other planning lists maintained by the division, as deemed by the division to be appropriate.

     i.     As used in this section:

     "Community-based residential facility" or "community-based residential housing" means a non-hospital facility that provides a supportive living environment, in a community-based setting, as well as appropriate mental health or substance use disorder treatment or recovery services or supports, to persons with mental health or substance use disorders who do not require hospitalization, and who are residents of the facility.  "Community-based residential facility" includes a residential substance use disorder treatment facility; a halfway house, group home, or supervised apartment; a rooming or boarding house that functions as a recovery residence or sober living home; any type of community housing that is established or used for persons with mental health disorders, pursuant to the State's Home to Recovery - CEPP Plan; any supportive housing developed by the Office of Housing and Community Development in the division; and any other similar community-based housing facility that provides services to persons with mental health or substance use disorders. 

     "Division" means the Division of Mental Health and Addiction Services in the Department of Human Services.

     "Hospital" includes a general hospital, but does not include a psychiatric hospital or special psychiatric hospital.

     "Patient" means a patient who is treated at a general hospital for a mental health or substance use disorder, and who is not in need of psychiatric hospitalization as a result of such mental health or substance use disorder, but who would benefit from admission to, and the continued receipt of mental health or substance use disorder treatment or recovery services or supports from, a community-based residential facility.

 

     2.    The Commissioner of Human Services shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as may be necessary to implement the provisions of this act.

 

     3.    This act shall take effect immediately.

 

 

STATEMENT

 

     This bill would require the Division of Mental Health and Addiction Services (division) in the Department of Human Services to develop and maintain an internal Statewide discharge planning list to facilitate the prompt and efficient discharge and transfer of patients with a mental health or substance use disorder from a general, non-psychiatric hospital, following the completion of treatment therein, to a community-based residential facility, such as a group home or recovery residence, that is appropriate for the patient's ongoing mental health and substance use disorder treatment or recovery needs. 

     The discharge planning list would:  1) identify the names and current treatment locations of all patients with a mental health or substance use disorder who are undergoing, or who have completed, medical treatment at a hospital for such disorder, and who have been determined by the attending physician to be in need of, and likely to benefit from, the continued receipt of community-based residential treatment or recovery services for the patient's mental health or substance use disorder, following the patient's discharge from the hospital; and 2) be used by hospital staff, and by other persons and entities, as deemed by the division to be appropriate, to facilitate the prompt and efficient discharge and transfer of each such patient from the hospital to an appropriate community-based residential facility, as soon as a residential bed becomes available therein.  A patient may only be included on the discharge planning list, if the patient, or the patient's legal guardian, has consented to the patient's admission to, and ongoing receipt of treatment or recovery services from, a community-based residential facility.  Patient names included on the list are to be listed in the order in which they were added, and those at the top of the list will receive priority for available residential beds.  

     The bill would require the Commissioner of Human Services, in consultation with the Assistant Commissioner of division, the New Jersey Hospital Association, the Hospital Alliance of New Jersey, the New Jersey Council of Teaching Hospitals, the New Jersey Chapter of the American College of Emergency Physicians, the New Jersey Psychiatric Association, the Olmstead Advisory Committee, the Olmstead Oversight Committee, Hospital-based Olmstead Committees, and local Olmstead Residential Planning Committees, to develop standardized medical clearance and other criteria, as well as uniform protocols and procedures, that are to be used by hospitals and practitioners when:  1) assessing a patient's ongoing mental health and substance use disorder treatment needs for the purposes of discharge planning; 2) obtaining consent from the patient, or the patient's guardian, regarding the patient's admission to, and continued receipt of mental health or substance use disorder treatment or recovery services from, a community-based residential facility; 3) adding the patient's name to the discharge planning list; and 4) effectuating the patient's discharge and transfer from the hospital, and the patient's admission to a community-based residential facility appropriate to the patient's needs, in cases where the patient's name reaches the top of the list and a residential bed becomes available. 

     The protocols and procedures established under the bill are to require hospital staff, at a minimum, to:  1) conduct an individualized assessment of each patient who is receiving hospital-based treatment for a mental health or substance use disorder, in order to determine the patient's individual needs and preferences with respect to the ongoing receipt of mental health and substance use disorder treatment or recovery services from a community-based residential facility; 2) develop an individualized discharge plan for each patient who is receiving hospital-based treatment for a mental health or substance use disorder, which plan shall identify the patient's needs for specialized community-based services and particular types of community-based residential housing; 3) make use of the LOCUS for Psychiatric and Addiction Services, or another similar clinical decision-making instrument, in order to ensure a high level of reliability in determining appropriate levels of continuing residential care for hospital patients with mental health or substance use disorders; and 4) utilize the State's existing residential beds database and data dashboard, as well as any other information on available residential bed space, when determining appropriate community-based residential placements.  

     To the extent practicable, the protocols and procedures developed under the bill are to be consistent with, or are to mirror, the existing protocols and procedures that are applicable to the residential placement of psychiatric hospital patients who are designated as having a Conditional Extension Pending Placement (CEPP), under Olmstead v. L.C., 527 U.S. 581 (1999).  The discharge planning list established pursuant to the bill may be linked to, or combined with, the existing planning list that is used for the residential placement of CEPP patients, or with any other planning lists that are maintained by the division, as deemed by the division to be appropriate.

     The DMHAS will be required to ensure that the discharge planning list reflects current information, and is updated on a daily basis, to the extent practicable.  It will further be required to ensure that all hospitals and other appropriate facilities and practitioners in the State have access to the discharge planning list, as well as access to updated information on available residential bed space, as may be necessary to effectuate the prompt discharge and transfer of patients on the list to residential placements.

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