SB 97: "An Act relating to confidential mental health records; relating to mental health services and programs; relating to liability for payment for mental health evaluation and treatment services; and providing for an effective date."
00SENATE BILL NO. 97 01 "An Act relating to confidential mental health records; relating to mental health 02 services and programs; relating to liability for payment for mental health 03 evaluation and treatment services; and providing for an effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 08.02 is amended by adding a new section to read: 06 Sec. 08.02.040. Access to certain mental health information and records 07 by the state. (a) Notwithstanding AS 08.29.200, AS 08.63.200, AS 08.86.200, 08 AS 08.95.900, another provision of this title, or a regulation adopted under this title, 09 a licensee or an entity employing or contracting with a licensee may disclose 10 confidential patient mental health information, communications, and records to the 11 Department of Health and Social Services when disclosure is required under 12 AS 47.30.540, 47.30.845, or AS 47.31. Information, communications, and records 13 received by the Department of Health and Social Services under this section are 14 confidential medical records of patients and are not open to public inspection and
01 copying under AS 09.25.110 - 09.25.120. 02 (b) In this section, "licensee" has the meaning given in AS 08.01.110. 03 * Sec. 2. AS 47.30.540(b) is amended to read: 04 (b) An entity designated by the department to receive money under 05 AS 47.30.520 - 47.30.620 shall ensure a broad base of community support as 06 evidenced by a governing board reasonably representative of the professional, civic, 07 and citizen groups in the community and including persons with mental disorders or 08 family members of persons with mental disorders. No more than two members, or 40 09 percent of the membership, whichever is greater, may be providers of services under 10 the program. In order to receive money [FUNDS] under AS 47.30.520 - 47.30.620, 11 a local community entity shall agree to 12 (1) give priority to mental health programs and services consistent with 13 the priorities set out in AS 47.30.056 and that provide the maximum services for the 14 least expenditure of money from the mental health trust settlement income account; 15 (2) furnish services through a qualified staff meeting reasonable 16 standards of experience and training; 17 (3) conform to a state cost accounting system showing the true cost 18 of services rendered, collect fees for services according to a schedule based on an 19 analysis of reasonable ability to pay, and provide that a person may not be refused 20 services because of inability to pay for those services; 21 (4) maintain adequate clinical and administrative records and furnish 22 periodic reports to the department , including the information or records described 23 in AS 47.30.585 and 47.30.590 ; 24 (5) furnish the authority and the department an annual report of the 25 preceding fiscal year, including an evaluation of the effectiveness of the previous year's 26 programs and their costs; [AND] 27 (6) furnish the authority and the department satisfactory needs 28 assessments for the population and area it serves and an annual update of a long-range 29 planning and budget statement that describes program goals for the coming year, the 30 steps and resources necessary to implement the goals, the projected means by which 31 these resources will be secured , and the procedures necessary to evaluate the program ;
01 and 02 (7) provide written notice prepared by the department to each 03 person receiving services financed in whole or in part by the department under 04 AS 47.30.520 - 47.30.620 that informs the person that information and records 05 about them and their services will be furnished to the department under 06 AS 47.30.585 and 47.30.590 . 07 * Sec. 3. AS 47.30 is amended by adding a new section to read: 08 Sec. 47.30.585. Service and program monitoring and evaluation. (a) The 09 department shall 10 (1) monitor and evaluate services and programs financed under 11 AS 47.30.520 - 47.30.620 and review patient eligibility for those services and 12 programs; 13 (2) adopt regulations to collect the patient, service, and program records 14 and information necessary to perform the duties identified in (1) of this subsection; and 15 (3) have access to the patient's name and information individually 16 identifying the patient as necessary to perform the duties identified in (1) of this 17 subsection. 18 (b) Confidential patient records and information collected by the department 19 under (a) of this section are not open to public inspection and copying under 20 AS 09.25.110 - 09.25.120. 21 * Sec. 4. AS 47.30.590 is amended to read: 22 Sec. 47.30.590. Patient rights and the confidential nature of records and 23 information. The department shall adopt regulations to assure patient rights and to 24 safeguard the confidential nature of records and information about the recipients of 25 services provided under this chapter. The regulations must require that entities 26 identified in AS 47.30.540(b) develop and include in any plan submitted for approval 27 adequate provisions for safeguarding confidential information. The regulations must 28 provide for disclosure of confidential records and information to the department, to 29 parents or guardians, to mental health professionals providing services to a recipient, 30 and to other appropriate service agencies when it is in the defined best interests of the 31 patient or necessary to monitor or evaluate services or programs financed by the
01 department under AS 47.30.520 - 47.30.620 . 02 * Sec. 5. AS 47.30.660(b) is amended to read: 03 (b) The department, in fulfilling its duties under this section and through its 04 division of mental health and developmental disabilities, shall 05 (1) administer a comprehensive program of services for persons with 06 mental disorders, for the prevention of mental illness, and for the care and treatment 07 of persons with mental disorders, including inpatient and outpatient care and treatment 08 and the procurement of services of specialists or other persons on a contractual or 09 other basis; 10 (2) take the actions and undertake the obligations that are necessary to 11 participate in federal grants-in-aid programs and accept federal or other financial aid 12 from whatever sources for the study, prevention, examination, care, and treatment of 13 persons with mental disorders; 14 (3) administer AS 47.30.660 - 47.30.915; 15 (4) designate, operate, and maintain treatment facilities equipped and 16 qualified to provide inpatient and outpatient care and treatment for persons with mental 17 disorders; 18 (5) provide for the placement of patients with mental disorders in 19 designated treatment facilities; 20 (6) enter into arrangements with governmental agencies for the care or 21 treatment of persons with mental disorders in facilities of the governmental agencies 22 in the state or in another state; 23 (7) enter into contracts with treatment facilities for the custody and care 24 or treatment of persons with mental disorders; contracts under this paragraph are 25 governed by AS 36.30 (State Procurement Code); 26 (8) enter into contracts, which incorporate safeguards consistent with 27 AS 47.30.660 - 47.30.915 and the preservation of the civil rights of the patients with 28 another state for the custody and care or treatment of patients previously committed 29 from this state under 48 U.S.C. 46 et seq., and P.L. 84-830, 70 Stat. 709; 30 (9) prescribe the form of applications, records, reports, request for 31 release, and consents to medical or psychological treatment required by AS 47.30.660 -
01 47.30.915; 02 (10) collect patient information on a schedule determined by the 03 department from facilities designated by the department to provide evaluation 04 and treatment services and require reports from the head of a treatment facility 05 concerning the care of those patients; 06 (11) visit each treatment facility at least annually to review methods 07 of care or treatment for patients; 08 (12) investigate complaints made by a patient or an interested party on 09 behalf of a patient; 10 (13) delegate upon mutual agreement to another officer or agency of 11 it, or a political subdivision of the state, or a treatment facility designated, any of the 12 duties and powers imposed upon it by AS 47.30.660 - 47.30.915; 13 (14) after consultation with the Alaska Mental Health Trust Authority, 14 adopt regulations to interpret or implement the provisions of this chapter 15 [AS 47.30.660 - 47.30.915]; 16 (15) provide technical assistance and training to providers of mental 17 health services; and 18 (16) set standards under which each designated treatment facility shall 19 provide programs to meet patients' medical, psychological, social, vocational, 20 educational, and recreational needs. 21 * Sec. 6. AS 47.30.845 is amended to read: 22 Sec. 47.30.845. Confidential records. Information and records obtained in 23 the course of a screening investigation, evaluation, examination, or treatment are 24 confidential and are not public records, except as the requirements of a hearing under 25 AS 47.30.670 - 47.30.915 [AS 47.30.660 - 47.30.915] may necessitate a different 26 procedure. Information and records may be copied and disclosed under regulations 27 established by the department only to 28 (1) a physician or a provider of health, mental health, or social and 29 welfare services involved in caring for, treating, or rehabilitating the patient; 30 (2) the patient or an individual to whom the patient has given written 31 consent to have information disclosed;
01 (3) a person authorized by a court order; 02 (4) a person doing research or maintaining health statistics [,] if the 03 anonymity of the patient is assured [,] and the facility recognizes the project as a bona 04 fide research or statistical undertaking; 05 (5) the Department of Corrections in a case in which a prisoner 06 confined to the state prison is a patient in the state hospital on authorized transfer 07 either by voluntary admission or by court order; 08 (6) a governmental or law enforcement agency when necessary to 09 secure the return of a patient who is on unauthorized absence from a facility where the 10 patient was undergoing evaluation or treatment; 11 (7) a law enforcement agency when there is substantiated concern over 12 imminent danger to the community by a presumed mentally ill person ; 13 (8) the department in a case in which services provided under 14 AS 47.30.670 - 47.30.915 are paid for in whole or in part by the department or 15 a person has applied for or has received assistance from the department for those 16 services . 17 * Sec. 7. AS 47.30.910 is repealed and reenacted to read: 18 Sec. 47.30.910. Liability for expense of placement in an evaluation or 19 treatment facility. (a) A patient, the patient's legal representative acting in a 20 representative capacity, the patient's spouse, or the patient's parents if the patient is 21 under the age of 18 shall pay or contribute to the payment of charges for the care, 22 transportation, and treatment of the patient when the patient is hospitalized under 23 AS 47.30.670 - 47.30.915. Charges assessed when a patient is hospitalized at a facility 24 operated by the department or a facility designated by the department to provide 25 services under AS 47.30.670 - 47.30.915 may not exceed the actual cost of care and 26 treatment. 27 (b) The department may order payment by the patient or by the person 28 responsible for payment for the patient's care and treatment under this section. The 29 department may investigate to determine the patient's ability to pay and may require 30 sworn statements of income by the patient, the patient's legal representative acting in 31 a representative capacity, the patient's spouse, or the patient's parent. The
01 commissioner may impose full liability for the patient's actual cost of care and 02 treatment on the patient, the patient's legal representative acting in a representative 03 capacity, the patient's spouse, or the patient's parent for refusal to supply a sworn 04 statement of income. In order to impose liability for the cost of a patient's care, an 05 order for payment shall be issued by the department within six months after the date 06 on which the charge was incurred. The order remains in effect unless modified by 07 subsequent court or department order. 08 (c) If a person described under (a) of this section cannot pay or contribute to 09 the payment of charges under this section, the patient may apply for assistance under 10 AS 47.31. 11 (d) The department may charge or accept money or property from a person for 12 the care or treatment of a patient. Money paid by the patient or on the patient's behalf 13 to the department under this section shall be deposited in the general fund. 14 (e) In this section, "actual cost of the care and treatment" means 15 (1) the rate provided for by a contract entered into under AS 47.30.660; 16 or 17 (2) in the absence of a contract under AS 47.30.660, a daily rate 18 determined by the department. 19 * Sec. 8. AS 47 is amended by adding a new chapter to read: 20 Chapter 31. Mental Health Treatment Assistance Program. 21 Sec. 47.31.005. Applicability. This chapter applies only to those patients who 22 have received treatment at a facility designated by the department as an evaluation 23 facility or a treatment facility under AS 47.30. 24 Sec. 47.31.010. Eligibility for assistance. (a) The department shall provide 25 financial assistance under this chapter to a patient who 26 (1) does not have the available means to pay or contribute to the 27 payment of charges assessed by a facility; 28 (2) has no other third party to pay for the evaluation or treatment 29 provided under AS 47.30; and 30 (3) meets the criteria in this chapter. 31 (b) To be eligible for assistance under this chapter, a patient must have
01 (1) been admitted for inpatient treatment at a facility; 02 (2) been determined by the patient's treating physician to be suffering 03 from a mental illness and 04 (A) as a result, is likely to cause serious harm to the patient or 05 to others; or 06 (B) is gravely disabled; and 07 (3) a gross monthly household income that does not exceed 185 percent 08 of the federal poverty guideline for this state for the month in which service was 09 provided. 10 Sec. 47.31.015. Application for assistance. (a) To receive assistance under 11 this chapter, a patient must apply in writing on a form provided by the department. 12 A patient must apply for assistance within 90 days after the date of discharge from the 13 facility. 14 (b) A patient who applies for assistance under this chapter must agree to 15 release records and information to the department necessary to verify eligibility for the 16 assistance. 17 Sec. 47.31.020. Decision on eligibility. (a) Within 30 days after receiving 18 a complete application, the department shall give notice in writing of an eligibility 19 determination to the patient or the patient's legal representative. If the patient is found 20 ineligible, the notice must contain the reason for the denial and an explanation of the 21 patient's right to an administrative appeal of the denial. 22 (b) The department shall provide a copy of the notice of eligibility or 23 ineligibility to the facility at which the patient was treated. 24 Sec. 47.31.025. Eligible services; rates. The department shall identify the 25 type and level of services for which assistance is available under this chapter. The 26 department shall establish the rates of payment for those services. 27 Sec. 47.31.030. Payment. If the department determines that a patient is 28 eligible for assistance under this chapter, the department shall provide for payment of 29 assistance directly to the facility. By endorsing the check received from the 30 department or authorizing the endorsement by the facility's agent, the facility certifies 31 that the claim for which the check is payment is true and accurate unless written notice
01 of an error is sent to the department by the facility within 30 days after the date the 02 check is presented by the facility for payment. 03 Sec. 47.31.035. Appeals. (a) A patient or the patient's legal representative 04 may appeal a denial of assistance by sending written notice of objection to the 05 department within 30 days after the date of the notice of denial. The written notice 06 of objection must include an explanation of the reasons for the objection and may 07 include documentation supporting the objection. AS 44.62 (Administrative Procedure 08 Act) does not apply to the appeal. 09 (b) The commissioner or the commissioner's designee shall review the notice 10 of objection and issue a decision within 90 days after its receipt. The commissioner 11 or the commissioner's designee may request additional information on the appeal from 12 either the patient, the facility, or department staff. A request for additional information 13 suspends the time period for the appeal until the department determines that the 14 additional information has been received. 15 (c) The decision on the appeal under (b) of this section is a final agency 16 decision and may be appealed to the superior court under the Alaska Rules of 17 Appellate Procedure. 18 Sec. 47.31.900. Regulations. The department may adopt regulations to 19 interpret or implement this chapter. 20 Sec. 47.31.990. Definitions. In this chapter, unless the context otherwise 21 requires, 22 (1) "commissioner" means the commissioner of health and social 23 services; 24 (2) "department" means the Department of Health and Social Services; 25 (3) "facility" means a facility designated by the department as an 26 evaluation facility or a treatment facility under AS 47.30; 27 (4) "gravely disabled" has the meaning given in AS 47.30.915; 28 (5) "gross monthly household income" means all earned or unearned 29 income from any source of a member of the patient's household; 30 (6) "household" means persons who reside together in one residence 31 as a family unit;
01 (7) "likely to cause serious harm" has the meaning given in 02 AS 47.30.915; 03 (8) "mental illness" has the meaning given in AS 47.30.915. 04 * Sec. 9. This Act takes effect immediately under AS 01.10.070(c).