CSSB 97(FIN) AM: "An Act 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."
00CS FOR SENATE BILL NO. 97(FIN) am 01 "An Act relating to mental health services and programs; relating to liability for 02 payment for mental health evaluation and treatment services; and providing for 03 an effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 47.30.910 is repealed and reenacted to read: 06 Sec. 47.30.910. Liability for expense of placement in a facility. (a) A 07 patient, the patient's spouse, or the patient's parent if the patient is under 18 years of 08 age shall pay the charges for the care, transportation, and treatment of the patient when 09 the patient is hospitalized under AS 47.30.670 - 47.30.915 at a state-operated facility, 10 an evaluation facility, or a designated treatment facility providing services under 11 AS 47.30.670 - 47.30.915. The patient, the patient's spouse, or the patient's parent if 12 the patient is under 18 years of age shall make arrangements with a state-operated 13 facility, an evaluation facility, or a designated treatment facility for payment of 14 charges, including providing income information necessary to determine eligibility for
01 benefits under AS 47.31. Charges assessed for services provided under AS 47.30.670 - 02 47.30.915 when a patient is hospitalized at a state-operated facility may not exceed the 03 actual cost of care and treatment. The department may, when assessing charges for 04 services provided at a state-operated facility, consider the ability to pay of a patient, 05 a patient's spouse, or a patient's parent if the patient is under 18 years of age. In order 06 to impose liability for a patient's cost of care at a state-operated facility, the department 07 shall issue an order for payment within six months after the date on which the charge 08 was incurred. The order remains in effect unless modified by subsequent court order 09 or department order. The department may not impose liability for a patient's cost of 10 care at a state-operated facility if the patient would otherwise meet the eligibility 11 criteria, other than location of service, in AS 47.31.010. 12 (b) The department, the evaluation facility, or a designated treatment facility 13 shall make reasonable efforts to determine whether the patient, the patient's spouse, or 14 the patient's parent if the patient is under 18 years of age has a third-party payor or has 15 the available means to substantially contribute to the payment of charges, or whether 16 the patient is eligible for assistance under AS 47.31. 17 (c) If a patient is hospitalized at a state-operated facility and the patient, the 18 patient's spouse, or the patient's parent if the patient is under 18 years of age fails to 19 provide to the department information necessary to determine whether there is a third- 20 party payor or available means to substantially contribute to the payment of charges, or 21 whether the patient would, if not hospitalized at a state-operated facility, be eligible for 22 assistance under AS 47.31, the department may issue an administrative order imposing full 23 liability for the patient's actual cost of care on the patient, the patient's spouse, or the patient's 24 parent if the patient is under 18 years of age. The order remains in effect unless modified by 25 subsequent court order or department order. 26 (d) If a person who is hospitalized under AS 47.30.670 - 47.30.915 at an 27 evaluation facility or a designated treatment facility cannot pay or substantially 28 contribute to the payment of charges described under this section, the patient may 29 apply for assistance under AS 47.31. 30 (e) The department may charge or accept money or property from a person for 31 the care or treatment of a patient at a state-operated facility.
01 (f) Money paid by the patient or on the patient's behalf to the department 02 under this section shall be deposited in the general fund. 03 * Sec. 2. AS 47.30.910 is repealed and reenacted to read: 04 Sec. 47.30.910. Liability for expense of placement in a treatment facility. 05 (a) A patient, or the patient's legal representative acting in a representative capacity, 06 or the patient's spouse, or the patient's parents if the patient is under 18 years of age, 07 shall pay or contribute to the payment of the charges for the care, transportation, and 08 treatment of the patient when hospitalized under AS 47.30.660 - 47.30.915. Charges 09 assessed after an order for commitment for treatment is issued and charges assessed 10 when a patient is hospitalized at a facility operated by the department, or under a 11 contract for services with the department, may not exceed the actual cost of the care 12 and treatment. The department may order payment by the patient or by the person 13 responsible for payment for the patient's care and treatment under this subsection 14 according to ability to provide for payment. The department may make necessary 15 investigations to determine the ability to pay and may require sworn statements of 16 income by the patient, the patient's legal representative acting in a representative 17 capacity, or the patient's spouse or parent. In the exercise of the commissioner's 18 discretion, the commissioner may impose full liability for the patient's actual cost of 19 care and treatment on the patient, the patient's legal representative, the patient's spouse, 20 or parent for refusal to supply a sworn statement of income. An order for payment 21 must be issued by the department within six months after the date on which the charge 22 was incurred. The order must remain in full force and effect unless modified by 23 subsequent court or department order. Liability under this subsection shall be 24 determined as follows: a patient hospitalized under AS 47.30.660 - 47.30.915, or the 25 person responsible for payment of charges for the patient, may be required to pay 26 according to ability to provide for payment, and in the manner and proportion that the 27 department finds is not detrimental to the patient's rehabilitation. The department 28 shall, at any time that it determines the action will serve the best interests of the state 29 and the patient or the person responsible for payment, relieve the patient or the person 30 responsible for payment from liability for charges for the care, transportation, and 31 treatment of the patient.
01 (b) As used in (a) of this section, the term "actual cost of the care and 02 treatment" means either the rate provided for by a contract entered into under 03 AS 47.30.660 - 47.30.915, or, in the absence of a contract, a daily rate approved by 04 the department. 05 (c) The department may charge, or accept from a person money or property, 06 for the care or treatment of an inpatient or outpatient or for other purposes, even if the 07 payment is not required by an order of the department, so long as the total payments 08 received do not exceed the actual cost of care or treatment. 09 (d) All money paid by the patient or on the patient's behalf to the department 10 under this section must be deposited in the general fund. 11 (e) If an order for payment is entered by the department under this section, and 12 delinquency in the payment of any amount due the state under the order continues for 13 a period of more than 30 days after the notification to the patient or the legal 14 representative, spouse, or parent of the patient by the department, the state may 15 proceed to collect the amounts due by appropriate proceedings. An action to enforce 16 the collection of payments may only be brought within three years after the date of 17 notification of a delinquent payment. 18 (f) The orders of the department issued under this section may relate only to 19 charges incurred after July 1, 2001. 20 * Sec. 3. AS 47.30.915(4) is amended to read: 21 (4) "designated treatment facility" or "treatment facility" means a 22 hospital, clinic, institution, center, or other health care facility that has been designated 23 by the department for the treatment or rehabilitation of mentally ill persons under 24 AS 47.30.670 - 47.30.915 [AND FOR THE RECEIPT OF THESE PERSONS BY 25 COURT-ORDERED COMMITMENT,] but does not include correctional institutions; 26 * Sec. 4. AS 47.30.915(4) is repealed and reenacted to read: 27 (4) "designated treatment facility" means a hospital, clinic, institution, 28 center, or other health care facility that has been designated by the department for the 29 treatment or rehabilitation of mentally ill persons and for the receipt of these persons 30 by court-ordered commitment, but does not include correctional institutions; 31 * Sec. 5. AS 47 is amended by adding a new chapter to read:
01 Chapter 31. Mental Health Treatment Assistance Program. 02 Sec. 47.31.005. Applicability. This chapter applies only to those patients who 03 have received evaluation or treatment at an evaluation facility or a designated treatment 04 facility that is not a state-operated hospital. 05 Sec. 47.31.010. Eligibility for assistance. (a) The department shall provide 06 financial assistance under this chapter to a patient who 07 (1) does not have the available means to pay or substantially contribute 08 to the payment of charges assessed by a facility; 09 (2) has no other third party to pay for the evaluation or treatment 10 provided under AS 47.30; and 11 (3) meets the criteria in this chapter. 12 (b) To be eligible for assistance under this chapter, a patient must have 13 (1) been admitted for inpatient evaluation or treatment at an evaluation 14 facility or a designated treatment facility other than a state-operated hospital after 15 either 16 (A) an involuntary commitment under AS 47.30.700 - 17 47.30.915; or 18 (B) a voluntary admission chosen by the patient after a 19 determination by the patient's treating physician that the patient meets the 20 involuntary commitment criteria in AS 47.30.700 - 47.30.915 and that 21 involuntary commitment proceedings would be initiated if the patient did not 22 choose to be admitted voluntarily; and 23 (2) a gross monthly household income that does not exceed 185 percent 24 of the federal poverty guideline for this state for the calendar month in which service 25 was provided. 26 Sec. 47.31.015. Application for assistance. (a) To receive assistance under 27 this chapter, a patient or a patient's legal representative must apply in writing on a 28 form provided by the department. A patient must apply for assistance within 180 days 29 after the date of discharge from the facility. 30 (b) A patient is considered to have applied for assistance under (a) of this 31 section if the evaluation facility or designated treatment facility notifies the department
01 on a form provided by the department that there is good cause to believe that the 02 patient would be eligible for assistance under this chapter and 03 (1) the patient, the patient's spouse, or the patient's parent if the patient 04 is under 18 years of age failed within 150 days after the date of discharge from the 05 facility to make arrangements to pay the evaluation facility or designated treatment 06 facility; or 07 (2) the patient lacks the mental capacity to apply for benefits under this 08 chapter. 09 (c) A patient who applies or is considered to have applied for assistance under 10 this chapter, the patient's spouse, the patient's parent if the patient is under 18 years 11 of age, or a person in the patient's household shall release records and information to 12 the department necessary to verify eligibility for the assistance. 13 (d) If a patient, the patient's spouse, the patient's parent if the patient is under 14 18 years of age, or a person in the patient's household fails to provide records and 15 information to the department necessary to verify eligibility, the department may issue 16 an administrative order imposing full liability for the patient's cost of care and 17 treatment to the evaluation facility or designated treatment facility. 18 Sec. 47.31.020. Decision on eligibility. (a) Within 30 days after receiving 19 a complete application, the department shall give notice in writing of an eligibility 20 determination to the patient or the patient's legal representative. If the patient is found 21 ineligible, the notice must contain the reason for the denial and an explanation of the 22 patient's right to an administrative appeal of the denial. 23 (b) The department shall provide a copy of the notice of eligibility or 24 ineligibility to the facility at which the patient was treated. 25 Sec. 47.31.025. Eligible services; rates. The department shall identify the 26 type and level of services for which assistance is available under this chapter. An 27 evaluation facility or a designated treatment facility shall be reimbursed at a rate 28 established by the department that is equivalent to the Medicaid rate for that facility 29 at the time service was rendered as determined under AS 47.07.070. 30 Sec. 47.31.030. Payment. If the department determines that a patient is 31 eligible for assistance under this chapter, the department shall provide for payment of
01 assistance directly to the facility. By endorsing the check received from the 02 department or authorizing the endorsement by the facility's agent, the facility certifies 03 that the claim for which the check is payment is true and accurate unless written notice 04 of an error is sent to the department by the facility within 30 days after the date the 05 check is presented by the facility for payment. 06 Sec. 47.31.035. Appeals. (a) A patient or the patient's legal representative 07 may appeal a denial of assistance by sending written notice of objection to the 08 department within 30 days after the date of the notice of denial. The written notice 09 of objection must include an explanation of the reasons for the objection and may 10 include documentation supporting the objection. AS 44.62 (Administrative Procedure 11 Act) does not apply to the appeal. 12 (b) The commissioner or the commissioner's designee shall review the notice 13 of objection and issue a decision within 90 days after its receipt. The commissioner 14 or the commissioner's designee may request additional information on the appeal from 15 either the patient, the evaluation facility or designated treatment facility, or department 16 staff. A request for additional information suspends the time period for the appeal 17 until the department determines that the additional information has been received. If 18 more than 180 days have passed from the date of submission of a notice of appeal and 19 the additional information requested by the commissioner or the commissioner's 20 designee has not been received from a patient, the evaluation facility, the designated 21 treatment facility, or the department, the appeal shall be considered denied. 22 (c) The decision on the appeal under (b) of this section, including an appeal 23 denied for failure to submit additional information, is a final agency decision and may 24 be appealed to the superior court under the Alaska Rules of Appellate Procedure. 25 Sec. 47.31.900. Regulations. The department shall, after consultation with the 26 Alaska Mental Health Trust Authority, adopt regulations to interpret or implement this 27 chapter. 28 Sec. 47.31.990. Definitions. In this chapter, unless the context otherwise 29 requires, 30 (1) "commissioner" means the commissioner of health and social 31 services;
01 (2) "department" means the Department of Health and Social Services; 02 (3) "designated treatment facility" has the meaning given in 03 AS 47.30.915; 04 (4) "evaluation facility" means a health care facility that has been 05 designated by the department to perform the evaluations described in AS 47.30.670 - 06 47.30.915, including a facility licensed under AS 18.20.020 or operated by the federal 07 government; 08 (5) "gross monthly household income" means all earned or unearned 09 income from any source of a member of the patient's household; 10 (6) "household" means a patient and each person 11 (A) residing with the patient; and 12 (B) related to the patient by marriage or other legal relationship 13 giving rise to a duty of support and maintenance; 14 (7) "mental illness" has the meaning given in AS 47.30.915. 15 * Sec. 6. AS 47.31.005, 47.31.010, 47.31.015, 47.31.020, 47.31.025, 47.31.030, 47.31.035, 16 47.31.900, and 47.31.990 are repealed. 17 * Sec. 7. APPLICABILITY. Sections 1, 3, and 5 of this Act apply to expenses incurred 18 for mental health services received on or after the effective date of secs. 1, 3, and 5 of this 19 Act. 20 * Sec. 8. Except as provided in sec. 9 of this Act, this Act takes effect immediately under 21 AS 01.10.070(c). 22 * Sec. 9. Sections 2, 4, and 6 of this Act take effect July 1, 2001.