Bill Summary – FastDemocracy

67th Legislature                                                                                                     HB 691.1
                                                    HOUSE BILL NO. 691
                                                 INTRODUCED BY D. LENZ
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   A BILL FOR AN ACT ENTITLED: “AN ACT ESTABLISHING REQUIREMENTS FOR CRISIS RESPONSE
   SERVICES IN THE DEVELOPMENTAL DISABILITIES SYSTEM; PROVIDING DIRECTION TO THE
   DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES ON THE USE OF EXISTING FUNDING;
   PROVIDING RULEMAKING AUTHORITY; PROVIDING AN APPROPRIATION; AMENDING SECTION 53-20-
   204, MCA; AND PROVIDING AN EFFECTIVE DATE.”
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   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
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              NEW SECTION. Section 1.         Crisis response services -- department and provider
   responsibilities. (1) (a) The department shall establish crisis response services to help individuals with
   developmental disabilities minimize or avoid instances of crisis. The services must assist providers and families
   in preventing, deescalating, and intervening in instances in which individuals with developmental disabilities are
   likely to go into crisis.
              (b)   For the purposes of this section, "crisis" means an instance in which an individual is upset, afraid,
   confused, or otherwise experiencing emotional or physical disequilibrium, which negatively affects the
   individual's actions and places the individual at risk of incarceration, hospitalization, civil commitment, or loss of
   the individual's placement in community services.
              (2)   The crisis response services must consist of three different levels of prevention, intervention, and
   crisis support services:
              (a)   a preventive level of response that involves training providers and families in identifying and
   preventing crisis and in responding to a crisis in its initial stages before the crisis escalates to require a higher
   level of intervention;
              (b)   an intermediate level of response that involves providing direct professional staff support to an
   individual in the individual's current community placement when the individual is in or is approaching crisis; and
              (c)   an advanced level of response that involves qualified providers providing support services to an
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67th Legislature                                                                                                     HB 691.1
   individual approaching or in crisis outside of the individual's current community placement. A provider offering
   crisis support services at this level must receive an enhanced reimbursement rate that reflects the higher level
   of support being provided to the individual in crisis.
              (3)   (a) To access crisis response services, providers shall:
              (i)   contact the department for assistance when an individual with developmental disabilities is in or is
   approaching crisis; and
              (ii) implement the suggestions made for crisis response.
              (b)   If the individual needs the highest level of response, the department shall find an appropriate
   placement for the individual if the provider is unable to offer the level of response needed to mitigate the crisis
   and maintain the individual in the current placement.
              (4)   (a) A person offering training in crisis response or providing direct crisis response services must:
              (i)   be licensed in the practice of applied behavior analysis pursuant to Title 37, chapter 17; and
              (ii) meet other requirements established by the department by rule.
              (b)   If a team of individuals is offering training under this section, at least one member of the team
   must meet the licensure requirements of Title 37, chapter 17.
              (5)   The department may not provide the training or direct services described under this section and
   shall contract with one or more private entities for the services.
              (6)   In developing and carrying out crisis response services, the department shall consult with and
   include other entities that respond to crisis situations involving individuals with developmental disabilities,
   including but not limited to law enforcement agencies, hospitals, and mental health providers.
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              Section 2. Section 53-20-204, MCA, is amended to read:
              "53-20-204. Rules. (1) The department may adopt rules necessary for the proper administration of
   this part, including but not limited to:
              (a)   the training and other standards necessary to provide crisis support services as allowed under
   [section 1]; and
              (b)   the reimbursement rates for crisis support services provided pursuant to [section 1].
              (2)   The department shall adopt rules in cooperation with the board of nursing under which a properly
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67th Legislature                                                                                                     HB 691.1
   trained staff member of a facility providing services to persons with developmental disabilities under this part
   may assist and supervise a client of the facility in taking medication if the medication is usually self-
   administered and if a physician has prescribed the assistance."
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              NEW SECTION. Section 3.         Appropriation. (1) There is appropriated $476,725 from the federal
   special revenue fund and $476,725 from the general fund to the department of public health and human
   services for the biennium beginning July 1, 2021.
              (2)   The appropriation may be used only for the crisis response services provided for in [section 1].
              (3)   The legislature intends that funding for the program be considered a part of the ongoing base for
   the next legislative session.
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              NEW SECTION. Section 4.         Direction to department of public health and human services --
   reporting requirement. (1) The department of public health and human services shall replace the services
   currently provided by the behavior consultation team in the developmental services division with the crisis
   response services established pursuant to [section 1]. During the biennium beginning July 1, 2021, the
   department shall develop the crisis response services provided for in [section 1] by using the appropriation in
   [section 3], which is intended to consist of:
              (a)   $359,000 in federal special revenue money and $359,000 in general fund money built into the
   base budget in the House Bill No. 2 appropriation for the developmental services division for the 2023 biennium
   and representing the amount of money allocated for the behavior consultation team in the 2021 biennium; and
              (b)   $117,725 in additional federal special revenue money and $117,725 in additional general fund
   money appropriated for the purposes of [section 1].
              (2)   The appropriation in [section 3] and the coordination instruction in [section 6] represent the
   legislature's intent that the crisis response services be funded with a combination of existing funding and new
   funding.
              (3)   The department may implement the crisis response services in areas of the state with the highest
   need if existing funding does not allow for development of statewide crisis response services.
              (4)   The department shall report to the 2021-2022 children, families, health, and human services
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67th Legislature                                                                                                      HB 691.1
   interim committee on:
              (a)   the status of the implementation of the crisis response services;
              (b)   the number of community providers who received training in crisis prevention and intervention;
              (c)   the amount and type of direct services provided to individuals in their community placement
   settings pursuant to [section 1(2)(b)];
              (d)   the number of individuals receiving advanced crisis support services pursuant to [section 1(2)(c)]
   and the cost of the services provided;
              (e)   to the extent possible, the degree to which higher levels of crisis response were avoided because
   of the training, prevention, or intervention services that were provided; and
              (f)   the cost of expanding the program in the future, if statewide services cannot be carried out within
   existing resources.
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              NEW SECTION. Section 5.         Codification instruction. [Section 1] is intended to be codified as an
   integral part of Title 53, chapter 20, part 2, and the provisions of Title 53, chapter 20, part 2, apply to [section 1].
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              COORDINATION SECTION. Section 6.             Coordination instruction. If both House Bill No. 2 and [this
   act] are passed and approved and [this act] contains an appropriation from the federal special revenue fund
   and the general fund to the department of public health and human services totaling $718,000 or more for the
   biennium beginning July 1, 2021, then the House Bill No. 2 appropriation for the developmental services
   division of the department of public health and human services must be reduced by the following amounts in
   each year of the biennium:
              $179,500 federal special revenue
              $179,500 general fund.
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              NEW SECTION. Section 7.         Effective date. [This act] is effective July 1, 2021.
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                                                                   -4-                       Authorized Print Version – HB 691
Statutes affected: 
HB0691_1.pdf: 53-20-204
HB0691_2.pdf: 53-20-204
HB0691_3.pdf: 53-20-204
HB0691_X.pdf: 53-20-204
Amended: 53-20-204
Introduced: 53-20-204