2007 Legislation
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SENATE BILL NO. 1147 – Childrens mental hlth/at risk teens

SENATE BILL NO. 1147

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Bill Status



S1147.................................................by HEALTH AND WELFARE
CHILDREN'S MENTAL HEALTH - Amends and adds to existing law relating to
children's mental health to provide for collaboration and cooperation among
certain governmental entities; to provide the Department of Health and
Welfare the authority to enter into contracts; to provide rulemaking
authority to the Department of Health and Welfare to prescribe
qualifications for teen early intervention specialists; to provide salary
equivalence for teen early intervention specialists; to provide
responsibilities for the specialists; to provide conditions when teens at
risk who are not currently enrolled in school may participate in counseling
sessions or services; to permit school districts to apply for the placement
of teen early intervention specialists and to provide limits on the number
of placements; to provide criteria for evaluation of school district
applications; to require the Department of Health and Welfare to work with
school districts to gather data on the program's effectiveness; and to
permit courts to include teen intervention specialists on screening teams.

02/12    Senate intro - 1st rdg - to printing
02/13    Rpt prt - to Health/Wel
03/01    Rpt out - rec d/p - to 2nd rdg
03/02    2nd rdg - to 3rd rdg
03/06    3rd rdg - PASSED - 27-8-0
      AYES -- Andreason, Bastian, Bilyeu, Broadsword, Burkett, Cameron,
      Coiner, Corder, Darrington, Davis, Gannon, Goedde, Hammond, Heinrich,
      Hill, Kelly, Keough, Langhorst, Little, Lodge, Malepeai, McGee,
      McKenzie, Schroeder, Stegner, Stennett, Werk
      NAYS -- Bair, Fulcher, Geddes, Jorgenson, McKague, Pearce,
      Richardson, Siddoway
      Absent and excused -- None
    Floor Sponsor - Corder
    Title apvd - to House
03/07    House intro - 1st rdg - to Health/Wel
03/15    Rpt out - rec d/p - to 2nd rdg
03/16    2nd rdg - to 3rd rdg
03/22    3rd rdg - PASSED - 69-0-1
      AYES -- Anderson, Andrus, Barrett, Bayer, Bedke, Bell, Bilbao, Black,
      Block, Bock, Boe, Bolz, Brackett, Bradford, Chadderdon, Chavez, Chew,
      Clark, Collins, Crane, Durst, Edmunson, Eskridge, Hagedorn, Hart,
      Harwood, Henbest, Henderson, Jaquet, Killen, King, Kren, Labrador,
      Lake, LeFavour, Loertscher, Luker(Luker), Marriott, Mathews,
      McGeachin, Mortimer, Moyle, Nielsen, Nonini, Pasley-Stuart, Patrick,
      Pence, Raybould, Ring, Ringo, Roberts, Ruchti, Rusche, Sayler,
      Schaefer, Shepherd(2), Shepherd(8), Shirley, Shively, Smith(30),
      Smith(24), Snodgrass, Stevenson, Thayn, Trail, Vander Woude,
      Wood(27), Wood(35), Mr. Speaker
      NAYS -- None
      Absent and excused -- Wills
    Floor Sponsors - LeFavour & Henbest
    Title apvd - to Senate
03/23    To enrol
03/26    Rpt enrol - Pres signed - Sp signed - To Governor
03/30    Governor signed
         Session Law Chapter 309
         Effective: 07/01/07

Bill Text


                                                                        
                                                                        
  ]]]]              LEGISLATURE OF THE STATE OF IDAHO             ]]]]
 Fifty-ninth Legislature                   First Regular Session - 2007
                                                                        
                                                                        
                                       IN THE SENATE
                                                                        
                                    SENATE BILL NO. 1147
                                                                        
                              BY HEALTH AND WELFARE COMMITTEE
                                                                        
  1                                        AN ACT
  2    RELATING TO CHILDREN'S MENTAL HEALTH; AMENDING SECTION 16-2403, IDAHO CODE, TO
  3        DEFINE A TERM; AMENDING SECTION 16-2404, IDAHO CODE, TO PROVIDE  FOR  COL-
  4        LABORATION AND COOPERATION AMONG CERTAIN GOVERNMENTAL ENTITIES AND TO PRO-
  5        VIDE THE DEPARTMENT OF HEALTH AND WELFARE THE AUTHORITY TO ENTER INTO CON-
  6        TRACTS;  AMENDING  CHAPTER  24, TITLE 16, IDAHO CODE, BY THE ADDITION OF A
  7        NEW SECTION 16-2404A, IDAHO CODE, TO PROVIDE THE DEPARTMENT OF HEALTH  AND
  8        WELFARE  CONTRACTING POWER, TO PROVIDE THE DEPARTMENT RULEMAKING AUTHORITY
  9        TO PRESCRIBE QUALIFICATIONS FOR TEEN EARLY  INTERVENTION  SPECIALISTS,  TO
 10        PROVIDE  SALARY EQUIVALENCE FOR SUCH SPECIALISTS, TO PROVIDE RESPONSIBILI-
 11        TIES FOR SUCH SPECIALISTS, TO PROVIDE CONDITIONS WHEN TEENS  AT  RISK  NOT
 12        CURRENTLY  ENROLLED  IN  SCHOOL  MAY PARTICIPATE IN COUNSELING SESSIONS OR
 13        SERVICES, TO PERMIT SCHOOL DISTRICTS TO APPLY FOR THE  PLACEMENT  OF  SUCH
 14        SPECIALISTS,  TO  PROVIDE THE DEPARTMENT RULEMAKING AUTHORITY TO ESTABLISH
 15        PROCEDURE, TO PROVIDE FOR LIMITS ON THE NUMBER OF SUCH PLACEMENTS, TO PRO-
 16        VIDE CRITERIA FOR EVALUATION OF SCHOOL DISTRICT APPLICATIONS,  TO  REQUIRE
 17        THE DEPARTMENT TO WORK WITH SCHOOL DISTRICTS TO GATHER CERTAIN DATA ON THE
 18        PILOT  PROGRAM'S EFFECTIVENESS AND TO PERMIT COOPERATIVE PROJECTS IN GATH-
 19        ERING THE DATA; AND AMENDING SECTION 20-511A, IDAHO CODE, TO PERMIT COURTS
 20        TO INCLUDE TEEN EARLY INTERVENTION SPECIALISTS ON SCREENING TEAMS  AND  TO
 21        REQUIRE SUCH SPECIALISTS TO ATTEND CASE REVIEW HEARINGS.
                                                                        
 22    Be It Enacted by the Legislature of the State of Idaho:
                                                                        
 23        SECTION  1.  That  Section 16-2403, Idaho Code, be, and the same is hereby
 24    amended to read as follows:
                                                                        
 25        16-2403.  DEFINITIONS. As used in this chapter:
 26        (1)  "Child" means an individual less than eighteen (18) years of age  and
 27    not emancipated by either marriage or legal proceeding.
 28        (2)  "Consistent  with  the least restrictive alternative principle" means
 29    that services are delivered in the setting which places  the  fewest  restric-
 30    tions on the personal liberty of the child, and provides the greatest integra-
 31    tion  with individuals who do not have disabilities, in typical and age appro-
 32    priate, school, community and family environments, which  is  consistent  with
 33    safe, effective and cost-effective treatment for the child and family.
 34        (3)  "Department" means the department of health and welfare.
 35        (4)  "Designated examiner" means a psychiatrist, psychologist, psychiatric
 36    nurse,  or  social worker and such other mental health professionals as may be
 37    designated in accordance with rules promulgated pursuant to the provisions  of
 38    chapter 52, title 67, Idaho Code, by the department of health and welfare. Any
 39    person  designated  by  the department director will be specially qualified by
 40    training and experience in the diagnosis and treatment of mental  or  mentally
 41    related illnesses or conditions.
 42        (5)  "Director"  means  the director of the state department of health and
 43    welfare.
                                                                        
                                       2
                                                                        
  1        (6)  "Emergency" means a situation in which the child's condition, as evi-
  2    denced by recent behavior, poses a significant threat to the health or  safety
  3    of  the  child,  his  family or others, or poses a serious risk of substantial
  4    deterioration in the child's condition which cannot be eliminated by  the  use
  5    of  supportive  services  or  intervention  by  the child's parents, or mental
  6    health professionals, and treatment in the community while the  child  remains
  7    in his family home.
  8        (7)  "Informed  consent  to treatment" means a knowing and voluntary deci-
  9    sion  to undergo a specific course of treatment,  evidenced  in  writing,  and
 10    made  by  an  emancipated child, or a child's parent, or guardian, who has the
 11    capacity to make an informed decision, after the  staff  of  the  facility  or
 12    other  provider of treatment have explained the nature and effects of the pro-
 13    posed treatment.
 14        (8)  "Involuntary treatment" means treatment, services  and  placement  of
 15    children  provided without consent of the parent of a child, under the author-
 16    ity of a court order obtained pursuant to this  chapter,  as  directed  by  an
 17    order  of  disposition  issued  by  a designated employee of the department of
 18    health and welfare under section 16-2415, Idaho Code.
 19        (9)  "Lacks capacity to make an informed  decision  concerning  treatment"
 20    means that the parent is unable to understand the nature and effects of hospi-
 21    talization  or treatment, or is unable to engage in a rational decision-making
 22    process regarding such  hospitalization  or  treatment,  as  evidenced  by  an
 23    inability  to  weigh  the risks and benefits, despite conscientious efforts to
 24    explain them in terms that the parent can understand.
 25        (10) "Likely to cause harm to himself or to suffer substantial  mental  or
 26    physical  deterioration"  means  that,  as  evidenced  by recent behavior, the
 27    child:
 28        (a)  Is likely in the near future to inflict substantial  physical  injury
 29        upon himself; or
 30        (b)  Is  likely  to  suffer significant deprivation of basic needs such as
 31        food, clothing, shelter, health or safety; or
 32        (c)  Will suffer a substantial increase or persistence of symptoms of men-
 33        tal illness or serious emotional disturbance which is likely to result  in
 34        an  inability  to  function in the community without risk to his safety or
 35        well-being or the safety or well-being of  others,  and  which  cannot  be
 36        treated adequately with available home and community-based outpatient ser-
 37        vices.
 38        (11) "Likely  to  cause harm to others" means that, as evidenced by recent
 39    behavior causing, attempting, or threatening such harm with the apparent abil-
 40    ity to complete the act, a child is likely to cause physical injury or  physi-
 41    cal abuse to another person.
 42        (12) "Protection  and  advocacy system" means the agency designated by the
 43    governor as the state protection and advocacy system  pursuant  to  42  U.S.C.
 44    6042 and 42 U.S.C. 10801 et seq.
 45        (13) "Serious emotional disturbance" means an emotional or behavioral dis-
 46    order, or a neuropsychiatric condition  which results in a serious disability,
 47    and  which  requires sustained treatment interventions, and causes the child's
 48    functioning to be impaired in thought, perception, affect or behavior. A  dis-
 49    order  shall  be  considered  to "result in a serious disability" if it causes
 50    substantial impairment of functioning in family, school or community.  A  sub-
 51    stance abuse disorder does not, by itself, constitute a serious emotional dis-
 52    turbance, although it may coexist with serious emotional disturbance.
 53        (14) "Special therapy" means any treatment modality used to treat children
 54    with  serious  emotional disturbances which is subject to restrictions or spe-
 55    cial conditions imposed by the department of health and welfare rules.
                                                                        
                                       3
                                                                        
  1        (15) "Surrogate parent" means any person appointed to act in the place  of
  2    the  parent of a child for purposes of developing an individual education pro-
  3    gram under the authority of the individuals with disabilities  education  act,
  4    20 U.S.C. 1400 et seq., as amended.
  5        (16) "Teens  at risk" means children attending Idaho public schools grades
  6    seven (7) through twelve (12) who have been identified as expressing or exhib-
  7    iting indications of depression, suicidal inclination, emotional trauma,  sub-
  8    stance abuse or other behaviors or symptoms that indicate the existence of, or
  9    that may lead to, the development of mental illness or substance abuse.
 10        (17) "Treatment  facility"  means a facility or program meeting applicable
 11    licensing standards, that has been approved for  the  provisions  of  services
 12    under this chapter by the department of health and welfare.
                                                                        
 13        SECTION  2.  That  Section 16-2404, Idaho Code, be, and the same is hereby
 14    amended to read as follows:
                                                                        
 15        16-2404.  COMMUNITY SERVICES AND SUPPORTS AND  INTERAGENCY  COLLABORATION.
 16    (1) Lead agency. The department of health and welfare shall be the lead agency
 17    in  establishing  and  coordinating community supports, services and treatment
 18    for children with serious emotional disturbance and their families,  utilizing
 19    public  and  private  resources  available  in  the  child's  community.  Such
 20    resources  shall  be  utilized  to  provide services consistent with the least
 21    restrictive alternative principle, to assist the child's family  to  care  for
 22    the child in his home and community whenever possible. The state department of
 23    education shall be the lead agency for educational services.
 24        (2)  Planning.  The department of health and welfare, the state department
 25    of education, the department of  juvenile  corrections,  counties,  and  local
 26    school  districts  shall  collaborate and cooperate in planning and developing
 27    comprehensive mental health services  and  individual  treatment  and  service
 28    plans  for  children with serious emotional disturbance making the best use of
 29    public and private resources to provide or obtain needed services  and  treat-
 30    ment.
 31        (3)  Teens  at  risk.  The  department  of  health  and welfare, the state
 32    department of education, the department  of  juvenile  corrections,  counties,
 33    courts  and  local  school districts may collaborate and cooperate in planning
 34    and developing mental health counseling, substance abuse treatment and  recov-
 35    ery support services and individual service plans for teens at risk.
 36        (4)  Contracting. The department of health and welfare shall also have the
 37    authority  to enter into contracts with school districts to provide teen early
 38    intervention specialists as provided for in section 16-2404A, Idaho Code.
                                                                        
 39        SECTION 3.  That Chapter 24, Title 16, Idaho Code, be,  and  the  same  is
 40    hereby  amended by the addition thereto of a NEW SECTION, to be known and des-
 41    ignated as Section 16-2404A, Idaho Code, and to read as follows:
                                                                        
 42        16-2404A.  TEEN EARLY INTERVENTION MENTAL HEALTH AND SUBSTANCE ABUSE  SPE-
 43    CIALIST  PROGRAM. (1) The department of health and welfare shall be authorized
 44    to contract for teen early intervention specialists to work with teens at risk
 45    and their families in school districts.
 46        (2)  The teen early intervention specialist shall be a certified counselor
 47    or a social worker with a clinical background in mental  health  or  substance
 48    abuse as prescribed by the department of health and welfare by rule.
 49        (3)  The  salary  paid  to the teen early intervention specialist shall be
 50    equivalent to the salary paid to comparably trained and experienced  individu-
 51    als  employed  by  the  school  district  in the region in which the community
                                                                        
                                       4
                                                                        
  1    resource is employed.
  2        (4)  Teen early intervention specialists shall work with individual  teens
  3    at  risk  to  offer group counseling, recovery support, suicide prevention and
  4    other mental health and  substance  abuse  counseling  services  to  teens  as
  5    needed, regardless of mental health diagnosis.
  6        (5)  By  permission of school administrators, as prescribed in rule, teens
  7    at risk not currently enrolled in a public school may, if assigned by a judge,
  8    participate in group or individual teen early intervention specialist counsel-
  9    ing sessions or services for teens at risk as appropriate.
 10        (6)  School districts seeking to have one (1) or more teen early interven-
 11    tion specialists placed within its district may apply  to  the  department  of
 12    health  and  welfare  for such placement. The department of health and welfare
 13    shall establish by rule a simple application process and criteria  for  place-
 14    ment  of  teen early intervention specialists in districts. The number of teen
 15    early intervention specialists placed in school districts in  any  given  year
 16    shall be limited by the funds appropriated to the teen early intervention spe-
 17    cialist  program in that fiscal year. In evaluating applications for the three
 18    (3) year pilot project, the department of health and welfare shall  give  spe-
 19    cial consideration to rural districts and shall consider:
 20        (a)  The  demonstrated need for mental health and substance abuse counsel-
 21        ing and treatment for teens at risk in the school district;
 22        (b)  The resources and cooperation which the school district has  proposed
 23        to  contribute  to  the  support of the teen early intervention specialist
 24        program for teens at risk; and
 25        (c)  The funding appropriated to the teen  early  intervention  specialist
 26        program for teens at risk.
 27        (7)  Through  an  initial  three (3) year period beginning at the start of
 28    the 2008 school year, the department of health and  welfare  shall  work  with
 29    local  school  districts  where  teen early intervention specialists have been
 30    placed to gather data on the effectiveness of this program. This data  may  be
 31    gathered and tracked through cooperative projects with Idaho colleges and uni-
 32    versities and may include, but not be limited to:
 33        (a)  Impacts on the number and nature of teen arrests;
 34        (b)  Reductions in the number of teen suicides and suicide attempts;
 35        (c)  Changes in patterns of teen incarceration or involvement with Idaho's
 36        juvenile justice system;
 37        (d)  Impacts  on  local  caseloads  of  practitioners in the department of
 38        health and welfare;
 39        (e)  Where applicable, impacts to juvenile mental health or drug courts;
 40        (f)  Changes in academic achievement by teens at risk and by those partic-
 41        ipating in the teen early intervention specialist program; and
 42        (g)  Changes in the number and nature of student disciplinary  actions  in
 43        schools where teen early intervention specialists have been placed.
                                                                        
 44        SECTION  4.  That  Section 20-511A, Idaho Code, be, and the same is hereby
 45    amended to read as follows:
                                                                        
 46        20-511A.  MENTAL HEALTH ASSESSMENTS AND PLANS OF TREATMENT. (1) A judge of
 47    any court shall order the department of health and welfare to submit appropri-
 48    ate mental health assessments and a plan of treatment for the court's approval
 49    if at any stage of a proceeding under this chapter  or  the  child  protective
 50    act,  chapter  16,  title 16, Idaho Code, a judge has reason to believe, based
 51    upon the record and proceedings of the court or upon an affidavit of a  party,
 52    state  or county agency or any person having physical custody of the juvenile,
 53    that the juvenile:
                                                                        
                                       5
                                                                        
  1        (a)  Is suffering a substantial increase or persistence of a serious  emo-
  2        tional  disturbance  as  defined  in  section  16-2403,  Idaho Code, which
  3        impairs his or her ability to  comply with the orders  and  directives  of
  4        the court, or which presents a risk to the juvenile's safety or well-being
  5        or the safety of others; and
  6        (b)  Such condition has not been adequately addressed with supportive ser-
  7        vices  and/or  corrective measures previously provided to the juvenile, or
  8        the juvenile's needs with respect to the serious emotional disturbance are
  9        not being met or have not been met.
 10        (2)  The court may convene a screening team consisting of  representatives
 11    from  the  department  of  health  and welfare, county probation, local school
 12    officials, teen early intervention specialists as provided for  under  section
 13    16-2404A,  Idaho  Code,  the  department  of juvenile corrections and/or other
 14    agencies or persons designated by the court to review the  plan  of  treatment
 15    and provide written recommendations to the court. Parents and guardians of the
 16    juvenile,  if available, shall be included in the screening team and consulted
 17    with regard to the plan of treatment.
 18        (3)  If the court, after receiving the mental health assessment  and  plan
 19    of  treatment submitted by the department of health and welfare and any recom-
 20    mendations from the screening team, determines that additional information  is
 21    necessary  to determine whether the conditions set forth in subsections (1)(a)
 22    and (1)(b) of this section are present, or to determine an appropriate plan of
 23    treatment for the juvenile, the court may order an evaluation and/or recommen-
 24    dations for treatment to be furnished by a psychiatrist, licensed physician or
 25    licensed psychologist, with the expenses of such evaluation and/or recommenda-
 26    tions to be borne by the department of health and welfare.
 27        (4)  If the court concludes that the conditions set forth  in  subsections
 28    (1)(a)  and  (1)(b)  of  this  section  are present, the plan of treatment, as
 29    approved by the court, shall be entered into the record as  an  order  of  the
 30    court. The department of health and welfare shall provide mental health treat-
 31    ment  as  designated by the approved plan of treatment. If in-patient or resi-
 32    dential treatment is required as part of the  plan  of  treatment,  the  court
 33    shall  hold a hearing on whether to order such treatment unless the hearing is
 34    waived by the juvenile and the juvenile's parents or  guardians. The court may
 35    order parents, legal guardians or custodians to adhere to the treatment desig-
 36    nated in the plan of treatment. Representatives from the department of  health
 37    and welfare, county probation, local school officials, teen early intervention
 38    specialists as provided for under section 16-2404A, Idaho Code, the department
 39    of  juvenile  corrections  and/or  other agencies or persons designated by the
 40    court shall attend case review hearings as scheduled by the court.
 41        (5)  All costs associated with  assessment  and  treatment  shall  be  the
 42    responsibility  of  the  parents of the juvenile according to their ability to
 43    pay based upon the sliding fee scale established pursuant to section  16-2433,
 44    Idaho  Code.  The financial obligation of the family shall be determined after
 45    consideration of all available payment and funding sources including title XIX
 46    of the social security act, as amended, all available third party sources, and
 47    parent resources according to any order for child support  under  chapter  10,
 48    title  32, Idaho Code. Services shall not be conditioned upon transfer of cus-
 49    tody or parental rights.

Statement of Purpose / Fiscal Impact



                       STATEMENT OF PURPOSE

                            RS 16989

The purpose of this act is to create a three-year pilot project to
establish a new model for providing Idaho school districts with clinically
trained substance abuse and mental health specialist counselors and specialist
social workers to address critical shortages in mental health and substance
abuse practitioners and treatment services for teens in Idaho's rural areas.
It is this programs' intent to use group and individual support and treatment
counseling to increase crisis intervention and addiction recovery, address
teen suicide, depression, drug and alcohol use, classroom disruption,
violence, incarceration and other negative outcomes that may result from
leaving youth mental health and substance abuse issues untreated in Idaho's
schools and communities. This legislation provides for cooperation between
schools, the Department of Health and Welfare, County Law Enforcement and
Juvenile Corrections as well as the courts to address the mental health and
substance abuse needs of Idaho teens.

Data on the outcomes of this program will be tracked by the department and
school districts through contracts with universities. Such analysis will allow
for evaluation of program outcomes at the conclusion of the three year pilot
project period. This data is intended to allow the legislature to evaluate the
effectiveness of this program and determine if continuation and full
implementation would be an effective means of addressing mental health and
substance abuse problems in teens across Idaho. 
 
                          FISCAL IMPACT

Under the initial pilot project, $330,000 annually for three years or a one
time grant of $990,000 in one time funds for the three-year pilot project
period will provide salaries and benefits for 4 clinically trained mental
health and or substance abuse specialist counselors as well as funds for
contracts with a university to study outcomes for a report at the end of the
2010 fiscal year. The potential for pilot project expansion into additional
districts in future years would depend on an analysis of program outcomes and
the allocation of additional funding if appropriate. 
  Even over the course of the three year pilot project period, it can be
anticipated that there will be the potential for savings to the Department of
Corrections through reduced rates of addiction and incarceration; in the
Health and Welfare through increased self sufficiency, substance abuse
prevention and recovery; in Medicaid through improved health and reduction of
the need for crisis and emergency care: and in Idaho's Public Schools through
decreased need for crisis intervention and increased academic achievement.


Contact
Name: Senators Corder, Goedde, Kelly 
Phone:  
Representatives Henbest, Lefavour



STATEMENT OF PURPOSE/FISCAL NOTE                        S 1147