Mass. Gen. Laws ch. 19, sec. 26 — MA Code / Part I / Title II / Chapter 19 / Section 26
Expedited psychiatric inpatient admission advisory council; members; annual report; expedited psychiatric inpatient admissions protocol
Status: in_force

Section 26. (a) There shall be an expedited psychiatric inpatient admission advisory council within the department which shall investigate and recommend policies and solutions regarding the emergency department boarding of patients seeking mental health and substance use disorder services. The advisory council shall: (i) implement the expedited psychiatric inpatient admissions protocol, as established by the department; (ii) collect data on the number of patients boarding in emergency departments and the reasons for extended wait times, including capacity constraints; and (iii) make recommendations for measures to reduce the wait times for admissions. (b) The advisory council shall consist of the following members: the commissioner of mental health or a designee, who shall serve as chair; the commissioner of public health or a designee; the director of the office of Medicaid or a designee; the commissioner of insurance or a designee; a representative from the Massachusetts Association of Health Plans, Inc.; a representative of Blue Cross and Blue Shield of Massachusetts, Inc.; a representative of the Massachusetts Health and Hospital Association, Inc.; a representative of the Massachusetts College of Emergency Physicians, Inc.; a representative of the Association for Behavioral Healthcare, Inc.; a representative of the National Alliance on Mental Illness of Massachusetts, Inc.; a representative of the Massachusetts Association of Behavioral Health Systems, Inc.; a member representing emergency services providers; and a consumer representative with lived experience boarding in an emergency department. (c) Annually, not later than December 31, the advisory council shall file a report with the secretary of health and human services, the joint committee on mental health, substance use and recovery and the joint committee on health care financing. The report shall: (i) summarize the data collected on the number of patients boarding in emergency departments identified by age, gender identity, race, ethnicity, insurance status, diagnosis and reason for the delay in admission; and (ii) include recommendations for reducing boarding in emergency departments and any suggested legislative or regulatory action to implement those recommendations, which shall include, but not be limited to, requirements for the delivery system to operate on a 24 hours a day, 7 days a week basis for admissions and discharges and penalties for noncompliance. (d) Notwithstanding any general or special law to the contrary, the expedited psychiatric inpatient admissions protocol established by the department shall: (i) require, for patients under the age of 18, notification by the hospital emergency department to the department in order to expedite placement in or admission to an appropriate treatment program or facility within 48 hours of boarding or within 48 hours of being assessed to need acute psychiatric treatment and having been determined by a licensed health care provider to be medically stable without the need for urgent medical assessment or hospitalization for a physical health condition; (ii) include, within the escalation protocol, patients who initially had a primary medical diagnosis or primary presenting problem requiring treatment on a medical-surgical floor, who have been subsequently medically cleared and are boarding on a medical-surgical floor for an inpatient psychiatric placement; and (iii) include, for patients under the age of 18, notification upon discharge from the emergency department, satellite emergency facility or medical-surgical floor to the patient's primary care physician or treating behavioral health clinician, if known.

Section 26. (a) There shall be an expedited psychiatric inpatient admission advisory council within the department which shall investigate and recommend policies and solutions regarding the emergency department boarding of patients seeking mental health and substance use disorder services. The advisory council shall: (i) implement the expedited psychiatric inpatient admissions protocol, as established by the department; (ii) collect data on the number of patients boarding in emergency departments and the reasons for extended wait times, including capacity constraints; and (iii) make recommendations for measures to reduce the wait times for admissions.

(b) The advisory council shall consist of the following members: the commissioner of mental health or a designee, who shall serve as chair; the commissioner of public health or a designee; the director of the office of Medicaid or a designee; the commissioner of insurance or a designee; a representative from the Massachusetts Association of Health Plans, Inc.; a representative of Blue Cross and Blue Shield of Massachusetts, Inc.; a representative of the Massachusetts Health and Hospital Association, Inc.; a representative of the Massachusetts College of Emergency Physicians, Inc.; a representative of the Association for Behavioral Healthcare, Inc.; a representative of the National Alliance on Mental Illness of Massachusetts, Inc.; a representative of the Massachusetts Association of Behavioral Health Systems, Inc.; a member representing emergency services providers; and a consumer representative with lived experience boarding in an emergency department.

(c) Annually, not later than December 31, the advisory council shall file a report with the secretary of health and human services, the joint committee on mental health, substance use and recovery and the joint committee on health care financing. The report shall: (i) summarize the data collected on the number of patients boarding in emergency departments identified by age, gender identity, race, ethnicity, insurance status, diagnosis and reason for the delay in admission; and (ii) include recommendations for reducing boarding in emergency departments and any suggested legislative or regulatory action to implement those recommendations, which shall include, but not be limited to, requirements for the delivery system to operate on a 24 hours a day, 7 days a week basis for admissions and discharges and penalties for noncompliance.

(d) Notwithstanding any general or special law to the contrary, the expedited psychiatric inpatient admissions protocol established by the department shall: (i) require, for patients under the age of 18, notification by the hospital emergency department to the department in order to expedite placement in or admission to an appropriate treatment program or facility within 48 hours of boarding or within 48 hours of being assessed to need acute psychiatric treatment and having been determined by a licensed health care provider to be medically stable without the need for urgent medical assessment or hospitalization for a physical health condition; (ii) include, within the escalation protocol, patients who initially had a primary medical diagnosis or primary presenting problem requiring treatment on a medical-surgical floor, who have been subsequently medically cleared and are boarding on a medical-surgical floor for an inpatient psychiatric placement; and (iii) include, for patients under the age of 18, notification upon discharge from the emergency department, satellite emergency facility or medical-surgical floor to the patient's primary care physician or treating behavioral health clinician, if known.