AT A GLANCE

This bill requires hospitals and specified ambulatory and emergency entities to submit standardized hospital discharge data to the state agency at least quarterly beginning July 1, 2027.

FULL SUMMARY

The bill establishes a statewide hospital discharge data system requiring hospitals and specified ambulatory/emergency entities to submit standardized inpatient and selected ambulatory/emergency discharge-related data to a state agency, including audit access and procedures to support data quality. Beginning July 1, 2027, hospitals (except the state hospital) must submit inpatient hospital discharge data at least quarterly, with separate reports per location (or clearly identified combined reports), and must report live discharges and deaths from specified care settings (acute care, intensive care, long-term acute care, short- and long-term psychiatric, and substance abuse/comprehensive rehabilitation). The state agency may require hospitals, upon notice, to provide access to underlying medical records and billing documents and other documentation needed to conduct complete audits.

The bill requires additional reporting beginning July 1, 2027 from licensed short-term acute care hospitals, licensed organized ambulatory health care facilities, emergency departments, lithotripsy centers, and cardiac catheterization laboratories, also at least quarterly. Each entity must submit separate reports for each location, and services for non-emergency ambulatory surgical/operating-room procedures (including specified cardiology, gastrointestinal, lithotripsy, and endoscopy categories) must be included. It also sets certification/resubmission rules: designated facility leadership must certify reports as accurate, complete, and verifiable; facilities may request amendments to certified reports within twelve months of the initial submission due date if the state agency determines the amended report significantly impacts data quality, with required details on reasons, cause, corrective action plan, scope of records, data type, and the resubmission schedule. Reporting facilities must notify the state agency of certain personnel changes.

The bill defines relevant terms for the new hospital discharge data subpart (including “hospital discharge data,” “inpatient” excluding observation patients, and “discharge” following inpatient admission) and requires reporting of specified data elements and codes as required by the state agency, including institutional health care claim-form elements capturing patient information, diagnoses (ICD codes), procedures, dates, charges, and provider details using National Uniform Billing Committee standards. It further requires the state agency to make collected hospital discharge data reports available for public inspection during normal business hours, while patient-specific records are exempt from disclosure unless de-identified per enumerated criteria (including removal/de-identification of name/assigned identifiers, SSN, and birth date, with some substitutions such as age and day-interval substitutions for admission-to-procedure timing). The bill also creates/structures a “Hospital Discharge Data Working Group” within Chapter 323D: the agency must convene the working group no later than September 1, 2026 to develop submission nature, scope, and procedures; the group includes specified government officials and invited healthcare/data stakeholders (and a company with comprehensive health care data analytics experience), must hold public stakeholder meetings, selects a chair, serves without compensation (with expense reimbursement), issues findings and recommendations to the legislature no later than 20 days prior to the 2027 regular session, and ceases June 30, 2027.

The bill appropriates general revenues for fiscal year 2026–2027 to the Department of Health for purposes of the Act. The effective date stated in the bill is July 1, 3000.

AT A GLANCE

This bill requires all hospitals and designated ambulatory entities to submit inpatient and ambulatory discharge data at least quarterly to SHPDA beginning July 1, 2027, with location-specific reporting and certified accuracy.

FULL SUMMARY

The bill establishes a statewide system for collecting, auditing, and publicly releasing de-identified hospital discharge data and requires the State Health Planning and Development Agency (SHPDA) to convene a hospital discharge data working group.

Beginning July 1, 2027, the bill requires all hospitals to submit, at least quarterly, inpatient hospital discharge data to the state agency using procedures developed by the working group. Hospitals must report separately by location (or clearly identify locations in a combined report). The reporting scope covers live discharges and deaths (including newborns) across specified inpatient settings (acute care, intensive care, long-term acute care, short- and long-term psychiatric, and substance abuse/comprehensive rehabilitation). Hospitals must, upon state agency notice, provide access to underlying medical record and billing documentation needed for inpatient audit purposes. The bill also specifies inpatient reporting rules for transferred/discharged patients into rehabilitative distinct-part units or free-standing hospitals (requiring separate data types for acute vs comprehensive rehabilitative therapy discharges), ends reporting accountability upon transfer/discharge into certain skilled nursing or hospice settings, excludes observation patients unless they are admitted as inpatients, and includes a defined approach to counting “visits” for ambulatory procedures occurring one or more days before the procedure (as a single visit).

Beginning July 1, 2027, it requires designated ambulatory entities to submit, at least quarterly, hospital discharge data reports: licensed short-term acute care hospitals, licensed organized ambulatory health care facilities, emergency departments, lithotripsy centers, and cardiac catheterization laboratories. Each location must have separate reporting. The bill requires inclusion of non-emergency services tied to specified surgical and diagnostic/cardiology categories, including operating-room surgical procedures and ambulatory surgical care, cardiology services (including cardiac catheterization and percutaneous transluminal coronary angioplasty), gastrointestinal services, lithotripsy, and endoscopy. Reporting facilities must certify that submitted reports are accurate, complete, and verifiable; they may request permission to amend and resubmit certified reports within 12 months of the initial due date, with specified documentation of the reasons, contributing cause, corrective action plan, and the number of records affected; resubmission is permitted only if the state agency determines it would significantly impact data quality. The bill also requires notification to the state agency when specified data-submission personnel change.

The bill establishes required data elements/codes and standards for submitted records (including using national institutional billing claim form data elements such as patient information, diagnoses, procedures, dates, charges, and provider details based on National Uniform Billing Committee claim design). It requires the state agency to make the submitted hospital discharge data reports available for public inspection during normal business hours (with authority to charge reasonable copying fees), while exempting patient-specific records from disclosure unless the required fields are de-identified as specified (including name/assigned identifiers; social security number; birth date with age-in-years allowed; entry/discharge dates; procedure dates with substitution by days-from-admission; and medical/health record number). The bill appropriates $200,000 from general revenues for fiscal year 2026–2027 for the Department of Health to implement the act. The working group must be convened by SHPDA by September 1, 2026, hold public stakeholder meetings, and submit findings and recommendations (including any proposed legislation) to the legislature no later than 20 days before the 2027 regular session; the working group ceases June 30, 2027. The act takes effect July 1, 2026.

AT A GLANCE

This bill expands emergency hospitalization criteria by requiring courts to initiate release proceedings within seventy-two hours of emergency admission and allows detention until further court order when notice is provided.

FULL SUMMARY

The bill establishes changes to Hawaii’s involuntary/emergency psychiatric hospitalization standards by (1) revising the statutory definition of “dangerous to self,” (2) defining “gravely disabled” and “psychiatric deterioration” terms for use in the chapter, (3) broadening the reach of “imminently dangerous to self or others” by extending the look-ahead period, and (4) increasing the maximum duration of emergency hospitalization.

Specifically, it amends HRS §334-1 (Definitions) to replace the prior “dangerous to self” criteria (previously framed around recent threats/attempts and inability to provide basic needs with resulting probable harm) with a new criterion: a person is “dangerous to self” if the person is gravely disabled. The bill also adds/clarifies definitions: “gravely disabled” is defined as inability, without supervision and assistance, to prevent physical or psychiatric deterioration or to satisfy basic needs (nourishment, essential medical care including mental illness treatment, shelter, or self-protection) such that death, substantial bodily injury, or serious debilitation/disease is probable unless adequate treatment is afforded. “Psychiatric deterioration” is defined as a substantial impairment or obvious decline of judgment, reasoning, or ability to control behavior. In addition, the bill extends the definition of “imminently dangerous to self or others” so that without intervention the person will likely become dangerous within the next ninety days (from a shorter period referenced in the bill).

The bill further amends HRS §334-59 (Emergency hospitalization procedures). Under emergency hospitalization criteria, an examining physician/APRN/psychologist may direct emergency admission/transfer when the patient is (1) mentally ill or suffering from substance abuse, (2) imminently dangerous to self or others, and (3) in need of care or treatment (or both). It also revises patient notification language to include specified categories of people (e.g., family members, reciprocal beneficiaries, and an adult friend) regarding the right to telephone/notification, and clarifies staff obligations to make reasonable efforts to ensure notification unless the patient requests no notification. Finally, it increases the maximum period to initiate release proceedings after emergency admission (changing the time from forty-eight hours to seventy-two hours) and provides that if the time expires on a Saturday, Sunday, or holiday, initiation is extended to the close of the next court day; once proceedings are initiated, the facility may detain the patient until further court order.

The act takes effect July 1, 2025, and includes a standard savings clause preserving rights/duties that matured, penalties incurred, and proceedings begun before the effective date.

AT A GLANCE

This bill requires the Maryland Department of Health to establish and operate at least 24 licensed adolescent psychiatric inpatient beds in Prince George’s County by December 31, 2028.

FULL SUMMARY

The bill establishes new requirements for the Maryland Department of Health (MDH) related to adolescent psychiatric inpatient bed capacity in Prince George’s County and requires MDH to report both capacity and treatment outcomes to the Governor and the General Assembly.

MDH must, in consultation with the Prince George’s County local behavioral health authority, ensure the establishment and ongoing operation of at least 24 licensed adolescent psychiatric inpatient beds in the county. MDH must achieve this by (1) expanding licensed inpatient bed capacity at an existing facility in Prince George’s County, (2) contracting with a private or nonprofit operator to establish and operate a licensed adolescent psychiatric inpatient facility, or (3) establishing a public-private partnership to finance and operate the beds. In pursuing these options, MDH must prioritize solutions that reduce pediatric psychiatric emergency department boarding and inpatient overstays, that are measurable through Maryland’s inpatient psychiatric bed registry and referral system, and that ensure access regardless of payer source, including the Maryland Medical Assistance Program. If expanding capacity at an existing facility will not meet a statutory deadline (June 30, 2027), MDH must issue a request for proposals (RFP) for establishment of the beds, distributed to private or nonprofit operators with demonstrated experience in establishing adolescent psychiatric inpatient bed capacity. MDH must ensure the required beds are fully operational and available for patient admission by December 31, 2028.

The bill creates a competitive grant program administered by MDH to establish the required adolescent psychiatric inpatient beds. Grant funds may be disbursed only to hospitals, psychiatric facilities, nonprofit health care providers, or public-private partnerships, and may be used only for capital costs associated with operating the beds: renovation, construction, safety or ligature upgrades, and workforce start-up expenses.

The bill requires three reporting/study obligations: (1) MDH must report by October 1, 2027 and annually thereafter until 2030 on the number and location of licensed adolescent psychiatric inpatient beds by county; metrics for pediatric psychiatric emergency department boarding and overstay; barriers to staffing (including licensure barriers); and recommendations for rate or regulatory changes needed to maintain sufficient capacity. MDH must use available data systems, including the State inpatient psychiatric registry and referral system, to generate these report data. (2) By December 1, 2026, MDH must study and report (in consultation with the National Association of State Mental Health Program Directors and the Prince George’s County local behavioral health authority) on resources, staffing parameters, treatment plans, and therapeutic environments that would ensure best possible outcomes and that correct services are provided to adolescents. MDH may partner with relevant organizations in conducting this study. The bill takes effect June 1, 2026.

AT A GLANCE

This bill requires the Maryland Department of Health, in consultation with the Prince George’s County local behavioral health authority, to ensure at least 24 licensed adolescent psychiatric inpatient beds in Prince George’s County.

FULL SUMMARY

The bill establishes new requirements for the Maryland Department of Health (the “Department”) to ensure adolescent psychiatric inpatient bed capacity in Prince George’s County by defining key terms and mandating minimum, ongoing licensed capacity.

It adds new Section 19–310.7 to the Maryland Health–General article. “Adolescent” is defined as individuals at least 12 and under 17, and “adolescent psychiatric inpatient bed” is defined as a unit of licensed inpatient psychiatric capacity providing overnight, 24-hour facility-based psychiatric evaluation, stabilization, and treatment for adolescents. The Department, in consultation with the Prince George’s County local behavioral health authority, must ensure at least 24 licensed adolescent psychiatric inpatient beds in Prince George’s County, using one or more approaches: (i) expanding licensed capacity at an existing inpatient facility in the county, (ii) contracting with a private or nonprofit operator to establish and operate a licensed adolescent psychiatric inpatient facility, or (iii) establishing a public-private partnership to finance and operate adolescent psychiatric inpatient beds. In implementing these options, the Department must prioritize solutions that reduce pediatric psychiatric emergency department boarding and inpatient overstays; are reflected in and measurable through the State inpatient psychiatric bed registry and referral system; and ensure access regardless of payer source, including the Maryland Medical Assistance Program.

If the Department determines that expansion under the existing-facility pathway will not meet a specified deadline (June 30, 2027), the Department must issue, on or before June 30, 2027, a request for proposals to establish the adolescent psychiatric inpatient beds. The RFP must be distributed at minimum to private or nonprofit operators with demonstrated experience in establishing adolescent psychiatric inpatient bed capacity in the State. By December 31, 2028, the Department must ensure the required adolescent psychiatric inpatient beds are fully operational and available for patient admission. The Department must also administer a competitive grant program to establish the required beds; grant funds may go only to hospitals, psychiatric facilities, nonprofit health care providers, or public-private partnerships, and may be used only for specified capital costs tied to operating the beds: renovation, construction, safety or ligature upgrades, and workforce start-up expenses.

The bill further requires periodic reporting to the Governor and the General Assembly. On or before October 1, 2027, and annually thereafter until 2030, the Department must report, using available data systems including the State inpatient psychiatric registry and referral system, on: (1) the number and location of licensed adolescent psychiatric inpatient beds by county; (2) metrics for pediatric psychiatric emergency department boarding and overstay; (3) staffing barriers for licensed adolescent psychiatric inpatient beds (including licensure barriers); and (4) recommendations for rate or regulatory changes needed to maintain sufficient capacity. The act takes effect July 1, 2026.

AT A GLANCE

This act requires the Massachusetts Health Policy Commission to analyze COVID-19’s effects on behavioral health emergency-department boarding and issue recommendations to legislative leaders by July 1, 2023.

FULL SUMMARY

The document contains an analytical policy report by the Massachusetts Health Policy Commission (HPC) on emergency department (ED) boarding for behavioral health (BH) conditions in Massachusetts, focused on measurable trends (2020–2024 data) and policy recommendations to reduce boarding and improve outcomes and payer reimbursement.

The report is grounded in a specific statutory study directive: Chapter 126 of the Acts of 2022, Section 145 requires the HPC to conduct an analysis and issue a report on the ongoing effects of COVID-19 on BH-related boarding in acute care hospital settings (including EDs, medical-surgical units, and observation units). The mandated scope includes review of ED visits in the Commonwealth classified as mental health, behavioral health, substance use disorder, or other alcohol-related diagnosis, and analysis of boarding-related length of stay, primary reason for wait, level of care required, insurance coverage and payer reimbursement, available demographic data (age, race, ethnicity, preferred spoken language, gender, homelessness), ability to facilitate care coordination, and COVID-19 effects on length of stay and on workforce shortages, plus other COVID-related factors affecting hospital burden, patient outcomes/quality, and resources provided by health plans. It also requires the HPC to review similar BH boarding efforts/best practices in other states and to submit recommendations to legislative leaders by July 1, 2023.

Operationally, the report establishes a working definition of BH ED boarding for its analyses: ED visits with a BH primary diagnosis lasting 12 or more hours (unless otherwise specified). It summarizes key findings about system bottlenecks (inflow and outflow), including shortages of inpatient/residential capacity, delays in medical clearance processes, and discharge bottlenecks (including homelessness/unstable housing and lack of coordinated discharge planning). It describes observed trends: overall ED boarding rises from 2020 to 2024, while the share of BH-related visits that board increases sharply through 2022 and then moderates; it also provides episode-level breakdowns by discharge destination and average length of stay, notes the role and limitations of “observation” status in measurement, and highlights demographic patterns and placement-time differences across age groups and clinical categories.

The report then lays out policy recommendations in two broad areas: (1) data collection/continued reporting and additional planning studies (e.g., expanding CHIA data and revising EPIA reporting so it captures observation and non-psychiatric inpatient boarding/placement situations; conducting broader BH capacity/bed-type planning studies including autism/developmental and forensic needs; and studying freestanding psychiatric facility practices such as medical clearance and discharge planning), and (2) practices/policies to support admission and transitions into more appropriate care (best practices for harder-to-place patients; stakeholder convening on safe discharge options; continued promotion of “front door” BH access through the BH Roadmap, including BH helpline and CBHCs; enabling direct admissions from the community with appropriate medical screening; and regulation review/development of ED diversion and alternative transport approaches). It also recommends clarifying ED-to-inpatient payment pathways for boarders and continuing workforce-focused actions via the state’s Behavioral Health Workforce Center. The appendix lists selected crisis BH service types (BH helpline, CBHCs, community crisis stabilization, BH urgent care, and CBAT) as alternative care pathways to ED boarding.

Confirming what the document does establish/change/contain: it primarily contains a mandated-state-policy study/report (with definitional and analytic findings) plus detailed recommendations; it does not itself enact new statutory text in the provided materials.

AT A GLANCE

This bill requires licensed behavioral health facilities to admit patients meeting general admission criteria when capacity allows, prohibits refusals that exceed operational limits, and mandates monthly reporting of admission denials and reasons.

FULL SUMMARY

The bill creates new behavioral health planning, commission, and hospital-care standards within Massachusetts General Laws and related sections. It establishes (1) an interagency statewide planning committee within the Executive Office of Health and Human Services to annually study statewide need for behavioral health services beginning with inpatient psychiatric units and Department of Mental Health beds, using facility census reporting and the expedited psychiatric admissions process; and (2) a special commission charged with expanding access to specialty behavioral health inpatient beds for adults and youth, including recommendations for funding and a potential rate structure for high-intensity specialty beds. The statewide planning committee must publish an annual report by December 31 each year that includes recommendations for reducing emergency department boarding, and must submit copies to specified legislative joint committees.

The bill’s new commissions/committees must produce needs and access analyses for specialty populations (including children, geriatric patients, individuals with autism spectrum disorder, intellectual/developmental disabilities, co-occurring substance use disorder, co-occurring medical conditions, high-acuity patients with severe behavior/assault risk, and eating-disorder patients), estimate required bed/unit capacity by geography and cost to operate units at needed capacity, and consult stakeholders on achieving needed capacity and services. The specialty-bed commission is composed of specified agency leaders (including mental health, public health, insurance, MassHealth, Mass General laws-related entities) plus six appointed stakeholders from behavioral health and health-plan/provider organizations, and it must consider availability data, populations facing longer waits, differences between licensed and operational beds, payer mix and payment models, and feasibility of alternative and multi-payer equitable payment/rate structures; it must submit findings and recommendations (with drafts of needed legislation or regulations) within one year of enactment.

Operational changes tighten behavioral health and integrated-care requirements. It revises Chapter 6D (Massachusetts ACO-related framework) by replacing a specific set of minimum standards for certified ACOs and adds/clarifies requirements including: functional interoperable health information technology for care coordination/population management; internal appeals plan participation requirements; provision of medically necessary services across the care continuum (behavioral and physical health); and detailed expectations for evidence-based behavioral health service delivery (including 24/7 access, admissions/discharges, treatment/discharge planning, quality/outcome measure compliance, and coordination/communication). It further requires ACO reporting on the share of total expenditures paid to behavioral health providers and shared decision-making, including for palliative care and long-term services/supports.

The bill adds multiple new requirements for licensed facilities and hospital standards. It directs the Department of Public Health (and/or the relevant department in the bill’s provisions) to establish clinical competencies and additional operational standards for patients admitted to facilities licensed under 104 CMR 27.00, requiring incorporation of national/local standards where available, biennial (or as-needed) updates, and stakeholder consultation; it requires regulations for free-standing licensed facilities to maintain a clinical affiliation with a medical facility for access to medical services. It mandates reporting of quality and outcome measures, requires licensed facilities to operate 24/7 for admissions and discharges, and authorizes regulations and enforcement remedies including remediation plans or financial penalties ($100 per day per affected patient during noncompliance, capped at $500,000 annually). It also creates a “no refusal” policy: facilities may not refuse admission to patients meeting general admission criteria (including clinical competencies) where admission would not exceed operational capacity, and must collect/report admission request/denial data and monthly reasons for denials; written justifications may include limits based on medical director determination of capability and must be recorded in writing without patient-identifiable information in monthly reporting. Finally, it adds Hospital Standards for Delivery of Behavioral Health Care in Hospitals in Chapter 111 requiring acute-care hospitals and satellite emergency facilities to apply non-discriminatory policies/protocols, conduct annual comprehensive policy/procedure reviews across specified operational domains, submit signed CEO/Chief Medical Officer certifications to the Department of Public Health and Department of Mental Health, establish a complaint submission process with published instructions, and promulgate regulations including standard reporting/self-reporting formats.

The bill establishes time limits and procedural safeguards intended to reduce emergency department boarding by restricting the duration and oversight of involuntary holds in facilities not authorized to perform required mental health evaluations.

It amends Section 12 of Chapter 123 of the Massachusetts General Laws by adding new paragraphs in subsection (a) (after the first paragraph). First, it requires that no person be involuntarily held for more than 72 hours at a facility that has not been authorized by the Department to perform evaluations under Section 12(b); any person held longer than 72 hours must be released.

Second, it provides that any psychiatric hold lasting more than 48 hours at a facility that has not been authorized by the Department to perform evaluations under Section 12(b) must be referred to the Committee for Public Counsel Services for appointment of counsel.

AT A GLANCE

This bill prohibits unauthorized facilities from restraining a person under Section 12(a) unless the person (or parent or legal guardian) receives an opportunity to apply for voluntary admission and is informed the restraint cannot exceed 72 hours.

FULL SUMMARY

The bill amends Massachusetts General Laws, Chapter 123 (Section 12) to add a new subsection (a½) governing when and how a person may be restrained at a facility not authorized by the Department to perform mental health evaluations under Section 12(b).

The new restriction prohibits restraining a person under Section 12(a) at an unauthorized facility unless the person (or the person’s parent or legal guardian on the person’s behalf) is (1) given an opportunity to apply for voluntary admission under Section 10(a), and (2) informed that the person has a right to voluntary admission and that the restraint period cannot exceed 72 hours. If restraint lasts longer than 72 hours, the person must be released or transferred to a Department-authorized evaluation facility. The bill also preserves authority for the superintendent to discharge the person at any time during hospitalization if the superintendent determines the person is not in need of care and treatment.

For restraints at an unauthorized facility lasting more than 48 hours, the bill requires the facility to inform the Committee for Public Counsel Services upon the person’s request. It further requires the Committee to immediately appoint an attorney to meet with the person. The attorney must notify the Committee if the person voluntarily and knowingly waives representation, is already represented, or will be represented by another attorney; in those circumstances, the Committee must withdraw the appointment.

The bill also adds an emergency district court hearing mechanism: any person restrained under subsection (a½) who has reason to believe the restraint results from abuse or misuse of the subsection may request an emergency hearing. Unless a delay is requested, the district court must hold the hearing either the day the request is filed or not later than the next business day, using the facility’s jurisdiction.

AT A GLANCE

This bill makes the FY2026 appropriations effective immediately and requires agencies to provide nondiscrimination and equal-opportunity hiring and employment practices when spending appropriated funds.

FULL SUMMARY

The bill establishes the act as an emergency law to make FY2026 appropriations effective immediately and to implement changes necessary for those appropriations. It requires nondiscrimination and equal opportunity in the spending of appropriated funds, including affirmative obligations for agencies and employees regarding hiring and employment practices. It authorizes FY2026 General Fund appropriations for Commonwealth operations and certain permanent improvements, and imposes detailed conditions on eligibility, reporting, grant administration and matching, spending floors and limits, administrative-cost restrictions, and restrictions on transfers within and among budget items. It also requires the Comptroller to maintain distinct accounts for actual tax and non-tax revenue receipts, and to issue quarterly statements and annual reporting comparing actual receipts to projections.

The bill makes multiple non-appropriation legal changes. It restructures the Massachusetts civil-rights governance by replacing prior provisions on the Massachusetts Commission Against Discrimination with a new independent-agency structure, including commissioner appointment and quorum rules, an executive director and staffing framework subject to civil service protections, regional offices and public hearings in specified cities, and an advisory board. It changes dispute-resolution personnel by modifying Section 18N of chapter 6A to replace specified judicial designees with a governor-appointed retired trial judge. It reduces a specified funding figure in chapter 6C. It creates new non-budgeted special revenue funds—including an “Old Harbor Reservation Trust Fund” administered by the Department of Conservation and Recreation with permitted fee-based expenditures, annual reporting to the ways and means committees, and a prohibition on actions causing fund deficiency—and a new “Affirming Health Care Trust Fund” for broadly defined gender-affirming health care services and related purposes, with an annual reporting requirement by October 1. It makes targeted policy changes across licensing, records, governance, and operational statutes, including (among other items) clarifying tourism-related restrictions, adding a small-business ombudsperson with defined duties and annual legislative reporting, requiring a housing funding transparency dashboard with specified exclusions and confidentiality protections, adjusting operator-license public-access treatment for proprietary information, redesigning the Board of Appeal on motor vehicle liability policies and bonds, expanding permitted uses in specific funding statutes, creating a Massachusetts Secure Choice Savings program with default enrollment and opt-out mechanics plus confidentiality, employer penalty and enforcement limits, and board reporting, updating transit fare rules to require fare-free service for ADA-required paratransit and fixed routes with DOT reimbursement of lost fare revenue, and establishing multiple procedural changes in the administration of motor-vehicle and electronic-title processes.

The bill also significantly revises vital-records law and related administrative rules. It replaces the process for correcting, completing, or supplementing birth, marriage, and death records, including an affidavit-and-documentation framework supported by documentary evidence beyond a reasonable doubt, plus a limited one-year correction period that may be allowed by regulation without that affidavit/documentation requirement. It creates or revises mechanisms to change birth-record parentage and sex designation (including allowing sex designation changes for eligible adults and certain minors using a perjury affidavit without requiring medical, court, or name-change proof), ties name changes to sex designation with timing rules and waivers for good cause, and provides adoption-related correction procedures tied to adoption certificates or decrees. It authorizes certain delayed vital-record completions using affidavits or certified statements from deceased persons and other municipal records while imposing time limits on establishing delayed birth records for deceased persons and on establishing marriage records when both spouses are deceased. It adds abandoned-child/foundling procedures governed by state registrar requirements and sets a fee requirement for approved corrections or amendments. It also provides for joint marriage-record removal of sex designation and name change where supported by perjury affidavits and proof of legal name change.

The bill further adjusts campaign finance treatment for adult-care services, clarifies certain vehicle registration interpretation and estate tax base calculations, changes agency and record-management rules for victim and witness assistance administration and compensation confidentiality, revises district court locality listings and specialty-court staffing authorization, modifies several other licensing and administrative provisions, and creates multiple study and task-force mandates—including reports on pyrite/pyrrhotite foundation remediation, housing construction cost support options, third-party inspection feasibility for manufactured/off-site and multifamily projects, local tax exemptions for affordable housing, and interstate barriers for telehealth and medical practice—along with secure choice implementation notice and delayed penalties, personal care attendant implementation planning and progress reporting, and a commission to study the Pappas Rehabilitation Hospital for Children. It requires specified implementing actions and sets operation dates for particular provisions, including deadlines for regulations, a housing dashboard operational requirement, and staggered effective dates for certain sections, while setting a general effective date stated for the act.

The uploaded material is an Office of the Child Advocate (Massachusetts) annual report for Fiscal Year 2024, describing activities, oversight functions, research, and initiatives. It contains narrative descriptions and performance/issue data, but it does not establish or change Massachusetts law or implement regulatory requirements.

AT A GLANCE

This report authorizes the EPIA Advisory Council to investigate and recommend 24/7 policies that reduce emergency department psychiatric inpatient boarding delays by collecting placement-delay data and issuing system-improvement recommendations.

FULL SUMMARY

The document transmits Massachusetts Department of Mental Health’s 2023 Annual Expedited Psychiatric Inpatient Admission (EPIA) Advisory Council report (submitted under the authority created by Chapter 177 of the Acts of 2022) and summarizes the Council’s 2023 work addressing emergency department (ED) boarding delays for patients seeking inpatient psychiatric admission. The report describes the EPIA Advisory Council’s charge to investigate and recommend policies and solutions to reduce ED boarding for mental health and substance use disorder patients, including collecting boarding/admission delay data and developing recommendations for improving the delivery system over a 24/7 basis.

The report documents Council data collection and analysis for the period February through September 2023 and presents demographic and clinical breakdowns of EPIA referrals (including age-group patterns, gender identity, race/ethnicity and Hispanic/Latino designation, insurance coverage, and frequently recorded diagnoses). It also summarizes reasons for extended wait times and boarding (reported as “barriers to placement”), distinguishing major categories such as aggression, disposition issues, “no bed availability,” and insurance/insurance-network or compliance-related barriers, with differences in barrier patterns between youth and adults. The report highlights aggregate placement timing and “average time to placement” findings, and notes that the barriers observed often reflect system-level constraints (bed availability, capacity constraints, and placement/escalation processes) rather than solely patient-specific clinical suitability.

The document includes a “Council Review” of efforts and initiatives intended to address acute behavioral health needs, and provides a set of Council “Recommendations” aimed at improving timeliness, consistency, communication, and diversion/alternative pathways to inpatient admission to reduce ED boarding. Recommendations include: ongoing training for stakeholders on the EPIA process; expanding diversion knowledge and ED-to-community resources; using expert panels/best-practice models for high-acuity behavioral presentations; increasing the use of crisis stabilization units, respite, and peer specialists for patients no longer meeting inpatient level of care; continuing full implementation of the Behavioral Health Roadmap (including requiring commercial carriers to cover community-based services); legislative oversight of Mental Health ABC Act and Cares Act provisions affecting service payment and collaboration models; increasing direct admission capacity from the community; ensuring all psychiatric inpatient units can accept and discharge within specific time frames on 24/7/7-day-week coverage expectations; and authorizing/continuing steps to permit direct EMS transport to appropriate CBHC/MCI locations to avoid inappropriate ED-based boarding.

The document further contains appendices that (i) list the EPIA Advisory Council membership and (ii) reproduce key supporting materials, including DOl/DPH/DMH insurance bulletins governing prevention of ED boarding and the updated “EPIA Protocol 2023” escalation framework. The EPIA Protocol 2023 outlines a time-based escalation process for securing appropriate inpatient psychiatric placement (including explicit time thresholds tied to ED arrival/boarding episodes), assigns roles among ED Evaluation Teams, insurance carriers, inpatient psychiatric providers, and DMH, and describes required communication/authorization workflows (including for specialty services and network/payment issues) and the standardized bed-search/“standardized admission packet” approach used to support decisions and reduce delays.

AT A GLANCE

This bill requires the Department of Human Services, with designated division directors, to establish and operate a statewide behavioral health crisis mobile response system for eligible Medicaid/NJ FamilyCare-covered adults.

FULL SUMMARY

The bill establishes New Jersey’s “Behavioral Health Crisis Mobile Response Act,” creating a statewide behavioral health crisis mobile response system for adults with disabilities experiencing behavioral health crises, and defining eligibility, service components, staffing qualifications, licensing requirements, documentation, reimbursement, and related 9-8-8 crisis hotline infrastructure.

It requires the Department of Human Services, with the Department of Health and specific DHS division directors, to establish a statewide mobile crisis response system designed to prevent hospitalization and provide crisis stabilization in the least restrictive environment. The system must operate statewide with at least one mobile crisis response agency and at least one temporary stabilization unit in each of the Northern, Central, and Southern regions, and it must be able to refer eligible adults through a designated 9-8-8 hotline designated under the bill. Eligibility is limited to adults with disabilities who are Medicaid/NJ FamilyCare-covered or otherwise receiving disability services from DHS divisions, and (for crisis response) deemed necessary by the department or the mobile crisis response team; for stabilization management, deemed necessary by both the team and the department and approved by the department.

Mobile crisis response agencies must be approved and contracted by DHS and also approved by Medicaid/NJ FamilyCare (fee-for-service) to provide services. Agencies must employ mobile crisis response teams that provide (1) face-to-face mobile crisis response in the person’s home or other community location, (2) transport to a licensed “temporary stabilization unit” when needed, and (3) stabilization management services in the individual’s home when authorized. Crisis response is required to occur up to 72 hours per episode over up to a four-day span, with face-to-face contact within 24 hours of referral/dispatch (or within one hour for immediate response unless delayed at family request). The bill requires daily documentation and review when an adult is placed in a crisis bed (temporary placement not exceeding seven days) and immediate discharge when no longer necessary.

The bill also creates the “individualized crisis stabilization plan (ICSP)” process, including required content and deadlines: after initial face-to-face contact, the ICSP must be developed and registered with the department within 24 hours, and stabilization management services (when needed beyond the initial crisis response period) may last up to eight weeks and require prior department approval. Stabilization management includes ongoing ICSP review at least weekly (with ICSP amendments filed within 24 hours after each review), provision of mental/behavioral health interventions (including community-based rehabilitation and medication management), and advocacy/referrals for benefits and community supports. The bill establishes reimbursement rules (fee-for-service; temporary stabilization unit reimbursement paid to the unit; stabilization management reimbursing the team only for ICSP monitoring/management units with limits), requires each mobile crisis response agency to maintain detailed individual service records, mandates licensing/requirements for temporary stabilization units (non-clinical, non-punitive, separate from emergency departments, with specified staffing and inspection/discipline authority), and requires group home direct care staff to complete crisis de-escalation/stabilization and behavioral health crisis recognition training. It further authorizes DHS to designate 9-8-8 crisis hotline center(s) (with NSPL network participation, interoperable technology, follow-up services, reporting, and authority to deploy mobile teams and coordinate referrals), requires DHS to provide onsite responses for crisis calls using state/local mobile teams (with peers and law enforcement co-response for unmanageable high-risk situations), funds crisis receiving and stabilization when individuals lack coverage, and establishes a statewide 9-8-8 trust fund financed by a monthly statewide 9-8-8 fee on commercial mobile/IP-enabled voice subscribers (with Lifeline exemptions), including limits on allowable uses and reporting. The act takes effect on the first day of the sixth month following enactment, with anticipatory administrative actions permitted by DHS and the Department of Health.

AT A GLANCE

This bill establishes the New York-Dominican health partnership commission to study feasibility and draft a Medicaid primary-care pilot framework, delivering interim findings within 12 months and a final report within two years.

FULL SUMMARY

The bill establishes the “New York-Dominican health partnership act,” including (1) a New York-Dominican health partnership commission and (2) a time-limited, state-only funded pilot concept for providing primary and preventive health services to certain New York Medicaid beneficiaries who reside part-time in the Dominican Republic. It also authorizes/defines the pilot’s contemplated scope (with specific exclusions) and creates a process for developing a framework for a potential future federal section 1115 demonstration waiver and related “designated state health program” (DSHP) status.

The commission is created as a 12-member body chaired by the Commissioner of Health, with members appointed from New York state health-aging-temporary/disability assistance-Medicaid-budget leadership, legislative leaders (each with a Dominican community representative), a governor-appointed international health policy/cross-border expert, a Dominican consulate designee in an advisory, non-voting role, and a New York academic/medical center global health expert. Members are appointed within set timelines (and serve without compensation, with expense reimbursement). The Department of Health must provide staffing support and coordinate agency cooperation; all state agencies must provide information and assistance needed to carry out commission duties.

Core duties require a comprehensive feasibility study (including legal/regulatory requirements, comparative costs, estimated eligible population counts based on time abroad, provider network quality/accreditation, and barriers), and development of a detailed pilot program framework (including beneficiary eligibility with residency/time-in-Dominican-Republic attestation, Medicaid enrollment verification, exclusion of those with other Dominican private/senior/retiree insurance, an explicit covered-services scope limited to primary/preventive/chronic disease management, enrollment/outreach/education, proposed pilot size/geographic targeting, quality/utilization review, care coordination, and payment/claims/financial controls). The commission must also explore partnership and operational models (including MOUs with SeNaSa, credentialing/accreditation approaches, telehealth, health information exchange, and geriatrics exchange programs), assess fiscal impacts (costs, projected Medicaid savings, net state impact, and potential federal/Medicare savings where applicable), and recommend state statutory/regulatory changes and a funding/implementation plan for an initial three-year pilot period.

The commission must report an interim set of findings/recommendations within 12 months and a final report within 2 years after the act’s effective date; the final report must include (among other items) a proposed pilot design, draft statutory language and draft MOUs, fiscal impact estimates, an implementation plan, an evaluation framework with performance metrics, and a strategy for a section 1115 waiver. The act takes effect immediately and expires (and is deemed repealed) three years after the effective date.

The Medicaid Care Transition Program has been established by the Department of Human Services in Pennsylvania to enhance the transition of Medicaid patients from hospital emergency departments to suitable postacute care settings. This initiative aims to address the challenges associated with patient placement delays, which can adversely affect hospital operations and resource management.

The program is expected to significantly impact the healthcare industry, particularly hospitals, behavioral health crisis centers, and Medicaid managed care plans. By streamlining the transition process, the program seeks to alleviate issues such as prolonged hospital stays and emergency department overcrowding, which can lead to increased operational costs for healthcare facilities.

To ensure accountability and transparency, the Department of Human Services will prepare and submit an annual report on the program's implementation and outcomes, beginning one year after the program's effective date. This reporting requirement will help track the program's effectiveness in improving patient outcomes and reducing the strain on emergency services.

Overall, the Medicaid Care Transition Program is designed to facilitate a more efficient placement process for Medicaid patients, ultimately benefiting both patients and healthcare providers by improving care continuity and resource allocation.

The Medicaid Care Transition Program is designed to improve the efficiency of patient placements from hospital emergency departments to appropriate postacute care settings for individuals enrolled in Medicaid. This initiative particularly focuses on those requiring behavioral health or long-term care services, aiming to streamline care transitions and enhance the quality of care.

The program will significantly impact the healthcare industry, especially hospitals, behavioral health crisis centers, and Medicaid managed care plans. It requires collaboration between hospitals and responsible entities to ensure timely patient placements, thereby addressing delays that can affect patient outcomes.

While specific monetary impacts are not detailed, the program is anticipated to reduce costs associated with prolonged emergency department stays. By improving resource allocation and decreasing the financial burden on hospitals due to overcrowding and delayed treatments, the program aims to create a more efficient healthcare system.

Overall, the Medicaid Care Transition Program seeks to enhance the care experience for Medicaid enrollees by minimizing delays in patient placement and ensuring that individuals receive the appropriate care in a timely manner.

AT A GLANCE

This bill permits hospitals to use patient beds in hallways, corridors, and other means of egress during a justified emergency only after a designated emergency department leadership-team member determines written policy supports exhausted treatment space and jeopardized patient safety.

FULL SUMMARY

The bill establishes new definitions and operational requirements under South Carolina’s hospital licensure framework for handling patient beds in hallways, corridors, and other means of egress during certain emergency conditions.

It adds Section 44-7-255 to define “justified emergency” to include specified disaster/incident categories (e.g., declared state of emergency, natural/manmade disasters, mass transit/industrial accidents, chemical/biological/radiological/nuclear events, certain violent acts, acute outbreaks of contagious/infectious disease, and situations where emergency department treatment space is exhausted). It also defines “hallways,” “corridors,” and “means of egress” by reference to the building codes/standards in effect at the time of the incident, as identified in Section 1-34-20 and adopted by the Building Codes Council.

During a justified emergency, hospitals are permitted to use patient beds in hallways/corridors/means of egress only when a designated emergency department leadership-team member determines—under the hospital’s written policy/procedures—that (1) other appropriate treatment space has been exhausted and (2) patient health and safety are jeopardized without using beds in these areas. The determination must be documented within seven calendar days using an electronic Department of Public Health form; the form must record the incident timing, nature of the emergency, findings about exhausted treatment space and increased patient risk, and the signature of the designated leadership-team member. The hospital must retain records of each instance and provide copies of the form to the department at least quarterly.

Outside the care and treatment of patients during a justified emergency, hospitals must remove any beds from hallways/corridors/means of egress. In a justified emergency, hospitals must maintain a clear pathway in hallways/corridors/means of egress and must not block exits; additionally, hospitals may not erect or construct partitions/structures that obstruct the building’s fire protection systems, including automatic sprinkler systems and fire alarm/detection components. The bill also requires hospitals to develop written protocols for justified emergency conditions and to require relevant employees to familiarize themselves with those protocols, and it becomes effective upon Governor approval.

AT A GLANCE

This bill authorizes South Carolina hospitals, during a justified emergency, to place patient beds in hallways, corridors, or other egress only if a designated leadership team member determines and documents exhaustion and patient risk within seven days using a Department of Public Health form.

FULL SUMMARY

The bill adds a new South Carolina Code section (Section 44-7-255) establishing fire and building code exceptions that allow hospitals, during specified “justified emergencies,” to place patient beds in hallways, corridors, and other means of egress under strict conditions. It defines “justified emergency” to include (1) a declared state of emergency, (2) natural or manmade disasters, (3) mass transit accidents, (4) industrial or construction accidents, (5) chemical/biological/radiological/nuclear events, (6) acts of crowd/spree/terrorist violence causing injuries, (7) acute outbreaks of contagious or infectious disease, and (8) exhaustion of all available emergency department treatment space.

During a justified emergency, patient beds may be used in those areas only if a designated emergency department leadership team member, as determined by the hospital’s written policies, makes the determinations and—within seven calendar days of the start of the emergency—documents them using an electronic form developed by the Department of Public Health. The required determinations are that all other appropriate treatment space in the hospital has been exhausted and that patient health and safety are jeopardized without using beds in hallways/corridors/other egress areas.

The bill requires the Department of Public Health form to capture specific details, including the start and end date/time of the emergency, the nature of the emergency, confirmation that other appropriate treatment space has been exhausted, and that patient risk is increased without use of beds in those areas, plus the signature of the designated emergency department leadership team member at the onset. Hospitals must maintain records of each instance when the bed-use determination occurs, provide quarterly copies of the form to the department for each qualifying instance, remove beds from hallways/corridors/egress when they are not needed for patient care during the emergency, and maintain clear pathways and ensure exits are not blocked.

Finally, the bill directs hospitals not to erect or construct partitions/structures that obstruct the building’s fire protection systems (including automatic sprinkler systems and fire alarm/detection components), and to develop written protocols for justified emergency conditions requiring all patient-care employees to familiarize themselves with those protocols. The bill takes effect upon approval by the Governor.

AT A GLANCE

This bill revises Virginia’s temporary hospital detention overlap provisions to require the correct community services board designee’s evaluation before the detention order expires and aligns detention assistance liability coverage.

FULL SUMMARY

The bill amends and reenacts two provisions of Virginia’s law on temporary hospital detention for testing, observation, or treatment (§§ 37.2-1104 and 37.2-1106). It revises the subsection of § 37.2-1104 that governs when temporary detention orders may be issued for people who are also subject to an emergency custody order under § 37.2-808, including how community services board evaluation is handled and the personnel responsible to perform that evaluation. It also adjusts the corresponding liability rule in § 37.2-1106 to cover detention-related assistance tied to the relevant subsection of § 37.2-1104.

More specifically, § 37.2-1104 continues to authorize (with physician involvement and probable cause findings plus a near-term medical standard of care) up to 24 hours of temporary detention in a hospital emergency department or appropriate facility when an adult cannot make or communicate an informed treatment decision (and, separately, when intoxication renders the person incapable). The revision concerns the “emergency custody order” overlap provision (subsection D), including an earlier version labeled to expire July 1, 2026 and a later effective version beginning July 1, 2026, and it changes which community services board designee is empowered/required to conduct the evaluation before the temporary detention order expires. The bill also retains the requirement that if, after testing/observation/treatment, the person does not meet criteria for continued temporary detention under § 37.2-809, evaluators/treating professionals must consider whether a referral to a community-based outpatient stabilization program is appropriate.

Finally, § 37.2-1106 maintains a no-liability rule for licensed health professionals and licensed hospitals (including associated security personnel assisting them) for claims based on lack of consent to treatment/testing/detention, and extends similar protections regarding capacity-to-consent claims when a court or magistrate denied a petition and the denial was based on an affirmative finding of capacity. The bill’s operative change is to align the set of covered detention-assisting parties with the revised cross-reference to the specific subsection of § 37.2-1104 governing emergency custody overlap detention.