Legislative Alert: October, 2000
by Louise Browning, CAE
Executive Director and Lobbyist
Mental Health & Developmental Disabilities Public Chapter 947
On June 23, Governor Don Sundquist signed into law a total revision of Tennessee Code Annotated Title 33 – the area of the law that governs the delivery of services to Tennesseans with mental illness, severe emotional disturbance, developmental disabilities, and persons who need inpatient alcohol and /or drug services.
Rep. Mary Ann Eckles of Murfreesboro is to be commended for her untiring efforts to champion this bill through the House, and adding much time and energy also to ensure passage in the Senate. The Department has furnished this summary of the major changes in the new law and would like for TNA members to become familiar with it and share it with your colleagues.
The name of the department changed to the Department of Mental Health and Developmental Disabilities on the date the governor signed Public Chapter 947. Other Title 33 revisions are effective March 1, 2001, except for eligibility for developmental disabilities, which is effective March 1, 2002.
This legislation, which unanimously passed both houses of the Legislature, sets the tone of practice for service delivery for the future. Under its provisions, the department must plan for and promote the availability of a comprehensive array of high quality prevention, early intervention, treatment and rehabilitation services and supports based on the needs and choices of service recipients and families served.
The new law significantly expands the department’s regulatory authority and the disabilities eligible for services; requires providers to meet basic quality standards and to have conflict resolution procedures; makes the department more accountable; includes families and consumers in all aspects of the planning, developing and monitoring of service systems; and extends the rights of service recipients to the total service system.
It also extends criminal background checks to mental health provider employees who have direct contact with or direct responsibility for service recipients; requires all mental health providers that serve people involuntarily committed to services (including services for children) to have Treatment Review Committees to assist in decision-making about treatment; provides for mental health consumers to make declarations for mental health treatment to be implemented during periods when they are not able to state their preference; and extends the requirement for mandatory prescreening to all hospitalizations for people whose services are publicly funded. No changes were made to the mental health or mental retardation commitment criteria.
Below is a summary of other significant changes brought about by this law:
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The old Title 33 covers mental illness and mental retardation, but covers developmental disabilities only under the family support law. The new law extends the eligibility for services from the department to people with developmental disabilities. In essence this new provision gives people with developmental disabilities a home agency. |
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The new law extends licensure requirements to cover services to people with mental illness, serious emotional disturbance and developmental disabilities such as supported living and continuous treatment teams in addition to the licensure of facilities. The old law authorizes licensure of facilities. |
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Under the new law, the department is required to develop and update a three-year plan as a basis for budget requests while the old law does not address budget planning. Under the old Title 33, programs or laws are not tied to the appropriations act, but under the new law, the appropriations act governs implementation of any program at state expense. This requires ongoing program and budget planning efforts. |
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The new law establishes a statewide planning and policy council composed of a majority of consumers to advise the department about the service system, policy development, budget requests and system monitoring. This differs from the old law where the Board of Trustees is not required to include consumers or families or to play a role in setting budget priorities. |
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The new law provides for access to mental retardation/developmental disability services through designated entities, which must provide information and updates on available services and supports. The old law provides no such access. |
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The new law permits decisions about medical and dental services to be made by surrogates for adults with developmental disabilities due to mental impairment. The old law has no such authority. |
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The new law requires interagency agreements when more than one agency delivers services to the same population. The old law does not mention interagency agreements or foster interagency cooperation. |
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The new Title 33 permits in-patient mental health services for up to 72 hours without judicial proceedings for persons with severe impairments when two physicians certify the need for psychiatric services. This alternative is absent in the old law. |
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The new law permits mandatory community-based services for up to two years for persons charged with felonies and incompetent to stand trail, but not committable. The old law has no such provision. |
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The new Title 33 creates Chapter 8 with special provisions for children and their families that are absent from the old law, among which are stringent, comprehensive criteria for the administration of electroconvulsive or other convulsive therapy to children. |
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The new legislation allows for declaration for mental health treatment preferences (advance directives), which gives consumers a role in their care. The old law does not address this issue. |
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The new legislation allows the sheriff, under specific limited circumstances, to designate a secondary transportation agent for transporting persons requiring involuntary hospitalization. It also clarifies that the transporting responsibility lies with the county in which the person is detained but allows for billing the county of residence. |
For further information about this new law, you may contact Joseph Brenner, Deputy Director, Office of Legal Counsel, TDMHDD at 615-741-4588, Janice Spillman, Commissioner’s Office, 615- 532-6509, or Marthagem Whitlock, Deputy Assistant Commissioner, 615-532-6744.
Tennessee Tobacco Reserve Funds
Public Chapter 999
In 1998, Tennessee joined in the historic Attorneys General Master Tobacco Settlement Agreement that provides payment to Tennessee of almost $5 billion to be spread over a twenty-five-year period ending in 2025. Tennessee has already received $202 million. These monies came from the five major tobacco companies, and smaller companies can join the settlement at any time.
Legislation was passed on June 29, the last day of the session this year, and became effective on July 11, without the Governor’s signature. It was the last law to take effect in 2000.
The new law places the monies in a reserve fund that is not to be co-mingled with the general fund. The Legislature established in the bill, “This unprecedented windfall should be safeguarded for future generations of Tennesseans and not frittered away on normal expenses of government or expended on unsustainable programs or projects, nor supersede Tennessee’s tradition of careful management of public resources and expenditures.”
Also established by the Legislature was, “The most prudent and beneficial use of this long-term, but finite, resource is to place the payments in trust and expend only the resulting income.” Indeed, the major fear among the proponents of this legislation was that due to the budget crunch the Legislature would decide to use the funds already in our possession, or part of them, to balance the 2000-2001 budget. This did not happen.
The bill creates an agricultural reserve account and a health reserve account with a 50/50 split. Funds may be spent only in accordance with appropriations made by the General Assembly. An agriculture fund committee and a health fund committee will be appointed. The Speaker of the House will appoint five members of the General Assembly to serve on the agriculture fund committee and five members to serve on the health fund committee. The speaker of the Senate will appoint an equal number for each committee. Additionally, the commissioners of Finance and Administration, Agriculture, Health, and Education will serve on each committee as ex-officio, nonvoting members. As we go to press, neither committee has been appointed.
Acupuncture State Certification
Public Chapter 685
Acupuncturists can now be certified to practice in Tennessee under their new law. TNA was successful in amending this law to exempt Registered Nurses who practice acupuncture if they are nationally certified as holistic nurses and have successfully completed an accredited program in acupuncture.
Read public chapters in their entirety at www.legislature.state.tn.us.
