Summary of the House Committee Version of the Bill


SPONSOR:  Gibbons (Bean)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Health
Care Policy by a vote of 13 to 0.

This substitute establishes a comprehensive mental health
services system for children.  The system will be required to:

(1)  Be child centered, family focused, and family driven.  The
needs of the child and family will dictate the types and mix of
services provided;

(2)  Provide community-based mental health services to children
and their families;

(3)  Respond in a culturally competent and responsive manner;

(4)  Stress prevention, early identification, and intervention;

(5)  Assure access to a continuum of services;

(6)  Include early screening services;

(7)  Address problems associated with paying for mental health
services for children;

(8)  Assure a smooth transition from mental health services
appropriate for children to mental health services appropriate
for adults;

(9)  Coordinate a service delivery system with providers and
schools that serves children with emotional and behavioral
disturbance problems; and

(10)  Be outcome based.

The substitute requires the Department of Mental Health to
develop a comprehensive children's mental health service system
plan, which must be submitted to the General Assembly and the
Children's Services Commission by December 2004.  The
requirements for the plan include:

(1)  Defining the mental health service and support needs of
children and their families;

(2)  Defining a comprehensive array of services to be provided;

(3)  Establishing short- and long-term goals;

(4)  Describing the parameters for local implementation of the
comprehensive children's mental health system;

(5)  Describing the importance of family involvement;

(6)  Describing financing mechanisms for the comprehensive
children's mental health system;

(7)  Describing the coordination of services across child-serving
agencies with emphasis on the involvement of local schools;

(8)  Describing methods for service, program and system
evaluation, and the need for training and technical assistance;

(9)  Describing the roles and responsibilities of state and local
child-service agencies in the comprehensive children's mental
health system.

The substitute also makes various changes to laws relating to
children's mental health services.  The substitute:

(1)  Adds child-serving agencies within the comprehensive
children's mental health service system to the definition of
"mental health services" for the purpose of defining services for
the Medicaid Program;

(2)  Requires the Children's Division within the Department of
Social Services to look at the children in its custody and
determine which are there solely because of a mental health
issue.  Within 60 days of a child being identified, an
individualized service plan must be developed to provide the
appropriate and necessary services for the child;

(3)  Requires the departments of Social Services and Mental
Health to jointly develop a financing plan to provide for the
payment by the Department of Social Services for services
provided to children who are returned to their parents' custody;

(4)  Requires the Department of Mental Health to develop a
Comprehensive System Management Team to facilitate interagency
cooperation and to assist the departments in developing
strategies and ensuring positive outcomes for children who are
served by the system; and

(5)  Allows the means test of the Department of Mental Health to
be waived for a child in need of mental health services in order
to avoid transfer of custody to the Children's Division.

FISCAL NOTE:  Total Estimated Net Cost on General Revenue Fund of
Unknown in FY 2005, FY 2006, and FY 2007.  Subject to
Appropriations.  Total Estimated Net Effect on Other State Funds
of $0 in FY 2005, FY 2006, and FY 2007.

PROPONENTS:  Supporters say that the current delivery system for
providing mental health care services to children is fragmented,
underfunded, and needs improvement.  Many parents have had to
temporarily relinquish custody of their children in order to
obtain adequate mental health care services.  The bill requires a
judicial review or family support team meetings that identify
children who need mental health care services which will expand
the mental health care delivery system for children and will
improve treatment outcomes.

Testifying for the bill were Senator Gibbons; Representatives
Stefanick and Bean; Department of Mental Health; Department of
Social Services; Beth Viviano; Rita Prindiville Jurotich; Cindy
Fefferman; Missouri Statewide Parent Advisory Network; Coalition
of Community Mental Health Centers; Stephen Osmon, M.D.; Colleen
Dolnick; Debra Bryant Kornmann; Missouri Coalition of Children's
Agencies; Citizens for Missouri's Children; National Association
of the Mentally Ill; Missouri Nurses Association; and Eastern
Missouri Psychiatric Society.

OPPONENTS:  There was no opposition voiced to the committee.

Joseph Deering, Legislative Analyst

Copyright (c) Missouri House of Representatives

Missouri House of Representatives
92nd General Assembly, 2nd Regular Session
Last Updated September 23, 2004 at 11:16 am