REPORT TITLE:
Substance Abuse Treatment


DESCRIPTION:
Removes the certification requirements for physicians providing
substance abuse treatment for insurance coverage purposes. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        
THE SENATE                              S.B. NO.           2588
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO INSURANCE. 


BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  Section 431M-1, Hawaii Revised Statutes, is
 
 2 amended by amending the definitions of "alcohol or drug
 
 3 dependence outpatient services", "certified substance abuse
 
 4 staff", "substance abuse services", and "treatment episode" to
 
 5 read as follows:
 
 6      ""Alcohol or drug dependence outpatient services" means
 
 7 alcohol or drug dependence nonresidential treatment provided on
 
 8 an ambulatory basis to patients with alcohol or drug dependence
 
 9 problems that includes interventions prescribed and performed by
 
10 physicians, and psychologists, clinical social workers, or
 
11 advanced practice registered nurses who have been certified
 
12 pursuant to chapter 321.  This definition shall not imply a
 
13 broadening of the scope of or granting of prescriptive authority
 
14 privileges, except as otherwise allowed pursuant to chapter 457.
 
15      "Certified substance abuse staff" means professionals and
 
16 paraprofessionals with current full certification as substance
 
17 abuse counselors or program administrators under chapter 321[,
 
18 physicians who hold a current American Society of Addiction
 
19 Medicine certificate or who are board certified in addiction
 

 
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                                     S.B. NO.           2588
                                                        
                                                        

 
 1 psychiatry,] and psychologists who hold a current certification
 
 2 from the American Psychological Association College of
 
 3 Professional Psychology in the treatment of alcohol and other
 
 4 psychoactive substance use disorders.
 
 5      "Substance abuse services" means the provision of medical,
 
 6 psychological, nursing, counseling, or therapeutic services in
 
 7 response to a treatment plan for alcohol or drug dependence or
 
 8 both which shall include, when appropriate, a combination of
 
 9 aftercare and individual, group and family counseling services
 
10 provided by physicians and certified substance abuse staff.
 
11      "Treatment episode" means one admission to an accredited
 
12 hospital or nonhospital facility, [or] office of a physician, or
 
13 office of a psychologist, clinical social worker, or advanced
 
14 practice registered nurse certified pursuant to chapter 321 for
 
15 treatment of alcohol or drug dependence, or both, as stipulated
 
16 in a prescribed treatment plan and which would generally produce
 
17 remission in those who complete the treatment.  The prescribed
 
18 treatment plan may include the provision of substance abuse
 
19 services in more than one location and may include in-hospital,
 
20 nonhospital residential, day treatment, or alcohol or drug
 
21 dependence outpatient services, or any combination thereof.  An
 
22 admission for only detoxification services shall not constitute a
 
23 treatment episode."
 

 
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                                     S.B. NO.           2588
                                                        
                                                        

 
 1      SECTION 2.  Section 431M-4, Hawaii Revised Statutes, is
 
 2 amended by amending subsection (b) to read as follows:
 
 3      "(b)  Alcohol and drug dependence benefits shall be as
 
 4 follows:
 
 5      (1)  Detoxification services as a covered benefit under this
 
 6           chapter shall be provided either in a hospital or in a
 
 7           nonhospital facility which has a written affiliation
 
 8           agreement with a hospital for emergency, medical, and
 
 9           mental health support services.  The following services
 
10           shall be covered under detoxification services:
 
11           (A)  Room and board;
 
12           (B)  Diagnostic x-rays;
 
13           (C)  Laboratory testing; and
 
14           (D)  Drugs, equipment use, special therapies, and
 
15                supplies.
 
16           Detoxification services shall be included as part of
 
17           the covered in-hospital services, but shall not be
 
18           included in the treatment episode limitation, as
 
19           specified in subsection (a);
 
20      (2)  Alcohol or drug dependence treatment through in-
 
21           hospital, nonhospital residential, or day treatment
 
22           substance abuse services as a covered benefit under
 
23           this chapter shall be provided in a hospital or
 

 
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                                     S.B. NO.           2588
                                                        
                                                        

 
 1           nonhospital facility.  Before a person qualifies to
 
 2           receive benefits under this subsection, a physician, or
 
 3           a psychologist, clinical social worker, or advanced
 
 4           practice registered nurse certified pursuant to
 
 5           chapter 321, shall determine that the person suffers
 
 6           from alcohol or drug dependence, or both.  The
 
 7           substance abuse services covered under this paragraph
 
 8           shall include those services which are required for
 
 9           licensure and accreditation, and shall be included as
 
10           part of the covered in-hospital services as specified
 
11           in subsection (a).  Excluded from alcohol or drug
 
12           dependence treatment under this subsection are
 
13           detoxification services and educational programs to
 
14           which drinking or drugged drivers are referred by the
 
15           judicial system, and services performed by mutual self-
 
16           help groups; and
 
17      (3)  Alcohol or drug dependence outpatient services as a
 
18           covered benefit under this chapter shall be provided
 
19           under an individualized treatment plan approved by a
 
20           physician, or a psychologist, clinical social worker,
 
21           or advanced practice registered nurse certified
 
22           pursuant to chapter 321, and must be reasonably
 
23           expected to produce remission of the patient's
 

 
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                                     S.B. NO.           2588
                                                        
                                                        

 
 1           condition.  An individualized treatment plan approved
 
 2           by a clinical social worker or an advanced practice
 
 3           registered nurse for a patient already under the care
 
 4           or treatment of a physician or psychologist shall be
 
 5           done in consultation with the physician or
 
 6           psychologist.  Services covered under this paragraph
 
 7           shall be included as part of the covered outpatient
 
 8           services as specified in subsection (a)."
 
 9      SECTION 3.  Statutory material to be repealed is bracketed.
 
10 New statutory material is underscored.
 
11      SECTION 4.  This Act shall take effect upon its approval.
 
12 
 
13                       INTRODUCED BY:  ___________________________