As Introduced

135th General Assembly

Regular Session H. B. No. 231

2023-2024

A BILL

To amend section 340.03 and to enact sections 5119.80, 5119.801, 5119.803, 5119.805, 5119.807, 5119.809, 5119.8011, 5119.8013, 5119.8014, 5119.8015, and 5119.8017 of the Revised Code to establish a 9-8-8 suicide prevention and mental health crisis telephone line.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That section 340.03 be amended and sections 5119.80, 5119.801, 5119.803, 5119.805, 5119.807, 5119.809, 5119.8011, 5119.8013, 5119.8014, 5119.8015, and 5119.8017 of the Revised Code be enacted to read as follows:

Sec. 340.03. (A) Subject to rules issued by the director of mental health and addiction services after consultation with relevant constituencies as required by division (A)(10) of section 5119.21 of the Revised Code, each board of alcohol, drug addiction, and mental health services shall:

(1) Serve as the community addiction and mental health planning agency for the county or counties under its jurisdiction, and in so doing it shall:

(a) Evaluate the need for facility services, addiction services, mental health services, and recovery supports;

(b) In cooperation with other local and regional planning and funding bodies and with relevant ethnic organizations, evaluate strengths and challenges and set priorities for addiction services, mental health services, and recovery supports. A board shall include treatment and prevention services when setting priorities for addiction services and mental health services. When a board sets priorities for addiction services, the board shall consult with the county commissioners of the counties in the board's service district regarding the services described in section 340.15 of the Revised Code and shall give priority to those services, except that those services shall not have a priority over services provided to pregnant women under programs developed in relation to the mandate established in section 5119.17 of the Revised Code.

(c) In accordance with guidelines issued by the director of mental health and addiction services under division (F) of section 5119.22 of the Revised Code, annually develop and submit to the department of mental health and addiction services a community addiction and mental health plan that addresses both of the following:

(i) The needs of all residents of the district currently receiving inpatient services in state-operated hospitals, the needs of other populations as required by state or federal law or programs, and the needs of all children subject to a determination made pursuant to section 121.38 of the Revised Code;

(ii) The department's priorities for facility services, addiction services, mental health services, and recovery supports during the period for which the plan will be in effect. The department shall inform all of the boards of the department's priorities in a timely manner that enables the boards to know the department's priorities before the boards develop and submit the plans.

In alcohol, drug addiction, and mental health service districts that have separate alcohol and drug addiction services and community mental health boards, the alcohol and drug addiction services board shall submit a community addiction plan and the community mental health board shall submit a community mental health plan. Each board shall consult with its counterpart in developing its plan and address the interaction between the local addiction and mental health systems and populations with regard to needs and priorities in developing its plan.

The department shall approve or disapprove the plan, in whole or in part, in accordance with division (G) of section 5119.22 of the Revised Code. Eligibility for state and federal funding shall be contingent upon an approved plan or relevant part of a plan.

If a board determines that it is necessary to amend an approved plan, the board shall submit a proposed amendment to the director. The director shall approve or disapprove all or part of the amendment in accordance with division (H) of section 5119.22 of the Revised Code.

The board shall operate in accordance with the plan approved by the department.

(d) Promote, arrange, and implement working agreements with social agencies, both public and private, and with judicial agencies.

(2) Investigate, or request another agency to investigate, any complaint alleging abuse or neglect of any person receiving addiction services, mental health services, or recovery supports from a community addiction services provider or community mental health services provider or alleging abuse or neglect of a resident receiving addiction services or with mental illness or severe mental disability residing in a residential facility licensed under section 5119.34 of the Revised Code. If the investigation substantiates the charge of abuse or neglect, the board shall take whatever action it determines is necessary to correct the situation, including notification of the appropriate authorities. Upon request, the board shall provide information about such investigations to the department.

(3) For the purpose of section 5119.36 of the Revised Code, cooperate with the director of mental health and addiction services in visiting and evaluating whether the certifiable services and supports of a community addiction services provider or community mental health services provider satisfy the certification standards established by rules adopted under that section;

(4) In accordance with criteria established under division (D) of section 5119.22 of the Revised Code, conduct program audits that review and evaluate the quality, effectiveness, and efficiency of addiction services, mental health services, and recovery supports provided by community addiction services providers and community mental health services providers under contract with the board and submit the board's findings and recommendations to the department of mental health and addiction services;

(5) In accordance with section 5119.34 of the Revised Code, review an application for a residential facility license and provide to the department of mental health and addiction services any information about the applicant or facility that the board would like the department to consider in reviewing the application;

(6) Audit, in accordance with rules adopted by the auditor of state pursuant to section 117.20 of the Revised Code, at least annually all programs, addiction services, mental health services, and recovery supports provided under contract with the board. In so doing, the board may contract for or employ the services of private auditors. A copy of the fiscal audit report shall be provided to the director of mental health and addiction services, the auditor of state, and the county auditor of each county in the board's district.

(7) Recruit and promote local financial support for addiction services, mental health services, and recovery supports from private and public sources;

(8) In accordance with guidelines issued by the department as necessary to comply with state and federal laws pertaining to financial assistance, approve fee schedules and related charges or adopt a unit cost schedule or other methods of payment for addiction services, mental health services, and recovery supports provided by community addiction services providers and community mental health services providers that have contracted with the board under section 340.036 of the Revised Code;

(9) Submit to the director and the county commissioners of the county or counties served by the board, and make available to the public, an annual report of the addiction services, mental health services, and recovery supports under the jurisdiction of the board, including a fiscal accounting;

(10) Establish a method for evaluating referrals for court-ordered treatment and affidavits filed pursuant to section 5122.11 of the Revised Code in order to assist the probate division of the court of common pleas in determining whether there is probable cause that a respondent is subject to court-ordered treatment and whether alternatives to hospitalization are available and appropriate;

(11) Designate the treatment services, provider, facility, or other placement for each person involuntarily committed to the board pursuant to Chapter 5122. of the Revised Code. The board shall provide the least restrictive and most appropriate alternative that is available for any person involuntarily committed to it and shall assure that the list of addiction services, mental health services, and recovery supports submitted and approved in accordance with division (B) of section 340.08 of the Revised Code are available to persons with severe mental disabilities residing within its service district. The board shall establish the procedure for authorizing payment for the services and supports, which may include prior authorization in appropriate circumstances. In accordance with section 340.037 of the Revised Code, the board may provide addiction services and mental health services directly to a person with a severe mental disability when life or safety is endangered and when no community addiction services provider or community mental health services provider is available to provide the service.

(12) Ensure that housing built, subsidized, renovated, rented, owned, or leased by the board or a community addiction services provider or community mental health services provider has been approved as meeting minimum fire safety standards and that persons residing in the housing have access to appropriate and necessary services, including culturally relevant services, from a community addiction services provider or community mental health services provider. This division does not apply to residential facilities licensed pursuant to section 5119.34 of the Revised Code.

(13) Establish a mechanism for obtaining advice and involvement of persons receiving addiction services, mental health services, or recovery supports on matters pertaining to services and supports in the alcohol, drug addiction, and mental health service district;

(14) Perform the duties required by rules adopted under section 5119.22 of the Revised Code regarding referrals by the board or community mental health services providers under contract with the board of individuals with mental illness or severe mental disability to class two residential facilities licensed under section 5119.34 of the Revised Code and effective arrangements for ongoing mental health services for the individuals. The board is accountable in the manner specified in the rules for ensuring that the ongoing mental health services are effectively arranged for the individuals.

(15) Work in partnership with the 9-8-8 administrator to oversee the operation of crisis centers and mobile crisis teams pursuant to sections 5119.803 and 5119.805 of the Revised Code.

(B) Each board of alcohol, drug addiction, and mental health services shall establish such rules, operating procedures, standards, and bylaws, and perform such other duties as may be necessary or proper to carry out the purposes of this chapter.

(C) A board of alcohol, drug addiction, and mental health services may receive by gift, grant, devise, or bequest any moneys, lands, or property for the benefit of the purposes for which the board is established, and may hold and apply it according to the terms of the gift, grant, or bequest. All money received, including accrued interest, by gift, grant, or bequest shall be deposited in the treasury of the county, the treasurer of which is custodian of the alcohol, drug addiction, and mental health services funds to the credit of the board and shall be available for use by the board for purposes stated by the donor or grantor.

(D) No member or employee of a board of alcohol, drug addiction, and mental health services shall be liable for injury or damages caused by any action or inaction taken within the scope of the member's official duties or the employee's employment, whether or not such action or inaction is expressly authorized by this section or any other section of the Revised Code, unless such action or inaction constitutes willful or wanton misconduct. Chapter 2744. of the Revised Code applies to any action or inaction by a member or employee of a board taken within the scope of the member's official duties or employee's employment. For the purposes of this division, the conduct of a member or employee shall not be considered willful or wanton misconduct if the member or employee acted in good faith and in a manner that the member or employee reasonably believed was in or was not opposed to the best interests of the board and, with respect to any criminal action or proceeding, had no reasonable cause to believe the conduct was unlawful.

(E) The meetings held by any committee established by a board of alcohol, drug addiction, and mental health services shall be considered to be meetings of a public body subject to section 121.22 of the Revised Code.

(F)(1) A board of alcohol, drug addiction, and mental health services may establish a rule, operating procedure, standard, or bylaw to allow the executive director of the board to execute both of the following types of contracts valued at twenty-five thousand dollars or less, as determined by the board, on behalf of the board without the board's prior approval:

(a) Emergency contracts for clinical services or recovery support services;

(b) Standard service contracts pertaining to the board's operations.

(2) If a board establishes a rule, operating procedure, standard, or bylaw under division (F)(1) of this section, both of the following shall be the case:

(a) The board shall define the scope of contracts described in divisions (F)(1)(a) and (b) of this section in that rule, operating procedure, standard, or bylaw.

(b) The board shall disclose the existence of a contract executed pursuant to the rule, operating procedure, standard, or bylaw at the first board meeting that occurs after the contract was executed and ensure that a record of that disclosure is included in the written minutes of that meeting.

Sec. 5119.80. As used in sections 5119.80 to 5119.8017 of the Revised Code:

(A) "9-8-8 administrator" means the administrator of the 9-8-8 suicide prevention and mental health crisis hotline system, as established in section 5119.801 of the Revised Code.

(B) "9-8-8 suicide prevention and mental health crisis hotline" or "9-8-8 hotline" means the 9-8-8 universal telephone number in the United States, as established under 47 U.S.C. 251(e), for the national suicide prevention and mental health crisis hotline system operating through the national suicide prevention lifeline program.

(C) "Certified community behavioral health clinics" means a facility meeting the criteria established under section 223 of the "Protecting Access to Medicare Act of 2014," 42 U.S.C. 1396a note.

(D) "Community mental health center" means a facility meeting the criteria set forth in section 1913(c) of the "Public Health Service Act," 42 U.S.C. 300x-2."

(E) "Crisis receiving and stabilization services facility" means a facility providing short-term (under twenty-four hour) care, with the capacity for diagnosis, initial management, observation, crisis stabilization, and follow-up referral services to individuals in a home-like environment.

(F) "Local jurisdiction" means a county, municipal corporation, combination of two or more counties, combination of two or more municipal corporations, or combination of one or more counties and one or more municipal corporations, provided that a combination has been established by a memorandum of understanding.

(G) "National suicide prevention lifeline program" means the national suicide prevention lifeline program maintained by the assistant secretary for mental health in the substance abuse and mental health services administration of the United States department of health and human services under 42 U.S.C. 290bb-36c.

(H) "Peer recovery supporter" means an individual employed on the basis of personal lived experience of mental illness or addiction and recovery who is certified under section 5119.36 of the Revised Code.

(I) "Prepaid wireless calling service" has the same meaning as in section 5739.01 of the Revised Code.

(J) "Seller," "reseller," "wireless service," "wireless service provider," "wireline service," and "wireline service provider" have the same meanings as in section 128.01 of the Revised Code.

(K) "Voice over internet protocol service" has the same meaning as in section 4927.01 of the Revised Code.

Sec. 5119.801. (A) There is hereby established a 9-8-8 administrator within the department of mental health and addiction services to oversee the administration of the 9-8-8 suicide prevention and mental health crisis hotline system statewide.

(B) The 9-8-8 administrator shall do all of the following:

(1) Work with local alcohol, drug addiction, and mental health services boards and local jurisdictions to designate and oversee crisis centers and mobile crisis teams pursuant to sections 5119.803 and 5119.805 of the Revised Code;

(2) Collect and maintain data and submit an annual report pursuant to section 5119.807 of the Revised Code;

(3) Oversee the collection and disbursement of money from the 9-8-8 fund pursuant to sections 5119.809 to 5119.8013 of the Revised Code;

(4) Coordinate with the veterans crisis line, maintained by the United States secretary of veterans affairs under 38 U.S.C. 1720F(h), and with the national suicide prevention lifeline program to ensure consistent public messaging about 9- 8-8 services.

Sec. 5119.803. (A) The 9-8-8 administrator, in conjunction with the appropriate local jurisdictions, shall designate crisis centers to participate in the 9-8-8 suicide prevention and mental health crisis hotline to provide or coordinate crisis stabilization and intervention services and crisis care coordination to individuals accessing the 9-8-8 hotline in this state. The local jurisdiction shall ensure that all residents within the jurisdiction have access to the services of a designated crisis center upon accessing the 9-8-8 hotline. The 9-8-8 administrator shall ensure that an adequate number of crisis centers are designated so that all residents of the state have access to a crisis center.

(B) Administration and operation of a crisis center shall be overseen by the local alcohol, drug addiction, and mental health services board whose jurisdiction covers the location of the crisis center, in collaboration with the 9-8-8 administrator.

(1) Provide crisis response and outgoing services to calls twenty-four hours a day, seven days a week by personnel who reflect the demographics of the served community and are trained to serve at-risk communities, including culturally and linguistically competent services for LGBTQ, racially, ethnically, and linguistically diverse communities;

(2) Deploy mobile crisis teams to the location of an individual accessing the 9-8-8 hotline, as appropriate;

(3) Provide follow-up services to individuals accessing the 9-8-8 hotline;

(4) Utilize technology to allow real-time crisis care coordination, including text and electronic chat, that enables information sharing and communication between crisis and emergency response systems throughout this state, such as 9-1-1, and the national suicide prevention lifeline program administrator;

(5) Coordinate and, where appropriate, establish formal agreements and parameters for information sharing, with mental health and substance use disorder treatment providers, including all of the following, to provide individuals contacting the 9-8-8 hotline access to the appropriate resources and services:

(a) Hospital emergency departments;

(b) Inpatient psychiatric settings;

(c) Community mental health services providers, including certified community behavioral health clinics and community mental health centers;

(d) Crisis receiving and stabilization services facilities;

(e) Mobile crisis teams.

(6) Maintain and disburse documents and resources for individuals accessing the hotline in languages other than English that are deemed appropriate for the area served;

(7) Maintain a partnership with the local alcohol, drug abuse, and mental health services board whose jurisdiction includes the location of the crisis center to ensure coordination with, and access to, crisis receiving and stabilization services for individuals accessing the 9-8-8 hotline, including guidelines for appropriate information sharing about the availability of services and operational processes;

(8) Maintain a valid agreement with the national suicide prevention lifeline program administrator to participate in the 9-8-8 hotline;

(9) Meet all national suicide prevention lifeline program requirements and guidelines for operational and clinical standards and other relevant federal laws;

(10) Collect and submit to the 9-8-8 administrator on a quarterly basis all of the following information:

(a) The total number of calls received by the crisis center;

(b) Demographic information about the callers, including age, sexual orientation or gender identity, and race and ethnicity;

(d) Any other information that the 9-8-8 administrator deems necessary to comply with federal law.

(11) Participate in evaluations and quality improvement activities, as required by the 9-8-8 administrator.

Sec. 5119.805. (A) The 9-8-8 administrator, in conjunction with the appropriate local jurisdictions, shall designate mobile crisis teams to deploy response services to the location of an individual accessing the 9-8-8 hotline, as appropriate. The local jurisdiction shall ensure that all residents within the jurisdiction have access to the services of a designated mobile crisis team. The 9-8-8 administrator shall ensure that an adequate number of mobile crisis teams are designated so that all residents of the state have access to a mobile crisis team.

(B) Administration and operation of a mobile crisis team shall be overseen by the local alcohol, drug addiction, and mental health services board whose jurisdiction covers the location of the mobile crisis team, in collaboration with the 9-8-8 administrator.

(C) A mobile crisis team shall be a locally-based professional mental health and behavioral health team that operates as a distinct entity within a crisis center or as part of a local emergency medical services personnel department or other emergency response setting, such as a police department. The team shall include licensed community mental health services providers, community addiction services providers, and peer recovery supporters.

(D) A mobile crisis team shall do all of the following:

(1) Provide onsite, community-based intervention services, such as de-escalation and stabilization, for individuals who are experiencing a mental health crisis;

(2) Collaborate with local law enforcement agencies to establish policies and procedures regarding data sharing and response protocols under the 9-8-8 hotline;

(3) Include local law enforcement officers as co-responders to 9-8-8 calls only as needed to respond to high-risk situations that cannot be managed without law enforcement present;

(4) Maintain and disburse documents and resources for individuals accessing the hotline in languages other than English that are deemed appropriate for the area served.

(E) A mobile crisis team shall meet both of the following criteria:

(1) Be designed in partnership with community members, including individuals with lived experience using crisis response and stabilization services;

(2) Be staffed by personnel that reflect the demographics of the community served.

Sec. 5119.807. (A) Not later than one year after the effective date of this section and annually thereafter, the 9-8-8 administrator shall compile an annual report regarding both of the following:

(1) Data collected from local crisis centers pursuant to division (C)(10) of section 5119.803 of the Revised Code;

(2) Deposits and expenditures from the 9-8-8 fund, pursuant to sections 5119.809 to 5119.8013 of the Revised Code.

(B) The 9-8-8 administrator shall submit the report to all of the following:

(1) The general assembly, in accordance with section 101.68 of the Revised Code;

(2) The state's congressional delegation;

(3) The federal communications commission.

Sec. 5119.809. (A) There is hereby created in the state treasury the 9-8-8 fund. The fund shall consist of all money from the following sources:

(1) The 9-8-8 charge authorized by section 5119.8011 of the Revised Code;

(2) Appropriations made by the general assembly;

(3) Money awarded to the state by donation, gift, or bequest, and other money received for purposes of this section;

(4) Interest or other earnings on the fund.

(B) Money in the 9-8-8 fund is not subject to transfer to any other fund or for any other purpose other than what is provided in section 5119.8013 of the Revised Code.

(C) Any money remaining in the fund, including interest thereon, at the end of each fiscal year shall not revert to the general revenue fund but shall remain in the fund.

Sec. 5119.8011. (A) There is hereby imposed a 9-8-8 charge per month on the following:

(1) Each subscriber of wireless service or voice over internet protocol service who has a billing address in this state and each wireline service customer;

(2) Each retail sale of a prepaid wireless calling service occurring in this state as provided in section 128.42 of the Revised Code.

(B) The charge amount shall be ten cents per month for each subscriber or customer and for each retail sale of a prepaid wireless calling service described under division (A) of this section.

Sec. 5119.8013. (A) The revenue generated by the 9-8-8 charge authorized under section 5119.8011 of the Revised Code shall be used only for costs that are reasonably attributed to any of the following:

(1) Ensuring the efficient and effective routing of calls made to the 9-8-8 hotline to the appropriate crisis center, including technological infrastructure enhancements necessary to achieve operational and clinical standards and best practices as established by the national suicide prevention lifeline program;

(2) Maintaining 9-8-8 hotline personnel for crisis centers and mobile crisis teams throughout the state to provide crisis response and outgoing services to 9-8-8 hotline callers, including recruiting personnel who reflect the demographics of the served community and providing specialized training to serve at-risk communities, including culturally and linguistically competent services for LGBTQ, racially, ethnically, and linguistically diverse communities;

(3) Operating costs related to serving at-risk communities, crisis centers, or comparable service providers and costs related to the provision of allowable behavioral health, crisis outreach, and stabilization services for individuals needing support;

(4) Hiring staff at local alcohol, drug addiction, and mental health services boards and the department of mental health and addiction services to oversee the 9-8-8 hotline and assist the 9-8-8 administrator;

(5) Provision of data, reporting, and participation in evaluations and related quality improvement activities as required by the 9-8-8 administrator;

(6) Administration, oversight, and evaluation of the fund.

(B) The treasurer shall disburse money from the 9-8-8 fund only upon the request of, or consultation with, the 9-8-8 administrator.

Sec. 5119.8014. (A) The 9-8-8 administrator shall ensure that no 9-1-1 charges collected under Chapter 128. of the Revised Code and that no other funds that are otherwise appropriated for the 9-1-1 system are used for the benefit of the 9-8-8 hotline.

(B) The 9-8-8 administrator shall ensure that no 9-8-8 charges imposed under section 5119.8011 of the Revised Code and deposited in the 9-8-8 fund under section 5119.809 of the Revised Code are used for the benefit of the 9-1-1 system.

Sec. 5119.8015. The 9-8-8 hotline shall provide crisis response and outgoing services to all callers at no cost.

Sec. 5119.8017. Not later than ninety days after the effective date of this section, the department of mental health and addiction services shall adopt rules in accordance with Chapter 119. of the Revised Code as necessary to develop and implement the 9-8-8 hotline and carry out the requirements of sections 5119.801 to 5119.8017 of the Revised Code. The rules shall do all of the following:

(A) Establish qualifications and responsibilities for the 9-8-8 administrator within the department, which shall oversee the administration of the 9-8-8 hotline in conjunction with local alcohol, drug addiction, and mental health services boards;

(B) Establish the scope of powers for the department of mental health and addiction services and local alcohol, drug addiction, and mental health services boards for overseeing the 9-8-8 hotline;

(C) Assign tasks to one or more new or existing agencies, boards, commissions, or other entities to accomplish the planning required to implement and oversee the requirements of sections 5119.801 to 5119.8017 of the Revised Code, in coordination with the department of mental health and addiction services, 9-1-1 administrators, hospital emergency departments, and the national suicide prevention lifeline program;

(D) Establish timeframes to accomplish the requirements of sections 5119.801 to 5119.8017 of the Revised Code that are consistent with the timeframes required by the "National Suicide Hotline Designation Act of 2020," 47 U.S.C. 251 and rules adopted by the United States federal communications commission on July 16, 2020;

(E) Provide for the collection and return of the 9-8-8 charge authorized under section 5119.8011 of the Revised Code, including rules that do the following:

(1) Require each wireline service provider, wireless service provider, seller of prepaid wireless calling service, reseller, and voice over internet protocol service provider to remit the 9-8-8 charge amounts to the 9-8-8 administrator;

(2) Require the 9-8-8 administrator to deposit 9-8-8 charge funds into the 9-8-8 fund established under section 5119.809 of the Revised Code;

(3) Specify how the providers, sellers, and resellers are to collect and remit the 9-8-8 charge and how the 9-8-8 administrator is to deposit the charge amounts into the 9-8-8 fund.

(F) Provide for information sharing and communication between crisis and emergency response systems to offer both of the following:

(1) Real-time coordination between crisis response and outgoing services;

(2) Linked, flexible services specific to crisis response, such as mobile crisis teams and crisis stabilization facilities.

(G) Notwithstanding any provision of section 121.95 of the Revised Code to the contrary, a regulatory restriction contained in a rule adopted under this section is not subject to sections 121.95 to 121.953 of the Revised Code.

Section 2. That existing section 340.03 of the Revised Code is hereby repealed.

Section 3. Section 340.03 of the Revised Code as presented in this act takes effect on the later of April 6, 2023, or the effective date of this section. April 6, 2023, is the effective date of an earlier amendment to that section by H.B. 281 of the 134th General Assembly.