Resolve, To Demonstrate Cost Savings by Preventing the Onset of Severe Mental Illness in Youth

Emergency preamble. Whereas,  acts and resolves of the Legislature do not become effective until 90 days after adjournment unless enacted as emergencies; and

Whereas,  the State has the responsibility to provide treatment and care for its citizens with severe mental illness; and

Whereas,  that responsibility is a considerable financial burden to the citizens of the State; and

Whereas,  the Portland Identification and Early Referral Program, referred to in this resolve as "PIER," at Maine Medical Center has conducted a research project that has indicated that a large proportion of adolescents and young adults within PIER who are at high risk for severe mental illness, including mental illness that begins with an episode of psychosis, have not had the onset of psychosis at the expected rate; and

Whereas,  such prevention of psychosis is associated with a much reduced degree of disability in youth in academic, social and vocational activities; and

Whereas,  the rate of new cases of psychosis with hospitalizations is rising across the State, except in the area served by PIER; and

Whereas,  this increased rate will lead directly to an increased financial and social burden to the State; and

Whereas,  PIER has documented substantial savings for the costs of psychiatric hospitalizations for the greater Portland area for the past five years; and

Whereas,  there is a need to determine if the increase of young people developing a severe psychotic mental illness being seen in the State can be prevented; and

Whereas,  in the judgment of the Legislature, these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety; now, therefore, be it

Sec. 1. Department of Health and Human Services to initiate demonstration program. Resolved: That the Department of Health and Human Services shall:

1. Initiate a demonstration program to determine whether the methods used by PIER can have the effect of preventing a substantial number of new cases of psychosis and psychotic disorders in young people from 12 years of age to 25 years of age; and

2. Provide financial resources to PIER to continue to prevent new cases of psychosis and psychotic disorders in the greater Portland area and provide training and consultation necessary to ensure that a new program developed in the State will be as effective and reliable as PIER; and be it further

Sec. 2. Elements of demonstration program and financial assistance. Resolved: That the elements of the demonstration program and financial assistance under section 1 include:

1. A person 12 years of age to 25 years of age must be determined to be at high risk for a psychotic disorder only by using internationally accepted criteria, assessed by reliable and trained staff;

2. A program authorized by the Department of Health and Human Services must integrate training, evaluation and certification by PIER in assessments and preventive treatment for young people at high risk for psychosis to be eligible for financial resources by the State for those services;

3. The Department of Health and Human Services shall use MaineCare funds, including funds pursuant to the Katie Beckett option authorized by the federal Tax Equity and Fiscal Responsibility Act of 1982 to support certified psychosis prevention services for 75 young persons during fiscal year 2008-09;

4. The Department of Health and Human Services may spend up to $400,000 of MaineCare funds in addition to the funds expended in subsection 3 to support the demonstration program in section one, subsection 1;

5. The Department of Health and Human Services annually shall evaluate the clinical and financial outcomes of the project and only continue the program if the services are found to be cost-effective; and

6. The Department of Health and Human Services shall evaluate the feasibility and expected effectiveness of expanding psychosis prevention programs similar to PIER to include other areas of the State.

Emergency clause. In view of the emergency cited in the preamble, this legislation takes effect when approved.

summary

This resolve directs the Department of Health and Human Services to initiate a demonstration program to determine whether the methods used by the Portland Identification and Early Referral Program, or PIER, can have the effect of preventing a substantial number of new cases of psychosis and psychotic disorders in young people from 12 years of age to 25 years of age. The demonstration program would provide financial resources to PIER to continue to prevent new cases of psychosis and psychotic disorders in the greater Portland area and would provide training and consultation necessary to ensure that a new program developed in the State will be as effective and reliable as PIER.