HB3498 Improving the Mental Health Examination Process of Inmates at Places of Detention

Joint Committee on Judiciary

The Massachusetts Health & Hospital Association (MHA), on behalf of our member hospitals, health systems, physician organizations and allied health care providers, appreciates the opportunity to submit comments in support of HB3498, “An Act Improving the Mental Health Examination Process of Inmates at Places of Detention.”

MHA and our member hospitals strongly support HB3498, which would allow a collaborative prescription arrangement for licensed clinicians to work with psychiatrists to issue prescriptions for patients with psychiatric illnesses at places of detention in the state. There continues to be a substantial shortage of psychiatrists in the state who are available to evaluate and issue a valid prescription for patients who are receiving inpatient and/or outpatient psychiatric services. This shortage of psychiatrists in the state has been documented by every provider group, patient advocate organization, government regulators, and others as the major factor negatively impacting access to needed mental health services. In particular, the lack of psychiatrists practicing in a community who can evaluate and issue a prescription has led to substantial delays for inmates to receive necessary treatment, which has resulted in more patients failing their treatment plans and ending up in a hospital emergency department looking for inpatient services to stabilize their immediate psychiatric crisis.

A solution that many communities are developing is a collaborative prescription arrangement for licensed clinicians to work with a psychiatrist. Specifically, the concept allows for a psychiatrist to continue to evaluate and determine a treatment plan for the patient, but then work with a general healthcare provider (including but not limited to, a nurse practitioner, a psychiatric clinical nurse specialist, licensed mental health professionals, or other primary care clinicians) to issue and monitor the prescriptions for the patients. By allowing other providers to work in a collaborative prescriptive arrangement, more patients can be seen by the psychiatrist for clinical evaluations, and then be managed in the community for their prescription needs by the general healthcare provider. As the state is considering innovative models of integrated and collaborative care, HB3498 would provide a necessary and appropriate improvement in the scope of work to address a significant public health crisis in the Commonwealth. For these reasons, we strongly urge the committee to give HB3498 a favorable report.

Thank you for the opportunity to offer comments on this important matter. If you have any questions or concerns or require further information, please contact Michael Sroczynski, MHA’s Vice President of Government Advocacy, at (781) 262-6055 or msroczynski@mhalink.org