2013 -- S 0834 SUBSTITUTE A

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LC00805/SUB A/2

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2013

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J O I N T R E S O L U T I O N

CREATING A SPECIAL JOINT COMMISSION TO STUDY THE INTEGRATION OF

PRIMARY AND BEHAVIORAL HEALTH IN THE STATE OF RHODE ISLAND

     Introduced By: Senators Miller, Sosnowski, Cool Rumsey, Sheehan, and Goldin

     Date Introduced: April 04, 2013

     Referred To: Senate Health & Human Services

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     WHEREAS, It is the long-standing policy of the State of Rhode Island to take cognizance

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of the interests of life and health among the peoples of the state, to make investigations into the

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causes of diseases, the prevalence of epidemics and endemics among the people, the sources of

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mortality, the effect of localities, employments, and all other conditions and circumstances on the

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public health, do all in its power to ascertain the causes and the best means for the prevention and

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control of diseases or conditions detrimental to the public health, and adopt proper and expedient

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measures to prevent and control diseases and conditions detrimental to the public health in the

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state; and

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     WHEREAS, Population health outcomes in Rhode Island, as in the nation as a whole, are

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persistently and significantly worse for factors such as infant mortality, prevalence of chronic

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disease, serious mental illness, and life expectancy than in other developed countries with similar

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socio-economic resources; and

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     WHEREAS, The federal Substance Abuse and Mental Health Services Administration

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(SAMHSA) and the Health Research and Services Administration (HRSA) established the Center

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for Integrated Health Solutions (CIHS) to promote the development of integrated primary and

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behavioral health services to better address the needs of individuals with mental health and

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substance use conditions; and

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     WHEREAS, Despite these inferior health outcomes, the global cost of medical and other

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health care services in the State of Rhode Island, as in the nation as a whole, is among the highest

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in the world and imposes significant burdens on business, government, families, and individuals;

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and

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     WHEREAS, Rhode Island’s Health Homes Project is working to integrate physical and

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mental health services, partly by requiring care providers to collaborate with community

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organizations and in-the-market resources; and

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     WHEREAS, The Rhode Island Chronic Care Sustainability Initiative (CSI-RI), is one of

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the first multi-payer patient-centered medical home (PCMH) demonstration projects in the

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country, with plans to expand the successful project; and

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     WHEREAS, In Rhode Island, as in the nation as a whole, global medical and other health

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care costs are projected to continue rising faster than the gross national product, than family

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income, and than the rate of inflation, and unless effectively addressed, will soon become

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unsustainable, threatening the economy, public budgets, and Rhode Islanders’ access to

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affordable care; and

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     WHEREAS, There is a large body of data and other research that demonstrate the

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potential for improving the public health and population-based outcomes through improving the

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delivery of and access to primary care that is community-based and patient-centered; and

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     WHEREAS, Improving population-based health outcomes and integrating behavioral

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health and primary care will result in significant savings by averting the costs incurred by treating

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chronic diseases, premature death, and diminished productivity at work and school; now

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therefore, be it

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     RESOLVED,  That a special joint commission be and the same hereby is created and

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shall consist of  twenty-one (21) members: one of whom shall be a member of the Senate, to be

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appointed by the Senate President, who shall serve as co-chairman; one of whom shall be a

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member of the House, to be appointed by the Speaker of the House, who shall serve as co-

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chairman; one of whom shall be the Director of the Department of Health or his/her designee; one

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of whom shall be the Director of the Department of Behavioral Healthcare, Developmental

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Disabilities, and Hospitals or his/her designee; one of whom shall be a representative of the

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Rhode Island AFL-CIO;  one of whom shall be a representative of the UNAP; one of whom shall

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be the President of the Hospital Association of Rhode Island or his/her designee; one of whom

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shall be Family Physician who is a member of the Rhode Island Chronic Care Sustainability

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Initiative Committee or his/her designee; one of whom shall be the President of the American

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Academy of Pediatrics Rhode Island Chapter or his/her designee; one of whom shall be President

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of the Rhode Island Academy of Physician Assistants or his/her designee; one of whom shall be

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the Executive Director of the Rhode Island Medical Society or his/her designee; one of whom

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shall be the President of the Rhode Island Psychological Association or his/her designee; one of

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whom shall be the Executive Director of the Rhode Island State Nurses Association or his/her

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designee; one of whom shall be the Executive Director of the National Association of Social

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Workers Rhode Island Chapter or his/her designee; one of whom shall be the President/CEO of

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the Rhode Island Health Centers Association or his/her designee; one of whom shall be the

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President/CEO of  Blue Cross and Blue Shield of Rhode Island or his/her designee; one of whom

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shall be the Associate Dean of Medicine for Brown University School of Public Health or his/her

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designee; one of whom shall be President of United Healthcare of Rhode Island or his/her

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designee; one of whom shall be the CEO of Neighborhood Health Plan of Rhode Island or his/her

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designee; one of whom shall be the President of the Rhode Island Council of Community Mental

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Health Organizations or his/her designee; and one of whom shall be the Executive Director of the

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Drug and Alcohol Treatment Association of Rhode Island or his/her designee.

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     In lieu of any appointment of a member of the legislature to this commission, the

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appointing authority may appoint a member of the general public to serve in lieu of a legislator,

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provided that the majority leader or minority leader of the political party which is entitled to the

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appointment consents to the appointment of the member of the general public and the public

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member is a resident of the State of Rhode Island.

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     The purpose of said commission shall be to make a comprehensive study of the current

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status of primary care and behavioral health in Rhode Island; of the available research, data and

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analyses of the impact of primary care and behavioral health service availability and delivery

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system architecture on population outcomes; and of the advisability of creating a Primary Care

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Trust or other mechanism to fund and otherwise support a comprehensive integrated primary care

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and behavioral health system for all Rhode Islanders.  In studying this issue, the commission is

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encouraged to:

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     (1) Examine trends, current policies, and data pertaining to Rhode Island behavioral

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health and primary care utilization trends;

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     (2) Identify policy restrictions which currently prevent Rhode Island from integrating

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primary care and behavioral health systems;

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     (3) Identify and seek ways to remedy gaps in the system, specifically in the area of

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linkages and connections among providers and agencies in delivering comprehensive,

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community-based healthcare services;

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     (4) Examine the role of multi payers within the market and potential innovative delivery

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systems and payment reforms.

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     (5) Examine potential funding and grant opportunities to advance the recommendations

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of the commission.

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     Forthwith upon passage of the resolution, the members of the commission shall meet at

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the call of the Speaker of the House and President of the Senate. The commission shall have the

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authority to organize and form subcommittees, when deemed appropriate by a majority of the

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members.

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     Vacancies in said commission shall be filled in the manner as the original appointment.

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     The membership of said commission shall receive no compensation for their services.      

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     All departments and agencies of the state shall furnish such advice and information,

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documentary and otherwise, to said commission and its agents as is deemed necessary or

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desirable by the commission to facilitate the purposes of this resolution.

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     The Joint Committee on Legislative Services is hereby authorized and directed to provide

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suitable quarters for said commission; and be it further

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     RESOLVED, That the commission shall report its findings and recommendations to the

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Governor, the Secretary of the Executive Office of Health and Human Services, and the General

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Assembly no later than January 28, 2014, and said commission shall expire on June 13, 2016.

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LC00805/SUB A/2

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

J O I N T R E S O L U T I O N

CREATING A SPECIAL JOINT COMMISSION TO STUDY THE INTEGRATION OF

PRIMARY AND BEHAVIORAL HEALTH IN THE STATE OF RHODE ISLAND

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     This resolution would create a twenty-three (23) member special joint commission whose

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purpose would be to make a comprehensive study of the current status of primary care and

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behavioral health services in Rhode Island; of the available research, data and analyses of the

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impact of primary care and behavioral health service availability and delivery system architecture

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on population outcomes; and of the advisability of creating a Primary Care Trust or other

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mechanism to fund and otherwise support a comprehensive integrated primary care and

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behavioral health system for all Rhode Islanders, and who would report back to the general

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assembly no later than January 28, 2014, and whose life would expire on June 13, 2016.

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LC00805/SUB A/2

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