§ 7253. Clinical resource management and oversight

The Commissioner of Mental Health, in consultation with health care providers as defined in section 9432 of this title, including designated hospitals, designated agencies, individuals with mental conditions or psychiatric disabilities, and other stakeholders, shall design and implement a clinical resource management system that ensures the highest quality of care and facilitates long-term, sustained recovery for individuals in the custody of the Commissioner.

(1) For the purpose of coordinating the movement of individuals across the continuum of care to the most appropriate services, the clinical resource management system shall:

(A) Ensure that all individuals in the care and custody of the Commissioner receive the highest quality and least restrictive care necessary.

(B) Develop a process for receiving direct input from persons receiving services on treatment opportunities and the location of services.

(C) Use State-employed clinical resource management coordinators to work collaboratively with community partners, including designated agencies, hospitals, individuals with mental conditions or psychiatric disabilities, and peer groups, to ensure access to services for individuals in need. Clinical resource management coordinators or their designees shall be available 24 hours a day, seven days a week to assist emergency service clinicians in the field to access necessary services.

(D) Use an electronic, web-based bed board to track in real time the availability of bed resources across the continuum of care.

(E) Use specific level-of-care descriptions, including admission, continuing stay, and discharge criteria, and a mechanism for ongoing assessment of service needs at all levels of care.

(F) Specify protocols for medical clearance, bed location, transportation, information sharing, census management, and discharge or transition planning.

(G) Coordinate transportation resources so that individuals may access the least restrictive mode of transport consistent with safety needs.

(H) Ensure that to the extent patients' protected health information pertaining to any identifiable person that is otherwise confidential by State or federal law is used within the clinical resource management system, the health information exchange privacy standards and protocols as described in subsection 9351(e) of this title shall be followed.

(I) Review the options for the use of ambulance transport, with security as needed, as the least restrictive mode of transport consistent with safety needs required pursuant to section 7511 of this title.

(J) Ensure that individuals under the custody of the Commissioner being served in designated hospitals, intensive residential recovery facilities, and the secure residential recovery facility shall have access to a mental health patient representative. The patient representative shall advocate for persons receiving services and shall also foster communication between persons receiving services and health care providers. The Department of Mental Health shall contract with an independent, peer-run organization to staff the full-time equivalent of a representative of persons receiving services.

(2) For the purpose of maintaining the integrity and effectiveness of the clinical resource management system, the Department of Mental Health shall:

(A) require a designated team of clinical staff to review the treatment received and clinical progress made by individuals within the Commissioner's custody;

(B) coordinate care across the mental and physical health care systems as well as ensure coordination within the Agency of Human Services, particularly the Department of Corrections, the Department of Health's Alcohol and Drug Abuse Programs, and the Department of Disabilities, Aging, and Independent Living;

(C) coordinate service delivery with Vermont's Blueprint for Health and health care reform initiatives, including the health information exchange as defined in section 9352 of this title and the Health Benefit Exchange as defined in 33 V.S.A. § 1803;

(D) use quality measures, manageable data requirements, and quality improvement processes to monitor, evaluate, and continually improve the results for individuals and the performance of the clinical resource management system;

(E) actively engage stakeholders and providers in oversight processes; and

(F) provide mechanisms for dispute resolution. (Added 2011, No. 79 (Adj. Sess.), § 1a, eff. April 4, 2012; amended 2013, No. 96 (Adj. Sess.), § 101; 2015, No. 11, § 18.)