"Behavioral Health Crisis Mobile Response Act."

A4896

ASSEMBLY, No. 4896

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED MAY 7, 2026

Sponsored by:

Assemblywoman� VERLINA REYNOLDS-JACKSON

District 15 (Hunterdon and Mercer)

Assemblywoman� LINDA S. CARTER

District 22 (Somerset and Union)

Co-Sponsored by:

Assemblymen Danielsen and G.Rodriguez

SYNOPSIS

���� "Behavioral Health Crisis Mobile Response
Act."

CURRENT VERSION OF TEXT

���� As introduced.

��

An Act

concerning behavioral crisis mobile response and
supplementing Titles 26 and 30 of the Revised Statutes.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.��� This act shall be known,
and may be cited, as the �Behavioral Health Crisis Mobile Response Act.�

���� 2.��� As used in this act:

���� �9-8-8 Crisis Hotline Center�
or �hotline center� means a State identified and funded center participating in
the National Suicide Prevention Lifeline Network to respond to Statewide or
regional 9- 8-8 calls.

���� �9-8-8 Suicide Prevention and
Mental Health Crisis Hotline� means the National Suicide Prevention Lifeline
(NSPL) or its successor maintained by the Assistant Secretary for Mental
Health� and Substance Use under section 520E�3 of the federal Public Health
Service Act.

���� �Adult in crisis� means an
adult with disabilities who is experiencing a behavioral health crisis.

���� �Behavioral health crisis�
means an emergency or crisis situation� in which an adult with a disability
experiences mental, emotional, or behavioral health challenges that endanger
the health, safety, or wellbeing of the disabled adult, or of other persons
interacting with the disabled adult, and which cannot be controlled, or
otherwise properly addressed or stabilized by the adult, or by the adult�s
family members, attendant caregivers, or direct care staff members, without
professional assistance.

���� �Crisis bed� means an
available bed in a temporary stabilization unit that is used, when needed, for
the temporary placement, not exceeding seven days, and stabilization of an
adult in crisis.

���� �Crisis response� means
face-to-face emergency response, which� is provided by a mobile crisis response
team under this act, with the� assistance of a temporary stabilization unit,
where needed, and which is available 24 hours a day, 365 days a year, to de-escalate
and stabilize any behavioral health crisis being experienced by an adult with
disabilities.

���� �Crisis response services�
means services that are provided during the initial crisis response period,
either by a mobile crisis response team, or by a temporary stabilization unit,
to stabilize the adult in crisis.

���� �Department� means the
Department of Human Services.

���� �Direct care staff member�
means a person 18 years of age or older who is employed by a group home, and
who may come into direct contact with group home residents.

���� �Disability� means an
intellectual or developmental disability, or a mental illness.

���� �Group home� means the same as
that term is defined by section� 1 of P.L.2017, c.238 (C.30:6D-9.1).

���� �Home� means a private
residence or a community-based residential facility, such as a group home or
halfway house, where an adult in crisis is a resident.

���� �Individualized crisis
stabilization plan (ICSP)� means an individualized service plan, developed by a
mobile crisis response team for an adult in crisis, which identifies target
behaviors to be addressed in, desired outcomes to be attained by, and necessary
mental or behavioral health services to be provided to, the adult in crisis,
both during the initial crisis response period and, if indicated, during a
subsequent stabilization management period lasting up to eight weeks
thereafter, as necessary to ensure the stabilization of the adult in crisis and
minimize or eliminate the dangers stemming from the crisis.

���� �Initial 72-hour mobile
response period� means the initial period of time, lasting 72 hours, over a
four-day span of time, during which a mobile crisis response team is required
to provide mobile� crisis response services to an adult in crisis, while at the
adult�s home or at another place where the adult is located, as provided by
section 5 of this act.

���� �Initial 72-hour mobile
response period� does not include any time during which the adult in crisis is
housed in a temporary stabilization unit.

���� �Initial crisis response
period� means the initial 72-hour mobile response period, and any additional
period of time, lasting up to seven days, during which the adult in crisis is
housed in a temporary stabilization unit.

���� �Initial crisis response
period� shall include the period of time during which an adult in crisis is
being� transported by a mobile crisis response unit from the person�s home, or
other place where the person is located, to a temporary� stabilization unit.

���� �Mental health care
professional� means a psychiatrist, professional counselor, practicing
psychologist, psychoanalyst, clinical social worker, or psychiatric nurse
practitioner licensed pursuant to Title 45 of the Revised Statutes.

���� �Mobile crisis response
agency� means an entity that is approved and authorized, pursuant to subsection
a. of section 4 of this act, to provide mobile crisis response services and
stabilization 36 management services to adults in crisis.

���� �Mobile crisis response
services� means services, as described in� subsection b. of section 5 of this
act, which are provided by a mobile crisis response team during the initial
72-hour mobile response period.

���� �Mobile crisis response team�
means a mobile team of mental health care professionals who are qualified to
assess and stabilize a� behavioral health crisis situation, and address the
immediate needs of an adult with disabilities who is in crisis.

���� �National Suicide Prevention
Lifeline� or �NSPL� means a national network of local crisis centers that
provide free and confidential emotional support to people in suicidal crisis or
emotional distress 24 hours a day, 7 days a week.

���� �Peers� means individuals
employed on the basis of their personal experience of mental illness,
addiction, or both, and recovery therefrom, and who meet the State�s peer
certification requirements. �Veterans Crisis Line� or �VCL� means the Veterans
Crisis Line maintained by the Secretary of Veterans Affairs pursuant to section
1720F(h) of Title 38 of the United States Code.

���� �Stabilization,� �initial
stabilization,� or �stabilize� means the initial stabilization of an adult in
crisis, which is effectuated by a mobile crisis response team or staff at a
temporary stabilization unit during the initial crisis response period, and
prior to any stabilization management period, and which effectively calms and
stabilizes the behavior of the adult in crisis, and removes the immediate
potential for danger arising out of the crisis situation.

���� �Stabilization management
period� means a period of time, lasting no more than eight weeks, and
commencing at the end of the� initial 72-hour mobile response period, or at the
time that the adult is discharged from a temporary stabilization unit, whichever
is later, during which the mobile crisis response team provides ongoing
stabilization management services to the adult with disabilities in the adult�s
home.

���� �Stabilization management
services� means the ongoing provision, monitoring, and coordination of, and
referral to, services and supports identified in the ICSP, in accordance with
section 6 of this act, for up to eight weeks immediately following the completion
of the initial crisis response period, as necessary for the� mobile crisis
response team to ensure the long-term stabilization of the crisis situation.

���� �Temporary stabilization unit�
means a facility, or a part of a facility, which is licensed pursuant to
section 9 of this act, and which is authorized to provide a safe, non-clinical,
and non-punitive inpatient space to be used to stabilize an adult in crisis,
for a period of no more than seven days, in cases where the responding mobile
crisis response team has determined that the adult is in need of a crisis bed.

���� 3. �a. �The Commissioner of
Human Services, in consultation with the Commissioner of Health, and the
Directors of the Division of Mental Health and Addiction Services, and the
Division of Developmental Disabilities in the Department of Human Services,
shall establish a Statewide mobile crisis response system, in accordance with
the provisions of this section, which shall be designed to provide immediate
crisis response services, and ongoing stabilization management services, upon
request, to adults� with disabilities who are experiencing a behavioral health
crisis, and their families and attendant caregivers or other staff.

���� b. �The mobile crisis response
system established pursuant to this section shall:

���� (1) be designed to prevent the
hospitalization of adults in crisis, and to provide for the stabilization of
adults in crisis in the least restrictive environment;

���� (2) be implemented on a
Statewide basis, with at least one mobile crisis response agency available to
provide crisis response services and stabilization management services, and at
least one� temporary stabilization unit available to provide temporary crisis
beds, in each of the Northern, Central, and Southern regions of the State; and

���� (3) be designed to allow the
mobile crisis response system to access to the 9-8-8 suicide prevention and
behavioral health crisis hotline designated pursuant to section 11 of this act in
order to refer an eligible adult for crisis response services and stabilization
management services in accordance with section 5 of this act.

���� c. �An adult with a disability
shall be eligible to receive crisis response services and stabilization
management services, as provided in this act, if:

���� (1) the adult is covered under
the Medicaid or NJ FamilyCare programs, or the adult is ineligible for coverage
under the Medicaid or NJ FamilyCare programs, but is receiving services for a
disability from the Division of Developmental Disabilities, or from the
Division of Mental Health and Addiction Services, in the department;

���� (2) in the case of crisis
response services, the services are deemed to be necessary, either by the
department, or by the mobile crisis response team that is authorized to assess
the need for those services; and

���� (3) in the case of
stabilization management services, the services are deemed to be necessary by
both the mobile crisis response team� and the department, and are approved by
the department pursuant to� subsection b. of section 6 of this act.

���� 4.� a.� Any person, group, or
entity wishing to provide mobile crisis response services or stabilization
management services, pursuant to this act, shall:

���� (1) submit an application to
the Department of Human Services, and be approved and contracted by the
department as a mobile response agency; and

���� (2) submit an application to,
and be approved by, the New Jersey Medicaid and NJ FamilyCare fee-for-service
program as a mobile response agency.

���� b.��� Each mobile crisis
response agency approved pursuant to this section shall employ one or more
mobile crisis response teams to:�

���� (1) provide mobile crisis
response services in the home of a person in crisis, or at another community
location where a person in crisis is located, as described in section 5 of this
act;

���� (2) when deemed to be
appropriate, transport the adult in crisis to a temporary stabilization unit
established and licensed pursuant to section 9 of this act; and

���� (3) provide ongoing
stabilization management services to the adult in crisis, in the adult�s home,
when authorized to do so pursuant to section 6 of this act.

���� c.� Mobile crisis response
services and stabilization management services, which are provided by a mobile
crisis response team under this act, shall be delivered directly by, or under
the supervision of, a licensed psychiatrist who, at a minimum, has three and a
half years of applicable clinical and supervisory experience, and has the
authority to directly provide, or to supervise the provision of, these services
within the scope of the psychiatrist�s authorized practice, as defined by law.�
Any other staff member on a mobile crisis response team shall have, at a
minimum, a master�s degree in behavioral health or a related human services
field, such as social work, counseling, or psychology; or shall have a
bachelor�s degree in a behavioral health or a related human services field, and
a minimum of one year of related field work experience.�

���� d.� Any person seeking to
deliver crisis response services or stabilization management services, pursuant
to this act, as a member of a mobile crisis response team, or as a staff member
at a temporary stabilization unit, shall be deemed to be a �community agency
employee,� as defined by section 1 of P.L.1999, c.358 (C.30:6D-63), and shall
be required to comply with the criminal history record background check
requirements established by P.L.1999, c.358 (C.30:6D-63 et seq.) as a condition
of the person�s employment with the mobile crisis response agency or temporary
stabilization unit.�

���� 5.� a.� Mobile crisis response
services under this act shall be provided by a mobile crisis response team to
an eligible adult in crisis for a period of up to 72 hours per episode, over
the course of up to a four-day period, immediately following the initial
referral or dispatch, and shall be designed to stabilize the presenting
behaviors and crisis situation, with the goal of preventing a disruption of the
current living arrangement, and avoiding inappropriate psychiatric
hospitalization or residential placement, of the adult in crisis.� Each
referral to, or dispatch of, a mobile crisis response team shall be registered
with the department within 24 hours after the team receives notice thereof.�

���� b.� Mobile crisis response
services provided by a mobile crisis response team shall include, but need not
be limited to:

���� (1) mobile outreach and
face-to-face contact with the adult in crisis, which face-to-face contact shall
occur within 24 hours following the initial referral or dispatch, except in
situations requiring an immediate response, in which case, face-to-face contact
shall occur within one hour after the initial referral or dispatch, unless a
delay is requested by the family of the adult in crisis, in order to meet the
family�s needs;

���� (2) the immediate assessment
and evaluation of the presenting crisis, which shall include an assessment of
the safety of, or danger to, the adult in crisis, other residents of the home,
and members of the community, as well as an assessment of caregiver culpability
and clinical and environmental factors that contributed to the crisis;

���� (3) the immediate use of
clinical and therapeutic interventions to stabilize the presenting crisis;

���� (4) the development of an
individualized crisis stabilization plan, as provided by subsection d. of this
section; and

���� (5) the provision of relevant
information, crisis training, and program and service referrals to the family
members or caregivers of the adult in crisis.

���� c.� (1) If, at any time during
the initial 72-hour mobile response period, the mobile crisis response team
determines that the presenting crisis can only be stabilized through the
temporary placement of the adult in a temporary stabilization unit, the crisis
response team shall transport the adult in crisis to a temporary stabilization
unit, and the adult shall be admitted to the unit, for a period not exceeding
seven days, as necessary to facilitate the initial stabilization of the
crisis.�

���� (2) Whenever an adult is
placed in a crisis bed in a temporary stabilization unit pursuant to this
subsection, the need for such placement shall be reviewed and documented by the
mobile crisis response team on a daily basis during such placement, and the adult
shall be immediately discharged from such placement upon a determination by the
team that continued placement is no longer necessary.

���� d.� The individualized crisis
stabilization plan developed under paragraph (4) of subsection b. of this
section shall be prepared after the mobile crisis response team has made
initial face-to-face contact with the adult in crisis and the family members or
caregivers thereof, and shall be registered with the department within 24 hours
after such contact.� At a minimum, the ICSP shall:�

���� (1) identify the mental health
diagnoses of the adult in crisis;

���� (2) identify the
environmental, situational, mental, physical, and other factors that
contributed to the presenting crisis;

���� (3) identify appropriate
clinical and therapeutic interventions to be used in addressing and stabilizing
the presenting crisis;

���� (4) include a plan to ensure
the stabilization of the adult in crisis in the least restrictive environment,
which plan shall:� (a) provide for the adult in crisis to remain in the home,
if the initial stabilization of the crisis can be effectuated in the home
within the initial 72-hour mobile response period; (b) provide for the adult in
crisis to be transported, and temporarily admitted to, a temporary
stabilization unit, at any time during the initial 72-hour mobile response
period, and for a period of not more than seven days, if the team determines,
at any time, that initial stabilization of the crisis cannot be achieved while
at the home; (c) provide for the immediate discharge of the adult from a
temporary stabilization unit to their home following a determination by the
team, under paragraph (2) of subsection c. of this section, that such placement
is no longer necessary; and (d) provide for the at-home provision of ongoing
stabilization management services, as deemed by the mobile crisis response team
to be appropriate, and as approved by the department pursuant to subsection b.
of section 6 of this act, for a period of up to eight weeks following initial
stabilization;

���� (5) a description of services
that will be provided to the adult in crisis, and the adult�s family and
attendant caregivers and staff, during the stabilization management period, in
cases where the ongoing provision of stabilization management services is deemed
by the team to be appropriate and is approved by the department pursuant to
subsection b. of section 6 of this act; and

���� (6) a transition plan that
links the adult in crisis to clinical and therapeutic mental and behavioral
health services, formal and informal community supports, and appropriate system
partners that can be used as resources following the completion of the stabilization
management period.�

���� 6.� a.� If a crisis is not
sufficiently stabilized during the initial 72-hour mobile response period, or
during a related stay at a temporary stabilization unit, the mobile crisis
response team shall provide the adult in crisis with ongoing stabilization management
services, in the home, for a period of up to eight weeks following the
completion of the initial crisis response period, as provided in this section.

���� b.� Stabilization management
services shall not be provided under this section, unless the mobile crisis
response team obtains prior approval from the department authorizing the
provision of such services to the adult in crisis.� The department may
authorize the mobile crisis response team to provide stabilization management
services for a period of up to eight weeks, as deemed by the department to be
appropriate.�

���� c.� During the stabilization
management period, a designated representative of the mobile crisis response
team shall, on at least a weekly basis, review the ICSP, in order to ensure
that the services included therein are effectively addressing the presenting
crisis and any factors that contributed to the crisis.� Any necessary
amendments to the ICSP shall be registered with the department within 24 hours
after each review is concluded pursuant to this subsection.�

���� d.� The following
stabilization management services may be provided during the stabilization
management period:

���� (1) necessary mental or
behavioral health intervention services to maintain the stabilization of the
crisis and minimize or eliminate the factors that contributed to the crisis,
including, but not limited to, psychiatric or psychological services,
medication management services, community-based mental health rehabilitation
services, such as behavioral assistance services and intensive in-community
services, and any other formal or informal community-based mental health or
behavioral health rehabilitation services; and

���� (2) continued advocacy,
networking, and support by the mobile crisis response team, as may be necessary
to provide linkages and referrals to appropriate community-based services, and
to assist the adult in crisis, and the family members or caregivers thereof, in
accessing other benefits or assistance programs for which they may be eligible.

���� 7.� a.� (1) �Reimbursement for
services provided during the initial crisis response period shall be paid on a
fee-for-service basis, and shall cover the costs of all the services provided
during this time period, including the costs of services provided by the mobile
crisis response team during the initial 72-hour mobile response period, and the
costs of services provided by a temporary stabilization unit during any
temporary placement therein.� Reimbursement for services provided by a
temporary stabilization unit shall be paid directly to the temporary
stabilization unit, and reimbursement for other services provided during the
initial 72-hour mobile response period shall be paid to the mobile crisis
response team that provided the services.

���� (2) Reimbursement for
stabilization management services, which are provided for a period of up to
eight weeks following the initial crisis response period, shall be paid on a
fee-for-service basis, but shall cover only the mobile crisis response team�s
monitoring and management of the ICSP.� Each unit of service shall be for 15
minutes of continuous services provided directly to, or on behalf of, the adult
in crisis, including collateral contacts and activities that are necessary to
develop, implement, coordinate, monitor, and support the ICSP.� A provider may
bill for a maximum of 64 units (16 hours) over the eight-week maximum
stabilization management period, as authorized by the department.� Each
provider shall bill only for the amount of time actually provided for
stabilization management on each date of service.

���� (3) Reimbursement for services
rendered by an individual Medicaid or NJ FamilyCare provider, in accordance
with an ICSP developed under this act, shall be paid in accordance with the
provider-specific rules relative to the respective type of provider, including,
but not limited to, provider qualification, prior authorization, and service
delivery requirements.

���� b.� (1) If an adult in crisis
is not provided with ongoing stabilization management services in response to a
crisis episode, and the mobile crisis response team, within three days after
the termination of the initial crisis response period, receives another referral
or dispatch request for another crisis episode involving the same adult, the
mobile crisis response team shall provide mobile crisis response services to
the adult in crisis without additional reimbursement.

���� (2) If an adult in crisis is
provided with stabilization management services, and the mobile crisis response
team, following the completion of the stabilization management period, receives
a subsequent referral or dispatch request for another crisis episode involving
the same adult, the mobile crisis response team shall initiate a new course of
treatment, beginning with an initial 72-hour mobile crisis response period, and
shall be reimbursed accordingly.

���� 8.� a.� Each mobile crisis
response agency shall maintain an individual service record for each adult
served thereby.�

���� b.� Each individual service
record shall contain, at a minimum, the following information:

���� (1) the name and address of
the adult in crisis who has received services from the mobile crisis response
agency;

���� (2) the mental health
diagnosis of the adult in crisis;

���� (3) the ISCP developed by the
mobile crisis response team for each separate crisis episode involving the same
adult, and all approved amendments to each such ISCP;

���� (4) weekly quantifiable
progress notes toward the defined goals stipulated in each ISCP;

���� (5) documentation of any and
all crisis or emergency situations that have occurred during the provision of
stabilization management services to the adult, including a summary of the
corrective action that was taken to resolve each such situation;

���� (6) the total number of care
hours, across episodes, that the adult in crisis has received from the mobile
crisis response agency; and

���� (7) for each distinct crisis
episode:� (a) the date on which the initial 72-hour mobile response period was
commenced, and the date and time on which initial face-to-face contact actually
occurred; (b) the exact dates and times when, and locations where, mobile
crisis response services and stabilization management services, if any, were
provided to the adult in crisis; (c) the stated reason for the team�s
involvement; (d) the total amount of face-to-face contact engaged in, and the
type of services provided, during the initial 72-hour mobile response period;
(e) whether the adult in crisis was temporarily placed in a crisis
stabilization unit, and the length of the person�s stay in such unit; (f)
whether the adult in crisis was approved for ongoing stabilization management
services following the initial crisis response period; and (g) the types of
stabilization management services, if any, that were provided to the adult in
crisis, and the manner in which such services were consistent with, and
supportive of, the goals specified in the ICSP.

���� 9.� a.� Within 180 days after
the effective date of this act, the Commissioner of Health shall provide for
the establishment and licensure of a sufficient number of temporary
stabilization units throughout the State to handle the behavioral health crisis
needs of adults with disabilities, as provided by this act.� At a minimum, at
least one temporary stabilization unit shall be licensed to operate in each of
the northern, central and southern regions of the State.� No person shall
operate a temporary stabilization unit, unless the person has applied for, and
has obtained, a license pursuant to this section.�

���� b.� A temporary stabilization
unit approved and licensed pursuant to this section shall:

���� (1) provide a calming,
non-clinical, and non-punitive environment for the stabilization of adults in
crisis;

���� (2) be staffed by properly
credentialed mental health professionals who are capable of, and have expertise
in, calming and stabilizing crisis situations in adults with disabilities;

���� (3) have a sufficient number
of crisis beds to meet the behavioral health crisis needs of citizens in the
region in which the unit is situated; and

���� (4) be situated separately and
apart from any other clinical or mental health care unit or facility.� If the
temporary stabilization unit is a part of a separately licensed health care
facility or hospital, the temporary stabilization unit shall be unconnected to,
and shall be located separately from, any emergency department or other
department or unit of medicine, and shall utilize an entrance that is separate
from the entrance that is used by patients of, and visitors to, such other
departments or units.

���� c.� On at least a biennial
basis, the Commissioner of Health shall perform an on-site inspection of each
temporary stabilization unit licensed pursuant to this section, in order to
ensure that each such unit is complying with the provisions of this section and
all other applicable laws or regulations.�

���� d.� If the commissioner finds,
based on a facility inspection or other information, that a temporary
stabilization unit is violating the provisions of this section or any other
applicable laws or regulations, the commissioner shall undertake appropriate
disciplinary action, including, but not limited to, ordering the temporary
stabilization unit to undertake corrective action, imposing an appropriate
administrative penalty, or suspending or revoking the unit�s license.

���� 10.� a.� The Commissioner of
Human Services shall require all direct care staff members providing services
at a group home for individuals with intellectual or developmental disabilities
to successfully complete a course of training on:�

���� (1) the de-escalation and
stabilization of crisis episodes in adults with disabilities;

���� (2) behavioral analysis and
management; and

���� (3) behavioral health crisis recognition
and identification.

���� b.� The training provided
under this section shall also inform direct care staff members of the
provisions of this act and the procedures that may be used under this act to
obtain assistance from a mobile crisis response team whenever a group home
resident is experiencing a behavioral health crisis.

���� 11.� The Commissioner of Human
Services shall, on or before July 16, 2022, designate a crisis hotline center
or centers to receive crisis calls by individuals accessing the 9-8-8 suicide
prevention and behavioral health crisis hotline from anywhere within the State
24 hours a day, seven days a week.

���� a.� A designated hotline
center shall have an active agreement with the administrator of the National
Suicide Prevention Lifeline for participation within the network.

���� b.� A designated hotline
center shall meet NSPL requirements and best practices guidelines for
operational and clinical standards.

���� c.� To ensure cohesive and
coordinated crisis care, a designated hotline center shall utilize technology
that is interoperable between and across crisis and emergency response systems
used throughout the State and with the Administrator of the National Suicide
Prevention Lifeline.

���� d.� A designated hotline
center shall have the authority to deploy crisis and outgoing services,
including mobile crisis teams, and coordinate access to crisis receiving and
stabilization services as appropriate and according to guidelines and best
practices established by the NSPL.

���� e.� A designated hotline
center shall be utilized by the mobile crisis response system to refer an
eligible adult for mobile crisis response services and stabilization management
services pursuant to section 5 of this act.

���� f.� A designated hotline
center shall coordinate access to crisis response services and stabilization
management services for individuals accessing the 9-8-8 suicide prevention and
behavioral health crisis hotline through appropriate information sharing
regarding availability of services.

���� g.� The Commissioner of Human
Services shall have primary oversight of suicide prevention and crisis service
activities and essential coordination with a designated 9-8-8 hotline center,
and shall work in concert with NSPL and VCL networks for the purposes of
ensuring consistency of public messaging about 9-8-8 services.

���� h.� A designated hotline
center shall meet the requirements set forth by NSPL for serving high risk and
specialized populations as identified by the Substance Abuse and Mental Health
Services Administration, including training requirements and policies for transferring
such callers to an appropriate specialized center or subnetworks within or
outside the NSPL network and for providing linguistically and culturally
competent care.

���� i.���� A designated hotline
center shall provide follow-up services to individuals accessing the 9-8-8
suicide prevention and behavioral health crisis hotline consistent with
guidance and policies established by the NSPL.

���� j.���� An annual report of the
9-8-8 suicide prevention and behavioral health crisis hotline�s usage and
services provided shall be transmitted to the Legislature and the Substance
Abuse and Mental Health Services Administration.

���� 12.� The Commissioner of Human
Services shall provide onsite response services for crisis calls utilizing
State or local mobile crisis teams.

���� a.� A mobile crisis team shall
include a behavioral health team, licensed behavioral health professionals, and
peers, or a behavioral health team and peers embedded within an emergency
medical services entity.

���� b.� A mobile crisis team shall
collaborate on data and crisis response protocols with local law enforcement
agencies and include police as co-responders in behavioral health teams, and
licensed behavioral health professionals and peers, only as needed to respond
to high-risk situations that are unmanageable without law enforcement.

���� c.� A mobile crisis team shall
be designed in partnership with community members, including people with
experience utilizing crisis services.

���� 13.� Crisis receiving and
stabilization services as related to crisis calls shall be funded by the
Commissioner of Human Services with available funds if the individual that is
the subject of the crisis call lacks health insurance or if the crisis
stabilization service is not a covered service under the individual�s health
coverage, as determined by the commissioner.

���� 14.� The Commissioner of Human
Services shall establish and maintain a 9-8-8 trust fund for the purposes of
creating and maintaining a Statewide 9-8-8 suicide prevention and mental health
crisis system pursuant to the National Suicide Hotline Designation Act of 2020
and the Federal Communication Commission�s rules adopted July 16, 2020, and
national guidelines for crisis care.

���� a.� The fund shall consist of:

���� (1)�� monies from a Statewide
9-8-8 fee assessed on users pursuant to section 8 of this act;

���� (2)� appropriations, if any;

���� (3)� grants and gifts intended
for deposit in the fund;

���� (4)� interest, premiums,
gains, or other earnings on the fund; and

���� (5)� any other monies that are
deposited in or transferred to the fund.

���� b.��� Monies in the fund:

���� (1)�� do not revert at the end
of any fiscal year and remain available for the purposes of the fund in
subsequent fiscal years;

���� (2)�� are not subject to
transfer to any other fund or to transfer, assignment, or reassignment for any
other use or purpose outside of those specified in section 15 of this act; and

���� (3)�� are continuously
dedicated for the purposes of the fund.

���� c.���� An annual report of
fund deposits and expenditures shall be to the transmitted to the Legislature
and the Federal Communications Commission.

���� 15.� The Commissioner of Human
Services, consistent with the National Suicide Hotline Designation Act of 2020,
shall establish a monthly Statewide 9-8-8 fee on each resident that is a
subscriber of commercial mobile services or IP-enabled voice services at a fixed
rate that provides for the creation, operation, and maintenance of a Statewide
9-8-8 suicide prevention and behavioral health crisis system and the continuum
of services provided pursuant to federal guidelines for crisis services.� The
9-8-8 fee shall not be applied to mobile service users who receive benefits
under the federal Lifeline program as defined in 47 CFR 54.401.

���� a.� Revenue generated by the
9-8-8 fee shall be expended only in support of 9�8�8 services or enhancements
of such services.

���� b.� The revenue generated by a
9-8-8 fee shall only be used to offset costs that are reasonably attributed to:

���� (1)�� ensuring efficient and
effective routing of calls made to the 9-8-8 suicide prevention and behavioral
health crisis hotline to a designated hotline center, including staffing and
technological infrastructure enhancements necessary to achieve operational and
clinical standards and best practices set forth by NSPL;

���� (2)�� personnel; specialized
training of staff to serve at-risk communities, including culturally and
linguistically competent services for LGBTQ+, racially, ethnically, and
linguistically diverse communities; and the provision of acute behavioral
health, crisis outreach and stabilization services by directly responding to
the 9�8�8 national suicide prevention and behavioral health crisis hotline; and

���� (3)�� administration,
oversight, and evaluation of the fund.

���� 16.� The Commissioner of Human
Services shall implement the provisions of this act in a manner that is
consistent with timeframes required by the National Suicide Hotline Designation
Act of 2020 and the Federal Communication Commission�s rules adopted on July
16, 2020.

���� 17.� a.� The Commissioners of
Health and Human Services shall each adopt rules and regulations, in accordance
with each agency�s respective jurisdiction, and pursuant to the �Administrative
Procedure Act,� P.L.1968, c.410 (C.52:14B-1 et seq.), as may be necessary to
implement the provisions of this act.

���� b.� Departments within the
executive branch shall promulgate rules and regulations in accordance with the
�Administrative Procedure Act,� P.L.1968, c.410 (C.52:14B-1 et seq.), as are
necessary to allow appropriate information sharing and communication between
and across crisis and emergency response systems for the purpose of real-time
crisis care coordination including, but not limited to, deployment of crisis
and outgoing services and linked, flexible services specific to crisis
response.

�

���� 18.� This act shall take
effect on the first day of the sixth month next following the date of
enactment, except that the Commissioner of Human Services and the Commissioner
of Health may each take anticipatory administrative action, in advance of the
effective date, as may be necessary to implement the provisions of this act.

STATEMENT

���� This bill, to be known as the
�Behavioral Health Crisis Mobile Response Act,� requires the Commissioner of
Human Services (the commissioner), in consultation with the Commissioner of
Health, and the Directors of the Division of Mental Health and Addiction
Services, and the Division of Developmental Disabilities in the Department of
Human Services (DHS), to establish a Statewide mobile crisis response system to
provide immediate crisis response services, and ongoing stabilization
management services, upon request, to adults with disabilities (i.e., with
intellectual or developmental disabilities, or mental illness) who are
experiencing a behavioral health crisis, and their families and attendant
caregivers or other staff.

���� The mobile crisis response
system would be designed to prevent the hospitalization of adults in crisis to
provide for the stabilization of adults in crisis in the least restrictive
environment, and to allow the mobile crisis response system to access to the
9-8-8 suicide prevention and behavioral health crisis hotline in order to refer
an eligible adult for crisis response services and stabilization management
services in accordance with the provisions of the bill.�

���� The system would be
implemented on a Statewide basis, with at least one mobile crisis response
agency available to provide crisis response services and stabilization
management services, and at least one temporary stabilization unit available to
provide temporary crisis beds, in each of the northern, central, and southern
regions of the State.

���� Any person, group, or entity
wishing to provide initial crisis response services or stabilization management
services, pursuant to this bill�s provisions, would need to be approved by the
New Jersey Medicaid and FamilyCare programs, and by the DHS, as a mobile
response agency.� Each mobile crisis response agency approved under the bill
would be required to employ one or more mobile crisis response teams, composed
of mental health professionals, to:

���� 1)��� provide mobile crisis
response services in the home of a person in crisis, or at another community
location where a person in crisis is located; 2) when deemed to be appropriate,
transport the adult in crisis to a temporary stabilization unit established and
licensed pursuant to the bill; and 3)��������������� provide ongoing
stabilization management services to the adult in crisis, in the adult�s home,
when authorized to do so by the DHS.

���� Mobile crisis response
services and stabilization management services, which are provided by a mobile
crisis response team under this bill�s provisions, are to be delivered directly
by, or under the supervision of, a licensed and experienced psychiatrist.�

���� Mobile crisis response
services are to be provided to an eligible adult in crisis for a period of up
to 72 hours per crisis episode, over the course of up to a four-day period,
immediately following the initial referral or dispatch, and are to be designed
to stabilize the presenting behaviors and crisis situation, with the goal of
preventing a disruption of the current living arrangement, and avoiding
inappropriate psychiatric hospitalization or residential placement, of the
adult in crisis.� Each referral to, or dispatch of, a mobile crisis response
team will be registered with the DHS within 24 hours after the team receives
notice thereof.�

���� Mobile crisis response
services provided by a mobile crisis response team are to include, but need not
be limited to: 1)�������� mobile outreach and face-to-face contact with the
adult in crisis, which face-to-face contact is to occur within 24 hours
following the initial referral or dispatch, except in situations requiring an
immediate response, in which case, face-to-face contact is to occur within one
hour after the initial referral or dispatch, unless a delay is requested by the
family of the adult in crisis, in order to meet the family�s needs; 2)����� the
immediate assessment and evaluation of the presenting crisis, including an
assessment of the safety of, or danger to, the adult in crisis, other residents
of the home, and members of the community, as well as an assessment of
caregiver culpability and clinical and environmental factors that contributed
to the crisis; 3)������� the immediate use of clinical and therapeutic
interventions to stabilize the presenting crisis; 4)�������� the development of
an individualized crisis stabilization plan (ICSP), as provided by the bill,
which plan is to include, among other things, an indication of appropriate
clinical and therapeutic interventions to be used in addressing and stabilizing
the presenting crisis; and a plan to ensure the stabilization and treatment of
the adult in crisis in the least restrictive environment; and 5) the provision
of relevant information, crisis training, and program and service referrals to
the family members or caregivers of the adult in crisis.

���� If, at any time during the
initial 72-hour mobile response period, the mobile crisis response team
determines that the presenting crisis can only be stabilized through the
temporary placement of the adult in a temporary stabilization unit, the crisis
response team will be required to transport the adult in crisis to a temporary
stabilization unit, and the adult will be admitted to the unit, for a period
not exceeding seven days, as necessary to facilitate the initial stabilization
of the crisis.� A temporary stabilization unit is to be approved and licensed
by the Department of Health, and is to:� 1) provide a calming, non-clinical,
and non-punitive environment for the stabilization of adults in crisis; 2) be
staffed by properly credentialed mental health professionals who are capable
of, and have expertise in, calming and stabilizing crisis situations in adults
with disabilities; 3) have a sufficient number of crisis beds to meet the
behavioral health crisis needs of citizens in the region in which the unit is
situated; and 4) be situated separately and apart from any other clinical or
mental health care unit or facility.� If the temporary stabilization unit is a
part of a separately licensed health care facility or hospital, the temporary
stabilization unit is to be unconnected to, and located separately from, any
emergency department or other department or unit of medicine, and is to utilize
an entrance that is separate from the entrance that is used by patients of, and
visitors to, such other departments or units.

���� Whenever an adult is placed in
a crisis bed in a temporary stabilization unit, the need for such placement is
to be reviewed and documented by the mobile crisis response team on a daily
basis during such placement, and the adult is to be immediately discharged from
such placement upon a determination by the team that continued placement is no
longer necessary.�

���� If a crisis is not
sufficiently stabilized during the initial 72-hour mobile response period, or
during a related stay at a temporary stabilization unit, the mobile crisis
response team will be required to provide the adult in crisis with ongoing
stabilization management services, in the adult�s home, following the
completion of the initial crisis response period.� Stabilization management
services may not be provided, unless the DHS grants prior approval authorizing
the provision of such services to the adult in crisis.� The DHS may authorize
the mobile crisis response team to provide stabilization management services
for a period of up to eight weeks, as deemed by the department to be
appropriate.�

���� Stabilization management
services may include: 1) necessary mental or behavioral health intervention
services to maintain the stabilization of the crisis and minimize or eliminate
the factors that contributed to the crisis, including, but not limited to,
psychiatric or psychological services, medication management services,
community-based mental health rehabilitation services, such as behavioral
assistance services and intensive in-community services, and any other formal
or informal community-based mental health or behavioral health rehabilitation
services; and 2) continued advocacy, networking, and support by the mobile
crisis response team, as may be necessary to provide linkages and referrals to
appropriate community-based services, and to assist the adult in crisis, and
the family members or caregivers thereof, in accessing other benefits or
assistance programs for which they may be eligible.

���� During the stabilization
management period, the mobile crisis response team will be required to review
the ICSP on a weekly basis, in order to ensure that the services included
therein are effectively addressing the presenting crisis and any factors that
contributed to the crisis.� Any necessary amendments to the ICSP are to be
registered with the division within 24 hours after each review is concluded.�

���� Each mobile crisis response
agency will be required, under the bill, to maintain an individual service
record for each adult who is served thereby.�

���� Each mobile crisis response
agency and temporary stabilization unit will be eligible for reimbursement, as
described in the bill, for the services provided thereby under the bill�s
provisions.�

���� Any person seeking to deliver
crisis response services or stabilization management services as a member of a
mobile crisis response team, or as a staff member at a temporary stabilization
unit, will be required to comply with the criminal history record background
check requirements established by P.L.1999, c.358 (C.30:6D-63 et seq.), which
are applicable to �community agency employees,� as a condition of the person�s
employment.�

���� The bill also requires all
direct care staff members providing services at group homes for individuals
with intellectual or developmental disabilities to successfully complete a
course of training on:� 1) the de-escalation and stabilization of crisis episodes
in adults with disabilities; 2) behavioral analysis and management; and 3)
behavioral health crisis recognition and identification.� The training would
also be required to inform direct care staff members of the mobile crisis
response system established under the bill, and the procedures that may be used
to obtain assistance from a mobile crisis response team whenever a group home
resident is experiencing a behavioral health crisis.

���� The bill also requires the commissioner
to, on or before July 16, 2022, designate a crisis hotline center or centers to
provide crisis intervention services and crisis care coordination to
individuals accessing the 9-8-8 suicide prevention and behavioral health crisis
hotline from anywhere within the State 24 hours a day, seven days a week.� A
designated hotline center is to have an active agreement with the administrator
of the National Suicide Prevention Lifeline (NSPL) for participation within the
network.� To ensure cohesive and coordinated crisis care, a designated hotline
center is to utilize technology that is interoperable between and across crisis
and emergency response systems used throughout the State and with the
Administrator of the National Suicide Prevention Lifeline.

���� The bill provides that a
designated hotline center is to have the authority to deploy crisis and
outgoing services, including mobile crisis teams, and coordinate access to
crisis receiving and stabilization services as appropriate and according to
guidelines and best practices established by the NSPL.� A designated hotline
center is to coordinate access to crisis receiving and stabilization services
for individuals accessing the 9-8-8 suicide prevention and behavioral health
crisis hotline through appropriate information sharing regarding availability
of services.� A designated hotline center is to be utilized by the mobile
crisis response system to refer an eligible adult for mobile crisis response
services and stabilization management services pursuant to the bill.

���� The commissioner is to have
primary oversight of suicide prevention and crisis service activities and
essential coordination with a designated 9-8-8 hotline center.� A designated
hotline center is to meet the requirements set forth by NSPL for serving high
risk and specialized populations as identified by the Substance Abuse and
Mental Health Services Administration, including training requirements and
policies for transferring such callers to an appropriate specialized center or
subnetworks within or outside the NSPL network and for providing linguistically
and culturally competent care.� A designated hotline center is to provide
follow-up services to individuals accessing the 9-8-8 suicide prevention and
behavioral health crisis hotline consistent with guidance and policies
established by the NSPL.

���� Under the bill, the
commissioner is to provide onsite response services for crisis calls utilizing
State or local mobile crisis teams.� A mobile crisis team is to include a
behavioral health team, licensed behavioral health professionals, and peers, or
a behavioral health team and peers embedded within an emergency medical
services entity.� A mobile crisis team is to collaborate on data and crisis
response protocols with local law enforcement agencies and include police as
co-responders in behavioral health teams, and licensed behavioral health
professionals and peers, only as needed to respond to high-risk situations that
are unmanageable without law enforcement.� A mobile crisis team is to be
designed in partnership with community members, including people with
experience utilizing crisis services.

���� The commissioner is to
establish and maintain a 9-8-8 trust fund for the purposes of creating and
maintaining a Statewide 9-8-8 suicide prevention and mental health crisis
system pursuant to the National Suicide Hotline Designation Act of 2020 and the
Federal Communication Commission�s rules adopted July 16, 2020, and national
guidelines for crisis care.� The fund is to consist of: monies from a Statewide
9-8-8 fee assessed on users pursuant to the bill�s provisions; appropriations,
if any; grants and gifts intended for deposit in the fund; interest, premiums,
gains, or other earnings on the fund; and any other monies that are deposited
in or transferred to the fund.

���� Under the bill, monies in the
fund: do not revert at the end of any fiscal year and remain available for the
purposes of the fund in subsequent fiscal years; are not subject to transfer to
any other fund or to transfer, assignment, or reassignment for any other use or
purpose outside of those specified in the bill; and are continuously dedicated
for the purposes of the fund.

���� The bill provides that the
commissioner, consistent with the National Suicide Hotline Designation Act of
2020, is to establish a monthly Statewide 9-8-8 fee on each resident that is a
subscriber of commercial mobile services or IP-enabled voice services at a
fixed rate that provides for the creation, operation, and maintenance of a
Statewide 9-8-8 suicide prevention and behavioral health crisis system and the
continuum of services provided pursuant to federal guidelines for crisis
services.

���� Under the bill, the 9-8-8 fee
is not to be applied to mobile service users who receive benefits under the
federal Lifeline program as defined in 47 CFR 54.401.