SENATE AMENDED

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY DiGIROLAMO, COHEN, BAKER, BRENNAN, CALTAGIRONE, CAUSER, D. COSTA, CUTLER, J. EVANS, FLECK, GEIST, GEORGE, GINGRICH, GODSHALL, GOODMAN, HORNAMAN, JOHNSON, KAUFFMAN, KILLION, KORTZ, KOTIK, MANN, MURPHY, M. O'BRIEN, O'NEILL, PASHINSKI, PYLE, READSHAW, REED, SABATINA, SANTARSIERO, SCHRODER, TAYLOR, VULAKOVICH, WATSON, CLYMER, K. SMITH, DAVIS, DENLINGER, KULA, MATZIE, MURT, YOUNGBLOOD, HESS, BOBACK AND RAVENSTAHL, JANUARY 20, 2011

AS AMENDED ON THIRD CONSIDERATION, IN SENATE, OCTOBER 15, 2012   

AN ACT

Establishing the Methadone Death and Incident Review Team and

providing for its powers and duties; and imposing a penalty.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Short title.

This act shall be known and may be cited as the Methadone

Death and Incident Review Act.

Section 2.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Department."  The Commonwealth department charged with

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oversight of drug and alcohol programs, currently the Department

of Health of the Commonwealth.

"Drug-free drug and alcohol addiction treatment program."  A

drug and alcohol addiction treatment program that is not

licensed as a narcotic treatment program by the department.

"Methadone-related incident."  Any situation not involving a

fatality where methadone may be a contributing factor in the

behavior of an individual.

"Patient or family advocate."  A person who works as a

patient or family advocate at a drug and alcohol addiction

treatment program or a group of programs.

"Secretary."  The secretary of the department as defined in

this section.

"Department."  The Department of Drug and Alcohol Programs of

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the Commonwealth.

"Methadone-related death."  A death where methadone was:

(1)  a primary or secondary cause of death; or

(2)  may have been a contributing factor.

"Methadone-related incident."  A situation where methadone

may be a contributing factor which:

(1)  does not involve a fatality; and 

(2)  involves:

(i)  a serious injury; or

(ii)  unreasonable risk of death or serious injury.

"Narcotic treatment program."  A program licensed and

approved by the Department of Drug and Alcohol Programs for

chronic opiate drug users that administers or dispenses agents

under a narcotic treatment physician's order, either for

detoxification purposes or for maintenance.

"Secretary."  The Secretary of Drug and Alcohol Programs of

the Commonwealth.

"Team."  The Methadone Death and Incident Review Team

established under section 3.

Section 3.  Establishment of Methadone Death and Incident Review

Team.

(a)  Team established.--The department shall establish a

Methadone Death and Incident Review Team and conduct a methadone

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death review for all deaths where methadone was either a primary

or secondary cause of death. The team review and shall examine

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the circumstances surrounding methadone-related deaths and

methadone-related incidents in this Commonwealth for the purpose

of promoting safety and, reducing methadone-related deaths and

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methadone-related incidents and improving treatment practices.

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(b)  Composition.--The team shall consist of the following

individuals:

(1)  The secretary or a designee, who shall serve as the

chairperson of the team.

(2)  The Director of the Bureau of Drug and Alcohol

Programs.

(3)  The following individuals appointed by the  

secretary:

(i)  A representative from narcotic treatment

programs as defined in 28 Pa. Code § 701.1 (relating to

general definitions).

(ii)  A representative from a licensed drug and

alcohol addiction treatment program that is not defined

as a narcotic treatment program.

(iii)  A representative from law enforcement

recommended by a Statewide association representing

members of law enforcement.

(iv)  A representative from the medical community

recommended by a Statewide association representing

physicians.

(v)  A district attorney recommended by a Statewide

association representing district attorneys.

(vi)  A coroner or medical examiner recommended by a

Statewide association representing county coroners and 

medical examiners.

(vii)  A member of the public.

(viii)  A patient or family advocate.

(c)  Initial meeting.--The initial meeting of the team shall

take place within 90 days of the effective date of this act 

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section. During this initial meeting, the team shall develop a

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schedule for its work and reports.

(d)  Expenses.--Members of the team shall not receive

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compensation but shall be reimbursed for travel and other

necessary expenses.

(d)  Expenses.--Members of the team shall not receive

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compensation but shall be reimbursed for necessary travel and

other reasonable expenses incurred in connection with the

performance of their duties as members. If possible, the team

shall utilize the services and expertise of existing personnel

and staff of State government.

Section 4.  Team duties.

The team shall:

(1)  Review each death where methadone was either the

primary or a secondary cause of death and review methadone-

related incidents.

(2)  Determine the role that methadone played in each

death and methadone-related incident.

(3)  Communicate concerns to regulators and facilitate

communication within the health care and legal systems about

issues that could threaten health and public safety.

(4)  Develop best practices to prevent future methadone-

related deaths and methadone-related incidents. The best

practices shall be:

(i)  Promulgated by the department as regulations.

(ii)  Posted on the department's Internet website.

(5)  Collect and store data on the number of complaints

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and problems arising from the operation of opiate treatment

programs, methadone-related deaths and methadone-related

incidents, and provide a brief description of each death and

incident. These aggregate statistics shall be posted on the

department's Internet website.

(6)  Develop a form for the submission of methadone-

related incidents to the team by any concerned party.

(7)  Develop in consultation with the coroners and

medical examiners a model form for county coroners and

medical examiners to use to report and transmit information

regarding methadone-related deaths to the team.

(5)  Collect and store data on the number of methadone-

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related deaths and methadone-related incidents, and provide a

brief description of each death and incident. The aggregate

statistics shall be posted on the department's Internet

website. The team may collect and store data concerning

deaths and incidents related to other drugs used in opiate

treatment.

(6)  Develop a form for the submission of methadone-

related deaths and methadone-related incidents to the team by

any concerned party.

(7)  Develop in consultation with a Statewide association

representing county coroners and medical examiners a model

form for county coroners and medical examiners to use to

report and transmit information regarding methadone-related

deaths to the team. The team and the Statewide association

representing county coroners and medical examiners shall

collaborate to ensure that all methadone-related deaths are,

to the fullest extent possible, identified by coroners and

medical examiners.

(8)  Develop and implement any other strategies that the

team identifies to ensure that the most complete collection

of methadone-related death and methadone-related serious

incident cases reasonably possible is created.

 (8) (9)  Prepare an annual report that shall be posted

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on the department's Internet website and distributed to the

chairman and minority chairman of the Judiciary Committee of

the Senate, the chairman and minority chairman of the Public

Health and Welfare Committee of the Senate, the chairman and

minority chairman of the Judiciary Committee of the House of

Representatives and the chairman and minority chairman of the

Human Services Committee of the House of Representatives.

Each report shall:

(i)  Provide public information regarding the number 

and causes of methadone-related deaths and methadone-

related incidents.

(ii)  Provide aggregate data on five-year trends on

methadone use and abuse and methadone-related deaths and

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methadone-related incidents when such information is

available.

(iii)  Make recommendations to prevent future

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methadone deaths and abuse and methadone-related

incidents.

(iii)  Make recommendations to prevent future

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methadone-related deaths, methadone-related incidents and

abuse and set forth the department's plan for

implementing the recommendations.

(iv)  Recommend changes to statutes and regulations

to decrease methadone-related deaths and methadone-

related incidents.

(v)  Provide a report on methadone-related deaths and

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methadone-related incidents and concerns regarding

narcotic treatment programs.

 (9) (10)  Develop and publish on the department's

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Internet website a list of meetings for each year.

Section 5.  Duties of coroner and medical examiner.

A county coroner or medical examiner shall forward all 

methadone-related death cases involving methadone as the primary

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or secondary cause of death to the team for review. The county

coroner and medical examiner shall use the model form developed

by the team to transmit the data.

Section 6.  Review procedures.

The team may review the following information:

(1)  Coroner's reports or postmortem examination records 

unless otherwise prohibited by Federal or State laws,

regulations or court decisions.

(2)  Death certificates and birth certificates.

(3)  Law enforcement records and interviews with law

enforcement officials as long as the release of such records

will not jeopardize an ongoing criminal investigation or

proceeding.

(4)  Medical records from hospitals and, other health

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care providers and narcotic treatment programs.

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(5)  Information and reports made available by the county

children and youth agency in accordance with 23 Pa.C.S. Ch.

63 (relating to child protective services).

(6)  Information made available by firefighters or

emergency services personnel.

(7)  Reports and records made available by the court to

the extent permitted by law or court rule.

(8)  EMS records.

(9)  Traffic fatality reports.

(10)  Any other records necessary to conduct the review.

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(11)  Facility licensure surveys from the department's 

Bureau of Community Program Licensure and Certification,

Division of Drug and Alcohol Program Licensure.

(10)  Narcotic treatment program incident reports.

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(11)  Narcotic treatment program licensure surveys from

the program licensure division.

(12)  Any other records necessary to conduct the review.

Section 7.  Access to records.

(a)  Juvenile records.--When deemed necessary for its review,

the team may review and inspect all files and records of the

court relating to a child pursuant to a proceeding under 42

Pa.C.S. Ch. 63 (relating to juvenile matters) in accordance with

42 Pa.C.S. § 6307 (relating to inspection of court files and

records). However, this This subsection shall not apply to files

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and records of the court subject to a child fatality or near

fatality review pursuant to 23 Pa.C.S. Ch. 63 (relating to child

protective services).

(b)  Medical records.--Notwithstanding any other provision of

law and consistent with the Health Insurance Portability and

Accountability Act of 1996 (Public Law 104-191, 110 Stat. 1936)

and 42 CFR Pt. 2 (relating to confidentiality of alcohol and

drug abuse patient records), health care facilities and health

care providers shall provide medical records of an individual

under review without the authorization of a person of interest

to the team for purposes of review under this act.

(c)  Other records.--Other records pertaining to the

individual under review for the purposes of this act shall be

open to inspection as permitted by law.

Section 8.  Confidentiality.

(a)  Maintenance.--The team shall maintain the

confidentiality of any identifying information obtained relating

to the death of an individual or adverse incidents regarding

methadone, including the name of the individual, guardians,

family members, caretakers or alleged or suspected perpetrators

of abuse, neglect or a criminal act.

(b)  Agreement.--Each member of the team and any person

appearing before the team shall sign a confidentiality agreement

applicable to all proceedings and reviews conducted by the team. 

(c)  Liability.--An individual or agency that in good faith

provides information or records to the team shall not be subject

to civil or criminal liability as a result of providing the

information or record.

(d)  Discovery.--The proceedings, deliberations and records

of the team are privileged and confidential and shall not be

subject to the act of February 14, 2008 (P.L.6, No.3), known as

the Right-to-Know Law, discovery, subpoena or introduction into

evidence in any civil or criminal action.

(e)  Meetings.--Meetings of the team at which a specific

death is discussed shall be closed to the public and shall not

be subject to the provisions of 65 Pa.C.S. Ch. 7 (relating to

open meetings).

(f)  Attendance.--Nothing in this act shall prevent the team

from allowing the attendance of a person with information

relevant to a review at a methadone death and incident team

review meeting.

(g)  Penalty.--A person who violates the provisions of this

section commits a misdemeanor of the third degree.

Section 9.  Regulations.

The department shall promulgate regulations as necessary to

carry out the purposes of this act.

Section 20.  Effective date.

This act shall take effect in 90 days.