Bill Text: CT HB07010 | 2017 | General Assembly | Comm Sub

Connecticut House Bill 7010 (Prior Session Legislation)

Bill Title: An Act Concerning Opioids And Substance Use Disorders.

Spectrum: Committee Bill

Status: (Introduced - Dead) 2017-05-10 - Referred by House to Committee on Appropriations [HB07010 Detail]

Download: Connecticut-2017-HB07010-Comm_Sub.html

General Assembly		*Substitute Bill No. 7010*
*January Session, 2017*		_____HB07010PH____032917____

AN ACT CONCERNING OPIOIDS AND SUBSTANCE USE DISORDERS.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Section 17a-684 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2017):

(a) A person who is intoxicated at the time of application for commitment pursuant to subsection (b) of this section and who (1) is dangerous to himself or herself, or dangerous to others unless committed, which may be evidenced by behavior, including, but not limited to, such person having repeatedly overdosed on drugs or been administered an opioid antagonist on multiple occasions, (2) needs medical treatment for detoxification for potentially life-threatening symptoms of withdrawal from alcohol or drugs, which may be evidenced by behavior, including, but not limited to, such person having repeatedly overdosed on drugs or been administered an opioid antagonist on multiple occasions, or (3) is incapacitated by alcohol, may be committed for emergency treatment to a treatment facility operated by the Department of Mental Health and Addiction Services or a private treatment facility approved by the department to provide emergency treatment. The requirement that a person be intoxicated at the time of application may be waived if a licensed physician determines that the person is in immediate need of medical treatment for detoxification for potentially life-threatening withdrawal symptoms. A refusal to undergo treatment shall not constitute evidence of lack of judgment as to the need for treatment.

(b) A physician, spouse, guardian or relative of the person to be committed, or any other responsible person, may make a written application for commitment under this section, directed to the administrator of a treatment facility operated by the department or approved by the department to provide emergency treatment. The application shall state facts to support the need for emergency treatment and be accompanied by a physician's certificate stating that he or she has examined the person sought to be committed within two days before the certificate's date and facts supporting the need for emergency treatment.

(c) Upon tentative approval of the application by the administrator of the treatment facility, the person shall be transferred to the facility. The medical officer of the treatment facility shall immediately examine the person sought to be committed and advise the administrator of the treatment facility whether the application sustains the grounds to commit the person for emergency treatment. The administrator shall either accept the application or refuse the application if the application fails to sustain the grounds for commitment. If the administrator accepts the application, the person shall be retained at the facility to which he or she was admitted, or transferred to another appropriate treatment facility, until discharged under subsection (d) of this section.

(d) When, on the advice of the medical officer, the administrator determines that the grounds for commitment for emergency treatment no longer exist, the administrator shall discharge a person committed under this section. No person committed under this section may be detained in any treatment facility for more than five days. If an application for involuntary commitment under section 17a-685 has been filed within the five-day period and the administrator of the treatment facility, on the advice of the medical officer of the facility, finds that grounds for commitment exist under the provisions of said section, he or she may detain the person until the application has been heard and determined, but no longer than seven business days after filing the application.

(e) A copy of the written application for commitment and a written explanation of the person's right to counsel, shall be given by the administrator of the treatment facility to the person within twenty-four hours after commitment under this section. The administrator shall provide a reasonable opportunity for the person to consult counsel.

Sec. 2. (NEW) (Effective July 1, 2017) (a) As used in this section:

(1) "Health care provider" means any person or organization that furnishes health care services and is licensed or certified to furnish such services pursuant to chapters 370, 372, 373, 375, 376, 376a, 376b, 377, 378, 379, 380, 383, 383a, 383b and 383c of the general statutes, or is licensed or certified pursuant to chapter 368d, of the general statutes;

(2) "Pharmacist" means a pharmacist licensed pursuant to chapter 400j of the general statutes;

(3) "Opioid drug" has the same meaning as provided in section 20-14o of the general statutes; and

(4) "Opioid antagonist" has the same meaning as provided in section 17a-714a of the general statutes, as amended by this act.

(b) On or before October 1, 2017, the Department of Public Health, in collaboration with the Departments of Consumer Protection and Mental Health and Addiction Services, shall make available for dissemination by health care providers and pharmacists to any person (1) whom such provider treats for symptoms of opioid use disorder, (2) to whom such provider issues a prescription for or administers an opioid drug or opioid antagonist, or (3) to whom such pharmacist dispenses an opioid drug or opioid antagonist or issues a prescription for an opioid antagonist, a one-page fact sheet developed by the Connecticut State Medical Society and approved by said departments that includes, in clear and readily understandable language in at least twelve-point font size, the risks of taking an opioid drug, the symptoms of opioid use disorder and services available in the state for persons who experience symptoms of or are otherwise affected by opioid use disorder. Said departments shall encourage all health care providers and pharmacists to disseminate the one-page fact sheet to every such person.

Sec. 3. (NEW) (Effective July 1, 2017) On or before October 1, 2017, the Department of Public Health shall develop a marketing campaign and make a monthly public service announcement on its Internet web site, its social media accounts and any radio station and television station broadcasting to persons in the state regarding (1) the risks of taking opioid drugs, as defined in section 20-14o of the general statutes, (2) symptoms of opioid use disorder, (3) the availability of opioid antagonists, as defined in section 17a-714a of the general statutes, as amended by this act, in the state, and (4) services in the state for persons with or affected by opioid use disorder.

Sec. 4. (NEW) (Effective July 1, 2017) (a) On or before January 1, 2018, the Department of Public Health, in collaboration with the Department of Mental Health and Addiction Services, shall establish a publicly accessible electronic information portal, in the form of an Internet web site or application, as a single point of entry for information regarding the availability of (1) beds at a facility in the state for persons in need of medical treatment for (A) detoxification for potentially life-threatening symptoms of withdrawal from alcohol or drugs, and (B) rehabilitation or treatment for alcohol dependency, drug dependency or intoxication, and (2) slots for outpatient treatment using opioid medication that is used to treat opioid use disorder, including methadone and buprenorphine. Such portal shall provide real-time data on the availability of beds and slots, including, but not limited to, the types of beds and slots available, the location of such beds and slots and the wait times, if available, for such beds and slots. Such portal shall be accessible to the public.

(b) Every treatment facility in the state with beds and slots of the type described in subsection (a) of this section shall report to the state portal on a daily basis regarding the availability of beds and slots at its facility. If the availability of beds and slots at a facility changes during the day, the facility shall notify the portal of such change not later than one hour after the change occurs.

Sec. 5. (Effective July 1, 2017) On or before October 1, 2017, the Department of Public Health shall post information on its Internet web site concerning the ability of a prescribing practitioner, as defined in section 20-14c of the general statutes, to obtain certification to prescribe medicine indicated for treatment of opioid use disorder that a patient may take at home. Such information shall include, but need not be limited to, a list of educational requirements, available courses and information regarding waivers from such requirements. On or before November 1, 2017, every medical director in the state who supervises a prescribing practitioner shall be responsible for communicating with each such prescribing practitioner regarding such requirements, courses and information.

Sec. 6. (NEW) (Effective January 1, 2018) (a) Each insurance company, hospital service corporation, medical service corporation, health care center, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues in this state an individual health insurance policy providing coverage of the type specified in subdivision (1), (2), (4), (11) or (12) of section 38a-469 of the general statutes that provides coverage to an insured or enrollee who has been diagnosed with a substance use disorder, as described in section 17a-458 of the general statutes, shall cover inpatient substance abuse services provided to the insured or enrollee until such time as the health condition of the insured or enrollee has been stabilized. For the purposes of this section, "stabilized" means, with respect to an insured or enrollee receiving substance abuse services described in this subsection, that no material deterioration in the health condition of the insured or enrollee is likely, within reasonable medical probability, to result from or occur during the transfer of the insured or enrollee from an inpatient facility.

(b) Nothing in this section shall be construed to prohibit utilization review.

(c) Any insurance company, hospital service corporation, medical service corporation, health care center, fraternal benefit society or other entity providing coverage for the substance abuse services described in subsection (a) of this section may seek recovery from an insured or enrollee for the cost of such services if such services are not medically necessary, provided the amount of such recovery shall not exceed the Medicare reimbursement rate for such services. For the purposes of this subsection, "medically necessary" has the same meaning as provided in section 38a-482a of the general statutes.

Sec. 7. (NEW) (Effective January 1, 2018) (a) Each insurance company, hospital service corporation, medical service corporation, health care center, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues in this state a group health insurance policy providing coverage of the type specified in subdivision (1), (2), (4), (11) or (12) of section 38a-469 of the general statutes that provides coverage to an insured or enrollee who has been diagnosed with a substance use disorder, as described in section 17a-458 of the general statutes, shall cover inpatient substance abuse services provided to the insured or enrollee until such time as the health condition of the insured or enrollee has been stabilized. For the purposes of this section, "stabilized" means, with respect to an insured or enrollee receiving substance abuse services described in this subsection, that no material deterioration in the health condition of the insured or enrollee is likely, within reasonable medical probability, to result from or occur during the transfer of the insured or enrollee from an inpatient facility.

(b) Nothing in this section shall be construed to prohibit utilization review.

Sec. 8. (Effective July 1, 2017) The Department of Public Health shall convene a working group consisting of representatives of (1) said department, (2) the Department of Mental Health and Addiction Services, (3) the Judicial Department, (4) at least two emergency medical services providers in the state, (5) the health law and estates and probate sections of the Connecticut Bar Association, (6) at least two municipal police departments in the state, (7) the Connecticut State Police, (8) the Drug Control Division of the Department of Consumer Protection, (9) the Connecticut Hospital Association, and (10) the Connecticut State Medical Society to advise the Department of Public Health regarding any recommendations for statutory or policy changes that would enable first responders or health care providers to safely dispose of a person's opioid drugs upon their death. Not later than February 1, 2018, the Commissioner of Public Health shall report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committee of the General Assembly having cognizance of matters relating to public health regarding the recommendations of the working group.

Sec. 9. Subsection (a) of section 17b-10 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2017):

(a) The Department of Social Services shall prepare and routinely update state medical services and public assistance manuals. The pages of such manuals shall be consecutively numbered and indexed, containing all departmental policy regulations and substantive procedure, written in clear and concise language. Said manuals shall be published online by the department and linked to the eRegulations System. All policy manuals of the department, as they exist on May 23, 1984, including the supporting bulletins but not including statements concerning only the internal management of the department and not affecting private rights or procedures available to the public, shall be construed to have been adopted as regulations in accordance with the provisions of chapter 54. After May 23, 1984, any policy issued by the department, except a policy necessary to conform to a requirement of a federal or joint federal and state program administered by the department, including, but not limited to, the state supplement program to the Supplemental Security Income Program, shall be adopted as a regulation in accordance with the provisions of chapter 54. Not later than thirty days prior to implementing any new guidelines contained in a provider bulletin issued by the department that are not being adopted as regulations in accordance with the provisions of chapter 54, the department shall release such guidelines to (1) all appropriate provider types enrolled in the department's provider enrollment system that are listed in the provider bulletin as the formal recipients of such provider bulletin and that are affected by the new guidelines contained in the bulletin, as determined by the department, and (2) any provider or person who has signed up to receive electronic notification of provider bulletins on an Internet web site maintained by or on behalf of the department. The thirty-day-notice period shall not apply if the bulletin contains guidelines that must be implemented immediately to (A) address a health, safety or program integrity concern, as determined by the Commissioner of Social Services, (B) comply with federal requirements for one or more department programs, or (C) implement one or more technical corrections, clarifications or updates to a previously issued provider bulletin.

Sec. 10. Subsection (e) of section 17a-714a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):

(e) Not later than October 1, 2016, each municipality shall amend its local emergency medical services plan, as described in section 19a-181b, to ensure that the emergency responder, including, but not limited to, emergency medical services personnel, as defined in section 20-206jj, or a resident state trooper, who is likely to be the first person to arrive on the scene of a medical emergency in the municipality is equipped with an opioid antagonist and such person has received training, approved by the Commissioner of Public Health, in the administration of opioid antagonists. Nothing shall prohibit an emergency responder from administering any brand of opioid antagonist in whatever form or method of administration the emergency responder deems appropriate.


This act shall take effect as follows and shall amend the following sections:
Section 1	July 1, 2017	17a-684
Sec. 2	July 1, 2017	New section
Sec. 3	July 1, 2017	New section
Sec. 4	July 1, 2017	New section
Sec. 5	July 1, 2017	New section
Sec. 6	January 1, 2018	New section
Sec. 7	January 1, 2018	New section
Sec. 8	July 1, 2017	New section
Sec. 9	July 1, 2017	17b-10(a)
Sec. 10	October 1, 2017	17a-714a(e)

Statement of Legislative Commissioners:

In Section 1(a), "behavior, including, but not limited to," was inserted before "such person" for clarity, in Section 4(a) and (b), "clearinghouse" was changed to "portal" for consistency with other provisions of this section, and in Section 5, "(NEW)" was deleted for consistency with standard drafting conventions, and section "20-635" was changed to "20-14c" for accuracy.

Joint Favorable Subst.