HB 7010 — AN ACT CONCERNING OPIOIDS AND SUBSTANCE USE DISORDERS.

General Assembly   RaisedSubstitute Bill No.

7010 January Session, 2017   LCO*_____HB07010PH____032917____* No.AN ACT CONCERNING OPIOIDS AND SUBSTANCE USE DISORDERS.

3402   *03402_______PH_* Referred to Committee on PUBLIC HEALTH   Introduced by:

  (PH)   AN ACT CONCERNING OPIOIDS AND SUBSTANCE USE DISORDERS.

(a) A person [whowho is intoxicated at the time of application] for whom an application for commitment is made 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.

[TheThe 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.]symptoms. A refusal to undergo treatment shall not constitute evidence of lack of judgment as to the need for treatment.

(b) A physician,refusal spouse, guardian or relative of the person to beundergo committed,treatment orshall any other responsible person, including, but not limitedconstitute to,evidence anyof physicianlack whoof providesjudgment emergencyas medical services to such person in connection with a drug overdose, may make a written application for commitment under this section, directed to the administratorneed offor a treatment facility operated by the department or approved by the department to provide emergency 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.

(NEW) (Effective July 1, 2017) No(a) personAs shallused be refused admission into a rehabilitation facility that treats persons with substance use disorders solely due to the fact that the person was intoxicated or tested positive for the use of an illegal substance or opioid antagonist, as defined in sectionthis 17a-714asection: of the general statutes, at the time he or she applied for or otherwise sought admission.

(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.

(NEW) (Effective July 1, 2017) TheOn sumor ofbefore ____October dollars1, is2017, appropriated to the Department of MentalPublic Health shall develop a marketing campaign and Addictionmake Services,a frommonthly public service announcement on its Internet web site, its social media accounts and any radio station and television station broadcasting to persons in the Generalstate Fund,regarding for(1) the fiscalrisks yearof endingtaking Juneopioid 30,drugs, 2018,as fordefined purposesin section 20-14o of increasingthe general statutes, (2) symptoms of opioid use disorder, (3) the numberavailability of bedsopioid atantagonists, in-patientas rehabilitationdefined in section 17a-714a of the general statutes, as amended by this act, in the state, and treatment(4) facilitiesservices toin accommodatethe patientsstate for persons with or affected by opioid use disorders.disorder.

(NEW) (Effective July 1, 2017) (a) ThereOn isor establishedbefore January 1, 2018, the Department of Public Health, in collaboration with the Department of Mental Health and Addiction Services, shall establish a psychiatrypublicly servicesaccessible electronic information portal, in the form of an Internet web site or application, as a single point of entry for substanceinformation useregarding disordersthe loanavailability reimbursementof program(1) tobeds beat administereda byfacility in the Boardstate for persons in need of Regentsmedical treatment for Higher(A) Education.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.

(b)Such Aportal Connecticutshall residentprovide who,real-time data on orthe afteravailability May 1, 2017, (1) graduated from an institution of higherbeds education with a doctor of medicine degree, (2) successfully completed a psychiatry residency program, and (3)slots, hasincluding, providedbut psychiatrynot serviceslimited into, the statetypes toof personsbeds withand substanceslots useavailable, disorders for at least two years after completion of the residencylocation program shall be eligible for reimbursement of federalsuch orbeds stateand educationalslots loansand up to a maximum of two thousand five hundred dollars per year or five per cent of the amountwait oftimes, suchif loansavailable, per year, whichever is less, for upsuch tobeds fourand years.slots.

(c)Such Notwithstandingportal theshall provisionsbe ofaccessible subsection (b) of this section, the total dollar value of loan reimbursements available to a person under this section, when combined with loan reimbursements available to such person under any other provision of the generalpublic. statutes, shall not exceed ten thousand dollars per recipient.

(d)(b) TheEvery Boardtreatment offacility Regentsin forthe Higherstate Educationwith maybeds adoptand regulations,slots inof accordance with the provisionstype ofdescribed chapterin 54subsection (a) of thethis generalsection statutes,shall report to carrythe outstate theportal provisionson ofa subsectionsdaily (a)basis toregarding (c),the inclusive,availability of thisbeds section.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.

(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-513c of the general statutes.