Bill S.2281

SENATE DOCKET, NO. 2425 FILED ON: 2/25/2010

SENATE . . . . . . . . . . . . . . No. 2281

The Commonwealth of Massachusetts

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In the Year Two Thousand Ten

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An act relative to substance abuse education and prevention.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Chapter 15 of the General Laws is hereby amended by adding the following section:-

Section 68. Each school district shall adopt a substance abuse education and prevention policy, pursuant to guidelines established by the commissioner, in consultation with the commissioner of public health. Each school district shall involve students, parents, guardians, teachers, administrators, school staff, community representatives, and local law enforcement agencies in the development of the policy. The policy shall be in writing and formally adopted by the school committee as a school district policy. A copy of the policy shall be distributed to each student and their parents or legal guardian by October 1st of each year, and shall be provided to any person upon request by the principal of every school within the district. A copy of each school district’s policy as adopted shall be sent to the commissioner who shall periodically review each policy for compliance with established guidelines.

SECTION 2. The first sentence of subsection (b) of section 91 of chapter 71 of the General Laws, as inserted by section 65 of chapter 27 of the acts of 2009, is hereby amended by striking out the words “chapter 70” and inserting in place thereof the following words:- foundation budget.

SECTION 3. Section 1 of chapter 94C of the General Laws, as appearing in the 2008 Official Edition, is hereby amended by inserting after the definition of “Agent” the following definition:-

“Board”, the board of registration in pharmacy established pursuant to section 22 of chapter 13.

SECTION 4. Said section 1 of said chapter 94C, as so appearing, is hereby further amended by inserting after the definition of “Dispense” the following definition:-

“Dispenser”, a person who delivers a schedule II to V, inclusive, controlled substance to the ultimate user, but does not include: (a) a licensed hospital pharmacy that distributes such substances for the purpose of inpatient hospital care or the dispensing of prescriptions for controlled substances at the time of discharge from such a facility; or (b) a wholesale distributor of a schedule II to V, inclusive, controlled substance.

SECTION 5. Said section 1 of said chapter 94C, as so appearing, is hereby further amended by inserting after the definition of “Drug paraphernalia” the following definition:-

“Facility”, a health care provider, registered with the department of public health, which employs more than 1 person who can prescribe drugs.

SECTION 6. Section 18 of said chapter 94C, as so appearing, is hereby amended by adding the following subsections:-

(e) Prescribing practitioners seeking to obtain or renew a Massachusetts professional license shall be required to demonstrate completion of no less than 10 per cent of the required training hours for each such professional license in effective pain management including, but not limited to the identification of patients at high risk for substance abuse and other aspects of prescription medication abuse. Professional licensing boards may count these hours as part of their regular continuing education licensing requirements. The department of public health shall assist professional education organizations in developing training programs that achieve the stated purposes and which shall qualify toward the satisfaction of continuing education licensing requirements.

(f) the board of registration of medicine shall development a training program, to be required of all physicians prescribing schedule II-V pain medications, that trains patients on the prescriptions they are receiving, the side effects of the medications, the addictive nature of the medications and proper storage and disposal techniques for prescription pain medications. The training program shall require patients to sign a waiver that they understand the information they have been given.

SECTION 7. Said chapter 94C is hereby further amended by adding the following 2 sections:-

Section 49. (a) The board shall designate an official prescription form for use by practitioners authorized to write prescriptions for controlled substances in the commonwealth.

(b) The commissioner shall establish security regulations concerning the procurement of the official prescription forms. The forms shall be serialized and tamper resistant so that they cannot be altered, copied or counterfeited. The board may contract with a private vendor to develop and print the official prescription form, provided that the vendor meets security regulations promulgated by the commissioner. Each series of prescriptions shall be issued to a specific practitioner in consecutively numbered blocks of 50 and shall only be used by that practitioner. Official prescription forms shall be provided by the board or by the private vendor to registered practitioners and facilities without charge.

(c) A practitioner authorized to write a prescription in the commonwealth shall issue all written prescriptions upon an official prescription form. A pharmacist shall not fill a written prescription from a Massachusetts practitioner unless issued upon an official prescription form. Nothing in this section shall be construed to impact regulations regarding oral, electronic, or out-of-state prescription practices.

(d) A practitioner or facility shall register with the department in order to be issued official prescription forms. Registration shall be without charge. Registration shall include, but not be limited to:

(1) the name of a practitioner authorized to prescribe controlled substances;

(2) the primary address and the address of additional places of business;

(3) the practitioner’s federal Drug Enforcement Agency number; and

(4) practitioner’s license number.

A practitioner's or facility's registration shall be subject to approval by the department, pursuant to rules promulgated by the commissioner. Any change to a practitioner's or a facility's registered information shall be promptly reported to the department in a manner promulgated by the commissioner.

(e) A registered facility shall obtain official prescription forms for use at the facility and shall assign the forms to registered staff practitioners. The number of official prescription forms issued to a registered practitioner or facility, by the department or the private vendor, shall be a reasonable quantity and at the discretion of the commissioner. Official prescription forms shall be imprinted with:

(1) the name of the registered practitioner or the registered practitioners at a registered facility;

(2) the registered practitioner’s federal Drug Enforcement Agency’s identification number;

(3) the primary address and the address of additional places of business of the registered practitioner; and

(4) the registered practitioner’s license number.

An official prescription form is not transferable and shall be used only by the registered practitioner or facility to whom issued.

(f) A registered practitioner or facility shall undertake adequate safeguards and security measures promulgated by the commissioner to assure against destruction, theft, or unauthorized use of an official prescription form. A registered practitioner shall, at minimum, maintain a record of official prescription forms received and establish a system requiring forms be secure pursuant to security measures promulgated by the commissioner. A registered facility shall, at minimum, maintain a record of official prescription forms received, maintain a record of forms assigned to its registered staff practitioners, establish a system requiring forms be secure pursuant to security measures promulgated by the commissioner and require a registered staff practitioner to surrender their assigned forms when the practitioner terminates affiliation with the registered facility.

(g) A registered practitioner or facility shall immediately notify the department, in a manner promulgated by the commissioner, upon their knowledge of the loss, destruction, theft or unauthorized use of an official prescription form. A registered practitioner or facility shall report the failure to receive official prescription forms to the department within a reasonable time after ordering the forms. A registered practitioner or facility shall immediately notify the board upon their knowledge of prescription diversion or suspected diversion pursuant to the loss, theft, or unauthorized use of an official prescription form.

(h) Whoever violates a provision of this section shall be punished by imprisonment for not more than 2 1/2 years in a house of correction or by imprisonment in a state prison for 3 years or by a fine of not more that $2,000, or both; and, for a second or subsequent offense in this section or in this chapter, by imprisonment for not more than 2 1/2 years in a house of correction or by imprisonment in a state prison for 10 years or by a fine of not more that $10,000, or both.

(i) The board, in conjunction with the executive office of public safety, shall submit an annual report on the effectiveness the official Massachusetts prescription form to the general court by filing the report with the clerk of the house of representatives and the clerk of the senate.

Section 50. The executive office of public safety, in consultation with the board, shall enforce section 49. To carry out this purpose, the executive office of public safety shall:

(a) inspect, copy, and audit records, inventories of controlled substances, and reports required under said section and rules adopted under said sections;

(b) enter the premises of regulated distributors and dispensers during normal business hours to conduct administrative inspections;

(d) conduct investigations to enforce this chapter;

(e) present evidence obtained from investigations conducted in conjunction with the office of the attorney general and the appropriate district attorneys for civil or criminal prosecution or for administrative action against regulated distributors, dispensers and licensees; and

(f) work in cooperation with the board, to accomplish the purposes of said section.

SECTION 8. Section 12F of chapter 112 of the General Laws, as appearing in the 2008 Official Edition, is hereby amended by striking out, in lines 37 and 38, the words “minor or a proper judicial order” and inserting in place thereof the following words: - minor, a proper judicial order or in case of the minor’s treatment for a drug or alcohol overdose, as defined by department of public health in its regulations.

SECTION 9. Said chapter 112 is hereby further amended by inserting after section 12F the following section:-

Section 12F ½. Any physician or hospital that treats a person under the age of 18 for a drug or alcohol overdose, as defined by department of public health in its regulations, shall notify the minor’s parents or legal guardian of the overdose as part of the discharge planning process. The parents or legal guardian shall be provided with contact information for the bureau of substance abuse services within the department of public health and the substance abuse helpline operated by the department of public health. The department of public health will produce a pamphlet to be distributed in emergency departments to the parents or legal guardian of a person under the age of 18 who is treated for a non fatal drug or alcohol overdose. The pamphlet shall include: information on how treatment can help, information on what a parent or legal guardian can do to prevent future overdoses, and information on where the patient can go to get treatment.

SECTION 10. Said chapter 112 hereby further amended by inserting after section 12CC the following section:-

Section 12DD. (a) Any person, who in good faith, seeks medical assistance for someone who is or there is reason to believe is experiencing a drug related overdose shall not be charged or prosecuted for possession of a controlled substance, pursuant chapter 94C, if the evidence for the charge of or prosecution for possession of a controlled substance was obtained as a result of the seeking of medical assistance.

(b) Any person who experiences or has reason to believe he or she is experiencing a drug-related overdose and is in need of medical assistance shall not be charged or prosecuted for possession of a controlled substance, pursuant to chapter 94C, if the evidence for the charge of or prosecution for possession of a controlled substance was obtained as a result of the seeking of medical assistance.

(c) Nothing in this section shall prohibit a charge or prosecution for possession with intent to manufacture, distribute or dispense a controlled substance or the entry of a plea or verdict of guilty for possession of a controlled substance as a lesser included offense of a complaint or indictment charging possession of a controlled substance with intent to manufacture, distribute, or dispense. The act of seeking medical assistance for someone who is or there is reason to believe is experiencing a drug-related overdose shall be admissible as evidence in a criminal prosecution pursuant to chapter 94C, if the evidence for the charge or prosecution was obtained as a result of the seeking of medical assistance.

SECTION 11. Section 12 of chapter 176O of the General Laws, as appearing in the 2008 Official Edition, is hereby amended by inserting after the word “provider”, in line 20, the following words:- provided, however, that in making an adverse determination for mental health or substance abuse treatment, the carrier or its designated utilization review organization shall defer to the judgment of the treating clinician unless there is a preponderance of evidence that the requested admission, continued stay or other health care service does not meet the requirements for coverage based on medical necessity, appropriateness of health care setting and level of care, or effectiveness.

SECTION 12. Section 99 of chapter 276 of the General Laws, as so appearing, is hereby amended by adding the following paragraph:-

The commissioner shall, in conjunction with the criminal history systems board and the bureau of substance abuse services within the department of public health, create a substance abuse certificate program for those individuals with criminal offender record information. The substance abuse certificate program shall enable a person convicted of or adjudicated delinquent by reason of any felony or misdemeanor charges in the commonwealth or a person who has been charged with a crime in the commonwealth but which charges did not result in a conviction to petition the superior court of the trial court department in the county in which he then resides, to enter a substance abuse certificate program if the charges were a consequence of substance abuse, for ascertainment and declaration of the fact of his rehabilitation or recovery and rehabilitation on that individual’s criminal offender record information, if the following conditions are met:

(a) the petitioner has not been sentenced to incarceration since being discharged from a felony or misdemeanor or since the termination of any ancillary proceedings related to such felony or misdemeanor including, but not limited to, any period of probation, parole or continuation;

(b) the petitioner is not the subject of a probationary or parole term for the commission of any other felony or misdemeanor;

(c) the petitioner presents satisfactory evidence of 2 years of residence in the commonwealth prior to the filing of the petition;

(d) the petitioner has demonstrated a period of rehabilitation, as defined in the General Laws, and

(e) the petitioner has completed a substance abuse treatment program approved by the bureau of substance abuse treatment services;

SECTION 13. The commissioner of elementary and secondary education, in consultation with the commissioner of public health, shall establish a pilot program for the purpose of providing substance abuse and addiction training to a teacher, a guidance counselor or a school nurse in at least 1 middle school and at least 1 high school in each county of the commonwealth. The teacher, guidance counsel, or school nurse shall conduct an initial screening, intervention and referral of those students who are identified as having substance abuse or addiction needs for a subsequent comprehensive assessment and appropriate treatment.

SECTION 14. The bureau of substance abuse services within the department of public health, in consultation with the supreme judicial court, shall develop and implement a program for judges and court personnel that examines substance abuse treatment resources in the commonwealth for persons convicted of or adjudicated delinquent by reason of any felony or misdemeanor charges in the commonwealth or a person who has been charged with a crime in the commonwealth but which charges did not result in a conviction. The program shall also include instruction for said participating individuals in developing skills to recognize the signs of persons with a substance abuse disorder that could benefit from treatment.

SECTION 15. The bureau of substance abuse services within the department of public health shall establish and advertise a free, anonymous, and confidential toll free telephone helpline that shall provide comprehensive, accurate, and current information and referrals related to addiction treatment and prevention services. The administration of the helpline shall be coordinated with the other departments and agencies of the commonwealth in order to prevent the duplication of similar services. The operation of the helpline may be contracted to third parties, provided that any such contracts shall be performance based and subject to approval by the commissioner of the department of public health.

SECTION 16. The department of public health shall issue regulations to include all schedule II, schedule III, schedule IV, and schedule V prescriptions in electronic reporting and prescription monitoring program requirements within 90 days of the passage of this act.

SECTION 17. The department of public health shall issue a report relative to the modification and improvement of health care to increase the flow of information to prescribing physicians and law enforcement personnel. The report shall include the department’s efforts to update the prescription monitoring program by streamlining case reporting, expanding proactive reporting, including additional prescription schedules, increasing reporting frequency, implementing an online system accessible to prescribers, pharmacies and law enforcement personnel, reducing Medicaid fraud, and improving interstate operability. The report shall include specific timelines to achieve the goals stated in the report. The report shall be issued within 90 days of the passage of this act.

SECTION 18. The department of public health shall issue requirements on all state licensed treatment facilities to include mandated discharge plans for all clients leaving said facility. The discharge plans shall include follow up treatment, contact information for shelters in the area, additional resources for substance abuse treatment and workforce options.

SECTION 19. The department of labor and workforce development, in consultation with the department of public health, shall conduct an investigation and study on the feasibility of a post treatment job skills training program and/or re-entry program for individuals recovering from substance use disorders. The study shall include information on best practices for similar job training programs, guidelines by which the commonwealth can use to establish an effective job skills training program, projected costs of such a program, and types of job skills that can be utilized by a program. Results of said study shall be filed with the clerk of the house of representatives and the clerk of the senate and, the joint committee on mental health and substance abuse, and the joint committee on labor and workforce development by July 15, 2011.

SECTION 20. The bureau of substance abuse services within the department of public health shall develop a statewide parent support network. The network shall include a support group that assists parents with issues of substance abuse disorders, facilitation of local forums to help educate the public on the issues of substance use disorders and coordination with other state agencies to disseminate information throughout the commonwealth.

SECTION 21. The board of registration in pharmacy and the executive office of public safety shall submit a report on the status of this act to the general court by filing it with the clerk of the house of representatives and the clerk of the senate on or before July 15, 2011.

SECTION 22. Section 7 shall take effect on July 1, 2011.