Bill S.1296

SENATE DOCKET, NO. 1621 FILED ON: 2/18/2021

SENATE . . . . . . . . . . . . . . No. 1296

By Mr. Keenan, a petition (accompanied by bill, Senate, No. 1296) of John F. Keenan and John C. Velis for legislation relative to consistent care for addiction rooted in evidence. Mental Health, Substance Use and Recovery.

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Second General Court
(2021-2022)

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An Act regarding consistent care for addiction rooted in evidence.

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. Section 1 of chapter 127 of the General Laws, as appearing in the 2018 Official Edition, is hereby amended by striking out the definition of “Medication-assisted treatment” and replacing it with the following definition:-

“Medication for opioid use disorder”, treatment for an opioid-related substance use disorder that: (i) is determined to be clinically indicated by a qualified addiction specialist; (ii) involves the use of medication that is approved by the federal Food and Drug Administration for treatment of an opioid-related substance use disorder; and (iii) is offered in accordance with a treatment plan that is reviewed by a qualified addiction specialist at a frequency consistent with appropriate clinical standards. “Medication for opioid use disorder” is sometimes referred to as “medication-assisted treatment”, “medication for addiction treatment”, or “MAT”.

SECTION 2. Section 16 of said chapter 127, as so appearing, is hereby amended by striking out in the second paragraph the words “who is committed for a term of 30 days’ imprisonment or more.” and inserting in place thereof the following:-

within 24 hours of admission to the facility. Such examination shall include assessment for treatment with medication for opioid use disorder, whether or not the individual was receiving medication for opioid use disorder immediately prior to admission to the facility.

SECTION 3. Said chapter 127, as so appearing, is hereby further amended by striking out section 17B and replacing it with the following:-

Section 17B. All correctional facilities, jails and houses of correction, in consultation with the commissioner of public health, shall offer medication for opioid use disorder to a detainee or prisoner, upon the recommendation of a qualified addiction specialist. All correctional facilities, jails and houses of correction shall maintain or provide for the capacity to possess, dispense and administer all medications approved by the federal Food and Drug Administration for treatment of opioid use disorder; provided however, that such facilities shall not be required to maintain or provide a medication that is not also a MassHealth covered benefit.

The commissioner and county sheriffs shall ensure that each detainee or prisoner who was receiving medication for opioid use disorder immediately preceding incarceration or commitment continues to have such treatment available as soon as practicable, and in any event within 24 hours of admission to the facility, unless such person voluntarily discontinues the treatment or unless a qualified addiction specialist determines that maintaining the same treatment is no longer clinically indicated. Each detainee or prisoner shall receive the same dose of the same medication that the person was receiving before incarceration or detention, unless a qualified addiction specialist determines, based on individual medical need, that a change in dose or medication is clinically indicated.

The commissioner and county sheriffs shall ensure that each detainee or prisoner who was not receiving medication for opioid use disorder immediately preceding incarceration or commitment, and for whom medication for opioid use disorder is clinically indicated, shall be offered such medication within 24 hours of the assessment required by section 16 of chapter 127. The determinations of which medication to prescribe and the dosage shall be made based on individual medical need. Detainees and prisoners shall be authorized to receive the medication for as long as clinically indicated.

All state and county correctional facilities shall ensure access to a qualified addiction specialist by a detainee or prisoner.

Treatment established under this section shall include behavioral health counseling for individuals diagnosed with opioid use disorder; provided, however, that counseling services shall be consistent with current therapeutic standards for these therapies in a community setting.

No incentives, rewards or punishments shall be used to encourage or discourage a detainee's or prisoner's decision to receive medication for opioid use disorder, or any particular such medication.

The commissioner of public health may promulgate regulations and guidelines necessary to implement the treatment program under this section.

SECTION 4. Section 17C of said chapter 127, as so appearing, is hereby amended by striking out the first paragraph and replacing it with the following:-

Not later than 120 days prior to the expected discharge date of a detainee or prisoner serving a sentence to a state prison or county facility, a qualified addiction specialist shall establish a medically appropriate re-entry treatment plan for the detainee or prisoner. A re-entry treatment plan may include any treatment upon discharge that the qualified addiction specialist shall recommend and deem appropriate, which may include, but shall not be limited to, all medications approved by the federal Food and Drug Administration for use in treatment for opioid use disorder. A re-entry treatment plan shall ensure that a detainee or prisoner is directly connected to an appropriate provider or treatment site in the geographic region to which the detainee or prisoner shall reside upon release. The commissioner and county sheriffs shall further ensure that, for a detainee or prisoner with a re-entry treatment plan under this section, the facility shall request reinstatement or apply for MassHealth benefits for the detainee or prisoner at least 30 days prior to release.

SECTION 5. Said chapter 127, as so appearing, is hereby amended by striking out section 17D and replacing it with the following:-

(a) Every six months, on a schedule to be established by the department of public health, the commissioner and the administrator of each county correctional facility shall report, in a format determined by the commissioner of public health, to the commissioner of public health, the house and senate committees on ways and means, the joint committee on mental health, substance use and recovery, the joint committee on public safety and homeland security and the joint committee on the judiciary the following information for the prior six months: (i) at the time of the report, the number of persons in the custody of the facility receiving each medication for opioid use disorder, in total and disaggregated by dosage; (ii) the number of persons in the custody of the facility, in any status, who continued to receive the same medication for opioid use disorder as they received prior to incarceration, by medication type; (iii) the number of persons in the custody of the facility, in any status, who discontinued medication for opioid use disorder that they received prior to incarceration, by medication type; (iv) the number of persons in the custody of the facility, in any status, who received a different medication for opioid use disorder than they received prior to incarceration, by medication type; (v) the number of persons in the custody of the facility, in any status, who received medication for opioid use disorder who did not receive such treatment prior to incarceration, by medication type; (vi) a summary of facility practices and any changes to those practices related to medication for opioid use disorder; (vii) the number of persons who were connected to treatment after release; (viii) the number of nonfatal and fatal overdoses in the facility; (ix) the number of nonfatal and fatal overdoses within one year of release from the department of correction and each county facility, provided, however, that the commissioner, the sheriffs, and the commissioner public health shall coordinate to provide such information; (x) the number of persons who received a re-entry treatment plan under section 17C and were subsequently enrolled in MassHealth upon discharge; provided, however, that the commissioner, the sheriffs, the commissioner of medical assistance and the commissioner of public health shall coordinate to provide such information; and (xi) any other information requested by the commissioner of public health related to the provision of medication for opioid use disorder.

(b) Every 2 years, not later than April 30, the commissioner of public health shall prepare a report, pursuant to section 237 of chapter 111, regarding outcomes for the treatment programs established under sections 17B and 17C to the house and senate committees on ways and means, the joint committee on mental health, substance use and recovery, the joint committee on public safety and homeland security and the joint committee on the judiciary. The department of correction and county correctional facilities shall provide, upon request from the commissioner of public health, information necessary to prepare the report. The report shall, to the extent possible, provide a comparison between the detainees and prisoners who did not receive medication for opioid use disorder and those who did, reported separately for each medication type, in order to determine the impact of the treatment programs on the following: (i) treatment retention after release; (ii) substance use and relapse after release; (iii) rates of recidivism; (iv) rates of nonfatal and fatal overdose; and (v) other outcome measures identified by the commissioner of public health.

SECTION 6. As soon as practicable, and in any event within 30 days of passage of this legislation, all state and county correctional facilities shall assess for treatment with medication for opioid use disorder all prisoners and detainees in their respective institutions who have been diagnosed with opioid use disorder, but who are not currently receiving medication for opioid use disorder. Prisoners or detainees for whom such medication is clinically indicated shall be offered medication within 24 hours of such assessment, and such medication shall be prescribed and provided in a manner consistent with the provisions of section 17B of chapter 127.

SECTION 7. Section 98 of chapter 208 of the acts of 2018 is hereby repealed.

Name:	District/Address:
John F. Keenan	Norfolk and Plymouth
John C. Velis	Second Hampden and Hampshire	2/26/2021