Consolidated Amendment "E" to H3400
Public Health
Fiscal Note: $8,947,909
Amendments from Public Health: 35, 38, 63, 79, 124, 150, 164, 173, 176, 216, 224, 272, 321, 354, 360, 373, 377, 378, 400, 401, 422, 425, 440, 442, 450, 486, 499, 500, 502, 510, 534, 565, 567, 568, 573, 607, 611, 630, 632, 633, 634, 642, 643, 647, 648, 655, 712, 721, 722, 739.
Mr. Dempsey of Haverhill and others move to amend the bill in section 2 by inserting before item 4510-0025 the following item:-
4510-0020For the department of public health; which may expend not more than $375,000 in revenues collected from fees charged by the food protection programs for program costs of the Department's Food Protection Program; provided, that notwithstanding any general or special law to the contrary, for the purpose of accommodating timing discrepancies between the receipt of retained revenue and related expenditures, the department may incur expenses and the comptroller may certify for payment amounts not to exceed the lesser of this authorization or the most recent revenue estimate as reported in the state accounting system………………………..$375,000
And further amend the bill in section 2, in item 4510-0615, by inserting after the word “reactors” the following words: “provided further, that not less than $90,000 shall be expended to the C-10 Research & Education Foundation of Newburyport for the purposes of providing radiological monitoring of the six Massachusetts communities within the plume exposure emergency planning zone of Seabrook Nuclear Power Plant;”; and in said item by striking out the figures “$1,534,791” and inserting in place thereof the figures “$1,624,791”.
And further amend the bill in section 2, in item 4513-0103, by striking out the figure “$31,097,810” and inserting in place thereof the figure: “$33,597,810”.
And further amend the bill in section 2, in item 4512-0200, by adding the following: “; and provided further, that not less than $125,000 shall be expended for Self Esteem Boston’s substance abuse direct service prevention, and provider training programs”; and in said item by striking out the figures “$75,185,802” and inserting in place thereof the figures “$75,310,802”.
And further amend the bill in section 2, in item 4512-0201, by striking out the figure “$2,400,000” and inserting in place thereof the figure: “$4,800,000”.
And further amend the bill in section 2, in item 4512-0500, by adding the following: “; and provided further, that funds shall be expended for the Forsyth Institute’s Center for Children’s Oral Health”.
And further amend the bill in section 2, in item 4513-1000, by striking out the figure “$3,659,311” and inserting in place thereof the figure: “$3,959,311”.
And further amend the bill in section 2, in item 4513-1002, by striking out the figure “$9,766,617” and inserting in place thereof the figure: “$10,266,617”.
And further amend the bill in section 2, in item 4513-1020, by striking out the figure “$21,491,404” and inserting in place thereof the figure: “$23,991,404”.
And further amend the bill in section 2 by striking out item 4513-1111 and inserting in place thereof the following item:-
4513-1111For the promotion of health and disease prevention including, but not limited to, the following programs: breast cancer prevention; diabetes screening and outreach; ovarian cancer screening; a statewide STOP stroke program and ongoing stroke prevention and education; hepatitis C prevention and management; multiple sclerosis screening, information, education and treatment programs and the Multiple Sclerosis Home Living Navigating Key Services program administered by the Central New England Chapter of the National Multiple Sclerosis Society; colorectal cancer prevention; prostate cancer screening, education and treatment with a particular focus on African American males; osteoporosis education; maintenance of the Amyotrophic Lateral Sclerosis registry created pursuant to section 25A of chapter 111 of the General Laws; and maintenance of the statewide lupus database; and provided further, that funds may be expended for the operation of the Betsy Lehman Center for patient safety…………..$3,400,000
And further amend the bill in section 2, in item 4590-0250, by adding the following: “; and provided further, that funds may be expended for the Massachusetts Model of Community Coalitions”.
And further amend the bill in section 2, in item 4590-0300, by striking out the figure “$4,150,703” and inserting in place thereof the figure: “$4,485,983”.
And further amend the bill in section 2, in item 4590-0912, by striking out the figure “$15,962,194” and inserting in place therefore the figure: “$16,212,194”.
And further amend the bill in section 2 by striking out item 4590-1507 and inserting in place thereof the following item:-
4590-1507For matching grants to the Massachusetts Alliance of Boys & Girls Clubs, the Alliance of Massachusetts YMCAs, the YWCA organizations, nonprofit community centers, and youth development programs; provided, that the department of public health shall award the full amount of each grant to each organization previously included in the youth-at-risk grants, upon commitment of matching funds from such organizations; provided further, that each organization previously included in the youth-at-risk grants shall receive in fiscal year 2012 a grant amount not less than that received in fiscal year 2011; and provided further, that any allocation less than $2,000,000 to a recipient of a youth-at-risk grant must be distributed equally between said recipient’s member organizations…...$1,500,000
And further amend the bill by adding the following sections:
SECTION XX. Chapter 111 of the General Laws is hereby amended by striking out section 25I, as appearing in the 2008 Official Edition, and inserting in place thereof the following section:-
Section 25I. The department, in conjunction with the board of registration in pharmacy and the division of medical assistance, shall establish and implement methods to reduce medication waste in facilities licensed by the departments of public health, mental health and corrections. The department shall establish such methods, based on its review, that are determined to be effective in reducing waste without imposing unreasonable costs on the health care delivery system. Such methods may be based on, but not be limited to, the following: (1) current technology, standards and reimbursement mechanisms for dispensing and distributing medications to facilities; (2) other states' requirements for limiting prescription drug waste and any cost savings realized; (3) the commonwealth's standards for the return and re-dispensing of patient-specific schedule VI prescription drugs; and (4) possible incentive mechanisms to prevent the creation of prescription drug waste. The department shall promulgate regulations to implement this section.
SECTION XX. The fifth paragraph of section 70E of said chapter 111, as so appearing, is hereby amended by adding the following subsection:-
(p) to obtain from the facility in charge of the patient’s care, upon discharge, any bulk medications that were prescribed for the patient during the patient’s stay including, but not limited to, aerosol inhalers, topical products such as creams and powders eye drops, insulins and special order items, provided that any such items are patient specific and personal and would not otherwise be used in the treatment of another patient. Upon discharge from the hospital, these bulk items shall be considered the personal property of the patient and at the prescribing physician’s discretion may include in discharge orders that the patient be provided with the specific bulk products that were used in the hospital with use directions. The department shall promulgate regulations to implement this section.
SECTION XX. The department of public health, in consultation with the board of registration in pharmacy shall, as shall provide to the joint committee on health care financing and the joint committee on public health, on or before April 1, 2012 a report and legislative recommendations relative to issues of implementation of the programs established under subsection p of section 70E of chapter 111 and section 25I of chapter 111, including, but not limited to: savings and costs related to the implementation of the programs established and recommendations related to penalties for violations of subsection p of section 70E of chapter 111 and section 25I of chapter 111.
SECTION XX. Notwithstanding any general or special law to the contrary, the department of public health, in consultation with the department of environmental protection, shall make an investigation and study regarding the issue of pharmaceutical drug waste and its effect on the environment in the Commonwealth. The department shall report on the following: (1) the estimated quantity of pharmaceutical drug waste in the Commonwealth; (2) the quantity of such waste that may be recovered prior to disposal; (3) the methods and techniques used in other states or local governments to reduce the amount of pharmaceutical drug waste, and identify model programs used to recover or recycle such waste; and (4) the efforts of pharmaceutical drug industry to mitigate waste through consumer support or take-back programs. The department shall make recommendations, consistent with its report, regarding: (1) the feasibility of expanding a drug recycling program similar to that prescribed in section 25I of chapter 111 to all consumers; (2) the feasibility of adopting similar programs adopted by other states or local governments to reduce drug waste; and (3) the feasibility of the department assisting municipal governments to establish local programs to reduce such waste. The department shall make its report and recommendations together with legislation to implement those recommendations by filing the same with the clerks of the senate and house not later than July 31, 2012.
SECTION XX. Notwithstanding any general or special law or regulation to the contrary, a special commission hereafter referred to as the commission, is hereby established for the purpose of investigating and studying the incidence and impacts in the commonwealth of Lyme disease and other tick-borne diseases, including but not limited to anaplasmosis, babesiosis, bartonellosis, and ehrlichiosis.
Said study shall include, but not be limited to, a cost-benefit analysis of: (i) conducting a Lyme disease public health clinical screening study in high risk regions; (ii) developing education materials and training resources for detecting signs and symptoms of tick-borne illnesses in school-aged populations, to be used by clinical providers and school health personnel (iii) statewide surveillance and testing for tick-borne diseases in both Ixodes scapularis (black-legged deer tick) and Amblyomma americanum (Lone Star) ticks, and (iv) educating the medical community about research on all aspects of Lyme, both acute and chronic. The commission shall also investigate the availability of grants and federal funds for the study of Lyme disease and other tick-borne diseases to determine if future action is feasible and warranted to support Lyme and tick-borne diseases research in the Commonwealth. (v) The Commission shall review mandatory reporting procedures to promote improved compliance both for CDC-positive and clinically diagnosed cases of Lyme disease and associated tick-borne co-infections.
Said commission shall consist of: 3 members of the Senate, 1 of whom shall be appointed by the Senate Minority Leader; 3 members of the House of Representatives, 1 of whom shall be appointed by the House Minority Leader; the Commissioner of the Department of Public Health or a designee; the Commissioner of the Division of Health Care Finance and Policy or a designee, 3 members of local boards of health from different Lyme endemic areas of the state; the Director of the State Laboratory Institute or a designee; the State Epidemiologist or a designee; and 4 members to be appointed by the Governor, 1 of whom shall be a physician specialized in infectious disease, 1 of whom shall be a professional member of the International Lyme and Associated Diseases Society, and 2 members who shall be considered experts in the treatment or research of Lyme disease. Additionally, there shall be 4 public members, 2 of whom shall be patients or family members of patients; and 2 shall be members of Lyme and other tick-borne diseases organizations representing diverse regions across the state. One patient shall be appointed by the Senate, one patient by the House of Representatives and the 2 members of Lyme & other tick-borne diseases organizations shall be appointed by the Governor.
Said commission shall report to the Senate and House of Representatives the results of its investigation and study, together with drafts of legislation, if any, necessary to carry its recommendations into effect, by filing the same with the clerks of the Senate and House of Representatives, who shall forward the same to the Joint Committee on Public Health and the House and Senate Committees on Ways and Means by April 1, 2012.