Consolidated Amendment #F to H.4200

Consolidated Amendment "F" to H4200

Public Health

Fiscal Note: $8,974,225

Amendment 53 has been re-categorized to Social Services and Vets

Amendment 562 has been re-categorized to Education and Local Aid

Amendments 479 and 753 have been re-categorized from Health and Human Services

Amendments from Public Health: 2, 36, 61, 73, 74, 81, 87, 120, 125, 134, 139, 141, 144, 153, 170, 171, 200, 204, 207, 213, 226, 228, 238, 252, 256, 270, 272, 274, 286, 294, 300, 314, 331, 372, 373, 405, 406, 413, 417, 448, 471, 477, 479, 501, 503, 506, 516, 524, 531, 540, 550, 571, 572, 603, 606, 622, 628, 650, 654, 661, 662, 685, 698, 740, 753, 757, 760, 762, 776, 777, 782, 790, 829, 831, 856, 857, 858, 898, 899, 901, 903, 907, 909, 917, 919, 920, 922, 929, 930, 934, 940, 942, 948, 955, 957, 961, 966, 970, 980, 982, 986, 1003, 1014, 1034, 1036, 1054, 1055, 1057, 1067, 1099, 1115, 1120, 1132, 1137, 1229, 1231, 1234, 1237, 1244, 1246, 1247, 1248, 1251, 1283, 1297

Mr. Dempsey of Haverhill and others move to amend H.4200 in section 2, by adding after item 1595-1069 the following item:-

“1595-4510 For an operating transfer to the Substance Abuse Services Fund established in section 2I of chapter 111 of the General Laws; provided, that the funds in this item shall be expended to increase the number of clients receiving substance abuse treatment through the bureau of substance abuse services; provided further, that in meeting that requirement, the bureau shall utilize a range of treatment settings including, but not limited to: (i) detoxification services; (ii) clinical stabilization services; (iii) residential treatment services; (iv) outpatient treatment services; (v) counseling; (vi) promoting primary care practitioners' access to available, trained and certified addiction specialists for consultation or referral; and (vii) educating primary care providers, including nurse practitioners and physician assistants, about addiction prevention and treatment and to encourage primary care physicians, nurse practitioners and physician assistants to screen for signs of substance abuse; provided further, that in determining the range of services to expand, the bureau shall select a range of treatment settings that prioritizes: (a) treatment methods that are evidence-based and cost effective; (b) ensuring substance abuse treatment access to historically underserved populations; and (c) availability of a continuum of services and care for clients entering substance abuse treatment at any level; and provided further, that the commissioner of public health shall report quarterly to the executive office for administration and finance, the joint committee on mental health and substance abuse and the house and senate committees on ways and means on: (1) the way funds were spent in the previous quarter, including, but not limited to, an itemized accounting of the goods and services that were procured; (2) an accounting of substance abuse services provided by the fund, broken down by month and type of service, since 2011 through the current quarter; (3) the number of clients served, by month and type of service; (4) the number of new and returning clients, by service; (5) amounts expended by type of service for each month in the prior quarter; and (6) procurement and service goals for the subsequent quarter………………………………….$1,000,000.”

And further amend section 2, in item 4510-0110, by inserting after words “254c(f)(1)” the following:- ; provided further, that not less than $100,000 shall be expended for the operation of the South Boston Community Health Center and its Youth Ambassador Program and South Boston Leadership Initiative; provided further, that not less than $50,000 shall be expended for the Mattapan Integrative Care Partnership Pilot program among the Mattapan Community Health Center, Mattahunt Community Center, Mattahunt Elementary School, and the Wheelock College Social Work Department for a behavioral health practice at the Mattapan Community Health Center and support a full time licensed social worker to bring mental health care to the community’s youth and to improve the coordination of care; provided further, that not less than $50,000 shall be expended for the operation of the daytime resource center at the Grace Center, Inc.; and provided further, that not less than $125,000 shall be expended towards the North End Waterfront Neighborhood Health Center for the purpose of operations and maintenance of treating substance abuse;

And further amend said item by striking out the figure “$1,223,773” and inserting in place thereof the following figure:- $1,548,773;

And further amend section 2, by inserting after item 4510-0110 the following item:-

4510-0112 For the department of public health to conduct a postpartum depression pilot program at community health centers in the cities of Holyoke, Lynn and Worcester and the Jamaica Plain……….$200,000;

And further amend section 2, in item 4510-0710, by inserting after words “education, training, intervention, support, surveillance and evaluation” the following:- provided further, that not less than $50,000 shall be expended for Operation House Call at The Arc of Massachusetts to maintain and expand training to medical students and other graduate level health care professionals to work with individuals with autism and other developmental and intellectual disabilities;

And further amend said item by striking out the figure “$10,760,498” and inserting in place thereof the following figure:- $10,810,498;

And further amend section 2, by inserting after item 4510-0712 the following item:-

And further amend section 2, in item 4512-0200, by inserting after words “Chapter 46 of the Acts of 2015” the following:- provided further, that not less than $100,000 shall be expended to the Berkshire County Youth Development Project for youth intervention services; provided further that no less than $150,000 shall be expended to Harbor Health Services for a grant program to prevent and treat addiction to opioid and related substances; provided further, that not less than $150,000 shall be expended for the operation of the Behavioral Health and Outpatient Substance Abuse Services to provide counseling and treatment for individuals suffering from behavioral health challenges and/or substance abuse at the Dimock Community Center; provided further, that not less than $84,000 shall be expended for the Milford Police Department and the Juvenile Advocacy Group to maintain a regional substance abuse outreach and intervention program in the Greater Milford area; provided further that not less than $250,000 shall be expended for a federally qualified community health center with a 24/7 emergency department licensed as a satellite emergency facility under 105 CMR 130 that has a written affiliation agreement with a mental and behavioral health provider to integrate primary care and mental/behavioral health services for the treatment and prevention of substance abuse, among other health conditions; provided further, that programs in substantial regulatory and contractual compliance shall receive not less than the same level of funding in fiscal year 2017 as received in fiscal year 2016; provided further, that not less than $150,000 shall be expended for a behavioral health pilot program in the towns of Quincy and Hull to be developed and run by the Manet Community Health Center, provided further that said program shall focus on the assessment, counseling and treatment of individuals struggling with mental health and/or substance abuse at Manet Community Health Center; provided further, that not less than $100,000 shall be expended to the city of Melrose for the purpose of funding the substance abuse coalition and hiring a coordinator; provided further, that no less than $75,000 shall be allotted to the George Crane Memorial Center in Pittsfield for peer support programming and operational costs; provided further, that not less than $200,000 shall be expended for the purchase and renovation of an opiate recovery treatment facility of Into Action Recover, Inc; provided further, that not less than $75,000 shall be allocated to substance abuse prevention in the city of Everett for the hiring of a school prevention specialist, as well as materials for relevant resources and training; provided further, that no less than $150,000 shall be expended to the town of Braintree for Braintree’s Community Partnership on Substance Abuse; provided further, that not less than $150,000 shall be expended for Self-Esteem Boston’s direct services programs for women in the Boston region and provider training programs; provided further, that not less than $10,000 shall be expended for Haven of Hope for community outreach and services in Methuen and Lawrence; provided further, that not less than $20,000 shall be expended for the Merrimack Valley Prevention and Substance Abuse Project toward resources, community outreach and programs in Methuen, Lawrence, Haverhill and North Andover; provided further, that not less than $100,000 shall be expended for the New Beginnings program that targets youth at risk and in recovery in collaboration with school districts; provided further, providing further, that not less than $50,000 shall be expended to The Psychological Center in Lawrence toward the Pegasus House residential treatment facility; provided further, that not less than $95,000 shall be expended for the Eastern Massachusetts Goal Setting and Relapse Prevention program in collaboration with the Juvenile Court Department office situated in Dedham; provided further, that the department of public health shall provide not less than $100,000 for a statewide program to improve the care and training for newborns with neonatal abstinence syndrome at hospital-based facilities that care for mothers and newborns, including the ten level III neonatal intensive care units in the commonwealth; provided further, that the program shall encourage collaboration between medical providers, community organizations and public health agencies to educate and increase the standardization of practices while developing a robust statewide database to allow for measured improvements in care and outcomes for newborns with neonatal abstinence syndrome, including reductions in length of stay and pharmacologic treatment; provided further, that not less than $100,000 shall be expended for Project RIGHT’s substance abuse and trauma prevention initiative in the Grove Hall area of Boston; "; provided further that not less than $75,000 shall be expended to the City of Leominster for the one-time purpose of the development of a comprehensive, real time referral and information system to address mental health and support services, including the opiate addiction epidemic in North Worcester County; provided further, not less than $175,000 shall be expended for the continuation of a comprehensive substance abuse and narcotic use reduction program at a federally qualified community health center located in South Boston; provided further that $25,000 shall be made available for the purchasing of Narcan for the police and fire personnel in the Town of Wakefield;

And further amend said item by striking out the figure “$126,588,987” and inserting in place thereof the following figure:- $128,972,987;

And further amend section 2, in item 4513-1000, by striking out the figure “$5,529,706” and inserting in place thereof the following figure:- $5,624,931;

And further amend section 2, in item 4513-1020, by striking out the figure “$27,400,167” and inserting in place thereof the following figure:- $28,400,167;

And further amend section 2, in item 4513-1026 by inserting after words “elder affairs” the following:- provided, that not less than $50,000 shall be expended to Call 2 Talk in Framingham to provide suicide prevention, intervention and post-intervention services;

And further amend said item by striking out the figure “$4,130,748” and inserting in place thereof the following figure:- $4,180,748;

And further amend section 2, by inserting after item 4513-1026 the following item:-

4513-1027 For Samaritans Inc.; provided, that funds may be used for suicide prevention services…….$400,000;

And further amend section 2, in item 4513-1098, by striking out the figure “$150,000” each time it appears and inserting in place thereof the following figure:- $200,000;

And further amend section 2, by striking line item 4513-1111, and inserting the following:-

4513-1111 For 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 Independently Navigating Key Services program administered by the Greater 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; and maintenance of the statewide lupus database; provided, that not less than $50,000 shall be expended for education and support of patients diagnosed with phenylketonuria, PKU, or related disorders and their families through a grant to the New England Connection for PKU and Allied Disorders, Inc; provided further, that funds may be expended for the operation of the Betsy Lehman Center for patient safety; provided, that funds may be expended for the operation of the Betsy Lehman Center for patient safety; provided further, that $100,000 shall be appropriated to the University of Massachusetts – Dartmouth to be expended for the operation of the Cranberry Health Research Center at the University of Massachusetts – Dartmouth; and provided further, that not less than $50,000 shall be expended to fund the Haitian American Public Health Initiative (HAPHI) to provide vital healthcare and education services to thousands of families and children in the Haitian community in the City of Boston and Town of Milton;

And further amend said item by striking out the figure “$3,599,010” and inserting in place thereof the following figure:- $3,749,010;

And further amend section 2, in item 4513-1130, by inserting after words “hotline” the following:- provided further that services funded through this line shall include a statewide domestic violence hotline, community based domestic violence response, emergency and transitional residential services for domestic violence victims and their children, supervised visitation and trauma services for children who witness violence and targeted services for department of children and families involved families; provided further, that no less than $75,000 be allocated for the Katie Brown Educational Program for a pilot instructional initiative, the Train the Trainer program, to train educators and increase the number of Southeastern Massachusetts students who acquire invaluable knowledge about the prevention of relationship violence; provided further, that $150,000 be expended for the operation of the Portal to Hope servicing Everett, Malden & Medford;

And further amend said item by striking out the figure “$30,572,153” and inserting in place thereof the following figure:- $30,797,153;

And further amend section 2, in item 4590-0250, by inserting after words “School-based health center programs” the following:- provided further, that not less than $100,000 shall be expended for the Massachusetts Model of Community Coalitions; provided further, that no less than $35,000 shall be expended for the purpose of establishing and supporting a school-based health center at Malden High School in the City of Malden; provided further, that not less than $25,000 shall be expended to Methuen High School toward the Students Against Destructive Decisions substance abuse program;

And further amend said item by striking out the figure “$11,932,830” and inserting in place thereof the following figure:- $12,092,830;

And further amend section 2, in item 4590-0915, by inserting after words “pharmacy services” the following:- provided, that the Massachusetts Hospital School shall maintain not less than 120 beds for clients in its inpatient setting to the extent feasible within the appropriation; provided further, that not less than $150,000 shall be expended for the Massachusetts Hospital School Summer Program; and provided further, that Tewksbury hospital shall maintain the same number of beds in fiscal year 2017 as was maintained in fiscal year 2016;

And further amend said item by striking out the figure “$157,667,054” and inserting in place thereof the following figure:- $157,817,054;

And further amend said section 2, by striking out item 4590-0925 and inserting in place thereof the following item:-

4590-0925 For the costs of a prostate cancer awareness and education program focusing in particular on men with African-American heritage, family history of the disease, and other men at high risk; provided, that the department of public health shall oversee and manage said program and shall grant not less than eighty-five percent of the funds from this item to a non-profit foundation that shall leverage existing partnerships with other state-funded non- profit organizations and current and past federally, state and privately funded prostate cancer programs aimed at saving lives, improving quality of life and reducing health care costs ............ $500,000

And further amend section 2, in item 4590-1507, by inserting after words “those organizations” the following:- provided further, that not less than $50,000 shall be expended for programs and services at the Milford Youth Center; provided further, that not less than $100,000 shall be expended for the Center for Teen Empowerment, Inc; provided further, that not less than $20,000 shall be expended to the Methuen YMCA toward child abuse prevention programs; provided further that not less than $15,000 shall be expended to the Salvation Army Bridging the Gap Between Youth and Community Services program in Lawrence; provided further, that the department of public health shall award not less than $1,200,000 to the Massachusetts Alliance of Boys and Girls Clubs, which shall be distributed equally between said recipient’s member organizations; and provided further, that the department shall award not less than $1,000,000 to the Alliance of Massachusetts YMCA’s Inc., which shall be distributed between the alliances member organizations;

And further amend said item by striking out the figure “$1,950,000” and inserting in place thereof the following figure:- $4,335,000;

And further amend the bill by inserting after section 7 the following section:-

SECTION 7A. Section 1 of chapter 94C of the General Laws, as so appearing, is hereby amended by striking out, in the definition of “administer”, clause (c) and inserting in place thereof the following clauses:-

(c) a registered pharmacist at the direction of a prescribing practitioner in the course of the practitioner’s professional practice with respect to prescriptions for mental health and substance abuse only; or

(d) an ultimate user or research subject at the direction of a practitioner in the course of his professional practice.

And move to further amend the bill by inserting after section 16 the following section:-

SECTION 16A. Section 2 of chapter 111C of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by adding the following clause:-

(16) provide for mobile integrated health programs that are also the primary ambulance service for a jurisdiction to avert emergency calls for EMS from emergency departments when care is more appropriate in a non-emergency department setting, provided, however, that: i) the care occurs with qualified medical direction; ii) the mobile integrated health program shall be approved by the department pursuant to chapter 111O; and, iii) each mobile integrated health program’s emergency department aversion protocols are approved by the department.".

And move to further amend the bill by inserting after section 19 the following section:-

SECTION 19A. Subsection (a) section 12EE of Chapter 112 of the General Laws, as so appearing, is hereby amended by striking out, in line 17, the words “biosimilar and interchangeable with” and inserting in place thereof the following words:- therapeutically equivalent to.

And move to further amend the bill by inserting after section 26 the following sections:-

SECTION 26A: The department of public health and the department of elementary and secondary education shall develop a transportation plan for recovery high schools. The plan shall ensure that each student attending a recovery high school, as defined in section 91 of chapter 71, has access to transportation between home and school.

SECTION 26B. Notwithstanding any general or special law to the contrary, there is hereby established a special commission for the purpose of conducting an investigation and study of strategies to promote public awareness and increase knowledge of the causes of chronic obstructive pulmonary disease (COPD), the importance of early diagnosis, effective prevention strategies, and disease management. The special commission shall: (i) determine what existing resources are currently being utilized; (ii) to the extend feasible determine if there exists a scientific base of knowledge concerning COPD through surveillance, epidemiology and research and; (iii) assess whether there is a need for improving the quality and accessibility of existing community-based COPD services. The special commission shall consist of the following members or their designees: the chairs of the joint committee on public health; the commissioner of public health; the secretary of elder affairs; a representative of the American Lung Association; and 4 members to be appointed by the governor as follows: a patient representative; a pulmonologist; a respiratory therapist; and a representative of the health insurance industry. The special commission shall report, in writing the results of said study together with its recommendations, if any, t to the joint committee on public health not later than December 31, 2017.

SECTION 26C: Notwithstanding any special or general law to the contrary, there shall be a special commission to study and develop recommendations to broaden the availability of naloxone without a prescription, including but not limited to recommendations on the standing order process, the collaborative practice agreement process, and any legislative recommendations.

The special commission shall consist of the following 11 members or their designees: the secretary of health and human services, who shall serve as chair; the commissioner of the division of insurance; 3 members to be appointed by the governor, one of whom shall be a prescribing physician, one of whom shall be a stakeholder within a retail pharmacy company, and one shall be an individual personally effected by the opiate epidemic; 2 members of the house of representatives, one of whom shall be appointed by the minority leader; 2 members of the senate, one of whom shall be appointed by the minority leader; the director of the board of pharmacy and; the director of the bureau of substance abuse services within the department of public health.

The special commission shall submit its recommendations, together with drafts of any legislation, to the clerks of the house of representatives and the senate and the chairs of the joint committee on mental health and substance abuse not later than December 31, 2016.

SECTION 26D. Notwithstanding any general or special law to the contrary, the department of public health shall issue, not later than October 1, 2016, recommendations to encourage the co-prescription of naloxone to patients at risk who are taking opioid analgesics.