Amendment #51 to H4725
Medication-Assisted Treatment in Correctional Facilities
Ms. Decker of Cambridge moves to amend the bill by inserting after section 61 the following 2 sections:
“SECTION 61A. Section 1 of chapter 127 of the General Laws is hereby amended by inserting after the definition of “Commissioner,” as appearing in the 2016 Official Edition, the following definitions:-
“Medically necessary”, health care services that are appropriate in terms of type, amount, frequency, level, setting, and duration to the individual’s diagnosis or condition, are informed by generally accepted medical or scientific evidence, are consistent with generally accepted practice parameters, and assessed by a physician or advanced practice nurse. Such services shall be informed by the unique needs of each individual and each presenting situation, and shall include a determination that a service is needed to achieve proper growth and development or to prevent the onset or worsening of a health condition.
“Medication-assisted treatment”, the use of U.S. Federal Drug Administration-approved medications also included in the MassHealth drug list, in combination with counseling and behavioral therapies, to provide a whole patient approach to the treatment of substance use disorders.
SECTION 61B. Said chapter 127 is hereby amended by inserting after section 17A, as so appearing, the following section:-
Section 17B. (a) Upon admission to a correctional facility for a minimum of 14 consecutive days, each inmate shall be given a physical assessment unless extenuating circumstances exist.
(b) Within 24 hours after admission to a correctional facility, each inmate shall be screened for substance use disorders as part of the initial and ongoing substance use screening and assessment process. This process includes screening and assessment for opioid use disorders.
(c) Except as otherwise provided in this subsection, an offender inmate who is admitted to a correctional facility while under the medical care of a licensed physician, a licensed physician assistant, or a licensed advanced practice registered nurse, or a licensed nurse practitioner and who is taking medication at the time of admission pursuant to a valid prescription as verified by the inmate’s pharmacy of record, primary care provider, other licensed care provider, and is included in the MassHealth drug list, including buprenorphine, methadone, or other medication prescribed in the course of medication-assisted treatment, shall be entitled to continue that medication and to be provided that medication by the department of correction pending an evaluation by a licensed physician, a licensed physician assistant, a licensed nurse practitioner, or a licensed advanced practice registered nurse.
(d) Notwithstanding subsection (a), the department of correction may defer provision of a validly prescribed medication in accordance with this subsection if, in the clinical judgment of a licensed physician, a physician assistant, a nurse practitioner, or an advanced practice registered nurse, it is not in the inmate’s best interest medically necessary to continue the medication at that time.
(e) The licensed practitioner who makes the clinical judgment to discontinue a medication shall enter cause the reason for the discontinuance to be entered into the inmate’s permanent medical record, specifically stating the reason for the discontinuance. The inmate shall be provided, both orally and in writing, with a specific explanation of the decision to discontinue the medication and with notice of the right to have his or her community-based prescriber notified of the decision. If the inmate provides signed authorization, the department of correction shall notify the community-based prescriber in writing of the decision to discontinue the medication.
(g) If an inmate receiving medication-assisted treatment prior to entering the correctional facility continues to receive medication prescribed in the course of medication-assisted treatment pursuant to this section, the inmate shall be authorized to receive that medication for as long as medically necessary.
(h) If at any time an inmate screens positive as having an opioid use disorder, the inmate may elect to commence buprenorphine-specific medication-assisted treatment if it is deemed medically necessary by a provider authorized to prescribe buprenorphine. The inmate shall be authorized to receive the medication as soon as possible and for as long as medically necessary.
(i) Nothing in this section shall prevent an inmate who commences medication-assisted treatment while in a correctional facility from transferring from buprenorphine to methadone if: (i) methadone is deemed medically necessary by a provider authorized to prescribe methadone; and (ii) the inmate elects to commence methadone as recommended by a provider authorized to prescribe methadone.
(j) The licensed practitioner who makes the clinical judgment to discontinue a medication shall cause the reason for the discontinuance to be entered into the inmate’s medical record, specifically stating the reason for the discontinuance. The inmate shall be provided, both orally and in writing, with a specific explanation of the decision to discontinue the medication and with notice of the right to have his or her community-based prescriber notified of the decision. If the inmate provides signed authorization, the department of correction shall notify the community-based prescriber in writing of the decision to discontinue the medication.
(k) As part of reentry planning, the department of correction shall commence medication-assisted treatment prior to an inmate’s release if: (i) the inmate screens positive for an opioid use disorder; (ii) medication-assisted treatment is medically necessary; and (iii) the inmate elects to commence medication-assisted treatment. If medication-assisted treatment is indicated and despite best efforts induction is not possible prior to release, the department of correction shall ensure comprehensive care coordination with a community-based provider.
(l) Any counseling or behavioral therapies provided in conjunction with the use of medication-assisted treatment shall be medically necessary.
(m) The department of correction shall annually, on or before December 31, issue a report on the effectiveness of the medication-assisted treatment program. The report shall be submitted to the joint committee on mental health, substance use and recovery; the joint committee on the judiciary, the joint committee on public safety and homeland security; the clerks of the house of representatives and the senate; the executive office of health and human services; and the executive office of public safety and security.”.