Amendment ID: S2609-61-R3

3rd Redraft Amendment 61

Medically Assisted

Messrs. Tarr, Ross and Humason move that the proposed new text be amended by striking out section 61 and inserting in place thereof the following section:- 

“SECTION 61. Said chapter 127 is hereby further amended by inserting after section 17A the following 3 sections:-

Section 17B. Each county correctional facility shall maintain or provide for the capacity to possess, dispense and administer all drugs approved by the federal Food and Drug Administration for use in opioid agonist treatment and opioid antagonist treatment for addiction; provided, however, that a facility shall not be required to maintain or provide an opioid agonist treatment or opioid antagonist treatment that is not also included as a MassHealth covered benefit.

If a person in the custody of a county correctional facility, in any status, was receiving opioid agonist treatment or opioid antagonist treatment for opioid addiction through any legally authorized medical program or by a valid prescription immediately preceding incarceration, the treatment shall not be involuntarily changed or discontinued except upon a determination by a qualified addiction specialist that the treatment is no longer appropriate. The qualified addiction specialist who makes a determination to change or discontinue treatment shall provide the reason for the change or discontinuance in the person’s medical record. The person shall be provided, both orally and in writing, with a specific explanation of the decision to change or discontinue the treatment and with notice of the right to have the person’s community-based prescriber notified of the decision. If the person provides signed authorization, the superintendent or sheriff shall notify the community-based prescriber in writing of the decision to change or discontinue the treatment.

Treatment established under this section shall be subject to section 7 of chapter 111E and facilities shall report not less than biannually to the commissioner of public health in a manner to be determined by the commissioner of public health for the evaluation of such treatment.

A county correctional facility shall also make treatment under this section available not less than 30 days prior to release to any person in the custody of a  county correctional facility for whom such treatment is determined to be medically appropriate by a qualified addiction specialist. Treatment established under this section shall include behavioral health counseling for individuals diagnosed with substance use disorder and such counseling services shall be consistent with current therapeutic standards for these therapies in a community setting.

Section 17C. The commissioner, in consultation with the commissioner of public health, shall provide medication-assisted treatment for opioid use disorder to a detainee or prisoner at the Massachusetts Alcohol and Substance Abuse Center, the Massachusetts Correctional Institution at Framingham or South Middlesex Correctional Center, upon the recommendation of a qualified addiction specialist. The medication-assisted treatment program shall not be required to be administered in any other state correctional facility; provided, however, that for the first 90 days during which a prisoner is serving a sentence to the state prison, the commissioner shall provide medication-assisted treatment for such prisoner at the Massachusetts Correctional Institution at Cedar Junction upon the recommendation of a qualified addiction specialist.

Such facilities shall maintain or provide for the capacity to possess, dispense and administer all drugs approved by the federal Food and Drug Administration for use in medication-assisted treatment for opioid use disorder; provided however, that such facilities shall not be required to maintain or provide a drug that is not is not a MassHealth covered benefit.

Such facilities shall ensure that each detainee or prisoner who is receiving medication-assisted treatment for opioid use disorder continues the treatment unless such person voluntarily discontinues the treatment or unless a qualified addiction specialist determines that treatment is no longer medically necessary.

Such facilities shall ensure access to a qualified addiction specialist by a detainee or prisoner.

Treatment established under this section shall include, but not be limited to, 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.

Section 17D. The commissioner shall ensure that, not later than 120 days prior to the expected discharge date of a prisoner serving a sentence to the state prison, a prisoner shall have access to a qualified addiction specialist who shall conduct an assessment of the prisoner. Upon a determination by the qualified addiction specialist that the prisoner requires treatment for opioid use disorder, the qualified addiction specialist shall establish a medically appropriate treatment plan for the prisoner, which may include, but shall not be limited to, medication-assisted treatment during the final 90 days of incarceration. A 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 drugs approved by the federal Food and Drug Administration for use in medication-assisted treatment for opioid use disorder; provided, however, that the treatment plan shall not be required to include a drug that is not a MassHealth covered benefit.

The treatment plant shall be forwarded to the parole board  and shall be incorporated into any treatment plan included within the terms and conditions of parole.

Section 17E. Not later than February 1, each state and county correctional facility shall report to the commissioner and the commissioner of public health the following information for the prior calendar year: (i) the cost to the facility of providing opioid agonist treatment and opioid antagonist treatment for addiction; (ii) the type and prevalence of opioid agonist treatment and opioid antagonist treatment for addiction provided; (iii) the number of persons in the custody of the facility, in any status, who continued to receive the same opioid agonist treatment or opioid antagonist treatment for addiction as they received prior to incarceration; (iv) the number of persons in the custody of the facility, in any status, who voluntarily changed or discontinued the opioid agonist treatment or opioid antagonist treatment for addiction that they received prior to incarceration; (v) the number of persons in the custody of the facility, in any status, who changed or discontinued opioid agonist treatment and opioid antagonist treatment for addiction that they received prior to incarceration due to a determination by a physician or addiction specialist; (vi) the number of persons in the custody of the facility, in any status, who received opioid agonist treatment or opioid antagonist treatment for addiction not less than 30 days prior to release; (vii) the number of persons in the custody of the facility, in any status, who received opioid agonist treatment or opioid antagonist treatment for addiction who did not receive such treatment prior to incarceration; and (viii) any other information requested by the commissioner related to the provision of opioid agonist treatment and opioid antagonist treatment for addiction.

Annually, not later than March 1, the department of correction, in consultation with the department of public health, shall submit a report on the findings collected from facilities under this section to the joint committee on mental health, substance use and recovery and the house and senate committees on ways and means.

The report shall include, but not be limited to: (a) the cost of providing opioid agonist treatment and opioid antagonist treatment for addiction for all persons in the custody of state and correctional facilities, regardless of status; (b) the type and prevalence of opioid agonist treatment and opioid antagonist treatment for addiction provided at state and correctional facilities in the commonwealth; (c) a summary of facility practices and any changes to those practices related to opioid agonist treatment or opioid antagonist treatment for addiction; and (d) the aggregated results of the information collected pursuant to clauses (iii) to (vii), inclusive, of the first paragraph.”; and

by striking out sections 62 to 64, inclusive; and

by inserting after section 92 the following section:-

“SECTION 92A. There shall be a county correctional facility working group to provide recommendations on the feasibility of offering of medication-assisted treatment to all persons, regardless of status, in the custody of a county correctional facility.

The working group shall consist of: the commissioner of public health or a designee; 5 county sheriffs from geographically diverse regions of the commonwealth appointed by the Massachusetts Sheriffs’ Association; and 1 representative of each of the following 7 organizations: the Massachusetts Medical Society; the Massachusetts Health and Hospital Association; the Association for Behavioral Healthcare; the Disability Law Center; Prisoner’s Legal Services of Massachusetts; the Massachusetts Society of Addiction Medicine; and the Massachusetts Organization for Addiction Recovery. The chair shall be selected by a majority of members.

The working group shall file its recommendations with the clerks of the senate and house of representatives, the joint committee on mental health, substance abuse and recovery and the senate and house committees on ways and means not later than July 1, 2019.”; and

by striking out sections 95 to 97, inclusive and inserting in place thereof the following 2 sections:-

“SECTION 95. Section 17B of chapter 127 of the General Laws shall take effect on July 1, 2019.

SECTION 96. Sections 17C to 17E, inclusive, of chapter 127 of the General Laws shall take effect April 1, 2019.”.