Consolidated Amendment "D" to H4700
Public Health and Mental Health and Disability Services
Public Health/Mental Health & Disability
Fiscal Note: $14,665,000
Amendments 335, 495, 1484 have been recategorized from Labor and Economic Development to Public Health.
Amendment 511 has been recategorized from Social Services to Public Health.
Amendment 1147 has been recategorized from Education and Local Aid to Public Health.
Amendments from Public Health: 8, 22, 92, 105, 117, 129, 135, 136, 138, 150, 164, 170, 174, 186, 187, 190, 194, 199, 208, 235, 240, 262, 263, 302, 333, 335, 353, 379, 418, 428, 437, 438, 471, 475, 491, 495, 499, 511, 524, 539, 548, 550, 557, 572, 584, 597, 598, 611, 622, 624, 641, 661, 665, 667, 672, 691, 692, 704, 717, 722, 741, 744, 746, 755, 758, 761, 773, 787, 798, 846, 855, 861, 869, 873, 877, 883, 884, 892, 903, 905, 953, 980, 988, 1008, 1009, 1010, 1011, 1015, 1035, 1042, 1047, 1053, 1074, 1077, 1085, 1095, 1107, 1108, 1109, 1110, 1143, 1147, 1160, 1201, 1202, 1224, 1237, 1244, 1246, 1250, 1278, 1279, 1283, 1286, 1296, 1302, 1307, 1311, 1334, 1336, 1342, 1343, 1351, 1356, 1359, 1362, 1365, 1367, 1378, 1391, 1395, 1407, 1409, 1417, 1422, 1423, 1425, 1429, 1431, 1438, 1447, 1450, 1465, 1470, 1482, 1484, 1499, 1504, 1506, 1508, 1510, 1512, 1514
Amendments from Mental Health & Disability Services: 4, 145, 205, 241, 342, 351, 386, 396, 479, 644, 731, 759, 777, 805, 811, 821, 842, 899, 900, 958, 1012, 1019, 1082, 1113, 1129, 1145, 1187, 1204, 1209, 1258, 1293, 1318, 1323, 1373
Mr. Michlewitz of Boston and others move to amend H.4700 in section 2, in line item 4510-0100, by inserting after the words "section 27D of chapter 111 of the General Laws” the following:- ; provided further, that not less than $75,000 shall be expended for Volunteers in Medicine Berkshires to provide increased access to care for income-eligible residents; provided further, that not less than $100,000 shall be expended for the medical On-Site Academy to address the many behavioral health needs of those employees working in the medical field, including but not limited to: (a) critical incident stress management; (b) substance abuse; (c) post-traumatic stress disorder; (d) issues resulting from increased stress due to the novel coronavirus 2019 pandemic; (e) staffing shortages; and (f) workplace violence in the medical field; provided further, that not less than $75,000 shall be expended for the purpose of the commissioner implementing section 220A of chapter 111 of the General Laws to provide information about the health risks and emotional trauma inflicted by the practice of female genital mutilation, as well as the criminal penalties for committing female genital mutilation; provided further, that not less than $100,000 shall be expended for Community Servings, Inc. for the purpose of providing medically tailored meals to persons battling chronic illnesses, workforce training programs to those recovering from addiction and opportunities for expanded services and locations; provided further, that not less than $30,000 shall be expended for the Matt Brown Foundation, Inc. in Norwood to support individuals and families living with or recovering from illness or injury, with a particular emphasis on those living with or recovering from spinal cord injuries
And further amend said item by striking out the figure “$23,038,252” and inserting in place thereof the following figure:- $23,418,252
And further amend said section 2, in line item 4510-0110, by inserting after figure “254c(f)(1)” the following:- ; provided further, that not less than $200,000 shall be expended for NEW Health – Charlestown for the purpose of operating and maintaining treatment of substance use disorder; and provided further, that not less than $200,000 shall be expended for the Public Health Institute of Western Massachusetts to support 413Cares regional response to the 2019 novel coronavirus
And further amend said item by striking out the figure “$3,010,599” and inserting in place thereof the following figure:- $3,410,599
And further amend said section 2, in line item 4510-0600, by inserting after the words “111F of the General Laws” the following:- ; provided further, that not less than $100,000 shall be expended for the city of Beverly for testing, monitoring and analysis of the environmental cleanup efforts for the Varian site located at and near 150 Sohier road, Beverly
And further amend said item by striking out the figure “$5,998,591” and inserting in place thereof the following figure:- $6,098,591
And further amend said section 2, in line item 4510-0710, by inserting after the words “healthcare program” the following:- ; provided further, that not less than $100,000 shall be expended for South Shore Health to support its efforts to advance health equity and improve access for underserved communities
And further amend said item by striking out the figure “$14,129,190” and inserting in place thereof the following figure:- $14,229,190
And further amend said section 2, in line item 4512-0200, by inserting after the words “MA-ATR, program” the following:- ; provided further, that not less than $3,000,000 shall be expended for the bureau to provide technical assistance and training to increase the number of providers delivering culturally, ethnically and linguistically diverse services in communities of color
And further amend said item by striking out the words “provided further, that funds appropriated for this item in fiscal year 2022 for the purpose of funding additional family supportive housing programs, formerly called family sober living programs, across the state, and for the purpose of providing technical assistance and training to the services systems of medication management, medication-assisted treatment and treatment of co-occurring disorders, shall not revert but shall be made available for this item for these purposes in fiscal year 2023” and inserting in place thereof the following:- provided further, that funds appropriated for this item in fiscal year 2022 for the purpose of funding recovery centers first funded in fiscal year 2021, for the purpose of outpatient and mobile services for individuals who are deaf, hard of hearing or blind with substance use disorders, shall not revert but shall be made available for this item for these purposes in fiscal year 2023
And further amend said section 2, in line item 4512-0205, by inserting after the words “services” the following:- ; provided, that not less than $50,000 shall be expended for Baystate Health Eastern Region for a grant program to prevent and treat addiction to opioids and related substances; provided further, that not less than $20,000 shall be expended for DuxburyFACTs Corp for substance misuse and behavioral health education efforts; provided further, that not less than $40,000 shall be expended for Crossroads Family Shelter in East Boston to provide mental health, substance use and clinical recovery services for those impacted by family homelessness; provided further, that not less than $150,000 shall be expended for the police department of the city of Lynn for its behavioral health unit; provided further, that not less than $175,000 shall be expended for Self Esteem Boston’s direct service and provider training programs; provided further, that not less than $100,000 shall be expended for expanding substance use counseling in the Everett health department and Everett police department in the city of Everett; provided further, that not less than $25,000 shall be expended for the purposes of the operation of Resources for Recovery Inc., formerly known as the Dennis Messing Memorial Foundation, Inc. located in the Hyde Park section of the city of Boston; provided further, that not less than $50,000 shall be expended for the Greater New Bedford Community Health Center, Inc. office-based addiction and opioid treatment program; provided further, that not less than $50,000 shall be expended for RICKY, Inc. in Norwood for the delivery of substance use recovery care materials to homeless individuals with substance abuse and mental health disorders within the Greater Boston region; provided further, that not less than $100,000 shall be expended for Project R.I.G.H.T., Inc.’s substance use and trauma prevention initiative in the Grove Hall area of Boston; provided further, that not less than $200,000 shall be expended for the operation of the Dimock Center’s behavioral health continuum of substance use care to provide comprehensive treatment for individuals suffering from substance use disorder and other behavioral health challenges; provided further, that not less than $100,000 shall be expended for the operation of the Gavin Foundation, Inc.’s behavioral health continuum of substance use care to provide comprehensive treatment for individuals suffering from substance use disorder and other behavioral health challenges; provided further, that not less than $75,000 shall be expended for continued capital improvements to the Cambridge Community Center and for the expansion of their community-based behavioral health program; provided further, that not less than $2,000,000 shall be expended for the RIZE Massachusetts Foundation, Inc. to assist in their work to end the opioid epidemic in the commonwealth; provided further, that not less than $200,000 shall be expended for the Joseph Nee Collaborative Center for substance abuse programming; provided further, that not less than $150,000 shall be expended for Harbor Health Services, Inc. for a grant program to prevent and treat addiction to opioid and related substances; provided further, that not less than $50,000 shall be expended for the city known as the town of Braintree for Braintree Community Partnership on Substance Use; provided further, that not less than $200,000 shall be expended for One Life at a Time, Inc., located in the city known as the town of Braintree, for the facilitation of access to sober living programs and job training services for people in recovery and associated operational costs; provided further, that not less than $100,000 shall be expended for the continuation of a comprehensive substance abuse and narcotic use reduction program at a federally qualified health center located in South Boston; provided further, that not less than $100,000 shall be expended for the Weymouth veterans services department for substance abuse and recovery for veterans; provided further, that not less than $100,000 shall be expended for Roxbury Main Streets for health and safety initiatives in Nubian Square; provided further, that notwithstanding any general or specific law to the contrary, no funds shall be transferred from this item to any other item of appropriation; and provided further, that funds shall be expended fully and on a schedule consistent with section 9B of chapter 29 of the General Laws
And further amend said item by striking out the figure “$100,000” and inserting in place thereof the following figure:- $4,035,000
And further amend said section 2, in line item 4513-1005, by striking out the words “for comprehensive family planning services previously funded by Title X Family Planning funding due to restrictions applied federally” and inserting in place thereof the following:- for enhancing comprehensive family planning services funded by Title X Family Planning funding; provided further, that of said amount, not less than $1,660,000 shall be allocated to Action for Boston Community Development, Inc. to continue services previously funded by Title X funding
And further amend said item by inserting after the words “monitoring program” the following:- ; provided further, that not less than $50,000 shall be expended for Martin Luther King Jr. Family Services, Inc.; provided further, that not less than $100,000 shall be expended for the Neighborhood Birth Center in the city of Boston to provide perinatal health care and prenatal and postpartum support to birthing people; provided further, that not less than $500,000 shall be expended for the purpose of improving reproductive health care access, infrastructure and security, including grants to the Jane Fund of Central Massachusetts, the Abortion Rights Fund of Western Massachusetts and the Eastern Massachusetts Abortion Fund
And further amend said item by striking out the figure “$18,000,000” and inserting in place thereof the following figure:- $20,310,000
And further amend said section 2, in line item 4513-1112, by inserting after the words “developmental disabilities” the following:- ; provided further, that not less than $475,000 shall be expended for the Forsyth Institute’s Center for Children’s Oral Health to expand its ForsythKids programming focused on children and adolescents and to explore the emerging association between oral health status and academic performance
And further amend said item by inserting after the words “Disorders, Inc” the following:- ; provided further, that not less than $100,000 shall be expended for the operation of the Cranberry Health Research Center at the University of Massachusetts at Dartmouth; provided further, that not less than $50,000 shall be expended for the Cancer House of Hope in West Springfield; provided further, that not less than $25,000 shall be expended for the operation of VITFriends Vitiligo Support Group, Inc. in Hyde Park
And further amend said item by striking out the figure “$11,994,932” and inserting in place thereof the following figure:- $12,169,932
And further amend said section 2, in line item 4513-1136, by inserting after the words “Alliance, Inc.” the following:- ; provided further, that the department of public health shall make a payment of not less than the amount appropriated in fiscal year 2013 for children’s advocacy centers
And further amend said item by inserting after the words “fiscal year 2023” the following :- ; provided further, that not less than $125,000 shall be expended for Portal to Hope to develop programs combatting domestic violence in Medford, Malden, Everett and Winthrop; provided further, that not less than $100,000 shall be expended for the Baystate Family Advocacy Center in Hampden county to serve children and families traumatized by child abuse, sexual assault or exploitation; provided further, that not less than $100,000 shall be expended 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
And further amend said item by striking out the figure “$72,485,333” and inserting in place thereof the following figure:- $72,910,333;
And further amend said section 2, in line item 4590-0250, by inserting after the words “health center programs” the following:- ; provided further, that not less than $50,000 shall be expended for the North Quabbin Community Coalition; provided further, that not less than $75,000 shall be expended for the Amherst Regional Public Schools to support mental health services for students; provided further, that not less than $1,000,000 shall be expended for school-based health centers
And further amend said item by striking out the figure “$19,066,196” and inserting in place thereof the following figure:- $20,191,196;
And further amend said Section 2, in line item 4590-0915, by inserting after the words “section 2B” the following:- ; provided further, that the Pappas Rehabilitation Hospital for Children 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 Pappas Rehabilitation Hospital for Children summer programs; provided further, that Tewksbury hospital shall maintain the same number of beds in fiscal year 2023 as was maintained in fiscal year 2022
And further amend said item by striking out the figure “$190,394,958” and inserting in place thereof of the following figure:- $190,544,958
And further amend said section 2, in line item 4590-1507, by inserting after the words “questioning youth” the following:- ; provided, that not less than $2,000,000 shall be expended for the Massachusetts Alliance of Boys and Girls Clubs, Inc.; provided further, that not less than $1,300,000 shall be expended for the Alliance of Massachusetts YMCAs, Inc. which shall be distributed between the alliance’s member organizations; provided further, that not less than $50,000 shall be expended for the operation of the city of Revere’s Robert J. Haas Jr. Health and Wellness Center; provided further, that not less than $25,000 shall be expended for the YMCA youth programming in the city of Lynn; provided further, that not less than $50,000 shall be expended for the Lawrence Sueños Basketball summer league to support the recreational, social and health benefits the league provides to low-income youth in the city of Lawrence; provided further, that not less than $600,000 shall be expended for the YWCA organizations, which shall be distributed equally between the Alliance of YWCA member organizations; provided further, that not less than $50,000 shall be expended for the YMCA of the North Shore, Inc. for the Haverhill YMCA for a capital feasibility study; provided further, that not less than $30,000 shall be expended for the Boys & Girls Club of Greater Haverhill, Inc. for capital needs; provided further, that not less than $20,000 shall be expended for the Martha’s Vineyard Boys & Girls Club, Inc. for facility infrastructure improvements; provided further, that not less than $150,000 shall be expended for the Watertown Boys & Girls Club, Inc. for capital improvements; provided further, that not less than $75,000 shall be expended for the Center for Teen Empowerment, Inc.; provided further, that not less than $50,000 shall be expended for the Tobin Community Center for summer and fall events to reduce violence and to build unity and civic leadership among street-involved youth in partnership with Metro Boston and other public housing-based youth programs; provided further, that not less than $200,000 shall be expended for the Big Brothers Big Sisters of Massachusetts Bay Mentor 2.0 program; and provided further, that not less than $100,000 shall be expended for the Randolph community programs department in the town of Randolph for the hiring of a full-time community social worker
And further amend said item by striking out the figure “$2,550,000” and inserting in place thereof the following figure:- $7,250,000
And further amend said section 2, in line item 5042-5000, by inserting after the words "specialty psychiatry” the following:- ; provided further, that not less than $75,000 shall be expended for YouthConnect to provide community-based mental health services to high-risk youth and their families residing in the East Boston community; provided further, that not less than $50,000 shall be expended for Shrewsbury Youth and Family Services, Inc. for the organization’s continued implementation across the commonwealth of the National Council for Behavioral Health’s Youth Mental Health First Aid program; provided further, that not less than $100,000 shall be expended for the Franklin County Children’s Advocacy Center to provide mental health services; provided further, that not less than $90,000 shall be expended for the Northwestern Juvenile Fire Intervention, Response, Education and Safety Partnership, Inc. for a juvenile fire setter intervention and prevention program; provided further, that not less than $75,000 shall be expended for the Massachusetts Association for Mental Health, Inc. and the BIRCh Center to continue collaborating on the establishment of a school based behavioral health technical assistance center; provided further, that not less than $150,000 shall be expended for the NAN Project to increase mental health awareness and suicide prevention
And further amend said item by striking out the figure “$111,823,937” and inserting in place thereof the following figure:- $112,363,937
And further amend said section 2, in line item 5046-0000, by inserting after the words “outcomes measured” the following:- ; provided further, that not less than $50,000 shall be expended for a grant to the Massachusetts Chapter of the National Association of Social Workers, Inc. for the purposes of providing assistance in connecting consumers to licensed clinical social workers through the Therapy Matcher program; provided further, that not less than $25,000 shall be expended for the International Institute of New England, Inc. for culturally and linguistically appropriate mental health services for immigrants and refugees who have experienced torture and trauma
And further amend said item by striking out the figure “$514,301,841” and inserting in place thereof the following figure:- $514,376,841
And further amend said section 2, in line item 5095-0015, by inserting after the words “centers and facilities” the following:- ; provided further, that not less than $100,000 shall be expended for the development of Family Health Center of Worcester, Inc.’s facility at 192 Chandler street in Worcester, in collaboration with UMass Memorial Medical Center, to serve the healthcare needs of people experiencing homelessness
And further amend said item by striking out the figure “$274,828,823” and inserting in place thereof the following figure:- $274,928,823
And further amend said section 2, in line item 5911-1003, by inserting after the words “funded by the department” the following:- ; provided further, that not less than $75,000 shall be expended for Community Access to the Arts, Inc. in the town of Great Barrington; provided further, that not less than $25,000 shall be expended for the Charles River Center to provide grants for individuals to meaningfully participate in their community
And further amend said item by striking out the figure “$175,000” and inserting in place thereof the following figure:- $200,000
And further amend said item by striking out the figure “$88,067,555” and inserting in place thereof the following figure:- $88,192,555
And further amend said section 2, in line item 5920-2000, by inserting after the words “any such transfer” the following:- ; provided further, that not less than $25,000 shall be expended for the Center of Hope Foundation for parking improvements at the Center of Hope facility located at 54 Foster street in the town of Southbridge
And further amend said item by striking out the figure “$1,442,359,037” and inserting in place thereof the following figure:- $1,442,384,037
And moves to further amend the bill by inserting after section 22 the following section:-
SECTION 22A. Chapter 38 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by inserting after section 2A the following new section:-
Section 2B. In the case of the death of a child under the age of 2, the chief medical examiner shall review and approve: (i) the findings and report of the medical examiner performing the autopsy to determine the cause of death; and (ii) any change to the autopsy report.
And moves to further amend the bill by inserting after section 27A, inserted by Consolidated Amendment “A”, the following 10 sections:-
SECTION 27B. Section 117 of chapter 111 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by inserting after the word “providing”, in line 1, and the first time it appears in line 12, the following words:- prevention of HIV or.
SECTION 27C. Said section 117 of said chapter 111, as so appearing, is hereby further amended by inserting after the word “provide”, in line 7, the following words:- prevention of HIV or.
SECTION 27D. Said section 117 of said chapter 111, as so appearing, is hereby further amended by striking out the last paragraph and inserting in place thereof the following paragraph:-
For the purposes of this section, physical examination, prevention of HIV and treatment provided by a health care provider, as defined in section 1, upon the person of a minor who voluntarily appears therefor shall not constitute an assault and battery upon said minor.
SECTION 27E. Chapter 111D of the General Laws is hereby amended by striking out section 1, as so appearing, and inserting in place thereof the following section:-
Section 1. As used in this chapter, the following words shall, unless the context clearly requires otherwise, have the following meanings:
(1) “CLIA-waived test”, a test that the federal Centers for Medicare and Medicaid Services has determined qualifies for a Certificate of Waiver under the federal Clinical Laboratory Improvement Amendments of 1988, 42 U.S.C. § 263a.
(2) “Clinical laboratory”, a facility or place, however named, the purpose of which is to make biological, serological, chemical, immuno-hematological, cytological, pathological or other examinations of materials derived from a human body.
(3) “Commissioner”, the commissioner of public health.
(4) “Company”, a corporation, partnership, limited liability company, limited liability partnership, an association, a trust or an organized group of persons, whether incorporated or not.
(5) “Complex laboratory test”, a test which requires sophisticated technique, interpretation of multiple signals or proven technical skill. Such test shall require, but not be limited to, 1 or more of the following steps: (a) highly skilled physical manipulation; (b) technique-dependent steps in the testing, sampling or reading of results; (c) user programming of the device or devices; (d) detailed calculation of the results; (e) dilution of samples with chemically reactive substances; or (f) preparation of reagents.
(6) “Department”, the department of public health in the executive office of health and human services.
(7) “Exempt test”, a test which is generally noninstrumental in nature and the results of which are determined by observation of a visual signal.
(8) “Ownership interest”, interests, including, but not limited to, any membership, proprietary interest, shares of stock in a corporation, units or other interest in a partnership, bonds, debentures, notes or other equity interest or debt instrument or co-ownership in any form.
(9) “Person”, corporations, societies, associations, partnerships, limited liability companies, limited liability partnerships, trusts, organized group of persons, whether incorporated or not, an individual or the individual’s estate upon death, any other entity, including, but not limited to, medical practice, medical office, clinic, counseling center, substance use disorder treatment program or sober house or a political subdivision of the commonwealth.
(10) “Simple laboratory test”, a test which may require a series of steps, reagent additions or instrumentation and the results of which are generally determined by a visual signal, but which is not a complex laboratory test.
SECTION 27F. Said chapter 111D is hereby further amended by striking out section 4, as so appearing, and inserting in place thereof the following section:-
Section 4. No person shall maintain a clinical laboratory in the commonwealth apart from a hospital or clinic licensed under section 51 of chapter 111, unless the person holds, and there is in effect, a license issued under section 5; provided, however, that the licensing requirement of this section shall not apply to: (a) a clinical laboratory maintained by not more than 2 licensed physicians exclusively in connection with the diagnosis and treatment of the physician’s own patients; provided, that: (i) the physician or the physician’s assistant under the direct supervision of such physician performs all testing; and (ii) the clinical laboratory performs only laboratory tests which the commissioner, with the advice of the advisory committee on clinical laboratories, has determined to be exempt from licensure; (b) a clinical laboratory maintained by 3 or more licensed physicians exclusively in connection with the diagnosis and treatment of the physician’s own patients; provided, that: (i) the physician or the physician’s assistant under the direct supervision of such physician performs all testing; and (ii) the clinical laboratory performs only laboratory tests which the commissioner, with the advice of the advisory committee on clinical laboratories, has determined to be exempt from licensure; (c) a clinical laboratory performing only CLIA-waived tests; provided, that clinical laboratories performing non-CLIA waived tests in addition to CLIA-waived tests must obtain a clinical laboratory license; (d) a clinical laboratory maintained exclusively for research and teaching purposes and not providing reports for diagnosis and treatment of patients or for a public health purpose; (e) any laboratory with respect to tests or other procedures made by it for any person engaged in the business of insurance if made for purposes of determining whether to write an insurance contract or determining eligibility or continued eligibility thereunder, or for the examination of its employees or officers; or (f) any laboratory maintained exclusively for a health promotion screening program, as defined in regulations of the department, which does not provide reports for diagnosis or treatment of patients and which meets standards for such program established by the department. No provision of this chapter other than section 6 shall apply to any agency of the commonwealth, nor shall any provision of this chapter relative to licensing apply to any hospital or clinic licensed under section 51 of chapter 111.
SECTION 27G. Section 12F of chapter 112 of the General Laws, as so appearing, is hereby amended by striking out, in line 1, the words “physician, dentist” and inserting in place thereof the following words:- health care provider, as defined in section 1 of chapter 111.
SECTION 27H. Said section 12F of said chapter 112, as so appearing, is hereby further amended by inserting after the word “patient”, in line 6, the following words:- , or for the prevention of HIV.
SECTION 27I. Said section 12F of said chapter 112, as so appearing, is hereby further amended by inserting after the word “be”, in line 14, the following words:- at risk of exposure to,.
SECTION 27J. Said section 12F of said chapter 112, as so appearing, is hereby amended by inserting after the word “disease”, in line 18, the following words:- , or prevention of HIV.
SECTION 27K. Said section 12F of said chapter 112, as so appearing, is hereby further amended by striking out, in line 28, the words “physician or dentist” and inserting in place thereof the following words:- health care provider, as defined in section 1 of chapter 111.
And moves to further amend the bill by inserting after section 37 the following section:-
SECTION 37A. Said chapter 118E is hereby amended by adding the following section:-
Section 80. (a) Every 2 years, not later than November 15, the executive office shall review data and report on findings from the review based on data collected for the prior 2 years. The review shall consist of: (i) the available covered medications; (ii) treatments; and (iii) whether health care services were adequate to meet the needs of enrollees collected, including, but not limited to, input received pursuant to subsection (c). Each report shall include, but not be limited to: (i) detailed results of the review; (ii) recommendations, if any, for improvements in the delivery of health care services to enrollees with a diagnosis of sickle cell disease; and (iii) recommendations, if any, on whether the division shall seek to add or facilitate access to additional medications, treatments or services.
(b) Each review pursuant to subsection (a) shall include, but not be limited to:
(1) the extent to which healthcare transitional programs or services for enrollees that are covered by the division prepare, transfer and integrate emerging adults with sickle cell disease into the adult care setting;
(2) the extent to which providers of emergency medical services to enrollees are adequately trained and otherwise prepared to treat and manage sickle cell patients presenting with vaso-occlusive crises, including, but not limited to, the extent to which such providers follow clinically validated algorithms and protocols regarding such treatment and management; and
(3) the number of people with sickle cell disease who had 2 or more hospitalizations or emergency department visits with a vaso-occlusive episode or pain crisis, including the average length of stay for such visits.
(c) When conducting a review pursuant to subsection (a), the executive office shall solicit and consider input from the public, with specific emphasis on receiving input from patients with a sickle cell disease diagnosis as well as persons or groups with knowledge, experience or specialized expertise in the area of sickle cell disease treatment. Not later than April 30 of each year that the review is conducted, the executive office shall hold not less than 1 public hearing to solicit input.
(d) Each report required under this section shall be filed with the clerks of the house of representatives and the senate, the joint committee on health care financing and the house and senate committees on ways and means. The division shall post the report on the division’s website in a manner accessible by the public.
And moves to further amend the bill by striking out section 54, in lines 760 to 780, inclusive, and inserting in place thereof the following section:-
SECTION 54. Notwithstanding any general or special law to the contrary, the health policy commission established in chapter 6D of the General Laws, shall conduct an analysis and issue a report on the ongoing effects of the COVID-19 pandemic on behavioral health-related boarding in acute care hospital settings, including, but not limited to, boarding in emergency departments, medical surgical units or observation units, in the commonwealth. The study shall consider emergency department visits in the commonwealth classified as mental health, behavioral health, substance use disorder or other alcohol-related diagnosis and shall review: (i) length of stay for boarding; (ii) primary reason for wait; (iii) level of care required; (iv) type of insurance coverage; (v) payer reimbursement to care for boarders in emergency departments, medical surgical units, or observation units; (vi) available data on patient age, race, ethnicity, preferred spoken language, gender and homelessness; (vii) the ability to facilitate care coordination among health care providers; (viii) effects of COVID-19 on length of stay; (ix) effects of COVID-19 on workforce and any workforce shortages; and (x) other factors related to COVID-19 affecting the: (a) increased burden on acute care hospitals as a result of behavioral health-related boarding; (b) outcomes and quality of care for patients boarded in acute care hospitals; (c) resources provided by health plans to care for boarders. The health policy commission shall also review behavioral health-related boarding in other states and actions taken and any best practices to address the pressure on acute care hospitals as a result of the effects of the COVID-19 pandemic on behavioral health-related boarding. Not later than July 1, 2023 the health policy commission shall submit to the clerks of the house of representatives and the senate, the house and senate committees on ways and means, the joint committee on mental health, substance use and recovery and the joint committee on healthcare financing the report, including recommendations on how to address: (i) the burden on acute care hospitals; (ii) outcomes for patients with behavioral diagnoses; (iii) quality of care for patients boarded in acute care hospitals; and (iv) payer reimbursement to care for boarders in acute care hospitals.
And moves to further amend the bill by inserting after section 54 the following section:-
SECTION 54A. (a) Notwithstanding any general or special law to the contrary, the secretary of health and human services, in collaboration with the commissioner of public health, shall conduct or provide for an examination of the prescribing and treatment history, including court-ordered treatment or treatment within the criminal legal system, of persons in the commonwealth who suffered fatal overdoses in calendar years 2019 to 2021, inclusive, and annually thereafter, and shall report in an aggregate and de-identified form on trends discovered through the examination. The secretary of health and human services may contract with a non-profit or educational entity to conduct data analytics on the data set generated in the examination; provided, that the executive office shall implement appropriate privacy safeguards consistent with state and federal law.
(b) To facilitate the examination pursuant to subsection (a), the department of public health shall request, and the relevant offices and agencies shall provide, information necessary to complete the examination from the division of medical assistance, the executive office of public safety and security, the center for health information and analysis, the office of patient protection, the department of revenue and the chief justice of the trial court, which may include, but shall not be limited to, data from the: (i) prescription drug monitoring program, established in section 24A of chapter 94C of the General Laws; (ii) all-payer claims database, established in section 12 of chapter 12C; (iii) criminal offender record information database, established in section 172 of chapter 6; and (iv) court activity record information system, established in section 9 of chapter 258E. To the extent feasible, the department of public health shall request data from the Massachusetts Sheriffs Association, Inc. relating to treatment within houses of correction.
(c) Not later than July 1, 2023, and annually thereafter, the secretary of health and human services shall publish a report on the findings of the examination, including, but not limited to: (i) the overall prescription history of the individuals, including both agonist and antagonist medications for opioid use disorder; (ii) the mental and behavioral health and substance use treatment history of the individuals, including an outcomes comparison of voluntary versus involuntary treatment, controlling for other factors; (iii) structural factors that contribute to heightened risk of overdose, including, but not limited to, employment status, housing status, criminal legal involvement, income, medical comorbidities, including, but not limited to, bacterial or viral infections and substance use sequalae and other demographic markers, including, but not limited to, race, ethnicity, age, gender identity, sexual orientation and immigration status; (iv) trends in the substances observed in overdose events; (v) whether the individuals had attempted to enter but were denied access to mental or behavioral health or substance use treatment; (vi) whether the individuals had received past treatment for a substance overdose; and (vii) whether any individuals had been previously detained, committed or incarcerated and, if so, whether they had received treatment and treatment type during the detention, commitment or incarceration.
The reports shall be filed with the clerks of the house of representatives and senate, the house and senate committees on ways and means, the chairs of the joint committee on mental health, substance use and recovery, the chairs of the joint committee on public health and the chairs of the joint committee on health care financing.