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The 190th General Court of the Commonwealth of Massachusetts

Section 511/2: Substance abuse evaluation and treatment for acute-care hospital or satellite emergency facility patient experiencing opiate-related overdose

[ Text of section added by 2016, 52, Sec. 32 as amended by 2016, 133, Sec. 138 effective July 1, 2016. See 2016, 52, Sec. 71 and 2016, 133, Sec. 203.]

  Section 51 1/2. (a) For the purposes of this section, the following words shall have the following meanings:-

  "Acute-care hospital'', any hospital licensed under section 51 that contains a majority of medical-surgical, pediatric, obstetric, and maternity beds, as defined by the department and the teaching hospital of the University of Massachusetts Medical School.

  "Licensed mental health professional'', a licensed physician who specializes in the practice of psychiatry or addiction medicine, a licensed psychologist, a licensed independent social worker, a licensed mental health counselor, a licensed psychiatric clinical nurse specialist or a licensed alcohol and drug counselor I as defined in section 1 of chapter 111J.

  "Satellite emergency facility'', a health care facility that operates on a 7-day per week, 24-hour per day basis that is located off the premises of a hospital, but is listed on the license of a hospital, and is authorized to accept patients transported to the facility by ambulance.

  "Substance abuse evaluation'', an evaluation ordered pursuant to subsection (b) that is conducted by a licensed mental health professional or through an emergency services program, which shall include, but not be limited to, the following information: (1) history of the patient's use of alcohol, tobacco and other drugs, including age of onset, duration, patterns and consequences of use; (2) the use of alcohol, tobacco and other drugs by family members; (3) types of and responses to previous treatment for substance use disorders or other psychological disorders; (4) an assessment of the patient's psychological status including co-occurring disorders, trauma history and history of compulsive behaviors; and (4) an assessment of the patient's human immunodeficiency virus, hepatitis C, and tuberculosis risk status.

  (b) A person presenting in an acute-care hospital or a satellite emergency facility who is reasonably believed by the treating clinician to be experiencing an opiate-related overdose, or who has been administered naloxone prior to arriving at the hospital or facility, shall receive a substance abuse evaluation within 24 hours of receiving emergency room services. A substance abuse evaluation shall conclude with a diagnosis of the status and nature of the patient's substance use disorder, using standardized definitions as set forth in the Diagnostic and Statistical Manual of Mental Disorders as published by the American Psychiatric Association a diagnosis of a mental or behavioral disorder due to the use of psychoactive substances, as defined and coded by the World Health Organization. Each patient shall be presented with the findings of the evaluation in person and in writing, and the findings shall include recommendations for further treatment, if necessary, with an assessment of the appropriate level of care needed. Findings from the evaluation shall be entered into the patient's medical record. No acute-care hospital or satellite emergency facility shall permit early discharge, defined as less than 24 hours after presentation or before the conclusion of a substance abuse evaluation, whichever occurs sooner. If a patient does not receive an evaluation within 24 hours, the treating clinician shall note in the medical record the reason the evaluation did not take place and authorize the discharge of the patient. No clinician shall be held liable in a civil suit for releasing a patient who does not wish to remain in the emergency department after stabilization, but before a substance abuse evaluation has taken place.

  (c) After a substance abuse evaluation has been completed pursuant to subsection (b) a patient may consent to further treatment. Treatment may occur within the acute-care hospital or satellite emergency facility, if appropriate services are available; provided, however, that if the hospital or satellite emergency facility is unable to provide such services, the hospital or satellite emergency facility shall refer the patient to treatment center outside of the hospital or satellite emergency facility. Medical necessity for further treatment shall be determined by the treating clinician in consultation with the patient and noted in the medical record. If a patient refuses further treatment after the evaluation is complete, and is otherwise medically stable, the hospital or satellite emergency facility may initiate discharge proceedings. All patients receiving an evaluation under subsection (b) shall receive, upon discharge, information on local and statewide treatment options, providers and other relevant information as deemed appropriate by the treating clinician.

  (d) If a person has received a substance abuse evaluation within the past 3 months, further treatment and the need for a further evaluation shall be determined by the treating clinician according to best practices and procedures.

  (e) If a person under 18 years of age is ordered to undergo a substance abuse evaluation, a parent or guardian shall be notified that the minor has suffered from an opiate-related overdose and that an evaluation has been ordered. A parent or guardian may be present when the findings of the evaluation are presented to the minor.

  (f) Upon discharge of a patient who experienced an opiate-related overdose, the acute-care hospital or satellite emergency facility shall notify the patient's primary care physician, if known, of the opiate-related overdose and any recommendations for further treatment.

  (g) Upon discharge of a patient who experienced an opiate-related overdose, the acute-care hospital or satellite emergency facility shall record the opiate-related overdose on the patient's electronic medical record.

  (h) Nothing in this section shall interfere with an individual's right to refuse medical care.

  (i) The department of public health shall annually collect, in a manner to be determined by the department, the frequency and location of substance abuse evaluations ordered pursuant to this section. The department shall report such information to the joint committee on health care financing, the joint committee on mental health and substance abuse and the house and senate committees on ways and means not later than January 1, annually.