HB 7395

Version: Raised+Bill+R00+HB
Author: Judiciary Committee

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Referred to Committee on JUDICIARY

Introduced by: (JUD)

AN ACT CONCERNING OPIOID ABUSE AND TREATMENT.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

6collect, by electronic means, prescription information for schedules II,

7III, IV and V controlled substances and any opioid antagonist, as

8 defined in section 17a-714a, that are dispensed by pharmacies,

9nonresident pharmacies, as defined in section 20-627, outpatient

10pharmacies in hospitals or institutions or by any other dispenser. The

11program shall be designed to provide information regarding the

12prescription of controlled substances in order to prevent the improper

13or illegal use of the controlled substances and shall not infringe on the

14legitimate prescribing of a controlled substance by a prescribing

15practitioner acting in good faith and in the course of professional

16practice.

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17(2) The commissioner may identify other products or substances to

18be included in the electronic prescription drug monitoring program

19established pursuant to subdivision (1) of this subsection.

20(3) Prior to July 1, 2016, each pharmacy, nonresident pharmacy, as

21defined in section 20-627, outpatient pharmacy in a hospital or

22institution and dispenser shall report to the commissioner, at least

23weekly, by electronic means or, if a pharmacy or outpatient pharmacy

24does not maintain records electronically, in a format approved by the

25commissioner, the following information for all controlled substance

26prescriptions dispensed by such pharmacy or outpatient pharmacy:

27(A) Dispenser identification number; (B) the date the prescription for

28the controlled substance was filled; (C) the prescription number; (D)

29whether the prescription for the controlled substance is new or a refill;

30(E) the national drug code number for the drug dispensed; (F) the

31amount of the controlled substance dispensed and the number of days'

32supply of the controlled substance; (G) a patient identification number;

33(H) the patient's first name, last name and street address, including

34 postal code; (I) the date of birth of the patient; (J) the date the

35prescription for the controlled substance was issued by the prescribing

36practitioner and the prescribing practitioner's Drug Enforcement

37Agency's identification number; and (K) the type of payment.

38(4) (A) Except as provided in this subdivision, on and after July 1,

392016, each pharmacy, nonresident pharmacy, as defined in section 20-

40627, outpatient pharmacy in a hospital or institution, and dispenser

41shall report to the commissioner by electronic means, in a format

42approved by the commissioner, the following information for all

43controlled substance prescriptions dispensed by such pharmacy or

44outpatient pharmacy immediately upon, but in no event later than the

45next business day after, dispensing such prescriptions: (i) Dispenser

46identification number; (ii) the date the prescription for the controlled

47substance or opioid antagonist was filled; (iii) the prescription number;

48(iv) whether the prescription for the controlled substance or opioid

49antagonist is new or a refill; (v) the national drug code number for the

50drug dispensed; (vi) the amount of the controlled substance or opioid

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51antagonist dispensed and the number of days' supply of the controlled

52substance or uses of the opioid antagonist; (vii) a patient identification

53number; (viii) the patient's first name, last name and street address,

54including postal code; (ix) the date of birth of the patient; (x) the date

55the prescription for the controlled substance or opioid antagonist was

56issued by the prescribing practitioner and the prescribing practitioner's

57Drug Enforcement Agency's identification number; and (xi) the type of

58payment.

59(B) If the electronic prescription drug monitoring program is not

60operational, such pharmacy or dispenser shall report the information

61described in this subdivision not later than the next business day after

62regaining access to such program. For purposes of this subdivision,

63"business day" means any day during which the pharmacy is open to

64the public.

65(C) Each veterinarian, licensed pursuant to chapter 384, who

66dispenses a controlled substance prescription shall report to the

67commissioner the information described in subparagraph (A) of this

68subdivision, at least weekly, by electronic means or, if the veterinarian

69does not maintain records electronically, in a format approved by the

70commissioner.

71(5) The commissioner may contract with a vendor for purposes of

72electronically collecting such controlled substance or opioid antagonist

73prescription information. The commissioner and any such vendor shall

74maintain the information in accordance with the provisions of chapter

75400j.

76(6) The commissioner and any such vendor shall not disclose

77controlled substance or opioid antagonist prescription information

78reported pursuant to subdivisions (3) and (4) of this subsection, except

79as authorized pursuant to the provisions of sections 21a-240 to 21a-283,

80inclusive. Any person who knowingly violates any provision of this

81subdivision or subdivision (5) of this subsection shall be guilty of a

82class D felony.

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83(7) The commissioner shall provide, upon request, controlled

84substance or opioid antagonist prescription information obtained in

85accordance with subdivisions (3) and (4) of this subsection to the

86following: (A) The prescribing practitioner or such practitioner's

87authorized agent, who is treating or has treated a specific patient,

88provided the information is obtained for purposes related to the

89treatment of the patient, including the monitoring of controlled

90substances or opioid antagonist obtained by the patient; (B) the

91prescribing practitioner with whom a patient has made contact for the

92purpose of seeking medical treatment or such practitioner's authorized

93agent, provided the request is accompanied by a written consent,

99management of the patient's drug therapy, including the monitoring of

100controlled substances or opioid antagonists obtained by the patient.

101The prescribing practitioner, such practitioner's authorized agent, or

102the pharmacist shall submit a written and signed request to the

103 commissioner for controlled substance or opioid antagonist

104prescription information. Such prescribing practitioner or pharmacist

105shall not disclose any such request except as authorized pursuant to

106sections 20-570 to 20-630, inclusive, or sections 21a-240 to 21a-283,

107inclusive.

108(8) No person or employer shall prohibit, discourage or impede a

109prescribing practitioner or pharmacist from requesting controlled

110substance or opioid antagonist prescription information pursuant to

111this subsection.

112(9) Prior to prescribing greater than a seventy-two-hour supply of

113any controlled substance to any patient, the prescribing practitioner or

114such practitioner's authorized agent shall review the patient's records

115in the electronic prescription drug monitoring program established

116pursuant to this subsection. Whenever a prescribing practitioner

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117prescribes a controlled substance, other than a schedule V nonnarcotic

118controlled substance, for the continuous or prolonged treatment of any

119patient, such prescriber, or such prescriber's authorized agent, shall

120review, not less than once every ninety days, the patient's records in

121such prescription drug monitoring program. Whenever a prescribing

122practitioner prescribes a schedule V nonnarcotic controlled substance,

123for the continuous or prolonged treatment of any patient, such

124prescribing practitioner, or such prescribing practitioner's authorized

125agent, shall review, not less than annually, the patient's records in such

126prescription drug monitoring program. If such electronic prescription

127drug monitoring program is not operational, such prescribing

128practitioner may prescribe greater than a seventy-two-hour supply of a

129controlled substance to a patient during the time of such program's

130 inoperability, provided such prescribing practitioner or such

131authorized agent reviews the records of such patient in such program

132not more than twenty-four hours after regaining access to such

133program.

134(10) (A) A prescribing practitioner may designate an authorized

135agent to review the electronic prescription drug monitoring program

136and patient controlled substance or opioid antagonist prescription

137information on behalf of the prescribing practitioner. The prescribing

138practitioner shall ensure that any authorized agent's access to such

139program and patient controlled substance or opioid antagonist

140prescription information is limited to the purposes described in this

141section and occurs in a manner that protects the confidentiality of

142information that is accessed through such program. The prescribing

143practitioner and any authorized agent shall be subject to the provisions

144of 45 CFR 164.308, as amended from time to time, concerning

145administrative safeguards for the protection of electronic protected

146health information. A prescribing practitioner may receive disciplinary

147action for acts of the authorized agent as provided in section 21a-322.

148(B) Notwithstanding the provisions of subparagraph (A) of this

149subdivision, a prescribing practitioner who is employed by or provides

150professional services to a hospital shall, prior to designating an

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151authorized agent to review the electronic prescription drug monitoring

152program and patient controlled substance prescription or opioid

153antagonist information on behalf of the prescribing practitioner, (i)

154submit a request to designate one or more authorized agents for such

155purposes and a written protocol for oversight of the authorized agent

156or agents to the commissioner, in the form and manner prescribed by

157the commissioner, and (ii) receive the commissioner's approval to

158designate such authorized agent or agents and of such written

159protocol. Such written protocol shall designate either the hospital's

160medical director, a hospital department head, who is a prescribing

161 practitioner, or another prescribing practitioner as the person

162responsible for ensuring that the authorized agent's or agents' access to

163such program and patient controlled substance or opioid antagonist

164prescription information is limited to the purposes described in this

165section and occurs in a manner that protects the confidentiality of

166information that is accessed through such program. A hospital medical

167director, a hospital department head, who is a prescribing practitioner,

168 or another prescribing practitioner designated as the person

169responsible for overseeing an authorized agent's or agents' access to

170such program and information in the written protocol approved by the

171 commissioner may receive disciplinary action for acts of the

172authorized agent or agents as provided in section 21a-322. The

173commissioner may inspect hospital records to determine compliance

174with written protocols approved in accordance with this section.

175(11) The commissioner shall adopt regulations, in accordance with

176chapter 54, concerning the reporting, evaluation, management and

177storage of electronic controlled substance or opioid antagonist

178prescription information.

179(12) The provisions of this section shall not apply to (A) samples of

180controlled substances dispensed by a physician to a patient, or (B) any

181controlled substances dispensed to hospital inpatients.

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184facility, licensed under section 19a-495 and regulations adopted

185pursuant to said section 19a-495, that dispenses or administers directly

186to a patient an opioid agonist for treatment of a substance use disorder.

187(14) The commissioner may provide controlled substance or opioid

188antagonist prescription information obtained in accordance with

189subdivisions (3) and (4) of this subsection to other state agencies,

190pursuant to an agreement between the commissioner and the head of

191such agency, provided the information is obtained for a study of

192disease prevention and control related to opioid abuse or the study of

193morbidity and mortality caused by overdoses of controlled substances

194or opioid antagonist. The provision of such information shall be in

195accordance with all applicable state and federal confidentiality

196requirements.

197Sec. 2. (NEW) (Effective October 1, 2019) Not later than forty-five

198days before the scheduled release of an inmate from the custody of the

199Commissioner of Correction, including release subject to parole or

200supervised community setting, the commissioner shall provide each

201inmate suffering from opioid use disorder, or at risk of developing or

202relapsing into an opioid use disorder, information and counseling

203regarding treatment options, including accessing such options after

204being released into the community.

205Sec. 3. (NEW) (Effective July 1, 2019) (a) On or before January 1, 2020,

206the Department of Correction, in consultation with the Departments of

207Public Health and Mental Health and Addiction Services, shall

208establish a medication-assisted treatment program in correctional

209facilities for inmates with opioid use disorder. During the first year of

210operation, at least five correctional facilities shall participate in the

211program. During the second year of operation, at least thirty per cent

212of all inmates in correctional facilities shall have access to the program.

213During the third year of operation, at least sixty per cent of all inmates

214in correctional facilities shall have access to the program. During the

215fourth year and for each subsequent year of operation, one hundred

216per cent of all inmates in correctional facilities shall have access to the

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217program.

218(b) Correctional facilities that participate in the program shall (1)

219establish procedures that enable qualified correctional staff to dispense

220and administer all drugs approved by the federal Food and Drug

221Administration for use in medication-assisted treatment of opioid use

222disorder, and (2) make such treatment available under the program to

223any inmate for whom such treatment is found to be appropriate by a

224qualified, licensed health care provider. The program shall ensure that

225an inmate who has been receiving medication-assisted treatment for

226opioid use disorder immediately preceding the inmate's incarceration

227shall continue such treatment while incarcerated unless the inmate

228voluntarily discontinues such treatment or a qualified, licensed health

229care provider determines that such treatment is no longer appropriate.

230To the extent practicable, the Department of Correction shall prioritize

231placement of inmates who have been receiving medication-assisted

232treatment for opioid use disorder immediately preceding their

233incarceration in a correctional facility that provides access to the

234program.

235(c) Not later than November 1, 2020, and annually thereafter until

236November 1, 2024, the Commissioner of Correction shall report to the

237Governor and, in accordance with the provisions of section 11-4a of the

238general statutes, to the joint standing committees of the General

239Assembly having cognizance of matters relating to public health and

240the judiciary:

241(1) The cost of the program in the prior year;

242(2) The projected cost associated with expanding the program to

243additional correctional facilities for the following year;

244(3) A summary of changes to correctional facility practices related to

245implementation of the program;

246(4) The type and prevalence of medication-assisted treatment

247provided under the program; and

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248 (5) The number of inmates who (A) received medication-assisted 249 treatment under the program, (B) voluntarily discontinued

250medication-assisted treatment, and (C) requested but did not receive

251medication-assisted treatment.

This act shall take effect as follows and shall amend the following sections:

Statement of Purpose:

To add opioid antagonists to drugs monitored as part of the electronic prescription drug monitoring program, to require counseling for inmates vulnerable to opioid use disorder counseling prior to release from a correctional facility and to establish a medication-assisted treatment program in correctional facilities for inmates with opioid use disorder.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]