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General Assembly Raised Bill No. 1057
January Session, 2019
LCO No. 5456
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT CONCERNING OP IOID USE DISORDER.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective July 1, 2019) (a) Not later than January 1, 1
2020, the president of each institution of higher education in the state 2
shall (1) develop and implement a policy consistent with this section 3
concerning the availability and use of opioid antagonists, as defined in 4
section 17a-714 of the general statutes, by students and employees of 5
the institution, and (2) post such policy on its Internet web site. 6
(b) Each institution of higher education shall (1) provide and 7
maintain a supply of opioid antagonists on each of its campuses in a 8
central location, (2) make such central location known and accessible to 9
students and employees of such institution during all hours, (3) 10
maintain the supply of opioid antagonists in accordance with the 11
manufacturer's guidelines, and (4) notify a local emergency medical 12
services provider as soon as practicable after each use of an opioid 13
antagonist on the institution's campus that is reported to the institution 14
or observed by an employee of the institution, unless the person to 15
whom the opioid antagonist was administer has already received 16 Raised Bill No. 1057
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medical treatment for his or her opioid-related drug overdose. 17
Sec. 2. (Effective July 1, 2019) The Department of Mental Health and 18
Addiction Services, in collaboration with the Department of Social 19
Services, shall study the efficacy of establishing a community-based 20
opioid use disorder treatment program that uses one or more home 21
health agencies, as defined in section 19a-490 of the general statutes, to 22
provide medication-assisted treatment, as defined in section 19a-906 of 23
the general statutes, to any Medicaid recipient who presents to an 24
emergency department as a result of a suspected opioid drug overdose 25
or with a primary or secondary opioid use disorder diagnosis and a 26
moderate to severe risk of relapse and the potential for continued use 27
of an opioid drug, as determined by an emergency department 28
physician. On or before January 1, 2020, the Commissioner of Mental 29
Health and Addiction Services shall report, in accordance with the 30
provisions of section 11-4a of the general statutes, to the joint standing 31
committees of the General Assembly having cognizance of matters 32
related to public health and human services on the outcome of such 33
study. 34
Sec. 3. (NEW) (Effective October 1, 2019) (a) As used in this section: 35
(1) "Treatment program" means a program operated by the 36
Department of Mental Health and Addiction Services or approved by 37
the Commissioner of Mental Health and Addiction Services for 38
treatment of the physical and psychological effects of drug 39
dependency or for the detoxification of a drug-dependent person, as 40
defined in section 17a-680 of the general statutes; 41
(2) "Opioid use disorder" means a problematic pattern of opioid use 42
leading to clinically significant impairment or distress; and 43
(3) "Opioid antagonist" means naloxone hydrochloride or any other 44
similarly acting and equally safe drug approved by the federal Food 45
and Drug Administration for the treatment of a drug overdose. 46
(b) A treatment program that provides treatment or detoxification 47 Raised Bill No. 1057
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services to any person with an opioid use disorder shall (1) educate 48
such person regarding opioid antagonists and the administration 49
thereof at the time such person is admitted to or first receives services 50
from such program, (2) offer education regarding opioid antagonists 51
and the administration thereof to the relatives and significant other of 52
such person if the relatives and significant other have been identified 53
by such person, and (3) if there is a prescribing practitioner affiliated 54
with such program who determines that such person would benefit 55
from access to an opioid antagonist, issue a prescription for or deliver 56
to such person at least one dose of an opioid antagonist at the time 57
such person is admitted to or first receives treatment services from 58
such program. 59
Sec. 4. Section 20-206mm of the general statutes is repealed and the 60
following is substituted in lieu thereof (Effective October 1, 2019): 61
(a) Except as provided in subsections (b) and (c) of this section, an 62
applicant for a license as a paramedic shall submit evidence 63
satisfactory to the Commissioner of Public Health that the applicant 64
has successfully (1) completed a paramedic training program 65
approved by the commissioner, [and] (2) for applicants applying on 66
and after January 1, 2020, completed mental health first aid training as 67
part of a program approved by the Department of Public Health, and 68
(3) passed an examination prescribed by the commissioner. 69
(b) An applicant for licensure by endorsement shall present 70
evidence satisfactory to the commissioner that the applicant (1) is 71
licensed or certified as a paramedic in another state or jurisdiction 72
whose requirements for practicing in such capacity are substantially 73
similar to or higher than those of this state and that the applicant has 74
no pending disciplinary action or unresolved complaint against him or 75
her, or (2) (A) is currently licensed or certified as a paramedic in good 76
standing in any New England state, New York or New Jersey, (B) has 77
completed an initial training program consistent with the National 78
Emergency Medical Services Education Standards, as promulgated by 79
the National Highway Traffic Safety Administration for the paramedic 80 Raised Bill No. 1057
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scope of practice model conducted by an organization offering a 81
program that is recognized by the national emergency medical services 82
program accrediting organization, [and] (C) for applicants applying on 83
or after January 1, 2020, has completed mental health first aid training 84
as part of a program approved by the Department of Public Health, 85
and (D) has no pending disciplinary action or unresolved complaint 86
against him or her. 87
(c) Any person who is certified as an emergency medical technician-88
paramedic by the Department of Public Health on October 1, 1997, 89
shall be deemed a licensed paramedic. Any person so deemed shall 90
renew his license pursuant to section 19a-88 for a fee of one hundred 91
fifty dollars. 92
(d) The commissioner may issue an emergency medical technician 93
certificate, emergency medical responder certificate or advanced 94
emergency medical technician certificate to an applicant who presents 95
evidence satisfactory to the commissioner that the applicant (1) is 96
currently certified as an emergency medical technician, emergency 97
medical responder, or advanced emergency medical technician in good 98
standing in any New England state, New York or New Jersey, (2) has 99
completed an initial training program consistent with the National 100
Emergency Medical Services Education Standards, as promulgated by 101
the National Highway Traffic Safety Administration for the emergency 102
medical technician, emergency medical responder curriculum, or 103
advanced emergency medical technician, [and] (3) for applicants 104
applying on and after January 1, 2020, has completed mental health 105
first aid training as part of a program approved by the Department of 106
Public Health, and (4) has no pending disciplinary action or 107
unresolved complaint against him or her. 108
(e) An emergency medical responder, emergency medical 109
technician, advanced emergency medical technician or emergency 110
medical services instructor shall be recertified every three years. For 111
the purpose of maintaining an acceptable level of proficiency, each 112
emergency medical technician who is recertified for a three-year 113 Raised Bill No. 1057
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period shall complete thirty hours of refresher training approved by 114
the commissioner or meet such other requirements as may be 115
prescribed by the commissioner. The refresher training or other 116
requirements shall include, but not be limited to, training in 117
Alzheimer's disease and dementia symptoms and care. 118
(f) The commissioner may issue a temporary emergency medical 119
technician certificate to an applicant who presents evidence 120
satisfactory to the commissioner that (1) the applicant was certified by 121
the department as an emergency medical technician prior to becoming 122
licensed as a paramedic pursuant to section 20-206ll, or (2) the 123
applicant's certification as an emergency medical technician has 124
expired and the applicant's license as a paramedic has become void 125
pursuant to section 19a-88. Such temporary certificate shall be valid for 126
a period not to exceed one year and shall not be renewable. 127
(g) An applicant who is issued a temporary emergency medical 128
technician certificate pursuant to subsection (f) of this section may, 129
prior to the expiration of such temporary certificate, apply to the 130
department for: (1) Renewal of such person's paramedic license, giving 131
such person's name in full, such person's residence and business 132
address and such other information as the department requests, 133
provided the application for license renewal is accompanied by 134
evidence satisfactory to the commissioner that the applicant was under 135
the medical oversight of a sponsor hospital, as those terms are defined 136
in section 19a-175, on the date the applicant's paramedic license 137
became void for nonrenewal; or (2) recertification as an emergency 138
medical technician, provided the application for recertification is 139
accompanied by evidence satisfactory to the commissioner that the 140
applicant completed emergency medical technician refresher training 141
approved by the commissioner not later than one year after issuance of 142
the temporary emergency medical technician certificate. The 143
department shall recertify such person as an emergency medical 144
technician without the examination required for initial certification 145
specified in regulations adopted by the commissioner pursuant to 146
section 20-206oo. 147 Raised Bill No. 1057
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(h) The commissioner may issue an emergency medical responder, 148
emergency medical technician or advanced emergency medical 149
technician certificate to an applicant for certification by endorsement 150
who presents evidence satisfactory to the commissioner that the 151
applicant (1) is currently certified as an emergency medical responder, 152
emergency medical technician or advanced emergency medical 153
technician in good standing by a state that maintains licensing 154
requirements that the commissioner determines are equal to, or greater 155
than, those in this state, (2) has completed an initial [department-156
approved] emergency medical responder, emergency medical 157
technician or advanced emergency medical technician training 158
program approved by the Department of Public Health that includes 159
written and practical examinations at the completion of the course, or a 160
program outside the state that adheres to national education standards 161
for the emergency medical responder, emergency medical technician 162
or advanced emergency medical technician scope of practice and that 163
includes an examination, [and] (3) for applicants applying on or after 164
January 1, 2020, has completed mental health first aid training as part 165
of a training program approved by the Department of Public Health, 166
and (4) has no pending disciplinary action or unresolved complaint 167
against him or her. 168
(i) The commissioner may issue an emergency medical service 169
instructor certificate to an applicant who presents (1) evidence 170
satisfactory to the commissioner that the applicant is currently certified 171
as an emergency medical technician in good standing, (2) 172
documentation satisfactory to the commissioner, with reference to 173
national education standards, regarding qualifications as an 174
emergency medical service instructor, (3) a letter of endorsement 175
signed by two instructors holding current emergency medical service 176
instructor certification, (4) documentation of having completed written 177
and practical examinations as prescribed by the commissioner, and (5) 178
evidence satisfactory to the commissioner that the applicant has no 179
pending disciplinary action or unresolved complaints against him or 180
her. 181 Raised Bill No. 1057
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(j) Any person certified as an emergency medical responder, 182
emergency medical technician, advanced emergency medical 183
technician or emergency medical services instructor pursuant to this 184
chapter and the regulations adopted pursuant to section 20-206oo 185
whose certification has expired may apply to the Department of Public 186
Health for reinstatement of such certification as follows: (1) If such 187
certification expired one year or less from the date of the application 188
for reinstatement, such person shall complete the requirements for 189
recertification specified in regulations adopted pursuant to section 20-190
206oo; (2) if such recertification expired more than one year but less 191
than three years from the date of application for reinstatement, such 192
person shall complete the training required for recertification and the 193
examination required for initial certification specified in regulations 194
adopted pursuant to section 20-206oo; or (3) if such certification 195
expired three or more years from the date of application for 196
reinstatement, such person shall complete the requirements for initial 197
certification set forth in this section. Any certificate issued pursuant to 198
this section shall remain valid for ninety days after the expiration date 199
of such certificate and become void upon the expiration of such ninety-200
day period. 201
(k) The Commissioner of Public Health shall issue an emergency 202
medical technician certification to an applicant who is a member of the 203
armed forces or the National Guard or a veteran and who (1) presents 204
evidence satisfactory to the commissioner that such applicant holds a 205
current certification as a person entitled to perform similar services 206
under a different designation by the National Registry of Emergency 207
Medical Technicians, or (2) satisfies the regulations promulgated 208
pursuant to subdivision (4) of subsection (a) of section 19a-179. Such 209
applicant shall be exempt from any written or practical examination 210
requirement for certification. 211
(l) For the purposes of this section, "veteran" means any person who 212
was discharged or released under conditions other than dishonorable 213
from active service in the armed forces and "armed forces" has the 214
same meaning as provided in section 27-103. 215 Raised Bill No. 1057
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Sec. 5. Section 19a-127q of the general statutes is repealed and the 216
following is substituted in lieu thereof (Effective October 1, 2019): 217
(a) On and after January 1, 2019, any hospital licensed pursuant to 218
chapter 368v or emergency medical services personnel, as defined in 219
section 20-206jj, that treats a patient for an overdose of an opioid drug, 220
as defined in section 20-14o, shall report such overdose to the 221
Department of Public Health in a form and manner prescribed by the 222
Commissioner of Public Health. 223
(b) On and after January 1, 2020, any hospital licensed pursuant to 224
chapter 368v that treats a patient for a nonfatal overdose of an opioid 225
drug, as defined in section 20-14o, shall administer a mental health 226
screening or assessment of the patient and provide the results of such 227
screening or assessment to the patient, or, (1) if the patient is mentally 228
incapacitated, to the patient's guardian or legal representative, or (2) if 229
the patient is a minor, to the patient's parent or guardian. 230
[(b)] (c) On or before January 1, 2020, the Department of Public 231
Health shall provide the data reported pursuant to subsection (a) of 232
this section to the municipal health department or district department 233
of health that has jurisdiction over the location in which such overdose 234
occurred, or, if such location is unknown, the location in which the 235
hospital or emergency medical services personnel treated the patient, 236
as the department, in its discretion, deems necessary to develop 237
preventive initiatives. 238
[(c)] (d) Data reported to the Department of Public Health by a 239
hospital or emergency medical services personnel shall at all times 240
remain confidential pursuant to section 19a-25. 241
Sec. 6. Subsection (a) of section 20-633c of the general statutes is 242
repealed and the following is substituted in lieu thereof (Effective from 243
passage): 244
(a) A person who is licensed as a pharmacist under part II of this 245
chapter and is certified in accordance with subsection (b) of this section 246 Raised Bill No. 1057
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may prescribe, in good faith, an opioid antagonist, as defined in 247
section 17a-714a. Such pharmacist shall (1) provide appropriate 248
training regarding the administration of such opioid antagonist to the 249
person to whom the opioid antagonist is [dispensed] delivered, and (2) 250
maintain a record of [such] the dispensing and delivering of the opioid 251
antagonist and the training required pursuant to this chapter. 252
Sec. 7. Subsection (a) of section 20-633d of the general statutes is 253
repealed and the following is substituted in lieu thereof (Effective from 254
passage): 255
(a) A prescribing practitioner, as defined in section 20-14c, who is 256
authorized to prescribe an opioid antagonist, as defined in section 17a-257
714a, and a pharmacy may enter into an agreement for a medical 258
protocol standing order at such pharmacy allowing a pharmacist 259
licensed under part II of this chapter to dispense an opioid antagonist 260
that is (1) administered by an intranasal application delivery system or 261
an auto-injection delivery system, (2) approved by the federal Food 262
and Drug Administration, and (3) [dispensed] delivered to any person 263
at risk of experiencing an overdose of an opioid drug, as defined in 42 264
CFR 8.2, or to a family member, friend or other person in a position to 265
assist a person at risk of experiencing an overdose of an opioid drug. 266
Sec. 8. Subsection (d) of section 20-633d of the general statutes is 267
repealed and the following is substituted in lieu thereof (Effective from 268
passage): 269
(d) A pharmacist who dispenses an opioid antagonist pursuant to a 270
medical protocol standing order shall (1) provide appropriate training 271
regarding the administration of such opioid antagonist to the person to 272
whom the opioid antagonist is [dispensed] delivered, (2) maintain a 273
record of such dispensing and delivering and the training required 274
pursuant to this chapter, and (3) send a copy of the record of such 275
dispensing and delivering to the prescribing practitioner who entered 276
into an agreement for a medical protocol standing order with the 277
pharmacy. 278 Raised Bill No. 1057
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Sec. 9. Subdivision (7) of subsection (a) of section 20-74s of the 279
general statutes is repealed and the following is substituted in lieu 280
thereof (Effective from passage): 281
(7) "Supervision" means the regular on-site observation, by a 282
licensed alcohol and drug counselor or other licensed [mental] 283
behavioral health professional whose scope of practice includes the 284
screening, assessment, diagnosis and treatment of substance use 285
disorders and co-occurring disorders, of the functions and activities of 286
an alcohol and drug counselor in the performance of his or her duties 287
and responsibilities to include a review of the records, reports, 288
treatment plans or recommendations with respect to an individual or 289
group; 290
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2019 New section
Sec. 2 July 1, 2019 New section
Sec. 3 October 1, 2019 New section
Sec. 4 October 1, 2019 20-206mm
Sec. 5 October 1, 2019 19a-127q
Sec. 6 from passage 20-633c(a)
Sec. 7 from passage 20-633d(a)
Sec. 8 from passage 20-633d(d)
Sec. 9 from passage 20-74s(a)(7)
Statement of Purpose:
To combat opioid use disorder in the state.
[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.]