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General Assembly Substitute Bill No. 1057
January Session, 2019
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 administered has already received 16
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 Substitute Bill No. 1057
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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 medical condition characterized 42
by a problematic pattern of opioid use and misuse leading to clinically 43
significant impairment or distress; and 44
(3) "Opioid antagonist" means naloxone hydrochloride or any other 45
similarly acting and equally safe drug approved by the federal Food 46
and Drug Administration for the treatment of a drug overdose. 47
(b) A treatment program that provides treatment or detoxification 48
services to any person with an opioid use disorder shall (1) educate 49
such person regarding opioid antagonists and the administration 50 Substitute Bill No. 1057
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thereof at the time such person is admitted to or first receives services 51
from such program, (2) offer education regarding opioid antagonists 52
and the administration thereof to the relatives and significant other of 53
such person if the relatives and significant other have been identified 54
by such person, and (3) if there is a prescribing practitioner affiliated 55
with such program who determines that such person would benefit 56
from access to an opioid antagonist, issue a prescription for or deliver 57
to such person at least one dose of an opioid antagonist at the time 58
such person is admitted to or first receives treatment services from 59
such program. 60
Sec. 4. Section 20-206mm of the general statutes is repealed and the 61
following is substituted in lieu thereof (Effective October 1, 2019): 62
(a) Except as provided in subsections (b) and (c) of this section, an 63
applicant for a license as a paramedic shall submit evidence 64
satisfactory to the Commissioner of Public Health that the applicant 65
has successfully (1) completed a paramedic training program 66
approved by the commissioner, [and] (2) for applicants applying on 67
and after January 1, 2020, completed mental health first aid training as 68
part of a program approved by the Department of Public Health, and 69
(3) passed an examination prescribed by the commissioner. 70
(b) An applicant for licensure by endorsement shall present 71
evidence satisfactory to the commissioner that the applicant (1) is 72
licensed or certified as a paramedic in another state or jurisdiction 73
whose requirements for practicing in such capacity are substantially 74
similar to or higher than those of this state and that the applicant has 75
no pending disciplinary action or unresolved complaint against him or 76
her, or (2) (A) is currently licensed or certified as a paramedic in good 77
standing in any New England state, New York or New Jersey, (B) has 78
completed an initial training program consistent with the National 79
Emergency Medical Services Education Standards, as promulgated by 80
the National Highway Traffic Safety Administration for the paramedic 81
scope of practice model conducted by an organization offering a 82
program that is recognized by the national emergency medical services 83 Substitute Bill No. 1057
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program accrediting organization, [and] (C) for applicants applying on 84
or after January 1, 2020, has completed mental health first aid training 85
as part of a program approved by the Department of Public Health, 86
and (D) has no pending disciplinary action or unresolved complaint 87
against him or her. 88
(c) Any person who is certified as an emergency medical technician-89
paramedic by the Department of Public Health on October 1, 1997, 90
shall be deemed a licensed paramedic. Any person so deemed shall 91
renew his license pursuant to section 19a-88 for a fee of one hundred 92
fifty dollars. 93
(d) The commissioner may issue an emergency medical technician 94
certificate, emergency medical responder certificate or advanced 95
emergency medical technician certificate to an applicant who presents 96
evidence satisfactory to the commissioner that the applicant (1) is 97
currently certified as an emergency medical technician, emergency 98
medical responder, or advanced emergency medical technician in good 99
standing in any New England state, New York or New Jersey, (2) has 100
completed an initial training program consistent with the National 101
Emergency Medical Services Education Standards, as promulgated by 102
the National Highway Traffic Safety Administration for the emergency 103
medical technician, emergency medical responder curriculum, or 104
advanced emergency medical technician, [and] (3) for applicants 105
applying on and after January 1, 2020, has completed mental health 106
first aid training as part of a program approved by the Department of 107
Public Health, and (4) has no pending disciplinary action or 108
unresolved complaint against him or her. 109
(e) An emergency medical responder, emergency medical 110
technician, advanced emergency medical technician or emergency 111
medical services instructor shall be recertified every three years. For 112
the purpose of maintaining an acceptable level of proficiency, each 113
emergency medical technician who is recertified for a three-year 114
period shall complete thirty hours of refresher training approved by 115
the commissioner or meet such other requirements as may be 116 Substitute Bill No. 1057
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prescribed by the commissioner. The refresher training or other 117
requirements shall include, but not be limited to, training in 118
Alzheimer's disease and dementia symptoms and care. 119
(f) The commissioner may issue a temporary emergency medical 120
technician certificate to an applicant who presents evidence 121
satisfactory to the commissioner that (1) the applicant was certified by 122
the department as an emergency medical technician prior to becoming 123
licensed as a paramedic pursuant to section 20-206ll, or (2) the 124
applicant's certification as an emergency medical technician has 125
expired and the applicant's license as a paramedic has become void 126
pursuant to section 19a-88. Such temporary certificate shall be valid for 127
a period not to exceed one year and shall not be renewable. 128
(g) An applicant who is issued a temporary emergency medical 129
technician certificate pursuant to subsection (f) of this section may, 130
prior to the expiration of such temporary certificate, apply to the 131
department for: (1) Renewal of such person's paramedic license, giving 132
such person's name in full, such person's residence and business 133
address and such other information as the department requests, 134
provided the application for license renewal is accompanied by 135
evidence satisfactory to the commissioner that the applicant was under 136
the medical oversight of a sponsor hospital, as those terms are defined 137
in section 19a-175, on the date the applicant's paramedic license 138
became void for nonrenewal; or (2) recertification as an emergency 139
medical technician, provided the application for recertification is 140
accompanied by evidence satisfactory to the commissioner that the 141
applicant completed emergency medical technician refresher training 142
approved by the commissioner not later than one year after issuance of 143
the temporary emergency medical technician certificate. The 144
department shall recertify such person as an emergency medical 145
technician without the examination required for initial certification 146
specified in regulations adopted by the commissioner pursuant to 147
section 20-206oo. 148
(h) The commissioner may issue an emergency medical responder, 149 Substitute Bill No. 1057
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emergency medical technician or advanced emergency medical 150
technician certificate to an applicant for certification by endorsement 151
who presents evidence satisfactory to the commissioner that the 152
applicant (1) is currently certified as an emergency medical responder, 153
emergency medical technician or advanced emergency medical 154
technician in good standing by a state that maintains licensing 155
requirements that the commissioner determines are equal to, or greater 156
than, those in this state, (2) has completed an initial [department-157
approved] emergency medical responder, emergency medical 158
technician or advanced emergency medical technician training 159
program approved by the Department of Public Health that includes 160
written and practical examinations at the completion of the course, or a 161
program outside the state that adheres to national education standards 162
for the emergency medical responder, emergency medical technician 163
or advanced emergency medical technician scope of practice and that 164
includes an examination, [and] (3) for applicants applying on or after 165
January 1, 2020, has completed mental health first aid training as part 166
of a training program approved by the Department of Public Health, 167
and (4) has no pending disciplinary action or unresolved complaint 168
against him or her. 169
(i) The commissioner may issue an emergency medical service 170
instructor certificate to an applicant who presents (1) evidence 171
satisfactory to the commissioner that the applicant is currently certified 172
as an emergency medical technician in good standing, (2) 173
documentation satisfactory to the commissioner, with reference to 174
national education standards, regarding qualifications as an 175
emergency medical service instructor, (3) a letter of endorsement 176
signed by two instructors holding current emergency medical service 177
instructor certification, (4) documentation of having completed written 178
and practical examinations as prescribed by the commissioner, and (5) 179
evidence satisfactory to the commissioner that the applicant has no 180
pending disciplinary action or unresolved complaints against him or 181
her. 182 Substitute Bill No. 1057
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(j) Any person certified as an emergency medical responder, 183
emergency medical technician, advanced emergency medical 184
technician or emergency medical services instructor pursuant to this 185
chapter and the regulations adopted pursuant to section 20-206oo 186
whose certification has expired may apply to the Department of Public 187
Health for reinstatement of such certification as follows: (1) If such 188
certification expired one year or less from the date of the application 189
for reinstatement, such person shall complete the requirements for 190
recertification specified in regulations adopted pursuant to section 20-191
206oo; (2) if such recertification expired more than one year but less 192
than three years from the date of application for reinstatement, such 193
person shall complete the training required for recertification and the 194
examination required for initial certification specified in regulations 195
adopted pursuant to section 20-206oo; or (3) if such certification 196
expired three or more years from the date of application for 197
reinstatement, such person shall complete the requirements for initial 198
certification set forth in this section. Any certificate issued pursuant to 199
this section shall remain valid for ninety days after the expiration date 200
of such certificate and become void upon the expiration of such ninety-201
day period. 202
(k) The Commissioner of Public Health shall issue an emergency 203
medical technician certification to an applicant who is a member of the 204
armed forces or the National Guard or a veteran and who (1) presents 205
evidence satisfactory to the commissioner that such applicant holds a 206
current certification as a person entitled to perform similar services 207
under a different designation by the National Registry of Emergency 208
Medical Technicians, or (2) satisfies the regulations promulgated 209
pursuant to subdivision (4) of subsection (a) of section 19a-179. Such 210
applicant shall be exempt from any written or practical examination 211
requirement for certification. 212
(l) For the purposes of this section, "veteran" means any person who 213
was discharged or released under conditions other than dishonorable 214
from active service in the armed forces and "armed forces" has the 215 Substitute Bill No. 1057
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same meaning as provided in section 27-103. 216
Sec. 5. Section 19a-127q of the general statutes is repealed and the 217
following is substituted in lieu thereof (Effective October 1, 2019): 218
(a) On and after January 1, 2019, any hospital licensed pursuant to 219
chapter 368v or emergency medical services personnel, as defined in 220
section 20-206jj, that treats a patient for an overdose of an opioid drug, 221
as defined in section 20-14o, shall report such overdose to the 222
Department of Public Health in a form and manner prescribed by the 223
Commissioner of Public Health. 224
(b) On and after January 1, 2020, any hospital licensed pursuant to 225
chapter 368v that treats a patient for a nonfatal overdose of an opioid 226
drug, as defined in section 20-14o, shall administer a mental health 227
screening or assessment of the patient and provide the results of such 228
screening or assessment to the patient, or, (1) if the patient is mentally 229
incapacitated, to the patient's guardian or legal representative, or (2) if 230
the patient is a minor, to the patient's parent or guardian. 231
[(b)] (c) On or before January 1, 2020, the Department of Public 232
Health shall provide the data reported pursuant to subsection (a) of 233
this section to the municipal health department or district department 234
of health that has jurisdiction over the location in which such overdose 235
occurred, or, if such location is unknown, the location in which the 236
hospital or emergency medical services personnel treated the patient, 237
as the department, in its discretion, deems necessary to develop 238
preventive initiatives. 239
[(c)] (d) Data reported to the Department of Public Health by a 240
hospital or emergency medical services personnel shall at all times 241
remain confidential pursuant to section 19a-25. 242
Sec. 6. Subsection (a) of section 20-633c of the general statutes is 243
repealed and the following is substituted in lieu thereof (Effective from 244
passage): 245 Substitute Bill No. 1057
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(a) A person who is licensed as a pharmacist under part II of this 246
chapter and is certified in accordance with subsection (b) of this section 247
may prescribe, in good faith, an opioid antagonist, as defined in 248
section 17a-714a. Such pharmacist shall (1) provide appropriate 249
training regarding the administration of such opioid antagonist to the 250
person to whom the opioid antagonist is [dispensed] delivered, and (2) 251
maintain a record of [such] the dispensing and delivering of the opioid 252
antagonist and the training required pursuant to this chapter. 253
Sec. 7. Subsection (a) of section 20-633d of the general statutes is 254
repealed and the following is substituted in lieu thereof (Effective from 255
passage): 256
(a) A prescribing practitioner, as defined in section 20-14c, who is 257
authorized to prescribe an opioid antagonist, as defined in section 17a-258
714a, and a pharmacy may enter into an agreement for a medical 259
protocol standing order at such pharmacy allowing a pharmacist 260
licensed under part II of this chapter to dispense an opioid antagonist 261
that is (1) administered by an intranasal application delivery system or 262
an auto-injection delivery system, (2) approved by the federal Food 263
and Drug Administration, and (3) [dispensed] delivered to any person 264
at risk of experiencing an overdose of an opioid drug, as defined in 42 265
CFR 8.2, or to a family member, friend or other person in a position to 266
assist a person at risk of experiencing an overdose of an opioid drug. 267
Sec. 8. Subsection (d) of section 20-633d of the general statutes is 268
repealed and the following is substituted in lieu thereof (Effective from 269
passage): 270
(d) A pharmacist who dispenses an opioid antagonist pursuant to a 271
medical protocol standing order shall (1) provide appropriate training 272
regarding the administration of such opioid antagonist to the person to 273
whom the opioid antagonist is [dispensed] delivered, (2) maintain a 274
record of such dispensing and delivering and the training required 275
pursuant to this chapter, and (3) send a copy of the record of such 276
dispensing and delivering to the prescribing practitioner who entered 277 Substitute Bill No. 1057
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into an agreement for a medical protocol standing order with the 278
pharmacy. 279
Sec. 9. Subdivision (7) of subsection (a) of section 20-74s of the 280
general statutes is repealed and the following is substituted in lieu 281
thereof (Effective from passage): 282
(7) "Supervision" means the regular on-site observation, by a 283
licensed alcohol and drug counselor or other licensed [mental] 284
behavioral health professional whose scope of practice includes the 285
screening, assessment, diagnosis and treatment of substance use 286
disorders and co-occurring disorders, of the functions and activities of 287
an alcohol and drug counselor in the performance of his or her duties 288
and responsibilities to include a review of the records, reports, 289
treatment plans or recommendations with respect to an individual or 290
group; 291
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)
PH Joint Favorable Subst.