LCO No. 5876 1 of 7 General Assembly Raised Bill No. 1086 January Session, 2021 LCO No. 5876 Referred to Committee on PUBLIC HEALTH Introduced by: (PH) AN ACT CONCERNING ME NTAL AND BEHAVIORAL HEALTH SERVICES. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section 19a-14c of the general statutes is repealed and the 1 following is substituted in lieu thereof (Effective July 1, 2021): 2 (a) For the purposes of this section, "outpatient mental health 3 treatment" means the treatment of mental disorders, emotional 4 problems or maladjustments with the object of (1) removing, modifying 5 or retarding existing symptoms; (2) improving disturbed patterns of 6 behavior; and (3) promoting positive personality growth and 7 development. Treatment shall not include prescribing or otherwise 8 dispensing any medication which is a legend drug as defined in section 9 20-571. 10 (b) A psychiatrist licensed pursuant to chapter 370, a psychologist 11 licensed pursuant to chapter 383, an independent social worker certified 12 pursuant to chapter 383b or a marital and family therapist licensed 13 pursuant to chapter 383a may provide outpatient mental health 14 treatment to a minor without the consent or notification of a parent or 15 Raised Bill No. 1086 LCO No. 5876 2 of 7 guardian at the request of the minor if (1) requiring the consent or 16 notification of a parent or guardian would cause the minor to reject such 17 treatment; (2) the provision of such treatment is clinically indicated; (3) 18 the failure to provide such treatment would be seriously detrimental to 19 the minor's well-being; (4) the minor has knowingly and voluntarily 20 sought such treatment; and (5) in the opinion of the provider of 21 treatment, the minor is mature enough to participate in treatment 22 productively. The provider of such treatment shall document the 23 reasons for any determination made to treat a minor without the consent 24 or notification of a parent or guardian and shall include such 25 documentation in the minor's clinical record, along with a written 26 statement signed by the minor stating that (A) he is voluntarily seeking 27 such treatment; (B) he has discussed with the provider the possibility of 28 involving his parent or guardian in the decision to pursue such 29 treatment; (C) he has determined it is not in his best interest to involve 30 his parent or guardian in such decision; and (D) he has been given 31 adequate opportunity to ask the provider questions about the course of 32 his treatment. 33 [(c) After the sixth session of outpatient mental health treatment 34 provided to a minor pursuant to this section, the provider of such 35 treatment shall notify the minor that the consent, notification or 36 involvement of a parent or guardian is required to continue treatment, 37 unless such a requirement would be seriously detrimental to the minor's 38 well-being. If the provider determines such a requirement would be 39 seriously detrimental to the minor's well-being, he shall document such 40 determination in the minor's clinical record, review such determination 41 every sixth session thereafter and document each such review. If the 42 provider determines such a requirement would no longer be seriously 43 detrimental to the minor's well-being, he shall require the consent, 44 notification or involvement of a parent or guardian as a condition of 45 continuing treatment. No provider shall notify a parent or guardian of 46 treatment provided pursuant to this section or disclose any information 47 concerning such treatment to a parent or guardian without the consent 48 of the minor.] 49 Raised Bill No. 1086 LCO No. 5876 3 of 7 [(d)] (c) A parent or guardian who is not informed of the provision of 50 outpatient mental health treatment for his minor child pursuant to this 51 section shall not be liable for the costs of the treatment provided. 52 Sec. 2. (NEW) (Effective from passage) On and after October 1, 2021, 53 each physician licensed pursuant to chapter 370 of the general statutes, 54 physician assistant licensed pursuant to chapter 370 of the general 55 statutes and advanced practice registered nurse licensed pursuant to 56 chapter 378 of the general statutes shall perform a mental health 57 examination on a patient during the physician's annual physical 58 examination of the patient. 59 Sec. 3. (Effective from passage) (a) There is established a task force to 60 study the health benefits of psilocybin. Such study shall include, but 61 need not be limited to, an examination of whether the use of psilocybin 62 by a person under the direction of a health care provider may be 63 beneficial to the person's physical or mental well-being. As used in this 64 subsection, "psilocybin" means the chemical compound obtained from 65 certain types of hallucinogenic mushrooms that grow naturally in 66 regions of Europe, South America, Mexico and the United States. 67 (b) The task force shall consist of the following members: 68 (1) Two appointed by the speaker of the House of Representatives; 69 (2) Two appointed by the president pro tempore of the Senate; 70 (3) One appointed by the majority leader of the House of 71 Representatives; 72 (4) One appointed by the majority leader of the Senate; 73 (5) One appointed by the minority leader of the House of 74 Representatives; 75 (6) One appointed by the minority leader of the Senate; 76 (7) The Commissioner of Mental Health and Addiction Services, or 77 Raised Bill No. 1086 LCO No. 5876 4 of 7 the commissioner's designee; and 78 (8) The Commissioner of Public Health, or the commissioner's 79 designee. 80 (c) Any member of the task force appointed under subdivision (1), 81 (2), (3), (4), (5) or (6) of subsection (b) of this section may be a member 82 of the General Assembly. 83 (d) All initial appointments to the task force shall be made not later 84 than thirty days after the effective date of this section. Any vacancy shall 85 be filled by the appointing authority. 86 (e) The speaker of the House of Representatives and the president pro 87 tempore of the Senate shall select the chairpersons of the task force from 88 among the members of the task force. Such chairpersons shall schedule 89 the first meeting of the task force, which shall be held not later than sixty 90 days after the effective date of this section. 91 (f) The administrative staff of the joint standing committee of the 92 General Assembly having cognizance of matters relating to public 93 health shall serve as administrative staff of the task force. 94 (g) Not later than January 1, 2022, the task force shall submit a report 95 on its findings and recommendations to the joint standing committee of 96 the General Assembly having cognizance of matters relating to public 97 health, in accordance with the provisions of section 11-4a of the general 98 statutes. The task force shall terminate on the date that it submits such 99 report or January 1, 2022, whichever is later. 100 Sec. 4. Subsection (a) of section 38a-510 of the general statutes is 101 repealed and the following is substituted in lieu thereof (Effective January 102 1, 2022): 103 (a) No insurance company, hospital service corporation, medical 104 service corporation, health care center or other entity delivering, issuing 105 for delivery, renewing, amending or continuing an individual health 106 insurance policy or contract that provides coverage for prescription 107 Raised Bill No. 1086 LCO No. 5876 5 of 7 drugs may: 108 (1) Require any person covered under such policy or contract to 109 obtain prescription drugs from a mail order pharmacy as a condition of 110 obtaining benefits for such drugs; or 111 (2) Require, if such insurance company, hospital service corporation, 112 medical service corporation, health care center or other entity uses step 113 therapy for such drugs, the use of step therapy for: 114 (A) [any] Any prescribed drug for longer than sixty days; [,] or 115 (B) [a] A prescribed drug for [cancer] treatment of a behavioral health 116 condition or for an insured who has been diagnosed with stage IV 117 metastatic cancer, provided such prescribed drug is in compliance with 118 approved federal Food and Drug Administration indications. 119 (3) At the expiration of the time period specified in subparagraph (A) 120 of subdivision (2) of this subsection, [or for a prescribed drug described 121 in subparagraph (B) of subdivision (2) of this subsection,] an insured's 122 treating health care provider may deem such step therapy drug regimen 123 clinically ineffective for the insured, at which time the insurance 124 company, hospital service corporation, medical service corporation, 125 health care center or other entity shall authorize dispensation of and 126 coverage for the drug prescribed by the insured's treating health care 127 provider, provided such drug is a covered drug under such policy or 128 contract. If such provider does not deem such step therapy drug 129 regimen clinically ineffective or has not requested an override pursuant 130 to subdivision (1) of subsection (b) of this section, such drug regimen 131 may be continued. For purposes of this section, "step therapy" means a 132 protocol or program that establishes the specific sequence in which 133 prescription drugs for a specified medical condition are to be prescribed. 134 Sec. 5. Subsection (a) of section 38a-544 of the general statutes is 135 repealed and the following is substituted in lieu thereof (Effective January 136 1, 2022): 137 Raised Bill No. 1086 LCO No. 5876 6 of 7 (a) No insurance company, hospital service corporation, medical 138 service corporation, health care center or other entity delivering, issuing 139 for delivery, renewing, amending or continuing a group health 140 insurance policy or contract that provides coverage for prescription 141 drugs may: 142 (1) Require any person covered under such policy or contract to 143 obtain prescription drugs from a mail order pharmacy as a condition of 144 obtaining benefits for such drugs; or 145 (2) Require, if such insurance company, hospital service corporation, 146 medical service corporation, health care center or other entity uses step 147 therapy for such drugs, the use of step therapy for: 148 (A) [any] Any prescribed drug for longer than sixty days; [,] or 149 (B) [a] A prescribed drug for [cancer] treatment of a behavioral health 150 condition or for an insured who has been diagnosed with stage IV 151 metastatic cancer, provided such prescribed drug is in compliance with 152 approved federal Food and Drug Administration indications. 153 (3) At the expiration of the time period specified in subparagraph (A) 154 of subdivision (2) of this subsection, [or for a prescribed drug described 155 in subparagraph (B) of subdivision (2) of this subsection,] an insured's 156 treating health care provider may deem such step therapy drug regimen 157 clinically ineffective for the insured, at which time the insurance 158 company, hospital service corporation, medical service corporation, 159 health care center or other entity shall authorize dispensation of and 160 coverage for the drug prescribed by the insured's treating health care 161 provider, provided such drug is a covered drug under such policy or 162 contract. If such provider does not deem such step therapy drug 163 regimen clinically ineffective or has not requested an override pursuant 164 to subdivision (1) of subsection (b) of this section, such drug regimen 165 may be continued. For purposes of this section, "step therapy" means a 166 protocol or program that establishes the specific sequence in which 167 prescription drugs for a specified medical condition are to be prescribed. 168 Raised Bill No. 1086 LCO No. 5876 7 of 7 This act shall take effect as follows and shall amend the following sections: Section 1 July 1, 2021 19a-14c Sec. 2 from passage New section Sec. 3 from passage New section Sec. 4 January 1, 2022 38a-510(a) Sec. 5 January 1, 2022 38a-544(a) Statement of Purpose: To improve the provision of mental and behavioral health services 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.]