Connecticut 2021 Regular Session

Connecticut Senate Bill SB01086 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1
2	2
3		-	LCO \\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-01086-R01-
4		-	SB.docx
5		-	1 of 7
6	3
7		-	General Assembly Substitute Bill No. 1086
	4	+	LCO No. 5876 1 of 7
	5	+
	6	+	General Assembly Raised Bill No. 1086
8	7		January Session, 2021
	8	+	LCO No. 5876
	9	+
	10	+
	11	+	Referred to Committee on PUBLIC HEALTH
	12	+
	13	+
	14	+	Introduced by:
	15	+	(PH)
	16	+
9	17
10	18
11	19
12	20		AN ACT CONCERNING ME NTAL AND BEHAVIORAL HEALTH
13	21		SERVICES.
14	22		Be it enacted by the Senate and House of Representatives in General
15	23		Assembly convened:
16	24
17	25		Section 1. Section 19a-14c of the general statutes is repealed and the 1
18	26		following is substituted in lieu thereof (Effective July 1, 2021): 2
19	27		(a) For the purposes of this section, "outpatient mental health 3
20	28		treatment" means the treatment of mental disorders, emotional 4
21	29		problems or maladjustments with the object of (1) removing, modifying 5
22	30		or retarding existing symptoms; (2) improving disturbed patterns of 6
23	31		behavior; and (3) promoting positive personality growth and 7
24	32		development. Treatment shall not include prescribing or otherwise 8
25	33		dispensing any medication which is a legend drug as defined in section 9
26	34		20-571. 10
27	35		(b) A psychiatrist licensed pursuant to chapter 370, a psychologist 11
28	36		licensed pursuant to chapter 383, an independent social worker certified 12
29	37		pursuant to chapter 383b or a marital and family therapist licensed 13
30	38		pursuant to chapter 383a may provide outpatient mental health 14
31		-	treatment to a minor without the consent or notification of a parent or 15
	39	+	treatment to a minor without the consent or notification of a parent or 15 Raised Bill No. 1086
	40	+
	41	+
	42	+
	43	+	LCO No. 5876 2 of 7
	44	+
32	45		guardian at the request of the minor if (1) requiring the consent or 16
33	46		notification of a parent or guardian would cause the minor to reject such 17
34		-	treatment; (2) the provision of such treatment is clinically indicated; (3) 18 Substitute Bill No. 1086
35		-
36		-
37		-	LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-01086-
38		-	R01-SB.docx }
39		-	2 of 7
40		-
	47	+	treatment; (2) the provision of such treatment is clinically indicated; (3) 18
41	48		the failure to provide such treatment would be seriously detrimental to 19
42	49		the minor's well-being; (4) the minor has knowingly and voluntarily 20
43	50		sought such treatment; and (5) in the opinion of the provider of 21
44	51		treatment, the minor is mature enough to participate in treatment 22
45	52		productively. The provider of such treatment shall document the 23
46	53		reasons for any determination made to treat a minor without the consent 24
47	54		or notification of a parent or guardian and shall include such 25
48	55		documentation in the minor's clinical record, along with a written 26
49	56		statement signed by the minor stating that (A) he is voluntarily seeking 27
50	57		such treatment; (B) he has discussed with the provider the possibility of 28
51	58		involving his parent or guardian in the decision to pursue such 29
52	59		treatment; (C) he has determined it is not in his best interest to involve 30
53	60		his parent or guardian in such decision; and (D) he has been given 31
54	61		adequate opportunity to ask the provider questions about the course of 32
55	62		his treatment. 33
56	63		[(c) After the sixth session of outpatient mental health treatment 34
57	64		provided to a minor pursuant to this section, the provider of such 35
58	65		treatment shall notify the minor that the consent, notification or 36
59	66		involvement of a parent or guardian is required to continue treatment, 37
60	67		unless such a requirement would be seriously detrimental to the minor's 38
61	68		well-being. If the provider determines such a requirement would be 39
62	69		seriously detrimental to the minor's well-being, he shall document such 40
63	70		determination in the minor's clinical record, review such determination 41
64	71		every sixth session thereafter and document each such review. If the 42
65	72		provider determines such a requirement would no longer be seriously 43
66	73		detrimental to the minor's well-being, he shall require the consent, 44
67	74		notification or involvement of a parent or guardian as a condition of 45
68	75		continuing treatment. No provider shall notify a parent or guardian of 46
69	76		treatment provided pursuant to this section or disclose any information 47
70	77		concerning such treatment to a parent or guardian without the consent 48
71		-	of the minor.] 49
72		-	[(d)] (c) A parent or guardian who is not informed of the provision of 50
73		-	outpatient mental health treatment for his minor child pursuant to this 51 Substitute Bill No. 1086
	78	+	of the minor.] 49 Raised Bill No. 1086
74	79
75	80
76		-	LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-01086-
77		-	R01-SB.docx }
78		-	3 of 7
79	81
	82	+	LCO No. 5876 3 of 7
	83	+
	84	+	[(d)] (c) A parent or guardian who is not informed of the provision of 50
	85	+	outpatient mental health treatment for his minor child pursuant to this 51
80	86		section shall not be liable for the costs of the treatment provided. 52
81	87		Sec. 2. (NEW) (Effective from passage) On and after October 1, 2021, 53
82	88		each physician licensed pursuant to chapter 370 of the general statutes, 54
83	89		physician assistant licensed pursuant to chapter 370 of the general 55
84	90		statutes and advanced practice registered nurse licensed pursuant to 56
85		-	chapter 378 of the general statutes shall conduct a mental health 57
86		-	examination of a patient during the physician's, physician assistant's or 58
87		-	advanced practice registered nurse's annual physical examination of the 59
88		-	patient. 60
89		-	Sec. 3. (Effective from passage) (a) There is established a task force to 61
90		-	study the health benefits of psilocybin. Such study shall include, but 62
91		-	need not be limited to, an examination of whether the use of psilocybin 63
92		-	by a person under the direction of a health care provider may be 64
93		-	beneficial to the person's physical or mental well-being. As used in this 65
94		-	subsection, "psilocybin" means the chemical compound obtained from 66
95		-	certain types of hallucinogenic mushrooms that grow naturally in 67
96		-	regions of Europe, South America, Mexico and the United States. 68
97		-	(b) The task force shall consist of the following members: 69
98		-	(1) Two appointed by the speaker of the House of Representatives; 70
99		-	(2) Two appointed by the president pro tempore of the Senate; 71
100		-	(3) One appointed by the majority leader of the House of 72
101		-	Representatives; 73
102		-	(4) One appointed by the majority leader of the Senate; 74
103		-	(5) One appointed by the minority leader of the House of 75
104		-	Representatives; 76
105		-	(6) One appointed by the minority leader of the Senate; 77
106		-	(7) The Commissioner of Mental Health and Addiction Services, or 78
107		-	the commissioner's designee; and 79 Substitute Bill No. 1086
	91	+	chapter 378 of the general statutes shall perform a mental health 57
	92	+	examination on a patient during the physician's annual physical 58
	93	+	examination of the patient. 59
	94	+	Sec. 3. (Effective from passage) (a) There is established a task force to 60
	95	+	study the health benefits of psilocybin. Such study shall include, but 61
	96	+	need not be limited to, an examination of whether the use of psilocybin 62
	97	+	by a person under the direction of a health care provider may be 63
	98	+	beneficial to the person's physical or mental well-being. As used in this 64
	99	+	subsection, "psilocybin" means the chemical compound obtained from 65
	100	+	certain types of hallucinogenic mushrooms that grow naturally in 66
	101	+	regions of Europe, South America, Mexico and the United States. 67
	102	+	(b) The task force shall consist of the following members: 68
	103	+	(1) Two appointed by the speaker of the House of Representatives; 69
	104	+	(2) Two appointed by the president pro tempore of the Senate; 70
	105	+	(3) One appointed by the majority leader of the House of 71
	106	+	Representatives; 72
	107	+	(4) One appointed by the majority leader of the Senate; 73
	108	+	(5) One appointed by the minority leader of the House of 74
	109	+	Representatives; 75
	110	+	(6) One appointed by the minority leader of the Senate; 76
	111	+	(7) The Commissioner of Mental Health and Addiction Services, or 77 Raised Bill No. 1086
108	112
109	113
110		-	LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-01086-
111		-	R01-SB.docx }
112		-	4 of 7
113	114
114		-	(8) The Commissioner of Public Health, or the commissioner's 80
115		-	designee. 81
116		-	(c) Any member of the task force appointed under subdivision (1), 82
117		-	(2), (3), (4), (5) or (6) of subsection (b) of this section may be a member 83
118		-	of the General Assembly. 84
119		-	(d) All initial appointments to the task force shall be made not later 85
120		-	than thirty days after the effective date of this section. Any vacancy shall 86
121		-	be filled by the appointing authority. 87
122		-	(e) The speaker of the House of Representatives and the president pro 88
123		-	tempore of the Senate shall select the chairpersons of the task force from 89
124		-	among the members of the task force. Such chairpersons shall schedule 90
125		-	the first meeting of the task force, which shall be held not later than sixty 91
126		-	days after the effective date of this section. 92
127		-	(f) The administrative staff of the joint standing committee of the 93
128		-	General Assembly having cognizance of matters relating to public 94
129		-	health shall serve as administrative staff of the task force. 95
130		-	(g) Not later than January 1, 2022, the task force shall submit a report 96
131		-	on its findings and recommendations to the joint standing committee of 97
132		-	the General Assembly having cognizance of matters relating to public 98
133		-	health, in accordance with the provisions of section 11-4a of the general 99
134		-	statutes. The task force shall terminate on the date that it submits such 100
135		-	report or January 1, 2022, whichever is later. 101
136		-	Sec. 4. Subsection (a) of section 38a-510 of the general statutes is 102
137		-	repealed and the following is substituted in lieu thereof (Effective January 103
138		-	1, 2022): 104
139		-	(a) No insurance company, hospital service corporation, medical 105
140		-	service corporation, health care center or other entity delivering, issuing 106
141		-	for delivery, renewing, amending or continuing an individual health 107
142		-	insurance policy or contract that provides coverage for prescription 108
143		-	drugs may: 109 Substitute Bill No. 1086
	115	+	LCO No. 5876 4 of 7
	116	+
	117	+	the commissioner's designee; and 78
	118	+	(8) The Commissioner of Public Health, or the commissioner's 79
	119	+	designee. 80
	120	+	(c) Any member of the task force appointed under subdivision (1), 81
	121	+	(2), (3), (4), (5) or (6) of subsection (b) of this section may be a member 82
	122	+	of the General Assembly. 83
	123	+	(d) All initial appointments to the task force shall be made not later 84
	124	+	than thirty days after the effective date of this section. Any vacancy shall 85
	125	+	be filled by the appointing authority. 86
	126	+	(e) The speaker of the House of Representatives and the president pro 87
	127	+	tempore of the Senate shall select the chairpersons of the task force from 88
	128	+	among the members of the task force. Such chairpersons shall schedule 89
	129	+	the first meeting of the task force, which shall be held not later than sixty 90
	130	+	days after the effective date of this section. 91
	131	+	(f) The administrative staff of the joint standing committee of the 92
	132	+	General Assembly having cognizance of matters relating to public 93
	133	+	health shall serve as administrative staff of the task force. 94
	134	+	(g) Not later than January 1, 2022, the task force shall submit a report 95
	135	+	on its findings and recommendations to the joint standing committee of 96
	136	+	the General Assembly having cognizance of matters relating to public 97
	137	+	health, in accordance with the provisions of section 11-4a of the general 98
	138	+	statutes. The task force shall terminate on the date that it submits such 99
	139	+	report or January 1, 2022, whichever is later. 100
	140	+	Sec. 4. Subsection (a) of section 38a-510 of the general statutes is 101
	141	+	repealed and the following is substituted in lieu thereof (Effective January 102
	142	+	1, 2022): 103
	143	+	(a) No insurance company, hospital service corporation, medical 104
	144	+	service corporation, health care center or other entity delivering, issuing 105
	145	+	for delivery, renewing, amending or continuing an individual health 106
	146	+	insurance policy or contract that provides coverage for prescription 107 Raised Bill No. 1086
144	147
145	148
146		-	LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-01086-
147		-	R01-SB.docx }
148		-	5 of 7
149	149
150		-	(1) Require any person covered under such policy or contract to 110
151		-	obtain prescription drugs from a mail order pharmacy as a condition of 111
152		-	obtaining benefits for such drugs; or 112
153		-	(2) Require, if such insurance company, hospital service corporation, 113
154		-	medical service corporation, health care center or other entity uses step 114
155		-	therapy for such drugs, the use of step therapy for: 115
156		-	(A) [any] Any prescribed drug for longer than sixty days; [,] or 116
157		-	(B) [a] A prescribed drug for [cancer] treatment of a behavioral health 117
158		-	condition or for an insured who has been diagnosed with stage IV 118
159		-	metastatic cancer, provided such prescribed drug is in compliance with 119
160		-	approved federal Food and Drug Administration indications. 120
161		-	(3) At the expiration of the time period specified in subparagraph (A) 121
162		-	of subdivision (2) of this subsection, [or for a prescribed drug described 122
163		-	in subparagraph (B) of subdivision (2) of this subsection,] an insured's 123
164		-	treating health care provider may deem such step therapy drug regimen 124
165		-	clinically ineffective for the insured, at which time the insurance 125
166		-	company, hospital service corporation, medical service corporation, 126
167		-	health care center or other entity shall authorize dispensation of and 127
168		-	coverage for the drug prescribed by the insured's treating health care 128
169		-	provider, provided such drug is a covered drug under such policy or 129
170		-	contract. If such provider does not deem such step therapy drug 130
171		-	regimen clinically ineffective or has not requested an override pursuant 131
172		-	to subdivision (1) of subsection (b) of this section, such drug regimen 132
173		-	may be continued. For purposes of this section, "step therapy" means a 133
174		-	protocol or program that establishes the specific sequence in which 134
175		-	prescription drugs for a specified medical condition are to be prescribed. 135
176		-	Sec. 5. Subsection (a) of section 38a-544 of the general statutes is 136
177		-	repealed and the following is substituted in lieu thereof (Effective January 137
178		-	1, 2022): 138
179		-	(a) No insurance company, hospital service corporation, medical 139
180		-	service corporation, health care center or other entity delivering, issuing 140 Substitute Bill No. 1086
	150	+	LCO No. 5876 5 of 7
	151	+
	152	+	drugs may: 108
	153	+	(1) Require any person covered under such policy or contract to 109
	154	+	obtain prescription drugs from a mail order pharmacy as a condition of 110
	155	+	obtaining benefits for such drugs; or 111
	156	+	(2) Require, if such insurance company, hospital service corporation, 112
	157	+	medical service corporation, health care center or other entity uses step 113
	158	+	therapy for such drugs, the use of step therapy for: 114
	159	+	(A) [any] Any prescribed drug for longer than sixty days; [,] or 115
	160	+	(B) [a] A prescribed drug for [cancer] treatment of a behavioral health 116
	161	+	condition or for an insured who has been diagnosed with stage IV 117
	162	+	metastatic cancer, provided such prescribed drug is in compliance with 118
	163	+	approved federal Food and Drug Administration indications. 119
	164	+	(3) At the expiration of the time period specified in subparagraph (A) 120
	165	+	of subdivision (2) of this subsection, [or for a prescribed drug described 121
	166	+	in subparagraph (B) of subdivision (2) of this subsection,] an insured's 122
	167	+	treating health care provider may deem such step therapy drug regimen 123
	168	+	clinically ineffective for the insured, at which time the insurance 124
	169	+	company, hospital service corporation, medical service corporation, 125
	170	+	health care center or other entity shall authorize dispensation of and 126
	171	+	coverage for the drug prescribed by the insured's treating health care 127
	172	+	provider, provided such drug is a covered drug under such policy or 128
	173	+	contract. If such provider does not deem such step therapy drug 129
	174	+	regimen clinically ineffective or has not requested an override pursuant 130
	175	+	to subdivision (1) of subsection (b) of this section, such drug regimen 131
	176	+	may be continued. For purposes of this section, "step therapy" means a 132
	177	+	protocol or program that establishes the specific sequence in which 133
	178	+	prescription drugs for a specified medical condition are to be prescribed. 134
	179	+	Sec. 5. Subsection (a) of section 38a-544 of the general statutes is 135
	180	+	repealed and the following is substituted in lieu thereof (Effective January 136
	181	+	1, 2022): 137 Raised Bill No. 1086
181	182
182	183
183		-	LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-01086-
184		-	R01-SB.docx }
185		-	6 of 7
186	184
187		-	for delivery, renewing, amending or continuing a group health 141
188		-	insurance policy or contract that provides coverage for prescription 142
189		-	drugs may: 143
190		-	(1) Require any person covered under such policy or contract to 144
191		-	obtain prescription drugs from a mail order pharmacy as a condition of 145
192		-	obtaining benefits for such drugs; or 146
193		-	(2) Require, if such insurance company, hospital service corporation, 147
194		-	medical service corporation, health care center or other entity uses step 148
195		-	therapy for such drugs, the use of step therapy for: 149
196		-	(A) [any] Any prescribed drug for longer than sixty days; [,] or 150
197		-	(B) [a] A prescribed drug for [cancer] treatment of a behavioral health 151
198		-	condition or for an insured who has been diagnosed with stage IV 152
199		-	metastatic cancer, provided such prescribed drug is in compliance with 153
200		-	approved federal Food and Drug Administration indications. 154
201		-	(3) At the expiration of the time period specified in subparagraph (A) 155
202		-	of subdivision (2) of this subsection, [or for a prescribed drug described 156
203		-	in subparagraph (B) of subdivision (2) of this subsection,] an insured's 157
204		-	treating health care provider may deem such step therapy drug regimen 158
205		-	clinically ineffective for the insured, at which time the insurance 159
206		-	company, hospital service corporation, medical service corporation, 160
207		-	health care center or other entity shall authorize dispensation of and 161
208		-	coverage for the drug prescribed by the insured's treating health care 162
209		-	provider, provided such drug is a covered drug under such policy or 163
210		-	contract. If such provider does not deem such step therapy drug 164
211		-	regimen clinically ineffective or has not requested an override pursuant 165
212		-	to subdivision (1) of subsection (b) of this section, such drug regimen 166
213		-	may be continued. For purposes of this section, "step therapy" means a 167
214		-	protocol or program that establishes the specific sequence in which 168
215		-	prescription drugs for a specified medical condition are to be prescribed. 169 Substitute Bill No. 1086
	185	+	LCO No. 5876 6 of 7
	186	+
	187	+	(a) No insurance company, hospital service corporation, medical 138
	188	+	service corporation, health care center or other entity delivering, issuing 139
	189	+	for delivery, renewing, amending or continuing a group health 140
	190	+	insurance policy or contract that provides coverage for prescription 141
	191	+	drugs may: 142
	192	+	(1) Require any person covered under such policy or contract to 143
	193	+	obtain prescription drugs from a mail order pharmacy as a condition of 144
	194	+	obtaining benefits for such drugs; or 145
	195	+	(2) Require, if such insurance company, hospital service corporation, 146
	196	+	medical service corporation, health care center or other entity uses step 147
	197	+	therapy for such drugs, the use of step therapy for: 148
	198	+	(A) [any] Any prescribed drug for longer than sixty days; [,] or 149
	199	+	(B) [a] A prescribed drug for [cancer] treatment of a behavioral health 150
	200	+	condition or for an insured who has been diagnosed with stage IV 151
	201	+	metastatic cancer, provided such prescribed drug is in compliance with 152
	202	+	approved federal Food and Drug Administration indications. 153
	203	+	(3) At the expiration of the time period specified in subparagraph (A) 154
	204	+	of subdivision (2) of this subsection, [or for a prescribed drug described 155
	205	+	in subparagraph (B) of subdivision (2) of this subsection,] an insured's 156
	206	+	treating health care provider may deem such step therapy drug regimen 157
	207	+	clinically ineffective for the insured, at which time the insurance 158
	208	+	company, hospital service corporation, medical service corporation, 159
	209	+	health care center or other entity shall authorize dispensation of and 160
	210	+	coverage for the drug prescribed by the insured's treating health care 161
	211	+	provider, provided such drug is a covered drug under such policy or 162
	212	+	contract. If such provider does not deem such step therapy drug 163
	213	+	regimen clinically ineffective or has not requested an override pursuant 164
	214	+	to subdivision (1) of subsection (b) of this section, such drug regimen 165
	215	+	may be continued. For purposes of this section, "step therapy" means a 166
	216	+	protocol or program that establishes the specific sequence in which 167
	217	+	prescription drugs for a specified medical condition are to be prescribed. 168 Raised Bill No. 1086
216	218
217	219
218		-	LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-01086-
219		-	R01-SB.docx }
220		-	7 of 7
	220	+
	221	+	LCO No. 5876 7 of 7
221	222
222	223		This act shall take effect as follows and shall amend the following
223	224		sections:
224	225
225	226		Section 1 July 1, 2021 19a-14c
226	227		Sec. 2 from passage New section
227	228		Sec. 3 from passage New section
228	229		Sec. 4 January 1, 2022 38a-510(a)
229	230		Sec. 5 January 1, 2022 38a-544(a)
230	231
231		-	Statement of Legislative Commissioners:
232		-	In Section 2, "perform a mental health examination on a patient" was
233		-	changed to "conduct a mental health examination of a patient", and
234		-	physician assistant's or advanced practice registered nurse's" was
235		-	inserted after "physician's" for clarity and consistency.
236		-
237		-
238		-	PH Joint Favorable Subst. -LCO
	232	+	Statement of Purpose:
	233	+	To improve the provision of mental and behavioral health services in
	234	+	the state.
	235	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	236	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	237	+	underlined.]
239	238