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General Assembly Substitute Bill No. 1086
January Session, 2021
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 Section 19a-14c of the general statutes is repealed and the 1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
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 Substitute Bill No. 1086
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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
[(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 Substitute Bill No. 1086
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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 conduct a mental health 57
examination of a patient during the physician's, physician assistant's or 58
advanced practice registered nurse's annual physical examination of the 59
patient. 60
Sec. 3. (Effective from passage) (a) There is established a task force to 61
study the health benefits of psilocybin. Such study shall include, but 62
need not be limited to, an examination of whether the use of psilocybin 63
by a person under the direction of a health care provider may be 64
beneficial to the person's physical or mental well-being. As used in this 65
subsection, "psilocybin" means the chemical compound obtained from 66
certain types of hallucinogenic mushrooms that grow naturally in 67
regions of Europe, South America, Mexico and the United States. 68
(b) The task force shall consist of the following members: 69
(1) Two appointed by the speaker of the House of Representatives; 70
(2) Two appointed by the president pro tempore of the Senate; 71
(3) One appointed by the majority leader of the House of 72
Representatives; 73
(4) One appointed by the majority leader of the Senate; 74
(5) One appointed by the minority leader of the House of 75
Representatives; 76
(6) One appointed by the minority leader of the Senate; 77
(7) The Commissioner of Mental Health and Addiction Services, or 78
the commissioner's designee; and 79 Substitute Bill No. 1086
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(8) The Commissioner of Public Health, or the commissioner's 80
designee. 81
(c) Any member of the task force appointed under subdivision (1), 82
(2), (3), (4), (5) or (6) of subsection (b) of this section may be a member 83
of the General Assembly. 84
(d) All initial appointments to the task force shall be made not later 85
than thirty days after the effective date of this section. Any vacancy shall 86
be filled by the appointing authority. 87
(e) The speaker of the House of Representatives and the president pro 88
tempore of the Senate shall select the chairpersons of the task force from 89
among the members of the task force. Such chairpersons shall schedule 90
the first meeting of the task force, which shall be held not later than sixty 91
days after the effective date of this section. 92
(f) The administrative staff of the joint standing committee of the 93
General Assembly having cognizance of matters relating to public 94
health shall serve as administrative staff of the task force. 95
(g) Not later than January 1, 2022, the task force shall submit a report 96
on its findings and recommendations to the joint standing committee of 97
the General Assembly having cognizance of matters relating to public 98
health, in accordance with the provisions of section 11-4a of the general 99
statutes. The task force shall terminate on the date that it submits such 100
report or January 1, 2022, whichever is later. 101
Sec. 4. Subsection (a) of section 38a-510 of the general statutes is 102
repealed and the following is substituted in lieu thereof (Effective January 103
1, 2022): 104
(a) No insurance company, hospital service corporation, medical 105
service corporation, health care center or other entity delivering, issuing 106
for delivery, renewing, amending or continuing an individual health 107
insurance policy or contract that provides coverage for prescription 108
drugs may: 109 Substitute Bill No. 1086
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(1) Require any person covered under such policy or contract to 110
obtain prescription drugs from a mail order pharmacy as a condition of 111
obtaining benefits for such drugs; or 112
(2) Require, if such insurance company, hospital service corporation, 113
medical service corporation, health care center or other entity uses step 114
therapy for such drugs, the use of step therapy for: 115
(A) [any] Any prescribed drug for longer than sixty days; [,] or 116
(B) [a] A prescribed drug for [cancer] treatment of a behavioral health 117
condition or for an insured who has been diagnosed with stage IV 118
metastatic cancer, provided such prescribed drug is in compliance with 119
approved federal Food and Drug Administration indications. 120
(3) At the expiration of the time period specified in subparagraph (A) 121
of subdivision (2) of this subsection, [or for a prescribed drug described 122
in subparagraph (B) of subdivision (2) of this subsection,] an insured's 123
treating health care provider may deem such step therapy drug regimen 124
clinically ineffective for the insured, at which time the insurance 125
company, hospital service corporation, medical service corporation, 126
health care center or other entity shall authorize dispensation of and 127
coverage for the drug prescribed by the insured's treating health care 128
provider, provided such drug is a covered drug under such policy or 129
contract. If such provider does not deem such step therapy drug 130
regimen clinically ineffective or has not requested an override pursuant 131
to subdivision (1) of subsection (b) of this section, such drug regimen 132
may be continued. For purposes of this section, "step therapy" means a 133
protocol or program that establishes the specific sequence in which 134
prescription drugs for a specified medical condition are to be prescribed. 135
Sec. 5. Subsection (a) of section 38a-544 of the general statutes is 136
repealed and the following is substituted in lieu thereof (Effective January 137
1, 2022): 138
(a) No insurance company, hospital service corporation, medical 139
service corporation, health care center or other entity delivering, issuing 140 Substitute Bill No. 1086
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for delivery, renewing, amending or continuing a group health 141
insurance policy or contract that provides coverage for prescription 142
drugs may: 143
(1) Require any person covered under such policy or contract to 144
obtain prescription drugs from a mail order pharmacy as a condition of 145
obtaining benefits for such drugs; or 146
(2) Require, if such insurance company, hospital service corporation, 147
medical service corporation, health care center or other entity uses step 148
therapy for such drugs, the use of step therapy for: 149
(A) [any] Any prescribed drug for longer than sixty days; [,] or 150
(B) [a] A prescribed drug for [cancer] treatment of a behavioral health 151
condition or for an insured who has been diagnosed with stage IV 152
metastatic cancer, provided such prescribed drug is in compliance with 153
approved federal Food and Drug Administration indications. 154
(3) At the expiration of the time period specified in subparagraph (A) 155
of subdivision (2) of this subsection, [or for a prescribed drug described 156
in subparagraph (B) of subdivision (2) of this subsection,] an insured's 157
treating health care provider may deem such step therapy drug regimen 158
clinically ineffective for the insured, at which time the insurance 159
company, hospital service corporation, medical service corporation, 160
health care center or other entity shall authorize dispensation of and 161
coverage for the drug prescribed by the insured's treating health care 162
provider, provided such drug is a covered drug under such policy or 163
contract. If such provider does not deem such step therapy drug 164
regimen clinically ineffective or has not requested an override pursuant 165
to subdivision (1) of subsection (b) of this section, such drug regimen 166
may be continued. For purposes of this section, "step therapy" means a 167
protocol or program that establishes the specific sequence in which 168
prescription drugs for a specified medical condition are to be prescribed. 169 Substitute Bill No. 1086
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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 Legislative Commissioners:
In Section 2, "perform a mental health examination on a patient" was
changed to "conduct a mental health examination of a patient", and
physician assistant's or advanced practice registered nurse's" was
inserted after "physician's" for clarity and consistency.
PH Joint Favorable Subst. -LCO