LCO No. 2872 1 of 10 General Assembly Raised Bill No. 5396 February Session, 2022 LCO No. 2872 Referred to Committee on PUBLIC HEALTH Introduced by: (PH) AN ACT INCREASING ACCESS TO MENTAL HEALTH MEDICATION. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. (Effective July 1, 2022) (a) As used in this section and section 1 2 of this act: 2 (1) "MDMA" means the synthetic psychoactive drug, 3,4-3 methylenedioxymethamphetamine, commonly known as ecstasy or 4 molly, that acts as a serotonin receptor agonist and reuptake inhibitor of 5 serotonin and dopamine. 6 (2) "Psilocybin" means a serotonin receptor agonist that occurs 7 naturally in some mushroom species. 8 (3) "Qualified patient" means a resident of the state who is (A) a 9 veteran, (B) a retired first responder, (C) a direct care health care worker, 10 or (D) from a historically underserved community, and who has a 11 serious or life-threatening mental or behavioral health disorder and 12 without access to effective mental or behavioral health medication. 13 (4) "Qualified applicant" means a provider of mental or behavioral 14 Raised Bill No. 5396 LCO No. 2872 2 of 10 health services that has received approval from the federal Food and 15 Drug Administration as an approved treatment site with an expanded 16 access protocol that allows the provider access to an investigational 17 drug for treatment use, including emergency use, pursuant to 21 CFR 18 312, as amended from time to time. 19 (5) "Approved treatment site" means the location where a qualified 20 applicant that has been selected under subsection (e) of this section as a 21 provider of MDMA-assisted or psilocybin-assisted therapy under the 22 pilot program established pursuant to subsection (b) of this section will 23 provide such therapy. 24 (b) There is established, within the Department of Mental Health and 25 Addiction Services, a psychedelic-assisted therapy pilot program to 26 provide qualified patients with the funding necessary to receive 27 MDMA-assisted or psilocybin-assisted therapy as part of an expanded 28 access program approved by the federal Food and Drug Administration 29 pursuant to 21 CFR 312, as amended from time to time. The department 30 shall cease to operate the pilot program when MDMA and psilocybin 31 have been approved to have a medical use by the Drug Enforcement 32 Administration, or any successor agency. 33 (c) There is established a Qualified Patients for Approved Treatment 34 Sites Fund, "PAT Fund". The fund shall contain any moneys required by 35 law to be deposited in the fund and may contain any other funds as 36 provided in subsection (d) of this section. The Department of Mental 37 Health and Addiction Services shall administer and use the fund for 38 grants to qualified applicants to provide MDMA-assisted or psilocybin-39 assisted therapy to qualified patients under the pilot program 40 established pursuant to subsection (b) of this section. 41 (d) For the fiscal year ending on June 30, 2023, and for each fiscal year 42 thereafter, block grant funds allocated to the department pursuant to 43 section 4-28b of the general statutes may be deposited in said fund, and 44 the department may accept contributions from any source, public or 45 private, for deposit in said fund. 46 Raised Bill No. 5396 LCO No. 2872 3 of 10 (e) On or before November 29, 2022, a qualified applicant may apply 47 to the Department of Mental Health and Addiction Services for selection 48 as an approved treatment site. The department shall: 49 (1) Develop an application form for qualified applicants seeking 50 selection as an approved treatment site and, not later than October 31, 51 2022, post such application on the department's Internet web site; 52 (2) Select up to three qualified applicants as approved treatment sites 53 not later than December 28, 2022; 54 (3) Distribute one million five hundred thousand dollars from the 55 PAT Fund equally amongst the approved treatment sites; and 56 (4) Distribute an additional one million five hundred thousand 57 dollars from the PAT Fund equally amongst the approved treatment 58 sites that, prior to March 31, 2023, provided proof of receipt of a one 59 million five hundred thousand dollar matching grant from a private 60 foundation to treat qualified patients. If no approved treatment site 61 provides proof of receipt of such matching grant on or before March 31, 62 2023, the department shall distribute an additional one million five 63 hundred thousand dollars from the PAT Fund equally amongst the 64 approved treatment sites not later than March 31, 2024. 65 (f) Approved treatment sites shall collect and submit data to the 66 Department of Mental Health and Addiction Services, including, but 67 not limited to, its protocols for the provision of MDMA-assisted and 68 psilocybin-assisted treatment, training on the facilitation of such 69 treatment, implementation of facility standards, strategies for patient 70 protection and mitigation of drug diversion. Approved treatment sites 71 shall follow all applicable patient privacy laws in the collection and 72 submission of data to the department. As used in this subsection, "drug 73 diversion" means the transfer of a legally prescribed drug from the 74 individual for whom it was prescribed to another individual for any 75 illicit use. 76 Sec. 2. (Effective July 1, 2022) (a) There is established the Connecticut 77 Raised Bill No. 5396 LCO No. 2872 4 of 10 Psychedelic Treatment Advisory Board, which shall be part of the 78 Department of Mental Health and Addiction Services. 79 (b) The board shall consist of the following members: (1) Two 80 appointed by the speaker of the House of Representatives; (2) two 81 appointed by the president pro tempore of the Senate; (3) one appointed 82 by the minority leader of the House of Representatives; (4) one 83 appointed by the minority leader of the Senate; (5) two appointed by the 84 Office of the Governor; (6) one appointed by the Commissioner of 85 Mental Health and Addiction Services; (7) one appointed by the 86 Commissioner of Public Health; and (8) one appointed by the 87 Commissioner of Consumer Protection. The board shall include 88 members with experience or expertise in psychedelic research, 89 psychedelic-assisted therapy, public health, access to mental and 90 behavioral health care in underserved communities, veteran mental and 91 behavioral health care, harm reduction and sacramental use of 92 psychedelic substances. 93 (c) The speaker of the House of Representatives and the president pro 94 tempore of the Senate shall select the chairpersons of the board from 95 among the members of the board. The chairpersons shall oversee the 96 establishment of and make recommendations regarding the voting 97 procedures of the board. 98 (d) The administrative staff of the joint standing committee of the 99 General Assembly having cognizance of matters relating to consumer 100 protection shall serve as administrative staff of the board, with 101 assistance as needed provided by employees of the Offices of Legislative 102 Research and Fiscal Analysis. 103 (e) The board shall advise the Department of Mental Health and 104 Addiction Services on the design and development of the regulations 105 and infrastructure necessary to safely allow for therapeutic access to 106 psychedelic-assisted therapy upon the legalization of MDMA, 107 psilocybin and any other psychedelic compounds. In advising the 108 department under this subsection, the board shall be responsible for: (1) 109 Raised Bill No. 5396 LCO No. 2872 5 of 10 Reviewing and considering the data from the psychedelic-assisted 110 therapy pilot program established under section 1 of this act to inform 111 the development of such regulations; (2) advising the department on the 112 necessary education, training, licensing and credentialing of therapists 113 and facilitators, patient safety, harm reduction, the establishment of 114 equity measures in both clinical and therapeutic settings, cost and 115 insurance reimbursement considerations and standards of treatment 116 facilities; (3) advising the department on the use of group therapy and 117 other therapy options to reduce cost and maximize public health 118 benefits from psychedelic treatments; (4) monitoring updated federal 119 regulations and guidelines for referral and consideration by the state 120 agencies of cognizance for implementation of such regulations and 121 guidelines; (5) developing a long-term strategic plan to improve mental 122 health care through the use of psychedelic treatment; (6) recommending 123 equity measures for clinical subject recruitment and facilitator training 124 recruitment; and (7) assisting with the development of public awareness 125 and education campaigns. 126 (f) The board may establish committees and subcommittees 127 necessary for the operation of the board. 128 Sec. 3. Section 21a-243 of the general statutes is repealed and the 129 following is substituted in lieu thereof (Effective July 1, 2022): 130 (a) The Commissioner of Consumer Protection shall adopt 131 regulations for the efficient enforcement and operation of sections 21a-132 244 to 21a-282, inclusive. 133 (b) The Commissioner of Consumer Protection may, so far as may be 134 consistent with sections 21a-244 to 21a-282, inclusive, adopt the 135 regulations existing under the federal Controlled Substances Act and 136 pertinent regulations existing under the federal food and drug laws and 137 conform regulations adopted hereunder with those existing under the 138 federal Controlled Substances Act and federal food and drug laws. 139 (c) The Commissioner of Consumer Protection, acting upon the 140 advice of the Commission of Pharmacy, may by regulation designate, 141 Raised Bill No. 5396 LCO No. 2872 6 of 10 after investigation, as a controlled substance, a substance or chemical 142 composition containing any quantity of a substance which has been 143 found to have a stimulant, depressant or hallucinogenic effect upon the 144 higher functions of the central nervous system and having a tendency 145 to promote abuse or physiological or psychological dependence or both. 146 Such substances are classifiable as amphetamine-type, barbiturate-type, 147 cannabis-type, cocaine-type, hallucinogenic, morphine-type and other 148 stimulant and depressant substances, and specifically exclude alcohol, 149 caffeine and nicotine. Substances which are designated as controlled 150 substances shall be classified in schedules I to V by regulations adopted 151 pursuant to subsection (a) of this section. 152 (d) The Commissioner of Consumer Protection may by regulation 153 change the schedule in which a substance classified as a controlled 154 substance in schedules I to V of the controlled substance scheduling 155 regulations is placed. On or before December 15, 1986, and annually 156 thereafter, the commissioner shall submit a list of all such schedule 157 changes to the chairmen and ranking members of the joint standing 158 committee of the General Assembly having cognizance of matters 159 relating to public health. 160 (e) Notwithstanding the provisions of subsections (a) to (d), inclusive, 161 of this section, not later than January 1, 2013, the Commissioner of 162 Consumer Protection shall submit amendments to sections 21a-243-7 163 and 21a-243-8 of the regulations of Connecticut state agencies to the 164 standing legislative regulation review committee to reclassify marijuana 165 as a controlled substance in schedule II under the Connecticut 166 controlled substance scheduling regulations, except that for any 167 marijuana product that has been approved by the federal Food and 168 Drug Administration or successor agency to have a medical use and that 169 is reclassified in any schedule of controlled substances or unscheduled 170 by the federal Drug Enforcement Administration or successor agency, 171 the commissioner shall adopt the schedule designated by the Drug 172 Enforcement Administration or successor agency. 173 (f) Notwithstanding the provisions of subsections (a) to (d), inclusive, 174 Raised Bill No. 5396 LCO No. 2872 7 of 10 of this section, the Commissioner of Consumer Protection shall adopt 175 the schedule designated by the Drug Enforcement Administration or 176 successor agency for MDMA, as defined in section 1 of this act, and 177 psilocybin, as defined in said section, if MDMA and psilocybin have 178 been approved by said administration, or successor agency, to have a 179 medical use and are reclassified in any schedule of controlled substances 180 or unscheduled by said administration or successor agency. 181 [(f)] (g) A new or amended regulation under this chapter shall be 182 adopted in accordance with the provisions of chapter 54. 183 [(g)] (h) In the event of any inconsistency between the contents of 184 schedules I, II, III, IV and V of the controlled substance scheduling 185 regulations and schedules I, II, III, IV and V of the federal Controlled 186 Substances Act, as amended, the provisions of the federal act shall 187 prevail, except (1) when the provisions of the Connecticut controlled 188 substance scheduling regulations place a controlled substance in a 189 schedule with a higher numerical designation, schedule I being the 190 highest designation, or (2) as provided in subsection (e) of this section. 191 [(h)] (i) When a drug that is not a controlled substance in schedule I, 192 II, III, IV or V, as designated in the Connecticut controlled substance 193 scheduling regulations, is designated to be a controlled substance under 194 the federal Controlled Substances Act, such drug shall be considered to 195 be controlled at the state level in the same numerical schedule from the 196 effective date of the federal classification. Nothing in this section shall 197 prevent the Commissioner of Consumer Protection from designating a 198 controlled substance differently in the Connecticut controlled substance 199 scheduling regulations than such controlled substance is designated in 200 the federal Controlled Substances Act, as amended from time to time. 201 [(i)] (j) The Commissioner of Consumer Protection shall, by 202 regulation adopted pursuant to this section, designate the following 203 substances, by whatever official, common, usual, chemical or trade 204 name designation, as controlled substances and classify each such 205 substance in the appropriate schedule: 206 Raised Bill No. 5396 LCO No. 2872 8 of 10 (1) 1-pentyl-3-(1-naphthoyl)indole (JWH-018); 207 (2) 1-butyl-3-(1-naphthoyl)indole (JWH-073); 208 (3) 1-[2-(4-morpholinyl)ethyl]-3-(1-naphthoyl)indole (JWH-200); 209 (4) 5-(1,1-dimethylheptyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol 210 (CP-47,497); 211 (5) 5-(1,1-dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol 212 (cannabicyclohexanol; CP-47,497 C8 homologue); 213 (6) Salvia divinorum; and 214 (7) Salvinorum A. 215 [(j)] (k) Notwithstanding the provisions of subsection (c) of this 216 section, the Commissioner of Consumer Protection shall designate the 217 following substances, by whatever official, common, usual, chemical or 218 trade name designation, as controlled substances in schedule I of the 219 controlled substances scheduling regulations: 220 (1) Mephedrone (4-methylmethcathinone); and 221 (2) MDPV (3,4-methyenedioxypyrovalerone). 222 Sec. 4. (NEW) (Effective July 1, 2022) The Department of Consumer 223 Protection shall consider for adoption any nonbinding federal 224 guidelines from the federal Department of Health and Human Services 225 regarding the practice of psychedelic-assisted therapy. The Connecticut 226 Psychedelic Treatment Advisory Board established under section 2 of 227 this act and members of the public may submit written comments to the 228 department during a notice and comment period established by the 229 department regarding adoption of and any suggested changes to such 230 guidelines that may better meet the needs of state residents. The 231 department shall post the procedures and deadline for submission of 232 written comments during such notice and comment period on its 233 Internet web site. 234 Raised Bill No. 5396 LCO No. 2872 9 of 10 Sec. 5. Subdivision (29) of section 21a-240 of the 2022 supplement to 235 the general statutes is repealed and the following is substituted in lieu 236 thereof (Effective July 1, 2022): 237 (29) "Marijuana" means all parts of any plant, or species of the genus 238 cannabis or any infra specific taxon thereof, whether growing or not; the 239 seeds thereof; the resin extracted from any part of the plant; every 240 compound, manufacture, salt, derivative, mixture, or preparation of 241 such plant, its seeds or resin, any product made using hemp, as defined 242 in section 22-61l, which exceeds three-tenths per cent total THC 243 concentration on a dry-weight basis; manufactured cannabinoids, 244 synthetic cannabinoids, except as provided in subparagraph (E) of this 245 subdivision; or cannabinon, cannabinol or cannabidiol and chemical 246 compounds which are similar to cannabinon, cannabinol or cannabidiol 247 in chemical structure or which are similar thereto in physiological effect, 248 which are controlled substances under this chapter, except cannabidiol 249 derived from hemp, as defined in section 22-61l, with a total THC 250 concentration of not more than three-tenths per cent on a dry-weight 251 basis. "Marijuana" does not include: (A) The mature stalks of such plant, 252 fiber produced from such stalks, oil or cake made from the seeds of such 253 plant, any other compound, manufacture, salt, derivative, mixture or 254 preparation of such mature stalks, except the resin extracted from such 255 mature stalks or fiber, oil or cake; (B) the sterilized seed of such plant 256 which is incapable of germination; (C) hemp, as defined in section 22-257 61l, with a total THC concentration of not more than three-tenths per 258 cent on a dry-weight basis; (D) any substance approved by the federal 259 Food and Drug Administration or successor agency as a drug and 260 reclassified in any schedule of controlled substances or unscheduled by 261 the federal Drug Enforcement Administration or successor agency 262 which is included in the same schedule designated by the federal Drug 263 Enforcement Administration or successor agency; or (E) synthetic 264 cannabinoids which are controlled substances that are designated by the 265 Commissioner of Consumer Protection, by whatever official, common, 266 usual, chemical or trade name designation, as controlled substances and 267 are classified in the appropriate schedule in accordance with 268 Raised Bill No. 5396 LCO No. 2872 10 of 10 subsections [(i)] (j) and [(j)] (k) of section 21a-243, as amended by this 269 act; 270 Sec. 6. (Effective July 1, 2022) The sum of three million dollars is 271 appropriated to the Department of Mental Health and Addiction 272 Services from the General Fund, for the fiscal year ending June 30, 2023, 273 for deposit in the Qualified Patients for Approved Treatment Sites Fund 274 established under section 1 of this act. 275 This act shall take effect as follows and shall amend the following sections: Section 1 July 1, 2022 New section Sec. 2 July 1, 2022 New section Sec. 3 July 1, 2022 21a-243 Sec. 4 July 1, 2022 New section Sec. 5 July 1, 2022 21a-240(29) Sec. 6 July 1, 2022 New section Statement of Purpose: To increase access to mental health medication. [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.]