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SENATE DOCKET, NO. 2018 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 1252
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
John F. Keenan
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act regarding consistent care for addiction rooted in evidence.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :John F. KeenanNorfolk and PlymouthRuth B. Balser12th MiddlesexJason M. LewisFifth Middlesex2/9/2023 1 of 8
SENATE DOCKET, NO. 2018 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 1252
By Mr. Keenan, a petition (accompanied by bill, Senate, No. 1252) of John F. Keenan, Ruth B.
Balser and Jason M. Lewis for legislation relative to consistent care for addiction rooted in
evidence. Mental Health, Substance Use and Recovery.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 1296 OF 2021-2022.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act regarding consistent care for addiction rooted in evidence.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 1 of chapter 127 of the General Laws, as appearing in the 2020
2Official Edition, is hereby amended by striking out the definition of “Medication-assisted
3treatment” and replacing it with the following definition:-
4 “Medication for addiction treatment”, treatment for a substance use disorder or alcohol
5use disorder that: (i) is determined to be clinically indicated by a qualified addiction specialist;
6(ii) involves the use of medication that is approved by the federal Food and Drug Administration
7for treatment of a substance use disorder; and (iii) is offered in accordance with a treatment plan
8that is reviewed by a qualified addiction specialist at a frequency consistent with appropriate
9clinical standards. “Medication for addiction treatment” is sometimes referred to as “medication-
10assisted treatment”, or “MAT”. 2 of 8
11 SECTION 2. Section 16 of said chapter 127 is amended by striking out in the second
12paragraph, in lines 13 and 14, the words “who is committed for a term of 30 days’ imprisonment
13or more.” and inserting in place thereof the following:-
14 within 24 hours of admission to the facility. Regardless of whether the individual was
15receiving medication for addiction treatment immediately prior to admission to the facility, the
16examination shall include an assessment for treatment with medication for addiction treatment.
17 SECTION 3. Said chapter 127 is further amended by striking out section 17B and
18replacing it with the following:-
19 Section 17B. Medication-assisted treatment for substance use conditions for state
20detainees or prisoners at correctional facilities.
21 (a) All correctional facilities, jails and houses of correction, in consultation with the
22commissioner of public health, shall offer all medications for addiction treatment to a detained,
23committed or incarcerated person, upon the recommendation of a qualified addiction specialist.
24All correctional facilities, jails and houses of correction shall maintain or provide for the capacity
25to possess, dispense and administer all medications for addiction treatment; provided, however,
26that such facilities shall not be required to maintain or provide a medication for addiction
27treatment that is not also a MassHealth covered benefit.
28 (b) No detained, committed or incarcerated person shall be denied medication for
29addiction treatment on the basis of a positive drug screening upon entering custody or at any time
30during the incarceration, detention or commitment of the person; nor shall any detained,
31committed or incarcerated person receive a disciplinary infraction for a positive drug screening.
32The medication for addiction treatment of a detained, committed or incarcerated person shall not 3 of 8
33be discontinued due to any disciplinary infraction. A detained, committed or incarcerated person
34may request medication for addiction treatment at any time during the incarceration, detention or
35commitment of such detained, committed or incarcerated person.
36 (c) The commissioner and county sheriffs shall ensure that each detained, committed or
37incarcerated person who was receiving medication for addiction treatment immediately
38preceding incarceration, detention or commitment continues to have such treatment available as
39soon as practicable, and in any event within 24 hours of admission to the facility, unless such
40person voluntarily discontinues the treatment or unless a qualified addiction specialist
41determines, based on individual medical need, that maintaining the same treatment is no longer
42clinically indicated. Each detained, committed or incarcerated person shall receive the same dose
43of the same medication that the person was receiving before incarceration, commitment or
44detention, unless a qualified addiction specialist determines, based on individual medical need
45and in consultation with the person, that a change in dose or medication is clinically indicated.
46 (d) The commissioner and county sheriffs shall ensure that each detained, committed or
47incarcerated person who was not receiving medication for addiction treatment immediately
48preceding incarceration, detention or commitment, and for whom medication for addiction
49treatment is clinically indicated, shall be offered such medication within 24 hours of the
50assessment required by section 16. The determinations of which medication to prescribe and the
51dosage shall be made based on individual medical need in consultation with the patient.
52Detained, committed or incarcerated persons shall be authorized to receive the medication for as
53long as clinically indicated. 4 of 8
54 (e) All state and county correctional facilities shall ensure consistent and ongoing access
55to a qualified addiction specialist by a detained, committed or incarcerated person.
56 (f) Treatment established under this section shall include behavioral health counseling for
57individuals diagnosed with substance use disorder or substance use-related needs; provided,
58however, that counseling services shall be consistent with current therapeutic standards for these
59therapies in a community setting and shall not be a substitute for medication for addiction
60treatment. The commissioner and county sheriffs may make such treatment available by directly
61engaging qualified providers of substance use services, through collaboration with other
62agencies, and by utilizing volunteers from community recovery programs.
63 (g) No incentives, rewards or punishments shall be used to encourage or discourage a
64detained, committed or incarcerated person’s decision to receive or decline medication for
65addiction treatment, or any particular such medication.
66 (h) The commissioner of public health may promulgate regulations and guidelines
67necessary to implement the treatment program under this section.
68 SECTION 4. Section 17C of said chapter 127 is hereby amended by striking out the first
69paragraph and replacing it with the following:-
70 Not later than 120 days prior to the expected discharge date of a person detained,
71committed or incarcerated in a state prison or county facility, or within a reasonable timeframe if
72the length of incarceration, detention or commitment is less than 120 days, but in any event no
73less than 30 days prior to such expected discharge date, a qualified addiction specialist shall
74establish a medically appropriate re-entry treatment plan for the person. A re-entry treatment
75plan may include any treatment upon discharge that the qualified addiction specialist shall 5 of 8
76recommend and deem appropriate, which may include, but shall not be limited to, any
77medication for addiction treatment. A re-entry treatment plan shall ensure that a detained,
78committed or incarcerated person is directly connected to an appropriate provider or treatment
79site in the geographic region in which the person shall reside upon release. A detained,
80committed or incarcerated person upon release shall receive information regarding treatment
81facilities in their area, information on available housing and employment resources, and any
82other information that will assist the individual as they continue their addiction recovery. The
83commissioner and county sheriffs shall further ensure that, for a person with a re-entry treatment
84plan under this section, the facility shall request reinstatement or apply for MassHealth benefits
85for the person at least 30 days prior to release or shall use best efforts to request such
86reinstatement of or apply for MassHealth benefits or other public assistance for the person within
87a reasonable timeframe if the person’s sentence, detention or commitment is less than 30 days.
88Notwithstanding the foregoing, nothing in this section shall authorize a state prison or county
89facility to extend a person’s sentence, detention or commitment to comply with this section. In
90the event the expected discharge date of a detained, committed or incarcerated person serving a
91sentence to a state prison or county facility is less than 30 days following the start date of said
92detained, committed or incarcerated person’s sentence, detention or commitment, a qualified
93addiction specialist shall use best efforts to establish a medically appropriate treatment plan for
94the person prior to the expected discharge date.
95 SECTION 5. Said chapter 127 is hereby amended by striking out section 17D and
96replacing it with the following:-
97 (a) Every six months, on a schedule to be established by the department of public health,
98the commissioner and the administrator of each county correctional facility shall report, in a 6 of 8
99format determined by the commissioner of public health, to the commissioner of public health,
100the house and senate committees on ways and means, the joint committee on mental health,
101substance use and recovery, the joint committee on public safety and homeland security and the
102joint committee on the judiciary the following information for the prior six months: (i) at the
103time of the report, the number of persons in the custody of the facility receiving each medication
104for addiction treatment, in total and disaggregated by dosage; (ii) the number of persons in the
105custody of the facility, in any status, who continued to receive the same medication for addiction
106treatment as they received prior to incarceration, detention or commitment, by medication type;
107(iii) the number of persons in the custody of the facility, in any status, who discontinued
108medication for addiction treatment that they received prior to incarceration, detention or
109commitment by medication type; (iv) the number of persons in the custody of the facility, in any
110status, who received a different medication for addiction treatment than they received prior to
111incarceration, detention or commitment, by medication type; (v) the number of persons in the
112custody of the facility, in any status, who received medication for addiction treatment who did
113not receive such treatment prior to incarceration, detention or commitment, by medication type;
114(vi) a summary of facility practices and any changes to those practices related to medication for
115addiction treatment; (vii) the number of persons who were connected to treatment after release;
116(viii) the number of nonfatal and fatal overdoses in the facility; (ix) the number of nonfatal and
117fatal overdoses within 1 year of release from the department of correction and each county
118facility, provided, however, that the commissioner, the sheriffs, and the commissioner of public
119health shall coordinate to provide such information; (x) the number of persons who received a re-
120entry treatment plan under section 17C and were subsequently enrolled in MassHealth upon
121discharge; provided, however, that the commissioner, the sheriffs, the commissioner of medical 7 of 8
122assistance and the commissioner of public health shall coordinate to provide such information;
123and (xi) any other information requested by the commissioner of public health related to the
124provision of medication for addiction treatment.
125 (b) Every 2 years, not later than April 30, the commissioner of public health shall prepare
126a report, pursuant to section 237 of chapter 111, regarding outcomes for the treatment programs
127established under sections 17B and 17C to the house and senate committees on ways and means,
128the joint committee on mental health, substance use and recovery, the joint committee on public
129safety and homeland security and the joint committee on the judiciary. The department of
130correction and county correctional facilities shall provide, upon request from the commissioner
131of public health, information necessary to prepare the report. The report shall, to the extent
132possible, provide a comparison between the detained, committed and incarcerated persons who
133did not receive medication for addiction treatment and those who did, reported separately for
134each medication type, in order to determine the impact of the treatment programs on the
135following: (i) treatment retention after release; (ii) substance use after release; (iii) rates of
136recidivism; (iv) rates of nonfatal and fatal overdose; and (v) other outcome measures identified
137by the commissioner of public health.
138 SECTION 6. As soon as practicable, and in any event within 30 days of passage of this
139legislation, all state and county correctional facilities shall assess for treatment with medication
140for addiction treatment all detained, committed or incarcerated persons in their respective
141institutions who have substance use-related needs but who are not currently receiving medication
142for addiction treatment. Detained, committed or incarcerated persons for whom such medication
143is clinically indicated shall be offered such medication within 24 hours of such assessment, and 8 of 8
144such medication shall be prescribed and provided in a manner consistent with the provisions of
145section 17B of chapter 127.
146 SECTION 7. Section 98 of chapter 208 of the acts of 2018 is hereby repealed.