1Providing for duties of the Department of Corrections and the
2Department of Drug and Alcohol Programs, for educating and
3training of government-funded professionals who come into
4contact with individuals engaged in risky substance use and
5for training programs to educate physicians and nonphysicians
6in addressing risky substance use and addiction; developing
7screening and assessment instruments for addictive
8substances; requiring treatment programs and providers to
9utilize evidence-based prevention and treatment approaches;
10mandating insurance coverage for screening, brief
11intervention, referral to treatment for individuals at risk
12for substance use and treatment and disease management for
13addiction; and providing for screening at the time of
14arraignment.

15The General Assembly finds that:

16(1) Seventy percent of inmates in the State correctional
17system have some level of substance abuse.

18(2) One in four families in Pennsylvania is struggling to
19help a loved one with an untreated alcohol or drug-related
20addiction.

21(3) Addiction involving nicotine, alcohol and other drugs
22affects 16% of Americans who are more than 11 years of age,
23which represents 40,000,000 people.

24(4) Most health professionals are not sufficiently trained

1to educate patients about risky use and addiction, conduct
2screening and interventions for risky use or diagnose and treat
3addiction.

4(5) Many of those who currently make up the addiction
5treatment provider work force are not equipped with the
6knowledge, skills or credentials necessary to provide the full
7range of evidence-based services to treat addiction.

8(6) Addiction is a disease that can be treated and managed
9effectively at venues where regular medical care is delivered by
10physicians, including addiction physician specialists, and
11including a multidisciplinary team of other health professionals
12using an array of evidence-based pharmaceutical and psychosocial
13approaches.

14The General Assembly of the Commonwealth of Pennsylvania
15hereby enacts as follows:

16Section 1. Short title.

17This act shall be known and may be cited as the Criminal
18Justice and Addiction Treatment Act.

19Section 2. Definitions.

20The following words and phrases when used in this act shall
21have the meanings given to them in this section unless the
22context clearly indicates otherwise:

23"Board." The State Board of Medicine, the State Board of
24Osteopathic Medicine, the State Board of Nursing, the State
25Board of Psychology, the State Board of Social Workers, Marriage
26and Family Therapists and Professional Counselors, the State
27Board of Dentistry and the State Board of Pharmacy.

28"Clinical standards committee." A committee administratively
29established within the Department of Drug and Alcohol Programs
30that consists of representatives from providers, single county

1authorities, managed care organizations, physicians, recovery
2advocate organizations, educational institutions and State
3agencies and that, upon the request of the department, may make
4recommendations to the department.

5"Department." The Department of Drug and Alcohol Programs of
6the Commonwealth.

7"Evidence-based practices." Interventions and treatment
8approaches that have been proven effective through appropriate
9empirical analysis.

10"Health insurance policy." Any group health, sickness or
11accident policy or subscriber contract or certificate offered to
12groups of 51 or more employees issued by an entity subject to
13any one of the following:

14(1) The act of May 17, 1921 (P.L.682, No.284), known as
15the Insurance Company Law of 1921.

16(2) The act of December 29, 1972 (P.L.1701, No.364),
17known as the Health Maintenance Organization Act.

18(3) 40 Pa.C.S. Ch. 61 (relating to hospital plan
19corporations) or 63 (relating to professional health services
20plan corporations).

21The term does not include accident only, fixed indemnity,
22limited benefit, credit, dental, vision, specified disease,
23Medicare supplement, Civilian Health and Medical Program of the
24Uniformed Services (CHAMPUS) supplement, long-term care or
25disability income, workers' compensation or automobile medical
26payment insurance.

27"Insurer." An entity offering a health insurance policy in
28this Commonwealth.

29"Risky substance use." Any of the following activities:

30(1) the use of tobacco or a tobacco product;

1(2) the use of alcoholic beverages in excess of the
2dietary guidelines of the United States Department of
3Agriculture;

4(3) the misuse of a prescription drug; or

5(4) the illegal use of a controlled substance, but which
6activity does not meet clinical diagnostic criteria for
7addiction.

8"Secretary." The Secretary of Corrections of the
9Commonwealth.

10Section 3. Offenders in State correctional institutions.

11The secretary shall utilize drug and alcohol treatment
12services for offenders in State correctional institutions that
13are certified by the department as utilizing evidence-based
14practices tailored to the needs of offenders. The secretary
15shall also develop a prerelease plan for inmates with substance-
16use disorders that provides transition to a broad range of
17integrated reentry services.

18Section 4. Training and education of government-funded
19professionals.

20The department shall provide courses to educate and train
21government-funded professionals, including, but not limited to:

22(1) law enforcement and other criminal justice
23personnel;

24(2) legal staff, child welfare and other social service
25workers; and

26(3) educators

27who do not provide direct addiction-related services but who
28come into contact with significant numbers of individuals who
29engage in risky substance use or who may have addiction. The
30courses shall contain best practices for recognizing substance-

1involved individuals and knowing how to respond.

2Section 5. Education and training of health care professionals.

3(a) Physicians.--

4(1) The department shall, in consultation with the
5clinical standards committee, develop:

6(i) core clinical competencies that can be
7incorporated as required components of all medical
8schools curricula, residency training programs, licensing
9examinations and continuing education requirements to
10address risky substance use and addiction;

11(ii) prevention, intervention, treatment and
12management options; and

13(iii) co-occurring conditions and special population
14and specialty-care needs.

15(2) The competencies shall include:

16(i) What constitutes risky substance use, the harms
17of such use to health and safety and the importance of
18reducing risky substance use.

19(ii) How to screen for risky substance use and to
20conduct brief interventions when indicated.

21(iii) The causes and correlates of addiction.

22(iv) How to diagnose addiction; evaluate disease
23stage, severity, co-occurring disorders and needs of
24special populations; and develop a treatment and disease
25management plan, including appropriate support services.

26(v) How to collaborate with and manage a
27multidisciplinary team of providers.

28(vi) How to provide or supervise psychosocial and
29pharmaceutical treatments for addiction and disease
30management.

1(vii) How to arrange for and connect patients with
2auxiliary support services.

3(viii) How to determine the need for specialty care
4and connect patients with such care.

5(b) Nonphysicians.--

6(1) The department shall, in consultation with the
7clinical standards committee, develop core clinical
8competencies that can be incorporated as required components
9of all professional health care program curricula, graduate
10fellowship training programs, professional licensing
11examinations and continuing education requirements in
12addressing risky substance use and preventing and treating
13addiction for each type of nonphysician health professional,
14including physician assistants, nurses and nurse
15practitioners, dentists, pharmacists and graduate-level
16clinical mental health professionals.

17(2) These competencies shall include:

18(i) What constitutes risky substance use, the harms
19of such use to health and safety and the importance of
20reducing risky use.

21(ii) How to screen for risky substance use and
22conduct brief interventions when indicated.

23(iii) The causes and correlates of addiction.

24(iv) Available psychosocial and pharmaceutical
25treatments for addiction and disease management.

26(v) How to arrange for and connect patients with
27auxiliary support services.

28(vi) How to determine the need for specialty care
29and connect patients with such care.

30(c) Cooperation with boards.---In carrying out its duties

1under subsections (a) and (b), the department shall work with
2the boards to incorporate the core clinical competencies into
3continuing education requirements.

4(d) Prescriber training.---Each board shall establish
5continuing education requirements and criteria appropriate to
6its respective discipline for training on best practices of
7prescribing controlled substances for a person issued a license
8or certificate by the board that prescribes, administers or
9dispenses a controlled substance.

10Section 6. Screening and assessment instruments.

11The department shall, in consultation with the clinical
12standards committee, develop screening and assessment
13instruments for all types of addictive substances that physician
14and nonphysician health professionals can use for diagnosing
15addiction.

16Section 7. State accreditation standards.

17The department shall develop State accreditation standards
18for all drug and alcohol treatment facilities and programs that
19reflect evidence-based practices. As a condition of
20accreditation, the department shall require all facilities and
21programs providing addiction treatment to meet all of the
22following:

23(1) Have on staff or available for consultation a
24certified addiction physician specialist.

25(2) Provide comprehensive assessment and treatment that
26uses evidence-based practices for addiction involving all
27substances that are tailored to the stage and severity of the
28disease, co-occurring conditions and patient characteristics.

29(3) Collect and report comprehensive quality assessment
30data, including process and outcome measurements related to

1screening, intervention, treatment and disease management, in
2accordance with established guidelines developed in
3collaboration with the American Board of Addiction Medicine.

4Section 8. Conditional funding.

5As a condition of receiving any funding through the
6department, any drug and alcohol treatment facility, whether
7freestanding or within a hospital setting, shall utilize
8evidence-based practices, including, but not limited to,
9pharmaceutical therapies provided or managed by a physician and
10psychosocial therapies provided by medical professionals or
11graduate-level clinical mental health professionals trained and
12licensed in core competencies of addiction treatment.

13Section 9. Insurance coverage.

14An insurer shall provide coverage for screening, brief
15intervention, referral to treatment for individuals at risk for
16substance use and treatment and disease management for addiction
17consistent with standards of medical practice. An insurer may
18require, as a condition of payment, for addiction intervention
19and treatment by a drug and alcohol treatment provider that the
20services are directly provided, supervised or managed by trained
21medical professionals.

22Section 10. Screening at the time of arraignment.

23At the time of arraignment a defendant shall be directed by
24the court to undergo screening for substance abuse and
25addiction. At the time of setting bail, the court may include
26drug and alcohol treatment as a condition of bail.

27Section 11. Effective date.

28This act shall take effect in 60 days.