Regular Session 2017-2018 Senate Bill 1089 P.N. 1580

PRINTER'S NO. 1580

THE GENERAL ASSEMBLY OF PENNSYLVANIA

SENATE BILL

No.

1089

Session of

2018

INTRODUCED BY STEFANO, MENSCH, WARD, ARGALL, BARTOLOTTA,

BREWSTER, EICHELBERGER, FOLMER, KILLION, MARTIN, McGARRIGLE,

RAFFERTY, RESCHENTHALER, SCAVELLO, WILLIAMS AND YUDICHAK,

MARCH 23, 2018

REFERRED TO HEALTH AND HUMAN SERVICES, MARCH 23, 2018

AN ACT

Amending the act of April 9, 1929 (P.L.177, No.175), entitled,

as amended, "An act providing for and reorganizing the

conduct of the executive and administrative work of the

Commonwealth by the Executive Department thereof and the

administrative departments, boards, commissions, and officers

thereof, including the boards of trustees of State Normal

Schools, or Teachers Colleges; abolishing, creating,

reorganizing or authorizing the reorganization of certain

administrative departments, boards, and commissions; defining

the powers and duties of the Governor and other executive and

administrative officers, and of the several administrative

departments, boards, commissions, and officers; fixing the

salaries of the Governor, Lieutenant Governor, and certain

other executive and administrative officers; providing for

the appointment of certain administrative officers, and of

all deputies and other assistants and employes in certain

departments, boards, and commissions; providing for judicial

administration; and prescribing the manner in which the

number and compensation of the deputies and all other

assistants and employes of certain departments, boards and

commissions shall be determined," in powers and duties of the

Department of Human Services and its departmental

administrative and advisory boards and commissions, further

providing for medical assistance payments and for admissions

to drug and alcohol facilities.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. Article XXIII heading and sections 2334 and 2335

of the act of April 9, 1929 (P.L.177, No.175), known as The

Administrative Code of 1929, are amended to read:

ARTICLE XXIII

POWERS AND DUTIES OF THE DEPARTMENT OF

[PUBLIC WELFARE] HUMAN SERVICES AND ITS DEPARTMENTAL

ADMINISTRATIVE AND ADVISORY BOARDS

AND COMMISSIONS

Section 2334. Medical Assistance Payments.--(a) It is the

general purpose of this section to provide for a continuum of

alcohol and drug detoxification and rehabilitation services to

persons eligible for medical assistance. Facilities serving as

appropriate treatment settings include hospital and nonhospital

drug detoxification and rehabilitation facilities, hospital and

nonhospital alcohol detoxification and rehabilitation

facilities, and hospital and nonhospital drug and alcohol

detoxification and rehabilitation facilities and outpatient

services licensed by the [Office] Department of Drug and Alcohol

Programs [of the Department of Health]. The General Assembly

recognizes that the fluctuating nature of alcohol and drug

dependency, in combination with the associated physical

complications often arising from long-term use of alcohol and

drugs, necessitates that a variety of treatment modalities and

settings be made available to persons eligible for medical

assistance. The availability of a new service in this area is in

no way intended to limit access to or funding of services

available currently.

(b) Consistent with section 2301, the Department of [Public

Welfare] Human Services shall:

(1) Provide, on behalf of persons eligible for medical

assistance, medical assistance coverage for detoxification,

20180SB1089PN1580 - 2 -

treatment and care in a nonhospital alcohol detoxification

facility, nonhospital drug detoxification facility, nonhospital

alcohol and drug detoxification facility, or a nonhospital

treatment facility which can provide services for either drug or

alcohol detoxification or treatment or for both, provided that

the facility is licensed by the [Office] Department of Drug and

Alcohol Programs [in the Department of Health].

(2) Use criteria developed by the [Office] Department of

Drug and Alcohol Programs for governing the type, level and

length of care or treatment, including hospital detoxification,

as a basis for the development of standards for services

provided under clause (1).

[(3) Notwithstanding clause (1), provide by regulation for

gradual implementation of medical assistance coverage under this

subsection to client populations which shall be identified in

cooperation with the Department of Health. The regulations shall

provide for full implementation of clause (1) to all medical

assistance eligibles in phases over a period of time not to

exceed five years from the effective date of the regulations.

The program phases shall be structured so as to allow for

independent evaluation of each phase on an ongoing basis.

Initial regulations adopted pursuant to this subsection shall

not be subject to review pursuant to the act of June 25, 1982

(P.L.633, No.181), known as the "Regulatory Review Act," except

that the regulations may be reviewed under section 5(h) of that

act.

Health and the Office of Drug and Alcohol Programs shall jointly

provide for an independent evaluation of the program authorized

by this section in accordance with specific evaluation criteria,

20180SB1089PN1580 - 3 -

which shall include, but not be limited to: (i) comparison of

medical costs before and after program implementation; (ii)

employment history; and (iii) involvement with other programs of

the Department of Health, the Department of Public Welfare, the

Department of Corrections and any other appropriate agencies.

The evaluation shall be conducted in compliance with all

applicable Federal and State confidentiality requirements.]

(4) Require each medical assistance behavioral health

managed care organization administering a provider network on

behalf of a county for treatment of substance abuse to maintain

a provider network that is geographically accessible to members.

The access standard for ambulatory substance abuse treatment to

which a member travels shall be at least two providers within:

(i) thirty minutes travel time in urban areas; and

(ii) thirty minutes travel time in rural areas if licensed

substance abuse treatment centers are accessible, otherwise

within sixty minutes of travel time.

(d) For the purposes of this section, "ambulatory substance

abuse treatment" means treatment provided by a facility approved

by the Department of Human Services to participate in the

Medical Assistance Program and which is fully or provisionally

licensed by the Department of Drug and Alcohol Programs to

provide regular psychotherapy, client management, medical and

psychological outpatient services for the diagnosis and

treatment of drug and alcohol abuse and dependence to eligible

Medical Assistance outpatient recipients who are not residents

of a treatment institution.

Section 2335. Admissions to Drug and Alcohol Facilities.--

(a) Drug or alcohol abusers and drug or alcohol dependent

persons shall be admitted to and treated in all facilities

20180SB1089PN1580 - 4 -

licensed by the Department [of Health and Office] of Drug and

Alcohol Programs, at reasonable rates on the basis of medical or

psychotherapeutic need, and shall not be discriminated against

on the basis of medical assistance eligibility.

(b) As part of its licensure process, the [Office]

Department of Drug and Alcohol Programs shall review each

facility's admission policies for compliance and shall

investigate complaints.

suspend or revoke the license of any facility which fails to

maintain an admission policy consistent with the requirements of

this section and may impose a fine not to exceed one thousand

dollars ($1,000) for each violation.

(d) Nothing in this section shall require any facility to

accept medical assistance eligible patients for whom payment is

not available pursuant to regulations adopted under former

section 2334(b)(3).

Section 2. This act shall take effect in 60 days.

20180SB1089PN1580 - 5 -