PRINTER'S NO. 1124
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
860
Session of
2017
INTRODUCED BY GREENLEAF, YUDICHAK, BROWNE, SCHWANK, MENSCH AND
WHITE, AUGUST 29, 2017
REFERRED TO JUDICIARY, AUGUST 29, 2017
AN ACT
Providing for duties of the Department of Corrections and the
Department of Drug and Alcohol Programs, for educating and
training of government-funded professionals who come into
contact with individuals engaged in risky substance use and
for training programs to educate physicians and nonphysicians
in addressing risky substance use and addiction; developing
screening and assessment instruments for addictive
substances; requiring treatment programs and providers to
utilize evidence-based prevention and treatment approaches;
and providing for screening at the time of arraignment.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Criminal
Justice and Addiction Treatment Act.
Section 2. Legislative findings.
The General Assembly finds that:
(1) Seventy percent of inmates in the State correctional
system have some level of substance abuse.
(2) One in four families in Pennsylvania is struggling
to help a loved one with an untreated alcohol or drug-related
addiction.
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(3) Addiction involving nicotine, alcohol and other
drugs affects 16% of Americans who are more than 11 years of
age, which represents 40,000,000 people.
(4) Most medical professionals are not sufficiently
trained to educate patients about risky use and addiction,
conduct screening and interventions for risky use or diagnose
and treat addiction.
(5) Many of the physicians and other medical
professionals are not equipped with the knowledge, skills or
credentials necessary to provide the full range of evidence-
based services to screen, assess and refer to appropriate
addiction treatment.
(6) Addiction is a disease that can be screened for at
venues where regular medical care is delivered by physicians,
including addiction physician specialists, and including a
multidisciplinary team of other health professionals using an
array of evidence-based pharmaceutical and psychosocial
approaches.
Section 3. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Board." The State Board of Medicine, the State Board of
Osteopathic Medicine, the State Board of Nursing, the State
Board of Psychology, the State Board of Social Workers, Marriage
and Family Therapists and Professional Counselors, the State
Board of Dentistry and the State Board of Pharmacy.
"Clinical standards committee." A committee administratively
established within the Department of Drug and Alcohol Programs
that consists of representatives from addiction treatment
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programs, single county authorities, managed care organizations,
physicians, recovery advocate organizations, educational
institutions and State agencies and that, upon the request of
the department, may make recommendations to the department.
"Department." The Department of Drug and Alcohol Programs of
the Commonwealth.
"Evidence-based practices." Structured interventions and
treatment approaches that have been proven effective for
specific populations and settings through appropriate empirical
analysis and were previously evidence-informed practices that
were validated by additional research.
"Evidence-informed practices." Practices that are based in
research-supported theory and utilize evidence-based principles
that have been modified and adapted so that the techniques may
be individualized to the specific treatment needs of an
individual with substance use disorder.
"Risky substance use." Any of the following activities:
(1) the use of tobacco or a tobacco product;
(2) the use of alcoholic beverages in excess of the
dietary guidelines of the United States Department of
Agriculture;
(3) the misuse of a prescription drug; or
(4) the illegal use of a controlled substance, but which
activity does not meet clinical diagnostic criteria for
addiction.
"Screening." A brief assessment by healthcare professionals
that assesses a patient for risky substance use behaviors using
standardized screening tools and that is used to determine if a
full assessment is recommended.
"Secretary." The Secretary of Corrections of the
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Commonwealth.
Section 4. Offenders in State correctional institutions.
The secretary, in consultation with the department, shall
utilize drug and alcohol addiction treatment services for
offenders in State correctional institutions that are certified
by the department as utilizing evidence-based practices and
evidence-informed practices tailored to the needs of offenders.
The secretary shall ensure that prerelease plans are developed
for inmates with substance-use disorders that provide transition
to a broad range of integrated reentry services. The duties
under this section include development of procedures that ensure
enrollment in Medicaid is in effect at the time of release.
Section 5. Training and education of government-funded
professionals.
The department shall provide courses to educate and train
government-funded professionals, including, but not limited to:
(1) law enforcement and other criminal justice
personnel;
(2) legal staff, child welfare and other social service
workers; and
(3) educators.
who do not provide direct addiction-related services but who
come into contact with significant numbers of individuals who
engage in risky substance use or who may have addiction. The
courses shall contain best practices for recognizing substance-
involved individuals and knowing how to respond.
Section 6. Education and training of health care professionals.
(a) Physicians.--
(1) The department shall, in consultation with the
clinical standards committee, develop:
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(i) core clinical competencies that can be
incorporated as required components of all medical
schools' curricula, residency training programs,
licensing examinations and continuing education
requirements to address risky substance use and
addiction;
(ii) prevention, intervention, treatment and
management options; and
(iii) competencies for co-occurring conditions and
special population and specialty-care needs.
(2) The competencies shall include:
(i) What constitutes risky substance use, the harms
of such use to health and safety and the importance of
reducing risky substance use.
(ii) How to screen for risky substance use and to
conduct brief interventions when indicated.
(iii) The causes and correlates of addiction.
(iv) How to diagnose addiction, evaluate disease
stage, severity, co-occurring disorders and needs of
special populations and develop a treatment and disease
management plan, including appropriate support services.
(v) How to collaborate with and manage a
multidisciplinary team of providers.
(vi) How to provide or supervise psychosocial and
pharmaceutical treatments for addiction and disease
management.
(vii) How to arrange for and connect patients with
auxiliary support services.
(viii) How to determine the need for specialty care
and connect patients with such care.
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(b) Nonphysicians.--
(1) The department shall, in consultation with the
clinical standards committee, develop core clinical
competencies that can be incorporated as required components
of all professional health care program curricula, graduate
fellowship training programs, professional licensing
examinations and continuing education requirements in
addressing risky substance use and preventing and treating
addiction for each type of nonphysician health professional,
including physician assistants, nurses and nurse
practitioners, dentists, pharmacists and graduate-level
clinical mental health professionals.
(2) These competencies shall include:
(i) What constitutes risky substance use, the harms
of such use to health and safety and the importance of
reducing risky use.
(ii) How to screen for risky substance use and
conduct brief interventions when indicated.
(iii) The causes and correlates of addiction.
(iv) Available psychosocial and pharmaceutical
treatments for addiction and disease management.
(v) How to arrange for and connect patients with
auxiliary support services.
(vi) How to determine the need for specialty care
and connect patients with such care.
(c) Cooperation with boards.--In carrying out its duties
under subsections (a) and (b), the department shall work with
each board to incorporate the core clinical competencies into
continuing education requirements.
(d) Prescriber training.--Each board shall establish
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continuing education requirements and criteria appropriate to
its respective discipline for training on best practices of
prescribing controlled substances for a person issued a license
or certificate by the board that prescribes, administers or
dispenses a controlled substance.
Section 7. Screening and assessment instruments.
The department shall, in consultation with the clinical
standards committee, develop screening and assessment
instruments for all types of addictive substances that physician
and nonphysician health professionals can use for diagnosing
addiction.
Section 8. Conditional funding.
As a condition of receiving any funding through the
department, any drug and alcohol treatment facility, whether
freestanding or within a hospital setting, shall utilize
evidence-based practices or evidence-informed practices.
Section 9. Screening at the time of arraignment.
At the time of arraignment a defendant shall be directed by
the court to undergo preliminary screening for substance abuse
and addiction. At the time of setting bail, the court may
include drug and alcohol treatment based on a complete
assessment in accordance with criteria set by the department as
a condition of bail.
Section 10. Effective date.
This act shall take effect in 60 days.
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