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PRIOR PRINTER'S NO. 2207
PRINTER'S NO. 2528
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1662
Session of
2019
INTRODUCED BY DiGIROLAMO, KINSEY, ZABEL, SCHLOSSBERG, MILLARD,
HOHENSTEIN, HOWARD, DeLUCA, SAYLOR, T. DAVIS, FREEMAN,
NEILSON, SIMS, MOUL, HILL-EVANS, WEBSTER, POLINCHOCK, ROZZI,
NELSON, STRUZZI, PASHINSKI, RIGBY, SCHLEGEL CULVER, COMITTA,
GREGORY AND MIHALEK, JUNE 19, 2019
AS AMENDED ON SECOND CONSIDERATION, HOUSE OF REPRESENTATIVES,
SEPTEMBER 19, 2019
AN ACT
Amending the act of October 24, 2012 (P.L.1198, No.148),
entitled "An act establishing the Methadone Death and
Incident Review Team and providing for its powers and duties;
and imposing a penalty," further providing for title of act,
for short title, for definitions, for establishment of
Methadone Death and Incident Review Team, for team duties,
for duties of coroner and medical examiner, for review
procedures and for confidentiality.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The title and sections 1, 2, 3 heading, (a) and
(b)(3), 4, 5, 6 and 8(a) and (f) of the act of October 24, 2012
(P.L.1198, No.148), known as the Methadone Death and Incident
Review Act, are amended to read:
An Act
Establishing the [Methadone] and Buprenorphine MEDICATION Death
and Incident Review Team and providing for its powers and
duties; and imposing a penalty.
Section 1. Short title.
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This act shall be known and may be cited as the [Methadone]
and Buprenorphine MEDICATION Death and Incident Review Act.
Section 2. 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:
"Department." The Department of Drug and Alcohol Programs of
the Commonwealth.
["Methadone-related] or buprenorphine-related "MEDICATION-
RELATED death." A death where [methadone] or buprenorphine A
MEDICATION APPROVED BY THE UNITED STATES FOOD AND DRUG
ADMINISTRATION FOR THE TREATMENT OF OPIOID USE DISORDER was:
(1) a primary or secondary cause of death; or
(2) may have been a contributing factor.
["Methadone-related] or buprenorphine-related "MEDICATION-
RELATED incident." A situation where [methadone] or
buprenorphine A MEDICATION APPROVED BY THE UNITED STATES FOOD
AND DRUG ADMINISTRATION FOR THE TREATMENT OF OPIOID USE DISORDER
may be a contributing factor which:
(1) does not involve a fatality; and
(2) involves:
(i) a serious injury; or
(ii) unreasonable risk of death or serious injury.
["Narcotic treatment program."] "Opioid-assisted treatment
program." A program licensed and approved by the Department of
Drug and Alcohol Programs for chronic opiate drug users that
administers or dispenses agents under a narcotic treatment
physician's order, either for detoxification purposes or for
maintenance.
"OPIOID USE DISORDER." A PROBLEMATIC PATTERN OF OPIOID USE
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LEADING TO CLINICALLY SIGNIFICANT IMPAIRMENT OR DISTRESS.
"Secretary." The Secretary of Drug and Alcohol Programs of
the Commonwealth.
"Team." The [Methadone] and Buprenorphine MEDICATION Death
and Incident Review Team established under section 3.
Section 3. Establishment of [Methadone] and Buprenorphine
MEDICATION Death and Incident Review Team.
(a) Team established.--The department shall establish a
[Methadone] and Buprenorphine MEDICATION Death and Incident
Review Team and conduct a review and shall examine the
circumstances surrounding [methadone-related] or buprenorphine-
related MEDICATION-RELATED deaths and [methadone-related] or
buprenorphine-related MEDICATION-RELATED incidents in this
Commonwealth for the purpose of promoting safety, reducing
[methadone-related] or buprenorphine-related MEDICATION-RELATED
deaths and [methadone-related] or buprenorphine-related
MEDICATION-RELATED incidents and improving treatment practices.
(b) Composition.--The team shall consist of the following
individuals:
* * *
(3) The following individuals appointed by the
secretary:
(i) A representative from [narcotic treatment
programs as defined in 28 Pa. Code ยง 701.1 (relating to
definitions)] an opioid-assisted treatment program.
(ii) A representative from a licensed drug and
alcohol addiction treatment program that is not defined
as [a narcotic treatment program] an opioid-assisted
treatment program.
(iii) A representative from law enforcement
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recommended by a Statewide association representing
members of law enforcement.
(iv) A representative from the medical community
recommended by a Statewide association representing
physicians.
(v) A district attorney recommended by a Statewide
association representing district attorneys.
(vi) A coroner or medical examiner recommended by a
Statewide association representing county coroners and
medical examiners.
(vii) A member of the public.
(viii) A patient or family advocate.
(ix) A representative from a recovery organization.
(X) AN OFFICE-BASED AGONIST TREATMENT PROVIDER WHO
IS ASSIGNED A WAIVER FROM THE DRUG ENFORCEMENT
ADMINISTRATION, INCLUDING A SPECIAL IDENTIFICATION
NUMBER, COMMONLY REFERRED TO AS THE "X" DEA NUMBER, TO
PROVIDE OFFICE-BASED PRESCRIBING OF BUPRENORPHINE.
(XI) A REPRESENTATIVE OF THE DEPARTMENT OF HEALTH
WHO IS AFFILIATED WITH THE ACHIEVING BETTER CARE BY
MONITORING ALL PRESCRIPTIONS PROGRAM (ABC-MAP)
ESTABLISHED UNDER THE ACT OF OCTOBER 27, 2014 (P.L.2911,
NO.191) , KNOWN AS THE ACHIEVING BETTER CARE BY MONITORING
ALL PRESCRIPTIONS PROGRAM (ABC-MAP) ACT .
(XII) A TOXICOLOGIST.
* * *
Section 4. Team duties.
The team shall:
(1) Review each MEDICATION-RELATED death where
[methadone] or buprenorphine A MEDICATION APPROVED BY THE
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UNITED STATES FOOD AND DRUG ADMINISTRATION FOR THE TREATMENT
OF OPIOID USE DISORDER was either the primary or a secondary
cause of death and review [methadone-related] or
buprenorphine-related MEDICATION-RELATED incidents.
(2) Determine the role that [methadone] or buprenorphine
A MEDICATION APPROVED BY THE UNITED STATES FOOD AND DRUG
ADMINISTRATION FOR THE TREATMENT OF OPIOID USE DISORDER
played in each death and [methadone-related] or
buprenorphine- related MEDICATION-RELATED incident.
(3) Communicate concerns to regulators and facilitate
communication within the health care and legal systems about
issues that could threaten health and public safety.
(4) Develop best practices to prevent future [methadone-
related] or buprenorphine-related MEDICATION-RELATED deaths
and [methadone-related] or buprenorphine-related MEDICATION-
RELATED incidents. The best practices shall be:
(i) Promulgated by the department as regulations.
(ii) Posted on the department's Internet website.
(5) Collect and store data on the number of [methadone-
related] or buprenorphine-related MEDICATION-RELATED deaths
and [methadone-related] or buprenorphine-related MEDICATION-
RELATED incidents and provide a brief description of each
death and incident. The aggregate statistics shall be posted
on the department's Internet website. [The team may collect
and store data concerning deaths and incidents related to
other drugs used in opiate treatment.]
(6) Develop a form for the submission of [methadone-
related] or buprenorphine-related MEDICATION-RELATED deaths
and [methadone-related] or buprenorphine-related MEDICATION-
RELATED incidents to the team by any concerned party.
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(7) Develop, in consultation with a Statewide
association representing county coroners and medical
examiners, a model form for county coroners and medical
examiners to use to report and transmit information regarding
[methadone-related] or buprenorphine-related MEDICATION-
RELATED deaths to the team. The team and the Statewide
association representing county coroners and medical
examiners shall collaborate to ensure that all [methadone-
related] or buprenorphine-related MEDICATION-RELATED deaths
are, to the fullest extent possible, identified by coroners
and medical examiners.
(8) Develop and implement any other strategies that the
team identifies to ensure that the most complete collection
of [methadone-related] or buprenorphine-related MEDICATION-
RELATED death and [methadone-related] or buprenorphine-
related MEDICATION-RELATED serious incident cases reasonably
possible is created.
(9) Prepare an annual report that shall be posted on the
department's Internet website and distributed to the chairman
and minority chairman of the Judiciary Committee of the
Senate, the chairman and minority chairman of the [Public
Health and Welfare] HEALTH AND HUMAN SERVICES Committee of
the Senate, the chairman and minority chairman of the
Judiciary Committee of the House of Representatives and the
chairman and minority chairman of the Human Services
Committee of the House of Representatives. Each report shall:
(i) Provide public information regarding the number
and causes of [methadone-related] or buprenorphine-
related MEDICATION-RELATED deaths and [methadone-related]
or buprenorphine-related MEDICATION-RELATED incidents.
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(ii) Provide aggregate data on five-year trends on
[methadone-related] or buprenorphine-related MEDICATION-
RELATED deaths and [methadone-related] or buprenorphine-
related MEDICATION-RELATED incidents when such
information is available.
(iii) Make recommendations to prevent future
[methadone-related] or buprenorphine-related MEDICATION-
RELATED deaths, [methadone-related] or buprenorphine-
related MEDICATION-RELATED incidents and abuse and set
forth the department's plan for implementing the
recommendations.
(iv) Recommend changes to statutes and regulations
to decrease [methadone-related] or buprenorphine-related
MEDICATION-RELATED deaths and [methadone-related] or
buprenorphine-related MEDICATION-RELATED incidents.
(v) Provide a report on [methadone-related] or
buprenorphine-related MEDICATION-RELATE D deaths and
[methadone-related] or buprenorphine-related MEDICATION-
RELATED incidents and concerns regarding [narcotic]
opioid-assisted treatment programs.
(10) Develop and publish on the department's Internet
website a list of meetings for each year.
Section 5. Duties of coroner and medical examiner.
A county coroner or medical examiner shall forward all
[methadone-related] or buprenorphine-related MEDICATION-RELATED
death cases to the team for review. The county coroner and
medical examiner shall use the model form developed by the team
to transmit the data.
Section 6. Review procedures.
The team may review the following information:
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(1) Coroner's reports or postmortem examination records
unless otherwise prohibited by Federal or State laws,
regulations or court decisions.
(2) Death certificates and birth certificates.
(3) Law enforcement records and interviews with law
enforcement officials as long as the release of such records
will not jeopardize an ongoing criminal investigation or
proceeding.
(4) Medical records from hospitals, other health care
providers and [narcotic treatment programs] opioid-assisted
treatment programs.
(5) Information and reports made available by the county
children and youth agency in accordance with 23 Pa.C.S. Ch.
63 (relating to child protective services).
(6) Information made available by firefighters or
emergency services personnel.
(7) Reports and records made available by the court to
the extent permitted by law or court rule.
(8) EMS records.
(9) Traffic fatality reports.
(10) [Narcotic treatment program] O pioid-assisted
treatment program incident reports.
(11) [Narcotic treatment program] Opioid-assisted
treatment program licensure surveys from the program
licensure division.
(12) Any other records necessary to conduct the review.
Section 8. Confidentiality.
(a) Maintenance.--The team shall maintain the
confidentiality of any identifying information obtained relating
to the death of an individual or adverse incidents regarding
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[methadone] or buprenorphine MEDICATION, including the name of
the individual, guardians, family members, caretakers or alleged
or suspected perpetrators of abuse, neglect or a criminal act.
* * *
(f) Attendance.--Nothing in this act shall prevent the team
from allowing the attendance of a person with information
relevant to a review at a [methadone] or buprenorphine
MEDICATION death and incident team review meeting.
* * *
Section 2. This act shall take effect in 60 days.
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