PRINTER'S NO. 843
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
867
Session of
2023
INTRODUCED BY D. WILLIAMS, BRENNAN, GUENST, HANBIDGE, HILL-
EVANS, HOWARD, KINSEY, KRAJEWSKI, MADDEN, OTTEN, RABB,
SANCHEZ AND SCHLOSSBERG, APRIL 10, 2023
REFERRED TO COMMITTEE ON HUMAN SERVICES, APRIL 10, 2023
AN ACT
Relating to immediate access to treatment for substance use
disorder; establishing the Substance Use Disorder Early
Intervention Pilot Program; and imposing powers and duties on
the Department of Drug and Alcohol Programs.
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 Early Access
to Substance Use Disorder Treatment 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:
"Clinical settings." Health care locations, including, but
not limited to, school clinics, mental health clinics, public
health clinics, emergency departments and primary, urgent and
psychiatric care offices in which the severity of an
individual's substance use or misuse can be assessed or
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identified and the need for substance use disorder treatment may
be determined.
"Controlled substance." As defined in section 2 of the act
of April 14, 1972 (P.L.233, No.64), known as The Controlled
Substance, Drug, Device and Cosmetic Act.
"Department." The Department of Drug and Alcohol Programs of
the Commonwealth.
"Immediate access to treatment." Early intervention
services, including appropriate evidence-based treatment,
provided to individuals who present with questionable or
problematic signs of controlled substance misuse or mild
substance use disorder in a variety of clinical settings and
which are designed to help prevent more severe substance use
disorders. For an individual who presents with severe substance
use disorder, intervention in a clinical setting may serve as
the mechanism or bridge to engage the individual into specialty
substance use disorder treatment.
"Medication-assisted treatment." The use of medication, in
combination with counseling and behavioral therapies, to provide
a whole-patient approach to the treatment of substance use
disorders.
"Participating county." A county selected by the department
to participate in the pilot program in accordance with section
3.
"Pilot program." The Substance Use Disorder Early
Intervention Pilot Program established under section 3.
"Substance use disorder." A disease which:
(1) Results from the inability of an individual to
control recurrent use of a legal or an illegal controlled
substance.
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(2) Causes clinically significant impairment to the
individual, including behavior and health problems, or
disability and failure to meet major responsibilities of
home, work or school.
"Treatment services." An individualized set of evidence-
based clinical services or set of such services which may
include medication, counseling and other supportive services
designed to enable an individual to reduce or eliminate the use
of a controlled substance, address associated physical, mental
or behavioral health problems and restore the individual to
maximum functional ability.
Section 3. Pilot program.
(a) Establishment and purpose.--The following apply:
(1) The Substance Use Disorder Early Intervention Pilot
Program is established in the department. The department
shall administer the pilot program for the purpose of
determining the effectiveness of promoting immediate access
to treatment for adolescents and adults who:
(i) suffer nonfatal overdoses from the use of
opioids, including fentanyl, or any other controlled
substance included on a schedule of controlled substances
that has a potential for abuse;
(ii) present in a clinical setting with problematic
signs of substance misuse or mild substance use disorder;
or
(iii) present in a clinical setting with a severe
substance use disorder.
(2) The primary components of the pilot program shall,
to the extent feasible, include medications, behavioral
therapies and recovery support services.
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(3) The pilot program shall be designed to include:
(i) The delivery of early intervention and treatment
services into general health care practice and other
appropriate clinical settings.
(ii) A process designed to establish a direct link
between clinical settings and appropriate substance use
disorder treatment programs and resources, including the
availability of medication-assisted treatment.
(iii) Substance misuse and substance use disorder
screening in appropriate clinical settings.
(iv) The use of medication-assisted treatment to
treat serious substance use disorders by existing
treatment programs, general health care practices and
other appropriate clinical settings, as determined by the
department.
(v) The use of peer recovery support mentors to
facilitate the link between clinical settings and
appropriate substance use disorder treatment programs and
resources.
(vi) Other programming aimed at reducing deaths
caused by opioids, fentanyl and other controlled
substance overdoses by providing immediate access to
appropriate substance use disorder treatment and
resources to individuals who suffer nonfatal overdoses.
(vii) The use of electronic technologies, including
telehealth, to access, engage, monitor and continue
supportive care for individuals with substance use
disorders and those who misuse controlled substances.
(b) Implementation.--The following apply:
(1) The department shall implement the pilot program in
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the five counties in this Commonwealth with the highest
reported opioid, fentanyl or controlled substance overdose
death rates per 10,000 inhabitants in the 2023 calendar year.
(2) The department shall consult with each county
selected to participate in the pilot program in accordance
with paragraph (1) to determine the following:
(i) if there is a hospital with an emergency
department in the county;
(ii) the availability of substance use disorder
treatment programs and resources in the county and the
extent of such programs and resources; and
(iii) the manner of oversight and form and content
of any reporting requirement, as may be determined and
required by the department.
(3) If the department determines that a county selected
to participate in the pilot program does not have a hospital
with an emergency department or does not have sufficient
substance use disorder treatment programs and resources, the
department shall select the next county that has the highest
rate of reported opioid and fentanyl nonfatal and fatal
overdoses in the preceding calendar year.
Section 4. Reports.
(a) Submission of report.--No later than December 31, 2025,
and each December 31 thereafter, the department shall compile
and submit a report on the implementation and efficacy of the
pilot program. The report shall include, but not be limited to,
the following:
(1) The number of individuals who suffered nonfatal and
fatal overdoses in each participating county.
(2) The participating county or counties where the
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nonfatal and fatal overdoses occurred.
(3) The number of individuals who received immediate
access to substance use disorder treatment as a result of a
nonfatal overdose in each participating county.
(4) Demographic data on individuals who received
immediate access to substance use disorder treatment,
including medication-assisted treatment, by each
participating county.
(5) Information on any individual under paragraph (2)
who suffered a subsequent nonfatal or fatal overdose.
(6) Recommendations for legislation, policies or other
activities to improve the administration of the pilot
program, if any.
(7) Any other information the department determines
necessary and appropriate to determine the efficacy of the
pilot program.
(b) Distribution.--
(1) The department shall:
(i) transmit the report to the Legislative Reference
Bureau for publication in the Pennsylvania Bulletin; and
(ii) post the executive summary on the department's
publicly accessible Internet website. The executive
summary shall include a link to the online location of
the report.
(2) An executive summary of the report consisting of no
more than two pages shall be distributed to every member of
the General Assembly by email.
(3) One copy of the report shall be submitted to the
Chief Clerk of the Senate and the Chief Clerk of the House of
Representatives.
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(4) One copy of the report shall be submitted to the
chair and minority chair of:
(i) the Health and Human Services Committee of the
Senate;
(ii) the Health Committee of the House of
Representatives; and
(iii) the Human Services Committee of the House of
Representatives.
(5) The executive summary under paragraph (2) shall
include an explanation of how a member of the General
Assembly may obtain a full copy of the report.
(6) Notwithstanding paragraph (2), if a member of the
General Assembly requests a paper copy of a report or
executive summary, the department must supply a paper copy of
the report or executive summary to the member.
Section 5. Confidentiality and disclosures.
(a) General rule.--
(1) Except as provided in subsection (c), all working
papers, recorded information, documents and copies of working
papers, recorded information and documents produced by,
obtained by or disclosed to the department, a county,
individuals employed by or affiliated with a clinical setting
or any other person under this act:
(i) shall be confidential;
(ii) may not be subject to subpoena;
(iii) shall not be subject to access under the act
of February 14, 2008 (P.L.6, No.3), known as the Right-
to-Know Law;
(iv) shall not be subject to discovery or admissible
in evidence in any private civil action; and
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(v) may not be made public by the department, a
county, an individual affiliated with or employed in a
clinical setting or any other person.
(2) (Reserved).
(b) Personal health and financial information.--The
department, participating counties and clinical settings shall
protect identifiable personal, health and financial information
in accordance with all applicable Federal and State laws and
regulations, including the Health Insurance Portability and
Accountability Act of 1996 (Public Law 104-191, 110 Stat. 1936),
the Health Information Technology for Economic and Clinical
Health Act (Public Law 111-5, 123 Stat. 226-279 and 467-496) and
implementing regulations.
(c) Information disclosure.--Subject to subsections (a) and
(b):
(1) Information may be shared, as appropriate, for the
purpose of determining and coordinating the eligibility of
individuals for substance use disorder treatment services and
resources, including medication-assisted treatment, or for
compliance under any Federal or State law, as follows:
(i) Among the department and the participating
counties and other State departments and agencies,
including:
(A) The Department of Health.
(B) The Department of Human Services.
(C) Any other department or agency of the
Commonwealth or a county as determined necessary and
appropriate by the department.
(ii) Between the department and the Health Care Cost
Containment Council, provided that the information is raw
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data shared for statistical analysis purposes.
(2) Information may be disclosed as necessary in
accordance with the following:
(i) To comply with reporting or any audit
requirements, provided that the information is shared
only in an aggregated and disidentified form.
(ii) In any circumstance, only if the prior written
consent of the individual to whom the information
pertains has been obtained.
(d) Statistics.--The department shall compile and publish
statistics derived from raw data collected by the department or
a county under this act.
(e) Construction.--Nothing in this section shall be
construed to prohibit the department or a participating county
from accessing the information necessary to carry out its
responsibilities in accordance with law.
Section 6. Effective date.
This act shall take effect immediately.
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