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NO. 123. AN ACT RELATING TO TREATMENT OF OPIATE ADDICTION.

(S.303)

It is hereby enacted by the General Assembly of the State of Vermont:

Sec. 1. 18 V.S.A. chapter 92 is added to read:

CHAPTER 92. TREATMENT OF OPIATE ADDICTION

§ 4701. PURPOSE

It is the purpose of this chapter to authorize the department of health to establish comprehensive guidelines for a regional system of opiate addiction treatment.

§ 4702. ESTABLISHMENT OF GUIDELINES FOR OPIATE TREATMENT

(a) The department of health, in collaboration with the opiate addiction treatment advisory committee, shall develop by rule comprehensive guidelines for a regional system of opiate addiction treatment.

(b) The guidelines shall include the following requirements:

(1) Patients shall receive appropriate, comprehensive behavioral therapy;

(2) If pharmacological treatment is medically appropriate, a medical assessment shall be conducted for the appropriateness of treatment with buprenorphine, once it is federally approved for opiate addiction treatment, prior to prescribing methadone;

(3) A routine medical assessment of the appropriateness for the patient of continued pharmacological treatment based on protocols designed to encourage cessation of pharmacological treatment as soon as medically appropriate for the individual treatment needs of the patient;

(4) Federally approved pharmacological treatments for opiate addiction shall be dispensed only by authorized treatment programs;

(5) Comprehensive education and training requirements shall be established, including relevant aspects of behavioral therapy and pharmacological treatment, for physicians, pharmacists, and certified or licensed alcohol and drug abuse counselors affiliated with an approved treatment program;

(6) Rules of conduct for patients, violation of which may result in discharge from the treatment program, shall include required urinalysis at such times as the program may direct, restrictions on medication dispensing designed to prevent diversion of medications and to diminish the potential for patient relapse, and such other rules of conduct as the department and the program may require; and

(7) Opiate addiction treatment that includes the prescription of pharmacological therapy shall be operated only through treatment programs located in medical hospitals or medical school facilities, that have agreed to provide such treatment, in geographically well-suited locations in this state.

(c) The commissioner shall report annually to the general assembly on or before January 1 on the effectiveness of this chapter in the treatment of opiate addiction.

§ 4703. OPIATE ADDICTION TREATMENT ADVISORY COMMITTEE

(a) The opiate addiction treatment advisory committee shall be established for the purpose of working with the department of health to develop comprehensive guidelines for a regional system of opiate addiction treatment, in accordance with the provisions of this chapter.

(b) The committee shall be comprised of the following members:

(1) A representative appointed by the Vermont medical society.

(2) A representative of the Brattleboro Retreat.

(3) A representative appointed by the University of Vermont substance abuse treatment center.

(4) A representative appointed by the chiefs of police association of Vermont.

(5) A representative appointed by the harm reduction coalition.

(6) A representative from the department of public safety, appointed by the governor.

(7) A physician, board certified in addiction, appointed by the governor.

(8) A certified or licensed alcohol and drug abuse counselor, appointed by the governor.

(9) A representative of youth and family services, appointed by the governor.

(10) A representative of the Vermont association of alcohol and drug abuse programs, appointed by the governor.

(11) A representative appointed by the Vermont hospital association.

(c) Members of the advisory committee shall be appointed to represent diverse geographic regions of the state of Vermont.

Sec. 3. REPORT ON DRAFT RULES

The commissioner of health and the opiate addiction treatment advisory committee shall report to the House and Senate Health and Welfare Committees on or before January 15, 2001 with draft rules for pharmacological treatment of opiate addiction based upon the guidelines established pursuant to chapter 92 of Title 18. The report shall include a recommended appropriation and source of funding, which may include federal funds. The report also shall include recommendations concerning a comprehensive list of addiction treatment options. Unless such authority is rescinded or delayed by legislative enactment, the commissioner shall commence rule-making to establish such guidelines upon adjournment of the year 2001 session of the general assembly.

Sec. 4. TREATMENT PROGRAM IMPLEMENTATION STUDIES

By January 15, 2001, the commissioner of health and the opiate addiction treatment advisory committee shall report to the general assembly with its findings and recommendations relating to the following issues:

(1) In order to assess whether the medical care authorized under this act will be available in every region of the state, the committee shall survey Vermont hospitals to determine whether they will provide the addiction treatments authorized under this act. If a region of the state does not have a hospital willing to provide such treatment, the committee shall report the reasons provided by the hospitals in such regions for their decision, together with any committee recommendations on ways to make treatment available in that region.

(2) The committee shall consider opiate addiction treatment delivery systems that would support the integration of such treatments into the comprehensive medical care of addiction patients.

(3) The committee shall survey medical studies and state and federal regulations on medication dispensing and its relationship to minimizing diversion and relapse.

Sec. 5. EFFECTIVE DATE

The act shall take effect upon passage. This act and any rules adopted pursuant to this act are repealed two years after the date of authorization by the department of health of the first pharmacological treatment program established pursuant to the guidelines adopted under this act.

Approved: May 18, 2000