June 10, 2015

Legislative Wrap Up: Bills Passed To Stem Substance Abuse, Reduce Restraint Use

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Lawmakers this session approved bills that put in place new initiatives to stem substance abuse and opioid overdoses, change the way restraints and seclusion are used in Connecticut schools and limit the use of shackles on juveniles in court.

Those were just some of the legislature’s health and safety measures reported on by C-HIT during the year. The session, which ended last week, was largely dominated by budget and transportation issues.

Under the bills approved:

• Any prescriber supplying more than a 72-hour supply of a controlled substance must first review the patient’s record in a statewide database. In addition, practitioners must review the patient’s record at least every 90 days if prescribing for prolonged treatment. Doctors, advanced registered nurses, dentists and physician assistants are required to participate in continuing education on prescribing controlled substances and pain management.

The legislation, introduced by Gov. Dannel P. Malloy, aims to reduce occurrences of prescription drug addiction and overdoses tied to opioids and other substances. It also makes naloxone, a drug that treats overdoses, more widely available.

“Not only do we need to eliminate a lifetime of permanent punishment with our drug laws by giving people a second chance, but we also need to prevent addiction in the first place,” Malloy said in a statement. “By ensuring that health care professionals prescribing treatment are utilizing patient history data to help them make smart decisions, we’ll curb potential abuse.”

• The use of restraints and seclusion in schools to discipline children would be restricted to only emergencies, and for only 15 minutes in most cases. The measure also requires school staff to meet when a child is restrained or secluded four or more times in a 20-day span.

In each of the last three years, the state Department of Education has reported about 30,000 incidents of restraints or seclusion, with autistic students the most frequently subjected to the practices.

The state Office of the Child Advocate pushed for a policy change, saying that restraint and seclusion can be “traumatizing and ineffective for both students and staff.” In testimony, the child advocate’s office said that restraint and seclusion are harmful to children when used inappropriately, increase rather than decrease the likelihood of staff injury, and are less effective than therapeutic behavior interventions.

• Additional funding will be allocated for Emergency Mobile Psychiatric Services (EMPS), the statewide crisis intervention program for youth.

The current $9.4 million budget for EMPS will increase by $4.46 million in the next two years. The expansion funds include $1.91 million in the first year and $2.55 million during the second year, according to the state Office of Policy and Management. Last fiscal year, EMPS provided 12,376 instances of care – up 11.4 percent from the previous fiscal year.

Some advocates were concerned that demand for services would soon exceed the program’s capacity.

• The use of shackles on juveniles appearing in court will be limited. The change, originally proposed in bills introduced by Rep. Bruce Morris and Rep. Toni Walker of New Haven, was prompted by concerns that juveniles appearing in court were often shackled unless their attorneys asked that they not be. Legislation ultimately passed as part of a juvenile justice omnibus bill spearheaded by Walker.

Juveniles in court will be restrained – with handcuffs, leg irons and belly chains – only when a judge deems it necessary due to potential flight risk or other factors, said Marisa Mascolo Halm, director of the TeamChild Juvenile Justice Project at the Hartford-based Center for Children’s Advocacy.

“There’s a presumption of guilt if a child is coming into the courtroom with shackles on,” Halm said. Also, many juveniles in court have experienced trauma and being restrained can have “extremely negative” psychological impacts on them and inhibit them from communicating with their lawyers, she said.

“(The legislation) was something that folks really cared about and the juvenile justice community really cared about,” she said. “We feel like we accomplished a lot.”

• The Department of Veterans’ Affairs would be required to reach out to female veterans and make them aware of federal and state services that are available to them. It also requires the state to consider establishing programs for female veterans, but not funding is attached to the legislation.

A bill to increase the minimum assets to $50,000 that a spouse living in community can keep in order for his or her partner to be eligible for Medicaid nursing home care failed to get out of committee this year. The proposal to increase the minimum from $23,844 to $50,000, was introduced by Sen. Kevin Kelly of Monroe. It was lauded by advocates for the elderly, who said it would help spouses to afford to live independently, but opposed by the state Department of Social Services because it would increase Medicaid costs.

C-HIT writer Magaly Olivero contributed to this story.

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