Amended  IN  Assembly  March 21, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 2332

Introduced by Assembly Member Connolly

February 12, 2024

An act to add Sections 2694.51, 2694.52, and 5058.55 to the Penal Code, relating to corrections.


LEGISLATIVE COUNSEL'S DIGEST


AB 2332, as amended, Connolly. Corrections: health care.
Existing law establishes the Division of Health Care Operations and the Division of Health Care Policy and Administration within the Department of Corrections and Rehabilitation (CDCR) under the supervision of the Undersecretary of Health Care Services. Existing law requires the department to expand substance abuse treatment services in prisons to accommodate at least 4,000 additional inmates who have histories of substance abuse. Existing law requires the department to establish a 3-year pilot program to provide a medically assisted substance use disorder treatment model for the treatment of inmates, as specified.
This bill would require the CDCR to take specific actions in the provision of substance use treatment, such as ensuring uniform application of the California Correctional Health Care Services Care Guide and retaining at least one full-time addiction medicine physician and surgeon at each facility to be assigned medication-assisted treatment patients exclusively. The bill would require the CDCR to provide physicians and surgeons clear guidance on interpretation of certain toxicology tests, the misuse, abuse, and illegal distribution of substances, and access to alternative medication. The bill would require the CDCR to provide physicians and surgeons training consisting of at least 8 hours of integrated substance use disorder treatment didactic training, 3 days of shadowing an integrated substance use disorder treatment practice, and an annual training of at least 8 hours covering specified topics.
The bill would require the CDCR to form a working group consisting of 6 members of the Union of American Physicians and Dentists and integrated substance use disorder treatment program departmental representation with the authority to make decisions for the purpose of identifying program areas for improvement or additional training that could be offered to certain employees, in order to enhance program success.
Existing regulations establish a process for the CDCR to verify licenses and credentials of newly hired health care providers.
This bill would require that process to include addiction medicine as an additional qualification.

Existing law establishes the Department of Corrections and Rehabilitation and charges it with various duties and obligations. Existing law requires the department to maintain a statewide utilization management program, as defined, in order to promote the best possible patient outcomes, eliminate unnecessary medical and pharmacy costs, and ensure consistency in the delivery of health care services, as specified.

The bill would state the intent of the Legislature to enact legislation to improve inmate health outcomes in state prisons.

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: NOYES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 2694.51 is added to the Penal Code, to read:

2694.51.
 Notwithstanding any other law, the department shall do all of the following:
(a) Ensure the uniform application of the California Correctional Health Care Services Care Guide on substance use disorder in order to assess and enhance integrated substance use disorder treatment infrastructure, including cognitive behavior intervention, supportive housing, and adherence to the informed consent for medication-assisted treatment for substance use disorder.
(b) Uphold the terms of the medication-assisted treatment agreement entered into with patients.
(c) Provide physicians and surgeons all of the following:
(1) Adequate training to prepare providers for practicing addiction medicine.
(2) Clear guidance on clinical interpretation of urine toxicology tests, ongoing illicit buprenorphine misuse and abuse, polysubstance use, and the misuse, abuse, and illegal distribution of substances.
(3) Ready access to alternative medication, to include naltrexone and buprenorphine at the point of care, as appropriate.
(d) Authorize physicians and surgeons to use a criteria-based approach when prescribing alternative medications, rather than requiring approval.
(e) Ensure that physicians and surgeons have the ability to move patients out of housing assignments that place the patient at high risk.
(f) Provide all of the following training to physicians and surgeons, during regular work hours with time specifically dedicated to the training:
(1) A minimum of eight hours of integrated substance use disorder treatment didactic training and a minimum of three workdays of shadowing an integrated substance use disorder treatment practice.
(2) In addition to the training described in paragraph (1), eight hours annually of integrated substance use disorder treatment training to include all of the following topics:
(A) Brief cognitive behavioral intervention.
(B) Motivational interviewing.
(C) Rapid induction.
(D) Induction.
(E) Difficult case management.
(F) Higher risk.
(g) Ensure that physicians and surgeons represented by State Bargaining Unit 16 have real-time access to integrated substance use disorder treatment physicians and surgeons qualified and capable of providing consultation or support to manage patients at the point of care, including in-house consultation, central team consultation, and on-call consultation.
(h) Conduct direct and real-time observation and oversight of a physician and surgeon, only with the physician and surgeon’s consent.
(i) Authorize a provider to determine whether to combine chronic care visits with medication-assisted treatment visits.
(j) Ensure that physicians and surgeons represented by State Bargaining Unit 16 who received extra training during the implementation of the integrated substance use disorder treatment program and are assigned full time to a facility are not assigned chronic care patient responsibilities in addition to a full schedule of medication-assisted treatment patient responsibilities. The department shall give priority to those physicians and surgeons who are currently working or formerly worked extensively in medication-assisted treatment during their service with the department.
(k) Make every effort to ensure that at least one full-time addiction medicine physician and surgeon is retained at each facility to be assigned medication-assisted treatment patients exclusively.
(l) Monitor the workload of primary care providers to ensure there is adequate time to properly treat integrated substance use disorder treatment patients within the standard 40-hour workweek.

SEC. 2.

 Section 2694.52 is added to the Penal Code, to read:

2694.52.
 The department shall establish a working group to improve the integrated substance use disorder treatment program. The working group shall consist of six members of the Union of American Physicians and Dentists and integrated substance use disorder treatment program departmental representation with the authority to make decisions. The working group shall meet quarterly and shall focus on identifying program areas for improvement or additional training that could be offered to State Bargaining Unit 16 employees, in order to enhance program success.

SEC. 3.

 Section 5058.55 is added to the Penal Code, to read:

5058.55.
 Notwithstanding any other law, the credentialing process described in Section 3999.134 of Title 15 of the California Code of Regulations shall include addiction medicine as an additional qualification.

SECTION 1.

It is the intent of the Legislature to enact legislation to improve inmate health outcomes in state prisons.