Saturday, March 24, 2018

House bill to allow detention and treatment of revived overdose victims falls short in Senate panel and is likely dead for session

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. -- Despite considerable support for the concept, a bill to allow first responders to detain and hospitalize individuals who have been revived after an overdose is likely dead for this legislative session, due to concerns about liability and personal freedom.

Rep. Kim Moser
House Bill 428, sponsored by Kim Moser, R-Taylor Mill, would have applied only in Lexington, Louisville and Northern Kentucky because they have resources in place to immediately connect overdose victims with treatment.

Moser, who is also the director of the Northern Kentucky Office of Drug Control Policy, told the Senate Health and Welfare Committee that the bill was inspired by first responders who are often called to resuscitate the same person for opioid overdose multiple times, but can't get them to treatment.

Moser said the bill also has the support of citizens who are increasingly frustrated with the ever-increasing use of expensive Narcan to revive overdose victims at taxpayer expense, with no requirement for treatment. Currently, victims can refuse further treatment and simply walk away. She said the number of overdose deaths is "going down because we are saving people with Narcan, but we are not able to get them into treatment."

Moser and her guests at the March 8 House Health and Family Services Committee meeting said the average cost of Narcan is $110 per dose and the state spent $1.66 million in 2017 to administer 15,000 doses of Narcan, not including Louisville's Narcan expense -- or the cost of ambulance runs.

The House committee approved the bill without dissent and the House passed it 92-3, but it couldn't muster enough support in the Senate health committee. The chair, Sen. Julie Raque Adams, R-Louisville, passed up a vote after a long debate and said the bill would remain on the committee agenda.

Sen. Danny Carroll, R-Paducah, a former police officer, voiced concerns about the liability the bill would place on police officers and their departments because of the fine line between detention and arrest.

"I question the legality of doing this without actually having a criminal statute to detain them," Carroll said. "Don't get me wrong, I applaud you for the effort and I understand that we need to take stricter measures to control these situations. I don't want to put our officers at risk of civil suits."

Moser responded that the bill's "immediate detention form," which must be signed by a peace officer, covers this concern, making the bill "legal and constitutional." Christopher Nieves, special agent with the federal Bureau of Alcohol, Tobacco, Firearms and Explosives, cited a Supreme Court case to support Moser's claim, but Carroll and Sen. Reginald Thomas, D-Lexington, disagreed.

"Under criminal law jurisprudence, arrest is defined as the absence of freedom of movement," Thomas said, and suggested that the bill should have probably been placed in the Judiciary Committee. "I have no problem with the intent of this bill," he said. "But I just think that this bill, as presently written, is flawed and I can't vote for it."

Republican Sen. Ralph Alvarado, a Winchester physician, voiced concerns about infringing on individuals personal freedoms, adding that as a physician he can recommend treatment all he wants, but people don't have to follow his recommendations.

"It's not necessarily holding them against their will in the ER," said Moser. "As with any other patient, they can get up and leave. It does get them to the hospital. The immediate detention is creating a touch point."

Sen. Steve Meredith, R-Leitchfield, suggested that the program be called a pilot because otherwise it would create a dual standard of care that could create confusion. "I do appreciate what you are attempting to accomplish," he said.

Earlier, Nieves noted that HB 428 was modeled after an Indiana bill to address the same problem, and that he had found it to be effective. He said that simply giving Naloxone without connecting the individual to treatment was nothing more than a band-aid. "I think we are shortchanging ourselves if we don't get these people long-term treatment," he said.

Sen. Julian Carroll, D-Frankfort, also a lawyer, agreed with Moser and Nieves. "We need to do something," he said.

Steve Rath, assistant chief of Southgate Volunteer Fire Department in Campbell County, told the panel that the bill had wide support among firefighter organizations and that this bill would give them another tool in their toolbox to get people to treatment, and also create a record of repeat offenders.

Moser told Kentucky Health News  the bill is likely dead but she would continue to work on it.

Rep. Addia Wuchner, R-Florence, who chairs the House health committee and was standing nearby, said, "Nothing is buried until sine die," the final motion of any session.

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