2663-S2 AAS 3/3/00 S5065

2663-S2 AAS 3/3/00 S5065.6

2SHB 2663 - S AMD - 239

By Senators Hargrove and Long

ADOPTED 3/3/00

Strike everything after the enacting clause and insert the following:

"NEW SECTION. Sec. 1. The legislature finds that schizophrenia is a devastating and costly disease. Atypical antipsychotic medications have been developed for treatment of schizophrenia and other similar psychiatric and neurological conditions, which have been effective at treating these conditions with less severe side effects than the side effects that accompany typical antipsychotics. Atypical antipsychotic medications are commonly prescribed and are within the standard of care. In order to protect the public health, safety, and welfare, and reduce the economic and societal costs associated with untreated schizophrenia and other similar psychiatric and neurological conditions, the legislature intends to promote access to atypical antipsychotic medications by those unable to access them and who present a risk of harm to themselves and to the community.

NEW SECTION. Sec. 2. (1) To the extent funds are appropriated, the department of social and health services shall request proposals that promote access to atypical antipsychotic medications to persons who meet the following criteria:

(a) The person has schizophrenia or other psychiatric or neurological condition that is treated with atypical antipsychotic medication;

(b) The person's income is less than two hundred percent of the federal poverty level; and

(c) The person is not covered by insurance or other benefit that pays for atypical antipsychotic medications. The person may have a copayment requirement under available coverage, which is cost prohibitive for the person given his or her income level, which would not disqualify the person under the requirement of this section.

(2) Contracts shall be awarded to contractors whose proposal meets the following criteria:

(a) Has a distribution mechanism that achieves cost savings in service delivery and medication costs;

(b) Targets children and adults who are transitioning out of state or local correctional or detention facilities or who have recently received mental health services under chapter 71.05 or 71.34 RCW;

(d) Is designed to provide temporary access to these atypical antipsychotic medications until the person has obtained coverage or achieved financial capacity to retain them;

(e) Proposes to dispense the atypical antipsychotic medications as a part of a comprehensive program designed to achieve an improved mental status and stable living situation; and

(f) Maximizes cost savings of the atypical antipsychotic medications.

(3)(a) "Atypical antipsychotic medications" means drugs with a pharmacological classification of dibenzodiazepines, benzisoxazoles, thienobenzodiazepines, and dibenzothiazepines, and such other drugs as are defined in rule by the department which have the same or very similar utility in treating schizophrenia or other similar psychiatric and neurological conditions.

(b) "Access to atypical antipsychotic medications" includes:

(i) Pharmaceutical companies participating in this program shall increase access to their products for the targeted population through intensive outreach to their respective indigent drug programs as of the effective date of this act. The eligibility criteria of their respective indigent drug programs shall not be changed to decrease access or availability from the criteria as they exist on March 15, 2000; and

(ii) Other drugs or laboratory tests when used in conjunction with the atypical antipsychotic medications to achieve maximum therapeutic effect, or to treat side effects.

(4) Nothing in this section creates or provides any individual with an entitlement to services or benefits. It is the intent of the legislature that atypical antipsychotic medications shall be made available under this section only to the extent of the availability and level of appropriation made by the legislature.

(5) The distribution mechanism shall require successful recipients to comply with data collection needs of the Washington institute for public policy.

(6) The department is authorized to establish rules necessary to implement the provisions of this act.

NEW SECTION. Sec. 3. (1) The Washington institute for public policy shall conduct an evaluation of this act to determine the following:

(a) Outcomes for persons receiving atypical antipsychotic medications under the provisions of this act, including, but not limited to the person's: (i) Ability to perform basic living skills and maintain a job; (ii) adherence to medication regimens; (iii) number of inpatient placement or acute care services after having received atypical antipsychotic medications; and (iv) criminal conviction record for further offenses, if any, after having received atypical antipsychotic medications;

(b) The extent to which this act increases access to atypical antipsychotic medications to the targeted population; and

(c) The uniformity by health care providers in prescribing atypical antipsychotic medications among the population identified under the provisions of this act.

(2) The Washington institute for public policy shall identify the number of children and the number of adults served; and outcomes, access, and uniformity for both children and adults.

(3) The Washington institute for public policy shall report to the legislature by January 1, 2002.

NEW SECTION. Sec. 4. This act expires June 30, 2002."

2SHB 2663 - S AMD - 239

By Senators Hargrove and Long

ADOPTED 3/3/00

On page 1, line 2 of the title, after "populations;" strike the remainder of the title and insert "creating new sections; and providing an expiration date."