Amends TCA Title 4; Title 7; Title 33; Title 53; Title 63; Title 68 and Title 71.

This bill enacts the "Overdose Fatality Review Act," which authorizes a county to establish a multidisciplinary and multiagency overdose fatality review local team ("local team"), and authorizes two or more counties to agree to jointly establish a single multicounty team. Counties that participate in a multicounty team are required to execute a memorandum of understanding between the counties regarding team membership, staffing, and operations.<br /> <br /> COMPOSITION OF A LOCAL TEAM<br /> <br /> This bill requires local teams, the members of which serve without compensation, to consist of the following, if available:<br /> <br /> (1) Representatives from the sectors and areas of expertise of public health; social services; medicolegal death investigation; the local criminal justice system, including criminal prosecution, criminal courts, recovery courts, and jails; harm reduction; and the local public education system;<br /> <br /> (2) Representatives who are, or who have experience as, a substance abuse treatment provider; law enforcement officer, firefighter, paramedic, or other first responder; person with lived experience of substance use disorder; peer recovery support specialist; healthcare provider; healthcare provider specializing in pain management; mental healthcare provider; pharmacist or pharmacy technician; or case worker or other employee or service provider with the department of children's services; and<br /> <br /> (3) Representatives from other sectors or agencies whose membership is deemed necessary for the local team to complete its duties.<br /> <br /> DUTIES OF THE COORDINATOR<br /> <br /> This bill requires the coordinator of a local team to report to the local or regional county health officer. However, if the local team is a multicounty team, then the coordinator may report to the local or regional county health officer of any one of the counties represented by the multicounty team. The coordinator is responsible for the following:<br /> <br /> (1) Soliciting and recruiting the necessary and appropriate members to serve on the local team;<br /> <br /> (2) Facilitating each local team meeting and implementing the protocols and procedures of the local team;<br /> <br /> (3) Ensuring members of the local team and guest observers sign confidentiality forms;<br /> <br /> (4) Requesting and collecting information needed for the local team's case review;<br /> <br /> (5) Filling vacancies on the local team with an individual from the same or equivalent position or discipline; and<br /> <br /> (6) Serving as a liaison for the local team when necessary.<br /> <br /> DUTIES OF A LOCAL TEAM<br /> <br /> This bill provides the following concerning the duties of local teams:<br /> <br /> (1) A local team must establish and implement protocols and procedures;<br /> <br /> (2) A local team must conduct a multidisciplinary review of information received regarding a decedent, including consideration of the decedent's points of contact with healthcare systems, social services, educational institutions, child and family services, the criminal justice system, and other systems with which the decedent had contact prior to death; and identification of the specific factors and social determinants of health that put the decedent at risk for an overdose;<br /> <br /> (3) A local team must recommend prevention and intervention strategies to improve coordination of services among member agencies to reduce overdose deaths;<br /> <br /> (4) A local team must collect, analyze, interpret, and maintain local data on overdose deaths; and<br /> <br /> (5) A local team must submit an annual de-identified report to the county health department for the local jurisdiction or jurisdictions and to the department of health. Reports with de-identified data are not confidential and may be shared with the public;<br /> <br /> (6) A local team may hold meetings of the team in person or virtually using a secure web-based audio-visual meetings platform; and<br /> <br /> (7) A local team may investigate non-fatal overdose cases that occur within the local jurisdiction.<br /> <br /> ANNUAL REPORT<br /> <br /> This bill requires the department of health to combine each report submitted pursuant to (5) above to create a single statewide report containing an aggregate of the submitted data and to submit that report to the governor, the health committee of the house of representatives, and the health and welfare committee of the senate. The annual report must include the following:<br /> <br /> (1) The total number of fatal overdoses that occurred within the local team's jurisdiction;<br /> <br /> (2) The number of fatal overdose cases investigated by the local team;<br /> <br /> (3) Recommendations for state and local agencies, or the general assembly, to assist in preventing fatal and non-fatal overdoses in this state; and<br /> <br /> (4) Assessable results of recommendations made by the local team.<br /> <br /> LOCAL TEAM MEETINGS<br /> <br /> This bill requires members of a local team, and other individuals in attendance at a local team meeting, to adhere to the following:<br /> <br /> (1) They must sign a confidentiality agreement;<br /> <br /> (2) They may discuss confidential matters and share confidential information during the local team meeting without violating state privacy laws. However, confidential information disclosed during a local team meeting must not be further disclosed outside of the meeting;<br /> <br /> (3) They are bound by all applicable state and federal laws concerning the confidentiality of matters reviewed by the local team; and<br /> <br /> (4) They are not subject to civil or criminal liability, or professional disciplinary action, for the sharing or discussion of a confidential matter with the local team during a local team meeting. However, this immunity does not apply to a local team member or attendee who negligently discloses confidential information, or who knowingly and willfully discloses the information, in violation of this bill or state or federal law.<br /> <br /> ACCESS TO INFORMATION<br /> <br /> On written request of the coordinator, and as necessary to carry out the purpose and duties of the local team, this bill generally requires the local team to be provided with the following information:<br /> <br /> (1) Information and records regarding the physical health, mental health, and treatment for substance use disorder, maintained by a healthcare provider, substance use disorder treatment provider, hospital, or health system for an individual whose death or near death is being reviewed by the local team; and<br /> <br /> (2) Information and records maintained by a state or local government agency or entity.<br /> <br /> This bill requires the following persons, agencies, or entities to comply with a records request by a local team: a medical examiner; a fire department; a health system; a hospital; a law enforcement agency; local or state governmental agencies; a mental health services provider; a healthcare provider; a substance use disorder treatment provider; a local education agency or a school, including an elementary school, secondary school, or institution of higher education; an emergency medical services provider; a social services provider; a prescription drug monitoring program; and another person or entity who is in possession of records pertinent to the local team's investigation of an overdose fatality.<br /> <br /> However, this bill authorizes a person or entity subject to a records request to charge the local team a reasonable fee for the service of duplicating the requested records. Information requested by the coordinator must be provided within 10 business days of receipt of the written request and any required written consent, excluding weekends and holidays, unless an extension is granted by the coordinator. Written requests may include a request submitted via email or facsimile transmission. A local team does not need an administrative subpoena or other form of legal compulsion to receive the requested records.<br /> <br /> An individual, entity, or local or state agency that in good faith provides information or records to the local team is not subject to civil or criminal liability or professional disciplinary action as a result of providing the information or record.<br /> <br /> This bill requires the coordinator, or the coordinator's designee, to request the individual whose overdose is under review or, if deceased, the individual's personal representative, to provide written consent for the release of confidential information. A member of a local team may contact, interview, or obtain information by request from a consenting family member or friend of an individual whose death is being reviewed by the local team. So long as each individual present at a local team meeting has signed a confidentiality form, information received by the coordinator in response to a request may be shared at a local team meeting with local team members and non-member attendees. The disclosure or redisclosure of a medical record developed in connection with the provision of substance use disorder treatment services, without the authorization of a person in interest, is subject to limitations that exist under state and federal law.<br /> <br /> CONFIDENTIALITY<br /> <br /> This bill provides the following with regard to confidentiality:<br /> <br /> (1) Local team meetings in which confidential information is discussed are closed to the public. All local team members and non-member individuals in attendance must sign a confidentiality form and review the purpose and goal of the local team before they may participate in the review;<br /> <br /> (2) All information and records acquired by a local team are confidential and are not subject to subpoena, discovery, or introduction into evidence in a civil or criminal proceeding or disciplinary action. However, information and records that are otherwise available from other sources are not immune from subpoena, discovery, or introduction into evidence through those sources solely because the information or record was presented to or reviewed by a local team;<br /> <br /> (3) Information and records acquired or created by a local team are not subject to state public inspection or open records laws, except information regarding de-identified annual reporting as described above;<br /> <br /> (4) Substance use disorder treatment records requested or provided to the local team are subject to additional limitations on redisclosure of a medical record developed in connection with the provisions of substance use disorder treatment services under state or federal law;<br /> <br /> (5) Local team members and individuals who present or provide information to a local team must not be questioned in a civil or criminal proceeding or disciplinary action regarding the information presented or provided. However, this provision does not prevent a person from testifying regarding information obtained independently of the local team or as to public information;<br /> <br /> (6) The confidentiality of information provided to the local team must be maintained as required by state and federal law. A person damaged by the negligent or knowing and willful disclosure of the confidential information by the local team or its members may maintain an action for damages, costs, and attorney fees;<br /> <br /> (7) A person who violates the confidentiality provisions of this bill commits a Class B misdemeanor and is subject to a fine not to exceed $500 or imprisonment for a term not to exceed six months, or both; and<br /> <br /> (8) A local team is not prohibited from requesting the attendance at a team meeting of a person who has information relevant to the team's exercise of its purpose and duties.<br /> <br /> RULEMAKING AUTHORITY<br /> <br /> This bill authorizes the department of health to promulgate rules to effectuate this bill.<br />