LB570 LB570
2023 2023
Introduced by Vargas, 7; Hunt, 8.
Read first time January 17, 2023
Committee: Health and Human Services
1 A BILL FOR AN ACT relating to public health; to adopt the Overdose
2 Fatality Review Teams Act; to provide severability; and to declare
3 an emergency.
4 Be it enacted by the people of the State of Nebraska,
LB570 LB570
2023 2023
1 Section 1. Sections 1 to 17 of this act shall be known and may be
2 cited as the Overdose Fatality Review Teams Act.
3 Sec. 2. (1) The Legislature finds that:
4 (a) Substance use disorders and drug overdoses are major health
5 problems that affect the lives of many people and multiple services
6 systems and lead to profound consequences, including permanent injury and
7 death;
8 (b) Overdoses caused by heroin, fentanyl, other opioids, stimulants,
9 controlled substance analogs, novel psychoactive substances, and other
10 legal and illegal drugs are a public health crisis that stress and strain
11 financial, public health, health care, and public safety resources in
12 Nebraska;
13 (c) Overdose fatality reviews, which are designed to uncover the
14 who, what, when, where, why, and how of fatal overdoses, allow local
15 authorities to examine and understand the circumstances leading to a
16 fatal drug overdose; and
17 (d) Through a comprehensive and multidisciplinary review, overdose
18 fatality review teams can better understand the individual and population
19 factors and characteristics of potential overdose victims. This provides
20 local authorities with a greater sense of the strategies and multiagency
21 coordination needed to prevent future overdoses and results in the more
22 productive allocation of overdose prevention resources and services
23 within Nebraska communities.
24 Sec. 3. The purposes of the Overdose Fatality Review Teams Act are
25 to:
26 (1) Create a legislative framework for establishing county-level,
27 multidisciplinary overdose fatality review teams in Nebraska;
28 (2) Provide overdose fatality review teams with duties and
29 responsibilities to examine and understand the circumstances leading up
30 to overdoses so that the teams can make recommendations on policy changes
31 and resource allocation to prevent future overdoses; and
LB570 LB570
2023 2023
1 (3) Allow overdose fatality review teams to obtain and review
2 records and other documentation related to overdoses from relevant
3 agencies, entities, and individuals while remaining compliant with local,
4 state, and federal confidentiality laws and regulations.
5 Sec. 4. For purposes of the Overdose Fatality Review Teams Act:
6 (1) Department means the Department of Health and Human Services;
7 (2) Drug means a substance which produces a physiological effect
8 when ingested or otherwise introduced into the body, and includes both
9 controlled substances and lawful substances;
10 (3) Health care provider means any of the following individuals who
11 are licensed, certified, or registered to perform specified health
12 services consistent with state law: A physician, a physician assistant,
13 or an advanced practice registered nurse;
14 (4) Local team means the multidisciplinary and multiagency drug
15 overdose fatality review team established for a county, a group of
16 counties, a tribe, or one or more counties and tribes;
17 (5) Mental health provider means:
18 (a) A psychiatrist licensed to practice under the Medicine and
19 Surgery Practice Act;
20 (b) A psychologist licensed to engage in the practice of psychology
21 in this state as provided in section 38-3111 or as provided in similar
22 provisions of the Psychology Interjurisdictional Compact;
23 (c) A person licensed as an independent mental health practitioner
24 under the Mental Health Practice Act; or
25 (d) A professional counselor who holds a privilege to practice in
26 Nebraska as a professional counselor under the Licensed Professional
27 Counselors Interstate Compact;
28 (6) Next of kin means the person or persons most closely related to
29 a decedent by blood or affinity;
30 (7) Overdose fatality review means a process in which a local team
31 performs a series of individual overdose fatality reviews to effectively
LB570 LB570
2023 2023
1 identify system gaps and innovative, community-specific overdose
2 prevention and intervention strategies;
3 (8) Overdose means injury to the body that happens when one or more
4 drugs are taken in excessive amounts. An overdose can be fatal or
5 nonfatal;
6 (9) Substance use disorder means a pattern of use of alcohol or
7 other drugs leading to clinical or functional impairment, in accordance
8 with the definition in the Diagnostic and Statistical Manual of Disorders
9 (DSM-5) of the American Psychiatric Association, or a subsequent edition
10 of such manual; and
11 (10) Substance use disorder treatment provider means any individual
12 or entity who is licensed, registered, or certified within Nebraska to
13 treat substance use disorders or who has a federal Drug Addiction
14 Treatment Act of 2000 waiver from the Substance Abuse and Mental Health
15 Services Administration to treat individuals with substance use disorder
16 using medications approved for that indication by the United States Food
17 and Drug Administration.
18 Sec. 5. (1) A local team shall consist of the core members that may
19 include one or more members from the following backgrounds:
20 (a) City or county public health official or such officials'
21 designees;
22 (b) Behavioral health providers or officials;
23 (c) Law enforcement personnel;
24 (d) Representatives of jails or detention centers;
25 (e) The coroner or the coroner's designee;
26 (f) Health care providers who specialize in the prevention,
27 diagnosis, and treatment of substance use disorders;
28 (g) Mental health providers who specialize in substance use
29 disorders;
30 (h) Representatives of emergency medical services providers in the
31 county;
LB570 LB570
2023 2023
1 (i) The Director of Children and Family Services of the Division of
2 Children and Family Services of the Department of Health and Human
3 Services or the director's designee; and
4 (j) Representatives from the Board of Parole, the Office of
5 Probation Administration, the Division of Parole Supervision, or the
6 Community Corrections Division of the Nebraska Commission on Law
7 Enforcement and Criminal Justice.
8 (2) A local team may also include, either as permanent or temporary
9 members:
10 (a) A local school superintendent or the superintendent's designee;
11 (b) A representative of a local hospital;
12 (c) A health care provider who specializes in emergency medicine;
13 (d) A health care provider who specializes in pain management;
14 (e) A pharmacist with a background in prescription drug misuse and
15 diversion;
16 (f) A substance use disorder treatment provider from a licensed
17 substance use disorder treatment program;
18 (g) A poison control center representative;
19 (h) A mental health provider who is a generalist;
20 (i) A prescription drug monitoring program administrator or such
21 administrator's designee;
22 (j) A representative from a harm reduction provider;
23 (k) A recovery coach, peer support worker, or other representative
24 of the recovery community;
25 (l) A representative from the local drug court; and
26 (m) Any other individual necessary for the work of the local team,
27 recommended by the local team and appointed by the chairperson.
28 (3) The members of the team shall select from among themselves a
29 chairperson, who shall be a city or county public health official or such
30 official's designee. The chairperson of the local team shall:
31 (a) Solicit and recruit members and fill vacancies that may arise on
LB570 LB570
2023 2023
1 the team. In carrying out this responsibility, the chairperson shall, at
2 a minimum, attempt to appoint at least one member from each of the
3 backgrounds or positions described in subsection (1) of this section;
4 (b) Facilitate local team meetings and implement the protocols and
5 procedures of the local team;
6 (c) Request and collect the information needed for the local team's
7 case review;
8 (d) Gather, store, and distribute the necessary records and
9 information for reviews conducted by the team;
10 (e) Ensure timely notification of the team members of upcoming
11 meetings;
12 (f) Ensure the team fulfills the requirements of section 6 of this
13 act to publish an annual report, including recommendations to prevent
14 future drug overdose deaths;
15 (g) Ensure that all members of the local team and all guest
16 observers or participants sign confidentiality forms as required under
17 section 13 of this act;
18 (h) Oversee compliance with the Overdose Fatality Review Teams Act
19 and the protocols developed by the team;
20 (i) Serve as a liaison for the local team; and
21 (j) Perform such other duties as the team deems appropriate.
22 (4) Members of the local team shall not receive compensation for
23 their services.
24 Sec. 6. (1) A local team shall:
25 (a) Promote cooperation and coordination among agencies involved in
26 the investigation of drug overdose fatalities;
27 (b) Examine the incidence, causes, and contributing factors of drug
28 overdose deaths in jurisdictions where the local team operates;
29 (c) Develop recommendations for changes within communities, public
30 and private agencies, institutions, and systems, based on an analysis of
31 the causes and contributing factors of drug overdose deaths;
LB570 LB570
2023 2023
1 (d) Advise local, regional, and state policymakers about potential
2 changes to law, policy, funding, or practices to prevent drug overdoses;
3 (e) Establish and implement protocols and procedures for overdose
4 investigations and to maintain confidentiality;
5 (f) Conduct a multidisciplinary review of information received
6 pursuant to section 9 of this act regarding a person who died of a drug
7 overdose. Such review shall include, but not be limited to:
8 (i) Consideration of the decedent's points of contact with health
9 care systems, social services, educational institutions, child and family
10 services, law enforcement and the criminal justice system, and any other
11 systems with which the decedent had contact prior to death; and
12 (ii) Identification of the specific factors and social determinants
13 of health that put the decedent at risk for an overdose;
14 (g) Recommend prevention and intervention strategies to improve
15 coordination of services and investigations among member agencies and
16 providers to reduce overdose deaths; and
17 (h) Collect, analyze, interpret, and maintain data on local overdose
18 deaths.
19 (2) A local team may investigate nonfatal overdose cases occurring
20 within the team's jurisdiction.
21 (3)(a) On or before June 1, 2024, and on or before each June 1
22 thereafter, each local team shall submit a report to the department. The
23 report shall include at least the following:
24 (i) The total number of fatal drug overdoses that occurred within
25 the jurisdiction of the local team;
26 (ii) The number of fatal drug overdoses investigated by the local
27 team;
28 (iii) The causes, manner, and contributing factors of drug overdose
29 deaths in the team's jurisdiction, including trends;
30 (iv) Recommendations regarding the prevention of fatal and nonfatal
31 drug overdoses for changes within communities, public and private
LB570 LB570
2023 2023
1 agencies, institutions, and systems, based on an analysis of such causes
2 and contributing factors. Such recommendations shall include recommended
3 changes to laws, rules and regulations, policies, training needs, or
4 service gaps to prevent future drug overdose deaths; and
5 (v) Follow-up analysis of the implementation of and results from any
6 recommendations made by the local team, including, but not limited to,
7 changes in local or state law, policy, or funding made as a result of the
8 local team's recommendations.
9 (b) The report shall include only de-identified information and
10 shall not identify any victim, living or dead, of a drug overdose.
11 (c) The report is not confidential and shall be made available to
12 the public.
13 (d) The department may analyze each annual report submitted pursuant
14 to this subsection and create a single report containing an aggregate of
15 the data submitted. The department shall make any such report publicly
16 available and submit it electronically to the Clerk of the Legislature.
17 Sec. 7. (1) Members of a local team and other individuals in
18 attendance at a local team meeting, including, but not limited to,
19 experts, health care professionals, or other observers:
20 (a) Shall sign a confidentiality agreement as provided in section 13
21 of this act;
22 (b) Are bound by all applicable state and federal laws concerning
23 the confidentiality of matters reviewed by the local team, but may
24 discuss confidential matters and share confidential information during
25 such meeting; and
26 (c) Except as otherwise permitted by law, shall not disclose
27 confidential information outside of the meeting.
28 (2) A member of a local team or an individual in attendance at a
29 local team meeting shall not be subject to civil or criminal liability or
30 any professional disciplinary action for the sharing or discussion of any
31 confidential matter with the local team during a local team meeting. This
LB570 LB570
2023 2023
1 immunity does not apply to a local team member or attendee who
2 intentionally or knowingly discloses confidential information in
3 violation of the Overdose Fatality Review Teams Act or any state or
4 federal law.
5 Sec. 8. (1) A local team shall not be considered a public body for
6 purposes of the Open Meetings Act.
7 (2) Except for reports published under section 6 of this act,
8 information and records acquired or created by a local team are not
9 public records subject to disclosure pursuant to sections 84-712 to
10 84-712.09.
11 Sec. 9. (1) Except as provided in subsection (4) of this section,