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General Assembly Substitute Bill No. 5044
February Session, 2022
AN ACT IMPLEMENTING THE GOVERNOR'S BUDGET
RECOMMENDATIONS REGARDING THE USE OF OPIOID LITIGATION
PROCEEDS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective July 1, 2022) As used in this section and 1
sections 2 to 5, inclusive, of this act: 2
(1) "Commissioner" means the Commissioner of Mental Health and 3
Addiction Services. 4
(2) "Committee" means the Opioid Settlement Advisory Committee 5
established pursuant to section 3 of this act. 6
(3) "Department" means the Department of Mental Health and 7
Addiction Services. 8
(4) "Evidence-based" means meeting one of the following evidentiary 9
criteria for an activity, practice, program, service, support or strategy: 10
(A) Meta-analyses or systematic reviews have found the activity, 11
practice, program, service, support or strategy to be effective; (B) 12
evidence from a scientifically rigorous experimental study, including, 13
but not limited to, a randomized controlled trial, demonstrates the 14
activity, practice, program, service, support or strategy is effective; or 15 Substitute Bill No. 5044
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(C) multiple observational studies from locations in the United States 16
indicate the activity, practice, program, service, support or strategy is 17
effective. As used in this subdivision, "effective" means helping persons 18
avoid the development and progression of substance use disorders or 19
drug-related harms, reducing the adverse consequences of substance 20
use among persons who use substances, or managing, slowing the 21
progression of, or supporting recovery from a person's substance use 22
disorder or co-occurring mental health disorder. 23
(5) "Fund" means the Opioid Settlement Fund established pursuant 24
to section 2 of this act. 25
(6) "Harm reduction" means a reduction of, or attempt to reduce, the 26
adverse consequences of substance use, including, but not limited to, by 27
addressing the substance use and conditions that give rise to such 28
substance use. "Harm reduction" includes, but is not limited to, syringe 29
service programs, naloxone distribution and public awareness 30
campaigns about Good Samaritan laws. 31
(7) "Infrastructure" means the resources, including, but not limited to, 32
personnel, buildings and equipment, required for an agency of the state, 33
municipality, other government entity or nonprofit organization to 34
provide substance use disorder prevention, treatment, recovery and 35
harm reduction programs, services, supports and resources. 36
(8) "Prevention" means efforts to avoid the development and 37
progression of substance use disorders and drug-related harms. 38
(9) "Recovery" means an active process of continual growth that 39
addresses the biological, psychological, social and spiritual disturbances 40
inherent in addiction. 41
(10) "Substance use disorder" means a pattern of use of alcohol or 42
other substances that meets the applicable diagnostic criteria delineated 43
in the most recent edition of the American Psychiatric Association's 44
Diagnostic and Statistical Manual of Mental Disorders. 45 Substitute Bill No. 5044
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(11) "Treatment" means a service to intervene upon, care for, manage, 46
slow progression of or support recovery from a substance use disorder 47
or co-occurring mental health disorder. "Treatment" includes, but is not 48
limited to, an individualized service to address a person's medical 49
needs, including, screening for and diagnosing of substance use 50
disorders and co-occurring mental or physical health disorders and 51
pharmacological and nonpharmacological therapeutic interventions. 52
Sec. 2. (NEW) (Effective July 1, 2022) (a) There is established an Opioid 53
Settlement Fund which shall be a separate nonlapsing fund 54
administered by the committee. 55
(b) Any moneys intended to address opioid use, related disorders or 56
the impact of the opioid epidemic that are received by the state from any 57
judgment, consent decree or settlement paid by any defendant, which is 58
finalized on or after July 1, 2021, related to the production, distribution, 59
dispensing and other activities related to opioids shall be deposited into 60
the fund. Moneys remaining in the fund at the end of a fiscal year shall 61
not revert to the General Fund. 62
(c) Notwithstanding any provision of subsection (b) of this section, if 63
the commissioner and the Attorney General certify that the purposes of 64
such judgment, consent decree or settlement are inconsistent with the 65
intent of the provisions of this section and sections 3 to 5, inclusive, of 66
this act, the commissioner and Attorney General (1) shall report in 67
writing to the committee such certification, including any identification 68
by the commissioner and Attorney General of an alternate fund or 69
account and explanation of the reasons for depositing such moneys in 70
such alternate fund or account, and (2) may deposit such moneys into 71
such alternate fund or account. The commissioner and Attorney General 72
shall jointly report, in accordance with the provisions of section 11-4a of 73
the general statutes, to the joint standing committee of the General 74
Assembly having cognizance of matters relating to public health 75
regarding the intended use of such moneys in such alternate fund or 76
account prior to allocating such moneys for other purposes. 77 Substitute Bill No. 5044
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(d) Beginning on December 31, 2022, and annually thereafter, the 78
State Treasurer shall report the following to the committee: 79
(1) An inventory of fund investments as of the most recent fiscal year; 80
and 81
(2) The net income earned by the fund in the most recent fiscal year. 82
(e) Moneys in the fund shall be spent only for the following substance 83
use disorder abatement purposes, in accordance with the controlling 84
judgment, consent decree or settlement, as confirmed by the Attorney 85
General's review of such judgment, consent decree or settlement and 86
upon the approval of the committee and the Secretary of the Office of 87
Policy and Management: 88
(1) State-wide, regional or community substance use disorder needs 89
assessments to identify structural gaps and needs to inform 90
expenditures from the fund; 91
(2) Infrastructure required for evidence-based substance use disorder 92
prevention, treatment, recovery or harm reduction programs, services 93
and supports; 94
(3) Programs, services, supports and resources for evidence-based 95
substance use disorder prevention, treatment, recovery or harm 96
reduction; 97
(4) Evidence-informed substance use disorder prevention, treatment, 98
recovery or harm reduction pilot programs or demonstration studies 99
that are not evidence-based, but are approved by the committee as an 100
appropriate use of moneys for a limited period of time as specified by 101
the committee, provided the committee shall assess whether the 102
evidence supports funding such programs or studies or whether it 103
provides a basis for funding such programs or studies with an 104
expectation of creating an evidence base for such programs and studies; 105
(5) Evaluation of effectiveness and outcomes reporting for substance 106 Substitute Bill No. 5044
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use disorder abatement infrastructure, programs, services, supports and 107
resources for which moneys from the fund have been disbursed, 108
including, but not limited to, impact on access to harm reduction 109
services or treatment for substance use disorders or reduction in drug-110
related mortality; 111
(6) One or more publicly available data interfaces managed by the 112
commissioner to aggregate, track and report data on (A) substance use 113
disorders, overdoses and drug-related harms, (B) spending 114
recommendations, plans and reports, and (C) outcomes of programs, 115
services, supports and resources for which moneys from the fund were 116
disbursed; 117
(7) Expenses incurred in administering and staffing the fund and the 118
committee, as permitted by the controlling judgment, consent decree or 119
settlement; and 120
(8) Expenses associated with managing, investing and disbursing 121
moneys in the fund. 122
(f) (1) For purposes of this section, the fund balance shall be 123
determined by the State Treasurer as of July first, annually. 124
(2) Unless otherwise required by court order to refund to the federal 125
government a portion of the proceeds, moneys in the fund shall be used 126
for prospective purposes and shall not be used to reimburse 127
expenditures incurred prior to July 1, 2022. 128
(3) Proceeds derived from any state settlement of claims against a 129
defendant shall be allocated and disbursed only to those municipalities 130
that execute an agreement to participate in such settlement and adhere 131
to the terms of such agreement, provided the allocation or disbursement 132
of such settlement proceeds for the benefit of persons within 133
municipalities that do not execute an agreement to participate in such 134
settlement or do not adhere to the terms of such agreement shall not be 135
precluded or limited. 136 Substitute Bill No. 5044
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(4) Governmental and private provider, nongovernmental entities 137
shall be eligible to receive moneys from the fund for programs, services, 138
supports and resources for prevention, treatment, recovery and harm 139
reduction. 140
(5) Subject to the provisions of subdivision (6) of this subsection, fund 141
disbursements shall be made by the commissioner upon approval of the 142
committee. The commissioner shall not make or refuse to make any 143
disbursement allowable under this subsection without the approval of 144
the committee. The commissioner shall adhere to the committee's 145
decisions regarding disbursement of moneys from the fund, provided 146
such disbursement is a permissible expenditure under this section. The 147
commissioner's role in the distribution of moneys after the distribution 148
has been approved by the committee and after the review and approval 149
required under subsection (e) of this section shall be ministerial and 150
shall not be discretionary. 151
(6) Moneys expended from the fund for the purposes set forth in 152
subsection (d) of this section shall be supplemental to, and shall not 153
supplant or take the place of, any other funds, including, but not limited 154
to, insurance benefits or local, state or federal funding, that would 155
otherwise have been expended for such purposes. The commissioner 156
shall not disburse moneys from the fund during any fiscal year unless 157
the Secretary of the Office of Policy and Management transmits to the 158
committee a letter verifying that funds appropriated and allocated in 159
such fiscal year's budget for substance use disorder abatement 160
infrastructure, programs, services, supports and resources for 161
prevention, treatment, recovery and harm reduction are in an amount 162
not less than the sum of the funds for such purposes appropriated and 163
allocated in the previous fiscal year's budget. As used in this 164
subdivision, "supplemental" means additional funding, consistent with 165
the provisions of this section, for substance use disorder abatement 166
infrastructure or a substance use disorder abatement program, service, 167
support or resource to ensure that funding in the current fiscal year 168
exceeds the sum of federal, state, and local funds allocated in the 169 Substitute Bill No. 5044
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previous fiscal year for such substance use disorder abatement 170
infrastructure, program, service, support or resource. 171
Sec. 3. (NEW) (Effective July 1, 2022) (a) There is established an Opioid 172
Settlement Advisory Committee to ensure (1) that proceeds received by 173
the state pursuant to section 2 of this act are allocated and spent on 174
substance use disorder abatement infrastructure, programs, services, 175
supports and resources for prevention, treatment, recovery and harm 176
reduction, and (2) robust public involvement, accountability and 177
transparency in allocating and accounting for the moneys in the fund. 178
(b) The committee shall consist of the following members: 179
(1) The Secretary of the Office of Policy and Management, or the 180
secretary's designee; 181
(2) The Attorney General, or the Attorney General's designee; 182
(3) The Commissioners of Children and Families, Mental Health and 183
Addiction Services and Public Health, or said commissioners' designees, 184
who shall serve as ex-officio members; 185
(4) The president pro tempore of the Senate, the speaker of the House 186
of Representatives, the majority leaders of the Senate and House of 187
Representatives and the minority leaders of the Senate and House of 188
Representatives, or their designees; 189
(5) Sixteen individuals representing municipalities, who shall be 190
appointed by the Governor; 191
(6) The executive director of the Commission on Racial Equity in 192
Public Health, or a representative of the commission designated by the 193
executive director; and 194
(7) Seven individuals appointed by the commissioner as follows: (A) 195
Two individuals in recovery from a substance use disorder or 196
representing an advocacy group for individuals with a substance use 197 Substitute Bill No. 5044
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disorder; (B) a provider of community-based substance use treatment 198
services for adults, who shall be a nonvoting member; (C) a provider of 199
community-based substance use treatment services for adolescents, 200
who shall be a nonvoting member; (D) an addiction medicine licensed 201
health care professional with prescribing ability, who shall be a 202
nonvoting member; and (E) two family members of individuals with a 203
substance use disorder. 204
(c) The commissioner shall be chairperson of the committee. 205
(d) Notwithstanding any other provision of the general statutes, it 206
shall not be a conflict of interest for a trustee, director, officer or 207
employee of an organization, or for any person having a financial 208
interest in such organization, to serve as a member of the committee, 209
provided such trustee, director, officer, employee or person shall 210
disclose such position or interest to all other members of the committee 211
and abstain from deliberation, action and vote by the committee under 212
this section that specifically concerns the organization of which such 213
member is a trustee, director, officer or employee, or in which such 214
member has a financial interest. 215
(e) All initial appointments to the committee shall be made not later 216
than October 1, 2022. Each member of the committee, other than the ex-217
officio members, shall serve for a term of two years, shall serve no more 218
than two consecutive terms and may serve until a successor is 219
appointed, except that in the event of any vacancy, the appointing 220
authority shall fill such vacancy for the unexpired portion of such term. 221
Any member of the committee may be removed by the appointing 222
authority for misfeasance, malfeasance or wilful neglect of duty. 223
(f) The committee shall have the following duties and powers: 224
(1) Recommend and approve policies and procedures for 225
administration of the committee and criteria for the application, 226
awarding and disbursement of moneys from the fund, to be used for the 227
purposes set forth in section 2 of this act; 228 Substitute Bill No. 5044
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(2) Recommend and approve goals, objectives, rationales for such 229
goals and objectives, sustainability plans and performance indicators 230
relating to: (A) Substance use disorder prevention, treatment, recovery 231
and harm reduction efforts; (B) reducing disparities in access to 232
prevention, treatment, recovery and harm reduction programs, services, 233
supports and resources; and (C) improving health outcomes in 234
traditionally underserved populations, including, but not limited to, 235
persons who live in rural or tribal communities, are members of racial 236
or ethnic minorities or were formerly incarcerated; and 237
(3) Approve the allocation of moneys from the fund. 238
(g) The department shall: 239
(1) Employ a full-time manager of the committee and provide public 240
health research and policy expertise, support staff, facilities, technical 241
assistance and other resources to (A) assist the manager of the 242
committee in planning and supporting the functions of the committee, 243
including ensuring that proceeds received by this state pursuant to 244
section 2 of this act are allocated and spent on substance use disorder 245
abatement infrastructure, programs, services, supports, and resources 246
for prevention, treatment, recovery and harm reduction, and (B) ensure 247
robust public involvement, accountability and transparency in 248
allocating and accounting for the moneys in the fund; 249
(2) Utilize, where feasible, appropriations from the General Fund and 250
existing infrastructure, programs, services, supports or other resources 251
to address substance use disorders, overdoses and drug-related harms; 252
(3) Prepare for review and approval by the committee of the 253
department's goals, objectives, rationales for such goals and objectives, 254
sustainability plans and performance indicators relating to (A) 255
substance use disorder prevention, treatment, recovery and harm 256
reduction efforts, and (B) reducing disparities in access to prevention, 257
treatment, recovery and harm reduction programs, services, supports 258
and resources; 259 Substitute Bill No. 5044
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(4) Evaluate applications and make recommendations to the 260
committee for the awarding of contracts and disbursements of moneys 261
from the fund exclusively for permissible expenditures set forth in 262
section 2 of this act; 263
(5) Upon receipt of final approval by the committee, disburse moneys 264
from the fund exclusively for permissible expenditures set forth in 265
section 2 of this act; 266
(6) Approve suspensions of allocations of moneys from the fund to 267
recipients found by the committee or commissioner to (A) be 268
substantially out of compliance with applicable contracts, policies, 269
procedures, rules, regulations or state or federal law, or (B) have used 270
such awards for a purpose other than an approved purpose, provided 271
the committee may resume approval of such allocations once the 272
committee has determined the recipient has adequately remedied the 273
cause of such suspension; 274
(7) Maintain oversight over the expenditure of moneys from the fund 275
to ensure moneys are used exclusively for the purposes set forth in 276
section 2 of this act; and 277
(8) Implement and publish on the department's Internet web site 278
policies and procedures for administration of the committee and for the 279
application, awarding and disbursement of moneys from the fund, to be 280
used for the purposes set forth in section 2 of this act. 281
(h) On or before October 1 2023, and annually thereafter, recipients 282
of moneys from the fund shall file with the committee an annual report 283
for the prior fiscal year detailing the effectiveness of infrastructure, 284
programs, services, supports or resources that were funded, including, 285
but not limited to, the following: 286
(1) A description of how the recipient used the moneys for their 287
intended purposes; 288
(2) The number of individuals served, delineated by race, age, gender 289 Substitute Bill No. 5044
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and any other relevant demographic factor, which shall be reported in a 290
deidentified manner; 291
(3) A specific analysis of whether the infrastructure, program, service, 292
support or resources reduced mortality or improved prevention, 293
treatment, harm reduction or recovery outcomes; and 294
(4) If a plan to ensure the sustainability of the infrastructure, program, 295
service, support or resources funded exists, a summary of such plan. 296
(i) The committee shall hold quarterly public meetings. A meeting 297
may be called by the chairperson or by a majority of the committee's 298
members. Members may attend meetings in person, remotely by 299
audiovisual means or, upon approval by the chairperson, by audio-only 300
means. For each meeting of the committee, a majority of the voting 301
members shall constitute a quorum for the transaction of business. If 302
there is a quorum, then all actions of the committee shall be taken by an 303
affirmative vote of a majority of the members present at the meeting. 304
Each voting member shall have one vote. The committee shall terminate 305
when all moneys received pursuant to section 2 of this act have been 306
received and disbursed unless the Attorney General certifies that 307
additional moneys are anticipated. 308
(j) The department shall create and maintain an Internet web site 309
where the committee shall publish (1) meeting minutes, including, but 310
not limited to, records of all votes to approve expenditures of moneys 311
from the fund, (2) recipient agreements and reports required under 312
subsection (h) of this section, (3) policies and procedures approved by 313
the committee, and (4) the committee's annual reports. 314
Sec. 4. (NEW) (Effective July 1, 2022) The department shall disburse 315
moneys from the fund in a manner consistent with the limitations on 316
uses of litigation proceeds set forth in any controlling court order. If a 317
controlling court order permits expenditures other than or in excess of 318
expenditures authorized under section 2 of this act, the department shall 319
adhere to the limitations on use of moneys set forth in section 2 of this 320 Substitute Bill No. 5044
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act. If the provisions of section 2 of this act permit expenditures other 321
than or in excess of those authorized in a controlling court order, the 322
department shall adhere to the limitations on use of moneys set forth in 323
the court order. 324
Sec. 5. (NEW) (Effective July 1, 2022) (a) Not later than January 15, 325
2023, and annually thereafter, the committee shall report, in accordance 326
with the provisions of section 11-4a of the general statutes, to the joint 327
standing committees of the General Assembly having cognizance of 328
matters relating to public health and appropriations and the budgets of 329
state agencies, on the activities carried out by the committee pursuant 330
to sections 2 to 4, inclusive, of this act, including, but not limited to, the 331
following: 332
(1) The opening and closing balance of the fund for the most recent 333
fiscal year; 334
(2) An accounting of all credits to, and expenditures from, the fund; 335
(3) An inventory of fund investments as of the most recent fiscal year 336
and the net income the fund earned for the most recent fiscal year as 337
determined by the State Treasurer pursuant to section 2 of this act; 338
(4) The name and a description of each recipient of moneys from the 339
fund, and the amount awarded to such recipient; 340
(5) A description of each award's intended use, including, but not 341
limited to, the (A) specific program, service or resource funded, (B) 342
population served, and (C) measures that the recipient will use to assess 343
the impact of the award; 344
(6) The primary criteria used to determine each recipient and its 345
respective award amount; 346
(7) A summary of information included in the recipient report 347
required under subsection (h) of section 3 of this act; 348 Substitute Bill No. 5044
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(8) All applications for an award of moneys from the fund received 349
during the most recent fiscal year; 350
(9) A description of any finding or concern as to whether all moneys 351
disbursed from the fund, other than expenses authorized under section 352
2 of this act, supplemented, and did not supplant or replace, any existing 353
or future local, state or federal government funding; 354
(10) The performance indicators and progress toward achieving the 355
goals and objectives developed pursuant to section 3 of this act, 356
including, but not limited to, metrics on improving outcomes and 357
reducing mortality and other harms related to substance use disorders; 358
(11) The dollar amount and the percentage of the fund balance 359
incurred for expenses of administering and staffing the fund and the 360
committee during the most recent fiscal year; 361
(12) The dollar amount and the percentage of the fund balance 362
incurred for expenses associated with managing, investing and 363
disbursing moneys in the fund during the most recent fiscal year; and 364
(13) An explanation of any funds certified by the commissioner and 365
Attorney General pursuant to section 2 of this act as being inconsistent 366
with the intent of this section and sections 2 to 4, inclusive, of this act 367
and the account or fund where such funds were deposited. 368
(b) The commissioner shall post the report required under subsection 369
(a) of this section on the department's Internet web site. 370
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2022 New section
Sec. 2 July 1, 2022 New section
Sec. 3 July 1, 2022 New section
Sec. 4 July 1, 2022 New section
Sec. 5 July 1, 2022 New section
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PH Joint Favorable Subst.
APP Joint Favorable