Florida 2023 2023 Regular Session

Florida House Bill H0783 Analysis / Analysis

Filed 04/18/2023

                    This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives. 
STORAGE NAME: h0783e.HHS 
DATE: 4/18/2023 
 
HOUSE OF REPRESENTATIVES STAFF ANALYSIS  
 
BILL #: CS/CS/HB 783    Emergency Opioid Antagonists 
SPONSOR(S): Health & Human Services Committee, Healthcare Regulation Subcommittee, Caruso 
TIED BILLS:   IDEN./SIM. BILLS: SB 704 
 
REFERENCE 	ACTION ANALYST STAFF DIRECTOR or 
BUDGET/POLICY CHIEF 
1) Healthcare Regulation Subcommittee 14 Y, 0 N, As CS Osborne McElroy 
2) Health Care Appropriations Subcommittee 13 Y, 0 N Fontaine Clark 
3) Health & Human Services Committee 18 Y, 0 N, As CS Osborne Calamas 
SUMMARY ANALYSIS 
Opioids are psychoactive substances which are highly effective pain relievers. Opioids are commonly 
prescribed to treat acute and chronic pain; however, while highly effective, they are also highly addictive and 
an overabundance of opioids in the body can lead to a fatal overdose. More than 106,000 Americans died from 
drug-involved overdose in 2021, including illicit drugs and prescription opioids. In 2021, there were 6,442 
opioid overdose deaths reported in Florida, a 22% increase from 2019. 
 
Opioid antagonists are used to treat opioid overdoses to counteract the life-threatening depression of the 
central nervous system and respiratory system that results from an opioid overdose. Under current law, a 
pharmacist is authorized to order and dispense an emergency opioid antagonist to a patient or caregiver 
without a prescription or a non-patient-specific standing order being in place. Emergency responders, crime 
laboratory personnel, and personnel of a law enforcement agency or another agency who, if they are likely to 
come in contact with a controlled substance or persons at risk of an overdose, are authorized to possess, 
store, and administer emergency opioid antagonists. 
 
In September 2022, the Department of Health (DOH) issued a statewide Standing Order for Naloxone, an 
emergency opioid antagonist. The Standing Order authorizes pharmacists to dispense certain naloxone 
formulations to emergency responders for administration to persons exhibiting signs of opioid overdose. Under 
the Standing Order, emergency responders, including law enforcement, firefighters, paramedics, and 
emergency medical technicians, can go to a pharmacy or community-based program for training on opioid 
antagonist administration and receive an opioid antagonist without a patient-specific prescription. 
 
CS/CS/HB 783 revises the definitions of the terms “authorized health care practitioner,” and “caregiver,” in the 
context of emergency opioid antagonist administration. The changes broaden the definitions of these terms to 
eliminate unintended restrictions on how and by whom emergency opioid antagonists may be dispensed, 
possessed, and administered. 
 
The bill creates the Statewide Council on Opioid Abatement within the Department of Children and Families for 
the purpose of enhancing the development and coordination of state and local efforts to abate the opioid 
epidemic and to support the victims of the opioid crisis. 
 
The bill has an indeterminate, negative fiscal impact on the Department of Children and Families and the 
Department of Legal Affairs.  
 
The bill provides an effective date of July 1, 2023.   STORAGE NAME: h0783e.HHS 	PAGE: 2 
DATE: 4/18/2023 
  
FULL ANALYSIS 
I.  SUBSTANTIVE ANALYSIS 
 
A. EFFECT OF PROPOSED CHANGES: 
Background 
 
Opioids are psychoactive substances derived from the opium poppy, or their synthetic analogues.
1
 
Opioids are highly effective pain relievers, and as such are commonly used to treat acute and chronic 
pain. An individual experiences pain because of a series of electrical and chemical exchanges across 
the individual’s peripheral nerves, spinal cord, and brain.
2
 Opioid receptors occur naturally and are 
distributed widely throughout the central nervous system and in peripheral sensory and autonomic 
nerves and modulate the body’s perception of pain.
3
 Opioids bind to specific opioid receptors, disrupt 
the transmission of pain signals through the central nervous system and reduce the perception of pain.
4
  
 
Opioids include prescription medications used to treat pain, as well as illegal drugs. Opioids include:
5
 
 
 Buprenorphine (Subutex, Suboxone), 
 Codeine, 
 Fentanyl (Duragesic, Fentora), 
 Heroin, 
 Hydrocodone (Vicodin, Lortab, Norco), 
 Hydromorphone (Dilaudid, Exalgo), 
 Meperidine, 
 Methadone, 
 Morphine, 
 Oxycodone (OxyContin, Percodan, Percocet), 
 Oxymorphone, 
 Tramadol, and 
 U-47700. 
 
Opioids can create a euphoric feeling because they affect the regions of the brain involved with 
pleasure and reward, which can lead to abuse.
6
 In 2019, an estimated 62 million people used opioids 
for non-medical reasons worldwide.
7
 Opioids are commonly misused, with an estimated 36.3 million 
people worldwide suffering from drug use disorders.
8
 Continued use of opioids can lead to the 
development of tolerance and psychological and physical dependence.
9
 This dependence is 
characterized by a strong desire to take opioids, impaired control over opioid use, persistent opioid use 
                                                
1
 World Health Organization, Opioid Overdose, available at https://www.who.int/news-room/fact-sheets/detail/opioid-overdose (last 
visited March 20, 2023).  
2
 Medical News Today, What is pain, and how do you treat it? (Sept. 7, 2020), available at 
https://www.medicalnewstoday.com/articles/145750#:~:text=People%20feel%20pain%20when%20specific,immediate%20contraction%
20of%20the%20muscles (last visited March 20, 2023). 
3
 Gjermund Henriksen, Frode Willoch, Imaging of Opioid Receptors in the Central Nervous System, Brain (2008) 131 (5): 1171-1196. 
4
 Id. 
5
 U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, SAMHSA Opioid 
Overdose Toolkit: Facts for Community Members (2018), available at https://store.samhsa.gov/sites/default/files/d7/priv/sma18-
4742.pdf (last visited March 20, 2023). 
6
 National Institute on Drug Abuse, How Do Opioids Affect the Brain and Body?, (June 2020), available at 
http://www.drugabuse.gov/publications/research-reports/prescription-drugs/opioids/how-do-opioids-affect-brain-body (last visited March 
20, 2023). 
7
 Florida Department of Law Enforcement, Drugs Identified in Deceased Persons by Florida Medical Examiners 2019 Report, (Nov. 
2020), available at https://www.fdle.state.fl.us/MEC/Publications-and-Forms/Documents/Drugs-in-Deceased-Persons/2019-Annual-
Drug-Report.aspx#:~:text=%E2%9C%93%20The%20most%20frequently%20occurring,)%20and%20oxycodone%20(1%2C181 ) (last 
visited March 20, 2023). 
8
 United Nations Office on Drugs and Crime, World Drug Report 2021, Global Overview: Drug Demand and Drug Supply (Jun. 2021), 
available at https://www.unodc.org/res/wdr2021/field/WDR21_Booklet_2.pdf (last visited March 20, 2023). 
9
 Supra, note 4.  STORAGE NAME: h0783e.HHS 	PAGE: 3 
DATE: 4/18/2023 
  
despite harmful consequences, a higher priority given to opioid use than to other activities and 
obligations, and a physical withdrawal reaction when opioids are discontinued.
10
 
 
Opioid Overdose  
 
An overabundance of opioids in the body can lead to a fatal overdose. The opioid receptors that are 
located in major pain pathways, thus enabling opioids to alleviate the sensation of pain, are also found 
in the respiratory control centers of the brain.
11
 Opioids disrupt the transmission of signals for 
respiration in the identical manner as they disrupt the transmission of pain signals. This leads to a 
reduction, and possible cessation, of an individual’s respiration. Oxygen starvation will eventually stop 
vital organs like the heart and brain and can lead to unconsciousness, coma, and possible death.
12
 
Within 3-5 minutes without oxygen, brain damage starts to occur, soon followed by death.
13
 
However, a person’s breathing will commonly slow gradually over time and breathing may not stop until 
minutes to hours after the drug or drugs were used.
14
 An opioid overdose can be identified by a 
combination of three signs and symptoms referred to as the “opioid overdose triad”:
15
 
 
 Pinpoint pupils;  
 Unconsciousness; and  
 Respiratory depression. 
 
More than 106,000 Americans died from drug-involved overdose in 2021, including illicit drugs and 
prescription opioids.
16
 Opioid-involved overdose deaths increased from 21,088 in 2010 to 47,600 in 
2017; the rate of such deaths remained relatively consistent for the next two years with 49,860 opioid-
involved overdose deaths in 2019.
17
 This was followed by a sharp increase in opioid-involved overdose 
deaths associated with the COVID-19 pandemic beginning in 2020.
18
 Nationally, there were 63,630 
reported opioid-involved overdose deaths in 2020 and 80,411 in 2021.
19
 
 
 
 
 
 
 
 
 
 
 
 
 
The graph below demonstrates the total number of U.S. overdose deaths involving any opioid
20
 from 
1999 to 2021.
21
 
 
                                                
10
 Supra, note 1. 
11
 Pattinson, K.T.S., Opioids and the Control of Respiration, BJA, Vol. 100, Issue 6, Pages 747-758, available at 
https://doi.org/10.1093/bja/aen094. 
12
 Harm Reduction Coalition, Guide to Developing and Managing Overdose Prevention and Take-Home Naloxone Projects, (Aug. 31, 
2020), available at http://harmreduction.org/our-work/overdose-prevention/ (last visited March 20, 2023). 
13
 Id. 
14
 Id. 
15
 Supra, note 1. 
16
 National Institute on Drug Abuse, Overdose Death Rates, available at https://www.drugabuse.gov/drug-topics/trends-
statistics/overdose-death-rates (last visited March 20, 2023).  
17
 Id. 
18
 Ghose, R., Forati, A.M. & Mantsch, J.R. Impact of the COVID-19 Pandemic on Opioid Overdose Deaths: A Spatiotemporal Analysis. 
J Urban Health 99, 316–327 (2022), available at https://doi.org/10.1007/s11524-022-00610-0 (last visited March 27, 2023).  
19
 Supra, note 16. 
20
 Any opioid includes prescription opioids (natural and semi-synthetic opioids and methadone), heroin and synthetic opioids other than 
methadone (primarily fentanyl).  
21
 Supra, note 16.   STORAGE NAME: h0783e.HHS 	PAGE: 4 
DATE: 4/18/2023 
  
Opioid Deaths in the United States, 1999-2021
22
 
 
Prior to the COVID-19 pandemic, the increase in opioid overdose deaths can be outlined in three 
distinct waves: 
 
 The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths 
involving prescription opioids increasing since at least 1999. 
 The second wave began in 2010, with rapid increase in overdose deaths involving heroin. 
 The third wave began in 2013, with significant increases in overdose deaths involving synthetic 
opioids, particularly those involving illicitly manufactured fentanyl. The market for illicitly 
manufactured fentanyl continues to change, and the drug can be found in combination with 
heroin, counterfeit pills, and cocaine.
23
  
 
In 2021, there were 6,442 opioid overdose deaths reported in Florida, a 22% increase from 2019.
24
 
There were an additional 50,803 all-drug, non-fatal overdoses resulting in an emergency department 
visit in 2021.
25
 Additionally, fentanyl, an extremely potent opioid drug, is the leading cause of overdose 
deaths in Florida, and the incidence of fentanyl overdose deaths increased by 38 percent from 2,348 in 
2019 to 3,244 in 2020.
26
 
 
 
 
Opioid Antagonists 
 
An opioid antagonist, such as Narcan or Naloxone, is a drug that blocks the effects of exogenously 
administered opioids. Opioid antagonists are used in opioid overdoses to counteract life-threatening 
depression of the central nervous system and respiratory system, allowing an overdose victim to 
breathe normally.
27
 This occurs because opioid antagonists create a stronger bond with opioid 
                                                
22
 Supra, note 16. 
23
 Centers for Disease Control and Prevention, Understanding the Opioid Overdose Epidemic, available at 
https://www.cdc.gov/opioids/basics/epidemic.html (last visited March 20, 2023). 
24
 Florida Department of Health, FL Health Charts: Substance Use Dashboard, available at 
https://www.flhealthcharts.gov/ChartsDashboards/rdPage.aspx?rdReport=SubstanceUse.Overdose (last visited March 20, 2023). 
25
 Id. 
26
 Project Opioid, A Pandemic Fueling an Epidemic in Florida in 2020, available at https://projectopioid.org/wp-
content/uploads/2020/12/PO-2020-Data-Study-Final_New-Section.pdf (last visited March 20, 2023). 
27
 Harm Reduction Coalition, Understanding Naloxone, (Sept. 8, 2020), available at http://harmreduction.org/issues/overdose-
prevention/overview/overdose-basics/understanding-naloxone/ (last visited March 20, 2023).  STORAGE NAME: h0783e.HHS 	PAGE: 5 
DATE: 4/18/2023 
  
receptors than opioids. This forces the opioids from the opioid receptors and allows the transmission of 
signals for respiration to resume.
28
 This effect lasts only for a short period of time,
29
 with the narcotic 
effect of the opioids returning if still present in large quantities in the body. In this scenario, additional 
doses of an opioid antagonist would be required, which is why it is generally recommended that anyone 
who has experienced an overdose seek medical attention. 
 
Opioid antagonists, such as naloxone, have no potential for abuse
30
 and will not cause harm if 
mistakenly administered to a person who is not overdosing on an opioid.
31
 
 
Dispensing of Opioid Antagonists 
 
Under current law, an authorized health care practitioner may prescribe and dispense an emergency 
opioid antagonist to a patient or caregiver without a prescription or a non-patient specific standing order 
being in place.
32
 A pharmacist licensed under Ch. 465, F.S, is authorized to order and dispense an 
emergency opioid antagonist to a patient or caregiver without a prescription or a non-patient specific 
standing order being in place.
33
 A “patient” means any person at risk of experiencing an opioid 
overdose, and a “caregiver” means a family member, friend, or person in a position to have recurring 
contact with a person at risk of experiencing an opioid overdose.
34
 
 
Under current law, emergency responders, crime laboratory personnel, and personnel of a law 
enforcement agency or another agency who are likely to come in contact with a controlled substance or 
persons at risk of an overdose, are authorized to possess, store, and administer emergency opioid 
antagonists. Such individuals are immune from civil liability for administering an emergency opioid 
antagonist in accordance with the Good Samaritans Act.
35
 
 
In September 2022, the State Surgeon General issued a statewide Standing Order for Naloxone 
(Standing Order).
36
 The Standing Order authorizes pharmacists to dispense certain naloxone 
formulations to emergency responders for administration to persons exhibiting signs of opioid 
overdose. Under the Standing Order, emergency responders, including law enforcement, firefighters, 
paramedics, and emergency medical technicians, can go to a pharmacy or community-based program 
for training on opioid antagonist administration and receive an opioid antagonist without a patient-
specific prescription.
37
 
 
Multistate Opioid Lawsuit and Settlement 
 
                                                
28
 Supra, note 11. 
29
 The half-life for a common opioid antagonist in adults ranged from 30 to 81 minutes. Acute opiate withdrawal is a potential side-effect 
of naloxone; however, this would be time limited to the half-life of naloxone. 
30
 Supra, note 27. 
31
 Centers for Disease Control and Prevention, 5 Things to Know About Naloxone, (Oct. 25, 2022), available at 
https://www.cdc.gov/drugoverdose/featured-
topics/naloxone.html#:~:text=Naloxone%20is%20safe.,Small%2C%20constricted%20%E2%80%9Cpinpoint%20pupils%E2%80%9D 
(last visited March 20, 2023). 
32
 S. 381.887, F.S. An “authorized health care practitioner” means a licensed practitioner who is authorized to prescribe drugs under 
Florida law. 
33
 S. 381.887, F.S. 
34
 Id. 
35
 S. 381.887(5), F.S.; see also s. 768.13, F.S. The Good Samaritans Act provides civil immunity to any person, including licensed 
medical professionals, who gratuitously and in good faith renders emergency care or treatment in direct response to an emergency 
situation. 
36
 Florida Department of Health, Statewide Standing Order for Naloxone, (Sep. 30, 2022), available at 
https://www.floridahealth.gov/licensing-and-regulation/ems-system/_documents/standing-order-naloxone.pdf (last visited March 20, 
2023). 
37
 Id.  STORAGE NAME: h0783e.HHS 	PAGE: 6 
DATE: 4/18/2023 
  
In 2018, Attorney General Pam Bondi filed a lawsuit against multiple opioid manufacturers and 
distributors. The suit was later expanded to include the pharmacies CVS and Walgreens.
38
 The 
complaint alleged that the defendants caused the opioid crisis by, among other things:
39
 
 
 Engaging in a campaign of misrepresentations and omissions about opioid use designed to 
increase opioid prescriptions and opioid use, despite the risks. 
 Funding ostensibly neutral and independent “front” organizations to publish information touting 
the benefits of opioids for chronic pain while omitting the information about the risks of opioid 
treatment. 
 Paying ostensibly neutral medical experts called “key opinion leaders” who were really 
manufacturer “mouthpieces” to publish articles promoting the use of opioids to treat pain while 
omitting information regarding the risks. 
 
In 2021, McKesson, Cardinal Health, and AmerisourceBergen, the nation’s three largest 
pharmaceutical distributors, as well as manufacturer Janssen Pharmaceuticals, Inc., agreed to a 
national settlement in which the distributors agreed to pay $21 billion over 18 years and Janssen 
agreed to pay $5 billion over nine years.
40
 Of the $26 billion available, approximately $22.7 billion is 
earmarked for use by states that participated in the lawsuit, including Florida.
41
 
 
Florida has additionally negotiated individual settlements with multiple other companies including:
42
 
 
 $65 million settlement with Endo Health Solutions; 
 $440 million settlement with CVS Pharmacy, Inc.; 
 $177,114,999 settlement with Teva Pharmaceuticals Industries, Ltd.; 
 $122 million settlement with Allergan Finance, LLC.; 
 $620 million settlement with Walgreens Boots Alliance, Inc. and Walgreens Co.; and 
 $215 million settlement with Walmart. 
 
These settlements will pay out over a period of time ranging from 10 to 18 years. The monies from the 
settlements in general must be used for the purpose of opioid abatement, including prevention efforts, 
treatment, and recovery services, and to pay fees and costs incurred by the state, cities, and 
counties.
43
 Additionally, Teva Pharmaceuticals has agreed to provide the state with a supply of 
Naloxone Hydrochloride, an opioid antagonist, valued at $84 million.
44
 
 
To ensure the settlement proceeds described above are used to fund opioid and substance abuse 
education, treatment, prevention, and other related programs and services, the Office of the Attorney 
General coordinated with certain local governments in the state on the terms of the Florida Opioid 
Allocation and Statewide Response Agreement.
45
 The agreement requires the state establish an Opioid 
Abatement Taskforce or Council to advise the Governor, the Legislature, DCF, and local governments 
on the priorities that should be addressed by the expenditure of settlement funds, as well as review the 
spending of such funds and the results achieved. The Council’s membership, administration, and duties 
are outlined in the agreement.
46
 
                                                
38
 Sullivan, E., NPR, Florida Sues Walgreens, CVS for Alleged Role in Opioid Crisis, (Nov. 2018), available at 
https://www.npr.org/2018/11/19/669146432/florida-sues-walgreens-cvs-for-alleged-role-in-opioid-crisis (last visited March 20, 2023). 
39
 Florida Attorney General, Florida’s Opioid Lawsuit, available at http://myfloridalegal.com/webfiles.nsf/WF/MNOS-
AYSNED/$file/Complaint+summary.pdf (last visited March 20, 2023). 
40
 National Opioid Settlement, Executive Summary of National Opioid Settlements, (Feb. 2023), available at 
https://nationalopioidsettlement.com/executive-
summary/#:~:text=In%20all%2C%20the%20Distributors%20will,additional%20manufacturers%E2%80%94Allergan%20and%20Teva 
(last visited March 20, 2023). 
41
 Office of the Attorney General, Attorney General Moody Secures Relief for Opioid Crisis, available at 
https://myfloridalegal.com/opioidsettlement (last visited March 20, 2023). 
42
 Id. 
43
 Id. 
44
 Id. 
45
 Florida Opioid Allocation and Statewide Response Agreement Between State of Florida Department of Legal Affairs, Office of the 
Attorney General and Certain Local Governments in the State of Florida (Nov. 2021), available at 
https://nationalopioidsettlement.com/wp-content/uploads/2021/11/FL-Opioid-AllocSW-Resp-Agreement.pdf (last visited April 17, 2023). 
46
 Id.  STORAGE NAME: h0783e.HHS 	PAGE: 7 
DATE: 4/18/2023 
  
 
Effect of Proposed Changes 
 
Opioid Antagonists 
 
CS/CS/HB 783 revises the definitions of the terms “authorized health care practitioner,” and “caregiver,” 
in the context of emergency opioid antagonist administration. The changes broaden the definitions of 
these terms to eliminate unintended restrictions on how and by whom emergency opioid antagonists 
may be dispensed, possessed, and administered. 
 
Statewide Council on Opioid Abatement 
 
The bill establishes the Statewide Council on Opioid Abatement (Council) in accordance with the terms 
of an agreement between the state and various local governments in the state regarding the distribution 
of opioid settlement funds. The bill establishes the Council within DCF for the purpose of enhancing the 
development and coordination of state and local efforts to abate the opioid epidemic and to support the 
victims of the opioid crisis and their families.  
 
 Membership 
 
The bill requires that the Council be composed of 10 members as follows: 
 
 The Attorney General, or a designee, who serves as chair; 
 The Secretary of DCF, or a designee, who serves as vice-chair; 
 A member appointed by the Governor; 
 A member appointed by the President of the Senate; 
 A member appointed by the Speaker of the House; 
 Two members appointed by the Florida League of Cities who are commissioners or mayors of 
municipalities. At least one of such members must be from a municipality with a population of 
less than 50,000; 
 Two members appointed by, or through, the Florida Association of Counties who are county 
commissioners or mayors. One of such members must represent a county with a population of 
more than 200,000; the other must represent a county with a population of fewer than 200,000; 
and 
 One member who is appointed on a rotational basis by either the Florida Association of 
Counties or the Florida League of Cities. 
 
The bill specifies that members are appointed to two-year terms and may not receive a commission, 
fee, or financial benefit in connection with their service on the Council, but may be reimbursed for per 
diem and travel expenses in accordance with s. 112.061, F.S.,
47
 by the agency that the member 
represents, or by DCF if the member is not affiliated with a state agency. 
 
 
 
 Organization and Support 
 
The bill requires that the first meeting of the Council be held by August 31, 2023. The Council is 
directed to meet quarterly thereafter, and upon the call of the chair or two other members. The bill 
allows for meetings of the Council to take place in person or virtually. The bill specifies that a majority of 
the members of the Council is necessary for a quorum. 
 
The bill requires that DCF and DLA provide the Council with staff as necessary for the performance of 
the Council’s duties. The bill authorizes the Council to apply for and accept funds, grants, gifts, and 
services from the state, the Federal Government and its agencies, or any other public or private source 
for the purposes of defraying costs or performing its duties. The bill specifies that Council members are 
                                                
47
 See S. 112.061, F.S., which sets rates for travel and per diem reimbursement.  STORAGE NAME: h0783e.HHS 	PAGE: 8 
DATE: 4/18/2023 
  
required to adhere to all laws, rules, and regulations, including s. 112.311, F.S., relating to the 
disclosure of conflicts of interest and recusal. 
 
 Duties of the Council 
 
The bill assigns the Council a series of duties associated with the monitoring of the abatement of the 
opioid epidemic in Florida and review of settlement fund expenditures associated with the opioid 
litigation. The duties of the Council include the following: 
 
 Advising the state and local governments on resolving or abating the opioid epidemic and 
reviewing how settlement monies recovered from the opioid litigation brought by the state and 
its subdivisions have been spent and the results that have been achieved from those 
expenditures; 
 Working with and exchanging information with the Statewide Drug Policy Advisory Council to 
ensure that the recommendations and actions of each are consistent to the extent possible; 
 Reviewing data from local, state, and national agencies on a regional and statewide basis to 
advise the state and local governments on the status of the opioid epidemic; 
 Reviewing data from local, state, and national agencies regarding how monies are being spent 
to abate the opioid epidemic, the success of such programs, and the appropriate metrics 
necessary for assessing the opioid epidemic; 
 Developing and recommending metrics, measures, or data sets for the assessment of the 
progress and success of programs funded by expenditures of opioid settlement monies. The 
Council is directed to align its recommended metrics, measures, or data sets with those the 
state uses with its managing entities, as well as any required by the Substance Abuse and 
Mental Health Services Administration of the US Department of Health and Human Services in 
connection with grants received by the state; 
 With the assistance and support of DCF, providing a system of documentation and reporting 
commensurate with the requirements of federal and other agencies providing funding to the 
state, including, but not limited to, auditing expenditures consistent with any requirements 
imposed by the Legislature; 
 Publishing an annual report containing how settlement moneys were spent in the previous fiscal 
year by the state, managing entities, and each county and municipality. The report must also 
contain recommendations to the Governor, the Legislature, and local governments for how 
moneys should be prioritized and spent the coming fiscal year in response to the opioid 
epidemic. The first report is required to be published by December 1, 2023, and must be posted 
on the website of DCF and DLA. 
 
Each county, city, managing entity, or state agency which receives settlement monies from an opioid 
settlement is required to annually provide to the Council information regarding how it intends to use 
settlement funds and collect data on its use of funds and the expenditure of settlement moneys and the 
results of those expenditures. The Council may also request information relating to metrics, measures, 
or data sets from each county, city, managing entity, or agency. 
 
If a county, city, managing entity, or agency fails to provide information requested by the Council, the 
DLA, acting on behalf of the Council, may seek such information through civil investigative demand, 
subpoena, or by commencing an action seeking such information. 
 
The bill provides an effective date of July 1, 2023. 
 
 
B. SECTION DIRECTORY: 
Section 1: Amends s. 381.887, F.S., relating to emergency treatment for suspected opioid 
overdose. 
Section 2: Creates s. 397.335, F.S., relating to the Statewide Council on Opioid Abatement. 
Section 3: Provides an effective date of July 1, 2023. 
  STORAGE NAME: h0783e.HHS 	PAGE: 9 
DATE: 4/18/2023 
  
II.  FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT 
 
A. FISCAL IMPACT ON STATE GOVERNMENT: 
 
1. Revenues: 
None. 
 
2. Expenditures: 
The bill may have an indeterminate, negative fiscal impact on DCF and DLA associated with 
establishing and staffing the Council. However, the impact on each agency will likely be insignificant 
and can be absorbed within existing resources. 
 
B. FISCAL IMPACT ON LOCAL GOVERNMENTS: 
 
1. Revenues: 
None. 
 
2. Expenditures: 
None. 
 
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR: 
None. 
 
D. FISCAL COMMENTS: 
None. 
 
III.  COMMENTS 
 
A. CONSTITUTIONAL ISSUES: 
 
 1. Applicability of Municipality/County Mandates Provision: 
Not applicable. The bill does not appear to affect county or municipal governments.  
 
 2. Other: 
None. 
 
B. RULE-MAKING AUTHORITY: 
DOH has sufficient rulemaking authority to implement the bill’s provisions.  
 
C. DRAFTING ISSUES OR OTHER COMMENTS: 
None. 
IV.  AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES 
On March 22, 2023, the Healthcare Regulation Subcommittee adopted an amendment and reported the bill 
favorably as a committee substitute. The amendment removed legislative intent provisions from the bill. 
 
On April 17, 2023, the Health and Human Services committee adopted an amendment and reported the bill 
favorably as a committee substitute. The amendment: 
 
 Revises the definitions of “authorized health care practitioner,” and “caregiver,” as related to the 
administration of emergency opioid antagonists.  STORAGE NAME: h0783e.HHS 	PAGE: 10 
DATE: 4/18/2023 
  
 Deletes redundant language pertaining to the Good Samaritan Act. 
 
The bill analysis is drafted to the committee substitute adopted by the Health and Human Services 
Committee.