Florida 2023 2023 Regular Session

Florida House Bill H0783 Analysis / Analysis

Filed 05/23/2023

                     
This document does not reflect the intent or official position of the bill sponsor or House of Representatives. 
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HOUSE OF REPRESENTATIVES STAFF FINAL BILL ANALYSIS  
 
BILL #: CS/CS/HB 783    Emergency Opioid Antagonists 
SPONSOR(S): Health & Human Services Committee and Healthcare Regulation Subcommittee, Caruso and 
others 
TIED BILLS:   IDEN./SIM. BILLS: CS/SB 704 
 
 
 
 
FINAL HOUSE FLOOR ACTION: 116 Y’s 
 
0 N’s GOVERNOR’S ACTION: N/A 
 
 
SUMMARY ANALYSIS 
CS/CS/HB 783 passed the House on April 26, 2023. The bill was amended in the Senate on May 2, 2023, and 
returned to the House. The House concurred on the Senate amendment and subsequently passed the bill as 
amended on May 3, 2023. 
 
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. 
 
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 standing order. Any person, including emergency medical responders, crime 
laboratory personnel, and personnel of a law enforcement agency, is authorized to possess, store, and 
administer emergency opioid antagonists, if they are likely to come in contact with a person at risk of an 
overdose. 
 
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 expands caregiver authority to possess and administer emergency opioid antagonists by 
removing the criterion that a caregiver have recurring, rather than any, contact with a person at risk of 
overdose. 
 
The bill creates the Statewide Council on Opioid Abatement within the Department of Children and Families 
(DCF) to enhance 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 requires each Florida College System institution and state university to have a supply of emergency 
opioid antagonists in clearly marked locations within residence halls and dormitory residences. The bill 
establishes guidance for such supplies, and provides civil and criminal immunity to campus law enforcement 
officers who administer or attempt to administer an emergency opioid antagonist. 
 
The bill has an indeterminate, negative fiscal impact on DCF and the Department of Legal Affairs.  
 
Subject to the Governor’s veto powers, the bill is effective on July 1, 2023.     
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I. SUBSTANTIVE INFORMATION 
 
A. EFFECT OF CHANGES:  
 
Background 
 
Opioids 
 
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 
                                                
1
 World Health Organization, Opioid Overdose, available at https://www.who.int/news-room/fact-sheets/detail/opioid-overdose (last 
visited May 12, 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 May 12, 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 May 12, 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 May 
12, 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 May 12, 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 May 12, 2023). 
9
 Supra, note 4.   
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characterized by a strong desire to take opioids, impaired control over opioid use, persistent opioid use 
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
 
 
 
 
 
 
 
 
 
Opioid Deaths in the United States, 1999-2021
22
 
                                                
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. (last visited May 12, 2023). 
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 May 12, 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 May 12, 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 May 12, 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.  
22
 Id.   
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Prior to the COVID-19 pandemic, the increase in opioid overdose deaths formed 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, 6,442 opioid overdose deaths were reported in Florida, a 22% increase from 2019.
24
 
Additionally, 50,803 all-drug, non-fatal overdoses resulted in an emergency department visit in 2021.
25
 
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 
receptors than opioids. This forces the opioids from the opioid receptors and allows the transmission of 
                                                
23
 Centers for Disease Control and Prevention, Understanding the Opioid Overdose Epidemic, available at 
https://www.cdc.gov/opioids/basics/epidemic.html (last visited May 12, 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 May 12, 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 May 12, 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 May 12, 2023).   
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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
 
 
Opioid Antagonist Dispensing 
 
Under current law, an authorized health care practitioner may prescribe and dispense an emergency 
opioid antagonist to any person at risk of experiencing an opioid overdose, and for any person in a 
position to have recurring contact with a person at risk of experiencing an opioid overdose, such as a 
family member or friend.
32
 A pharmacist may also order and dispense an emergency opioid antagonist 
to a patient or caregiver without a prescription or a nonpatient-specific standing order.
33
 
 
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.
34
 
 
In September 2022, the State Surgeon General issued a statewide Standing Order for Naloxone 
(Standing Order).
35
 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.
36
 
 
 
  
                                                
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%20pu pils%E2%80%9D 
(last visited May 12, 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. A nonpatient-specific standing order allows pharmacists to dispense specified medications without a patient-specific 
prescription. 
34
 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. 
35
 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 May 12, 
2023). 
36
 Id.   
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Multistate Opioid Lawsuit and Settlement 
 
In 2018, Attorney General Pam Bondi filed a lawsuit against multiple opioid manufacturers and 
distributors. The lawsuit was later expanded to include the pharmacies CVS and Walgreens.
37
 The 
complaint alleged that the defendants caused the opioid crisis by, among other things:
38
 
 
 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.
39
 Of the $26 billion available, approximately $22.7 billion is 
earmarked for use by states that participated in the lawsuit, including Florida.
40
 
 
Florida additionally negotiated individual settlements with multiple other companies including:
41
 
 
 $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. 
 
Additionally, Teva Pharmaceuticals has agreed to provide the state with a supply of Naloxone 
Hydrochloride, an opioid antagonist, valued at $84 million.
42
 
 
These settlements will pay out over a period of time ranging from 10 to 18 years. In general, the monies 
from the settlements must be used for opioid abatement, including prevention efforts, treatment, and 
recovery services, and to pay litigation fees and costs incurred by the state, cities, and counties.
43
 
 
To ensure the settlement proceeds 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 to enter into the Florida Opioid Allocation and Statewide 
Response Agreement. The agreement requires the state to establish an opioid abatement task force or 
council to advise the Governor, the Legislature, the Department of Children and Families (DCF), and 
local governments on the priorities that should be addressed by the expenditure of settlement funds, as 
                                                
37
 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 May 12, 2023). 
38
 Florida Attorney General, Florida’s Opioid Lawsuit, available at http://myfloridalegal.com/webfiles.nsf/WF/MNOS-
AYSNED/$file/Complaint+summary.pdf (last visited May 12, 2023). 
39
 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 May 12, 2023). 
40
 Office of the Attorney General, Attorney General Moody Secures Relief for Opioid Crisis, available at 
https://myfloridalegal.com/opioidsettlement (last visited May 12, 2023). 
41
 Id. 
42
 Id. 
43
 Id.   
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well as review the spending of such funds and the results achieved. The Council’s membership, 
administration, and duties are outlined in the agreement.
44
 
 
Effect of Proposed Changes 
 
Opioid Antagonists 
 
CS/CS/HB 783 includes pharmacists in the definition of “authorized health care practitioner”, which 
authorizes pharmacists to prescribe, dispense, administer, possess and store emergency opioid 
antagonists subject to the same requirements and immunities as other practitioners under the law. This 
appears to be duplicative or clarifying, as current law already authorizes pharmacists to perform these 
functions.
45
  
 
The bill expands who may possess, store and administer opioid antagonists for people at risk of 
overdose. Current law requires caregivers to have recurring contact with such a person to perform 
these functions; the bill eliminates the recurring contact requirement. Any contact with such a person 
makes one a “caregiver” under the law. The bill eliminates a subjective barrier that may have limited 
access to emergency opioid antagonists. 
 
Florida College System Institutions and State Universities 
 
The bill requires each Florida College System (FCS) institution and state university
46
 to maintain a 
supply of emergency opioid antagonists in clearly marked locations within residence halls and 
dormitory residences that are owned or operated by the institution or university. Such emergency opioid 
antagonists must be easily accessible to campus law enforcement officers who are trained in the 
administration of emergency opioid antagonists. 
 
The bill provides civil and criminal immunity to campus law enforcement officers who administer or 
attempt to administer an emergency opioid antagonist as authorized under laws related to emergency 
treatment for suspected opioid overdoes and the Good Samaritan Act. The institution that employs the 
officer is also granted civil and criminal immunity under the bill. The State Board of Education and the 
Board of Governors are directed to adopt rules and regulations, respectively, in order to execute the 
provisions of the bill. 
 
Statewide Council on Opioid Abatement 
 
The bill establishes the Statewide Council on Opioid Abatement (Council) in accordance with the terms 
of the Florida Opioid Allocation and Statewide Response 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 the Council to be composed of 10 members as follows: 
                                                
44
 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 May 12, 2023). 
45
 See, s. 381.887(3)(a) (authorizing pharmacists to order opioid antagonists); s. 381.887(3)(b) (authorizing pharmacists to dispense 
opioid antagonists); s. 381.887(5) (granting pharmacists civil immunity for possessing, administering, prescribing dispensing or storing 
opioid antagonists). 
46
 There are currently 28 FCS institutions and 12 state universities in Florida.   
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 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 the Council to hold the first meeting by August 31, 2023. The bill directs the Council to 
meet quarterly thereafter, and upon the call of the chair or two other members. The bill allows meetings 
of the Council to take place in person or virtually, and sets the quorum at a majority of the members. 
 
The bill requires DCF and DLA to provide the Council staff necessary for the performance of the its 
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 required to 
adhere to all laws, rules, and regulations, including s. 112.311, F.S., relating to conflict of interest 
disclosure 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; 
                                                
47
 See S. 112.061, F.S., which sets rates for travel and per diem reimbursement.   
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 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 DCF assistance and support, 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 on how settlement moneys were spent in the previous fiscal year by 
the state, managing entities, and each county and municipality, and making recommendations 
to the Governor, the Legislature, and local governments for how expenditures should be 
prioritized in the coming fiscal year in response to the opioid epidemic. The first report must be 
published on the DCF and DLA websites by December 1, 2023. 
 
The bill requires each county, city, managing entity, or state agency which receives settlement monies 
from an opioid settlement 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. 
 
The bill provides an effective date of July 1, 2023. 
 
II.  FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT 
 
A. FISCAL IMPACT ON STATE GOVERNMENT: 
 
1. Revenues: 
 
None. 
 
2. Expenditures: 
 
The bill has an indeterminate, negative fiscal impact on DLA associated with establishing and 
staffing the Council. The impact on DLA associated with staffing the Council is insignificant and 
absorbable within existing resources. 
 
The bill has an indeterminate, negative fiscal impact on DCF. Under the bill, DCF must reimburse 
Council members’ per diem and travel expenses if they are not employed by a state agency. DCF 
estimates this to cost approximately $44,520 annually.
48
 Other expenditures associated with the 
staffing the Council are expected to be absorbable within existing resources. 
 
FCS institutions and state universities may incur expenses for the purchase and storage of 
emergency opioid antagonists pursuant to the provisions of the bill.
49
 
 
 
B. FISCAL IMPACT ON LOCAL GOVERNMENTS: 
 
1. Revenues: 
 
None. 
                                                
48
 Department of Children and Families, Agency Analysis: HB 783 (2023), p. 6. On file with the Healthcare Regulation Subcommittee. 
49
 Department of Education, Agency Analysis: HB 39 (2023), p. 4. On file with the Healthcare Regulation Subcommittee.   
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2. Expenditures: 
 
None. 
 
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR: 
 
None. 
 
D. FISCAL COMMENTS: 
 
None.