EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb1155*
HOUSE BILL 1155
J1, J3 4lr1499
CF SB 1071
By: Delegates Stewart and Buckel
Introduced and read first time: February 7, 2024
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Hospitals – Opioid Overdose – Medication–Assisted Treatment 2
FOR the purpose of requiring hospitals to establish and maintain certain protocols and 3
capacity related to the treatment of patients who are being treated for an 4
opioid–related overdose; requiring hospitals to connect patients who are 5
administered or prescribed medication–assisted treatment to an appropriate 6
provider to voluntarily continue treatment under certain circumstances; requiring 7
the Governor to include in the annual budget bill for a certain fiscal year a certain 8
appropriation from the Opioid Restitution Fund for hospitals to provide training and 9
resources to implement the requirements of this Act; and generally relating to 10
hospitals and treatment for opioid use disorder. 11
BY adding to 12
Article – Health – General 13
Section 19–308.10 14
Annotated Code of Maryland 15
(2023 Replacement Volume) 16
BY repealing and reenacting, with amendments, 17
Article – State Finance and Procurement 18
Section 7–331 19
Annotated Code of Maryland 20
(2021 Replacement Volume and 2023 Supplement) 21
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 22
That the Laws of Maryland read as follows: 23
Article – Health – General 24
19–308.10. 25 2 HOUSE BILL 1155
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANI NGS 1
INDICATED. 2
(2) “MEDICATION” MEANS A DRUG APPROVE D BY THE U.S. FOOD AND 3
DRUG ADMINISTRATION FOR TH E TREATMENT OF OPIOI D USE DISORDER . 4
(3) “MEDICATION–ASSISTED TREATMENT ” MEANS THE USE OF 5
MEDICATION, IN COMBINATION WITH COU NSELING AND BEHAVIOR AL HEALTH 6
THERAPIES, TO PROVIDE A HOLISTI C APPROACH TO THE TR EATMENT OF OPIOID US E 7
DISORDER. 8
(4) “OPIOID USE DISORDER ” MEANS A MEDICALLY DI AGNOSED 9
PROBLEMATIC PATTERN OF OPIOID USE THAT C AUSES A SIGNIFICANT IMPAIRMENT 10
OR DISTRESS. 11
(B) EACH HOSPITAL SHALL ESTABLISH AND MAINTAIN, AS PART OF ITS 12
EMERGENCY SERVICES , PROTOCOLS AND CAPACI TY TO: 13
(1) PROVIDE TO A PATIENT BEFORE DISCHARGING THE PATI ENT 14
APPROPRIATE , EVIDENCE–BASED INTERVENTIONS THAT REDUCE THE RISK OF 15
SUBSEQUENT HARM AND FATALITY FOLLOWING A N OPIOID–RELATED OVERDOSE ; 16
(2) POSSESS, DISPENSE, ADMINISTER, AND PRESCRIBE 17
MEDICATION–ASSISTED TREATMENT , INCLUDING AT LEAST ONE FORMULAT ION OF 18
EACH U.S. FOOD AND DRUG ADMINISTRATION –APPROVED FULL OPIOID AGONIST, 19
PARTIAL OPIOID AGONI ST, AND LONG–ACTING OPIOID ANTAGO NIST USED FOR THE 20
TREATMENT OF OPIOID USE DISORDER ; AND 21
(3) TREAT A PATIENT WHO PRESENT S IN A HOSPITAL EMERGENCY 22
DEPARTMENT FOR CARE AND TREATMENT OF AN OPIOID–RELATED OVERDOSE IF 23
THE TREATMENT: 24
(I) OCCURS AS RECOMMENDED BY THE T REATING HEALTH 25
CARE PRACTITIONER ; AND 26
(II) IS VOLUNTARILY AGREED TO BY THE PATIENT . 27
(C) A PROTOCOL ESTABLISHED BY A HOSPITAL UNDER THIS SECTION SHALL 28
COMPLY WITH: 29
(1) APPLICABLE TRAINING A ND WAIVER REQUIREMEN TS 30
ESTABLISHED BY THE F EDERAL DRUG ENFORCEMENT AGENCY; AND 31 HOUSE BILL 1155 3
(2) ANY REQUIREMENT BY THE DEPARTMENT REGARDING 1
PRESCRIBING OPIOID A GONIST TREATMENT . 2
(D) BEFORE DISCHARGING A PATIENT WHO IS ADMINISTERED OR 3
PRESCRIBED MEDICATIO N–ASSISTED TREATMENT , A HOSPITAL SHALL CON NECT 4
THE PATIENT WITH AN APPROPRIATE PROVI DER OR FACILITY TO VOLUNTARILY 5
CONTINUE TREATMENT . 6
Article – State Finance and Procurement 7
7–331. 8
(a) In this section, “Fund” means the Opioid Restitution Fund. 9
(b) There is an Opioid Restitution Fund. 10
(c) The purpose of the Fund is to retain the amount of settlement revenues 11
deposited to the Fund in accordance with subsection (e)(1) of this section. 12
(d) (1) The Fund is a special, nonlapsing fund that is not subject to § 7–302 of 13
this subtitle. 14
(2) The State Treasurer shall hold the Fund separately, and the 15
Comptroller shall account for the Fund. 16
(e) The Fund consists of: 17
(1) all revenues received by the State from any source resulting, directly or 18
indirectly, from any judgment against, or settlement with, opioid manufacturers, opioid 19
research associations, or any other person in the opioid industry relating to any claims 20
made or prosecuted by the State to recover damages for violations of State law; and 21
(2) the interest earnings of the Fund. 22
(f) The Fund may be used only to provide funds for: 23
(1) programs, services, supports, and resources for evidence–based 24
substance use disorder prevention, treatment, recovery, or harm reduction that have the 25
purpose of: 26
(i) improving access to medications proven to prevent or reverse an 27
overdose; 28
4 HOUSE BILL 1155
(ii) supporting peer support specialists and screening, brief 1
intervention, and referral to treatment services for hospitals, correctional facilities, and 2
other high–risk populations; 3
(iii) increasing access to medications that support recovery from 4
substance use disorders; 5
(iv) expanding the Heroin Coordinator Program, including for 6
administrative expenses; 7
(v) expanding access to crisis beds and residential treatment 8
services for adults and minors; 9
(vi) expanding and establishing safe stations, mobile crisis response 10
systems, and crisis stabilization centers; 11
(vii) supporting the behavioral health crisis hotline; 12
(viii) organizing primary and secondary school education campaigns 13
to prevent opioid use, including for administrative expenses; 14
(ix) enforcing the laws regarding opioid prescriptions and sales, 15
including for administrative expenses; 16
(x) research regarding and training for substance use treatment and 17
overdose prevention, including for administrative expenses; and 18
(xi) supporting and expanding other evidence–based interventions 19
for overdose prevention and substance use treatment; 20
(2) evidence–informed substance use disorder prevention, treatment 21
recovery, or harm reduction pilot programs or demonstration studies that are not 22
evidence–based if the Opioid Restitution Fund Advisory Council, established under § 23
7.5–902 of the Health – General Article: 24
(i) determines that emerging evidence supports the distribution of 25
money for the pilot program or that there is a reasonable basis for funding the 26
demonstration study with the expectation of creating an evidence–based program; and 27
(ii) approves the use of money for the pilot program or demonstration 28
study; and 29
(3) evaluations of the effectiveness and outcomes reporting for substance 30
use disorder abatement infrastructure, programs, services, supports, and resources for 31
which money from the Fund was used, including evaluations of the impact on access to 32
harm reduction services or treatment for substance use disorders and the reduction in 33
drug–related mortality. 34 HOUSE BILL 1155 5
(g) (1) The State Treasurer shall invest the money of the Fund in the same 1
manner as other State money may be invested. 2
(2) Any interest earnings of the Fund shall be credited to the Fund. 3
(h) (1) Expenditures from the Fund may be made only in accordance with the 4
State budget. 5
(2) FOR FISCAL YEAR 2026, THE GOVERNOR SHALL INCLUD E IN THE 6
ANNUAL BUDGET BILL A N APPROPRIATION OF $500,000 FROM THE FUND TO 7
PROVIDE TRAINING AND RESOURCES TO HOSPITA LS TO IMPLEMENT THE 8
REQUIREMENTS OF § 19–308.10 OF THE HEALTH – GENERAL ARTICLE. 9
[(2)] (3) For settlement funds received in accordance with the final 10
distributor agreement of July 21, 2021, with McKesson Corporation, Amerisource Bergen 11
Corporation, and Cardinal Health Incorporated, as amended, the Janssen settlement 12
agreement of July 21, 2021, as amended, or any other op ioid–related court or 13
administrative judgment or settlement agreement involving the State and one or more of 14
its political subdivisions: 15
(i) appropriations from the Fund in the State budget shall be made 16
in accordance with the allocation and distribution of funds to the State and its political 17
subdivisions: 18
1. as agreed on in the State–subdivision agreement of 19
January 21, 2022, as amended; or 20
2. required under any other opioid –related court or 21
administrative judgment or settlement agreement, or any similar agreement reached under 22
an opioid–related court or administrative judgment or settlement agreement, involving the 23
State and one or more of its political subdivisions; and 24
(ii) the Secretary of Health shall establish and administer a grant 25
program for the distribution of funds to political subdivisions of the State in accordance 26
with: 27
1. the State–subdivision agreement of January 21, 2022, as 28
amended; or 29
2. the requirements of any other opioid–related court or 30
administrative judgment or settlement agreement, or any similar agreement reached under 31
an opioid–related court or administrative judgment or settlement agreement, involving the 32
State and one or more of its political subdivisions. 33
6 HOUSE BILL 1155
[(3)] (4) The Attorney General shall ident ify and designate the 1
controlling version of any agreement or amendment described under paragraph [(2)] (3) of 2
this subsection. 3
(i) (1) Money expended from the Fund for the programs and services described 4
under subsection (f) of this section is supplemental to and is not intended to take the place 5
of funding that otherwise would be appropriated for the programs and services. 6
(2) Except as specified in subsection (f) of this section, money expended 7
from the Fund may not be used for administrative expenses. 8
(j) The Governor shall: 9
(1) develop key goals, key objectives, and key performance indicators 10
relating to substance use treatment and prevention efforts; 11
(2) subject to subsection [(h)(2)] (H)(3) of this section, at least twice 12
annually, consult with the Opioid Restitution Fund Advisory Council to identify 13
recommended appropriations from the Fund; and 14
(3) report on or before November 1 each year, in accordance with § 2–1257 15
of the State Government Article, to the General Assembly on: 16
(i) an accounting of total funds expended from the Fund in the 17
immediately preceding fiscal year, by: 18
1. use; 19
2. if applicable, jurisdiction; and 20
3. budget program and subdivision; 21
(ii) the performance indicators and progress toward achieving the 22
goals and objectives developed under item (1) of this subsection; and 23
(iii) the recommended appropriations from the Fund identified in 24
accordance with item (2) of this subsection. 25
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 26
October 1, 2024. 27