EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb1155*
HOUSE BILL 1155
J1, J3 4lr1499
CF SB 1071
By: Delegates Stewart and Buckel, Buckel, Pena–Melnyk, Cullison, Alston,
Bagnall, Bhandari, Chisholm, Guzzone, Hill, Hutchinson, Kaiser, Kerr,
Kipke, R. Lewis, Lopez, Martinez, M. Morgan, Reilly, Rosenberg, Szeliga,
Taveras, White Holland, and Woods
Introduced and read first time: February 7, 2024
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 4, 2024
CHAPTER ______
AN ACT concerning 1
Hospitals – Opioid Overdose – Medication–Assisted Treatment and 2
Opioid–Related Emergency Medical Conditions – Treatment 3
FOR the purpose of requiring hospitals to establish and maintain certain protocols and 4
capacity related to the treatment of patients who are being treated for an 5
opioid–related overdose or opioid–related emergency medical condition; requiring 6
hospitals to connect make a referral for patients who are diagnosed with opioid use 7
disorder or administered or prescribed medication–assisted treatment medication 8
for opioid use disorder to an appropriate provider to voluntarily continue treatment 9
in the community under certain circumstances and work with peer support 10
professionals for a certain purpose; requiring the Governor to include in the annual 11
budget bill for a certain fiscal year a certain appropriation from the Opioid 12
Restitution Fund for hospitals to provide training and resources to implement the 13
requirements of this Act; and generally relating to hospitals and treatment for opioid 14
use disorder and opioid–related emergency medical conditions. 15
BY adding to 16
Article – Health – General 17
Section 19–308.10 18
Annotated Code of Maryland 19
(2023 Replacement Volume) 20
2 HOUSE BILL 1155
BY repealing and reenacting, with amendments, 1
Article – State Finance and Procurement 2
Section 7–331 3
Annotated Code of Maryland 4
(2021 Replacement Volume and 2023 Supplement) 5
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 6
That the Laws of Maryland read as follows: 7
Article – Health – General 8
19–308.10. 9
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 10
INDICATED. 11
(2) “MEDICATION” MEANS, “MEDICATION FOR OPIOI D USE 12
DISORDER”: 13
(1) MEANS A DRUG APPROVED BY T HE U.S. FOOD AND DRUG 14
ADMINISTRATION FOR TH E TREATMENT OF OPIOI D USE DISORDER ; AND 15
(2) DOES NOT INCLUDE A DR UG ADMINISTERED TO M ITIGATE 16
OPIOID–RELATED OVERDOSE SYM PTOMS. 17
(3) “MEDICATION–ASSISTED TREATMENT ” MEANS THE USE OF 18
MEDICATION, IN COMBINATION WITH COUNSELING AND BEHAV IORAL HEALTH 19
THERAPIES, TO PROVIDE A HOLISTI C APPROACH TO THE TR EATMENT OF OPIOID US E 20
DISORDER. 21
(4) “OPIOID USE DISORDER ” MEANS A MEDICALLY DI AGNOSED 22
PROBLEMATIC PATTERN OF OPIOID USE THAT C AUSES A SIGNIFICANT IMPAIRMENT 23
OR DISTRESS. 24
(B) EACH HOSPITAL SHALL E STABLISH AND MAINTAI N, AS PART OF ITS 25
EMERGENCY SERVICES , PROTOCOLS AND CAPACI TY TO: 26
(1) PROVIDE TO A PATIENT BEFORE DISCHARGING T HE PATIENT 27
APPROPRIATE , EVIDENCE–BASED INTERVENTIONS THAT REDUCE THE RISK OF 28
SUBSEQUENT HARM AND FATALITY FOLLOWING A N OPIOID–RELATED OVERDOSE OR 29
A VISIT FOR AN OPIOI D–RELATED EMERGENCY ME DICAL CONDITION ; 30
(2) POSSESS, DISPENSE, ADMINISTER, AND PRESCRIBE 31
MEDICATION–ASSISTED TREATMENT , INCLUDING AT LEAST ONE FORMULA TION OF 32
EACH U.S. FOOD AND DRUG ADMINISTRATION –APPROVED FULL OPIOID AGONIST, 33 HOUSE BILL 1155 3
AND PARTIAL OPIOID AGONI ST, AND LONG–ACTING OPIOID ANTAGO NIST USED FOR 1
THE TREATMENT OF OPIOID USE DISORDER ; AND 2
(3) TREAT A PATIENT WHO P RESENTS IN A HOSPITA L EMERGENCY 3
DEPARTMENT FOR CARE AND TREATMENT OF AN OPIOID–RELATED OVERDOSE OR 4
OPIOID–RELATED EMERGENCY ME DICAL CONDITION WITH A MEDICATION FOR 5
OPIOID USE DISORDER IF THE TREATMENT : 6
(I) OCCURS AS RECOMMENDED BY THE TREATING HEAL TH 7
CARE PRACTITIONER ; AND 8
(II) IS VOLUNTARILY AGREED TO BY THE PATIENT . 9
(C) A PROTOCOL ESTABLISHED BY A HOSPITAL UNDER THIS SECTION SHALL 10
COMPLY WITH INCLUDE: 11
(1) APPLICABLE TRAINING AND WAIVER REQUIREME NTS 12
ESTABLISHED BY THE F EDERAL DRUG ENFORCEMENT AGENCY; AND 13
(2) ANY REQUIREMENT BY TH E DEPARTMENT REGARDING 14
PRESCRIBING OPIOID A GONIST TREATMENT ; 15
(2) UNIFORM PRACTICES FOR SCREENING AND DIAGNO SING 16
INDIVIDUALS WHO PRES ENT WITH AN OPIOID–RELATED OVERDOSE OR 17
OPIOID–RELATED EMERGENCY ME DICAL CONDITION FOR AN OPIOID USE DISORD ER 18
BASED ON THE CRITERI A IN THE MOST RECENT EDITION OF THE DIAGNOSTIC AND 19
STATISTICAL MANUAL OF MENTAL DISORDERS; 20
(3) UNIFORM PRACTICES FOR OFFERING AND ADMINIS TERING 21
OPIOID AGONIST MEDIC ATION TO TREAT AN OP IOID–RELATED OVERDOSE OR 22
OPIOID USE DISORDER ; AND 23
(4) UNIFORM PRACTICES TO IDENTIFY COMMUNITY –BASED 24
TREATMENT SERVICES T HAT ARE APPROPRIATE FOR: 25
(I) TREATING OPIOID USE DISORDERS ; AND 26
(II) ASSISTING PATIENTS TO VOLUNTARILY ACCESS O NGOING 27
COMMUNITY –BASED TREATMENT AT D ISCHARGE. 28
(D) BEFORE DISCHARGING A PATIENT WHO IS DIAGNOSED WITH AN OP IOID 29
USE DISORDER OR ADMINISTERED OR PRES CRIBED MEDICATION–ASSISTED 30
TREATMENT MEDICATION FOR OPIOI D USE DISORDER , A HOSPITAL SHALL CONNECT 31 4 HOUSE BILL 1155
THE PATIENT WITH AN APPROPRIATE PROVIDER OR FACILITY TO VOLUN TARILY 1
CONTINUE TREATMENT : 2
(1) MAKE A REFERRAL OF TH E PATIENT TO AN APPR OPRIATE 3
PROVIDER OR FACILITY FOR A TIMELY APPOINT MENT, WHEN POSSIBLE , TO 4
VOLUNTARILY CONTINUE TREATMENT IN THE COM MUNITY; AND 5
(2) WORK WITH PEER SUPPOR T PROFESSIONALS , AS AVAILABLE, OR 6
OTHER RESOURCES TO A SSIST THE PATIENT IN ACCES SING THE IDENTIFIED 7
TREATMENT SERVICES . 8
Article – State Finance and Procurement 9
7–331. 10
(a) In this section, “Fund” means the Opioid Restitution Fund. 11
(b) There is an Opioid Restitution Fund. 12
(c) The purpose of the Fund is to retain the amount of settlement revenues 13
deposited to the Fund in accordance with subsection (e)(1) of this section. 14
(d) (1) The Fund is a special, nonlapsing fund that is not subject to § 7–302 of 15
this subtitle. 16
(2) The State Treasurer shall hold the Fund separately, and the 17
Comptroller shall account for the Fund. 18
(e) The Fund consists of: 19
(1) all revenues received by the State from any source resulting, directly or 20
indirectly, from any judgment against, or settlement with, opioid manufacturers, opioid 21
research associations, or any other person in the opioid industry relating to any claims 22
made or prosecuted by the State to recover damages for violations of State law; and 23
(2) the interest earnings of the Fund. 24
(f) The Fund may be used only to provide funds for: 25
(1) programs, services, supports, and resources for evidence–based 26
substance use disorder prevention, treatment, recovery, or harm reduction that have the 27
purpose of: 28
(i) improving access to medications proven to prevent or reverse an 29
overdose; 30
HOUSE BILL 1155 5
(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 6 HOUSE BILL 1155
(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 TRAININ G AND RESOURCES TO H OSPITALS TO IMPLEMEN T 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 opioid –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
HOUSE BILL 1155 7
[(3)] (4) The Attorney General shall identify 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: 26
(a) The Maryland Department of Health shall study whether and how funding 27
from the Opioid Restitution Fund can be used to provide training and resources to hospitals 28
to implement Section 1 of the Act, including a recommended funding amount. 29
(b) On or before January 1, 2025, the Department shall report its findings and 30
recommendations to the Senate Finance Committee and House Health and Government 31
Operations Committee, in accordance with § 2–1257 of the State Government Article. 32 8 HOUSE BILL 1155
SECTION 3. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall take 1
effect January 1, 2025. 2
SECTION 2. 4. AND BE IT FURTHER ENACTED, That, except as provided in 3
Section 3 of this Act, this Act shall take effect October 1, 2024. 4
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.