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.
Italics indicate opposite chamber/conference committee amendments.
*hb1155*
HOUSE BILL 1155
J1, J3 (4lr1499)
ENROLLED BILL
— Health and Government Operations/Finance —
Introduced 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
Read and Examined by Proofreaders:
_______________________________________________
Proofreader.
_______________________________________________
Proofreader.
Sealed with the Great Seal and presented to the Governor, for his approval this
_______ day of _______________ at ________________ ________ o’clock, ________M.
______________________________________________
Speaker.
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 2 HOUSE BILL 1155
Restitution Fund for hospitals to provide training and resources to implement the 1
requirements of this Act; and generally relating to hospitals and treatment for opioid 2
use disorder and opioid–related emergency medical conditions. 3
BY adding to 4
Article – Health – General 5
Section 19–308.10 6
Annotated Code of Maryland 7
(2023 Replacement Volume) 8
BY repealing and reenacting, with amendments, 9
Article – State Finance and Procurement 10
Section 7–331 11
Annotated Code of Maryland 12
(2021 Replacement Volume and 2023 Supplement) 13
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14
That the Laws of Maryland read as follows: 15
Article – Health – General 16
19–308.10. 17
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 18
INDICATED. 19
(2) “MEDICATION” MEANS, “MEDICATION FOR OPIOI D USE 20
DISORDER”: 21
(1) MEANS A DRUG APPROVED BY T HE U.S. FOOD AND DRUG 22
ADMINISTRATION FOR TH E TREATMENT OF OPIOI D USE DISORDER ; AND 23
(2) DOES NOT INCLUDE A DR UG ADMINISTERED TO M ITIGATE 24
OPIOID–RELATED OVERDOSE SYM PTOMS. 25
(3) “MEDICATION–ASSISTED TREATMENT ” MEANS THE USE OF 26
MEDICATION, IN COMBINATION WITH COUNSELING AND BEHAV IORAL HEALTH 27
THERAPIES, TO PROVIDE A HOLISTI C APPROACH TO THE TR EATMENT OF OPIOID US E 28
DISORDER. 29
(4) “OPIOID USE DISORDER ” MEANS A MEDICALLY DI AGNOSED 30
PROBLEMATIC PATTERN OF OPIOID USE THAT C AUSES A SIGNIFICANT IMPAIRMENT 31
OR DISTRESS. 32
HOUSE BILL 1155 3
(B) EACH HOSPITAL SHALL E STABLISH AND MAINTAI N, AS PART OF ITS 1
EMERGENCY SERVICES , PROTOCOLS AND CAPACI TY TO: 2
(1) PROVIDE TO A PATIENT BEFORE DISCHARGING T HE PATIENT 3
APPROPRIATE , EVIDENCE–BASED INTERVENTIONS THAT REDUCE THE RISK OF 4
SUBSEQUENT HARM AND FATALITY FOLLOWING A N OPIOID–RELATED OVERDOSE OR 5
A VISIT FOR AN OPIOI D–RELATED EMERGENCY ME DICAL CONDITION ; 6
(2) POSSESS, DISPENSE, ADMINISTER, AND PRESCRIBE 7
MEDICATION–ASSISTED TREATMENT , INCLUDING AT LEAST ONE FORMULA TION OF 8
EACH U.S. FOOD AND DRUG ADMINISTRATION –APPROVED FULL OPIOID AGONIST, 9
AND PARTIAL OPIOID AGONI ST, AND LONG–ACTING OPIOID ANTAGO NIST USED FOR 10
THE TREATMENT OF OPIOID USE DISORDER ; AND 11
(3) TREAT A PATIENT WHO P RESENTS IN A HOSPITA L EMERGENCY 12
DEPARTMENT FOR CARE AND TREATMENT OF AN OPIOID–RELATED OVERDOSE OR 13
OPIOID–RELATED EMERGENCY ME DICAL CONDITION WITH A MEDICATION FOR 14
OPIOID USE DISORDER IF THE TREATMENT : 15
(I) OCCURS AS RECOMMENDED BY THE TREATING HEAL TH 16
CARE PRACTITIONER ; AND 17
(II) IS VOLUNTARILY AGREED TO BY THE PATIENT . 18
(C) A PROTOCOL ESTABLISHED BY A HOSPITAL UNDER THIS SECTION SHALL 19
COMPLY WITH INCLUDE: 20
(1) APPLICABLE TRAINING AND WAIVER REQUIREME NTS 21
ESTABLISHED BY THE F EDERAL DRUG ENFORCEMENT AGENCY; AND 22
(2) ANY REQUIREMENT BY TH E DEPARTMENT REGARDING 23
PRESCRIBING OPIOID A GONIST TREATMENT ; 24
(2) UNIFORM PRACTICES FOR SCREENING AND DIAGNO SING 25
INDIVIDUALS WHO PRES ENT WITH AN O PIOID–RELATED OVERDOSE OR 26
OPIOID–RELATED EMERGENCY ME DICAL CONDITION FOR AN OPIOID USE DISORD ER 27
BASED ON THE CRITERI A IN THE MOST RECENT EDITION OF THE DIAGNOSTIC AND 28
STATISTICAL MANUAL OF MENTAL DISORDERS; 29
(3) UNIFORM PRACTICES FOR OFFERING AND ADMINIS TERING 30
OPIOID AGONIST MEDIC ATION TO TREAT AN OP IOID–RELATED OVERDOSE OR 31
OPIOID USE DISORDER ; AND 32
4 HOUSE BILL 1155
(4) UNIFORM PRACTICES TO IDENTIFY COMMUNITY –BASED 1
TREATMENT SERVICES T HAT ARE APPROPRIATE FOR: 2
(I) TREATING OPIOID USE DISORDERS ; AND 3
(II) ASSISTING PATIENTS TO VOLUNTARILY ACCESS O NGOING 4
COMMUNITY –BASED TREATMENT AT D ISCHARGE. 5
(D) BEFORE DISCHARGING A PATIENT WHO IS DIAGNOSED WITH AN OP IOID 6
USE DISORDER OR ADMINISTERED OR PRES CRIBED MEDICATION–ASSISTED 7
TREATMENT MEDICATION FOR OPIOI D USE DISORDER , A HOSPITAL SHALL CONNECT 8
THE PATIENT WITH AN APPROPRIATE PROVIDER OR FACILITY TO VOLUN TARILY 9
CONTINUE TREATMENT : 10
(1) MAKE A REFERRAL OF TH E PATIENT TO AN APPR OPRIATE 11
PROVIDER OR FACILITY FOR A TIMELY APPOINT MENT, WHEN POSSIBLE , TO 12
VOLUNTARILY CONTINUE TREATMENT IN THE COM MUNITY; AND 13
(2) WORK WITH PEER SUPPOR T PROFESSIONALS , AS AVAILABLE, OR 14
OTHER RESOURCES TO A SSIST THE PATIENT IN ACCES SING THE IDENTIFIED 15
TREATMENT SERVICES . 16
Article – State Finance and Procurement 17
7–331. 18
(a) In this section, “Fund” means the Opioid Restitution Fund. 19
(b) There is an Opioid Restitution Fund. 20
(c) The purpose of the Fund is to retain the amount of settlement revenues 21
deposited to the Fund in accordance with subsection (e)(1) of this section. 22
(d) (1) The Fund is a special, nonlapsing fund that is not subject to § 7–302 of 23
this subtitle. 24
(2) The State Treasurer shall hold the Fund separately, and the 25
Comptroller shall account for the Fund. 26
(e) The Fund consists of: 27
(1) all revenues received by the State from any source resulting, directly or 28
indirectly, from any judgment against, or settlement with, opioid manufacturers, opioid 29
research associations, or any other person in the opioid industry relating to any claims 30
made or prosecuted by the State to recover damages for violations of State law; and 31 HOUSE BILL 1155 5
(2) the interest earnings of the Fund. 1
(f) The Fund may be used only to provide funds for: 2
(1) programs, services, supports, and resources for evidence–based 3
substance use disorder prevention, treatment, recovery, or harm reduction that have the 4
purpose of: 5
(i) improving access to medications proven to prevent or reverse an 6
overdose; 7
(ii) supporting peer support specialists and screening, brief 8
intervention, and referral to treatment services for hospitals, correctional facilities, and 9
other high–risk populations; 10
(iii) increasing access to medications that support recovery from 11
substance use disorders; 12
(iv) expanding the Heroin Coordinator Program, including for 13
administrative expenses; 14
(v) expanding access to crisis beds and residential treatment 15
services for adults and minors; 16
(vi) expanding and establishing safe stations, mobile crisis response 17
systems, and crisis stabilization centers; 18
(vii) supporting the behavioral health crisis hotline; 19
(viii) organizing primary and secondary school education campaigns 20
to prevent opioid use, including for administrative expenses; 21
(ix) enforcing the laws regarding opioid prescriptions and sales, 22
including for administrative expenses; 23
(x) research regarding and training for substance use treatment and 24
overdose prevention, including for administrative expenses; and 25
(xi) supporting and expanding other evidence–based interventions 26
for overdose prevention and substance use treatment; 27
(2) evidence–informed substance use disorder prevention, treatment 28
recovery, or harm reduction pilot programs or demonstration studies that are not 29
evidence–based if the Opioid Restitution Fund Advisory Council, established under § 30
7.5–902 of the Health – General Article: 31
6 HOUSE BILL 1155
(i) determines that emerging evidence supports the distribution of 1
money for the pilot program or that there is a reasonable basis for funding the 2
demonstration study with the expectation of creating an evidence–based program; and 3
(ii) approves the use of money for the pilot program or demonstration 4
study; and 5
(3) evaluations of the effectiveness and outcomes reporting for substance 6
use disorder abatement infrastructure, programs, services, supports, and resources for 7
which money from the Fund was used, including evaluations of the impact on access to 8
harm reduction services or treatment for substance use disorders and the reduction in 9
drug–related mortality. 10
(g) (1) The State Treasurer shall invest the money of the Fund in the same 11
manner as other State money may be invested. 12
(2) Any interest earnings of the Fund shall be credited to the Fund. 13
(h) (1) Expenditures from the Fund may be made only in accordance with the 14
State budget. 15
(2) FOR FISCAL YEAR 2026, THE GOVERNOR SHALL INCLUD E IN THE 16
ANNUAL BUDGET BILL A N APPROPRIATION OF $500,000 FROM THE FUND TO 17
PROVIDE TRAINING AND RESOURC ES TO HOSPITALS TO I MPLEMENT THE 18
REQUIREMENTS OF § 19–308.10 OF THE HEALTH – GENERAL ARTICLE. 19
[(2)] (3) For settlement funds received in accordance with the final 20
distributor agreement of July 21, 2021, with McKesson Corporation, Amerisource Bergen 21
Corporation, and Cardinal Health Incorporated, as amended, the Janssen settlement 22
agreement of July 21, 2021, as amended, or any other opioid –related court or 23
administrative judgment or settlement agreement involving the State and one or more of 24
its political subdivisions: 25
(i) appropriations from the Fund in the State budget shall be made 26
in accordance with the allocation and distribution of funds to the State and its political 27
subdivisions: 28
1. as agreed on in the State–subdivision agreement of 29
January 21, 2022, as amended; or 30
2. required under any other opioid –related court or 31
administrative judgment or settlement agreement, or any similar agreement reached under 32
an opioid–related court or administrative judgment or settlement agreement, involving the 33
State and one or more of its political subdivisions; and 34
HOUSE BILL 1155 7
(ii) the Secretary of Health shall establish and administer a grant 1
program for the distribution of funds to political subdivisions of the State in accordance 2
with: 3
1. the State–subdivision agreement of January 21, 2022, as 4
amended; or 5
2. the requirements of any other opioid–related court or 6
administrative judgment or settlement agreement, or any similar agreement reached under 7
an opioid–related court or administrative judgment or settlement agreement, involving the 8
State and one or more of its political subdivisions. 9
[(3)] (4) The Attorney General shall identify and designate the 10
controlling version of any agreement or amendment described under paragraph [(2)] (3) of 11
this subsection. 12
(i) (1) Money expended from the Fund for the programs and services described 13
under subsection (f) of this section is supplemental to and is not intended to take the place 14
of funding that otherwise would be appropriated for the programs and services. 15
(2) Except as specified in subsection (f) of this section, money expended 16
from the Fund may not be used for administrative expenses. 17
(j) The Governor shall: 18
(1) develop key goals, key objectives, and key performance indicators 19
relating to substance use treatment and prevention efforts; 20
(2) subject to subsection [(h)(2)] (H)(3) of this section, at least twice 21
annually, consult with the Opioid Restitution Fund Advisory Council to identify 22
recommended appropriations from the Fund; and 23
(3) report on or before November 1 each year, in accordance with § 2–1257 24
of the State Government Article, to the General Assembly on: 25
(i) an accounting of total funds expended from the Fund in the 26
immediately preceding fiscal year, by: 27
1. use; 28
2. if applicable, jurisdiction; and 29
3. budget program and subdivision; 30
(ii) the performance indicators and progress toward achieving the 31
goals and objectives developed under item (1) of this subsection; and 32 8 HOUSE BILL 1155
(iii) the recommended appropriations from the Fund identified in 1
accordance with item (2) of this subsection. 2
SECTION 2. AND BE IT FURTHER ENACTED, That: 3
(a) The Maryland Department of Health shall study whether and how funding 4
from the Opioid Restitution Fund can be used to provide training and resources to hospitals 5
to implement Section 1 of the Act, including a recommended funding amount. 6
(b) On or before January 1, 2025, the Department shall report its findings and 7
recommendations to the Senate Finance Committee and House Health and Government 8
Operations Committee, in accordance with § 2–1257 of the State Government Article. 9
SECTION 3. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall take 10
effect January 1, 2025. 11
SECTION 2. 4. 2. AND BE IT FURTHER ENACTED, That , except as provided in 12
Section 3 of this Act, this Act shall take effect October 1, 2024 January 1, 2025. 13
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.