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Chapter 885
(House Bill 1155)
AN ACT concerning
Hospitals – Opioid Overdose – Medication–Assisted Treatment and
Opioid–Related Emergency Medical Conditions – Treatment
FOR the purpose of requiring hospitals to establish and maintain certain protocols and
capacity related to the treatment of patients who are being treated for an
opioid–related overdose or opioid–related emergency medical condition; requiring
hospitals to connect make a referral for patients who are diagnosed with opioid use
disorder or administered or prescribed medication–assisted treatment medication
for opioid use disorder to an appropriate provider to voluntarily continue treatment
in the community under certain circumstances and work with peer support
professionals for a certain purpose; requiring the Governor to include in the annual
budget bill for a certain fiscal year a certain appropriation from the Opioid
Restitution Fund for hospitals to provide training and resources to implement the
requirements of this Act; and generally relating to hospitals and treatment for opioid
use disorder and opioid–related emergency medical conditions.
BY adding to
Article – Health – General
Section 19–308.10
Annotated Code of Maryland
(2023 Replacement Volume)
BY repealing and reenacting, with amendments,
Article – State Finance and Procurement
Section 7–331
Annotated Code of Maryland
(2021 Replacement Volume and 2023 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health – General
19–308.10.
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.
(2) “MEDICATION” MEANS, “MEDICATION FOR OPIOI D USE
DISORDER”: Ch. 885 2024 LAWS OF MARYLAND
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(1) MEANS A DRUG APPROVED BY T HE U.S. FOOD AND DRUG
ADMINISTRATION FOR TH E TREATMENT OF OPIOI D USE DISORDER ; AND
(2) DOES NOT INCLUDE A DR UG ADMINISTERED TO M ITIGATE
OPIOID–RELATED OVERDOSE SYM PTOMS.
(3) “MEDICATION–ASSISTED TREATMENT ” MEANS THE USE OF
MEDICATION, IN COMBINATION WITH COUNSELING AND BEHAV IORAL HEALTH
THERAPIES, TO PROVIDE A HOLISTI C APPROACH TO THE TR EATMENT OF OPIOID US E
DISORDER.
(4) “OPIOID USE DISORDER ” MEANS A MEDICALLY DI AGNOSED
PROBLEMATIC PATTERN OF OPIOID USE THAT CAUS ES A SIGNIFICANT IMP AIRMENT
OR DISTRESS.
(B) EACH HOSPITAL SHALL E STABLISH AND MAINTAI N, AS PART OF ITS
EMERGENCY SERVICES , PROTOCOLS AND CAPACI TY TO:
(1) PROVIDE TO A PATIENT BEFORE DISCHARGING T HE PATIENT
APPROPRIATE , EVIDENCE–BASED INTERVENTIONS THAT REDUCE THE RISK OF
SUBSEQUENT HARM AND FATALITY FOLLOWING A N OPIOID–RELATED OVERDOSE OR
A VISIT FOR AN OPIOI D–RELATED EMERGENCY ME DICAL CONDITION ;
(2) POSSESS, DISPENSE, ADMINISTER, AND PRESCRIBE
MEDICATION–ASSISTED TREATMENT , INCLUDING AT LEAST ONE FORMULA TION OF
EACH U.S. FOOD AND DRUG ADMINISTRATION –APPROVED FULL OPIOID AGONIST,
AND PARTIAL OPIOID AGONI ST, AND LONG–ACTING OPIOID ANTAGO NIST USED FOR
THE TREATMENT OF OPIOID USE DISORDER ; AND
(3) TREAT A PATIENT WHO P RESENTS IN A HOSPITA L EMERGENCY
DEPARTMENT FOR CARE AND TREATMENT OF AN OPIOID–RELATED OVERDOSE OR
OPIOID–RELATED EMERGENCY ME DICAL CONDITION WITH A MEDICATION FOR
OPIOID USE DISORDER IF THE TREATMENT :
(I) OCCURS AS RECOMMENDED BY THE TREATING HEAL TH
CARE PRACTITIONER ; AND
(II) IS VOLUNTARILY AGREED TO BY THE PATIENT .
(C) A PROTOCOL ESTABLISHED BY A HOSPITAL UNDER THIS SECTION SHALL
COMPLY WITH INCLUDE:
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(1) APPLICABLE TRAINING AND WAIVER REQUIREME NTS
ESTABLISHED BY THE F EDERAL DRUG ENFORCEMENT AGENCY; AND
(2) ANY REQUIREMENT BY TH E DEPARTMENT REGARDING
PRESCRIBING OPIOID A GONIST TREATMENT ;
(2) UNIFORM PRACTICES FOR SCREENING AND DIAGNO SING
INDIVIDUALS WHO PRES ENT WITH AN O PIOID–RELATED OVERDOSE OR
OPIOID–RELATED EMERGENCY ME DICAL CONDITION FOR AN OPIOID USE DISORD ER
BASED ON THE CRITERI A IN THE MOST RECENT EDITION OF THE DIAGNOSTIC AND
STATISTICAL MANUAL OF MENTAL DISORDERS;
(3) UNIFORM PRACTICES FOR OFFERING AND ADMINI STERING
OPIOID AGONIST MEDIC ATION TO TREAT AN OP IOID–RELATED OVERDOSE OR
OPIOID USE DISORDER ; AND
(4) UNIFORM PRACTICES TO IDENTIFY COMMUNITY –BASED
TREATMENT SERVICES T HAT ARE APPROPRIATE FOR:
(I) TREATING OPIOID USE D ISORDERS; AND
(II) ASSISTING PATIENTS TO VOLUNTARILY ACCESS O NGOING
COMMUNITY –BASED TREATMENT AT D ISCHARGE.
(D) BEFORE DISCHARGING A PATIENT WHO IS DIAGNOSED WITH AN OP IOID
USE DISORDER OR ADMINISTERED OR PRES CRIBED MEDICATION–ASSISTED
TREATMENT MEDICATION FOR OPIOI D USE DISORDER, A HOSPITAL SHALL CONNECT
THE PATIENT WITH AN APPROPRIATE PROVIDER OR FACILITY TO VOLUN TARILY
CONTINUE TREATMENT :
(1) MAKE A REFERRAL OF TH E PATIENT TO AN APPR OPRIATE
PROVIDER OR FACILITY FOR A TIMELY APPOINT MENT, WHEN POSSIBLE , TO
VOLUNTARILY CONTINUE TREATMENT I N THE COMMUNITY ; AND
(2) WORK WITH PEER SUPPOR T PROFESSIONALS , AS AVAILABLE, OR
OTHER RESOURCES TO A SSIST THE PATIENT IN ACCESSING THE IDENTI FIED
TREATMENT SERVICES .
Article – State Finance and Procurement
7–331.
(a) In this section, “Fund” means the Opioid Restitution Fund.
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(b) There is an Opioid Restitution Fund.
(c) The purpose of the Fund is to retain the amount of settlement revenues
deposited to the Fund in accordance with subsection (e)(1) of this section.
(d) (1) The Fund is a special, nonlapsing fund that is not subject to § 7–302 of
this subtitle.
(2) The State Treasurer shall hold the Fund separately, and the
Comptroller shall account for the Fund.
(e) The Fund consists of:
(1) all revenues received by the State from any source resulting, directly or
indirectly, from any judgment against, or settlement with, opioid manufacturers, opioid
research associations, or any other person in the opioid industry relating to any claims
made or prosecuted by the State to recover damages for violations of State law; and
(2) the interest earnings of the Fund.
(f) The Fund may be used only to provide funds for:
(1) programs, services, supports, and resources for evidence–based
substance use disorder prevention, treatment, recovery, or harm reduction that have the
purpose of:
(i) improving access to medications proven to prevent or reverse an
overdose;
(ii) supporting peer support specialists and screening, brief
intervention, and referral to treatment services for hospitals, correctional facilities, and
other high–risk populations;
(iii) increasing access to medications that support recovery from
substance use disorders;
(iv) expanding the Heroin Coordinator Program, including for
administrative expenses;
(v) expanding access to crisis beds and residential treatment
services for adults and minors;
(vi) expanding and establishing safe stations, mobile crisis response
systems, and crisis stabilization centers;
(vii) supporting the behavioral health crisis hotline; WES MOORE, Governor Ch. 885
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(viii) organizing primary and secondary school education campaigns
to prevent opioid use, including for administrative expenses;
(ix) enforcing the laws regarding opioid prescriptions and sales,
including for administrative expenses;
(x) research regarding and training for substance use treatment and
overdose prevention, including for administrative expenses; and
(xi) supporting and expanding other evidence–based interventions
for overdose prevention and substance use treatment;
(2) evidence–informed substance use disorder prevention, treatment
recovery, or harm reduction pilot programs or demonstration studies that are not
evidence–based if the Opioid Restitution Fund Advisory Council, established under §
7.5–902 of the Health – General Article:
(i) determines that emerging evidence supports the distribution of
money for the pilot program or that there is a reasonable basis for funding the
demonstration study with the expectation of creating an evidence–based program; and
(ii) approves the use of money for the pilot program or demonstration
study; and
(3) evaluations of the effectiveness and outcomes reporting for substance
use disorder abatement infrastructure, programs, services, supports, and resources for
which money from the Fund was used, including evaluations of the impact on access to
harm reduction services or treatment for substance use disorders and the reduction in
drug–related mortality.
(g) (1) The State Treasurer shall invest the money of the Fund in the same
manner as other State money may be invested.
(2) Any interest earnings of the Fund shall be credited to the Fund.
(h) (1) Expenditures from the Fund may be made only in accordance with the
State budget.
(2) FOR FISCAL YEAR 2026, THE GOVERNOR SHALL INCLUD E IN THE
ANNUAL BUDGET BILL A N APPROPRIATION OF $500,000 FROM THE FUND TO
PROVIDE TRAINING AND RESOURCES TO HOSPITA LS TO IMPLEMENT THE
REQUIREMENTS OF § 19–308.10 OF THE HEALTH – GENERAL ARTICLE.
[(2)] (3) For settlement funds received in accordance with the final
distributor agreement of July 21, 2021, with McKesson Corporation, Amerisource Bergen Ch. 885 2024 LAWS OF MARYLAND
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Corporation, and Cardinal Health Incorporated, as amended, the Janssen settlement
agreement of July 21, 2021, as am ended, or any other opioid–related court or
administrative judgment or settlement agreement involving the State and one or more of
its political subdivisions:
(i) appropriations from the Fund in the State budget shall be made
in accordance with the allocation and distribution of funds to the State and its political
subdivisions:
1. as agreed on in the State–subdivision agreement of
January 21, 2022, as amended; or
2. required under any other opioid –related court or
administrative judgment or settlement agreement, or any similar agreement reached under
an opioid–related court or administrative judgment or settlement agreement, involving the
State and one or more of its political subdivisions; and
(ii) the Secretary of Health shall establish and administer a grant
program for the distribution of funds to political subdivisions of the State in accordance
with:
1. the State–subdivision agreement of January 21, 2022, as
amended; or
2. the requirements of any other opioid–related court or
administrative judgment or settlement agreement, or any similar agreement reached under
an opioid–related court or administrative judgment or settlement agreement, involving the
State and one or more of its political subdivisions.
[(3)] (4) The Attorney General shall identify and designate the
controlling version of any agreement or amendment described under paragraph [(2)] (3) of
this subsection.
(i) (1) Money expended from the Fund for the programs and services described
under subsection (f) of this section is supplemental to and is not intended to take the place
of funding that otherwise would be appropriated for the programs and services.
(2) Except as specified in subsection (f) of this section, money expended
from the Fund may not be used for administrative expenses.
(j) The Governor shall:
(1) develop key goals, key objectives, and key performance indicators
relating to substance use treatment and prevention efforts;
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(2) subject to subsection [(h)(2)] (H)(3) of this section, at least twice
annually, consult with the Opioid Restitution Fund Advisory Council to identify
recommended appropriations from the Fund; and
(3) report on or before November 1 each year, in accordance with § 2–1257
of the State Government Article, to the General Assembly on:
(i) an accounting of total funds expended from the Fund in the
immediately preceding fiscal year, by:
1. use;
2. if applicable, jurisdiction; and
3. budget program and subdivision;
(ii) the performance indicators and progress toward achieving the
goals and objectives developed under item (1) of this subsection; and
(iii) the recommended appropriations from the Fund identified in
accordance with item (2) of this subsection.
SECTION 2. AND BE IT FURTHER ENACTED, Th at:
(a) The Maryland Department of Health shall study whether and how funding
from the Opioid Restitution Fund can be used to provide training and resources to hospitals
to implement Section 1 of the Act, including a recommended funding amount.
(b) On or before January 1, 2025, the Department shall report its findings and
recommendations to the Senate Finance Committee and House Health and Government
Operations Committee, in accordance with § 2–1257 of the State Government Article.
SECTION 3. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall take
effect January 1, 2025.
SECTION 2. 4. 2. AND BE IT FURTHER ENACTED, That , except as provided in
Section 3 of this Act, this Act shall take effect October 1, 2024 January 1, 2025.
Approved by the Governor, May 16, 2024.