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.
*sb1071*
SENATE BILL 1071
J1, J3 4lr1663
CF HB 1155
By: Senator McKay
Introduced and read first time: February 2, 2024
Assigned to: Finance
Committee Report: Favorable with amendments
Senate 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
BY repealing and reenacting, with amendments, 21
Article – State Finance and Procurement 22
Section 7–331 23 2 SENATE BILL 1071
Annotated Code of Maryland 1
(2021 Replacement Volume and 2023 Supplement) 2
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 3
That the Laws of Maryland read as follows: 4
Article – Health – General 5
19–308.10. 6
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 7
INDICATED. 8
(2) “MEDICATION” MEANS, “MEDICATION FOR OPIOI D USE 9
DISORDER”: 10
(1) MEANS A DRUG APPROVED BY T HE U.S. FOOD AND DRUG 11
ADMINISTRATION FOR TH E TREATMENT OF OPIOI D USE DISORDER ; AND 12
(2) DOES NOT INCLUDE A DR UG ADMINISTERED TO M ITIGATE 13
OPIOID–RELATED OVERDOSE SYM PTOMS. 14
(3) “MEDICATION–ASSISTED TREATMENT ” MEANS THE USE OF 15
MEDICATION, IN COMBINATION WITH COUNSELING AND BEHAV IORAL HEALTH 16
THERAPIES, TO PROVIDE A HOLISTI C APPROACH TO THE TR EATMENT OF OPIOID US E 17
DISORDER. 18
(4) “OPIOID USE DISORDER ” MEANS A MEDICALLY DI AGNOSED 19
PROBLEMATIC PATTERN OF OPIOID USE THAT CAUS ES A SIGNIFICANT IMP AIRMENT 20
OR DISTRESS. 21
(B) EACH HOSPITAL SHALL E STABLISH AND MAINTAI N, AS PART OF ITS 22
EMERGENCY SERVICES , PROTOCOLS AND CAPACI TY TO: 23
(1) PROVIDE TO A PATIENT BEFORE DISCHARGING T HE PATIENT 24
APPROPRIATE , EVIDENCE–BASED INTERVENTIONS THAT REDUCE THE RISK OF 25
SUBSEQUENT HARM AND FATALITY FOLLOWING A N OPIOID–RELATED OVERDOSE OR 26
A VISIT FOR AN OPIOI D–RELATED EMERGENCY ME DICAL CONDITION ; 27
(2) POSSESS, DISPENSE, ADMINISTER, AND PRESCRIBE 28
MEDICATION–ASSISTED TREATMENT , INCLUDING AT LEAST ONE FORMULA TION OF 29
EACH U.S. FOOD AND DRUG ADMINISTRATION –APPROVED FULL OPIOID AGONIST, 30
AND PARTIAL OPIOID AGONI ST, AND LONG–ACTING OPIOID ANTAGO NIST USED FOR 31
THE TREATMENT OF OPIOID USE DISORDER ; AND 32
SENATE BILL 1071 3
(3) TREAT A PATIENT WHO P RESENTS IN A HOSPITA L EMERGENCY 1
DEPARTMENT FOR CARE AND TREATMENT OF AN OPIOID–RELATED OVERDOSE OR 2
OPIOID–RELATED EMERGENCY ME DICAL CONDITION WITH A MEDICATION FOR 3
OPIOID USE DISORDER IF THE TREATMENT : 4
(I) OCCURS AS RECOMMENDED BY THE TREATING HEAL TH 5
CARE PRACTITIONER ; AND 6
(II) IS VOLUNTARILY AGREED TO BY THE PATIENT . 7
(C) A PROTOCOL ESTABLISHED BY A HOSPITAL UNDER THIS SECTION SHALL 8
COMPLY WITH INCLUDE: 9
(1) APPLICABLE TRAINING AND WAIVER REQUIREME NTS 10
ESTABLISHED BY THE F EDERAL DRUG ENFORCEMENT AGENCY; AND 11
(2) ANY REQUIREMENT BY TH E DEPARTMENT REGARDING 12
PRESCRIBING OPIOID A GONIST TREATMENT ; 13
(2) UNIFORM PRACTICES FOR SCREENING AND DIAGNO SING 14
INDIVIDUALS WHO PRES ENT WITH AN OPIOID–RELATED OVERDOSE OR 15
OPIOID–RELATED EMERGENCY ME DICAL CONDITION FOR AN OPIOID USE DISORD ER 16
BASED ON THE CRITERI A IN THE MOST RECENT EDITION OF THE DIAGNOSTIC AND 17
STATISTICAL MANUAL OF MENTAL DISORDERS; 18
(3) UNIFORM PRACTICES FOR OFFERING AND ADMIN ISTERING 19
OPIOID AGONIST MEDIC ATION TO TREAT AN OP IOID–RELATED OVERDOSE OR 20
OPIOID USE DISORDER ; AND 21
(4) UNIFORM PRACTICES TO IDENTIFY COMMUNITY –BASED 22
TREATMENT SERVICES T HAT ARE APPROPRIATE FOR: 23
(I) TREATING OPIOID USE D ISORDERS; AND 24
(II) ASSISTING PATIENTS TO VOLUNTARILY ACCESS O NGOING 25
COMMUNITY –BASED TREATMENT AT D ISCHARGE. 26
(D) BEFORE DISCHARGING A PATIENT WHO IS DIAGNOSED WITH AN OP IOID 27
USE DISORDER OR ADMINISTERED OR PRES CRIBED MEDICATION–ASSISTED 28
TREATMENT MEDICATION FOR OPIOI D USE DISORDER, A HOSPITAL SHALL CONNECT 29
THE PATIENT WITH AN APPROPRIATE PROVIDER OR FACILITY TO VOLUN TARILY 30
CONTINUE TREATMENT : 31
4 SENATE BILL 1071
(1) MAKE A REFERRAL OF TH E PATIENT TO AN APPR OPRIATE 1
PROVIDER OR FACILITY FOR A TIMELY APPOINT MENT, WHEN POSSIBLE , TO 2
VOLUNTARILY CONTINUE TREATMENT IN THE COM MUNITY; AND 3
(2) WORK WITH PEER SUPPOR T PROFESSIONALS , AS AVAILABLE, OR 4
OTHER RESOURCES TO A SSIST THE PATIENT IN ACCES SING THE IDENTIFIED 5
TREATMENT SERVICES . 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
(ii) supporting peer support specialists and screening, brief 29
intervention, and referral to treatment services for hospitals, correctional facilities, and 30
other high–risk populations; 31 SENATE BILL 1071 5
(iii) increasing access to medications that support recovery from 1
substance use disorders; 2
(iv) expanding the Heroin Coordinator Program, including for 3
administrative expenses; 4
(v) expanding access to crisis beds and residential treatment 5
services for adults and minors; 6
(vi) expanding and establishing safe stations, mobile crisis response 7
systems, and crisis stabilization centers; 8
(vii) supporting the behavioral health crisis hotline; 9
(viii) organizing primary and secondary school education campaigns 10
to prevent opioid use, including for administrative expenses; 11
(ix) enforcing the laws regarding opioid prescriptions and sales, 12
including for administrative expenses; 13
(x) research regarding and training for substance use treatment and 14
overdose prevention, including for administrative expenses; and 15
(xi) supporting and expanding other evidence–based interventions 16
for overdose prevention and substance use treatment; 17
(2) evidence–informed substance use disorder prevention, treatment 18
recovery, or harm reduction pilot programs or demonstration studies that are not 19
evidence–based if the Opioid Restitution Fund Advisory Council, established under § 20
7.5–902 of the Health – General Article: 21
(i) determines that emerging evidence supports the distribution of 22
money for the pilot program or that there is a reasonable basis for funding the 23
demonstration study with the expectation of creating an evidence–based program; and 24
(ii) approves the use of money for the pilot program or demonstration 25
study; and 26
(3) evaluations of the effectiveness and outcomes reporting for substance 27
use disorder abatement infrastructure, programs, services, supports, and resources for 28
which money from the Fund was used, including evaluations of the impact on access to 29
harm reduction services or treatment for substance use disorders and the reduction in 30
drug–related mortality. 31
(g) (1) The State Treasurer shall invest the money of the Fund in the same 32
manner as other State money may be invested. 33 6 SENATE BILL 1071
(2) Any interest earnings of the Fund shall be credited to the Fund. 1
(h) (1) Expenditures from the Fund may be made only in accordance with the 2
State budget. 3
(2) FOR FISCAL YEAR 2026, THE GOVERNOR SHALL INCLUD E IN THE 4
ANNUAL BUDGET BILL A N APPROPRIATION OF $500,000 FROM THE FUND TO 5
PROVIDE TRAININ G AND RESOURCES TO H OSPITALS TO IMPLEMEN T THE 6
REQUIREMENTS OF § 19–308.10 OF THE HEALTH – GENERAL ARTICLE. 7
[(2)] (3) For settlement funds received in accordance with the final 8
distributor agreement of July 21, 2021, with McKesson Corporation, Amerisource Bergen 9
Corporation, and Cardinal Health Incorporated, as amended, the Janssen settlement 10
agreement of July 21, 2021, as amended, or any other opioid –related court or 11
administrative judgment or settlement agreement involving the State and one or more of 12
its political subdivisions: 13
(i) appropriations from the Fund in the State budget shall be made 14
in accordance with the allocation and distribution of funds to the State and its political 15
subdivisions: 16
1. as agreed on in the State–subdivision agreement of 17
January 21, 2022, as amended; or 18
2. required under any other opioid –related court or 19
administrative judgment or settlement agreement, or any similar agreement reached under 20
an opioid–related court or administrative judgment or settlement agreement, involving the 21
State and one or more of its political subdivisions; and 22
(ii) the Secretary of Health shall establish and administer a grant 23
program for the distribution of funds to political subdivisions of the State in accordance 24
with: 25
1. the State–subdivision agreement of January 21, 2022, as 26
amended; or 27
2. the requirements of any other opioid–related court or 28
administrative judgment or settlement agreement, or any similar agreement reached under 29
an opioid–related court or administrative judgment or settlement agreement, involving the 30
State and one or more of its political subdivisions. 31
[(3)] (4) The Attorney General shall identify and designate the 32
controlling version of any agreement or amendment described under paragraph [(2)] (3) of 33
this subsection. 34
SENATE BILL 1071 7
(i) (1) Money expended from the Fund for the programs and services described 1
under subsection (f) of this section is supplemental to and is not intended to take the place 2
of funding that otherwise would be appropriated for the programs and services. 3
(2) Except as specified in subsection (f) of this section, money expended 4
from the Fund may not be used for administrative expenses. 5
(j) The Governor shall: 6
(1) develop key goals, key objectives, and key performance indicators 7
relating to substance use treatment and prevention efforts; 8
(2) subject to subsection [(h)(2)] (H)(3) of this section, at least twice 9
annually, consult with the Opioid Restitution Fund Advisory Council to identify 10
recommended appropriations from the Fund; and 11
(3) report on or before November 1 each year, in accordance with § 2–1257 12
of the State Government Article, to the General Assembly on: 13
(i) an accounting of total funds expended from the Fund in the 14
immediately preceding fiscal year, by: 15
1. use; 16
2. if applicable, jurisdiction; and 17
3. budget program and subdivision; 18
(ii) the performance indicators and progress toward achieving the 19
goals and objectives developed under item (1) of this subsection; and 20
(iii) the recommended appropriations from the Fund identified in 21
accordance with item (2) of this subsection. 22
SECTION 2. AND BE IT FURTHER ENACTED, That: 23
(a) The Maryland Department of Health shall study whether and how funding 24
from the Opioid Restitution Fund can be used to provide training and resources to hospitals 25
to implement Section 1 of this Act, including a recommended funding amount. 26
(b) On or before January 1, 2025, the Department shall report its findings and 27
recommendations to the Senate Finance Committee and House Health and Government 28
Operations Committee, in accordance with § 2–1257 of the State Government Article. 29
SECTION 3. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall take 30
effect January 1, 2025. 31
8 SENATE BILL 1071
SECTION 2. 4. AND BE IT FURTHER ENACTED, That , except as provided in 1
Section 3 of this Act, this Act shall take effect October 1, 2024. 2
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.