EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0942*
SENATE BILL 942
E5 5lr3421
HB 1031/24 – JUD & HGO CF 5lr3426
By: Senator Sydnor
Introduced and read first time: January 28, 2025
Assigned to: Judicial Proceedings and Finance
A BILL ENTITLED
AN ACT concerning 1
Correctional Services – Medication–Assisted Treatment Funding 2
FOR the purpose of repealing the requirement that each local correctional facility make 3
available at least one formulation of certain Food and Drug 4
Administration–approved opioid medications used for the treatment of opioid use 5
disorders; requiring the Maryland Secretary of Health to provide annually each 6
county a grant equal to the costs incurred by the county for the implementation of a 7
certain medication–assisted treatment program; authorizing the Governor to include 8
in the annual budget bill an appropriation for the purpose of providing grants under 9
certain circumstances; expanding the authorized uses of the Opioid Restitution 10
Fund; and generally relating to medication–assisted treatment for incarcerated 11
individuals. 12
BY repealing and reenacting, with amendments, 13
Article – Correctional Services 14
Section 9–603 15
Annotated Code of Maryland 16
(2017 Replacement Volume and 2024 Supplement) 17
BY repealing and reenacting, with amendments, 18
Article – State Finance and Procurement 19
Section 7–331 20
Annotated Code of Maryland 21
(2021 Replacement Volume and 2024 Supplement) 22
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 23
That the Laws of Maryland read as follows: 24
Article – Correctional Services 25
9–603. 26 2 SENATE BILL 942
(a) (1) Subject to paragraph (2) of this subsection, the requirements under this 1
section shall apply to: 2
(i) local detention centers in the following counties by January 1, 3
2020: 4
1. Howard County; 5
2. Montgomery County; 6
3. Prince George’s County; and 7
4. St. Mary’s County; and 8
(ii) local detention centers in six additional counties by October 1, 9
2021. 10
(2) (i) The Governor’s Office of Crime Prevention and Policy, the 11
Maryland Department of Health, and the Maryland Correctional Administrators 12
Association shall evaluate the implementation of the requirements of this section and 13
determine a schedule to add additional counties, provided that the provisions of this section 14
shall apply to all local detention centers and the Baltimore Pre–trial Complex by January 15
2023. 16
(ii) If the Baltimore Pre–trial Complex has not fully implemented 17
the provisions of this section by January 2023, the Department of Public Safety and 18
Correctional Services shall report to the Senate Finance Committee and the House 19
Judiciary Committee, in accordance with § 2–1257 of the State Government Article, on the 20
status and timeline of implementation. 21
(iii) Funding for the program at the Baltimore Pre–trial Complex 22
shall be as provided in the State budget. 23
(b) (1) In this section the following words have the meanings indicated. 24
(2) “Health care practitioner” means an individual who is licensed, 25
certified, or otherwise authorized to practice under the Health Occupations Article. 26
(3) “Incarcerated individual” means an individual confined within a local 27
correctional facility. 28
(4) “Medication” means a medication approved by the federal Food and 29
Drug Administration for the treatment of opioid use disorder. 30
SENATE BILL 942 3
(5) “Medication–assisted treatment” means the use of medication, in 1
combination with counseling and behavioral health therapies, to provide a holistic 2
approach to the treatment of opioid use disorder. 3
(6) “Opioid use disorder” means a medically diagnosed problematic pattern 4
of opioid use that causes significant impairment or distress. 5
(7) “Peer recovery specialist” means an individual who has been certified 6
by an entity approved by the Maryland Department of Health for the purpose of providing 7
peer support services, as defined under § 7.5–101(n) of the Health – General Article. 8
(c) An incarcerated individual in a State or local correctional facility shall be 9
placed on a properly supervised program of methadone detoxification if: 10
(1) a physician determines that the incarcerated individual is a person 11
with an opioid use disorder; 12
(2) the treatment is prescribed by a physician; and 13
(3) the incarcerated individual consents in writing to the treatment. 14
(d) (1) Each local correctional facility shall conduct an assessment of the 15
mental health and substance use status of each incarcerated individual using 16
evidence–based screenings and assessments, to determine: 17
(i) if the medical diagnosis of an opioid use disorder is appropriate; 18
and 19
(ii) if medication–assisted treatment is appropriate. 20
(2) If an assessment conducted under paragraph (1) of this subsection 21
indicates opioid use disorder, an evaluation of the incarcerated individual shall be 22
conducted by a health care practitioner with prescriptive authority authorized under Title 23
8, Title 14, or Title 15 of the Health Occupations Article. 24
(3) Information shall be provided to the incarcerated individual describing 25
medication options used in medication–assisted treatment. 26
(4) Medication–assisted treatment shall be available to an incarcerated 27
individual for whom such treatment is determined to be appropriate under this subsection. 28
(5) [Each local correctional facility shall make available at least one 29
formulation of each FDA–approved full opioid agonist, partial opioid agonist, and 30
long–acting opioid antagonist used for the treatment of opioid use disorders. 31
(6)] Each pregnant woman identified with an opioid use disorder shall 32
receive evaluation and be offered medication–assisted treatment as soon as practicable. 33 4 SENATE BILL 942
(e) Each local correctional facility shall: 1
(1) following an assessment using clinical guidelines for 2
medication–assisted treatment: 3
(i) make medication available by a qualified provider to the 4
incarcerated individual; or 5
(ii) begin withdrawal management services prior to administration 6
of medication; 7
(2) make available and administer medications for the treatment of opioid 8
use disorder; 9
(3) provide behavioral health counseling for incarcerated individuals 10
diagnosed with opioid use disorder consistent with therapeutic standards for such therapies 11
in a community setting; 12
(4) provide access to a health care practitioner who can provide access to 13
all FDA–approved medications for the treatment of opioid use disorders; and 14
(5) provide on–premises access to peer recovery specialists. 15
(f) If an incarcerated individual received medication or medication–assisted 16
treatment for opioid use disorder immediately preceding or during the incarcerated 17
individual’s incarceration, a local correctional facility shall continue the treatment after 18
incarceration or transfer unless: 19
(1) the incarcerated individual voluntarily discontinues the treatment, 20
verified through a written agreement that includes a signature; or 21
(2) a health care practitioner determines that the treatment is no longer 22
medically appropriate. 23
(g) Before the release of an incarcerated individual diagnosed with opioid use 24
disorder under subsection (d) of this section, a local correctional facility shall develop a plan 25
of reentry that: 26
(1) includes information regarding postincarceration access to medication 27
continuity, peer recovery specialists, other supportive therapy, and enrollment in health 28
insurance plans; 29
(2) includes any recommended referrals by a health care practitioner to 30
medication continuity, peer recovery specialists, and other supportive therapy; and 31
SENATE BILL 942 5
(3) is reviewed and, if needed, revised by a health care practitioner or peer 1
recovery specialist. 2
(h) The procedures and standards used to determine substance use disorder 3
diagnosis and treatment of incarcerated individuals are subject to the guidelines and 4
regulations adopted by the Maryland Department of Health. 5
[(i) As provided in the State budget, the State shall fund the program of opioid 6
use disorder screening, evaluation, and treatment of incarcerated individuals as provided 7
under this section.] 8
(I) (1) SUBJECT TO SUBSECTION (J) OF THIS SECTION, FOR EACH FISCAL 9
YEAR THE SECRETARY OF HEALTH THROUGH THE OFFICE OF OVERDOSE 10
RESPONSE SHALL PROVID E EACH COUNTY A GRAN T EQUAL TO THE COSTS 11
INCURRED BY THE COU NTY FOR THE IMPLEMEN TATION OF A 12
MEDICATION–ASSISTED TREATMENT P ROGRAM IN ACCORDANCE WITH THIS 13
SECTION DURING THE P RECEDING FISCAL YEAR . 14
(2) THE SECRETARY OF HEALTH, IN CONSULTATION WITH THE 15
OFFICE OF OVERDOSE RESPONSE, SHALL PROVIDE A GRAN T UNDER PARA GRAPH 16
(1) OF THIS SUBSECTION F ROM: 17
(I) THE OPIOID RESTITUTION FUND ESTABLISHED UNDE R § 18
7–331 OF THE STATE FINANCE AND PROCUREMENT ARTICLE; AND 19
(II) ANY MONEY APPROPRIAT ED IN THE STATE BUDGET FOR 20
THE PURPOSE OF PROVI DING GRANTS UNDER TH IS SUBSECTION. 21
(3) FUNDS DISTRIBUTED UNDER THIS SUBSECTION MAY BE REDUCED 22
BY THE AMOUNT OF AN AWARD FROM THE GOVERNOR’S OFFICE OF CRIME 23
PREVENTION AND POLICY OR THE MARYLAND DEPARTMENT OF HEALTH, OR A 24
FEDERAL AWARD FOR THE SAME PURPOSES . 25
(J) (1) ON OR BEFORE OCTOBER 1 EACH YEAR, EACH COUNTY SHALL 26
SUBMIT TO THE OFFICE OF OVERDOSE RESPONSE A REPORT ON: 27
(I) THE NUMBER OF DAYS E ACH INCARCERATED IND IVIDUAL 28
WAS PROVIDED A SERVI CE UNDER A MEDICATIO N–ASSISTED TREATMENT P ROGRAM 29
IN ACCORDANCE WITH T HIS SECTION DURING THE P REVIOUS FISCAL YEAR ; 30
(II) THE TOTAL ITEMIZED C OSTS INCURRED FOR 31
MEDICATION–ASSISTED TREATMENT S ERVICES BY EACH LOCA L CORRECTIONAL 32
FACILITY; AND 33
6 SENATE BILL 942
(III) ANY OTHER INFORMATIO N THAT THE OFFICE OF OVERDOSE 1
RESPONSE REQUIRES . 2
(2) IF A COUNTY FAILS TO SUBMIT THE INFORMATI ON REQUIRED 3
UNDER PARAGRAPH (1) OF THIS SUBSECTION W HEN DUE, THE SECRETARY OF 4
HEALTH SHALL DEDUCT A N AMOUNT EQUAL TO 20% OF ANY GRANT AWARDED 5
UNDER SUBSECTION (I) OF THIS SECTION FOR EACH 30 DAYS OR PART OF 30 DAYS 6
AFTER THE DUE DATE TH AT THE INFORMATION W AS NOT SUBMITTED . 7
(K) (1) THE GOVERNOR MAY INCLUDE IN THE ANNUAL BUDGET BILL AN 8
APPROPRIATION TO THE MARYLAND DEPARTMENT OF HEALTH FOR THE PURPOSE 9
OF PROVIDING GRANTS UNDER SUBSECTION (I) OF THIS SECTION. 10
(2) AN APPROPRIATION UNDER THIS SUBSECTION MAY BE USED ONLY 11
TO PROVIDE FUNDING EQUAL TO THE COSTS INCURRED BY A COUNTY FOR THE 12
IMPLEMENTATION OF A MEDICATION –ASSISTED TREATMENT PROGRAM IN 13
ACCORDANCE WITH THIS SECTION. 14
[(j)] (L) On or before November 1, 2020, and annually thereafter, the Governor’s 15
Office of Crime Prevention and Policy shall report data from individual local correctional 16
facilities to the General Assembly, in accordance with § 2–1257 of the State Government 17
Article, on: 18
(1) the number of incarcerated individuals diagnosed with: 19
(i) a mental health disorder; 20
(ii) an opioid use disorder; 21
(iii) a non–opioid substance use disorder; and 22
(iv) a dual diagnosis of mental health and substance use disorder; 23
(2) the number and cost of assessments for incarcerated individuals in local 24
correctional facilities, including the number of unique incarcerated individuals examined; 25
(3) the number of incarcerated individuals who were receiving medication 26
or medication–assisted treatment for opioid use disorder immediately prior to 27
incarceration; 28
(4) the type and prevalence of medication or medication –assisted 29
treatments for opioid use disorder provided; 30
(5) the number of incarcerated individuals diagnosed with opioid use 31
disorder; 32
SENATE BILL 942 7
(6) the number of incarcerated individuals for whom medication and 1
medication–assisted treatment for opioid use disorder was prescribed; 2
(7) the number of incarcerated individuals for whom medication and 3
medication–assisted treatment was prescribed and initiated for opioid use disorder; 4
(8) the number of medications and medication–assisted treatments for 5
opioid use disorder provided according to each type of medication and medication–assisted 6
treatment options; 7
(9) the number of incarcerated individuals who continued to receive the 8
same medication or medication–assisted treatment for opioid use disorder as the 9
incarcerated individual received prior to incarceration; 10
(10) the number of incarcerated individuals who received a different 11
medication or medication–assisted treatment for opioid use disorder compared to what the 12
incarcerated individual received prior to incarceration; 13
(11) the number of incarcerated individuals who initiated treatment with 14
medication or medication–assisted treatment for opioid use disorder who were not being 15
treated for opioid use disorder prior to incarceration; 16
(12) the number of incarcerated individuals who discontinued medication or 17
medication–assisted treatment for opioid use disorder during incarceration; 18
(13) [a review and summary of the percent of days, including the average 19
percent, median percent, mode percent, and interquartile range of percent, for incarcerated 20
individuals with opioid use disorder receiving medication or medication–assisted treatment 21
for opioid use disorder as calculated overall and stratified by other factors, such as type of 22
treatment received] THE AVERAGE NUMBER OF DAYS INCARCERATED INDIVIDUALS 23
RECEIVED MEDICATION –ASSISTED TREATMENT IN ACCORDANCE WITH THIS 24
SECTION; 25
(14) the number of incarcerated individuals receiving medication or 26
medication–assisted treatment for opioid use disorder prior to release; 27
(15) the number of incarcerated individuals receiving medication or 28
medication–assisted treatment prior to release for whom the facility had made a prerelease 29
reentry plan; 30
(16) a review and summary of practices related to medication and 31
medication–assisted treatment for opioid use disorder for incarcerated individuals with 32
opioid use disorder before October 1, 2019; 33
(17) a review and summary of prerelease planning practices relative to 34
incarcerated individuals diagnosed with opioid use disorder prior to, and following, October 35
1, 2019; [and] 36 8 SENATE BILL 942
(18) THE TOTAL ITEMIZED COSTS INCURRED FOR 1
MEDICATION–ASSISTED TREATMENT SERVICES BY EACH LOCAL CORRECTIONAL 2
FACILITY; AND 3
[(18)] (19) any other information requested by the [Maryland Department 4
of Health] OFFICE OF OVERDOSE RESPONSE related to the administration of the 5
provisions under this section. 6
[(k)] (M) Any behavioral health assessment, evaluation, treatment 7
recommendation, or course of treatment shall be reported to the Governor’s Office of Crime 8
Prevention and Policy and also include any other data necessary to meet reporting 9
requirements under this section. 10
Article – State Finance and Procurement 11
7–331. 12
(a) In this section, “Fund” means the Opioid Restitution Fund. 13
(b) There is an Opioid Restitution Fund. 14
(c) The purpose of the Fund is to retain the amount of settlement revenues 15
deposited to the Fund in accordance with subsection (e)(1) of this section. 16
(d) (1) The Fund is a special, nonlapsing fund that is not subject to § 7–302 of 17
this subtitle. 18
(2) The State Treasurer shall hold the Fund separately, and the 19
Comptroller shall account for the Fund. 20
(e) The Fund consists of: 21
(1) all revenues received by the State from any source resulting, directly or 22
indirectly, from any judgment against, or settlement with, opioid manufacturers, opioid 23
research associations, or any other person in the opioid industry relating to any claims 24
made or prosecuted by the State to recover damages for violations of State law; and 25
(2) the interest earnings of the Fund. 26
(f) The Fund may be used only to provide funds for: 27
(1) programs, services, supports, and resources for evidence–based 28
substance use disorder prevention, treatment, recovery, or harm reduction that have the 29
purpose of: 30
SENATE BILL 942 9
(i) improving access to medications proven to prevent or reverse an 1
overdose, including by supporting the initiative to co–locate naloxone with automated 2
external defibrillators placed in public buildings under § 13–518 of the Education Article; 3
(ii) supporting peer support specialists and screening, brief 4
intervention, and referral to treatment services for hospitals, correctional facilities, and 5
other high–risk populations; 6
(iii) increasing access to medications that support recovery from 7
substance use disorders; 8
(iv) expanding the Heroin Coordinator Program, including for 9
administrative expenses; 10
(v) expanding access to crisis beds and residential treatment 11
services for adults and minors; 12
(vi) expanding and establishing safe stations, mobile crisis response 13
systems, and crisis stabilization centers; 14
(vii) supporting the behavioral health crisis hotline; 15
(viii) organizing primary and secondary school education campaigns 16
to prevent opioid use, including for administrative expenses; 17
(ix) enforcing the laws regarding opioid prescriptions and sales, 18
including for administrative expenses; 19
(x) research regarding and training for substance use treatment and 20
overdose prevention, including for administrative expenses; and 21
(xi) supporting and expanding other evidence–based interventions 22
for overdose prevention and substance use treatment; 23
(2) supporting community–based nonprofit recovery organizations that 24
provide nonclinical substance use recovery support services in the State; 25
(3) evidence–informed substance use disorder prevention, treatment 26
recovery, or harm reduction pilot programs or demonstration studies that are not 27
evidence–based if the Opioid Restitution Fund Advisory Council, established under § 28
7.5–902 of the Health – General Article: 29
(i) determines that emerging evidence supports the distribution of 30
money for the pilot program or that there is a reasonable basis for funding the 31
demonstration study with the expectation of creating an evidence–based program; and 32
10 SENATE BILL 942
(ii) approves the use of money for the pilot program or demonstration 1
study; [and] 2
(4) evaluations of the effectiveness and outcomes reporting for substance 3
use disorder abatement infrastructure, programs, services, supports, and resources for 4
which money from the Fund was used, including evaluations of the impact on access to 5
harm reduction services or treatment for substance use disorders and the reduction in 6
drug–related mortality; AND 7
(5) GRANTS TO COUNTIES F OR THE IMPLEMENTATIO N OF A 8
MEDICATION–ASSISTED TREATMENT P ROGRAM UNDER TITLE 9, SUBTITLE 6 OF THE 9
CORRECTIONAL SERVICES ARTICLE. 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 settlement funds received in accordance with the final distributor 16
agreement of July 21, 2021, with McKesson Corporation, Amerisource Bergen Corporation, 17
and Cardinal Health Incorporated, as amended, the Janssen settlement agreement of July 18
21, 2021, as amended, or any other opioid–related court or administrative judgment or 19
settlement agreement involving the State and one or more of its political subdivisions: 20
(i) appropriations from the Fund in the State budget shall be made 21
in accordance with the allocation and distribution of funds to the State and its political 22
subdivisions: 23
1. as agreed on in the State–subdivision agreement of 24
January 21, 2022, as amended; or 25
2. required under any other opioid –related court or 26
administrative judgment or settlement agreement, or any similar agreement reached under 27
an opioid–related court or administrative judgment or settlement agreement, involving the 28
State and one or more of its political subdivisions; and 29
(ii) the Secretary of Health shall establish and administer a grant 30
program for the distribution of funds to political subdivisions of the State in accordance 31
with: 32
1. the State–subdivision agreement of January 21, 2022, as 33
amended; or 34
SENATE BILL 942 11
2. the requirements of any other opioid–related court or 1
administrative judgment or settlement agreement, or any similar agreement reached under 2
an opioid–related court or administrative judgment or settlement agreement, involving the 3
State and one or more of its political subdivisions. 4
(3) The Attorney General shall identify and designate the controlling 5
version of any agreement or amendment described under paragraph (2) of this subsection. 6
(i) (1) Money expended from the Fund for the programs and services described 7
under subsection (f) of this section is supplemental to and is not intended to take the place 8
of funding that otherwise would be appropriated for the programs and services. 9
(2) Except as specified in subsection (f) of this section, money expended 10
from the Fund may not be used for administrative expenses. 11
(j) The Governor shall: 12
(1) develop key goals, key objectives, and key performance indicators 13
relating to substance use treatment and prevention efforts; 14
(2) subject to subsection (h)(2) of this section, at least twice annually, 15
consult with the Opioid Restitution Fund Advisory Council to identify recommended 16
appropriations from the Fund; and 17
(3) report on or before November 1 each year, in accordance with § 2–1257 18
of the State Government Article, to the General Assembly on: 19
(i) an accounting of total funds expended from the Fund in the 20
immediately preceding fiscal year, by: 21
1. use; 22
2. if applicable, jurisdiction; and 23
3. budget program and subdivision; 24
(ii) the performance indicators and progress toward achieving the 25
goals and objectives developed under item (1) of this subsection; and 26
(iii) the recommended appropriations from the Fund identified in 27
accordance with item (2) of this subsection. 28
SECTION 2. AND BE IT FURTHER ENACTED, That this Act s hall take effect 29
October 1, 2025. 30