First Ular Assembly STATE OF COLORADO .. INTRODUCED LLS NO. 19-0690.01 Christy Chase x2008 SENATE BILL 194?? I. . SENATE SPONSORSHIP Carola, HOUSE (None), Senate Committees House Committees Health Human Services A BILL FOR AN ACT 101 CONCERNING THE EXPANSION OF THE MEDICATION-ASSISTED 1 02 TREATMENT EXPANSION PILOT PROGRAM, AND, IN CONNECTION 103 THEREWITH, SHIFTING ADMINISTRATION OF THE PROGRAM 104 FROM THE COLLEGE OF NURSING TO THE CENTER FOR 105 RESEARCH INTO SUBSTANCE USE DISORDER PREVENTION, 1 O6 TREATMENT, AND RECOVERY SUPPORT 107 THE COUNTIES THAT MAY PARTICIPATE IN THE 108 EXTENDING THE DURATION OF THE AND INCREASING 109 THE FUNDING FOR THE PROGRAM. Bill Summary (Note: This summary applies to this bill as introduced and does not re?ect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that Shading denotes HOUSE amendment. Dhouble u?darlining denotes SENATE amendment. Capital letters or bold italic numbers Indicate new material to be added to existing statute. Dashes through the words mdzcate deletions from existing statute. p?n 0 applies to the reengrossed verSiO? Of this bill will be available at MUM/lee. colorado. gov.) In 2017, the general assembly enacted Senate Bill 17-074, which created a 2-year medication?assisted Treatment (MAT) expansion pilot program, administered by the 0f Colorado college of nursing, to expand access to medication?aSSISted treatment to Opioid-dependent patients in Pueblo and Routt counties- The 2017 act directs the general assembly to appropriate $500,000 per year for the 2017-18 and 2018-19 ?scal years from the marijuana tax cash fund to the university 0f Colorado board of regents, for allocatlon to the college of nursing to implement the pilot program. The pilOt prOgram repeals on June 30, 2020. The bill: Expands the pilot program to the counties in the San Luis valley and 2 additional counties in Which a need is demonstrated; . Shifts responsibility to administer the pilot program from the college of nursing to the center for research into substance use disorder prevention, treatment, and recovery support strategies; . Adds representatives from the San Luis valley and any other counties selected to participate in the pilot program to the advisory board that assists in administering the program; 0 Increases the annual appropriation for the pilot program to $5 million for the 2019-20 and 2020-21 ?scal years; and Extends the program an additional 2 years. Be it enacted by the General Assembly of the State of Colorado: SECTION 1. In Colorado Revised Statutes, 23?21-802, add (2) as follows: 23-21?802. Legislative declaration. (2) THE GENERALASSEMBLY FURTHER FINDS THAT: SINCE ITS CREATION, THE PILOT PROGRAM HAS ACHIEVED NUMEROUS SUCCESSES TOWARD PROGRAM GOALS AS FOLLOWS: (1) WITH REGARD To THE PROGRAM GOAL OF INCREASING THE NUMBER OF ADVANCED PRACTICE PROVIDERS ABLE TO PRESCRIBE MEDICATIONS TO TREAT INDIVIDUALS WITH OPIOID USE DISORDERS IN PUEBLO AND ROUTT COUNTIES: (A) TWO MEDICATION-ASSISTED TREATMENT (MAT) PROGRAMS IN PUEBLO COUNTY WERE SELECTED TO RECEIVE FUNDING AND ONE MAT PROGRAM WAS STARTED IN ROUTT (B) AS OF AUGUST 2018, FOUR PROVIDERS CERTIFIED TO PRESCRIBE MAT MEDICATIONS WERE ADDED TO THE TWO MAT PROGRAMS TN PUEBLO COUNTY AND SIX MAT MEDICATION-CERTIFIED PRESCRIBERS ARE AVAILABLE IN THE ROUTT COUNTY AND (C) THROUGH JULY 1, 2018, FIFTY PROVIDERS RECEIVED EDUCATION ON OPIOID USE DISORDERS AND RELATED ISSUES IN D?d ASSESSMENT AND AND y?l (11) WITH REGARD TO THE PROGRAM GOAL OF INCREASING ACCESS DJ TO MAT SERVICES IN PUEBLO AND ROUTT COUNTIES: y?a A (A) PUEBLO COUNTY INCREASED MAT SERVICES FROM A TOTAL p?a kl] OF NINETY-NINE CLIENTS TREATED THROUGH ITS TWO MAT PROGRAMS IN 2017 TO FIVE HUNDRED SEVENTY-SIX CLIENTS TREATED THROUGH THE p?a TWO PROGRAMS THROUGH OCTOBER 2018; AND p?a. 00 (B) ROUTT COUNTY HAD VERY LIMITED MAT SERVICES \0 AVAILABLE IN 2017 AND, THROUGH OCTOBER OF 2018, PROVIDED MAT 0 SERVICES THROUGH ITS NEW MAT PROGRAM TO FIFTY n?n GIVEN THE SUCCESSES OF THE PROGRAM IN EXPANDING ACCESS TO MAT SERVICES IN PUEBLO AN ROUTT COUNTIES, THE PILOT PROGRAM DJ SHOULD BE EXTENDED AND MADE AVAILABLE TO ADDITIONAL AREAS OF A THE STATE THAT ARE EXPERIENCING SIGNIFICANT PUBLIC HEALTH CONCERNS DUE TO THE PREVALENCE OF OPIOID ADDICTION AND OVERDOSE O). INCIDENCES AND INADEQUATE NUMBERS OF IN THE SAN LUIS VALLEY, WHICH HAS APPROXIMATELY FIFTY ALAN OF THOUSAND RESIDENTS AND CONSISTS THE COUNTIES OF ALAMOSA, AND CONEJOS, COSTILLA, CUSTER, HUERF RIO GRANDE, AND SAGUACHE, OPIOID OVERDOSES HAVE BE INCREASING SINCE 2010, WITH RECENT REPORTS OF MORE THAN TEN OVERDOSES PER ONE HUNDRED THOUSAND 1N POPULATION YEARLY IN EACH OF THE COUNTIES IN HUERFANO couNTY, WHICH HAS ABOUT SIX THOUSAND SIX HUNDRED RESIDENTS, HAD SIX OVERDOSE DEATHS IN 2016, A RATE OF 152.6 PER ONE HUNDRED THOUSAND IN POPULATION, WHICH WAS THE HIGHEST OVERDOSE RATE FOR ANY COUNTY IN THE MANY OTHER COUNTIES INT STATE ARE ALSO EXPERIENCING HIGH INCIDENCES OF OVERDOSE AND LACK AVAILABLE, QUALIFIED PROVIDERS TO MEET THE ADDICTION TREATMENT NEEDS IN THE (I) GIVEN THE PREVALENCE OF OPIOID OVERDOSES IN THE SAN LUIS VALLEY AND OTHER AREAS OF THE STATE, IT IS NECESSARY TO EXTEND THE PILOT PROGRAM ESTABLISHED PURSUANT TO THIS PART 8 FOR AN ADDITIONAL TWO YEARS, EXPAND ITS AVAILABILITY TO AREAS OF THE STATE, AND INCREASE ITS FUNDING IN ORDER TO INCREASE ACCESS TO ADDICTION TREATMENT IN THESE AREAS WHERE OPIOID ADDICTION AND OVERDOSE INCIDENCES ARE AT SIGNIFICANT LEVELS. SECTION 2. In Colorado Revised Statutes, 23-21?803, add (1 .5) and (10) as follows: 23-21-803. De?nitions, As used in this part 8, unless the context otherwise requires: (1-5) MEANS THE CENTER FOR RESEARCH INTO TREATMENT, AN ON 27-80?118. SUBSTANCE USE DISORDER PREVENTION, RE SUPPORT STRATEGIES ESTABLISHED PURSUANT TO 8819-001 -4- MN \10\ (10) LUIS MEANS THE COUNTIES OF ALAMOSA, CONEJOS: COSTILLA, CUSTER, HUERFANO, MINERAL, RIO GRANDE, AND SAGUACHE. SECTION 3- 1n Colmado Revised Statutes, 23-21-804, amend (1X13), (3), and (4) as follows; 23-21-804. Medication?assisted treatment expansion pilot program created pilot program location - eligible grant recipients - rules. (1) The MAT expansion pilot program is available to provide grants to community agencies, of?ce-based practices, behavioral health organizations, and substance abuse treatment organizations practicing or providing treatment in Pueblo county or county, AND, STARTING IN THE 2019?20 FISCAL YEAR, THE SAN LUIS VALLEY AND UP TO TWO ADDITIONAL COUNTIES SELECTED BY THE CENTER FOR PARTICIPATION BASED ON DEMONSTRATED NEED. (3) The col-lege?Of-nursing CENTER shall administer the MAT expansion pilot program and, subject to available appropriations, shall award grants as provided in this part 8. Subject to available appropriations, grants shall be paid out of money annually appropriated for the pilot program as provided in section 23-21?808. (4) The eol-lege-O?F?rrumng CENTER shall implement the MAT expansion pilot program in accordance with this part 8 and shall develop, with assistance from and in coordination with the advisory board, pilot program guidelines and procedures as necessary to implement the pilot program, including guidelines and procedures specifying the time frames for applying for grants; the form Of the pilot program grant application; the time frames for distributing grant money, technical assistance, and -5- SB19-001 uation of the pilot program. sed Statutes, 23-21-805, amend 8 g. :3 8 2 SECTION 452.111, 3 (1), and 4 23.21305 ?5013? board - created - duties. 5 (1) There is hereby crea?y i 1' CENTER the MAT 6 expansion advisory boardi 7 Review and - a gram guidelines and procedures; 8 Advise and: . tance t0 the co?ege-of-ntn-sing 9 CENTER on the implemen ?PilOt program; 10 Review and ma]; ndations to the coHegc-of-nmsing 11 CENTER on grant apphca?d ding recommendations for grant 12 award amounts; i 13 Assist the - . 5?;sz- CENTER in evaluating the pilot :14 program; and 15 Perform 251.7 quested by the eo?egeofnursing CENTER, related to the :?fon and administration of the pilot program. at; consists of representatives of the ho are designated by the entity or ium for prescription drug abuse the school?WW the university of Colorado Anschutz -ers speci?ed in subsection of . I a . PARTICIPATING in the pilot a 9 $3190 6_ 01 program area, appointed as follows: shall serve on the advisory board: (I) The Northwest Colorado Community Health Partnership in Routt county shall appoint a medical or public health professional from Routt county; and (II) The Pueblo county heroin task force shall appoint a medical or public health professional from Pueblo county; (HI) VALLEY-WIDE HEALTH SYSTEMS, INC., SHALL APPOINT A MEDICAL PROFESSIONAL FROM THE SAN LUIS (IV) THE SAN LUIS VALLEY AREA HEALTH EDUCATION CENTER p?A SHALL APPOINT A MEDICAL OR PUBLIC HEALTH PROFESSIONAL FROM THE y?I y?l SAN LUIS pu?A (V) THE COLORADO ASSOCIATION OF LOCAL PUBLIC HEALTH p?l U.) OFFICIALS SHALL APPOINT A PUBLIC HEALTH PROFESSIONAL FROM THE SAN LUIS AND 15 (VI) IF ADDITIONAL COUNTIES ARE SELECTED To PARTICIPATE IN 16 THE PILOT PROGRAM, THE CENTER SHALL DETERMINE THE APPOINTING 1 7 AUTHORITY FOR AND TYPE OF PROFESSIONAL FROM EACH PARTICIPATING 1 8 COUNTY. 19 SECTION 5. In Colorado Revised Statutes, 23?21?806, amend 2O (1) introductory portion, (U6), (2) introductory portionfollows: 22 23-21?806. Grant application - criteria - awards. (1) To receive 23 a grant, an eligible organization or practice must submit an application to 24 the eoHege-of-nursmg CENTER in accordance with pilot program 25 guidelines and procedures established by the collegeof-nursi?ng CENTER. 26 At a minimum, the application must include the following information: -7- SB 1 9-001 SPECIFIC DESCRIPTION OF THE NEED IN THE COUNTY SERVED BY THE APPLICANT INCLUDING DATA ON THE PREVALENCE OF OPIOID ADDICTION, THE OVERDOSE RATE AND THE PROVIDER CAPACITY IN THE (a 5) THE PURPOSE FOR WHICH THE APPLICANT WILL USE THE A description of how the applicant will achieve improved access to medication-assisted treatment in the pilot program area THE APPLICANT (2) The advisory board shall review the applications received pursuant to this section and make recommendations to the eo?ege-of nursing CENTER regarding grant recipients and awards. In recommending grant awards and in awarding grants, the advisory board and the coilege O?Fn?ursing CENTER shall consider the following criteria: THE DEMONSTRATED NEED IN THE AREA SERVED BY THE The written commitment of the applicant to have nurse practitioners or physician assistants participate in periodic consultations with CENTER staff; and (3) Subject to available appropriations, in the 2020-21 ?scal years, theeolicge-ofmrsingCENTER shall award grants to applicants approved in accordance with this section and shall distribute the grant money to grant recipients within ninety days after issuing the grant awards. SECTION 6. In Colorado Revised Statutes, 23-21-807, amend (1) introductory portion, (2) introductory portion, and as follows: 23-21-807. Reporting requirements. 1) Each organization or SB19-OOI p?g racti . ce that rece1Ves a grant through the pilot program shall submlt an arm ual report to the CENTER by a date set by the college Ofnursmg At a minimum the report must include the following information: (2) On or before June 30 2018, and on or before EACH June 30 2&9 THROUGH JUNE 3 0, 2021 the CW CENTER shall submit a summarized report on the pilot program to the health and human serv1ces committee of the senate and the health AND insurance and and THE pubhc health care and human serv1ces committees of the house of representatives or any successor committees, and to the 9 p?A p?d governor. At a minimum, the report must include: A description of the pilot program, INCLUDING A LIST OF p?l U) COUNTIES PARTICIPATING IN THE PILOT A list identifying the grant recipients, including the amount p?A .ts. 15 awarded to each grant recipient, THE COUNTY IN WHICH THE GRANT 1 6 RECIPIENT Is PROVIDING SERVICES, and a detailed description of how each 17 grant recipient used the grant award; 18 SECTION 7. In Colorado Revised Statutes, amend 23?21-808 as 19 follows: 20 23?21-808. Funding for pilot program. (1) For the 26-14% 21 W9 2019?20 AND 2020-21 state ?scal years, the general 22 assembly shall annually appropriate ?ve Wed-thousand MILLION 23 dollars per ?scal year from the marijuana tax cash fund created in section 24 39-28.8-501 to the board of regents of the university of Colorado, for 25 allocation to the CENTER to implement AND 26 ADMINISTER the MAT expansion piIOt program. The eoHege-ofnursing portion Of the money annually appropriated for the CENTER may use a -9- rect and indll?CCt costs that the coHege?of pilot program to pay the d1 - inlster ?0 pilot program, as well as to nursing CENTER incurs t0 adm . services to and of grant recipients, for data mg provide consult sis evaluation of the pilot program, and program collection and analy reporting. uncomm1tted money appropriated for the 6 end Of that ?scal year, the school-of If any unexpended 2611-7-48 A ?scal year remains at th rim-sing CENTER may expend the money in accordance with this section in the SUCCEEDING ?scal year- Any unexpended or uncommitted money remaining at the end of the 2020-21 ?scal year reverts to the marijuana tax cash fund. (2) The college?W CENTER may accept and expend any gifts, grants, or donations it receives to implement or administer the pilot program. SECTION 8. In Colorado ReVised Statutes, amend 23-21?809 as follows: 23?21-809. Repeal of part. This part 8 is repealed, effective June 30, 2629 2022. SECTION 9. Safety clause. The general assembly hereby ?nds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety. _10_