HB 6913 — AN ACT CONCERNING OPIOIDS.

(Effective from passage) The Departments of Mental Health and Addiction Services, Social Services and Housing shall develop a plan to ensurethatpregnantandparentingpersonswithsubstanceusedisorder who are in treatment for substance use disorder have access to supportive housing.

Not later than January 1, 2024, the Commissioners of Mental Health and Addiction Services, Social Services and Housing shall jointly report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health, human services and housing regarding such plan.

Sec.

8.

(Effective from passage) The Departments of Mental Health and Addiction Services, Social Services and Children and Families shall developaplantoensurethatparentswithsubstanceusedisorderwhose children are receiving services from the Department of Children and Families have access to appropriate treatment for substance use disorder both to prevent removal of children from their parents where possible and to support reunification when removal is necessary, including, but not limited to, consideration of in-home parenting and child care services to assist with safety planning during initial stages of treatment and recovery.

Not later than January 1, 2024, the Commissioners of Mental Health and Addiction Services, Social Services and Children and Families shall jointly report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of sHB6913 / File No.

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595 mattersrelatingtopublichealth,humanservicesandchildrenregarding such plan.

Sec.

9.

(Effective from passage) The Departments of Mental Health and Addiction Services, Children and Families and Social Services shall evaluate existing substance use disorder treatment servicesfor pregnant and parenting persons, utilization of such services and areas where additional substance use disorder treatment services for such persons are necessary.

The Commissioners of Mental Health and Addiction Services, Children and Families and Social Services shall jointly report, not later than January 1, 2024, and semiannually thereafter until January 1, 2025, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health regarding such evaluation.

Sec.

10.

(Effective from passage) The Department of Children and Families shall evaluate the quality of practice, safety planning and service delivery to families who are receiving services from the department, including, but not limited to, the timely availability and utilization of services necessary to mitigate child safety concerns in the home when the child's caregiver has a substance use disorder and tracking of outcomes for treatment for persons with a substance use disorder who are caregivers of a child.

Not later than January 1, 2024, the Commissioner of Children and Families shall report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health and children regarding such plan.

Sec.

11.

Subsection (b) of section 17a-674d of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2023):

(b) The committee shall consist of the following members:

(1) The Secretary of the Office of Policy and Management, or the secretary's designee;

sHB6913 / File No.

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595 (2) The Attorney General, or the Attorney General's designee;

(3) The Commissioners of Children and Families, Mental Health and AddictionServicesandPublicHealth,orsaidcommissioners'designees, who shall serve as ex-officio members;

(4) The president pro tempore of the Senate, the speaker of the House of Representatives, the majority leaders of the Senate and House of Representatives, the minority leaders of the Senate and House of Representatives, the Senate and House chairpersons of the joint standing committee of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies, or their designees, provided such persons have experience living with a substance or disorder or are the family member of a person who has experience living with a substance use disorder;

(5) Seventeen individuals representing municipalities, who shall be appointed by the Governor;

(6) The executive director of the Commission on Racial Equity in Public Health, or a representative of the commission designated by the executive director;

and (7) [Six] Eight individuals appointed by the commissioner as follows:

(A) A provider of community-based substance use treatment services for adults, who shall be a nonvoting member;

(B) a provider of community-based substance use treatment services for adolescents, who shall be a nonvoting member;

(C) an addiction medicine licensed health care professional with prescribing ability, who shall be a nonvoting member;

[and] (D) three individuals with experience living with a substance use disorder or family members of an individual with experience living witha substance use disorder;

and (E) two individuals with experience supporting infants and children affected by the opioid crisis.

This act shall take effect as follows and shall amend the following sections:

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595 Section 1 from passage New section Sec.

4 October 1, 2023 21a-317 StatementSec. of Purpose:

To5 combatfrom thepassage opioidNew pandemic.section Sec.

that6 whenfrom thepassage entireNew text of a bill or resolution or a section ofSec. a bill or resolution is new, it is not underlined.] LCO No.

60137 5from ofpassage 5New section Sec.

8 from passage New section Sec.

9 from passage New section Sec.

10 from passage New section July 1, 2023 Sec.

11 17a-674d(b) Statement of Legislative Commissioners:

Section 1(1) was rewritten for clarity and in Section 10, "whose cases are open with" was changed to "who are receiving services from" and "when the child's caregiver has a substance use disorder" was inserted after "home" for clarity.

PH Joint Favorable Subst.

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595 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.

In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.

Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note State Impact:

Agency Affected Fund-Effect FY 24 $ FY 25 $ Mental Health & Addiction GF - Cost See Below See Below Serv., Dept.

Children & Families, Dept.

GF - Cost 70,256 None Note:

GF=General Fund Municipal Impact:

None Explanation Section 1 results in a significant cost to the Department of Mental Health and Addiction Services (DMHAS) to contact or attempt to contact individuals who have received treatment from substance abuse treatment facilities, at least once every four months for at least one year, after receiving treatment.

Approximately 42,500 clients were served in DMHAS funded substance use programs in FY 22.

It is anticipated that DMHAS would incur significant costs to establish a call center for such purposes.

This is anticipated to cost approximately $2 million to $4 million annually.

Section 3 results in a cost to DMHAS to establish a prescription digital therapeutics pilot program for patients with opioid use disorder or other substance use disorder, by January 1, 2024.

The program must include the provision of a prescription digital therapeutic for at least three months for up to 1,000 patients.

Assuming an average cost of approximately $1,500 for three months, this results in a cost of $1.5 million annually.

The actual cost of the program depends on the scope of the pilot and cost of the prescription digital therapeutic.

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595 Section 5 results in an anticipated cost of approximately $70,256 to the Department of Children and Families (DCF) for a consultant to conduct focus groups, review existing data, compile outcomes from current Department services that target parental/caregiver opioid use, coordinate with key stakeholders, and develop a plan for submission by 1/1/24.

Sections 5 – 9 result in a cost to DMHAS of approximately $100,000 to hire a consultant to evaluate and develop plans for various programs and report to relevant committees of the General Assembly by January 1, 2024.

The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to inflation and the scope and length of the pilot program.

The fiscal impact identified above for DCF and DMHAS consultants is in FY 24 only.

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595 OLR Bill Analysis sHB 6913 AN ACT CONCERNING OPIOIDS.

SUMMARY This bill makes various changes related to opioid use disorder prevention and treatment.

Principally, it:

1.

requires licensed substance abuse treatment facilities to comply with specified requirements for patient record retention, post- treatment contact, and referrals for additional treatment services (§ 1);

2.

requires the president of each higher education institution, by January 1, 2024, to report to the Public Health and Higher Education and Employment Advancement committees on the implementation of its required policy on opioid antagonist availability and use on campus (see BACKGROUND) (§ 2);

3.

requires the Department of Mental Health and Addiction Services (DMHAS), by January 1, 2024, to create a pilot program where licensed health care providers give prescription digital therapeutics to patients with opioid or other substance use disorders to manage or treat it (§ 3);

4.

prohibits practitioners authorized to dispense controlled substances (e.g., methadone) from a mobile unit from doing so within 500 feet of an elementary or secondary school, child care center, playground, or public park, except within a private residence (§ 4);

5.

requires DMHAS and certain other state agencies, such as the Department of Children and Families (DCF), to develop plans or conduct evaluations related to various supports for parents, sHB6913 / File No.

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595 other child caregivers, or pregnant individuals with substance use disorder (§§ 5-9);

6.

requires DCF to evaluate the quality of practice, safety planning, and service delivery to families with open department cases involving substance use disorder and report to the Public Health and Children’s committees on the evaluation by January 1, 2024 (§ 10);

and 7.

increases,from37to39,themembershipoftheOpioidSettlement Fund Advisory Committee, by adding two members with experiencesupportinginfantsandchildrenaffectedbytheopioid crisis, appointed by the DMHAS commissioner (see BACKGROUND) (§ 11).

EFFECTIVE DATE:

Upon passage except that the provisions on (1) mobile units for dispensing controlled substances take effect October 1, 2023, and (2) the Opioid Settlement Advisory Committee take effect July 1, 2023.

§ 1 — SUBSTANCE ABUSE TREATMENT FACILITIES The bill requires licensed substance abuse treatment facilities to do the following:

1.

retain patient records post-treatment according to standard record-keeping practices for these facilities and include the patient’s address, phone number, and any additional contact information they share;

2.

contact, or attempt to contact, the patient for a status update on his or her mental and physical health at least once every four months for at least one year after the patient last received treatment;

and 3.

offer to refer patients to additional substance use disorder treatmentservicesiftheyexpressaneedordesirefortheservices.

§ 3 — DIGITAL THERAPEUTICS PILOT PROGRAM By January 1, 2024, the bill requires DMHAS to collaborate with the sHB6913 / File No.

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595 Department of Public Health (DPH) to create a pilot program where licensed health care providers prescribe prescription digital therapeutics to patients with an opioid or other substance use disorder to manage and treat it.

Under the bill, “prescription digital therapeutics” are software-based medical devices that (1) are clearedor approved by thefederalFoodand Drug Administration, (2) are intended to prevent, manage, or treat a substance use disorder, (3) are prescribed to patients by licensed health care providers, and (4) patients can access through a mobile device application.

The bill requires the DMHAS and DPH commissioners to jointly develop the pilot program’s eligibility criteria and guidelines.

The guidelines must include authorizing prescription digital therapeutics to be provided to up to 1,000 patients for at least three months.

Under the bill, the DMHAS commissioner must report to the Public Health Committee by January 1, 2025, on the pilot program’s implementation and any recommendations to continue or expand it.

§ 4 — MOBILE UNITS FOR DISPENSING CONTROLLED SUBSTANCES The bill generally prohibits practitioners from dispensing controlled substances (e.g., methadone) from a mobile unit for patient treatment within 500 feet of an elementary or secondary school property, child care center, playground, or public park.

It exempts from the prohibition a private residence if the controlled substance is dispensed inside of it.

By law, practitioners authorized to distribute, administer, or prescribe controlled substances may dispense them from a mobile unit at a different location than the one they used for Department of Consumer Protection (DCP) controlled substances registration if they meet specified notification, reporting, and medication storage requirements.

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595 § 5 — CHILD CAREGIVER SUBSTANCE USE DISORDER PROGRAM PLAN The bill requires DMHAS, DCF, and the Department of Social Services (DSS) to evaluate substance use disorder programs for people who are child caregivers and related treatment barriers.

In conducting the evaluation, the departments must consult with direct service providers and people with lived experience.

The departments must also develop a plan to establish and implement programs to treat these people and their children, that include the following:

1.

in all geographic areas, same-day access to family-centered medication-assisted treatment, including prenatal and perinatal care, and access to supports that provide a bridge to the treatment;

2.

intensive in-home treatment supports;

3.

gender-specific programming;

4.

expanded access to residential programs for pregnant and parenting people, including residential programs for parents who have more than one child or who have children over age seven;

and 5.

access to recovery support specialists and peer support to provide care coordination.

The bill requires the commissioners, by January 1, 2024, to jointly report to theChildren’s, HumanServices,andPublic Healthcommittees on the plan and legislative recommendations needed to implement the programs.

§ 6 — CHILD CARE SUPPORTS AND SUBSIDIES PLAN The bill requires DMHAS and DSS to collaborate with the Office of Early Childhood and create a plan to allow parents in substance use disorder treatment to qualify for child care supports and subsidies.

The DMHAS and DSS commissioners must jointly report on the plan to the sHB6913 / File No.

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595 Human Services and Public Health committees by January 1, 2024.

§ 7 — HOUSING SUPPORTS PLAN The bill requires DMHAS, DSS, and the Department of Housing to develop a plan ensuring that pregnant and parenting persons in treatment for substance use disorder have access to supportive housing.

The commissioners must jointly report on the plan to the Housing, Public Health, and Human Services committees by January 1, 2024.

§ 8 — PLAN ON SUBSTANCE USE DISORDER TREATMENT FOR PARENTS INVOLVED WITH DCF The bill requires DCF, DMHAS, and DSS to develop a plan to ensure parents involved with DCF have appropriate substance use disorder treatment to prevent children’s removal from their parents, when possible, and to support reunification when removal is necessary.

The plan must consider in-home parenting and child care services to help with safety planning during initial stages of treatment and recovery.

The billrequiresthecommissionersto jointlyreport to theChildren’s, Human Services, and Public Health committees on the plan by January 1, 2024.

§ 9 — EVALUATION OF SERVICES FOR PREGNANT AND PARENTING INDIVIDUALS The bill requires DCF, DMHAS, and DSS to evaluate existing substance use disorder treatment services for pregnant and parenting people, their use, and any areas where additional services are necessary.

The commissioners must jointly report on the evaluation to the Public Health Committee by January 1, 2024, and then semiannually after that until January 1, 2025.

§ 10 — DCF EVALUATION ON SUBSTANCE USE DISORDER TREATMENT SERVICES FOR PREGNANT AND PARENTING PERSONS The bill requires DCF to evaluate the quality of practice, safety planning, and service delivery to families with open department cases, including (1) the timely availability and use of services necessary to mitigate child safety concerns in the home when the child’s caregiver sHB6913 / File No.

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595 has a substance use disorder and (2) tracking treatment outcomes for child caregivers.

The bill requires the DCF commissioner to report to the Children’s and Public Health committees on the evaluation by January 1, 2024.

BACKGROUND Higher Education Institution Opioid Antagonist Policies Existing law required each higher education institution, by January 1, 2020, to (1) develop and implement a policy on opioid antagonist availability and use by students and employees, (2) submit it to the Department of Consumer Protection for approval, and (3) post it on the institution’s website once approved.

Amongotherthings,thepolicymust (1)designateamedicalorpublic safety professional to oversee purchasing, storing, and distributing opioid antagonists on each campus;

(2) identify where on each campus opioid antagonists are stored and make the locations known and accessible to students and employees;

and (3) require an institution representative to call 9-1-1 or a local emergency medical services provider after each observed or reported use unless the person already received medical treatment for the opioid-related drug overdose.

Opioid Settlement Advisory Committee By law, the Opioid Settlement Advisory Committee ensures (1) Opioid Settlement Fund moneys are allocated and spent on specified substance use disorder abatement purposes and (2) robust public involvement, accountability, and transparency in allocating and accounting for the fund’s moneys.

Currently, the committee consists of 31 state and local government officials and six public members and is chaired by the DMHAS commissioner and a municipal representative.

The committee must meet quarterly and annually report to the Appropriations and Public Health committees on the fund’s activities.

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595 COMMITTEE ACTION Public Health Committee Joint Favorable Substitute Yea 37 Nay 0 (03/27/2023) sHB6913 / File No.

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