HB24-1003 – Opiate Antagonists and Detection Products in Schools

Concerning measures related to harm reduction for students.

This bill was introduced independent of the study committee.

SPONSORS: Rep. B. McLachlan | Rep. M. Young | Sen. C. Simpson | Sen. D. Michaelson Jenet

STATUS: This bill was passed and signed into law on April 22. It will go into effect on Aug. 7.

Bill summary

Under current law, a school district, the state charter school institute, or the governing board of a nonpublic school may adopt a policy for a school to maintain a supply of and distribute opiate antagonists. The bill allows the adoption of a similar policy for maintaining a supply of opiate antagonists on school buses and extends existing civil and criminal immunity to school bus operators and other employees present on buses if they furnish or administer an opiate antagonist in good faith, in addition to other requirements.

Under current law, a school district, the state charter school institute, or the governing board of a nonpublic school may adopt a policy for a school to maintain a supply of and distribute non-laboratory synthetic opiate detection tests. The bill allows the adoption of a similar policy for non-laboratory additive detection tests and extends existing civil immunity provisions to include non-laboratory additive detection tests.

The bill mandates that a school, school district, or the state charter school institute shall not prohibit a student to possess or administer on school grounds, on a school bus, or at any school-sponsored event an opiate antagonist and possess a non-laboratory synthetic opiate detection test or a non-laboratory additive detection test. The bill also mandates that students not be disciplined for carry and/or administering an opiate antagonist.

The bill also explicitly provides students immunity from civil and criminal liability with regard to administering an opiate antagonist.

HB24-1028 – Overdose Prevention Centers

Concerning the authorization for a municipality to allow for the operation of an overdose prevention center within its jurisdiction.

This bill was introduced independent of the study committee.

SPONSORS: Rep. E. Epps | Sen. K. Priola

STATUS: This bill was voted down in the Senate Health & Human Services Committee by a 5-4 vote. It had passed the House.

Bill summary

The bill specifies that the governing body of a municipality, which includes a city, town, and city and county, may authorize the operation of an overdose prevention center within the municipality’s boundaries for the purpose of saving the lives of persons at risk of preventable overdoses.

HB24-1037 – Substance Use Disorders Harm Reduction

Concerning reducing the harm caused by substance use disorders.

This bill was Bill C when drafted by the study committee.

SPONSORS: Rep. E. Epps | Rep. C. deGruy Kennedy | Sen. K. Priola

STATUS: This bill was passed and signed by the Governor on June 6. It went into effect immediately.

Bill summary

• Excludes injuries involving the possession of drugs or drug paraphernalia from a physician’s mandatory reporting requirements (Section 1)
• Clarifies that the civil and criminal immunity that protects a person who acts in good faith to furnish or administer an opioid antagonist also protects a person who distributes an opioid antagonist, including an expired opioid antagonist (Section 2)
• Authorizes and extends immunity for the distribution, furnishing, and administration of Naloxone beyond the date of expiration of the product, including law enforcement personnel, school districts personnel, and healthcare providers (Sections 2 and 3)
• Stipulates that the presence or possession of an opioid antagonist shall be used as the sole basis for probable cause to perform a warrantless search and seizure if the individual (Section 4)
• Adds exemption to the prohibition on possessing drug paraphernalia for possession of drug paraphernalia that a person receives from an approved syringe exchange program, or a program carried out by a harm reduction organization while participating in the program (Section 5)
• Specifies that money received through the Harm Reduction Grant Program may be used for purchasing other drug testing equipment in addition to non-laboratory synthetic opiate detection tests (Section 6)
• Authorizes clean syringe exchange programs to purchase and distribute other supplies and tools intended to reduce health risks associated with drug use, including, but not limited to, smoking materials (Section 7)
• Authorizes clean syringe exchange programs to acquire and use supplies or devices intended for use in testing controlled substances or controlled substance analogs for potentially dangerous adulterants (Section 7)
• Updates the term “opiate antagonist” to “opioid antagonist” in state statute (Section 2 and Sections 7-23)
• Specifies that the statutory definition of “opioid antagonist” includes expired opioid antagonists (Section 9)

HB24-1045 – Treatment for Substance Use Disorders

Concerning treatment for substance use disorders.

This bill was Bill B when drafted by the study committee.

SPONSORS: Rep. R. Armagost | Rep. C. deGruy Kennedy | Sen. K. Mullica | Sen. P. Will

STATUS: This bill was passed and signed by the Governor on June 6. Portions of the bill will go into effect on July 1, while others will go into effect on Aug. 7.

Bill summary

• Prohibits a carrier that provides coverage under a health benefit plan for a drug used to treat a substance use disorder from requiring prior authorization for the drug based solely on the dosage amount (Section 1)
• Requires reimbursement of pharmacists at same rate as other providers of medication-assisted treatment (MAT) (Section 2, 24,and 25)
• Requires the state Medical Assistance Program to reimburse a pharmacist prescribing or administering medications for opioid use disorder pursuant to a collaborative agreement at a rate equal to the reimbursement rate for other providers (Section 23)
• Allows licensed clinical social workers and marriage and family therapists to provide clinical supervision for individuals seeking certification as addiction technicians and addiction specialists and directs the State Board of Human Services, as applicable, to adopt rules related to clinical supervision by these professionals (Sections 3, 4, 9).
• Allows a licensed addiction counselor to provide clinical supervision of individuals working toward licensure as a marriage and family therapist (Section 5 and 8).
• Allows licensed professional counselors to provide clinical supervision for individuals seeking certification as addiction technicians and addiction specialists and directs the State Board of Human Services, as applicable, to adopt rules related to clinical supervision by these professionals (Sections 6).
• Allows licensed addiction counselors to provide clinical supervision for individuals seeking certification as addiction technicians and addiction specialists and directs the State Board of Human Services, as applicable, to adopt rules related to clinical supervision by these professionals (Sections 7).
• Defines Medications for Opioid Use Disorders as treatment for an opioid use disorder using medications approved by the FDA and administered in accordance with national, evidence-based published guidelines (Section 10).
• Extends prescriptive authority of FDA-approved medications for opioid use disorders to pharmacists (Section 10, 12 and 13)
• Require the Board of Pharmacy to develop protocols for pharmacists to prescribe, dispense, and administer medications for opioid use disorders (Section 11)
• Add pharmacies and pharmacists as eligible entities for funds of the Colorado Medication-Assisted Treatment Expansion Program (Sections 12-17)
• Requires the Department of Health Care Policy and Finance (HCPF) to seek federal authorization for screening, medication-assisted treatment, prescription medications, case management, and care coordination services through the state Medical Assistance Program to persons up to 90 days prior to release from jail, a juvenile facility, or a Department of Corrections facility (Section 18)
• Adds substance use disorder treatment to the list of health-care or mental health-care services required to be reimbursed at the same rate for telemedicine as a comparable in-person service (Section 19)
• Requires HCPF to seek federal authorization for partial hospitalization for substance use disorders treatment with full federal financial participation and that partial hospitalization for substance use disorder treatment shall not take an effect until federal approval has been obtained (Section 20)
• Requires Managed Care Entities that provide prescription drug benefits for methadone administration for treatment of substance use disorders to: 1) Not impose any prior authorization requirements on any prescription medication approved by the FDA for the treatment of substance use disorders, regardless of the dosage amount; and 2) Set the reimbursement rate for take-home methadone treatment and office-administered methadone treatment at the same rate (Section 21)
• Requires the Behavioral Health Administration to collect data from each withdrawal management facility on the total number of individuals who were denied admittance or treatment for withdrawal management and the reason for the denial and review and approve any admission criteria established by a withdrawal management facility and to share the data received with Behavioral Health Administration services organizations (Section 22)
• Requires Managed Care Entities to disclose the aggregated average and lowest rates of reimbursement for a set of behavioral health services determined by HCPF. (Section 23)
• Appropriates $150,000 annually for the Colorado Child Abuse Prevention Trust Fund for programs that reduce prenatal substance exposure (Section 26)
• Appropriate $50,000 annually to the Colorado Child Abuse Prevention Trust Fund for convening stakeholders to identify strategies to increase access to childcare for families seeking SUD treatment and recovery services (Section 26)
• Requires the Behavioral Health Administration to contract with a third-party for support of behavioral health providers seeking to become behavioral health safety net providers with the goal of the provider becoming self-sustaining (Section 27)
• Creates the Contingency Management Grant Program in the Behavioral Health Administration with an allocation of $750,000 through June 30, 2027, to provide grants to SUD treatment programs for implementing contingency management for stimulant use disorder treatment (Section 28)
• Authorizes the Behavioral Health Administration to seek federal funding for fetal alcohol spectrum and to receive and disburse those funds to public and private nonprofit organizations (Section 29)
• Extends the repeal date of the Opioid and Other Substance Disorder Study Committee (C.R.S 10-22.3-102) from September 1, 2024 to September 1, 2026 (Section 30)
• Appropriations (Section 31):
  • $250,000 for 2024-25 to the Colorado Department of Human Services for implementing criminal justice diversion programs
  • $250,000 for 2024-25 to the Colorado Judicial Department for district attorney adult pretrial diversion programs
  • $1,325,647 for 2024-25 to the Colorado Department of Human Services for use by the Behavioral Health Administration to implement the following:
    • $30,152 for program administration related the community behavioral health administration, which amount is based on an assumption that the administration will require an additional 0.3 FTE;
    • $545,495 for contract and data management related to substance use treatment and prevention services; and
    • $750,000 for the contingency management grant related to substance use treatment and prevention services, which amount is based on an assumption that the administration will require an additional 1.0 FTE
  • $178,831 for 2024-25 to the Colorado Department of Health Care Policy and Finance for the following:
    • $117,563 for personnel services
    • $11,733 for operating expenses
    • $47,535 for Medicaid Management Information System maintenance and projectsoo
  • $525,189 in federal funds for 2024-25 for use by the Colorado Department of Health Care Policy and Finance related to personnel services, operating expenses and the Medicaid Management Information System maintenance and projects.
  • $25,060 for 2024-25 to the Colorado Department of Health Care Policy and Finance for the Colorado benefits management system’s operating and contract expenses.
  • $208,705 in federal funds for 2024-25 to Colorado Department of Health Care Policy and Finance for the Colorado benefits management system’s operating and contract expenses.
  • $200,000 in 2024-25 to the Colorado Department if Early Childhood for the Colorado Child Abuse Prevention Trust Fund.
  • $200,000 in 2024-25 to the Colorado Department of Early Childhood for use by the Community and Family Support Division, which is from reappropriated funds in the Colorado Child Abuse Prevention Trust Fund for child maltreatment prevention.
  • $36,514 in 2024-25 to the Colorado Department if Regulatory Affairs for use by the Division of Insurance for personnel and operating expenses.

SB24-047 – Prevention of Substance Use Disorders

Concerning the prevention of substance use disorders.

This bill was Bill A when drafted by the study committee.

SPONSORS: Sen. S. Jaquez Lewis | Sen. K. Priola | Rep. M. Young | Rep. E. Epps

STATUS: This bill was passed and signed into law by the Governor on June 6, and the policies are now in effect.

Fiscal note

Bill summary

As introduced, the bill:

Prescription Drug Abuse Monitoring Program (PDMP): 

Prescription Drug Abuse Monitoring Program (PDMP):

• Exempts veterinarians from some aspects of the PDMP (Sections 1, 6 and 8)
• Defines “Medical Director” to include Nurse Medical Director of a medical practice or hospital who is a prescriber with regard to the Prescription Drug Monitoring Program and allows medical director to query the Prescription Drug Monitoring Program (Sections 2, 4, and 5).
• Revises the term “prescription controlled substance electronic program” to “prescription drug electronic program” with regard to the Prescription Drug Monitoring Program (PDMP), requires each “medical director” to register and maintain a user account with the PDMP, and allows medical director to authorize designees to access the PDMP in accordance to statutory requirements (Section 3).
• Removes the requirement placed on the Department of Regulatory Affairs to identify prescription drugs and substance in addition to controlled substances that have a substantial potential for abuse and requires reporting on those prescription in the PDMP (Section 4).
• Revises state statute on the PDMP and requires that the program to track all controlled substances dispense in the state and that each pharmacy to upload that information in accordance with applicable reporting requirements (Section 4).
• Allows the Department of Health Care Policy and Finance access to the PMDP for review and analysis of data, consistent with federally required reporting relating to recipients of certain benefits (Section 4)
• Updates current language in the laws relating to the PDMP by using more modern terminology, striking “drug abuse” and substituting “substance use disorder” (Sections 4)

Substance Use Disorder Prevention: 

• Permits and defines the establishment of local Overdose Fatality Review Teams in a county, city, region or tribal community, and addresses confidentiality requirements (Section 7)
• Requires the Department of Health Care Policy and Finance to publish guidance for providers concerning reimbursement for all variations of screening, brief intervention, and referral top treatment (Section 8).
• Expands screening, brief Intervention, and referral to treatment (SBIRT) training and technical assistance to schools and pediatric settings to increase SBIRT with adolescents (Section 9).
• Expands the Perinatal Substance Use Data Linkage Project (Section 10).
• Appropriations:
  • $75,000 to the Department of Health Care Policy and Finance for general professional services and special projects related to this act which is expected to incur a match of federal funds in the amount of $75,000.
  • $250,000 to the Commission of Higher Education Special Purpose Programs for use by the Center for Substance Use Disorder Prevention, Treatment, and Recovery Support Strategies at the University of Colorado Anschutz Medical Campus

SB24-048 – Substance Use Disorders Recovery

Concerning recovery from substance use disorders.

This bill was Bill D when drafted by the study committee.

SPONSORS: Sen. K. Priola | Rep. C. deGruy Kennedy | Rep. M. Lynch

STATUS: This bill was passed and signed by the Governor on June 5. The policies will go into effect on Aug. 7.

Bill summary

• Establishing the Recovery-Friendly Workplace Program within the University of Colorado School of Public Health Center for Health, Work & Environment (Sections 1 and 2).
• Defines the voluntary designation process and requirements for a business to become a certified Recovery-Friendly Workplace (Section 1).
• Creates the Recovery School Grant Program within the Colorado Department of Education (Section 3).
• Allows a school district to include in the annual pupil count a student who has transferred to a recovery high school before the pupil count date (Section 4)
• Allows a recovery community organization that receives a grant through the Recovery Support Services Grant Program to use the money to provide guidance to individuals on the many pathways for recovery (Section 5).
• Authorizes the Behavioral Health Administration to shut down a recovery residence or similar facility in violation of regulations of recovery residences in C.R.S.§ 27-80-129 (Section 6).
• Declares that recovery residences are a matter of statewide concern (Section 7).
• Declares that recovery residences, sober living facilities, and sober homes are a residential use of land for zoning purposes (Section 8).
• Mandates the Liquor Enforcement Division of the Colorado Department of Regulatory Affairs to adopt rules related to the location of alcohol beverage displays by July 1, 2025 and to convene a stakeholder group of 12 individuals to develop the rules (Section 9).
• Appropriations (Section 10):
  • $144,321 to the Colorado Department of Education allocated as follows:
    • $19,010 for use on department management and administration for 0.2 FTE
    • $56,300 for use by department management and administration for information technology services.
    • $69,011 for by Student Pathways for Substance Use Disorders Recovery Grant Pilot Program.
  • $303,752 to the Colorado Department of Higher Education for allocation to the University School of Public Health to implement the Recovery Friendly Workplace Program.
  • $37,980 to the Colorado Department of Revenue for use as follows related to adopting rules regarding he location of alcohol beverage displays:
    • $37,798 for personal services, based on the need for a 0.4FTE.
    • $7,182 for operating expenses