March 2021 legislative update
By José Esquibel
Currently, four bills have been introduced in the current legislative session related to opioids and other substance use disorders. Here are brief summaries of the bills. This is up-to-date as of March 18 and synopsizes major provisions of the bills. Please visit the legislature’s page for the most recent versions with potential amendments.
SB21-011: Concerning the responsibilities of pharmacists related to opiate antagonists.
The bill requires a pharmacist who dispenses an opioid to an individual to inform the individual of the potential dangers of a high dose of opioid and offer to prescribe the individual an opiate antagonist if:
- In the pharmacist’s professional judgment, the individual would benefit from the information;
- The individual has a history of prior opioid overdose or substance use disorder;
- The individual is, at the same time, prescribed a benzodiazepine, a sedative hypnotic drug, carisoprodol, tramadol, or gabapentin; or
- The opioid prescription being dispensed is at or in excess of 90 morphine milligram equivalent.
Amendments are expected for this bill.
It was assigned to the Senate Health and Human Services Committee and was heard on March 10, 1:30 pm and passed out of Committee
SB21-098 Continuation of the Prescription Drug Monitoring Program (PDMP)
The bill implements the recommendations of the Department of Regulatory Affairs for continuation of the PDMP through September 1, 2028, including authorizing the State Board of Pharmacy to promulgate rules that identify the list of prescription drugs that are not currently listed as controlled substances and requiring such drugs to be tracked through the PDMP.
The bill also allows coroners to authorize deputy coroners to access the PDMP.
The bill was assigned to the Senate Health & Human Services Committee and was passed out of Committee on March 17.
SB21-122 Concerning the Bulk Purchase of Opiate Antagonists
The intent of the bill is to align statute related to standing orders for opiate antagonists with eligibility for use of the Opiate Antagonist Bulk Purchase Fund.
Section 1 of the bill adds a unit of local government to prescribing or dispensing opiate antagonists.
Section 2 and 3 adds a unit of local government to the immunity statutes for administration of an opiate antagonist.
Section 4 clarifies that eligible entities for use of the Bulk Purchase Fund are harm reduction orgs, law enforcement agencies and first responder.
The bill is clean up language proposed by the Colorado Department of Public Health and Environment based on the experience with administering the Bulk Purchase Fund.
The bill was assigned to the House Health & Human Services Committee and was heard on March 10 and passed out of Committee and then passed out of Senate. It will be heard in the House and no date is set for the House hearing.
SB21-137 Behavioral Health Recovery Act of 2021
The bill covers a broad array of policies and funding requests for programs and services related behavioral health and substance use disorders:
Section 2: Continues the requirement that a podiatrist must adhere to the limitations on prescribing opioids.
Sections 3 & 4: Continues the funding for the medication-assisted treatment (MAT) expansion pilot program for FY2020-21 through FY2022-23 and repeals the pilot program on June 30, 2023.
Section 5: Expands the Colorado State University AgrAbility project by providing funding for information, services, training, and referrals to farmers, ranchers, agricultural workers, and their families to address mental health, suicide, and substance use issues experienced by these individuals.
Section 6: Appropriates $2 million to Local Public Health Agencies to address behavioral health, mental health, and substance use priorities in their local communities.
Section 7: Continuously appropriates money to the Harm Reduction Grant Program.
Section 8: Requires a Medicaid managed care organization (MCO) to notify providers about their decision to approve or deny services within 24 hours of the submitted request, sets minimum days that must be approved for certain types of residential SUD treatment, requires an MCO to approve care recommended by a provider, and requires an MCO to provide specific justification for each denial of continued care for all 6 dimensions of the ASAM Criteria for Addictive, Substance-Related and Co-Occurring Conditions.
Section 9: Requires Medicaid to include screening for perinatal mood and anxiety disorders for each child enrolled.
Section 10: Requires CDHS to develop a statewide data collection and information system to analyze implementation data and selected outcomes to identify areas for improvement, promote accountability, and provide insights to continually improve child and program outcomes.
Section 11: Requires CDHS, in collaboration with the Department of Agriculture, to contract with a nonprofit organization primarily focused on serving agricultural and rural communities in Colorado to provide vouchers to individuals living in rural and frontier communities in need of behavioral health-care services.
Section 12: Requires the Center for Research into SUD Prevention, Treatment, and Recovery Support Strategies (the Center) to engage in community engagement activities to address substance use prevention, harm reduction, criminal justice response, treatment, and recovery.
Section 13: Continues the building SUD Treatment Capacity in Underserved Communities Grant Program and strikes the repeal date.
Section 14: Requires the perinatal substance use data linkage project to utilize data from multiple state-administered data sources when examining certain issues related to pregnant and postpartum women with SUDs and their infants.
Section 15: Requires OBH to select a recovery residence certifying body to certify recovery residences and educate and train recovery residence owners and staff on industry best practices.
Section 16: Requires OBH to establish a program to provide temporary financial housing assistance to individuals with a SUD who have no supportive housing options when the individual is transitioning out of a residential treatment setting and into recovery or receiving treatment. Also creates the recovery support services grant program to provide recovery-oriented services to individuals with a substance use and co-occurring mental health disorder.
Section 17: Continues the appropriation to the maternal and child health pilot program
Section 18: Continues the program to increase public awareness concerning the safe use, storage, and disposal of opioids and the availability of naloxone and other drugs used to block the effects of an opioid overdose.
Section 19: Continues the Harm Reduction Grant Program and the Maternal and Child Health Pilot Program.
Section 20: Appropriates funding to community programs to respond to the impacts of the COVID-19 pandemic:
- $500,000 to CDE for the behavioral health care professional matching grant program
- $2,500,000 to CDE (from MTCF) for the K-5 social and emotional health pilot program
- For the 2021-22 state fiscal year, the following General Fund amounts to the Office of Behavioral Health:
- $3,530,000 to MSOs for SUD treatment and recovery providers for expenses related to COVID-19
- $3,250,000 for CMHCs for expenses related to COVID-19
- $500,00 to MSOs for SBIRT
- $2,000,000 for services provided to school-aged children and parents by CMHC school-based clinicians and prevention specialists.
- $3,800,000 for co-responder programs, Colorado crisis system services, housing assistance, including recovery residences and momentum and transition specialist programs, and treatment for rural communities.
- $2,000,000 for behavioral health treatment for children, youth, and their families
- $250,000 for treatment and detoxification programs
- $500,000 directed to community transition services for guardianship services for individuals transitioning out of mental health institutes
- $75,000 for the perinatal substance use data linkage project
- For FY2021-22, the following General Fund amounts to CDPHE:
- $250,000 for allocation to mental health first aid for in-person and virtual trainings.
- $1,150,000 for the opiate antagonist bulk purchase fund, and school-based health centers,
- $500,000 for the Colorado HIV and AIDS prevention grant program
- $500,000 to CDHS for the early childhood mental health consultation program
- $600,000 to the center for research into SUD prevention, treatment, and recovery support strategies for education for health-care professionals, grant writing assistance, and personal protective equipment and telehealth supplies for the medication-assisted treatment expansion pilot.
- $120,000 to the Department of law for the safe2tell program.
This bill is assigned to the Senate Health & Human Services Committee. For more information from the bill’s sponsors and supporters, read this fact sheet.
HB21-1012 Expand Prescription Drug Monitoring Program
Current law requires the prescription drug monitoring program (program) to track all controlled substances prescribed in Colorado. The bill expands the program, effective February 1, 2023, to track all prescription drugs prescribed in this state. The bill also extends the repeal of the program until September 1, 2028.
The bill was assigned to the House Health & Insurance Committee for a hearing on March 10 and is in lay over, unamended, amendments failed
HB21-1021 Concerning Supporting the Peer Support Professional Workforce
- Requires the department of human services (state department) to establish procedures to approve recovery support services organizations for reimbursement of peer support professional services.
- Gives the executive director of the state department rule-making authority to establish other criteria and standards as necessary.
- Permits a recovery support services organization to charge and submit for reimbursement from the medical assistance program certain eligible peer support services provided by peer support professionals.
- Authorizes the department of health care policy and financing to reimburse recovery support services organizations for permissible claims for peer support services submitted under the medical services program.
- Requires contracts entered into between the state department’s office of behavioral health and designated managed service organizations to include terms and conditions related to the support of peer-run recovery support services organizations.
The bill is assigned to the House Public Health, Behavioral Health and Human Services Committee and is scheduled for hearing on March 9 and passed unanimously and sent to the House Finance Committee.