Bill Summary – FastDemocracy

ENGROSSED ORIGINAL

                                               A BILL

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                                                  24-952

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                     IN THE COUNCIL OF THE DISTRICT OF COLUMBIA

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                                         ________________

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 To establish an Opioid Abatement Advisory Commission to make recommendations to the Mayor

        and Council regarding the use of opioid litigation settlement proceeds and District-wide

        goals, objectives, and performance indicators relating to opioid use disorder and co-

        occurring substance use and mental health disorders, and to establish an Office of Opioid

        Abatement and set forth its powers and duties; to amend the Attorney General for the

        District of Columbia Clarification and Elected Term Amendment Act of 2010 to make

        conforming changes; and to amend the Opioid Abatement Fund Establishment Act of 2022

        to clarify the monies to be deposited into the Opioid Abatement Fund, to provide for how

        monies in the Opioid Abatement Fund shall be spent, to require an annual report to the

        Mayor, Council, and Attorney General concerning opioid abatement activities and the use

        of monies deposited into the Opioid Abatement Fund, and to require an audit of the Opioid

        Abatement Fund.

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        BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this

 act may be cited as the Opioid Litigation Proceeds Amendment Act of 2022.

        Sec. 2. Definitions.

        For the purposes of this act, the term:

                 (1) Commission means the Opioid Abatement Advisory Commission established

 by section 3.

                 (2) Evidence-based means that an activity, practice, program, service, support, or

 strategy has undergone multiple randomized controlled trials and observational studies

 demonstrating that it helps individuals avoid the development and progression of opioid and other

 substance use disorders or drug-related harms, reduces the adverse consequences of opioid and

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 other substance use, or manages, slows the progression of, or supports recovery from an opioid

 use disorder or co-occurring substance use or mental health disorder.

                (3) Evidence-informed means an activity, practice, program, service, support, or

 strategy that incorporates the best available evidence, patient needs, values, and preferences, and

 practitioner expertise into the decision-making process.

                (4) Fund means the Opioid Abatement Fund established by section 5012 of the

 Opioid Abatement Fund Establishment Act of 2022, effective September 21, 2022 (D.C. Law 24-

 167; D.C. Official Code  1-325.441).

                (5) Harm reduction means an activity, practice, program, service, support, or

 strategy that addresses both conditions that precede and occur as a result of substance use and

 attempts to reduce the adverse consequences of opioid and other substance use among persons

 who continue to use those substances.

                (6) Infrastructure means the resources, such as personnel, buildings, or

 equipment, required for the District or another entity to provide evidence-based and evidence-

 informed harm reduction, prevention, recovery, and treatment activities, practices, programs,

 services, supports, and strategies to individuals with opioid use disorder and co-occurring

 substance use and mental health disorders.

                (7) Office means the Office of Opioid Abatement established by section 4.

                (8) Prevention means primary, secondary, and tertiary efforts to help individuals

 avoid the development and progression of opioid use disorder and co-occurring substance use and

 mental health disorders and drug-related harms.

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                (9) Recovery means a process through which an individual develops a healthier

 life, which may include:

                        (A) Improving the individuals quality of life, including the individuals

 physical and mental health;

                        (B) The individuals consistent pursuit of abstinence from the substances or

 behaviors that have negatively impacted them, their family, and their community;

                        (C) Relief of the individuals symptoms, including substance craving; and

                        (D) Improvement of the individuals relationships, social connectedness,

 and interpersonal skills.

                (10) Treatment:

                        (A) Means an evidence-based or evidence-informed activity, practice,

 program, service, support, or strategy to intervene upon, care for, manage, slow the progression

 of, or support recovery from opioid use disorder or co-occurring substance use or mental health

 disorders;

                        (B) Shall be individualized to address each individuals medical needs; and

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                        (C) Shall include screening for and diagnosis of substance use disorders or

 co-occurring mental or physical health disorders, as well as pharmacological and non-

 pharmacological therapeutic interventions for opioid use disorder or co-occurring substance use

 or mental health disorders.

        Sec. 3. Opioid Abatement Advisory Commission.

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        (a) There is established an Opioid Abatement Advisory Commission.

        (b) The purpose of the Commission shall be to:

                (1) Ensure that the monies the District receives and deposits into the Fund are

 appropriately expended on evidence-based and evidence-informed harm reduction, prevention,

 recovery, and treatment activities, practices, programs, services, supports, and strategies for opioid

 use disorder and co-occurring substance use and mental health disorders;

                (2) Prioritize and facilitate public involvement, accountability, and transparency in

 allocating and accounting for these monies; and

                (3) Ensure that the monies the District receives and deposits into the Fund have the

 effect of preventing, treating, and reducing opioid use disorder and co-occurring substance use and

 mental health disorders and reducing fatalities.

        (c) The Commission shall be composed of 21 members, as follows:

                (1) The Director of the Department of Behavioral Health, or the Directors

 designee;

                (2) The Director of the Department of Health, or the Directors designee;

                (3) The Director of the Department of Health Care Finance, or the Directors

 designee;

                (4) The Deputy Mayor for Health and Human Services, or the Deputy Mayors

 designee;

                (5) The Deputy Mayor for Public Safety and Justice, or the Deputy Mayors

 designee;

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                 (6) The Chief Medical Examiner, or the Chief Medical Examiners designee;

                 (7) The Attorney General, or the Attorney Generals designee;

                 (8) The Chairperson of the Council committee with jurisdiction over health matters,

  or the Chairpersons designee;

                (9) Five members appointed by the Mayor, with the following qualifications:

                       (A) One member with experience in providing prevention, recovery,

 treatment, or harm reduction services for opioid use disorder and co-occurring substance use and

 mental health disorders;

                       (B) Two members, respectively, with professional expertise and educational

 backgrounds in:

                               (i) Medicine; and

                               (ii) Mental health services;

                       (C) One member who has experienced opioid use disorder and co-occurring

 substance use and mental health disorders and recovery; and

                       (D) One family member of a person or decedent who experienced opioid

 use disorder and co-occurring substance use and mental health disorders;

                (10) One representative each from the:

                       (A) D.C. Behavioral Health Association;

                       (B) Medical Society of D.C.;

                       (C) D.C. Primary Care Association; and

                       (D) D.C. Hospital Association; and

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                   (11) Four members appointed by the Chairman of the Council, with the following

 qualifications:

                          (A) Two members with current experience as direct service providers of

 prevention, recovery, treatment, or harm reduction services for opioid use disorder and co-

 occurring substance use and mental health disorders;

                          (B) One member with professional expertise and an educational background

 in public health policy or research; and

                          (C) One member who has experienced opioid use disorder and co-occurring

 substance use and mental health disorders and recovery.

        (d) The Commission shall elect a Chair from among its members.

        (e)(1) Each member appointed pursuant to subsection (c)(9) and (11) of this section shall

 serve a 3-year term; except, that:

                          (A) Of the Mayors initial appointments, 2 members shall be appointed for

 terms of one year, and 2 members shall be appointed for terms of 2 years; and

                          (B) Of the Councils initial appointments, one member shall be appointed

 for a term of one year, and 2 members shall be appointed for terms of 2 years.

                   (2) Members shall serve:

                          (A) Following the expiration of their terms until their successors have been

 appointed;

                          (B) For a maximum of 2 full terms, with partial term service not counted

 toward this maximum; and

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                          (C) Without compensation; provided, that they shall be reimbursed for

 necessary expenses incurred in carrying out Commission duties.

                 (3) Vacancies shall be filled in the same manner as the original appointment for the

 remainder of the term.

          (f) The Commission shall hold public meetings at least quarterly, with meetings called by

 the Chair or a majority of Commission members. All Commission meetings shall be subject to the

 Open Meetings Act, effective March 31, 2011 (D.C. Law 18-350; D.C. Official Code  2-571 et

 seq.).

          (g) A majority of the Commissions members shall constitute a quorum, and actions of the

 Commission shall be taken by an affirmative vote of a majority of the members in attendance at a

 meeting where a quorum is present. Members may attend in person or remotely through audio or

 audiovisual means.

          (h) The Commission shall have the following powers and duties:

                 (1) Establish procedures for the Commissions operations; and

                 (2) Make recommendations to the Mayor and Council regarding:

                          (A) District-wide goals, objectives, and performance indicators relating to:

                                 (i)   Prevention,   recovery,   treatment,   and   harm    reduction

 infrastructure, activities, practices, programs, services, supports, and strategies for opioid use

 disorder and co-occurring substance use and mental health disorders;

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                                (ii) Reducing disparities in access to prevention, recovery,

 treatment, and harm reduction infrastructure, activities, practices, programs, services, supports,

 and strategies; and

                                (iii) Improving outcomes and reducing mortality in traditionally

 underserved populations, including for communities of color and current or formerly incarcerated

 individuals, with regard to prevention, recovery, treatment, and harm reduction infrastructure,

 activities, practices, programs, services, supports, and strategies;

                        (B) Governing principles, policies, and procedures for the application for

 and awarding of monies and grants from the Fund;

                        (C) Awards of monies and grants from the Fund;

                        (D) The performance and outcomes of Fund awardees and grantees;

                        (E) Management of the Fund; and

                        (F) Any changes to the Funds purposes.

          (i) The Commissions recommendations for the awarding of monies and grants pursuant to

 subsection (h)(2)(C) of this section shall include the consideration of the following:

                 (1) The number of individuals, per capita, with an opioid use disorder, and the

 number of overdose deaths per capita, in the area which a prospective awardee or grantee seeks to

 serve;

                 (2) Disparities in access to care and health outcomes in the area which a prospective

 awardee or grantee seeks to serve; and

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                (3) The infrastructure, activities, practices, programs, services, supports, and

 strategies currently available to individuals with an opioid use disorder in an area which a

 prospective awardee or grantee seeks to serve.

        Sec. 4. Office of Opioid Abatement.

        (a)(1) There is established, within the Department of Behavioral Health, an Office of

 Opioid Abatement.

                (2) The Office shall be led by a Director with at least 10 years professional.

 experience and education in prevention, recovery, treatment, and harm reduction efforts for opioid

 use disorder and co-occurring substance use and mental health disorders.

        (b) The Office shall have the following powers and duties:

                (1) Conducting a District-wide needs assessment to identify structural gaps and

 needs related to opioid use disorder and co-occurring substance use and mental health disorders;

                (2) Supporting the Commissions activities by providing staffing, research and

 policy expertise, facilities, technical assistance, and other resources;

                (3) Assisting the Commission in preparing its recommendations regarding goals,

 objectives, and performance indicators pursuant to section 3(h)(2)(A);

                (4) Integrating the work of the Office and Commission and Fund expenditures with

 existing District strategic planning related to opioid use disorder and co-occurring substance use

 and mental health disorders;

                (5) Developing governing principles, policies, and procedures for the application

 and awarding of monies and grants from the Fund;

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                (6) Overseeing expenditures from the Fund, including by preparing a quarterly

 accounting of expenditures from the Fund and the Fund balance;

                (7) Issuing, managing, and overseeing awards and grants from the Fund, including

 collecting and publicly reporting data from awardees and grantees concerning the effectiveness of

 infrastructure, activities, practices, programs, services, supports, and strategies funded; and

                (8) Preparing the annual report required by section 5012(f) of the Opioid Abatement

 Fund Establishment Act of 2022, effective September 21, 2022 (D.C. Law 24-167; D.C. Official

 Code  1-325.441(f)); and

                (9) Creating and maintaining a public website that includes:

                        (A) Commission meeting attendance, agendas, and minutes;

                        (B) The governing principles, policies, and procedures developed pursuant

 to paragraph (5) of this subsection;

                        (C) The quarterly accountings of Fund expenditures and Fund balance

 prepared pursuant to paragraph (6) of this subsection;

                        (D) A listing of awards and grants from the Fund and awardee and grantee

 data collected pursuant to paragraph (7) of this subsection; and

                        (E) The annual reports prepared pursuant to section 5012(f) of the Opioid

 Abatement Fund Establishment Act of 2022, effective September 21, 2022 (D.C. Law 24-167;

 D.C. Official Code  1-325.441(f)).

        (c) If the Office decides not to follow a Commission recommendation in whole or in part,

 the Office shall provide the Commission with a written explanation for its decision within 14 days

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 after the decision is made. The Commission shall have at least 7 days after receipt of the Offices

 written explanation to provide a written response before the Office proceeds with its decision.

         Sec. 5. Rules.

         The Mayor, pursuant to Title I of the District of Columbia Administrative Procedure Act,

 approved October 21, 1968 (82 Stat. 1204; D.C. Official Code 2-501 et seq.), may issue rules to

 implement the provisions of this act.

         Sec. 6. Section 106b of the Attorney General for the District of Columbia Clarification and

 Elected Term Amendment Act of 2010, effective October 22, 2015 (D.C. Law 21-36; D.C. Official

 Code  1-301.86b), is amended as follows:

         (a) Subsection (b) is amended as follows:

                 (1) Paragraph (2) is amended by striking the phrase ; and and inserting a

 semicolon in its place.

                 (2) Paragraph (3) is amended by striking the period and inserting the phrase ; and

 in its place.

                 (3) A new paragraph (4) is added to read as follows:

                 (4) Subject to the limitations of subsection (d)(3)(D) of this section, funds received

 pursuant to section 5012(b)(1) and (1A) of the Opioid Abatement Fund Establishment Act of 2022,

 effective September 21, 2022 (D.C. Law 24-167; D.C. Official Code  1-325.441(b)(1), (1A))..

         (b) Subsection (d)