Legislative Document No. 1662 S.P. 539 In Senate, April 30, 2019
An Act To Save Lives by Establishing the Low Barrier Opioid Treatment Response Program
(EMERGENCY)
Reference to the Committee on Health and Human Services suggested and ordered printed.
DAREK M. GRANT Secretary of the Senate
Presented by Senator CLAXTON of Androscoggin. Cosponsored by Representatives: O'CONNOR of Berwick, PERRY of Calais.
Printed on recycled paper 1 Emergency preamble. Whereas, acts and resolves of the Legislature do not 2 become effective until 90 days after adjournment unless enacted as emergencies; and
3 Whereas, opioid use disorder has reached epidemic proportions and threatens the 4 lives and well-being of many Maine residents; and
5 Whereas, existing modalities and strategies for treatment of opioid use disorder are 6 insufficient to end the epidemic of this disorder in Maine; and
7 Whereas, existing services are especially inadequate to address the impact of opioid 8 use disorder on those experiencing or having experienced unstable housing, minimal or 9 no employment, unreliable transportation, lack of insurance coverage, use of multiple 10 substances, frequent hospitalization or prior overdoses; and
11 Whereas, failure to provide timely treatment to those most at risk of overdose death 12 from opioid use leads to unnecessary loss of life and tragic dislocations of family life, 13 while imposing substantial additional costs on the State due to related increases in 14 incarcerations, hospital admissions and foster care for children affected by parental use of 15 opioids; and
16 Whereas, a low barrier, rapid access treatment system delivered and coordinated by 17 Maine's community health centers will provide an essential component of an improved 18 array of responses to this epidemic; and
19 Whereas, in the judgment of the Legislature, these facts create an emergency within 20 the meaning of the Constitution of Maine and require the following legislation as 21 immediately necessary for the preservation of the public peace, health and safety; now, 22 therefore,
23 Be it enacted by the People of the State of Maine as follows:
24 Sec. 1. 22 MRSA §259, sub-§1, ¶B, as amended by PL 2015, c. 267, Pt. JJJ, §1, 25 is further amended to read: 26 B. Six hundred ninety-nine thousand, one hundred fifty dollars in fiscal year 2001-02 27 to federally qualified health centers to support the infrastructure of these programs in 28 providing primary care services to underserved populations. Forty-four thousand, 29 two hundred fifty dollars must be provided to each federally qualified health center 30 with an additional $8,850 for the 2nd and each additional site operated by a federally 31 qualified health center. For the purposes of this paragraph, "site" means a site or sites 32 operated by the federally qualified health center within its scope of service that meet 33 all health center requirements, including providing primary care services, regardless 34 of patients' ability to pay, 5 days a week with extended hours. If there is not 35 sufficient funding to meet the formula in this paragraph, the $699,150 must be 36 allocated in proportion to the formula outlined in this paragraph; and 37 Sec. 2. 22 MRSA §259, sub-§1, ¶C, as enacted by PL 2015, c. 267, Pt. JJJ, §1, is 38 amended to read:
Page 1 - 129LR1646(01)-1 1 C. Five hundred thousand dollars, beginning with fiscal year 2015-16 and continuing 2 each fiscal year thereafter, to support access to primary medical, behavioral health 3 and dental services to residents of the State in rural and underserved communities and 4 to assist with provider recruitment and retention. Twenty-five thousand dollars must 5 be provided to each federally qualified health center.; and 6 Sec. 3. 22 MRSA §259, sub-§1, ¶D is enacted to read: 7 D. Four hundred thousand dollars, beginning with fiscal year 2019-20 and 8 continuing each fiscal year thereafter, to support pilot implementation and operation 9 of the Low Barrier Opioid Treatment Response Program established in section 2354, 10 to be allocated by the department to those federally qualified health centers approved 11 to participate in the pilot and subsequent implementation. The funds provided 12 pursuant to this paragraph are in addition to and do not alter or amend the purposes or 13 the allocation of the funds provided pursuant to paragraph C. 14 Sec. 4. 22 MRSA §2354 is enacted to read: 15 §2354. Low Barrier Opioid Treatment Response Program
16 1. Program establishment. The Low Barrier Opioid Treatment Response Program, 17 referred to in this section as "the program," is established in the department to provide 18 resources for federally qualified health centers, referred to in this section as "community 19 health centers," to develop and deploy low barrier, rapid access treatment models to treat 20 opioid use disorder. The program must provide low barrier, rapid access to treatment for 21 those persons typically unable to obtain timely treatment and at greatest risk of opioid 22 overdose, including but not limited to persons affected by unstable housing, minimal or 23 no employment, unreliable transportation, use of multiple substances associated with 24 addiction or chronic overuse, frequent hospitalization, prior overdoses or a lack of health 25 insurance coverage for substance use treatment services.
26 2. Program components. The program must include: 27 A. Support for clinic infrastructure to reduce barriers to access to treatment, 28 including incentives for community health centers to support additional qualified 29 providers in obtaining waivers to provide medication-assisted therapy services and 30 support for each community health center to identify and compensate an individual 31 within that community health center to help implement the program; 32 B. Support for community health centers to incentivize providers to accept increased 33 call responsibilities and to see greater numbers of patients with opioid use disorders; 34 C. A statewide program of anti-stigma training that includes providers, staff and 35 community health center patient-led boards; 36 D. Support for the development and implementation of a standardized induction 37 practice across all participating community health centers; 38 E. Increasing the availability of naloxone hydrochloride to community health centers 39 and training community health center personnel on the emergency administration of 40 naloxone hydrochloride; and
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