Bills address five critical areas: prevention, harm reduction, treatment, recovery and SUD treatment in the criminal justice system
DENVER, CO– The Opioid and Other Substance Use Disorders Study Committee today advanced five bipartisan bills to combat the opioid epidemic. Each bill addresses a specific area of focus in slowing the opioid crisis.
“The opioid epidemic is devastating communities across Colorado, and our state’s response must meet the urgency this crisis demands,” said Opioid and Other Substance Use Disorders Study Committee Vice Chair Rep. Chris Kennedy (D-Lakewood). “These bipartisan bills build on legislation we previously passed and advance a comprehensive set of policies in each of five categories– prevention, harm reduction, treatment, recovery and treatment for substance use disorders in the criminal justice system.”
“It’s been my honor to chair the Opioid and Other Substance Use Disorders Study Committee for the last three years to bring forth policies that are leading the nation to address the public health crisis we face,” said Opioid and Other Substance Use Disorders Study Committee Chair Senator Brittany Pettersen (D-Lakewood). “This year’s package builds on our previous success and each piece of legislation is essential in addressing the gaps we see in the continuum of care needed to move people into recovery here in Colorado. There is not one silver bullet to address the opioid epidemic; it’s a complex, enormous problem. While today we passed the most impactful package we’ve seen yet, I know that our work isn’t done, and we are committed to continuing the work to address this crisis.”
“Working to turn the tide in the deadly opioid epidemic has been one of my top priorities, and I’m proud of our committee’s bipartisan work to craft and move forward these incredibly important proposals,” said Rep. Bri Buentello (D-Pueblo). “From increasing access to treatment, recovery and prevention services to changing how insurance companies cover non-opioid pain treatments, we can make real progress and aggressively combat this crisis.”
“Tackling substance use disorder in our criminal justice system is critical to ensuring successful recoveries and for providing treatment services to those who need them,” said Rep. Leslie Herod (D-Denver). “I’m proud of our bill that would seal records for people who successfully complete treatment programs and which would make medically assisted treatment available to individuals in our criminal justice system.”
Prevention of Substance Use Disorders:
The first bill the committee passed focuses on prevention efforts. The bill would encourage best practices in healthcare settings to prevent opioid misuse, increase access to alternatives to opioids, expand continuing education for opioid prescribers and support local public health departments in their delivery of prevention services. It would also establish screening and brief intervention and referral to treatment (SBIRT) as a health care standard and improve the utilization of evidence-based prevention programs.
The bill would make several changes to insurance plans, prohibiting insurance carriers from requiring copayments that exceed the charges submitted by a physical therapist, occupational therapist or acupuncturist. It requires the Commissioner of Insurance to establish diagnosis for which alternatives to opioids are appropriate. Furthermore, it requires health benefit plans to cover a minimum number of physical therapy, occupational therapy and acupuncture per yearIt would require insurance companies to make the atypical opioid or nonopioid medication available at the lowest cost-sharing tier applicable and prohibit them from limiting or excluding coverage for an atypical opioid.
The bill also includes several provisions to improve opioid prescribing best practices. It continues the prescribing limitations currently in place, requires new rules to establish competency-based continuing education for prescribers and modifies requirements for adding information to the prescription drug monitoring program (PDMP).
The second bill aims to lower the rate of opioid overdoses and related deaths and better prevent the spread of communicable diseases. It would extend civil and criminal immunity for a person who acts in good faith to administer an opiate antagonist, such as naloxone, that has expired. Opiate antagonists that are beyond their expiration date can still be effective in reversing an overdose, but some providers are hesitant to administer them out of concern for their liability even though these expired medications can still save lives.
The bill would also require insurance plans to reimburse hospitals that provide a covered individual with an opiate antagonist when discharged. To help prevent communicable diseases, the bill would allow pharmacists to provide syringes and removes a regulatory barrier to operating syringe exchange programs.
Treatment in the Criminal Justice System:
The third bill the committee advanced would help combat substance use disorders in the criminal justice system. It would require the department of corrections and other agencies to make medication assisted treatment (MAT), continuity of care and community resources available prior to release. It would also allow safe stations (police stations, sheriff’s offices, and fire stations) to receive any controlled substance for disposal and refer individuals with SUD to treatment. Under the bill, if an individual enters or successfully completes a SUD treatment program, their records may be sealed. The bill also appropriates funding to criminal justice diversion programs.
Treatment of Opioid and Other Substance Use Disorders:
The fourth bill would make changes to insurance plans, managed care entities and pharmacy benefits to increase access to SUD treatment. Under the bill, insurance carriers must provide coverage for SUD treatment in accordance with the American Society of Addiction Medicine (ASAM) or an alternate nationally recognized criteria if ASAM criteria is no longer available, relevant, or follow best practices. Carriers are also required to provide coverage for naloxone, without prior authorization, deductibles, copayment, coinsurance or other cost-sharing requirements. Carriers must report the number of in-network providers who are licensed to prescribe MAT to the commissioner of insurance. The commissioner of insurance may also review and revise the essential health benefits package for MAT.
The bill further increases access to treatment by requiring managed care entities to provide care coordination for the full continuum of SUD treatment and recovery. It would prohibit denying access to MAT or SUD treatment services, including recovery services, to individuals who are participating in MAT provided by a recovery residence and entities contracting with the Office of Behavioral Health. Pharmacies would be able to receive an enhanced dispensing fee for the administration of all injectable medications for MAT.
The legislation would require an updated community assessment every two years on the sufficiency of SUD services in the community. With SUD impacting families in many different ways, the bill would also require a study of state child care and treatment to make findings and recommendations concerning gaps in family-centered SUD treatment. The study would also look to identify alternative payment structures for funding child care and children’s services alongside SUD treatment of a child’s parent.
Finally, the bill would increase access to treatment in rural communities by expanding the provider workforce. It increases funding to the Colorado Health Service Corps Fund for loan forgiveness and scholarships for individuals serving in areas with healthcare workforce shortages. It would also continue a grant writing program to help local communities access federal and state money to address the opioid epidemic, and requires the Office of Behavioral Health to implement a program for training and community outreach related to alcohol and SUD treatment.
The final bill advanced today seeks to increase access to recovery services. It increases funding for housing assistance by $4 million to $5 million total and extends the funding for an additional fiscal year. It would also appropriate $2 million to the Office of Behavioral Health in the Department of Human Services to expand the Individual Placement and Support Program, a program that helps people with mental illness and/or substance use disorders find and keep jobs. The bill supports recovery community organizations by appropriating $3.5 million to create the Recovery Support Services Grant Program and appropriates $250,000 to the Department of Labor and Employment to support individuals in recovery by providing peer coaching.
The bill also seeks to help policymakers better understand the connection between prenatal substance exposure and health outcomes by authorizing a statewide perinatal substance use data linkage project. It would also modify the how determinations of child abuse, neglect, or dependency are determined in situations involving alcohol or substance exposure.
Finally, the bill would continue the Opioid and Other Substance Use Disorders Study Committee for four additional years, meeting every other year beginning in 2021. It would require the State Substance Abuse Trend and Response Task Force to bring stakeholders together to review progress on bills introduced by the opioid committee and passed by the General Assembly and to generate policy recommendations. Furthermore, it would require the Center for Research into Substance Use Disorder Prevention, Treatment and Recovery Support Strategies to conduct a comprehensive study of Colorado’s SUD treatment and recovery services to inform a state plan for the delivery of services for individuals at risk of relapse.
Brief, comprehensive summaries of the legislation advanced today can be found here.