An Act To Save Lives by Establishing the Low Barrier Opioid Treatment Response Program
Emergency preamble. Whereas, acts and resolves of the Legislature do not become effective until 90 days after adjournment unless enacted as emergencies; and
Whereas, opioid use disorder has reached epidemic proportions and threatens the lives and well-being of many Maine residents; and
Whereas, existing modalities and strategies for treatment of opioid use disorder are insufficient to end the epidemic of this disorder in Maine; and
Whereas, existing services are especially inadequate to address the impact of opioid use disorder on those experiencing or having experienced unstable housing, minimal or no employment, unreliable transportation, lack of insurance coverage, use of multiple substances, frequent hospitalization or prior overdoses; and
Whereas, failure to provide timely treatment to those most at risk of overdose death from opioid use leads to unnecessary loss of life and tragic dislocations of family life, while imposing substantial additional costs on the State due to related increases in incarcerations, hospital admissions and foster care for children affected by parental use of opioids; and
Whereas, a low barrier, rapid access treatment system delivered and coordinated by Maine's community health centers will provide an essential component of an improved array of responses to this epidemic; and
Whereas, in the judgment of the Legislature, these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety; now, therefore,
Sec. 1. 22 MRSA §259, sub-§1, ¶B, as amended by PL 2015, c. 267, Pt. JJJ, §1, is further amended to read:
Sec. 2. 22 MRSA §259, sub-§1, ¶C, as enacted by PL 2015, c. 267, Pt. JJJ, §1, is amended to read:
Sec. 3. 22 MRSA §259, sub-§1, ¶D is enacted to read:
Sec. 4. 22 MRSA §2354 is enacted to read:
§ 2354. Low Barrier Opioid Treatment Response Program
(1) Emergency department utilization and hospital admissions;
(2) Time elapsed between first patient encounter and delivery of services in the program; and
(3) Any other outcome and quality indicators that the department may specify after consultation with participating health centers, without duplicating other existing reporting requirements.
Sec. 5. Review of barriers. In conjunction with review of the reports provided pursuant to the Maine Revised Statutes, Title 22, section 2354, subsection 3, paragraph A, the Department of Health and Human Services and representatives of federally qualified health centers shall examine the extent to which existing structures for reimbursement and delivery of services by federally qualified health centers and other providers may hamper or facilitate access to opioid use disorder treatment and develop proposed changes to address identified barriers, reduce unnecessary costs and enhance coordination between other providers and federally qualified health centers in serving persons at risk of opioid overdose. The department, with input from providers, shall present a report with the findings under this section to the Joint Standing Committee on Health and Human Services no later than January 15, 2020. The report must address the effectiveness of the implementation of the pilot project established pursuant to Title 22, section 2354, subsection 3, the schedule for full implementation and the extent of any additional funding needed to accomplish full implementation.
Sec. 6. Appropriations and allocations. The following appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Community Health Center Investment Fund
Initiative: Provides funds to establish and implement a pilot project for a low barrier, rapid access treatment program for opiate use disorder and other substance use disorders to be delivered by Maine's federally qualified health centers under the department's direction and in collaboration with other health care providers, with funds in addition to Medicaid reimbursement distributed to health centers pursuant to the Maine Revised Statutes, Title 22, section 259.
| GENERAL FUND | 2019-20 | 2020-21 |
|
All Other
|
$400,000 | $400,000 |
 |
|
|
| GENERAL FUND TOTAL | $400,000 | $400,000 |
Emergency clause. In view of the emergency cited in the preamble, this legislation takes effect when approved.
SUMMARY
This bill requires the Department of Health and Human Services to establish the Low Barrier Opioid Treatment Response Program in Maine's federally qualified health centers to improve the availability of medication-assisted treatment and enhance the effectiveness and sustainability of acute care responses to persons in urgent need of treatment for substance use disorders, including opioid use disorder. The department is required to implement the program on a pilot basis initially and expand the program statewide after reviewing initial outcomes of the pilot.
It also directs the department and representatives of federally qualified health centers to examine the extent to which existing structures for reimbursement and delivery of services by federally qualified health centers and other providers may hamper or facilitate access to opioid use disorder treatment and develop proposed changes to address identified barriers, reduce unnecessary costs and enhance coordination between federally qualified health centers and other providers serving persons at risk of opioid overdose. The department is required to report findings on these subjects and on initial pilot implementation of the Low Barrier Opioid Treatment Response Program to the Joint Standing Committee on Health and Human Services no later than January 15, 2020.