Bill Text: IA HF208 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to substance use disorder prevention and treatment, including creating an excise tax on the gross receipts of certain controlled substances sold at wholesale and an opioid abuse prevention and treatment fund, making appropriations, and providing penalties.
Spectrum: Partisan Bill (Democrat 9-0)
Status: (Introduced - Dead) 2019-02-04 - Introduced, referred to Human Resources. H.J. 200. [HF208 Detail]
Download: Iowa-2019-HF208-Introduced.html
House
File
208
-
Introduced
HOUSE
FILE
208
BY
ISENHART
,
STAED
,
BROWN-POWERS
,
ABDUL-SAMAD
,
KRESSIG
,
JACOBY
,
WOLFE
,
FORBES
,
and
RUNNING-MARQUARDT
A
BILL
FOR
An
Act
relating
to
substance
use
disorder
prevention
and
1
treatment,
including
creating
an
excise
tax
on
the
gross
2
receipts
of
certain
controlled
substances
sold
at
wholesale
3
and
an
opioid
abuse
prevention
and
treatment
fund,
making
4
appropriations,
and
providing
penalties.
5
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
6
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Section
1.
NEW
SECTION
.
124.309
Prescriptions
for
opioids
1
——
physician-patient
contracts.
2
1.
The
boards
of
medicine,
dentistry,
and
nursing
shall
3
adopt
rules
requiring
a
practitioner
to
furnish,
and
a
4
practitioner
and
patient
to
sign,
a
contract
regarding
the
5
risks
and
responsibilities
associated
with
opioid
use
prior
to
6
a
practitioner
issuing
a
prescription
for
more
than
a
seven-day
7
supply
of
an
opioid
to
a
patient
and
prior
to
issuing
any
8
additional
opioid
prescriptions
to
the
patient.
9
2.
The
form
and
content
of
a
contract
under
this
section
10
shall
be
determined
by
the
board
of
medicine
but
shall
be
based
11
upon
evidence
regarding
the
responsible
prescribing
of
opioids.
12
Sec.
2.
NEW
SECTION
.
135.192
Opioid
abuse
prevention
and
13
treatment
fund.
14
1.
An
opioid
abuse
prevention
and
treatment
fund
is
created
15
in
the
state
treasury
under
the
control
of
the
department.
16
The
fund
is
established
to
expand
treatment
for
and
access
17
to
treatment
for
opioid
use
disorders
and
to
assist
opioid
18
drug
abuse
prevention
and
treatment
programs
in
the
state
19
including
but
not
limited
to
medication-assisted
treatment
20
programs
that
provide
appropriate
holistic
services
and
21
treatment
programs
licensed
by
the
department,
in
accordance
22
with
programs
sponsored
by
community
organizations,
programs
23
that
provide
emergency
responders
with
affordable
access
24
to
opioid
antagonists,
and
programs
that
assist
in
paying
25
treatment
costs
for
individuals
who
are
ineligible
for
Medicaid
26
services
or
private
insurance
coverage.
The
fund
shall
also
27
provide
support
for
the
expansion
of
substance
abuse
and
pain
28
management
curricula
at
the
university
of
Iowa
college
of
29
medicine,
evidence-based
public
health
research
on
nonnarcotic
30
pain
treatment
and
management
alternatives,
and
expanded
mental
31
health
and
substance
abuse
education
and
training
for
emergency
32
medical
care
providers
as
defined
in
section
147A.1.
33
2.
Distribution
of
moneys
from
the
opioid
abuse
prevention
34
and
treatment
program
shall
be
made
to
eligible
applicants
in
35
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the
following
order
of
priority:
1
a.
A
public
entity,
including
but
not
limited
to
a
state,
2
county,
or
local
community
health
clinic
and
federally
3
qualified
health
center,
or
a
public
health
agency,
as
defined
4
in
section
135D.2,
that
provides
opioid
use
disorder
treatment.
5
b.
A
nonpublic
entity
that,
in
addition
to
opioid
use
6
disorder
treatment
services,
provides
required
primary
health
7
services
as
described
in
42
U.S.C.
§254b(b)(1)(A).
8
c.
A
nonpublic
entity
that
provides
opioid
use
disorder
9
treatment
but
does
not
provide
required
primary
health
services
10
as
described
in
42
U.S.C.
§254b(b)(1)(A).
11
3.
The
fund
shall
consist
of
all
moneys
deposited
in
the
12
fund
pursuant
to
section
423H.4
and
any
other
moneys
available
13
to,
obtained,
or
accepted
by
the
department
for
placement
in
14
the
fund.
Moneys
in
the
fund
are
not
subject
to
section
8.33.
15
Notwithstanding
section
12C.7,
interest
or
earnings
on
moneys
16
in
the
fund
shall
be
credited
to
the
fund.
17
Sec.
3.
NEW
SECTION
.
135.193
Opioid
abuse
prevention
and
18
treatment
workgroup.
19
1.
An
opioid
abuse
prevention
and
treatment
workgroup
shall
20
be
established
by
the
state
board
of
health.
The
workgroup
21
shall
be
composed
of
nine
members
appointed
by
the
governor
22
based
on
recommendations
by
the
department,
including
the
23
following:
24
a.
One
physician
licensed
under
chapter
148.
25
b.
One
pharmacist
licensed
under
chapter
155A.
26
c.
One
social
worker
licensed
under
chapter
154C.
27
d.
One
advanced
registered
nurse
practitioner
licensed
under
28
chapter
152.
29
e.
One
representative
of
a
county
board
of
health.
30
f.
One
representatives
of
a
substance
abuse
treatment
31
program
licensed
under
chapter
125.
32
g.
One
person
who
has
been
treated
for
and
has
recovered
33
from
opioid
abuse.
34
h.
Two
persons
who
are
not
licensed
to
practice
medicine,
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pharmacy,
social
work,
or
nursing
who
shall
represent
the
1
general
public.
2
2.
The
workgroup
shall
do
all
of
the
following:
3
a.
Promote
meetings
and
programs
for
the
discussion
of
4
methods
to
reduce
opioid
abuse
and
disseminate
information
5
in
cooperation
with
any
other
department,
agency,
or
other
6
governmental
or
nongovernmental
entity
on
the
prevention,
7
evaluation,
care,
treatment,
and
rehabilitation
of
persons
8
affected
by
opioid
abuse.
9
b.
Study
and
review
current
prevention,
evaluation,
care,
10
treatment,
and
rehabilitation
programs
and
strategies
and
11
recommend
appropriate
preparation,
training,
retraining,
and
12
distribution
of
personnel
and
resources
in
the
provision
of
13
services
to
persons
with
opioid
abuse
issues
through
treatment
14
programs
licensed
in
accordance
with
the
administrative
rules
15
of
the
department.
16
c.
Make
recommendations
to
the
department
to
expend
moneys
17
deposited
in
the
opioid
abuse
prevention
and
treatment
fund
18
created
in
section
135.192
to
carry
out
the
recommendations
19
of
the
workgroup
in
accordance
with
the
purposes
of
section
20
135.192,
subject
to
the
approval
of
the
department.
21
d.
Meet
at
least
quarterly.
22
e.
Make
recommendations
regarding
approval
by
the
state
23
board
of
health
of
administrative
rules
for
adoption
by
the
24
department
pursuant
to
chapter
17A.
25
3.
The
department
may
receive
gifts,
grants,
or
donations
26
made
for
any
of
the
purposes
of
the
workgroup’s
duties
and
27
disburse
and
administer
them
in
accordance
with
their
terms.
28
Sec.
4.
NEW
SECTION
.
135.194
Substance
abuse
treatment
29
programs.
30
1.
The
general
assembly
declares
that
it
is
the
public
31
policy
of
the
state
to
increase
the
percentage
of
people
32
receiving
treatment
for
substance
use
disorders
from
ten
33
percent
to
eighty
percent
and
to
ensure
that
all
effective
34
evidence-based
substance
use
disorder
treatments
are
covered
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by
the
authorization
and
payment
policies
of
all
public
and
1
private
payers.
2
2.
The
department,
in
consultation
with
the
Iowa
poison
3
control
center
and
the
Iowa
health
care
collaborative,
shall
4
develop
addiction,
addiction
treatment,
overdose,
and
overdose
5
death
surveillance
metrics,
standards,
and
requirements
for
6
data
collected
through
county
boards
of
health.
7
Sec.
5.
NEW
SECTION
.
137.105A
County
boards
of
health
——
8
opioid
epidemic
response.
9
Each
county
board,
in
cooperation
with
a
mental
health
and
10
disability
services
region
formed
in
accordance
with
section
11
331.389
and
substance
abuse
programs
licensed
pursuant
to
12
chapter
125,
shall
include
opioid
abuse
and
substance
use
13
disorder
treatment
in
each
community
health
needs
assessment
14
and
each
county
health
improvement
plan
shall
include
15
provisions
related
to
prevention,
harm
reduction,
and
treatment
16
associated
with
substance
use
disorders.
17
Sec.
6.
NEW
SECTION
.
155A.28A
Labeling
and
packaging
of
18
opioids.
19
Beginning
January
1,
2020,
any
packaging,
including
20
unit
dose
packaging,
of
an
opioid
that
is
prescribed
by
a
21
practitioner
or
directly
dispensed
by
a
pharmacist
and
that
22
is
not
for
immediate
administration
to
an
ultimate
user
shall
23
contain
a
label
including
information
about
the
risks
of
opioid
24
use
and
abuse
and
the
risks
of
addiction
and
overdose
pursuant
25
to
rules
of
the
board.
26
Sec.
7.
NEW
SECTION
.
272C.2D
Continuing
education
minimum
27
requirements
——
emergency
physicians.
28
The
board
of
medicine
shall
adopt
rules
requiring
emergency
29
physicians
to
receive
training
on
mental
illness
and
substance
30
use
disorders
as
a
condition
of
license
renewal.
31
Sec.
8.
Section
356.5,
Code
2019,
is
amended
by
adding
the
32
following
new
subsection:
33
NEW
SUBSECTION
.
7.
Ensure
that
each
prisoner
currently
34
receiving
medication-assisted
treatment
for
a
substance
use
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disorder
under
the
direction
of
a
licensed
health
care
provider
1
shall
continue
to
receive
such
treatment
while
the
prisoner
is
2
confined
in
jail.
3
Sec.
9.
NEW
SECTION
.
423H.1
Definitions.
4
1.
For
purposes
of
this
chapter,
unless
the
context
5
otherwise
requires:
6
a.
“Gross
receipts”
means
the
total
revenues
received
from
7
the
wholesale
sale
of
schedule
II
controlled
substances
to
8
practitioners
in
this
state.
9
b.
“Practitioner”
means
the
same
as
defined
in
section
10
124.101.
11
c.
“Schedule
II
controlled
substance”
means
a
controlled
12
substance
listed
in
the
schedule
provided
in
section
124.206.
13
d.
“Wholesaler”
means
a
person
operating
or
maintaining,
14
either
within
or
outside
this
state,
a
wholesale
distribution
15
center,
wholesale
business,
or
any
other
business
in
which
16
prescription
drugs
or
devices,
medicinal
chemicals,
medicines,
17
or
poisons
are
sold,
dispensed,
stocked,
exposed,
distributed
18
from,
or
offered
for
sale
at
wholesale
in
this
state.
19
“Wholesaler”
does
not
include
those
wholesalers
who
sell
only
20
proprietary
or
over-the-counter
medicines.
“Wholesaler”
also
21
does
not
include
a
commercial
carrier
that
temporarily
stores
22
prescription
drugs
or
devices,
medicinal
chemicals,
medicines,
23
or
poisons
while
in
transit.
24
2.
All
other
words
and
phrases
used
in
this
chapter
and
25
defined
in
section
423.1
have
the
meaning
given
them
by
section
26
423.1
for
purposes
of
this
chapter.
27
Sec.
10.
NEW
SECTION
.
423H.2
Tax
imposed.
28
A
tax
of
five
percent
is
imposed
on
the
gross
receipts
of
29
a
schedule
II
controlled
substance
sold
at
wholesale
to
a
30
practitioner
in
this
state.
The
tax
imposed
under
this
section
31
shall
be
collected
and
paid
over
to
the
department
by
the
32
wholesaler.
33
Sec.
11.
NEW
SECTION
.
423H.3
Administration
by
director.
34
1.
The
director
of
revenue
shall
administer
the
excise
tax
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on
the
gross
receipts
of
schedule
II
controlled
substances
as
1
nearly
as
possible
in
conjunction
with
the
administration
of
2
the
state
sales
and
use
tax
law,
except
that
portion
of
the
law
3
that
implements
the
streamlined
sales
and
use
tax
agreement.
4
The
director
shall
provide
appropriate
forms,
or
provide
on
the
5
regular
state
tax
forms,
for
reporting
tax
liability
pursuant
6
to
this
chapter.
7
2.
The
director
may
require
all
wholesalers
subject
to
tax
8
liability
under
this
chapter
to
register
with
the
department.
9
The
director
may
also
require
a
tax
permit
applicable
only
to
10
this
chapter
for
any
wholesaler
not
collecting
taxes
under
11
chapter
423.
12
3.
Section
422.25,
subsection
4,
sections
422.30,
422.67,
13
and
422.68,
section
422.69,
subsection
1,
sections
422.70,
14
422.71,
422.72,
422.74,
and
422.75,
section
423.14,
subsection
15
1,
and
sections
423.23,
423.24,
423.25,
423.31
through
16
423.35,
423.37
through
423.42,
and
423.47,
consistent
with
17
the
provisions
of
this
chapter,
shall
apply
with
respect
to
18
the
tax
authorized
under
this
chapter,
in
the
same
manner
19
and
with
the
same
effect
as
if
the
excise
tax
on
the
gross
20
receipts
of
schedule
II
controlled
substances
by
a
wholesaler
21
was
a
retail
sales
tax
within
the
meaning
of
those
provisions.
22
Notwithstanding
this
subsection,
the
director
shall
provide
for
23
quarterly
filing
of
returns
and
for
other
than
quarterly
filing
24
of
returns
both
as
prescribed
in
section
423.31.
All
taxes
25
collected
under
this
chapter
by
a
wholesaler
are
deemed
to
be
26
held
in
trust
for
the
state
of
Iowa.
27
4.
The
director
of
revenue
may
adopt
rules,
not
28
inconsistent
with
this
chapter,
necessary
and
advisable
for
its
29
administration
and
enforcement.
30
Sec.
12.
NEW
SECTION
.
423H.4
Deposit
of
revenues.
31
1.
All
moneys
received
and
all
refunds
shall
be
deposited
in
32
or
withdrawn
from
the
general
fund
of
the
state.
33
2.
Subsequent
to
the
deposit
in
the
general
fund
of
the
34
state,
the
department
shall
transfer
the
revenues
collected
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under
this
chapter
to
the
opioid
abuse
prevention
and
treatment
1
fund
created
in
section
135.192.
2
Sec.
13.
NEW
SECTION
.
423H.5
Violation
——
enforcement.
3
1.
A
wholesaler
who
violates
this
chapter
is
guilty
of
a
4
fraudulent
practice.
5
2.
The
director
may
designate
employees
to
administer
6
and
enforce
the
provisions
of
this
chapter,
including
7
the
collection
of
taxes
imposed
by
this
chapter.
In
the
8
enforcement
of
this
chapter,
the
director
may
request
aid
from
9
the
attorney
general,
the
special
agents
of
the
state,
any
10
county
attorney,
or
any
peace
officer.
11
Sec.
14.
SUBSTANCE
USE
DISORDER
TREATMENT
——
INSURANCE
12
COVERAGE.
The
insurance
division
of
the
department
of
commerce
13
shall
prepare
a
comprehensive
report
on
insurance
coverage
14
and
payment
policies
for
services
related
to
the
treatment
of
15
substance
use
disorders
by
commercial
insurance
companies
and
16
self-funded
plans,
as
well
as
data
on
current
utilization
and
17
expenditures
associated
with
such
benefit
plans.
The
report
18
shall
be
submitted
to
the
general
assembly
by
January
1,
2020.
19
Sec.
15.
OPIOIDS
——
USAGE
——
SUBSTANCE
USE
TREATMENT.
20
1.
The
department
of
administrative
services
shall,
in
21
cooperation
with
any
health
insurance
plans
or
health
plan
22
administrators
of
benefits
extended
to
state
employees,
create
23
a
model
benefit
plan
designed
to
incentivize
or
otherwise
24
promote
the
effective,
evidence-based
prescription
and
25
use
of
opioids
to
members
receiving
benefits
through
state
26
plans,
document
the
current
use
of
benefits
for
substance
27
use
disorders,
identify
gaps
or
unnecessary
restrictions
in
28
coverage,
and
expand
access
to
evidence-based
treatments
and
29
therapies,
including
nonpharmacological
treatments.
30
2.
The
department
of
human
services
and
the
Iowa
31
Medicaid
enterprise
shall,
in
cooperation
with
managed
care
32
organizations,
design
benefit
plans
to
incentivize
or
otherwise
33
promote
the
effective,
evidence-based
prescription
and
use
34
of
opioids
to
members
receiving
benefits
through
managed
35
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care
organizations,
document
the
current
use
of
benefits
1
for
substance
use
disorders,
identify
gaps
or
unnecessary
2
restrictions
in
coverage,
and
expand
access
to
evidence-based
3
treatment
and
therapies,
including
nonpharmacological
4
treatments,
by
application
for
a
Medicaid
waiver
if
necessary.
5
Sec.
16.
PROFESSIONAL
LICENSING
BOARDS
——
SUBSTANCE
6
USE
TREATMENT
PROGRAMS.
Each
professional
licensing
board
7
designated
in
section
147.13
shall
consider
the
adoption
of
8
a
program
modeled
after
the
Iowa
nurse
assistance
program
9
and
the
Iowa
physician
health
program
for
the
identification
10
and
treatment
of
licensees
who
may
be
at
risk
for
license
11
discipline
due
to
a
substance
use
disorder.
12
Sec.
17.
SUBSTANCE
USE
DISORDERS
——
RECOVERY
HIGH
13
SCHOOLS.
The
department
of
education
shall,
in
collaboration
14
with
the
department
of
public
health
and
the
department
15
of
human
services,
make
recommendations
regarding
the
16
establishment
of
one
or
more
recovery
high
schools
in
Iowa
17
designed
for
the
education
of
students
in
recovery
from
18
substance
use
disorders
or
dependency
or
co-occurring
19
disorders
such
as
anxiety,
depression,
and
attention
deficit
20
hyperactivity
disorder.
Such
schools
shall
meet
state
21
requirements
for
awarding
a
secondary
school
diploma
and
22
support
students
engaged
in
a
program
of
recovery.
The
23
department
of
education
shall
submit
its
recommendations
to
the
24
governor
and
the
general
assembly
by
November
1,
2019.
25
Sec.
18.
OPIOID
ABUSE
PREVENTION
AND
TREATMENT
FUND
——
26
APPROPRIATION.
There
is
appropriated
from
the
opioid
abuse
27
prevention
and
treatment
fund
created
in
section
135.192,
as
28
enacted
in
this
Act,
to
the
department
of
public
health
for
the
29
fiscal
year
beginning
July
1,
2019,
and
ending
June
30,
2020,
30
the
following
amounts,
or
so
much
thereof
as
is
necessary,
to
31
be
used
for
the
purposes
designated:
32
1.
For
contracting
with
the
Iowa
health
care
collaborative
33
to
develop
and
pilot
protocols
for
the
treatment
of
emergency
34
room
patients
experiencing
opioid
or
heroin
overdoses,
only
to
35
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the
extent
that
funding
is
matched
on
a
dollar-for-dollar
basis
1
from
private
or
public
sources
secured
by
the
Iowa
health
care
2
collaborative:
3
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
100,000
4
2.
For
the
psychiatric
residency
programs
involved
5
with
coordinated,
collaborative
care
at
newly
established,
6
community-based
behavioral
health
treatment
facilities
offering
7
residential
substance
use
disorder
treatment
for
twenty-nine
8
days
or
more:
9
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,000,000
10
Sec.
19.
OPIOID
ABUSE
PREVENTION
AND
TREATMENT
FUND
——
11
APPROPRIATION.
There
is
appropriated
from
the
opioid
abuse
12
prevention
and
treatment
fund
created
in
section
135.192,
as
13
enacted
in
this
Act,
to
the
state
board
of
regents
for
the
14
fiscal
year
beginning
July
1,
2019,
and
ending
June
30,
2020,
15
the
following
amounts,
or
so
much
thereof
as
is
necessary,
to
16
be
used
for
the
purposes
designated:
17
1.
For
the
funding
of
research
on
medication-assisted
18
treatment
for
substance
use
disorders
conducted
at
the
college
19
of
public
health
at
the
state
university
of
Iowa
to
identify
20
variability
in
outcomes,
demonstrate
efficacy
of
treatment,
and
21
refine
evidence-based
protocols:
22
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
500,000
23
2.
For
the
funding
of
research
and
education
conducted
at
24
the
Carver
college
of
medicine
at
the
state
university
of
Iowa
25
for
the
nonnarcotic
treatment
of
pain:
26
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
1,000,000
27
Sec.
20.
IMPLEMENTATION
OF
ACT.
Section
25B.2,
subsection
28
3,
shall
not
apply
to
this
Act.
29
EXPLANATION
30
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
31
the
explanation’s
substance
by
the
members
of
the
general
assembly.
32
This
bill
relates
to
the
treatment
of
substance
use
disorder
33
prevention
and
treatment,
including
creating
an
excise
tax
on
34
the
gross
receipts
of
certain
controlled
substances
sold
at
35
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wholesale
and
an
opioid
abuse
prevention
and
treatment
fund,
1
makes
appropriations,
and
provides
penalties.
2
The
bill
directs
the
board
of
medicine
to
adopt
rules
3
requiring
practitioners
to
present,
and
practitioners
4
and
patients
to
sign,
a
contract
regarding
the
risks
and
5
responsibilities
associated
with
opioid
use
prior
to
a
6
practitioner’s
prescription
of
a
course
of
treatment
including
7
opioids
to
a
patient
lasting
longer
than
seven
days
and
8
prior
to
issuing
a
second
or
subsequent
prescription
for
an
9
opioid
to
the
patient.
The
bill
requires
the
department
of
10
medicine
to
determine
the
form
and
content
of
the
contract
but
11
requires
that
the
contract
be
based
on
evidence
regarding
the
12
responsible
prescription
of
opioids.
13
The
bill
establishes
an
opioid
abuse
prevention
and
14
treatment
workgroup
within
the
department
of
public
health.
15
Under
the
bill,
the
membership
of
the
workgroup
includes
one
16
physician,
one
pharmacist,
one
social
worker,
one
advanced
17
registered
nurse
practitioner,
one
representative
of
a
county
18
board
of
health,
one
representative
of
a
substance
abuse
19
treatment
program
licensed
under
Code
chapter
125,
one
person
20
who
has
been
treated
for
and
has
recovered
from
opioid
abuse,
21
and
two
persons
who
are
not
licensed
to
practice
medicine,
22
pharmacy,
social
work,
or
nursing
who
shall
represent
the
23
general
public.
24
Under
the
bill,
the
workgroup
is
required
to
promote
25
meetings
and
programs
for
the
discussion
of
methods
to
reduce
26
opioid
abuse
and
disseminate
information
in
cooperation
27
with
any
other
department,
agency,
or
other
governmental
28
or
nongovernmental
entity
on
the
prevention,
evaluation,
29
care,
treatment,
and
rehabilitation
of
persons
affected
by
30
opioid
abuse.
The
bill
also
requires
the
workgroup
to
study
31
and
review
current
prevention,
evaluation,
care,
treatment,
32
and
rehabilitation
programs
and
strategies
and
recommend
33
appropriate
preparation,
training,
retraining,
and
distribution
34
of
personnel
and
resources
in
the
provision
of
services
to
35
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persons
with
opioid
abuse
issues
through
treatment
programs
1
licensed
in
accordance
with
the
administrative
rules
of
the
2
department.
3
The
bill
directs
the
workgroup
to
make
recommendations
to
4
the
department
to
expend
moneys
deposited
in
the
opioid
abuse
5
prevention
and
treatment
fund
to
carry
out
the
recommendations
6
of
the
workgroup
in
accordance
with
the
purposes
of
the
fund.
7
The
bill
also
directs
the
workgroup
to
make
recommendations
8
to
the
state
board
of
health
to
approve
administrative
rules
9
for
adoption
by
the
department
relating
to
the
workgroup’s
10
recommendations.
11
The
bill
provides
that
it
is
the
public
policy
of
the
12
state
of
Iowa
to
increase
the
percentage
of
people
receiving
13
treatment
for
substance
use
disorders
from
10
percent
to
14
80
percent
and
to
ensure
that
all
effective
evidence-based
15
treatments
for
substance
use
disorder
treatments
are
covered
16
by
the
authorization
and
payment
policies
of
all
public
and
17
private
payers.
The
bill
directs
the
department
of
public
18
health,
in
consultation
with
the
Iowa
poison
control
center
19
and
the
Iowa
health
care
collaborative,
to
develop
addiction,
20
addiction
treatment,
overdose,
and
overdose
death
surveillance
21
metrics,
standards,
and
requirements
for
data
collected
through
22
county
boards
of
health.
23
The
bill
requires
each
county
board
of
health,
in
24
cooperation
with
the
relevant
mental
health
and
disability
25
services
region
formed
in
accordance
with
Code
section
26
331.389
and
substance
abuse
programs
licensed
pursuant
to
Code
27
chapter
125,
to
include
information
regarding
opioid
abuse
and
28
substance
use
disorder
treatment
in
each
community
health
needs
29
assessment,
as
well
as
in
each
health
improvement
plan
when
the
30
county
board
of
health
deems
it
appropriate.
31
The
bill
directs
the
board
of
pharmacy
to
adopt
rules
32
requiring
that
packaging
for
certain
opioids
contain
a
label
33
including
information
regarding
the
dangers
of
opioid
use
and
34
abuse
and
the
risks
of
addiction
and
overdose
beginning
January
35
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1,
2020.
1
The
bill
directs
the
board
of
medicine
to
adopt
rules
2
requiring
emergency
physicians
to
receive
training
on
mental
3
illness
and
substance
use
disorders
as
a
condition
of
license
4
renewal.
5
The
bill
requires
the
appropriate
administrative
officer
6
of
each
county
jail
to
ensure
that
each
prisoner
currently
7
receiving
medication-assisted
treatment
for
a
substance
use
8
disorder
under
the
direction
of
a
licensed
health
care
provider
9
continue
to
receive
such
treatment
while
confined
in
jail.
10
The
bill
imposes
an
excise
tax
of
5
percent
on
the
gross
11
receipts
of
schedule
II
controlled
substances
sold
at
wholesale
12
to
practitioners
in
the
state.
The
tax
shall
be
collected
and
13
paid
over
to
the
department
of
revenue
by
the
wholesaler.
The
14
bill
contains
definitions
for
“gross
receipts”,
“practitioner”,
15
“schedule
II
controlled
substance”,
and
“wholesaler”.
16
The
bill
requires
the
director
of
revenue
to
administer
17
the
excise
tax
as
nearly
as
possible
in
conjunction
with
the
18
administration
of
the
state
sales
and
use
tax
laws,
and,
to
19
that
end,
the
bill
incorporates
by
reference
several
Code
20
sections
that
relate
to
general
tax
administration
and
the
21
sales
and
use
tax
laws.
22
The
bill
requires
excise
tax
revenues
collected
pursuant
to
23
the
bill
to
be
deposited
in
the
general
fund
of
the
state,
then
24
transferred
to
the
opioid
abuse
prevention
and
treatment
fund
25
created
in
the
bill.
The
fund
is
created
in
the
state
treasury
26
under
the
control
of
the
department
of
public
health.
The
fund
27
is
established
to
expand
treatment
for
and
access
to
treatment
28
for
opioid
use
disorders
and
to
assist
opioid
abuse
prevention
29
and
treatment
programs
in
the
state,
including
but
not
limited
30
to
programs
described
in
the
bill.
The
fund
consists
of
moneys
31
deposited
in
the
fund
from
the
revenues
of
the
excise
tax,
and
32
any
other
moneys
obtained
by
the
department
for
placement
in
33
the
fund.
Moneys
in
the
fund
are
not
subject
to
Code
section
34
8.33.
Notwithstanding
Code
section
12C.7,
interest
or
earnings
35
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on
moneys
in
the
fund
shall
be
credited
to
the
fund.
1
The
bill
directs
the
insurance
division
of
the
department
2
of
commerce
to
prepare
a
comprehensive
report
on
insurance
3
coverage
and
payment
policies
for
services
related
to
the
4
treatment
of
substance
use
disorders
by
commercial
insurance
5
companies
and
self-funded
plans,
as
well
as
data
on
current
6
utilization
and
expenditures
associated
with
such
benefit
7
plans.
The
bill
requires
this
report
to
be
submitted
to
the
8
general
assembly
by
March
1,
2020.
9
The
bill
directs
the
department
of
administrative
10
services,
in
cooperation
with
any
health
plans
or
health
11
plan
administrators
of
benefits
extended
to
state
employees,
12
to
create
a
model
benefit
plan
designed
to
incentivize
or
13
otherwise
promote
the
effective,
evidence-based
prescription
14
and
use
of
opioids
to
members
receiving
benefits
through
state
15
plans,
document
the
current
use
of
benefits
for
substance
16
use
disorders,
identify
gaps
or
unnecessary
restrictions
in
17
coverage,
and
expand
access
to
evidence-based
treatments
and
18
therapies,
including
nonpharmacological
treatments.
19
The
bill
directs
the
department
of
human
services
and
the
20
Iowa
Medicaid
enterprise,
in
cooperation
with
managed
care
21
organizations,
to
design
benefit
plans
to
incentivize
or
22
otherwise
promote
the
effective,
evidence-based
prescription
23
and
use
of
opioids
to
members
receiving
benefits
through
24
managed
care
organizations,
document
the
current
use
of
25
benefits
for
substance
use
disorders,
identify
gaps
or
26
unnecessary
restrictions
in
coverage,
and
expand
access
27
to
evidence-based
treatment
and
therapies,
including
28
nonpharmacological
treatments,
by
application
for
a
Medicaid
29
waiver
if
necessary.
30
The
bill
directs
the
department
of
education,
in
31
collaboration
with
the
department
of
public
health
and
the
32
department
of
human
services,
to
make
recommendations
to
the
33
governor
and
the
general
assembly
regarding
the
establishment
34
of
recovery
high
schools
for
the
education
of
students
35
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recovering
from
substance
abuse
and
related
disorders.
The
1
bill
requires
the
department
of
education
to
submit
its
2
recommendations
by
November
1,
2019.
3
The
bill
requires
each
professional
licensing
board
4
designated
in
Code
section
147.13
to
consider
the
adoption
5
of
a
program
modeled
after
the
Iowa
nurse
assistance
program
6
and
the
Iowa
physician
health
program
for
the
identification
7
and
treatment
of
licensees
who
may
be
at
risk
for
license
8
discipline
due
to
a
substance
use
disorder.
9
The
bill
appropriates
moneys
from
the
opioid
abuse
10
prevention
and
treatment
fund
to
the
department
of
public
11
health
for
contracting
with
the
Iowa
health
care
collaborative
12
to
develop
and
pilot
protocols
for
the
treatment
of
emergency
13
room
patients
experiencing
opioid
or
heroin
overdoses
14
contingent
on
the
Iowa
health
care
collaborative
receiving
15
dollar-for-dollar
matching
funding
from
private
or
public
16
sources
and
to
support
psychiatric
residency
programs
at
17
behavioral
health
treatment
facilities
offering
residential
18
substance
use
disorder
treatment
for
29
days
or
more.
The
19
bill
appropriates
moneys
from
the
opioid
abuse
prevention
and
20
treatment
fund
to
the
state
board
of
regents
for
FY
2019-2020
21
for
the
funding
of
research
conducted
at
the
college
of
public
22
health
at
the
state
university
of
Iowa
for
medication-assisted
23
treatment
of
substance
use
disorders
to
identify
variability
24
in
outcomes,
demonstrate
efficacy
of
treatment,
and
refine
25
evidence-based
protocols,
and
for
the
funding
of
research
and
26
education
conducted
at
the
Carver
college
of
medicine
at
the
27
state
university
of
Iowa
for
the
nonnarcotic
treatment
of
pain.
28
The
bill
may
include
a
state
mandate
as
defined
in
Code
29
section
25B.3.
The
bill
makes
inapplicable
Code
section
25B.2,
30
subsection
3,
which
would
relieve
a
political
subdivision
from
31
complying
with
a
state
mandate
if
funding
for
the
cost
of
32
the
state
mandate
is
not
provided
or
specified.
Therefore,
33
political
subdivisions
are
required
to
comply
with
any
state
34
mandate
included
in
the
bill.
35
-14-
LSB
1703YH
(3)
88
ss/rh
14/
14