Bill Text: IA HF726 | 2023-2024 | 90th General Assembly | Introduced

---

Bill Title: A bill for an act relating to services, treatment, research, education, and other activities relating to substance use disorder, mental health, and other conditions including opioid addiction and providing appropriations.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced - Dead) 2023-05-02 - Introduced, referred to Health and Human Services. H.J. 977. [HF726 Detail]

Download: Iowa-2023-HF726-Introduced.html

---

House File 726 - Introduced
HOUSE FILE 726
BY ISENHART and WILSON
A BILL FOR
An Act relating to services, treatment, research, education,
and other activities relating to substance use disorder,
mental health, and other conditions including opioid
addiction and providing appropriations.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
TLSB 1319YH (10) 90
pf/rn

H.F. 726
Section 1. IOWA BOARD OF PHARMACY —— REDUCTION OF OPIOID
MISUSE OR OVERUSE —— OPIOID SETTLEMENT.
1. There is appropriated from the opioid settlement fund
created in section 12.51 to the board of pharmacy for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
the following amounts, or so much thereof as is necessary, for
the purposes designated:
a. For the board of pharmacy to integrate the state’s
prescription monitoring program with health care providers’
electronic medical record or pharmacy dispensing systems to
allow a seamless connection between the prescription monitoring
program and those systems:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 60,000
b. For the board of pharmacy to implement the opioid and
naloxone education (ONE) program to provide resources to
pharmacists to educate patients regarding opioid misuse and
accidental overdose in order to decrease opioid prescription
rates and the related addiction and overdose deaths in the
state:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 450,000
2. If sufficient funds are not available through the opioid
settlement fund created in section 12.51, there is appropriated
from the Iowa coronavirus fiscal recovery fund created in
section 8.57G to the board of pharmacy for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, an amount
sufficient to provide the total amounts specified under
subsection 1 for the purposes designated under this section.
3. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until expended.
Sec. 2. INCREASED ACCESS TO NALOXONE —— OPIOID SETTLEMENT.
1. There is appropriated from the opioid settlement fund
created in section 12.51 for deposit in the opioid antagonist
medication fund created in section 135.190A for the fiscal year
-1-
LSB 1319YH (10) 90
pf/rn 1/ 24

H.F. 726
beginning July 1, 2023, and ending June 30, 2024, the following
amount, or so much thereof as is necessary, for the purpose
designated:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 250,000
2. The department of health and human services shall utilize
the moneys appropriated for deposit under this section for the
purchase, provision, maintenance, and replacement of opioid
antagonist medication administered by first responders to
persons experiencing an opioid-related overdose and to county
health departments for distribution to accredited schools and
institutions of higher education upon request.
3. If sufficient funds are not available through the
opioid settlement fund created in section 12.51, there is
appropriated from the Iowa coronavirus fiscal recovery fund
created in section 8.57G for deposit in the opioid antagonist
medication fund created in section 135.190A for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, for direct
appropriation to the department of health and human services
for the fiscal year beginning July 1, 2023, and ending June
30, 2024, an amount sufficient to provide the total amount
specified under subsection 1 for the purposes designated under
this section.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until expended.
Sec. 3. SUBSTANCE USE DISORDER RECOVERY HIGH SCHOOLS ——
OPIOID SETTLEMENT.
1. There is appropriated from the opioid settlement fund
created in section 12.51 to the department of health and human
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the following amount, or so much thereof as is
necessary, for the purpose designated:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,000
2. The department of health and human services, in
-2-
LSB 1319YH (10) 90
pf/rn 2/ 24

H.F. 726
collaboration with the department of education, shall study
and make recommendations regarding the establishment of one or
more public or private recovery high schools in Iowa designed
for the education of students in recovery from substance
use disorders or dependency or co-occurring disorders such
as anxiety, depression, or attention deficit hyperactivity
disorder. Such schools shall meet state requirements for
awarding a secondary school diploma and support students
engaged in a program of recovery. The department of health
and human services shall complete the study and submit its
recommendations to the governor and the general assembly by
November 1, 2023. The recommendations shall include provisions
for students to be eligible for education savings accounts
without regard to family financial capacity.
3. If sufficient funds are not available through the opioid
settlement fund created in section 12.51, there is appropriated
from the Iowa coronavirus fiscal recovery fund created in
section 8.57G for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, to the department of health and human
services an amount sufficient to provide the total amount
specified under subsection 1 for the purposes designated under
this section.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until expended.
Sec. 4. SUBSTANCE USE DISORDER —— PERSONS COMMITTED
TO CORRECTIONAL INSTITUTIONS AND COUNTY JAILS —— OPIOID
SETTLEMENT.
1. a. There is appropriated from the opioid settlement
fund created in section 12.51 to the department of health and
human services, annually, an amount sufficient to implement
this section.
b. The department of health and human services shall
transfer the amount appropriated under this section to the
-3-
LSB 1319YH (10) 90
pf/rn 3/ 24

H.F. 726
department of corrections for use in subsidizing the costs of
providing medication-assisted treatment to persons committed to
department of corrections institutions or county jails being
treated for opioid use disorder to purchase state-of-the-art
urine sample cups for use in the drug monitoring programs and
to fund efforts to fight hepatitis C, a potentially devastating
but curable disease spread through intravenous needle use of
opioids and other drugs in prison populations. If a county
is receiving opioid settlement funds to otherwise cover the
costs of medication-assisted treatment, the county shall match
the funding provided under this section on a dollar-for-dollar
basis.
2. If sufficient funds are not available through the
opioid settlement fund created in section 12.51, there is
appropriated from the Iowa coronavirus fiscal recovery fund
created in section 8.57G to the department of health and human
services for transfer to the department of corrections for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
an amount sufficient for the purposes designated under this
section.
3. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until expended.
Sec. 5. VETERANS COURTS —— OPIOID SETTLEMENT.
1. There is appropriated from the opioid settlement fund
created in section 12.51 to the department of veterans affairs
for the fiscal year beginning July 1, 2023, and ending June 30,
2024, the following amount, or so much thereof as is necessary,
for the purpose designated:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000
2. a. The moneys appropriated under this section shall
be transferred to the judicial branch to establish a veterans
court with a full-time outreach coordinator in each judicial
district to provide court services to veterans and to integrate
-4-
LSB 1319YH (10) 90
pf/rn 4/ 24

H.F. 726
court sanctions and incentives with substance use disorder
treatment, mental health treatment, and transitional services
for veterans in a judicially supervised setting.
b. It is the intent of the general assembly that the
jurisdiction of the veterans court may be exercised by any
district judge and by any district associate judge who is
designated by the chief judge of a judicial district as a judge
of the veterans court. The chief judge shall designate one
or more district judges and district associate judges to act
as judges of the veterans court for a judicial district. The
chief judge may designate a veterans court judge to preside in
more than one county.
3. If sufficient funds are not available through the opioid
settlement fund created in section 12.51, there is appropriated
from the Iowa coronavirus fiscal recovery fund created in
section 8.57G for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, to the department of veterans affairs for
transfer to the judicial branch an amount sufficient to provide
the total amount specified under subsection 1 for the purposes
designated under this section.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until expended.
Sec. 6. STATE EMPLOYEE BENEFITS —— SUBSTANCE USE DISORDER
BENEFITS —— USE OF OPIOIDS —— OPIOID SETTLEMENT.
1. a. There is appropriated from the opioid settlement fund
created in section 12.51 to the department of administrative
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the following amount, or so much thereof as is
necessary, for the purposes designated:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000
b. The department of administrative services, in cooperation
with any health insurance plans or health plan administrators
of benefits extended to state employees, shall utilize the
-5-
LSB 1319YH (10) 90
pf/rn 5/ 24

H.F. 726
funds appropriated in this subsection to create a model
benefit plan designed to incentivize or otherwise promote the
effective, evidence-based prescription and use of opioids to
members receiving benefits through state plans, document the
current use of benefits for substance use disorders, identify
gaps or unnecessary restrictions in coverage, and expand
access to evidence-based treatments and therapies, including
nonpharmacological treatments.
3. If sufficient funds are not available through the opioid
settlement fund created in section 12.51, there is appropriated
from the Iowa coronavirus fiscal recovery fund created in
section 8.57G to the department of administrative services
for the fiscal year beginning July 1, 2023, and ending June
30, 2024, an amount sufficient to provide the total amount
specified under subsection 1 for the purposes designated under
this section.
4. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until expended.
Sec. 7. MEDICAID RECIPIENTS —— SUBSTANCE USE DISORDER
BENEFITS —— USE OF OPIOIDS —— OPIOID SETTLEMENT.
1. a. There is appropriated from the opioid settlement fund
created in section 12.51 to the department of health and human
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the following amount, or so much thereof as is
necessary, for the purposes designated:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000
b. The department of health and human services, in
cooperation with Medicaid managed care organizations, shall
utilize the funds appropriated under this section to design
benefit plans to incentivize or otherwise promote the
effective, evidence-based prescription and use of opioids to
Medicaid recipients, document the current use of benefits
for substance use disorders, identify gaps or unnecessary
-6-
LSB 1319YH (10) 90
pf/rn 6/ 24

H.F. 726
restrictions in coverage, and expand access to evidence-based
treatment and therapies, including nonpharmacological
treatments. The department shall seek any Medicaid state plan
amendment or waiver necessary to administer this subsection.
2. If sufficient funds are not available through the opioid
settlement fund created in section 12.51, there is appropriated
from the Iowa coronavirus fiscal recovery fund created in
section 8.57G to the department of health and human services
for the fiscal year beginning July 1, 2023, and ending June
30, 2024, an amount sufficient to provide the total amount
specified under subsection 1 for the purposes designated under
this section.
3. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until expended.
Sec. 8. SUBSTANCE USE DISORDER AND OPIOID USE RESEARCH AND
EDUCATION —— OPIOID SETTLEMENT.
1. There is appropriated from the opioid settlement fund
created in section 12.51 to the following entities for the
fiscal year beginning July 1, 2023, and ending June 30, 2024,
the following amounts, or so much thereof as is necessary, for
the purposes designated:
a. To the department of health and human services:
(1) To contract with the Iowa health care collaborative to
do all of the following:
(a) To develop and pilot protocols for the treatment
of emergency room patients experiencing opioid or heroin
overdoses, including the provision of peer counseling and
advocacy:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000
(b) To reduce opioid exposure by educating doctors and
hospitals, especially in rural areas, to adopt the enhanced
recovery after surgery (ERAS) principles:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000
-7-
LSB 1319YH (10) 90
pf/rn 7/ 24

H.F. 726
(2) For the psychiatric residency programs involved
with coordinated, collaborative care at newly established,
community-based behavioral health treatment facilities offering
residential substance use disorder treatment for twenty-nine
days or more:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000
(3) To pilot the establishment and operation of three
community-based syringe service programs developed to provide
substance use prevention and response including linkages
to substance use disorder treatment; vaccination, testing,
and access to care for infectious diseases; and access to,
education regarding the safe utilization of, and proper
disposal of, fentanyl test strips, sterile syringes, and
injection equipment:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 450,000
The pilot program supported with the funding appropriated
under this subparagraph is conditioned on the implementation
of written agreements with local law enforcement agencies
and county attorneys to refrain from charging or prosecuting
program sponsors or participants for violations of section
124.414.
b. To the state board of regents:
(1) To fund research on medication-assisted treatment for
substance use disorders conducted at the university of Iowa
college of public health to identify variability in outcomes,
demonstrate efficacy of treatment, and refine evidence-based
protocols:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000
(2) To fund research and education conducted at the
university of Iowa Carver college of medicine for the
nonnarcotic treatment of pain:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000
c. To the department of public safety to establish and
direct a task force, in collaboration with the department of
health and human services, to make recommendations, based on
-8-
LSB 1319YH (10) 90
pf/rn 8/ 24

H.F. 726
public health principles, to restructure the response of the
state’s health and justice systems to illicit drug use and to
individuals suffering from substance use disorders:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000
The department of public safety shall submit a report of the
recommendations specified in this paragraph “c” to the governor
and the general assembly by July 1, 2024.
2. If sufficient funds are not available through the opioid
settlement fund created in section 12.51, there is appropriated
from the Iowa coronavirus fiscal recovery fund created in
section 8.57G to the entities specified in subsection 1,
for the fiscal year beginning July 1, 2023, and ending June
30, 2024, a sufficient amount to provide the total amounts
specified to the entities specified under subsection 1 for the
purposes designated under this section.
3. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until the close of the
succeeding fiscal year.
Sec. 9. PUBLIC HEALTH STRUCTURE AND INFRASTRUCTURE AND
SUBSTANCE USE DISORDER PREVENTION AND TREATMENT —— OPIOID
SETTLEMENT.
1. There is appropriated from the opioid settlement fund
created in section 12.51 to the university of Iowa college of
public health for the fiscal year beginning July 1, 2023, and
ending June 30, 2024, the following amounts, or so much thereof
as is necessary, for the purposes designated:
a. To conduct a comprehensive review and evaluation of
the existing public health structure and infrastructure in
Iowa, and to make recommendations for policy and funding to
improve capacity of the state and local communities to address
substance use and related issues:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 250,000
b. To coordinate increased, systematic efforts with local
-9-
LSB 1319YH (10) 90
pf/rn 9/ 24

H.F. 726
public health authorities to address the personal behaviors,
societal conditions, and lack of access to services that are
identified as risk factors for substance use disorders and
related co-occurring health conditions:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000
The amount appropriated may be used to provide grants to
county boards of health to implement evidence-based community
programming, policies, and collaborative projects with health
care providers to address the identified risk factors.
c. To provide paid internships for college of public
health students paired with local health departments to
support the development of local public health infrastructure,
conduct community health needs assessments, and assist in
the successful implementation of health improvement plans to
address substance use disorders and co-occurring brain health
and related conditions:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000
2. If sufficient funds are not available through the
opioid settlement fund created in section 12.51 to satisfy the
appropriations under subsection 1, there is appropriated from
the Iowa coronavirus fiscal recovery fund created in section
8.57G to the university of Iowa college of public health
for the fiscal year beginning July 1, 2023, and ending June
30, 2024, a sufficient amount to provide the total amounts
specified under subsection 1 for the purposes designated under
this section.
3. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until the close of the
succeeding fiscal year.
Sec. 10. SUBSTANCE USE DISORDER —— RECOVERY HOUSING ——
SUPPORTIVE SERVICES —— OPIOID SETTLEMENT.
1. a. There is appropriated from the opioid settlement fund
created in section 12.51 to the department of health and human
-10-
LSB 1319YH (10) 90
pf/rn 10/ 24

H.F. 726
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, the following amount, or so much thereof as is
necessary, for the purpose designated:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000
b. Moneys appropriated under this section shall be used
by the department, in collaboration with the Iowa finance
authority and community-based organizations, to engage in work
to increase the availability of recovery housing throughout the
state. The moneys shall be distributed as grants to recovery
housing providers whose application for assistance is in
accordance with a county community health needs assessment and
health improvement plan. If a county is otherwise receiving
opioid settlement funds, the county shall match the grant
funding provided under this section on a dollar-for-dollar
basis.
2. If sufficient funds are not available through the
opioid settlement fund created in section 12.51 to satisfy the
appropriations under subsection 1, there is appropriated from
the Iowa coronavirus fiscal recovery fund created in section
8.57G to the department of health and human services for the
fiscal year beginning July 1, 2023, and ending June 30, 2024, a
sufficient amount to provide the total amount specified under
subsection 1 for the purposes designated under this section.
3. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until the close of the
succeeding fiscal year.
Sec. 11. COMPREHENSIVE STUDY AND REPORT OF SUBSTANCE USE
DISORDER TREATMENT COVERAGE, UTILIZATION, AND EXPENDITURES ——
OPIOID SETTLEMENT.
1. a. There is appropriated from the opioid settlement
fund created in section 12.51 to the department of insurance
and financial services for the fiscal year beginning July 1,
2023, and ending June 30, 2024, the following amount, or so
-11-
LSB 1319YH (10) 90
pf/rn 11/ 24

H.F. 726
much thereof as is necessary, for the purposes designated:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000
b. The department of insurance and financial services shall
utilize the funds appropriated under this subsection to perform
a comprehensive study and prepare a comprehensive report on
insurance coverage and payment policies for services related
to the treatment of substance use disorders by commercial
insurance companies and self-funded plans, as well as data
on current utilization and expenditures associated with such
benefit plans. The report shall be submitted to the general
assembly by January 1, 2024.
2. If sufficient funds are not available through the opioid
settlement fund created in section 12.51, there is appropriated
from the Iowa coronavirus fiscal recovery fund created in
section 8.57G to the department of insurance and financial
services for the fiscal year beginning July 1, 2023, and ending
June 30, 2024, an amount sufficient to provide the total amount
specified under subsection 1 for the purposes designated under
this section.
3. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until the close of the
succeeding fiscal year.
Sec. 12. TASK FORCE ON AN INTEGRATED SYSTEM FOR PREVENTION,
TREATMENT, RECOVERY, AND RESOURCES —— APPROPRIATIONS.
1. a. The director of health and human services
shall convene a task force to research and develop policy
recommendations to implement an integrated behavioral health
and substance use disorder system and services structure that
blends funding in the areas of prevention, treatment, recovery,
and resources.
b. The task force shall include the director of health
and human services, appropriate departmental personnel, two
representatives of each mental health and disability services
-12-
LSB 1319YH (10) 90
pf/rn 12/ 24

H.F. 726
region appointed by the region, and three experts each
representing the fields of prevention, treatment, and recovery
selected by the department based on recommendations from the
mental health and disability services region chief executive
officers.
c. The task force shall submit a report to the governor
and the general assembly by June 30, 2024, including
recommendations that address all of the following:
(1) Prevention policy, including measures to ensure
consistent and sustained funding for prevention activities,
enhanced early intervention techniques, and a plan for
well-rounded prevention programs that address alcohol,
methamphetamine, opioid use, and co-occurring disorders.
(2) Treatment policy, built on the premise that
co-occurring issues are the norm rather than the exception,
and includes methods to deliver services through integrated
care models that regulate team-based care or close coordination
between providers, use of dual treatment planning methods,
standards for counselors to attain and practice with dual
certification, licensure solutions for dual programs and
practitioners, and effective treatment modalities for
short-term and long-term outcomes.
(3) Recovery policy, including practices to integrate
co-occurring approaches in mobile crisis response and other
crisis services, implementation of harm reduction practices,
integration of feasible medication strategies to support
mental health issues in alignment with substance use disorder
recovery, and incentive programs to support recovery efforts.
(4) Resource deployment policy including all of the
following:
(a) The combining and leveraging of state, regional,
and local partnerships to optimize opioid settlement funds
available to the state and counties.
(b) Allocation of federal substance abuse and mental health
services administration block grants for substance abuse
-13-
LSB 1319YH (10) 90
pf/rn 13/ 24

H.F. 726
prevention and treatment and community mental health services.
(c) Other related federal government and private funding
opportunities.
(5) Provisions for peer support workers consistent with
the guidance of the federal substance abuse and mental health
services administration’s bringing recovery supports to scale
technical assistance center strategy.
(6) Opportunities through the alignment of the department
of health and human services to integrate the fragmented
behavioral health and substance use disorder services systems
into a system of comprehensive, whole-person care, that
utilizes public funding more efficiently and increases the
return on investment through enhanced community health for all
Iowans.
2. There is appropriated from the opioid settlement fund
created in section 12.51 to the department of health and
human services, for task force support for the fiscal year
beginning July 1, 2023, and ending June 30, 2024, the following
amount, or so much thereof as is necessary, for the purposes
designated:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 150,000
The task force shall approve any contract for external
assistance to the task force.
3. a. There is appropriated from the opioid settlement
fund created in section 12.51 to the department of health and
human services, for the fiscal year beginning July 1, 2024, and
ending June 30, 2025, the following amount, or so much thereof
as is necessary for the purposes designated:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000,000
b. For dollar-for-dollar matching grants to mental health
and disability services regions to be used for long-term
residential treatment and recovery services for persons
diagnosed with one or more disorders including a substance use
disorder in accordance with the recommendations of the task
force convened under this section.
-14-
LSB 1319YH (10) 90
pf/rn 14/ 24

H.F. 726
c. Notwithstanding section 8.33, moneys appropriated in
this subsection that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for the purposes designated until expended.
Sec. 13. IOWA FINANCE AUTHORITY —— TRANSITIONAL HOUSING
FOR ELIGIBLE SERVICE MEMBERS. There is appropriated from the
opioid settlement fund established in section 12.51 to the
Iowa finance authority for the fiscal year beginning July 1,
2023, and ending June 30, 2024, the following amount, or so
much thereof as is necessary, to be used for the purposes
designated:
To provide grants, low-interest loans, and loan guarantees
to veteran-led nonprofit organizations:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,300,000
1. Amounts appropriated pursuant to this section shall be
distributed to veteran-led nonprofit organizations provided
that the organization meets all of the following conditions:
a. The funds will be used to purchase land, construct
housing, or furnish housing for the purpose of providing
transitional housing to homeless veterans.
b. The veterans receiving transitional housing benefits
pursuant to paragraph “a” are suffering from or are at risk of
opioid or other substance abuse disorder, post-traumatic stress
disorder, or another mental illness or life disruption as the
Iowa finance authority, in consultation with the department
of health and human services and the department of veterans
affairs, deems appropriate.
c. The funds are used as a part of a wraparound health
and social services program provided by or through the
organization.
2. Notwithstanding section 8.33, moneys appropriated in
this section that remain unencumbered or unobligated at the
close of the fiscal year shall not revert but shall remain
available for expenditure for the purposes designated until the
close of the succeeding fiscal year.
-15-
LSB 1319YH (10) 90
pf/rn 15/ 24

H.F. 726
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
This bill relates to services, treatment, research,
education, and other activities relating to substance use
disorders, mental health, and other conditions, including those
relating to opioids, and provides appropriations.
BOARD OF PHARMACY. The bill appropriates funds from the
opioid settlement fund created in Code section 12.51 to the
board of pharmacy for fiscal year 2023-2024 for the board of
pharmacy to integrate the state’s prescription monitoring
program with health care providers’ electronic medical record
or pharmacy dispensing systems to allow a seamless connection
between the prescription monitoring program and those systems;
and for the board of pharmacy to implement the opioid and
naloxone education (ONE) program to provide resources to
pharmacists to educate patients regarding opioid misuse and
accidental overdose in order to decrease opioid prescription
rates and the related addiction and overdose deaths in the
state. If sufficient funds are not available through the
opioid settlement fund to satisfy the appropriations, there is
appropriated from the Iowa coronavirus fiscal recovery fund
created in Code section 8.57G to the board of pharmacy for
fiscal year 2023-2024, an amount sufficient to provide the
total amounts specified for the purposes designated. Funds
appropriated shall not revert but shall remain available until
the close of the succeeding fiscal year.
ACCESS TO NALOXONE. The bill appropriates funds from the
opioid settlement fund for deposit in the opioid antagonist
medication fund created in Code section 135.190A for fiscal
year 2023-2024 to be used by the department of health and human
services (HHS) for the purchase, provision, maintenance, and
replacement of opioid antagonist medication administered by
first responders to persons experiencing an opioid-related
overdose and to county health departments for distribution to
-16-
LSB 1319YH (10) 90
pf/rn 16/ 24

H.F. 726
accredited schools and institutions of higher education upon
request. If sufficient funds are not available through the
opioid settlement fund to satisfy the appropriation, there
is appropriated from the Iowa coronavirus fiscal recovery
fund for fiscal year 2023-2024 for deposit in the opioid
antagonist medication fund an amount sufficient to provide the
total amount specified for the purposes designated. Funds
appropriated shall not revert but shall remain available until
the close of the succeeding fiscal year.
RECOVERY HIGH SCHOOLS. The bill appropriates funds from the
opioid settlement fund to HHS for fiscal year 2023-2024 to be
used by HHS in collaboration with the department of education
to study and make recommendations regarding the establishment
of one or more public or private recovery high schools in
Iowa designed for the education of students in recovery from
substance use disorders or dependency or co-occurring disorders
such as anxiety, depression, or attention deficit hyperactivity
disorder. The schools must meet state requirements for
awarding a secondary school diploma and support students
engaged in a program of recovery. The department of health
and human services shall complete the study and submit its
recommendations to the governor and the general assembly by
November 1, 2023. The recommendations shall include provisions
for students to be eligible for education savings accounts
without regard to family financial capacity. If sufficient
funds are not available through the opioid settlement fund to
satisfy the appropriation, there is appropriated from the Iowa
coronavirus fiscal recovery fund for fiscal year 2023-2024 to
HHS an amount sufficient to provide the total amount specified
for the purposes designated. Funds appropriated shall not
revert but shall remain available until the close of the
succeeding fiscal year.
CORRECTIONAL INSTITUTIONS AND COUNTY JAILS. The bill
appropriates funds from the opioid settlement fund to
HHS for fiscal year 2023-2024 for HHS to transfer to the
-17-
LSB 1319YH (10) 90
pf/rn 17/ 24

H.F. 726
department of corrections for use in subsidizing the costs of
providing medication-assisted treatment to persons confined
to correctional institutions or county jails being treated
for opioid use disorder, to purchase state-of-the-art urine
sample cups for use in the drug monitoring programs, and to
fund efforts to fight hepatitis C, a potentially devastating
but curable disease spread through intravenous needle use
of opioids and other drugs in prison populations. For
counties, the funding is subject to a dollar-to-dollar match of
county opioid settlement funds. If sufficient funds are not
available through the opioid settlement fund to satisfy the
appropriation, there is appropriated from the Iowa coronavirus
fiscal recovery fund to HHS for transfer to the department of
corrections for fiscal year 2023-2024 an amount sufficient to
provide the total amount specified for the purposes designated.
Funds appropriated shall not revert but shall remain available
until the close of the succeeding fiscal year.
VETERANS COURTS. The bill appropriates funds from the
opioid settlement fund to the department of veterans affairs
for fiscal year 2023-2024 to be transferred to the judicial
branch to establish a veterans court with a full-time outreach
coordinator in each judicial district to provide court services
to veterans and to integrate court sanctions and incentives
with substance use disorder treatment, mental health treatment,
and transitional services for veterans in a judicially
supervised setting. The jurisdiction of the veterans court
may be exercised by any district judge and by any district
associate judge who is designated by the chief judge of a
judicial district as a judge of the veterans court. The chief
judge shall designate one or more district judges and district
associate judges to act as judges of the veterans courts for a
judicial district. The chief judge may designate a veterans
court judge to preside in more than one county. If sufficient
funds are not available through the opioid settlement fund to
satisfy the appropriation, there is appropriated from the Iowa
-18-
LSB 1319YH (10) 90
pf/rn 18/ 24

H.F. 726
coronavirus fiscal recovery fund for fiscal year 2023-2024 to
the department of veterans affairs for transfer to the judicial
branch an amount sufficient to provide the total amount
specified for the purposes designated. Funds appropriated
shall not revert but shall remain available until the close of
the succeeding fiscal year.
STATE EMPLOYEE BENEFITS. The bill appropriates funds from
the opioid settlement fund to the department of administrative
services (DAS) for fiscal year 2023-2024 to be used by DAS
in cooperation with any health insurance plans or health
plan administrators of benefits extended to state employees
to create a model benefit plan designed to incentivize or
otherwise promote the effective, evidence-based prescription
and use of opioids to members receiving benefits through state
plans, document the current use of benefits for substance
use disorders, identify gaps or unnecessary restrictions in
coverage, and expand access to evidence-based treatments
and therapies, including nonpharmacological treatments.
If sufficient funds are not available through the opioid
settlement fund to satisfy the appropriation, there is
appropriated from the Iowa coronavirus fiscal recovery fund to
DAS for fiscal year 2023-2024 an amount sufficient to provide
the total amount specified for the purposes designated. Funds
appropriated shall not revert but shall remain available until
the close of the succeeding fiscal year.
MEDICAID RECIPIENTS. The bill appropriates funds from
the opioid settlement fund to HHS for fiscal year 2023-2024
to be used by HHS, in cooperation with Medicaid managed care
organizations, to design benefit plans to incentivize or
otherwise promote the effective, evidence-based prescription
and use of opioids to Medicaid recipients, document the
current use of benefits for substance use disorders, identify
gaps or unnecessary restrictions in coverage, and expand
access to evidence-based treatment and therapies, including
nonpharmacological treatments. The department of health and
-19-
LSB 1319YH (10) 90
pf/rn 19/ 24

H.F. 726
human services shall seek any Medicaid state plan amendment
or waiver necessary to administer this provision of the
bill. If sufficient funds are not available through the
opioid settlement fund to satisfy the appropriation, there is
appropriated from the Iowa coronavirus fiscal recovery fund to
HHS for fiscal year 2023-2024 an amount sufficient to provide
the total amount specified for the purposes designated. Funds
appropriated shall not revert but shall remain available until
the close of the succeeding fiscal year.
RESEARCH AND EDUCATION. The bill appropriates funds
from the opioid settlement fund to HHS, the state board
of regents, and the department of public safety. The
appropriation to HHS is to contract with the Iowa health
care collaborative to develop and pilot protocols for the
treatment of emergency room patients experiencing opioid or
heroin overdoses, including the provisions of peer counseling
and advocacy and to reduce opioid exposure by educating
doctors and hospitals, especially in rural areas, to adopt
the enhanced recovery after surgery (ERAS) principles; for
the psychiatric residency programs involved with coordinated,
collaborative care at newly established, community-based
behavioral health treatment facilities offering residential
substance use disorder treatment for 29 days or more; and to
pilot the establishment and operation of three community-based
syringe service programs, conditioned on the implementation
of written agreements with local law enforcement agencies
and county attorneys to refrain from charging or prosecuting
program sponsors or participants for violations of Code
section 124.414 (drug paraphernalia). The appropriation to
the state board of regents is to be used to fund research
on medication-assisted treatment for substance use disorders
conducted at the university of Iowa college of public health
to identify variability in outcomes, demonstrate efficacy of
treatment, and refine evidence-based protocols; and to fund
research and education conducted at the university of Iowa
-20-
LSB 1319YH (10) 90
pf/rn 20/ 24

H.F. 726
Carver college of medicine for the nonnarcotic treatment
of pain. The appropriation to the department of public
safety is to be used to establish and direct a task force,
in collaboration with HHS, to make recommendations, based on
public health principles, to restructure the response of the
state’s health and justice systems to illicit drug use and to
individuals suffering from substance use disorders, with a
report submitted to the governor and the general assembly by
July 1, 2024. If sufficient funds are not available through
the opioid settlement fund to satisfy the appropriations, there
is appropriated from the Iowa coronavirus fiscal recovery
fund created in section 8.57G, to the entities specified for
fiscal year 2023-2024, sufficient amounts to provide the total
amounts specified to the entities specified for the purposes
designated. Funds appropriated shall not revert but shall
remain available until the close of the succeeding fiscal year.
PUBLIC HEALTH STRUCTURE AND INFRASTRUCTURE. The bill
appropriates funds from the opioid settlement fund to the
university of Iowa college of public health for fiscal year
2023-2024 to conduct a comprehensive review and evaluation of
the existing public health structure and infrastructure in
Iowa, and to make recommendations for policy and funding to
improve capacity of the state and local communities to address
substance use and related issues; to coordinate increased,
systematic efforts with local public health authorities to
address the personal behaviors, societal conditions, and lack
of access to services that are identified as risk factors
for substance use disorders and related co-occurring health
conditions; and to provide paid internships for college of
public health students paired with local health departments to
support the development of local public health infrastructure,
conduct community health needs assessments, and assist in
the successful implementation of health improvement plans
to address substance use disorders and co-occurring brain
health and related conditions. If sufficient funds are not
-21-
LSB 1319YH (10) 90
pf/rn 21/ 24

H.F. 726
available through the opioid settlement fund to satisfy the
appropriations, there is appropriated from the Iowa coronavirus
fiscal recovery fund to the university of Iowa college of
public health for fiscal year 2023-2024 a sufficient amount
to provide the total amounts specified for the purposes
designated. Funds appropriated shall not revert but shall
remain available until the close of the succeeding fiscal year.
RECOVERY HOUSING. The bill appropriates funds from the
opioid settlement fund to HHS for fiscal year 2023-2024, to be
used by HHS, in collaboration with the Iowa finance authority
and community-based organizations, to engage in work to
increase the availability of recovery housing throughout the
state. The moneys shall be distributed as grants to recovery
housing providers whose application for assistance is in
accordance with a county community health needs assessment and
health improvement plan. A county otherwise receiving opioid
settlement funds shall match the grant funding provided on a
dollar-for-dollar basis. If sufficient funds are not available
through the opioid settlement to satisfy the appropriation,
there is appropriated from the Iowa coronavirus fiscal recovery
fund to HHS for fiscal year 2023-2024, a sufficient amount to
provide the total amount specified for the purposes designated.
Funds appropriated shall not revert but shall remain available
until the close of the succeeding fiscal year.
INSURANCE COVERAGE STUDY —— REPORT. The bill appropriates
funds from the opioid settlement fund to the department of
insurance and financial services, for fiscal year 2023-2024,
for the department of insurance and financial services to
perform a comprehensive study and prepare a comprehensive
report on insurance coverage and payment policies for services
related to the treatment of substance use disorders by
commercial insurance companies and self-funded plans, as well
as data on current utilization and expenditures associated
with such benefit plans. The report shall be submitted
to the general assembly by January 1, 2024. If sufficient
-22-
LSB 1319YH (10) 90
pf/rn 22/ 24

H.F. 726
funds are not available through the opioid settlement fund to
satisfy the appropriation, there is appropriated from the Iowa
coronavirus fiscal recovery fund to the division of insurance
of the department of commerce for fiscal year 2023-2024 an
amount sufficient to provide the total amount specified for the
purposes designated. Funds appropriated shall not revert but
shall remain available until the close of the succeeding fiscal
year.
INTEGRATED SYSTEM FOR PREVENTION, TREATMENT, RECOVERY, AND
RESOURCES. The bill requires the director of health and human
services to convene a task force to develop recommendations
regarding an integrated system for prevention, treatment,
recovery, and resources. The bill specifies the membership
of the task force, and requires the task force to submit a
report to the governor and the general assembly by June 30,
2024, specifying recommendations for an integrated system
that blends funding and provides an efficient system of
comprehensive, whole-person care. The bill appropriates
funding from the opioid settlement fund to support the task
force and provides that the task force shall approve any
contract for external assistance to the task force. The
bill appropriates funds from the opioid settlement fund to
the department of health and human services for FY 2024-2025
to provide for dollar-for-dollar matching grants to mental
health and disability services regions to be used for long-term
residential treatment and recovery services in accordance with
the recommendations of the task force. Moneys appropriated
shall not revert but shall remain available for the purposes
designated until the close of the succeeding fiscal year.
TRANSITIONAL HOUSING FOR HOMELESS VETERANS. The bill
relates to transitional housing for specified homeless
veterans.
The bill appropriates $4.3 million from the opioid
settlement fund to the Iowa finance authority (IFA) for FY
2023-2024 to provide grants, low-interest loans, and loan
-23-
LSB 1319YH (10) 90
pf/rn 23/ 24

H.F. 726
guarantees to veteran-led nonprofit organizations (VNO).
The bill makes the distribution of such moneys appropriated
to the IFA contingent on a VNO using the funds to purchase
land, construct housing, or furnish housing for the purpose of
providing transitional housing to homeless veterans; ensuring
the veterans receiving such transitional housing benefits are
suffering from or are at risk of opioid or other substance
abuse disorder, post-traumatic stress disorder, or another
mental illness or life disruption as the IFA, in consultation
with the department of health and human services and the
department of veterans affairs, deems appropriate; and that
the funds are used as a part of a wraparound health and social
services program provided by or through the VNO.
All moneys appropriated pursuant to this section of the bill
that remain unencumbered or unobligated at the close of the
fiscal year shall not revert but shall remain available for
expenditure for the purposes designated until the close of the
succeeding fiscal year.
-24-
LSB 1319YH (10) 90
pf/rn 24/ 24