Bill Text: NH SB239 | 2023 | Regular Session | Amended
Bill Title: Relative to the use of harm reduction services to treat alcohol and other substance misuse.
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Engrossed - Dead) 2023-09-05 - Division III Work Session: 10/03/2023 10:00 am Legislative Office Building 210-211 House Calendar 36 [SB239 Detail]
Download: New_Hampshire-2023-SB239-Amended.html
SB 239-FN - AS AMENDED BY THE HOUSE
03/16/2023 0867s
18May2023... 1754h
18May2023... 1861h
2023 SESSION
23-0971
05/04
SENATE BILL 239-FN
AN ACT relative to the use of harm reduction services to treat alcohol and other substance misuse.
SPONSORS: Sen. Watters, Dist 4; Sen. Soucy, Dist 18; Rep. Meuse, Rock. 37
COMMITTEE: Health and Human Services
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ANALYSIS
This bill defines alcohol and drug abuse prevention programs under RSA 12-J to include harm reduction services; establishes the doorways program to provide drug and alcohol abuse information, referral, and treatment services; incorporates recommendations of the governor's commission on alcohol and other drugs in the use of opioid abatement fund expenditures; expands the syringe services program; and addresses license renewal criteria for physicians and physician assistants.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
03/16/2023 0867s
18May2023... 1754h
18May2023... 1861h 23-0971
05/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Three
AN ACT relative to the use of harm reduction services to treat alcohol and other substance misuse.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Governor's Commission. Amend the introductory paragraph of RSA 12-J:1 and RSA 12-J:1, I to read as follows:
12-J:1 Commission Established; Membership; Terms. There is hereby established a commission which shall serve in an advisory capacity to the governor and the general court regarding the delivery of effective and coordinated alcohol and other drug [abuse] misuse prevention, including harm reduction, treatment, and recovery services throughout the state. The commission shall consist of the following members:
I. Seven public members, 2 of whom shall be professionals knowledgeable about alcohol and other drug [abuse] misuse prevention, including harm reduction, one of whom shall be appointed by the governor and one of whom shall be appointed by the senate president; 2 of whom shall be professionals knowledgeable about alcohol and other drug [abuse] misuse treatment, one of whom shall be appointed by the governor and one of whom shall be appointed by the speaker of the house of representatives; 2 of whom shall be public members who are not professionals within the alcohol and drug [addiction] misuse prevention and treatment system, one of whom shall be appointed by the senate president and one of whom shall be appointed by the speaker of the house of representatives; and one member in long-term recovery, appointed by the governor.
2 New Subparagraph; Members of Commission. Amend RSA 12-J:1, IV(a) by inserting after subparagraph (7) the following new subparagraph:
(8) The president of the New Hampshire Association of Chiefs of Police, or designee.
3 Organization of Commission; Task Force. Amend RSA 12-J:2, II(a)(1) to read as follows:
(1) Prevention and harm reduction.
4 Organization of Commission; Task Force. Amend RSA 12-J:2, II-a to read as follows:
II-a. The chairperson shall create a budget task force comprised of the individuals listed in RSA 12-J:1, III(a) to report biannually on financial expenditures for substance [abuse] misuse related work throughout state government as detailed in RSA 12-J:4, III and recommend budget policy priorities to the commission regarding the allocation of funding alcohol and other drug prevention, harm reduction, treatment, and recovery services across state agencies and throughout the state.
5 Commission Duties. Amend RSA 12-J:3, I and II to read as follows:
I. Develop and revise, as necessary, a statewide plan for the effective prevention of alcohol and other drug [abuse] misuse, including harm reduction, particularly among youth, and a comprehensive system of treatment and recovery services for individuals and families affected by alcohol and other drug [abuse] misuse. Nothing in RSA 12-J should be construed to limit care of chronic pain and hospice and palliative care patients, including use of the term “misuse” which shall be utilized, as intended, to broaden the scope of work across the substance use continuum of care. The statewide plan shall:
(a) Identify the causes, the nature and scope, and the impact of alcohol and other drug [abuse] misuse in New Hampshire.
(b) Identify and prioritize unmet needs for prevention, harm reduction, treatment, and recovery services.
(c) Recommend initiatives and policy considerations to the general court to reduce the incidence of alcohol and other drug [abuse] misuse in New Hampshire.
(d) Identify and quantify public and private resources available to support alcohol and other drug [abuse] misuse prevention, harm reduction, treatment, and recovery.
(e) Specify additional resources necessary to address unmet needs for prevention, harm reduction, treatment, and recovery.
(f) Specify evaluation and monitoring methodology.
II. Advise the governor and general court on and promote the development of effective community-based alcohol and other drug [abuse] misuse prevention and harm reduction strategies.
6 Meetings and Reports. Amend RSA 12-J:4, II to read as follows:
II. The commission shall submit an annual report to the governor, speaker of the house of representatives, president of the senate, chairpersons of the house and senate finance committees, chairperson of the house health, human services and elderly affairs committee, the chairperson of the senate health and human services committee, and the chairperson of the fiscal committee of the general court by October 1 of each year regarding the activities of the commission. The annual report shall:
(a) Identify alcohol and other drug [abuse] misuse prevention, harm reduction, treatment, and recovery services and programs provided by state departments and agencies or funded in whole or in part by state or federal funds;
(b) Indicate the progress made during the prior year toward the implementation of the statewide plan developed by the commission pursuant to RSA 12-J:3, I;
(c) Recommend any revisions to the statewide plan developed pursuant to RSA 12-J:3, I;
(d) Identify and prioritize unmet needs for prevention, harm reduction, treatment, and recovery;
(e) Indicate the progress, or lack thereof, in addressing the unmet needs;
(f) Recommend initiatives and/or policy considerations to the governor and the general court to address the unmet needs;
(g) Specify the resources and any legislation necessary to support existing programs for prevention, harm reduction, treatment, and recovery and to develop, implement, support, and evaluate the initiatives recommended by the commission;
(h) In even-numbered years the report may include specific recommendations for funds to be included in the next state biennial budget to support alcohol and other drug [abuse] misuse prevention, harm reduction, treatment, and recovery services and programs; and
(i) Incorporate the findings and recommendations of the report required under paragraph II-a and make specific findings and recommendations regarding public awareness, education, and legislation to address the dangers of synthetic drugs.
7 Meetings; Report. Amend the introductory paragraph of RSA 12-J:4, III(b) to read as follows:
(b) The commission shall submit a mid-year report to the governor, speaker of the house of representatives, president of the senate, chairpersons of the house and senate finance committees, chairperson of the house health, human services and elderly affairs committee, chairperson of the senate health and human services committee, and chairperson of the fiscal committee of the general court by March 1 of each year regarding the current state of drug [abuse] misuse, prevention, harm reduction, treatment, and recovery. The commission shall include a dashboard of the following, both in the interim and the annual report as required in RSA 12-J:4, II, that includes but is not limited to:
8 Report. Amend RSA 12-J:5, I(a)(1) to read as follows:
(1) Treatment programs, including harm reduction.
9 New Subparagraph; Opioid Abatement Advisory Commission Duties. Amend RSA 126-A:86, I(b) by inserting after subparagraph (16) the following new subparagraph:
(17) Upon consultation with the governor’s commission on alcohol and other drugs, provide funding for syringe service programs as authorized in RSA 318-B:43, including harm reduction supplies.
10 New Section; Substance Use Disorder Access Points. Amend RSA 126-A by inserting after section 98 the following new section:
126-A:99 Substance Use Disorder Access Points Established.
I. With the availability of sufficient federal funding, the department of health and human services shall establish and administer statewide access points for delivery of substance use services and supports. The access points shall provide information and referrals for screening and evaluation; treatment, including medications for substance use disorders; prevention, including naloxone; supports and services to assist in long-term recovery; and peer recovery support services.
II. The commissioner of the department of health and human services shall include the administration and operation of the access points in the department's report to the governor's commission on alcohol and other drug misuse prevention, treatment, and recovery under RSA 12-J:4, III.
III. The program shall be funded through the state opioid response grant from the Substance Abuse and Mental Health Services Administration. In addition, the department may accept funds from any source, including state appropriations, federal funds, and private gifts, grants, or donations to operate and sustain the access points.
11 Syringe Service Programs; Activities. Amend RSA 318-B:43, II(b) to read as follows:
(b) Coordinate and collaborate with other local agencies, including criminal justice, organizations, and providers involved in comprehensive prevention programs for people who inject drugs to minimize duplication of effort.
12 Syringe Service Programs; Activities. RSA 318-B:43, II by inserting after subparagraph (b) the following new subparagraph:
(b-1) Consult and inform municipal law enforcement agencies concerning syringe service program and harm reduction activities.
13 Syringe Service Programs; Funding. Amend RSA 318-B:43, III to read as follows:
III. Nothing in this section shall be construed to prohibit the department of health and human services from administering and/or disbursing federal or other funds to syringe service programs authorized under this section. [The use of state general funds shall be prohibited unless otherwise appropriated by the general court or if deemed necessary to control a disease outbreak pursuant to RSA 141-C:3.]
14 New Section; Controlled Drug Act; Syringe Service Programs. Amend RSA 318-B by inserting after section 43 the following new section:
318:43-a Syringe Service Programs; Authorized Activities and Funding Sources.
I. Notwithstanding any other law to the contrary, any person authorized under RSA 318-B:43 to operate a syringe service program may engage in eligible activities, as defined in paragraph IV.
II. State funds including, but not limited to, funds received by the state in the New Hampshire opioid litigation settlement may be used to support the activities of syringe service programs as permitted under this section and RSA 318-B:43.
III. No person shall be prohibited from using federal funds for eligible activities and syringe service programs as authorized in RSA 318-B:43, so long as the use of the federal funds is consistent with federal law and any rules governing use of the funds.
IV. In this section:
(a) “Drug checking” means the process of identifying, analyzing, or detecting the composition of a drug or the presence or composition of an unexpected substance within the drug.
(b) "Drug checking equipment” means equipment, products, or materials used, designed for use, or intended for use to perform drug checking, including materials and items used by the person operating the equipment or products to store, measure, or process samples for analysis. Drug checking equipment includes fentanyl test strips, other immunoassay drug testing strips, colorimetric reagents, spectrometers such as Fourier Transform Infrared and Raman spectrometers, and equipment that uses high-performance liquid chromatography, gas chromatography, mass spectrometry, and nuclear magnetic resonance techniques. Drug checking equipment does not include the substances being analyzed, drug packaging, or drug supplies.
(c) “Drug supplies” means hypodermic needles, syringes, preparation containers, cotton, filters, alcohol wipes, water, saline, tourniquets, disposal containers, wound care items, pipes, bubbles, snorting straws, pipe covers, and other items used in the consumption of drugs;
(d) “Eligible activities” means:
(1) Purchasing, obtaining, providing, transporting, distributing, using, or evaluating the use of drug checking equipment;
(2) Training, both initial and ongoing, about drug checking equipment, the process of drug checking, and the purpose of drug checking;
(3) Technical assistance concerning drug checking equipment, the process of drug checking, and the purpose of drug checking; and
(4) Providing drug supplies.
15 New Paragraph; Physicians Assistants. Amend RSA 328-D:3 by inserting after paragraph III the following new paragraph:
IV. Each applicant for the first renewal of a license under this chapter shall show proof of medical education on substance misuse disorder harm reduction including medication assisted treatment.
16 Physicians and Surgeons; Continuing Medical Education Requirement. Amend RSA 329:16-g to read as follows:
329:16-g Continuing Medical Education Requirement. As a condition of renewal of license, the board shall require each licensee to show proof at least at every biennial license renewal that the licensee has completed 100 hours of approved continuing medical education program within the preceding 2 years. For the purposes of this section, an approved continuing medical education program is a program designed to continue the education of the licensee in current developments, skills, procedures, or treatment in the licensee's field of practice, which has been certified by a national, state, or county medical society or college or university. All licensees required to register with the controlled drug prescription health and safety program shall complete 3 credit hours of approved online continuing education or pass an online examination in the area of pain management or addiction disorders. There shall be a complete audit of all continuing education credits annually by the New Hampshire Medical Society. Each licensee shall submit a continuing medical education report with copies of continuing medical education course certificates earned by the licensee and other documents which establish that continuing medical education course requirements have been met, using a form approved by the board. The complete audit shall include the collection, review, verification, and preservation of the continuing medical education documentation of each licensed physician and a report which records the credits awarded to each licensee during the 2-year period applicable to each licensee. The fee charged to licensees for continuing medical education verification shall not exceed 125 percent of the actual cost of providing the service. The New Hampshire Medical Society is prohibited from using any information from this program for promotional purposes or any other purpose not necessary for continuing education verification.
17 New Paragraph; Definition of Drug Misuse Added. Amend RSA 318-B:1 by inserting after paragraph XV the following new paragraph:
XV-a. "Drug misuse" refers to the use of a substance for a purpose that is not consistent with legal or medical guidelines.
18 New Paragraph; Governor's Commission on Alcohol and Drug Abuse Prevention, Treatment, and Recovery; Definition of Harm Reduction. Amend RSA 12-J:2 by inserting after paragraph IV the following new paragraph:
V. For the purposes of this chapter, RSA 126:A, RSA 318-B:93, RSA 328-D:3, and RSA 329:16-g, "harm reduction" is an approach that emphasizes engaging directly with people who use alcohol and other drugs to prevent overdose and infectious disease transmission, improve the physical, mental, and social function of those served, and offer low-threshold options for accessing substance use disorder treatment and other health care services. This shall be limited to the following:
(a) Connect individuals to overdose education, counseling, and referral to treatment for infectious diseases and substance use disorders.
(b) Distribute opioid overdose reversal medications (e.g., naloxone) to individuals at risk of overdose, or to those who might respond to an overdose, and provide training in overdose reversal and prevention.
(c) Make available substance test kits, including fentanyl test strips.
(d) Lessen harms associated with drug use and related behaviors that increase the risk of infectious diseases, including HIV, viral hepatitis, and bacterial and fungal infections; via referrals, syringe service programs, sharps disposal and medication disposal kits, wound care supplies medication lock boxes, education, testing, and prophylactic measures.
(e) Reduce infectious disease transmission among people who use drugs, including those who inject drugs by equipping them with accurate information and facilitating referral to resources.
(f) Reduce overdose deaths, promote linkages to care, facilitate co-location of services as part of a comprehensive, integrated approach.
(g) Provide education and public awareness programs to reduce stigma associated with substance use and co-occurring disorders.
(h) Promote a philosophy of hope and healing by utilizing those with lived experience of recovery in the management of harm reduction services, and connecting those who have expressed interest to treatment, peer support workers and other recovery support services.
19 Effective Date. This act shall take effect July 1, 2023.
23-0971
Amended 4/27/23
SB 239-FN- FISCAL NOTE
AS AMENDED BY THE SENATE (AMENDMENT #2023-0867s)
AN ACT relative to the use of harm reduction services to treat alcohol and other substance misuse.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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| Estimated Increase / (Decrease) | |||
STATE: | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
Appropriation | $0 | $0 | $0 | $0 |
Revenue | $0 | Indeterminable | Indeterminable | Indeterminable |
Expenditures | $0 | Indeterminable | Indeterminable | Indeterminable |
Funding Source: | [ ] General [ ] Education [ ] Highway [ X ] Other - Federal funds; gifts, grants, and donations | |||
METHODOLOGY:
This bill makes a variety of changes to state laws governing the state's alcohol and drug abuse response efforts. In part, the bill establishes syringe service programs under RSA 318-B, the Controlled Drug Act. The Department of Health and Human Services states that it expects to meet these responsibilities with existing resources. In addition, the bill requires the Department, "with the availability of sufficient federal funding," to establish and administer statewide access points for delivery of substance use services and reports. In addition to federal funds, the bill authorizes the department to accept funds from any source, including gifts, grants, and donations, in order to operate and sustain the access points. The bill does not appropriate general funds, nor does it require the Department to continue providing services in the absence of federal or other available funding sources.
AGENCIES CONTACTED:
Department of Health and Human Services
