Sec. 17a-674c. Opioid Settlement Fund. Establishment. Report. Spending of funds.
Sec. 17a-674d. Opioid Settlement Advisory Committee. Membership. Duties.
Sec. 17a-674h. Opioid Antagonist Bulk Purchase Fund. Report.
Sec. 17a-673c. Pilot program to prevent drug overdoses. Establishment of harm reduction centers in three municipalities. Funding. (a) As used in this section:
(1) “Harm reduction center” means a medical facility where a person with a substance use disorder may (A) receive substance use disorder and other mental health counseling, (B) use a test strip to test a substance for traces of fentanyl or xylazine, or traces of any other substance recognized by the Commissioner of Mental Health and Addiction Services as having a high risk of causing an overdose, (C) receive educational information regarding opioid antagonists, as defined in section 17a-714a, and the risks of contracting diseases from sharing hypodermic needles, (D) receive referrals to substance use disorder treatment services, and (E) receive access to basic support services, including, but not limited to, laundry machines, a bathroom, a shower and a place to rest; and
(2) “Test strip” means a product that a person may use to test any substance prior to injection, inhalation or ingestion of the substance to prevent accidental overdose by injection, inhalation or ingestion of the substance.
(b) Not later than July 1, 2027, the Department of Mental Health and Addiction Services, in consultation with the Department of Public Health, shall establish a pilot program to prevent drug overdoses through the establishment of harm reduction centers in three municipalities in the state selected by the Commissioner of Mental Health and Addiction Services, subject to the approval of the chief elected officials of each municipality selected by said commissioner. No harm reduction center established pursuant to this subsection shall be subject to regulation by the Department of Public Health until the termination of the pilot program.
(c) Each harm reduction center established pursuant to subsection (b) of this section shall (1) employ persons, including, but not limited to, licensed health care providers with experience treating persons with substance use disorders to provide substance use disorder or other mental health counseling and monitor persons utilizing the harm reduction center for the purpose of providing medical treatment to any person who experiences symptoms of an overdose, in a number determined sufficient by the Commissioner of Mental Health and Addiction Services, (2) provide persons with test strips at the request of such persons, and (3) provide referrals for substance use disorder or other mental health counseling or other mental health or medical treatment services that may be appropriate for persons utilizing the harm reduction center. A licensed health care provider's participation in the pilot program shall not be grounds for disciplinary action by the Department of Public Health pursuant to section 19a-17 or by any board or commission listed in subsection (b) of section 19a-14.
(d) The Commissioner of Mental Health and Addiction Services may request a disbursement of funds from the Opioid Settlement Fund established pursuant to section 17a-674c, in whole or in part, the establishment and administration of the pilot program.
(P.A. 23-97, S. 3.)
History: P.A. 23-97 effective June 28, 2023.
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Sec. 17a-674c. Opioid Settlement Fund. Establishment. Report. Spending of funds. (a) There is established an Opioid Settlement Fund which shall be a separate nonlapsing fund administered by the committee.
(b) Any moneys intended to address opioid use, related disorders or the impact of the opioid epidemic that are received by the state from any judgment, consent decree or settlement paid by any defendant, which is finalized on or after July 1, 2021, related to the production, distribution, dispensing and other activities related to opioids shall be deposited into the fund. Moneys remaining in the fund at the end of a fiscal year shall not revert to the General Fund.
(c) Notwithstanding any provision of subsection (b) of this section, if the commissioner and the Attorney General certify that the purposes of such judgment, consent decree or settlement are inconsistent with the intent of the provisions of this section and sections 17a-674d to 17a-674f, inclusive, the commissioner and Attorney General (1) shall report in writing to the committee such certification, including any identification by the commissioner and Attorney General of an alternate fund or account and explanation of the reasons for depositing such moneys in such alternate fund or account, and (2) may deposit such moneys into such alternate fund or account. The commissioner and Attorney General shall jointly report, in accordance with the provisions of section 11-4a, to the joint standing committee of the General Assembly having cognizance of matters relating to public health regarding the intended use of such moneys in such alternate fund or account prior to allocating such moneys for other purposes.
(d) Beginning on December 31, 2022, and annually thereafter, the State Treasurer shall report the following to the committee:
(1) An inventory of fund investments as of the most recent fiscal year; and
(2) The net income earned by the fund in the most recent fiscal year.
(e) Any municipality that receives moneys directly from a settlement administrator pursuant to a judgment, consent decree or settlement related to opioid litigation shall submit an annual report to the committee detailing its expenditures for the preceding fiscal year on a form prescribed by the committee. Each such municipality shall submit such report to the committee on or before October 1, 2023, and annually thereafter, until the total amount of such moneys received by the municipality has been expended.
(f) Moneys in the fund shall be spent only for the following substance use disorder abatement purposes, in accordance with the controlling judgment, consent decree or settlement, as confirmed by the Attorney General's review of such judgment, consent decree or settlement and upon the approval of the committee and the Secretary of the Office of Policy and Management:
(1) State-wide, regional or community substance use disorder needs assessments to identify structural gaps and needs to inform expenditures from the fund;
(2) Infrastructure required for evidence-based substance use disorder prevention, treatment, recovery or harm reduction programs, services and supports;
(3) Programs, services, supports and resources for evidence-based substance use disorder prevention, treatment, recovery or harm reduction;
(4) Evidence-informed substance use disorder prevention, treatment, recovery or harm reduction pilot programs or demonstration studies that are not evidence-based, but are approved by the committee as an appropriate use of moneys for a limited period of time as specified by the committee, provided the committee shall assess whether the evidence supports funding such programs or studies or whether it provides a basis for funding such programs or studies with an expectation of creating an evidence base for such programs and studies;
(5) Evaluation of effectiveness and outcomes reporting for substance use disorder abatement infrastructure, programs, services, supports and resources for which moneys from the fund have been disbursed, including, but not limited to, impact on access to harm reduction services or treatment for substance use disorders or reduction in drug-related mortality;
(6) One or more publicly available data interfaces managed by the commissioner to aggregate, track and report data on (A) substance use disorders, overdoses and drug-related harms, (B) spending recommendations, plans and reports, and (C) outcomes of programs, services, supports and resources for which moneys from the fund were disbursed;
(7) Research on opioid abatement, including, but not limited to, development of evidence-based treatment, barriers to treatment, nonopioid treatment of chronic pain and harm reduction, supply-side enforcement;
(8) Documented expenses incurred in administering and staffing the fund and the committee, and expenses, including, but not limited to, legal fees, incurred by the state or any municipality in securing settlement proceeds, deposited in the fund as permitted by the controlling judgment, consent decree or settlement;
(9) Documented expenses associated with managing, investing and disbursing moneys in the fund;
(10) Documented expenses, including legal fees, incurred by the state or any municipality in securing settlement proceeds deposited in the fund to the extent such expenses are not otherwise reimbursed pursuant to a fee agreement provided for by the controlling judgment, consent decree or settlement; and
(11) Provision of funds to municipal police departments for the purpose of equipping police officers with opioid antagonists, with priority given to departments that do not currently have a supply of opioid antagonists.
(g) (1) For purposes of this section, the fund balance shall be determined by the State Treasurer as of July first, annually.
(2) Except as permitted by subdivision (8) of subsection (f) of this section, or unless otherwise required by court order to refund to the federal government a portion of the proceeds, moneys in the fund shall be used for prospective purposes and shall not be used to reimburse expenditures incurred prior to July 1, 2022.
(3) Proceeds derived from any state settlement of claims against a defendant shall be allocated and disbursed only to those municipalities that execute an agreement to participate in such settlement and adhere to the terms of such agreement, provided the allocation or disbursement of such settlement proceeds for the benefit of persons within municipalities that do not execute an agreement to participate in such settlement or do not adhere to the terms of such agreement shall not be precluded or limited.
(4) Governmental and nonprofit nongovernmental entities shall be eligible to receive moneys from the fund for programs, services, supports and resources for prevention, treatment, recovery and harm reduction.
(5) Subject to the provisions of subdivision (6) of this subsection, fund disbursements shall be made by the commissioner upon approval of the committee. The commissioner shall not make or refuse to make any disbursement allowable under this subsection without the approval of the committee. The commissioner shall adhere to the committee's decisions regarding disbursement of moneys from the fund, provided such disbursement is a permissible expenditure under this section. The commissioner's role in the distribution of moneys after the distribution has been approved by the committee and after the review and approval required under subsection (f) of this section shall be ministerial and shall not be discretionary.
(6) Moneys expended from the fund for the purposes set forth in subsection (d) of this section shall be supplemental to, and shall not supplant or take the place of, any other funds, including, but not limited to, insurance benefits or local, state or federal funding, that would otherwise have been expended for such purposes. The commissioner shall not disburse moneys from the fund during any fiscal year unless the Secretary of the Office of Policy and Management transmits to the committee a letter verifying that funds appropriated and allocated in such fiscal year's budget for substance use disorder abatement infrastructure, programs, services, supports and resources for prevention, treatment, recovery and harm reduction are in an amount not less than the sum of the funds for such purposes appropriated and allocated in the previous fiscal year's budget. As used in this subdivision, “supplemental” means additional funding, consistent with the provisions of this section, for substance use disorder abatement infrastructure or a substance use disorder abatement program, service, support or resource to ensure that funding in the current fiscal year exceeds the sum of federal, state, and local funds allocated in the previous fiscal year for such substance use disorder abatement infrastructure, program, service, support or resource.
(P.A. 22-48, S. 2; P.A. 23-92, S. 2; 23-204, S. 184.)
History: P.A. 22-48 effective July 1, 2022; P.A. 23-92 added new Subsec. (e) re annual reports by municipalities that receive moneys directly from a settlement administrator, redesignated existing Subsecs. (e) and (f) as Subsecs. (f) and (g), and made conforming changes, effective July 1, 2023; P.A. 23-204 amended Subsec. (e) by adding Subdiv. (11), codified by the Revisors as Subsec. (f)(11), re provision of funds to equip police officers with opioid antagonists, effective July 1, 2023.
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Sec. 17a-674d. Opioid Settlement Advisory Committee. Membership. Duties. (a) There is established an Opioid Settlement Advisory Committee to ensure (1) that proceeds received by the state pursuant to section 17a-674c are allocated and spent on substance use disorder abatement infrastructure, programs, services, supports and resources for prevention, treatment, recovery and harm reduction, and (2) robust public involvement, accountability and transparency in allocating and accounting for the moneys in the fund.
(b) The committee shall consist of the following members:
(1) The Secretary of the Office of Policy and Management, or the secretary's designee;
(2) The Attorney General, or the Attorney General's designee;
(3) The Commissioners of Children and Families, Mental Health and Addiction Services and Public Health, or said commissioners' designees, who shall serve as ex-officio members;
(4) The president pro tempore of the Senate, the speaker of the House of Representatives, the majority leaders of the Senate and House of Representatives, the minority leaders of the Senate and House of Representatives, the Senate and House chairpersons of the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies and public health, or their designees, provided such persons have experience living with a substance use disorder or are the family member of a person who has experience living with a substance use disorder;
(5) Twenty-one individuals representing municipalities, who shall be appointed by the Governor;
(6) The executive director of the Commission on Racial Equity in Public Health, or a representative of the commission designated by the executive director; and
(7) Eight individuals appointed by the commissioner as follows: (A) A provider of community-based substance use treatment services for adults, who shall be a nonvoting member; (B) a provider of community-based substance use treatment services for adolescents, who shall be a nonvoting member; (C) an addiction medicine licensed health care professional with prescribing ability, who shall be a nonvoting member; (D) three individuals with experience living with a substance use disorder or family members of an individual with experience living with a substance use disorder; and (E) two individuals with experience supporting infants and children affected by the opioid crisis.
(c) The commissioner shall be co-chairperson of the committee. The speaker of the House of Representatives and the president pro tempore of the Senate shall appoint a co-chairperson from among the individuals representing municipalities appointed pursuant to subdivision (5) of subsection (b) of this section. The co-chairpersons of the committee shall be nonvoting members.
(d) Notwithstanding any other provision of the general statutes, it shall not be a conflict of interest for a trustee, director, officer or employee of an organization, or for any person having a financial interest in such organization, to serve as a member of the committee, provided such trustee, director, officer, employee or person shall disclose such position or interest to all other members of the committee and abstain from deliberation, action and vote by the committee under this section that specifically concerns the organization of which such member is a trustee, director, officer or employee, or in which such member has a financial interest.
(e) All initial appointments to the committee shall be made not later than October 1, 2022. Each member of the committee, other than the ex-officio members, shall serve for a term of two years, shall serve no more than two consecutive terms and may serve until a successor is appointed, except that in the event of any vacancy, the appointing authority shall fill such vacancy for the unexpired portion of such term. Any member of the committee may be removed by the appointing authority for misfeasance, malfeasance or wilful neglect of duty.
(f) The committee shall have the following duties and powers:
(1) Recommend and approve policies and procedures for administration of the committee and criteria for the application, awarding and disbursement of moneys from the fund, to be used for the purposes set forth in section 17a-674c;
(2) Recommend and approve goals, objectives, rationales for such goals and objectives, sustainability plans and performance indicators relating to: (A) Substance use disorder prevention, treatment, recovery and harm reduction efforts, including, but not limited to, methods of engaging persons who utilize harm reduction services in treatment and recovery; (B) reducing disparities in access to prevention, treatment, recovery and harm reduction programs, services, supports and resources; and (C) improving health outcomes in traditionally underserved populations, including, but not limited to, persons who live in rural or tribal communities, are members of racial or ethnic minorities or were formerly incarcerated; and
(3) Approve the allocation of moneys from the fund.
(g) Notwithstanding the provisions of section 2-5, the department shall:
(1) Employ a full-time manager of the committee and provide public health research and policy expertise, support staff, facilities, technical assistance and other resources to (A) assist the manager of the committee in planning and supporting the functions of the committee, including ensuring that proceeds received by this state pursuant to section 17a-674c are allocated and spent on substance use disorder abatement infrastructure, programs, services, supports, and resources for prevention, treatment, recovery and harm reduction, and (B) ensure robust public involvement, accountability and transparency in allocating and accounting for the moneys in the fund;
(2) Utilize, where feasible, appropriations from the General Fund and existing infrastructure, programs, services, supports or other resources to address substance use disorders, overdoses and drug-related harms;
(3) Prepare for review and approval by the committee of the department's goals, objectives, rationales for such goals and objectives, sustainability plans and performance indicators relating to (A) substance use disorder prevention, treatment, recovery and harm reduction efforts, including, but not limited to, methods of engaging persons who utilize harm reduction services in treatment and recovery, and (B) reducing disparities in access to prevention, treatment, recovery and harm reduction programs, services, supports and resources;
(4) Evaluate applications and make recommendations to the committee for the awarding of contracts and disbursements of moneys from the fund exclusively for permissible expenditures set forth in section 17a-674c;
(5) Upon receipt of final approval by the committee, disburse moneys from the fund exclusively for permissible expenditures set forth in section 17a-674c;
(6) Approve suspensions of allocations of moneys from the fund to recipients found by the committee or commissioner to (A) be substantially out of compliance with applicable contracts, policies, procedures, rules, regulations or state or federal law, or (B) have used such awards for a purpose other than an approved purpose, provided the committee may resume approval of such allocations once the committee has determined the recipient has adequately remedied the cause of such suspension;
(7) Maintain oversight over the expenditure of moneys from the fund to ensure moneys are used exclusively for the purposes set forth in section 17a-674c, including, but not limited to, implementing procedures for evaluating the effectiveness of the infrastructure, programs, services, supports or resources that are funded pursuant to said section; and
(8) Implement and publish on the department's Internet web site policies and procedures for administration of the committee and for the application, awarding and disbursement of moneys from the fund, to be used for the purposes set forth in section 17a-674c.
(h) On or before October 1, 2023, and annually thereafter, recipients of moneys from the fund shall file with the committee an annual report for the prior fiscal year detailing the effectiveness of infrastructure, programs, services, supports or resources that were funded, including, but not limited to, the following:
(1) A description of how the recipient used the moneys for their intended purposes;
(2) The number of individuals served, delineated by race, age, gender and any other relevant demographic factor, which shall be reported in a deidentified manner;
(3) A specific analysis of whether the infrastructure, program, service, support or resources reduced mortality or improved prevention, treatment, harm reduction or recovery outcomes; and
(4) If a plan to ensure the sustainability of the infrastructure, program, service, support or resources funded exists, a summary of such plan.
(i) The committee shall hold quarterly public meetings. A meeting may be called by the chairperson or by a majority of the committee's members. Members may attend meetings in person, remotely by audiovisual means or, upon approval by the chairperson, by audio-only means. For each meeting of the committee, a majority of the voting members shall constitute a quorum for the transaction of business. If there is a quorum, then all actions of the committee shall be taken by an affirmative vote of a majority of the members present at the meeting. Each voting member shall have one vote. The committee shall terminate when all moneys received pursuant to section 17a-674c have been received and disbursed unless the Attorney General certifies that additional moneys are anticipated.
(j) The department shall create and maintain an Internet web site where the committee shall publish (1) meeting minutes, including, but not limited to, records of all votes to approve expenditures of moneys from the fund, (2) recipient agreements and reports required under subsection (h) of this section, (3) policies and procedures approved by the committee, (4) reports received from municipalities pursuant to subsection (e) of section 17a-674c, and (5) the committee's annual reports.
(P.A. 22-48, S. 3; P.A. 23-92, S. 3; 23-97, S. 35.)
History: P.A. 22-48 effective July 1, 2022; P.A. 23-92 amended Subsec. (j) by adding new Subdiv. (4) re reports received from municipalities pursuant to Sec. 17a-674c and redesignated existing Subdiv. (4) as Subdiv. (5), effective July 1, 2023; P.A. 23-97 amended Subsec. (b) by adding reference to joint standing committee of the General Assembly having cognizance of matters relating to public health and making technical changes in Subdiv. (4), replacing “Seventeen” with “Twenty-one” in Subdiv. (5) and replacing “Six” with “Eight” and adding Subpara. (E) re individuals with experience supporting infants and children affected by the opioid crisis in Subdiv. (7), effective July 1, 2023.
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Sec. 17a-674h. Opioid Antagonist Bulk Purchase Fund. Report. (a) As used in this section:
(1) “Eligible entity” means (A) a municipality, (B) a local or regional board of education, (C) a similar body governing one or more nonpublic schools, (D) a district department of health, (E) a municipal health department, (F) a law enforcement agency, or (G) an emergency medical services organization;
(2) “Emergency medical services personnel” has the same meaning as provided in section 19a-175;
(3) “Opioid antagonist” means naloxone hydrochloride or any other similarly acting and equally safe drug approved by the federal Food and Drug Administration for the treatment of a drug overdose;
(4) “Opioid drug” has the same meaning as provided in 42 CFR 8.2, as amended from time to time;
(5) “Opioid use disorder” means a medical condition characterized by a problematic pattern of opioid use and misuse leading to clinically significant impairment or distress;
(6) “Pharmacist” has the same meaning as provided in section 20-609a; and
(7) “Wholesaler” or “distributor” has the same meaning as provided in section 21a-70.
(b) There is established an Opioid Antagonist Bulk Purchase Fund which shall be a separate nonlapsing account within the General Fund. The account shall contain any (1) amounts appropriated or otherwise made available by the state for the purposes of this section, (2) moneys required by law to be deposited in the account, and (3) gifts, grants, donations or bequests made for the purposes of this section. Investment earnings credited to the assets of the account shall become part of the assets of the account. Any balance remaining in the account at the end of any fiscal year shall be carried forward in the account for the fiscal year next succeeding. The State Treasurer shall administer the account. All moneys deposited in the account shall be used by the Department of Mental Health and Addiction Services for the purposes of this section. The department may deduct and retain from the moneys in the account an amount equal to the costs incurred by the department in administering the provisions of this section, except that said amount shall not exceed two per cent of the moneys deposited in the account in any fiscal year.
(c) Not later than January 1, 2024 the Department of Mental Health and Addiction Services, in collaboration with the Department of Public Health, shall use the Opioid Antagonist Bulk Purchase Fund for the provision of opioid antagonists to eligible entities and by emergency medical services personnel to certain members of the public. Emergency medical services personnel shall distribute an opioid antagonist kit containing a personal supply of opioid antagonists and the one-page fact sheet developed by the Connecticut Alcohol and Drug Policy Council pursuant to section 17a-667a regarding the risks of taking an opioid drug, symptoms of opioid use disorder and services available in the state for persons who experience symptoms of or are otherwise affected by opioid use disorder to a patient who (1) is treated by such personnel for an overdose of an opioid drug, (2) displays symptoms to such personnel of opioid use disorder, or (3) is treated at a location where such personnel observes evidence of illicit use of an opioid drug, or to such patient's family member, caregiver or friend who is present at the location. Emergency medical services personnel shall refer the patient or such patient's family member, caregiver or friend to the written instructions regarding the administration of such opioid antagonist, as deemed appropriate by such personnel.
(d) The Department of Mental Health and Addiction Services may, within available appropriations, contract with a wholesaler or distributor for the purchasing and distribution of opioid antagonists in bulk to eligible entities pursuant to subsection (c) of this section. Each eligible entity shall make such bulk-purchased opioid antagonists available at no charge to a family member, caregiver or friend of a person who has experienced an overdose of an opioid drug or displays symptoms of opioid use disorder.
(e) Emergency medical services organizations may obtain opioid antagonists for dissemination pursuant to subsection (c) of this section from a pharmacist pursuant to section 20-633c, 20-633d or 21a-286.
(f) Emergency medical services personnel shall document the number of opioid antagonist kits distributed pursuant to subsection (c) of this section, including, but not limited to, the number of doses of an opioid antagonist included in each kit.
(g) Not later than January 1, 2025, and annually thereafter, the executive director of the Office of Emergency Medical Services shall report to the Department of Mental Health and Addiction Services regarding the implementation of the provisions of subsections (c), (e) and (f) of this section, including, but not limited to, any information required under subsection (h) of this section for inclusion in the state substance use disorder plan developed pursuant to subsection (j) of section 17a-451 known to the executive director.
(h) The Commissioner of Mental Health and Addiction Services shall include in the state substance use disorder plan developed pursuant to subsection (j) of section 17a-451 the following information: (1) The amount of funds used to purchase and distribute opioid antagonists, (2) the number of eligible entities that received opioid antagonists under this section, (3) the amount of opioid antagonists purchased under this section, (4) the use of the opioid antagonists purchased by each such eligible entity, if known by the commissioner, and (5) any recommendations regarding the Opioid Antagonist Bulk Purchase Fund, including any proposed legislation to facilitate the purposes of this section.
(P.A. 23-97, S. 5.)
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Sec. 17a-718. Nicotine addiction programs for persons under twenty-one years of age. Settlement disbursement. Report. (a) Commencing with the fiscal year ending June 30, 2024, any moneys received in the preceding fiscal year pursuant to the stipulated judgment in State of Connecticut v. JUUL Labs, Inc., shall be disbursed to the Commissioner of Mental Health and Addiction Services for distribution to the regional behavioral health action organizations, as described in section 17a-484f, for the funding of programs to support the abatement, mitigation, cessation, reduction or prevention of the use of nicotine or nicotine-synthetic products by residents under twenty-one years of age in accordance with such judgment.
(b) Not later than September 1, 2024, and annually thereafter, the Commissioner of Mental Health and Addiction Services shall submit a report to the board of trustees of the Tobacco and Health Trust Fund established pursuant to section 4-28f detailing how the moneys disbursed in the preceding fiscal year were distributed by the commissioner and summarizing how the regional behavioral health action organizations expended such moneys for the purposes described in subsection (a) of this section in the preceding fiscal year.
(P.A. 23-92, S. 1.)
History: P.A. 23-92, effective July 1, 2023.
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