House File 2578 H-8329 Amend House File 2578 as follows: 1 1. Page 7, after line 16 by inserting: 2 < Sec. ___. IOWA BOARD OF PHARMACY —— REDUCTION OF OPIOID 3 MISUSE OR OVERUSE —— OPIOID SETTLEMENT. 4 1. There is appropriated from the opioid settlement fund 5 or a similar fund, if enacted by 2022 Iowa Acts, House File 6 2573, or similar legislation, to the board of pharmacy for the 7 fiscal year beginning July 1, 2022, and ending June 30, 2023, 8 the following amounts, or so much thereof as is necessary, for 9 the purposes designated: 10 a. For the board of pharmacy to integrate the state’s 11 prescription monitoring program with health care providers’ 12 electronic medical record or pharmacy dispensing systems to 13 allow a seamless connection between the prescription monitoring 14 program and those systems: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 60,000 16 b. For the board of pharmacy to implement the opioid and 17 naloxone education (ONE) program to provide resources to 18 pharmacists to educate patients regarding opioid misuse and 19 accidental overdose in order to decrease opioid prescription 20 rates and the related addiction and overdose deaths in the 21 state: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 450,000 23 2. Notwithstanding any provision of law to the contrary, if 24 legislation is not enacted to create a specific fund for the 25 deposit of the state portion of moneys paid to the state as a 26 result of a national settlement of litigation with entities 27 that manufactured, marketed, sold, distributed, dispensed, 28 or promoted opioids, made in connection with claims arising 29 from the manufacturing, marketing, selling, distributing, 30 dispensing, or promoting of opioids, a sufficient amount of 31 these moneys received by the state is appropriated to the board 32 of pharmacy for the fiscal year beginning July 1, 2022, and 33 ending June 30, 2023, to provide the total amounts specified 34 under subsection 1 for the purposes designated under this 35 -1- HF 2578.4247 (2) 89 pf/rn 1/ 17 #1.

section. 1 3. If sufficient funds are not available through the 2 opioid settlement fund or a similar fund, if enacted by 3 2022 Iowa Acts, House File 2573, or similar legislation, or 4 directly through the national settlement as specified under 5 subsection 2, there is appropriated from the Iowa coronavirus 6 fiscal recovery fund created in section 8.57G, to the board 7 of pharmacy for the fiscal year beginning July 1, 2022, and 8 ending June 30, 2023, an amount sufficient to provide the 9 total amounts specified under subsection 1 for the purposes 10 designated under this section. > 11 2. Page 7, before line 17 by inserting: 12 < Sec. ___. INCREASED ACCESS TO NALOXONE —— OPIOID 13 SETTLEMENT. 14 1. There is appropriated from the opioid settlement fund or 15 a similar fund, if enacted by 2022 Iowa Acts, House File 2573, 16 or similar legislation, for deposit in the opioid antagonist 17 medication fund or a similar fund, if enacted by 2022 Iowa 18 Acts, House File 2573, or similar legislation for the fiscal 19 year beginning July 1, 2022, and ending June 30, 2023, the 20 following amount, or so much thereof as is necessary, for the 21 purpose designated: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 200,000 23 2. The department of public health shall utilize the moneys 24 appropriated for deposit under this section for the purchase, 25 maintenance, and replacement of opioid antagonist medication 26 administered by first responders to persons experiencing an 27 opioid-related overdose. 28 3. Notwithstanding any provision of law to the contrary, if 29 legislation is not enacted to create a specific fund for the 30 deposit of the state portion of moneys paid to the state as a 31 result of a national settlement of litigation with entities 32 that manufactured, marketed, sold, distributed, dispensed, 33 or promoted opioids, made in connection with claims arising 34 from the manufacturing, marketing, selling, distributing, 35 -2- HF 2578.4247 (2) 89 pf/rn 2/ 17 #2.

dispensing, or promoting of opioids, a sufficient amount of 1 these moneys received by the state is appropriated for deposit 2 in the opioid antagonist medication fund or a similar fund, 3 if enacted by 2022 Iowa Acts, House File 2573, or similar 4 legislation, or if an opioid antagonist medication fund or 5 a similar fund is not created, a sufficient amount of these 6 moneys received by the state is appropriated to the department 7 of public health for the fiscal year beginning July 1, 2022, 8 and ending June 30, 2023, to provide the total amount specified 9 under subsection 1 for the purposes designated under this 10 section. 11 4. If sufficient funds are not available through the opioid 12 settlement fund or a similar fund, if enacted by 2022 Iowa 13 Acts, House File 2573, or similar legislation, or directly 14 through the national settlement as described under subsection 15 2, there is appropriated from the Iowa coronavirus fiscal 16 recovery fund created in section 8.57G, for the fiscal year 17 beginning July 1, 2022, and ending June 30, 2023, for deposit 18 in the opioid antagonist medication fund or a similar fund, 19 if enacted by 2022 Iowa Acts, House File 2573, or similar 20 legislation, or if an opioid antagonist medication fund or a 21 similar fund is not created, for direct appropriation to the 22 department of public health for the fiscal year beginning July 23 1, 2022, and ending June 30, 2023, an amount sufficient to 24 provide the total amount specified under subsection 1 for the 25 purposes designated under this section. > 26 3. Page 7, after line 28 by inserting: 27 < Sec. ___. SUBSTANCE USE DISORDER RECOVERY HIGH SCHOOLS —— 28 OPIOID SETTLEMENT. 29 1. There is appropriated from the opioid settlement fund or 30 a similar fund, if enacted by 2022 Iowa Acts, House File 2573, 31 or similar legislation, to the department of public health for 32 the fiscal year beginning July 1, 2022, and ending June 30, 33 2023, the following amount, or so much thereof as is necessary, 34 for the purpose designated: 35 -3- HF 2578.4247 (2) 89 pf/rn 3/ 17 #3.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,000 1 2. The department of public health, in collaboration 2 with the department of education and the department of human 3 services, shall study and make recommendations regarding 4 the establishment of one or more recovery high schools in 5 Iowa designed for the education of students in recovery from 6 substance use disorders or dependency or co-occurring disorders 7 such as anxiety, depression, or attention deficit hyperactivity 8 disorder. Such schools shall meet state requirements for 9 awarding a secondary school diploma and support students 10 engaged in a program of recovery. The department shall 11 complete the study and submit its recommendations to the 12 governor and the general assembly by November 1, 2022. 13 3. Notwithstanding any provision of law to the contrary, if 14 legislation is not enacted to create a specific fund for the 15 deposit of the state portion of moneys paid to the state as a 16 result of a national settlement of litigation with entities 17 that manufactured, marketed, sold, distributed, dispensed, 18 or promoted opioids, made in connection with claims arising 19 from the manufacturing, marketing, selling, distributing, 20 dispensing, or promoting of opioids, a sufficient amount of 21 these moneys received by the state is appropriated to the 22 department of public health for the fiscal year beginning July 23 1, 2022, and ending June 30, 2023, to provide the total amount 24 specified under subsection 1 for the purposes designated under 25 this section. 26 4. If sufficient funds are not available through the opioid 27 settlement fund or a similar fund, if enacted by 2022 Iowa 28 Acts, House File 2573, or similar legislation, or directly 29 through the national settlement as described under subsection 30 3, there is appropriated from the Iowa coronavirus fiscal 31 recovery fund created in section 8.57G, for the fiscal year 32 beginning July 1, 2022, and ending June 30, 2023, to the 33 department of public health an amount sufficient to provide 34 the total amount specified under subsection 1 for the purposes 35 -4- HF 2578.4247 (2) 89 pf/rn 4/ 17

designated under this section. > 1 4. Page 7, before line 29 by inserting: 2 < Sec. ___. SUBSTANCE USE DISORDER —— INMATES —— OPIOID 3 SETTLEMENT. 4 1. a. There is appropriated from the opioid settlement 5 fund or a similar fund, if enacted by 2022 Iowa Acts, House 6 File 2573, or similar legislation, to the department of public 7 health for the fiscal year beginning July 1, 2022, and ending 8 June 30, 2023, the following amount, or so much thereof as is 9 necessary, for the purpose designated: 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 11 b. The department of public health shall transfer the 12 amount appropriated under this section to the department of 13 corrections for use in subsidizing the costs of providing 14 medication-assisted treatment to inmates being treated for 15 opioid use disorder, to purchase state-of-the-art urine 16 sample cups for use in the drug monitoring programs, and to 17 fund efforts to fight hepatitis C, a potentially devastating 18 but curable disease spread through intravenous needle use of 19 opioids and other drugs in prison populations. 20 2. Notwithstanding any provision of law to the contrary, if 21 legislation is not enacted to create a specific fund for the 22 deposit of the state portion of moneys paid to the state as a 23 result of a national settlement of litigation with entities 24 that manufactured, marketed, sold, distributed, dispensed, 25 or promoted opioids, made in connection with claims arising 26 from the manufacturing, marketing, selling, distributing, 27 dispensing, or promoting of opioids, a sufficient amount of 28 these moneys received by the state is appropriated to the 29 department of public health for transfer to the department of 30 corrections for the fiscal year beginning July 1, 2022, and 31 ending June 30, 2023, to provide the total amount specified 32 under subsection 1 for the purposes designated under this 33 section. 34 3. If sufficient funds are not available through the opioid 35 -5- HF 2578.4247 (2) 89 pf/rn 5/ 17 #4.

settlement fund or a similar fund, if enacted by 2022 Iowa 1 Acts, House File 2573, or similar legislation, or directly 2 through the national settlement as described in subsection 3 2, there is appropriated from the Iowa coronavirus fiscal 4 recovery fund created in section 8.57G, to the department of 5 public health for transfer to the department of corrections, 6 for the fiscal year beginning July 1, 2022, and ending June 7 30, 2023, an amount sufficient to provide the total amount 8 specified under subsection 1 for the purposes designated under 9 this section. > 10 5. Page 9, after line 5 by inserting: 11 < Sec. ___. VETERANS COURTS —— OPIOID SETTLEMENT. 12 1. There is appropriated from the opioid settlement fund or 13 a similar fund, if enacted by 2022 Iowa Acts, House File 2573, 14 or similar legislation, to the department of veterans affairs 15 for the fiscal year beginning July 1, 2022, and ending June 30, 16 2023, the following amount, or so much thereof as is necessary, 17 for the purpose designated: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 19 2. a. The moneys appropriated under this section shall 20 be transferred to the judicial branch to establish a veterans 21 court with a full-time outreach coordinator in each judicial 22 district to provide court services to veterans and to integrate 23 court sanctions and incentives with substance use disorder 24 treatment, mental health treatment, and transitional services 25 for veterans, in a judicially supervised setting. 26 b. It is the intent of the general assembly that the 27 jurisdiction of the veterans court may be exercised by any 28 district judge and by any district associate judge who is 29 designated by the chief judge of a judicial district as a judge 30 of the veterans court. The chief judge shall designate one 31 or more district judges and district associate judges to act 32 as judges of the veterans court for a judicial district. The 33 chief judge may designate a veterans court judge to preside in 34 more than one county. 35 -6- HF 2578.4247 (2) 89 pf/rn 6/ 17 #5.

3. Notwithstanding any provision of law to the contrary, if 1 legislation is not enacted to create a specific fund for the 2 deposit of the state portion of moneys paid to the state as a 3 result of a national settlement of litigation with entities 4 that manufactured, marketed, sold, distributed, dispensed, 5 or promoted opioids, made in connection with claims arising 6 from the manufacturing, marketing, selling, distributing, 7 dispensing, or promoting of opioids, a sufficient amount of 8 these moneys received by the state is appropriated to the 9 department of veterans affairs for transfer to the judicial 10 branch for the fiscal year beginning July 1, 2022, and ending 11 June 30, 2023, to provide the total amount specified under 12 subsection 1 for the purpose designated under this section. 13 4. If sufficient funds are not available through the opioid 14 settlement fund or a similar fund, if enacted in 2022 Iowa 15 Acts, House File 2573, or similar legislation, or directly 16 through the national settlement as described under subsection 17 3, there is appropriated from the Iowa coronavirus fiscal 18 recovery fund created in section 8.57G, for the fiscal year 19 beginning July 1, 2022, and ending June 30, 2023, to the 20 department of veterans affairs for transfer to the judicial 21 branch an amount sufficient to provide the total amount 22 specified under subsection 1 for the purposes designated under 23 this section. > 24 6. Page 66, after line 23 by inserting: 25 < DIVISION ___ 26 STATE EMPLOYEE BENEFITS —— USE OF OPIOIDS —— OPIOID SETTLEMENT 27 Sec. ___. STATE EMPLOYEE BENEFITS —— SUBSTANCE USE DISORDER 28 BENEFITS —— USE OF OPIOIDS —— OPIOID SETTLEMENT. 29 1. a. There is appropriated from the opioid settlement 30 fund or a similar fund, if enacted by 2022 Iowa Acts, House 31 File 2573, or similar legislation, to the department of 32 administrative services, for the fiscal year beginning July 1, 33 2022, and ending June 30, 2023, the following amount, or so 34 much thereof as is necessary, for the purposes designated: 35 -7- HF 2578.4247 (2) 89 pf/rn 7/ 17 #6.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 1 b. The department of administrative services, in cooperation 2 with any health insurance plans or health plan administrators 3 of benefits extended to state employees, shall utilize the 4 funds appropriated in this subsection to create a model 5 benefit plan designed to incentivize or otherwise promote the 6 effective, evidence-based prescription and use of opioids to 7 members receiving benefits through state plans, document the 8 current use of benefits for substance use disorders, identify 9 gaps or unnecessary restrictions in coverage, and expand 10 access to evidence-based treatments and therapies, including 11 nonpharmacological treatments. 12 2. Notwithstanding any provision of law to the contrary, if 13 legislation is not enacted to create a specific fund for the 14 deposit of the state portion of moneys paid to the state as a 15 result of a national settlement of litigation with entities 16 that manufactured, marketed, sold, distributed, dispensed, 17 or promoted opioids, made in connection with claims arising 18 from the manufacturing, marketing, selling, distributing, 19 dispensing, or promoting of opioids, a sufficient amount of 20 these moneys received by the state is appropriated to the 21 department of administrative services for the fiscal year 22 beginning July 1, 2022, and ending June 30, 2023, to provide 23 the total amount specified under subsection 1 for the purposes 24 designated under this section. 25 3. If sufficient funds are not available through the opioid 26 settlement fund or a similar fund, if enacted by 2022 Iowa 27 Acts, House File 2573, or similar legislation, or directly 28 through the national settlement as specified under subsection 29 2, there is appropriated from the Iowa coronavirus fiscal 30 recovery fund created in section 8.57G, to the department of 31 administrative services for the fiscal year beginning July 1, 32 2022, and ending June 30, 2023, an amount sufficient to provide 33 the total amount specified under subsection 1 for the purposes 34 designated under this section. > 35 -8- HF 2578.4247 (2) 89 pf/rn 8/ 17

7. Page 66, before line 24 by inserting: 1 < DIVISION ___ 2 MEDICAID RECIPIENTS —— SUBSTANCE USE DISORDER BENEFITS —— 3 OPIOID USE —— OPIOID SETTLEMENT 4 Sec. ___. MEDICAID RECIPIENTS —— SUBSTANCE USE DISORDER 5 BENEFITS —— USE OF OPIOIDS —— OPIOID SETTLEMENT. 6 1. a. There is appropriated from the opioid settlement 7 fund or a similar fund, if enacted by 2022 Iowa Acts, House 8 File 2573, or similar legislation, to the department of human 9 services, for the fiscal year beginning July 1, 2022, and 10 ending June 30, 2023, the following amount, or so much thereof 11 as is necessary, for the purposes designated: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 13 b. The department of human services and the Iowa Medicaid 14 enterprise, in cooperation with Medicaid managed care 15 organizations, shall utilize the funds appropriated under 16 this section to design benefit plans to incentivize or 17 otherwise promote the effective, evidence-based prescription 18 and use of opioids to Medicaid recipients, document the 19 current use of benefits for substance use disorders, identify 20 gaps or unnecessary restrictions in coverage, and expand 21 access to evidence-based treatment and therapies, including 22 nonpharmacological treatments. The department shall seek any 23 Medicaid state plan amendment or waiver necessary to administer 24 this subsection. 25 2. Notwithstanding any provision of law to the contrary, if 26 legislation is not enacted to create a specific fund for the 27 deposit of the state portion of moneys paid to the state as a 28 result of a national settlement of litigation with entities 29 that manufactured, marketed, sold, distributed, dispensed, 30 or promoted opioids, made in connection with claims arising 31 from the manufacturing, marketing, selling, distributing, 32 dispensing, or promoting of opioids, a sufficient amount of 33 these moneys received by the state is appropriated to the 34 department of human services for the fiscal year beginning July 35 -9- HF 2578.4247 (2) 89 pf/rn 9/ 17 #7.

1, 2022, and ending June 30, 2023, to provide the total amount 1 specified under subsection 1 for the purposes designated under 2 this section. 3 3. If sufficient funds are not available through the opioid 4 settlement fund or a similar fund, if enacted by 2022 Iowa 5 Acts, House File 2573, or similar legislation, or directly 6 through the national settlement as specified under subsection 7 2, there is appropriated from the Iowa coronavirus fiscal 8 recovery fund created in section 8.57G, to the department of 9 human services for the fiscal year beginning July 1, 2022, and 10 ending June 30, 2023, an amount sufficient to provide the total 11 amount specified under subsection 1 for the purposes designated 12 under this section. > 13 8. Page 69, after line 2 by inserting: 14 < DIVISION ___ 15 SUBSTANCE USE DISORDER AND OPIOID USE RESEARCH, EDUCATION, 16 PREVENTION, AND TREATMENT —— OPIOID SETTLEMENT 17 Sec. ___. SUBSTANCE USE DISORDER AND OPIOID USE RESEARCH, 18 EDUCATION, PREVENTION, AND TREATMENT —— OPIOID SETTLEMENT. 19 1. There is appropriated from the opioid settlement fund 20 or a similar fund, if enacted in 2022 Iowa Acts, House File 21 2573, or similar legislation, to the following entities for the 22 fiscal year beginning July 1, 2022, and ending June 30, 2023, 23 the following amounts, or so much thereof as is necessary, for 24 the purposes designated: 25 a. To the department of public health: 26 (1) To provide for training, equipment, and initial 27 operation in twelve county jails throughout the state 28 of appropriate evidence-based treatment of incarcerated 29 individuals diagnosed with substance use disorders, in 30 accordance with rules adopted by the department: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,500,000 32 (2) To contract with the Iowa health care collaborative to 33 do all of the following: 34 (a) To develop and pilot protocols for the treatment 35 -10- HF 2578.4247 (2) 89 pf/rn 10/ 17 #8.

of emergency room patients experiencing opioid or heroin 1 overdoses, only to the extent funding is matched on a 2 dollar-for-dollar basis from private or public sources secured 3 by the Iowa health care collaborative: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 5 (b) To reduce opioid exposure by educating doctors and 6 hospitals, especially in rural areas, to adopt the enhanced 7 recovery after surgery (ERAS) principles: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 9 (3) For the psychiatric residency programs involved 10 with coordinated, collaborative care at newly established, 11 community-based behavioral health treatment facilities offering 12 residential substance use disorder treatment for twenty-nine 13 days or more: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 15 (4) To pilot the establishment and operation of three 16 community-based syringe service programs developed to provide 17 substance use prevention and response including linkages 18 to substance use disorder treatment; vaccination, testing, 19 and access to care for infectious diseases; and access to, 20 education regarding the safe utilization of, and proper 21 disposal of sterile syringes and injection equipment: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 450,000 23 The pilot program supported with the funding appropriated 24 under this subparagraph is conditioned on the implementation 25 of written agreements with local law enforcement agencies 26 and county attorneys to refrain from charging or prosecuting 27 program sponsors or participants for violations of section 28 124.414. 29 b. To the state board of regents: 30 (1) To fund research on medication-assisted treatment for 31 substance use disorders conducted at the university of Iowa 32 college of public health to identify variability in outcomes, 33 demonstrate efficacy of treatment, and refine evidence-based 34 protocols: 35 -11- HF 2578.4247 (2) 89 pf/rn 11/ 17

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 1 (2) To fund research and education conducted at the 2 university of Iowa Carver college of medicine for the 3 nonnarcotic treatment of pain: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 5 c. To the governor’s office of drug control policy to 6 establish and direct a task force, in collaboration with the 7 department of public health, department of human services, and 8 department of public safety, to make recommendations, based on 9 public health principles, to restructure the response of the 10 state’s health and justice systems to illicit drug use and to 11 individuals suffering from substance use disorders: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 13 The governor’s office of drug control policy shall submit a 14 report of the recommendations specified in this paragraph “c” 15 to the governor and the general assembly by November 1, 2022. 16 2. Notwithstanding any provision of law to the contrary, if 17 legislation is not enacted to create a specific fund for the 18 deposit of the state portion of moneys paid to the state as a 19 result of a national settlement of litigation with entities 20 that manufactured, marketed, sold, distributed, dispensed, 21 or promoted opioids, made in connection with claims arising 22 from the manufacturing, marketing, selling, distributing, 23 dispensing, or promoting of opioids, a sufficient amount 24 of these moneys received by the state is appropriated to 25 the entities specified in subsection 1, for the fiscal year 26 beginning July 1, 2022, and ending June 30, 2023, to provide 27 the total amounts specified to the entities specified under 28 subsection 1 for the purposes designated under this section. 29 3. If sufficient funds are not available through the opioid 30 settlement fund or a similar fund, if enacted in 2022 Iowa 31 Acts, House File 2573, or similar legislation, or directly 32 through the national settlement as described under subsection 33 2, there is appropriated from the Iowa coronavirus fiscal 34 recovery fund created in section 8.57G, to the entities 35 -12- HF 2578.4247 (2) 89 pf/rn 12/ 17

specified in subsection 1, for the fiscal year beginning July 1 1, 2022, and ending June 30, 2023, a sufficient amount to 2 provide the total amounts specified to the entities specified 3 under subsection 1 for the purposes designated under this 4 section. > 5 9. Page 71, after line 10 by inserting: 6 < DIVISION ___ 7 PUBLIC HEALTH INFRASTRUCTURE AND SUBSTANCE USE DISORDER 8 PREVENTION AND TREATMENT —— OPIOID SETTLEMENT 9 Sec. ___. PUBLIC HEALTH INFRASTRUCTURE AND SUBSTANCE USE 10 DISORDER PREVENTION AND TREATMENT —— OPIOID SETTLEMENT. 11 1. There is appropriated from the opioid settlement fund or 12 a similar fund, if enacted in 2022 Iowa Acts, House File 2573, 13 or similar legislation, to the university of Iowa college of 14 public health for the fiscal year beginning July 1, 2022, and 15 ending June 30, 2023, the following amounts, or so much thereof 16 as is necessary, for the purposes designated: 17 a. To conduct a comprehensive review and evaluation of 18 the existing public health structure and infrastructure in 19 Iowa, and to make recommendations for policy and funding to 20 improve capacity of the state and local communities to address 21 substance use and related issues: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 250,000 23 b. To coordinate increased, systematic efforts with local 24 public health authorities to address the personal behaviors, 25 societal conditions, and lack of access to services that are 26 identified as risk factors for substance use disorders and 27 related co-occurring health conditions: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 29 The amount appropriated may be used to provide grants to 30 county boards of health to implement evidence-based community 31 programming, policies, and collaborative projects with health 32 care providers to address the identified risk factors. 33 c. To provide paid internships for college of public 34 health students paired with local health departments to 35 -13- HF 2578.4247 (2) 89 pf/rn 13/ 17 #9.

support the development of local public health infrastructure, 1 conduct community health needs assessments, and assist in 2 the successful implementation of health improvement plans to 3 address substance use disorders and co-occurring brain health 4 and related conditions: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 400,000 6 2. Notwithstanding any provision of law to the contrary, if 7 legislation is not enacted to create a specific fund for the 8 deposit of the state portion of moneys paid to the state as a 9 result of a national settlement of litigation with entities 10 that manufactured, marketed, sold, distributed, dispensed, 11 or promoted opioids, made in connection with claims arising 12 from the manufacturing, marketing, selling, distributing, 13 dispensing, or promoting of opioids, a sufficient amount of 14 these moneys received by the state is appropriated to the 15 university of Iowa college of public health, for the fiscal 16 year beginning July 1, 2022, and ending June 30, 2023, to 17 provide the total amounts specified under subsection 1 for the 18 purposes designated under this section. 19 3. If sufficient funds are not available through the opioid 20 settlement fund or a similar fund, if enacted in 2022 Iowa 21 Acts, House File 2573, or similar legislation, or directly 22 through the national settlement as described under subsection 23 2 to satisfy the appropriations under subsection 1, there is 24 appropriated from the Iowa coronavirus fiscal recovery fund 25 created in section 8.57G, to the university of Iowa college 26 of public health for the fiscal year beginning July 1, 2022, 27 and ending June 30, 2023, a sufficient amount to provide the 28 total amounts specified under subsection 1 for the purposes 29 designated under this section. > 30 10. Page 71, before line 11 by inserting: 31 < DIVISION ___ 32 SUBSTANCE USE DISORDER —— SUPPORTIVE SERVICES —— OPIOID 33 SETTLEMENT 34 Sec. ___. SUBSTANCE USE DISORDER —— SUPPORTIVE SERVICES —— 35 -14- HF 2578.4247 (2) 89 pf/rn 14/ 17 #10.

OPIOID SETTLEMENT. 1 1. a. There is appropriated from the opioid settlement 2 fund or a similar fund, if enacted by 2022 Iowa Acts, House 3 File 2573, or similar legislation, to the department of public 4 health for the fiscal year beginning July 1, 2022, and ending 5 June 30, 2023, the following amount, or so much thereof as is 6 necessary, for the purpose designated: 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 8 b. Moneys appropriated under this section shall be used 9 by the department, in collaboration with the Iowa finance 10 authority and community-based organizations, to engage in work 11 to increase the availability of recovery housing throughout the 12 state. The moneys shall be distributed as grants to recovery 13 housing providers whose application for assistance is in 14 accordance with a county community health needs assessment and 15 health improvement plan. 16 2. Notwithstanding any provision of law to the contrary, if 17 legislation is not enacted to create a specific fund for the 18 deposit of the state portion of moneys paid to the state as a 19 result of a national settlement of litigation with entities 20 that manufactured, marketed, sold, distributed, dispensed, 21 or promoted opioids, made in connection with claims arising 22 from the manufacturing, marketing, selling, distributing, 23 dispensing, or promoting of opioids, a sufficient amount of 24 these moneys received by the state is appropriated to the 25 department of public health, for the fiscal year beginning July 26 1, 2022, and ending June 30, 2023, to provide the total amount 27 specified under subsection 1 for the purposes designated under 28 this section. 29 3. If sufficient funds are not available through the opioid 30 settlement fund or a similar fund, if enacted in 2022 Iowa 31 Acts, House File 2573, or similar legislation, or directly 32 from the national settlement as described under subsection 2 33 to satisfy the appropriations under subsection 1, there is 34 appropriated from the Iowa coronavirus fiscal recovery fund 35 -15- HF 2578.4247 (2) 89 pf/rn 15/ 17

created in section 8.57G, to the department of public health 1 for the fiscal year beginning July 1, 2022, and ending June 30, 2 2023, a sufficient amount to provide the total amount specified 3 under subsection 1 for the purposes designated under this 4 section. > 5 11. Page 72, after line 11 by inserting: 6 < DIVISION ___ 7 COMPREHENSIVE STUDY AND REPORT OF SUBSTANCE USE DISORDER 8 TREATMENT COVERAGE, UTILIZATION, AND EXPENDITURES —— OPIOID 9 SETTLEMENT 10 Sec. ___. COMPREHENSIVE STUDY AND REPORT OF SUBSTANCE USE 11 DISORDER TREATMENT COVERAGE, UTILIZATION, AND EXPENDITURES —— 12 OPIOID SETTLEMENT. 13 1. a. There is appropriated from the opioid settlement fund 14 or a similar fund, if enacted by 2022 Iowa Acts, House File 15 2573, or similar legislation, to the division of insurance of 16 the department of commerce, for the fiscal year beginning July 17 1, 2022, and ending June 30, 2023, the following amount, or so 18 much thereof as is necessary, for the purposes designated: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 20 b. The division of insurance shall utilize the funds 21 appropriated under this subsection to perform a comprehensive 22 study and prepare a comprehensive report on insurance coverage 23 and payment policies for services related to the treatment of 24 substance use disorders by commercial insurance companies and 25 self-funded plans, as well as data on current utilization and 26 expenditures associated with such benefit plans. The report 27 shall be submitted to the general assembly by January 1, 2023. 28 2. Notwithstanding any provision of law to the contrary, if 29 legislation is not enacted to create a specific fund for the 30 deposit of the state portion of moneys paid to the state as a 31 result of a national settlement of litigation with entities 32 that manufactured, marketed, sold, distributed, dispensed, 33 or promoted opioids, made in connection with claims arising 34 from the manufacturing, marketing, selling, distributing, 35 -16- HF 2578.4247 (2) 89 pf/rn 16/ 17 #11.

dispensing, or promoting of opioids, a sufficient amount of 1 these moneys received by the state is appropriated to the 2 division of insurance of the department of commerce for the 3 fiscal year beginning July 1, 2022, and ending June 30, 2023, 4 to provide the total amount specified under subsection 1 for 5 the purposes designated under this section. 6 3. If sufficient funds are not available through the opioid 7 settlement fund or a similar fund, if enacted by 2022 Iowa 8 Acts, House File 2573, or similar legislation, or directly 9 through the national settlement as specified under subsection 10 2, there is appropriated from the Iowa coronavirus fiscal 11 recovery fund created in section 8.57G, to the division 12 of insurance of the department of commerce for the fiscal 13 year beginning July 1, 2022, and ending June 30, 2023, an 14 amount sufficient to provide the total amount specified under 15 subsection 1 for the purposes designated under this section. > 16 12. By renumbering, redesignating, and correcting internal 17 references as necessary. 18 ______________________________ ISENHART of Dubuque -17- HF 2578.4247 (2) 89 pf/rn 17/ 17 #12.