Senate File 624 S-3189 Amend Senate File 624 as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < DIVISION I 4 OPIOID SETTLEMENT FUND 5 Section 1. Section 12.51, Code 2025, is amended to read as 6 follows: 7 12.51 Opioid settlement fund. 8 1. As used in this section unless the context otherwise 9 requires: 10 a. “Administrative services organization” means the same as 11 defined in section 225A.1, as enacted in 2024 Iowa Acts, ch. 12 1161, §1. 13 b. “Behavioral health district” means the same as defined in 14 section 225A.1, as enacted in 2024 Iowa Acts, ch. 1161, §1. 15 c. “Department” means the department of health and human 16 services. 17 d. “District behavioral health advisory council” means the 18 same as defined in section 225A.1, as enacted in 2024 Iowa 19 Acts, ch. 1161, §1. 20 1. 2. a. An opioid settlement fund is created in the 21 office of the treasurer of state. The fund shall be separate 22 from the general fund of the state and the balance in the fund 23 shall not be considered part of the balance of the general fund 24 of the state. 25 b. (1) The state portion of any moneys paid to the state as 26 a 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, shall be deposited in the 31 fund. 32 (2) (a) For each fiscal year for the period beginning July 33 1, 2025, and ending June 30, 2030, of the total amount of the 34 state portion of the moneys paid to the state as described in 35 -1- SF 624.2128 (1) 91 lh/ko 1/ 8 #1.

paragraph “b” and deposited in the fund, plus any interest 1 and earnings on moneys in the fund, seventy-five percent is 2 appropriated to the department and twenty-five percent is 3 appropriated to the office of the attorney general for purposes 4 of abating the opioid crisis in this state. 5 (b) Notwithstanding section 8.33, moneys appropriated 6 under subparagraph division (a) that remain unencumbered and 7 unobligated at the close of each fiscal year shall not revert 8 but shall remain available for expenditure for the purposes 9 designated until June 30, 2030. 10 (c) Notwithstanding section 12C.7, subsection 2, the 11 interest or earnings on moneys appropriated under subparagraph 12 division (a) are appropriated to the entity receiving the 13 appropriation to be used for the purposes designated. 14 (3) The department and the office of the attorney general 15 shall do all of the following: 16 (a) Review each administrative services organization’s 17 proposed uses of the appropriated moneys for crisis response, 18 early intervention, and treatment for opioid addiction, and 19 recovery from opioid addiction, for the behavioral health 20 district for which the administrative services organization has 21 been designated. 22 (b) Disburse the moneys appropriated under subparagraph 23 (2), subparagraph division (a), in accordance with the national 24 opioid settlement agreements and this section. 25 (c) Identify indicators and outcomes applicable to each 26 disbursement to be used to determine if the services and 27 activities that are funded achieve the intended outcomes, which 28 may include prevention of opioid-related deaths, reduction of 29 opioid misuse, and increased access to opioid use disorder 30 medications and services. 31 (d) Submit an annual report on or before November 1 to the 32 general assembly and the governor that contains all of the 33 following for the immediately preceding fiscal year: 34 (i) Information related to each disbursement from the 35 -2- SF 624.2128 (1) 91 lh/ko 2/ 8

fund, and if the intended outcomes of each disbursement were 1 achieved. 2 (ii) Input from each district behavioral health advisory 3 council regarding disbursements from the fund, intended 4 outcomes, and recommendations for future disbursements from the 5 fund. 6 (iii) A list of the current opioid-related initiatives 7 within the behavioral health district that are funded by 8 moneys from the national settlements that are earmarked for 9 or otherwise required to be transferred or distributed to 10 counties, cities, or other local governmental entities. 11 (e) Adopt rules pursuant to chapter 17A to administer this 12 paragraph. 13 (4) A recipient shall receive no more than one disbursement 14 under paragraph “b” , subparagraph (3), subparagraph division 15 (b). 16 (5) The department and the office of the attorney general 17 may, but are not required to, ensure that moneys appropriated 18 under subparagraph (2) are distributed equally to the 19 administrative services organizations. 20 (6) The department and the office of the attorney general 21 shall use no more than two and one-half percent of the moneys 22 appropriated under subparagraph (2) for administrative costs. 23 c. This subsection does not apply to such moneys paid to 24 the state that are earmarked for or otherwise required to be 25 transferred or distributed to counties, cities, or other local 26 governmental entities. 27 2. 3. a. Moneys in the fund shall not be transferred, 28 used, obligated, appropriated, or otherwise encumbered except 29 as provided in this section . 30 b. Moneys in the fund shall only be used pursuant to 31 appropriations from the fund by the general assembly for 32 purposes of abating the opioid crisis in this state, which 33 may include but are not limited to the purposes specified in 34 section 135.190A for moneys in the opioid antagonist medication 35 -3- SF 624.2128 (1) 91 lh/ko 3/ 8

fund. 1 3. c. Notwithstanding section 8.33 , moneys in the fund 2 that remain unencumbered or unobligated at the close of a 3 fiscal year shall not revert. Notwithstanding section 12C.7, 4 subsection 2 , interest or earnings on moneys in the fund shall 5 be credited to the fund. 6 DIVISION II 7 OPIOID SETTLEMENT FUND —— FY 2024-2025 8 Sec. 2. OPIOID SETTLEMENT FUND —— DEPARTMENT OF HEALTH AND 9 HUMAN SERVICES. 10 1. There is appropriated from the opioid settlement fund 11 created in section 12.51 to the department of health and human 12 services for the fiscal year beginning July 1, 2024, and ending 13 June 30, 2025, the following amount, or so much thereof is as 14 necessary, for the purposes designated: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 29,000,000 16 2. Notwithstanding any provision of law to the contrary, of 17 the moneys appropriated to the department of health and human 18 services under subsection 1, the department shall disburse to 19 the following entities, the following amounts, for the purposes 20 designated: 21 a. To a youth-serving nonprofit organization that has been 22 in existence for at least forty-five years that provides crisis 23 stabilization, emergency shelter, and residential addiction 24 treatment, and that is located in a central Iowa county with 25 a population between ninety-eight thousand and ninety-nine 26 thousand based on the 2020 federal decennial census, to support 27 the development of a recovery-focused high school and workforce 28 training center that integrates education, job training, and 29 therapeutic support to empower youth in recovery from substance 30 use disorder to successfully transition into the workforce upon 31 graduation: 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,000,000 33 b. To an opioid treatment program incorporated as a 34 nonprofit organization in 1997, that operates fourteen 35 -4- SF 624.2128 (1) 91 lh/ko 4/ 8

locations and offers behavioral and medical health care 1 to patients, and that is licensed in the state to provide 2 medication-assisted treatment, mental health therapy, 3 counseling, and primary health care, to expand access to 4 medication-assisted treatment in rural and underserved areas 5 of the state through co-located and mobile recovery units 6 and to collaborate with jail-based screening, assessment, 7 diagnosis, and treatment service providers to extend support 8 to incarcerated individuals and individuals who are no longer 9 incarcerated, and sustain established infrastructure for 10 dispensing medications for opioid use disorder services in 11 rural and underserved areas: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,000,000 13 c. To the administrative services organization designated 14 pursuant to section 225A.4, as enacted in 2024 Iowa Acts, 15 ch. 1161, §4, to contract with a collaborative mental health 16 services organization that operates in Iowa to provide 17 jail-based screening, assessment, diagnosis, and treatment 18 service providers and system navigation to all county jails, to 19 ensure inmates receive necessary mental health and substance 20 use care, regardless of the mental health and substance use 21 resources available in the county in which the inmate is 22 incarcerated: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,500,000 24 d. To a nonprofit organization headquartered in a western 25 Iowa county with a population between one hundred thousand and 26 one hundred six thousand based on the 2020 federal decennial 27 census, for a recovery project that involves recovery housing 28 and post-treatment support based on a recovery cafe model, for 29 individuals in addiction recovery including those experiencing 30 homelessness and transitioning from incarceration, and the 31 nonprofit organization provides an appropriate physical 32 location and a dollar-for-dollar match for each dollar 33 disbursed to the nonprofit organization: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 35 -5- SF 624.2128 (1) 91 lh/ko 5/ 8

e. To the administrative services organization designated 1 pursuant to section 255A.4, as enacted in 2024 Iowa Acts, ch. 2 1161, §4, to contract with local peer-recovery specialists in 3 four rural locations in the state to provide post-overdose 4 response services through emergency departments that connect 5 individuals and families to post-overdose treatment and 6 recovery support, and to train peer recovery coaches using the 7 linkage to outreach referrals and engagement model: 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 9 f. To provide grants to nonprofit organizations for each 10 nonprofit organization to establish recovery community centers, 11 including for the purchase or lease of physical space and 12 programming, in behavioral health districts four, five, and 13 seven to connect members of the recovery community to support, 14 education, resources, and advocacy: 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,500,000 16 g. To provide grants to nonprofit organizations to 17 establish recovery cafes in behavioral health districts 18 five and seven to support members of the recovery community, 19 focusing on health maintenance and opioid addiction prevention 20 by providing a safe environment to cultivate meaningful 21 connections, compassionate understanding, and a culture of 22 affirmation that enhances well-being and self-worth: 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,500,000 24 h. To provide grants to nonprofit organizations in 25 behavioral health districts one, four, five, and seven 26 for recovery respite that focuses on women, and women with 27 children, who are in substance use disorder treatment or 28 recovery to provide the women appropriate resources to enhance 29 their recovery efforts and transition to independent living: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,500,000 31 i. To provide a grant to a nonprofit organization 32 headquartered in a city with a population between twenty-four 33 thousand five hundred and twenty-five thousand based on the 34 2020 federal decennial census, that is a member of the Iowa 35 -6- SF 624.2128 (1) 91 lh/ko 6/ 8

substance use and problem gambling services integrated provider 1 network and that specializes in treatment and prevention 2 services, including outpatient, residential treatment, and 3 detoxification for adolescents and adults who are experiencing 4 mental health and substance use disorders: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,000,000 6 j. To provide a grant to a nonprofit organization 7 headquartered in a city with a population between one hundred 8 seventy-four thousand and one hundred seventy-five thousand 9 based on the 2020 federal decennial census, that is a community 10 mental health center under chapter 230A, and that maintains 11 or conducts a program licensed under chapter 125 the primary 12 purpose of which is the treatment and rehabilitation of persons 13 with a substance use disorder, including outpatient care, 14 residential care, habilitation homes, crisis stabilization 15 residential services, assertive community treatment, 16 multisystemic therapy, and integrated home health and 17 supportive and affordable housing for adolescents and adults 18 experiencing substance use or mental health disorders: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 20 3. Notwithstanding any provision of law to the contrary, of 21 the moneys appropriated to the department of health and human 22 services under subsection 1, $3,000,000 shall be disbursed as 23 grants to nonprofit organizations that submit a proposal to 24 the department of health and human services for development of 25 recovery housing in behavioral health districts that do not 26 have established recovery housing capacity. 27 4. a. Moneys disbursed under subsections 2 and 3 shall be 28 used by the recipient in compliance with the requirements of 29 the national opioid settlement agreements and section 12.51. 30 b. A recipient shall utilize the indicators and outcomes 31 identified by the department of health and human services 32 and the office of the attorney general under section 12.51, 33 subsection 2, paragraph “b”, subparagraph (3), subparagraph 34 division (c), to determine whether the services and activities 35 -7- SF 624.2128 (1) 91 lh/ko 7/ 8

that are funded by the disbursement achieve the intended 1 outcomes, and shall report the recipient’s findings to the 2 department of health and human services and the office of the 3 attorney general. 4 c. Moneys disbursed under subsection 2 shall be fully 5 obligated by the recipient no later than June 30, 2027. 6 d. A recipient shall receive no more than one disbursement 7 under subsections 2 and 3. 8 Sec. 3. EFFECTIVE DATE. This division of this Act, being 9 deemed of immediate importance, takes effect upon enactment. 10 Sec. 4. RETROACTIVE APPLICABILITY. This division of this 11 Act applies retroactively to July 1, 2024. > 12 2. Title page, by striking line 2 and inserting 13 < appropriations and disbursements, and including effective date 14 and retroactive applicability provisions. > 15 ______________________________ TIM KRAAYENBRINK -8- SF 624.2128 (1) 91 lh/ko 8/ 8 #2.