House File 618 - Introduced HOUSE FILE 618 BY ISENHART , BROWN-POWERS , and FORBES A BILL FOR An Act relating to opioid abuse prevention and treatment by 1 creating an opioid abuse prevention and treatment workgroup 2 and excise tax on the gross receipts of certain controlled 3 substances sold at wholesale and providing for the transfer 4 of the excise tax revenues to a newly created fund. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 2475YH (7) 87 tr/rj

H.F. 618 Section 1. NEW SECTION . 135.191 Opioid abuse prevention 1 and treatment fund. 2 1. An opioid abuse prevention and treatment fund is created 3 in the state treasury under the control of the department. The 4 fund is established to expand treatment and access to opioid 5 use disorder and to assist opioid drug abuse prevention and 6 treatment programs in the state including but not limited 7 to medication-assisted treatment programs that provide 8 appropriate holistic services, treatment programs licensed 9 in the administrative rules of the department, in accordance 10 with programs sponsored by community organizations, programs 11 that provide emergency responders with affordable access 12 to opioid antagonists, and programs that assist in paying 13 treatment costs for individuals who are ineligible for Medicaid 14 services or private insurance coverage. The fund shall also 15 provide support for the expansion of substance abuse and pain 16 management curricula at the university of Iowa college of 17 medicine, evidence-based public health research on nonnarcotic 18 pain treatment and management alternatives, and expanded mental 19 health and substance abuse education and training for emergency 20 medical care providers as defined in section 147A.1. 21 2. Distribution of moneys from the opioid abuse prevention 22 and treatment program shall be made to eligible applicants in 23 the following order of priority: 24 a. A public entity, including but not limited to a state, 25 county, or local community health clinic and federally 26 qualified health center, or a public health agency, as 27 defined in section 135.154, that provides opioid use disorder 28 treatment. 29 b. A nonpublic entity that, in addition to opioid use 30 disorder treatment services, provides required primary health 31 services as described in 42 U.S.C. §254b(b)(1)(A). 32 c. A nonpublic entity that provides opioid use disorder 33 treatment but does not provide required primary health services 34 as described in 42 U.S.C. b(b)(1)(A). 35 -1- LSB 2475YH (7) 87 tr/rj 1/ 7

H.F. 618 3. The fund shall consist of all moneys deposited in the 1 fund pursuant to section 423G.4 and any other moneys available 2 to, obtained, or accepted by the department for placement in 3 the fund. Moneys in the fund are not subject to section 8.33. 4 Notwithstanding section 12C.7, interest or earnings on moneys 5 in the fund shall be credited to the fund. 6 Sec. 2. NEW SECTION . 135.192 Opioid abuse prevention and 7 treatment workgroup. 8 1. An opioid abuse prevention and treatment workgroup shall 9 be established by the state board of health. The workgroup 10 shall be composed of nine members appointed by the governor 11 based on recommendations by the department, including the 12 following: 13 a. One physician licensed under chapter 148. 14 b. One pharmacist licensed under chapter 155A. 15 c. One social worker licensed under chapter 154C. 16 d. One advanced registered nurse practitioner licensed under 17 chapter 152. 18 e. One representative of a county board of health. 19 f. One representatives of a substance abuse treatment 20 program licensed under chapter 125. 21 g. One person who has been treated for and has recovered 22 from opioid abuse. 23 h. Two persons who are not licensed to practice medicine, 24 pharmacy, social work, or nursing who shall represent the 25 general public. 26 2. The workgroup shall do all of the following: 27 a. Promote meetings and programs for the discussion of 28 methods to reduce opioid abuse and disseminate information 29 in cooperation with any other department, agency, or other 30 governmental or nongovernmental entity on the prevention, 31 evaluation, care, treatment, and rehabilitation of persons 32 affected by opioid abuse. 33 b. Study and review current prevention, evaluation, care, 34 treatment, and rehabilitation programs and strategies and 35 -2- LSB 2475YH (7) 87 tr/rj 2/ 7

H.F. 618 recommend appropriate preparation, training, retraining, and 1 distribution of personnel and resources in the provision of 2 services to persons with opioid abuse issues through treatment 3 programs licensed in accordance with the administrative rules 4 of the department. 5 c. Make recommendations to the department to expend moneys 6 deposited in the opioid abuse prevention and treatment fund 7 created in section 135.191 to carry out the recommendations of 8 the workgroup in accordance with section 135.191, subject to 9 the approval of the department. 10 d. Meet at least quarterly. 11 e. Make recommendations regarding approval by the state 12 board of health of administrative rules for adoption by the 13 department pursuant to chapter 17A. 14 3. The department may receive gifts, grants, or donations 15 made for any of the purposes of the workgroup’s duties and 16 disburse and administer them in accordance with their terms. 17 Sec. 3. NEW SECTION . 423G.1 Definitions. 18 1. For purposes of this chapter, unless the context 19 otherwise requires: 20 a. “Gross receipts” means the total revenues received from 21 the wholesale sale of schedule II controlled substances to 22 practitioners in this state. 23 b. “Practitioner” means the same as defined in section 24 124.101. 25 c. “Schedule II controlled substance” means a controlled 26 substance listed in the schedule provided in section 124.206. 27 d. “Wholesaler” means a person other than a distributor or 28 distributing agent who engages in the business of selling or 29 distributing schedule II controlled substances to practitioners 30 in this state, for the purpose of resale. 31 2. All other words and phrases used in this chapter and 32 defined in section 423.1 have the meaning given them by section 33 423.1 for purposes of this chapter. 34 Sec. 4. NEW SECTION . 423G.2 Tax imposed. 35 -3- LSB 2475YH (7) 87 tr/rj 3/ 7

H.F. 618 A tax of five percent is imposed on the gross receipts of 1 a schedule II controlled substance sold at wholesale to a 2 practitioner in this state. The tax imposed under this section 3 shall be collected and paid over to the department by the 4 wholesaler. 5 Sec. 5. NEW SECTION . 423G.3 Administration by director. 6 1. The director of revenue shall administer the excise tax 7 on the gross receipts of schedule II controlled substances as 8 nearly as possible in conjunction with the administration of 9 the state sales and use tax law, except that portion of the law 10 that implements the streamlined sales and use tax agreement. 11 The director shall provide appropriate forms, or provide on the 12 regular state tax forms, for reporting tax liability pursuant 13 to this chapter. 14 2. The director may require all wholesalers subject to tax 15 liability under this chapter to register with the department. 16 The director may also require a tax permit applicable only to 17 this chapter for any wholesaler not collecting taxes under 18 chapter 423. 19 3. Section 422.25, subsection 4, sections 422.30, 422.67, 20 and 422.68, section 422.69, subsection 1, sections 422.70, 21 422.71, 422.72, 422.74, and 422.75, section 423.14, subsection 22 1, and sections 423.23, 423.24, 423.25, 423.31 through 23 423.35, 423.37 through 423.42, and 423.47, consistent with 24 the provisions of this chapter, shall apply with respect to 25 the tax authorized under this chapter, in the same manner 26 and with the same effect as if the excise tax on the gross 27 receipts of schedule II controlled substances by a wholesaler 28 was a retail sales tax within the meaning of those provisions. 29 Notwithstanding this subsection, the director shall provide for 30 quarterly filing of returns and for other than quarterly filing 31 of returns both as prescribed in section 423.31. All taxes 32 collected under this chapter by a wholesaler are deemed to be 33 held in trust for the state of Iowa. 34 Sec. 6. NEW SECTION . 423G.4 Deposit of revenues. 35 -4- LSB 2475YH (7) 87 tr/rj 4/ 7

H.F. 618 1. All moneys received and all refunds shall be deposited in 1 or withdrawn from the general fund of the state. 2 2. Subsequent to the deposit in the general fund of the 3 state, the department shall transfer the revenues collected 4 under this chapter to the opioid abuse prevention and treatment 5 fund created in section 135.191. 6 EXPLANATION 7 The inclusion of this explanation does not constitute agreement with 8 the explanation’s substance by the members of the general assembly. 9 This bill relates to opioid abuse prevention and treatment 10 by creating an opioid abuse prevention and treatment workgroup 11 and an excise tax on the gross receipts of certain controlled 12 substances sold at wholesale and providing for the transfer of 13 the excise tax revenues to a newly created fund. 14 The bill establishes an opioid abuse prevention and 15 treatment workgroup within the department of public health. 16 Under the bill, the membership of the workgroup includes one 17 physician, one pharmacist, one social worker, one advanced 18 registered nurse practitioner, one representative of a county 19 board of health, one representative of a substance abuse 20 treatment program licensed under Code chapter 125, one person 21 who has been treated for and has recovered from opioid abuse, 22 and two persons who are not licensed to practice medicine, 23 pharmacy, social work, or nursing who shall represent the 24 general public. 25 Under the bill, the workgroup is required to promote 26 meetings and programs for the discussion of methods to reduce 27 opioid abuse and disseminate information in cooperation 28 with any other department, agency, or other governmental 29 or nongovernmental entity on the prevention, evaluation, 30 care, treatment, and rehabilitation of persons affected by 31 opioid abuse. The bill also requires the workgroup to study 32 and review current prevention, evaluation, care, treatment, 33 and rehabilitation programs and strategies and recommend 34 appropriate preparation, training, retraining, and distribution 35 -5- LSB 2475YH (7) 87 tr/rj 5/ 7

H.F. 618 of personnel and resources in the provision of services to 1 persons with opioid abuse issues through treatment programs 2 licensed in accordance with the administrative rules of the 3 department. 4 The bill directs the workgroup to make recommendations to 5 the department to expend moneys deposited in the opioid abuse 6 prevention and treatment fund to carry out the recommendations 7 of the workgroup in accordance with criteria set forth in 8 Code section 135.191. The bill also directs the workgroup to 9 make recommendations to the state board of health to approve 10 administrative rules for adoption by the department relating to 11 the workgroup’s recommendations. 12 The bill imposes an excise tax of 5 percent on the gross 13 receipts of schedule II controlled substances sold at wholesale 14 to practitioners in the state. The tax shall be collected and 15 paid over to the department of revenue by the wholesaler. The 16 bill contains definitions for “gross receipts”, “practitioner”, 17 “schedule II controlled substance”, and “wholesaler”. 18 The bill requires the director of revenue to administer 19 the excise tax as nearly as possible in conjunction with the 20 administration of the state sales and use tax laws, and, to 21 that end, the bill incorporates by reference several Code 22 sections that relate to general tax administration and the 23 sales and use tax laws. 24 The bill requires excise tax revenues collected pursuant 25 to the bill to be deposited in the general fund of the state, 26 then transferred to the opioid abuse prevention and treatment 27 fund created in the bill. The fund is created in the state 28 treasury under the control of the department of public health. 29 The fund is established to assist opioid abuse prevention and 30 treatment programs in the state, including but not limited to 31 programs described in the bill. The fund consists of moneys 32 deposited in the fund from the revenues of the excise tax, and 33 any other moneys obtained by the department for placement in 34 the fund. Moneys in the fund are not subject to Code section 35 -6- LSB 2475YH (7) 87 tr/rj 6/ 7