House File 208 - Introduced HOUSE FILE 208 BY ISENHART , STAED , BROWN-POWERS , ABDUL-SAMAD , KRESSIG , JACOBY , WOLFE , FORBES , and RUNNING-MARQUARDT A BILL FOR An Act relating to substance use disorder prevention and 1 treatment, including creating an excise tax on the gross 2 receipts of certain controlled substances sold at wholesale 3 and an opioid abuse prevention and treatment fund, making 4 appropriations, and providing penalties. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 1703YH (3) 88 ss/rh

H.F. 208 Section 1. NEW SECTION . 124.309 Prescriptions for opioids 1 —— physician-patient contracts. 2 1. The boards of medicine, dentistry, and nursing shall 3 adopt rules requiring a practitioner to furnish, and a 4 practitioner and patient to sign, a contract regarding the 5 risks and responsibilities associated with opioid use prior to 6 a practitioner issuing a prescription for more than a seven-day 7 supply of an opioid to a patient and prior to issuing any 8 additional opioid prescriptions to the patient. 9 2. The form and content of a contract under this section 10 shall be determined by the board of medicine but shall be based 11 upon evidence regarding the responsible prescribing of opioids. 12 Sec. 2. NEW SECTION . 135.192 Opioid abuse prevention and 13 treatment fund. 14 1. An opioid abuse prevention and treatment fund is created 15 in the state treasury under the control of the department. 16 The fund is established to expand treatment for and access 17 to treatment for opioid use disorders and to assist opioid 18 drug abuse prevention and treatment programs in the state 19 including but not limited to medication-assisted treatment 20 programs that provide appropriate holistic services and 21 treatment programs licensed by the department, in accordance 22 with programs sponsored by community organizations, programs 23 that provide emergency responders with affordable access 24 to opioid antagonists, and programs that assist in paying 25 treatment costs for individuals who are ineligible for Medicaid 26 services or private insurance coverage. The fund shall also 27 provide support for the expansion of substance abuse and pain 28 management curricula at the university of Iowa college of 29 medicine, evidence-based public health research on nonnarcotic 30 pain treatment and management alternatives, and expanded mental 31 health and substance abuse education and training for emergency 32 medical care providers as defined in section 147A.1. 33 2. Distribution of moneys from the opioid abuse prevention 34 and treatment program shall be made to eligible applicants in 35 -1- LSB 1703YH (3) 88 ss/rh 1/ 14

H.F. 208 the following order of priority: 1 a. A public entity, including but not limited to a state, 2 county, or local community health clinic and federally 3 qualified health center, or a public health agency, as defined 4 in section 135D.2, that provides opioid use disorder treatment. 5 b. A nonpublic entity that, in addition to opioid use 6 disorder treatment services, provides required primary health 7 services as described in 42 U.S.C. §254b(b)(1)(A). 8 c. A nonpublic entity that provides opioid use disorder 9 treatment but does not provide required primary health services 10 as described in 42 U.S.C. §254b(b)(1)(A). 11 3. The fund shall consist of all moneys deposited in the 12 fund pursuant to section 423H.4 and any other moneys available 13 to, obtained, or accepted by the department for placement in 14 the fund. Moneys in the fund are not subject to section 8.33. 15 Notwithstanding section 12C.7, interest or earnings on moneys 16 in the fund shall be credited to the fund. 17 Sec. 3. NEW SECTION . 135.193 Opioid abuse prevention and 18 treatment workgroup. 19 1. An opioid abuse prevention and treatment workgroup shall 20 be established by the state board of health. The workgroup 21 shall be composed of nine members appointed by the governor 22 based on recommendations by the department, including the 23 following: 24 a. One physician licensed under chapter 148. 25 b. One pharmacist licensed under chapter 155A. 26 c. One social worker licensed under chapter 154C. 27 d. One advanced registered nurse practitioner licensed under 28 chapter 152. 29 e. One representative of a county board of health. 30 f. One representatives of a substance abuse treatment 31 program licensed under chapter 125. 32 g. One person who has been treated for and has recovered 33 from opioid abuse. 34 h. Two persons who are not licensed to practice medicine, 35 -2- LSB 1703YH (3) 88 ss/rh 2/ 14

H.F. 208 pharmacy, social work, or nursing who shall represent the 1 general public. 2 2. The workgroup shall do all of the following: 3 a. Promote meetings and programs for the discussion of 4 methods to reduce opioid abuse and disseminate information 5 in cooperation with any other department, agency, or other 6 governmental or nongovernmental entity on the prevention, 7 evaluation, care, treatment, and rehabilitation of persons 8 affected by opioid abuse. 9 b. Study and review current prevention, evaluation, care, 10 treatment, and rehabilitation programs and strategies and 11 recommend appropriate preparation, training, retraining, and 12 distribution of personnel and resources in the provision of 13 services to persons with opioid abuse issues through treatment 14 programs licensed in accordance with the administrative rules 15 of the department. 16 c. Make recommendations to the department to expend moneys 17 deposited in the opioid abuse prevention and treatment fund 18 created in section 135.192 to carry out the recommendations 19 of the workgroup in accordance with the purposes of section 20 135.192, subject to the approval of the department. 21 d. Meet at least quarterly. 22 e. Make recommendations regarding approval by the state 23 board of health of administrative rules for adoption by the 24 department pursuant to chapter 17A. 25 3. The department may receive gifts, grants, or donations 26 made for any of the purposes of the workgroup’s duties and 27 disburse and administer them in accordance with their terms. 28 Sec. 4. NEW SECTION . 135.194 Substance abuse treatment 29 programs. 30 1. The general assembly declares that it is the public 31 policy of the state to increase the percentage of people 32 receiving treatment for substance use disorders from ten 33 percent to eighty percent and to ensure that all effective 34 evidence-based substance use disorder treatments are covered 35 -3- LSB 1703YH (3) 88 ss/rh 3/ 14

H.F. 208 by the authorization and payment policies of all public and 1 private payers. 2 2. The department, in consultation with the Iowa poison 3 control center and the Iowa health care collaborative, shall 4 develop addiction, addiction treatment, overdose, and overdose 5 death surveillance metrics, standards, and requirements for 6 data collected through county boards of health. 7 Sec. 5. NEW SECTION . 137.105A County boards of health —— 8 opioid epidemic response. 9 Each county board, in cooperation with a mental health and 10 disability services region formed in accordance with section 11 331.389 and substance abuse programs licensed pursuant to 12 chapter 125, shall include opioid abuse and substance use 13 disorder treatment in each community health needs assessment 14 and each county health improvement plan shall include 15 provisions related to prevention, harm reduction, and treatment 16 associated with substance use disorders. 17 Sec. 6. NEW SECTION . 155A.28A Labeling and packaging of 18 opioids. 19 Beginning January 1, 2020, any packaging, including 20 unit dose packaging, of an opioid that is prescribed by a 21 practitioner or directly dispensed by a pharmacist and that 22 is not for immediate administration to an ultimate user shall 23 contain a label including information about the risks of opioid 24 use and abuse and the risks of addiction and overdose pursuant 25 to rules of the board. 26 Sec. 7. NEW SECTION . 272C.2D Continuing education minimum 27 requirements —— emergency physicians. 28 The board of medicine shall adopt rules requiring emergency 29 physicians to receive training on mental illness and substance 30 use disorders as a condition of license renewal. 31 Sec. 8. Section 356.5, Code 2019, is amended by adding the 32 following new subsection: 33 NEW SUBSECTION . 7. Ensure that each prisoner currently 34 receiving medication-assisted treatment for a substance use 35 -4- LSB 1703YH (3) 88 ss/rh 4/ 14

H.F. 208 disorder under the direction of a licensed health care provider 1 shall continue to receive such treatment while the prisoner is 2 confined in jail. 3 Sec. 9. NEW SECTION . 423H.1 Definitions. 4 1. For purposes of this chapter, unless the context 5 otherwise requires: 6 a. “Gross receipts” means the total revenues received from 7 the wholesale sale of schedule II controlled substances to 8 practitioners in this state. 9 b. “Practitioner” means the same as defined in section 10 124.101. 11 c. “Schedule II controlled substance” means a controlled 12 substance listed in the schedule provided in section 124.206. 13 d. “Wholesaler” means a person operating or maintaining, 14 either within or outside this state, a wholesale distribution 15 center, wholesale business, or any other business in which 16 prescription drugs or devices, medicinal chemicals, medicines, 17 or poisons are sold, dispensed, stocked, exposed, distributed 18 from, or offered for sale at wholesale in this state. 19 “Wholesaler” does not include those wholesalers who sell only 20 proprietary or over-the-counter medicines. “Wholesaler” also 21 does not include a commercial carrier that temporarily stores 22 prescription drugs or devices, medicinal chemicals, medicines, 23 or poisons while in transit. 24 2. All other words and phrases used in this chapter and 25 defined in section 423.1 have the meaning given them by section 26 423.1 for purposes of this chapter. 27 Sec. 10. NEW SECTION . 423H.2 Tax imposed. 28 A tax of five percent is imposed on the gross receipts of 29 a schedule II controlled substance sold at wholesale to a 30 practitioner in this state. The tax imposed under this section 31 shall be collected and paid over to the department by the 32 wholesaler. 33 Sec. 11. NEW SECTION . 423H.3 Administration by director. 34 1. The director of revenue shall administer the excise tax 35 -5- LSB 1703YH (3) 88 ss/rh 5/ 14

H.F. 208 on the gross receipts of schedule II controlled substances as 1 nearly as possible in conjunction with the administration of 2 the state sales and use tax law, except that portion of the law 3 that implements the streamlined sales and use tax agreement. 4 The director shall provide appropriate forms, or provide on the 5 regular state tax forms, for reporting tax liability pursuant 6 to this chapter. 7 2. The director may require all wholesalers subject to tax 8 liability under this chapter to register with the department. 9 The director may also require a tax permit applicable only to 10 this chapter for any wholesaler not collecting taxes under 11 chapter 423. 12 3. Section 422.25, subsection 4, sections 422.30, 422.67, 13 and 422.68, section 422.69, subsection 1, sections 422.70, 14 422.71, 422.72, 422.74, and 422.75, section 423.14, subsection 15 1, and sections 423.23, 423.24, 423.25, 423.31 through 16 423.35, 423.37 through 423.42, and 423.47, consistent with 17 the provisions of this chapter, shall apply with respect to 18 the tax authorized under this chapter, in the same manner 19 and with the same effect as if the excise tax on the gross 20 receipts of schedule II controlled substances by a wholesaler 21 was a retail sales tax within the meaning of those provisions. 22 Notwithstanding this subsection, the director shall provide for 23 quarterly filing of returns and for other than quarterly filing 24 of returns both as prescribed in section 423.31. All taxes 25 collected under this chapter by a wholesaler are deemed to be 26 held in trust for the state of Iowa. 27 4. The director of revenue may adopt rules, not 28 inconsistent with this chapter, necessary and advisable for its 29 administration and enforcement. 30 Sec. 12. NEW SECTION . 423H.4 Deposit of revenues. 31 1. All moneys received and all refunds shall be deposited in 32 or withdrawn from the general fund of the state. 33 2. Subsequent to the deposit in the general fund of the 34 state, the department shall transfer the revenues collected 35 -6- LSB 1703YH (3) 88 ss/rh 6/ 14

H.F. 208 under this chapter to the opioid abuse prevention and treatment 1 fund created in section 135.192. 2 Sec. 13. NEW SECTION . 423H.5 Violation —— enforcement. 3 1. A wholesaler who violates this chapter is guilty of a 4 fraudulent practice. 5 2. The director may designate employees to administer 6 and enforce the provisions of this chapter, including 7 the collection of taxes imposed by this chapter. In the 8 enforcement of this chapter, the director may request aid from 9 the attorney general, the special agents of the state, any 10 county attorney, or any peace officer. 11 Sec. 14. SUBSTANCE USE DISORDER TREATMENT —— INSURANCE 12 COVERAGE. The insurance division of the department of commerce 13 shall prepare a comprehensive report on insurance coverage 14 and payment policies for services related to the treatment of 15 substance use disorders by commercial insurance companies and 16 self-funded plans, as well as data on current utilization and 17 expenditures associated with such benefit plans. The report 18 shall be submitted to the general assembly by January 1, 2020. 19 Sec. 15. OPIOIDS —— USAGE —— SUBSTANCE USE TREATMENT. 20 1. The department of administrative services shall, in 21 cooperation with any health insurance plans or health plan 22 administrators of benefits extended to state employees, create 23 a model benefit plan designed to incentivize or otherwise 24 promote the effective, evidence-based prescription and 25 use of opioids to members receiving benefits through state 26 plans, document the current use of benefits for substance 27 use disorders, identify gaps or unnecessary restrictions in 28 coverage, and expand access to evidence-based treatments and 29 therapies, including nonpharmacological treatments. 30 2. The department of human services and the Iowa 31 Medicaid enterprise shall, in cooperation with managed care 32 organizations, design benefit plans to incentivize or otherwise 33 promote the effective, evidence-based prescription and use 34 of opioids to members receiving benefits through managed 35 -7- LSB 1703YH (3) 88 ss/rh 7/ 14

H.F. 208 care organizations, document the current use of benefits 1 for substance use disorders, identify gaps or unnecessary 2 restrictions in coverage, and expand access to evidence-based 3 treatment and therapies, including nonpharmacological 4 treatments, by application for a Medicaid waiver if necessary. 5 Sec. 16. PROFESSIONAL LICENSING BOARDS —— SUBSTANCE 6 USE TREATMENT PROGRAMS. Each professional licensing board 7 designated in section 147.13 shall consider the adoption of 8 a program modeled after the Iowa nurse assistance program 9 and the Iowa physician health program for the identification 10 and treatment of licensees who may be at risk for license 11 discipline due to a substance use disorder. 12 Sec. 17. SUBSTANCE USE DISORDERS —— RECOVERY HIGH 13 SCHOOLS. The department of education shall, in collaboration 14 with the department of public health and the department 15 of human services, make recommendations regarding the 16 establishment of one or more recovery high schools in Iowa 17 designed for the education of students in recovery from 18 substance use disorders or dependency or co-occurring 19 disorders such as anxiety, depression, and attention deficit 20 hyperactivity disorder. Such schools shall meet state 21 requirements for awarding a secondary school diploma and 22 support students engaged in a program of recovery. The 23 department of education shall submit its recommendations to the 24 governor and the general assembly by November 1, 2019. 25 Sec. 18. OPIOID ABUSE PREVENTION AND TREATMENT FUND —— 26 APPROPRIATION. There is appropriated from the opioid abuse 27 prevention and treatment fund created in section 135.192, as 28 enacted in this Act, to the department of public health for the 29 fiscal year beginning July 1, 2019, and ending June 30, 2020, 30 the following amounts, or so much thereof as is necessary, to 31 be used for the purposes designated: 32 1. For contracting with the Iowa health care collaborative 33 to develop and pilot protocols for the treatment of emergency 34 room patients experiencing opioid or heroin overdoses, only to 35 -8- LSB 1703YH (3) 88 ss/rh 8/ 14

H.F. 208 the extent that funding is matched on a dollar-for-dollar basis 1 from private or public sources secured by the Iowa health care 2 collaborative: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 4 2. For the psychiatric residency programs involved 5 with coordinated, collaborative care at newly established, 6 community-based behavioral health treatment facilities offering 7 residential substance use disorder treatment for twenty-nine 8 days or more: 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 10 Sec. 19. OPIOID ABUSE PREVENTION AND TREATMENT FUND —— 11 APPROPRIATION. There is appropriated from the opioid abuse 12 prevention and treatment fund created in section 135.192, as 13 enacted in this Act, to the state board of regents for the 14 fiscal year beginning July 1, 2019, and ending June 30, 2020, 15 the following amounts, or so much thereof as is necessary, to 16 be used for the purposes designated: 17 1. For the funding of research on medication-assisted 18 treatment for substance use disorders conducted at the college 19 of public health at the state university of Iowa to identify 20 variability in outcomes, demonstrate efficacy of treatment, and 21 refine evidence-based protocols: 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 23 2. For the funding of research and education conducted at 24 the Carver college of medicine at the state university of Iowa 25 for the nonnarcotic treatment of pain: 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 27 Sec. 20. IMPLEMENTATION OF ACT. Section 25B.2, subsection 28 3, shall not apply to this Act. 29 EXPLANATION 30 The inclusion of this explanation does not constitute agreement with 31 the explanation’s substance by the members of the general assembly. 32 This bill relates to the treatment of substance use disorder 33 prevention and treatment, including creating an excise tax on 34 the gross receipts of certain controlled substances sold at 35 -9- LSB 1703YH (3) 88 ss/rh 9/ 14

H.F. 208 wholesale and an opioid abuse prevention and treatment fund, 1 makes appropriations, and provides penalties. 2 The bill directs the board of medicine to adopt rules 3 requiring practitioners to present, and practitioners 4 and patients to sign, a contract regarding the risks and 5 responsibilities associated with opioid use prior to a 6 practitioner’s prescription of a course of treatment including 7 opioids to a patient lasting longer than seven days and 8 prior to issuing a second or subsequent prescription for an 9 opioid to the patient. The bill requires the department of 10 medicine to determine the form and content of the contract but 11 requires that the contract be based on evidence regarding the 12 responsible prescription of opioids. 13 The bill establishes an opioid abuse prevention and 14 treatment workgroup within the department of public health. 15 Under the bill, the membership of the workgroup includes one 16 physician, one pharmacist, one social worker, one advanced 17 registered nurse practitioner, one representative of a county 18 board of health, one representative of a substance abuse 19 treatment program licensed under Code chapter 125, one person 20 who has been treated for and has recovered from opioid abuse, 21 and two persons who are not licensed to practice medicine, 22 pharmacy, social work, or nursing who shall represent the 23 general public. 24 Under the bill, the workgroup is required to promote 25 meetings and programs for the discussion of methods to reduce 26 opioid abuse and disseminate information in cooperation 27 with any other department, agency, or other governmental 28 or nongovernmental entity on the prevention, evaluation, 29 care, treatment, and rehabilitation of persons affected by 30 opioid abuse. The bill also requires the workgroup to study 31 and review current prevention, evaluation, care, treatment, 32 and rehabilitation programs and strategies and recommend 33 appropriate preparation, training, retraining, and distribution 34 of personnel and resources in the provision of services to 35 -10- LSB 1703YH (3) 88 ss/rh 10/ 14

H.F. 208 persons with opioid abuse issues through treatment programs 1 licensed in accordance with the administrative rules of the 2 department. 3 The bill directs the workgroup to make recommendations to 4 the department to expend moneys deposited in the opioid abuse 5 prevention and treatment fund to carry out the recommendations 6 of the workgroup in accordance with the purposes of the fund. 7 The bill also directs the workgroup to make recommendations 8 to the state board of health to approve administrative rules 9 for adoption by the department relating to the workgroup’s 10 recommendations. 11 The bill provides that it is the public policy of the 12 state of Iowa to increase the percentage of people receiving 13 treatment for substance use disorders from 10 percent to 14 80 percent and to ensure that all effective evidence-based 15 treatments for substance use disorder treatments are covered 16 by the authorization and payment policies of all public and 17 private payers. The bill directs the department of public 18 health, in consultation with the Iowa poison control center 19 and the Iowa health care collaborative, to develop addiction, 20 addiction treatment, overdose, and overdose death surveillance 21 metrics, standards, and requirements for data collected through 22 county boards of health. 23 The bill requires each county board of health, in 24 cooperation with the relevant mental health and disability 25 services region formed in accordance with Code section 26 331.389 and substance abuse programs licensed pursuant to Code 27 chapter 125, to include information regarding opioid abuse and 28 substance use disorder treatment in each community health needs 29 assessment, as well as in each health improvement plan when the 30 county board of health deems it appropriate. 31 The bill directs the board of pharmacy to adopt rules 32 requiring that packaging for certain opioids contain a label 33 including information regarding the dangers of opioid use and 34 abuse and the risks of addiction and overdose beginning January 35 -11- LSB 1703YH (3) 88 ss/rh 11/ 14

H.F. 208 1, 2020. 1 The bill directs the board of medicine to adopt rules 2 requiring emergency physicians to receive training on mental 3 illness and substance use disorders as a condition of license 4 renewal. 5 The bill requires the appropriate administrative officer 6 of each county jail to ensure that each prisoner currently 7 receiving medication-assisted treatment for a substance use 8 disorder under the direction of a licensed health care provider 9 continue to receive such treatment while confined in jail. 10 The bill imposes an excise tax of 5 percent on the gross 11 receipts of schedule II controlled substances sold at wholesale 12 to practitioners in the state. The tax shall be collected and 13 paid over to the department of revenue by the wholesaler. The 14 bill contains definitions for “gross receipts”, “practitioner”, 15 “schedule II controlled substance”, and “wholesaler”. 16 The bill requires the director of revenue to administer 17 the excise tax as nearly as possible in conjunction with the 18 administration of the state sales and use tax laws, and, to 19 that end, the bill incorporates by reference several Code 20 sections that relate to general tax administration and the 21 sales and use tax laws. 22 The bill requires excise tax revenues collected pursuant to 23 the bill to be deposited in the general fund of the state, then 24 transferred to the opioid abuse prevention and treatment fund 25 created in the bill. The fund is created in the state treasury 26 under the control of the department of public health. The fund 27 is established to expand treatment for and access to treatment 28 for opioid use disorders and to assist opioid abuse prevention 29 and treatment programs in the state, including but not limited 30 to programs described in the bill. The fund consists of moneys 31 deposited in the fund from the revenues of the excise tax, and 32 any other moneys obtained by the department for placement in 33 the fund. Moneys in the fund are not subject to Code section 34 8.33. Notwithstanding Code section 12C.7, interest or earnings 35 -12- LSB 1703YH (3) 88 ss/rh 12/ 14

H.F. 208 on moneys in the fund shall be credited to the fund. 1 The bill directs the insurance division of the department 2 of commerce to prepare a comprehensive report on insurance 3 coverage and payment policies for services related to the 4 treatment of substance use disorders by commercial insurance 5 companies and self-funded plans, as well as data on current 6 utilization and expenditures associated with such benefit 7 plans. The bill requires this report to be submitted to the 8 general assembly by March 1, 2020. 9 The bill directs the department of administrative 10 services, in cooperation with any health plans or health 11 plan administrators of benefits extended to state employees, 12 to create a model benefit plan designed to incentivize or 13 otherwise promote the effective, evidence-based prescription 14 and use of opioids to members receiving benefits through state 15 plans, document the current use of benefits for substance 16 use disorders, identify gaps or unnecessary restrictions in 17 coverage, and expand access to evidence-based treatments and 18 therapies, including nonpharmacological treatments. 19 The bill directs the department of human services and the 20 Iowa Medicaid enterprise, in cooperation with managed care 21 organizations, to design benefit plans to incentivize or 22 otherwise promote the effective, evidence-based prescription 23 and use of opioids to members receiving benefits through 24 managed care organizations, document the current use of 25 benefits for substance use disorders, identify gaps or 26 unnecessary restrictions in coverage, and expand access 27 to evidence-based treatment and therapies, including 28 nonpharmacological treatments, by application for a Medicaid 29 waiver if necessary. 30 The bill directs the department of education, in 31 collaboration with the department of public health and the 32 department of human services, to make recommendations to the 33 governor and the general assembly regarding the establishment 34 of recovery high schools for the education of students 35 -13- LSB 1703YH (3) 88 ss/rh 13/ 14

H.F. 208 recovering from substance abuse and related disorders. The 1 bill requires the department of education to submit its 2 recommendations by November 1, 2019. 3 The bill requires each professional licensing board 4 designated in Code section 147.13 to consider the adoption 5 of a program modeled after the Iowa nurse assistance program 6 and the Iowa physician health program for the identification 7 and treatment of licensees who may be at risk for license 8 discipline due to a substance use disorder. 9 The bill appropriates moneys from the opioid abuse 10 prevention and treatment fund to the department of public 11 health for contracting with the Iowa health care collaborative 12 to develop and pilot protocols for the treatment of emergency 13 room patients experiencing opioid or heroin overdoses 14 contingent on the Iowa health care collaborative receiving 15 dollar-for-dollar matching funding from private or public 16 sources and to support psychiatric residency programs at 17 behavioral health treatment facilities offering residential 18 substance use disorder treatment for 29 days or more. The 19 bill appropriates moneys from the opioid abuse prevention and 20 treatment fund to the state board of regents for FY 2019-2020 21 for the funding of research conducted at the college of public 22 health at the state university of Iowa for medication-assisted 23 treatment of substance use disorders to identify variability 24 in outcomes, demonstrate efficacy of treatment, and refine 25 evidence-based protocols, and for the funding of research and 26 education conducted at the Carver college of medicine at the 27 state university of Iowa for the nonnarcotic treatment of pain. 28 The bill may include a state mandate as defined in Code 29 section 25B.3. The bill makes inapplicable Code section 25B.2, 30 subsection 3, which would relieve a political subdivision from 31 complying with a state mandate if funding for the cost of 32 the state mandate is not provided or specified. Therefore, 33 political subdivisions are required to comply with any state 34 mandate included in the bill. 35 -14- LSB 1703YH (3) 88 ss/rh 14/ 14