House File 726 - Introduced HOUSE FILE 726 BY ISENHART and WILSON A BILL FOR An Act relating to services, treatment, research, education, 1 and other activities relating to substance use disorder, 2 mental health, and other conditions including opioid 3 addiction and providing appropriations. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 1319YH (10) 90 pf/rn

H.F. 726 Section 1. IOWA BOARD OF PHARMACY —— REDUCTION OF OPIOID 1 MISUSE OR OVERUSE —— OPIOID SETTLEMENT. 2 1. There is appropriated from the opioid settlement fund 3 created in section 12.51 to the board of pharmacy for the 4 fiscal year beginning July 1, 2023, and ending June 30, 2024, 5 the following amounts, or so much thereof as is necessary, for 6 the purposes designated: 7 a. For the board of pharmacy to integrate the state’s 8 prescription monitoring program with health care providers’ 9 electronic medical record or pharmacy dispensing systems to 10 allow a seamless connection between the prescription monitoring 11 program and those systems: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 60,000 13 b. For the board of pharmacy to implement the opioid and 14 naloxone education (ONE) program to provide resources to 15 pharmacists to educate patients regarding opioid misuse and 16 accidental overdose in order to decrease opioid prescription 17 rates and the related addiction and overdose deaths in the 18 state: 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 450,000 20 2. If sufficient funds are not available through the opioid 21 settlement fund created in section 12.51, there is appropriated 22 from the Iowa coronavirus fiscal recovery fund created in 23 section 8.57G to the board of pharmacy for the fiscal year 24 beginning July 1, 2023, and ending June 30, 2024, an amount 25 sufficient to provide the total amounts specified under 26 subsection 1 for the purposes designated under this section. 27 3. Notwithstanding section 8.33, moneys appropriated in 28 this section that remain unencumbered or unobligated at the 29 close of the fiscal year shall not revert but shall remain 30 available for the purposes designated until expended. 31 Sec. 2. INCREASED ACCESS TO NALOXONE —— OPIOID SETTLEMENT. 32 1. There is appropriated from the opioid settlement fund 33 created in section 12.51 for deposit in the opioid antagonist 34 medication fund created in section 135.190A for the fiscal year 35 -1- LSB 1319YH (10) 90 pf/rn 1/ 24

H.F. 726 beginning July 1, 2023, and ending June 30, 2024, the following 1 amount, or so much thereof as is necessary, for the purpose 2 designated: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 250,000 4 2. The department of health and human services shall utilize 5 the moneys appropriated for deposit under this section for the 6 purchase, provision, maintenance, and replacement of opioid 7 antagonist medication administered by first responders to 8 persons experiencing an opioid-related overdose and to county 9 health departments for distribution to accredited schools and 10 institutions of higher education upon request. 11 3. If sufficient funds are not available through the 12 opioid settlement fund created in section 12.51, there is 13 appropriated from the Iowa coronavirus fiscal recovery fund 14 created in section 8.57G for deposit in the opioid antagonist 15 medication fund created in section 135.190A for the fiscal year 16 beginning July 1, 2023, and ending June 30, 2024, for direct 17 appropriation to the department of health and human services 18 for the fiscal year beginning July 1, 2023, and ending June 19 30, 2024, an amount sufficient to provide the total amount 20 specified under subsection 1 for the purposes designated under 21 this section. 22 4. Notwithstanding section 8.33, moneys appropriated in 23 this section that remain unencumbered or unobligated at the 24 close of the fiscal year shall not revert but shall remain 25 available for the purposes designated until expended. 26 Sec. 3. SUBSTANCE USE DISORDER RECOVERY HIGH SCHOOLS —— 27 OPIOID SETTLEMENT. 28 1. There is appropriated from the opioid settlement fund 29 created in section 12.51 to the department of health and human 30 services for the fiscal year beginning July 1, 2023, and ending 31 June 30, 2024, the following amount, or so much thereof as is 32 necessary, for the purpose designated: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 50,000 34 2. The department of health and human services, in 35 -2- LSB 1319YH (10) 90 pf/rn 2/ 24

H.F. 726 collaboration with the department of education, shall study 1 and make recommendations regarding the establishment of one or 2 more public or private recovery high schools in Iowa designed 3 for the education of students in recovery from substance 4 use disorders or dependency or co-occurring disorders such 5 as anxiety, depression, or attention deficit hyperactivity 6 disorder. Such schools shall meet state requirements for 7 awarding a secondary school diploma and support students 8 engaged in a program of recovery. The department of health 9 and human services shall complete the study and submit its 10 recommendations to the governor and the general assembly by 11 November 1, 2023. The recommendations shall include provisions 12 for students to be eligible for education savings accounts 13 without regard to family financial capacity. 14 3. If sufficient funds are not available through the opioid 15 settlement fund created in section 12.51, there is appropriated 16 from the Iowa coronavirus fiscal recovery fund created in 17 section 8.57G for the fiscal year beginning July 1, 2023, and 18 ending June 30, 2024, to the department of health and human 19 services an amount sufficient to provide the total amount 20 specified under subsection 1 for the purposes designated under 21 this section. 22 4. Notwithstanding section 8.33, moneys appropriated in 23 this section that remain unencumbered or unobligated at the 24 close of the fiscal year shall not revert but shall remain 25 available for the purposes designated until expended. 26 Sec. 4. SUBSTANCE USE DISORDER —— PERSONS COMMITTED 27 TO CORRECTIONAL INSTITUTIONS AND COUNTY JAILS —— OPIOID 28 SETTLEMENT. 29 1. a. There is appropriated from the opioid settlement 30 fund created in section 12.51 to the department of health and 31 human services, annually, an amount sufficient to implement 32 this section. 33 b. The department of health and human services shall 34 transfer the amount appropriated under this section to the 35 -3- LSB 1319YH (10) 90 pf/rn 3/ 24

H.F. 726 department of corrections for use in subsidizing the costs of 1 providing medication-assisted treatment to persons committed to 2 department of corrections institutions or county jails being 3 treated for opioid use disorder to purchase state-of-the-art 4 urine sample cups for use in the drug monitoring programs and 5 to fund efforts to fight hepatitis C, a potentially devastating 6 but curable disease spread through intravenous needle use of 7 opioids and other drugs in prison populations. If a county 8 is receiving opioid settlement funds to otherwise cover the 9 costs of medication-assisted treatment, the county shall match 10 the funding provided under this section on a dollar-for-dollar 11 basis. 12 2. If sufficient funds are not available through the 13 opioid settlement fund created in section 12.51, there is 14 appropriated from the Iowa coronavirus fiscal recovery fund 15 created in section 8.57G to the department of health and human 16 services for transfer to the department of corrections for the 17 fiscal year beginning July 1, 2023, and ending June 30, 2024, 18 an amount sufficient for the purposes designated under this 19 section. 20 3. Notwithstanding section 8.33, moneys appropriated in 21 this section that remain unencumbered or unobligated at the 22 close of the fiscal year shall not revert but shall remain 23 available for the purposes designated until expended. 24 Sec. 5. VETERANS COURTS —— OPIOID SETTLEMENT. 25 1. There is appropriated from the opioid settlement fund 26 created in section 12.51 to the department of veterans affairs 27 for the fiscal year beginning July 1, 2023, and ending June 30, 28 2024, the following amount, or so much thereof as is necessary, 29 for the purpose designated: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 31 2. a. The moneys appropriated under this section shall 32 be transferred to the judicial branch to establish a veterans 33 court with a full-time outreach coordinator in each judicial 34 district to provide court services to veterans and to integrate 35 -4- LSB 1319YH (10) 90 pf/rn 4/ 24

H.F. 726 court sanctions and incentives with substance use disorder 1 treatment, mental health treatment, and transitional services 2 for veterans in a judicially supervised setting. 3 b. It is the intent of the general assembly that the 4 jurisdiction of the veterans court may be exercised by any 5 district judge and by any district associate judge who is 6 designated by the chief judge of a judicial district as a judge 7 of the veterans court. The chief judge shall designate one 8 or more district judges and district associate judges to act 9 as judges of the veterans court for a judicial district. The 10 chief judge may designate a veterans court judge to preside in 11 more than one county. 12 3. If sufficient funds are not available through the opioid 13 settlement fund created in section 12.51, there is appropriated 14 from the Iowa coronavirus fiscal recovery fund created in 15 section 8.57G for the fiscal year beginning July 1, 2023, and 16 ending June 30, 2024, to the department of veterans affairs for 17 transfer to the judicial branch an amount sufficient to provide 18 the total amount specified under subsection 1 for the purposes 19 designated under this section. 20 4. Notwithstanding section 8.33, moneys appropriated in 21 this section that remain unencumbered or unobligated at the 22 close of the fiscal year shall not revert but shall remain 23 available for the purposes designated until expended. 24 Sec. 6. STATE EMPLOYEE BENEFITS —— SUBSTANCE USE DISORDER 25 BENEFITS —— USE OF OPIOIDS —— OPIOID SETTLEMENT. 26 1. a. There is appropriated from the opioid settlement fund 27 created in section 12.51 to the department of administrative 28 services for the fiscal year beginning July 1, 2023, and ending 29 June 30, 2024, the following amount, or so much thereof as is 30 necessary, for the purposes designated: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 32 b. The department of administrative services, in cooperation 33 with any health insurance plans or health plan administrators 34 of benefits extended to state employees, shall utilize the 35 -5- LSB 1319YH (10) 90 pf/rn 5/ 24

H.F. 726 funds appropriated in this subsection to create a model 1 benefit plan designed to incentivize or otherwise promote the 2 effective, evidence-based prescription and use of opioids to 3 members receiving benefits through state plans, document the 4 current use of benefits for substance use disorders, identify 5 gaps or unnecessary restrictions in coverage, and expand 6 access to evidence-based treatments and therapies, including 7 nonpharmacological treatments. 8 3. If sufficient funds are not available through the opioid 9 settlement fund created in section 12.51, there is appropriated 10 from the Iowa coronavirus fiscal recovery fund created in 11 section 8.57G to the department of administrative services 12 for the fiscal year beginning July 1, 2023, and ending June 13 30, 2024, an amount sufficient to provide the total amount 14 specified under subsection 1 for the purposes designated under 15 this section. 16 4. Notwithstanding section 8.33, moneys appropriated in 17 this section that remain unencumbered or unobligated at the 18 close of the fiscal year shall not revert but shall remain 19 available for the purposes designated until expended. 20 Sec. 7. MEDICAID RECIPIENTS —— SUBSTANCE USE DISORDER 21 BENEFITS —— USE OF OPIOIDS —— OPIOID SETTLEMENT. 22 1. a. There is appropriated from the opioid settlement fund 23 created in section 12.51 to the department of health and human 24 services for the fiscal year beginning July 1, 2023, and ending 25 June 30, 2024, the following amount, or so much thereof as is 26 necessary, for the purposes designated: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 28 b. The department of health and human services, in 29 cooperation with Medicaid managed care organizations, shall 30 utilize the funds appropriated under this section to design 31 benefit plans to incentivize or otherwise promote the 32 effective, evidence-based prescription and use of opioids to 33 Medicaid recipients, document the current use of benefits 34 for substance use disorders, identify gaps or unnecessary 35 -6- LSB 1319YH (10) 90 pf/rn 6/ 24

H.F. 726 restrictions in coverage, and expand access to evidence-based 1 treatment and therapies, including nonpharmacological 2 treatments. The department shall seek any Medicaid state plan 3 amendment or waiver necessary to administer this subsection. 4 2. If sufficient funds are not available through the opioid 5 settlement fund created in section 12.51, there is appropriated 6 from the Iowa coronavirus fiscal recovery fund created in 7 section 8.57G to the department of health and human services 8 for the fiscal year beginning July 1, 2023, and ending June 9 30, 2024, an amount sufficient to provide the total amount 10 specified under subsection 1 for the purposes designated under 11 this section. 12 3. Notwithstanding section 8.33, moneys appropriated in 13 this section that remain unencumbered or unobligated at the 14 close of the fiscal year shall not revert but shall remain 15 available for the purposes designated until expended. 16 Sec. 8. SUBSTANCE USE DISORDER AND OPIOID USE RESEARCH AND 17 EDUCATION —— OPIOID SETTLEMENT. 18 1. There is appropriated from the opioid settlement fund 19 created in section 12.51 to the following entities for the 20 fiscal year beginning July 1, 2023, and ending June 30, 2024, 21 the following amounts, or so much thereof as is necessary, for 22 the purposes designated: 23 a. To the department of health and human services: 24 (1) To contract with the Iowa health care collaborative to 25 do all of the following: 26 (a) To develop and pilot protocols for the treatment 27 of emergency room patients experiencing opioid or heroin 28 overdoses, including the provision of peer counseling and 29 advocacy: 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 31 (b) To reduce opioid exposure by educating doctors and 32 hospitals, especially in rural areas, to adopt the enhanced 33 recovery after surgery (ERAS) principles: 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 35 -7- LSB 1319YH (10) 90 pf/rn 7/ 24

H.F. 726 (2) For the psychiatric residency programs involved 1 with coordinated, collaborative care at newly established, 2 community-based behavioral health treatment facilities offering 3 residential substance use disorder treatment for twenty-nine 4 days or more: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 6 (3) To pilot the establishment and operation of three 7 community-based syringe service programs developed to provide 8 substance use prevention and response including linkages 9 to substance use disorder treatment; vaccination, testing, 10 and access to care for infectious diseases; and access to, 11 education regarding the safe utilization of, and proper 12 disposal of, fentanyl test strips, sterile syringes, and 13 injection equipment: 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 450,000 15 The pilot program supported with the funding appropriated 16 under this subparagraph is conditioned on the implementation 17 of written agreements with local law enforcement agencies 18 and county attorneys to refrain from charging or prosecuting 19 program sponsors or participants for violations of section 20 124.414. 21 b. To the state board of regents: 22 (1) To fund research on medication-assisted treatment for 23 substance use disorders conducted at the university of Iowa 24 college of public health to identify variability in outcomes, 25 demonstrate efficacy of treatment, and refine evidence-based 26 protocols: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 28 (2) To fund research and education conducted at the 29 university of Iowa Carver college of medicine for the 30 nonnarcotic treatment of pain: 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 32 c. To the department of public safety to establish and 33 direct a task force, in collaboration with the department of 34 health and human services, to make recommendations, based on 35 -8- LSB 1319YH (10) 90 pf/rn 8/ 24

H.F. 726 public health principles, to restructure the response of the 1 state’s health and justice systems to illicit drug use and to 2 individuals suffering from substance use disorders: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 4 The department of public safety shall submit a report of the 5 recommendations specified in this paragraph “c” to the governor 6 and the general assembly by July 1, 2024. 7 2. If sufficient funds are not available through the opioid 8 settlement fund created in section 12.51, there is appropriated 9 from the Iowa coronavirus fiscal recovery fund created in 10 section 8.57G to the entities specified in subsection 1, 11 for the fiscal year beginning July 1, 2023, and ending June 12 30, 2024, a sufficient amount to provide the total amounts 13 specified to the entities specified under subsection 1 for the 14 purposes designated under this section. 15 3. Notwithstanding section 8.33, moneys appropriated in 16 this section that remain unencumbered or unobligated at the 17 close of the fiscal year shall not revert but shall remain 18 available for the purposes designated until the close of the 19 succeeding fiscal year. 20 Sec. 9. PUBLIC HEALTH STRUCTURE AND INFRASTRUCTURE AND 21 SUBSTANCE USE DISORDER PREVENTION AND TREATMENT —— OPIOID 22 SETTLEMENT. 23 1. There is appropriated from the opioid settlement fund 24 created in section 12.51 to the university of Iowa college of 25 public health for the fiscal year beginning July 1, 2023, and 26 ending June 30, 2024, the following amounts, or so much thereof 27 as is necessary, for the purposes designated: 28 a. To conduct a comprehensive review and evaluation of 29 the existing public health structure and infrastructure in 30 Iowa, and to make recommendations for policy and funding to 31 improve capacity of the state and local communities to address 32 substance use and related issues: 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 250,000 34 b. To coordinate increased, systematic efforts with local 35 -9- LSB 1319YH (10) 90 pf/rn 9/ 24

H.F. 726 public health authorities to address the personal behaviors, 1 societal conditions, and lack of access to services that are 2 identified as risk factors for substance use disorders and 3 related co-occurring health conditions: 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 5 The amount appropriated may be used to provide grants to 6 county boards of health to implement evidence-based community 7 programming, policies, and collaborative projects with health 8 care providers to address the identified risk factors. 9 c. To provide paid internships for college of public 10 health students paired with local health departments to 11 support the development of local public health infrastructure, 12 conduct community health needs assessments, and assist in 13 the successful implementation of health improvement plans to 14 address substance use disorders and co-occurring brain health 15 and related conditions: 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 17 2. If sufficient funds are not available through the 18 opioid settlement fund created in section 12.51 to satisfy the 19 appropriations under subsection 1, there is appropriated from 20 the Iowa coronavirus fiscal recovery fund created in section 21 8.57G to the university of Iowa college of public health 22 for the fiscal year beginning July 1, 2023, and ending June 23 30, 2024, a sufficient amount to provide the total amounts 24 specified under subsection 1 for the purposes designated under 25 this section. 26 3. Notwithstanding section 8.33, moneys appropriated in 27 this section that remain unencumbered or unobligated at the 28 close of the fiscal year shall not revert but shall remain 29 available for the purposes designated until the close of the 30 succeeding fiscal year. 31 Sec. 10. SUBSTANCE USE DISORDER —— RECOVERY HOUSING —— 32 SUPPORTIVE SERVICES —— OPIOID SETTLEMENT. 33 1. a. There is appropriated from the opioid settlement fund 34 created in section 12.51 to the department of health and human 35 -10- LSB 1319YH (10) 90 pf/rn 10/ 24

H.F. 726 services for the fiscal year beginning July 1, 2023, and ending 1 June 30, 2024, the following amount, or so much thereof as is 2 necessary, for the purpose designated: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 4 b. Moneys appropriated under this section shall be used 5 by the department, in collaboration with the Iowa finance 6 authority and community-based organizations, to engage in work 7 to increase the availability of recovery housing throughout the 8 state. The moneys shall be distributed as grants to recovery 9 housing providers whose application for assistance is in 10 accordance with a county community health needs assessment and 11 health improvement plan. If a county is otherwise receiving 12 opioid settlement funds, the county shall match the grant 13 funding provided under this section on a dollar-for-dollar 14 basis. 15 2. If sufficient funds are not available through the 16 opioid settlement fund created in section 12.51 to satisfy the 17 appropriations under subsection 1, there is appropriated from 18 the Iowa coronavirus fiscal recovery fund created in section 19 8.57G to the department of health and human services for the 20 fiscal year beginning July 1, 2023, and ending June 30, 2024, a 21 sufficient amount to provide the total amount specified under 22 subsection 1 for the purposes designated under this section. 23 3. Notwithstanding section 8.33, moneys appropriated in 24 this section that remain unencumbered or unobligated at the 25 close of the fiscal year shall not revert but shall remain 26 available for the purposes designated until the close of the 27 succeeding fiscal year. 28 Sec. 11. COMPREHENSIVE STUDY AND REPORT OF SUBSTANCE USE 29 DISORDER TREATMENT COVERAGE, UTILIZATION, AND EXPENDITURES —— 30 OPIOID SETTLEMENT. 31 1. a. There is appropriated from the opioid settlement 32 fund created in section 12.51 to the department of insurance 33 and financial services for the fiscal year beginning July 1, 34 2023, and ending June 30, 2024, the following amount, or so 35 -11- LSB 1319YH (10) 90 pf/rn 11/ 24

H.F. 726 much thereof as is necessary, for the purposes designated: 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100,000 2 b. The department of insurance and financial services shall 3 utilize the funds appropriated under this subsection to perform 4 a comprehensive study and prepare a comprehensive report on 5 insurance coverage and payment policies for services related 6 to the treatment of substance use disorders by commercial 7 insurance companies and self-funded plans, as well as data 8 on current utilization and expenditures associated with such 9 benefit plans. The report shall be submitted to the general 10 assembly by January 1, 2024. 11 2. If sufficient funds are not available through the opioid 12 settlement fund created in section 12.51, there is appropriated 13 from the Iowa coronavirus fiscal recovery fund created in 14 section 8.57G to the department of insurance and financial 15 services for the fiscal year beginning July 1, 2023, and ending 16 June 30, 2024, an amount sufficient to provide the total amount 17 specified under subsection 1 for the purposes designated under 18 this section. 19 3. Notwithstanding section 8.33, moneys appropriated in 20 this section that remain unencumbered or unobligated at the 21 close of the fiscal year shall not revert but shall remain 22 available for the purposes designated until the close of the 23 succeeding fiscal year. 24 Sec. 12. TASK FORCE ON AN INTEGRATED SYSTEM FOR PREVENTION, 25 TREATMENT, RECOVERY, AND RESOURCES —— APPROPRIATIONS. 26 1. a. The director of health and human services 27 shall convene a task force to research and develop policy 28 recommendations to implement an integrated behavioral health 29 and substance use disorder system and services structure that 30 blends funding in the areas of prevention, treatment, recovery, 31 and resources. 32 b. The task force shall include the director of health 33 and human services, appropriate departmental personnel, two 34 representatives of each mental health and disability services 35 -12- LSB 1319YH (10) 90 pf/rn 12/ 24

H.F. 726 region appointed by the region, and three experts each 1 representing the fields of prevention, treatment, and recovery 2 selected by the department based on recommendations from the 3 mental health and disability services region chief executive 4 officers. 5 c. The task force shall submit a report to the governor 6 and the general assembly by June 30, 2024, including 7 recommendations that address all of the following: 8 (1) Prevention policy, including measures to ensure 9 consistent and sustained funding for prevention activities, 10 enhanced early intervention techniques, and a plan for 11 well-rounded prevention programs that address alcohol, 12 methamphetamine, opioid use, and co-occurring disorders. 13 (2) Treatment policy, built on the premise that 14 co-occurring issues are the norm rather than the exception, 15 and includes methods to deliver services through integrated 16 care models that regulate team-based care or close coordination 17 between providers, use of dual treatment planning methods, 18 standards for counselors to attain and practice with dual 19 certification, licensure solutions for dual programs and 20 practitioners, and effective treatment modalities for 21 short-term and long-term outcomes. 22 (3) Recovery policy, including practices to integrate 23 co-occurring approaches in mobile crisis response and other 24 crisis services, implementation of harm reduction practices, 25 integration of feasible medication strategies to support 26 mental health issues in alignment with substance use disorder 27 recovery, and incentive programs to support recovery efforts. 28 (4) Resource deployment policy including all of the 29 following: 30 (a) The combining and leveraging of state, regional, 31 and local partnerships to optimize opioid settlement funds 32 available to the state and counties. 33 (b) Allocation of federal substance abuse and mental health 34 services administration block grants for substance abuse 35 -13- LSB 1319YH (10) 90 pf/rn 13/ 24

H.F. 726 prevention and treatment and community mental health services. 1 (c) Other related federal government and private funding 2 opportunities. 3 (5) Provisions for peer support workers consistent with 4 the guidance of the federal substance abuse and mental health 5 services administration’s bringing recovery supports to scale 6 technical assistance center strategy. 7 (6) Opportunities through the alignment of the department 8 of health and human services to integrate the fragmented 9 behavioral health and substance use disorder services systems 10 into a system of comprehensive, whole-person care, that 11 utilizes public funding more efficiently and increases the 12 return on investment through enhanced community health for all 13 Iowans. 14 2. There is appropriated from the opioid settlement fund 15 created in section 12.51 to the department of health and 16 human services, for task force support for the fiscal year 17 beginning July 1, 2023, and ending June 30, 2024, the following 18 amount, or so much thereof as is necessary, for the purposes 19 designated: 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 150,000 21 The task force shall approve any contract for external 22 assistance to the task force. 23 3. a. There is appropriated from the opioid settlement 24 fund created in section 12.51 to the department of health and 25 human services, for the fiscal year beginning July 1, 2024, and 26 ending June 30, 2025, the following amount, or so much thereof 27 as is necessary for the purposes designated: 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,000,000 29 b. For dollar-for-dollar matching grants to mental health 30 and disability services regions to be used for long-term 31 residential treatment and recovery services for persons 32 diagnosed with one or more disorders including a substance use 33 disorder in accordance with the recommendations of the task 34 force convened under this section. 35 -14- LSB 1319YH (10) 90 pf/rn 14/ 24

H.F. 726 c. Notwithstanding section 8.33, moneys appropriated in 1 this subsection that remain unencumbered or unobligated at the 2 close of the fiscal year shall not revert but shall remain 3 available for the purposes designated until expended. 4 Sec. 13. IOWA FINANCE AUTHORITY —— TRANSITIONAL HOUSING 5 FOR ELIGIBLE SERVICE MEMBERS. There is appropriated from the 6 opioid settlement fund established in section 12.51 to the 7 Iowa finance authority for the fiscal year beginning July 1, 8 2023, and ending June 30, 2024, the following amount, or so 9 much thereof as is necessary, to be used for the purposes 10 designated: 11 To provide grants, low-interest loans, and loan guarantees 12 to veteran-led nonprofit organizations: 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,300,000 14 1. Amounts appropriated pursuant to this section shall be 15 distributed to veteran-led nonprofit organizations provided 16 that the organization meets all of the following conditions: 17 a. The funds will be used to purchase land, construct 18 housing, or furnish housing for the purpose of providing 19 transitional housing to homeless veterans. 20 b. The veterans receiving transitional housing benefits 21 pursuant to paragraph “a” are suffering from or are at risk of 22 opioid or other substance abuse disorder, post-traumatic stress 23 disorder, or another mental illness or life disruption as the 24 Iowa finance authority, in consultation with the department 25 of health and human services and the department of veterans 26 affairs, deems appropriate. 27 c. The funds are used as a part of a wraparound health 28 and social services program provided by or through the 29 organization. 30 2. Notwithstanding section 8.33, moneys appropriated in 31 this section that remain unencumbered or unobligated at the 32 close of the fiscal year shall not revert but shall remain 33 available for expenditure for the purposes designated until the 34 close of the succeeding fiscal year. 35 -15- LSB 1319YH (10) 90 pf/rn 15/ 24

H.F. 726 EXPLANATION 1 The inclusion of this explanation does not constitute agreement with 2 the explanation’s substance by the members of the general assembly. 3 This bill relates to services, treatment, research, 4 education, and other activities relating to substance use 5 disorders, mental health, and other conditions, including those 6 relating to opioids, and provides appropriations. 7 BOARD OF PHARMACY. The bill appropriates funds from the 8 opioid settlement fund created in Code section 12.51 to the 9 board of pharmacy for fiscal year 2023-2024 for the board of 10 pharmacy to integrate the state’s prescription monitoring 11 program with health care providers’ electronic medical record 12 or pharmacy dispensing systems to allow a seamless connection 13 between the prescription monitoring program and those systems; 14 and for the board of pharmacy to implement the opioid and 15 naloxone education (ONE) program to provide resources to 16 pharmacists to educate patients regarding opioid misuse and 17 accidental overdose in order to decrease opioid prescription 18 rates and the related addiction and overdose deaths in the 19 state. If sufficient funds are not available through the 20 opioid settlement fund to satisfy the appropriations, there is 21 appropriated from the Iowa coronavirus fiscal recovery fund 22 created in Code section 8.57G to the board of pharmacy for 23 fiscal year 2023-2024, an amount sufficient to provide the 24 total amounts specified for the purposes designated. Funds 25 appropriated shall not revert but shall remain available until 26 the close of the succeeding fiscal year. 27 ACCESS TO NALOXONE. The bill appropriates funds from the 28 opioid settlement fund for deposit in the opioid antagonist 29 medication fund created in Code section 135.190A for fiscal 30 year 2023-2024 to be used by the department of health and human 31 services (HHS) for the purchase, provision, maintenance, and 32 replacement of opioid antagonist medication administered by 33 first responders to persons experiencing an opioid-related 34 overdose and to county health departments for distribution to 35 -16- LSB 1319YH (10) 90 pf/rn 16/ 24

H.F. 726 accredited schools and institutions of higher education upon 1 request. If sufficient funds are not available through the 2 opioid settlement fund to satisfy the appropriation, there 3 is appropriated from the Iowa coronavirus fiscal recovery 4 fund for fiscal year 2023-2024 for deposit in the opioid 5 antagonist medication fund an amount sufficient to provide the 6 total amount specified for the purposes designated. Funds 7 appropriated shall not revert but shall remain available until 8 the close of the succeeding fiscal year. 9 RECOVERY HIGH SCHOOLS. The bill appropriates funds from the 10 opioid settlement fund to HHS for fiscal year 2023-2024 to be 11 used by HHS in collaboration with the department of education 12 to study and make recommendations regarding the establishment 13 of one or more public or private recovery high schools in 14 Iowa designed for the education of students in recovery from 15 substance use disorders or dependency or co-occurring disorders 16 such as anxiety, depression, or attention deficit hyperactivity 17 disorder. The schools must meet state requirements for 18 awarding a secondary school diploma and support students 19 engaged in a program of recovery. The department of health 20 and human services shall complete the study and submit its 21 recommendations to the governor and the general assembly by 22 November 1, 2023. The recommendations shall include provisions 23 for students to be eligible for education savings accounts 24 without regard to family financial capacity. If sufficient 25 funds are not available through the opioid settlement fund to 26 satisfy the appropriation, there is appropriated from the Iowa 27 coronavirus fiscal recovery fund for fiscal year 2023-2024 to 28 HHS an amount sufficient to provide the total amount specified 29 for the purposes designated. Funds appropriated shall not 30 revert but shall remain available until the close of the 31 succeeding fiscal year. 32 CORRECTIONAL INSTITUTIONS AND COUNTY JAILS. The bill 33 appropriates funds from the opioid settlement fund to 34 HHS for fiscal year 2023-2024 for HHS to transfer to the 35 -17- LSB 1319YH (10) 90 pf/rn 17/ 24