Purpose

• Adjust how counties pay for substance use disorder services and expand funding for opioid and opiate-related programs. Create and allocate money from the Opiate Epidemic Response Fund to tribes, urban Indian communities, recovery and prevention efforts, and related administrative needs. Establish criteria to identify economically distressed counties and provide relief to those counties from certain cost-sharing requirements.

Main Provisions

• County cost-sharing adjustments

  • Counties generally must contribute 22.95% of the cost of substance use disorder services, with some exceptions for services under specific laws and for certain individuals.
  • Counties may use the indigent hospitalization levy for related treatment and hospital payments.
  • If a county is classified as economically distressed, it is not responsible for its share of the cost of substance use disorder services.
  • Economically distressed status is defined by two criteria: more than 15% of the population living in poverty (per the latest U.S. Census data) and more than 70% of the county’s land taxed is exempt from property taxation.

• Opiate Epidemic Response Fund allocations (from the registration and license fee account)

  • 100,000 for grants for opiate antagonist distribution, including overdose prevention, asset mapping, and education.
  • 2,000,000 for direct payments to Tribal nations and five urban Indian communities for traditional healing practices and to increase capacity of culturally specific providers; evaluations must be cooperative with tribes/urban Indian communities, and recipients need not share all details of ceremonies or healer identities.
  • 400,000 for competitive grants for opioid-focused Project ECHO programs (tele-education services for providers).
  • 277,000 in FY 2024 and 321,000 each year thereafter to administer the funding distribution and reporting requirements.
  • 3,000,000 in FY 2025, with 2,000,000 per year thereafter, for safe recovery sites startup and capacity-building grants.
  • 395,000 in FY 2024 and 415,000 each year thereafter for the opioid overdose surge alert system.
  • 300,000 for evaluation activities by the Department of Management and Budget (as directed by statute).
  • 261,000 for administrative services to the Opiate Epidemic Response Advisory Council and for administering the grants under paragraph n.
  • 126,000 for the Board of Pharmacy to collect registration fees.
  • 672,000 for the Bureau of Criminal Apprehension within the Department of Public Safety, including funds for drug scientists/lab supplies and drug interdiction positions.
  • After these items, 50% of the remaining funds are to be distributed to county social service agencies and Tribal social service agency initiative projects to provide prevention and child protection services to children and families affected by addiction; distribution is based on a formula using intake data from the previous three calendar years related to substance use and out-of-home placements where parental drug abuse is a factor. Projects must not supplant existing funding.
  • The remaining funds after b–m are awarded as grants by the Opiate Epidemic Response Advisory Council (per §256.042) unless the Legislature otherwise directs.

• Use and timing of funds

  • Some funds may be distributed on a calendar year basis starting in 2022.
  • Funds appropriated in several paragraphs may be available for three years after appropriation.
  • The bill emphasizes non-supplanting of current state or local funding and establishing measurable outcomes for prevention and child protection services.

Significant Changes to Law

• Economic distress criteria tied to county cost-sharing

  • Creates a formal process for classifying counties as economically distressed using poverty rate and property tax exemptions, which can relieve those counties from paying the county share for certain services.

• Expanded funding for opioid/opiate response

  • Establishes a dedicated fund (Opiate Epidemic Response Fund) with explicit allocations to tribes, urban Indian communities, Project ECHO programs, safe recovery sites, overdose surveillance, and administrative supports.
  • Adds direct tribal and urban Indian support for traditional healing and culturally specific providers.
  • Introduces and funds a recovery-site initiative and a surge-alert system for overdoses.
  • Creates grants and evaluation requirements to monitor outcomes and ensure accountability.

• Focus on prevention and child protection in addiction contexts

  • Directs a large portion of remaining funds to county and Tribal social service agency initiatives focused on prevention and protective services for children and families affected by addiction, with a data-driven distribution method and anti-supplanting safeguards.

Implementation Details

• Funding sources and administration

  • Revenue comes from the registration and license fee account.
  • Several programs have dedicated administrative and evaluation funding to ensure distribution, reporting, and oversight.
  • Some funds are earmarked for Tribes, urban Indian communities, and culturally specific providers; others support law enforcement, public safety, and public health surveillance.

• Oversight and accountability

  • Agencies must report how funds are used and show measurable outcomes.
  • Funds must not replace existing funding for child protection services.
  • Calendar-year distribution is allowed for certain programs, and funds are time-limited (available for up to three years after appropriation).

Summary of Key Impacts

• Reduces financial burden on economically distressed counties for substance use disorder services.
• Expands state support for opioid/often-opioid-related programs and services, including tribal and urban Indian communities, prevention, education, and recovery efforts.
• Improves data-driven funding decisions and accountability for child welfare and addiction-related services.
• Enhances public safety and enforcement funding related to drug abuse and trafficking.

Practical Considerations

• The bill sets specific eligibility criteria and reporting requirements that counties and tribal entities would need to meet to receive funds.
• The availability and carryover of funds are governed by three-year timeframes, affecting long-term program planning.

Potential Questions to Explore

• How will the economically distressed designation be updated or appealed if county conditions change?
• How will funding allocations be monitored to ensure adequate use for prevention and non-supplanting?
• What metrics will be used to measure outcomes for traditional healing practices and culturally specific providers?

Relevant Terms - economically distressed counties - poverty rate (15% threshold) - property tax exemptions (70% threshold) - county costshare - substance use disorder services - opiate epidemic response fund - opiate antagonist distribution - overdose prevention - Tribal nations - urban Indian communities - traditional healing practices - Project ECHO programs - safe recovery sites - opioid overdose surge alert system - Opiate Epidemic Response Advisory Council - registration and license fee account - indigent hospitalization levy - county social service agencies - Tribal social service agency initiative projects - intake data - out-of-home placement - addiction prevention and child protection services - non-supplanting of funds - calendar year distribution - three-year availability of funds - drug interdiction and BCA funding - drug prevention and enforcement grants