Substance Use Disorder Study Committee Approves Five Bills

Legislators approve dozens of bill amendments before bills go to Legislative Council Committee

After weeks of work sessions and a few dozen amendments, Colorado legislators will introduce at least five bills to address the state’s substance use crisis once the legislative session starts in January. The interim study committee on opioid and other substance use disorders voted Wednesday to refer a package of bills to the Legislative Council Committee. Some bills included more amendments than original provisions, but a few hotspots of debate stood out among the dozens of amendments proposed.  

The five bills, broadly, are designed to address treatment, recovery, harm reduction, prevention and substance use in the criminal justice system. Committee chair Rep. Brittany Pettersen and Sen. Cheri Jahn clashed over an amendment to the proposed recovery bill for allocating an additional $4.3 million in funding over five years to a housing voucher program for people with substance use disorders, which currently is in is its first year of funding. Jahn said she believes the legislature should know how the program is currently performing before appropriating more to it, and Pettersen seemed to interpret her concern as not supporting the program.  

“There are objections to housing people who are struggling with a substance use disorder to ensure that they’re not homeless,” Pettersen quipped when Jahn objected to the amendment. She insisted even with increased funding, the voucher program is a drop in the bucket compared to the resources needed to fully address housing challenges for those with substance use disorders. 

Jahn repeatedly emphasized she is not opposed to the housing voucher program. She said she believes knowing how the money is spent before allocating more is a valid question. 

The committee eventually passed a revised amendment as a compromise. Rep. Chris Kennedy proposed a reporting requirement in SMART Act hearings for the Department of Local Affairs for the department to report the number of projects funded under the voucher program, the units per project and the number of people who have been housed as a result.  

E-Prescribing Spun Off

As a key change to the harm reduction bill, the committee approved removing a provision to require pharmacies to receive prescriptions for controlled substances electronically in order to dispense them. Sen. Kevin Priola, a vocal proponent of the e-prescription requirement, said it should instead be considered as a standalone bill to be worked on into the winter because of its potential impact and in-depth discussion that needs to go into it. Pettersen had previously voiced doubt over whether the element should go in the harm reduction bill. 

“I like a lot of the stuff we’re doing here, but a lot of these maybe move the ball, in my opinion, a couple inches or a couple yards down the field,” Priola said. “I think e-prescribing will definitely give 10 yards for a first down.” 

In January 2020, Walmart will begin allowing only electronic prescriptions for controlled substances. The switch aims to reduce mistakes in prescriptions and fraudulent practices by patients, such as “doctor shopping.” 

An Apolitical Board of Governors 

Another proposed amendment to the committee’s recovery bill would create an opioid crisis recovery fund to collect any monetary awards or settlements from litigation over the crisis, such as the multi-district litigation currently pending in Ohio against several pharmaceutical manufacturers. The amendment would also establish a board of governors to lay out parameters for the money’s use if a court order does not specify how it can be used.  

Robert Valuck, a professor of pharmacy at the University of Colorado, spoke to the committee about studying steps other states are considering to prepare for any money they may receive from litigation. No state has yet actually formed a board of governors to oversee similar funds set up, but some are considering boards structured with a mix of legislators, governor appointees and members of stakeholder groups. Valuck said there seems to be a concern that waiting until money is awarded to set up a system for allocating it will create conflict and infighting. 

“Trying to set up the process at that point is going to be a whole lot more politicized and heavily fought over than an arguably more rational approach we can take now for any money that’s on the table,” he said. 

Pettersen emphasized the importance of using the possible money to address the substance use crisis, rather than to balance the state budget. The amendment originally proposed including governor appointees and legislators on the board, looking at how other states setting up funds are considering structuring their boards. But Jahn expressed concern about including legislators, saying it would politicize the board. 

“I’d be happy to entertain why everybody thinks that we should, but I think it makes it more political,” she said. The committee eventually agreed to a revised amendment striking the proposal for legislators to sit on the board. 

Identification Documents for Treatment 

A key amendment to the committee’s treatment bill would ensure the Office of Behavioral Health does not penalize substance abuse treatment providers for accepting patients who do not immediately have the necessary identification documents, such as a driver’s license or birth certificate. A patient would have up to six weeks to produce the needed documents under the amendment.  

Pettersen emphasized that the amendment does not relax requirements for the types of identification patients must produce. The six-week window is crucial, legislators said, because it’s important to take advantage of the moment when someone is actively seeking help for their substance use disorder at a time when they may have hit rock bottom. Removing the barrier to treatment if a person does not have immediate access to their identification could save their life, Pettersen said. 

“The person’s using heroin tonight” if they can’t get immediate access to help, Valuck said. “That moment is where we lose people.” 

— Julia Cardi

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