An Act To Save Lives by Establishing the Low Barrier Opioid Treatment Response Program
Maine Legislature, Session 129, LD 1662
Committee Amendment CA_A_S398 (Senate)

COMMITTEE AMENDMENT" ~ "to S.P. 539, L.D. 1662, Bill, "An Act To Save 
Lives by Establishing the Low Barrier Opioid Treatment Response Program" 
Amend the bill by striking out the title and substituting the following: 
'Resolve, To Save Lives by Establishing the Low Barrier Opioid Treatment 
Response Pilot Project within the Department of Health and Human Services' 
Amend the bill by striking out everything after the title and inserting the following: 
'Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, opioid use disorder has reached epidemic proportions and threatens the 
lives and well-being of many Maine residents; and 
Whereas, existing modalities and strategies for treatment of opioid use disorder are 
insufficient to end the epidemic of this disorder in Maine; and 
Whereas, existing services are especially inadequate to address the impact of opioid 
use disorder on those experiencing or having experienced unstable housing, minimal or 
no employment, unreliable transp01iation, lack of insurance coverage, use of multiple 
substances, frequent hospitalization or prior overdoses; and 
Whereas, failure to provide timely treatment to those most at risk of overdose death 
from opioid use leads to unnecessary loss of life and tragic dislocations of family life, 
while imposing substantial additional costs on the State due to related increases in 
incarcerations, hospital admissions and foster care for children affected by parental use of 
opioids; and 
Whereas, a low barrier, rapid access treatment system delivered and coordinated by 
Maine's community health centers will provide an essential component of an improved 
array of responses to this epidemic; and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" A "to S.P. 539, L.D. 1662 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, be it 
Sec. 1. Low barrier opioid treatment response pilot project. Resolved: 
That there is established within the Department of Health and Human Services, referred 
to in this resolve as "the department," a low barrier opioid treatment response pilot project 
to provide resources for federally qualified health centers, referred to in this resolve as 
"community health centers," to develop and deploy low barrier, rapid access to treatment 
for those persons typically unable to obtain timely treatment and at greatest risk of opioid 
overdose, including but not limited to persons affected by unstable housing, minimal or 
no employment, unreliable transportation, use of multiple substances associated with 
addiction or chronic overuse, frequent hospitalization, prior overdoses or a lack of health 
insurance coverage for substance use treatment services. 
1. Pilot project components. To the extent permitted by resources allocated to the 
pilot project, the pilot project must be designed to include the following: 
A. 
Support for clinic infrastructure to reduce barriers to access to treatment, 
including incentives for community health centers to support additional qualified 
providers in obtaining waivers to provide medication-assisted therapy services and 
support for each community health center to identify and compensate an individual 
within that community health center to help implement the pilot project; 
B. A statewide program of antistigma training that includes providers, staff and 
community health center patient-led boards; 
C. Support for the development and implementation of a standardized induction 
practice across all participating community health centers; 
D. Increased availability of naloxone hydrochloride to community health centers and 
training of community health center personnel on the emergency administration of 
naloxone hydrochloride; and 
E. Strategies to increase the number of providers willing to issue prescriptions for 
medication-assisted therapy services in a manner that facilitates rapid access to 
treatment. 
2. Pilot project implementation. The pilot project must be operated by at least 3 
community health centers selected on the basis of applications demonstrating interest in 
implementing the pilot project and capacity to implement the pilot project. 
The 
department shall strive to approve applications of community health centers of varying 
sizes and as geographically diverse as practicable given the pool of applicants. The 
department may phase in selected elements of the pilot project over the course of the pilot 
project. 
3. Reimbursement. 
The department shall modify and supplement the 
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reimbursement of community health centers provided under the Maine Revised Statutes, 
Title 22, section 3174-V to the extent necessary to implement the pilot project. 
4. Duration of pilot project. The depatiment shall enter into contracts no later than 
July 1, 2020 with the community health centers selected pursuant to subsection 2 to 
implement the pilot project. The pilot project must operate for 24 months from the date 
all of the contracts have been awarded. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" A "toS.P.539,L.D.1662 (S ·_?;°ffc,\ 
5. Data collection. Each community health center participating in the pilot project 
shall collect and report to the department the following information regarding the pilot 
project: 
A. The number of patients served; 
B. For each patient served, the time elapsed between first patient encounter and 
delivery of services; 
C. Overdose and mortality rates of patients; 
D. The number of patients who transition to long-term recovery programs; 
E. The number of patients who are employed; and 
F. Any other outcome and quality indicators that the department may specify after 
consultation with participating community health centers, without duplicating other 
existing rep01ting requirements. 
6. Report on pilot project. The department shall report to the joint standing 
committee of the Legislature having jurisdiction over health and human services matters 
regarding the pilot project by December 1, 2021 and at the conclusion of the pilot project. 
The reports must address the effectiveness of the implementation of the pilot project 
established pursuant to this resolve, including a review of the information collected under 
subsection 5, the schedule for full implementation if recommended by the department and 
the extent of any additional funding needed to accomplish full implementation. The joint 
standing committee may submit legislation to the Second Regular Session of the 130th 
Legislature regarding the pilot project, including legislation to continue or expand the 
pilot project. 
Sec. 2. 
Appropriations and allocations. 
Resolved: 
That the following 
appropriations and allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Office of Substance Abuse and Mental Health Services Z199 
Initiative: Provides one-time funding for a 24-month pilot project to provide low barrier, 
rapid access treatment for opioid use disorder and other substance use disorders to be 
delivered by 8 federally qualified health centers in Maine under the direction of the 
Department of Health and Human Services and in collaboration with other health care 
providers. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
2019-20 
$0 
$0 
2020-21 
$460,000 
$460,000 
Emergency clause. 
In view of the emergency cited in the preamble, this 
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legislation takes effect when approved.' 
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Amend the bill by re lettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
COMMITTEE AMENDMENT 
,~ ()Y: (-=· 
COMMITTEE AMENDMENT"/) "to S.P. 539, L.D. 1662 
SUMMARY 
This amendment, which is the unanimous report of the committee, replaces the bill 
with a resolve. The resolve requires the Department of Health and Human Services to 
establish a 24-month pilot project to provide low barrier opioid treatment response in 
Maine's federally qualified health centers to improve the availability of medication-
assisted therapy and enhance the effectiveness and sustainability of acute care responses 
to persons in urgent need of treatment for substance use disorder, including opioid use 
disorder. The resolve provides funding of $460,000 for implementing the first year of the 
24-month pilot project in 8 federally qualified health centers. It is anticipated that the 
same amount of funding will be required in fiscal year 2021-22. 
It also directs the department to submit rep01is by December 1, 2021 and at the 
conclusion of the pilot project regarding the implementation of the pilot project to the 
joint standing committee of the Legislature having jurisdiction over health and human 
services matters. The joint standing committee of the Legislature having jurisdiction over 
health and human services matters may submit legislation relating to the pilot project to 
the Second Regular Session of the 130th Legislature. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 02/03/20 fb/ac 
LD 1662 
LR 1646(02) 
An Act To Save Lives by Establishing the Low Barrier Opioid Treatment Response Program 
Fiscal Note for Bill as Amended by Committee Amendment "A" ( s-31'8.J 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2019-20 
$0 
FY 2020-21 
$460,000 
Projections 
FY 2021-22 
Projections 
FY 2022-23 
Net Cost (Savings) 
General Fund 
Appropriations/Allocations 
General Fund 
Fiscal Detail and Notes 
$0 
$460,000 
$460,000 
$0 
$460,000 
$0 
This bill includes a General Fund appropriation to the Department of Health and Human Services of$460,000 in 
fiscal year 2020-21 for a 24-month pilot project to provide low barrier, rapid access treatment for opioid use disorders 
and other substance use disorders to be delivered by 8 federally qualified health centers in Maine under the 
department's direction and in collaboration with other health care providers. The same amount of funding will be 
needed in fiscal year 2021-22. 
LR1646(02) - Fiscal Note - Page 1 of 1