An Act to Establish the Homeless Substance Use Disorder Service Program
Maine Legislature, Session 131, LD 1781
Committee: Health and Human Services
Sponsors: GATTINE
Amends: 5 MRSA §20003, 5 MRSA §20056

Legislative Document
No. 1781
H.P. 1144
House of Representatives, April 25, 2023
An Act to Establish the Homeless Substance Use Disorder Service 
Program
(EMERGENCY)
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative GATTINE of Westbrook.
Emergency preamble.  Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and
Whereas, substance use disorder is a crisis in this State, and housing is a critical 
service when assisting individuals with substance use disorder; and
Whereas, the homeless opioid users service engagement pilot project is currently in 
operation and it is important that the lessons of the pilot project are immediately 
incorporated into the Homeless Substance Use Disorder Service Program; 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 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore,
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  5 MRSA §20003, sub-§17-C is enacted to read:
17-C.  Person experiencing homelessness.  "Person experiencing homelessness" 
means:
A.  A person who is an adult, an unaccompanied youth or an adult with a family who 
lacks a fixed, regular and adequate nighttime residence or is at risk of imminently 
losing that person's primary nighttime residence, including a person who is sharing 
another person's dwelling on a temporary basis under which permission to remain is 
contingent upon the hospitality of the primary leaseholder or owner and can be 
rescinded at any time without notice;
B.  A person who is fleeing or attempting to flee domestic violence, dating violence, 
sexual assault, stalking or another dangerous or life-threatening situation involving 
violence against the person or a member of the person's family; and
C.  A person who is exiting an institution where the person resided for 90 or fewer days 
and who resided in an emergency shelter or place not meant for human habitation 
immediately before entering the institution.
Sec. 2.  5 MRSA §20056 is enacted to read:
§20056.  Homeless Substance Use Disorder Service Program
The department shall establish and administer the Homeless Substance Use Disorder 
Service Program, referred to in this section as "the program," to provide rapid access to 
low-barrier treatment for substance use disorder and stable housing to support recovery.  
The program includes the following requirements.  
1.  Participants.  A participant receiving services in the program must be a person with 
substance use disorder and a person experiencing homelessness who has a history of drug 
overdose.  Participation is voluntary, and a participant may withdraw from the program at 
any time.
2. Contracts; services.  The department shall contract with one or more social service 
or health care providers for the program.  The contracts must be sufficient to provide 
services for up to 50 participants in each year.  The contractor may subcontract with partner 
providers to implement portions of the program.  Services provided in the program must 
include, but are not limited to, integrated medication-assisted treatment; inpatient treatment 
programs; intensive case management services; access to stable housing that facilitates 
recovery and independence and offers a harm reduction approach; housing assistance; 
recovery support services that are flexible and appropriate to the participant; peer support 
services; outreach services to identify and engage with potential participants; transition 
services for a participant recently incarcerated or hospitalized; transportation services; and 
any other appropriate services.  Services provided to participants are individualized and 
flexible as appropriate to each participant's needs.  Each participant shall engage in 
developing an individual plan with the provider.
3.  Service locations.  The department shall ensure that the program is available in at 
least one urban and one rural area of the State and is based on the geographic location of 
potential participants described in subsection 1.
4.  Housing assistance fund.  The contractor shall administer a housing assistance 
fund to provide participants with immediate access to stable housing.  The housing 
assistance fund must contain sufficient capital to provide all participants with 18 months 
of rent at fair market value based on the location of the housing.  The contractor may 
provide a participant with more or less than 18 months of financial assistance from the 
housing assistance fund, depending on the participant's need for financial assistance to 
achieve housing stability.  The contractor shall assist participants in securing an alternative 
financial resource or resources for housing including but not limited to employment, 
general assistance, the Bridging Rental Assistance Program established in Title 34-B, 
section 3011, the federal shelter plus care program authorized by the federal McKinney-
Vento Homeless Assistance Act, Public Law 100-77 (1987) as amended by the federal 
Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009, Public Law 
111-22, Division B (2009) and housing choice vouchers under Section 8 of the United 
States Housing Act of 1937, Public Law 75-412, 50 Stat. 888, as amended.
5.  Housing funding.  The Maine State Housing Authority shall collaborate with the 
department to provide funding for costs associated with housing provided under this 
section.
6.  Rulemaking.  The department shall adopt rules to implement the program.  Rules 
adopted pursuant to this section are routine technical rules as defined in chapter 375, 
subchapter 2-A.
7.  Reports.  The department shall provide a report to the joint standing committee of 
the Legislature having jurisdiction over health and human services matters every 2 years 
beginning January 2, 2025 regarding the program.  The report must include numbers of 
participants including those who leave the program because they no longer need services 
and those who are unsuccessful, descriptions of services provided, evaluation data, funding 
levels and continuing challenges.  The joint standing committee is authorized to report out 
legislation related to the report in any regular or special session in the year in which the 
committee receives the report.
Sec. 3. Rulemaking.  Rules adopted by the Department of Health and Human 
Services pursuant to the Maine Revised Statutes, Title 5, section 20056 to develop the 
Homeless Substance Use Disorder Service Program must incorporate the evaluation 
information from the homeless opioid users service engagement pilot project established 
in Resolve 2019, chapter 105.  The department shall include the contractors and 
subcontractors that provided the services pursuant to the homeless opioid users service 
engagement pilot project in developing the program rules adopted pursuant to Title 5, 
section 20056, subsection 6.
Emergency clause.  In view of the emergency cited in the preamble, this legislation 
takes effect when approved.
SUMMARY
This bill establishes the Homeless Substance Use Disorder Service Program to provide 
rapid access to low-barrier treatment for substance use disorder and stable housing to 
support recovery.  The program is similar to the homeless opioid users service engagement 
pilot project established in Resolve 2019, chapter 105, but the program is not limited to 
opioid use and provides additional services including transportation, community services 
and inpatient treatment services.  The evaluation of the pilot project must be used to inform 
the rules implementing the program and the contractors and subcontractors of the pilot 
project must be included in developing the rules.