Texas must radically change the way it deals with substance use and drug possession. Tens of thousands of people are arrested each year for possession of small amounts of drugs, which is a felony offense; yet, low-income Texans who want help for substance use disorder must wait for weeks or months to find services. When people are arrested for possessing drugs, the vast majority receive time in county or state jail, and are deprived potentially life-saving treatment and recovery supports. The cycle of substance use, arrest, and incarceration simply continues – ravaging families, perpetuating the drug crisis in Texas, and squandering resources that could be used to truly prevent crime. The Legislature made progress in addressing one part of this issue, thanks to an increased focus on opioid overdose deaths as well as new federal dollars to combat opioid use disorder in Texas.
HB 405 (Authors: Minjarez, Howard, Hinojosa, Ortega, Cecil Bell | Sponsor: Kolkhorst), Relating to designating June as Neonatal Abstinence Syndrome Awareness Month. Designating June as Neonatal Abstinence Syndrome Awareness Month is intended to increase awareness of the syndrome and to encourage the following:
- awareness of the dangers of opioid and substance abuse during pregnancy to prevent neonatal abstinence syndrome;
- the creation and update of lists of recommended materials to address neonatal abstinence syndrome available through Texas’ Department of State Health Services and Health and Human Services Commission;
- electronic circulation of and posting on state and local agency websites of recommended treatment and recovery resources; and
- collaboration between state and federal governmental agencies, hospitals, private health care practices, health insurance providers, Medicaid providers, and mental health agencies to increase awareness.
Signed by the Governor; effective on 9/1/2019
Additional provisions of this bill are included in the section titled “Women’s Justice Bills,” specifically in the sub-section on “State-Level Reforms.”
HB 3285 (Authors: Sheffield, Zerwas, Price, Moody, Klick | Sponsor: Huffman), Relating to programs and initiatives to prevent and respond to opioid addiction, misuse, abuse, and overdose and identify and treat co-occurring substance use disorders and mental illness. This bill takes various steps to research, prevent, and respond to opioid and other drug misuse. For instance:
Research into substance use disorders: The Texas Higher Education Coordinating Board must encourage health-related institutions and their faculty – either individually or through collaborative effort – to conduct research for public health purposes regarding substance use disorders and addiction issues involving prescription drugs.
Pharmacist delivery of services: The Texas State Board of Pharmacy must encourage pharmacists to participate in a program that provides a comprehensive approach to the delivery of early intervention and treatment services for people with substance use disorders and people at risk of developing substance use disorders.
Telehealth treatment for substance use disorders: The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) must, by rule, establish a program to increase opportunities and expand access to telehealth treatment for substance use disorders in this state.
University training for R.A.’s on overdoses: Beginning with the 2019-2020 academic year, an institution of higher education that imposes any mandatory training requirements on residential advisors or officers of student organizations must ensure that overdose awareness and appropriate response training is included with that training.
Reimbursement for Medication-Assisted Treatment for opioid or substance use disorder: Until August 2023, HHSC must provide medical assistance reimbursement for medication-assisted opioid or substance use disorder treatment (including methadone, buprenorphine, oral buprenorphine/naloxone, or naltrexone) without requiring a medical assistance recipient or health care provider to obtain prior authorization or precertification for the treatment. The duty to provide reimbursement does not apply with respect to a prescription for methadone, a recipient for whom treatment is determined to be medically contraindicated by the recipient’s physician, or a recipient who is subject to an age-related restriction for applicable treatment.
Opioid misuse public awareness campaign: From December 2019 until August 2023, the Texas Department of State Health Services (DSHS) must operate a statewide public awareness campaign to deliver public service announcements that explain and clarify certain risks related to opioid misuse, including: (1) the risk of overdose, addiction, respiratory depression, or over-sedation, and (2) risks involved in mixing opioids with alcohol or other medications.
Opioid antagonist program: DSHS’s Executive Commissioner must establish and operate a program by December 2019 that provides opioid antagonists for the prevention of overdoses. The Executive Commissioner can provide such antagonists to emergency medical services personnel, first responders, public schools, community centers, and other individuals likely to be in a position to respond to an overdose.
Opioid antagonist grant program for law enforcement: The Governor’s Criminal Justice Division must establish and administer a grant program to provide funding to law enforcement agencies that want to provide opioid antagonists to officers, evidence technicians, and related personnel who, in the course of their job, are likely to encounter opioids or people overdosing on opioids. An agency can apply for a grant only if it first adopts a policy relating to using the antagonist for an overdose.
Data collection on opioid overdoses and co-occurring disorders: DSHS must collect data regarding opioid overdose deaths and the co-occurrence of substance use disorders and mental illness. In analyzing collected data, DSHS must evaluate the capacity for the treatment of co-occurring substance use disorders and mental illness.
Continuing education for pharmacists on opioids: A prescriber or dispenser whose practice includes the prescription or dispensation of opioids must annually attend at least one hour of continuing education covering best practices, alternative treatment options, and multi-modal approaches to pain management that can include physical therapy, psychotherapy, and other treatments.
Statewide behavioral health strategic plan: In preparing the statewide behavioral health strategic plan, the Statewide Behavioral Health Coordinating Council must incorporate strategies for:
- addressing the challenges of existing prevention, intervention, and treatment programs;
- evaluating substance use disorder prevalence involving the use of opioids;
- identifying substance abuse treatment services availability and gaps; and
- collaborating with state agencies to expand substance abuse treatment services capacity.
Funding for state agency actions under this bill: A state agency is only required to implement a provision of this bill if the Legislature appropriates money specifically for that purpose; if not, the state agency can – but is not required to – implement this bill using other appropriations available for that purpose. – Signed by the Governor; effective on 9/1/2019
SB 340 (Author: Huffman | Sponsors: Phil King, Guillen, Parker, Sheffield), Relating to the creation of a grant program to assist law enforcement agencies with the purchase of opioid antagonists. The Governor’s Criminal Justice Division must establish and administer a grant program to provide funding to law enforcement agencies that want to provide opioid antagonists to officers, evidence technicians, and related personnel who, in the course of their job, are likely to encounter opioids or people overdosing on opioids.
An agency can apply for a grant only if it first adopts a policy relating to using the antagonist for an overdose. In its grant application, the agency must provide information on the frequency and nature of its interactions with people suffering from an overdose, calls for assistance based on an overdose, and any exposure of officers or personnel to opioids or suspected opioids and any reactions by those individuals to those substances.
The Criminal Justice Division is only required to implement a provision of this bill if the Legislature appropriates money specifically for that purpose; if not, the Criminal Justice Division can – but is not required to – implement this bill using other appropriations available for that purpose. – Signed by the Governor; effective immediately, 6/10/2019
SB 436 (Author: Nelson | Sponsors: Price, Rose, Minjarez, Sheffield, VanDeaver), Relating to statewide initiatives to improve maternal and newborn health for women with opioid use disorder. The Department of State Health Services (DSHS) and the Maternal Mortality and Morbidity Task Force must develop and implement initiatives to:
- improve screening procedures to better identify and care for women with opioid use disorder;
- ensure health care providers refer such women to appropriate treatment and verify they receive it;
- optimize care provided to pregnant women with opioid use disorder, as well as to newborns with neonatal abstinence syndrome by encouraging maternal engagement;
- increase access to medication-assisted treatment during pregnancy and the postpartum period; and
- reduce the number of opioid drugs prescribed before, during, and following delivery to prevent opioid use disorder.
DSHS can first conduct a limited pilot program (until March 2020) at hospitals that have expertise in caring for newborns with neonatal abstinence syndrome or related conditions.
By December 2020, DSHS must create a report evaluating the success of any implemented initiatives and, if applicable, the pilot program. DSHS and the Task Force must separately promote and facilitate the use of maternal health informational materials by health care providers, including tools and procedures related to best practices in maternal health to improve obstetrical care for women with opioid use disorder. – Signed by the Governor; effective immediately, 6/7/2019
This bill is also included in the section titled “Women’s Justice Bills,” specifically in the sub-section on “State-Level Reforms.”