I_OpioidSubstance_2018A 09/18/2018 09:36:17 AM Committee Summary

Dr. Robert Werthwein, Director, Office of Behavioral Health (OBH), Department of Human Services (DHS), and Cristen Bates, OBH, DHS, provided an overview of the State Opioid Response Grant Plan and distributed a handout (Attachment B).

Dr. Werthwein provided data on DHS programs related to substance use disorder (SUD) treatment and prevention.  He described prevention programs including family support services, increased community outreach, and improving prescribing practices in hospitals.

Dr. Werthwein described DHS SUD treatment initiatives including increasing access to medication assisted treatment (MAT) and residential treatment, supporting the American Indian population, and the Lift the Label campaign to decrease stigma around SUD.  Ms. Bates and Dr. Werthwein responded to questions regarding the number of MAT providers and facilities in Colorado, funding to support SUD services for American Indians, and detoxification faclities.

Dr. Werthwein provided an update on funding and implementation of mobile health units in rural Colorado that will provide MAT treatment and telehealth services.

Dr. Werthwein described DHS initiatives related to SUD recovery, including hiring additional peer navigators and supporting peer-run recovery housing.  He told the committee that three additional jails will offer pre-release SUD services in the next year.  He noted that DHS includes education on MAT and SUD stigma when training jail-based behavioral health providers.  Dr. Werthwein responded to questions on diversion programs for persons with SUD who are involved in the criminal justice system.    

Dr. Werthwein updated the committee on the distribution of naloxone across Colorado.  He described DHS support for local community efforts to prevent SUD.  He responded to questions regarding SUD treatment in jails and the cost of naloxone.

Ms. Bates described the work of the Behavioral Health Care Facility Licensing Task Force.  The task force is working to update licensing and standards for SUD treatment and recovery facilities.  Dr. Werthwein described ongoing efforts to create a sustainable system to train the SUD workforce, create more access points to treatment, and increase coordination with other state agencies to pay for SUD care.  He responded to questions on recent federal legislation related to SUD.

Lindsey Myers, Colorado Department of Public Health and Environment, updated the committee on a pilot program to link the Prescription Data Monitoring Program (PDMP) to other electronic health information systems.  She noted that additional funds for the pilot program have been provided by the federal government.

Representative Pettersen called the meeting to order and commented on the process for drafting and amending bills.  An agenda was distributed to the committee (Attachment A).

Representative Pettersen explained the status of the committee's draft bills and the process to hold stakeholder meetings.  Copies of the committee's five bill drafts were distributed to the committee (Attachment C).  

Representative Kennedy provided a summary of draft bill #1 regarding treatment of SUD.  He explained that the bill requires OBH to create a system to tracking treatment capacity, requires OBH to coordinate SUD care, and creates a grant program to increase treatment options in rural communities.  Committee members commented on provisions of the bill.

Representative Pettersen summarized draft bill #2, which creates a process to establish standards for recovery facilities, and funds research on innovative SUD recovery models.  Committee members commented on the draft bill.

Senator Priola summarized the components of draft bill #3 regarding harm reduction.  The bill allows school districts to create programs to obtain naloxone, sets requirements on electronic prescribing and use of the PDMP, allows syringe exchanges at hospitals, and expedites issuing identification cards to persons with SUD.  Committee discussion ensued regarding the bill draft.

Representative Singer described draft bill #4 regarding SUD prevention.  The bill requires continuing education on SUD for some health care providers, amends the definition of child abuse, adds funding for prenatal screening, brief intervention, and referral to treatment, expands the household medication take back program, provides additional support for persons diagnosed with infectious diseases, and creates programs to increases public awareness of disposal of drugs, integrates SUD treatment and prenatal care, and increases funding for local prevention programs.  Committee discussion ensued regarding the bill draft.

Senator Moreno summarized draft bill #5 regarding SUD and the criminal justice system.  The bill requires some jails to provide MAT, clarifies the investigation of black market opioid operations, and appropriates funding to law enforcement assisted diversion and coresponder programs.  Committee members commented on the draft bill.

Dr. Rob Valuck, Consortium for Prescription Drug Abuse Prevention, and Jose Esquibel, Office of the Attorney General, discussed the process for stakeholder input regarding the bill drafts.  Committee discussion ensured regarding dates for future stakeholder meetings.

Representative Pettersen proceeded with public comment.

Lauren Snyder, Mental Health Colorado, testified regarding draft bill #1.  Ms. Snyder responded to committee questions.

Frank Cornelia, Colorado Behavioral Healthcare Council, testified regarding draft bill #1.  Mr. Cornelia responded to committee questions.

Lisa Pearson, representing herself, testified regarding draft bill #3 on harm reduction.

Angela Bonaguidi, Colorado Organization for the Treatment of Opioid Dependence, testified regarding reimbursements for SUD treatment providers and distributed a handout (Attachment D).  Ms. Bonaguidi responded to committee questions.

Denise Vincioni, Colorado Organization for the Treatment of Opioid Dependence, testified regarding SUD treatment providers.  Ms. Vincioni responded to committee questions.

Anna Warrener, representing herself, testified regarding her father's experience with chronic pain.  Ms. Warrener responded to committee questions.

Dr. Jonathan Clapp, Colorado Pain Society, testified regarding insurance policies and opioid medication.  Dr. Clapp responded to committee questions.

Suzanne Hamilton, Colorado Chapter - American College of Emergency Physicians, testified regarding electronic prescribing.  Ms. Hamilton responded to committee questions.