Correctional Services – Medication–Assisted Treatment Funding

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb1162*

HOUSE BILL 1162
E5 6lr3376

By: Delegate Alston
Introduced and read first time: February 11, 2026
Assigned to: Health and Government, Labor, and Elections

A BILL ENTITLED

AN ACT concerning 1

Correctional Services – Medication–Assisted Treatment Funding 2

FOR the purpose of requiring the Special Secretary of Overdose Response to provide 3
annually each county funding equal to the costs incurred by the county for the 4
implementation of a certain medication –assisted treatment program; requiring 5
certain counties to submit a certain report; authorizing the Governor to include in 6
the annual budget bill an appropriation for the purpose of providing funds under 7
certain circumstances; expanding the authorized uses of the Opioid Restitution 8
Fund; and generally relating to medication –assisted treatment for incarcerated 9
individuals. 10

BY repealing and reenacting, with amendments, 11
Article – Correctional Services 12
Section 9–603 13
Annotated Code of Maryland 14
(2025 Replacement Volume) 15

BY repealing and reenacting, with amendments, 16
Article – State Finance and Procurement 17
Section 7–331 18
Annotated Code of Maryland 19
(2021 Replacement Volume and 2025 Supplement) 20

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 21
That the Laws of Maryland read as follows: 22

Article – Correctional Services 23

9–603. 24

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(a) (1) Subject to paragraph (2) of this subsection, the requirements under this 1
section shall apply to: 2

(i) local detention centers in the following counties by January 1, 3
2020: 4

1. Howard County; 5

2. Montgomery County; 6

3. Prince George’s County; and 7

4. St. Mary’s County; and 8

(ii) local detention centers in six additional counties by October 1, 9
2021. 10

(2) (i) The Governor’s Office of Crime Prevention and Policy, the 11
Maryland Department of Health, and the Maryland Correctional Administrators 12
Association shall evaluate the implementation of the requirement s of this section and 13
determine a schedule to add additional counties, provided that the provisions of this section 14
shall apply to all local detention centers and the Baltimore Pre –trial Complex by January 15
2023. 16

(ii) If the Baltimore Pre –trial Complex has not fully implemented 17
the provisions of this section by January 2023, the Department of Public Safety and 18
Correctional Services shall report to the Senate Finance Committee and the House 19
Judiciary Committee, in accordance with § 2–1257 of the State Government Article, on the 20
status and timeline of implementation. 21

(iii) Funding for the program at the Baltimore Pre –trial Complex 22
shall be as provided in the State budget. 23

(b) (1) In this section the following words have the meanings indicated. 24

(2) “Health care practitioner” means an individual who is licensed, 25
certified, or otherwise authorized to practice under the Health Occupations Article. 26

(3) “Incarcerated individual” means an individual confined within a local 27
correctional facility. 28

(4) “Medication” means a medication approved by the federal Food and 29
Drug Administration for the treatment of opioid use disorder. 30

(5) “Medication–assisted treatment” means the use of medication, in 31
combination with counseling and behavioral health therapie s, to provide a holistic 32
approach to the treatment of opioid use disorder. 33
HOUSE BILL 1162 3

(6) “Opioid use disorder” means a medically diagnosed problematic pattern 1
of opioid use that causes significant impairment or distress. 2

(7) “Peer recovery specialist” means an individual who has been certified 3
by an entity approved by the Maryland Department of Health for the purpose of providing 4
peer support services, as defined under § 7.5–101(n) of the Health – General Article. 5

(c) An incarcerated individual in a State or local correctional facility shall be 6
placed on a properly supervised program of methadone detoxification if: 7

(1) a physician determines that the incarcerated individual is a person 8
with an opioid use disorder; 9

(2) the treatment is prescribed by a physician; and 10

(3) the incarcerated individual consents in writing to the treatment. 11

(d) (1) Each local correctional facility shall conduct an assessment of the 12
mental health and substance use status of each incarcerated individual using 13
evidence–based screenings and assessments, to determine: 14

(i) if the medical diagnosis of an opioid use disorder is appropriate; 15
and 16

(ii) if medication–assisted treatment is appropriate. 17

(2) If an assessment conducted under paragraph (1) of this subsection 18
indicates opioid use disorder, an evaluation of the incarcerated individual shall be 19
conducted by a health care practitioner with prescriptive authority authorized under Title 20
8, Title 14, or Title 15 of the Health Occupations Article. 21

(3) Information shall be provided to the incarcerated individual describing 22
medication options used in medication–assisted treatment. 23

(4) Medication–assisted treatment shall be available to an incarcerated 24
individual for whom such treatment is determined to be appropriate under this subsection. 25

(5) Each local correctional facility shall make available at least one 26
formulation of each FDA –approved full opioid agonist, partial opioid agonist, and 27
long–acting opioid antagonist used for the treatment of opioid use disorders. 28

(6) Each pregnant woman identified with an opioid use disorder shall 29
receive evaluation and be offered medication–assisted treatment as soon as practicable. 30

(e) Each local correctional facility shall: 31

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(1) following an assessment using clinical guidelines for 1
medication–assisted treatment: 2

(i) make medication available by a qualified provider to the 3
incarcerated individual; or 4

(ii) begin withdrawal management services prior to administration 5
of medication; 6

(2) make available and administer medications for the treatment of opioid 7
use disorder; 8

(3) provide behavioral health counseling for incarcerated individuals 9
diagnosed with opioid use disorder consistent with therapeutic standards for such therapies 10
in a community setting; 11

(4) provide access to a health care practitioner who can provide access to 12
all FDA–approved medications for the treatment of opioid use disorders; and 13

(5) provide on–premises access to peer recovery specialists. 14

(f) If an incarcerated individual rece ived medication or medication –assisted 15
treatment for opioid use disorder immediately preceding or during the incarcerated 16
individual’s incarceration, a local correctional facility shall continue the treatment after 17
incarceration or transfer unless: 18

(1) the incarcerated individual voluntarily discontinues the treatment, 19
verified through a written agreement that includes a signature; or 20

(2) a health care practitioner determines that the treatment is no longer 21
medically appropriate. 22

(g) Before the rele ase of an incarcerated individual diagnosed with opioid use 23
disorder under subsection (d) of this section, a local correctional facility shall develop a plan 24
of reentry that: 25

(1) includes information regarding postincarceration access to medication 26
continuity, peer recovery specialists, other supportive therapy, and enrollment in health 27
insurance plans; 28

(2) includes any recommended referrals by a health care practitioner to 29
medication continuity, peer recovery specialists, and other supportive therapy; and 30

(3) is reviewed and, if needed, revised by a health care practitioner or peer 31
recovery specialist. 32

HOUSE BILL 1162 5

(h) The procedures and standards used to determine substance use disorder 1
diagnosis and treatment of incarcerated individuals are subject to the g uidelines and 2
regulations adopted by the Maryland Department of Health. 3

[(i) As provided in the State budget, the State shall fund the program of opioid 4
use disorder screening, evaluation, and treatment of incarcerated individuals as provided 5
under this section.] 6

(I) (1) SUBJECT TO SUBSECTION (J) OF THIS SECTION, FOR EACH FISCAL 7
YEAR THE SPECIAL SECRETARY OF OVERDOSE RESPONSE SHALL PROVID E EACH 8
COUNTY FUNDING EQUAL TO THE COSTS I NCURRED BY THE COUNT Y FOR THE 9
IMPLEMENTATION OF A MEDICATION–ASSISTED TREA TMENT PROGRAM IN 10
ACCORDANCE WITH THIS SECTION DURING THE PRECEDING FISCAL YEAR. 11

(2) THE OFFICE OF OVERDOSE RESPONSE SHALL PROVIDE FUNDING 12
UNDER PARAGRAPH (1) OF THIS SUBSECTION FROM: 13

(I) THE OPIOID RESTITUTION FUND ESTABLISHED UNDE R § 14
7–331 OF THE STATE FINANCE AND PROCUREMENT ARTICLE; 15

(II) ANY MONEY APPROPRIAT ED IN THE STATE BUDGET FOR 16
THE PURPOSE OF PROVIDING FUNDS UNDER THIS SUBSECTION; AND 17

(III) OTHER ELIGIBLE GRANT FUNDING AVAILA BLE FOR THE 18
PURPOSE OF PROVIDING MEDICATION–ASSISTED TREATMENT. 19

(3) FUNDING UNDER PARAGRAPH (2) OF THIS SUBSECTION FOR THE 20
PRIOR FISCAL YEAR SH ALL BE REIMBURSED ON RECEIPT OF FINAL ITEMIZE D 21
EXPENSES. 22

(4) FUNDS DISTRIBUTED UNDER THIS SUBSECTION MAY BE REDUCED 23
BY THE AMOUNT OF AN AWARD FROM THE GOVERNOR’S OFFICE OF CRIME 24
PREVENTION AND POLICY OR THE MARYLAND DEPARTMENT OF HEALTH, OR A 25
FEDERAL AWARD FOR THE SAME PURPOSES. 26

(J) (1) ON OR BEFORE JULY 30 EACH YEAR , EACH COUNTY SHALL 27
SUBMIT TO THE OFFICE OF OVERDOSE RESPONSE ALL ESTIMATED ITEMIZED COSTS 28
FOR THE ANNUAL OPERATION OF THE LOCAL MEDICATION–ASSISTED TREATMENT 29
PROGRAM IN THE LOCAL DETENTION CENTER FOR THE CURRENT FISCAL YEAR AND 30
THE FINAL ITEMIZED EXPENSES FOR THE PRIOR FISCAL YEAR. 31

(2) IF A COUNTY FAILS TO SUBMIT THE INFORMATI ON REQUIRED 32
UNDER PARAGRAPH (1) OF THIS SUBSECTION OR INFORMATION REQUESTED BY THE 33
GOVERNOR’S OFFICE OF CRIME PREVENTION AND POLICY IN ACCORDANCE WITH 34
6 HOUSE BILL 1162

SUBSECTION (L) OF THIS SECTION WHEN DUE , THE OFFICE OF OVERDOSE 1
RESPONSE SHALL DEDUCT AN AMOUNT EQUAL TO 20% OF ANY FUNDING AWARDED 2
UNDER SUBSECTION (I) OF THIS SECTION FOR EACH 30 DAYS OR PART OF 30 DAYS 3
AFTER THE DUE DATE THAT THE INFORMATION WAS NOT SUBMITTED. 4

(K) (1) THE GOVERNOR MAY INCLUDE IN THE ANNUAL BUDGET BILL AN 5
APPROPRIATION TO THE OFFICE OF OVERDOSE RESPONSE SUFFICIENT TO 6
IMPLEMENT SUBSECTION (I) OF THIS SECTION. 7

(2) AN APPROPRIATION UNDER THIS SUBSECTION MAY BE USED ONLY 8
TO PROVIDE FUNDING EQUAL TO THE COSTS INCURRED BY A COUNTY FOR THE 9
IMPLEMENTATION OF A MEDICATION –ASSISTED TREATMENT PROGRAM IN 10
ACCORDANCE WITH THIS SECTION. 11

(3) PRIOR TO RECEIVING FUNDING FROM THE OPIOID RESTITUTION 12
FUND, A COUNTY SHALL DEMON STRATE AN ATTEMPT TO OBTAIN AT LEAST ONE 13
GRANT FROM THE MARYLAND DEPARTMENT OF HEALTH OR THE GOVERNOR’S 14
OFFICE OF CRIME PREVENTION AND POLICY FOR THE FISCAL YEAR IN WHICH THE 15
COUNTY IS REQUESTING REIMBURSEMENT. 16

[(j)] (L) On or before November 1, 2020, and annually thereafter, the Governor’s 17
Office of Crime Prevention and Policy shall report data from individual local correctional 18
facilities to the General Assembly, in accordance with § 2 –1257 of the State Government 19
Article, on: 20

(1) the number of incarcerated individuals diagnosed with: 21

(i) a mental health disorder; 22

(ii) an opioid use disorder; 23

(iii) a non–opioid substance use disorder; and 24

(iv) a dual diagnosis of mental health and substance use disorder; 25

(2) the number and cost of assessments for incarcerated individuals in local 26
correctional facilities, including the number of unique incarcerated individuals examined; 27

(3) the number of incarcerated individuals who were receiving medication 28
or medication –assisted treatment for opioid use disorder immediately prior to 29
incarceration; 30

(4) the type and prevalence of medication o r medication –assisted 31
treatments for opioid use disorder provided; 32

HOUSE BILL 1162 7

(5) the number of incarcerated individuals diagnosed with opioid use 1
disorder; 2

(6) the number of incarcerated individuals for whom medication and 3
medication–assisted treatment for opioid use disorder was prescribed; 4

(7) the number of incarcerated individuals for whom medication and 5
medication–assisted treatment was prescribed and initiated for opioid use disorder; 6

(8) the number of medications and medication –assisted treatments for 7
opioid use disorder provided according to each type of medication and medication–assisted 8
treatment options; 9

(9) the number of incarcerated individuals who continued to receive the 10
same medication or medication –assisted treatment for opioid use diso rder as the 11
incarcerated individual received prior to incarceration; 12

(10) the number of incarcerated individuals who received a different 13
medication or medication–assisted treatment for opioid use disorder compared to what the 14
incarcerated individual received prior to incarceration; 15

(11) the number of incarcerated individuals who initiated treatment with 16
medication or medication –assisted treatment for opioid use disorder who were not being 17
treated for opioid use disorder prior to incarceration; 18

(12) the number of incarcerated individuals who discontinued medication or 19
medication–assisted treatment for opioid use disorder during incarceration; 20

(13) [a review and summary of the percent of days, including the average 21
percent, median percent, mode percent, and interquartile range of percent, for incarcerated 22
individuals with opioid use disorder receiving medication or medication–assisted treatment 23
for opioid use disorder as calculated overall and stratified by other factors, such as type of 24
treatment received] THE AVERAGE NUMBER OF DAYS INCARCERATED INDIVIDUALS 25
RECEIVED MEDICATION –ASSISTED TREATMENT IN ACCORDANCE WITH THIS 26
SECTION; 27

(14) the number of incarcerated individuals receiving medication or 28
medication–assisted treatment for opioid use disorder prior to release; 29

(15) the number of incarcerated individuals receiving medication or 30
medication–assisted treatment prior to release for whom the facility had made a prerelease 31
reentry plan; 32

(16) a review and summary of practices related to medica tion and 33
medication–assisted treatment for opioid use disorder for incarcerated individuals with 34
opioid use disorder before October 1, 2019; 35

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(17) a review and summary of prerelease planning practices relative to 1
incarcerated individuals diagnosed with opioid use disorder prior to, and following, October 2
1, 2019; and 3

(18) any other information requested by the Maryland Department of 4
Health OFFICE OF OVERDOSE RESPONSE OR THE GOVERNOR’S OFFICE OF CRIME 5
PREVENTION AND POLICY related to the administration of the provisions under this 6
section. 7

[(k)] (M) Any behavioral health assessment, evaluation, treatment 8
recommendation, or course of treatment shall be reported to the Governor’s Office of Crime 9
Prevention and Policy and also include any other data neces sary to meet reporting 10
requirements under this section. 11

Article – State Finance and Procurement 12

7–331. 13

(a) In this section, “Fund” means the Opioid Restitution Fund. 14

(b) There is an Opioid Restitution Fund. 15

(c) The purpose of the Fund is to retain the amount of settlement revenues 16
deposited to the Fund in accordance with subsection (e)(1) of this section. 17

(d) (1) The Fund is a special, nonlapsing fund that is not subject to § 7–302 of 18
this subtitle. 19

(2) The State Treasurer shall hold the Fund s eparately, and the 20
Comptroller shall account for the Fund. 21

(e) The Fund consists of: 22

(1) all revenues received by the State from any source resulting, directly or 23
indirectly, from any judgment against, or settlement with, opioid manufacturers, opioid 24
research associations, or any other person in the opioid industry relating to any claims 25
made or prosecuted by the State to recover damages for violations of State law; and 26

(2) the interest earnings of the Fund. 27

(f) The Fund may be used only to provid e funds for the purposes specified in 28
settlement agreements and judgments relating to claims by the State against opioid 29
manufacturers, opioid research associations, or any other person in the opioid industry for 30
violations of State law, including: 31

(1) programs, services, supports, and resources for evidence –based 32
substance use disorder prevention, treatment, recovery, or harm reduction; 33
HOUSE BILL 1162 9

(2) supporting community –based nonprofit recovery organizations that 1
provide nonclinical substance use recovery support services in the State; 2

(3) addressing racial disparities in access to prevention, harm reduction, 3
treatment, and recovery support services; 4

(4) addressing socioeconomic disparities in access to prevention, harm 5
reduction, treatment, and recovery support services; 6

(5) evidence–informed substance use disorder prevention, treatment 7
recovery, or harm reduction pilot programs or demonstration studies that are not 8
evidence–based if the Opioid Restitution Fund Advisory Council, established under § 9
7.5–902 of the Health – General Article: 10

(i) determines that emerging evidence supports the distribution of 11
money for the pilot program or that there is a reasonable basis for funding the 12
demonstration study with the expectation of creating an evidence–based program; and 13

(ii) approves the use of money for the pilot program or demonstration 14
study; 15

(6) evaluations of the effectiveness and outcomes reporting for substance 16
use disorder abatement infrastructure, programs, services, supports, and resou rces for 17
which money from the Fund was used, including evaluations of the impact on access to 18
harm reduction services or treatment for substance use disorders and the reduction in 19
drug–related mortality; 20

(7) operating expenses and personnel costs for investigations, enforcement 21
actions, and other activities conducted by the Opioids Enforcement Unit within the Office 22
of the Attorney General that are related to the recovery of funds from opioid –related 23
judgments or settlements; [and] 24

(8) the Buprenorphi ne Training Grant Program established under § 25
13–5802 of the Health – General Article; AND 26

(9) FUNDING TO COUNTIES FOR THE IMPLEMENTATION OF A 27
MEDICATION–ASSISTED TREATMENT PROGRAM UNDER TITLE 9, SUBTITLE 6 OF THE 28
CORRECTIONAL SERVICES ARTICLE. 29

(g) (1) The State Treasurer shall invest the money of the Fund in the same 30
manner as other State money may be invested. 31

(2) Any interest earnings of the Fund shall be credited to the Fund. 32

10 HOUSE BILL 1162

(h) (1) Expenditures from the Fund may be made only in accordance w ith the 1
State budget. 2

(2) For settlement funds received in accordance with the final distributor 3
agreement of July 21, 2021, with McKesson Corporation, Amerisource Bergen Corporation, 4
and Cardinal Health Incorporated, as amended, the Janssen settlement agreement of July 5
21, 2021, as amended, or any other opioid –related court or administrative judgment or 6
settlement agreement involving the State and one or more of its political subdivisions: 7

(i) appropriations from the Fund in the State budget shall be made 8
in accordance with the allocation and distribution of funds to the State and its political 9
subdivisions: 10

1. as agreed on in the State –subdivision agreement of 11
January 21, 2022, as amended; or 12

2. required under any other opioid –related court or 13
administrative judgment or settlement agreement, or any similar agreement reached under 14
an opioid–related court or administrative judgment or settlement agreement, involving the 15
State and one or more of its political subdivisions; and 16

(ii) the Secretary of Health shall establish and administer a grant 17
program for the distribution of funds to political subdivisions of the State in accordance 18
with: 19

1. the State–subdivision agreement of January 21, 2022, as 20
amended; or 21

2. the requirement s of any other opioid –related court or 22
administrative judgment or settlement agreement, or any similar agreement reached under 23
an opioid–related court or administrative judgment or settlement agreement, involving the 24
State and one or more of its political subdivisions. 25

(3) The Attorney General shall identify and designate the controlling 26
version of any agreement or amendment described under paragraph (2) of this subsection. 27

(i) (1) (i) This paragraph does not apply in fiscal years 2025 and 2026. 28

(ii) Money expended from the Fund for the programs and services 29
described under subsection (f) of this section is supplemental to and is not intended to take 30
the place of funding that otherwise would be appropriated for the programs and services. 31

(2) Except as specified in subsection (f) of this section, money expended 32
from the Fund may not be used for administrative expenses. 33

(j) The Governor shall: 34

HOUSE BILL 1162 11

(1) develop key goals, key objectives, and key performance indicators 1
relating to substance use treatment and prevention efforts; 2

(2) subject to subsection (h)(2) of this section, at least twice annually, 3
consult with the Opioid Restitution Fund Advisory Council to identify recommended 4
appropriations from the Fund; and 5

(3) report on or before November 1 each year, in accordance with § 2–1257 6
of the State Government Article, to the General Assembly on: 7

(i) an accounting of total funds expended from the Fund in the 8
immediately preceding fiscal year, by: 9

1. use; 10

2. if applicable, jurisdiction; and 11

3. budget program and subdivision; 12

(ii) the performance indicators and progress toward achieving the 13
goals and objectives developed under item (1) of this subsection; and 14

(iii) the recommended appropriations from the Fund ide ntified in 15
accordance with item (2) of this subsection. 16

(k) Beginning on or before October 1, 2025, and each October 1 thereafter, the 17
Office of the Attorney General shall report to the Governor and, in accordance with § 18
2–1257 of the State Government Article, the General Assembly on the status of activity of 19
the Opioids Enforcement Unit, including: 20

(1) the number of investigations taking place; 21

(2) the number of lawsuits filed; and 22

(3) the disposition of lawsuits filed. 23

SECTION 2. AND BE IT F URTHER ENACTED, That this Act shall take effect 24
October 1, 2026. 25