HB0002ham001 103RD GENERAL ASSEMBLY

Rep. La Shawn K. Ford

Filed: 2/22/2023

10300HB0002ham001 LRB103 04457 KTG 57820 a

AMENDMENT TO HOUSE BILL 2

AMENDMENT NO. ______. Amend House Bill 2 by replacing everything after the enacting clause with the following:

"Section 5. The Substance Use Disorder Act is amended by changing Section 15-10 and by adding Section 5-26 as follows:

(20 ILCS 301/5-26 new)

Sec. 5-26. Harm reduction services.

(a) Legislative findings. The General Assembly finds the following:

(1) Illinois is experiencing a growing overdose crisis. According to the Centers for Disease Control and Prevention, over 4,000 Illinoisans died from overdoses between January 2021 and January 2022, a 12.6% increase from the previous year. Most of those preventable deaths involved opioids.

(2) A significant reason for the increase in deaths is a poisoned drug supply, with illicit fentanyl killing people using street-bought substances. With the increasing use of potent fentanyl in the illicit substance supply in Illinois, more lives will continue to be lost.

(3) Nearly all witnessed opioid overdoses are reversible with the provision of oxygen, naloxone, and other emergency care. However, many people use drugs alone or use them with people who do not have naloxone and are not trained in overdose response.

(4) Overdose prevention sites can save lives. Overdose prevention sites provide individuals with a safe, hygienic space to consume pre-obtained drugs and access to other harm reduction, treatment, recovery, and ancillary support services.

(5) The goals of overdose prevention sites are:

(A) Saving lives by quickly providing emergency care to persons experiencing an overdose.

(B) Reducing the spread of infectious diseases, such as AIDS and hepatitis.

(C) Reducing public injection of substances and discarded syringes in surrounding areas.

(D) Linking those with substance use disorders to behavioral and physical health supports.

(b) Definitions. As used in this Section:

"Harm reduction" means a philosophical framework and set of strategies designed to reduce harm and promote dignity and well-being among persons and communities who engage in substance use.

"Overdose prevention sites" or "OPS" means hygienic locations where individuals may safely consume pre-obtained substances.

(c) Overdose prevention sites; licensure. The Department shall develop a pilot program aimed at saving the lives of people who use substances that shall include the establishment of at least one overdose prevention site. The pilot overdose prevention sites shall be exempt from the intervention licensure requirements under Section 15-10 for harm reduction services until the Department has adopted rules for harm reduction services. Overdose prevention sites shall offer people who are most likely to use drugs in public, unobserved, high-risk, and unsanitary locations a safe space to use pre-obtained substances and to connect with community supports or other existing treatment and recovery programs, harm reduction services, and health care.

(d) Pilot overdose prevention sites shall abide by the following principles:

(1) Nothing About Us Without Us: OPS programs and services shall be formulated with transparency, community involvement, and direct input by people who use substances.

(2) Equity: OPS staff and programs shall provide equal support, services, and resources to all participants and ensure accessibility to the greatest extent possible.

(3) Harm Reduction: OPS programs and services shall prioritize individual dignity and autonomy in decision-making while encouraging people to reduce high-risk behaviors.

(4) OPS programs and services shall affirm the humanity and dignity of people who use substances and shall be operated in a way that is safe, clean, inclusive, and welcoming to reduce stigma and build trust.

(5) OPS programs and services shall prioritize relationship-building and trust among staff and participants in order to create safe spaces and provide increased opportunities to connect with additional services that promote health and well-being.

(e) Staffing.

(1) OPS staff, at a minimum, shall consist of trained peers with lived experience of substance use or overdose, along with other necessary professionals such as community health workers, behavioral health professionals, physicians, nurses, or medical personnel who have been trained in overdose responses.

(2) A majority of the OPS staff shall include peers.

(3) Staffing decisions must ensure that participants utilize the service, feel safe, and are connected to resources.

(4) The Department may not prohibit persons with criminal records from frontline, management, or executive positions within entities that operate an overdose prevention site.

(f) Location. Pilot overdose prevention sites shall be established in physical locations with high need determined by rates of overdoses and substance use; and as a natural development or extension of existing harm reduction and outreach programming. Priority shall be given to communities that have the highest number of fatal and non-fatal overdoses as determined by public health data from the Department of Public Health. Pilot overdose prevention sites shall specifically target high-risk and socially marginalized drug users in a municipality with a population greater than 2,000,000, not to exceed 12 months from implementation.

(g) Pilot OPS features. An overdose prevention site shall at a minimum:

(1) provide a hygienic space where participants may consume their pre-obtained substances;

(2) administer first aid, if needed, and monitor participants for potential overdose;

(3) provide sterile injection or other substance use supplies, collect used hypodermic needles and syringes, provide secure hypodermic needle and syringe disposal services;

(4) provide access to naloxone or naloxone nasal spray;

(5) ensure confidentiality of OPS participants by using an anonymous unique identifier;

(6) provide education on safe consumption practices, proper disposal of hypodermic needles and syringes, and overdose prevention, including written information in, at a minimum, the 4 most commonly spoken languages in the State as determined by the Department;

(7) provide referrals to substance use disorder and mental health treatment services, medication-assisted treatment or recovery services, recovery support services, medical services, job training and placement services, and other services that address social determinants of health;

(8) provide wound kits;

(9) offer a space on-site for participants to stay safely sheltered and supervised after consuming substances; and

(10) provide adequate staffing by health care professionals or other trained staff.

(h) Other OPS program designs and implementation shall be informed by the target community.

(i) The Department may approve an entity to operate a pilot program in one or more jurisdictions upon satisfaction of the requirements set forth in this Section. The Department shall establish standards for program approval and training.

(j) Notwithstanding the Illinois Controlled Substances Act, the Drug Paraphernalia Control Act, or any other provision of law to the contrary, the following persons shall not be arrested, charged, or prosecuted for any criminal offense or be subject to any civil or administrative penalty, including seizure or forfeiture of assets or real property or disciplinary action by a professional licensing board, or be denied any right or privilege, solely for participation or involvement in a program approved by the Department under this Act:

(1) any individual who seeks to utilize, utilizes, or has utilized services provided at an overdose prevention site established in accordance with this Section;

(2) a staff member or administrator of an overdose prevention site, including a healthcare professional, manager, employee, or volunteer; and

(3) an individual who owns real property at which an overdose prevention site is located or operates.

(20 ILCS 301/15-10)

Sec. 15-10. Licensure categories and services. No person, entity, or program may provide the services or conduct the activities described in this Section without first obtaining a license therefor from the Department, unless otherwise exempted under this Act. The Department shall, by rule, provide requirements for each of the following types of licenses and categories of service:

(a) Treatment: Categories of service authorized by a treatment license are Early Intervention, Outpatient, Intensive Outpatient/Partial Hospitalization, Subacute Residential/Inpatient, and Withdrawal Management. Medication assisted treatment that includes methadone used for an opioid use disorder can be licensed as an adjunct to any of the treatment levels of care specified in this Section.

(b) Intervention: Categories of service authorized by an intervention license are DUI Evaluation, DUI Risk Education, Designated Program, Harm Reduction Services, and Recovery Homes for persons in any stage of recovery from a substance use disorder.

The Department may, under procedures established by rule and upon a showing of good cause for such, exempt off-site services from having to obtain a separate license for services conducted away from the provider's licensed location.

(Source: P.A. 100-759, eff. 1-1-19.)".