Model State Legislation & Initiatives
A resource guide for the Recovery Community to think & act locally!
Policy Resource Hub
The Recovery Advocacy Project (RAP) is committed to providing the tools and resources to grassroots advocates from all pathways of recovery, family members and allies, that will assist in organizing locally in their communities and statewide.
While many solutions may come from direct community organizing, much of the work that impacts the recovery community can also come from:
This Resource Hub will highlight some model laws and initiatives in hopes that organizers can duplicate some of the great work already accomplished around a number of issues impacting the recovery community in other states.
This effort is collaborative and ongoing. If you would like to recommend additional topics that impact the recovery community and a state law or local policy that addresses it please contact firstname.lastname@example.org
Please note, many of the examples highlighted here can always be improved and amended through grassroots advocacy work in the legislative process.
All of these policies on this page began with an idea, a policy maker, and some sort of grassroots base behind the idea. Take a look at the recovery related categories you are passionate about and then check out the RAP How a Bill becomes Law Guide to get started.
*This website is not a legal resource and is intended to be a guide and reference only.
Good Samaritan Laws encourage people to save lives if the event of a medical emergency, including a drug overdose. Many Good Samaritan Laws cover both alcohol and drug emergencies and include an expansion of Narcan in the state.
Since 2014, many states have passed laws that provide immunity (generally for drug paraphernalia and possession charges) for an individual calling for emergency medical assistance in the event of a drug overdose, but not all states offer protection for individuals on parole or probation. In many cases, state’s add overdose immunity protection language to existing Good Samaritan Laws.
The Missouri Good Samaritan Law is one of the strongest in the country. The law includes protections for anyone calling for emergency medical attention in the event of drug overdose in addition to covering in the event of alcohol poisoning (underage drinking and minor possession) and includes protections for people on probation or parole.
The Massachusetts Good Samaritan Law is also a good model for states that have Good Samaritan Laws not yet expanded to provide immunity for people on parole or probation to consider.
The scope of immunity protections vary by state. It is important to research who is eligible for protection and what they are protected from in each state to be sure the laws provide immunity for all, to encourage emergency medical assistance in the event of a drug overdose.
You can check your state’s status regarding 911 Good Samaritan Laws here
Many states are also working towards better and more accurate reporting for overdose incidents through legislation. The Legislative Analysis and Public Policy Association has published a Model Overdose and Response Act
There is also an important resource called Never Use Alone which encourages people who use drugs (PWUD) to stay on the phone while using which can help with emergency attention if needed. Visit www.neverusealone.com or call (800)484-3731 for more information.
In 2008, the Federal Mental Health & Addiction Equity Act passed and was intended to encourage health insurance plans to cover mental health and addiction services equally to any other health conditions. This is referred to as Parity and works to remove discriminatory practices against individuals with substance use disorder or mental illness by ensuring access to quality behavioral health care.
Enforcement of this Federal law is left up to the states. It may be helpful to research what local mental health and addiction recovery nonprofits are already engaged in this issue in your state and ask how you can get involved. A number of states may already have coalitions focused on addressing health insurance inequality.
Illinois enacted the enforcement law Senate Bill 1707 to advance parity implementation and expand on the Federal law. The law includes important provisions to extend and clarify coverage, educate consumers about their rights, require certain minimum treatment benefits, and improve enforcement of the law and has served as a model for other states.
For state to state behavioral health Parity enforcement laws visit this ParityTrack resource
Virginia SB 1287 is another model state parity bill that prohibits health insurance plans from descriminating people on the basis of gender identity or status as transgender individuals. This bill does a good job in defining descrimination as any form of denial, limitation, or restriction on any level of care or higher shared costs based on a person’s gender identity. This specific bill is not yet state law. This healthcare guide for transgender individuals can also be useful for transgender indiduals experiencing descrimination in healthcare.
“Words are important. If you want to care for something, you call it a ‘flower’; if you want to kill something, you call it a ‘weed’.”
Don Coyhis, Founder of White Bison
A number of states have removed offensive and pejorative language when referring to people in recovery and people who use drugs (PWUD) from their statutes. Here is an example that has passed the Nevada state legislature and has been enacted to use less stigmatizing language.
The Nevada AB367 bill “establishes the preferred manner of referring to persons affected by addictive disorders and other terms related to such persons in the Nevada Revised Statutes and the Nevada Administrative Code. The bill requires the Legislative Counsel, to the extent practicable, to ensure that persons affected by addictive disorders are referred to in Nevada Revised Statutes using language that is commonly viewed as respectful and sentence structure that refers to the person before referring to his or her disorder, and provides that it is the policy of this State that such persons are referred to in a similar manner in the Nevada Administrative Code.”
Recovery Advocacy Project has also put together a language guide on how to Effectively speak out as a recovery community advocate that you may find useful in your efforts.
You may find that an issue you care about may not need to be addressed in specific state legislation but can be implemented through your local, state, or state agency budget. Many recovery advocates have also found state budgets to be useful in establishing their ideas through pilot programs (such as Peer Coaching in hospitals or Recovery Community Centers) .
A budget is much more than numbers and line items, it is a reflection of priorities and values.
You, as an advocate, can participate in highlighting the issues you care for most in this process. Getting to know your local officials and their staff (mayors, city council) is a good first step in making your own priorities and values known to those making decisions on your behalf.
Each State also has its own budget process and the timing will vary depending on the State you live in, so you will have to do a little research. A good place to begin to get familiar is your State Legislature Website
Advocating as a part of your state’s budget process and encouraging decision makers to invest in recovery can help your community thrive, address longstanding racial and social inequities, raise the issues and voices of the recovery community and most marginalized individuals, and build a strong organizing foundation for the future.
There are plenty of opportunities to get involved by providing testimony on the issues you care about throughout the year and will depend on your state’s budget cycle.
The budget cycle typically includes the following and many States allow for public input or written submissions. You will have to do a little research on how to submit testimony and when in your state.
- State Agency submits a budget for their respective agencies.
- Governor collects and submits potential budget to State Legislature
- State Legislature (most often through Budget or Appropriation Committees)
The Recovery Advocacy Project has also published a Guide on giving effective Public Testimony that will be helpful to you in this process. Remember, you do not need to be an expert on numbers or budgets to submit public testimony, but be able to effectively share your priorities and story. It is also recommended that you connect with some local recovery related nonprofit organizations that may have some additional input on your state or local budget.
Here are a few additional Citizen Guides from states to take a look at if you want to dive deeper into the process.
Narcan has been used to reverse overdoses in every state in the country. State advocates have worked tirelessly to expand efforts to get Narcan in the hands of as many people as possible. One of the ways advocates have been successful is in working to establish standing orders in their state.
Standing Order Laws allow for permission to prescribe Naloxone to at risk populations without the individual being physically examined. These laws make Naloxone (narcan) more accessible to at risk populations, and can be expanded to a third party (such as a family member)
Here s a good state – by – state resource to check on where your state stands on standing orders around Naloxone.
Narcan has been used to reverse overdoses in every state in the country. State advocates have worked tirelessly to expand efforts to get Narcan in the hands of as many people as possible, including educational settings.
Narcan in all education settings can become a reality.
Legislation has passed in some states to provide Narcan in all state High Schools
This New Jersey Law “requires public and private high schools to maintain a supply of opioid antidotes; authorizes its emergency administration by school nurse and other trained school personnel; provides legal indemnification for individuals who administer the antidote.”
Narcan has been used to reverse overdoses in every state in the country. State advocates have worked tirelessly to expand efforts to get Narcan in the hands of as many people as possible. This has been done through health care settings.
Only a handful of states have what is known as Naloxone Co-Prescribing Laws on the books. These laws require all prescribers of opioids to also offer a prescription for naloxone. Some of these laws also require information about overdose to patients that are prescribed opioids.
One example of these laws that has passed is AB 2760 in California.
Narcan has been used to reverse overdoses in every state in the country, but what happens after that individual’s life is saved with Narcan?
Depending on policies in place once an overdose is reversed, the protocol in place (or lack of protocol) for helping that individual can be the difference between a person’s return to use or a pathway to recovery.
Danny’s Law in Virginia serves to lay a foundation on which to provide standard operating procedures and discharge planning in ER’s and hospitals for those who have experienced a substance use related emergency. The legislation provides greater consistency across the state to ensure quality care for the targeted population. Essentially, Danny’s Law outlines a roadmap for hospitals in the development of their protocol to handle such crises in the event of an overdose.
A Massachusettes Law H.4742 was also passed to require 80 hospitals and ERs to offer anyone that overdoses medication (Buprenorphine/Suboxone) to curb cravings.
Peer support for people in recovery saves lives. States are working to implement peer recovery in post treatment plans, hospitals, corrections, recovery housing, recovery community centers and throughout communities.
Here is Model State Legislation to expand access to Peer Recovery Support Services in your state that was developed for advocates to work with elected officials to introduce. This is a model provided by the Legislative Analysis & Public Policy Association (LAPPA)
Maine passed a law (Chapter 378 in the ME Public Law Ref Section D-1) that expanded peer recovery support services to peer recovery community centers all across the state, with a focus on prioritizing peer support in more rural, hard to reach parts of the state that were lacking access.
California also passed SB 803, a law specifically passed to increase access to peer support for individuals with lower incomes.
Many examples exist regarding denials and lack of access for individuals whose recovery pathway is medication assisted. Some states have enacted legislation to prevent that descrimination.
New Jersey passed * P.L. 1975, c. 305 (C.26: 2B-16) which states an admission to a drug or alcohol treatment facility shall not be denied because the person is currently receiving medication assisted treatment. This barrier still exists in many states.
The full text of the bill can be found here
Access to medication assisted recovery for people who are currently incarcerated is also being addressed through state law.
Maryland passed HB 116 that “requires local correctional facilities to conduct assessments of the mental health and substance use status of each inmate using evidence-based screenings and assessments to determine if a certain diagnosis is appropriate and if medication-assisted recovery is appropriate.”
This New Jersey Law requires correctional facilities to provide prisoners with prescription medication that was prescribed for chronic conditions existing prior to incarceration.
The Legislative Analysis & Public Policy Association also published a Model Access to Medication for Addiction Treatment in Correctional Settings Act
Rhode Island was the first state to pass a law that establishes Medication Assisted Recovery programs available for its entire prison population (individuals lose health insurance upon becoming incarcerated), and this effort has shown it drastically reduced overdose within prisons and upon reentry. Within 1 year, drug overdoses in prison dropped by 61%. This program was implemented through work directly in the State’s Budget with a $2 million investment.
Syringe Service Programs (SSPs) provide sterile syringes as well as access to health services for people who use drugs (PWUD). SSPs are safe and cost-effective ways to reduce transmission of bloodborne illness like HIV and HCV and can also contribute to safer communities by decreasing the number of improperly discarded syringes.
Even though there are evidence based guidelines from the Center for Disease Control around SSPs, some states have laws that authorize these programs while other states have laws that lead to the perception that SSPs are illegal, so there is much to do on the state level here.
Here are just a few examples of what states have done through Executive Order, as well as through their state legislatures.
North Carolina passed HB972 to legalize Syringe Service Programs in the state and is a good Model Law. You can read the text of the law in Section 4 of HB972 here
The New York State Legislature directly changed its Public Health Law to authorize a demonstration program to expand access to sterile hypodermic needles and syringes.
Kentucky also has a syringe service law on the books that can serve as models for other states. Before March of 2015 Syringe Services were illegal in Kentucky until they revised their state statute around drug paraphernalia This is an effort many states are working towards.
Here is a helpful fact sheet from Florida that may help grassroots advocates in other states to pass similar legislation.
Syringe Services were expanded during Covid 19 through Maine Executive Order from the Governor.
If you are unsure where your state stands on SSPs here is a good state – by – state map that may indicate if legislative action in your state is needed
Working with local health and elected officials to declare addiction public health emergencies can potentially address stigma, shift resources, create access, and commit funding towards solutions. Here are a few examples to show how a state Health Commissioner and Governor declared emergencies in their respective states.
Working to dismantle systemic racism can require both community action and legislative advances. In Oregon, racial justice advocates are working to require racial impact statements from chief sponsors of all legislative bills to analyze potential impacts to black, indigenous, people of color (BIPOC) communities. Assessing existing and future state laws for racial impacts and consequences can help communities that historically have been most marginalized and make sure nobody is being left behind when drafting state policy that impacts the recovery community.
There are also a few examples of state legislatures requiring an assessment of the racial and ethnic impacts of all laws addressing the criminal justice population, a population of which BIPOC are over-represented within corrections.
Washington State passed the first legislation in the country to address systematic disparities within the state. The state appropriated $2.5 million to fully fund an Equity Office for the state and will help agencies develop their own diversity, equity and inclusion plans.
You can review the full text of the Washington law HB 1783 here
Prioritizing access to addiction and mental health funding and resources for BIPOC individuals can also be advocated for on the federal level and can be found in HR8141 and could be adapted in some way towards state legislation and budgets.
Minnesota passed what is known as an opioid stewardship bill that taxes opioid manufacturers and wholesalers to fund prevention, treatment, and recovery support services in the state. Only a handful of states have this type of law on the books.
The Minnesota Law CHAPTER 63–H.F.No. 400) can be found here and the summary of what is in the law can be found here.
Delaware also has an opioid stewardship law on the books. In Delaware, the first $700,000 from the fees were designated towards addiction services, and included the purchase of 925 naloxone kits.
Here is the breakdown from Delaware to give you an idea of the good that can come from an Opioid Stewardship Bill in your state.
“$300,000 will be combined with federal grant money to expand Bridge Clinics, which exist during regular business hours to help those discharged from hospitals get additional care, but Hall-Long said needs to become 24/7 “because that’s when the family, friends, and members of our community need it.”
$250,000 is earmarked for helping those recovering find transportation and housing to expedite treatment
$100,000 will go towards administrative costs when it comes to collecting the fee
$50,000 will purchase 925 additional naloxone kits” ( source )
The National Association of Recovery Residences (NARR) drafted national standards that serve as a basis for state legislation to follow as a model, in addition to creating a helpful toolkit when drafting policy around recovery residences
Ohio is considered to be a model for other states to follow. Statutes for Ohio’s recovery housing are spelled out here to define recovery housing in the state , here regarding licensure and certification of recovery residences , and here regarding establishing continuum of care
The standards are set by Ohio Recovery Housing (affiliate of NARR) and can be found here
California Bill AB 1779 is another example working to establish the standards around its recovery residences. Here is also a good fact sheet advocates are using in that state to build grassroots momentum.
Screening, Brief Intervention,Referral to Treatment (SBIRT) is a public health approach aimed at early intervention of Substance Use Disorder in addition to problem gambling. While SBIRT can be used within healthcare/primary care settings, advocates have also worked to implement it in environments with young people.
Massachusetts passed The Step Act (Chapter 52) which mandates SBIRT in all MA public schools and can be used as a model for other states. MA was the first (and to our knowledge only) state to pass this type of legislation to reach young people.
Massachusetts also developed a toolkit to assist clinicians implement SBIRT in the state.
There are many local grassroots examples around what many know to be termed as “Ban the Box” which refers to removing the box on job applications that asks potential employees about criminal records before an interview. One in three working-aged Americans have a criminal record so efforts to give everyone a fair playing field while applying for employment is happening in some capacity in every state across the country.
Model Executive Orders, State Legislation, Local Resolutions & Ordinances, and administrative memos regarding fairness in hiring practices (Ban the Box/Opportunity to Compete) can be found in this Toolkit for Advocates for Localities and State Ban the Box Laws from the National Employment Law Project
Many states may have enacted Ban the Box county wide or city wide. Here is an example of a statewide Ban the Box Law from Maryland.
According to a national study, about 9% of people in recovery are unemployed* (source)
Incentives for employers to hire people in recovery, many of which struggle to find employment due to a past criminal record, is needed.
States have addressed this issue in a few ways.
Through the New York State Budget, NY designates $2 million per year to reduce stigma of people in recovery and boost employment by allocating money towards a Recovery Tax Credit Program for employers to hire people in recovery. Employers receive $2,000 per individual in recovery they hire.
New Jersey had a different approach and introduced the idea through legislation. Here is the full text of that bill S1968
Models around employer incentives can be done without legislation. Recovery Friendly WorkPlace Initiatives have been created through grants and budget dollars with backing by the Governors in Rhode Island and New Hampshire
Advocates can also work with individual employers in their area to educate them around the benefits of having a Recovery Friendly Workplace. Recovery Friendly Workplaces can also be established by the employer taking the initiative like DV8 Kitchen in Lexington KY
LGTBQ+ individuals have a disproportionately high rate of substance use in comparison to other demographics as an estimated 20-30 percent of gay and transgender individuals struggle with addiction ( source ) as compared to 9% of the general population.
There are a number of initiatives that can benefit LGTBQ+ individuals in the recovery community.
Equitable access to services continues to be a major barrier. Virginia SB 1287 is a model state bill that prohibits health insurance plans from descriminating people on the basis of gender identity or status as transgender individuals. This bill does a good job in defining descrimination as any form of denial, limitation, or restriction on any level of care or higher shared costs based on a person’s gender identity. This specific bill is not yet state law but, can be used as a model to fight against efforts in other states working to restrict healthcare access to transgrender. This healthcare guide for transgender individuals can also be useful for transgender individuals experiencing descrimination in healthcare.
California also has a number of bills that benefit LGTBQ + individuals.
California SB 12 establishes mental health programs with core components focusing on vulnerable and marginalized youths including LGTBQ youth.
California AB 512 requires all mental health plans under the state medicaid to go through a cultural competency assessment plan to identify disparities and outcomes by race, ethnicity, language, sexual orientation, gender identity, and immigration status.
California SB 42 is also known as the “Getting Home Safe Act” and addresses dangerous late night release practices from county jails that are especially dangerous for women, including transgender women. This bill also gives all individuals being released the right to request assistance in accessing addition or mental health services.
Suicide rates are also disproportionetely high among the LGTBQ population and there are tools to help advocates work with state policymakers around enacting suicide prevention programs in your state
There are a number of local and statewide LGTBQ caucuses of elected officials and decision makers across the country that could assist you in identifying priorities for the LGTBQ+ community in your state. Here are a few examples.
Drug Decriminalization (particularly around smaller amounts of marijuana) has passed in more than half the states in the country. Possession charges fuel mass incarceration and the criminalization of a health issue.
Virginia HB 972 is just one example of decriminalizing possession and drug use.
Oregon has become the first state in the country to decriminalize all drugs and expand access to addiction services through marijuna tax revenue. They did it by giving voters a chance to approve it by Ballot Measure 110
Here is a great guide on how to get ballot initiatives in your state
There are also examples of local grassroots efforts to decriminalize possession of psychedelic drugs like through the city council in Ann Arbor, Michigan and a ballot initiative in Denver, Colorado . Decriminalization in these cases means law enforcement considers it to be of low priority.
Another way states and local municipalities are decriminalizing drug use and possession is diverting people to access addiction programs instead of getting people caught up in the criminal justice system. Maine changed its public law Chapter 378 that establishes Law Enforcement Assistance Diversion programs that offer law enforcement an alternative to booking people with addiction charges, and instead provides an access point to addiction services.
Diversion efforts can impact those who are currently incarcerated as well. Maryland HB295 passed and redirected non violent drug offenders from prison into treatment, and prevented their return to prison for minor crimes.
Criminal records can be major barriers for people in recovery working towards employment, housing, and education. Every state has different expungement laws and eligibility can be determined by a number of factors such as time since the last offense, or the type of offense.
New Jersey passed one of the most promising expungement laws in terms of eligibility of types of offenses to expunge and shortening wait times after last offences. It also eliminated filing fees for people working to get their record expunged and created an efiling mechanism to streamline the process.
The bill summary and full text of S4154 can be found here
Many states are currently legalizing marijuana. This opens the door to simultaneously expunge the records of anyone with drug offenses, particularly people of color who have been disproportionately impacted. Automatic expungement of offenses can be paired with legalization initiatives.
Automatic expungement for marijuna offenses for over 150,000 people in NY was signed into law and could be used as a model.
This has also been done on a city-wide level working with District Attorney’s offices. San Francisco officials plan to expunge more than 9,000 marijuana convictions dating back to 1975.
Voting is a right originally provided in the US Constitution to some and expanded with amendments 15th, 19th, and 26th in addition to state laws.
This right has been taken away from many individuals with criminal records across the country which impacts the recovery community. It is important to acknowledge that this striping away of a basic right disproportionately affects people of color. Fighting for the right to restore everyone’s right to vote invites citizenship and civic engagement back into the lives of those that have been affected.
Each state has different right to vote laws for people with felony convictions. Many people with felony convictions have lost their right to vote and may not know they can restore that right. Please take a moment to check your state’s right to vote laws at our Recovery Voter Hub
There is also an excellent state by state resource from the Brennan Institute here
Here are just a few of the ways states have restored voting rights and re-enfranchised people with criminal records.
Kentucky restored the voting rights of 140,000 persons with felony convictions by Governor’s Executive Order
New Jersey automatically restored the voting rights of more than 80,000 people that were on parole or probation in the state by passing A5823
In 2018, Florida voters restored the voting rights of persons formerly incarcerated with a statewide ballot initiative overwhelmingly at 64% approval.
Here is a great guide on how to get ballot initiatives in your state
For more information and tools from the Recovery Advocacy Project’s Vote Recovery initiative go to www.recoveryvoices.com.vote
Spaces that allow people in recovery to thrive at the high school and college level have found grassroots success over the years. There are roughly 35 recovery high schools and over 200 collegiate recovery programs in the United States.
Some are funded through grants, foundations, or through the Universities themselves while others (although rare) were created through legislation. Here are examples of legislation that prioritizes recovery at the high school and collegiate level.
New Jersey passed a law that establishes recovery high school pilot programs in the state. S2058 can be found here
New Jersey also passed S2377 that requires every four-year public college or university in the state, in which at least 25% of the students live on-campus, to establish a substance abuse recovery housing program.
Patient brokering is an unethical practice that takes advantage of a vulnerable population looking to get help for their addiction issues. Family members also fall prey to patient brokers as they look for assistance in getting help for their loved ones. Common examples are when facilities pay a third party to procure patients for them, and in many cases receive commission per referral.
States are beginning to address this issue through legislation.
Florida strengthened its statute in 2019 to make patient brokering illegal and penalize patient brokers and the facilities practicing it.