Resources

Drug User Health Policy Map

Last Updated

Use this interactive map to better understand select drug user health policies in your state or jurisdiction. These indicators include:

  • Laws criminalizing HIV and hepatitis exposure through use of drug paraphernalia,
  • Unique requirements of your jurisdiction’s Good Samaritan laws related to overdose response, and
  • Details of state-level Section 1115 Medicaid waivers that expand services for people who use drugs

For more information on Section 1115 Medicaid waivers and how they impact people living with or at risk for HIV and hepatitis, please see NASTAD’s related Medicaid Waiver Map and fact sheets: Medicaid 1115 Waivers: Considerations for HIV and Hepatitis Programs and Medicaid 1115 Waivers: Exemptions for People Living with HIV and Hepatitis.

Drug User Health Policies

Drug User Health Policies Available
No Information Available
Does the state have a law criminalizing transmission of or exposure to HIV and/or hepatitis through use of drug paraphernalia?
Yes
No
Does the state have an approved or pending Section 1115 waiver expanding access to SUD-related services in its Medicaid program?
Yes
No
Does the state’s drug overdose Good Samaritan law provide protections from violations of a condition of pretrial release, probation, and/or parole?
Yes
No
Does the state’s drug overdose Good Samaritan law apply to drug paraphernalia crimes?
Yes
No
Does the state’s drug overdose Good Samaritan law require the help-seeker to take additional action to qualify for immunity (e.g., remain at scene, cooperate with police, etc.)?
Yes
No

Alabama

Drug User Health Policies Available

Drug Overdose Good Samaritan Law

Alabama’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance medical assistance for another person experiencing a drug-related overdose. The law does not provide immunity for a person experiencing a drug-related overdose. Despite the reference to seeking medical assistance under Article 13 (“Opioid Antagonist Administration”), the explicit requirements for the protection to apply do not include administration of naloxone. Ala. Code § 20-2-281.

What legal protections does the Good Samaritan law provide?

The law provides immunity from prosecution for misdemeanor controlled substance offenses (except for driving under the influence). This includes some drug paraphernalia offenses. Ala. Code § 13A-12-260.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if:

  • they act upon reasonable belief that they were the first to call for assistance,
  • they use their own name when contacting authorities,
  • they remain with the person experiencing the overdose until help arrives, and
  • law enforcement became aware of the offense solely because the person was seeking medical assistance for another.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Ala. Code § 13A-6-242 (Assault with bodily fluids)

Although Ala. Code § 13A-6-242 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes causing or attempting to cause another person to come into contact with bodily fluid without consent. This could apply to sharing drug paraphernalia.

- criminal code

- actual transmission not required

- intent to transmit not required

- applies to communicable diseases (not defined)

- felony (although assault with bodily fluids is a misdemeanor in most cases, the law imposes increased penalties if the defendant is living with a communicable disease)

Ala. Code § 22-11A-21 (Penalty for person afflicted with sexually transmitted disease to transmit such disease to another person)

Although Ala. Code § 22-11A-21 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes doing any act which will probably or likely transmit disease. This could include sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to communicable diseases designated as sexually transmitted diseases (includes HIV but not hepatitis A, B, or C)

- misdemeanor

Section 1115 Medicaid Waivers

Alabama Section 1115 Institutions for Mental Disease Waiver for Serious Mental Illness

Alabama’s proposal to expand SUD services is still pending CMS approval.

Alaska

Drug Overdose Good Samaritan Law

Alaska’s over­dose Good Samaritan law offers some legal protections for a person who in good faith seeks medical or law enforcement assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Alaska Stat. Ann. § 11.71.311.

What legal protections does the Good Samaritan law provide?

The law provides immunity from prosecution for certain fourth, fifth, and sixth degree controlled substance offenses. Possession of drug paraphernalia is not a crime in Alaska.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or rec­eiving medical or law enforcement assistance.

Additionally, person who seeks medical or law enforcement assistance for another person must:

  • remain at the scene until medical or law enforcement assistance arrives, and
  • cooperate with medical or law enforcement personnel, including by providing identification.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in sentencing for a controlled substance offense if the defendant sought medical assistance contemporaneously with the commission of the offense. Alaska Stat. Ann. § 12.55.155(d)(19).

HIV/Hepatitis Criminalization

Alaska does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

Alaska Substance Use Disorder and Behavioral Health Program (SUD-BHP)

Expanded SUD/OUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Intensive outpatient services
    • Residential treatment
    • Medication-assisted treatment (MAT)
    • Opioid treatment services
    • Partial hospitalization
    • Medically monitored intensive inpatient services
    • Medically managed intensive inpatient services
    • Ambulatory withdrawal management services
    • Clinically managed residential withdrawal management
    • Medically monitored inpatient withdrawal management services
    • Medically managed inpatient withdrawal management services
  • Expands access to other SUD benefits
    • Community recovery support services
    • Intensive case management services
    • Peer-based crisis services
    • Intensive outpatient services
    • Partial hospitalization
    • Medically monitored intensive inpatient services
    • Medically managed intensive inpatient services
    • Ambulatory withdrawal management services
    • Clinically managed residential withdrawal management
    • Medically monitored inpatient withdrawal management services
    • Medically managed inpatient withdrawal management services

Expanded Behavioral Health Benefits Coverage

Authorizes expenditures for an expanded set of behavioral health services for children and adolescents age 0-20 at risk of mental health and substance use disorders, and transition age youth and adults with acute mental health needs.

  • Intensive case management services
  • Partial hospitalization
  • Community recovery support services

American Samoa

No Information Available

Arizona

Drug Overdose Good Samaritan Law 

Arizona’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Ariz. Rev. Stat. Ann. § 13-3423.

What legal protections does the Good Samaritan law provide?

The law provides immunity from charge and prosecution for possession or use of a controlled substance or drug paraphernalia. For a person seeking assistance for another, immunity also extends to preparatory offenses.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize contraband or make an arrest for any other offense.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeks medical assistance” means to report the overdose to 911, law enforcement, or a hospital emergency department.

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in a prosecution for a controlled substance offense. 

HIV/Hepatitis Criminalization

Ariz. Rev. Stat. Ann. § 36-631 (Person with contagious or infectious disease exposing himself to public)

Although Ariz. Rev. Stat. Ann. § 36-631 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes exposure of oneself or another in a public place or thoroughfare. This could apply to use of drug paraphernalia in public spaces.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to “contagious or infectious” diseases (not defined)

- misdemeanor

Section 1115 Medicaid Waivers

Arizona Health Care Cost Containment System (AHCCCS)

Arizona’s proposals to expand SUD services are still pending CMS approval.

Arkansas

Drug Overdose Good Samaritan Law

Arkansas’ overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Ark. Code Ann. §§ 20-13-1701 to 20-13-1705.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for possession of a controlled substance.

A person who qualifies for immunity may not be penalized for violations of a permanent or temporary protective or restraining order or a condition of pretrial release, probation, or parole.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize contraband, take a person into custody in the course of an investigation, or make an arrest for any other offense.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeks medical assistance” means to report or assist in reporting the overdose to 911, law enforcement, or a poison control center and provide care to the person experiencing the overdose.

A person may qualify for immunity only if evidence for the offense was obtained solely as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Ark. Code Ann. § 5-14-123 (Exposing another person to human immunodeficiency virus)

Although Ark. Code Ann. § 5-14-123 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes exposure of another through parenteral transfer without first disclosing HIV status. This could apply to sharing drug paraphernalia.

- criminal code

- actual transmission not required

- intent to transmit not required

- HIV-specific

- felony

Section 1115 Medicaid Waivers

Arkansas does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

California

Drug Overdose Good Samaritan Law 

California’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Cal. Health & Safety Code § 11376.5.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for being under the influence of, or possessing for personal use, a controlled substance, controlled substance analogue, or drug paraphernalia.

Possession of hypodermic needles and syringes solely for personal use is not a crime in California, although this provision is currently in effect only until January 1, 2026. Cal. Health & Safety Code § 11364.

Under what circumstances may someone qualify for Good Samaritan protections?

A person who seeks medical assistance for another person may qualify for immunity only if the overdose is related to a controlled substance, controlled substance analogue, or drug paraphernalia in their possession. This suggests that a person may be subject to criminal liability for controlled substances or paraphernalia that are not directly related to the overdose.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Cal. Health & Safety Code § 120290(a)(1) (Intentional transmission of an infectious or communicable disease)

Although Cal. Health & Safety Code § 120290(a)(1) does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes conduct that poses a substantial risk of transmission unless the defendant took or attempted to take practical means to prevent transmission. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit required

- applies to “infectious or communicable” diseases (defined as "a disease that spreads from person to person, directly or indirectly, that has significant public health implications”)

- misdemeanor

Cal. Health & Safety Code § 120290(a)(2) (Willful exposure)

Although Cal. Health & Safety Code § 120290(a)(2) does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes engaging in conduct that poses a substantial risk of transmission within 96 hours of receiving instruction from a health officer not to engage in such conduct. A health officer may issue a maximum of two instructions to a defendant that may result in a violation. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to “infectious or communicable” diseases (defined as "a disease that spreads from person to person, directly or indirectly, that has significant public health implications”)

- misdemeanor

Section 1115 Medicaid Waivers

California Medi-Cal 2020

Whole Person Care Pilot Programs

Whole Person Care (WPC) Pilot programs provide target populations with a range of comprehensive services and supports to address unmet needs and improve the quality and outcomes of high-risk populations, including but not limited to individuals with mental health and/or substance use disorders. WPC Pilots have discretion to provide services Available to individuals not enrolled in Medicaid, but expenditures for these individuals are not eligible for FFP. WPC Pilots support infrastructure to integrate services among local entities that serve target populations; provide services, such as housing and supportive services, not otherwise covered to improve care for target populations; and implement other strategies to improve integration, reduce unnecessary utilization of health care services, and improve health outcomes.

The overarching goal of the WPC Pilots is the coordination of health, behavioral health, and social services in a patient-centered manner with the goals of improved beneficiary health and wellbeing through more efficient and effective use of resources. WPC Pilots will provide an option to a county, a city and county, a health or hospital authority, or a consortium of any of the above entities serving a county or region consisting of more than one county, or a health authority, to receive support to integrate care for a particularly vulnerable group of Medi-Cal beneficiaries who have been identified as high users of multiple systems and continue to have poor health outcomes. Through collaborative leadership and systematic coordination among public and private entities, WPC Pilot entities will identify target populations, share data between systems, coordinate care real time, and evaluate individual and population progress with the goal of providing comprehensive coordinated care for the beneficiary resulting in better health outcomes.

Drug Medi-Cal Organized Delivery System Pilot

The DMC-ODS is a voluntary pilot program which offers California counties the opportunity to expand access to high-quality care for Medi-Cal members with an SUD. The goal of the DMC-ODS is to demonstrate how organized SUD care improves beneficiary health outcomes, while decreasing system-wide health care costs. Counties that choose to participate in the DMC-ODS are required to provide access to a full continuum of SUD benefits modeled after the American Society of Addiction Medicine (ASAM) Criteria. This approach is expected to provide eligible Medi-Cal members with access to the care and services they need for a sustainable and successful recovery. Professional and non-professional providers must comply with DMC-ODC licensing and certification requirements.

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Residential treatment
    • Withdrawal management
  • Expands continuum of care services, detoxification, and withdrawal management services (some services are provided only at county option)
  • Expands community-based SUD services in participating counties
    • Case management
    • Withdrawal management
    • Recovery services
    • Additional MAT (at county option)
    • Partial hospitalization (at county option)
    • Physician consultation (DMC-ODC physicians’ counseling with addiction medicine physicians, addiction psychiatrists, or clinical pharmacists to assist physicians with seeking expert advice on designing treatment plans)
    • Intersection with criminal justice system (additional services for criminal justice-involved individuals, including extended lengths of stay for withdrawal and residential services and Drug Court services)

Colorado

Drug Overdose Good Samaritan Law

Colorado’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical or law enforcement assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Colo. Rev. Stat. Ann. § 18-1-711.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest and prosecution for possession or use of a controlled substance, possession of drug paraphernalia, and certain marijuana offenses.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

A person who seeks medical or law enforcement assistance for another person may qualify for immunity only if:

  • they report the overdose to a law enforcement officer, the 911 system, or a medical provider,
  • they remain at the scene until a law enforcement officer or emergency medical responder arrives, or remain at the medical facility until a law enforcement officer arrives,
  • they identify themselves to and cooperate with the law enforcement officer, emergency medical responder, or medical provider, and
  • the offense arises from the same course of events from which the overdose arose (this suggests that a person may be subject to criminal liability for controlled substances or paraphernalia that are not directly related to the overdose).

If these conditions are satisfied, immunity also extends to the person who experienced the overdose.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Colorado does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

Expanding the Substance Use Disorder Continuum of Care

Expanded SUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Clinically managed residential services
  • Medically monitored intensive inpatient services
  • Medically managed inpatient withdrawal management

Connecticut

Drug Overdose Good Samaritan Law

Connecticut’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Conn. Gen. Stat. Ann. §§ 21a-267, 21a-279.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for use of or possession with intent to use drug paraphernalia, possession of a controlled substance, and possession of more than one-half ounce of a cannabis-type substance (except for offenses occurring within 1,500 feet of an elementary or secondary school by a person who is not enrolled as a student).

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Connecticut does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia. 

Section 1115 Medicaid Waivers

Connecticut does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

Delaware

Drug Overdose Good Samaritan Law 

Delaware’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical or law enforcement assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Del. Code Ann. tit. 16, § 4769.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for all offenses in the state’s Uniform Controlled Substances Act that are not class A, B, or C felonies. This includes possession of drug paraphernalia.

A person who qualifies for immunity may not be subject to revocation or modification of the conditions of probation.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize any controlled substances or drug paraphernalia.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if:

  • they report or assist in reporting the overdose to a law enforcement officer, the 911 system, or a medical provider (or are the subject of such a report), and
  • they share relevant medical information about the overdose event with medical providers, either when medical providers arrive on the scene or at the providers’ facilities.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Delaware does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

Delaware Diamond State Health Plan

Expanded SUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT)

PROMISE Program

The PROMISE program (Promoting Optimal Mental Health for Individuals through Supports and Empowerment) will target individuals with behavioral health needs and functional limitations to offer an array of home and community-based services (HCBS) that are person-centered, recovery-oriented, and aimed at supporting beneficiaries in the community. PROMISE will help improve clinical and recovery outcomes and reduce unnecessary institutional care through better care coordination, and thereby also reduce the growth in overall program costs. Beneficiaries will continue to receive state plan benefits through MCOs, but will have a Department of Substance Abuse and Mental Health counselor as their primary or secondary care manager.

  • Eligibility: Individuals who have a severe and persistent mental illness and/or SUD and require HCBS to live and work in integrated settings.
  • Services:
    • Benefits Counseling
    • Care Management
    • Community Psychiatric Support and Treatment
    • Community-Based Residential Supports (excluding assisted living)
    • Community Transition Services
    • Financial Coaching
    • Non-Medical Transportation
    • Nursing
    • Peer supports
    • Personal Care
    • Respite
    • Independent Activities of Daily Living/Chore Skill Building
    • Individual Employment Supports
    • Psychosocial Rehabilitation and Community Psychiatric Support and Treatment (provided by non-licensed clinical staff, includes assertive community treatment and intensive case management)
    • Short-Term Small Group Supported Employment

All individuals will receive behavioral health state plan benefits for SUD, including MAT

Federated States of Micronesia

Florida

Drug Overdose Good Samaritan Law

Florida’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Fla. Stat. Ann. § 893.21.

A person who seeks medical assistance for another person but is uncooperative with first responders may still be immune from prosecution if they acted in good faith in seeking the assistance. Pope v. State, 246 So. 3d 1282, 1284 (Fla. Dist. Ct. App. 2018) (“Regardless of whether Pope should have behaved better, his purpose in contacting 911 was to save his friend. That was a good-faith purpose.”).

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for possession or use of drug paraphernalia, possession of a controlled substance (depending on quantity and the type of substance), and possession of less than 20 grams of marijuana.

A person who qualifies for immunity may not be penalized for a violation of a condition of pretrial release, probation, or parole.

Evidence may still be admissible in other criminal prosecutions.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of obtaining or providing medical assistance for someone experiencing an overdose may be considered a mitigating factor in sentencing for any felony offense, except for capital felonies.

HIV/Hepatitis Criminalization

Florida does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia. 

Section 1115 Medicaid Waivers

Florida Managed Medical Assistance (MMA)

Behavioral Health and Supportive Housing Assistance Pilot

State website description: Florida Medicaid will be providing evidence-based community supports and services that will assist in securing housing for Medicaid recipients ages 21 and older who are homeless or at risk of homelessness and have a serious mental illness (SMI) and/or substance use disorder (SUD). The overall goal is to facilitate housing stability and improve health outcomes for participants.

  • Eligibility: Medicaid recipients ages 21 and older with a serious mental illness (SMI) and/or substance use disorder (SUD) and who are homeless or at risk of homelessness due to their disability
  • Services:
    • Transitional housing services
    • Tenancy sustaining services
    • Mobile crisis management
    • Self-help/peer support

Georgia

Drug Overdose Good Samaritan Law

Georgia’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Ga. Code Ann. § 16-13-5.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for possession of a controlled substance (depending on quantity), possession of less than one ounce of marijuana, and use or possession of drug-related objects.

A person who qualifies for immunity may not be penalized for violations of a permanent or temporary protective or restraining order or a condition of pretrial release, probation, or parole.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize contraband, take a person into custody in the course of an investigation, or make an arrest for any other offense.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeks medical assistance” means to report or assist in reporting the overdose to 911, law enforcement, or a poison control center and provide care to the person experiencing the overdose until medical or law enforcement assistance arrives. However, a defendant who experiences an overdose and is the subject of a request for assistance may still qualify for immunity if the overdose reporter does not provide care to the defendant while awaiting assistance. State v. Mercier, 826 S.E.2d 422, 425 (Ga. Ct. App. 2019) (defendant qualified for immunity after bystanders found him lying on the street and called 911 even though the bystanders did not provide any care to defendant while awaiting medical assistance).

A person may qualify for immunity only if evidence for the offense was obtained solely as a result of the person seeking or receiving medical assistance. When determining whether evidence was obtained “solely as a result” of a call for medical assistance, courts have looked to the reasons police officers were at the scene. If the police were at the scene because someone called for emergency medical assistance, evidence supporting the charges would not have been discovered but for the request for medical assistance and immunity applies. This is true even if the police and emergency responders were summoned to the scene without knowledge of a drug-related emergency. In Mercier, the defendant qualified for immunity even though the bystanders who found him lying on the street and called for assistance were unaware that his condition was related to drug use and did not describe the event as an overdose when calling 911. S.E.2d at 425. The court found that the defendant could not be prosecuted based on evidence discovered by law enforcement officers on the scene because, even though law enforcement did not know they were responding to a drug-related overdose, the prosecution was nonetheless the result of the defendant being the subject of a request for medical assistance while experiencing an overdose. Id. (“without the calls from bystanders, no emergency responders, including law enforcement, would have been on the scene”).

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Ga. Code Ann. § 16-5-60 (Reckless conduct)

Ga. Code Ann. § 16-5-60 criminalizes knowingly allowing another person to use a hypodermic needle or syringe that has previously been used by the defendant, without first disclosing HIV status.

- criminal code

- actual transmission not required

- intent to transmit not required

- HIV-specific

- felony 

Section 1115 Medicaid Waivers

Georgia does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

Guam

Hawaii

Drug Overdose Good Samaritan Law

Hawaii’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Haw. Rev. Stat. Ann. § 329-43.6.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, prosecution, and conviction for possession of a controlled substance or drug paraphernalia.

A person who qualifies for immunity may not be subject to civil forfeiture or penalized for violations of a restraining order or a condition of probation or parole.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeking medical assistance” includes (but is not limited to) reporting or assisting in reporting the overdose to 911, law enforcement, a medical provider, or a poison control center, or providing care to the person experiencing the overdose until medical or law enforcement assistance arrives.

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in a prosecution for a controlled substance offense. 

HIV/Hepatitis Criminalization

Hawaii does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

Hawaii QUEST Integration

Hawaii QUEST Integration Community Integration Services

Provides housing-related community integration services for beneficiaries who are homeless or at risk of homelessness, and who also have a behavioral health need, complex physical health need, or substance use need.

  • Eligibility: Medicaid enrollees age 18 or older with a behavioral health, mental health, substance use, and/or complex physical health need who are homeless or at risk of homelessness.
  • Services:
    • Pre-tenancy supports
    • Tenancy sustaining services
    • Community transition services pilot program – provides various housing-related services, including:
      • transitional case management
      • housing quality and safety improvements (repair or remediation for issues such as mold and pests, if a cost-effective method of addressing health condition and not covered under any other program)
      • assistance (connects individuals to expert community resources to address legal issues impacting housing and thereby adversely impacting health, such as assistance with breaking a lease due to unhealthy living conditions; does not actually pay for legal assistance)
      • one-time payments for security deposits and/or first month’s rent (if not available through any other program)

Idaho

Drug Overdose Good Samaritan Law

Idaho’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for any person experiencing the overdose. Idaho Code Ann. § 37-2739C.

What legal protections does the Good Samaritan law provide?

The law provides immunity from charge and prosecution for possession of a controlled substance, possession of marijuana, using or possessing with intent to use drug paraphernalia, and using or being under the influence of certain enumerated controlled substances on a public roadway, a public conveyance, or public property.

Evidence may still be obtained and used to charge or prosecute any crime for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Idaho Code Ann. § 39-608 (Transfer of body fluid which may contain the HIV virus)

Although Idaho Code Ann. § 39-608 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes transfer or attempted transfer of any bodily fluid or tissue to another person unless the defendant disclosed their HIV status or received advice from a licensed physician that they were non-infectious. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- HIV-specific

- felony 

Section 1115 Medicaid Waivers

Idaho Behavioral Health Transformation

Expanded SUD/SMI Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SMI/SED and/or SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Inpatient services
  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT)

Illinois

Drug Overdose Good Samaritan Law

Illinois’ overdose Good Samaritan law offers some legal protections for a person who in good faith seeks or obtains medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. 720 Ill. Comp. Stat. Ann. 646/115, 720 Ill. Comp. Stat. Ann. 570/414 (amended by 2021 Ill. Legis. Serv. P.A. 102-4 (H.B. 158), eff. April 27, 2021).

A person must demonstrate that their actions were, in good faith, for the purpose of seeking or obtaining medical assistance for an overdose victim—simply being present at the scene or observing the overdose is not sufficient. People v. O'Malley, No. 5-19-0127, 2021 WL 1060209, ¶ 31 (Ill. App. Ct. Mar. 19, 2021) (defendant did not qualify for immunity where passenger in defendant’s car passively obtained medical assistance from police during a routine traffic stop, because defendant did not state to police that medical assistance was needed or take any other action to obtain medical assistance). However, a person experiencing an overdose may qualify for immunity if they passively obtain medical assistance from law enforcement officers while unconscious and unable to actively seek assistance for themselves. People v. Teper, 74 N.E.3d 1011, 1019-20 (Ill. App. Ct. 2016).

What legal protections does the Good Samaritan law provide?

The law provides immunity (depending on quantity and type of drug) from arrest, charge, and prosecution for manufacture, delivery, or possession with intent to manufacture or deliver a controlled, counterfeit, or look-alike substance or a controlled substance analogue; possession of a controlled or counterfeit substance; possession of drug paraphernalia; drug-induced homicide; possession of methamphetamine; delivery of methamphetamine; and aggravated battery by unlawful delivery of a controlled substance to another that results in great bodily harm or permanent disability to the user.

A person who qualifies for immunity may not be subject to civil forfeiture or penalized for violations of parole, mandatory supervised release, probation, or conditional discharge.

Immunity does not apply if law enforcement has reasonable suspicion or probable cause to detain, arrest, or search the person for criminal activity based on information obtained prior to or independent of the seeking or obtaining of medical assistance.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance. A person may be prosecuted based on evidence obtained prior to or independent of the act of seeking or receiving medical assistance.

When determining whether evidence is obtained “as a result of” the defendant seeking or obtaining medical assistance, courts have placed significant weight on the timeline of events that occurred prior to the provision of medical assistance and discovery of contraband. If police are summoned to the scene with knowledge of a drug overdose in progress, immunity is triggered at the time of the 911 call and evidence obtained thereafter may be considered to have been obtained “as a result of” the defendant seeking or receiving medical assistance. People v. Markham, 126 N.E.3d 759, 764 (Ill. App. Ct. 2019). However, if police develop probable cause to seize evidence before realizing that an overdose is in progress—for example, if police discover contraband in plain view in a car during a routine traffic stop, before determining that the defendant is experiencing an overdose—the evidence obtained may be considered not to have been obtained “as a result of” seeking or obtaining medical assistance. Teper, 74 N.E.3d at 1015-16, 1019-21.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The fact that a defendant sought or received medical assistance for a drug overdose may be considered a mitigating factor in sentencing for certain enumerated controlled substance offenses. 730 Ill. Comp. Stat. Ann. 5/5-5-3.1(a)(14).

HIV/Hepatitis Criminalization

720 Ill. Comp. Stat. 5/12-5.01 (Criminal transmission of HIV)

720 Ill. Comp. Stat. 5/12-5.01 criminalizes dispensing, delivering, exchanging, selling, or in any other way transferring non-sterile intravenous or intermuscular drug paraphernalia to another person unless the other person consented to the act of exposure with knowledge of the defendant’s status.

- criminal code

- actual transmission not required

- intent to transmit required

- HIV-specific

- felony 

Section 1115 Medicaid Waivers

Illinois Behavioral Health Transformation

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT)
  • Clinically managed withdrawal management
  • SUD case management
  • Peer support services

SUD and Mental/Behavioral Health Pilot Programs

Authorizes 10 pilot programs that provide an array of comprehensive community-based services, which may be provided by providers with varying levels of education and lived experience, for adults and children with behavioral health, mental health, and/or substance use needs. The state may implement annual enrollment limits unless otherwise specified.

  • Eligibility: Varies by program. Unless otherwise specific, the state may institute enrollment limits in pilot programs.
  • Services:
    • Residential and Inpatient Treatment for Individuals with SUD Pilot: This pilot includes services listed under Expanded SUD/OUD Benefits Coverage above. This pilot will be statewide and will have no annual enrollment limits.
    • Clinically Managed Withdrawal Management Services Pilot: Intake, observation, medication services, and discharge services provided by qualified treatment professionals (includes physician and non-physician providers) in DASA-licensed residential facilities.
    • SUD Case Management Pilot: Various individualized services to assist with accessing needed medical, social, educational, and other services provided by case managers.
    • Peer Recovery Support Services Pilot: Counseling support and care coordination activities provided by certified peer recovery coaches.
    • Crisis Intervention Services Pilot: Crisis assessment and stabilization, treatment planning, counseling, and discharge services provided by qualified mental health professionals or rehabilitative services associates (provider qualifications are the same as those described in the Medicaid State Plan) in acute care general hospital, psychiatric residential treatment facilities, or non-IMD community residential treatment center with 16 or fewer beds.
    • Evidence-based Home Visiting Services Pilot: Various postpartum home visiting and child home visit services provided by qualified mental health professionals or rehabilitative services associates (provider qualifications are the same as those described in the Medicaid State Plan).
    • Assistance in Community Integration Services Pilot: Pre-tenancy supports and tenancy sustaining services provided by Assistance in Community Integration Services Providers with case management or field experience.
    • Supported Employment Services Pilot: Supported employment services provided by Supported Employment Service Providers with case management or field experience.
    • Intensive In-Home Services Pilot: Intensive in-home clinical and support services provided by Community Mental Health Center or Behavioral Health Clinic staff with case management or field experience.
    • Respite Services Pilot: Individualized time-limited respite services provide in-home or in community-based settings by Respite Service Providers with case management or field experience.

Indiana

Drug Overdose Good Samaritan Law

Indiana’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance after administering an overdose intervention drug to another person experiencing an opioid-related overdose. The law does not provide immunity for a person experiencing a drug-related overdose. Ind. Code Ann. § 16-42-27-2.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest and prosecution for possession of a controlled substance; possession of cocaine; possession of methamphetamine; possession of marijuana; possession of a synthetic drug, controlled substance analog, or look-alike controlled substance; or possession of drug paraphernalia.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if:

  • they lawfully received an overdose intervention drug from a prescriber,
  • they administer the overdose intervention drug to a person experiencing an apparent overdose,
  • they attempt to summon emergency services either immediately before or after administering the overdose intervention drug,
  • they provide their full name and any other relevant information requested by the law enforcement officer,
  • they remain at the scene until emergency medical assistance arrives,
  • they cooperate with emergency medical assistance personnel and law enforcement officers at the scene, and
  • they came in contact with law enforcement because they requested emergency medical assistance for another person.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in sentencing for a controlled substance offense if the person’s arrest or prosecution was facilitated in part because they sought medical assistance. Ind. Code Ann. § 35-38-1-7.1(b)(12).

HIV/Hepatitis Criminalization

Ind. Code Ann. § 16-41-7-1 (Duty of individuals with communicable disease to warn persons at risk)

Ind. Code Ann. § 16-41-7-1 criminalizes failure to disclose status to another person prior to engaging in needle-sharing contact that has been demonstrated epidemiologically to transmit HIV or hepatitis B.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to HIV and hepatitis B

- felony (knowing or intentional failure to disclose) or misdemeanor (reckless failure to disclose)

Ind. Code § 35-42-2-1 (Battery)

Although Ind. Code § 35-42-2-1 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes placing bodily fluid or waste on another person in a rude, insolent, or angry manner. This could apply to sharing drug paraphernalia.

- criminal code

- actual transmission not required

- intent to transmit not required

- applies to HIV and hepatitis (type not specified)

- felony (although battery is a misdemeanor in most cases, the law imposes increased penalties if the bodily waste or fluid was infected with hepatitis or HIV)

Ind. Code § 35-45-16-2 (Malicious mischief)

Although Ind. Code § 35-45-16-2 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes recklessly, knowingly, or intentionally placing bodily fluid in a location with the intent that another person will ingest or involuntarily touch the body fluid. This could apply to sharing drug paraphernalia.

- criminal code

- actual transmission not required

- defendant must act with intent that another person will involuntarily touch the bodily fluid

- applies to HIV and hepatitis A, B, C, D, E, G

- felony (although malicious mischief is a misdemeanor in most cases, the law imposes increased penalties if the bodily fluid was infected with hepatitis or HIV)

Section 1115 Medicaid Waivers

Healthy Indiana Plan

Expanded SUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Residential treatment
  • Withdrawal management
  • Opioid treatment services
  • Addiction recovery management services

Iowa

Drug Overdose Good Samaritan Law 

Iowa’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. A person may not receive immunity more than once. Iowa Code Ann. § 124.418.

What legal protections does the Good Samaritan law provide?

Evidence collected or derived as a result of the seeking of medical assistance may not support probable cause and may not be admissible as evidence for delivery of a controlled substance without profit (depending on quantity and type of drug); possession of a controlled substance; promoting, aiding, sponsoring, or assisting in the sponsoring or promoting of a meeting, gathering, or assemblage with the knowledge or intent that a controlled substance be there distributed, used, or possessed; and manufacture, delivery, sale, or possession of drug paraphernalia.

A person who qualifies for immunity may not be subject to revocation of pretrial release, probation, supervised release, or parole.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still investigate the overdose, or investigate or prosecute a person based on evidence obtained from sources other than the specific drug-related overdose where medical assistance was provided.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if:

  • they have not previously received immunity under the Good Samaritan law, and
  • the evidence for the offense was obtained as a result of the specific drug-related overdose where medical assistance was provided.

Additionally, a person who seeks medical assistance for another person must:

  • be the first person to seek medical assistance,
  • provide their name and contact information to medical or law enforcement personnel,
  • remain on the scene until assistance arrives or is provided, and
  • cooperate with medical and law enforcement personnel.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of providing first aid or other medical assistance to a person experiencing an overdose may be considered a mitigating factor in any criminal prosecution.

HIV/Hepatitis Criminalization

Iowa Code Ann. § 709D.3 (Criminal transmission of a contagious or infectious disease)

Although Iowa Code Ann. § 709D.3 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes engaging in conduct that poses a substantial risk of transmission unless the defendant took or attempted to take practical means to prevent transmission or the other person consented to the act of exposure with knowledge of the defendant’s status. This could apply to sharing drug paraphernalia.

- criminal code

- actual transmission not required

- intent to transmit not required

- applies to “contagious or infectious diseases” (including HIV and hepatitis in any form)

- felony or misdemeanor (penalties vary depending on whether the defendant acted with intent to transmit, and whether transmission actually occurred) 

Section 1115 Medicaid Waivers

Iowa does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

Kansas

Drug Overdose Good Samaritan Law 

Kansas does not have a drug overdose Good Samaritan law.

HIV/Hepatitis Criminalization

Kan. Stat. Ann. § 21-5424 (Exposing another to a life-threatening communicable disease)

Kan. Stat. Ann. § 21-5424 criminalizes sharing hypodermic needles and syringes.

- criminal code

- actual transmission not required

- intent to expose required

- applies to “life-threatening communicable diseases” (not defined)

- felony

Section 1115 Medicaid Waivers

KanCare

Expanded SUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT)

Additional Services for Individuals with Behavioral Health or SUD Needs

Authorizes expenditures for additional services for individuals with behavioral health or SUD needs.

  • Physician consultation (case conferences): Face-to-face patient consultation meetings for medical management of psychiatric conditions provided to adults and youth with serious mental health conditions by licensed mental health practitioners, advanced registered nurse practitioners, or psychiatrists.
  • Personal care services: Direct support and assistance with daily activities critical to residing in a home community provided to individuals with serious mental health conditions who would otherwise be placed in a more restrictive setting.
  • Rehabilitation services for all demonstration enrollees: SUD detox and treatment and step-down services from inpatient hospital, designed to meet more intensive needs of individuals with SUD in their community.

Disability and Behavioral Health Employment Support Pilot Program

Authorizes pre-vocational services, supported employment, personal assistant services, independent living skills training, assistive technology, and transportation services for SSI and SSDI recipients age 16-65 who have certain behavioral health diagnoses, including but limited to SUD, and certain individuals eligible for HCBS services. Certain individuals not otherwise eligible for Medicaid may be eligible for services under this pilot program.

 

Kentucky

Drug Overdose Good Samaritan Law

Kentucky’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical or law enforcement assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Ky. Rev. Stat. Ann. § 218A.133.

When contact information is available for the person who requested assistance, it shall be provided to the local health department for health department staff to offer referrals to substance use treatment, if appropriate.

What legal protections does the Good Samaritan law provide?

The law provides immunity from charge and prosecution for possession of a controlled substance and possession of drug paraphernalia.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Additionally, a person who seeks medical assistance for another person must remain with the person experiencing the overdose until the requested assistance is provided. However, the person experiencing the overdose may be entitled to immunity even if the person who sought assistance on their behalf leaves the scene before assistance is provided. Logsdon v. Commonwealth, 601 S.W.3d 477, 481 (Ky. Ct. App. 2020).

Is reporting an overdose a mitigating factor in sentencing?

No. 

HIV/Hepatitis Criminalization

Kentucky does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia. 

Section 1115 Medicaid Waivers

KY HEALTH

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT) (NOTE: non-emergency medical transportation (NEMT) services are not provided to all Medicaid beneficiaries for methadone services)
  • Peer support services
  • Residential crisis stabilization services

Louisiana

Drug Overdose Good Samaritan Law

Louisiana’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. La. Stat. Ann. § 14:403.10.

A person who is the subject of a good faith request for medical assistance may qualify for immunity if the amount of drugs consumed was not in fact life-threatening, as long as the person who sought assistance reasonably believed that medical attention was needed for a life-threatening overdose; however, immunity will not apply if the defendant did not actually need medical assistance. State v. Jago, 228 So. 3d 1218, 1219 (La. 2017) (defendant was not shielded from prosecution where he was quickly roused from unconsciousness and required no medical attention of any kind).

What legal protections does the Good Samaritan law provide?

The law provides immunity from charge, prosecution, and other penalties for possession of a controlled dangerous substance.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

A person who seeks medical assistance for another person may not qualify for immunity if they “illegally provided or administered” a controlled dangerous substance to the person needing assistance.

Is reporting an overdose a mitigating factor in sentencing?

No. 

HIV/Hepatitis Criminalization

La. Stat. Ann. § 14:43.5 (Intentional exposure to HIV)

Although La. Stat. Ann. § 14:43.5 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes exposing another to HIV through any means or contact unless the other person consented to the act of exposure with knowledge of the defendant’s HIV status, the defendant disclosed their HIV status and received advice from a licensed physician that they were non-infectious, or the defendant disclosed their HIV status and took practical means to prevent transmission. This could apply to sharing drug paraphernalia.

- criminal code

- actual transmission not required

- intent to expose required

- HIV-specific

- felony

 Section 1115 Medicaid Waivers

Healthy Louisiana OUD/SUD Demonstration

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT)
  • Inpatient services
  • Clinically managed withdrawal management

Maine

Drug Overdose Good Samaritan Law

 Maine’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, a person who in good faith administers naloxone to a person experiencing an overdose, and the person experiencing the overdose. Me. Rev. Stat. tit. 17-A, § 1111-B.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest or prosecution for possession of a controlled substance, acquiring drugs by deception, illegal possession of hypodermic apparatuses (defined as possession of 11 or more hypodermic apparatuses, unless the person is enrolled in a hypodermic apparatus exchange program certified by the health department and is transporting the hypodermic apparatuses to the program), and use of drug paraphernalia.

A person who qualifies for immunity may not be penalized for violations of probation.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance or administering naloxone.

Is reporting an overdose a mitigating factor in sentencing?

No. 

HIV/Hepatitis Criminalization

Maine does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia. 

Section 1115 Medicaid Waivers 

Maine Substance Use Disorder Care Initiative

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD. Services provided in IMDs include but are not limited to:

  • Inpatient services
  • Residential treatment services
  • Medically monitored withdrawal management
  • Medication-assisted treatment (MAT)

Marshall Islands

Maryland

Drug Overdose Good Samaritan Law

Maryland’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks, provides, or assists with provision of medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Md. Code Ann., Crim. Proc. § 1-210.

A person experiencing an overdose may qualify for immunity if they passively obtain medical assistance—for example, because another person made the call to 911. Noble v. State, 189 A.3d 807, 815 (Md. 2018).

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for criminal possession or administration of a controlled dangerous substance; use, possession with intent to use, delivery, sale, or advertisement of drug paraphernalia; obtaining or attempting to obtain “controlled paraphernalia” by fraud; and possession or distribution of “controlled paraphernalia” with intent to use the controlled paraphernalia for the purposes of illegally administering a controlled dangerous substance.

A person who qualifies for immunity may not be penalized for violations of a condition of pretrial release, probation, or parole.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. E.g., Gerety v. State, 246 A.3d 629, 642 (Md. 2021).

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if the evidence for the offense was obtained solely as a result of the person seeking or receiving medical assistance.

When determining whether evidence was obtained “solely as a result” of a call for medical assistance, courts must focus on the reason police officers were at the scene. If the police were at the scene because someone called for medical assistance for a suspected overdose, evidence supporting the charges would not have been discovered but for the report of a drug-related emergency and immunity applies; however, if police were present for reasons other than a call for medical assistance, evidence found would not be obtained “solely” as a result of the medical emergency. Gerety, 246 A.3d at 643 (defendant qualified for immunity where police responded to a call for medical assistance for a suspected overdose, discovered the defendant’s outstanding warrants after a routine identification check, and obtained evidence while conducting a search to execute the warrant because officers would not have been on the scene and discovered the warrants if not for the call for medical assistance for an overdose).

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in any criminal prosecution of the person who sought assistance or the person who experienced the overdose. 

HIV/Hepatitis Criminalization

Md. Code Ann., Health-Gen. § 18-601.1 (Knowing transfer of HIV)

Although Md. Code Ann., Health-Gen. § 18-601.1 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes transferring or attempting to transfer HIV to another person. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- HIV-specific

- misdemeanor

Md. Code Ann., Health-Gen. § 18-601 (Exposure of others to infectious disease)

Although Md. Code Ann., Health-Gen. § 18-601 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes being in a public place without taking precautions against exposing others to the disease, or transferring to another any article that has been exposed to the disease without thoroughly disinfecting the article. This could apply to sharing drug paraphernalia or use of drug paraphernalia in public spaces.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to "infectious diseases that endanger public health” (not defined)

- misdemeanor

Md. Code Ann., Health-Gen. § 18-602 (Exposure of infectious disease by third party)

Although Md. Code Ann., Health-Gen. § 18-602 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes willfully or knowingly taking an individual who has an infectious disease into the home of another or carelessly exposing someone to an infected individual. This could apply to sharing drug paraphernalia or gathering in a person’s home for the purpose of using drugs.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to "infectious diseases that endanger public health” (not defined)

- misdemeanor 

Section 1115 Medicaid Waivers

Maryland Health Choice

Expanded SUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Residential treatment
    • Medically managed intensive inpatient hospital services
    • Medically supervised withdrawal management
    • Medication-assisted treatment (MAT)
  • Expands access to other SUD benefits
    • Clinically managed residential services
    • Medically monitored intensive inpatient services
    • Opioid treatment services
    • Medically monitored inpatient withdrawal management

Collaborative Care Model (CoCM) Pilot Program

Authorizes evidence-based therapeutic intervention services and targeted case management services providing patient-centered, evidence-based approach for integrating physical and behavioral health services to a limited number of beneficiaries who screen positive for a behavioral health condition, including SUD. The goal of the pilot program is to provide coverage for beneficiaries who have experienced mental illness or have an SUD, but have not received effective treatment, and to further integrate primary and behavioral health care.

Massachusetts

Drug Overdose Good Samaritan Law

Massachusetts’ overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Mass. Gen. Laws Ann. ch. 94C, § 34A.

What legal protections does the Good Samaritan law provide?

The law provides immunity from charge and prosecution for possession of a controlled substance.

A person who qualifies for immunity may not be penalized for violations of a condition of probation, pretrial release, or parole.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in a prosecution for a controlled substance offense. 

HIV/Hepatitis Criminalization

Massachusetts does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

MassHealth

Diversionary Behavioral Health Services

Diversionary services include home and community-based mental health and SUD services as clinically appropriate alternatives to and diversions from inpatient mental health and SUD services in more community-based, less structured environments, services provided to support an individual’s return to the community following a 24-hour acute placement, and services to provide intensive support to maintain functioning in the community. Diversionary services may be provided in a 24-hour facility (IMD or non-IMD) or a non-24-hour facility or setting, and are generally provided by community-based or hospital-based programs licensed by the Department of Mental Health or the Department of Public Health. Services are intended to provide interventions and stabilization to persons experiencing mental health or substance use crises in order to divert from acute inpatient hospitalization or to stabilize after discharge. These services do not include long-term residential programs.

  • Community Crisis Stabilization
  • Community Support Program
  • Partial Hospitalization
  • Acute Treatment Services for Substance Abuse
  • Clinical Support Services for Substance Abuse
  • Transitional Care Unit Services
  • Psychiatric Day Treatment
  • Intensive Outpatient Program
  • Structured Outpatient Additional Program
  • Program of Assertive Community Treatment
  • Emergency Services Program
  • Community-Based Acute Treatment for Children and Adolescents 

Expanded SUD Benefits

Authorizes expenditures for additional SUD services to improve access to treatment and ongoing recovery support.

  • Clinically Managed Residential Services (may be provided in IMDs)
  • Recovery Support Navigator Services
  • Recovery Coach Services

Michigan

Drug Overdose Good Samaritan Law

Michigan’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, a person who accompanies another person requiring medical assistance, and for the person experiencing the overdose. Mich. Comp. Laws Ann. §§ 333.7403, 333.7404.

A person experiencing an overdose may qualify for immunity only if they are incapacitated, or reasonably believed to be incapacitated, because of the overdose. However, total incapacitation is not required. People v. Meeker, No. 355046, 2021 WL 1822910, at *2-3 (Mich. Ct. App. May 6, 2021) (defendant may qualify for immunity if they are conscious but unfit for normal functioning).

Health facilities and agencies must notify a parent, guardian, or custodian of a non-emancipated minor under age 18 who voluntarily presents themselves or is presented by another person to the health facility or agency for emergency medical treatment. However, notification to a parent, guardian, or custodian for non-emergency treatment is permitted only with the minor’s consent.

What legal protections does the Good Samaritan law provide?

The law provides immunity from criminal liability for possession of a controlled substance or controlled substance analogue, use of a controlled substance or controlled substance analogue, and unlawful possession of a prescription form.

Evidence may still be obtained and used to investigate, arrest, charge, or prosecute a person for any crime for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeks medical assistance” means to report or assist in reporting the overdose to law enforcement, the 911 system, a poison control center, or a medical provider.

A person may qualify for immunity only if:

  • the overdose is related to use of controlled substance that the person possesses in an amount sufficient only for personal use (this suggests that a person may be subject to criminal liability for controlled substances that are not directly related to the overdose, or for larger quantities of controlled substances), and
  • evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Michigan does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

Michigan 1115 Pathway to Integration

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Opioid treatment program services
  • Office-based opioid treatment services
  • Residential treatment
  • Medically supervised withdrawal management
  • Inpatient services
  • SUD support services

Minnesota

Drug Overdose Good Samaritan Law

Minnesota’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Minn. Stat. Ann. § 604A.05.

What legal protections does the Good Samaritan law provide?

The law provides immunity from charge and prosecution for possession of a controlled substance in the third degree (only certain provisions), fourth degree, or fifth degree, and possession of drug paraphernalia. For a person seeking assistance for another, immunity also extends to sharing or use of a controlled substance.

A person who qualifies for immunity may not be subject to revocation of pretrial release, furlough, supervised release, or parole.

Evidence may still be obtained and used to investigate or prosecute any crime or violation for which immunity is not available. A person may be prosecuted based on evidence obtained from an independent source.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance. A person may be prosecuted based on evidence obtained from an independent source.

Additionally, a person who seeks medical assistance for another person must:

  • be the first person to seek assistance,
  • provide a name and contact information,
  • remain on the scene until assistance arrives, and
  • cooperate with authorities.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of providing medical assistance to someone experiencing an overdose may be considered a mitigating factor in a prosecution for any other offense for which immunity is not available.

HIV/Hepatitis Criminalization

Minn. Stat. Ann. § 609.2241 (Knowing transfer of communicable disease)

Minn. Stat. Ann. § 609.2241 criminalizes sharing non-sterile syringes or needles unless the defendant took practical means to prevent transmission as advised by a health professional or is a health care provider who was following professionally accepted infection control procedures. The defendant must have received information from a health professional regarding their disease status, behaviors that pose risk of transmission, and practical means of preventing transmission.

- criminal code

- actual transmission not required

- intent to transmit not required

- applies to “communicable diseases” (defined as "a disease that causes serious illness, serious disability, or death; the infectious agent of which may pass or be carried from the body of one person to the body of another through direct transmission”)

- felony or misdemeanor (knowing transfer of a communicable disease may be charged as assault, attempted assault, murder, or attempted murder)

Section 1115 Medicaid Waivers 

Minnesota Substance Use Disorder System Reform

Expanded SUD/OUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Residential treatment
    • Medically monitored withdrawal management
    • Clinically managed withdrawal management
    • Medication-assisted treatment (MAT)
    • Recovery peer support services
    • Comprehensive assessment services
    • SUD treatment coordination services
  • Expands access to other SUD benefits:

Intensive outpatient services not otherwise covered under the Medicaid State Plan

Mississippi

Drug Overdose Good Samaritan Law

Mississippi’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Miss. Code. Ann. § 41-29-149.1.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for possession of a controlled substance (depending on quantity), possession of marijuana (30 grams or less) or synthetic cannabinoids (10 grams or less), and possession and use of paraphernalia.

A person who qualifies for immunity may not be subject to civil forfeiture or penalized for violations of a permanent or temporary protective or restraining order or a condition of pretrial release, probation, or parole.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize contraband, take a person into custody in the course of an investigation, or make an arrest for any other offense.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeks medical assistance” means to report or assist in reporting the overdose to law enforcement, the 911 system, or a poison control center, or providing care to the person experiencing the overdose until medical assistance arrives.

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Miss. Code. Ann. § 97-27-14 (Endangerment by bodily substance)

Although Miss. Code. Ann. § 97-27-14 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes exposing another person to HIV, hepatitis B, or hepatitis C unless the other person consented to the act of exposure with knowledge of the defendant’s status. This could apply to sharing drug paraphernalia.

- criminal code

- actual transmission not required

- intent to transmit not required

- applies to HIV, hepatitis B, and hepatitis C

- felony

Section 1115 Medicaid Waivers

Mississippi does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

Missouri

Drug Overdose Good Samaritan Law

Missouri’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Mo. Ann. Stat. § 195.205.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, prosecution, conviction, and any other penalties for possession of a controlled substance, possession of drug paraphernalia, possession of an imitation controlled substance, and keeping or maintaining a public nuisance.

A person who qualifies for immunity may not be subject to civil forfeiture or penalized for violations of a restraining order or a condition of probation or parole.

Evidence may still be obtained and used to prosecute any crime for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

“Medical assistance” includes (but is not limited to) reporting or assisting in reporting the overdose to law enforcement, the 911 system, a poison control center, or a medical provider, or providing care to the person experiencing the overdose until medical assistance arrives.

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Effective until August 27, 2021:

Mo. Ann. Stat. § 191.677 (Title XII, Ch. 191, AIDS—Prohibited acts)

Mo. Ann. Stat. § 191.677 criminalizes exposing another person to HIV through sharing of needles without the other person’s knowledge and consent to be exposed to HIV.

- public health code

- actual transmission not required

- intent to transmit not required

- HIV-specific

- felony

Effective August 28, 2021 (amended by 2021 Mo. Legis. Serv. S.B. 53 & 60):

Mo. Ann. Stat. § 191.677 (Title XII, Ch. 191, AIDS—Prohibited acts)

Although Mo. Ann. Stat. § 191.677 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes exposing another person to a serious infectious or communicable disease through conduct that poses a substantial risk of transmission as determined by competent medical or epidemiological evidence unless the other person consented to the act of exposure with knowledge of the defendant’s status. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to “serious and infectious communicable diseases”

- felony or misdemeanor (penalties vary depending on whether the defendant acted knowingly or recklessly, and whether transmission actually occurred) 

Section 1115 Medicaid Waivers

Missouri Gateway to Better Health

Expanded SUD Benefits Coverage

Authorizes expenditures for limited outpatient SUD benefits.

  • Eligibility: Individuals age 19-64 with incomes below 100% FPL who are not eligible for Medicaid under the State Plan and are living in St. Louis City or St. Louis County. The state may restrict enrollment once the program reaches 16,000 enrollees.
  • Services:
  • Screening, evaluation, and assessment
  • Medication-assisted treatment (MAT)
  • Psychotherapy
  • Group therapy
  • Peer support services
  • Case management services

Montana

Drug Overdose Good Samaritan Law

Montana’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Mont. Code Ann. § 50-32-609.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for possession of drug paraphernalia, possession of dangerous drugs, and possession of precursors to dangerous drugs.

A person who qualifies for immunity may not be subject to revocation of pretrial release, probation, furlough, supervised release, or parole.

A pregnant person seeking or receiving evaluation, treatment, or support services for a substance use disorder is immune from criminal liability for possession of drug paraphernalia, possession of dangerous drugs, and possession of precursors to dangerous drugs.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of providing medical assistance to someone experiencing an overdose may be considered a mitigating factor in a prosecution for any other offense for which immunity is not available.

HIV/Hepatitis Criminalization

Mont. Code Ann. § 50-18-112 (Infected person not to expose another to sexually transmitted disease)

Although Mont. Code Ann. § 50-18-112 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes exposing another person to a sexual transmitted disease. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to "sexually transmitted diseases" (including HIV but not hepatitis)

- misdemeanor

Section 1115 Medicaid Waivers

Montana does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

Nebraska

Drug Overdose Good Samaritan Law

Nebraska’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Neb. Rev. Stat. Ann. § 28-472.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest and prosecution for possession of controlled substance and possession or use of drug paraphernalia.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Additionally, person who seeks medical assistance for another person must:

  • request assistance as soon as the drug overdose was apparent,
  • remain at the scene until medical or law enforcement assistance arrives, and
  • cooperate with medical or law enforcement personnel.

Is reporting an overdose a mitigating factor in sentencing?

No. 

HIV/Hepatitis Criminalization

Nebraska does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia. 

Section 1115 Medicaid Waivers 

Nebraska Substance Use Disorder Section 1115 Demonstration

Expanded SUD/OUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Inpatient services
    • Residential treatment
    • Medically supervised withdrawal management
    • Opioid treatment program services
    • Office-based opioid treatment

Nevada

Drug Overdose Good Samaritan Law

Nevada’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Nev. Rev. Stat. Ann. § 453C.150.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, prosecution, conviction, and any other penalties for possession of a controlled substance (except for trafficking in controlled substances and possession of more than 12 marijuana plants) or a violation of a similar local ordinance, use of a controlled substance, and any offense relating to drug paraphernalia.

A person who qualifies for immunity may not be subject to civil forfeiture or revocation of pretrial release, probation, furlough, supervised release, or parole, or penalized for violations of a restraining order or a condition of parole or probation.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeks medical assistance” means reporting or assisting in reporting the overdose to law enforcement, the 911 system, a poison control center, a medical facility, or a provider of emergency medical services; providing care to the person experiencing the overdose until medical assistance arrives; or delivering a person experiencing an overdose to a medical facility and notifying the appropriate authorities.

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in a prosecution for any other offense for which immunity is not available.

HIV/Hepatitis Criminalization

Nev. Rev. Stat. Ann. § 441A.180 (Contagious person to prevent exposure to others)

Although Nev. Rev. Stat. Ann. § 441A.180 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes engaging in conduct likely to expose others to disease after receiving a written warning from a health authority notifying the defendant of the behavior which constitutes a violation of the law and the precautions that the defendant must take to avoid exposing others. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- communicable diseases (defined as "a disease which is caused by a specific infectious agent or its toxic products, and which can be transmitted, either directly or indirectly, from a reservoir of infectious agents to a susceptible host organism”)

- misdemeanor

Amended by 2021 Nevada Laws Ch. 491 (S.B. 275) (eff. June 6, 2021).

Nev. Rev. Stat. Ann. § 441A.180 (Intentional transmission of a communicable disease)

Although Nev. Rev. Stat. Ann. § 441A.180 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes engaging in conduct that has a high probability of transmission unless the defendant took practical means to prevent transmission or the other person consented to the act of exposure with knowledge of the defendant’s status. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission required

- intent to transmit required

- communicable diseases (defined as "a disease which is caused by a specific infectious agent or its toxic products, and which can be transmitted, either directly or indirectly, from a reservoir of infectious agents to a susceptible host organism”)

- misdemeanor

Added by 2021 Nevada Laws Ch. 491 (S.B. 275) (eff. June 6, 2021).

Section 1115 Medicaid Waivers

Nevada does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

New Hampshire

Drug Overdose Good Samaritan Law

 New Hampshire’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. N.H. Rev. Stat. Ann. § 318-B:28-b.

Effective August 17, 2021, the Good Samaritan protections also apply to a person who in good faith and in a timely manner reports that they or another person have been a victim of a violent crime, and to the victim of the reported crime. 2021 New Hampshire Laws Ch. 85 (H.B. 546) (eff. Aug. 17, 2021). “Violent crimes” do not include any drug-related offenses. N.H. Rev. Stat. Ann. § 651:5.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, prosecution, and conviction for possession of a controlled substance.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize contraband, take a person into custody in the course of an investigation, or make an arrest for any other offense.

Under what circumstances may someone qualify for Good Samaritan protections?

“Requests medical assistance” means requesting health care services for an overdose from a licensed health care professional and providing care to the person experiencing the overdose until medical assistance arrives.

A person may qualify for immunity only if:

  • the request for assistance is made in a timely manner, and
  • evidence for the offense was obtained as a proximate result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

No. 

HIV/Hepatitis Criminalization

New Hampshire does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

 New Hampshire SUD Treatment and Recovery Access

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Outpatient services
  • Intensive outpatient services
  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT)
  • Screening, brief intervention, and referral to treatment (SBIRT)
  • Partial hospitalization
  • Recovery support services

New Jersey

Drug Overdose Good Samaritan Law

New Jersey’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. N.J. Stat. Ann. §§ 2C:35-30, 2C:35-31.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, prosecution, and conviction for possession or use of a controlled substance or controlled substance analogue; inhaling or possessing a toxic chemical; obtaining a controlled substance or controlled substance analogue by fraud; unlawful possession of a controlled dangerous substance that was lawfully prescribed or dispensed; use of, or possession with intent to use, drug paraphernalia; and obtaining, using, or possessing a prescription legend drug or stramonium preparation.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize contraband, take a person into custody in the course of an investigation, or make an arrest for any other offense.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance. Evidence obtained by other means, such as by a search warrant or constitutional warrantless search, unconnected from an attempt to seek medical assistance for a drug overdose is beyond the immunity’s reach. State v. W.S.B., 180 A.3d 1168, 1179 (N.J. Super. Ct. App. Div. 2018).

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

New Jersey does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

New Jersey FamilyCare Comprehensive Demonstration

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Residential treatment
  • Withdrawal management
  • Medication-assisted treatment (MAT)
  • Peer support services
  • Targeted case management services

New Mexico

Drug Overdose Good Samaritan Law

New Mexico’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. N.M. Stat. Ann. § 30-31-27.1.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, prosecution, and other penalties for possession of a controlled substance, and use of, or possession with intent to use, drug paraphernalia.

A person who qualifies for immunity may not be subject to civil forfeiture or penalized for violations of a restraining order or a condition of probation or parole.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeking medical assistance” means reporting or assisting in reporting an overdose to law enforcement, 911 or another emergency dispatch system, a poison control center, or a health care provider, or providing care to a person experiencing an overdose while awaiting the arrival of a health care provider.

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in a prosecution for a controlled substance offense. 

HIV/Hepatitis Criminalization

New Mexico does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia. 

Section 1115 Medicaid Waivers

New Mexico Centennial Care 2.0

Expanded SUD/OUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Residential treatment (youth and adult)
    • Medically supervised withdrawal management
    • Medication-assisted treatment (MAT)
  • Expands access to early intervention services

New York

Drug Overdose Good Samaritan Law

New York’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. N.Y. Penal Law § 220.78.

A defendant who tampers with physical evidence prior to seeking health care for someone experiencing an overdose does not act “in good faith” and does not qualify for immunity. People v. Taylor, 60 N.Y.S.3d 779, 785 (Yates Cnty. Ct. 2017) (defendant did not seek health care “in good faith” where the evidence showed that the defendant took the time to dress the overdosing person, who was naked when the defendant first found her unresponsive, and dispose of needles and leftover drugs before calling 911).

What legal protections does the Good Samaritan law provide?

The law provides immunity from charge and prosecution for all controlled substance and marijuana offenses not involving sale for consideration or other benefit or gain, and possession of drug paraphernalia. Immunity does not apply to class A-I felonies.

The law provides an affirmative defense to criminal sale of a controlled substance or cannabis. The affirmative defense does not apply to class A-I or class A-II felonies.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize contraband.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity or raise an affirmative defense only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

A person may raise an affirmative defense to a criminal sale of a controlled substance or cannabis offense only if they do not have a prior conviction for commission or attempted commission of a class A-I, A-II, or B felony controlled substance offense.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in a prosecution for a controlled substance offense. 

HIV/Hepatitis Criminalization

New York does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

New York Medicaid Redesign Team

Health and Recovery Plans (HARP)

Health and Recovery Plans (HARPs) manage care for adults with significant behavioral health needs. They facilitate integration of physical health, mental health, and substance use services for enrollees requiring specialized approaches, expertise, and protocols not consistently found within most medical plans. HARPs offer an enhanced benefit package comprised of home and community-based services (HCBS) designed to provide a specialized scope of support services not currently covered under the state plan.

  • Eligibility: Individuals age 21 or older with a specified SMI and/or serious SUD diagnosis who are insured only by Medicaid and eligible for Medicaid managed care. Enrollees must meet categorical criteria or risk factors specified by New York’s Office of Mental Health (OMH) or New York’s Office of Alcoholism and Substance Abuse Services (OASAS). Individuals enrolled in HIV Special Needs Plans (HIV SNPs) meeting the targeting criteria and risk factors for HARP are eligible to receive HCBS services while enrolled in their HIV SNP.
  • Benefits:
    • Psychosocial rehabilitation
    • Community psychiatric support and treatment
    • Empowerment services—peer supports
    • Habilitation services
    • Respite (short-term and intensive)
    • Non-medical transportation
    • Family support and training
    • Employment supports
    • Education support services
    • Health Home care management services

HIV Special Needs Plans (HIV SNP)

HIV Special Needs Plans (HIV SNP) cover all Medicaid services, and additional special services for people living with HIV/AIDS, transgender individuals, and people experiencing homelessness. Individuals enrolled in HIV Special Needs Plans (HIV SNPs) meeting the targeting criteria and risk factors for HARP are eligible to receive HCBS services while enrolled in their HIV SNP.

  • Eligibility: People living with HIV/AIDS, transgender individuals, and people experiencing homelessness. Dependent children may also enroll in an HIV SNP.
  • Benefits:
    • Coordinated care from HIV experienced primary care providers (includes coordination of medical services, non-medical services that support wellness, and special programs for people who use drugs)
    • Coordinated special services important for people living with or at risk for HIV/AIDS
    • Treatment adherence services
    • HIV prevention and risk-reduction education services
    • Other specialty services

Behavioral Health Self-Direction Pilot

The Behavioral Health Self-Direction Pilot was in effect from January 1, 2017 through March 31, 2021, although the state is currently seeking approval to extend this program. Self-direction is a person-centered process for accessing supports and services. It is funded with state and federal Medicaid funds, and overseen by the New York State Office for People with Developmental Disabilities (OPWDD). Enrollees must choose a support broker within one of the eight pilot site service centers.

  • Eligibility: HARP and HIV SNP enrollees eligible for behavioral health HCBS and certain children receiving HCBS.
  • Benefits: Enrollees may access an array of non-treatment goods and services including wellness activities, occupational/skills development, transportation, and in-home/social/community supports. Services must decrease the need for other Medicaid services, promote inclusion in the community, or increase the enrollee’s safety in the home environment. To be an eligible service, the enrollee must lack funds to purchase the item or service and the service must not be available through another source.

North Carolina

Drug Overdose Good Samaritan Law 

North Carolina’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. N.C. Gen. Stat. Ann. § 90-96.2.

What legal protections does the Good Samaritan law provide?

The law provides immunity from prosecution for misdemeanor possession of a controlled substance, felony possession of less than one gram of cocaine, felony possession of less than one gram of heroin, and possession of drug paraphernalia.

A person who qualifies for immunity may not be subject to arrest or revocation of pretrial release, probation, parole, or post-release.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize contraband, take a person into custody in the course of an investigation, or make an arrest for any other offense. A probation officer may still conduct drug testing of persons on pretrial release, probation, or parole.

Under what circumstances may someone qualify for Good Samaritan protections?

A person who seeks medical assistance for another person may qualify for immunity only if:

  • they report the overdose to a law enforcement officer, the 911 system, or emergency medical services personnel,
  • they act in good faith upon a reasonable belief that they were the first to call for assistance,
  • they provide their own name to the 911 system or a law enforcement officer upon arrival, and
  • evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

If these conditions (except for the requirement that the person seeking assistance provide their name to 911 or law enforcement) are satisfied, immunity also extends to the person who experienced the overdose.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

N.C. Gen. Stat. Ann. § 130A-25 (Violation of public health regulations a misdemeanor)

North Carolina does not have a criminal transmission statute, but it is a misdemeanor to violate administrative regulations concerning public health, including “control measures” related to a number of diseases. Sharing drug paraphernalia violates control measures for HIV, hepatitis B, and hepatitis C.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to HIV, hepatitis B, and hepatitis C

- misdemeanor

Section 1115 Medicaid Waivers

North Carolina’s Medicaid Reform Demonstration

Expanded SUD/OUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Intensive outpatient services
    • Comprehensive outpatient treatment services
    • Halfway house services
    • Clinically managed residential services
    • Residential treatment (non-medical and medically monitored community residential treatment)
    • Medically managed intensive inpatient services
    • Outpatient opioid treatment program services
    • Office-based opioid treatment program services
    • Social setting detoxification withdrawal management services
    • Non-hospital medical detoxification withdrawal management
    • Medically supervised or Alcohol and Drug Abuse Treatment Center (ADATC) detoxification crisis stabilization services
    • Medically managed intensive inpatient withdrawal management services
    • Medically supervised withdrawal management
  • Expands access to medication-assisted treatment (MAT)

North Dakota

Drug Overdose Good Samaritan Law

North Dakota’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. N.D. Cent. Code Ann. § 19-03.1-23.4.

What legal protections does the Good Samaritan law provide?

The law provides immunity from prosecution for inhalation of vapors; possession or use of a controlled substance or controlled substance analogue; use of, or possession with intent to use, an imitation controlled substance; possession of drug paraphernalia; and sharing controlled substances among those present.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if:

  • they remain on the scene until assistance arrives,
  • they cooperate with the medical treatment of the overdosed individual, and
  • evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

No. 

HIV/Hepatitis Criminalization

N.D. Cent. Code Ann. § 12.1-20-17 (Transfer of body fluid that may contain HIV)

N.D. Cent. Code Ann. § 12.1-20-17 criminalizes permitting reuse of a hypodermic needle, syringe, or other device without sterilization.

- criminal code

- actual transmission not required

- intent to transmit not required

- HIV-specific

- felony 

Section 1115 Medicaid Waivers

North Dakota does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

Northern Mariana Islands

Ohio

Drug Overdose Good Samaritan Law

Ohio’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. A person may not receive immunity more than twice. Ohio Rev. Code Ann. § 2925.11.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, prosecution, conviction, and other penalties for minor drug possession offenses.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seek or obtain medical assistance” includes (but is not limited to) reporting the overdose to the 911 system, contacting an on-duty peace officer, or transporting or presenting a person experiencing an overdose to a health care facility.

A person may qualify for immunity only if:

  • they have previously received immunity under the Good Samaritan law no more than once,
  • they are not on community control or post-release control,
  • they seek and obtain a screening and receive referral for treatment from a community addiction services provider or a properly credentialed addiction treatment professional within 30 days after seeking or receiving medical assistance,
  • they provide documentation (limited to date and time of screening), upon the request of the prosecuting attorney, verifying that they sought and obtained the required screening and referral for treatment, and
  • evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

A person may not be compelled to disclose protected health information in conflict with HIPAA requirements.

Is reporting an overdose a mitigating factor in sentencing?

Yes. If a person is found to be in violation of a post-release or community control sanction as a result of seeking or receiving medical assistance for an overdose, the court or parole board must consider ordering the person’s participation in a drug treatment program or mitigating the penalty. The court or parole board has discretion to order participation in a drug treatment program or impose penalties with the mitigating factor. 

HIV/Hepatitis Criminalization

Ohio Rev. Code Ann. § 3701.81 (Spreading contagion)

Although Ohio Rev. Code Ann. § 3701.81 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes failure to take reasonable measures to prevent others from being exposed to the defendant (or a person within the defendant’s charge or care) and failure to take reasonable measures to protect the public from exposure where a public conveyance or place of accommodation within the defendant’s charge is knowingly being used by people who have been or are being exposed to a disease. This could apply to sharing drug paraphernalia or use of drug paraphernalia in public spaces.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to “dangerous, contagious diseases” (not defined)

- misdemeanor

Section 1115 Medicaid Waivers

Ohio Section 1115 Demonstration Waiver for Substance Use Disorder Treatment

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Outpatient services
  • Intensive outpatient services
  • Residential treatment
  • Medically monitored withdrawal management
  • Medication-assisted treatment (MAT)
  • Partial hospitalization
  • Inpatient services 

Oklahoma

Drug Overdose Good Samaritan Law

Oklahoma’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person experiencing a drug-related overdose. The law does not provide immunity for a person experiencing a drug-related overdose. Okla. Stat. Ann. tit. 63, § 2-413.1.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest and prosecution for possession of a Schedule I or II controlled substance (provided the amount does not constitute trafficking) and possession of drug paraphernalia.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if:

  • they provide their full name and any other relevant information requested by the law enforcement officer,
  • they remain with the person needing assistance until help arrives, and
  • they cooperate with emergency medical assistance personnel at the scene.

Additionally, a person may qualify for immunity from prosecution only if the offense involved a state of intoxication caused by use of a controlled substance.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Okla. Stat. Ann. tit. 21, § 1192.1 (Knowingly engaging in conduct reasonably likely to transfer HIV virus)

Although Okla. Stat. Ann. tit. 21, § 1192.1 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes engaging in conduct reasonably likely to result in the transfer of blood or bodily fluids into the bloodstream of another person or through the skin or other membranes of another person unless the other person consented to the act of exposure with knowledge of the defendant’s HIV status. This could apply to sharing drug paraphernalia.

- criminal code

- actual transmission not required

- intent to transmit required

- HIV-specific

- felony

Okla. Stat. Ann. tit. 21, § 1199 (Exposing oneself or another with contagious disease)

Although Okla. Stat. Ann. tit. 21, § 1199 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes exposing oneself or another in a public place or thoroughfare. This could apply to use of drug paraphernalia in public spaces.

- criminal code

- actual transmission not required

- intent to transmit not required

- applies to “contagious diseases” (not defined)

- misdemeanor 

Section 1115 Medicaid Waivers

Oklahoma Institutions for Mental Disease Waiver for Serious Mental Illness/Substance Use Disorder

Expanded SUD/OUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SMI/SED and/or SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Medically supervised withdrawal management
    • Residential treatment
    • Outpatient services
    • Intensive outpatient services
    • Medication-assisted treatment (MAT)
    • Intensive care services
  • Expands access to other SUD services:
    • Medication-assisted treatment (MAT)
    • Intensive levels of care in residential and inpatient settings

Oregon

Drug Overdose Good Samaritan Law

Oregon’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical or law enforcement assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Or. Rev. Stat. Ann. § 475.898.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest and prosecution for various controlled substance possession offenses, frequenting a place where controlled substances are used, and possession with intent to sell or deliver drug paraphernalia.

A person who qualifies for immunity may not be arrested or penalized for violations of a condition of pretrial release, probation, post-prison supervision, or parole if the violation involves possession or use of a controlled substance or frequenting a place where controlled substances are used.

The law provides immunity from arrests on outstanding warrants (except for federal warrants or warrants from other states) for:

  • any of the offenses to which immunity applies, or
  • violations (other than commission of a new crime) of the conditions of probation, post-prison supervision, or parole for conduct that would constitute an offense to which immunity applies.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity from arrest (except for arrests on outstanding warrants) and prosecution only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Immunity from arrests on certain outstanding warrants applies only if law enforcement obtained the person’s location because the person sought or received assistance for an overdose.

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Or. Rev. Stat. Ann. § 433.010 (Prohibition on the spreading of communicable diseases)

Although Or. Rev. Stat. Ann. § 433.010 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes willfully causing the spread of communicable disease. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to communicable diseases (defined as "a disease or condition, the infectious agent of which may be transmitted by any means from one person or from an animal to another person, that may result in illness, death or severe disability”)

- felony

Section 1115 Medicaid Waivers 

Oregon Health Plan Substance Use Disorder 1115 Demonstration

Expanded SUD/OUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
  • Authorizes community integration services for individuals transitioning back into the community from an inpatient or other residential setting where they have received SUD treatment.
    • Housing transition services
    • Tenancy sustaining services
    • Employment supports

Palau

Pennsylvania

Drug Overdose Good Samaritan Law

Pennsylvania’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. 35 Pa. Stat. Ann. § 780-113.7.

A person who is the subject of a good faith request for medical assistance may qualify for immunity if they do not actually require immediate medical attention or are not actually experiencing an overdose, as long as the person who sought assistance reasonably believed immediate medical attention was needed to prevent death or serious bodily injury from an overdose. Commonwealth v. Lewis, 180 A.3d 786, 791 (Pa. Super. Ct. 2018). Similarly, a defendant who experiences an overdose and requests medical assistance for themselves may qualify for immunity if they had a reasonable belief that they required emergency care for an overdose. Id. However, simply reporting a state of intoxication is not sufficient. E.g., Commonwealth v. Nunez, 238 A.3d 420, 425 (Pa. Super. Ct. 2020) (defendant did not qualify for immunity because the caller reported that defendant was intoxicated, but did not state that they reasonably believed the defendant was in need of immediate medical attention for an overdose); Commonwealth v. South, 238 A.3d 413, 420 (Pa. Super. Ct. 2020); Commonwealth v. Fehr, No. 457 MDA 2019, 2020 WL 788750, at *3 (Pa. Super. Ct. Feb. 18, 2020) (defendant did not qualify for immunity where bystanders reported to police that defendant was walking in and out of traffic and seemed “out of it,” but did not say defendant was having a medical emergency or experiencing an overdose).

What legal protections does the Good Samaritan law provide?

The law provides immunity from charge and prosecution for possession of a controlled or counterfeit substance; purchase or receipt of a controlled substance in commerce; possession of a small amount of marijuana; various offenses related to use, possession, delivery, and manufacture of drug paraphernalia; unlawful possession of anabolic steroids; and adulteration or removal of drug labels.

A person who qualifies for immunity may not be charged or prosecuted for violations of probation or parole.

Evidence may still be obtained and used to investigate or prosecute any crime or violation for which immunity is not available. A person may be prosecuted based on evidence obtained prior to or independent of the act of seeking or receiving medical assistance.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if law enforcement became aware of the offense because the person transported someone experiencing an overdose to a law enforcement agency, campus security office, or a health care facility, or if all of the following apply:

  • they report the overdose to a law enforcement officer, the 911 system, campus security officer, or emergency services personnel,
  • they provide their own name and location when reporting the overdose,
  • they cooperate law enforcement, the 911 system, campus security, or emergency services personnel,
  • they remain with the person needing medical attention until assistance arrives, and
  • evidence for the offense was not obtained prior to or independent of the act of seeking or receiving medical assistance.

If these conditions are satisfied, immunity also extends to the person who experienced the overdose. The statute affords immunity to a person experiencing an overdose even if the overdose reporter cannot be charged with any crimes, as long as the overdose reporter meets the statutory requirements. E.g., Commonwealth v. Markun, 185 A.3d 1026, 1035 (Pa. Super. Ct. 2018); Commonwealth v. Carontenuto, 148 A.3d 448, 453 (Pa. Super. Ct. 2016). For example, the requirement that the overdose reporter remain with the person experiencing the overdose until assistance arrives applies even if the overdose reporter is a bystander who had no knowledge of or involvement in the events that led to the overdose. E.g., Nunez, 238 A.3d at 428; South, 238 A.3d at 420; Fehr, 2020 WL 788750, at *3.

A person may be prosecuted based on evidence obtained prior to or independent of the act of seeking or receiving medical assistance. When determining whether evidence is obtained “prior to or independent of” the defendant seeking or obtaining medical assistance, courts have placed significant weight on the timeline of events that occurred prior to the provision of medical assistance and discovery of contraband. 

If police are initially summoned to the scene without knowledge of a drug overdose in progress, evidence obtained thereafter may be considered to have been obtained prior to or independent of the seeking or obtaining of medical assistance. In Nunez, the defendant did not qualify for immunity where the Taco Bell store manager who called 911 reported that defendant was intoxicated and disrupting business, but did not state a belief that defendant was in need of medical assistance for an overdose. 238 A.3d at 425-27. The store manager then placed a second 911 call, after the police had already been dispatched but before they arrived on the scene, stating that the defendant had become unconscious. Although the court acknowledged that the second call could arguably qualify as a report of a drug overdose requiring immediate medical attention, the court found that the defendant did not qualify for immunity because the police had already obtained information about the defendant prior to the request for assistance for an overdose.

Is reporting an overdose a mitigating factor in sentencing?

No. 

HIV/Hepatitis Criminalization

Pennsylvania does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia. 

Section 1115 Medicaid Waivers 

Pennsylvania Medicaid Coverage Former Foster Care Youth From a Different State & SUD Demonstration

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT)
  • Inpatient services
  • Recovery support services

Puerto Rico

Rhode Island

Drug Overdose Good Samaritan Law

Rhode Island’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. 21 R.I. Gen. Laws Ann. § 21-28.9-4.

What legal protections does the Good Samaritan law provide?

The law provides immunity from charge and prosecution for possession of a controlled substance, possession of drug paraphernalia, and operation of a drug-involved premises.

A person who qualifies for immunity may not be penalized for violations of probation or parole.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of providing first aid or other medical assistance for someone experiencing an overdose may be considered a mitigating factor in a prosecution for a controlled substance offense.

HIV/Hepatitis Criminalization

23 R.I. Gen. Laws Ann. § 23-11-1 (Exposure of another to infection)

Although 23 R.I. Gen. Laws Ann. § 23-11-1 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes knowingly exposing another person while the defendant is in an infectious condition. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to sexually transmitted diseases (not defined)

- misdemeanor 

Section 1115 Medicaid Waivers

Rhode Island does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

South Carolina

Drug Overdose Good Samaritan Law

South Carolina’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. S.C. Code Ann. §§ 44-53-1910 to 44-53-1970.

If a person seeking assistance for another has previously sought assistance pursuant to the Good Samaritan law, the court may consider the circumstances of the prior incidents and related offenses when determining whether to grant immunity.

What legal protections does the Good Samaritan law provide?

The law provides immunity from prosecution for possession of a controlled substance, possession of less than one gram of methamphetamine or cocaine, possession of drug paraphernalia, sale or delivery of drug paraphernalia (if the sale or delivery is to a person who appears to be experiencing the overdose), and sale or delivery of a controlled substance, methamphetamine, or cocaine (if the sale or delivery is to a person who appears to be experiencing the overdose).

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize contraband, take a person into custody in the course of an investigation, or make an arrest for any other offense.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeks medical assistance” means contacting the 911 system, law enforcement, or emergency services personnel.

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Additionally, a person who seeks medical assistance for another must:

  • act upon reasonable belief that they were the first to call for assistance,
  • provide their own name to the 911 system or law enforcement officer upon arrival,
  • cooperate with law enforcement and medical personnel, and
  • remain with the person experiencing the overdose until assistance arrives.

Additionally, a person who is the subject of a request for medical assistance may qualify for immunity only if the person who requested assistance used their own name when contacting authorities and fully cooperated with law enforcement and medical personnel.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in a prosecution for a controlled substance offense. 

HIV/Hepatitis Criminalization

S.C. Code § 44-29-145 (Penalty for exposing others to Human Immunodeficiency Virus)

S.C. Code § 44-29-145 criminalizes knowingly sharing needles or syringes without informing the person that the needle or syringe has been used by someone living with HIV.

- public health code

- actual transmission not required

- intent to transmit not required

- HIV-specific

- felony

S.C. Code Ann. § 44-29-60 (Infection of another with sexually transmitted disease)

Although S.C. Code Ann. § 44-29-60 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes knowingly exposing another to disease. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to communicable diseases (including HIV, hepatitis B, and hepatitis C)

- misdemeanor 

Section 1115 Medicaid Waivers

South Carolina Palmetto Pathways to Independence

Expanded eligibility
South Carolina’s waiver provides Medicaid benefits under the “Targeted Adult Group” to certain individuals who would otherwise not be eligible for Medicaid coverage. Enrollment for Targeted Adults is limited to 12 months, unless the enrollee continues to be actively engaged in SUD treatment at the end of the 12-month period.

  • Eligibility: Individuals age 19 to 64 who are either:
    • Chronically homeless (income cutoff: 5% FPL)
    • Involved in the criminal justice system and in need of substance use or mental health treatment (income cutoff: 100% FPL)
    • In need of substance treatment (income cutoff: 100% FPL).
  • To promote positive fetal maternal health, the state has set aside 1,000 slots for:
    • Individuals with a diagnosed SUD and/or SMI who are pregnant or up to 12 months postpartum (income cutoff: 194% FPL)
    • Parents of foster children who are completing or complying with an SUD treatment program as part of a family reunification plan (income cutoff: 138% FPL)

South Dakota

Drug Overdose Good Samaritan Law

South Dakota’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. A person may not receive immunity more than once. S.D. Codified Laws §§ 34-20A-109 to 34-20A-113.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest and prosecution for misdemeanor and felony offenses of possession, inhalation, ingestion, or otherwise taking into the body a controlled substance.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if:

  • they have not previously received immunity under the Good Samaritan law, and
  • evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Additionally, a person who seeks medical assistance for another must:

  • cooperate with law enforcement and medical personnel, and
  • remain on the scene until assistance arrives.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of providing first aid or other medical assistance for someone experiencing an overdose may be considered a mitigating factor in any criminal prosecution.

HIV/Hepatitis Criminalization

S.D. Codified Laws §§ 22-18-31 - 22-18-34 (Intentional exposure to HIV infection)

S.D. Codified Laws §§ 22-18-31 - 22-18-34 criminalizes dispensing, delivering, exchanging, selling, or in any other way transferring to another person any nonsterile intravenous or intramuscular drug paraphernalia unless the other person consented to the act of exposure with knowledge of the defendant’s HIV status.

- criminal code

- actual transmission not required

- intent to transmit required

- HIV-specific

- felony

Section 1115 Medicaid Waivers

South Dakota does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

Tennessee

Drug Overdose Good Samaritan Law

Tennessee’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Immunity for the person experiencing an overdose applies only on the person’s first such overdose. Tenn. Code Ann. § 63-1-156.

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for simple possession of a controlled substance; casual exchange of a controlled substance; various offenses related to use, possession, delivery, and manufacture of drug paraphernalia; and placing an advertisement with the purpose of promoting the sale of objects designed or intended for use as drug paraphernalia.

A person who qualifies for immunity may not be penalized for violations of a permanent or temporary protective or restraining order or a condition of pretrial release, probation, or parole.

Evidence may still be obtained and used to investigate or prosecute any crime for which immunity is not available. Law enforcement may still seize contraband, take a person into custody in the course of an investigation, or make an arrest for any other offense. 

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeks medical assistance” means reporting or assisting in reporting the overdose to the 911 system, law enforcement, or a poison control center, or providing care to the person while awaiting medical assistance.

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Additionally, immunity for the person experiencing an overdose applies only on the person’s first such overdose.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of providing first aid or other medical assistance for someone experiencing an overdose may be considered a mitigating factor in any criminal prosecution.

HIV/Hepatitis Criminalization

Tenn. Code Ann. § 39-13-109 (Criminal exposure of another to HIV, HBV, or HCV)

Tenn. Code Ann. § 39-13-109 criminalizes dispensing, delivering, exchanging, selling, or in any way transferring to another person any nonsterile intravenous or intramuscular drug paraphernalia unless the other person consented to the act of exposure with knowledge of the defendant’s status.

- criminal code

- actual transmission not required

- intent to transmit not required

- applies to HIV, hepatitis B, and hepatitis C

- felony (HIV) or misdemeanor (hepatitis B or hepatitis C)

Section 1115 Medicaid Waivers

 TennCare II

Tennessee’s amendment to expand SUD services is still pending CMS approval.

Texas

Drug Overdose Good Samaritan Law

Texas does not have a drug overdose Good Samaritan law.

HIV/Hepatitis Criminalization

Texas does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

Texas does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

Utah

Drug Overdose Good Samaritan Law

Utah’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical or law enforcement assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Utah Code Ann. § 58-37-8.

What legal protections does the Good Samaritan law provide?

The law provides an affirmative defense in a prosecution for possession of use of less than 16 ounces of marijuana, possession or use of a scheduled controlled substance, any violation of the Utah Drug Paraphernalia Act, and any violation of the Imitation Controlled Substances Act.

Under what circumstances may someone qualify for Good Samaritan protections?

A person has an affirmative defense under the Good Samaritan law only if:

  • they report or assist in reporting the overdose to a medical provider, am emergency medical services provider, a law enforcement officer, the 911 system, or an emergency dispatch system (or are the subject of such a report),
  • they remain with the person experiencing the overdose until medical or law enforcement assistance arrives,
  • they cooperate with medical or law enforcement personnel, including by providing information regarding the overdose and substances used, and
  • the offense arises from the same course of events from which the overdose arose (this suggests that a person may be subject to criminal liability for controlled substances or paraphernalia that are not directly related to the overdose).

Is reporting an overdose a mitigating factor in sentencing?

Yes. The fact that a defendant sought or received medical assistance for a drug overdose may be considered a mitigating factor in sentencing for a violation of the Utah Controlled Substances Act if:

  • they report or assist in reporting the overdose to a medical provider, am emergency medical services provider, a law enforcement officer, the 911 system, or an emergency dispatch system (or are the subject of such a report),
  • they remain with the person experiencing the overdose until medical or law enforcement assistance arrives,
  • they cooperate with medical or law enforcement personnel, including by providing information regarding the overdose and substances used, and
  • the offense arises from the same course of events from which the overdose arose.

Utah Code Ann. § 76-3-203.11

HIV/Hepatitis Criminalization 

Utah Code Ann. § 26-6-5 (Willful introduction of communicable disease)

Although Utah Code Ann. § 26-6-5 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes willfully or knowingly introducing disease into any county, municipality, or community. This could apply to sharing drug paraphernalia or use of drug paraphernalia in public spaces.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to “communicable or infectious diseases” (defined as “illness due to a specific infectious agent or its toxic products which arises through transmission of that agent or its products from a reservoir to a susceptible host” or disease “resulting from an infection”)

- misdemeanor 

Section 1115 Medicaid Waivers

Utah Primary Care Network

Expanded SUD/OUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Residential treatment
    • Withdrawal management
    • Medication-assisted treatment (MAT)
    • Peer support services
    • Residential crisis stabilization services
  • Expands dental benefits to certain adults with income at 0% FPL who are receiving SUD treatment.

Clinically Managed Residential Withdrawal Pilot

This pilot provides clinically managed residential withdrawal services to adults residing in Salt Lake County.

  • Eligibility: Individuals must 1) be determined by physician or licensed practitioner of healing arts to demonstrate moderate withdrawal signs and symptoms, 2) have primary diagnosis of OUD/SUD, and 3) require 24-hour structure and support to complete withdrawal management and increase likelihood of continuing treatment and recovery.
  • Services: assessment, observation, medication services, psychoeducation, and discharge services
  • Provider qualifications: licensed clinical social workers, registered nurses, certified recovery associated, masters degree-level mental health clinicians, certified care managers, and certified peer support specialists

Vermont

Drug Overdose Good Samaritan Law

Vermont’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical or law enforcement assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Vt. Stat. Ann. tit. 18, § 4254.

What legal protections does the Good Samaritan law provide?

The law provides immunity from citation, arrest, and prosecution for possession of a controlled substance. Possession of drug paraphernalia is not a crime in Vermont.

A person who qualifies for immunity may not be subject to civil forfeiture or penalized for violations of a protection order or a condition of pretrial release, probation, furlough, or parole.

A person may be prosecuted based on evidence obtained from an independent source.

Under what circumstances may someone qualify for Good Samaritan protections?

“Seeks medical assistance” includes providing care to someone experiencing an overdose while awaiting the arrival of medical assistance.

A person may qualify for immunity only if evidence for the offense was obtained as a proximate result of the person seeking or receiving medical assistance. A person may be prosecuted based on evidence obtained from an independent source.

Additionally, a person who seeks medical assistance for another must seek assistance in a timely manner.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for or by someone experiencing an overdose may be considered a mitigating factor in any criminal prosecution.

HIV/Hepatitis Criminalization

Vermont does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

Vermont Global Commitment to Health

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT)

Virgin Islands

Virginia

Drug Overdose Good Samaritan Law

Virginia’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical or law enforcement assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. VA ST § 18.2-251.03 (amended by 2020 Virginia Laws Ch. 1016 (S.B. 667), eff. July 1, 2021).

Recently passed legislation, effective August 1, 2021, extends immunity to individuals who render emergency care or assistance, including by administering an opioid antagonist, to a person experiencing an overdose while another person seeks medical attention. 2021 Virginia Laws 1st Sp. Sess. Ch. 29 (H.B. 1821).

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest and prosecution for possession of a controlled substance, possession of marijuana, intoxication in public, and possession of controlled paraphernalia.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if:

  • they contemporaneously report the overdose to a firefighter, emergency medical services personnel, law enforcement, or the 911 system,
  • they remain at the scene of the overdose or other location to which the person experiencing the overdose has been transported until a law enforcement officer arrives,
  • they identify themselves to the law enforcement officer, and
  • evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

No. 

HIV/Hepatitis Criminalization

Virginia does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

Building and Transforming Coverage, Services, and Supports for a Healthier Virginia

Expanded SUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD
    • Intensive outpatient services
    • Residential treatment
    • Medically supervised withdrawal management
    • Medication-assisted treatment (MAT)
    • Clinically managed residential services
    • Medically monitored intensive inpatient services
  • Authorizes limited housing and employment supports to certain high needs enrollees with behavioral health needs.

Washington

Drug Overdose Good Samaritan Law 

Washington’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical or law enforcement assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. Wash. Rev. Code Ann. § 69.50.315.

What legal protections does the Good Samaritan law provide?

The law provides immunity from charge and prosecution for possession of a controlled substance and possession of 40 grams or less of marijuana.

Evidence may still be obtained and used to investigate or prosecute any crime or violation for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if evidence for the offense was obtained as a result of the person seeking or receiving medical assistance.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in any criminal prosecution. Wash. Rev. Code Ann. § 9.94A.535(1)(i).

HIV/Hepatitis Criminalization

Wash. Rev. Code Ann. § 9A.36.011 (Assault in the first degree)

Although Wash. Rev. Code Ann. § 9A.36.011 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes transmitting HIV to a child or “vulnerable adult.” This could apply to sharing drug paraphernalia.

- criminal code

- actual transmission not required

- defendant must act with intent to inflict great bodily harm

- HIV-specific

- felony

Section 1115 Medicaid Waivers 

Washington Medicaid Transformation Project

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Outpatient services
  • Intensive outpatient services
  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT)

District of Columbia

Drug Overdose Good Samaritan Law 

Washington, D.C.’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks health care for or administers an opioid antagonist to another person or themselves in the event of a drug-related overdose, the person experiencing the overdose, and bystanders. D.C. Code Ann. § 7-403 (amended by 2020 District of Columbia Laws 23-182 (Act 23-536), eff. Mar. 16, 2021).

What legal protections does the Good Samaritan law provide?

The law provides immunity from arrest, charge, and prosecution for possession of a controlled substance and use of, or possession with intent to use, drug paraphernalia.

A person who qualifies for immunity may not be subject to revocation or modification of supervision status.

Evidence may still be obtained and used to arrest, charge, prosecute, or revoke or modify supervision status based on any crime for which immunity is not available.

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if the offense arises from the same course of events from which the overdose arose. This suggests that a person may be subject to criminal liability for controlled substances or paraphernalia that are not directly related to the overdose.

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking health care for or administering an opioid antagonist to someone experiencing an overdose may be considered a mitigating factor in prosecution or sentencing for any offense for which immunity is not available.

HIV/Hepatitis Criminalization

Washington, D.C. does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

DC Behavioral Health Transformation

Expanded SUD/SMI Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SMI/SED and/or SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Inpatient services
    • Residential treatment
    • Medically supervised withdrawal management
    • Medication-assisted treatment (MAT)
    • Psychiatric residential crisis stabilization services
    • Recovery support services
    • Trauma-informed service: trauma recovery and empowerment model
    • Licensed behavioral health practitioner services
    • Transition planning services
  • Expands access to other SUD benefits
    • Comprehensive psychiatric emergency program
    • Mobile crisis intervention and outreach services
    • Psychosocial rehabilitative services
    • Trauma-informed service: trauma systems therapy
    • Supported employment

West Virginia

Drug Overdose Good Samaritan Law

West Virginia’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical or law enforcement assistance for another person or for themselves in the event of a drug-related overdose, and for the person experiencing the overdose. W. Va. Code Ann. §§ 16-47-1 to 16-47-6.

What legal protections does the Good Samaritan law provide?

The law provides immunity from criminal responsibility for possession of a controlled substance or imitation controlled substance without a prescription and public intoxication.

A person who seeks medical assistance for another person and is charged with an offense to which immunity does not apply may nevertheless enter a guilty plea to an offense to which immunity applies.

A person who qualifies for immunity may not be penalized for violations of a condition of pretrial release, probation, furlough, or parole.

Under what circumstances may someone qualify for Good Samaritan protections?

“Emergency medical assistance” means medical services provided by a licensed health care professional.

A person who seeks medical assistance for another person may qualify for immunity only if:

  • they request assistance in a timely manner,
  • they remain with the person experiencing the overdose until assistance is provided,
  • they identify themselves to emergency medical assistance personnel or law enforcement officers upon request, and
  • they cooperate with and provide any relevant information requested by emergency medical assistance personnel or law enforcement officers needed to treat the person experiencing the overdose.

Additionally, the person who experienced the overdose must, after receiving assistance, participate in, comply with, and complete a substance abuse treatment or recovery program approved by the court. As an alternative to immunity for a person who experiences the overdose, the court may consider the following sentencing and clemency options: deferred prosecution, pretrial diversion, adjudication, in drug court, or any other appropriate form of alternative sentencing or rehabilitation (including but not limited to probation, conditional discharge, the weekend jail program, the work program, or the community service program).

Is reporting an overdose a mitigating factor in sentencing?

Yes. The act of seeking medical assistance for someone experiencing an overdose may be considered a mitigating factor in sentencing for any criminal prosecution, if the criminal proceeding was instituted based on conduct or evidence obtained as a result of the defendant seeking emergency medical assistance. 

HIV/Hepatitis Criminalization

  1. Va. Code Ann. § 16-4-20 (Communication of disease)

Although W. Va. Code Ann. § 16-4-20 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes performing any act which exposes another person to infection with the disease, or knowingly infecting or exposing another person to infection. This could apply to sharing drug paraphernalia.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to “infectious venereal disease” (not defined)

- Punishable by up to 30 days imprisonment and/or $10-100 fine. The law does not specify the degree of the crime but, given the penalty, this is likely a misdemeanor. 

Section 1115 Medicaid Waivers

West Virginia Creating a Continuum of Care for Medicaid Enrollees with Substance Use Disorders

Expanded SUD Benefits Coverage

  • Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.
    • Targeted case management
    • Naloxone administration services
    • Peer recovery support services
    • Clinically managed residential services
    • Medically monitored intensive inpatient services
    • Clinically managed residential withdrawal management
    • Medically monitored inpatient withdrawal management
    • Opioid treatment program services (methadone treatment)
    • Office-based opioid treatment
    • Residential treatment
  • Expands access to other SUD services:
    • Methadone treatment
    • Peer recovery support services

Wisconsin

Drug Overdose Good Samaritan Law

Wisconsin’s overdose Good Samaritan law offers some legal protections for a person who in good faith seeks medical assistance for another person experiencing a drug-related overdose. The law does not provide immunity for a person experiencing a drug-related overdose. Wis. Stat. Ann. § 961.443.

From July 2017 until August 1, 2020, the law provided some protections for a person experiencing an overdose. 2017-2018 Wisc. Legis. Serv. Act 33 (2017 A.B. 3).

What legal protections does the Good Samaritan law provide?

The law provides immunity from prosecution for possession of a controlled substance or controlled substance analogue; possession of drug paraphernalia; and use of, or possession with intent to use, a masking agent.

From July 2017 until August 1, 2020, the law provided protections against revocation of parole, probation, or extended supervision. 2017-2018 Wisc. Legis. Serv. Act 33 (2017 A.B. 3).

Under what circumstances may someone qualify for Good Samaritan protections?

A person may qualify for immunity only if the offense arises from the same course of events from which the overdose arose. This means a person may be subject to criminal liability for controlled substances or paraphernalia that are not directly related to the overdose. In State v. Lecker, the defendant sought medical assistance for a person experiencing an overdose outside of the defendant’s apartment. 950 N.W.2d 910 (Wis. Ct. App. 2020). The next day, the defendant voluntarily went to the police department for an interview about the events concerning the overdose. Later that evening, police searched the defendant’s apartment based on information derived from the interview and discovered contraband. The contraband had not been used by the person experiencing the overdose and was not related to the overdose. The court found that the defendant did not qualify for immunity because, even though the contraband would not have been discovered but for the fact that the defendant sought aid for a person experiencing an overdose, the overdose itself was unrelated to the contraband in the defendant’s apartment (“the facts establishing the crimes—not the discovery of those facts—are what must be closely connected to the rendering of aid”). Id. at 915.

From July 2017 until August 1, 2020, the law required that the request for assistance be made immediately following the overdose. 2017-2018 Wisc. Legis. Serv. Act 33 (2017 A.B. 3).

Is reporting an overdose a mitigating factor in sentencing?

No.

HIV/Hepatitis Criminalization

Wis. Stat. Ann. § 252.19 (Communicable diseases; suspected cases; protection of public)

Although Wis. Stat. Ann. § 252.19 does not explicitly criminalize exposure to or transmission of HIV or hepatitis through use of drug paraphernalia, it criminalizes willfully violating the recommendations of a local health officer or subjecting others to danger of contracting a communicable disease (if the defendant is living with the communicable disease) or knowingly and willfully taking, aiding in taking, advising, or causing to be taken a person who is infected or suspected of being infected with a communicable disease into any public place or conveyance where the infected person would expose any other person to danger of contracting the disease (if the defendant is not living with the communicable disease). This could apply to sharing drug paraphernalia or use of drug paraphernalia in public spaces.

- public health code

- actual transmission not required

- intent to transmit not required

- applies to reportable communicable diseases (including HIV and hepatitis A, B, C, D, and E)

- punishable by up to 30 days imprisonment and/or up to $500 fine. Wis. Stat. § 252.25. The law does not specify the degree of the crime but, given the penalty, this is likely a misdemeanor. 

Section 1115 Medicaid Waivers

Wisconsin BadgerCare Reform

Expanded SUD/OUD Benefits Coverage

Authorizes expenditures for covered services for individuals primarily receiving treatment and withdrawal management services for SUD/OUD who are short-term residents in residential and inpatient treatment settings that qualify as an IMD.

  • Inpatient services
  • Residential treatment
  • Medically supervised withdrawal management
  • Medication-assisted treatment (MAT)

Wyoming

Drug Overdose Good Samaritan Law

Wyoming does not have a drug overdose Good Samaritan law.

HIV/Hepatitis Criminalization

Wyoming does not have a law criminalizing exposure to or transmission of HIV or hepatitis through use of drug paraphernalia.

Section 1115 Medicaid Waivers

Wyoming does not have a Section 1115 waiver expanding Medicaid benefits for people who use drugs.

Related Teams
Drug User Health