U.S. House Passes Sweeping Opioid Legislative Package
The U.S. House of Representatives approved an opioid legislative package in late June encompassing a wide-range of narrowly-focused opioid bills considered across multiple House committees during the first half of 2018. The comprehensive package titled the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (H.R. 6) will serve as the House legislative vehicle for dozens of opioid-related measures and contains key supports for counties struggling to address the opioid epidemic in their jurisdictions.
Provisions outlined in H.R. 6 center on adjustments to federal programs such as Medicaid that could expand addiction treatment options, as well as the creation of education and technical assistance programs for health care providers treating patients with substance use disorders.
Several of the programs included in H.R. 6 would be administered through state and local governments and could bolster counties’ response to the epidemic by providing additional resources and coordination across agencies. Key measures potentially affecting counties are highlighted below:
At-Risk Youth Medicaid Protection Act (H.R. 1925)
This bill would streamline the delivery of addiction treatment services for juveniles released from county correctional facilities and could help counties provide effective treatment and care coordination services pre- and post-release.
Medicaid Reentry Act (H.R. 4005)
This bill would direct the U.S. Department of Health and Human Services (HHS) to issue best practices around providing health care for justice- involved individuals returning to their communities from county correctional facilities.
Improving Access to Behavioral Health Information Technology Act (S. 1732/H.R. 3331)
This bill would direct the Centers for Medicare and Medicaid Innovation (CMMI) to incentivize health information technology demonstrations for behavioral health providers, including approximately 750 county-based behavioral health authorities.
Individuals in Medicaid Deserve Care that is Appropriate and Responsible in its Execution Act (H.R. 5797)
This bill would temporarily allow states to receive federal Medicaid payments for services provided in Institutions for Mental Diseases (IMDs) and for other medical services related to opioid and cocaine addiction.
In addition to these bills, the House also passed separate pieces of legislation that could positively impact counties’ ability to respond to opioid overdoses and deaths. These include the following bills:
Overdose Prevention and Patient Safety Act (H.R. 6082)
This bill would align privacy provisions governing substance use disorder records with 42 CFR, Part 2 laws allowing for information-sharing between behavioral health and other health providers treating addiction.
Coordinated Response through Interagency Strategy and Information Sharing (CRISIS) Act (H.R. 5925)
This bill would reauthorize the Office of National Drug Control Policy (ONDCP), which operates as a key coordinating agency between the many federal entities responding to the opioid epidemic. In addition, the bill would implement the recommendations put forth in 2017 by the White House’s opioid commission, promote evidence-based drug control policies and maintain the High-Intensity Drug Trafficking Areas (HIDTA) and the Drug-Free Communities (DFC) programs under ONDCP’s jurisdiction.
With the House’s action, the focus now turns to the Senate, where legislators on multiple committees have advanced dozens of separate proposals.
As part of the Senate’s efforts around the opioid crisis, the Health, Education, Labor and Pensions (HELP) Committee in May advanced the Opioid Crisis Response Act (S. 2680), a single, but wide-ranging bill that includes measures intended to expand patients’ access to medication-assisted treatment (MAT) and train first responders to administer overdose antidote drugs.
Other Senate committees have also approved proposals that could be combined with S. 2680 into a broader set of bills. In June, the Senate Finance Committee passed the Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act, and the Judiciary Committee advanced several pieces of legislation that focus on the public safety and law enforcement aspects of the epidemic.
It is unclear when the Senate will vote on a comprehensive package. Many are concerned with the limited time remaining as the Senate weighs these proposals, considering that Congress must also balance legislative priorities beyond opioid legislation, including reauthorization of the farm bill and the completion of spending bills before the end of Fiscal Year (FY) 2018 on September 30.