New Bills in the House Address SUDs and the Opioid Epidemic

In April 2018, both the House Energy and Commerce Committee and the Senate Committee on Health, Education, Labor, and Pensions (HELP)  advanced legislation to address the opioid epidemic. Addressed were issues pertaining to workforce, recovery residences, and medication-assisted  treatment (MAT), among many others. We are now in the process of waiting for both bodies to take up the legislation on their respective floors, where the enemy is rarely the content, but more often the calendar.
On April 24, the HELP Committee held a markup of an opioid package which included forty separate components authored by thirty-eight senators (HELP Committee, 2018). The introduction of this Opioid Crisis Response Act of 2018 and subsequent markup is the result of over half a year and six hearings on the topic. On April 25, the House Energy and Commerce Subcommittee on Health held a near eight-hour markup session including sixty-four individual pieces of legislation, some still in discussion draft form, offered by both Democrats and Republicans aimed at addressing the opioid epidemic. Following the markup, the Health Subcommittee adjourned with fifty-seven bills—56 of which were opioid-related—reported favorably to the full Energy and Commerce Committee (Energy and Commerce Committee, 2018).
Both committees addressed our depleted substance use disorder (SUD) workforce. House bill HR 5102, the SUD Workforce Loan Repayment Act, was sponsored by Rep. Hal Rogers (R-KY) and Rep. Katherine Clark (D-MA). The same language is found in the Senate bill, championed by Sen. Maggie Hassan (D-NH). According to Rep. Rogers’s website,
The legislation will improve access to desperately needed treatment for the millions of Americans struggling with a substance use disorder. Experts report that only 10 percent of the 22 million Americans with a substance use disorder receive treatment. This treatment gap is largely attributed to the shortage of workers in the substance use disorder field. The Substance Use Disorder Workforce Loan Repayment Act offers student loan repayment of up to $250,000 for participants who agree to work as a substance use disorder treatment professional in areas most in need of their services. The program will be available to a wide range of direct care providers, including physicians, registered nurses, social workers, and other behavioral health professionals.
. . . To qualify for the program, participants must agree to be employed in a full-time SUD treatment job in a high need area for up to six years. That job must involve serving in a direct patient care role, and can include serving as a physician, registered nurse, social worker, recovery coach, or any other role listed in the bill, as well as any additional titles added by the Department of Health and Human Services. Participants may serve in a wide range of facilities, so long as they are located in an area with a shortage of mental health professionals or a high rate of drug overdose deaths (“Rogers, Clark,” 2018).
Also addressed were potential higher standards for sober living environments. In an effort led by Rep. Judy Chu (D-CA), the Ensuring Access to Quality Sober Living Act was introduced in the House of Representatives. Cosponsors include Rep. Raul Ruiz (D-CA) and Rep. Mimi Walters (R-CA), among others. According to Rep. Chu’s website,
This bill would authorize the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop best practices for recovery residences that promote sustained recovery from substance use disorders. Recovery residences, often known as sober homes, are family-like, shared living environments that are free from alcohol and illicit drug use, and centered on peer support and connection to services that help individuals just out of treatment continue on their journey to recovery (“Rep. Chu,” 2017).
A plethora of other issues were also addressed by these bills, including a modification of the IMD exclusion, allowing for ninety days of inpatient treatment coverage under Medicaid; the establishment of a new program called “CORC,” which would recognize specific treatment facilities as nationally designated Community Opioid Recovery Centers; allowing the Centers for Disease Control and Prevention (CDC) to work with communities to reduce the spread of needle-sharing infections, such as HIV and hepatitis; and several others.
The process of course is long, as the bills must be accepted by leadership for consideration on the floor. While the House bills may receive a vote in the near future, the Senate tends to move slower. If both bills pass their respective chambers, then a conference must take place. Take into account that this is an election year, and the calendar becomes an even bigger enemy. In sum, the process will continue for quite some time.
About the Author
Andrew Kessler, JD, is founder and principal of Slingshot Solutions LLC, a consulting firm that specializes in behavioral health policy and federal policy liaison for IC&RC.
References
“Rep. Chu introduces bipartisan bill to improve sober homes that assist in opioid recovery.” (2017). Retrieved from https://chu.house.gov/media-center/press- releases/rep-chu-introduces-bipartisan-bill- improve-sober-homes-assist-opioid
“Rogers, Clark lead federal effort to reduce the shortage of substance use disorder treatment professionals.” (2018). Retrieved from https://halrogers.house.gov/press-releases?ID=F39DDD1C-5449-4653-B30F-8776445443A8
US Energy and Commerce Committee. (2018). #Subhealth votes to advance fifty-seven bills to combat the opioid crisis, reauthorization of ADUFA and AGDUFA. Retrieved from https://energycommerce.house.gov/news/press-release/subhealth-votes- to-advance-57-bills-to-combat-the-opioid-crisis- reauthorization-of-adufa-and-agdufa/
US Senate Committee on Health, Education, Labor, & Pensions (HELP Committee). (2018). Alexander: Senate Health Committee unanimously passes  bipartisan bill to take the next step in helping states fight opioid crisis. Retrieved from https://www.help.senate.gov/chair/newsroom/press/alexander- senate-health-committee-unanimously-passes- bipartisan-bill-to-take-next-step-in-helping-states-fight-opioid-crisis