Congress Sends 21st Century Cures to White House

On Wednesday, the Senate passed 21^st Century Cures (H.R. 34), a bill designed to spur medical innovation and research. The bill also establishes $1 billion in grants to states to help combat the nation’s opioid abuse epidemic. Cures now heads to White House, where it is expected to be signed by President Obama early next week.

OPIOID FUNDING

The approved bill authorizes $1 billion in grants to states over two years–$500 million for FY2017 and another $500 million for FY2018. The FY2017 dollars should be secured through a continuing budget resolution expected to pass Congress later this week. However, the funding for FY2018 is not yet secured and is subject to next year’s appropriations process. The National Council will be reliant upon its advocates to make the strong push for this funding in the coming months.

Of important note, the opioid funding in the bill is not tied to provisions within the Comprehensive Addiction and Recovery Act (CARA). The National Council remains committed in its advocacy efforts to secure full and proper funding of CARA, which authorizes $181 million in new addiction program spending annually. To date, CARA has only received $7 million, falling well short of the legislation’s potential. The National Council will alert members when the opportunity to advocate for CARA’s funding and Cures’ second year of opioid funding arise. For more detail on exactly how the funds will be used, see our Capitol Connector coverage from last week.

MENTAL HEALTH

The bill’s mental health provisions, drawn from Rep. Tim Murphy’s (R-PA) Helping Families in Mental Health Crisis Act, mainly reauthorize a number of existing federal grant programs focused on suicide prevention, workforce education and training, jail diversion, mental health awareness training, and more. A pending continuing budget resolution would provide these grant programs level-funding through April 28, 2017, after which their continued funding will be subject to Congressional appropriations process.

In addition to these reauthorizations, the bill includes some important policy clarifications and technical assistance resources such as:

• Same Day Billing for Mental Health and Primary Care: The legislation clarifies that nothing in the Medicaid statute should be interpreted as prohibiting separate payment for the provision of mental health and primary care services provided to an individual on the same day.
• Parity Enforcement: The legislation strengthens the implementation of the mental health and addiction parity law by requiring U.S. Health and Human Services Department (HHS) to issue new compliance guidance to health plans and to create an action plan for improved federal and state coordination related to parity enforcement.
• Health Information Portability and Accountability Act (HIPAA): The legislation requires HHS to issue final regulations within 1 year to clarify circumstances in which a health care provider may share protected health information.
• Providing EPSDT Services to Children in IMDs: The legislation specifies that, effective January 1, 2019, children receiving Medicaid-covered inpatient psychiatric hospital services are also eligible for the full range of early and periodic screening, diagnostic, and treatment (EPSDT) services.
• Technical Assistance Center for Primary-Behavioral Health Care Integration: Authorizes the creation of a technical assistance center to provide support to federal grant recipients working to fully integrate primary and behavioral health care clinical practices.

The Cures package additionally pulls provisions from Senator Al Franken’s (D-MN) Comprehensive Justice and Mental Health Act to help states better identify and appropriately respond to a person with a mental health condition who may otherwise become involved with the criminal justice system. These provisions include support for mental health courts and diversion programs (as authorized in the Mentally Ill Offender Treatment and Crime Reduction Act), crisis intervention teams, corrections-based programs, and training for law enforcement officers on how to safely handle and deescalate mental health crises.

The National Council applauds the lawmakers involved in the passage of the mental health provisions included the Cures package. Specifically, we thank Representatives Tim Murphy (R-PA) and Eddie Bernice Johnson (D-TX) for their leadership on the Helping Families in Mental Health Crisis Act and Senators Chris Murphy (D-CT) and Bill Cassidy (R-LA) for spearheading a similar proposal in the Senate. Additionally, we extend our thanks to Senators Al Franken (D-MN) and John Cornyn’s (R-TX) for their efforts to reduce the number of individuals with mental illness in jail and prison through the Comprehensive Justice and Mental Health Act.