Senate to Vote on The Opioid Crisis Response Act
This week, the Senate will vote on the Opioid Crisis Response Act, a large package of bills focused on addressing the opioid epidemic and substance use disorders throughout the country. As this crisis has spread through our nation, rural communities lacking the resources to grapple with the epidemic have been left devastated. Rural America has been disproportionally affected by this crisis, but those communities that have been provided the opportunities they need to act have been successful in reducing overdose deaths and increasing care.
NRHA has continuously supported key legislation that would help to fix the funding formula for opioid programs, increase access to care, improve recovery resources, and decrease stigma. We are happy to see that many of the bills that we have long fought for are included as pieces of this larger legislation. This is critical for the rural and Tribal communities that need tools to fight this epidemic.
As the Senate moves forward on this package, we thank them for accounting for the special needs of rural communities and for working across the aisle to address this issue, and we ask that they continue to provide those resources to underserved rural communities that make successfully stopping substance use disorders possible.
Funding
- 21st Century Cures Grant Changes – While the landmark 21st Century Cures legislation provided essential funding to address substance use disorders, the funding has been disproportionally targeted to larger population states, not those states and communities that have been the most impacted. In order to better focus federal funds on states and tribes that have been hit harder by the opioid crisis, the Opioid Crisis Response Act will update the funding formula authorized by the 21st Century Cures Act to account for the number of overdose deaths in each state and allow the funds to be used until they run out, rather than requiring states to spend them within the fiscal year.
- Even further, through the Tribal Training and Technical Assistance Center of SAMHSA, technical assistance will be provided for grant application and submission, enhancing outreach and support to rural and underserved communities. Rural providers struggle to access funds, not having the large grant writing teams or the time to devote to these projects that larger hospitals and systems do. This will help those small providers to better access the funds and opportunities created to help rural areas.
Workforce Needs
- First Responder Training – In many communities, especially in rural areas, first responders are a critical piece of the initial treatment process. To support first responders so that they can safely respond to cases involving fentanyl, the Opioid Crisis Response Act would expand a grant program originally authorized in the Comprehensive Addiction and Recovery Act (CARA) which was designed to allow first responders to administer a drug or device, like naloxone, to treat an opioid overdose.
- Services in Areas with Health Providers Shortages – In order to improve access to mental health, behavioral, substance use disorder services, the bill would allow health providers in the National Health Services Corps (NHSC) to provide critical services in schools located in areas that have been most impacted by the opioid crisis and those which with mental health professional shortages. This will also allow masters level, licensed substance use disorder treatment counselors to receive loan repayment for practicing in underserved areas. These two provisions will help ensure that more providers are encouraged to serve those rural areas where they are desperately needed.
- Loan Repayment for Substance Abuse Treatment Providers – The Opioid Crisis Response Act will require HHS to enter into contracts to provide loan repayment to behavioral health providers practicing in substance use disorder treatment facilities in mental health professional shortage areas through NHSC.
Grants for Treatment Expansion
- Building Communities of Recovery – Grants will be provided to recovery community organizations to enable these organizations to develop and grow recovery services. The legislation provides “special consideration to the unique needs of rural areas, including areas with an age adjusted rate of drug overdose deaths that is above the national average and areas with a shortage of prevention and treatment services.”
- Expanding Medication Assisted-Treatment for Recovery from Addiction – This will create a grant program to support development of curriculum that will help more health care practitioners obtain the necessary wavers to prescribe MAT.
Telemedicine
- Special Registration for Telemedicine – The Opioid Crisis Response Act will help to clarify the DEA’s ability to allow qualified providers to prescribe controlled substances in specific circumstances through telemedicine. The bill also eliminates certain statutory originating site requirements for telehealth services furnished to Medicare beneficiaries for the treatment of substance use disorders, and allows payment for SUD services furnished via telehealth to Medicare beneficiaries at originating sites, including a beneficiary’s home, regardless of geographic location.
- Improving Access to Telemedicine – In order to treat more rural and underserved patients, this will allow community mental health and addiction treatment centers to register with DEA to treat patients using MAT through the use of telemedicine. The section specifically focuses on those areas where care is most needed.
Neonatal Abstinence Syndrome (NAS)
- Caring Recovery – This will allow states to provide care for infants with NAS in residential pediatric recovery centers, as well as those centers option to provide services to mothers and caretakers under Medicaid. Centers like this already exist, such as Lily’s Place in West Virginia.
Centers for Disease Control Research
- CDC Surveillance and Data Collection for Child, Youth, and Adult Trauma – The CDC Director will ask each State that participates in collecting and reporting data under these programs to collect and report data from tribal and rural areas specifically, in order to create a reliable representation of such areas. This will help to improve our knowledge of the striking disparities between urban, suburban, and rural communities. Having this data will help in better targeting and implementing key programs.
We again appreciate the incredible efforts of Senators to work across the aisle and ensure that we do something to address the growing substance abuse issues in our country. As Senate Finance Committee Orrin Hatch said of the Opioid Crisis Response Act, “The fact that so many senators across so many committees were able to put aside political differences to reach an agreement on this legislation, especially given our current political environment, speaks to the seriousness and pervasiveness of opioid and substance use disorders.”
This landmark legislation includes key provisions for rural Americans, but we must remember that there is no one size fits all solution for rural communities combatting the opioid crisis. We must work together to guarantee that legislation finally makes it to the President’s desk to address substance abuse, and we must make certain that this legislation accounts for the unique needs of our rural communities.