Providing for Consideration of H.R. Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act; Providing for Consideration of H.R. Individuals in Medicaid Deserve Care That is Appropriate and Responsible in its Execution Act; and Providing for Consideration of H.R. Overdose Prevention and Patient Safety Act

Floor Speech

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Ms. MATSUI. Mr. Speaker, I rise in opposition to this rule. Throughout the Energy and Commerce Committee's process writing opioid legislation, I have raised the issue that we need to be making investments in the full spectrum of our behavioral health system in order to truly address the root causes and the results of the opioid epidemic.

While crisis and high-level inpatient care will always be necessary for a subset of the population, and we must ensure it is adequately funded, we cannot do so in a vacuum. We need to ensure that people also have access to adequate outpatient treatment and prevention services.

And while the opioid epidemic is front and center in all our minds, we cannot forget patients suffering from other substance use disorders. It is important that we do not unintentionally set up a discriminatory system that will be useless during the next epidemic, whatever that might be. We want our legislative efforts to both save lives today and to prevent epidemics like this one in the future.

States already have the option to work around outdated exclusions in IMD facilities. States like California are already doing so in a comprehensive way, taking into account the continuum of care for opioid and other substance use disorders.

If we are going to be spending an additional nearly $1 billion in the Medicaid program, we need to spend it wisely on expanding access to services, and not narrowly duplicating something that is already available.

Ever since the Excellence in Mental Health demonstration project passed into law in 2014, I have been fiercely advocating to expand the program.

The demonstration project, which I coauthored with my Republican colleague, Congressman Lance, and my Senate colleagues, Senators Stabenow and Blunt, certifies community behavioral health clinics, known as CCBHCs. The demonstration is currently about halfway through its 2-year period in eight States and already showing great success.

The National Council for Behavioral Health recently issued a report entitled, ``Bridging the Addiction Treatment Gap.'' It surveys CCBHCs operating in the Excellence Act demonstration States, and the results offer great hope.

First, the demonstration has enabled near-universal adoption of Medication Assisted Treatment, or MAT, for opioid use disorder. Ninety- two percent of certified clinics in the program are offering at least one type of FDA-approved MAT.

Second, 100 percent of CCBHCs have expanded the scope of addiction treatment services under the demonstration. For many clinics, this is the first time such services have been available in their communities, very often in medically-underserved areas.

Third, even while seeing more patients, two-thirds of surveyed CCBHCs have seen a decrease in patient wait times. After an initial call or referral, half of the clinics now offer same-day access to care, and four out of five can offer an appointment within a week or less.

Mr. Speaker, the Excellence Act is showing concrete results in terms of patient outcomes. In western New York State, more than 1,000 people in Erie County died of opioid overdoses over the last 5 years; 142 people lost their lives in 2016 alone.

At the same time, according to media reports, local police chiefs are reporting a 60 percent reduction in overdose calls in 2018. Authorities specifically credit a certified behavioral health clinic in the city of Buffalo that is providing medication assisted treatment for people battling opioid addiction within 24 to 48 hours after initial assessment.

We want to expand upon this success for certified community behavioral health clinics across the country by allowing Medicaid reimbursement on a larger scale. These clinics are the ones in people's neighborhoods and communities, the ones on the front lines of treating behavioral health and substance use disorder. If we do not build them up and integrate them with our health system, we will never achieve the full continuum of care that we are looking for.

Every time I have pushed for an expansion of the Excellence program in the Energy and Commerce Committee on funding legislation on the floor, I have been told that we don't have the dollars available.

However, today, we are talking about spending nearly $1 billion on something that is both redundant and, I believe, does not fully address the entire spectrum of care like the Excellence program has. That is why I offered an amendment to H.R. 5797, based on my bipartisan bill, H.R. 3931, and why I am here discussing this on the floor today.

Mr. Speaker, I urge my colleagues to consider funding community behavioral health clinics and outpatient treatment to help address the opioid epidemic. When you look back on what we have done to address this crisis, this will have more of a positive impact today and in the long term in comparison with the other proposals we are considering.

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