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Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act

Floor Speech

By: Frank Pallone, Jr.

Date: Sept. 28, 2018

Location: Washington, DC

Issues: Drugs

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I rise today in support of H.R. 6, the SUPPORT for Patients and Communities Act. This bill is the product of many months of hard work by several committees in the House and Senate. It is important that we pass this bill today as another step in addressing the opioid crisis that is ravaging every community in our Nation.

Last year, a record 72,000 Americans died of drug overdoses; that is about 200 people dying every day, and this is a national crisis that is devastating families and that this Congress must act on.

And while this legislation will not solve every problem, I do believe it includes important policies that will help turn the tide of this tragic opioid epidemic. It will also improve treatment options for those battling other substance-use disorders.

I am proud that H.R. 6 builds upon CARA, the Comprehensive Addiction and Recovery Act, by including a provision championed by my colleague, Congressman Tonko, that would allow all advanced practice registered nurses to treat patients with bupe for opioid-use disorder. It also gives nurse practitioners and physician assistants the authority to treat patients with bupe permanently, and it codifies the 275 patient physician cap. This is a critical step in expanding access to the treatment of these drugs, one of the major challenges that we continue to face in the fight against this epidemic.

Mr. Speaker, the legislation also expands access to coverage. It includes an important provision that I worked on with Ways and Means Committee Ranking Member Neal that expands Medicare coverage of opioid treatment programs and medication-assisted treatment.

In the Medicaid space, I am pleased to see the inclusion of several Democratic priorities. This bill requires State Medicaid programs to cover all forms of medication-assisted treatment, which plays a critical and lifesaving role in treating opioid use disorder.

It provides grants to State Medicaid programs to help increase the number of substance use disorder providers and services. It increases access to mental health and substance use disorder treatment for children and pregnant women covered by CHIP, and it ensures former foster youth are able to keep their Medicaid coverage across State lines up to the age of 26. And it improves the continuity of Medicaid coverage for juveniles in the justice system.

I am also pleased that we have been able to improve upon the House- passed IMD policy. This bill adds new safeguards to ensure that States continue to provide an adequate level of outpatient services and offer medication-assisted treatment. It does this by making clear that this policy does not impact the more comprehensive efforts to provide care in IMDs that is ongoing in many States today.

H.R. 6 also includes provisions from my legislation, the SCREEN Act, that would give the Food and Drug Administration the ability to take action against illicit controlled substances coming in through international mail facilities across the country.

FDA will now be able to prohibit the importation of drugs by people who have repeatedly imported illicit drugs. It also allows the agency to cease distribution of or recall controlled substances, like opioids, if they are endangering patients.

These provisions also provide FDA expanded authority and capacity needed to more effectively combat the influx of deadly synthetic opioids, like fentanyl, from reaching our shores through the mail in the first place.

It also provides the Federal Trade Commission with stronger enforcement tools to go after bad actors that are taking advantage of the suffering of individuals combating addictions.

Mr. Speaker, there is one provision that is concerning and that I do want to mention. It did not go through regular order and was not properly vetted. In fact, it was added at the very last minute. That is a proposal by Senator Rubio to create a new criminal antikickback statute.

I know this proposal is well-intentioned in addressing the serious problem of patient brokers who are taking advantage of individuals with opioid use disorders and referring them to substandard or fraudulent providers in exchange for kickbacks. This is an issue, but since the bill was introduced last Tuesday night, multiple stakeholders have raised concerns that the language does not do what we think it does. It may have unintended consequences.

Mr. Speaker, I hope this is a good lesson to all of us that passing legislation that has not been properly vetted, and that the public has not had an adequate chance to review, is unwise. I hope to get a commitment from Chairman Walden and Chairman Goodlatte to work to address any technical problems with this provision in the upcoming months.

In closing, Mr. Speaker, these are all policies that have the potential to make a real impact on this epidemic, but our work here is not complete. An epidemic of this size will take a long-term commitment to improving health insurance coverage, treatment, access, and affordability.

This bill is an important step, but I want to stress that we have to do a lot more. The opioid crisis continues to get worse. A lot more needs to be done to provide treatment and expand the treatment infrastructure. More resources are needed to support the families and communities impacted by this crisis. So what we are doing today is clearly helpful, but it is not enough.

Mr. GENE GREEN of Texas. Mr. Speaker, I thank the ranking member for yielding to me.

Mr. Speaker, I rise in support of the SUPPORT for Patients and Communities Act, bipartisan legislation that will help stem the tide against the Nation's opioid crisis and support Americans overcoming opioid addiction.

In 2016 alone, 42,000 Americans died from opioids, including prescription pain relievers and illicit opioids like fentanyl. This is a serious national crisis that affects public health and the social and economic welfare of communities throughout our great country.

The Energy and Commerce Health Subcommittee, which I am proud to serve on as ranking member, held several hearings on the opioid crisis last spring. I am proud to see our committee and both Chambers of Congress come together and support the package before us today that includes the Comprehensive Opioid Recovery Centers Act that I introduced, along with my friend Representative Brett Guthrie from Kentucky, earlier this year.

This legislation would fund designated treatment centers where Americans suffering from opioid abuse can receive comprehensive patient-centered care. The bill would allow designated treatment centers to provide wraparound services, including mental health, counseling, recovery housing, and job training and placement to support reintegration into the workforce. These wraparound services have been shown to help many Americans successfully overcome opioid addition.

The SUPPORT for Patients and Communities Act includes several provisions to combat this crisis, including strengthening the Federal Government's authority to restrict illegal drugs entering our country, and providing Medicaid for at-risk youth and former foster children.

Mr. Speaker, I ask my colleagues to join me and support this important legislation.

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Mr. PALLONE. Mr. Speaker, may I inquire as to how much time remains on each side.

Mr. BEN RAY LUJAN of New Mexico. Mr. Speaker, I rise today in support of H.R. 6, the SUPPORT for Patients and Communities Act.

This is an important step forward in the fight against the Nation's opioid epidemic. However, this Congress must acknowledge that this is not the end.

Healthcare is a right, not a privilege. There is much more work to do to ensure that families get the help that they deserve.

I am pleased that this package includes language that I have championed to address gaps in prevention and gaps in access to treatment. In addition, this bill will create pathways to behavioral healthcare jobs in communities like New Mexico.

Still, Congress must do more. As we have heard from Representative Cummings, this is going to take much more money, investment, and comprehensive legislation.

Mr. Speaker, before we conclude debate, let me just take a moment to thank everyone for all of their hard work getting this bill across the finish line.

This bill represents a collection of Member ideas and policies across the political spectrum. Many people may not know this, but the staff of the House and Senate committees negotiated this bill in a matter of weeks, and that is no small feat. It took a lot of effort, long hours and weekend work to pull this off. It is a product we can all be proud of.

So let me thank all legislative counsel and CBO for their efforts as well.

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