The Week in Drug Policy
Authorizations vs. Appropriations, Skinny Budgets, and Health Hubs
Earlier this week, the House Energy and Commerce Committee voted out The SUPPORT Act. The SUPPORT Act was signed into law in 2018 to much fanfare . The original legislation included some important provisions such as Medicare coverage for methadone, and preventing gaps in coverage for Medicaid eligible individuals who are incarcerated. It also authorized a number of grants, some of which were funded through the appropriations process.
This year stood in stark contrast to 2018, then, The SUPPORT Act passed out of committee unanimously. This week, The SUPPORT Act (HR 2483) passed out of committee with a 36-13 vote, garnering a no vote from Ranking Member Pallone.
The SUPPORT Act is an authorizing statute. It authorizes specific grant programs but it does not fund them. The word “grant” is mentioned 37 times in the 51 page bill. Therefore, it is up to the appropriators in Congress to fund these grant programs. The SUPPORT Act could be signed into law and not one penny would be spent on any SUPPORT Act grants if the grants don’t receive funding through the appropriations process.
There are a few non-grant provisions in the bill. For example, the legislation includes some requirements for federal agency working groups, as well as a requirement that the federal government develop drug disposal guidance. Ironically, The SUPPORT Act authorizes the naloxone distribution and training grant program, the same grant on the list targeted for elimination in the OMB pass back document.
The Skinny Budget
DC budget watchers eagerly await the arrival of The “Skinny” Budget, which is due any day. The Skinny Budget is a high-level budget, sent by the President to Congress to provide budget targets and direction for discretionary programs. It is typically a prelude to the President’s budget with greater detail, including justifications for every agency and spending request. (It only includes discretionary funding so it won’t include Medicaid or Medicare numbers.)
The Skinny Budget provides Congress and the public with an idea of the President’s budget priorities.
These are unusual times and the budget cutting that we’ve seen to date has provided us with an idea of the President’s priorities. However, the Skinny Budget will provide an official indication of his spending priorities.
Fatal Overdose Reduction Act
Senators Cantwell (WA) and Cassidy (LA) are co-sponsors of legislation entitled the Fatal Overdose Reduction Act. The legislation establishes a pilot program for Health Engagement Hubs. Health Engagement Hubs originated in Washington state where they were spearheaded by Dr. Caleb Banta-Green of the University of Washington.
Health Engagement Hubs provide convenient, low barrier options for people with opioid use disorder to receive buprenorphine treatment, primary care, and other social services.
This promising strategy meets people where they are without stigma and shame, while providing them with needed services. More information on the Hubs can be found here.