[Pages H2441-H2456]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

SUPPORT FOR PATIENTS AND COMMUNITIES REAUTHORIZATION ACT OF 2025

General Leave

Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days to revise and extend their remarks on the
legislation and to include extraneous material in the record on H.R.
2483.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Kentucky?
There was no objection.
The SPEAKER pro tempore. Pursuant to House Resolution 458 and rule
XVIII, the Chair declares the House in the Committee of the Whole House
on the state of the Union for the consideration of the bill, H.R. 2483.
The Chair appoints the gentleman from Tennessee (DesJarlais) to
preside over the Committee of the Whole.

{time} 1409

In the Committee of the Whole

Accordingly, the House resolved itself into the Committee of the
Whole House on the state of the Union for the consideration of the bill
(H.R. 2483) to reauthorize certain programs that provide for opioid use
disorder prevention, treatment, and recovery, and for other purposes,
with Mr. DesJarlais in the chair.
The Clerk read the title of the bill.
The CHAIR. Pursuant to the rule, the bill is considered read the
first time.
General debate shall be confined to the bill and shall not exceed 1
hour equally divided and controlled by the chair and ranking minority
member on the Committee on Energy and Commerce or their respective
designees.
The gentleman from Kentucky (Mr. Guthrie) and the gentleman from New
Jersey (Mr. Pallone) each will control 30 minutes.
The Chair recognizes the gentleman from Kentucky (Mr. Guthrie).
Mr. GUTHRIE. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, I rise today in support of H.R. 2483, the SUPPORT for
Patients and Communities Reauthorization Act.
When the Committee on Energy and Commerce led the way on the original
SUPPORT for Patients and Communities Act 7 years ago under the
leadership of Chairman Greg Walden, the opioid crisis looked different.
Overdose deaths were largely driven by prescription and semisynthetic
opioids, like oxycodone and heroin.
When the COVID-19 pandemic hit, government-enforced lockdowns hurt
patients in recovery and sent more people into despair, increasing the
amount of people taking illegal drugs for the first time.
Since then, the heartbreaking stories about the toll illicit fentanyl
and fentanyl-related substances have on our communities have continued.
The rate at which Americans are dying from fentanyl poisoning is just
devastating.
In our first Health Committee hearing this Congress, my colleagues
listened to the testimony of Ray Cullen, who lost his son Zach to
fentanyl poisoning. Nobody should have to experience this pain.
Earlier this year, the House took a critical step to get illicit
fentanyl off our streets in passing the HALT Fentanyl Act, which was
led by my friend, Congressman Morgan Griffith.
I am proud today to lead the reauthorization of the SUPPORT for
Patients and Communities Act. By passing this bill, my colleagues
continue our work to help improve treatment and recovery opportunities,
bolster prevention initiatives, and fight the fentanyl crisis.
This bill is about offering hope to those in despair, those battling
substance use disorder, their families and loved ones, healthcare
heroes, and first responders who need continued support to help save
lives.
I thank Congresswoman Pettersen and all the Members who have
supported this important bipartisan piece of legislation.
I am hopeful that by reauthorizing programs with proven success and
increasing access to treatment, Congress can continue to address and
prevent these tragic drug-related deaths and restore hope and healing
to those who need it. I urge all of my colleagues to support this bill,
and I reserve the balance of my time.
Mr. PALLONE. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, I rise in opposition to H.R. 2483, legislation that
reauthorizes the SUPPORT for Patients and Communities Act.
Last Congress, this bill passed with strong bipartisan support right
here on the House floor under suspension of the rules. Today it is
coming up under a rule because a lot has changed since last year. There
is a new administration, and the Trump administration is attacking
mental health and substance use response efforts on every front.
Republicans want to move forward with this legislation at the same
time that they are silently watching as the Trump administration
dismantles SAMHSA, the very agency that is responsible for carrying out
the programs that the SUPPORT for Patients and Communities Act
reauthorizes.
Thanks to our efforts in recent years, significant improvements have
been made in combating the opioid overdose epidemic that has devastated
families in every community throughout our Nation, but those
improvements are now threatened as the Trump administration guts the
very programs and funding that have helped us turn the corner.
In the past few months, the Trump administration has completely
eroded the mental health and substance use treatment landscape as we
know it. It has fired hundreds of workers at SAMHSA, including key
senior officials, such as the director of the center focused on mental
health. The department continues to refuse to respond to

[[Page H2442]]

my repeated requests about how many SAMHSA employees have been
terminated and how many additional firings are planned.

{time} 1415

The Trump administration has eliminated entire offices that are
responsible for collecting data on mental health and substance use and
helping people locate treatment services. These actions will only make
it harder for people who are seeking treatment to find care.
The Trump administration is also eliminating SAMHSA altogether
without congressional reauthorization. It will be combined with other
agencies that the Trump administration doesn't care about under the
banner of a larger make America healthy again office.
These critical programs to treat mental health and substance abuse
will be deprioritized or eliminated in favor of Secretary Kennedy's pet
projects, like destroying Americans' access to vaccines. Congress has
received zero--zero--information from the administration about how this
new office will work and how the work of SAMHSA to address the mental
health and substance use treatments needs of our communities will be
prioritized.
The Trump administration is also rescinding more than $1 billion in
essential funding that States rely on through block grants. It has also
proposed eliminating dozens of different mental health and substance
use programs, including eight programs reauthorized by the SUPPORT for
Patients and Communities Reauthorization Act of 2025.
This includes programs to train first responders who respond to
opioid overdose calls, provide residential treatment to pregnant and
postpartum women, and support people on long-term recovery.
If Republicans really support these programs, my colleagues should be
opposing the President's budget, which lays out plans to cut the very
programs Republican Members claim to care about. In fact, the Trump
administration budget goes further and proposes eliminating nearly all
of the SUPPORT for Patients and Communities Reauthorization Act of 2025
programs as my colleagues on the other side of the aisle propose to
eliminate all of the so-called programs of regional and national
significance.
This is the umbrella under which nearly all of the SUPPORT for
Patients and Communities Reauthorization Act of 2025 programs reside.
My colleagues have also proposed gutting the mental health block grant,
the substance abuse block grant, the State opioid response grants, and
consolidating them into one program with a deep funding cut.
I will be clear, Mr. Chair. This is not a budget proposal in the
traditional sense. This is a roadmap for what the Trump administration
plans to do unless the Federal courts prevent them from proceeding.
Their expansive and limitless view of the President's authority knows
no bounds. If DOGE wants to cut entire agencies, eliminate programs,
and impound funds, they will do it regardless of the law. The Trump
administration is making clear that funding treatment and prevention
for mental health and substance abuse issues is not a priority.
Unfortunately, Republican majorities of both the House and the Senate
silently sit by and watch all of the destruction and illegal actions.
House Republicans have not conducted any oversight of this
administration.
Let us not forget also, Mr. Chair, that last month, House Republicans
passed the biggest cut to Medicaid in history as part of their scheme
to fund giant tax breaks for billionaires. As the nonpartisan
Congressional Budget Office just announced this morning, the GOP tax
scam now cuts 16 million people, up from 13.5 million people, from
their healthcare, all to give tax breaks to their billionaire friends.
Medicaid covers 40 percent of all Americans with opioid use disorder.
Gutting the program will leave millions of Americans without access to
lifesaving care. We can't just go back to business as usual after that
devastation was supported and passed by my Republican colleagues.
All of these actions completely undermine the efforts we have made to
address substance use disorders in communities across the country. They
will have disastrous and deadly consequences on the millions of
Americans impacted by substance use disorder. Yet, House Republicans
are here on the floor today pretending that we are conducting business
as usual here in Washington.
If that were the case, I would join them in supporting the
legislation, just as I did last Congress. Yet, this administration is
not conducting business as usual, and Republicans are doing absolutely
nothing to fight back.
Therefore, Mr. Chair, I can't support this bill while our mental
health and substance use treatment infrastructure is being gutted by
the Trump administration. There needs to be a functioning agency to
implement the programs in this bill. There needs to be actual funding
for the agency to carry out these programs. Neither will exist under
what Trump has done or is proposing.
If Republicans were really interested in continuing to combat the
opioid overdose crisis, they would finally join us in opposing the
illegal actions of the Trump administration rather than hiding behind
this legislation today.
Mr. Chair, I reserve the balance of my time.
Mr. GUTHRIE. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, I point out, as they have had efficiencies in HHS in this
area, it has been reported to us that there are no material changes in
the programs before us today, showing that the Trump administration has
substance use disorder and drug addiction as a number one priority.
Mr. Chair, I don't understand the logic that the best way to send a
message to the President that you support these programs is to vote
``no'' on the bill. I just don't understand that logic. I hope we can
get bipartisan support. We will put the bill on the President's desk,
and I believe the President will sign the bill.
Mr. Chair, I yield 2 minutes the gentleman from Ohio (Mr. Latta), the
chairman of the Subcommittee on Energy.
Mr. LATTA. Mr. Chairman, I thank the chair of the full committee for
yielding. I appreciate it.
Mr. Chair, I rise in support of H.R. 2483, the SUPPORT for Patients
and Communities Reauthorization Act of 2025.
The SUPPORT for Patients and Communities Reauthorization Act of 2025
is one of the most impactful bills the Committee on Energy and Commerce
has worked on during my time in Congress. Simply put, we came together
to implement bipartisan policies that would save lives.
Gone are the days that substance abuse and addiction are a far off
problem that doesn't impact each one of our districts. Instead of
hearing the words: ``I know someone who knows someone,'' we hear too
often: ``I know someone personally who is impacted by addiction.''
That is why it is absolutely essential that we reauthorize the
SUPPORT for Patients and Communities Reauthorization Act of 2025, which
will ensure that we have the right tools at our disposal to fight the
scourge of fentanyl and opioids in our communities. We must continue
vital resources for prevention, education, treatment, recovery,
workforce, and law enforcement to help patients struggling with
substance abuse. This reauthorization ensures that we will continue to
make progress, continue to fight back, and will continue to save lives.
Mr. Chair, I again thank the chairman of the Committee on Energy and
Commerce, the gentleman from Kentucky (Mr. Guthrie), for his leadership
on this legislation. Let's fix it. Let's promote treatment before
tragedy, and stop the drug poisonings.
Mr. Chair, I thank the gentleman for yielding to me.
Mr. PALLONE. Mr. Chairman, I yield 4 minutes to the gentleman from
New York (Mr. Tonko), the ranking member of the Environment
Subcommittee.
Mr. TONKO. Mr. Chair, I thank the gentleman from New Jersey for
yielding.
Mr. Chair, SAMHSA's stated mission is to lead public health and
service delivery efforts that promote mental health, prevent substance
misuse, and provide treatments and supports to foster recovery while
ensuring access to better outcomes for all.
It is not an exaggeration to say that the public servants at SAMHSA
work

[[Page H2443]]

every day to prevent overdoses and suicides and save lives.
As a longtime champion for behavioral health parity and access to
treatment and as co-chair of the Congressional Addiction, Treatment,
and Recovery Caucus, bipartisan in nature, there have been a few
questions on my mind.
For instance, how many public servants need to be fired at SAMHSA
before we say enough? How many suicide prevention trainings need to be
canceled before Republicans can speak out? How many lifesaving naloxone
trainings need to be canceled for Republicans to say anything? How many
lives need to be lost before Republicans tell the Trump administration
to stop the decimation of SAMHSA?
I have other questions, too. They are simple ones like: How many
people work at SAMHSA currently? What divisions have no staff left at
all? What programs have they had to cut in local communities?
In February, following the firing of probationary employees, I
started asking these questions. Since the firing of nearly 50 percent
of SAMHSA's staff, I have continued asking those questions. To date, I
have gotten zero answers--zero.
Currently, we have lost 50 percent of SAMHSA's staff, and it is not
HHS or the Trump administration that shared that with Congress. We only
have confirmation that SAMHSA lost half of its staff from the press and
from the former SAMHSA employees. That simply is unacceptable.
As a Congress, if we say we care about behavioral health and if we
say there is a crisis, then we should be ashamed that we are okay not
knowing this. For 4 months, we have been asking questions. Instead of
answers, we have even more concerning questions.
I shared with our Committee on Energy and Commerce chair that, as the
committee that has jurisdiction over SAMHSA, how do we not have these
very important answers? This affects every community in the country,
and our first action should be finding out these answers.
If the administration refuses to come in, then let's bring in the
fired employees. These people are some of the most dedicated public
servants who did this work for all of the right reasons, and they
served an incredible need.
On behalf of all Americans, I thank all of the fired SAMHSA employees
for their service to our Nation. They deserved better. Frankly, all
Americans deserved better. Our loved ones should have access to
effective addiction treatment, prevention and recovery support, and
behavioral health support and services.
The recent actions of this Trump administration are betraying the
goal of access to behavioral health treatment and support. RFK and
Donald Trump have proposed to eliminate SAMHSA as an independent
agency, burying it somewhere in the so-called Administration for a
Healthy America, or AHA.
Let's remember that the whole reason Congress moved SAMHSA into an
independent agency was to ensure that behavioral health was prioritized
despite the longstanding stigma.
Instead, AHA would take us back to the time that behavioral health is
tucked away in another agency and deprioritized. When the agency is
gutted, the programs and the mission suffer. Ultimately, the
individuals we are trying to help with their mental health and
substance use struggles will simply not get the support they need.
People will die.
I beg my colleagues on the other side of the aisle: Let's reverse
course. We have an obligation to protect SAMHSA's mission and all of
our constituents who SAMHSA serves. Like many of my colleagues, I
support the programs in this package, but it is completely disingenuous
and, frankly, outrageous that Republicans are here today trying to pat
themselves on the back as doing something meaningful for those
struggling with addiction while the entire agency we are
authorizing programs for is being dismantled.

The people doing the work we are authorizing have all been fired, and
the administration is proposing even more draconian cuts for mental
health and substance use programs in the 2026 budget.
The CHAIR. The time of the gentleman has expired.
Mr. PALLONE. Mr. Chair, I yield an additional 1 minute to the
gentleman from New York.
Mr. TONKO. Mr. Chair, give me a break. It is like we are trying to
heal a bullet wound with a Band-Aid. I am regrettably going to have to
vote ``no'' and would respectfully ask my Republican colleagues to
pause today's vote and, instead, focus our attention on responding to
the actual crisis at SAMHSA.
Let's stop this performance. Instead, let's do the right thing and
walk out right now and meet, make calls, and work together to stop this
madness. Let's actually do something to meet this moment before it is
too late and we no longer have an agency focused on behavioral health.
This is truly a performative vote if Republicans are too scared to
say anything when the agency is being decimated and the mission is on
the line. My colleagues on the other side of the aisle want to go home
and say they voted for support, but my colleagues won't mention that.
It will never be implemented because the funding and staff are gone.
Let's return to my initial question: How many lives need to be lost
before Republicans tell the Trump administration to stop the decimation
of SAMHSA? If Republicans go forward with this vote today while staying
silent as this administration takes the chain saw to SAMHSA, then it is
clear that my Republican colleagues are willing to let SAMHSA lose all
of its capacity to serve its mission to save lives.
Mr. GUTHRIE. Mr. Chair, I yield 2 minutes to the gentleman from
Georgia (Mr. Carter), the chair of the Subcommittee on Health, an
important worker on this piece of legislation and my good friend.
Mr. CARTER of Georgia. Mr. Chair, I thank the gentleman for yielding.
Mr. Chair, I rise today in strong support of Chairman Guthrie's
SUPPORT for Patients and Communities Reauthorization Act of 2025.
This critical legislation reflects House Republicans' ongoing
commitment to fighting the opioid and fentanyl crisis that is
devastating families across this Nation.
Under the leadership of President Trump and Chairman Guthrie, we are
finally seeing real progress.
Listen to these figures, Mr. Chairman:
For the first time in years, opioid overdose deaths have declined,
dropping from over 83,000 in 2023 to under 55,000 by the most recent
data.
Those are good numbers. They did not happen by accident. It happened
because we took bold action to secure our borders, to prioritize
treatments, and invest in recovery programs that work.
We can help continue this trajectory by advancing the SUPPORT for
Patients and Communities Reauthorization Act of 2025, which is one of
the single largest congressional efforts to address our opioid crisis.
Through the SUPPORT for Patients and Communities Reauthorization Act
of 2025, we are reauthorizing prevention programs and recovery services
and ensuring that first responders can access and administer Naloxone.
We are ultimately restoring hope and healing by putting a stop to drug
overdose and poisoning.
Mr. Chair, I thank Chairman Guthrie for his work on this important
issue, and I urge my colleagues on both sides of the aisle to support
this legislation.
Mr. Chairman, let's pass this bill. Let's secure our borders. Let's
stem the tide of the growing fentanyl crisis, and let's save lives.
Mr. PALLONE. Mr. Chairman, I yield myself such time as I may consume.
Mr. Chairman, I have a great deal of respect for the chairman of the
Health Subcommittee, but he goes on to talk about how the Republicans
are supporting these programs, and it is simply not true.
Mr. Chair, I have in front of me the ``Fiscal Year 2026 Budget in
Brief'' that came from the Department of Health and Human Services.
On page 35 to 36 of the document, it says: ``The budget eliminates
the following programs to align investments with the administration's
priorities. . . . ''

{time} 1430

It lists the following programs. First responder training--there are
so many. I don't want to read them all. The chairman mentions helping
first responders. That first responder training

[[Page H2444]]

program is eliminated under the budget, right? A pregnant and
postpartum women program; building communities of recovery; treatment,
recovery, and workforce support; comprehensive opioid recovery centers;
and youth prevention and recovery initiatives are all eliminated.
I understand that the President is trying to prevent fentanyl from
coming in from across the border. I, obviously, support that. The
chairman from Georgia said we still need treatment and education. Of
course, we do, but that is not what is going on here.
The budget eliminates these programs, so my Republican colleagues
can't just come here on the floor and say that they support all this
and then authorize the very programs that are being eliminated, so
there is no funding and no staff to carry them out. It is not fair.
They are giving the impression to the public that they are doing
something that they are not.
Mr. Chair, I reserve the balance of my time.
Mr. GUTHRIE. Mr. Chair, I yield 2 minutes to the gentleman from
Florida (Mr. Dunn), my good friend who is the vice chair of the Health
Subcommittee of the Energy and Commerce Committee.
Mr. DUNN of Florida. Mr. Chair, I rise today in support of H.R. 2483,
the SUPPORT for Patients and Communities Reauthorization Act.
This bill is a critical piece of legislation that will help bolster
prevention, treatment, and recovery for millions of Americans suffering
from substance abuse disorders.
Thanks to the investments from the original SUPPORT for Patients and
Communities Act in 2018 and the efforts of the Trump administration, we
are finally starting to see a decrease in the overdose death rate.
Florida is a shining example of this progress. In Florida, pilot
programs have taken innovative steps, such as using long-acting
injectables to help fight opioid addiction. I am encouraged by the
number, and I also thoroughly believe that Congress needs to continue
the program to make this response possible.
One SUPPORT for Patients and Communities Reauthorization Act of 2025
program I am especially excited for is the first responder training
program, which helps ensure that first responders are prepared and
trained to administer Narcan.
I also strongly believe in the residential treatment program for
pregnant and postpartum women. This program is vital to help new moms
obtain treatment for substance abuse disorders.
Programs in this bill can change the lives of those who are suffering
from substance abuse disorders when they have nowhere else to turn.
For these reasons, I stand in strong support of H.R. 2483. I look
forward to voting in favor of this bill, and I encourage my colleagues
to do the same.
Mr. PALLONE. Mr. Chair, I yield 3 minutes to the gentlewoman from
Oregon (Ms. Dexter).
Ms. DEXTER. Mr. Chair, I rise today not just as a Member of this body
but as a physician who has spent nearly two decades caring for patients
in the intensive care unit, many of them fighting for their lives
because of a system that has failed to support them before a crisis
hit.
In Oregon's Third District, we see every day how critical prevention,
treatment, and recovery programs are. We need those programs that my
colleague from New Jersey just referred to as being cut. This bill does
nothing to repair those cuts.
These aren't abstract policy ideas. They are the difference between
life and death for many of my constituents. They are critical for the
health and safety of Oregonians and Americans across this country.
That is why efforts to sustain and strengthen these programs matter
deeply to the communities I represent. They are essential for the
parents working two jobs while navigating recovery, for the young
people trying to build a future after surviving an overdose, and for
families trying to heal.
Let's not kid ourselves. While Republicans bring this reauthorization
bill to the floor, they stand by as the Trump administration dismantles
the very agency responsible for implementing these programs. They have
fired experts, erased offices, and rescinded over a billion dollars
already allocated to State and local response. Just 2 weeks ago, they
passed the largest Medicaid cut in history out of this Chamber despite
the fact that Medicaid covers 40 percent of Americans addicted to
opioids.
This wasn't fiscal accountability. It was a decision to directly
undermine the access of care for millions of people who need it most.
These are people who desperately need our compassion and care.
Do not be fooled by this game of smoke and mirrors. This kind of
hypocrisy cannot go unchallenged. Claiming to support recovery while
simultaneously gutting the programs that make it possible is politics
at its worst.
My Republican colleagues cannot honestly stand for people's need to
access treatment while kneecapping the agency that is accountable for
providing it.
Lives are at stake, and the American people are watching. They do
know what it means when elected leaders say one thing and do another,
and they deserve honesty and real action.
Mr. Chair, I thank my colleague from New Jersey for this debate.
Mr. GUTHRIE. Mr. Chair, I want to point out that Medicaid reform
specifically exempted people with substance use disorder from being
defined as able-bodied for the purpose of the work requirement. It
specifically exempted them. We understand that Medicaid is a big payer
for people with substance use disorder recovery services, and our bill
exempted them. That will continue.
Mr. Chair, I yield 2 minutes to the gentleman from Ohio (Mr.
Balderson), my good friend.
Mr. BALDERSON. Mr. Chair, communities in my district and across the
country continue to feel the devastating impact of the opioid and
fentanyl crisis. We all know someone who has been affected, and many of
us felt that loss ourselves.
The SUPPORT for Patients and Communities Act, first signed into law
by President Trump in 2018, brought vital resources to those on the
front lines: patients, families, first responders, and recovery
providers.
Since then, overdose deaths have dropped significantly, but as we all
know too well in Appalachian Ohio, there is much more work to be done.
Today's reauthorization builds on that progress. This bill ensures
access to lifesaving medications for first responders, expands
treatment for pregnant women, strengthens prescription drug monitoring,
and supports recovery centers and workforce reentry programs.
By continuing this critical work, we can save more lives, restore
more families, and bring hope to communities hit hardest by the
addiction.
Mr. PALLONE. Mr. Chair, I yield 1 minute to the ranking member of the
Agriculture Committee, the gentlewoman from Minnesota (Ms. Craig).
Ms. CRAIG. Mr. Chair, overdose deaths are preventable, and we should
be using all the tools at our disposal to save American families from
the pain of losing a loved one to opioids. It is past time we treat the
opioid crisis like the public health crisis that it is.
My bipartisan RECONNECTIONS Act will do that by helping get overdose
education and prevention tools like naloxone into the hands of those
who need it. I am proud that my commonsense bill is included in the
SUPPORT for Patients and Communities Reauthorization Act of 2025.
It is great to see my colleagues recognizing the urgency of the
crisis, but we have to be clear-eyed about the moment we are in.
Medicaid is the country's single-largest payer of both mental health
and substance use services, and it is on the chopping block if my
Republican colleagues' budget bill is signed into law.
We have to protect Medicaid at all costs. I will continue standing up
against any cuts to these lifesaving benefits.
Mr. Chair, I thank everyone who has been part of this fight. This
bill will save lives.
Mr. GUTHRIE. Mr. Chair, I want to point out one more time that in
Medicaid reform, people with substance use disorder and mental health
issues are exempted from having to comply with the work requirement so
that hardworking taxpayers who go to work will provide the categories
we were just talking about today with Medicaid. They are not going to
provide for the able-bodied. There is an exemption

[[Page H2445]]

from the able-bodied requirement for substance use disorder recovery
and mental health.
Mr. Chair, I yield 2 minutes to the gentlewoman from Florida (Mrs.
Cammack), my great friend and a member of the Energy and Commerce
Committee.
Mrs. CAMMACK. Mr. Chair, I thank Chairman Guthrie for his leadership
on this bill and on this issue.
I have a hard time listening to opposition to this bill. Our
colleagues on the other side of the aisle for the last 4 years have
continuously voted against the HALT Fentanyl Act and have stood in
opposition to any effort to curb the opioid crisis in this country,
which up until recently was killing 100,000 people every single year.
That is why, today, I rise to urge passage of the SUPPORT for
Patients and Communities Reauthorization Act of 2025 because this
ongoing addiction crisis, fueled in large part by fentanyl, is still
killing Americans.
This legislation builds on the hard work that Republicans started
back in 2018 under President Trump. Guess what? That work has made a
difference.

Instead of studying something over and over, this bill, along with
other legislation, has directed resources to the ground where it is
intended.
Overdose deaths have dropped by nearly 30,000 last year. That is not
just a number. That is moms, dads, sons, and daughters who are still
with us today as a result of Congress stepping up.
This reauthorization keeps the momentum going, and it makes sure that
first responders--first responders like my husband, Matt, who is a
paramedic and a SWAT medic/firefighter--have the resources that they
need to save lives in the field.
It doesn't stop there. This bill supports a full range of evidence-
based treatment options, from emergency overdose reversal to long-term
recovery tools, like medication-assisted treatment, counseling, and
peer support.
The SUPPORT for Patients and Communities Reauthorization Act of 2025
has the backing of more than 160 different organizations dedicated to
substance abuse disorder treatment and recovery, and it expands care
for pregnant and postpartum women, strengthens prescription drug
monitoring, and helps individuals in recovery reenter the workforce and
rebuild their lives.
That is what real solutions look like, not another study. Stop
playing politics with people's lives, please. We need to support
prevention, treatment, and recovery at every single level.
Mr. Chair, I thank Chairman Guthrie again for leading on this issue,
and I urge every single one of my colleagues to support this bill.
Let's get it done.
Mr. PALLONE. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, I want to talk about not only the SUPPORT for Patients and
Communities Reauthorization Act of 2025 but the ineffectiveness of what
is going on today with this reauthorized bill, but also the Medicaid
cuts, which also affect people who are impacted by behavioral or mental
health problems.
I put up the budget before. This is the President's budget. This is
the Health and Human Services Department's budget. Again, I don't
understand how my Republican colleagues can come here and say they are
reauthorizing this program and ask what we are complaining about. The
programs that I had mentioned that are cut in the President's budget, I
am not going to go through them again, but I mentioned the first
responder training, the comprehensive opioid recovery centers, and the
youth prevention and recovery initiatives. All these programs are
reauthorized by the bill before us today, but in the budget, the
President eliminates the programs--no funding, no staff, no nothing.
How do they say that they are doing anything when the Trump
administration is publicly laying out its plans to eliminate the very
programs that they are reauthorizing? My colleagues on the other side
are applauding their efforts to pass this bill even though it is
meaningless.
How do they support a bill when the programs it reauthorizes are set
to be eliminated by the President of the United States and their own
party?
The same thing is true with regard to the Medicaid cuts. I hear my
colleague, who I respect, the chairman of our Energy and Commerce
Committee, keep saying that the Medicaid cuts in the budget bill that
they passed a couple of weeks ago affect only the able-bodied, that it
doesn't affect people with substance use disorders or those struggling
with mental illness because they are exempt from the work requirements
or the paperwork, if you will, that is in this bill, which CBO says is
going to result in 16 million people losing their health insurance.
This morning, CBO revised their analysis of the Republican budget
bill. They had said it was 13.5 million, but now, because of the
changes before the bill went from the Energy and Commerce Committee to
the floor, it is now 16 million people who will lose their health
insurance, primarily because of all this red tape.
Taking health coverage from 16 million Americans is entirely
unacceptable, and there is no amount of rationalizing that Republicans
can do to make it any better. They said they have exemptions from this
paperwork. Those exemptions have never worked.

{time} 1445

We have the example from the State of Georgia, which admitted that
there were 300,000 to 400,000 people under expanded Medicaid that were
eligible for Medicaid under the State program, but only 4,500 of those
300,000 to 400,000 qualified because of the paperwork.
It doesn't matter what you say. Eliminating these people is simply
unacceptable, and it just means they are going to go without health
insurance. Then the costs are going to go up for everybody else because
now the hospitals and the nursing homes that take them are not going to
get paid and then all your private insurance and other insurance bills
are going to go up. Your premiums are going to go up. Your deductibles
are going to go up.
Mr. Chair, I will use, if I can, two examples from organizations that
represent people with disabilities and know that the Republicans are
taking away their health coverage, regardless of what they say about
the red tape.
This is from a coalition of 425 disability and aging organizations.
They say: We strongly oppose Medicaid cuts in any form. Whether it is
done by imposing work requirements, repealing the eligibility and
enrollment rule, or further eliminating the way States fund their share
of Medicaid costs, these proposals all lead to the same result: People
with disabilities and older adults will lose care and support that keep
them healthy and independent. That is the bottom line. No rationalizing
away what is happening here.
This is from the Cystic Fibrosis Foundation. I could give you so many
examples. I don't want to use up all the time. The Cystic Fibrosis
Foundation says:

While people with chronic illnesses like cystic fibrosis
may be exempt from work requirements, we know exemptions for
people with disabilities and caregivers do not work.
Exemptions may not happen automatically and can require
complex paperwork and regular recertification even for those
with chronic lifelong conditions.

The bottom line is, it doesn't matter what you say. It doesn't matter
how you do it; 16 million Americans are going to lose their health
insurance under this legislation, and no amount of rationalizing on
your part is going to change that.
Mr. Chair, I reserve the balance of my time.
Mr. GUTHRIE. Mr. Chair, I will remind you that we spend about almost
$700 billion in Medicaid. When this bill goes into effect, 10 years
from now, we are going to spend $1.1 trillion in Medicaid. I just want
to make sure that point is made.
Mr. Chair, I yield 2 minutes to the gentleman from California (Mr.
Obernolte), my good friend and a great leader on the Energy and
Commerce Committee.
Mr. OBERNOLTE. Mr. Chair, I rise in strong support of this bipartisan
bill that reauthorizes the SUPPORT for Patients and Communities Act
programs from 2018.
Mr. Chair, we are facing an epidemic of fentanyl overdoses in this
country and this bill provides meaningful steps in countering them. The
programs that this bill reauthorize provide naloxone for first
responders, funding for prevention programs, funding for treatment
programs, funding for recovery services, and the efficacy of these
programs

[[Page H2446]]

is shown in the difference in overdose deaths that we have seen in this
country between when the program was first implemented in 2018 and last
year.
We have seen, Mr. Chair, a dramatic decline in overdose-related
deaths, but more work remains to be done.
Last year, Mr. Chair, over 50,000 Americans lost their lives to
opioid overdoses. That is why this bill is so important to reauthorize.
I thank my friend and the chairman for including my bill, the 9-8-8
Lifeline Cybersecurity Responsibility Act in this bill. I hope everyone
in the Chamber is aware of the 9-8-8 lifeline and the vital services
that it provides. It provides 24/7 crisis mental health counseling to
Americans that are facing mental health crises and are in danger of
committing suicide.
Mr. Chair, recently the crisis line was taken down by a cybersecurity
incident and I think we should all be able to agree that that is
unacceptable. My bill will solve that problem by improving information
sharing between law enforcement agencies and the operators of the
lifeline, which will keep that lifeline up for the people who need it.
Mr. Chair, this is a great bipartisan bill. I urge its support.
Mr. PALLONE. Mr. Chair, I yield myself 1 minute.
Mr. Chair, I appreciate what the gentleman from California is saying.
The bottom line is, if these programs are successful under the SUPPORT
for Patients and Communities Act, and I agree they have been, the
numbers in terms of people dying, people who are severely impacted by
opioid use and overdoses, clearly they have gone down because of the
SUPPORT for Patients and Communities Act programs, but that is the very
reason why the Republicans should speak out against the administration
that is rescinding a billion dollars in grants that are going for these
treatment centers. It is why they should speak out against the budget
on the part of President Trump that I have cited several times today
that eliminates these programs. It is why they should speak out against
these cuts in the staff for these programs.
It is the very fact that the programs have been successful is why the
administration should prioritize the programs. The Republican
leadership on our committee and in the House should say: What you are
proposing, what you are doing, President Trump, is not acceptable
because it is going to reverse this. It is going to reverse the trend
where opioid use and overdose goes down. It is going to reverse it if
we don't have these programs. That is why they are successful.
To just say we are going to reauthorize the SUPPORT for Patients and
Communities Act, which is meaningless because they are eliminating the
programs, that is not the answer. The answer is for all of you to get
up, go down to the White House, join us and say: What you are doing,
President Trump, is not acceptable. It is going to reverse the progress
that we have made.
Mr. Chair, I reserve the balance of my time.
Mr. GUTHRIE. Mr. Chair, I yield 2 minutes to the gentleman from
Michigan (Mr. James), my good friend and very strong leader on the
Energy and Commerce Committee.
Mr. JAMES. Mr. Chair, dramatic pause for effect, I rise today to
speak in favor of the SUPPORT for Patients and Communities
Reauthorization Act of 2025. I thank my friend, Chairman Guthrie, for
his very hard work and leadership in getting this done.
Fentanyl is a scourge on our Nation, leaving a trail of heartbreak
and destruction in its wake. We cannot allow this poison to continue
tearing our families apart, and I am proud the House Republicans are,
once again, leading the fight to protect our communities and get
fentanyl off our streets.
Nationally, in 2022, the United States saw over 107,000 overdose
deaths in 1 year. That is 45 more deaths in 1 year than we lost during
the entirety of the 20-year war in Afghanistan. It is unconscionable.
While I am thrilled to see that opioid overdose deaths have declined
from an estimated 83,000 in 2023 and 54,000 in 2024, there is still so
much more that we have to do.
The SUPPORT for Patients and Communities Reauthorization Act of 2025
plays a critical role by ensuring first responders have access to
lifesaving naloxone, increasing treatment options, and bolstering
support services.
I am especially pleased to see that provisions of my Road to Recovery
Act were included in this SUPPORT for Patients and Communities
Reauthorization Act of 2025. The bipartisan Road to Recovery Act
reauthorizes lifesaving resources vital to addressing opioid addiction
and substance abuse across the country.
It provides critical resources for SAMHSA's National Helpline, a
free, confidential, 24/7, 365-day-a-year treatment referral and
information service for individuals and families facing mental and/or
substance use disorders. This service provides referrals to local
treatment facilities, support groups, and community-based
organizations.
Mr. Chair, the American people are tired of Democrats and Republicans
bickering. I imagine both Democrats and Republicans agree on fentanyl
and any direction on fixing this scourge is a step in the right
direction.
Mr. Chair, with this bipartisan legislation and action that we are
taking to save lives, I encourage all of my colleagues to support this
crucial legislation.
Mr. PALLONE. Mr. Chair, I reserve the balance of my time.
Mr. GUTHRIE. Mr. Chair, I yield 2 minutes to the gentleman from
Kansas (Mr. Schmidt), one of our freshman Members, not a member of the
Energy and Commerce Committee, but he has been on the front lines of
the opioid crisis in Topeka as attorney general, and it is great to
have his expertise in the Congress.
Mr. SCHMIDT. Mr. Chair, I thank the chairman for his leadership on
this issue.
This is a subject near and dear to my heart. I come from a part of
the country in southeast Kansas where I have got a lot of classmates,
friends, and neighbors who have struggled with addiction over the
years. I know them personally.
When I started in public service, it was all about methamphetamine in
our part of the world. It was the clandestine meth lab in the trunk of
a car or an abandoned barn or an old house. We dealt with that, as a
matter of public policy, by putting Sudafed behind the counter. We made
it harder for people to pilfer Sudafed and go out and cook up their own
meth. We knew that that was going to cut down the number of clandestine
laboratories, but it wasn't going to decrease the demand; it was just
going to increase the demand for meth to come across the southern
border, and that is what happened. They created trade routes.
Then along came the 1990s and unrelated to methamphetamine, we had a
lot of big drug companies and some bad actors, who decided they were
going to make more money by doing a lot of stuff they shouldn't have
done to incent the medical community to prescribe more opioids, and
they did and it was illegal.
When I got to serve as attorney general, we joined together,
Republicans and Democrats. We didn't think about party affiliation, and
we sued some of these companies and held them accountable. When I left
office, we had recovered about $340 million, $350 million for my State
of Kansas to deal with drug treatment from Purdue Pharma and other
companies that had peddled addiction for profit.
It doesn't sound like a lot of money in this Chamber, but to put it
in context, that was many times more than the State of Kansas had ever
spent on addiction treatment and intervention and prevention.
We have an obligation to support these folks who are struggling down
the street from us with addiction. It shouldn't be a partisan issue. It
is more than just closing the border, although we have to do that. It
is about helping folks change their behavior and their lives.
There is a lot that needs to be done. This is one piece of it. I am a
little bit disappointed that this has been something of a partisan
debate. It never has been for me. It never was in my previous public
roles. It should not be now.
Mr. Chair, I thank the chairman for his leadership and encourage all
my colleagues to support this bill.
Mr. PALLONE. Mr. Chair, may I inquire as to the time remaining.

[[Page H2447]]

The CHAIR. The gentleman from New Jersey has 8 minutes remaining.
Mr. PALLONE. Mr. Chair, I yield myself the balance of my time.
Mr. Chair, I want everyone to understand my opposition to this bill.
While the SUPPORT for Patients and Communities Act was first passed
in 2018 with bipartisan support, the idea was to address the opioid
crisis by authorizing programs that aimed to prevent substance use
disorder and increase access to treatment and recovery, but the
Trump administration has unlawfully gutted the agency responsible for
carrying out these programs that the SUPPORT for Patients and
Communities Reauthorization Act of 2025 reauthorizes. Congressional
Republicans are trying to have it both ways. You really can't.

They are trying to have it both ways. They are saying we are going to
reauthorize the SUPPORT for Patients and Communities Act, but then they
silently stand by as the Trump administration dismantles the very
program under SAMHSA or the very agency, SAMHSA, that actually
implements the SUPPORT for Patients and Communities Reauthorization Act
of 2025.
The Trump administration is moving forward with its unauthorized and
illegal plans to eliminate SAMHSA altogether and combine mental health
and substance use programs under this unrelated agency called the new
Administration for a Healthy America.
Believe me, Secretary Kennedy has not explained in any way what this
new administration will do or how it will continue any of the programs
under SAMHSA.
What has the administration done? First, they fired hundreds of
workers at SAMHSA, including key senior officials such as the directors
of centers focused on mental health and substance use treatment. They
have eliminated entire offices authorized by this statute, including
the National Mental Health and Substance Use Policy Lab and the Center
for Behavioral Health Statistics and Quality, which has been opposed by
dozens of leading mental health and substance use groups that don't
want these agencies eliminated because they actually play a major role
in helping people with mental and behavioral health problems.
The Trump administration has rescinded over a billion dollars from
State and local behavioral health programs under mental health and
substance use block grants. This is the money that goes back to the
States, the counties, and the towns to open up the centers,
particularly for young people. That is where this all happens. It
happens at the local level where people are treated, where the
education programs take place. That billion dollars is gone. I am sure
it is in the courts and the courts may say you can't do it, hopefully,
but they have rescinded it.

{time} 1500

Lastly, the Trump administration has disregarded the will of Congress
by preparing to eliminate 40 different mental health and substance use
programs. I am not going to go through them again. I listed them. They
are all in the President's budget. It is terrible. It is things like
the centers for youth, the centers for first responders, who are the
ones who go and see people that overdose and try to make sure they
don't die.
Again, all of this is happening, and the House Republicans say: Oh,
don't worry about that because we are going to reauthorize the SUPPORT
for Patients and Communities Act, and this is 2 weeks after the biggest
cut to Medicaid in history with their GOP tax scam.
My only point is very simple, Mr. Chair, and that is this: The Energy
and Commerce Committee is an authorizing committee. Sure, you can get
up here and say we are going to authorize this program because we care
about all the programs under the SUPPORT for Patients and Communities
Reauthorization Act of 2025, but it is meaningless.
It makes no sense for us to authorize or reauthorize a program,
whether it is substance use abuse or whatever it is, and give the
impression to the public that somehow we are accomplishing something by
authorizing or reauthorizing a program where there is going to be no
agency to carry it out, no money, no staff.
I just think it is just not fair. It is trying to give the impression
that you are doing something when, in fact, you are not. I feel
obligated to expose that and to say, no, we are not going to vote for
this hollow bill that actually does nothing because it gives the
impression that we are doing something that we are not.
Mr. Chair, I yield back the balance of my time.
Mr. GUTHRIE. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, this isn't a hollow exercise. This is our opportunity to
say these programs are important to us. Article I of the Constitution
clearly gives us legislative authority: All legislative authority will
vest in the Congress of the United States.
We authorize these programs. I don't think the answer is to say we
believe in these programs, therefore we are not going to vote to
reauthorize them because we don't believe they are going to be carried
out. It is our job to authorize them, to work the appropriations
process, and then to do the oversight to make sure these are
implemented.
If the White House and the President can do this more efficiently, I
am all about doing it more efficiently, but our job is to ensure that
the mission is accomplished. If they can do that with different
agencies, we need to have that debate. I think that is important. It
starts with authorizing the program, and in this case reauthorizing the
program.
Mr. Chair, I just want you to know there are no reasons to vote
against this in substance. The language of this bill that we have
before us was negotiated by both the House and the Senate, with the
Democratic leaders and the Republican leaders in the House and the
Senate, so it was bipartisan and bicameral discussions. That is the
text of the bill before us.
What we are here doing today, it is not a hollow move. That is not it
at all. We are here today to say these are important to us. If there
are discussions on what is important and what is not important, the
first thing we need to do is come together as a House and say these
issues are important to us as a House. Let's get this bill to the
Senate and put it on the President's desk.
I strongly believe the President will sign this bill because he
believes, as we all believe, that people are hurting. They are hurting
with substance use disorder. You have the supply coming across the
border that he is shutting down and trying to shut down, but we also
have to deal with the demand side. We need not just to slow down the
demand, which is important, but change people's lives because when they
are suffering with substance use disorder, it is just chaotic on
themselves, their families, in which they live and the friends that
they have.
This truly changes people's lives. It is a bipartisan bill.
Everything in it is bipartisan and has been discussed. I just encourage
my colleagues to vote for this bill, reauthorize these provisions,
fight to get them through the Senate, put them on the President's desk,
and then fight for their authorization through the appropriations
process, as well. I am committed to doing that, and I look forward to
hopefully a bipartisan vote on this bill.
Mr. Chair, I yield back the balance of my time.
The CHAIR. All time for general debate has expired.
Pursuant to the rule, the bill shall be considered for amendment
under the 5-minute rule.
In lieu of the amendment in the nature of a substitute recommended by
the Committee on Energy and Commerce printed in the bill, an amendment
in the nature of a substitute consisting of the text of the Rules
Committee Print 119-4, shall be considered as adopted.
The bill, as amended, shall be considered as the original bill for
the purpose of further amendment under the 5-minute rule and shall be
considered as read.
The text of the bill, as amended, is as follows:

H.R. 2483

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the ``SUPPORT
for Patients and Communities Reauthorization Act of 2025''.
(b) Table of Contents.--The table of contents for this Act
is as follows:

Sec. 1. Short title; table of contents.

[[Page H2448]]

TITLE I--PREVENTION

Sec. 101. Prenatal and postnatal health.
Sec. 102. Monitoring and education regarding infections associated with
illicit drug use and other risk factors.
Sec. 103. Preventing overdoses of controlled substances.
Sec. 104. Support for individuals and families impacted by fetal
alcohol spectrum disorder.
Sec. 105. Promoting state choice in PDMP systems.
Sec. 106. First responder training program.
Sec. 107. Donald J. Cohen National Child Traumatic Stress Initiative.
Sec. 108. Protecting suicide prevention lifeline from cybersecurity
incidents.
Sec. 109. Monitoring and reporting of child, youth, and adult trauma.
Sec. 110. Bruce's law.
Sec. 111. Guidance on at-home drug disposal systems.
Sec. 112. Assessment of opioid drugs and actions.
Sec. 113. Grant program for State and Tribal response to opioid use
disorders.

TITLE II--TREATMENT

Sec. 201. Residential treatment program for pregnant and postpartum
women.
Sec. 202. Improving access to addiction medicine providers.
Sec. 203. Mental and behavioral health education and training grants.
Sec. 204. Loan repayment program for substance use disorder treatment
workforce.
Sec. 205. Development and dissemination of model training programs for
substance use disorder patient records.
Sec. 206. Task force on best practices for trauma-informed
identification, referral, and support.
Sec. 207. Grants to enhance access to substance use disorder treatment.
Sec. 208. State guidance related to individuals with serious mental
illness and children with serious emotional disturbance.
Sec. 209. Reviewing the scheduling of approved products containing a
combination of buprenorphine and naloxone.

TITLE III--RECOVERY

Sec. 301. Building communities of recovery.
Sec. 302. Peer support technical assistance center.
Sec. 303. Comprehensive opioid recovery centers.
Sec. 304. Youth prevention and recovery.
Sec. 305. CAREER Act.
Sec. 306. Addressing economic and workforce impacts of the opioid
crisis.

TITLE IV--MISCELLANEOUS MATTERS

Sec. 401. Delivery of a controlled substance by a pharmacy to a
prescribing practitioner.
Sec. 402. Required training for prescribers of controlled substances.

TITLE I--PREVENTION

SEC. 101. PRENATAL AND POSTNATAL HEALTH.

Section 317L(d) of the Public Health Service Act (42 U.S.C.
247b-13(d)) is amended by striking ``such sums as may be
necessary for each of the fiscal years 2019 through 2023''
and inserting ``$4,250,000 for each of fiscal years 2026
through 2030''.

SEC. 102. MONITORING AND EDUCATION REGARDING INFECTIONS
ASSOCIATED WITH ILLICIT DRUG USE AND OTHER RISK
FACTORS.

Section 317N(d) of the Public Health Service Act (42 U.S.C.
247b-15(d)) is amended by striking ``fiscal years 2019
through 2023'' and inserting ``fiscal years 2026 through
2030''.

SEC. 103. PREVENTING OVERDOSES OF CONTROLLED SUBSTANCES.

(a) In General.--Section 392A of the Public Health Service
Act (42 U.S.C. 280b-1) is amended--
(1) in subsection (a)(2)--
(A) in subparagraph (C), by inserting ``and associated
risks'' before the period at the end; and
(B) in subparagraph (D), by striking ``opioids'' and
inserting ``substances causing overdose''; and
(2) in subsection (b)(2)--
(A) in subparagraph (B), by inserting ``, and associated
risk factors,'' after ``such overdoses'';
(B) in subparagraph (C), by striking ``coding'' and
inserting ``monitoring and identifying'';
(C) in subparagraph (E)--
(i) by inserting a comma after ``public health
laboratories''; and
(ii) by inserting ``and other emerging substances related''
after ``analogues''; and
(D) in subparagraph (F), by inserting ``and associated risk
factors'' after ``overdoses''.
(b) Additional Grants.--Section 392A(a)(3) of the Public
Health Service Act (42 U.S.C. 280b-1(a)(3)) is amended--
(1) in the matter preceding subparagraph (A), by striking
``and Indian Tribes--'' and inserting ``and Indian Tribes for
the following purposes:'';
(2) by amending subparagraph (A) to read as follows:
``(A) To carry out innovative projects for grantees to
detect, identify, and rapidly respond to controlled substance
misuse, abuse, and overdoses, and associated risk factors,
including changes in patterns of such controlled substance
use. Such projects may include the use of innovative,
evidence-based strategies for detecting such patterns, such
as wastewater surveillance, if proven to support actionable
prevention strategies, in a manner consistent with applicable
Federal and State privacy laws.''; and
(3) in subparagraph (B), by striking ``for any'' and
inserting ``For any''.
(c) Authorization of Appropriations.--Section 392A(e) of
the Public Health Service Act (42 U.S.C. 280b-1(e)) is
amended by striking ``$496,000,000 for each of fiscal years
2019 through 2023'' and inserting ``$505,579,000 for each of
fiscal years 2026 through 2030''.

SEC. 104. SUPPORT FOR INDIVIDUALS AND FAMILIES IMPACTED BY
FETAL ALCOHOL SPECTRUM DISORDER.

(a) In General.--Part O of title III of the Public Health
Service Act (42 U.S.C. 280f et seq.) is amended to read as
follows:

``PART O--FETAL ALCOHOL SPECTRUM DISORDER PREVENTION AND SERVICES
PROGRAM

``SEC. 399H. FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION,
INTERVENTION, AND SERVICES DELIVERY PROGRAM.

``(a) In General.--The Secretary shall establish or
continue activities to support a comprehensive fetal alcohol
spectrum disorders (referred to in this section as `FASD')
education, prevention, identification, intervention, and
services delivery program, which may include--
``(1) an education and public awareness program to support,
conduct, and evaluate the effectiveness of--
``(A) educational programs targeting health professions
schools, social and other supportive services, educators and
counselors and other service providers in all phases of
childhood development, and other relevant service providers,
concerning the prevention, identification, and provision of
services for infants, children, adolescents, and adults with
FASD;
``(B) strategies to educate school-age children, including
pregnant and high-risk youth, concerning FASD;
``(C) public and community awareness programs concerning
FASD; and
``(D) strategies to coordinate information and services
across affected community agencies, including agencies
providing social services such as foster care, adoption, and
social work, agencies providing health services, and agencies
involved in education, vocational training, and civil and
criminal justice;
``(2) supporting and conducting research on FASD, as
appropriate, including to--
``(A) develop appropriate medical diagnostic methods for
identifying FASD; and
``(B) develop effective culturally and linguistically
appropriate evidence-based or evidence-informed interventions
and appropriate supports for preventing prenatal alcohol
exposure, which may co-occur with exposure to other
substances;
``(3) building State and Tribal capacity for the
identification, treatment, and support of individuals with
FASD and their families, which may include--
``(A) utilizing and adapting existing Federal, State, or
Tribal programs to include FASD identification and FASD-
informed support;
``(B) developing and expanding screening and diagnostic
capacity for FASD;
``(C) developing, implementing, and evaluating targeted
FASD-informed intervention programs for FASD;
``(D) providing training with respect to FASD for
professionals across relevant sectors; and
``(E) disseminating information about FASD and support
services to affected individuals and their families; and
``(4) an applied research program concerning intervention
and prevention to support and conduct service demonstration
projects, clinical studies and other research models
providing advocacy, educational and vocational training,
counseling, medical and mental health, and other supportive
services, as well as models that integrate and coordinate
such services, that are aimed at the unique challenges facing
individuals with fetal alcohol spectrum disorder or fetal
alcohol effect and their families.
``(b) Grants and Technical Assistance.--
``(1) In general.--The Secretary may award grants,
cooperative agreements and contracts and provide technical
assistance to eligible entities to carry out subsection (a).
``(2) Eligible entities.--To be eligible to receive a
grant, or enter into a cooperative agreement or contract,
under this section, an entity shall--
``(A) be a State, Indian Tribe or Tribal organization,
local government, scientific or academic institution, or
nonprofit organization; and
``(B) prepare and submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may require, including a description of the
activities that the entity intends to carry out using amounts
received under this section.
``(3) Additional application contents.--The Secretary may
require that an eligible entity include in the application
submitted under paragraph (2)(B)--
``(A) a designation of an individual to serve as a FASD
State or Tribal coordinator of activities such eligible
entity proposes to carry out through a grant, cooperative
agreement, or contract under this section; and
``(B) a description of an advisory committee the entity
will establish to provide guidance for the entity on
developing and

[[Page H2449]]

implementing a statewide or Tribal strategic plan to prevent
FASD and provide for the identification, treatment, and
support of individuals with FASD and their families.
``(c) Definition of FASD-Informed.--For purposes of this
section, the term `FASD-informed', with respect to support or
an intervention program, means that such support or
intervention program uses culturally and linguistically
informed evidence-based or practice-based interventions and
appropriate resources to support an improved quality of life
for an individual with FASD and the family of such
individual.

``SEC. 399I. STRENGTHENING CAPACITY AND EDUCATION FOR FETAL
ALCOHOL SPECTRUM DISORDERS.

``(a) In General.--The Secretary shall award grants,
contracts, or cooperative agreements, as the Secretary
determines appropriate, to public or nonprofit private
entities with demonstrated expertise in the field of fetal
alcohol spectrum disorders (referred to in this section as
`FASD'). Such awards shall be for the purposes of building
local, Tribal, State, and nationwide capacities to prevent
the occurrence of FASD by carrying out the programs described
in subsection (b).
``(b) Programs.--An entity receiving an award under
subsection (a) may use such award for the following purposes:
``(1) Developing and supporting public education and
outreach activities to raise public awareness of the risks
associated with alcohol consumption during pregnancy.
``(2) Acting as a clearinghouse for evidence-based
resources on FASD prevention, identification, and culturally
and linguistically appropriate best practices to help inform
systems of care for individuals with FASD across their
lifespan.
``(3) Increasing awareness and understanding of
efficacious, evidence-based screening tools and culturally
and linguistically appropriate evidence-based intervention
services and best practices, which may include improving the
capacity for State, Tribal, and local affiliates.
``(4) Providing technical assistance to recipients of
grants, cooperative agreements, or contracts under section
399H, as appropriate.
``(c) Application.--To be eligible for a grant, contract,
or cooperative agreement under this section, an entity shall
submit to the Secretary an application at such time, in such
manner, and containing such information as the Secretary may
require.
``(d) Subcontracting.--A public or private nonprofit entity
may carry out the following activities required under this
section through contracts or cooperative agreements with
other public and private nonprofit entities with demonstrated
expertise in FASD:
``(1) Resource development and dissemination.
``(2) Intervention services.
``(3) Training and technical assistance.

``SEC. 399J. AUTHORIZATION OF APPROPRIATIONS.

``There are authorized to be appropriated to carry out this
part $12,500,000 for each of fiscal years 2026 through
2030.''.
(b) Report.--Not later than 4 years after the date of
enactment of this Act, and every year thereafter, the
Secretary of Health and Human Services shall prepare and
submit to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and
Commerce of the House of Representatives a report
containing--
(1) a review of the activities carried out pursuant to
sections 399H and 399I of the Public Health Service Act, as
amended, to advance public education and awareness of fetal
alcohol spectrum disorders (referred to in this section as
``FASD'');
(2) a description of--
(A) the activities carried out pursuant to such sections
399H and 399I to identify, prevent, and treat FASD; and
(B) methods used to evaluate the outcomes of such
activities; and
(3) an assessment of activities carried out pursuant to
such sections 399H and 399I to support individuals with FASD.

SEC. 105. PROMOTING STATE CHOICE IN PDMP SYSTEMS.

Section 399O(h) of the Public Health Service Act (42 U.S.C.
280g-3(h)) is amended by adding at the end the following:
``(5) Promoting state choice.--Nothing in this section
shall be construed to authorize the Secretary to require
States to use a specific vendor or a specific
interoperability connection other than to align with
nationally recognized, consensus-based open standards, such
as in accordance with sections 3001 and 3004.''.

SEC. 106. FIRST RESPONDER TRAINING PROGRAM.

Section 546 of the Public Health Service Act (42 U.S.C.
290ee-1) is amended--
(1) in subsection (a), by striking ``tribes and tribal''
and inserting ``Tribes and Tribal'';
(2) in subsections (a), (c), and (d)--
(A) by striking ``approved or cleared'' each place it
appears and inserting ``approved, cleared, or otherwise
legally marketed''; and
(B) by striking ``opioid'' each place it appears;
(3) in subsection (f)--
(A) by striking ``approved or cleared'' each place it
appears and inserting ``approved, cleared, or otherwise
legally marketed'';
(B) in paragraph (1), by striking ``opioid'';
(C) in paragraph (2)--
(i) by striking ``opioid and heroin'' and inserting
``opioid, heroin, and other drug''; and
(ii) by striking ``opioid overdose'' and inserting
``overdose''; and
(D) in paragraph (3), by striking ``opioid and heroin'';
and
(4) in subsection (h), by striking ``$36,000,000 for each
of fiscal years 2019 through 2023'' and inserting
``$57,000,000 for each of fiscal years 2026 through 2030''.

SEC. 107. DONALD J. COHEN NATIONAL CHILD TRAUMATIC STRESS
INITIATIVE.

(a) Technical Amendment.--The second part G of title V of
the Public Health Service Act (42 U.S.C. 290kk et seq.), as
added by section 144 of the Community Renewal Tax Relief Act
of 2000 (Public Law 106-554), is amended--
(1) by redesignating such part as part J; and
(2) by redesignating sections 581 through 584 as sections
596 through 596C, respectively.
(b) In General.--Section 582 of the Public Health Service
Act (42 U.S.C. 290hh-1) is amended--
(1) in the section heading, by striking ``violence related
stress'' and inserting ``traumatic events'';
(2) in subsection (a)--
(A) in the matter preceding paragraph (1), by striking
``tribes and tribal'' and inserting ``Tribes and Tribal'';
and
(B) in paragraph (2), by inserting ``and dissemination''
after ``the development'';
(3) in subsection (b), by inserting ``and dissemination''
after ``the development'';
(4) in subsection (d)--
(A) by striking ``The NCTSI'' and inserting the following:
``(1) Coordinating center.--The NCTSI''; and
(B) by adding at the end the following:
``(2) NCTSI grantees.--In carrying out subsection (a)(2),
NCTSI grantees shall develop trainings and other resources,
as applicable and appropriate, to support implementation of
the evidence-based practices developed and disseminated under
such subsection.'';
(5) in subsection (e)--
(A) by redesignating paragraphs (1) and (2) as
subparagraphs (A) and (B), respectively, and adjusting the
margins accordingly;
(B) in subparagraph (A), as so redesignated, by inserting
``and implementation'' after ``the dissemination'';
(C) by striking ``The NCTSI'' and inserting the following:
``(1) Coordinating center.--The NCTSI''; and
(D) by adding at the end the following:
``(2) NCTSI grantees.--NCTSI grantees shall, as
appropriate, collaborate with other such grantees, the NCTSI
coordinating center, and the Secretary in carrying out
subsections (a)(2) and (d)(2).'';
(6) by amending subsection (h) to read as follows:
``(h) Application and Evaluation.--To be eligible to
receive a grant, contract, or cooperative agreement under
subsection (a), a public or nonprofit private entity or an
Indian Tribe or Tribal organization shall submit to the
Secretary an application at such time, in such manner, and
containing such information and assurances as the Secretary
may require, including--
``(1) a plan for the evaluation of the activities funded
under the grant, contract, or agreement, including both
process and outcomes evaluation, and the submission of an
evaluation at the end of the project period; and
``(2) a description of how such entity, Indian Tribe, or
Tribal organization will support efforts led by the Secretary
or the NCTSI coordinating center, as applicable, to evaluate
activities carried out under this section.''; and
(7) by amending subsection (j) to read as follows:
``(j) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section--
``(1) $98,887,000 for fiscal year 2026;
``(2) $98,887,000 for fiscal year 2027;
``(3) $98,887,000 for fiscal year 2028;
``(4) $100,000,000 for fiscal year 2029; and
``(5) $100,000,000 for fiscal year 2030.''.

SEC. 108. PROTECTING SUICIDE PREVENTION LIFELINE FROM
CYBERSECURITY INCIDENTS.

(a) National Suicide Prevention Lifeline Program.--Section
520E-3(b) of the Public Health Service Act (42 U.S.C. 290bb-
36c(b)) is amended--
(1) in paragraph (4), by striking ``and'' at the end;
(2) in paragraph (5), by striking the period at the end and
inserting ``; and''; and
(3) by adding at the end the following:
``(6) taking such steps as may be necessary to ensure the
suicide prevention hotline is protected from cybersecurity
incidents and eliminates known cybersecurity
vulnerabilities.''.
(b) Reporting.--Section 520E-3 of the Public Health Service
Act (42 U.S.C. 290bb-36c) is amended--
(1) by redesignating subsection (f) as subsection (g); and
(2) by inserting after subsection (e) the following:
``(f) Cybersecurity Reporting.--
``(1) Notification.--
``(A) In general.--The program's network administrator
receiving Federal funding pursuant to subsection (a) shall
report to the Assistant Secretary, in a manner that protects
personal privacy, consistent with applicable Federal and
State privacy laws--
``(i) any identified cybersecurity vulnerabilities to the
program within a reasonable amount of time after
identification of such a vulnerability; and

[[Page H2450]]

``(ii) any identified cybersecurity incidents to the
program within a reasonable amount of time after
identification of such incident.
``(B) Local and regional crisis centers.--Local and
regional crisis centers participating in the program shall
report to the program's network administrator identified
under subparagraph (A), in a manner that protects personal
privacy, consistent with applicable Federal and State privacy
laws--
``(i) any identified cybersecurity vulnerabilities to the
program within a reasonable amount of time after
identification of such vulnerability; and
``(ii) any identified cybersecurity incidents to the
program within a reasonable amount of time after
identification of such incident.
``(2) Notification.--If the program's network administrator
receiving funding pursuant to subsection (a) discovers, or is
informed by a local or regional crisis center pursuant to
paragraph (1)(B) of, a cybersecurity vulnerability or
incident, within a reasonable amount of time after such
discovery or receipt of information, such entity shall report
the vulnerability or incident to the Assistant Secretary.
``(3) Clarification.--
``(A) Oversight.--
``(i) Local and regional crisis centers.--Except as
provided in clause (ii), local and regional crisis centers
participating in the program shall oversee all technology
each center employs in the provision of services as a
participant in the program.
``(ii) Network administrator.--The program's network
administrator receiving Federal funding pursuant to
subsection (a) shall oversee the technology each crisis
center employs in the provision of services as a participant
in the program if such oversight responsibilities are
established in the applicable network participation
agreement.
``(B) Supplement, not supplant.--The cybersecurity incident
reporting requirements under this subsection shall
supplement, and not supplant, cybersecurity incident
reporting requirements under other provisions of applicable
Federal law that are in effect on the date of the enactment
of the SUPPORT for Patients and Communities Reauthorization
Act of 2025.''.
(c) Study.--Not later than 180 days after the date of the
enactment of this Act, the Comptroller General of the United
States shall--
(1) conduct and complete a study that evaluates
cybersecurity risks and vulnerabilities associated with the
9-8-8 National Suicide Prevention Lifeline; and
(2) submit a report on the findings of such study to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House
of Representatives.

SEC. 109. MONITORING AND REPORTING OF CHILD, YOUTH, AND ADULT
TRAUMA.

Section 7131(e) of the SUPPORT for Patients and Communities
Act (42 U.S.C. 242t(e)) is amended by striking ``$2,000,000
for each of fiscal years 2019 through 2023'' and inserting
``$9,000,000 for each of fiscal years 2026 through 2030''.

SEC. 110. BRUCE'S LAW.

(a) Youth Prevention and Recovery.--Section 7102(c) of the
SUPPORT for Patients and Communities Act (42 U.S.C. 290bb-
7a(c)) is amended--
(1) in paragraph (3)(A)(i), by inserting ``, which may
include strategies to increase education and awareness of the
potency and dangers of synthetic opioids (including drugs
contaminated with fentanyl) and, as appropriate, other
emerging drug use or misuse issues'' before the semicolon;
and
(2) in paragraph (4)(A), by inserting ``and strategies to
increase education and awareness of the potency and dangers
of synthetic opioids (including drugs contaminated with
fentanyl) and, as appropriate, emerging drug use or misuse
issues'' before the semicolon.
(b) Interdepartmental Substance Use Disorders Coordinating
Committee.--Section 7022 of the SUPPORT for Patients and
Communities Act (42 U.S.C. 290aa note) is amended--
(1) by striking subsection (g) and inserting the following:
``(g) Working Groups.--
``(1) In general.--The Committee may establish working
groups for purposes of carrying out the duties described in
subsection (e). Any such working group shall be composed of
members of the Committee (or the designees of such members)
and may hold such meetings as are necessary to carry out the
duties delegated to the working group.
``(2) Additional federal interagency work group on fentanyl
contamination of illegal drugs.--
``(A) Establishment.--The Secretary, acting through the
Committee, shall establish a Federal Interagency Work Group
on Fentanyl Contamination of Illegal Drugs (referred to in
this paragraph as the `Work Group') consisting of
representatives from relevant Federal departments and
agencies on the Committee.
``(B) Consultation.--The Work Group shall consult with
relevant stakeholders and subject matter experts, including--
``(i) State, Tribal, and local subject matter experts in
reducing, preventing, and responding to drug overdose caused
by fentanyl contamination of illicit drugs; and
``(ii) family members of both adults and youth who have
overdosed by fentanyl contaminated illicit drugs.
``(C) Duties.--The Work Group shall--
``(i) examine Federal efforts to reduce and prevent drug
overdose by fentanyl-contaminated illicit drugs;
``(ii) identify strategies to improve State, Tribal, and
local responses to overdose by fentanyl-contaminated illicit
drugs;
``(iii) coordinate with the Secretary, as appropriate, in
carrying out activities to raise public awareness of
synthetic opioids and other emerging drug use and misuse
issues;
``(iv) make recommendations to Congress for improving
Federal programs, including with respect to the coordination
of efforts across such programs; and
``(v) make recommendations for educating youth on the
potency and dangers of drugs contaminated by fentanyl.
``(D) Annual report to secretary.--The Work Group shall
annually prepare and submit to the Secretary, the Committee
on Health, Education, Labor, and Pensions of the Senate, and
the Committee on Energy and Commerce and the Committee on
Education and Workforce of the House of Representatives, a
report on the activities carried out by the Work Group under
subparagraph (C), including recommendations to reduce and
prevent drug overdose by fentanyl contamination of illegal
drugs, in all populations, and specifically among youth at
risk for substance misuse.''; and
(2) by striking subsection (i) and inserting the following:
``(i) Sunset.--The Committee shall terminate on September
30, 2030.''.

SEC. 111. GUIDANCE ON AT-HOME DRUG DISPOSAL SYSTEMS.

(a) In General.--Not later than one year after the date of
enactment of this Act, the Secretary of Health and Human
Services, in consultation with the Administrator of the Drug
Enforcement Administration, shall publish guidance to
facilitate the use of at-home safe disposal systems for
applicable drugs.
(b) Contents.--The guidance under subsection (a) shall
include--
(1) recommended standards for effective at-home drug
disposal systems to meet applicable requirements enforced by
the Food and Drug Administration;
(2) recommended information to include as instructions for
use to disseminate with at-home drug disposal systems;
(3) best practices and educational tools to support the use
of an at-home drug disposal system, as appropriate; and
(4) recommended use of licensed health providers for the
dissemination of education, instruction, and at-home drug
disposal systems, as appropriate.

SEC. 112. ASSESSMENT OF OPIOID DRUGS AND ACTIONS.

(a) In General.--Not later than one year after the date of
enactment of this Act, the Secretary of Health and Human
Services (referred to in this section as the ``Secretary'')
shall publish on the website of the Food and Drug
Administration (referred to in this section as the ``FDA'') a
report that outlines a plan for assessing opioid analgesic
drugs that are approved under section 505 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 355) that addresses
the public health effects of such opioid analgesic drugs as
part of the benefit-risk assessment and the activities of the
FDA that relate to facilitating the development of
nonaddictive medical products intended to treat pain or
addiction. Such report shall include--
(1) an update on the actions taken by the FDA to consider
the effectiveness, safety, benefit-risk profile, and use of
approved opioid analgesic drugs;
(2) a timeline for an assessment of the potential need, as
appropriate, for labeling changes, revised or additional
postmarketing requirements, enforcement actions, or
withdrawals for opioid analgesic drugs;
(3) an overview of the steps that the FDA has taken to
support the development and approval of nonaddictive medical
products intended to treat pain or addiction, and actions
planned to further support the development and approval of
such products; and
(4) an overview of the consideration by the FDA of clinical
trial methodologies for analgesic drugs, including the
enriched enrollment randomized withdrawal methodology, and
the benefits and drawbacks associated with different trial
methodologies for such drugs, incorporating any public input
received under subsection (b).
(b) Public Input.--In carrying out subsection (a), the
Secretary shall provide an opportunity for public input
concerning the regulation by the FDA of opioid analgesic
drugs, including scientific evidence that relates to
conditions of use, safety, or benefit-risk assessment
(including consideration of the public health effects) of
such opioid analgesic drugs.

SEC. 113. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO
OPIOID USE DISORDERS.

The activities carried out pursuant to section
1003(b)(4)(A) of the 21st Century Cures Act (42 U.S.C. 290ee-
3a(b)(4)(A)) may include facilitating access to products used
to prevent overdose deaths by detecting the presence of one
or more substances, such as fentanyl and xylazine test
strips, to the extent the purchase and possession of such
products is consistent with Federal and State law.

TITLE II--TREATMENT

SEC. 201. RESIDENTIAL TREATMENT PROGRAM FOR PREGNANT AND
POSTPARTUM WOMEN.

Section 508 of the Public Health Service Act (42 U.S.C.
290bb-1) is amended--

[[Page H2451]]

(1) in subsection (d)(11)(C), by striking ``providing
health services'' and inserting ``providing health care
services'';
(2) in subsection (g)--
(A) by inserting ``a plan describing'' after ``will
provide''; and
(B) by adding at the end the following: ``Such plan may
include a description of how such applicant will target
outreach to women disproportionately impacted by maternal
substance use disorder.''; and
(3) in subsection (s), by striking ``$29,931,000 for each
of fiscal years 2019 through 2023'' and inserting
``$38,931,000 for each of fiscal years 2026 through 2030''.

SEC. 202. IMPROVING ACCESS TO ADDICTION MEDICINE PROVIDERS.

Section 597 of the Public Health Service Act (42 U.S.C.
290ll) is amended--
(1) in subsection (a)(1), by inserting ``diagnosis,'' after
``related to''; and
(2) in subsection (b), by inserting ``addiction medicine,''
after ``psychiatry,''.

SEC. 203. MENTAL AND BEHAVIORAL HEALTH EDUCATION AND TRAINING
GRANTS.

Section 756(f) of the Public Health Service Act (42 U.S.C.
294e-1(f)) is amended by striking ``fiscal years 2023 through
2027'' and inserting ``fiscal years 2026 through 2030''.

SEC. 204. LOAN REPAYMENT PROGRAM FOR SUBSTANCE USE DISORDER
TREATMENT WORKFORCE.

Section 781(j) of the Public Health Service Act (42 U.S.C.
295h(j)) is amended by striking ``$25,000,000 for each of
fiscal years 2019 through 2023'' and inserting ``$40,000,000
for each of fiscal years 2026 through 2030''.

SEC. 205. DEVELOPMENT AND DISSEMINATION OF MODEL TRAINING
PROGRAMS FOR SUBSTANCE USE DISORDER PATIENT
RECORDS.

Section 7053 of the SUPPORT for Patients and Communities
Act (42 U.S.C. 290dd-2 note) is amended by striking
subsection (e).

SEC. 206. TASK FORCE ON BEST PRACTICES FOR TRAUMA-INFORMED
IDENTIFICATION, REFERRAL, AND SUPPORT.

Section 7132 of the SUPPORT for Patients and Communities
Act (Public Law 115-271; 132 Stat. 4046) is amended--
(1) in subsection (b)(1)--
(A) by redesignating subparagraph (CC) as subparagraph
(DD); and
(B) by inserting after subparagraph (BB) the following:
``(CC) The Administration for Community Living.'';
(2) in subsection (d)(1), in the matter preceding
subparagraph (A), by inserting ``, developmental disability
service providers'' before ``, individuals who are''; and
(3) in subsection (i), by striking ``2023'' and inserting
``2030''.

SEC. 207. GRANTS TO ENHANCE ACCESS TO SUBSTANCE USE DISORDER
TREATMENT.

Section 3203 of the SUPPORT for Patients and Communities
Act (21 U.S.C. 823 note) is amended--
(1) by striking subsection (b); and
(2) by striking ``(a) In General.--The Secretary'' and
inserting the following: ``The Secretary''.

SEC. 208. STATE GUIDANCE RELATED TO INDIVIDUALS WITH SERIOUS
MENTAL ILLNESS AND CHILDREN WITH SERIOUS
EMOTIONAL DISTURBANCE.

(a) Review of Use of Certain Funding.--Not later than 1
year after the date of enactment of this Act, the Secretary
of Health and Human Services (referred to in this section as
the ``Secretary''), acting through the Assistant Secretary
for Mental Health and Substance Use, shall conduct a review
of State use of funds made available under the Community
Mental Health Services Block Grant program under subpart I of
part B of title XIX of the Public Health Service Act (42
U.S.C. 300x et seq.) (referred to in this section as the
``block grant program'') for first episode psychosis
activities. Such review shall consider the following:
(1) How States use funds for evidence-based treatments and
services according to the standard of care for individuals
with early serious mental illness and children with a serious
emotional disturbance.
(2) The percentages of the State funding under the block
grant program expended on early serious mental illness and
first episode psychosis, and the number of individuals served
under such funds.
(b) Report and Guidance.--
(1) Report.--Not later than 180 days after the completion
of the review under subsection (a), the Secretary shall
submit to the Committee on Health, Education, Labor, and
Pensions and the Committee on Appropriations of the Senate
and the Committee on Energy and Commerce and the Committee on
Appropriations of the House of Representatives a report
describing--
(A) the findings of the review under subsection (a); and
(B) any recommendations for changes to the block grant
program that would facilitate improved outcomes for
individuals with serious mental illness and children with
serious emotional disturbance.
(2) Guidance.--Not later than 1 year after the date on
which the report is submitted under paragraph (1), the
Secretary shall update the guidance provided to States under
the block grant program on coordinated specialty care and
other evidence-based mental health care services for
individuals with serious mental illness and children with a
serious emotional disturbance, based on the findings and
recommendations of such report.

SEC. 209. REVIEWING THE SCHEDULING OF APPROVED PRODUCTS
CONTAINING A COMBINATION OF BUPRENORPHINE AND
NALOXONE.

(a) Secretary of HHS.--The Secretary of Health and Human
Services shall, consistent with the requirements and
procedures set forth in sections 201 and 202 of the
Controlled Substances Act (21 U.S.C. 811, 812)--
(1) review the relevant data pertaining to the scheduling
of products containing a combination of buprenorphine and
naloxone that have been approved under section 505 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355); and
(2) if appropriate, request that the Attorney General
initiate rulemaking proceedings to revise the schedules
accordingly with respect to such products.
(b) Attorney General.--The Attorney General shall review
any request made by the Secretary of Health and Human
Services under subsection (a)(2) and determine whether to
initiate proceedings to revise the schedules in accordance
with the criteria set forth in sections 201 and 202 of the
Controlled Substances Act (21 U.S.C. 811, 812).

TITLE III--RECOVERY

SEC. 301. BUILDING COMMUNITIES OF RECOVERY.

Section 547(f) of the Public Health Service Act (42 U.S.C.
290ee-2(f)) is amended by striking ``$5,000,000 for each of
fiscal years 2019 through 2023'' and inserting ``$17,000,000
for each of fiscal years 2026 through 2030''.

SEC. 302. PEER SUPPORT TECHNICAL ASSISTANCE CENTER.

Section 547A of the Public Health Service Act (42 U.S.C.
290ee-2a) is amended--
(1) in subsection (b)(4), by striking ``building; and'' and
inserting the following: ``building, such as--
``(A) professional development of peer support specialists;
and
``(B) making recovery support services available in
nonclinical settings; and'';
(2) by redesignating subsections (d) and (e) as subsections
(e) and (f), respectively;
(3) by inserting after subsection (c) the following:
``(d) Regional Centers.--
``(1) In general.--The Secretary may establish one regional
technical assistance center (referred to in this subsection
as the `Regional Center'), with existing resources, to assist
the Center in carrying out activities described in subsection
(b) within the geographic region of such Regional Center in a
manner that is tailored to the needs of such region.
``(2) Evaluation.--Not later than 4 years after the date of
enactment of the SUPPORT for Patients and Communities
Reauthorization Act of 2025, the Secretary shall evaluate the
activities of the Regional Center and submit to the Committee
on Health, Education, Labor, and Pensions of the Senate and
the Committee on Energy and Commerce of the House of
Representatives a report on the findings of such evaluation,
including--
``(A) a description of the distinct roles and
responsibilities of the Regional Center and the Center;
``(B) available information relating to the outcomes of the
Regional Center under this subsection, such as any impact on
the operations and efficiency of the Center relating to
requests for technical assistance and support within the
region of such Regional Center;
``(C) a description of any gaps or areas of duplication
relating to the activities of the Regional Center and the
Center within such region; and
``(D) recommendations relating to the modification,
expansion, or termination of the Regional Center under this
subsection.
``(3) Termination.--This subsection shall terminate on
September 30, 2030.''; and
(4) in subsection (f), as so redesignated, by striking
``$1,000,000 for each of fiscal years 2019 through 2023'' and
inserting ``$2,000,000 for each of fiscal years 2026 through
2030''.

SEC. 303. COMPREHENSIVE OPIOID RECOVERY CENTERS.

Section 552 of the Public Health Service Act (42 U.S.C.
290ee-7) is amended--
(1) in subsection (d)(2)--
(A) in the matter preceding subparagraph (A), by striking
``and in such manner'' and inserting ``, in such manner, and
containing such information and assurances, including
relevant documentation,''; and
(B) in subparagraph (A), by striking ``is capable of
coordinating with other entities to carry out'' and inserting
``has the demonstrated capability to carry out, through
referral or contractual arrangements'';
(2) in subsection (h)--
(A) by redesignating paragraphs (1) through (4) as
subparagraphs (A) through (D), respectively, and adjusting
the margins accordingly;
(B) by striking ``With respect to'' and inserting the
following:
``(1) In general.--With respect to''; and
(C) by adding at the end the following:
``(2) Additional reporting for certain eligible entities.--
An entity carrying out activities described in subsection (g)
through referral or contractual arrangements shall include in
the submissions required under paragraph (1) information
related to the status of such referrals or contractual
arrangements, including an assessment of whether such
referrals or contractual arrangements are supporting the
ability of such entity to carry out such activities.''; and
(3) in subsection (j), by striking ``2019 through 2023''
and inserting ``2026 through 2030''.

SEC. 304. YOUTH PREVENTION AND RECOVERY.

Section 7102(c) of the SUPPORT for Patients and Communities
Act (42 U.S.C. 290bb-

[[Page H2452]]

7a(c)) (as amended by section 110(a)) is amended--
(1) in paragraph (2)--
(A) in subparagraph (A)--
(i) in clause (i)--

(I) by inserting ``, or a consortium of local educational
agencies,'' after ``a local educational agency''; and
(II) by striking ``high schools'' and inserting ``secondary
schools''; and

(ii) in clause (vi), by striking ``tribe, or tribal'' and
inserting ``Tribe, or Tribal'';
(B) by amending subparagraph (E) to read as follows:
``(E) Indian tribe; tribal organization.--The terms `Indian
Tribe' and `Tribal organization' have the meanings given such
terms in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 5304).'';
(C) by redesignating subparagraph (K) as subparagraph (L);
and
(D) by inserting after subparagraph (J) the following:
``(K) Secondary school.--The term `secondary school' has
the meaning given such term in section 8101 of the Elementary
and Secondary Education Act of 1965 (20 U.S.C. 7801).'';
(2) in paragraph (3)(A), in the matter preceding clause
(i)--
(A) by striking ``and abuse''; and
(B) by inserting ``at increased risk for substance misuse''
after ``specific populations'';
(3) in paragraph (4)--
(A) in the matter preceding subparagraph (A), by striking
``Indian tribes'' and inserting ``Indian Tribes'';
(B) in subparagraph (A), by striking ``and abuse''; and
(C) in subparagraph (B), by striking ``peer mentoring'' and
inserting ``peer-to-peer support'';
(4) in paragraph (5), by striking ``tribal'' and inserting
``Tribal'';
(5) in paragraph (6)(A)--
(A) in clause (iv), by striking ``; and'' and inserting a
semicolon; and
(B) by adding at the end the following:
``(vi) a plan to sustain the activities carried out under
the grant program, after the grant program has ended; and'';
(6) in paragraph (8), by striking ``2022'' and inserting
``2028''; and
(7) by amending paragraph (9) to read as follows:
``(9) Authorization of appropriations.--To carry out this
subsection, there are authorized to be appropriated--
``(A) $10,000,000 for fiscal year 2026;
``(B) $12,000,000 for fiscal year 2027;
``(C) $13,000,000 for fiscal year 2028;
``(D) $14,000,000 for fiscal year 2029; and
``(E) $15,000,000 for fiscal year 2030.''.

SEC. 305. CAREER ACT.

(a) In General.--Section 7183 of the SUPPORT for Patients
and Communities Act (42 U.S.C. 290ee-8) is amended--
(1) in the section heading, by inserting ``; treatment,
recovery, and workforce support grants'' after ``career
act'';
(2) in subsection (b), by inserting ``each'' before ``for a
period'';
(3) in subsection (c)--
(A) in paragraph (1), by striking ``the rates described in
paragraph (2)'' and inserting ``the average rates for
calendar years 2018 through 2022 described in paragraph
(2)''; and
(B) by amending paragraph (2) to read as follows:
``(2) Rates.--The rates described in this paragraph are the
following:
``(A) The highest age-adjusted average rates of drug
overdose deaths for calendar years 2018 through 2022 based on
data from the Centers for Disease Control and Prevention,
including, if necessary, provisional data for calendar year
2022.
``(B) The highest average rates of unemployment for
calendar years 2018 through 2022 based on data provided by
the Bureau of Labor Statistics.
``(C) The lowest average labor force participation rates
for calendar years 2018 through 2022 based on data provided
by the Bureau of Labor Statistics.'';
(4) in subsection (g)--
(A) in each of paragraphs (1) and (3), by redesignating
subparagraphs (A) and (B) as clauses (i) and (ii),
respectively, and adjusting the margins accordingly;
(B) by redesignating paragraphs (1) through (3) as
subparagraphs (A) through (C), respectively, and adjusting
the margins accordingly;
(C) in the matter preceding subparagraph (A) (as so
redesignated), by striking ``An entity'' and inserting the
following:
``(1) In general.--An entity''; and
(D) by adding at the end the following:
``(2) Transportation services.--An entity receiving a grant
under this section may use not more than 5 percent of the
funds for providing transportation for individuals to
participate in an activity supported by a grant under this
section, which transportation shall be to or from a place of
work or a place where the individual is receiving vocational
education or job training services or receiving services
directly linked to treatment of or recovery from a substance
use disorder.
``(3) Limitation.--The Secretary may not require an entity
to, or give priority to an entity that plans to, use the
funds of a grant under this section for activities that are
not specified in this subsection.'';
(5) in subsection (i)(2), by inserting ``, which shall
include employment and earnings outcomes described in
subclauses (I) and (III) of section 116(b)(2)(A)(i) of the
Workforce Innovation and Opportunity Act (29 U.S.C.
3141(b)(2)(A)(i)) with respect to the participation of such
individuals with a substance use disorder in programs and
activities funded by the grant under this section'' after
``subsection (g)'';
(6) in subsection (j)--
(A) in paragraph (1), by inserting ``for grants awarded
prior to the date of enactment of the SUPPORT for Patients
and Communities Reauthorization Act of 2025'' after ``grant
period under this section''; and
(B) in paragraph (2)--
(i) in the matter preceding subparagraph (A), by striking
``2 years after submitting the preliminary report required
under paragraph (1)'' and inserting ``September 30, 2030'';
and
(ii) in subparagraph (A), by striking ``(g)(3)'' and
inserting ``(g)(1)(C)''; and
(7) in subsection (k), by striking ``$5,000,000 for each of
fiscal years 2019 through 2023'' and inserting ``$12,000,000
for each of fiscal years 2026 through 2030''.
(b) Reauthorization of the CAREER Act; Recovery Housing
Pilot Program.--
(1) In general.--Section 8071 of the SUPPORT for Patients
and Communities Act (42 U.S.C. 5301 note; Public Law 115-271)
is amended--
(A) by striking the section heading and inserting ``career
act; recovery housing pilot program'';
(B) in subsection (a), by striking ``through 2023'' and
inserting ``through 2030'';
(C) in subsection (b)--
(i) in paragraph (1), by striking ``not later than 60 days
after the date of enactment of this Act'' and inserting ``not
later than 60 days after the date of enactment of the SUPPORT
for Patients and Communities Reauthorization Act of 2025'';
and
(ii) in paragraph (2)(B)(i)--

(I) in subclause (I)--

(aa) by striking ``for calendar years 2013 through 2017'';
and
(bb) by inserting ``for calendar years 2018 through 2022''
after ``rates of unemployment'';

(II) in subclause (II)--

(aa) by striking ``for calendar years 2013 through 2017'';
and
(bb) by inserting ``for calendar years 2018 through 2022''
after ``participation rates''; and

(III) by striking subclause (III) and inserting the
following:
``(III) The highest age-adjusted average rates of drug
overdose deaths for calendar years 2018 through 2022 based on
data from the Centers for Disease Control and Prevention,
including, if necessary, provisional data for calendar year
2022.''; and

(D) in subsection (f), by striking ``For the 2-year period
following the date of enactment of this Act, the'' and
inserting ``The''.
(2) Conforming amendment.--Subtitle F of title VIII of the
SUPPORT for Patients and Communities Act (Public Law 115-271;
132 Stat. 4095) is amended by striking the subtitle heading
and inserting the following: ``Subtitle F--CAREER Act;
Recovery Housing Pilot Program'' .
(c) Clerical Amendments.--The table of contents in section
1(b) of the SUPPORT for Patients and Communities Act (Public
Law 115-271; 132 Stat. 3894) is amended--
(1) by striking the item relating to section 7183 and
inserting the following:

``Sec. 7183. CAREER Act; treatment, recovery, and workforce support
grants.'';
(2) by striking the item relating to subtitle F of title
VIII and inserting the following:

``Subtitle F--CAREER Act; Recovery Housing Pilot Program''; and

(3) by striking the item relating to section 8071 and
inserting the following:

``Sec. 8071. CAREER Act; Recovery Housing Pilot Program.''.

SEC. 306. ADDRESSING ECONOMIC AND WORKFORCE IMPACTS OF THE
OPIOID CRISIS.

Section 8041(g)(1) of the SUPPORT for Patients and
Communities Act (29 U.S.C. 3225a(g)(1)) is amended by
striking ``2023'' and inserting ``2030''.

TITLE IV--MISCELLANEOUS MATTERS

SEC. 401. DELIVERY OF A CONTROLLED SUBSTANCE BY A PHARMACY TO
A PRESCRIBING PRACTITIONER.

Section 309A(a) of the Controlled Substances Act (21 U.S.C.
829a(a)) is amended by striking paragraph (2) and inserting
the following:
``(2) the controlled substance is a drug in schedule III,
IV, or V to be administered--
``(A) by injection or implantation for the purpose of
maintenance or detoxification treatment; or
``(B) subject to a risk evaluation and mitigation strategy
pursuant to section 505-1 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355-1) that includes elements to
assure safe use of the drug described in subsection (f)(3)(E)
of such section, including a requirement for post-
administration monitoring by a health care provider;''.

SEC. 402. REQUIRED TRAINING FOR PRESCRIBERS OF CONTROLLED
SUBSTANCES.

(a) In General.--Section 303 of the Controlled Substances
Act (21 U.S.C. 823) is amended--
(1) by redesignating the second subsection designated as
subsection (l) as subsection (m); and
(2) in subsection (m)(1), as so redesignated--
(A) in subparagraph (A)--
(i) in clause (iv)--

(I) in subclause (I)--

[[Page H2453]]

(aa) by inserting ``the American Academy of Family
Physicians, the American Podiatric Medical Association, the
Academy of General Dentistry, the American Optometric
Association,'' before ``or any other organization'';
(bb) by striking ``or the Commission'' and inserting ``,
the Commission''; and
(cc) by inserting ``, or the Council on Podiatric Medical
Education'' before the semicolon at the end; and

(II) in subclause (III), by inserting ``or the American
Academy of Family Physicians'' after ``Association''; and

(ii) in clause (v), in the matter preceding subclause (I)--

(I) by striking ``osteopathic medicine, dental surgery''
and inserting ``osteopathic medicine, podiatric medicine,
dental surgery''; and
(II) by striking ``or dental medicine curriculum'' and
inserting ``or dental or podiatric medicine curriculum''; and

(B) in subparagraph (B)--
(i) in clause (i)--

(I) by inserting ``the American Pharmacists Association,
the Accreditation Council on Pharmacy Education, the American
Psychiatric Nurses Association, the American Academy of
Nursing, the American Academy of Family Physicians,'' before
``or any other organization''; and
(II) by inserting ``, the American Academy of Family
Physicians,'' before ``or the Accreditation Council''; and

(ii) in clause (ii)--

(I) by striking ``or accredited school'' and inserting ``,
an accredited school''; and
(II) by inserting ``, or an accredited school of pharmacy''
before ``in the United States''.

(b) Effective Date.--The amendment made by subsection (a)
shall take effect as if enacted on December 29, 2022.

The CHAIR. No further amendment to the bill, as amended, shall be in
order except those printed in part A of House Report 119-130. Each such
further amendment may be offered only in the order printed in the
report, by a Member designated in the report, shall be considered read,
shall be debatable for the time specified in the report equally divided
and controlled by the proponent and an opponent, shall not be subject
to amendment, and shall not be subject to a demand for division of the
question.

Amendment No. 1 Offered by Mr. Bresnahan

The CHAIR. It is now in order to consider amendment No. 1 printed in
part A of House Report 119-130.
Mr. BRESNAHAN. Mr. Chair, I have an amendment at the desk.
The CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:
At the end of title II, add the following:

SEC. __. REFERENCES TO OPIOID OVERDOSE REVERSAL AGENTS IN HHS
GRANT PROGRAMS.

(a) In General.--The Secretary of Health and Human Services
shall ensure that, as appropriate, whenever the Department of
Health and Human Services issues a regulation or guidance for
any grant program addressing opioid misuse and use disorders,
any reference to an opioid overdose reversal drug (such as a
reference to naloxone) is inclusive of any opioid overdose
reversal drug that has been approved under section 505 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355) for
emergency treatment of a known or suspected opioid overdose.
(b) Existing References.--
(1) Update.--Not later than one year after the date of
enactment of this Act, the Secretary of Health and Human
Services shall update all references described in paragraph
(2) to be inclusive of any opioid overdose reversal drug that
has been approved or otherwise authorized for use by the Food
and Drug Administration.
(2) References.--A reference described in this paragraph is
any reference to an opioid overdose reversal drug (such as
naloxone) in any regulation or guidance of the Department of
Health and Human Services that--
(A) was issued before the date of enactment of this Act;
and
(B) is included in--
(i) the grant program for State and Tribal response to
opioid use disorders under section 1003 of the 21st Century
Cures Act (42 U.S.C. 290ee-3 note) (commonly referred to as
``State Opioid Response Grants'' and ``Tribal Opioid Response
Grants''); or
(ii) the grant program for priority substance use disorder
prevention needs of regional and national significance under
section 516 of the Public Health Service Act (42 U.S.C.
290bb-22).

The CHAIR. Pursuant to House Resolution 458, the gentleman from
Pennsylvania (Mr. Bresnahan) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentleman from Pennsylvania.
Mr. BRESNAHAN. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, today I rise on my amendment to H.R. 2483, the SUPPORT for
Patients and Communities Reauthorization Act of 2025. Opioids, like
fentanyl, are incredibly dangerous. Last year, our Nation lost just
over 80,000 people to drug overdoses. That is 220 per day. In my home
State of Pennsylvania, someone dies of a drug overdose every 2 hours.
As we work to stop these dangerous drugs from entering the country,
it is important we make available the necessary resources to reverse
opioid overdoses as they happen. Emergency opioid overdose reversal
drugs are a lifeline, having the ability to save so many lives.
Currently, HHS regulations refer to certain name brand drugs, such as
Narcan, which can limit usage of other versions that may be more
readily available.
My amendment would require HHS regulations or guidance documents to
include any opioid overdose reversal drug approved by the FDA when
referring to these emergency drugs. This will expand and ensure better
access to these lifesaving drugs.
I lost my 16-year-old cousin to a drug overdose. It is incredibly
important to me that we are not limiting access to these resources.
By adjusting current regulations and language, we are protecting our
children, our families, and our communities. I encourage my colleagues
on both sides of the aisle to save lives and support this amendment.
Mr. Chair, I reserve the balance of my time.
Mr. PALLONE. Mr. Chair, I claim the time in opposition.
The CHAIR. The gentleman from New Jersey is recognized for 5 minutes.
Mr. PALLONE. Mr. Chair, I have no statement to make with regard to
the legislation. I will yield back after the gentleman closes. I
reserve the balance of my time.
Mr. BRESNAHAN. Mr. Chair, in closing, I urge my colleagues to vote
``yes'' on this amendment, and I yield back the balance of my time.
Mr. PALLONE. Mr. Chair, I yield back the balance of my time.
The CHAIR. The question is on the amendment offered by the gentleman
from Pennsylvania (Mr. Bresnahan).
The amendment was agreed to.

Amendment No. 2 Offered by Mrs. Kiggans of Virginia

The CHAIR. It is now in order to consider amendment No. 2 printed in
part A of House Report 119-130.
Mrs. KIGGANS of Virginia. Mr. Chair, I have an amendment at the desk.
The CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:

At the end of title II, add the following:

SEC. __. ROUNDTABLE ON USING HEALTH INFORMATION TECHNOLOGY TO
IMPROVE MENTAL HEALTH AND SUBSTANCE USE CARE
OUTCOMES.

(a) Roundtable.--Not later than 180 days after the date of
enactment of this Act, the National Coordinator for Health
Information Technology shall convene a public roundtable to
examine--
(1) how the expanded use of electronic health records among
mental health and substance use service providers can improve
outcomes for patients in mental health and substance use
settings; and
(2) how best to increase electronic health record adoption
among such providers.
(b) Participants.--The National Coordinator for Health
Information Technology shall ensure that the participants in
the roundtable under subsection (a) include private and
public sector stakeholders, including patients, providers
(including providers of inpatient services and providers of
outpatient services), and representatives of payors, health
information exchanges, professional associations, health
information technology vendors, health information technology
certification organizations, and State and Federal agencies.
(c) Report.--Not later than 180 days after the conclusion
of the public stakeholder roundtable under subsection (a),
the National Coordinator for Health Information Technology
shall submit to the Committee on Health, Education, Labor,
and Pensions of the Senate and the Committee on Energy and
Commerce of the House of Representatives a report outlining
information gathered from the roundtable under subsection
(a). Such report shall include an examination of--
(1) recommendations from the roundtable participants;
(2) unique considerations for using electronic health
record systems in mental health and substance use treatment
settings;
(3) unique considerations for developers of health
information technology relating to certification of
electronic health record systems for use in mental health and
substance use treatment settings where the applicable health
information technology is not subject to certification
requirements;
(4) current usage of electronic health record systems by
mental health and substance use disorder service providers,
and the

[[Page H2454]]

scope and magnitude of such providers that do not use
electronic health record systems;
(5) examples of how electronic health record systems enable
coordinated care and care management;
(6) how electronic health record systems advance
appropriate patient and provider access to secure, usable
electronic information exchange;
(7) how electronic health record systems can be connected
to or support existing systems, which may include the 9-8-8
National Suicide Prevention Lifeline, mobile crisis response
systems, and co-responder programs, to facilitate
connectivity, response, and integrated care;
(8) any existing programs to support greater adoption of
electronic health record systems among mental health and
substance use service providers;
(9) any limitations to greater adoption of electronic
health record systems among mental health and substance use
service providers;
(10) the costs of adoption of electronic health record
systems by mental health and substance use disorder service
providers; and
(11) best practices implemented by States and other
entities to support adoption of use of electronic health
records among mental health and substance use disorder
service providers.

The CHAIR. Pursuant to House Resolution 458, the gentlewoman from
Virginia (Mrs. Kiggans) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentlewoman from Virginia.
Mrs. KIGGANS of Virginia. Mr. Chair, I yield myself such time as I
may consume.
Mr. Chair, I rise today in support of my amendment. More than 50
million American adults consider themselves to be in recovery from a
substance use disorder or mental health condition.
In order to ensure that more patients can reach recovery, we must
bolster treatment integration and wraparound services for patients
suffering from substance use disorder and addiction.
This amendment directs the National Coordinator for Health
Information Technology to convene a public roundtable to examine the
use of electronic health records among certain providers and issue a
report of the findings. This would better inform policymakers about the
existing landscape and uptake of certain providers utilizing electronic
health records.
In closing, I urge support of this important amendment as well as the
underlying bill. I reserve the balance of my time.
Mr. PALLONE. Mr. Chair, I claim the time in opposition.
The CHAIR. The gentleman from New Jersey is recognized for 5 minutes.
Mr. PALLONE. Mr. Chair, I have no statement to make at this time. I
will yield back after the gentlewoman closes. I reserve the balance of
my time.
Mrs. KIGGANS of Virginia. Mr. Chair, in closing, I urge my colleagues
to vote ``yes'' on my amendment, and I yield back the balance of my
time.
Mr. PALLONE. Mr. Chair, I yield back the balance of my time.
The CHAIR. The question is on the amendment offered by the
gentlewoman from Virginia (Mrs. Kiggans).
The amendment was agreed to.

Amendment No. 3 Offered by Ms. Pettersen

The CHAIR. It is now in order to consider amendment No. 3 printed in
part A of House Report 119-130.
Ms. PETTERSEN. Mr. Chair, I have an amendment at the desk.
The CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:

At the end of title IV, add the following:

SEC. __. CODIFICATION OF BUDGET NEUTRALITY GUIDANCE IN SMD
#24-003.

The guidance for budget neutrality for Medicaid
demonstration projects under section 1115(a) of the Social
Security Act (42 U.S.C. 1315(a)) described in State Medicaid
Director letter #24-003 of the Centers for Medicare &
Medicaid Services (published on August 22, 2024) shall have
the force and effect of law.

The CHAIR. Pursuant to House Resolution 458, the gentlewoman from
Colorado (Ms. Pettersen) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentlewoman from Colorado.
Ms. PETTERSEN. Mr. Chair, I yield myself such time as I may consume.
Mr. Chair, I am here to beg for your consideration in support of my
amendment to address something that happened with the reconciliation
bill that changed the 1115 waiver.
Now, this sounds incredibly wonky. An 1115 waiver to Medicaid is
something that we are not going to be able to go home and talk to
constituents about what we were able to do for them. Nobody knows what
the 1115 waiver is.
However, when you talk about the impacts that this has made, this is
especially impactful when it comes to Colorado and what we have been
able to do to address the opioid epidemic. In Colorado, we were able to
utilize the 1115 waiver by proving that by covering substance use
disorder treatment, we could save money over time.
What happened in the reconciliation bill was language that said you
actually had to prove that it was cost neutral up front and that you
couldn't prove the cost savings over time.
What this language will do, it will take our ability in Colorado away
to utilize this waiver that has drawn down hundreds of millions of
dollars for substance use disorder treatment. In fact, we were the
second in the Nation to implement this waiver, and a total of 37 States
now take advantage of this.
Mr. Chair, 83 percent of people who are treated in the rural parts of
Colorado and across the Nation are on Medicaid. This will significantly
impact red States, blue States, and especially the rural places across
the United States.
Like many people, my family has been impacted by the opioid epidemic.
When I was just 6 years old, my mom hurt her back. She was
overprescribed opioids and became addicted like so many Americans.
Through my struggle fighting to save my mom's life, I saw how broken
our system was, and that is when I worked as a State legislator to
change that.
What I saw in my mom's fight when she was overdosing at a high rate
when fentanyl started coming into the supply chain, and she was begging
for help with nowhere to go, was that Medicaid did not cover substance
use disorder treatment. You actually had to go through this waiver
process.
I watched my mom being churned in and out of the ER, being kept alive
in the ICU in critical condition. The State of Colorado and the Federal
Government spent over a million dollars in one year keeping her alive
in the ER while denying her access to the care that she so desperately
sought.
I was finally able to go through a very complicated court order
process to get her the care that she needed. My mom now is about to
celebrate 8 years in recovery. She works at one of the places that
saved her life and gives back to the community. She is a taxpayer. She
is an example of what is possible when we actually invest in people and
give them the care that they need.
After hearing her story, we were able to implement this waiver to
really increase our capacity as a State to address the opioid crisis.
We know that more people have died from the opioid crisis than all
world wars combined, and these are people that we didn't have to lose
if we actually had the system to support them.

{time} 1515

Mr. Chairman, by rolling back this language, you are decimating the
substance use disorder treatment across the United States in 37 States
and many right now who are in the process of applying for the waiver
and who are looking to Colorado as an example.
This would mean hundreds of millions of dollars of treatment we would
be denied. The first year alone, we treated 58,000 people with the care
that they needed in Colorado. This is 5 years with implementation. It
is the reason why we now have a 35 percent reduction in overdose deaths
in Colorado. It is overwhelmingly the reason.
Addressing the Medicaid barrier is so important. Let me explain why.
People who struggle with the substance use disorder, this brain
disease, it increases the likelihood of a decrease in employment.
Mr. Chairman, 80 to 90 percent of people who are struggling with
substance use disorder qualify for Medicaid. When the treatment they
need and the healthcare they need is not covered and the healthcare
system they are relying on is dismantled, the people in this community
who are the most vulnerable are disproportionately impacted.
On a day when we are working to ensure that some of the critical
programs at the Federal level are funded in this bill which is an
important piece of this, we also have to support the structure

[[Page H2455]]

and the payment system that supports the people on the ground who are
doing this work.
It took us years to bring the study, bring the waiver, and prove that
this would be a cost savings over time, and then to implement it.
Madam Chair, I yield back the balance of my time.
Mr. GUTHRIE. Madam Chair, I rise in opposition to the amendment.
The Acting CHAIR (Ms. King-Hinds). The gentleman from Kentucky is
recognized for 5 minutes.
Mr. GUTHRIE. Madam Chair, I yield myself such time as I may consume.
Madam Chair, I really appreciate the hard work of the gentlewoman
from Colorado (Ms. Pettersen) on this issue. She is a leader in
Congress on substance use disorder.
I actually didn't know the story of my friend from Colorado's mother.
Certainly, when someone is touched by an issue, they certainly become
passionate about it. I greatly appreciate her passion on the issue.
The section 1115 waivers are important to the Medicaid program.
States are the laboratories for democracy. Section 1115 waivers provide
key State flexibility to test new authorities and ideas in the Medicaid
program.
In substance use disorder alone, 1115 waivers were pivotal in early
efforts to lift the IMD exclusion, an obsolete edifice to the Medicaid
program that undermines access to mental health care and substance use
disorder care by only allowing for Medicaid to reimburse for care in-
patient facilities with fewer than 16 beds.
Under President Trump's guidance, in 2018, States were able to use
1115 waivers to waive the IMD exclusion, expanding access to care as
the opioid epidemic began to grow worse.
After 5 years of State experimentation with 1115 waivers to lift the
IMD exclusion, Congress stepped in and ultimately lifted the IMD
exclusion. We took on that initiative in 2023, alongside the rest of
the SUPPORT for Patients and Communities Act. We were able to get that
signed into law, even when the Senate blocked the rest of the SUPPORT
for Patients and Communities Act, because it was important to get it
done.
The 1115 waivers have been on the books for decades, and States have
used them a multitude of ways to transform the Medicaid program. A key
tenet of those waivers, though, is that they have to be budget neutral.
This wasn't a problem when 1115 waivers were used to lift the IMD
exclusion. States were clearly able to demonstrate how early access to
care reduced emergency room services.
Nonetheless, the Biden administration in the use of 1115 waiver
authorities put forth new guidance that allowed States to rely on so-
called hypothetical expenditures that let States spend Medicaid dollars
on services that were over budget and unrelated to the core functions
of the Medicaid program.
Some examples of this included paying for air conditioning systems
for beneficiaries and for providing payments for legal support for
beneficiaries. This isn't to say that HVAC systems in a hot climate or
legal supports aren't important or may have some potential relation to
someone's health, but they fall far outside the scope of what Medicaid
is intended for. They open the door for States to draw down Federal
funds or for services that are oftentimes entirely funded by the
States.
In 2023, as the then-subcommittee chairman for Energy and Commerce's
Health Subcommittee, I raised concerns with that direction with the
Biden administration as they were moving toward these waivers.
Specifically, in this CMS, I wrote:
``The committee is also concerned about the potential for fraud,
waste, and abuse in calculation and application of States' budget
neutrality limits under Section 1115 Medicaid waivers.''
As chairman of the full committee, those concerns remain. Madam
Chair, 2 weeks ago, House Republicans began to take steps to address
this. In the reconciliation bill that we passed, we included key
language to require stricter adherence to the budget neutrality
requirements for 1115 waivers.
It doesn't matter if the President is Democrat or Republican who is
approving these waivers. It needs to be budget neutral. We need to be
good stewards for programs like Medicaid and to make sure that it is
spending in a fiscally responsible manner and that we aren't just
writing blank checks to States who can spend money how they choose.
I will close by saying I greatly appreciate the leadership my friend
from Colorado has shown. She is a leader in this House and in ensuring
that we deal with as much as we possibly can in every way possible with
substance use disorder. I believe we need to stick to the budget
neutrality.

Madam Chair, I oppose the amendment, and I yield back the balance of
my time.
The Acting CHAIR. The question is on the amendment offered by the
gentlewoman from Colorado (Ms. Pettersen).
The question was taken; and the Acting Chair announced that the noes
appeared to have it.
Ms. PETTERSEN. Madam Chair, I demand a recorded vote.
The Acting CHAIR. Pursuant to clause 6 of rule XVIII, further
proceedings on the amendment offered by the gentlewoman from Colorado
will be postponed.

Amendment No. 4 Offered by Mr. Wittman

The Acting CHAIR. It is now in order to consider amendment No. 4
printed in part A of House Report 119-130.
Mr. WITTMAN. Madam Chair, I have an amendment at the desk.
The Acting CHAIR. The Clerk will designate the amendment.
The text of the amendment is as follows:

At the end of title III, add the following:

SEC. __. REVIEW OF INFORMATION RELATED TO FUNDING
OPPORTUNITIES UNDER PROGRAMS ADMINISTERED BY
SAMHSA.

(a) In General.--Not later than one year after the date of
enactment of this Act, the Secretary of Health and Human
Services (referred to in this section as the ``Secretary'')
shall convene a public meeting for purposes of improving
awareness of, and access to, information related to current
and future funding opportunities under programs administered
by the Substance Abuse and Mental Health Services
Administration (in this section referred to as ``SAMHSA
funding opportunities'').
(b) Topics.--The public meeting under subsection (a) shall
include--
(1) opportunities to improve the utility and functionality
of internet websites maintained by the Secretary that provide
information related to SAMHSA funding opportunities, such as
Grants.gov;
(2) other models for displaying and disseminating
information related to SAMHSA funding opportunities, such as
interactive dashboards; and
(3) strategies to improve the ability of entities to apply
for SAMHSA funding opportunities, including entities that
have not traditionally applied for SAMHSA funding
opportunities.
(c) Website Improvements.--The Secretary shall implement
improvements to Grants.gov related to SAMHSA funding
opportunities based on stakeholder feedback received at the
public meeting under subsection (a), as appropriate, to the
maximum extent feasible.
(d) Report.--Not later than one year after the date on
which the public meeting under subsection (a) is convened,
the Secretary shall submit to the Committee on Health,
Education, Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House of
Representatives a report summarizing the findings of such
meeting, including how the Secretary has taken into account
the feedback received through such meeting and implemented--
(1) improvements to internet websites maintained by the
Secretary that provide information related to SAMHSA funding
opportunities; and
(2) strategies to improve awareness of SAMHSA funding
opportunities.

The Acting CHAIR. Pursuant to House Resolution 458, the gentleman
from Virginia (Mr. Wittman) and a Member opposed each will control 5
minutes.
The Chair recognizes the gentleman from Virginia.
Mr. WITTMAN. Madam Chair, I yield myself such time as I may consume.
Madam Chair, I rise today in support of my amendment. In 2018, the
Substance Use-Disorder Prevention that Promotes Opioid Recovery and
Treatment for Patients and Communities, otherwise known as the SUPPORT
for Patients and Communities Act, was signed into law.
In the years since, the bill has provided States and localities with
the tools to combat the opioid crisis.
The crisis, the scourge of this Nation, as of 2024 has taken the
lives of nearly 80,000 Americans. That is nearly 240 Americans every
day last year. That is equivalent to a jet airliner crashing every day.
If that were happening

[[Page H2456]]

every day, it would make the headlines. People would be up in arms,
saying: What are we doing about air safety? We should be doing that. We
should also be addressing issues with the opioid crisis.
While I am encouraged to see that number beginning to recede, it is
still way too high. The drop in number in 2023 is a good direction, but
there is still lots of work to be done.
That is why today I rise in support of an amendment to H.R. 2483, the
SUPPORT for Patients and Communities Reauthorization Act of 2025. This
amendment would require the Department of Health and Human Services to
convene a public hearing to improve awareness of, access to, and
information related to funding opportunities related to mental health
and SUD programs within SAMHSA, S-A-M-H-S-A.
This would be a review of not only current funding activities but
future funding activities. These activities would increase much-needed
awareness of important tools within States and localities.
Many times, there are tools there that people or local governments
are not aware of. This is going to extend and make sure everybody is
aware of the full scope of tools that are available to address the
scourge of this fentanyl crisis.
By closing this knowledge gap, we are going to help patients,
providers, and families with key access. Again, it is about getting
treatment for this addiction. This is a very debilitating addiction. It
is a biochemical addiction. It is something that takes a lot of effort
in order to separate people from that addiction.
This effort saves lives. It makes a difference in families. Families
that have been victimized by this addiction crisis will explain how
debilitating it is not just to their loved ones but also to families.
This crushes families in the things they have to endure and the folks
that have this biochemical addiction to opioids.
Madam Chair, in closing, I urge support of this important amendment.
I urge my colleagues to vote ``yes'' to my amendment, as well as the
underlying bill.
Madam Chair, I yield back the balance of my time.
The Acting CHAIR. The question is on the amendment offered by the
gentleman from Virginia (Mr. Wittman).
The amendment was agreed to.
Mr. WITTMAN. Madam Chair, I move that the Committee do now rise.
The motion was agreed to.
Accordingly, the Committee rose; and the Speaker pro tempore (Mr.
Wittman) having assumed the chair, Ms. King-Hinds, Acting Chair of the
Committee of the Whole House on the state of the Union, reported that
that Committee, having had under consideration the bill (H.R. 2483) to
reauthorize certain programs that provide for opioid use disorder
prevention, treatment, and recovery, and for other purposes, had come
to no resolution thereon.

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