The 21st Century Cures Act – Highlights
On December 7, the United States Senate passed the 21st Century Cures Act, a sweeping biomedical innovation bill that includes several legislative changes that will impact the field of addiction medicine. President Obama has indicated through a Statement of Administration Policy that he will sign the bill.
Highlights of the bill for addiction medicine specialists
Funding for States to Respond to the Opioid Epidemic
The law sets aside $1 billion over two years for the Secretary of Health and Human Services (HHS) to award grants to States to amplify their efforts to combat the opioid epidemic. Legislators must still act to appropriate the funds each year ($500 million each in fiscal years 2017 and 2018).
- NOTE: The first $500 million for fiscal year 2017 was included in the continuing resolution (CR) to fund the government through April 2017. Pending passage of the CR, these funds will be available for HHS to award to states immediately.
The funds are to be used to “supplement activities pertaining to opioids undertaken by the State agency responsible for administering the substance abuse prevention and treatment block grant,” such as:
- Improving prescription drug monitoring programs (PDMPs)
- Implementing and evaluating prevention activities
- Training for health care providers on safe opioid prescribing, pain management, recognizing substance use disorders, referral to treatment, and overdose prevention
- Supporting access to health care services
- Other public health-related activities
Mental Health Reform
The law includes significant mental health reforms based on the Helping Families in Mental Health Crisis Act, which was authored by Rep. Tim Murphy (R-PA), and the Mental Health Reform Act, which was authored by Senators Murphy (D-CT) and Cassidy (R-LA) such as:
- Establishing an Assistant Secretary for Mental Health and Substance Use, to be appointed by the President, who will head Substance Abuse and Mental Health Services Administration (SAMHSA) and assume the duties and authorities currently held by the SAMHSA Administrator. The Assistant Secretary must:Disseminate evidence-based practices and incorporate them into SAMHSA programs
- Ensure grants are subject to performance and outcome evaluations
- Improve recruitment and retention of mental health and substance use disorder professionals
- Collaborate with the criminal justice system to improve mental health and substance use disorder services for individuals who have been arrested or incarcerated Establishing a Chief Medical Officer (CMO) within SAMHSA who has real-world experience providing mental health or substance use disorder treatment and who will serve as a liaison between the Administration and providers of mental health and substance use disorder prevention, treatment and recovery support services.
- Requiring SAMHSA to develop a strategic plan every four years that identifies priorities, including a strategy for improving the recruitment, training, and retention of the mental health workforce.
- Requiring the Director of the Center for Substance Abuse Prevention to collaborate with the Directors of the National Institute on Drug Abuse (NIDA), National Institute on Alcoholism and Alcohol Abuse (NIAAA), and Centers for Disease Control and Prevention (CDC) to promote the study of substance use prevention and disseminate and implement findings that will improve prevention services.
- Creating a National Mental Health and Substance Use Policy Laboratory to promote evidence-based practices and service delivery models and authorizes $14 million for fiscal years 2018-2020 for such grants.
- Reauthorizing the Substance Abuse Prevention and Treatment Block Grant at $1.858 billion for fiscal years 2018-2022.