{"format":1,"id":"118-hr-4531","congress":118,"number":"H.R. 4531","kind":"bill","group":"bills","title":"Support for Patients and Communities Reauthorization Act","title_source":"Short Title(s) as Passed House","official_title":"To reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes.","titles":[{"type":"Official Title as Introduced","title":"To reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes."},{"type":"Display Title","title":"Support for Patients and Communities Reauthorization Act"},{"type":"Short Titles from RFS (Referred to Senate) bill text","title":"Support for Patients and Communities Reauthorization Act"},{"type":"Short Title(s) as Introduced","title":"Support for Patients and Communities Reauthorization Act"},{"type":"Short Title(s) as Passed House","title":"Support for Patients and Communities Reauthorization Act"}],"outcome":"passed_house","law_number":null,"introduced":"2023-07-11","chambers":{"house":{"status":"roll_call","date":"2023-12-12","vote":{"id":"118-2023-h715","question":"On Motion to Suspend the Rules and Pass, as Amended","title":"Support for Patients and Communities Reauthorization Act","result":"Passed","yea":386,"nay":37,"present":0,"not_voting":10,"source":"https://clerk.house.gov/evs/2023/roll715.xml"}},"senate":{"status":"na","date":null,"vote":null}},"president":{"status":"na","date":null},"vice_president_tie_breaker":null,"latest_action":{"text":"Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions.","date":"2023-12-13"},"nominees":null,"amendments":[],"other_votes":[],"crs_summary":{"date":"2023-12-12","stage":"Passed House","blocks":[{"k":"h","t":"Support for Patients and Communities Reauthorization Act"},{"k":"p","t":"This bill reauthorizes through FY2028 and modifies various grants, programs, and activities that address substance use and misuse."},{"k":"p","t":"This includes reauthorizing (1) data collection, education, and surveillance activities; (2) grants and other support for substance use disorder prevention, treatment, and recovery; (3) student loan repayment and other programs for the substance use disorder workforce; and (4) programs for addressing trauma, particularly for children, youth, and their families. Generally, the modifications expand programs."},{"k":"p","t":"Additionally, the bill modifies provisions related to the scheduling of controlled substances, including by incorporating illicit xylazine (a compound used in veterinary medicine as a nonopioid tranquilizer) into schedule III of the Controlled Substances Act."},{"k":"p","t":"Further, the bill makes permanent a requirement that Medicaid programs cover medication-assisted treatment for individuals with substance use disorders."}],"words":133},"summary":{"main_subject":{"text":"Extends authorizations for public health programs addressing substance use disorder through fiscal year 2028, amends the Controlled Substances Act, and amends Medicaid provisions on substance use disorder treatment.","cites":[{"label":"Sec. 1","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H325E80D22DEE476C9816EC67E02356BC"},{"label":"Sec. 103","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-HAFF43939A7E44C889777410BCD017888"},{"label":"Sec. 203","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H0799F273966147DCA4C0532ADAEB3088"},{"label":"Sec. 301","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H005E8ED40E684D088FF92B2BAD78D66E"}]},"core_areas":["Public Health Service Act substance use prevention, treatment and recovery grant authorizations","Controlled Substances Act scheduling and prescriber training","Medicaid coverage of substance use disorder treatment and related enrollment rules"],"what_it_does":[{"text":"Replaces the $496,000,000 authorization for each of fiscal years 2019 through 2023 with $505,579,000 for each of fiscal years 2024 through 2028 for the evidence-based overdose prevention grants under section 392A of the Public Health Service Act.","cite":{"label":"Sec. 103","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-HAFF43939A7E44C889777410BCD017888"}},{"text":"Raises the first responder training authorization from $36,000,000 to $56,000,000 for each of fiscal years 2024 through 2028.","cite":{"label":"Sec. 106","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H8850E16F6A404BFEBFC55B38001AE556"}},{"text":"Adds xylazine to schedule III of the Controlled Substances Act, defines the term, and excludes xylazine approved or used as an animal drug.","cite":{"label":"Sec. 203","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H0799F273966147DCA4C0532ADAEB3088"}},{"text":"Requires the Attorney General to submit to Congress a report on illicit xylazine use within 1 year of enactment and an additional report within 3 years.","cite":{"label":"Sec. 203","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H0799F273966147DCA4C0532ADAEB3088"}},{"text":"Removes the September 30, 2025 end date on the requirement that State Medicaid plans cover medication-assisted treatment, and requires State certification at least every 5 years.","cite":{"label":"Sec. 301","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H005E8ED40E684D088FF92B2BAD78D66E"}},{"text":"Allows States to use State Opioid Response grants for similar activities for alcohol use disorders co-occurring with opioid or stimulant use disorders, and adds new items to the annual report to Congress.","cite":{"label":"Sec. 119","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H74BBF0C790B1472C99E713DBF71B5F9C"}}],"unexpected":[{"category":"off_subject","items":[{"cite":{"label":"Sec. 110","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-HF0A123EBB1E3427991DB161D0D7819AA"},"heading":"Grants to address the problems of persons who experience violence related stress","effect":"Raises the authorization for grants for persons who experience violence related stress from $63,887,000 to $93,887,000 for each of fiscal years 2024 through 2028.","amount":"$93,887,000","quote":"by striking “$63,887,000 for each of fiscal years 2019 through 2023” and inserting “$93,887,000 for each of fiscal years 2024 through 2028”"},{"cite":{"label":"Sec. 111","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H1759F36B9A7D4332A25CE305F2626F1C"},"heading":"Mental and behavioral health education and training grants","effect":"Changes the fiscal year range for mental and behavioral health education and training grants from 2023–2027 to 2024–2028.","amount":null,"quote":"by striking “fiscal years 2023 through 2027” and inserting “fiscal years 2024 through 2028”"},{"cite":{"label":"Sec. 114","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-HBB14526F176F41F29DE51340BCC4B457"},"heading":"Monitoring and reporting of child, youth, and adult trauma","effect":"Raises the authorization for monitoring and reporting of child, youth, and adult trauma from $2,000,000 to $9,000,000 for each of fiscal years 2024 through 2028.","amount":"$9,000,000","quote":"by striking “$2,000,000 for each of fiscal years 2019 through 2023” and inserting “$9,000,000 for each of fiscal years 2024 through 2028”"},{"cite":{"label":"Sec. 115","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-HD36689486B7C40EB9C384FF439D32754"},"heading":"Task force to develop best practices for trauma-informed identification, referral, and support","effect":"Adds a reporting item for the trauma-informed task force and sets the task force to sunset on September 30, 2026.","amount":null,"quote":"The task force shall sunset on September 30, 2026."},{"cite":{"label":"Sec. 120","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-HFD85353894F445828BB290D86E2C580C"},"heading":"Providing for a study on the effects of remote monitoring on individuals who are prescribed opioids","effect":"Directs the Comptroller General to study remote monitoring of individuals who are prescribed opioids and report to congressional committees within 18 months of enactment.","amount":null,"quote":"the Comptroller General of the United States shall conduct a study and submit to the Committee on Energy and Commerce"},{"cite":{"label":"Sec. 302","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H9495CBC6C35F46D0AE1E4AD5CF0181F5"},"heading":"Expanding required reports on T-MSIS substance use disorder data to include mental health condition data","effect":"Expands the Medicaid substance use disorder data book to cover mental health conditions and renames it a behavioral health data book.","amount":null,"quote":"in the heading, by striking “substance use disorder data book” and inserting “behavioral health data book”"},{"cite":{"label":"Sec. 303","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H242B652BD477443EB30006B12B73A02A"},"heading":"Monitoring prescribing of antipsychotic medications","effect":"Extends the Medicaid antipsychotic prescribing monitoring program, beginning 24 months after enactment, to individuals over 18, individuals receiving home and community-based services, and individuals in institutional care settings.","amount":null,"quote":"individuals over the age of 18, individuals receiving home and community-based services"},{"cite":{"label":"Sec. 307","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-HDC107FEBDE4C4E2AA656E6E2BA052FF4"},"heading":"Permitting access to medical assistance under the Medicaid program for foster youth","effect":"Allows Medicaid medical assistance for items and services received outside a qualified residential treatment program by patients under age 21 in such programs that are institutions for mental diseases, for quarters beginning on or after January 1, 2025.","amount":null,"quote":"In the case of an individual who is under the age of 21 and who is a patient in an institution for mental diseases that is a qualified residential treatment program"},{"cite":{"label":"Sec. 401","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H09269317D65F459A94CE372040E77C46"},"heading":"Promoting value in Medicaid managed care","effect":"Strikes the words \"(and before fiscal year 2024)\" from Section 1903(m)(9)(A) of the Social Security Act, which concerns Medicaid managed care.","amount":null,"quote":"is amended by striking “(and before fiscal year 2024)”"}]},{"category":"selective_carve_out","items":[{"cite":{"label":"Sec. 116","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H6A1579F8B7F642088E18513B1ABED9CB"},"heading":"Treatment, recovery, and workforce support grants","effect":"Sets State overdose-death, unemployment, and labor-force-participation rate comparisons against national averages for calendar years 2018 through 2022 for the first grant cycle, and raises the authorization to $12,000,000 for each of fiscal years 2024 through 2028.","amount":null,"quote":"The amount by which the average rate of unemployment for the State, based on data provided by the Bureau of Labor Statistics"},{"cite":{"label":"Sec. 304","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh#toc-H30662AECD0C344BD98FA820E62B367B9"},"heading":"Lifting the IMD exclusion for substance use disorder","effect":"For States with a State plan amendment already in effect, applies the prior maintenance of effort rules for a 1-year period as if the amendments to that subparagraph had not been made.","amount":null,"quote":"In the case of a State with a State plan amendment in effect on the date of the enactment of this subparagraph, for the 1-year period beginning on such date"}]}],"version":{"type":"Engrossed in House","date":"2023-12-12","rule":"passed","href":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text/eh"},"current":true,"model":"claude-sonnet-5-5","approved":"2026-10-02","approved_by":"checks"},"sources":{"congress_gov":"https://www.congress.gov/bill/118th-congress/house-bill/4531","text":"https://www.congress.gov/bill/118th-congress/house-bill/4531/text"},"card":{"image":"card/item/118-hr-4531.png","v":"38676f549a5a","alt":"Votes on Record. H.R. 4531, 118th Congress: Support for Patients and Communities Reauthorization Act. House: 386 Yea, 37 Nay. Outcome: Passed House, 12 Dec 2023."}}