Congress works to reauthorize behavioral and mental health programs in SUPPORT Act

Key Takeaways

In 2018, Congress passed the Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act (P.L. 115-271). This comprehensive legislative package was the largest Congressional investment in overdose prevention at the time and was aimed to strengthen the country's response to the ongoing substance use crisis. 

On September 30, many policy provisions in the original package expired, requiring congressional reauthorization to continue these critical programs among a worsening overdose crisis. Below is a summary of SUPPORT Act reauthorization bills currently under consideration by Congress. 

Importance for Counties

Counties are the backbone of our nation’s mental and behavioral health service system, administering treatment, recovery and support services through nearly 750 behavioral health authorities and over $80 billion in community health investments. The reauthorization of the SUPPORT Act will offer continued support to counties in their ongoing efforts to respond effectively to the ongoing behavioral health crisis. Of importance to counties:

• The reauthorization contains several key funding streams to help support community-based substance use disorder related treatment and recovery, to include resources to bolster the behavioral health workforce.  
• The Better Mental Health Care, Lower- Cost Drugs and Extenders Act of 2023 (S. 3430) includes a scaled down version of the Due Process Continuity of Care Act (S. 971), which seeks to amend Medicaid Inmate Exclusion Policies (MIEP) to allow for Medicaid coverage of certain pre-trial populations. 

Next Steps & Advocacy 

• On November 17, Congress passed the Further Continuing Appropriations and Other Extensions Act, 2024 (P.L. 118-22). While this continuing resolution has kept many of the 2018 SUPPORT Act programs afloat past their original expiration, Congress is now working to reauthorize expired programs in a package to be passed alongside a beginning of year omnibus in January. 
• The NACo Mental Health Commission recently wrote a letter to the Chair and Ranking Members on the Senate Committee on Finance and the Senate Committee on Health, Education, Labor and Pensions expressing their policy priorities to be included in any mental health legislative packages, such as the SUPPORT Act Reauthorization.

NACo will be doing a full analysis of the legislation and key provisions for counties as this legislative packet moves through Congress.