Congressional Update – Continuing Resolution Passes & Lame Duck Session Updates

Prior to recessing this fall, federal lawmakers reached agreement at the end of September on a federal spending deal to avoid a government shutdown on October 1. President Biden signed the continuing resolution (CR, H.R. 9747) after the House approved the measure the day before by a vote of 341-82 and the Senate passed the bill by a vote of 78-18.  The CR funds most federal programs and activities at the FY 24 levels with several exceptions that provide funding flexibility and additional appropriations for various programs. The CR is effective through December 20, 2024. Congress is set to return to Capitol Hill on November 12^th and will resume negotiations on the various federal appropriations bill.

In anticipation of the post-election lame-duck session, our partners at The National Council, along with 70 leading mental health and substance use care organizations sent a joint letter to appropriators urging them to prioritize funding for key programs such as Certified Community Behavioral Health Clinics, Mental Health Awareness Training, Substance Use Prevention, Treatment and Recovery, and Community Mental Health Service Block grants. There are several possible factors that could influence both the lame duck session and policy priorities for the 119th Congress. The National Council plans to stay very engaged with lawmakers until the 119th Congress convenes in January 2025. 

Here are some key considerations and areas of focus our partners at the National Council will be monitoring in the coming months:

Timing of Election Results and Key Congressional Actions:

Congress is currently set to return on November 12th. Given how close the presidential race and several key congressional races are likely to be, it is possible that we will not know the results of the presidential election or who controls each chamber of Congress until several days after November 5th. With this potential uncertainty, the time needed for organizational efforts leading into the next Congress, and the need to address a disaster relief supplemental, there may be limited time for Congress to pass a substantial policy or funding package during the lame duck session. 

Disaster Relief Package: While Congress is not set to reconvene until November 12th, given the widespread impact of Hurricanes Helene and Milton, it is possible that they could return earlier to authorize additional disaster relief funding. Regardless of when Congress returns, they will be forced to move a large disaster relief package that may include funding for related behavioral health services, with funds for first responder mental health programs and other similar efforts potentially included. Given the extent of the storm damage in Florida, Georgia, North Carolina and Tennessee, a lame duck disaster supplemental appropriations bill could be of unprecedented size – with unpredictable effects on unrelated congressional healthcare spending priorities.

Lame Duck Mental Health and Substance Use Policy Considerations:  

• CCBHCs: National Council is actively engaged in discussions on Capitol Hill to ensure that key provisions of the Ensuring Excellence in Mental Health Act are included in a potential lame duck omnibus package. This includes:  
• Defining CCBHCs, their full scope of services as outlined in the SAMHSA criteria, and the prospective payment system (PPS) payment methodology; and
• Creating ongoing technical assistance infrastructure to enhance and improve existing CCBHCs and state-based implementation of the CCBHC model. 
• Telehealth: Several critical telehealth flexibilities are set to expire at the end of 2024. Among them is a Drug Enforcement Administration (DEA) waiver allowing certain controlled substances such as buprenorphine, to be prescribed via telehealth. However, the waiver will expire on Dec. 31, 2024, and there has been a strong and well-organized push by a large group of advocates, including National Council, to extend the waiver. A final rule creating another extension is currently with the White House Office of Management and Budget (OMB), and we expect the rule to mirror the flexibilities for prescribing of controlled substances that are currently in place. While we do not know exactly when the rule will be released, we will continue to keep you apprised of further developments as they unfold.
• SUPPORT Act Reauthorization: Several provisions of the original SUPPORT Act were made permanent as part of the Consolidated Appropriations Act, 2024, passed earlier this year. However, reauthorization of the remainder of the SUPPORT Act, which includes a range of substance use treatment programs, has bipartisan backing, but has been stalled since last year's deadline for renewal passed. If a large health package comes together during the lame duck session, the SUPPORT Act may be included. 

Regardless of how the presidential and congressional elections unfold, it is very unlikely that funding for CCBHCs and other core behavioral health programs will lapse or experience any significant shortfalls. 

In addition to monthly updates containing a revised version of this document, our partners at the National Council will continue to share relevant updates on developing legislative and regulatory news and priorities to our members, as well as through our weekly Capitol Connector newsletter, which any member can sign up to receive.