Consolidated Appropriations Act, 2023 Summary

The Consolidated Appropriations Act, 2023, a $1.7 trillion year-end omnibus spending bill, includes billions of dollars in funding to address mental health and addiction and several policy provisions that will make critical changes to the way our nation addresses addiction.

The law includes policy provisions that support:

Funding
- Reauthorizations of major funding sources for prevention, treatment, and recovery services
Prevention
- Opioid prescribing: Increased access to non-opioid treatments for pain, training for pharmacists on patient identification verification when dispensing opioids, grants for prescription drug monitoring programs
- Public awareness/education: Education for the public, health care providers, and first responders on synthetic opioids (e.g., fentanyl)
- Youth mental health: Support for school-based and other youth mental health and substance use services
Crisis Response
- Crisis continuums of care: Creation of a Behavioral Health Crisis Coordinating Office, guidance for implementing crisis response continuums of care, creation of a grant set-aside for crisis services
- Mobile crisis response services: Grants and support for 988 and mobile crisis response teams
Harm Reduction
- Naloxone: Grants for training, access and education
Treatment
- Medications for opioid use disorder: Elimination of the buprenorphine wavier requirement, the separate registration requirement for opioid treatment program (OTP) mobile medication units, and the requirement that patients have opioid use disorder for at least one year before being admitted to an OTP
- Contingency management: Study of a safe harbor for contingency management incentives and recommendations for improving access
- Mental health and addiction care for pregnant and postpartum individuals: Support for screening and treatment services and the maternal mental health hotline
- Mental health and addiction services during public health emergencies: Development of strategies/recommendations to make such services available and accessible during PHEs
- Care integration: Grants, technical assistance, and education to promote integration between physical and behavioral health
Insurance Coverage
- Parity enforcement: Elimination of the Parity Act opt-out for nonfederal governmental health plans, grants to states to enforce compliance
- Medicare mental health coverage: Coverage for marriage and family therapist, mental health counselor, and intensive outpatient services
Recovery Support
- Recovery housing: Requirements to develop guidelines, support federal coordination, and provide grants to promote the availability of evidence-based recovery housing
- Peer support services: Grants for virtual and other peer support services
- Expansion of the substance use block grant to include recovery support services
Behavioral Health Workforce
- Training: Requirement for health care practitioners to receive training on addiction to receive or renew their license to prescribe controlled substances
- Education support: Expansion of fellowship, scholarship, and loan repayment programs, creation of additional psychiatry residency slots

The law also includes funding for government agencies for FY 2023, which includes:

Increased funding for mental health and substance use prevention and treatment services through the Substance Abuse and Mental Health Services Administration (SAMHSA)
Increased funding for overdose surveillance and research through the Centers for Disease Control and Prevention (CDC)
Increased funding at the Food and Drug Administration (FDA) to address the opioid crisis
Increased funding at the National Institutes of Health (NIH) for research related to opioids, methamphetamines, and pain
Increased funding for maternal health, youth mental health services, behavioral health workforce programs, and rural behavioral health services through the Health Resources and Services Administration (HRSA)
Increased funding for the Office of National Drug Control Policy, including for the High-Intensity Drug Trafficking Area (HIDTA) and Drug-Free Communities programs
Increased funding for Department of Education programs to increase mental health services in schools and for social emotional learning programs
Funding for veteran mental health and substance use disorder prevention and treatment services
Funding for criminal justice, law enforcement, and reentry programs, including drug courts, prison treatment programs, crisis intervention teams, interdiction programs
Funding for drug interdiction and supply reduction
Increased funding for programs addressing social determinants of health, including nutrition, housing, child care, and education programs

For a more detailed summary, see: Consolidated Appropriations Act, 2023 Detailed Summary