On Monday evening, the U.S. Senate approved 99-1 the Opioid Crisis Response Act (OCRA) of 2018 (Senator Mike Lee, R-UT was the lone “no” vote).  The rare, multi-committee, bipartisan bill includes significant provisions taken from or aligned with the goals of the Heitkamp-Durbin Trauma-Informed Care for Children and Families Act (S. 774), including the creation of an interagency task force to identify trauma-informed best practices and grants for trauma-informed practices in schools. 

The differences between this legislation and the House-passed opioid legislation (H.R. 6) will now need to be reconciled. The House bill does not contain the trauma-related provisions of the Heitkamp-Durbin bill.  Organizations are invited to sign-on to a letter to key Senate and House leaders in support of the bill and its specific trauma-related provisions.  Click here for a copy of the letter and to add your organization or agency to the list of supporters.  The deadline for signing on is noon ET, Wednesday, Sept. 19.  The Senate-House negotiation is expected to move quickly and a final vote could happen the week of September 24.

As reported earlier in ACEs Connection, the trauma provisions are the result of “extensive engagement” of the offices of Senators Heitkamp (D-ND) and Durbin (D-IL) staff with Shelley Capito (R-WV), and Lisa Murkowski (R-AK). 

Specific trauma-related provisions of the Senate bill include:

—Sec. 1502 (Programs for Health Care Workforce): “Trauma” and “trauma-informed care” were added to provisions in the Mental and Behavioral Health Education and Training Program (see p. 152)

—Sec. 1506 (CDC Surveillance and Data Collection for Child, Youth, and Adult Trauma): Authorizes CDC to collect data, in cooperation with states, on ACEs  every two years and includes rural areas.  Authorizes the CDC director to provide technical assistance to tribes to collect and report data.  (p. 161-162)

—Section 1513 (Task Force to Develop Best Practices for Trauma-Informed Identification, Referral, and Support):  The Interagency Task Force on Trauma-Informed Care “shall identify, evaluate, and make recommendations regarding best practices with respect to children and youth, and their families as appropriate, who have experienced or are at risk of experiencing trauma.” The task force would be chaired by the Assistant Secretary for Mental Health and Substance Use and would seek input from various stakeholders and would make recommendations regarding a set of evidence-based, evidence-informed, and promising practices. (p. 176-186)

—Sec. 1514 (Grants to Improve Trauma Support Services and Mental Health Care for Children and Youth in Educational Settings). Authorizes the HHS Secretary to award grants to state and local educational agencies, Head Start, preschool programs, and others to increase student access to evidence-based trauma support services and mental health care. (p. 187-195)

—Sec. 1515 (National Child Traumatic Stress Initiative).  Increased authorized funding to address problems of people who experience violence-related stress. (p. 195-196)

Click here for a section-by-section of the bill (the attached version highlights the trauma-related provisions). 

While there is broad support for many of the policies articulated in the bill, critics point out that bill does not provide mechanisms to fund the programs needed to address crucial prevention and treatment strategies.  Preliminary data from the Centers for Disease Control and Prevention (CDC) released recently reveal that more than 72,000 Americans died from overdoses in 2017, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (synthetic opioids) with nearly 30,000 overdose deaths. (Click here for the National Institute on Drug Abuse charts on the latest numbers). Some critics, including Dr. Leana Wen, Baltimore’s Health Commissioner who was recently named the new president of Planned Parenthood and leader in the trauma movement, say that the legislation addresses the opioid problem only around the edges.