Turn the Tide Act

The Turn the Tide Act provides funding for various programs and activities under the SUPPORT for Patients and Communities Act, primarily through appropriations for fiscal years 2024 through 2028, and includes amendments to existing laws to enhance substance use disorder treatment, prevention, and recovery efforts.

Sec. 2, Controlled substance provisions: This section appropriates $4,000,000 for each fiscal year 2024 through 2027 for grants to enhance access to substance use disorder treatment, and $10,000,000 for each fiscal year 2024 through 2027 for increased drug disposal access.

Sec. 3, Public health provisions: This section appropriates $56,000,000 for each fiscal year 2024 through 2027 for first responder training; $15,000,000 for each fiscal year 2024 through 2027 for a public health laboratories pilot program; $4,000,000 for fiscal year 2024, $2,000,000 for fiscal year 2025, and $1,000,000 for each fiscal year 2026 and 2027 for model training programs for substance use disorder patient records; and $40,000,000 for each fiscal year 2024 through 2027 for residential treatment programs for pregnant and postpartum women.

Sec. 4, Housing and Department of Justice provisions: This section reauthorizes the recovery housing program with $60,000,000 for each fiscal year 2024 through 2029, establishes a priority funding formula based on unemployment rates, labor force participation rates, and drug overdose death rates, and requires at least 50 percent of funds to be spent within 2 years.

Sec. 5, Bolstering commitments to state grants: This section appropriates $5,500,000,000 for each fiscal year 2024 through 2028 for state opioid response grants, allows states and Indian tribes to use these funds for substance use disorder treatment regardless of primary diagnosis, and appropriates $3,000,000,000 for each fiscal year 2024 through 2028 and $2,500,000,000 for each fiscal year 2029 through 2033 for substance abuse prevention and treatment block grants.

Sec. 6, Eliminating insurance barriers to medication-assisted treatment: This section prohibits states from imposing utilization control policies, including prior authorization, on Medicaid medication-assisted treatment, effective October 1, 2024.

Sec. 7, Limitations on cost-sharing for opioid overdose reversal medications: This section requires group health plans and health insurance issuers to cover at least one formulation of an opioid overdose reversal agent without cost-sharing and prohibits utilization control policies for such agents.

Sec. 8, Targeting health workforce loan repayment assistance: This section appropriates $50,000,000 for each fiscal year 2024 through 2028 for a loan repayment program for substance use disorder treatment workforce, and $10,000,000 for each fiscal year 2024 through 2027 for a training demonstration program, with an additional $20,000,000 for each fiscal year 2024 through 2027 for states with the highest drug overdose death rates.

Sec. 9, Medicaid payments for behavioral health providers: This section requires state Medicaid programs to pay for mental health and behavioral health services at rates not less than 100 percent of Medicare rates for services provided from October 1, 2024, through September 30, 2028.

Sec. 10, CMI demonstration for recovery housing: This section directs the Center for Medicare and Medicaid Innovation to conduct a demonstration project testing whether providing Medicaid managed care entities with an elevated capitated budget for recovery housing reduces emergency department visits and hospitalizations.

Sec. 11, Extension of Medicaid delivery system reform waivers: This section requires the Secretary of Health and Human Services to extend certain Medicaid section 1115 waivers to December 31, 2026, for states with high drug poisoning death rates, and allows funds to support training of direct service workers.

Sec. 12, Expanding drug-free communities support grants: This section amends the Drug-Free Communities Support Program to authorize subsequent additional grants and renewal grants for up to 4 fiscal years, subject to matching requirements.

Sec. 13, Support for law enforcement mental health: This section appropriates $15,000,000 for each fiscal year 2024 through 2027 for grants to establish peer mentoring mental health and wellness pilot programs within law enforcement agencies.

Sec. 14, Adverse childhood experiences response team grant program: This section authorizes the Attorney General to make grants to establish adverse childhood experiences response teams, including for protocols, referral partnerships, training, and cross-system collaboration.