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Legislation with Provisions to Curb Methamphetamine Use Approved by Congress; States Retain Right to Adopt and Enforce More Restrictive Laws

On Thursday, March 2nd, the full Senate approved the conference report for H.R. 3199, the USA PATRIOT and Terrorism Prevention Reauthorization Act of 2005. The House of Representatives approved the final legislative package on March 8th. Provisions from the "Combat Meth Act," the "Drug Courts Improvement Act," and "The Meth Epidemic Elimination Act" were included in the legislation. The President is expected to sign H.R. 3199 into law shortly.

H.R. 3199 would impose federal regulations on the sale of products containing pseudoephedrine by requiring stores to keep medications with pseudoephedrine behind the counter and by requiring purchasers of the medication to show photo identification and sign a log. In addition, individuals would be restricted from buying more than 3.6 grams per day and 9 grams per month of medication with pseudoephedrine. H.R. 3199 would not preclude states from adopting or enforcing regulations or penalties more strict than those in the federal law.

H.R. 3199 would creating a sentencing enhancement for individuals convicted of manufacturing, distributing, or possessing with the intent to manufacture or distribute, methamphetamine on a premises where children reside. Under this provision, in addition to any other sentence imposed, another sentence of imprisonment for a period up 20 years, a fine or both would be applied. The Attorney General is authorized under the bill to award grants to States, territories, and American Indian tribes to address use of methamphetamine among pregnant and parenting women in the criminal justice system by facilitating or enhancing collaboration between the criminal justice, child welfare and State substance abuse systems.

Key provisions from the Drug Courts Improvement Act that were included in H.R. 3199 would add drug testing requirements for the Department of Justice (DOJ) Drug Court grant program. Drug courts receiving funds from the DOJ grant program would be required to:

Employ mandatory periodic drug testing according to standards set by the Attorney General; these drug testing standards must ensure that each participant is tested for every controlled substance or addictive substance that the participant has been known to use, and for every other commonly used controlled substance or addictive substance

Impose immediate punitive sanctions, therapeutic measures, or both whenever a participant fails a drug test; these sanctions could include incarceration, termination from the program, detoxification treatment, and residential treatment

The text of H.R. 3199 can be found at: http://thomas.loc.gov.

Legislation to Eradicate Methamphetamine Use Introduced in the House;
Includes Mandatory Minimum Provision, Grants for Prevention, Treatment and Research and Modifications to RSAT Program

On February 15th, Congressman James Oberstar (D-MN) introduced H.R. 4763, the "Methamphetamine Eradication Act." H.R. 4763 seeks to provide a comprehensive Federal response to the problems relating to methamphetamine use and addiction.

H.R. 4763 would:

Create a 20-year minimum mandatory imprisonment penalty for individuals who manufacture methamphetamine on a premises where children reside

Authorize a grant program where the Secretary of Health and Human Services can award grants to States, political subdivisions of States, American Indian Tribes, and private, nonprofit entities to provide treatment for addiction to methamphetamine; in determining who would be awarded the grants, priority would be given to organizations serving rural areas experiencing an increase in methamphetamine use

Direct the Office of National Drug Control Policy (ONDCP) to submit a report to Congress regarding the use of methamphetamine and make recommendations on how best to address the problem in rural areas

Authorize a grant program where the Secretary of Health and Human Services could award grants to State agencies, local educational agencies and nonprofit organizations to carry out programs to educate students on the mental, physical, and behavioral effects of methamphetamine and on the prevention and treatment of methamphetamine addiction; at least half of the funds allocated for these grants would be required to go to programs in schools located in rural areas

Require, in order for States to receive Residential Substance Abuse Treatment (RSAT) funds for prisoners, the State to implement or continue to require both periodic and random drug testing before, during and after an individual enters into treatment for drug addiction; this provision would also require, as a condition of participation in the treatment program, a drug test that indicates that the individual has been drug-free for at least three months; in the aftercare requirements following an individual's release from incarceration, H.R. 4763 would give priority to applications that involve a partnership between the State and a community-based drug treatment program within the State

Authorize the Secretary of Health and Human Services, acting through the Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA) with the Director of the National Institutes of Health, to award grants to, or enter into contracts with, public or private, nonprofit entities to establish a research, training and technical assistance center that would:

Engage in research and evaluation of the effectiveness of treatment modalities for the treatment of methamphetamine addiction

Disseminate information to public and private entities on effective treatments for methamphetamine addiction

Provide direct technical assistance to States, political subdivisions of States, and private entities on how to improve the treatment of methamphetamine addiction

Provide training on the effects of methamphetamine use and on effective ways of treatming addiction to addiction treatment professionals and community leaders

Following its introduction, H.R. 4763 was referred to the House Judiciary, Energy and Commerce, Science, Education and the Workforce, and Transportation and Infrastructure Committees where the bill awaits review. Text of H.R. 4763 can be found at: http://thomas.loc.gov/.

House Committees Approve Legislation to Reauthorize the Office of National Drug Control Policy; Full House Expected to Vote on Legislation This Week

On March 2nd, the full House Judiciary Committee met to mark-up (review) H.R. 2829, legislation to reauthorize the White House Office of National Drug Control Policy (ONDCP). Chairman James Sensenbrenner (R-WI) and Ranking Member John Conyers (D-MI) led the mark-up session. Following a session where Members offered amendments to the legislation and the Committee voted for their approval, the House Judiciary Committee then approved H.R. 2829. In addition, this week the House Energy and Commerce Committee approved and reported this legislation out of the Committee.

The legislation, as amended through the Committee process, would make a number of changes to current law. The "Office of National Drug Control Policy Reauthorization Act of 2005" would:

Require that the National Drug Control Strategy, submitted yearly by the President, include:

A review of the status of, and trends in, demand reduction activities by private sector entities and community-based organizations, including faith-based organizations, to determine their effectiveness and the extent of cooperation, coordination, and mutual support between such entities and organizations and Federal, State, and local government agencies
An assessment of current illicit drug use and availability, the impact of illicit drug use, and treatment availability; this assessment must include estimates of drug prevalence and frequency of use, drug use in the workplace and the productivity lost by such use, and drug use by people who have been arrested, or are on probation or parole
An assessment that examines hospital emergency use by individuals using illicit drugs, the quantity of illicit drug-related services provided, the annual national health care cost
of illicit drug use and the extent of drug-related crime and criminal activity
A review of the status of, and trends in, drug treatment in the United States, by assessing public and private treatment utilization and the number of individuals using drugs the Director estimates meet diagnostic criteria for treatment
A summary of the efforts made to coordinate with private sector entities to conduct private research and development of medications to treat addiction by screening chemicals for potential therapeutic value, developing promising compounds, conducting clinical trials, seeking Food and Drug Administration approval for drugs to treat addiction, marketing the drug for the treatment of addiction, urging physicians to use the drug in the treatment of addiction, and encouraging insurance companies to reimburse the cost of the drug for the treatment of addiction.

Prohibit the ONDCP Director from approving the budget of several programs under its jurisdiction if the budget:

Requests funding for the Department of Education for the 2007 fiscal year, unless it is accompanied by a plan for providing expedited consideration of student loan applications for those individuals who applied for federal financial assistance and were rejected or denied aid under the Higher Education Act ban that delays or denies federal student aid to individuals convicted of drug offenses prior to the period of enrollment

Requests funding for drug treatment activities that do not provide adequate result and accountability measures, or do not adequately support and enhance Federal drug treatment programs and capacity, as determined by the Director

Requests funding for any activities of the Safe and Drug Free Schools program that do not include a clear anti-drug message or purpose intended to reduce drug use

Require that the ONDCP Director coordinate with the private sector to promote private research and development of medications to treat addiction

Require that ONDCP evaluate the effectiveness of the national drug control policy and its agencies' programs by developing and applying specific goals and performance measures

Require the Attorney General to submit yearly reports with the number and type of arrests and prosecutions for drug violations

The full House of Representatives is scheduled to vote on H.R. 2829 this week. The text of H.R. 2829 can be found at: http://thomas.loc.gov/.

Senate Committee Convenes Hearing on Reauthorization of the Ryan White
CARE Act; HRSA Administrator References Important Role of
Drug Addiction Treatment Services

On March 1st, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing, "Fighting the AIDS Epidemic of Today: Reauthorizing the Ryan White CARE Act." The Ryan White CARE Act provides federal funding for health care and supportive services to people living with HIV/AIDS. Led by Committee Chairman Mike Enzi (R-WY) and Ranking Member Edward Kennedy (D-MA), this hearing focused on the need to reauthorize the CARE Act, whose authorization expired on September 30, 2005. Other Committee members participating in the hearing included: Senators Richard Burr (R-NC), Mike DeWine (R-OH), Orrin Hatch (R-UT), Hillary Clinton (D-NY), Patty Murray (D-WA) and Jeff Sessions (R-AL). Elizabeth Duke, Administrator of the Health Resources and Services Administration (HRSA), provided witness testimony to the Committee.

In his opening statement to the Committee, Chairman Enzi indicated that there was significant interest in completing reauthorization of the CARE Act this legislative session. Chairman Enzi noted the attention that had recently been placed on efforts to stop the spread of HIV/AIDS around the world, but asserted that the fight against HIV/AIDS in the United States was equally important. In his comments, Chairman Enzi acknowledged that in the United States, HIV/AIDS affects more women and more people of color now than ever before. Quoting data from the Kaiser Family Foundation, Chairman Enzi noted that African-Americans represent half of all AIDS diagnoses in 2004 compared to twenty-five percent in 1986. In addition, Chairman Enzi noted that, according to the Centers for Disease Control and Prevention, HIV/AIDS represents a growing and persistent health threat to women in the United States, especially young women and women of color.

Senator Ted Kennedy, in his opening comments, praised the early stages of CARE Act reauthorization, asserting that the process has been bipartisan and bicameral, and that it has also involved the Bush Administration. Referring to the CARE Act as one of the greatest public health investments made in recent history, Senator Kennedy emphasized the continuing need for CARE Act services needed by people living with HIV/AIDS. In addition, Senator Kennedy underscored the importance of mental health services, transitional housing and other supportive services funded by the CARE Act.

In her testimony to the Committee, HRSA Administrator Elizabeth Duke outlined the key principles for reauthorization of the Ryan White CARE Act that the Bush Administration released last July; these principles, which the Administration would like reflected in CARE Act Reauthorization legislation, are: to serve the neediest first; to focus on lifesaving, life-extending services; to increase prevention efforts; to increase accountability; and to increase flexibility. In determining who the neediest individuals are in order to prioritize funds, Dr. Duke spoke about how the Administration would like to establish objective indicators to determine the severity of need for funding core medical services. Under the Administration's proposal, seventy-five percent of CARE Act funds would be allocated for core medical services.

In addition, Dr. Duke responded to the concerns expressed by Senators Burr and Sessions about the formulas used to determine the amount of assistance through the CARE Act. Senators Burr and Sessions, both from States without an Eligible Metropolitan Area (EMA) and therefore not receiving those funds, expressed that their States received less funding per individual receiving services than States with EMAs. Dr. Duke acknowledged that there were a number of complex formulas and adjustments that had been considered in coming up with the funding amounts but expressed that the Administration wanted to work with the Committee to produce a piece of reauthorization that is fair and equitable.

Senator Hillary Clinton questioned Dr. Duke about the Administration's principles for CARE Act Reauthorization and raised several concerns. Senator Clinton referred to the discussion about changing the funding formulas, expressing concern that this would result in resources being removed from areas that have historically been hardest hit by the domestic AIDS epidemic, including New York. Senator Clinton noted that although New York only has seven percent of the nation's population, it has seventeen percent of the nation's AIDS cases and that over 100,000 people living with HIV and AIDS live in New York, more than any other state in the nation.

Senator Clinton also spoke about the need for a comprehensive response through the CARE Act and for continued funding for supportive services critical to getting people into care. Referring to the Administration's principle that seventy-five percent of CARE Act funds be spent on core medical services, Senator Clinton noted that these services had yet to be defined. Dr. Duke responded that in the Administration's review of where CARE Act dollars are being spent, they found that about 29 percent of the money is spent on health care and that nearly 42 percent of the funds are spent on medications. Dr. Duke also said that case management services, including drug addiction treatment services, outpatient services, oral health care, and mental health care, had come up most often as core medical services being provided and funded through the CARE Act.

In her testimony, Dr. Duke also noted the President's budget request for the 2007 fiscal year for the CARE Act was $2.16 billion, which would represent an increase of $95 million over last year's funding. Dr. Duke explained that the $95 million increase requested in the President's budget was intended to address the ongoing problem of state waiting lists, and to provide care and medications to newly diagnosed individuals. In addition, Dr. Duke expressed that a portion of this funding would also be used to expand outreach efforts by providing new grants to community- and faith-based organizations, and funds for technical assistance to grassroots organizations.

The HELP Committee has yet to release draft legislation to reauthorize the CARE Act. The House Energy and Commerce Committee, which has jurisdiction over CARE Act reauthorization on the House side, has also conducted hearings on reauthorization but has not yet introduced a piece of legislation. Senator Tom Coburn (R-OK) did introduce legislation to reauthorize the CARE Act, S. 2339 in late February, but this legislation is independent from the bill the HELP Committee will develop.

Full witness testimony can be found at: http://help.senate.gov/Hearings/2006_03_01_b/2006_03_01_b.html.

Senator Coburn's "Ryan White CARE Act Amendments Act of 2006" can be found at http://thomas.loc.gov/.