01/03/2024    Robert G. Smith DPM, MSc., RPh

HR 4531, the Support for Patients and Communities Reauthorization Act

I wanted to take this opportunity to thank APMA
leadership for their advocacy and determination
with ushering encouragement for our congressional
members for HR 4531, the Support for Patients and
Communities Reauthorization Act that modifies and
reauthorizes key programs that expand access to
substance use disorder prevention, treatment, and
recovery sponsored by Mr. Brett Guthrie and
cosponsored by a bipartisan group of 66
representatives.

According to the published Congressional Record
Proceedings and Debates of the 118th Congress,
First session dated 11-December-2023 and 12-
December-2023. HR 4531 was passed on 12-December-
2023 by a 2/3rds 386 members YEA (Democratic 196
members and Republicans 190 members) NAY 37 (11
Democratic members and 26 Republican members). As
of 31-December-2023 the Congressional Budget
Office cost estimate for HR 4531 measure had not
been received.

Of interest is Section 205. Required training for
prescribers of Controlled Substances
“Section 303 of the Controlled Substances Act (21
U.S.C. 823) is amended—

(1) by re-designating the second subsection (l)
(added by section 1263 of division FF of Public
Law 117–328) as subsection (m); and (2) in
subsection (m), as re-designated—
(A) in paragraph (1)(A)(iv)—(i)in subclause (I),
by striking or the Commission for Continuing
Education Provider Recognition (CCEPR) and
inserting the Commission for Continuing Education
Provider Recognition (CCEPR), the American
Podiatric Medical Association, the Council on
Podiatric Medical Education (CPME), or the Academy
of General Dentistry;

(iv) in subclause (V), as re-designated, by
striking any organization approved by the
Assistant Secretary for Mental Health and
Substance Use, the ACCME, or the CCEPR and
inserting any organization approved by the ACCME
or the CCEPR;

(B) in paragraph (1)(A)(v)—(i)by inserting
podiatric medicine, after allopathic medicine,
osteopathic medicine,; and (ii)by striking
allopathic or osteopathic medicine curriculum and
inserting allopathic, osteopathic, or podiatric
medicine curriculum;”

It is my humble opinion that the mockup of HR
4531, the Support for Patients and Communities
Reauthorization Act is 44 pages, four titles,
section 101-120, section 201-205, section 301-307,
and section 400 is a most interesting read. For
this reason, I am curious that HR4531 was not an
unanimous passage focusing on the 37 NAY votes I
have written to all of them and posed the
following question:

Inquiry: What provision(s) could have been
added/made to HR 4531, the Support for Patients
and Communities Reauthorization Act that modifies
and reauthorizes key programs that expand access
to substance use disorder prevention, treatment,
and recovery to foster your support and change
your vote from NAY to YEA?

I welcome 2024, in the hope that I will have
success with determining why 37 NAY sayers did not
support this bill, especially the section devoted
to promoting the profession of podiatry.

Robert G. Smith DPM, MSc., RPh, Ormond Beach, FL

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