Baldwin Introduces Comprehensive Bill to Combat the Fentanyl and Substance Use Epidemic

WASHINGTON, D.C. – Today, U.S. Senator Tammy Baldwin (D-WI) introduced the Comprehensive Addiction Resources Emergency (CARE) Act, comprehensive legislation to confront the fentanyl and substance use epidemic. The CARE Act would provide state, local, and tribal governments with $125 billion in federal funding over ten years to tackle the fentanyl, opioid, and substance use crisis by investing in research, education, prevention, treatment, and recovery efforts.

“Millions of families like mine have watched their loved ones struggle with substance use disorder, and too often, seen their family, friends, and neighbors lose their lives to overdose or poisoning. We can and must do more to stop the opioid and fentanyl epidemic in its tracks and save lives,” said Senator Baldwin. “The CARE Act gives states and local communities the resources they need to expand substance use prevention, treatment, research, and education to address this crisis head on and help Wisconsinites in need.”

According to recent data from the Centers for Disease Control and Prevention, it is estimated that more than 100,000 people died of drug overdoses between June 2022 and June 2023. Despite 48 million people reporting suffering from substance use disorder in the past year, only about 24% of those in need of treatment for substance use actually received it.

This is not the first time the United States has faced a public health crisis of this scale. During the 1980s and 1990s, deaths from HIV/AIDS grew rapidly and the country faced a public health crisis – the medical system was ill-equipped to provide effective, evidence-based care. In 1990, Congress passed the bipartisan Ryan White Comprehensive AIDS Resources Emergency Act (Ryan White Act) to provide funding to help state and local governments, and community-based organizations, combat the HIV/AIDS epidemic.  

The CARE Act is modeled directly on the Ryan White Act, supporting local decision-making and programs to expand access to evidence-based treatments and recovery support services. The CARE Act also recognizes the need for expanded mental health supports, early intervention, and harm reduction tactics.  

Under the CARE Act, Wisconsin would receive an estimated $54 million annually over ten years, with an estimated $37 million in state formula grants and an estimated $17.5 million distributed among the counties. 

The CARE Act would provide $125 billion over ten years to fight this crisis, including:

• $4.6 billion per year to states, territories, and tribal governments, including $2.3 billion to states with the highest levels of overdoses and $1.84 billion through competitive grants. 
• $3.3 billion per year to the hardest hit counties and cities, including $1.75 billion to counties and cities with the highest levels of overdoses and $1.22 billion through competitive grants. 
• $2 billion per year for public health surveillance, biomedical research, and improved training for health professionals, including $1 billion for the National Institutes of Health (NIH), $500 million for the Centers for Disease Control and Prevention (CDC) and regional tribal epidemiology centers, and $500 million to train and provide technical assistance to professionals treating substance use disorders;
• $1.6 billion per year to support expanded and innovative service delivery, including $1 billion for public and nonprofit entities, $500 million for projects of national significance that provide treatment, recovery, and harm reduction services, $50 million to help workers with or at risk for substance use disorders maintain and gain employment, and $50 million to expand treatment provider capacity; and
• $1 billion per year to expand access to overdose reversal drugs and provide this life-saving medicine to states for distribution to first responders, public health departments, and the public.

Of the total funding, the CARE Act would invest nearly $1 billion a year provided directly to tribal governments and organizations, including:

• $790 million per year for grants to tribal governments to help fight this crisis and invest in substance use prevention and treatment;
• $7.5 million in additional funding for tribal nations and regional tribal epidemiology centers to improve data collection on overdoses;
• $50 million a year to Tribal Colleges and Universities, Indian Health Service-funded organizations, and medical training programs that partner with tribal nations and tribal organizations to train Native health professionals to improve substance use disorder treatment services;
• $150 million a year in funding to Native non-profits and clinics, including to urban Indian organizations, Native Hawaiian organizations, and projects designed to test innovative service delivery and culturally-informed care models to tackle addiction; and
• $1 billion per year to expand access to the overdose reversal drug Naloxone and provide this life-saving medicine to states to distribute to tribal nations, first responders, public health departments, and the public.

In the Senate, the legislation is cosponsored by Senators Elizabeth Warren (D-MA), Cory Booker (D-NJ), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Bob Casey (D-PA), John Fetterman (D-PA), Martin Heinrich (D-NM), Amy Klobuchar (D-MN), Jeff Merkley (D-OR), Alex Padilla (D-CA), Brian Schatz (D-HI), Tina Smith (D-MN), Chris Van Hollen (D-MD), and Peter Welch (D-VT).

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