Two Reasons Why the 21st Century Cures Act is Good for Cities


The passage of the bill is an important step towards ensuring federal support for local efforts to address substance abuse and mental health needs, particularly when it comes to fighting the opioid epidemic.

The 21st Century Cures Act provides $1 billion of critical funding to communities combatting the opioid crisis. According to the CDC, more than 60 percent of drug overdose deaths involve an opioid. And since 1999, the rate of overdose deaths involving opioids (including prescription opioid pain relievers and heroin) has nearly quadrupled.

This post was co-authored by Yucel Ors and Stephanie Martinez-Ruckman.

Today the U.S. Senate passed the 21st Century Cures Act with overwhelming bipartisan support. The comprehensive health bill does many things, including reshaping how the Food and Drug Administration regulates drugs and medical devices and providing new funding for cutting-edge research on disease. But the bill does much more – in ways that impact cities and their communities.

  1. The 21st Century Cures Act provides $1 billion of critical funding to communities combatting the opioid crisis.
    The Cures Act builds on the programs authorized in the Comprehensive Addiction and Recovery Act (CARA) by providing $1 billion over two years for grants to state and local governments to supplement opioid abuse prevention and treatment programs. Areas covered include:
  2. Prescription drug monitoring programs
  3. Implementing prevention activities
  4. Training for health care providers

In November, the National League of Cities (NLC) and the National Association of Counties (NACo) City-County National Task Force on the Opioid Epidemic released the report, “A Prescription for Action: Local Leadership in Ending the Opioid Crisis.” The report provides recommendations for how local officials should address the opioid crisis and explores how cities and counties can strengthen collaboration with each other and state, federal, private-sector and nonprofit partners.

The passage of The Cures Act, in combination with CARA, are important legislative steps toward combatting the opioid crisis from a local level.

  1. The Cures Act addresses substance abuse and mental health needs.
    Cities have long been advocating for reforms to the mental health and criminal justice systems to better address substance abuse and mental health needs. Local elected officials have been leaders in the effort to reduce the criminalization of mentally ill persons, and NLC has made it a priority to advocate for legislation that would help local governments continue to make significant reforms to the criminal justice and mental health system.

The Cures Act addresses many of the criminal justice and mental health system reforms for which NLC has been advocating:

  • Second Chance Act amended to allow state and local governments to use reentry demonstration project grant funds for the provision of mental health treatment and transitional services (including housing) for mentally ill offenders who are re-entering the community
  • Drug Court Grant Program amended to allow state and local governments to use their existing grant funds to include targeted interventions for individuals who have both a mental health and substance abuse disorders
  • Byrne Justice Assistance Grant (JAG) Program changed to enable local law enforcement to use to funds for the creation of mental health response and corrections programs, including police crisis intervention teams
  • Community Oriented Policing Services Grant Program (COPS) amended to allow local law enforcement to use funds for specialized mental health response training
  • Federal mental health court grant funds can now be used for the creation of court-ordered outpatient treatment programs to prevent the escalation of mental health crises

On the bill’s passage, NLC President and Cleveland, Ohio, Councilmember Matt Zone said, “The Cures Act goes a long way to lay the groundwork for strong partnerships at every level of government – and it is our hope that before the 114th Congress adjourns it will appropriate the necessary funding authorized in the legislation.”

We are encouraged that Congress has taken a major step towards addressing one our nation’s greatest epidemics and is making it possible for local governments to make significant advances towards reforming the criminal justice system and combating the opioid epidemic. NLC looks forward to working closely with Congress and the Federal government to ensure the programs authorized in the 21st Century Cures Act and CARA help local governments build stronger and safer communities.

About the authors:

Yucel (“u-jel”) Ors is the Program Director of Public Safety and Crime Prevention at the National League of Cities. Follow Yucel on Twitter at @nlcpscp.

Stephanie Martinez-Ruckman is the Program Director for Human Development at the National League of Cities. Follow Stephanie on Twitter @martinezruckman.

Legislative Director, Public Safety & Crime Prevention