H.R. 5294 would clarify that the Appalachian Regional Commission (ARC) may enter into contracts with and provide grants to people and organizations in Appalachia for projects and other activities aimed at reducing drug abuse and the negative effects of drug abuse, including opioid abuse, in the region. Such projects would include facilitating the sharing of best practices among states for reducing drug abuse; creating programs designed to reduce harm to the workforce from drug abuse; attracting relevant health care services, businesses, and workers to the region; and developing infrastructure to support greater use of telemedicine in Appalachia.
Under current law, $110 million annually through 2020 is authorized to be appropriated to ARC to carry out various provisions in law, including the opioid provisions in H.R. 5294. Because the bill would not increase the amounts authorized to be appropriated for those projects, CBO estimates that implementing H.R. 5294 would have no budgetary effects. In 2018, ARC allocated approximately $3 million of the $155 million provided to ARC to projects addressing the opioid crisis and other drug abuse in Appalachia.
Enacting H.R. 5294 would not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply.
CBO estimates that enacting H.R. 5294 would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2029.
H.R. 5294 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.