Policy wins and the X waiver: MHA recaps the 117th congressional session

MHA Admin

Tue, 02/07/2023 – 12:20

by Caren Howard, MHA Director of Policy and Advocacy

As the new 118th Congress session begins, Mental Health America wants to take a moment to appreciate the major legislative victories in the last congressional session and highlight one new policy in particular, the X-waiver repeal.

Mental Health America affiliates and advocates participated in meetings, calls, and days of action, sharing their stories of lived experience with Congress and were able to secure many wins, including:

New Medicare coverage of certified peer specialists in integrated behavioral settings and as part of mobile crisis interventions.
Authority and funding for peer support services for veterans, birthing individuals, and individuals at risk of justice involvement.
A $150 million increase in the Mental Health Block Grant, bringing its total to over $1 billion for the first time in its history.
A set-aside for crisis services in the Mental Health Block Grant as well as over half a billion dollars for the 988 Suicide and Crisis Lifeline and a new crisis coordinating center at the Substance Abuse and Mental Health Services Administration (SAMHSA).
Over $1 billion in funding for school-based mental health professionals and a pipeline to increase this workforce’s diversity.
Millions in dollars funding youth mental health awareness and training for school personnel to detect and respond to mental health issues and connect school-aged youth to services.
New Medicare coverage of marriage and family therapists, licensed counselors, and expansion of psychiatric training residencies.
Elimination of the redundant X-waiver requirement to prescribe buprenorphine for substance use disorders.

X-waiver elimination

The Mainstreaming Addiction Treatment (MAT) Act, which eliminates the X waiver, was introduced and led by Rep. Paul Tonko (D-NY). Mental Health America is pleased that more individuals, whether in rural or urban areas, will have an improved ability to get treatment for opioid use disorder (OUD). Under Section 1262 of the Consolidated Appropriations Act, health providers no longer need to submit a Notice of Intent, or have a waiver, to prescribe certain medications, like buprenorphine, for the treatment of OUD. The Drug Enforcement Administration (DEA) and SAMHSA subsequently put out notices eliminating the additional X- waiver registration requirement, effective immediately.

The elimination of the X-Waiver requirement means that:

All prescriptions for buprenorphine for OUD now require only a standard DEA registration number.
SAMHSA is no longer accepting Notices of Intent to prescribe buprenorphine for opioid use disorder (i.e., X-waiver applications).
There are no longer any limits on the number of patients a prescriber may treat for OUD with buprenorphine.
All practitioners must still comply with applicable state laws and regulations.

All health care providers with a DEA registration that includes Schedule III medications can begin to prescribe buprenorphine for OUD. However, some state laws, such as in Kentucky, require providers to have the X-waiver to treat OUD with buprenorphine, also known as naloxone. Thus, advocates in states will need to conduct additional education of policymakers to ensure the repeal of any laws based on the X-waiver requirement to make sure consumers have broad access to OUD medications as federal lawmakers intended.

MHA continues to support the bipartisan work in Congress to address substance use disorders (SUDs), which most often co-occur with mental health conditions. The Health Subcommittee recently conducted a hearing on additional issues of importance in combating the opioid crisis, including legislation that would begin to ramp up surveillance of fentanyl trafficking, address cybersecurity threats associated with 988, and prohibit federal health plans from using quality- adjusted life year (QALY) in payment determinations.

To learn more about our recommendations to federal policymakers on SUD issues, visit the Partnership to Amend 42 CFR Part 2 coalition’s website, which just submitted comments to the administration on a rule aligning 42 CFR Part II with HIPAA.

While much progress was made, there is still much to do in the 118 th Congress to educate and promote early intervention and prevention, a livable wage for peer specialists, and equitable access to mental health and SUD services for Black, Indigenous, and people of color and LGBTQ+ populations. We are also working to hold technology companies accountable for the harms of social media overuse through the Kids Online Safety Act. Read more about our 2023 priorities and encourage a loved one to join our Advocacy Network to ramp up the number of voices that are part of our grassroots pressure on Congress and the Administration to design better policies.


The Capital City Emergency “Level II” Trauma & Wellness Center will house a “state of the art” Outreach Community Resource Center, that will provide case management, mental health community advocacy, and oversight from the M.I. Mother’s Keeper mental health advocates. 
The Capital City Emergency “Level II” Trauma & Wellness Center will offer patrons access to immediate coverage by general surgeons as well as coverage by the specialties of orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology and critical care.
Our goal is to help people in the best way possible in an effort to preserve and to save more lives in the Nation’s Capital and beyond.

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Code Red
Gunshot Victim
Life Threatening Wounds
Physical Assault Victim
Severely Injured Auto Accident Victim
Burn Victim
Choking & Breathing Obstructions
and more…


Child Sex Assault Victim
Domestic Violence Victim
Drug Overdose
Rape/Sex Crime Victim
Suicide Watch
Trafficking Victim
Nervous Breakdown
and more…

Mental Health

At Capital City Emergency Trauma & Wellness Center patrons with mental health emergencies that include life threatening situations in which an individual is imminently threatening harm to self or others, severely disoriented or out of touch with reality, has a severe inability to function or is otherwise distraught and out of control, will have access to quality and psychiatric emergency services and referrals.

Physical Health

Whether your life threatening medical emergency involves excessive or uncontrollable bleeding, head injury. difficulty with breathing, severe pain, heart attack, vision impairments, stroke, physically collapsing, or seizure related, rest assured that our professionals will properly assess and evaluate the level of response that will be most needed to help provide stabilized care solutions and minimize complications as well as reduce early mortality.

Holistic Healthcare

We offer healthcare solutions that will support the whole person which includes their physical, psychological, emotional, social, & spiritual wellbeing. Research supports that because your mental state can affect your overall health we support and offer the inclusion of complimentary and alternative medicine(CAM) practitioners and naturopathic doctor recommendations and referrals as a part of our Outreach Community Resource Center’s care regimen and support.


Emergency care can typically result in traumatic injuries for which rehabilitation becomes an essential component of care in trying to achieve the best long-term outcomes for the patient. In addition to speeding up recovery times and helping to prevent further complications, rehabilitative care also helps to support a patient’s self-managed recovery once discharged from our facility. Our Outreach Community Resource Center works closely with our trauma center’s discharge department to assure that patrons requiring these services are linked with qualified professionals who will be accountable to the standard of care required to help the patron be successful in their recovery.

Social Services

Our “state of the art” Outreach Community Resource Center intends to promote “expansive” beneficial community enriching services, programs, case management, & linkage to “approved” partner resources and supports in all of the following intended areas and more:

Social Services

  • Clothing
  • Food Pantry
  • Housing/Shelter
  • I.D. Credentials
  • Senior Wellness Check
  • Toiletries
  • Transportation
  • Etc.

Extended Family Services

  • Child Care
  • Credit Counseling
  • Family Court Services
  • Legal Aide

Career Training

  • Apprenticeship programs
  • Computer/Graphics Training
  • Culinary Program  
  • GED Courses
  • Hospitality Training
  • Job Etiquette & Grooming
  • Resume’ Prep
  • Sales Training
  • Software/Technology workshops
  • Small Business Training

Return Citizen
Program Partner
(Bridging the Gap)

  • Case Management
  • Temporary Boarding/Housing
  • Transitional Program Registration

Prevention/Intervention Outreach,
Workshops, & Programs

  • After-school Behavioral Health Program
  • Civic Engagement / Volunteer Sign-up
  • Fatherhood Rites of Passage
  • Gun Violence Town Hall Forum
  • Life Coaching & Coping Strategies
  • Marriage Counseling Workshops
  • Medicare Informational Workshops
  • Mentorship Training
  • Parental Classes
  • Support Groups
  • Town Hall Discussions
  • Violence De-Escalation Training
  • Voter Registration

Nutritional Outreach

  • Cooking Demonstrations
  • Dietary Programs
  • Exercise Classes
  • Recipe Sharing Workshops
  • Meal Prep

Community Outreach

The Healthy DC & Me Leadership Coalition is partnering with the M.I. Mother’s Keeper Mental Health advocacy organization to provide outreach services on the community level as an aid in reducing the existent health inequities that many District citizens are facing as a direct result of the presence of debilitating social determinants and the lack of culturally appropriate care choices and realities for community members residing in marginalized and lower-income communities.

It is the vision and intentions of the M.I. Mother’s Keeper Mental Health Advocates organization to help improve the quality of living for citizens living in our Nation’s Capital and beyond by overseeing the delicate linkage to services and by maintaining higher standards of care accountability for deserving citizens of the Nation’s Capital.

For more information or to enroll as one of our service providers, please email us at: