II
118THCONGRESS
1
STSESSION S. 2433
To reauthorize certain programs under the Substance Use-Disorder Preven-
tion that Promotes Opioid Recovery and Treatment for Patients and
Communities Act, and for other purposes.
IN THE SENATE OF THE UNITED STATES
JULY20, 2023
Mr. C
ASSIDYintroduced the following bill; which was read twice and referred
to the Committee on Health, Education, Labor, and Pensions
A BILL
To reauthorize certain programs under the Substance Use-
Disorder Prevention that Promotes Opioid Recovery and
Treatment for Patients and Communities Act, and for
other purposes.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3
(a) S
HORTTITLE.—This Act may be cited as the 4
‘‘SUPPORT for Patients and Communities Reauthoriza-5
tion Act of 2023’’. 6
(b) T
ABLE OFCONTENTS.—The table of contents for 7
this Act is as follows: 8
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Sec. 1. Short title; table of contents.
TITLE I—REAUTHORIZATIONS
Sec. 101. First responder training.
Sec. 102. Pilot program for public health laboratories to detect fentanyl and
other synthetic opioids.
Sec. 103. Residential treatment programs for pregnant and postpartum women.
Sec. 104. Prenatal and postnatal health.
Sec. 105. Plans of safe care.
Sec. 106. Loan repayment program for substance use disorder treatment work-
force.
Sec. 107. Youth prevention and recovery.
Sec. 108. Comprehensive opioid recovery centers.
Sec. 109. CDC surveillance and data collection for child, youth, and adult trau-
ma.
Sec. 110. Task force to develop best practices for trauma-informed identifica-
tion, referral, and support.
Sec. 111. Donald J. Cohen National child traumatic stress initiative.
Sec. 112. Surveillance and education regarding infections associated with illicit
drug use and other risk factors.
Sec. 113. Building communities of recovery.
Sec. 114. Peer support technical assistance center.
Sec. 115. Preventing overdoses of controlled substances.
Sec. 116. CAREER Act.
TITLE II—OTHER PROVISIONS
Sec. 201. Delivery of a controlled substance by a pharmacy.
Sec. 202. Regulations relating to a special registration for telemedicine.
Sec. 203. Review of at-home drug disposal systems.
Sec. 204. Report on at-home drug disposal systems.
Sec. 205. Ensuring State choice in PDMP systems.
Sec. 206. Mental health parity.
Sec. 207. State guidance on coverage for individuals with serious mental illness
and children with serious emotional disturbance.
Sec. 208. Community mental health services block grant service providers.
Sec. 209. Reports and studies on medication treatments for opioid use disorder.
Sec. 210. FASD Respect Act.
TITLE I—REAUTHORIZATIONS 1
SEC. 101. FIRST RESPONDER TRAINING. 2
Section 546(h) of the Public Health Service Act (42 3
U.S.C. 290ee–1(h)) is amended by striking ‘‘2019 through 4
2023’’ and inserting ‘‘2024 through 2028’’. 5
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SEC. 102. PILOT PROGRAM FOR PUBLIC HEALTH LABORA-1
TORIES TO DETECT FENTANYL AND OTHER 2
SYNTHETIC OPIOIDS. 3
Section 7011(d) of the SUPPORT for Patients and 4
Communities Act (42 U.S.C. 247d–10 note) is amended 5
by striking ‘‘2019 through 2023’’ and inserting ‘‘2024 6
through 2028’’. 7
SEC. 103. RESIDENTIAL TREATMENT PROGRAMS FOR 8
PREGNANT AND POSTPARTUM WOMEN. 9
Section 508(s) of the Public Health Service Act (42 10
U.S.C. 290bb–1(s)) is amended by striking ‘‘2019 through 11
2023’’ and inserting ‘‘2024 through 2028’’. 12
SEC. 104. PRENATAL AND POSTNATAL HEALTH. 13
Section 317L(d) of the Public Health Service Act (42 14
U.S.C. 247b–13(d)) is amended by striking ‘‘2019 15
through 2023’’ and inserting ‘‘2024 through 2028’’. 16
SEC. 105. PLANS OF SAFE CARE. 17
Section 105(a)(7)(H) of the Child Abuse Prevention 18
and Treatment Act (42 U.S.C. 5106(a)(7)(H)) is amend-19
ed by striking ‘‘2023’’ and inserting ‘‘2028’’. 20
SEC. 106. LOAN REPAYMENT PROGRAM FOR SUBSTANCE 21
USE DISORDER TREATMENT WORKFORCE. 22
Section 781(j) of the Public Health Service Act (42 23
U.S.C. 295h(j)) is amended by striking ‘‘2019 through 24
2023’’ and inserting ‘‘2024 through 2028’’. 25
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SEC. 107. YOUTH PREVENTION AND RECOVERY. 1
Section 7102(c)(9) of the SUPPORT for Patients 2
and Communities Act (42 U.S.C. 290bb–7a(c)(9)) is 3
amended by striking ‘‘2019 through 2023’’ and inserting 4
‘‘2024 through 2028’’. 5
SEC. 108. COMPREHENSIVE OPIOID RECOVERY CENTERS. 6
Section 552(j) of the Public Health Service Act (42 7
U.S.C. 290ee–7(j)) is amended by striking ‘‘2019 through 8
2023’’ and inserting ‘‘2024 through 2028’’. 9
SEC. 109. CDC SURVEILLANCE AND DATA COLLECTION FOR 10
CHILD, YOUTH, AND ADULT TRAUMA. 11
Section 7131(e) of the SUPPORT for Patients and 12
Communities Act (42 U.S.C. 242t(e)) is amended by strik-13
ing ‘‘2019 through 2023’’ and inserting ‘‘2024 through 14
2028’’. 15
SEC. 110. TASK FORCE TO DEVELOP BEST PRACTICES FOR 16
TRAUMA-INFORMED IDENTIFICATION, RE-17
FERRAL, AND SUPPORT. 18
Section 7132(i) of the SUPPORT for Patients and 19
Communities Act (Public Law 115–271) is amended by 20
striking ‘‘2023’’ and inserting ‘‘2028’’. 21
SEC. 111. DONALD J. COHEN NATIONAL CHILD TRAUMATIC 22
STRESS INITIATIVE. 23
Section 582(j) of the Public Health Service Act (42 24
U.S.C. 290hh–1(j)) (relating to grants to address the 25
problems of persons who experience violence-related 26
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stress) is amended by striking ‘‘2019 through 2023’’ and 1
inserting ‘‘2024 through 2028’’. 2
SEC. 112. SURVEILLANCE AND EDUCATION REGARDING IN-3
FECTIONS ASSOCIATED WITH ILLICIT DRUG 4
USE AND OTHER RISK FACTORS. 5
Section 317N(d) of the Public Health Service Act (42 6
U.S.C. 247b–15(d)) is amended by striking ‘‘2019 7
through 2023’’ and inserting ‘‘2024 through 2028’’. 8
SEC. 113. BUILDING COMMUNITIES OF RECOVERY. 9
Section 547(f) of the Public Health Service Act (42 10
U.S.C. 290ee–2(f)) is amended by striking ‘‘2019 through 11
2023’’ and inserting ‘‘2024 through 2028’’. 12
SEC. 114. PEER SUPPORT TECHNICAL ASSISTANCE CEN-13
TER. 14
Section 547A(e) of the Public Health Service Act (42 15
U.S.C. 290ee–2a(e)) is amended by striking ‘‘2019 16
through 2023’’ and inserting ‘‘2024 through 2028’’. 17
SEC. 115. PREVENTING OVERDOSES OF CONTROLLED SUB-18
STANCES. 19
Section 392A(e) of the Public Health Service Act (42 20
U.S.C. 280b–1(e)) is amended by striking ‘‘2019 through 21
2023’’ and inserting ‘‘2024 through 2028’’. 22
SEC. 116. CAREER ACT. 23
Section 7183(k) of the SUPPORT for Patients and 24
Communities Act (42 U.S.C. 290ee–8(k)) is amended by 25
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striking ‘‘2019 through 2023’’ and inserting ‘‘2024 1
through 2028’’. 2
TITLE II—OTHER PROVISIONS 3
SEC. 201. DELIVERY OF A CONTROLLED SUBSTANCE BY A 4
PHARMACY. 5
Section 309A(a) of the Controlled Substances Act 6
(21 U.S.C. 829a(a)) is amended by striking paragraph (2) 7
and inserting the following: 8
‘‘(2) the controlled substance is a drug in 9
schedule II, III, IV, or V and is— 10
‘‘(A) to be administered for the purpose of 11
initiation, maintenance, or detoxification treat-12
ment; or 13
‘‘(B) subject to conditions of approval im-14
posed by the Food and Drug Administration 15
pursuant to section 505–1 of the Federal Food, 16
Drug, and Cosmetic Act (21 U.S.C. 355–1), 17
which may require the drug to be administered 18
with post-administration monitoring by a health 19
care professional;’’. 20
SEC. 202. REGULATIONS RELATING TO A SPECIAL REG-21
ISTRATION FOR TELEMEDICINE. 22
Not later than 1 year after the date of enactment 23
of this Act, the Attorney General, in consultation with the 24
Secretary of Health and Human Services, shall promul-25
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gate the final regulations required under section 311(h)(2) 1
of the Controlled Substances Act (21 U.S.C. 831(h)(2)). 2
SEC. 203. REVIEW OF AT-HOME DRUG DISPOSAL SYSTEMS. 3
Section 505–1 of the Federal Food, Drug, and Cos-4
metic Act (21 U.S.C. 355–1) is amended by adding at the 5
end the following: 6
‘‘(n) A
T-HOMEDRUGDISPOSALSTANDARDS AND 7
S
YSTEMS.— 8
‘‘(1) E
STABLISHMENT OF AT -HOME DRUG DIS-9
POSAL STANDARDS.—Not later than one year after 10
the date of enactment of the SUPPORT for Patients 11
and Communities Reauthorization Act of 2023, the 12
Secretary shall publish guidance to facilitate the use 13
of at-home safe disposal systems for drugs subject to 14
a risk evaluation and mitigation strategy that in-15
cludes an element described in subsection (e)(4). 16
‘‘(2) G
UIDANCE.—The guidance under para-17
graph (1) shall include— 18
‘‘(A) recommended standards for effective 19
at-home disposal systems to meet the public 20
health or non-retrievability standard; 21
‘‘(B) recommended information to include 22
as instruction for use to disseminate with at- 23
home disposal systems; and 24
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‘‘(C) best practices and educational tools 1
to support the use of an at-home disposal sys-2
tem. 3
‘‘(3) U
PDATES.—The Secretary shall update 4
the guidance under this subsection not less fre-5
quently than every 5 years.’’. 6
SEC. 204. REPORT ON AT-HOME DRUG DISPOSAL SYSTEMS. 7
Subsection (n) of section 505–1 of the Federal Food, 8
Drug, and Cosmetic Act (21 U.S.C. 355–1), as added by 9
section 5, is amended by adding at the end the following: 10
‘‘(4) R
EPORT ON AT-HOME DRUG DISPOSAL 11
SYSTEMS.— 12
‘‘(A) I
N GENERAL.—Not later than one 13
year after the date of enactment of the SUP-14
PORT for Patients and Communities Reauthor-15
ization Act of 2023, the Secretary, in consulta-16
tion with the Administrator of the Drug En-17
forcement Administration, shall issue a report 18
outlining steps to improve access to at-home 19
drug disposal systems. 20
‘‘(B) R
EPORT.—The report required under 21
subparagraph (A) shall include— 22
‘‘(i) a review of commercially available 23
at-home drug disposal systems; 24
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‘‘(ii) current usage of at-home drug 1
disposal systems; 2
‘‘(iii) any barriers to development, in-3
cluding information necessary to independ-4
ently verify deactivation of appropriate 5
drugs and challenges with real world test-6
ing; 7
‘‘(iv) any barriers to distribution of 8
at-home drug disposal systems; and 9
‘‘(v) best practices for educational re-10
sources to inform distribution and use of 11
at-home drug disposal systems.’’. 12
SEC. 205. ENSURING STATE CHOICE IN PDMP SYSTEMS. 13
Section 399O(h) of the Public Health Service Act (42 14
U.S.C. 280g–3(h)) is amended by adding the following: 15
‘‘(5) E
NSURING STATE CHOICE .—Nothing in 16
this section shall be construed to— 17
‘‘(A) direct, require or encourage a State 18
to use a specific interstate data sharing pro-19
gram; 20
‘‘(B) limit or prohibit the discretion of a 21
PDMP to utilize interoperability connections of 22
its choice; 23
‘‘(C) permit, encourage, or otherwise con-24
dition Federal financial assistance to States 25
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based upon the use of open architecture by 1
PDMP systems or contracted vendors; or 2
‘‘(D) limit or prohibit the discretion of 3
States to utilize Federal financial assistance re-4
ceived under this section to enter into arrange-5
ments with vendors of their choice in order to 6
carry out a program under this section.’’. 7
SEC. 206. MENTAL HEALTH PARITY. 8
(a) I
NGENERAL.—Not later than January 1, 2025, 9
the Inspector General of the Department of Labor, in co-10
ordination with the Inspector General of the Department 11
of Health and Human Services, shall report to the Com-12
mittee on Health, Education, Labor, and Pensions of the 13
Senate and the Committee on Energy and Commerce and 14
the Committee on Education and the Workforce of the 15
House of Representatives on the following: 16
(1) The non-quantitative treatment limit (re-17
ferred to in this section as ‘‘NQTL’’) requirements 18
with respect to mental health and substance use dis-19
order benefits under group health plans and health 20
insurance issuers under section 2726(a)(8) of the 21
Public Health Service Act (42 U.S.C. 300gg– 22
26(a)(8)), section 712(a)(8) of the Employee Retire-23
ment Income Security Act of 1974 (29 U.S.C. 24
1185a(a)(8)), and section 9812(a)(8) of the Internal 25
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Revenue Code of 1986 (referred to in this section as 1
the ‘‘NQTL comparative analysis requirements’’), 2
and the requirements for the Secretary of Health 3
and Human Services, the Secretary of Labor, and 4
the Secretary of the Treasury to issue regulations, 5
a compliance program guide, and additional guid-6
ance documents and tools providing guidance relat-7
ing to mental health parity requirements under sec-8
tion 2726(a) of the Public Health Service Act (42 9
U.S.C. 300gg–26(a)), section 712(a) of the Em-10
ployee Retirement Income Security Act of 1974 (29 11
U.S.C. 1185a(a)), and section 9812(a) of the Inter-12
nal Revenue Code of 1986. 13
(2) With respect to the NQTL comparative 14
analysis requirements described in paragraph (1), an 15
analysis of the actions taken by the Secretary of 16
Labor, the Secretary of the Treasury, and the Sec-17
retary of Health and Human Services to provide 18
guidance to ensure that group health plans and 19
health insurance issuers can fully comply with men-20
tal health parity requirements under section 2726 of 21
the Public Health Service Act (42 U.S.C. 300gg–26, 22
section 712 of the Employee Retirement Income Se-23
curity Act of 1974 (29 U.S.C. 1185a), and section 24
9812 of the Internal Revenue Code of 1986 and the 25
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NQTL comparative analysis requirements described 1
in paragraph (1), including an analysis of— 2
(A) the extent to which the Secretary of 3
Labor, the Secretary of the Treasury, and the 4
Secretary of Health and Human Services have 5
fulfilled the requirement under section 203(b) 6
of division BB of the Consolidated Appropria-7
tions Act, 2021 (Public Law 116–260) to issue 8
the specific guidance and regulations pertaining 9
to the requirements for group health plans and 10
health insurance issuers to demonstrate compli-11
ance with the NQTL comparative analysis re-12
quirements; and 13
(B) whether sufficient guidance and exam-14
ples from the Department of Labor and De-15
partment of Health and Human Services, and 16
the Department of the Treasury exist to guide 17
and assist group health plans and health insur-18
ance issuers in complying with the requirements 19
to demonstrate compliance with mental health 20
parity NQTL comparative analysis require-21
ments/under such sections 2726(a)(8), 22
712(a)(8), and 9812(a)(8). 23
(3) A review of the enforcement processes of 24
the Department of Labor and the Department of 25
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Health and Human Services to evaluate the consist-1
ency of interpretation of the requirements under sec-2
tion 2726(a)(8) of the Public Health Service Act (42 3
U.S.C. 300gg–26(a)(8)), section 712(a)(8) of the 4
Employee Retirement Income Security Act of 1974 5
(29 U.S.C. 1185a(a)(8)), and section 9812(a)(8) of 6
the Internal Revenue Code of 1986, in particular 7
with respect to processes utilized for enforcement, 8
actions or inactions that constitute noncompliance, 9
and avoidance among the agencies of duplication of 10
enforcement, including an evaluation of compliance 11
with section 104 of the Health Insurance Portability 12
and Accountability Act of 1996 (Public Law 104– 13
191). 14
(4) A review of the implementation, by the De-15
partment of Labor, Department of Health and 16
Human Services, and Department of the Treasury, 17
of mental health parity requirements under section 18
2726 of the Public Health Service Act (42 U.S.C. 19
300gg–26), section 712 of the Employee Retirement 20
Income Security Act of 1974 (29 U.S.C. 1185a), 21
and section 9812 of the Internal Revenue Code of 22
1986, including all such requirements in effect 23
through the enactment of the Mental Health Parity 24
Act of 1996 (Public Law 104–204), the Paul 25
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Wellstone and Pete Domenici Mental Health Parity 1
and Addiction Equity Act of 2008 (Public Law 110– 2
460), the 21st Century Cures Act (Public Law 114– 3
255), and the Consolidated Appropriations Act, 4
2023 (Public Law 117–328) (including any amend-5
ments made by such Acts), and including with re-6
spect to the timing of all actions, delays of any ac-7
tions, reasons for any such delays, mandated re-8
quirements that were met only once but not each 9
time such requirements were mandated. 10
(b) D
EFINITIONS.—In this section, the terms ‘‘group 11
health plan’’ and ‘‘health insurance issuer’’ have the 12
meanings given such terms in section 733 of the Employee 13
Retirement Income Security Act of 1974 (29 U.S.C. 14
1191b). 15
SEC. 207. STATE GUIDANCE ON COVERAGE FOR INDIVID-16
UALS WITH SERIOUS MENTAL ILLNESS AND 17
CHILDREN WITH SERIOUS EMOTIONAL DIS-18
TURBANCE. 19
(a) R
EVIEW OFUSE OFCERTAINFUNDING.—Not 20
later than 180 days after the date of enactment of this 21
Act, the Secretary of Health and Human Services, acting 22
through the Assistant Secretary for Mental Health and 23
Substance Use, shall conduct a review of the use by States 24
of funds made available under the Community Mental 25
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Health Services Block Grant program under subpart I of 1
part B of title XIX of the Public Health Service Act (42 2
U.S.C. 300x et seq.) for First Episode Psychosis activities. 3
Such review shall consider the following: 4
(1) How the States use funds for evidence- 5
based treatments and services according to the 6
standard of care for individuals with serious mental 7
illness, including the comprehensiveness of such 8
treatments to include all aspects of the rec-9
ommended intervention. 10
(2) How State mental health departments are 11
coordinating with State Medicaid departments in the 12
delivery of the treatments and services described in 13
paragraph (1). 14
(3) What percentage of the State funding under 15
the block grant program is being applied toward 16
First Episode Psychosis in excess of 10 percent of 17
the amount of the grant, as broken down on a State- 18
by-State basis. The review shall also identify any 19
States that fail to expend the required 10 percent of 20
block grant funds on First Episode Psychosis activi-21
ties. 22
(4) How many individuals are served by the ex-23
penditures described in paragraph (3), broken down 24
on a per-capita basis. 25
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(5) How the funds are used to reach individuals 1
in underserved populations, including individuals in 2
rural areas and individuals from minority groups. 3
(b) R
EPORT ANDGUIDANCE.— 4
(1) R
EPORT.—Not later than 6 months after 5
the completion of the review under subsection (a), 6
the Secretary of Health and Human Services, acting 7
through the Assistant Secretary for Mental Health 8
and Substance Use, shall submit to the Committee 9
on Appropriations, the Committee on Health, Edu-10
cation, Labor, and Pensions, and the Committee on 11
Finance of the Senate and to the Committee on Ap-12
propriations and the Committee on Energy and 13
Commerce of the House of Representatives a report 14
on the findings made as a result of the review con-15
ducted under subsection (a). Such report shall in-16
clude any recommendations with respect to any 17
changes to the Community Mental Health Services 18
Block Grant program, including the set aside re-19
quired for First Episode Psychosis, that would facili-20
tate improved outcomes for the targeted population 21
involved. 22
(2) G
UIDANCE.—Not later than 1 year after 23
the date on which the report is submitted under 24
paragraph (1), the Secretary of Health and Human 25
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Services, acting through the Assistant Secretary for 1
Mental Health and Substance Use, shall update the 2
guidance provided to States under the Community 3
Mental Health Services Block Grant program based 4
on the findings and recommendations of the report. 5
(c) T
ECHNICALASSISTANCE.—The Director of the 6
National Institute of Mental Health shall coordinate with 7
the Assistant Secretary for Mental Health and Substance 8
Use in providing technical assistance to State grantees 9
and provider subgrantees in the delivery of services for 10
First Episode Psychosis under the Community Mental 11
Health Services Block Grant program. 12
(d) G
UIDANCE FORSTATESRELATING TOCOVERAGE 13
R
ECOMMENDATIONS OF HEALTHCARESERVICES AND 14
I
NTERVENTIONS FOR INDIVIDUALSWITHSERIOUSMEN-15
TALILLNESS ANDCHILDRENWITHSERIOUSEMOTIONAL 16
D
ISTURBANCE.—Not later than 2 years after the date of 17
enactment of this Act, the Administrator of the Centers 18
for Medicare & Medicaid Services, jointly with the Assist-19
ant Secretary for Mental Health and Substance Use and 20
the Director of the National Institute of Mental Health— 21
(1) shall provide updated guidance to States 22
concerning— 23
(A) coverage recommendations relating to 24
health care services and interventions for indi-25
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viduals with serious mental illness, specifically 1
First Episode Psychosis; and 2
(B) the manner in which Federal funding 3
provided to States through programs adminis-4
tered by such agencies, including the Commu-5
nity Mental Health Services Block Grant pro-6
gram under subpart I of part B of title XIX of 7
the Public Health Service Act (42 U.S.C. 300x 8
et seq.), may be coordinated to support individ-9
uals with serious mental illness and serious 10
emotional disturbance; and 11
(2) may streamline relevant State reporting re-12
quirements if such streamlining would result in mak-13
ing it easier for States to coordinate funding under 14
the programs described in paragraph (1)(B) to im-15
prove treatments for individuals with serious mental 16
illness and serious emotional disturbance. 17
SEC. 208. COMMUNITY MENTAL HEALTH SERVICES BLOCK 18
GRANT SERVICE PROVIDERS. 19
Subpart I of part B of title XIX of the Public Health 20
Service Act is amended— 21
(1) in section 1913(b)(1) (42 U.S.C. 300x– 22
2(b)(1)), by inserting ‘‘, and which may include, at 23
the discretion of the State, appropriate programs op-24
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erated by for-profit entities’’ after ‘‘consumer-di-1
rected programs’’; and 2
(2) in section 1916(a)(5) (42 U.S.C. 300x– 3
5(a)(5)), by inserting ‘‘, or a for-profit entity se-4
lected by a State pursuant to section 1913(b)(1)’’ 5
before the period at the end. 6
SEC. 209. REPORTS AND STUDIES ON MEDICATION TREAT-7
MENTS FOR OPIOID USE DISORDER. 8
(a) NIH S
TUDY ONMETHADONETREATMENT.—Not 9
later than 6 months after the date of the enactment of 10
this Act, and every 6 months thereafter, the Director of 11
the National Institutes of Health— 12
(1) shall submit to the Committee on Health, 13
Education, Labor, and Pensions of the Senate and 14
the Committee on Energy and Commerce of the 15
House of Representatives a report on ongoing and 16
new clinical studies conducted or funded by the Na-17
tional Institutes of Health on the access to, safety 18
of, and efficacy of methadone treatment for opioid 19
use disorder in accredited and certified opioid treat-20
ment programs and in other programs or settings; 21
and 22
(2) in conjunction with the Administrator of the 23
Drug Enforcement Administration, shall brief the 24
Committee on Health, Education, Labor, and Pen-25
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sions of the Senate and the Committee on Energy 1
and Commerce of the House of Representatives on— 2
(A) interim results from the studies de-3
scribed in paragraph (1); and 4
(B) any barriers that may prevent ade-5
quate and timely enrollment of patients in any 6
new clinical study described in paragraph (1). 7
(b) S
TUDY ON MEDICATIONTREATMENTS FOR 8
O
PIOIDUSEDISORDERS.—The Secretary of Health and 9
Human Services, acting through the Assistant Secretary 10
for Mental Health and Substance Use, shall— 11
(1) study— 12
(A) the early impact on access to medica-13
tion treatment for opioid use disorder and 14
opioid-related overdose deaths through 15
buprenorphine prescribing pursuant to section 16
303(g) of the Controlled Substances Act (21 17
U.S.C. 823(g)), as amended by section 1262 of 18
title I of division FF of the Mental Health and 19
Well-Being Act of 2022; 20
(B) an updated analysis of the effect of 21
methadone on opioid-related overdose death 22
rates, disaggregated by State; 23
(C) the number of patients with opioid use 24
disorder who are prescribed no medication for 25
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such disorder, and the number of patients with 1
opioid use disorder who are prescribed 2
naltrexone, buprenorphine, or methadone, re-3
spectively, at each opioid treatment program; 4
(D) the prevalence of patients with opioid 5
use disorder, disaggregated by county and the 6
number of patients with opioid use disorder in 7
each county; 8
(E) the number of addiction psychiatrists 9
and addiction medicine physicians within a 10
county who are not affiliated with an opioid 11
treatment program and, with respect to such 12
psychiatrists and physicians— 13
(i) whether such providers accept new 14
patients; 15
(ii) which types of health insurance 16
are accepted by such providers; and 17
(iii) wait times for new appointments; 18
and 19
(F) a survey of retail pharmacies nation-20
wide, disaggregated by State, to determine 21
which pharmacies serve as methadone dis-22
pensing units for opioid treatment programs, 23
and which such pharmacies are interested in 24
stocking or dispensing methadone; and 25
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(2) submit to the Committee on Health, Edu-1
cation, Labor, and Pensions of the Senate and the 2
Committee on Energy and Commerce of the House 3
of Representatives— 4
(A) not later than the earlier of 18 months 5
after the date of the enactment of this Act or 6
June 1, 2025, an initial report on the study 7
under paragraph (1); and 8
(B) not later than December 31, 2025, a 9
final report on the study under paragraph (1). 10
SEC. 210. FASD RESPECT ACT. 11
(a) I
NGENERAL.—Part O of title III of the Public 12
Health Service Act (42 U.S.C. 280f et seq.) is amended— 13
(1) by amending the part heading to read as 14
follows: ‘‘
FETAL ALCOHOL SPECTRUM DIS -15
ORDERS PREVENTION AND SERVICES PRO -16
GRAM’’; 17
(2) in section 399H (42 U.S.C. 280f)— 18
(A) in the section heading, by striking 19
‘‘
ESTABLISHMENT OF FETAL ALCOHOL 20
SYNDROME PREVENTION ’’ and inserting 21
‘‘
FETAL ALCOHOL SPECTRUM DISORDERS 22
PREVENTION , INTERVENTION ,’’; 23
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(B) by striking ‘‘Fetal Alcohol Syndrome 1
and Fetal Alcohol Effect’’ each place it appears 2
and inserting ‘‘FASD’’; 3
(C) in subsection (a)— 4
(i) by amending the heading to read 5
as follows: ‘‘I
NGENERAL’’; 6
(ii) in the matter preceding paragraph 7
(1)— 8
(I) by inserting ‘‘or continue ac-9
tivities to support’’ after ‘‘shall estab-10
lish’’; 11
(II) by striking ‘‘FASD’’ (as 12
amended by subparagraph (B)) and 13
inserting ‘‘fetal alcohol spectrum dis-14
orders (referred to in this section as 15
‘FASD’)’’; 16
(III) by striking ‘‘prevention, 17
intervention’’ and inserting ‘‘aware-18
ness, prevention, identification, inter-19
vention,’’; and 20
(IV) by striking ‘‘that shall’’ and 21
inserting ‘‘, which may’’; 22
(iii) in paragraph (1)— 23
(I) in subparagraph (A)— 24
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(aa) by striking ‘‘medical 1
schools’’ and inserting ‘‘health 2
professions schools’’; and 3
(bb) by inserting ‘‘infants,’’ 4
after ‘‘provision of services for’’; 5
and 6
(II) in subparagraph (D), by 7
striking ‘‘medical and mental’’ and in-8
serting ‘‘agencies providing’’; 9
(iv) in paragraph (2)— 10
(I) in the matter preceding sub-11
paragraph (A), by striking ‘‘a preven-12
tion and diagnosis program to support 13
clinical studies, demonstrations and 14
other research as appropriate’’ and in-15
serting ‘‘supporting and conducting 16
research on FASD, as appropriate, in-17
cluding’’; 18
(II) in subparagraph (B)— 19
(aa) by striking ‘‘prevention 20
services and interventions for 21
pregnant, alcohol-dependent 22
women’’ and inserting ‘‘culturally 23
and linguistically informed evi-24
dence-based or practice-based 25
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interventions and appropriate so-1
cietal supports for preventing 2
prenatal alcohol exposure, which 3
may co-occur with exposure to 4
other substances’’; and 5
(bb) by striking ‘‘; and’’ and 6
inserting a semicolon; 7
(v) by striking paragraph (3) and in-8
serting the following: 9
‘‘(3) integrating into surveillance practice an 10
evidence-based standard case definition for fetal al-11
cohol syndrome and, in collaboration with other Fed-12
eral and outside partners, support organizations of 13
appropriate medical and mental health professionals 14
in their development and refinement of evidence- 15
based clinical diagnostic guidelines and criteria for 16
all fetal alcohol spectrum disorders; and 17
‘‘(4) building State and Tribal capacity for the 18
identification, treatment, and support of individuals 19
with FASD and their families, which may include— 20
‘‘(A) utilizing and adapting existing Fed-21
eral, State, or Tribal programs to include 22
FASD identification and FASD-informed sup-23
port; 24
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‘‘(B) developing and expanding screening 1
and diagnostic capacity for FASD; 2
‘‘(C) developing, implementing, and evalu-3
ating targeted FASD-informed intervention 4
programs for FASD; 5
‘‘(D) increasing awareness of FASD; 6
‘‘(E) providing training with respect to 7
FASD for professionals across relevant sectors; 8
and 9
‘‘(F) disseminating information about 10
FASD and support services to affected individ-11
uals and their families.’’; 12
(D) in subsection (b)— 13
(i) by striking ‘‘described in section 14
399I’’; 15
(ii) by striking ‘‘The Secretary’’ and 16
inserting the following: 17
‘‘(1) I
N GENERAL.—The Secretary’’; and 18
(iii) by adding at the end the fol-19
lowing: 20
‘‘(2) E
LIGIBLE ENTITIES.—To be eligible to re-21
ceive a grant, or enter into a cooperative agreement 22
or contract, under this section, an entity shall— 23
‘‘(A) be a State, Indian Tribe or Tribal or-24
ganization, local government, scientific or aca-25
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demic institution, or nonprofit organization; 1
and 2
‘‘(B) prepare and submit to the Secretary 3
an application at such time, in such manner, 4
and containing such information as the Sec-5
retary may require, including a description of 6
the activities that the entity intends to carry 7
out using amounts received under this section. 8
‘‘(3) A
DDITIONAL APPLICATION CONTENTS .— 9
The Secretary may require that an entity using 10
amounts from a grant, cooperative agreement, or 11
contract under this section for an activity under sub-12
section (a)(4) include in the application for such 13
amounts submitted under paragraph (2)(B)— 14
‘‘(A) a designation of an individual to 15
serve as a FASD State or Tribal coordinator of 16
such activity; and 17
‘‘(B) a description of an advisory com-18
mittee the entity will establish to provide guid-19
ance for the entity on developing and imple-20
menting a statewide or Tribal strategic plan to 21
prevent FASD and provide for the identifica-22
tion, treatment, and support of individuals with 23
FASD and their families.’’; 24
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(E) by striking subsections (c) and (d); 1
and 2
(F) by adding at the end the following: 3
‘‘(c) D
EFINITION OFFASD-INFORMED.—For pur-4
poses of this section, the term ‘FASD-informed’, with re-5
spect to support or an intervention program, means that 6
such support or intervention program uses culturally and 7
linguistically informed evidence-based or practice-based 8
interventions and appropriate societal supports to support 9
an improved quality of life for an individual with FASD 10
and the family of such individual.’’; and 11
(3) by striking sections 399I, 399J, and 399K 12
(42 U.S.C. 280f–1, 280f–2, 280f–3) and inserting 13
the following: 14
‘‘SEC. 399I. FETAL ALCOHOL SPECTRUM DISORDERS CEN-15
TERS FOR EXCELLENCE. 16
‘‘(a) I
NGENERAL.—The Secretary shall, as appro-17
priate, award grants, cooperative agreements, or contracts 18
to public or nonprofit entities with demonstrated expertise 19
in the prevention of, identification of, and intervention 20
services with respect to, fetal alcohol spectrum disorders 21
(referred to in this section as ‘FASD’) and other related 22
adverse conditions. Such awards shall be for the purposes 23
of establishing Fetal Alcohol Spectrum Disorders Centers 24
for Excellence to build local, Tribal, State, and national 25
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capacities to prevent the occurrence of FASD and other 1
related adverse conditions, and to respond to the needs 2
of individuals with FASD and their families by carrying 3
out the programs described in subsection (b). 4
‘‘(b) P
ROGRAMS.—An entity receiving an award 5
under subsection (a) may use such award for the following 6
purposes: 7
‘‘(1) Initiating or expanding diagnostic capacity 8
for FASD by increasing screening, assessment, iden-9
tification, and diagnosis. 10
‘‘(2) Developing and supporting public aware-11
ness and outreach activities, including the use of a 12
range of media and public outreach, to raise public 13
awareness of the risks associated with alcohol con-14
sumption during pregnancy, with the goals of reduc-15
ing the prevalence of FASD and improving the de-16
velopmental, health (including mental health), and 17
educational outcomes of individuals with FASD and 18
supporting families caring for individuals with 19
FASD. 20
‘‘(3) Acting as a clearinghouse for evidence- 21
based resources on FASD prevention, identification, 22
and culturally and linguistically informed best prac-23
tices, including the maintenance of a national data- 24
based directory on FASD-specific services in States, 25
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Indian Tribes, and local communities, and dissemi-1
nating ongoing research and developing resources on 2
FASD to help inform systems of care for individuals 3
with FASD across their lifespan. 4
‘‘(4) Increasing awareness and understanding 5
of efficacious, evidence-based FASD screening tools 6
and culturally- and linguistically-appropriate evi-7
dence-based intervention services and best practices, 8
which may include by conducting national, regional, 9
State, Tribal, or peer cross-State webinars, work-10
shops, or conferences for training community lead-11
ers, medical and mental health and substance use 12
disorder professionals, education and disability pro-13
fessionals, families, law enforcement personnel, 14
judges, individuals working in financial assistance 15
programs, social service personnel, child welfare pro-16
fessionals, and other service providers. 17
‘‘(5) Improving capacity for State, Tribal, and 18
local affiliates dedicated to FASD awareness, pre-19
vention, and identification and family and individual 20
support programs and services. 21
‘‘(6) Providing technical assistance to grantees 22
under section 399H, as appropriate. 23
‘‘(7) Carrying out other functions, as appro-24
priate. 25
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‘‘(c) APPLICATION.—To be eligible for a grant, con-1
tract, or cooperative agreement under this section, an enti-2
ty shall submit to the Secretary an application at such 3
time, in such manner, and containing such information as 4
the Secretary may require. 5
‘‘(d) S
UBCONTRACTING.—A public or private non-6
profit entity may carry out the following activities required 7
under this section through contracts or cooperative agree-8
ments with other public and private nonprofit entities with 9
demonstrated expertise in FASD: 10
‘‘(1) Prevention activities. 11
‘‘(2) Screening and identification. 12
‘‘(3) Resource development and dissemination, 13
training and technical assistance, administration, 14
and support of FASD partner networks. 15
‘‘(4) Intervention services. 16
‘‘SEC. 399J. AUTHORIZATION OF APPROPRIATIONS. 17
‘‘There are authorized to be appropriated to carry out 18
this part such sums as may be necessary for each of fiscal 19
years 2024 through 2028.’’. 20
(b) R
EPORT.—Not later than 4 years after the date 21
of enactment of this Act, the Secretary of Health and 22
Human Services shall submit to the Committee on Health, 23
Education, Labor, and Pensions of the Senate and the 24
Committee on Energy and Commerce of the House of 25
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Representatives a report on the efforts of the Department 1
of Health and Human Services to advance public aware-2
ness on, and facilitate the identification of best practices 3
related to, fetal alcohol spectrum disorders identification, 4
prevention, treatment, and support. 5
(c) T
ECHNICALAMENDMENT.—Section 519D of the 6
Public Health Service Act (42 U.S.C. 290bb–25d) is re-7
pealed. 8
Æ
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