II
118THCONGRESS
1
STSESSION S. 3106
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
OCTOBER24, 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. Residential treatment programs for pregnant and postpartum women.
Sec. 103. Prenatal and postnatal health.
Sec. 104. Loan repayment program for substance use disorder treatment work-
force.
Sec. 105. Youth prevention and recovery.
Sec. 106. Comprehensive opioid recovery centers.
Sec. 107. CDC surveillance and data collection for child, youth, and adult trau-
ma.
Sec. 108. Task force to develop best practices for trauma-informed identifica-
tion, referral, and support.
Sec. 109. Donald J. Cohen National child traumatic stress initiative.
Sec. 110. Surveillance and education regarding infections associated with illicit
drug use and other risk factors.
Sec. 111. Building communities of recovery.
Sec. 112. Peer support technical assistance center.
Sec. 113. Preventing overdoses of controlled substances.
Sec. 114. CAREER Act.
Sec. 115. Grants to improve trauma support services and mental health care
for children and youth in educational settings.
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. Guidance on 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 ‘‘$36,000,000 4
for each of fiscal years 2019 through 2023’’ and inserting 5
‘‘$56,000,000 for each of fiscal years 2024 through 6
2028’’. 7
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SEC. 102. RESIDENTIAL TREATMENT PROGRAMS FOR 1
PREGNANT AND POSTPARTUM WOMEN. 2
Section 508(s) of the Public Health Service Act (42 3
U.S.C. 290bb–1(s)) is amended by striking ‘‘$29,931,000 4
for each of fiscal years 2019 through 2023’’ and inserting 5
‘‘$38,931,000 for each of fiscal years 2024 through 6
2028’’. 7
SEC. 103. PRENATAL AND POSTNATAL HEALTH. 8
Section 317L(d) of the Public Health Service Act (42 9
U.S.C. 247b–13(d)) is amended by striking ‘‘2019 10
through 2023’’ and inserting ‘‘2024 through 2028’’. 11
SEC. 104. LOAN REPAYMENT PROGRAM FOR SUBSTANCE 12
USE DISORDER TREATMENT WORKFORCE. 13
Section 781(j) of the Public Health Service Act (42 14
U.S.C. 295h(j)) is amended by striking ‘‘$25,000,000 for 15
each of fiscal years 2019 through 2023’’ and inserting 16
‘‘$40,000,000 for each of fiscal years 2024 through 17
2028’’. 18
SEC. 105. YOUTH PREVENTION AND RECOVERY. 19
Section 7102(c)(9) of the SUPPORT for Patients 20
and Communities Act (42 U.S.C. 290bb–7a(c)(9)) is 21
amended by striking ‘‘2019 through 2023’’ and inserting 22
‘‘2024 through 2028’’. 23
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SEC. 106. COMPREHENSIVE OPIOID RECOVERY CENTERS. 1
Section 552(j) of the Public Health Service Act (42 2
U.S.C. 290ee–7(j)) is amended by striking ‘‘2019 through 3
2023’’ and inserting ‘‘2024 through 2028’’. 4
SEC. 107. CDC SURVEILLANCE AND DATA COLLECTION FOR 5
CHILD, YOUTH, AND ADULT TRAUMA. 6
Section 7131(e) of the SUPPORT for Patients and 7
Communities Act (42 U.S.C. 242t(e)) is amended by strik-8
ing ‘‘$2,000,000 for each of fiscal years 2019 through 9
2023’’ and inserting ‘‘$9,000,000 for each of fiscal years 10
2024 through 2028’’. 11
SEC. 108. TASK FORCE TO DEVELOP BEST PRACTICES FOR 12
TRAUMA-INFORMED IDENTIFICATION, RE-13
FERRAL, AND SUPPORT. 14
Section 7132(i) of the SUPPORT for Patients and 15
Communities Act (Public Law 115–271) is amended by 16
striking ‘‘2023’’ and inserting ‘‘2028’’. 17
SEC. 109. DONALD J. COHEN NATIONAL CHILD TRAUMATIC 18
STRESS INITIATIVE. 19
Section 582(j) of the Public Health Service Act (42 20
U.S.C. 290hh–1(j)) (relating to grants to address the 21
problems of persons who experience violence-related 22
stress) is amended by striking ‘‘$63,887,000 for each of 23
fiscal years 2019 through 2023’’ and inserting 24
‘‘$93,887,000 for each of fiscal years 2024 through 25
2028’’. 26
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SEC. 110. SURVEILLANCE AND EDUCATION REGARDING IN-1
FECTIONS ASSOCIATED WITH ILLICIT DRUG 2
USE AND OTHER RISK FACTORS. 3
Section 317N(d) of the Public Health Service Act (42 4
U.S.C. 247b–15(d)) is amended by striking ‘‘2019 5
through 2023’’ and inserting ‘‘2024 through 2028’’. 6
SEC. 111. BUILDING COMMUNITIES OF RECOVERY. 7
Section 547(f) of the Public Health Service Act (42 8
U.S.C. 290ee–2(f)) is amended by striking ‘‘$5,000,000 9
for each of fiscal years 2019 through 2023’’ and inserting 10
‘‘$16,000,000 for each of fiscal years 2024 through 11
2028’’. 12
SEC. 112. 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 ‘‘$1,000,000 16
for each of fiscal years 2019 through 2023’’ and inserting 17
‘‘$2,000,000 for each of fiscal years 2024 through 2028’’. 18
SEC. 113. PREVENTING OVERDOSES OF CONTROLLED SUB-19
STANCES. 20
Section 392A(e) of the Public Health Service Act (42 21
U.S.C. 280b–1(e)) is amended by striking ‘‘$496,000,000 22
for each of fiscal years 2019 through 2023’’ and inserting 23
‘‘$505,579,000 for each of fiscal years 2024 through 24
2028’’. 25
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SEC. 114. CAREER ACT. 1
(a) I
NGENERAL.—Section 7183 of the SUPPORT 2
for Patients and Communities Act (42 U.S.C. 290ee–8) 3
is amended— 4
(1) in the section heading, by inserting ‘‘; 5
TREATMENT , RECOVERY, AND WORKFORCE 6
SUPPORT GRANTS ’’ after ‘‘CAREER ACT’’; 7
(2) in subsection (b), by inserting ‘‘each’’ before 8
‘‘for a period’’; 9
(3) in subsection (c)— 10
(A) in paragraph (1), by striking ‘‘the 11
rates described in paragraph (2)’’ and inserting 12
‘‘the average rates for calendar years 2018 13
through 2022 described in paragraph (2)’’; and 14
(B) by amending paragraph (2) to read as 15
follows: 16
‘‘(2) R
ATES.—The rates described in this para-17
graph are the following: 18
‘‘(A) The highest age-adjusted average 19
rates of drug overdose deaths for calendar years 20
2018 through 2022 based on data from the 21
Centers for Disease Control and Prevention, in-22
cluding, if necessary, provisional data for cal-23
endar year 2022. 24
‘‘(B) The highest average rates of unem-25
ployment for calendar years 2018 through 2022 26
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based on data provided by the Bureau of Labor 1
Statistics. 2
‘‘(C) The lowest average labor force par-3
ticipation rates for calendar years 2018 through 4
2022 based on data provided by the Bureau of 5
Labor Statistics.’’; 6
(4) in subsection (g)— 7
(A) in each of paragraphs (1) and (3), by 8
redesignating subparagraphs (A) and (B) as 9
clauses (i) and (ii), respectively, and adjusting 10
the margins accordingly; 11
(B) by redesignating paragraphs (1) 12
through (3) as subparagraphs (A) through (C), 13
respectively, and adjusting the margins accord-14
ingly; 15
(C) in the matter preceding subparagraph 16
(A) (as so redesignated), by striking ‘‘An enti-17
ty’’ and inserting the following: 18
‘‘(1) I
N GENERAL.—An entity’’; and 19
(D) by adding at the end the following: 20
‘‘(2) T
RANSPORTATION SERVICES .—An entity 21
receiving a grant under this section may use not 22
more than 5 percent of the funds for providing 23
transportation for individuals to participate in an ac-24
tivity supported by a grant under this section, which 25
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transportation shall be to or from a place of work 1
or a place where the individual is receiving voca-2
tional education or job training services or receiving 3
services directly linked to treatment of or recovery 4
from a substance use disorder. 5
‘‘(3) L
IMITATION.—The Secretary may not re-6
quire an entity to, or give priority to an entity that 7
plans to, use the funds of a grant under this section 8
for activities that are not specified in this sub-9
section.’’; 10
(5) in subsection (i)(2), by inserting ‘‘, which 11
shall include employment and earnings outcomes de-12
scribed in subclauses (I) and (III) of section 13
116(b)(2)(A)(i) of the Workforce Innovation and 14
Opportunity Act (29 U.S.C. 3141(b)(2)(A)(i)) with 15
respect to the participation of such individuals with 16
a substance use disorder in programs and activities 17
funded by the grant under this section’’ after ‘‘sub-18
section (g)’’; 19
(6) in subsection (j)— 20
(A) in paragraph (1), by inserting ‘‘for 21
grants awarded prior to the date of enactment 22
of the SUPPORT for Patients and Commu-23
nities Reauthorization Act of 2023’’ after 24
‘‘grant period under this section’’; and 25
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(B) in paragraph (2)— 1
(i) in the matter preceding subpara-2
graph (A), by striking ‘‘2 years after sub-3
mitting the preliminary report required 4
under paragraph (1)’’ and inserting ‘‘Sep-5
tember 30, 2028’’; and 6
(ii) in subparagraph (A), by striking 7
‘‘(g)(3)’’ and inserting ‘‘(g)(1)(C)’’; and 8
(7) in subsection (k), by striking ‘‘$5,000,000 9
for each of fiscal years 2019 through 2023’’ and in-10
serting ‘‘$12,000,000 for each of fiscal years 2024 11
through 2028’’. 12
(b) C
LERICALAMENDMENT.—The table of contents 13
in section 1(b) of the SUPPORT for Patients and Com-14
munities Act (Public Law 115–271; 132 Stat. 3894) is 15
amended by striking the item relating to section 7183 and 16
inserting the following: 17
‘‘Sec. 7183. CAREER Act; treatment, recovery, and workforce support
grants.’’.
SEC. 115. GRANTS TO IMPROVE TRAUMA SUPPORT SERV-
18
ICES AND MENTAL HEALTH CARE FOR CHIL-19
DREN AND YOUTH IN EDUCATIONAL SET-20
TINGS. 21
Section 7134 of the SUPPORT for Patients and 22
Communities Act (42 U.S.C. 280h–7) is amended— 23
(1) in subsection (c)— 24
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(A) by striking paragraph (2); 1
(B) by redesignating paragraphs (3) 2
through (8) as paragraphs (2) through (7), re-3
spectively; 4
(C) in subparagraph (A) of paragraph (2), 5
as so redesignated, by striking ‘‘, including 6
through social and emotional learning’’; and 7
(D) in paragraph (3), as so redesignated, 8
by inserting ‘‘, provided that the students’ 9
records are owned and maintained by the 10
school,’’ after ‘‘community school’’; 11
(2) in subsection (d)(4)— 12
(A) in subparagraph (A), by striking ‘‘; 13
and’’ and inserting a semicolon; 14
(B) in subparagraph (B), by striking the 15
period and inserting a semicolon; and 16
(C) by adding at the end the following: 17
‘‘(C) parents and guardians will be in-18
formed of what trauma support services and 19
mental health care are available to their stu-20
dents and what services and care their students 21
receive, and will receive updates on their stu-22
dents’ services and care; and 23
‘‘(D) parents and guardians will have ac-24
cess to all documents related to the trauma 25
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support services and mental health care that 1
their student receives.’’; 2
(3) in subsection (f)(1), by inserting ‘‘, includ-3
ing an assessment of how parents or guardians of 4
students are engaged in the design of, and informed 5
in the provision of, trauma support services and 6
mental health care in their student’s school’’ before 7
the semicolon; and 8
(4) in subsection (l), by striking ‘‘2019 through 9
2023’’ and inserting ‘‘2024 through 2028’’. 10
TITLE II—OTHER PROVISIONS 11
SEC. 201. DELIVERY OF A CONTROLLED SUBSTANCE BY A 12
PHARMACY. 13
Section 309A(a) of the Controlled Substances Act 14
(21 U.S.C. 829a(a)) is amended by striking paragraph (2) 15
and inserting the following: 16
‘‘(2) the controlled substance is a drug in 17
schedule III, IV, or V and is— 18
‘‘(A) to be administered for the purpose of 19
initiation, maintenance, or detoxification treat-20
ment; or 21
‘‘(B) subject to risk evaluation and mitiga-22
tion strategy pursuant to section 505–1 of the 23
Federal Food, Drug, and Cosmetic Act (21 24
U.S.C. 355–1), which may require the drug to 25
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be administered with post-administration moni-1
toring by a health care professional;’’. 2
SEC. 202. REGULATIONS RELATING TO A SPECIAL REG-3
ISTRATION FOR TELEMEDICINE. 4
Not later than 1 year after the date of enactment 5
of this Act, the Attorney General, in consultation with the 6
Secretary of Health and Human Services, shall promul-7
gate the final regulations required under section 311(h)(2) 8
of the Controlled Substances Act (21 U.S.C. 831(h)(2)). 9
SEC. 203. GUIDANCE ON AT-HOME DRUG DISPOSAL SYS-10
TEMS. 11
(a) I
NGENERAL.—Not later than one year after the 12
date of enactment of this Act, the Secretary of Health and 13
Human Services (referred to in this section as the ‘‘Sec-14
retary’’) shall publish guidance to facilitate the use of at- 15
home safe disposal systems for applicable drugs, including 16
for such at-home safe disposal systems that the Secretary 17
may require as a part of a risk evaluation and mitigation 18
strategy under section 505–1 of the Federal Food, Drug, 19
and Cosmetic Act (21 U.S.C. 355–1). 20
(b) C
ONTENTS.—The guidance under subsection (a) 21
shall include— 22
(1) recommended standards for effective at- 23
home drug disposal systems to meet the public 24
health or non-retrievability standard; 25
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(2) recommended information to include as in-1
struction for use to disseminate with at-home drug 2
disposal systems; 3
(3) best practices and educational tools to sup-4
port the use of an at-home drug disposal system; 5
and 6
(4) recommended use of licensed health pro-7
viders for the dissemination of education, instruc-8
tion, and at-home drug disposal systems. 9
(c) U
PDATES.—The Secretary shall update the guid-10
ance under this section not less frequently than every 5 11
years. 12
SEC. 204. REPORT ON AT-HOME DRUG DISPOSAL SYSTEMS. 13
(a) S
TUDY.—Not later than 60 days after the date 14
of enactment of this Act, the Secretary of Health and 15
Human Services, in consultation with the Administrator 16
of the Drug Enforcement Administration, shall enter into 17
an agreement with the National Academies of Sciences, 18
Engineering, and Medicine to— 19
(1) convene a committee of experts to examine 20
steps to improve access to at-home drug disposal 21
systems, including reviewing— 22
(A) commercially available at-home drug 23
disposal systems; 24
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(B) current State, local, and private pro-1
grams providing education and in-home drug 2
disposal systems; 3
(C) academic studies and real world test-4
ing regarding drug disposal system compliance, 5
effectiveness, and usage, and any challenges as-6
sociated with such systems; and 7
(D) any barriers to distribution of at-home 8
drug disposal systems; and 9
(2) issue an expert consensus report that sets 10
forth best practices for educational resources to in-11
form distribution and use of at-home drug disposal 12
systems. 13
(b) R
EPORT.—Upon completion of the consensus re-14
port under subsection (a)(2), the Health and Medicine Di-15
vision of the National Academies of Sciences, Engineering, 16
and Medicine shall transmit a copy of the report to— 17
(1) the Secretary of Health and Human Serv-18
ices; 19
(2) the Commissioner of Food and Drugs; 20
(3) the Administrator of the Drug Enforcement 21
Administration; 22
(4) the Committee on Health, Education, 23
Labor, and Pensions of the Senate; and 24
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(5) the Committee on Energy and Commerce of 1
the House of Representatives. 2
SEC. 205. ENSURING STATE CHOICE IN PDMP SYSTEMS. 3
Section 399O(h) of the Public Health Service Act (42 4
U.S.C. 280g–3(h)) is amended by adding the following: 5
‘‘(5) E
NSURING STATE CHOICE .—Nothing in 6
this section shall be construed to— 7
‘‘(A) direct, require or encourage a State 8
to use a specific interstate data sharing pro-9
gram; 10
‘‘(B) limit or prohibit the discretion of a 11
PDMP to utilize interoperability connections of 12
its choice; 13
‘‘(C) permit, encourage, or otherwise con-14
dition Federal financial assistance to States 15
based upon the use of open architecture, other 16
than nationally recognized, consensus-based 17
standards, by PDMP systems or contracted 18
vendors; or 19
‘‘(D) limit or prohibit the discretion of 20
States to utilize Federal financial assistance re-21
ceived under this section to enter into arrange-22
ments with vendors of their choice in order to 23
carry out a program under this section.’’. 24
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SEC. 206. MENTAL HEALTH PARITY. 1
(a) I
NGENERAL.—Not later than January 1, 2025, 2
the Inspector General of the Department of Labor, in co-3
ordination with the Inspector General of the Department 4
of Health and Human Services, shall report to the Com-5
mittee on Health, Education, Labor, and Pensions of the 6
Senate and the Committee on Energy and Commerce and 7
the Committee on Education and the Workforce of the 8
House of Representatives on the following: 9
(1) The non-quantitative treatment limit (re-10
ferred to in this section as ‘‘NQTL’’) requirements 11
with respect to mental health and substance use dis-12
order benefits under group health plans and health 13
insurance issuers under section 2726(a)(8) of the 14
Public Health Service Act (42 U.S.C. 300gg– 15
26(a)(8)), section 712(a)(8) of the Employee Retire-16
ment Income Security Act of 1974 (29 U.S.C. 17
1185a(a)(8)), and section 9812(a)(8) of the Internal 18
Revenue Code of 1986 (referred to in this section as 19
the ‘‘NQTL comparative analysis requirements’’), 20
and the requirements for the Secretary of Health 21
and Human Services, the Secretary of Labor, and 22
the Secretary of the Treasury to issue regulations, 23
a compliance program guide, and additional guid-24
ance documents and tools providing guidance relat-25
ing to mental health parity requirements under sec-26
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tion 2726(a) of the Public Health Service Act (42 1
U.S.C. 300gg–26(a)), section 712(a) of the Em-2
ployee Retirement Income Security Act of 1974 (29 3
U.S.C. 1185a(a)), and section 9812(a) of the Inter-4
nal Revenue Code of 1986. 5
(2) With respect to the NQTL comparative 6
analysis requirements described in paragraph (1), an 7
analysis of the actions taken by the Secretary of 8
Labor, the Secretary of the Treasury, and the Sec-9
retary of Health and Human Services to provide 10
guidance to ensure that group health plans and 11
health insurance issuers can fully comply with men-12
tal health parity requirements under section 2726 of 13
the Public Health Service Act (42 U.S.C. 300gg–26, 14
section 712 of the Employee Retirement Income Se-15
curity Act of 1974 (29 U.S.C. 1185a), and section 16
9812 of the Internal Revenue Code of 1986 and the 17
NQTL comparative analysis requirements described 18
in paragraph (1), including an analysis of— 19
(A) the extent to which the Secretary of 20
Labor, the Secretary of the Treasury, and the 21
Secretary of Health and Human Services have 22
fulfilled the requirement under section 203(b) 23
of division BB of the Consolidated Appropria-24
tions Act, 2021 (Public Law 116–260) to issue 25
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the specific guidance and regulations pertaining 1
to the requirements for group health plans and 2
health insurance issuers to demonstrate compli-3
ance with the NQTL comparative analysis re-4
quirements; and 5
(B) whether sufficient guidance and exam-6
ples from the Department of Labor and De-7
partment of Health and Human Services, and 8
the Department of the Treasury exist to guide 9
and assist group health plans and health insur-10
ance issuers in complying with the requirements 11
to demonstrate compliance with mental health 12
parity NQTL comparative analysis require-13
ments/under such sections 2726(a)(8), 14
712(a)(8), and 9812(a)(8). 15
(3) A review of the enforcement processes of 16
the Department of Labor and the Department of 17
Health and Human Services to evaluate the consist-18
ency of interpretation of the requirements under sec-19
tion 2726(a)(8) of the Public Health Service Act (42 20
U.S.C. 300gg–26(a)(8), section 712(a)(8) of the 21
Employee Retirement Income Security Act of 1974 22
(29 U.S.C. 1185a(a)(8)), and section 9812(a)(8) of 23
the Internal Revenue Code of 1986, in particular 24
with respect to processes utilized for enforcement, 25
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actions or inactions that constitute noncompliance, 1
and avoidance among the agencies of duplication of 2
enforcement, including an evaluation of compliance 3
with section 104 of the Health Insurance Portability 4
and Accountability Act of 1996 (Public Law 104– 5
191). 6
(4) A review of the implementation, by the De-7
partment of Labor, Department of Health and 8
Human Services, and Department of the Treasury, 9
of mental health parity requirements under section 10
2726 of the Public Health Service Act (42 U.S.C. 11
300gg–26), section 712 of the Employee Retirement 12
Income Security Act of 1974 (29 U.S.C. 1185a), 13
and section 9812 of the Internal Revenue Code of 14
1986, including all such requirements in effect 15
through the enactment of the Mental Health Parity 16
Act of 1996 (Public Law 104–204), the Paul 17
Wellstone and Pete Domenici Mental Health Parity 18
and Addiction Equity Act of 2008 (Public Law 110– 19
460), the 21st Century Cures Act (Public Law 114– 20
255), and the Consolidated Appropriations Act, 21
2023 (Public Law 117–328) (including any amend-22
ments made by such Acts), and including with re-23
spect to the timing of all actions, delays of any ac-24
tions, reasons for any such delays, mandated re-25
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quirements that were met only once but not each 1
time such requirements were mandated. 2
(b) D
EFINITIONS.—In this section, the terms ‘‘group 3
health plan’’ and ‘‘health insurance issuer’’ have the 4
meanings given such terms in section 733 of the Employee 5
Retirement Income Security Act of 1974 (29 U.S.C. 6
1191b). 7
SEC. 207. STATE GUIDANCE ON COVERAGE FOR INDIVID-8
UALS WITH SERIOUS MENTAL ILLNESS AND 9
CHILDREN WITH SERIOUS EMOTIONAL DIS-10
TURBANCE. 11
(a) R
EVIEW OFUSE OFCERTAINFUNDING.—Not 12
later than 1 year after the date of enactment of this Act, 13
the Secretary of Health and Human Services, acting 14
through the Assistant Secretary for Mental Health and 15
Substance Use, shall conduct a review of the use by States 16
of funds made available under the Community Mental 17
Health Services Block Grant program under subpart I of 18
part B of title XIX of the Public Health Service Act (42 19
U.S.C. 300x et seq.) for First Episode Psychosis activities. 20
Such review shall consider the following: 21
(1) How the States use funds for evidence- 22
based treatments and services, such as coordinated 23
specialty care, according to the standard of care for 24
individuals with early serious mental illness, includ-25
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ing the comprehensiveness of such treatments to in-1
clude all aspects of the recommended intervention. 2
(2) How State mental health departments are 3
coordinating with State Medicaid departments in the 4
delivery of the treatments and services described in 5
paragraph (1). 6
(3) What percentage of the State funding under 7
the block grant program is being applied toward 8
First Episode Psychosis in excess of 10 percent of 9
the amount of the grant, as broken down on a State- 10
by-State basis. The review shall also identify any 11
States that fail to expend the required 10 percent of 12
block grant funds on activities relating to early seri-13
ous mental illness, including First Episode Psy-14
chosis. 15
(4) How many individuals are served by the ex-16
penditures described in paragraph (3), broken down 17
on a per-capita basis. 18
(5) How the funds are used to reach individuals 19
in underserved populations, including individuals in 20
rural areas and individuals from minority groups. 21
(b) R
EPORT ANDGUIDANCE.— 22
(1) R
EPORT.—Not later than 6 months after 23
the completion of the review under subsection (a), 24
the Secretary of Health and Human Services, acting 25
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through the Assistant Secretary for Mental Health 1
and Substance Use, shall submit to the Committee 2
on Appropriations, the Committee on Health, Edu-3
cation, Labor, and Pensions, and the Committee on 4
Finance of the Senate and to the Committee on Ap-5
propriations and the Committee on Energy and 6
Commerce of the House of Representatives a report 7
on the findings made as a result of the review con-8
ducted under subsection (a). Such report shall in-9
clude any recommendations with respect to any 10
changes to the Community Mental Health Services 11
Block Grant program, including the set aside re-12
quired for First Episode Psychosis, that would facili-13
tate improved outcomes for the targeted population 14
involved. 15
(2) G
UIDANCE.—Not later than 1 year after 16
the date on which the report is submitted under 17
paragraph (1), the Secretary of Health and Human 18
Services, acting through the Assistant Secretary for 19
Mental Health and Substance Use, shall update the 20
guidance provided to States under the Community 21
Mental Health Services Block Grant program based 22
on the findings and recommendations of the report. 23
(c) A
DDITIONALGUIDANCE.—The Director of the 24
National Institute of Mental Health shall coordinate with 25
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the Assistant Secretary for Mental Health and Substance 1
Use in providing guidance to State grantees and provider 2
subgrantees about research advances in the delivery of 3
services for First Episode Psychosis under the Community 4
Mental Health Services Block Grant program. 5
(d) G
UIDANCE FORSTATESRELATING TOCOVERAGE 6
R
ECOMMENDATIONS OF HEALTHCARESERVICES AND 7
I
NTERVENTIONS FOR INDIVIDUALSWITHSERIOUSMEN-8
TALILLNESS ANDCHILDRENWITHSERIOUSEMOTIONAL 9
D
ISTURBANCE.—Not later than 2 years after the date of 10
enactment of this Act, the Administrator of the Centers 11
for Medicare & Medicaid Services, jointly with the Assist-12
ant Secretary for Mental Health and Substance Use and 13
the Director of the National Institute of Mental Health— 14
(1) shall provide updated guidance to States 15
concerning— 16
(A) coverage recommendations relating to 17
evidence-based health care services, such as co-18
ordinated specialty care, and interventions for 19
individuals with early serious mental illness, in-20
cluding First Episode Psychosis; and 21
(B) the manner in which Federal funding 22
provided to States through programs adminis-23
tered by such agencies, including the Commu-24
nity Mental Health Services Block Grant pro-25
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gram under subpart I of part B of title XIX of 1
the Public Health Service Act (42 U.S.C. 300x 2
et seq.), may be coordinated to support individ-3
uals with serious mental illness and serious 4
emotional disturbance; and 5
(2) may streamline relevant State reporting re-6
quirements if such streamlining would result in mak-7
ing it easier for States to coordinate funding under 8
the programs described in paragraph (1)(B) to im-9
prove treatments for individuals with serious mental 10
illness and serious emotional disturbance. 11
SEC. 208. COMMUNITY MENTAL HEALTH SERVICES BLOCK 12
GRANT SERVICE PROVIDERS. 13
Subpart I of part B of title XIX of the Public Health 14
Service Act is amended— 15
(1) in section 1913(b)(1) (42 U.S.C. 300x– 16
2(b)(1)), by inserting ‘‘, and which may include, at 17
the discretion of the State, appropriate programs op-18
erated by for-profit entities’’ after ‘‘consumer-di-19
rected programs’’; and 20
(2) in section 1916(a)(5) (42 U.S.C. 300x– 21
5(a)(5)), by inserting ‘‘, or a for-profit entity se-22
lected by a State pursuant to section 1913(b)(1)’’ 23
before the period at the end. 24
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SEC. 209. REPORTS AND STUDIES ON MEDICATION TREAT-1
MENTS FOR OPIOID USE DISORDER. 2
(a) NIH R
EPORT TOCONGRESS ON METHADONE 3
T
REATMENT.—Not later than 2 years after the date of 4
enactment of this Act, the Director of the National Insti-5
tutes of Health shall— 6
(1) submit to the Committee on Health, Edu-7
cation, Labor, and Pensions of the Senate and the 8
Committee on Energy and Commerce of the House 9
of Representatives a report on ongoing and new clin-10
ical studies conducted or funded by the National In-11
stitutes of Health on the access to, safety of, and ef-12
ficacy of methadone treatment for opioid use dis-13
order in accredited and certified opioid treatment 14
programs and in other programs or settings; and 15
(2) brief the Committee on Health, Education, 16
Labor, and Pensions of the Senate and the Com-17
mittee on Energy and Commerce of the House of 18
Representatives on— 19
(A) interim results from the studies de-20
scribed in paragraph (1); and 21
(B) any barriers that may prevent ade-22
quate and timely enrollment of patients in any 23
new clinical study described in paragraph (1). 24
(b) S
TUDY ON MEDICATIONTREATMENTS FOR 25
O
PIOIDUSEDISORDERS.—The Secretary of Health and 26
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Human Services, acting through the Assistant Secretary 1
for Mental Health and Substance Use, shall— 2
(1) study— 3
(A) the early impact on access to medica-4
tion treatment for opioid use disorder and 5
opioid-related overdose deaths through 6
buprenorphine prescribing pursuant to section 7
303(g) of the Controlled Substances Act (21 8
U.S.C. 823(g)), as amended by section 1262 of 9
title I of division FF of the Mental Health and 10
Well-Being Act of 2022; 11
(B) the prevalence of patients with opioid 12
use disorder, in each Substate region, as de-13
fined by the National Survey on Drug Use and 14
Health of the Substance Abuse and Mental 15
Health Services Administration; and 16
(C) a survey of retail pharmacies nation-17
wide, disaggregated by State, to determine 18
which pharmacies serve as methadone dis-19
pensing units for opioid treatment programs; 20
and 21
(2) submit to the Committee on Health, Edu-22
cation, Labor, and Pensions of the Senate and the 23
Committee on Energy and Commerce of the House 24
of Representatives— 25
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(A) not later than 3 years after the date 1
of enactment of this Act, an initial report on 2
the study under paragraph (1); and 3
(B) not later than 4 years after the date 4
of enactment of this Act, a final report on the 5
study under paragraph (1). 6
SEC. 210. FASD RESPECT ACT. 7
(a) I
NGENERAL.—Part O of title III of the Public 8
Health Service Act (42 U.S.C. 280f et seq.) is amended— 9
(1) by amending the part heading to read as 10
follows: ‘‘
FETAL ALCOHOL SPECTRUM DIS -11
ORDERS PREVENTION AND SERVICES PRO -12
GRAM’’; 13
(2) in section 399H (42 U.S.C. 280f)— 14
(A) in the section heading, by striking 15
‘‘
ESTABLISHMENT OF FETAL ALCOHOL 16
SYNDROME PREVENTION ’’ and inserting 17
‘‘
FETAL ALCOHOL SPECTRUM DISORDERS 18
PREVENTION , INTERVENTION ,’’; 19
(B) by striking ‘‘Fetal Alcohol Syndrome 20
and Fetal Alcohol Effect’’ each place it appears 21
and inserting ‘‘FASD’’; 22
(C) in subsection (a)— 23
(i) by amending the heading to read 24
as follows: ‘‘I
NGENERAL’’; 25
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(ii) in the matter preceding paragraph 1
(1)— 2
(I) by inserting ‘‘or continue ac-3
tivities to support’’ after ‘‘shall estab-4
lish’’; 5
(II) by striking ‘‘FASD’’ (as 6
amended by subparagraph (B)) and 7
inserting ‘‘fetal alcohol spectrum dis-8
orders (referred to in this section as 9
‘FASD’)’’; 10
(III) by striking ‘‘prevention, 11
intervention’’ and inserting ‘‘aware-12
ness, prevention, identification, inter-13
vention,’’; and 14
(IV) by striking ‘‘that shall’’ and 15
inserting ‘‘, which may’’; 16
(iii) in paragraph (1)— 17
(I) in subparagraph (A)— 18
(aa) by striking ‘‘medical 19
schools’’ and inserting ‘‘health 20
professions schools’’; and 21
(bb) by inserting ‘‘infants,’’ 22
after ‘‘provision of services for’’; 23
and 24
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(II) in subparagraph (D), by 1
striking ‘‘medical and mental’’ and in-2
serting ‘‘agencies providing’’; 3
(iv) in paragraph (2)— 4
(I) in the matter preceding sub-5
paragraph (A), by striking ‘‘a preven-6
tion and diagnosis program to support 7
clinical studies, demonstrations and 8
other research as appropriate’’ and in-9
serting ‘‘supporting and conducting 10
research on FASD, as appropriate, in-11
cluding’’; and 12
(II) in subparagraph (B)— 13
(aa) by striking ‘‘prevention 14
services and interventions for 15
pregnant, alcohol-dependent 16
women’’ and inserting ‘‘culturally 17
and linguistically informed evi-18
dence-based or practice-based 19
interventions and appropriate so-20
cietal supports for preventing 21
prenatal alcohol exposure, which 22
may co-occur with exposure to 23
other substances’’; and 24
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(bb) by striking ‘‘; and’’ and 1
inserting a semicolon; 2
(v) by striking paragraph (3) and in-3
serting the following: 4
‘‘(3) integrating into surveillance practice an 5
evidence-based standard case definition for fetal al-6
cohol spectrum disorders and, in collaboration with 7
other Federal and outside partners, support organi-8
zations of appropriate medical and mental health 9
professionals in their development and refinement of 10
evidence-based clinical diagnostic guidelines and cri-11
teria for all fetal alcohol spectrum disorders; and 12
‘‘(4) building State and Tribal capacity for the 13
identification, treatment, and support of individuals 14
with FASD and their families, which may include— 15
‘‘(A) utilizing and adapting existing Fed-16
eral, State, or Tribal programs to include 17
FASD identification and FASD-informed sup-18
port; 19
‘‘(B) developing and expanding screening 20
and diagnostic capacity for FASD; 21
‘‘(C) developing, implementing, and evalu-22
ating targeted FASD-informed intervention 23
programs for FASD; 24
‘‘(D) increasing awareness of FASD; 25
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‘‘(E) providing training with respect to 1
FASD for professionals across relevant sectors; 2
and 3
‘‘(F) disseminating information about 4
FASD and support services to affected individ-5
uals and their families.’’; 6
(D) in subsection (b)— 7
(i) by striking ‘‘described in section 8
399I’’; 9
(ii) by striking ‘‘The Secretary’’ and 10
inserting the following: 11
‘‘(1) I
N GENERAL.—The Secretary’’; and 12
(iii) by adding at the end the fol-13
lowing: 14
‘‘(2) E
LIGIBLE ENTITIES.—To be eligible to re-15
ceive a grant, or enter into a cooperative agreement 16
or contract, under this section, an entity shall— 17
‘‘(A) be a State, Indian Tribe or Tribal or-18
ganization, local government, scientific or aca-19
demic institution, or nonprofit organization; 20
and 21
‘‘(B) prepare and submit to the Secretary 22
an application at such time, in such manner, 23
and containing such information as the Sec-24
retary may require, including a description of 25
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the activities that the entity intends to carry 1
out using amounts received under this section. 2
‘‘(3) A
DDITIONAL APPLICATION CONTENTS .— 3
The Secretary may require that an entity using 4
amounts from a grant, cooperative agreement, or 5
contract under this section for an activity under sub-6
section (a)(4) include in the application for such 7
amounts submitted under paragraph (2)(B)— 8
‘‘(A) a designation of an individual to 9
serve as a FASD State or Tribal coordinator of 10
such activity; and 11
‘‘(B) a description of an advisory com-12
mittee the entity will establish to provide guid-13
ance for the entity on developing and imple-14
menting a statewide or Tribal strategic plan to 15
prevent FASD and provide for the identifica-16
tion, treatment, and support of individuals with 17
FASD and their families.’’; 18
(E) by striking subsections (c) and (d); 19
and 20
(F) by adding at the end the following: 21
‘‘(c) D
EFINITION OFFASD-INFORMED.—For pur-22
poses of this section, the term ‘FASD-informed’, with re-23
spect to support or an intervention program, means that 24
such support or intervention program uses culturally and 25
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linguistically informed evidence-based or practice-based 1
interventions and appropriate societal supports to support 2
an improved quality of life for an individual with FASD 3
and the family of such individual.’’; and 4
(3) by striking sections 399I, 399J, and 399K 5
(42 U.S.C. 280f–1, 280f–2, 280f–3) and inserting 6
the following: 7
‘‘SEC. 399I. FETAL ALCOHOL SPECTRUM DISORDERS CEN-8
TERS FOR EXCELLENCE. 9
‘‘(a) I
NGENERAL.—The Secretary shall, as appro-10
priate, award grants, cooperative agreements, or contracts 11
to public or nonprofit entities with demonstrated expertise 12
in the prevention of, identification of, and intervention 13
services with respect to, fetal alcohol spectrum disorders 14
(referred to in this section as ‘FASD’) and other related 15
adverse conditions. Such awards shall be for the purposes 16
of establishing Fetal Alcohol Spectrum Disorders Centers 17
for Excellence to build local, Tribal, State, and national 18
capacities to prevent the occurrence of FASD and other 19
related adverse conditions, and to respond to the needs 20
of individuals with FASD and their families by carrying 21
out the programs described in subsection (b). 22
‘‘(b) P
ROGRAMS.—An entity receiving an award 23
under subsection (a) may use such award for the following 24
purposes: 25
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‘‘(1) Initiating or expanding diagnostic capacity 1
for FASD by increasing screening, assessment, iden-2
tification, and diagnosis. 3
‘‘(2) Developing and supporting public aware-4
ness and outreach activities, including the use of a 5
range of media and public outreach, to raise public 6
awareness of the risks associated with alcohol con-7
sumption during pregnancy, with the goals of reduc-8
ing the prevalence of FASD and improving the de-9
velopmental, health (including mental health), and 10
educational outcomes of individuals with FASD and 11
supporting families caring for individuals with 12
FASD. 13
‘‘(3) Acting as a clearinghouse for evidence- 14
based resources on FASD prevention, identification, 15
and culturally and linguistically informed best prac-16
tices, including the maintenance of a national data- 17
based directory on FASD-specific services in States, 18
Indian Tribes, and local communities, and dissemi-19
nating ongoing research and developing resources on 20
FASD to help inform systems of care for individuals 21
with FASD across their lifespan. 22
‘‘(4) Increasing awareness and understanding 23
of efficacious, evidence-based alcohol and other sub-24
stance screening tools to prevent FASD and cul-25
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turally and linguistically appropriate evidence-based 1
intervention services and best practices, which may 2
include by conducting national, regional, State, Trib-3
al, or peer cross-State webinars, workshops, or con-4
ferences for training community leaders, medical and 5
mental health and substance use disorder profes-6
sionals, education and disability professionals, fami-7
lies, law enforcement personnel, judges, individuals 8
working in financial assistance programs, social 9
service personnel, child welfare professionals, and 10
other service providers. 11
‘‘(5) Improving capacity for State, Tribal, and 12
local affiliates dedicated to FASD awareness, pre-13
vention, and identification and family and individual 14
support programs and services. 15
‘‘(6) Providing technical assistance to grantees 16
under section 399H, as appropriate. 17
‘‘(7) Carrying out other functions, as appro-18
priate. 19
‘‘(c) A
PPLICATION.—To be eligible for a grant, con-20
tract, or cooperative agreement under this section, an enti-21
ty shall submit to the Secretary an application at such 22
time, in such manner, and containing such information as 23
the Secretary may require. 24
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‘‘(d) SUBCONTRACTING.—A public or private non-1
profit entity may carry out the following activities required 2
under this section through contracts or cooperative agree-3
ments with other public and private nonprofit entities with 4
demonstrated expertise in FASD: 5
‘‘(1) Prevention activities. 6
‘‘(2) Screening and identification. 7
‘‘(3) Resource development and dissemination, 8
training and technical assistance, administration, 9
and support of FASD partner networks. 10
‘‘(4) Intervention services. 11
‘‘SEC. 399J. AUTHORIZATION OF APPROPRIATIONS. 12
‘‘There are authorized to be appropriated to carry out 13
this part such sums as may be necessary for each of fiscal 14
years 2024 through 2028.’’. 15
(b) R
EPORT.—Not later than 4 years after the date 16
of enactment of this Act, the Secretary of Health and 17
Human Services shall submit to the Committee on Health, 18
Education, Labor, and Pensions of the Senate and the 19
Committee on Energy and Commerce of the House of 20
Representatives a report on the efforts of the Department 21
of Health and Human Services to advance public aware-22
ness on, and facilitate the identification of best practices 23
related to, fetal alcohol spectrum disorders identification, 24
prevention, treatment, and support. 25
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(c) TECHNICALAMENDMENT.—Section 519D of the 1
Public Health Service Act (42 U.S.C. 290bb–25d) is re-2
pealed. 3
Æ
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