II 

117TH CONGRESS 

2D SESSION S. 4839 

To reauthorize and expand a grant program for State and Tribal response 

to opioid and stimulant use and misuse, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 13, 2022 

Ms. BALDWIN (for herself and Mrs. SHAHEEN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To reauthorize and expand a grant program for State and 

Tribal response to opioid and stimulant use and misuse, 

and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘State Opioid Response 

5 Grant Authorization Act of 2022’’. 


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1 SEC. 2. GRANT PROGRAM FOR STATE AND TRIBAL RE2 SPONSE TO OPIOID AND STIMULANT USE AND 

3 MISUSE. 

4 Section 1003 of the 21st Century Cures Act (42 

5 U.S.C. 290ee3 note) is amended to read as follows: 

6 ‘‘SEC. 1003. GRANT PROGRAM FOR STATE AND TRIBAL RE7 SPONSE TO OPIOID AND STIMULANT USE AND 

8 MISUSE. 

9 ‘‘(a) IN GENERAL.—The Secretary of Health and 

10 Human Services (referred to in this section as the ‘Sec11 retary’) shall carry out the grant program described in 

12 subsection (b) for purposes of addressing opioid use dis13 order and stimulant misuse and use disorders, within 

14 States, Indian Tribes, and populations served by Tribal 

15 organizations and Urban Indian organizations. 

16 ‘‘(b) GRANTS PROGRAM.— 

17 ‘‘(1) IN GENERAL.—Subject to the availability 

18 of appropriations, the Secretary shall award grants 

19 to States, Indian Tribes, Tribal organizations, and 

20 Urban Indian organizations for the purpose of ad21 dressing opioid use disorder and stimulant use and 

22 misuse, within such States, such Indian Tribes, and 

23 populations served by such Tribal organizations and 

24 Urban Indian organizations, in accordance with 

25 paragraph (2). 


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1 ‘‘(2) MINIMUM ALLOCATIONS; PREFERENCE.— 

2 In determining grant amounts for each recipient of 

3 a grant under paragraph (1), the Secretary shall— 

4 ‘‘(A) ensure that each State receives not 

5 less than $12,000,000; and 

6 ‘‘(B) give preference to States, Indian 

7 Tribes, Tribal organizations, and Urban Indian 

8 organizations— 

9 ‘‘(i) whose populations have an inci10 dence or prevalence of opioid use disorder 

11 that is substantially higher relative to the 

12 populations of other States, Indian Tribes, 

13 Tribal organizations, or Urban Indian or14 ganizations, as applicable; or 

15 ‘‘(ii) whose areas are more rural rel16 ative to the populations of other States, In17 dian Tribes, Tribal organizations, or 

18 Urban Indian organizations, as applicable. 

19 ‘‘(3) FORMULA METHODOLOGY.— 

20 ‘‘(A) IN GENERAL.—At least 30 days be21 fore publishing a funding opportunity an22 nouncement with respect to grants under this 

23 section, the Secretary shall— 

24 ‘‘(i) develop a formula methodology, 

25 consistent with paragraph (2), to be folVerDate Sep 11 2014 04:27 Sep 15, 2022 Jkt 029200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4839.IS S4839

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1 lowed in allocating grant funds awarded 

2 under this section among grantees, which 

3 includes performance assessments for con4 tinuation awards; and 

5 ‘‘(ii) not later than 30 days after de6 veloping the formula methodology under 

7 clause (i), submit the formula methodology 

8 to— 

9 ‘‘(I) the Committee on Health, 

10 Education, Labor, and Pensions and 

11 the Committee on Appropriations of 

12 the Senate; and 

13 ‘‘(II) the Committee on Energy 

14 and Commerce and the Committee on 

15 Appropriations of the House of Rep16 resentatives. 

17 ‘‘(B) TRANSITION PERIOD FOR NEW FOR18 MULA METHODOLOGY.—The Secretary shall set 

19 a 2-year transition period for the implementa20 tion of any new formula methodology if such 

21 new formula methodology would reduce the allo22 cation of any State by more than 10 percent. 

23 ‘‘(C) CONSIDERATION.—The Secretary 

24 shall ensure that the formula developed under 

25 subparagraph (A) avoids a significant cliff beVerDate Sep 11 2014 04:27 Sep 15, 2022 Jkt 029200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4839.IS S4839

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1 tween States with similar mortality rates re2 lated to opioid use disorders to prevent unusu3 ally large funding changes in States when com4 pared to prior year allocations. 

5 ‘‘(D) REPORT.—Not later than 2 years 

6 after the date of the enactment of the State 

7 Opioid Response Grant Authorization Act of 

8 2022, the Comptroller General of the United 

9 States shall submit to the Committee on 

10 Health, Education, Labor, and Pensions of the 

11 Senate and the Committee on Energy and Com12 merce of the House of Representatives a report 

13 that assesses— 

14 ‘‘(i) how grant funding is allocated to 

15 States under this section and how such al16 locations have changed over time; 

17 ‘‘(ii) how any changes within the spec18 ified 2-year period after the date of enact19 ment of the State Opioid Response Grant 

20 Authorization Act of 2022 have affected 

21 the efforts of States to address opioid use 

22 disorder or stimulant use and misuse; and 

23 ‘‘(iii) the use of funding provided 

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1 ministered by the Substance Abuse and 

2 Mental Health Services Administration. 

3 ‘‘(4) USE OF FUNDS.—Grants awarded under 

4 this subsection shall be used for carrying out activi5 ties that supplement activities pertaining to opioid 

6 use disorder and stimulant use and misuse, under7 taken by the State agency responsible for admin8 istering the substance abuse prevention and treat9 ment block grant under subpart II of part B of title 

10 XIX of the Public Health Service Act (42 U.S.C. 

11 300x–21 et seq.), which may include public health12 related activities such as the following: 

13 ‘‘(A) Implementing substance use disorder 

14 and overdose prevention activities and evalu15 ating such activities to identify effective strate16 gies to prevent substance use disorders and 

17 overdoses. 

18 ‘‘(B) Establishing or improving prescrip19 tion drug monitoring programs. 

20 ‘‘(C) Training for health care practitioners, 

21 such as best practices for prescribing opioids 

22 and stimulants, pain management, recognizing 

23 potential cases of substance use disorders, re24 ferral of patients to treatment programs, preVerDate Sep 11 2014 04:27 Sep 15, 2022 Jkt 029200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S4839.IS S4839

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1 venting diversion of controlled substances, and 

2 overdose prevention. 

3 ‘‘(D) Supporting access to health care 

4 services, including— 

5 ‘‘(i) services provided by federally-cer6 tified opioid or stimulant treatment pro7 grams; 

8 ‘‘(ii) outpatient and residential sub9 stance use disorder treatment services that 

10 utilize, or refer patients to, medication-as11 sisted treatment, where clinically appro12 priate; 

13 ‘‘(iii) services to treat substance use 

14 disorders provided by other appropriate 

15 health care providers and at other loca16 tions; or 

17 ‘‘(iv) overdose prevention programs 

18 and services, including drugs or devices ap19 proved, cleared, or otherwise legally mar20 keted under the Federal Food, Drug, and 

21 Cosmetic Act for emergency treatment of 

22 known or suspected overdose. 

23 ‘‘(E) Recovery support services, includ24 ing— 


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1 ‘‘(i) community-based services that in2 clude peer supports; 

3 ‘‘(ii) mutual aid recovery programs 

4 that support medication-assisted treat5 ment; 

6 ‘‘(iii) services to address housing 

7 needs, transportation needs, food insecu8 rity, and employment issues; or 

9 ‘‘(iv) resources or programs that sup10 port families that include an individual 

11 with a substance use disorder, including 

12 education, training, outreach, and peer 

13 support services. 

14 ‘‘(F) Other public health-related activities, 

15 as the grant recipient determines appropriate, 

16 related to addressing substance use disorders 

17 within the State, Indian Tribe, Tribal organiza18 tion, or Urban Indian organization, including 

19 directing resources in accordance with local 

20 needs related to substance use disorders. 

21 ‘‘(c) ACCOUNTABILITY AND OVERSIGHT.—A State re22 ceiving a grant under subsection (b) shall include in re23 porting related to substance use disorders submitted to the 

24 Secretary pursuant to section 1942 of the Public Health 

25 Service Act (42 U.S.C. 300x–52), a description of— 


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1 ‘‘(1) the purposes for which the grant funds re2 ceived by the State under such subsection for the 

3 preceding fiscal year were expended and a descrip4 tion of the activities of the State under the grant; 

5 ‘‘(2) the ultimate recipients of amounts pro6 vided to the State; and 

7 ‘‘(3) the number of individuals served through 

8 each of the activities of the State under the grant 

9 and the total number of individuals served through 

10 the grant. 

11 ‘‘(d) LIMITATIONS.—Any funds made available pur12 suant to subsection (i)— 

13 ‘‘(1) notwithstanding any transfer authority in 

14 any appropriations Act, shall not be used for any 

15 purpose other than the grant program under sub16 section (b); and 

17 ‘‘(2) shall be subject to the same requirements 

18 as substance use disorders prevention and treatment 

19 programs under titles V and XIX of the Public 

20 Health Service Act (42 U.S.C. 290aa et seq., 300w 

21 et seq.). 

22 ‘‘(e) INDIAN TRIBES, TRIBAL ORGANIZATIONS, AND

23 URBAN INDIAN ORGANIZATIONS.—The Secretary, in con24 sultation with Indian Tribes, Tribal organizations, and 

25 Urban Indian organizations, shall identify and establish 


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1 appropriate mechanisms for Indian Tribes, Tribal organi2 zations, and Urban Indian organizations to demonstrate 

3 or report information as required under subsections (b), 

4 (c), and (d). 

5 ‘‘(f) REPORT TO CONGRESS.—Not later than Sep6 tember 30, 2024, and biennially thereafter, the Secretary 

7 shall submit to the Committee on Health, Education, 

8 Labor, and Pensions and the Committee on Appropria9 tions of the Senate and the Committee on Energy and 

10 Commerce and the Committee on Appropriations of the 

11 House of Representatives a report that includes a sum12 mary of the information provided to the Secretary in re13 ports made pursuant to subsections (c) and (e), includ14 ing— 

15 ‘‘(1) the purposes for which grant funds are 

16 awarded under this section; 

17 ‘‘(2) the activities of the grant recipients; and 

18 ‘‘(3) for each State, Indian Tribe, Tribal orga19 nization, and Urban Indian organization that re20 ceives a grant under this section, the funding level 

21 provided to such recipient. 

22 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary, act23 ing, as appropriate, through the Tribal Training and 

24 Technical Assistance Center of the Substance Abuse and 

25 Mental Health Services Administration, shall provide 


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1 States, Indian Tribes, Tribal organizations, and Urban In2 dian organizations, as applicable, with— 

3 ‘‘(1) technical assistance concerning grant ap4 plication and submission procedures under this sec5 tion; 

6 ‘‘(2) award management activities; and 

7 ‘‘(3) enhancement of outreach and direct sup8 port to rural and underserved communities and pro9 viders in addressing substance use disorders. 

10 ‘‘(h) DEFINITIONS.—In this section: 

11 ‘‘(1) INDIAN TRIBE; TRIBAL ORGANIZATION.— 

12 The terms ‘Indian Tribe’ and ‘Tribal organization’ 

13 have the meanings given such terms in section 4 of 

14 the Indian Self-Determination and Education Assist15 ance Act (25 U.S.C. 5304). 

16 ‘‘(2) STATE.—The term ‘State’ has the mean17 ing given such term in section 1954(b) of the Public 

18 Health Service Act (42 U.S.C. 300x–64(b)). 

19 ‘‘(3) URBAN INDIAN ORGANIZATION.—The term 

20 ‘Urban Indian organization’ has the meaning given 

21 such term in section 4 of the Indian Health Care 

22 Improvement Act (25 U.S.C. 1603). 

23 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 

24 ‘‘(1) IN GENERAL.—For purposes of carrying 

25 out the grant program under subsection (b), there is 


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1 authorized to be appropriated $2,700,000,000 for 

2 each of fiscal years 2023 through 2027, to remain 

3 available until expended. 

4 ‘‘(2) FEDERAL ADMINISTRATIVE EXPENSES.— 

5 Of the amounts made available for each fiscal year 

6 to award grants under subsection (b), the Secretary 

7 shall use not more than 2 percent for Federal ad8 ministrative expenses, training, technical assistance, 

9 and evaluation. 

10 ‘‘(3) SET ASIDE.—Of the amounts made avail11 able for each fiscal year to award grants under sub12 section (b) for a fiscal year, the Secretary shall— 

13 ‘‘(A) award 5 percent to Indian Tribes, 

14 Tribal organizations, and Urban Indian organi15 zations; and 

16 ‘‘(B) award up to 15 percent to States 

17 with the highest age-adjusted rates of drug 

18 overdose death over the most recent 2-year pe19 riod, according to the Director of the Centers 

20 for Disease Control and Prevention.’’. 

Æ 


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