I 

118TH CONGRESS 

2D SESSION H. R. 10047 

To amend the Public Health Service Act to direct the Secretary of Health 

and Human Services, acting through the Assistant Secretary for Mental 

Health and Substance Use, to award grants to support communitybased programs for harm reduction services for individuals who use 

substances. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 25, 2024 

Mr. LARSEN of Washington (for himself and Ms. KUSTER) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to direct the Secretary of Health and Human Services, acting through 

the Assistant Secretary for Mental Health and Substance 

Use, to award grants to support community-based programs for harm reduction services for individuals who 

use substances. 

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 ‘‘Closing the Substance 

5 Use Care Gap Act of 2024’’. 


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1 SEC. 2. GRANTS FOR COMMUNITY-BASED HARM REDUC2 TION SERVICES FOR SUBSTANCE USE DIS3 ORDER. 

4 Part D of title V of the Public Health Service Act 

5 (42 U.S.C. 290dd et seq.) is amended by inserting after 

6 section 544 of such Act (42 U.S.C. 290dd–3) the fol7 lowing: 

8 ‘‘SEC. 544A. GRANTS FOR COMMUNITY-BASED HARM RE9 DUCTION SERVICES FOR SUBSTANCE USE 

10 DISORDER. 

11 ‘‘(a) ESTABLISHMENT.—The Secretary, acting 

12 through the Assistant Secretary for Mental Health and 

13 Substance Use and in consultation with the Director of 

14 the Centers for Disease Control and Prevention, shall 

15 award grants to eligible entities to support community16 based programs for harm reduction services for individuals 

17 with substance use disorder or individuals who use sub18 stances. 

19 ‘‘(b) ELIGIBLE ENTITY.—In this section, the term 

20 ‘eligible entity’ means— 

21 ‘‘(1) a State, local, Tribal, or territorial govern22 ment; 

23 ‘‘(2) a Tribal organization; 

24 ‘‘(3) a community-based harm reduction pro25 gram, including a syringe services program; 


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1 ‘‘(4) a primary and behavioral health organiza2 tion; or 

3 ‘‘(5) an opioid treatment program. 

4 ‘‘(c) SUBGRANTS.—For the purposes for which a 

5 grant is awarded under this section, the eligible entity re6 ceiving the grant may award subgrants to— 

7 ‘‘(1) a Federally qualified health center; 

8 ‘‘(2) an opioid treatment program; 

9 ‘‘(3) a health care provider or organization pro10 viding services to individuals with substance use dis11 orders or individuals who use substances; and 

12 ‘‘(4) any nonprofit organization that the Sec13 retary deems appropriate, which may include Urban 

14 Indian organizations (as defined in section 4 of the 

15 Indian Health Care Improvement Act). 

16 ‘‘(d) APPLICATION.—To seek a grant under this sec17 tion, an eligible entity shall submit to the Secretary, in 

18 such form and manner as specified by the Secretary, an 

19 application that describes— 

20 ‘‘(1) the intended uses of funds provided 

21 through the grant; 

22 ‘‘(2) how the activities funded through the 

23 grant will support community-based harm reduction 

24 programs providing harm reduction services for indi25 viduals who use substances; and 


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1 ‘‘(3) any other information and assurances the 

2 Secretary determines to be appropriate. 

3 ‘‘(e) USE OF GRANT FUNDS.—Grant funds awarded 

4 under this section to an eligible entity shall be used to 

5 support community-based harm reduction programs pro6 viding harm reduction services for individuals who use 

7 substances, which— 

8 ‘‘(1) may include— 

9 ‘‘(A) preventing and controlling the spread 

10 of infectious diseases and the consequences of 

11 such diseases for individuals who use sub12 stances, such as through legally authorized or 

13 permitted syringe services programs, including 

14 the purchase of syringes; 

15 ‘‘(B) overdose prevention programs, such 

16 as distributing opioid overdose reversal medica17 tion to individuals at risk of overdose and indi18 viduals likely to witness or respond to an over19 dose; and 

20 ‘‘(C) connecting individuals who use sub21 stances to overdose education, harm reduction 

22 treatment and counseling, treatment services, 

23 recovery support services, and health education, 

24 and encouraging such individuals to take steps 


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1 to reduce the negative personal and public 

2 health impacts of substance use or misuse; and 

3 ‘‘(2) shall include establishing or maintaining 

4 processes, protocols, and mechanisms for referral to 

5 evidence-based treatment and recovery support serv6 ices. 

7 ‘‘(f) BEST PRACTICES.—The Secretary, acting 

8 through the Assistant Secretary, in consultation with the 

9 Director of the Centers for Disease Control and Preven10 tion, shall issue guidance, based on information collected 

11 from grantees under this section, detailing best practices 

12 and promising methods for community-based harm reduc13 tion programs providing harm reduction services described 

14 in subsection (e). 

15 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary, in16 cluding through the Tribal Training and Technical Assist17 ance Center of the Substance Abuse and Mental Health 

18 Services Administration, as applicable, shall provide eligi19 ble entities with technical assistance concerning— 

20 ‘‘(1) grant application and submission proce21 dures under this section; 

22 ‘‘(2) management activities for grant awards 

23 under this section; and 

24 ‘‘(3) enhancing outreach and direct support to 

25 rural and underserved communities and providers in 


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1 addressing substance use through a grant under this 

2 section. 

3 ‘‘(h) REPORT TO CONGRESS.—Not later than 2 years 

4 after the date of enactment of this section, and biennially 

5 thereafter, the Secretary shall submit to the Committee 

6 on Health, Education, Labor, and Pensions of the Senate 

7 and the Committee on Energy and Commerce of the 

8 House of Representatives a report that— 

9 ‘‘(1) assesses how grant funding allocated 

10 under this section has affected the efforts of States 

11 to— 

12 ‘‘(A) address substance use; 

13 ‘‘(B) prevent and control the spread of in14 fectious diseases, and the consequences of such 

15 diseases for individuals who use substances; and 

16 ‘‘(C) connect individuals who use sub17 stances to overdose education, harm reduction 

18 treatment and counseling, treatment services, 

19 recovery support services, and health education; 

20 and 

21 ‘‘(2) includes any other information the Sec22 retary determines to be appropriate. 

23 ‘‘(i) DEFINITIONS.—In this section: 


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1 ‘‘(1) The term ‘Federally qualified health cen2 ter’ has the meaning given to that term in section 

3 1861(aa) of the Social Security Act. 

4 ‘‘(2) The term ‘opioid treatment program’ has 

5 the meaning given to that term in section 8.2 of title 

6 42, Code of Federal Regulations (or any successor 

7 regulations). 

8 ‘‘(3) The term ‘Urban Indian organization’ has 

9 the meaning given to that term in section 4 of the 

10 Indian Health Care Improvement Act. 

11 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.— 

12 ‘‘(1) IN GENERAL.—There is authorized to be 

13 appropriated to carry out this section $30,000,000 

14 for each of fiscal years 2025 through 2029. 

15 ‘‘(2) FEDERAL ADMINISTRATIVE EXPENSES.— 

16 Of the amounts made available for each fiscal year 

17 to award grants under subsection (a), the Secretary 

18 shall use not more than 2 percent for Federal ad19 ministrative expenses, training, technical assistance, 

20 and evaluation.’’. 

Æ 


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