II 

118TH CONGRESS 

2D SESSION S. 4358 

To amend the Public Health Service Act to require the Secretary to establish 

a grant program under the Substance Abuse and Mental Health Services 

Administration to address substance use disorders among older adults, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 16, 2024 

Mr. CASEY (for himself, Mr. FETTERMAN, Ms. WARREN, Mr. BLUMENTHAL, 

and Mrs. GILLIBRAND) introduced the following bill; which was read 

twice and referred to the Committee on Health, Education, Labor, and 

Pensions 

A BILL 

To amend the Public Health Service Act to require the 

Secretary to establish a grant program under the Substance Abuse and Mental Health Services Administration 

to address substance use disorders among older adults, 

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 ‘‘Preventing and Treat5 ing Substance Use Disorders Among Older Adults Act’’. 


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1 SEC. 2. SUBSTANCE USE DISORDER TREATMENT AND 

2 EARLY INTERVENTION SERVICES FOR OLDER 

3 ADULTS. 

4 Subpart 1 of part B of title V of the Public Health 

5 Service Act (42 U.S.C. 290bb et seq.) is amended by add6 ing at the end the following: 

7 ‘‘SEC. 514C. SUBSTANCE USE DISORDER TREATMENT AND 

8 EARLY INTERVENTION SERVICES FOR OLDER 

9 ADULTS. 

10 ‘‘(a) DEFINITION OF OLDER ADULT.—In this sec11 tion, the term ‘older adult’ means an individual aged 60 

12 or older. 

13 ‘‘(b) AUTHORITY TO AWARD GRANTS.—The Sec14 retary shall award grants, contracts, or cooperative agree15 ments to public and private nonprofit entities, Indian 

16 Tribes or Tribal organizations (as such terms are defined 

17 in section 4 of the Indian Self-Determination and Edu18 cation Assistance Act), or other health facilities or pro19 grams operated by or in accordance with a contract or 

20 grant with the Indian Health Service, for the purposes 

21 of— 

22 ‘‘(1) providing early identification and services 

23 to meet the needs of older adults who are at risk of 

24 substance use disorders; 

25 ‘‘(2) providing substance use disorder treatment 

26 and prevention services for older adults, including 


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1 older adults with co-occurring mental illness and 

2 substance use disorders; 

3 ‘‘(3) linking older adults to resources, either in 

4 the community or within long-term care settings 

5 where they reside, to support independent lives; and 

6 ‘‘(4) providing integrated care and comprehen7 sive care coordination for substance use disorders 

8 and other health conditions. 

9 ‘‘(c) PRIORITY.—In awarding grants, contracts, or 

10 cooperative agreements under subsection (b), the Sec11 retary shall give priority to applicants who propose to— 

12 ‘‘(1) apply evidence-informed and cost-effective 

13 methods; 

14 ‘‘(2) improve data collection on the scope of 

15 substance use among older adults, the scope of avail16 ability and utilization of treatment and prevention 

17 services, and the scope of integrated care; 

18 ‘‘(3) coordinate and collect data on the provi19 sion of services with other social service agencies in 

20 the community, including congregate care, substance 

21 use, and mental health agencies; 

22 ‘‘(4) provide a continuum of integrated treat23 ment services, including case management and pri24 mary care services, for older adults with substance 

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1 ring mental illness and substance use disorders, and 

2 their families and caregivers; 

3 ‘‘(5) provide treatment that is person-centered, 

4 culturally appropriate, and age-sensitive; 

5 ‘‘(6) involve and work with peers and families 

6 and caregivers of older adults receiving services; and 

7 ‘‘(7) provide continuing care services for older 

8 adults and their families following the completion of 

9 a treatment episode. 

10 ‘‘(d) DURATION OF GRANTS.—The Secretary shall 

11 award grants, contracts, or cooperative agreements under 

12 subsection (b) for periods not to exceed 5 fiscal years. 

13 ‘‘(e) APPLICATION.—An entity desiring a grant, con14 tract, or cooperative agreement under subsection (b) shall 

15 submit an application to the Secretary at such time, in 

16 such manner, and accompanied by such information as the 

17 Secretary may reasonably require. 

18 ‘‘(f) EVALUATION.—An entity that receives a grant, 

19 contract, or cooperative agreement under subsection (b) 

20 shall submit, in the application for such grant, contract, 

21 or cooperative agreement, a plan for the evaluation of any 

22 project undertaken with funds provided under this section. 

23 Such entity shall provide the Secretary with periodic eval24 uations of the progress of such project and such evaluation 


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1 at the completion of such project as the Secretary deter2 mines to be appropriate. 

3 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated to carry out this section 

5 $25,000,000 for each of fiscal years 2025 through 2029.’’. 

6 SEC. 3. EVIDENCE-BASED DRUGS AND ALCOHOL TREAT7 MENT AND INTERVENTIONS DEMONSTRA8 TION. 

9 Subpart 1 of part B of title V of the Public Health 

10 Service Act (42 U.S.C. 290bb et seq.) (as amended by sec11 tion 2) is amended by adding at the end the following: 

12 ‘‘SEC. 514D. EVIDENCE-BASED DRUGS AND ALCOHOL 

13 TREATMENT AND INTERVENTIONS DEM14 ONSTRATION. 

15 ‘‘(a) GRANTS TO EXPAND ACCESS.— 

16 ‘‘(1) AUTHORITY TO AWARD GRANTS.—The 

17 Secretary shall award grants, contracts, or coopera18 tive agreements to State substance use disorder 

19 agencies, units of local government, United States 

20 territories, and Indian Tribes and Tribal organiza21 tions (as defined in section 4 of the Indian Self-De22 termination and Education Assistance Act) that 

23 have a high rate of, or have had a rapid increase in, 

24 the misuse of alcohol or prescription or illicit drugs, 

25 including opioids, in order to permit such entities to 


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1 expand activities, including an expansion in the 

2 availability of evidence-based medications for sub3 stance use disorder treatment and other clinically 

4 appropriate services with respect to the treatment of 

5 substance use disorders in the specific geographical 

6 areas of such entities where there is a high rate of, 

7 or rapid increase in, the misuse of alcohol or pre8 scription or illicit drugs, including opioids, or spe9 cific geographical areas where there is a high rate of 

10 unmet need for treatment, such as in rural areas 

11 and among communities of color. 

12 ‘‘(2) NATURE OF ACTIVITIES.—Funds awarded 

13 under paragraph (1) shall be used for activities that 

14 are based on reliable scientific evidence of efficacy in 

15 the treatment of substance use disorders. 

16 ‘‘(b) APPLICATION.—To be eligible for a grant, con17 tract, or cooperative agreement under subsection (a), an 

18 entity shall submit an application to the Secretary at such 

19 time, in such manner, and accompanied by such informa20 tion as the Secretary may reasonably require. 

21 ‘‘(c) EVALUATION.—An entity that receives a grant, 

22 contract, or cooperative agreement under subsection (a) 

23 shall submit, in the application for such grant, contract, 

24 or agreement a plan for the evaluation of any project un25 dertaken with funds provided under this section. Such enVerDate Sep 11 2014 02:25 Jun 27, 2024 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S4358.IS S4358

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1 tity shall provide the Secretary with periodic evaluations 

2 of the progress of such project and an evaluation at the 

3 completion of such project as the Secretary determines to 

4 be appropriate. 

5 ‘‘(d) GEOGRAPHIC DISTRIBUTION.—In awarding 

6 grants, contracts, and cooperative agreements under this 

7 section, the Secretary shall ensure that not less than 15 

8 percent of funds are awarded to eligible entities that are 

9 not located in metropolitan statistical areas (as defined by 

10 the Office of Management and Budget). The Secretary 

11 shall take into account the unique needs of rural commu12 nities, including communities with an incidence of individ13 uals with substance use disorder that is above the national 

14 average and communities with a shortage of prevention 

15 and treatment services. 

16 ‘‘(e) ADDITIONAL ACTIVITIES.—In administering 

17 grants, contracts, and cooperative agreements under sub18 section (a), the Secretary shall— 

19 ‘‘(1) evaluate the activities supported under 

20 such subsection; 

21 ‘‘(2) disseminate information, as appropriate, 

22 derived from evaluations as the Secretary considers 

23 appropriate; 

24 ‘‘(3) provide States, Indian Tribes and Tribal 

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1 ance in connection with the provision of treatment of 

2 substance use disorder; and 

3 ‘‘(4) fund only those applications that specifi4 cally support recovery services as a critical compo5 nent of the program involved. 

6 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

7 carry out this section, there are authorized to be appro8 priated $25,000,000 for each of fiscal years 2025 through 

9 2029.’’. 

Æ 


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