II 

118TH CONGRESS 

1ST SESSION S. 3106 

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. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 24, 2023 

Mr. CASSIDY introduced 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 UseDisorder Prevention that Promotes Opioid Recovery and 

Treatment for Patients and Communities Act, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘SUPPORT for Patients and Communities Reauthoriza6 tion Act of 2023’’. 

7 (b) TABLE OF CONTENTS.—The table of contents for 

8 this Act is as follows: 


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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 workforce. 

Sec. 105. Youth prevention and recovery. 

Sec. 106. Comprehensive opioid recovery centers. 

Sec. 107. CDC surveillance and data collection for child, youth, and adult trauma. 

Sec. 108. Task force to develop best practices for trauma-informed identification, 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. 

1 TITLE I—REAUTHORIZATIONS 

2 SEC. 101. FIRST RESPONDER TRAINING. 

3 Section 546(h) of the Public Health Service Act (42 

4 U.S.C. 290ee–1(h)) is amended by striking ‘‘$36,000,000 

5 for each of fiscal years 2019 through 2023’’ and inserting 

6 ‘‘$56,000,000 for each of fiscal years 2024 through 

7 2028’’. 


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1 SEC. 102. RESIDENTIAL TREATMENT PROGRAMS FOR 

2 PREGNANT AND POSTPARTUM WOMEN. 

3 Section 508(s) of the Public Health Service Act (42 

4 U.S.C. 290bb–1(s)) is amended by striking ‘‘$29,931,000 

5 for each of fiscal years 2019 through 2023’’ and inserting 

6 ‘‘$38,931,000 for each of fiscal years 2024 through 

7 2028’’. 

8 SEC. 103. PRENATAL AND POSTNATAL HEALTH. 

9 Section 317L(d) of the Public Health Service Act (42 

10 U.S.C. 247b–13(d)) is amended by striking ‘‘2019 

11 through 2023’’ and inserting ‘‘2024 through 2028’’. 

12 SEC. 104. LOAN REPAYMENT PROGRAM FOR SUBSTANCE 

13 USE DISORDER TREATMENT WORKFORCE. 

14 Section 781(j) of the Public Health Service Act (42 

15 U.S.C. 295h(j)) is amended by striking ‘‘$25,000,000 for 

16 each of fiscal years 2019 through 2023’’ and inserting 

17 ‘‘$40,000,000 for each of fiscal years 2024 through 

18 2028’’. 

19 SEC. 105. YOUTH PREVENTION AND RECOVERY. 

20 Section 7102(c)(9) of the SUPPORT for Patients 

21 and Communities Act (42 U.S.C. 290bb–7a(c)(9)) is 

22 amended by striking ‘‘2019 through 2023’’ and inserting 

23 ‘‘2024 through 2028’’. 


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1 SEC. 106. COMPREHENSIVE OPIOID RECOVERY CENTERS. 

2 Section 552(j) of the Public Health Service Act (42 

3 U.S.C. 290ee–7(j)) is amended by striking ‘‘2019 through 

4 2023’’ and inserting ‘‘2024 through 2028’’. 

5 SEC. 107. CDC SURVEILLANCE AND DATA COLLECTION FOR 

6 CHILD, YOUTH, AND ADULT TRAUMA. 

7 Section 7131(e) of the SUPPORT for Patients and 

8 Communities Act (42 U.S.C. 242t(e)) is amended by strik9 ing ‘‘$2,000,000 for each of fiscal years 2019 through 

10 2023’’ and inserting ‘‘$9,000,000 for each of fiscal years 

11 2024 through 2028’’. 

12 SEC. 108. TASK FORCE TO DEVELOP BEST PRACTICES FOR 

13 TRAUMA-INFORMED IDENTIFICATION, RE14 FERRAL, AND SUPPORT. 

15 Section 7132(i) of the SUPPORT for Patients and 

16 Communities Act (Public Law 115–271) is amended by 

17 striking ‘‘2023’’ and inserting ‘‘2028’’. 

18 SEC. 109. DONALD J. COHEN NATIONAL CHILD TRAUMATIC 

19 STRESS INITIATIVE. 

20 Section 582(j) of the Public Health Service Act (42 

21 U.S.C. 290hh–1(j)) (relating to grants to address the 

22 problems of persons who experience violence-related 

23 stress) is amended by striking ‘‘$63,887,000 for each of 

24 fiscal years 2019 through 2023’’ and inserting 

25 ‘‘$93,887,000 for each of fiscal years 2024 through 

26 2028’’. 


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1 SEC. 110. SURVEILLANCE AND EDUCATION REGARDING IN2 FECTIONS ASSOCIATED WITH ILLICIT DRUG 

3 USE AND OTHER RISK FACTORS. 

4 Section 317N(d) of the Public Health Service Act (42 

5 U.S.C. 247b–15(d)) is amended by striking ‘‘2019 

6 through 2023’’ and inserting ‘‘2024 through 2028’’. 

7 SEC. 111. BUILDING COMMUNITIES OF RECOVERY. 

8 Section 547(f) of the Public Health Service Act (42 

9 U.S.C. 290ee–2(f)) is amended by striking ‘‘$5,000,000 

10 for each of fiscal years 2019 through 2023’’ and inserting 

11 ‘‘$16,000,000 for each of fiscal years 2024 through 

12 2028’’. 

13 SEC. 112. PEER SUPPORT TECHNICAL ASSISTANCE CEN14 TER. 

15 Section 547A(e) of the Public Health Service Act (42 

16 U.S.C. 290ee–2a(e)) is amended by striking ‘‘$1,000,000 

17 for each of fiscal years 2019 through 2023’’ and inserting 

18 ‘‘$2,000,000 for each of fiscal years 2024 through 2028’’. 

19 SEC. 113. PREVENTING OVERDOSES OF CONTROLLED SUB20 STANCES. 

21 Section 392A(e) of the Public Health Service Act (42 

22 U.S.C. 280b–1(e)) is amended by striking ‘‘$496,000,000 

23 for each of fiscal years 2019 through 2023’’ and inserting 

24 ‘‘$505,579,000 for each of fiscal years 2024 through 

25 2028’’. 


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1 SEC. 114. CAREER ACT. 

2 (a) IN GENERAL.—Section 7183 of the SUPPORT 

3 for Patients and Communities Act (42 U.S.C. 290ee–8) 

4 is amended— 

5 (1) in the section heading, by inserting ‘‘; 

6 TREATMENT, RECOVERY, AND WORKFORCE

7 SUPPORT GRANTS’’ after ‘‘CAREER ACT’’; 

8 (2) in subsection (b), by inserting ‘‘each’’ before 

9 ‘‘for a period’’; 

10 (3) in subsection (c)— 

11 (A) in paragraph (1), by striking ‘‘the 

12 rates described in paragraph (2)’’ and inserting 

13 ‘‘the average rates for calendar years 2018 

14 through 2022 described in paragraph (2)’’; and 

15 (B) by amending paragraph (2) to read as 

16 follows: 

17 ‘‘(2) RATES.—The rates described in this para18 graph are the following: 

19 ‘‘(A) The highest age-adjusted average 

20 rates of drug overdose deaths for calendar years 

21 2018 through 2022 based on data from the 

22 Centers for Disease Control and Prevention, in23 cluding, if necessary, provisional data for cal24 endar year 2022. 

25 ‘‘(B) The highest average rates of unem26 ployment for calendar years 2018 through 2022 


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1 based on data provided by the Bureau of Labor 

2 Statistics. 

3 ‘‘(C) The lowest average labor force par4 ticipation rates for calendar years 2018 through 

5 2022 based on data provided by the Bureau of 

6 Labor Statistics.’’; 

7 (4) in subsection (g)— 

8 (A) in each of paragraphs (1) and (3), by 

9 redesignating subparagraphs (A) and (B) as 

10 clauses (i) and (ii), respectively, and adjusting 

11 the margins accordingly; 

12 (B) by redesignating paragraphs (1) 

13 through (3) as subparagraphs (A) through (C), 

14 respectively, and adjusting the margins accord15 ingly; 

16 (C) in the matter preceding subparagraph 

17 (A) (as so redesignated), by striking ‘‘An enti18 ty’’ and inserting the following: 

19 ‘‘(1) IN GENERAL.—An entity’’; and 

20 (D) by adding at the end the following: 

21 ‘‘(2) TRANSPORTATION SERVICES.—An entity 

22 receiving a grant under this section may use not 

23 more than 5 percent of the funds for providing 

24 transportation for individuals to participate in an ac25 tivity supported by a grant under this section, which 


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1 transportation shall be to or from a place of work 

2 or a place where the individual is receiving voca3 tional education or job training services or receiving 

4 services directly linked to treatment of or recovery 

5 from a substance use disorder. 

6 ‘‘(3) LIMITATION.—The Secretary may not re7 quire an entity to, or give priority to an entity that 

8 plans to, use the funds of a grant under this section 

9 for activities that are not specified in this sub10 section.’’; 

11 (5) in subsection (i)(2), by inserting ‘‘, which 

12 shall include employment and earnings outcomes de13 scribed in subclauses (I) and (III) of section 

14 116(b)(2)(A)(i) of the Workforce Innovation and 

15 Opportunity Act (29 U.S.C. 3141(b)(2)(A)(i)) with 

16 respect to the participation of such individuals with 

17 a substance use disorder in programs and activities 

18 funded by the grant under this section’’ after ‘‘sub19 section (g)’’; 

20 (6) in subsection (j)— 

21 (A) in paragraph (1), by inserting ‘‘for 

22 grants awarded prior to the date of enactment 

23 of the SUPPORT for Patients and Commu24 nities Reauthorization Act of 2023’’ after 

25 ‘‘grant period under this section’’; and 


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1 (B) in paragraph (2)— 

2 (i) in the matter preceding subpara3 graph (A), by striking ‘‘2 years after sub4 mitting the preliminary report required 

5 under paragraph (1)’’ and inserting ‘‘Sep6 tember 30, 2028’’; and 

7 (ii) in subparagraph (A), by striking 

8 ‘‘(g)(3)’’ and inserting ‘‘(g)(1)(C)’’; and 

9 (7) in subsection (k), by striking ‘‘$5,000,000 

10 for each of fiscal years 2019 through 2023’’ and in11 serting ‘‘$12,000,000 for each of fiscal years 2024 

12 through 2028’’. 

13 (b) CLERICAL AMENDMENT.—The table of contents 

14 in section 1(b) of the SUPPORT for Patients and Com15 munities Act (Public Law 115–271; 132 Stat. 3894) is 

16 amended by striking the item relating to section 7183 and 

17 inserting the following: 

‘‘Sec. 7183. CAREER Act; treatment, recovery, and workforce support 

grants.’’. 

18 SEC. 115. GRANTS TO IMPROVE TRAUMA SUPPORT SERV19 ICES AND MENTAL HEALTH CARE FOR CHIL20 DREN AND YOUTH IN EDUCATIONAL SET21 TINGS. 

22 Section 7134 of the SUPPORT for Patients and 

23 Communities Act (42 U.S.C. 280h–7) is amended— 

24 (1) in subsection (c)— 


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1 (A) by striking paragraph (2); 

2 (B) by redesignating paragraphs (3) 

3 through (8) as paragraphs (2) through (7), re4 spectively; 

5 (C) in subparagraph (A) of paragraph (2), 

6 as so redesignated, by striking ‘‘, including 

7 through social and emotional learning’’; and 

8 (D) in paragraph (3), as so redesignated, 

9 by inserting ‘‘, provided that the students’ 

10 records are owned and maintained by the 

11 school,’’ after ‘‘community school’’; 

12 (2) in subsection (d)(4)— 

13 (A) in subparagraph (A), by striking ‘‘; 

14 and’’ and inserting a semicolon; 

15 (B) in subparagraph (B), by striking the 

16 period and inserting a semicolon; and 

17 (C) by adding at the end the following: 

18 ‘‘(C) parents and guardians will be in19 formed of what trauma support services and 

20 mental health care are available to their stu21 dents and what services and care their students 

22 receive, and will receive updates on their stu23 dents’ services and care; and 

24 ‘‘(D) parents and guardians will have ac25 cess to all documents related to the trauma 


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1 support services and mental health care that 

2 their student receives.’’; 

3 (3) in subsection (f)(1), by inserting ‘‘, includ4 ing an assessment of how parents or guardians of 

5 students are engaged in the design of, and informed 

6 in the provision of, trauma support services and 

7 mental health care in their student’s school’’ before 

8 the semicolon; and 

9 (4) in subsection (l), by striking ‘‘2019 through 

10 2023’’ and inserting ‘‘2024 through 2028’’. 

11 TITLE II—OTHER PROVISIONS 

12 SEC. 201. DELIVERY OF A CONTROLLED SUBSTANCE BY A 

13 PHARMACY. 

14 Section 309A(a) of the Controlled Substances Act 

15 (21 U.S.C. 829a(a)) is amended by striking paragraph (2) 

16 and inserting the following: 

17 ‘‘(2) the controlled substance is a drug in 

18 schedule III, IV, or V and is— 

19 ‘‘(A) to be administered for the purpose of 

20 initiation, maintenance, or detoxification treat21 ment; or 

22 ‘‘(B) subject to risk evaluation and mitiga23 tion strategy pursuant to section 505–1 of the 

24 Federal Food, Drug, and Cosmetic Act (21 

25 U.S.C. 355–1), which may require the drug to 


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1 be administered with post-administration moni2 toring by a health care professional;’’. 

3 SEC. 202. REGULATIONS RELATING TO A SPECIAL REG4 ISTRATION FOR TELEMEDICINE. 

5 Not later than 1 year after the date of enactment 

6 of this Act, the Attorney General, in consultation with the 

7 Secretary of Health and Human Services, shall promul8 gate the final regulations required under section 311(h)(2) 

9 of the Controlled Substances Act (21 U.S.C. 831(h)(2)). 

10 SEC. 203. GUIDANCE ON AT-HOME DRUG DISPOSAL SYS11 TEMS. 

12 (a) IN GENERAL.—Not later than one year after the 

13 date of enactment of this Act, the Secretary of Health and 

14 Human Services (referred to in this section as the ‘‘Sec15 retary’’) shall publish guidance to facilitate the use of at16 home safe disposal systems for applicable drugs, including 

17 for such at-home safe disposal systems that the Secretary 

18 may require as a part of a risk evaluation and mitigation 

19 strategy under section 505–1 of the Federal Food, Drug, 

20 and Cosmetic Act (21 U.S.C. 355–1). 

21 (b) CONTENTS.—The guidance under subsection (a) 

22 shall include— 

23 (1) recommended standards for effective at24 home drug disposal systems to meet the public 

25 health or non-retrievability standard; 


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1 (2) recommended information to include as in2 struction for use to disseminate with at-home drug 

3 disposal systems; 

4 (3) best practices and educational tools to sup5 port the use of an at-home drug disposal system; 

6 and 

7 (4) recommended use of licensed health pro8 viders for the dissemination of education, instruc9 tion, and at-home drug disposal systems. 

10 (c) UPDATES.—The Secretary shall update the guid11 ance under this section not less frequently than every 5 

12 years. 

13 SEC. 204. REPORT ON AT-HOME DRUG DISPOSAL SYSTEMS. 

14 (a) STUDY.—Not later than 60 days after the date 

15 of enactment of this Act, the Secretary of Health and 

16 Human Services, in consultation with the Administrator 

17 of the Drug Enforcement Administration, shall enter into 

18 an agreement with the National Academies of Sciences, 

19 Engineering, and Medicine to— 

20 (1) convene a committee of experts to examine 

21 steps to improve access to at-home drug disposal 

22 systems, including reviewing— 

23 (A) commercially available at-home drug 

24 disposal systems; 


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1 (B) current State, local, and private pro2 grams providing education and in-home drug 

3 disposal systems; 

4 (C) academic studies and real world test5 ing regarding drug disposal system compliance, 

6 effectiveness, and usage, and any challenges as7 sociated with such systems; and 

8 (D) any barriers to distribution of at-home 

9 drug disposal systems; and 

10 (2) issue an expert consensus report that sets 

11 forth best practices for educational resources to in12 form distribution and use of at-home drug disposal 

13 systems. 

14 (b) REPORT.—Upon completion of the consensus re15 port under subsection (a)(2), the Health and Medicine Di16 vision of the National Academies of Sciences, Engineering, 

17 and Medicine shall transmit a copy of the report to— 

18 (1) the Secretary of Health and Human Serv19 ices; 

20 (2) the Commissioner of Food and Drugs; 

21 (3) the Administrator of the Drug Enforcement 

22 Administration; 

23 (4) the Committee on Health, Education, 

24 Labor, and Pensions of the Senate; and 


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1 (5) the Committee on Energy and Commerce of 

2 the House of Representatives. 

3 SEC. 205. ENSURING STATE CHOICE IN PDMP SYSTEMS. 

4 Section 399O(h) of the Public Health Service Act (42 

5 U.S.C. 280g–3(h)) is amended by adding the following: 

6 ‘‘(5) ENSURING STATE CHOICE.—Nothing in 

7 this section shall be construed to— 

8 ‘‘(A) direct, require or encourage a State 

9 to use a specific interstate data sharing pro10 gram; 

11 ‘‘(B) limit or prohibit the discretion of a 

12 PDMP to utilize interoperability connections of 

13 its choice; 

14 ‘‘(C) permit, encourage, or otherwise con15 dition Federal financial assistance to States 

16 based upon the use of open architecture, other 

17 than nationally recognized, consensus-based 

18 standards, by PDMP systems or contracted 

19 vendors; or 

20 ‘‘(D) limit or prohibit the discretion of 

21 States to utilize Federal financial assistance re22 ceived under this section to enter into arrange23 ments with vendors of their choice in order to 

24 carry out a program under this section.’’. 


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1 SEC. 206. MENTAL HEALTH PARITY. 

2 (a) IN GENERAL.—Not later than January 1, 2025, 

3 the Inspector General of the Department of Labor, in co4 ordination with the Inspector General of the Department 

5 of Health and Human Services, shall report to the Com6 mittee on Health, Education, Labor, and Pensions of the 

7 Senate and the Committee on Energy and Commerce and 

8 the Committee on Education and the Workforce of the 

9 House of Representatives on the following: 

10 (1) The non-quantitative treatment limit (re11 ferred to in this section as ‘‘NQTL’’) requirements 

12 with respect to mental health and substance use dis13 order benefits under group health plans and health 

14 insurance issuers under section 2726(a)(8) of the 

15 Public Health Service Act (42 U.S.C. 300gg– 

16 26(a)(8)), section 712(a)(8) of the Employee Retire17 ment Income Security Act of 1974 (29 U.S.C. 

18 1185a(a)(8)), and section 9812(a)(8) of the Internal 

19 Revenue Code of 1986 (referred to in this section as 

20 the ‘‘NQTL comparative analysis requirements’’), 

21 and the requirements for the Secretary of Health 

22 and Human Services, the Secretary of Labor, and 

23 the Secretary of the Treasury to issue regulations, 

24 a compliance program guide, and additional guid25 ance documents and tools providing guidance relat26 ing to mental health parity requirements under secVerDate Sep 11 2014 01:59 Oct 25, 2023 Jkt 049200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\S3106.IS S3106

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1 tion 2726(a) of the Public Health Service Act (42 

2 U.S.C. 300gg–26(a)), section 712(a) of the Em3 ployee Retirement Income Security Act of 1974 (29 

4 U.S.C. 1185a(a)), and section 9812(a) of the Inter5 nal Revenue Code of 1986. 

6 (2) With respect to the NQTL comparative 

7 analysis requirements described in paragraph (1), an 

8 analysis of the actions taken by the Secretary of 

9 Labor, the Secretary of the Treasury, and the Sec10 retary of Health and Human Services to provide 

11 guidance to ensure that group health plans and 

12 health insurance issuers can fully comply with men13 tal health parity requirements under section 2726 of 

14 the Public Health Service Act (42 U.S.C. 300gg–26, 

15 section 712 of the Employee Retirement Income Se16 curity Act of 1974 (29 U.S.C. 1185a), and section 

17 9812 of the Internal Revenue Code of 1986 and the 

18 NQTL comparative analysis requirements described 

19 in paragraph (1), including an analysis of— 

20 (A) the extent to which the Secretary of 

21 Labor, the Secretary of the Treasury, and the 

22 Secretary of Health and Human Services have 

23 fulfilled the requirement under section 203(b) 

24 of division BB of the Consolidated Appropria25 tions Act, 2021 (Public Law 116–260) to issue 


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1 the specific guidance and regulations pertaining 

2 to the requirements for group health plans and 

3 health insurance issuers to demonstrate compli4 ance with the NQTL comparative analysis re5 quirements; and 

6 (B) whether sufficient guidance and exam7 ples from the Department of Labor and De8 partment of Health and Human Services, and 

9 the Department of the Treasury exist to guide 

10 and assist group health plans and health insur11 ance issuers in complying with the requirements 

12 to demonstrate compliance with mental health 

13 parity NQTL comparative analysis require14 ments/under such sections 2726(a)(8), 

15 712(a)(8), and 9812(a)(8). 

16 (3) A review of the enforcement processes of 

17 the Department of Labor and the Department of 

18 Health and Human Services to evaluate the consist19 ency of interpretation of the requirements under sec20 tion 2726(a)(8) of the Public Health Service Act (42 

21 U.S.C. 300gg–26(a)(8), section 712(a)(8) of the 

22 Employee Retirement Income Security Act of 1974 

23 (29 U.S.C. 1185a(a)(8)), and section 9812(a)(8) of 

24 the Internal Revenue Code of 1986, in particular 

25 with respect to processes utilized for enforcement, 


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1 actions or inactions that constitute noncompliance, 

2 and avoidance among the agencies of duplication of 

3 enforcement, including an evaluation of compliance 

4 with section 104 of the Health Insurance Portability 

5 and Accountability Act of 1996 (Public Law 104– 

6 191). 

7 (4) A review of the implementation, by the De8 partment of Labor, Department of Health and 

9 Human Services, and Department of the Treasury, 

10 of mental health parity requirements under section 

11 2726 of the Public Health Service Act (42 U.S.C. 

12 300gg–26), section 712 of the Employee Retirement 

13 Income Security Act of 1974 (29 U.S.C. 1185a), 

14 and section 9812 of the Internal Revenue Code of 

15 1986, including all such requirements in effect 

16 through the enactment of the Mental Health Parity 

17 Act of 1996 (Public Law 104–204), the Paul 

18 Wellstone and Pete Domenici Mental Health Parity 

19 and Addiction Equity Act of 2008 (Public Law 110– 

20 460), the 21st Century Cures Act (Public Law 114– 

21 255), and the Consolidated Appropriations Act, 

22 2023 (Public Law 117–328) (including any amend23 ments made by such Acts), and including with re24 spect to the timing of all actions, delays of any ac25 tions, reasons for any such delays, mandated reVerDate Sep 11 2014 01:59 Oct 25, 2023 Jkt 049200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\S3106.IS S3106

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1 quirements that were met only once but not each 

2 time such requirements were mandated. 

3 (b) DEFINITIONS.—In this section, the terms ‘‘group 

4 health plan’’ and ‘‘health insurance issuer’’ have the 

5 meanings given such terms in section 733 of the Employee 

6 Retirement Income Security Act of 1974 (29 U.S.C. 

7 1191b). 

8 SEC. 207. STATE GUIDANCE ON COVERAGE FOR INDIVID9 UALS WITH SERIOUS MENTAL ILLNESS AND 

10 CHILDREN WITH SERIOUS EMOTIONAL DIS11 TURBANCE. 

12 (a) REVIEW OF USE OF CERTAIN FUNDING.—Not 

13 later than 1 year after the date of enactment of this Act, 

14 the Secretary of Health and Human Services, acting 

15 through the Assistant Secretary for Mental Health and 

16 Substance Use, shall conduct a review of the use by States 

17 of funds made available under the Community Mental 

18 Health Services Block Grant program under subpart I of 

19 part B of title XIX of the Public Health Service Act (42 

20 U.S.C. 300x et seq.) for First Episode Psychosis activities. 

21 Such review shall consider the following: 

22 (1) How the States use funds for evidence23 based treatments and services, such as coordinated 

24 specialty care, according to the standard of care for 

25 individuals with early serious mental illness, includVerDate Sep 11 2014 01:59 Oct 25, 2023 Jkt 049200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\S3106.IS S3106

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1 ing the comprehensiveness of such treatments to in2 clude all aspects of the recommended intervention. 

3 (2) How State mental health departments are 

4 coordinating with State Medicaid departments in the 

5 delivery of the treatments and services described in 

6 paragraph (1). 

7 (3) What percentage of the State funding under 

8 the block grant program is being applied toward 

9 First Episode Psychosis in excess of 10 percent of 

10 the amount of the grant, as broken down on a State11 by-State basis. The review shall also identify any 

12 States that fail to expend the required 10 percent of 

13 block grant funds on activities relating to early seri14 ous mental illness, including First Episode Psy15 chosis. 

16 (4) How many individuals are served by the ex17 penditures described in paragraph (3), broken down 

18 on a per-capita basis. 

19 (5) How the funds are used to reach individuals 

20 in underserved populations, including individuals in 

21 rural areas and individuals from minority groups. 

22 (b) REPORT AND GUIDANCE.— 

23 (1) REPORT.—Not later than 6 months after 

24 the completion of the review under subsection (a), 

25 the Secretary of Health and Human Services, acting 


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1 through the Assistant Secretary for Mental Health 

2 and Substance Use, shall submit to the Committee 

3 on Appropriations, the Committee on Health, Edu4 cation, Labor, and Pensions, and the Committee on 

5 Finance of the Senate and to the Committee on Ap6 propriations and the Committee on Energy and 

7 Commerce of the House of Representatives a report 

8 on the findings made as a result of the review con9 ducted under subsection (a). Such report shall in10 clude any recommendations with respect to any 

11 changes to the Community Mental Health Services 

12 Block Grant program, including the set aside re13 quired for First Episode Psychosis, that would facili14 tate improved outcomes for the targeted population 

15 involved. 

16 (2) GUIDANCE.—Not later than 1 year after 

17 the date on which the report is submitted under 

18 paragraph (1), the Secretary of Health and Human 

19 Services, acting through the Assistant Secretary for 

20 Mental Health and Substance Use, shall update the 

21 guidance provided to States under the Community 

22 Mental Health Services Block Grant program based 

23 on the findings and recommendations of the report. 

24 (c) ADDITIONAL GUIDANCE.—The Director of the 

25 National Institute of Mental Health shall coordinate with 


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1 the Assistant Secretary for Mental Health and Substance 

2 Use in providing guidance to State grantees and provider 

3 subgrantees about research advances in the delivery of 

4 services for First Episode Psychosis under the Community 

5 Mental Health Services Block Grant program. 

6 (d) GUIDANCE FOR STATES RELATING TO COVERAGE

7 RECOMMENDATIONS OF HEALTH CARE SERVICES AND

8 INTERVENTIONS FOR INDIVIDUALS WITH SERIOUS MEN9 TAL ILLNESS AND CHILDREN WITH SERIOUS EMOTIONAL

10 DISTURBANCE.—Not later than 2 years after the date of 

11 enactment of this Act, the Administrator of the Centers 

12 for Medicare & Medicaid Services, jointly with the Assist13 ant Secretary for Mental Health and Substance Use and 

14 the Director of the National Institute of Mental Health— 

15 (1) shall provide updated guidance to States 

16 concerning— 

17 (A) coverage recommendations relating to 

18 evidence-based health care services, such as co19 ordinated specialty care, and interventions for 

20 individuals with early serious mental illness, in21 cluding First Episode Psychosis; and 

22 (B) the manner in which Federal funding 

23 provided to States through programs adminis24 tered by such agencies, including the Commu25 nity Mental Health Services Block Grant proVerDate Sep 11 2014 01:59 Oct 25, 2023 Jkt 049200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6201 E:\BILLS\S3106.IS S3106

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1 gram under subpart I of part B of title XIX of 

2 the Public Health Service Act (42 U.S.C. 300x 

3 et seq.), may be coordinated to support individ4 uals with serious mental illness and serious 

5 emotional disturbance; and 

6 (2) may streamline relevant State reporting re7 quirements if such streamlining would result in mak8 ing it easier for States to coordinate funding under 

9 the programs described in paragraph (1)(B) to im10 prove treatments for individuals with serious mental 

11 illness and serious emotional disturbance. 

12 SEC. 208. COMMUNITY MENTAL HEALTH SERVICES BLOCK 

13 GRANT SERVICE PROVIDERS. 

14 Subpart I of part B of title XIX of the Public Health 

15 Service Act is amended— 

16 (1) in section 1913(b)(1) (42 U.S.C. 300x– 

17 2(b)(1)), by inserting ‘‘, and which may include, at 

18 the discretion of the State, appropriate programs op19 erated by for-profit entities’’ after ‘‘consumer-di20 rected programs’’; and 

21 (2) in section 1916(a)(5) (42 U.S.C. 300x– 

22 5(a)(5)), by inserting ‘‘, or a for-profit entity se23 lected by a State pursuant to section 1913(b)(1)’’ 

24 before the period at the end. 


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1 SEC. 209. REPORTS AND STUDIES ON MEDICATION TREAT2 MENTS FOR OPIOID USE DISORDER. 

3 (a) NIH REPORT TO CONGRESS ON METHADONE

4 TREATMENT.—Not later than 2 years after the date of 

5 enactment of this Act, the Director of the National Insti6 tutes of Health shall— 

7 (1) submit to the Committee on Health, Edu8 cation, Labor, and Pensions of the Senate and the 

9 Committee on Energy and Commerce of the House 

10 of Representatives a report on ongoing and new clin11 ical studies conducted or funded by the National In12 stitutes of Health on the access to, safety of, and ef13 ficacy of methadone treatment for opioid use dis14 order in accredited and certified opioid treatment 

15 programs and in other programs or settings; and 

16 (2) brief the Committee on Health, Education, 

17 Labor, and Pensions of the Senate and the Com18 mittee on Energy and Commerce of the House of 

19 Representatives on— 

20 (A) interim results from the studies de21 scribed in paragraph (1); and 

22 (B) any barriers that may prevent ade23 quate and timely enrollment of patients in any 

24 new clinical study described in paragraph (1). 

25 (b) STUDY ON MEDICATION TREATMENTS FOR

26 OPIOID USE DISORDERS.—The Secretary of Health and 


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1 Human Services, acting through the Assistant Secretary 

2 for Mental Health and Substance Use, shall— 

3 (1) study— 

4 (A) the early impact on access to medica5 tion treatment for opioid use disorder and 

6 opioid-related overdose deaths through 

7 buprenorphine prescribing pursuant to section 

8 303(g) of the Controlled Substances Act (21 

9 U.S.C. 823(g)), as amended by section 1262 of 

10 title I of division FF of the Mental Health and 

11 Well-Being Act of 2022; 

12 (B) the prevalence of patients with opioid 

13 use disorder, in each Substate region, as de14 fined by the National Survey on Drug Use and 

15 Health of the Substance Abuse and Mental 

16 Health Services Administration; and 

17 (C) a survey of retail pharmacies nation18 wide, disaggregated by State, to determine 

19 which pharmacies serve as methadone dis20 pensing units for opioid treatment programs; 

21 and 

22 (2) submit to the Committee on Health, Edu23 cation, Labor, and Pensions of the Senate and the 

24 Committee on Energy and Commerce of the House 

25 of Representatives— 


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1 (A) not later than 3 years after the date 

2 of enactment of this Act, an initial report on 

3 the study under paragraph (1); and 

4 (B) not later than 4 years after the date 

5 of enactment of this Act, a final report on the 

6 study under paragraph (1). 

7 SEC. 210. FASD RESPECT ACT. 

8 (a) IN GENERAL.—Part O of title III of the Public 

9 Health Service Act (42 U.S.C. 280f et seq.) is amended— 

10 (1) by amending the part heading to read as 

11 follows: ‘‘FETAL ALCOHOL SPECTRUM DIS12 ORDERS PREVENTION AND SERVICES PRO13 GRAM’’; 

14 (2) in section 399H (42 U.S.C. 280f)— 

15 (A) in the section heading, by striking 

16 ‘‘ESTABLISHMENT OF FETAL ALCOHOL

17 SYNDROME PREVENTION’’ and inserting 

18 ‘‘FETAL ALCOHOL SPECTRUM DISORDERS

19 PREVENTION, INTERVENTION,’’; 

20 (B) by striking ‘‘Fetal Alcohol Syndrome 

21 and Fetal Alcohol Effect’’ each place it appears 

22 and inserting ‘‘FASD’’; 

23 (C) in subsection (a)— 

24 (i) by amending the heading to read 

25 as follows: ‘‘IN GENERAL’’; 


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1 (ii) in the matter preceding paragraph 

2 (1)— 

3 (I) by inserting ‘‘or continue ac4 tivities to support’’ after ‘‘shall estab5 lish’’; 

6 (II) by striking ‘‘FASD’’ (as 

7 amended by subparagraph (B)) and 

8 inserting ‘‘fetal alcohol spectrum dis9 orders (referred to in this section as 

10 ‘FASD’)’’; 

11 (III) by striking ‘‘prevention, 

12 intervention’’ and inserting ‘‘aware13 ness, prevention, identification, inter14 vention,’’; and 

15 (IV) by striking ‘‘that shall’’ and 

16 inserting ‘‘, which may’’; 

17 (iii) in paragraph (1)— 

18 (I) in subparagraph (A)— 

19 (aa) by striking ‘‘medical 

20 schools’’ and inserting ‘‘health 

21 professions schools’’; and 

22 (bb) by inserting ‘‘infants,’’ 

23 after ‘‘provision of services for’’; 

24 and 


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1 (II) in subparagraph (D), by 

2 striking ‘‘medical and mental’’ and in3 serting ‘‘agencies providing’’; 

4 (iv) in paragraph (2)— 

5 (I) in the matter preceding sub6 paragraph (A), by striking ‘‘a preven7 tion and diagnosis program to support 

8 clinical studies, demonstrations and 

9 other research as appropriate’’ and in10 serting ‘‘supporting and conducting 

11 research on FASD, as appropriate, in12 cluding’’; and 

13 (II) in subparagraph (B)— 

14 (aa) by striking ‘‘prevention 

15 services and interventions for 

16 pregnant, alcohol-dependent 

17 women’’ and inserting ‘‘culturally 

18 and linguistically informed evi19 dence-based or practice-based 

20 interventions and appropriate so21 cietal supports for preventing 

22 prenatal alcohol exposure, which 

23 may co-occur with exposure to 

24 other substances’’; and 


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1 (bb) by striking ‘‘; and’’ and 

2 inserting a semicolon; 

3 (v) by striking paragraph (3) and in4 serting the following: 

5 ‘‘(3) integrating into surveillance practice an 

6 evidence-based standard case definition for fetal al7 cohol spectrum disorders and, in collaboration with 

8 other Federal and outside partners, support organi9 zations of appropriate medical and mental health 

10 professionals in their development and refinement of 

11 evidence-based clinical diagnostic guidelines and cri12 teria for all fetal alcohol spectrum disorders; and 

13 ‘‘(4) building State and Tribal capacity for the 

14 identification, treatment, and support of individuals 

15 with FASD and their families, which may include— 

16 ‘‘(A) utilizing and adapting existing Fed17 eral, State, or Tribal programs to include 

18 FASD identification and FASD-informed sup19 port; 

20 ‘‘(B) developing and expanding screening 

21 and diagnostic capacity for FASD; 

22 ‘‘(C) developing, implementing, and evalu23 ating targeted FASD-informed intervention 

24 programs for FASD; 

25 ‘‘(D) increasing awareness of FASD; 


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1 ‘‘(E) providing training with respect to 

2 FASD for professionals across relevant sectors; 

3 and 

4 ‘‘(F) disseminating information about 

5 FASD and support services to affected individ6 uals and their families.’’; 

7 (D) in subsection (b)— 

8 (i) by striking ‘‘described in section 

9 399I’’; 

10 (ii) by striking ‘‘The Secretary’’ and 

11 inserting the following: 

12 ‘‘(1) IN GENERAL.—The Secretary’’; and 

13 (iii) by adding at the end the fol14 lowing: 

15 ‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re16 ceive a grant, or enter into a cooperative agreement 

17 or contract, under this section, an entity shall— 

18 ‘‘(A) be a State, Indian Tribe or Tribal or19 ganization, local government, scientific or aca20 demic institution, or nonprofit organization; 

21 and 

22 ‘‘(B) prepare and submit to the Secretary 

23 an application at such time, in such manner, 

24 and containing such information as the Sec25 retary may require, including a description of 


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1 the activities that the entity intends to carry 

2 out using amounts received under this section. 

3 ‘‘(3) ADDITIONAL APPLICATION CONTENTS.— 

4 The Secretary may require that an entity using 

5 amounts from a grant, cooperative agreement, or 

6 contract under this section for an activity under sub7 section (a)(4) include in the application for such 

8 amounts submitted under paragraph (2)(B)— 

9 ‘‘(A) a designation of an individual to 

10 serve as a FASD State or Tribal coordinator of 

11 such activity; and 

12 ‘‘(B) a description of an advisory com13 mittee the entity will establish to provide guid14 ance for the entity on developing and imple15 menting a statewide or Tribal strategic plan to 

16 prevent FASD and provide for the identifica17 tion, treatment, and support of individuals with 

18 FASD and their families.’’; 

19 (E) by striking subsections (c) and (d); 

20 and 

21 (F) by adding at the end the following: 

22 ‘‘(c) DEFINITION OF FASD-INFORMED.—For pur23 poses of this section, the term ‘FASD-informed’, with re24 spect to support or an intervention program, means that 

25 such support or intervention program uses culturally and 


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1 linguistically informed evidence-based or practice-based 

2 interventions and appropriate societal supports to support 

3 an improved quality of life for an individual with FASD 

4 and the family of such individual.’’; and 

5 (3) by striking sections 399I, 399J, and 399K 

6 (42 U.S.C. 280f–1, 280f–2, 280f–3) and inserting 

7 the following: 

8 ‘‘SEC. 399I. FETAL ALCOHOL SPECTRUM DISORDERS CEN9 TERS FOR EXCELLENCE. 

10 ‘‘(a) IN GENERAL.—The Secretary shall, as appro11 priate, award grants, cooperative agreements, or contracts 

12 to public or nonprofit entities with demonstrated expertise 

13 in the prevention of, identification of, and intervention 

14 services with respect to, fetal alcohol spectrum disorders 

15 (referred to in this section as ‘FASD’) and other related 

16 adverse conditions. Such awards shall be for the purposes 

17 of establishing Fetal Alcohol Spectrum Disorders Centers 

18 for Excellence to build local, Tribal, State, and national 

19 capacities to prevent the occurrence of FASD and other 

20 related adverse conditions, and to respond to the needs 

21 of individuals with FASD and their families by carrying 

22 out the programs described in subsection (b). 

23 ‘‘(b) PROGRAMS.—An entity receiving an award 

24 under subsection (a) may use such award for the following 

25 purposes: 


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1 ‘‘(1) Initiating or expanding diagnostic capacity 

2 for FASD by increasing screening, assessment, iden3 tification, and diagnosis. 

4 ‘‘(2) Developing and supporting public aware5 ness and outreach activities, including the use of a 

6 range of media and public outreach, to raise public 

7 awareness of the risks associated with alcohol con8 sumption during pregnancy, with the goals of reduc9 ing the prevalence of FASD and improving the de10 velopmental, health (including mental health), and 

11 educational outcomes of individuals with FASD and 

12 supporting families caring for individuals with 

13 FASD. 

14 ‘‘(3) Acting as a clearinghouse for evidence15 based resources on FASD prevention, identification, 

16 and culturally and linguistically informed best prac17 tices, including the maintenance of a national data18 based directory on FASD-specific services in States, 

19 Indian Tribes, and local communities, and dissemi20 nating ongoing research and developing resources on 

21 FASD to help inform systems of care for individuals 

22 with FASD across their lifespan. 

23 ‘‘(4) Increasing awareness and understanding 

24 of efficacious, evidence-based alcohol and other sub25 stance screening tools to prevent FASD and culVerDate Sep 11 2014 23:33 Oct 25, 2023 Jkt 049200 PO 00000 Frm 00034 Fmt 6652 Sfmt 6201 E:\BILLS\S3106.IS S3106

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1 turally and linguistically appropriate evidence-based 

2 intervention services and best practices, which may 

3 include by conducting national, regional, State, Trib4 al, or peer cross-State webinars, workshops, or con5 ferences for training community leaders, medical and 

6 mental health and substance use disorder profes7 sionals, education and disability professionals, fami8 lies, law enforcement personnel, judges, individuals 

9 working in financial assistance programs, social 

10 service personnel, child welfare professionals, and 

11 other service providers. 

12 ‘‘(5) Improving capacity for State, Tribal, and 

13 local affiliates dedicated to FASD awareness, pre14 vention, and identification and family and individual 

15 support programs and services. 

16 ‘‘(6) Providing technical assistance to grantees 

17 under section 399H, as appropriate. 

18 ‘‘(7) Carrying out other functions, as appro19 priate. 

20 ‘‘(c) APPLICATION.—To be eligible for a grant, con21 tract, or cooperative agreement under this section, an enti22 ty shall submit to the Secretary an application at such 

23 time, in such manner, and containing such information as 

24 the Secretary may require. 


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1 ‘‘(d) SUBCONTRACTING.—A public or private non2 profit entity may carry out the following activities required 

3 under this section through contracts or cooperative agree4 ments with other public and private nonprofit entities with 

5 demonstrated expertise in FASD: 

6 ‘‘(1) Prevention activities. 

7 ‘‘(2) Screening and identification. 

8 ‘‘(3) Resource development and dissemination, 

9 training and technical assistance, administration, 

10 and support of FASD partner networks. 

11 ‘‘(4) Intervention services. 

12 ‘‘SEC. 399J. AUTHORIZATION OF APPROPRIATIONS. 

13 ‘‘There are authorized to be appropriated to carry out 

14 this part such sums as may be necessary for each of fiscal 

15 years 2024 through 2028.’’. 

16 (b) REPORT.—Not later than 4 years after the date 

17 of enactment of this Act, the Secretary of Health and 

18 Human Services shall submit to the Committee on Health, 

19 Education, Labor, and Pensions of the Senate and the 

20 Committee on Energy and Commerce of the House of 

21 Representatives a report on the efforts of the Department 

22 of Health and Human Services to advance public aware23 ness on, and facilitate the identification of best practices 

24 related to, fetal alcohol spectrum disorders identification, 

25 prevention, treatment, and support. 


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1 (c) TECHNICAL AMENDMENT.—Section 519D of the 

2 Public Health Service Act (42 U.S.C. 290bb–25d) is re3 pealed. 

Æ 


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