II 

118TH CONGRESS 

1ST SESSION S. 3393 

To reauthorize the SUPPORT for Patients and Communities Act, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 4, 2023 

Mr. SANDERS (for himself and 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 the SUPPORT 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’’. 

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

8 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—PREVENTION 

2 

•S 3393 IS

Sec. 101. First responder training program. 

Sec. 102. Surveillance and education regarding infections associated with illicit 

drug use and other risk factors. 

Sec. 103. Preventing overdoses of controlled substances. 

Sec. 104. Pilot program for public health laboratories to detect fentanyl and 

other synthetic opioids. 

Sec. 105. Prenatal and postnatal health. 

Sec. 106. Donald J. Cohen National Child Traumatic Stress Initiative. 

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

Sec. 108. Preventing adverse childhood experiences. 

Sec. 109. Clarification of use of funds for products used to prevent overdose 

deaths. 

Sec. 110. Support for individuals and families impacted by fetal alcohol spectrum disorder. 

Sec. 111. Promoting State choice in PDMP systems. 

TITLE II—TREATMENT 

Sec. 201. Residential treatment program for pregnant and postpartum women. 

Sec. 202. Loan repayment program for substance use disorder treatment workforce. 

Sec. 203. Regional centers of excellence in substance use disorder education. 

Sec. 204. Mental and behavioral health education and training program. 

Sec. 205. Grants to enhance access to substance use disorder treatment. 

Sec. 206. Grants to improve trauma support services and mental health care 

for children and youth in educational settings. 

Sec. 207. Development and dissemination of model training programs for substance use disorder patient records. 

Sec. 208. Task force on best practices for trauma-informed identification, referral, and support. 

Sec. 209. Program to support coordination and continuation of care for drug 

overdose patients. 

Sec. 210. Regulations relating to special registration for telemedicine. 

Sec. 211. Mental health parity. 

Sec. 212. State guidance related to individuals with serious mental illness and 

children with serious emotional disturbance. 

Sec. 213. Improving access to addiction medicine providers. 

TITLE III—RECOVERY 

Sec. 301. Youth prevention and recovery. 

Sec. 302. Comprehensive opioid recovery centers. 

Sec. 303. Building communities of recovery. 

Sec. 304. Peer support technical assistance center. 

Sec. 305. CAREER Act. 

Sec. 306. Office of recovery. 

TITLE IV—TECHNICAL AMENDMENTS 

Sec. 401. Delivery of a controlled substance by a pharmacy to an administering 

practitioner. 

Sec. 402. Technical correction on controlled substances dispensing. 

Sec. 403. Required training for prescribers of controlled substances. 

3 

•S 3393 IS

1 TITLE I—PREVENTION 

2 SEC. 101. FIRST RESPONDER TRAINING PROGRAM. 

3 Section 546 of the Public Health Service Act (42 

4 U.S.C. 290ee–1) is amended— 

5 (1) in subsection (a), by striking ‘‘tribes and 

6 tribal’’ and inserting ‘‘Tribes and Tribal’’; 

7 (2) in subsections (a), (c), and (d)— 

8 (A) by striking ‘‘approved or cleared’’ each 

9 place it appears and inserting ‘‘approved, 

10 cleared, or otherwise legally marketed’’; and 

11 (B) by striking ‘‘opioid’’ each place it ap12 pears; 

13 (3) in subsection (f)— 

14 (A) by striking ‘‘approved or cleared’’ each 

15 place it appears and inserting ‘‘approved, 

16 cleared, or otherwise legally marketed’’; 

17 (B) in paragraph (1), by striking ‘‘opioid’’; 

18 (C) in paragraph (2)— 

19 (i) by striking ‘‘opioid and heroin’’ 

20 and inserting ‘‘opioid, heroin, and other 

21 drug’’; and 

22 (ii) by striking ‘‘opioid overdose’’ and 

23 inserting ‘‘overdose’’; and 

24 (D) in paragraph (3), by striking ‘‘opioid 

25 and heroin’’; and 

4 

•S 3393 IS

1 (4) in subsection (h), by striking ‘‘$36,000,000 

2 for each of fiscal years 2019 through 2023’’ and in3 serting ‘‘$56,000,000 for each of fiscal years 2024 

4 through 2028’’. 

5 SEC. 102. SURVEILLANCE AND EDUCATION REGARDING IN6 FECTIONS ASSOCIATED WITH ILLICIT DRUG 

7 USE AND OTHER RISK FACTORS. 

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

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

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

11 SEC. 103. PREVENTING OVERDOSES OF CONTROLLED SUB12 STANCES. 

13 Section 392A of the Public Health Service Act (42 

14 U.S.C. 280b–1) is amended— 

15 (1) in subsection (a)— 

16 (A) in paragraph (2)— 

17 (i) in subparagraph (C), by inserting 

18 ‘‘and associated risks’’ before the period at 

19 the end; and 

20 (ii) in subparagraph (D), by striking 

21 ‘‘opioids’’ and inserting ‘‘substances caus22 ing overdose’’; 

23 (B) in paragraph (3)(A)— 

24 (i) by inserting ‘‘identify substances 

25 causing overdose and’’ after ‘‘rapidly’’; and 

5 

•S 3393 IS

1 (ii) by striking ‘‘abuse, and 

2 overdoses’’ and inserting ‘‘overdoses, and 

3 associated risk factors’’; 

4 (2) in subsection (b)(2)— 

5 (A) in subparagraph (B), by inserting ‘‘, 

6 and associated risk factors,’’ after ‘‘such 

7 overdoses’’; 

8 (B) in subparagraph (C), by striking ‘‘cod9 ing’’ and inserting ‘‘monitoring and identi10 fying’’; 

11 (C) in subparagraph (E)— 

12 (i) by inserting a comma after ‘‘public 

13 health laboratories’’; and 

14 (ii) by inserting ‘‘and other emerging 

15 substances related’’ after ‘‘analogues’’; and 

16 (D) in subparagraph (F,) by inserting 

17 ‘‘and associated risk factors’’ after ‘‘overdoses’’; 

18 and 

19 (3) in subsection (e) by striking ‘‘$496,000,000 

20 for each of fiscal years 2019 through 2023’’ and in21 serting ‘‘$505,579,000 for each of fiscal years 2024 

22 through 2028’’. 

6 

•S 3393 IS

1 SEC. 104. PILOT PROGRAM FOR PUBLIC HEALTH LABORA2 TORIES TO DETECT FENTANYL AND OTHER 

3 SYNTHETIC OPIOIDS. 

4 Section 7011 of the SUPPORT for Patients and 

5 Communities Act (42 U.S.C. 247d–10 note) is amended 

6 by striking subsection (d). 

7 SEC. 105. PRENATAL AND POSTNATAL HEALTH. 

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

9 U.S.C. 2476b–13(d)) is amended by striking ‘‘2019 

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

11 SEC. 106. DONALD J. COHEN NATIONAL CHILD TRAUMATIC 

12 STRESS INITIATIVE. 

13 Section 582 of the Public Health Service Act (42 

14 U.S.C. 290hh–1) is amended— 

15 (1) in the section heading, by striking ‘‘VIO16 LENCE RELATED STRESS’’ and inserting ‘‘TRAU17 MATIC EVENTS’’; 

18 (2) in subsection (a)— 

19 (A) in the matter preceding paragraph (1), 

20 by striking ‘‘tribes and tribal’’ and inserting 

21 ‘‘Tribes and Tribal’’; and 

22 (B) in paragraph (2), by inserting ‘‘and 

23 dissemination’’ after ‘‘the development’’; 

24 (3) in subsection (b), by inserting ‘‘and dissemi25 nation’’ after ‘‘the development’’; 

26 (4) in subsection (d)— 

7 

•S 3393 IS

1 (A) by striking ‘‘The NCTSI’’ and insert2 ing the following: 

3 ‘‘(1) COORDINATING CENTER.—The NCTSI’’; 

4 and 

5 (B) by adding at the end the following: 

6 ‘‘(2) NCTSI GRANTEES.—In carrying out sub7 section (a)(2), NCTSI grantees shall develop 

8 trainings and other resources, as applicable and ap9 propriate, to support implementation of the evi10 dence-based practices developed and disseminated 

11 under such subsection.’’; 

12 (5) in subsection (e)— 

13 (A) by redesignating paragraphs (1) and 

14 (2) as subparagraphs (A) and (B), respectively, 

15 and adjusting the margins accordingly; 

16 (B) in subparagraph (A), as so redesig17 nated, by inserting ‘‘and implementation’’ after 

18 ‘‘the dissemination’’; 

19 (C) by striking ‘‘The NCTSI’’ and insert20 ing the following: 

21 ‘‘(1) COORDINATING CENTER.—’’; and 

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

23 ‘‘(2) NCTSI GRANTEES.—NCTSI grantees 

24 shall, as appropriate, collaborate with other such 

25 grantees, the NCTSI coordinating center, and the 

8 

•S 3393 IS

1 Secretary in carrying out subsections (a)(2) and 

2 (d)(2).’’; 

3 (6) by amending subsection (h) to read as fol4 lows: 

5 ‘‘(h) APPLICATION AND EVALUATION.—To be eligible 

6 to receive a grant, contract, or cooperative agreement 

7 under subsection (a), a public or nonprofit private entity 

8 or an Indian Tribe or Tribal organization shall submit to 

9 the Secretary an application at such time, in such manner, 

10 and containing such information and assurances as the 

11 Secretary may require, including— 

12 ‘‘(1) a plan for the rigorous evaluation of the 

13 activities funded under the grant, contract or agree14 ment, including both process and outcomes evalua15 tion, and the submission of an evaluation at the end 

16 of the project period; and 

17 ‘‘(2) a description of how such entity, Indian 

18 Tribe, or Tribal organization will support efforts led 

19 by the Secretary or the NCTSI coordinating center, 

20 as applicable, to evaluate activities carried out under 

21 this section.’’; and 

22 (7) in subsection (j), by striking ‘‘, $63,887,000 

23 for each of fiscal years 2019 through 2023’’ and in24 serting ‘‘$93,887,000 for each of fiscal years 2024 

25 and 2025, $104,000,000 for fiscal year 2026, 

9 

•S 3393 IS

1 $110,000,000 for fiscal year 2027, and 

2 $112,661,000 for fiscal year 2028’’. 

3 SEC. 107. SURVEILLANCE AND DATA COLLECTION FOR 

4 CHILD, YOUTH, AND ADULT TRAUMA. 

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

6 Communities Act (42 U.S.C. 242t(e)) is amended by strik7 ing ‘‘2019 through 2023’’ and inserting ‘‘2024 through 

8 2028’’. 

9 SEC. 108. PREVENTING ADVERSE CHILDHOOD EXPERI10 ENCES. 

11 (a) GRANT PROGRAM.— 

12 (1) IN GENERAL.—The Secretary of Health and 

13 Human Services (referred to in this section as the 

14 ‘‘Secretary’’), acting through the Director of the 

15 Centers for Disease Control and Prevention, may 

16 award grants or cooperative agreements to States, 

17 territories, Indian Tribes and Tribal organizations 

18 (as such terms are defined in section 4 of the Indian 

19 Self-Determination and Education Assistance Act 

20 (25 U.S.C. 5304)), and local governmental entities 

21 for purposes of carrying out public health activities 

22 to improve health outcomes by preventing or reduc23 ing adverse childhood experiences. 

24 (2) USE OF FUNDS.—Recipients of an award 

25 under this subsection may use such award to— 

10 

•S 3393 IS

1 (A) identify, implement, and evaluate evi2 dence-based public health activities to prevent 

3 or reduce adverse childhood experiences and im4 prove health outcomes; 

5 (B) improve data collection and analysis 

6 regarding the prevention and reduction of ad7 verse childhood experiences, including any such 

8 data described in section 7131 of the SUP9 PORT for Patients and Communities Act (42 

10 U.S.C. 242t), to identify— 

11 (i) any geographic areas or popu12 lations within the jurisdiction of the recipi13 ent of an award that have disproportion14 ately high rates of adverse childhood expe15 riences; 

16 (ii) any types of adverse childhood ex17 periences of high prevalence within such 

18 jurisdiction; and 

19 (iii) any short-term health outcomes 

20 and long-term health outcomes associated 

21 with adverse childhood experiences, includ22 ing mental health and substance use dis23 orders; and 

24 (C) leverage such data and analysis to in25 form the identification, implementation, and 

11 

•S 3393 IS

1 evaluation of evidence-based public health ac2 tivities under subparagraph (A). 

3 (3) PARTNERSHIPS.—Recipients of an award 

4 under this subsection may identify opportunities to 

5 establish, or strengthen existing, partnerships with 

6 other relevant public and private entities within such 

7 jurisdiction for purposes of carrying out such award. 

8 (4) TECHNICAL ASSISTANCE.—The Secretary 

9 may provide training and technical assistance to re10 cipients of awards under this subsection. 

11 (5) EVALUATION.—Not later than 2 years after 

12 the date of enactment of this Act, and annually 

13 thereafter, the Secretary shall report to the Com14 mittee on Health, Education, Labor, and Pensions 

15 of the Senate and the Committee on Energy and 

16 Commerce of the House of Representatives on the 

17 specific activities supported through awards under 

18 this subsection, including the effectiveness of such 

19 activities in preventing or reducing adverse childhood 

20 experiences. 

21 (b) RESEARCH.—The Secretary may, as appropriate, 

22 conduct research to evaluate public health activities to ad23 dress adverse childhood experiences. 

12 

•S 3393 IS

1 (c) AUTHORIZATION OF APPROPRIATIONS.—To carry 

2 out this section, there is authorized to be appropriated 

3 $7,000,000 for each of fiscal years 2024 through 2028. 

4 SEC. 109. CLARIFICATION OF USE OF FUNDS FOR PROD5 UCTS USED TO PREVENT OVERDOSE DEATHS. 

6 The activities carried out pursuant to section 

7 1003(b)(4)(A) of the 21st Century Cures Act (42 U.S.C. 

8 290ee–3a(b)(4)(A)) may include facilitating access to 

9 products used to prevent overdose deaths by detecting the 

10 presence of one or more substances, to the extent the pur11 chase and possession of such products is consistent with 

12 Federal and State law. 

13 SEC. 110. SUPPORT FOR INDIVIDUALS AND FAMILIES IM14 PACTED BY FETAL ALCOHOL SPECTRUM DIS15 ORDER. 

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

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

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

19 follows: ‘‘FETAL ALCOHOL SPECTRUM DIS20 ORDERS PREVENTION AND SERVICES PRO21 GRAM’’; 

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

23 (A) in the section heading, by striking 

24 ‘‘ESTABLISHMENT OF FETAL ALCOHOL

25 SYNDROME PREVENTION’’ and inserting 

13 

•S 3393 IS

1 ‘‘FETAL ALCOHOL SPECTRUM DISORDERS

2 PREVENTION, INTERVENTION,’’; 

3 (B) by striking ‘‘Fetal Alcohol Syndrome 

4 and Fetal Alcohol Effect’’ each place it appears 

5 and inserting ‘‘FASD’’; 

6 (C) in subsection (a)— 

7 (i) by amending the heading to read 

8 as follows: ‘‘IN GENERAL’’; 

9 (ii) in the matter preceding paragraph 

10 (1)— 

11 (I) by inserting ‘‘or continue ac12 tivities to support’’ after ‘‘shall estab13 lish’’; 

14 (II) by striking ‘‘FASD’’ (as 

15 amended by subparagraph (B)) and 

16 inserting ‘‘fetal alcohol spectrum dis17 orders (referred to in this section as 

18 ‘FASD’)’’; 

19 (III) by striking ‘‘prevention, 

20 intervention’’ and inserting ‘‘aware21 ness, prevention, identification, inter22 vention,’’; and 

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

24 inserting ‘‘, which may’’; 

25 (iii) in paragraph (1)— 

14 

•S 3393 IS

1 (I) in subparagraph (A)— 

2 (aa) by striking ‘‘medical 

3 schools’’ and inserting ‘‘health 

4 professions schools’’; and 

5 (bb) by inserting ‘‘infants,’’ 

6 after ‘‘provision of services for’’; 

7 and 

8 (II) in subparagraph (D), by 

9 striking ‘‘medical and mental’’ and in10 serting ‘‘agencies providing’’; 

11 (iv) in paragraph (2)— 

12 (I) in the matter preceding sub13 paragraph (A), by striking ‘‘a preven14 tion and diagnosis program to support 

15 clinical studies, demonstrations and 

16 other research as appropriate’’ and in17 serting ‘‘supporting and conducting 

18 research on FASD, as appropriate, in19 cluding’’; 

20 (II) in subparagraph (B)— 

21 (aa) by striking ‘‘prevention 

22 services and interventions for 

23 pregnant, alcohol-dependent 

24 women’’ and inserting ‘‘culturally 

25 and linguistically informed eviVerDate Sep 11 2014 20:31 Dec 11, 2023 Jkt 049200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\S3393.IS S3393
15 

•S 3393 IS

1 dence-based or practice-based 

2 interventions and appropriate so3 cietal supports for preventing 

4 prenatal alcohol exposure, which 

5 may co-occur with exposure to 

6 other substances’’; and 

7 (bb) by striking ‘‘; and’’ and 

8 inserting a semicolon; 

9 (v) by striking paragraph (3) and in10 serting the following: 

11 ‘‘(3) integrating into surveillance practice an 

12 evidence-based standard case definition for FASD 

13 and, in collaboration with other Federal and outside 

14 partners, support organizations of appropriate med15 ical and mental health professionals in their develop16 ment and refinement of evidence-based clinical diag17 nostic guidelines and criteria for all FASD; and 

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

19 identification, treatment, and support of individuals 

20 with FASD and their families, which may include— 

21 ‘‘(A) utilizing and adapting existing Fed22 eral, State, or Tribal programs to include 

23 FASD identification and FASD-informed sup24 port; 

16 

•S 3393 IS

1 ‘‘(B) developing and expanding screening 

2 and diagnostic capacity for FASD; 

3 ‘‘(C) developing, implementing, and evalu4 ating targeted FASD-informed intervention 

5 programs for FASD; 

6 ‘‘(D) increasing awareness of FASD; 

7 ‘‘(E) providing training with respect to 

8 FASD for professionals across relevant sectors; 

9 and 

10 ‘‘(F) disseminating information about 

11 FASD and support services to affected individ12 uals and their families.’’; 

13 (D) in subsection (b)— 

14 (i) by striking ‘‘described in section 

15 399I’’; 

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

17 inserting the following: 

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

19 (iii) by adding at the end the fol20 lowing: 

21 ‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re22 ceive a grant, or enter into a cooperative agreement 

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

24 ‘‘(A) be a State, Indian Tribe or Tribal or25 ganization, local government, scientific or acaVerDate Sep 11 2014 20:31 Dec 11, 2023 Jkt 049200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\S3393.IS S3393
17 

•S 3393 IS

1 demic institution, or nonprofit organization; 

2 and 

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

4 an application at such time, in such manner, 

5 and containing such information as the Sec6 retary may require, including a description of 

7 the activities that the entity intends to carry 

8 out using amounts received under this section. 

9 ‘‘(3) ADDITIONAL APPLICATION CONTENTS.— 

10 The Secretary may require that an entity using 

11 amounts from a grant, cooperative agreement, or 

12 contract under this section for an activity under sub13 section (a)(4) include in the application for such 

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

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

16 serve as a FASD State or Tribal coordinator of 

17 such activity; and 

18 ‘‘(B) a description of an advisory com19 mittee the entity will establish to provide guid20 ance for the entity on developing and imple21 menting a statewide or Tribal strategic plan to 

22 prevent FASD and provide for the identifica23 tion, treatment, and support of individuals with 

24 FASD and their families.’’; and 

18 

•S 3393 IS

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

2 and 

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

4 ‘‘(c) DEFINITION OF FASD-INFORMED.—For pur5 poses of this section, the term ‘FASD-informed’, with re6 spect to support or an intervention program, means that 

7 such support or intervention program uses culturally and 

8 linguistically informed evidence-based or practice-based 

9 interventions and appropriate societal supports to support 

10 an improved quality of life for an individual with FASD 

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

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

13 (42 U.S.C. 280f–1, 280f–2, 280f–3) and inserting 

14 the following: 

15 ‘‘SEC. 399I. FETAL ALCOHOL SPECTRUM DISORDERS CEN16 TERS FOR EXCELLENCE. 

17 ‘‘(a) IN GENERAL.—The Secretary shall, as appro18 priate, award grants, cooperative agreements, or contracts 

19 to public or nonprofit entities with demonstrated expertise 

20 in the prevention of, identification of, and intervention 

21 services with respect to, fetal alcohol spectrum disorders 

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

23 adverse conditions. Such awards shall be for the purposes 

24 of establishing Fetal Alcohol Spectrum Disorders Centers 

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

19 

•S 3393 IS

1 capacities to prevent the occurrence of FASD and other 

2 related adverse conditions, and to respond to the needs 

3 of individuals with FASD and their families by carrying 

4 out the programs described in subsection (b). 

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

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

7 purposes: 

8 ‘‘(1) Initiating or expanding diagnostic capacity 

9 for FASD by increasing screening, assessment, iden10 tification, and diagnosis. 

11 ‘‘(2) Developing and supporting public aware12 ness and outreach activities, including the use of a 

13 range of media and public outreach, to raise public 

14 awareness of the risks associated with alcohol con15 sumption during pregnancy, with the goals of reduc16 ing the prevalence of FASD and improving the de17 velopmental, health (including mental health), and 

18 educational outcomes of individuals with FASD and 

19 supporting families caring for individuals with 

20 FASD. 

21 ‘‘(3) Acting as a clearinghouse for evidence22 based resources on FASD prevention, identification, 

23 and culturally and linguistically informed best prac24 tices, including the maintenance of a national data25 based directory on FASD-specific services in States, 

20 

•S 3393 IS

1 Indian Tribes, and local communities, and dissemi2 nating ongoing research and developing resources on 

3 FASD to help inform systems of care for individuals 

4 with FASD across their lifespan. 

5 ‘‘(4) Increasing awareness and understanding 

6 of efficacious, evidence-based screening tools and 

7 culturally and linguistically appropriate evidence8 based intervention services and best practices, which 

9 may include by conducting national, regional, State, 

10 Tribal, or peer cross-State webinars, workshops, or 

11 conferences for training community leaders, medical 

12 and mental health and substance use disorder pro13 fessionals, education and disability professionals, 

14 families, law enforcement personnel, judges, individ15 uals working in financial assistance programs, social 

16 service personnel, child welfare professionals, and 

17 other service providers. 

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

19 local affiliates dedicated to FASD awareness, pre20 vention, and identification and family and individual 

21 support programs and services. 

22 ‘‘(6) Providing technical assistance to recipients 

23 of grants, cooperative agreements, or contracts 

24 under section 399H, as appropriate. 

21 

•S 3393 IS

1 ‘‘(7) Carrying out other functions, as appro2 priate. 

3 ‘‘(c) APPLICATION.—To be eligible for a grant, con4 tract, or cooperative agreement under this section, an enti5 ty shall submit to the Secretary an application at such 

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

7 the Secretary may require. 

8 ‘‘(d) SUBCONTRACTING.—A public or private non9 profit entity may carry out the following activities required 

10 under this section through contracts or cooperative agree11 ments with other public and private nonprofit entities with 

12 demonstrated expertise in FASD: 

13 ‘‘(1) Prevention activities. 

14 ‘‘(2) Screening and identification. 

15 ‘‘(3) Resource development and dissemination, 

16 training and technical assistance, administration, 

17 and support of FASD partner networks. 

18 ‘‘(4) Intervention services. 

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

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

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

22 years 2024 through 2028.’’. 

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

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

25 Human Services shall submit to the Committee on Health, 

22 

•S 3393 IS

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

2 Committee on Energy and Commerce of the House of 

3 Representatives a report on the efforts of the Department 

4 of Health and Human Services to advance public aware5 ness on, and facilitate the identification of best practices 

6 related to, fetal alcohol spectrum disorders identification, 

7 prevention, treatment, and support. 

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

9 Public Health Service Act (42 U.S.C. 290bb–25d) is re10 pealed. 

11 SEC. 111. PROMOTING STATE CHOICE IN PDMP SYSTEMS. 

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

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

14 ‘‘(5) PROMOTING STATE CHOICE.—Nothing in 

15 this section shall be construed to authorize the Sec16 retary to require States to use a specific vendor or 

17 a specific interoperability connection other than to 

18 align with nationally recognized, consensus-based 

19 open standards, such as in accordance with sections 

20 3001 and 3004.’’. 

21 TITLE II—TREATMENT 

22 SEC. 201. RESIDENTIAL TREATMENT PROGRAM FOR PREG23 NANT AND POSTPARTUM WOMEN. 

24 Section 508 of the Public Health Service Act (42 

25 U.S.C. 290bb–1) is amended— 

23 

•S 3393 IS

1 (1) in subsection (d)(11)(C), by striking ‘‘pro2 viding health services’’ and inserting ‘‘providing 

3 health care services’’; 

4 (2) in subsection (g)— 

5 (A) by inserting ‘‘a plan describing’’ after 

6 ‘‘will provide’’; and 

7 (B) by adding at the end the following: 

8 ‘‘Such plan may include a description of how 

9 such applicant will target outreach to women 

10 disproportionately impacted by maternal sub11 stance use disorder.’’; and 

12 (3) in subsection (s), by striking ‘‘$29,931,000 

13 for each of fiscal years 2019 through 2023’’ and in14 serting ‘‘$38, 931,000 for each of fiscal years 2024 

15 through 2028’’. 

16 SEC. 202. LOAN REPAYMENT PROGRAM FOR SUBSTANCE 

17 USE DISORDER TREATMENT WORKFORCE. 

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

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

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

21 ‘‘$50,000,000 for each of fiscal years 2024 through 

22 2028’’. 

24 

•S 3393 IS

1 SEC. 203. REGIONAL CENTERS OF EXCELLENCE IN SUB2 STANCE USE DISORDER EDUCATION. 

3 Section 551 of the Public Health Service Act (42 

4 U.S.C. 290ee–6) is amended by striking subsection (f). 

5 SEC. 204. MENTAL AND BEHAVIORAL HEALTH EDUCATION 

6 AND TRAINING PROGRAM. 

7 Section 756(f) of the Public Health Service Act (42 

8 U.S.C. 294e–1(f)) is amended to read as follows: 

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

10 carry out this section, there is authorized to be appro11 priated the following: 

12 ‘‘(1) $50,000,000 for fiscal year 2024, to be al13 located as follows: 

14 ‘‘(A) For grants described in subsection 

15 (a)(1), $15,000,000. 

16 ‘‘(B) For grants described in subsection 

17 (a)(2), $15,000,000. 

18 ‘‘(C) For grants described in subsection 

19 (a)(3), $10,000,000. 

20 ‘‘(D) For grants described in subsection 

21 (a)(4), $10,000,000. 

22 ‘‘(2) $55,000,000 for fiscal year 2025, to be al23 located as follows: 

24 ‘‘(A) For grants described in subsection 

25 (a)(1), $16,500,000. 

25 

•S 3393 IS

1 ‘‘(B) For grants described in subsection 

2 (a)(2), $16,500,000. 

3 ‘‘(C) For grants described in subsection 

4 (a)(3), $11,000,000. 

5 ‘‘(D) For grants described in subsection 

6 (a)(4), $11,000,000. 

7 ‘‘(3) $60,000,000 for fiscal year 2026, to be al8 located as follows: 

9 ‘‘(A) For grants described in subsection 

10 (a)(1), $18,000,000. 

11 ‘‘(B) For grants described in subsection 

12 (a)(2), $18,000,000. 

13 ‘‘(C) For grants described in subsection 

14 (a)(3), $12,000,000. 

15 ‘‘(D) For grants described in subsection 

16 (a)(4), $12,000,000. 

17 ‘‘(4) $65,000,000 for fiscal year 2027, to be al18 located as follows: 

19 ‘‘(A) For grants described in subsection 

20 (a)(1), $19,500,000. 

21 ‘‘(B) For grants described in subsection 

22 (a)(2), $19,500,000. 

23 ‘‘(C) For grants described in subsection 

24 (a)(3), $13,000,000. 

26 

•S 3393 IS

1 ‘‘(D) For grants described in subsection 

2 (a)(4), $13,000,000. 

3 ‘‘(5) $75,000,000 for fiscal year 2028, to be al4 located as follows: 

5 ‘‘(A) For grants described in subsection 

6 (a)(1), $22,500,000. 

7 ‘‘(B) For grants described in subsection 

8 (a)(2), $22,500,000. 

9 ‘‘(C) For grants described in subsection 

10 (a)(3), $15,000,000. 

11 ‘‘(D) For grants described in subsection 

12 (a)(4), $15,000,000.’’. 

13 SEC. 205. GRANTS TO ENHANCE ACCESS TO SUBSTANCE 

14 USE DISORDER TREATMENT. 

15 Section 3203 of the SUPPORT for Patients and 

16 Communities Act (21 U.S.C. 823 note) is amended— 

17 (1) by striking subsection (b); and 

18 (2) by striking ‘‘IN GENERAL—The Secretary’’ 

19 and inserting the following: 

20 ‘‘The Secretary’’. 

27 

•S 3393 IS

1 SEC. 206. GRANTS TO IMPROVE TRAUMA SUPPORT SERV2 ICES AND MENTAL HEALTH CARE FOR CHIL3 DREN AND YOUTH IN EDUCATIONAL SET4 TINGS. 

5 Section 7134 of the SUPPORT for Patients and 

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

7 (1) in subsection (a), by striking ‘‘tribal’’ and 

8 inserting ‘‘Tribal’’; 

9 (2) in subsection (c)— 

10 (A) in paragraph (1), by inserting ‘‘early 

11 intervention,’’ after ‘‘screening,’’; 

12 (B) in paragraph (3)— 

13 (i) in the matter preceding subpara14 graph (A), by inserting ‘‘other staff,’’ after 

15 ‘‘support personnel,’’; and 

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

17 ‘‘social and emotional learning’’ and insert18 ing ‘‘developmentally appropriate prac19 tices’’; and 

20 (C) in paragraph (5), by inserting ‘‘reduce 

21 stigma associated with mental health care and’’ 

22 after ‘‘efforts to’’; 

23 (3) in subsection (d)— 

24 (A) in paragraph (4)— 

25 (i) in subparagraph (A), by striking ‘‘; 

26 and’’ and inserting a semicolon; 

28 

•S 3393 IS

1 (ii) in subparagraph (B)— 

2 (I) by striking ‘‘tribal organiza3 tions as appropriate, other school per4 sonnel’’ and inserting ‘‘Tribal organi5 zations as appropriate, other staff’’; 

6 and 

7 (II) by striking the period and 

8 inserting ‘‘; and’’; and 

9 (iii) by adding at the end the fol10 lowing: 

11 ‘‘(C) parents and guardians will be in12 formed of what trauma support services and 

13 mental health care are available to their stu14 dents and what services and care their students 

15 receive, in accordance with the parental consent 

16 requirements under subsection (h)(2).’’; and 

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

18 ‘‘(7) A plan for sustaining the program fol19 lowing the end of the award period.’’; 

20 (4) in subsection (f)(1), by inserting ‘‘, which 

21 shall include a description of how the school obtains 

22 consent from the student’s parent or guardian for 

23 the provision of trauma support services and mental 

24 health care’’ after ‘‘this section’’; 

29 

•S 3393 IS

1 (5) in subsection (g), by striking ‘‘tribal’’ and 

2 inserting ‘‘Tribal’’; 

3 (6) in subsection (h)— 

4 (A) in the subsection heading, by inserting 

5 ‘‘; APPLICATION OF CERTAIN PROVISIONS’’ 

6 after ‘‘CONSTRUCTION’’; 

7 (B) by striking ‘‘tribal’’ each place it ap8 pears and inserting ‘‘Tribal’’; 

9 (C) by redesignating paragraphs (1) and 

10 (2) as subparagraphs (A) and (B), respectively, 

11 and adjusting the margins accordingly; 

12 (D) by striking ‘‘Nothing in this section’’ 

13 and inserting the following: 

14 ‘‘(1) IN GENERAL.—Nothing in this section’’; 

15 and 

16 (E) by adding at the end the following: 

17 ‘‘(2) APPLICATION OF PROVISIONS.— 

18 ‘‘(A) RULES.—Section 4001 of the Ele19 mentary and Secondary Education Act of 1965 

20 (not including the exception under subsection 

21 (a)(2)(B)(i) of such section) shall apply to an 

22 entity receiving a grant, contract, or cooperative 

23 agreement under this section in the same man24 ner as such section 4001 applies to an entity 

25 receiving funding under title IV of such Act. 

30 

•S 3393 IS

1 ‘‘(B) PRIVACY PROTECTIONS.—Any edu2 cation record of a student collected or main3 tained under subsection (c)(4) shall have the 

4 protections required for education records 

5 under section 444 of the General Education 

6 Provisions Act.’’. 

7 (7) in subsection (k)— 

8 (A) by redesignating paragraphs (5) 

9 through (11) as paragraphs (6) through (12), 

10 respectively; and 

11 (B) by inserting after paragraph (4) the 

12 following: 

13 ‘‘(5) OTHER STAFF.—The term ‘other staff’ has 

14 the meaning given such term in section 8101 of the 

15 Elementary and Secondary Education Act of 1965.’’; 

16 and 

17 (8) in subsection (l), by striking ‘‘2019 through 

18 2023’’ and inserting ‘‘2024 through 2028’’. 

19 SEC. 207. DEVELOPMENT AND DISSEMINATION OF MODEL 

20 TRAINING PROGRAMS FOR SUBSTANCE USE 

21 DISORDER PATIENT RECORDS. 

22 Section 7053 of the SUPPORT for Patients and 

23 Communities Act (42 U.S.C. 290dd–2 note) is amended 

24 by striking subsection (e). 

31 

•S 3393 IS

1 SEC. 208. TASK FORCE ON BEST PRACTICES FOR TRAUMA2 INFORMED IDENTIFICATION, REFERRAL, AND 

3 SUPPORT. 

4 Section 7132 of the SUPPORT for Patients and 

5 Communities Act (Public Law 115–271; 132 Stat. 4046) 

6 is amended— 

7 (1) in subsection (b)(1)— 

8 (A) by redesignating subparagraph (CC) as 

9 subparagraph (DD); and 

10 (B) by inserting after subparagraph (BB) 

11 the following: 

12 ‘‘(CC) The Administration for Community 

13 Living.’’; 

14 (2) in subsection (d)(1), in the matter pre15 ceding subparagraph (A), by inserting ‘‘, develop16 mental disability service providers’’ before ‘‘, individ17 uals who are’’; and 

18 (3) in subsection (i), by striking ‘‘2023’’ and in19 serting ‘‘2028’’. 

20 SEC. 209. PROGRAM TO SUPPORT COORDINATION AND 

21 CONTINUATION OF CARE FOR DRUG OVER22 DOSE PATIENTS. 

23 Section 7081 of the SUPPORT for Patients and 

24 Communities Act (42 U.S.C. 290dd–4) is amended by 

25 striking subsection (f). 

32 

•S 3393 IS

1 SEC. 210. REGULATIONS RELATING TO SPECIAL REGISTRA2 TION FOR TELEMEDICINE. 

3 Not later than 1 year after the date of enactment 

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

5 Secretary of Health and Human Services, shall promul6 gate the final regulations required under section 311(h)(2) 

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

8 SEC. 211. MENTAL HEALTH PARITY. 

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

10 the Inspector General of the Department of Labor, in co11 ordination with the Inspector General of the Department 

12 of Health and Human Services, shall report to the Com13 mittee on Health, Education, Labor, and Pensions of the 

14 Senate and the Committee on Energy and Commerce and 

15 the Committee on Education and the Workforce of the 

16 House of Representatives on the following: 

17 (1) The non-quantitative treatment limit (re18 ferred to in this section as ‘‘NQTL’’) requirements 

19 with respect to mental health and substance use dis20 order benefits under group health plans and health 

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

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

23 26(a)(8)), section 712(a)(8) of the Employee Retire24 ment Income Security Act of 1974 (29 U.S.C. 

25 1185a(a)(8)), and section 9812(a)(8) of the Internal 

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

33 

•S 3393 IS

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

2 and the requirements for the Secretary of Health 

3 and Human Services, the Secretary of Labor, and 

4 the Secretary of the Treasury to issue regulations, 

5 a compliance program guide, and additional guid6 ance documents and tools providing guidance relat7 ing to mental health parity requirements under sec8 tion 2726(a) of the Public Health Service Act (42 

9 U.S.C. 300gg–26(a)), section 712(a) of the Em10 ployee Retirement Income Security Act of 1974 (29 

11 U.S.C. 1185a(a)), and section 9812(a) of the Inter12 nal Revenue Code of 1986. 

13 (2) With respect to the NQTL comparative 

14 analysis requirements described in paragraph (1), an 

15 analysis of the actions taken by the Secretary of 

16 Labor, the Secretary of the Treasury, and the Sec17 retary of Health and Human Services to provide 

18 guidance to ensure that group health plans and 

19 health insurance issuers can fully comply with men20 tal health parity requirements under section 2726 of 

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

22 26), section 712 of the Employee Retirement Income 

23 Security Act of 1974 (29 U.S.C. 1185a), and section 

24 9812 of the Internal Revenue Code of 1986 and the 

34 

•S 3393 IS

1 NQTL comparative analysis requirements described 

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

3 (A) the extent to which the Secretary of 

4 Labor, the Secretary of the Treasury, and the 

5 Secretary of Health and Human Services have 

6 fulfilled the requirement under section 203(b) 

7 of division BB of the Consolidated Appropria8 tions Act, 2021 (Public Law 116–260) to issue 

9 the specific guidance and regulations pertaining 

10 to the requirements for group health plans and 

11 health insurance issuers to demonstrate compli12 ance with the NQTL comparative analysis re13 quirements; and 

14 (B) whether sufficient guidance and exam15 ples from the Department of Labor and De16 partment of Health and Human Services, and 

17 the Department of the Treasury exist to guide 

18 and assist group health plans and health insur19 ance issuers in complying with the requirements 

20 to demonstrate compliance with mental health 

21 parity NQTL comparative analysis require22 ments/under such sections 2726(a)(8), 

23 712(a)(8), and 9812(a)(8). 

24 (3) A review of the enforcement processes of 

25 the Department of Labor and the Department of 

35 

•S 3393 IS

1 Health and Human Services to evaluate the consist2 ency of interpretation of the requirements under sec3 tion 2726(a)(8) of the Public Health Service Act (42 

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

5 Employee Retirement Income Security Act of 1974 

6 (29 U.S.C. 1185a(a)(8)), and section 9812(a)(8) of 

7 the Internal Revenue Code of 1986, in particular 

8 with respect to processes utilized for enforcement, 

9 actions or inactions that constitute noncompliance, 

10 and avoidance among the agencies of duplication of 

11 enforcement, including an evaluation of compliance 

12 with section 104 of the Health Insurance Portability 

13 and Accountability Act of 1996 (Public Law 104– 

14 191). 

15 (4) A review of the implementation, by the De16 partment of Labor, Department of Health and 

17 Human Services, and Department of the Treasury, 

18 of mental health parity requirements under section 

19 2726 of the Public Health Service Act (42 U.S.C. 

20 300gg–26), section 712 of the Employee Retirement 

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

22 and section 9812 of the Internal Revenue Code of 

23 1986, including all such requirements in effect 

24 through the enactment of the Mental Health Parity 

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

36 

•S 3393 IS

1 Wellstone and Pete Domenici Mental Health Parity 

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

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

4 255), and the Consolidated Appropriations Act, 

5 2023 (Public Law 117–328) (including any amend6 ments made by such Acts), and including with re7 spect to the timing of all actions, delays of any ac8 tions, reasons for any such delays, mandated re9 quirements that were met only once but not each 

10 time such requirements were mandated. 

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

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

13 meanings given such terms in section 733 of the Employee 

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

15 1191b). 

16 SEC. 212. STATE GUIDANCE RELATED TO INDIVIDUALS 

17 WITH SERIOUS MENTAL ILLNESS AND CHIL18 DREN WITH SERIOUS EMOTIONAL DISTURB19 ANCE. 

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

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

22 the Secretary of Health and Human Services, acting 

23 through the Assistant Secretary for Mental Health and 

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

25 of funds made available under the Community Mental 

37 

•S 3393 IS

1 Health Services Block Grant program under subpart I of 

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

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

4 Such review shall consider the following: 

5 (1) How the States use funds for evidence6 based treatments and services, such as coordinated 

7 specialty care, according to the standard of care for 

8 individuals with early serious mental illness, includ9 ing the comprehensiveness of such treatments to in10 clude all aspects of the recommended intervention. 

11 (2) How State mental health departments co12 ordinate with State Medicaid departments in the de13 livery of the treatments and services described in 

14 paragraph (1). 

15 (3) The percentage of the State funding under 

16 the block grant program that is applied toward early 

17 serious mental illness and funding in excess of, or 

18 under, 10 percent of the amount of the grant, bro19 ken down by State. 

20 (4) The percentage of funds expended by States 

21 through such block grant program specifically on 

22 First Episode Psychosis, to the extent such informa23 tion is available. 

38 

•S 3393 IS

1 (5) How many individuals are served by the ex2 penditures described in paragraph (3)and (4), on a 

3 per-capita basis. 

4 (6) How the funds are used to reach under5 served populations, including rural populations and 

6 racial and ethnic minority populations. 

7 (b) REPORT AND GUIDANCE.— 

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

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

10 the Secretary of Health and Human Services, acting 

11 through the Assistant Secretary for Mental Health 

12 and Substance Use, shall submit to the Committee 

13 on Appropriations, the Committee on Health, Edu14 cation, Labor, and Pensions, and the Committee on 

15 Finance of the Senate and to the Committee on Ap16 propriations and the Committee on Energy and 

17 Commerce of the House of Representatives a report 

18 on the findings made as a result of the review con19 ducted under subsection (a). Such report shall in20 clude any recommendations with respect to any 

21 changes to the Community Mental Health Services 

22 Block Grant program under subpart I of part B of 

23 title XIX of the Public Health Service Act (42 

24 U.S.C. 300x et seq.), including the set aside re25 quired for First Episode Psychosis, that would faciliVerDate Sep 11 2014 20:31 Dec 11, 2023 Jkt 049200 PO 00000 Frm 00038 Fmt 6652 Sfmt 6201 E:\BILLS\S3393.IS S3393
39 

•S 3393 IS

1 tate improved outcomes for the targeted population 

2 involved. 

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

4 the date on which the report is submitted under 

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

6 Services, acting through the Assistant Secretary for 

7 Mental Health and Substance Use, shall update the 

8 guidance provided to States under the Community 

9 Mental Health Services Block Grant program based 

10 on the findings and recommendations of the report. 

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

12 National Institute of Mental Health shall coordinate with 

13 the Assistant Secretary for Mental Health and Substance 

14 Use in providing guidance to State grantees and provider 

15 subgrantees about research advances in the delivery of 

16 services for First Episode Psychosis under the Community 

17 Mental Health Services Block Grant program. 

18 (d) GUIDANCE FOR STATES RELATING TO HEALTH

19 CARE SERVICES AND INTERVENTIONS FOR INDIVIDUALS

20 WITH SERIOUS MENTAL ILLNESS AND CHILDREN WITH

21 SERIOUS EMOTIONAL DISTURBANCE.—Not later than 2 

22 years after the date of enactment of this Act, the Assistant 

23 Secretary for Mental Health and Substance Use, jointly 

24 with the Administrator of the Centers for Medicare & 

40 

•S 3393 IS

1 Medicaid Services and the Director of the National Insti2 tute of Mental Health— 

3 (1) shall provide updated guidance to States 

4 concerning the manner in which Federal funding 

5 provided to States through programs administered 

6 by such agencies, including the Community Mental 

7 Health Services Block Grant program under subpart 

8 I of part B of title XIX of the Public Health Service 

9 Act (42 U.S.C. 300x et seq.), may be coordinated to 

10 provide evidence-based health care services such as 

11 coordinated specialty care to individuals with serious 

12 mental illness and serious emotional disturbance, 

13 and interventions for individuals with early serious 

14 mental illness, including First Episode Psychosis; 

15 and 

16 (2) may streamline relevant State reporting re17 quirements if such streamlining would result in mak18 ing it easier for States to coordinate funding under 

19 the programs described in paragraph (1) to improve 

20 treatments for individuals with serious mental illness 

21 and serious emotional disturbance. 

22 SEC. 213. IMPROVING ACCESS TO ADDICTION MEDICINE 

23 PROVIDERS. 

24 Section 597 of the Public Health Service Act (42 

25 U.S.C. 290ll) is amended— 

41 

•S 3393 IS

1 (1) in subsection (a)(1), by inserting ‘‘diag2 nosis,’’ after ‘‘related to’’; and 

3 (2) in subsection (b), by inserting ‘‘addiction 

4 medicine,’’ after ‘‘psychiatry,’’. 

5 TITLE III—RECOVERY 

6 SEC. 301. YOUTH PREVENTION AND RECOVERY. 

7 Section 7102(c) of the SUPPORT for Patients and 

8 Communities Act (42 U.S.C. 290bb–7a(c)) is amended— 

9 (1) in paragraph (2)— 

10 (A) in subparagraph (A)— 

11 (i) in clause (i)— 

12 (I) by inserting ‘‘, or a consortia 

13 of local educational agencies,’’ after 

14 ‘‘a local educational agency’’; and 

15 (II) by striking ‘‘high schools’’ 

16 and inserting ‘‘secondary schools’’; 

17 and 

18 (ii) in clause (vi), by striking ‘‘tribe, 

19 or tribal’’ and inserting ‘‘Tribe, or Tribal’’; 

20 (B) by amending subparagraph (E) to read 

21 as follows: 

22 ‘‘(E) INDIAN TRIBE; TRIBAL ORGANIZA23 TION.—The terms ‘Indian Tribe’ and ‘Tribal 

24 organization’ have the meanings given such 

25 terms in section 4 of the Indian Self-DeterVerDate Sep 11 2014 20:31 Dec 11, 2023 Jkt 049200 PO 00000 Frm 00041 Fmt 6652 Sfmt 6201 E:\BILLS\S3393.IS S3393
42 

•S 3393 IS

1 mination and Education Assistance Act (25 

2 U.S.C. 5304).’’; 

3 (C) by redesignating subparagraph (K) as 

4 subparagraph (L); and 

5 (D) by inserting after subparagraph (J) 

6 the following: 

7 ‘‘(K) SECONDARY SCHOOL.—The term 

8 ‘secondary school’ has the meaning given such 

9 term in section 8101 of the Elementary and 

10 Secondary Education Act of 1965 (20 U.S.C. 

11 7801).’’; 

12 (2) in paragraph (3)(A), in the matter pre13 ceding clause (i)— 

14 (A) by striking ‘‘and abuse’’; and 

15 (B) by inserting ‘‘at increased risk for sub16 stance misuse’’ after ‘‘specific populations’’; 

17 (3) in paragraph (4)— 

18 (A) in the matter preceding subparagraph 

19 (A), by striking ‘‘Indian tribes’’ and inserting 

20 ‘‘Indian Tribes’’; 

21 (B) in subparagraph (A), by striking ‘‘and 

22 abuse’’; and 

23 (C) in subparagraph (B), by striking ‘‘peer 

24 mentoring’’ and inserting ‘‘peer-to-peer sup25 port’’; 

43 

•S 3393 IS

1 (4) in paragraph (5), by striking ‘‘tribal’’ and 

2 inserting ‘‘Tribal’’; 

3 (5) in paragraph (6)(A)— 

4 (A) in clause (iv), by striking ‘‘; and’’ and 

5 inserting a semicolon; and 

6 (B) by adding at the end the following: 

7 ‘‘(vi) a plan to sustain the activities 

8 carried out under the grant program, after 

9 the grant program has ended; and’’; 

10 (6) in paragraph (8), by striking ‘‘2022’’ and 

11 inserting ‘‘2027’’; and 

12 (7) by amending paragraph (9) to read as fol13 lows: 

14 ‘‘(9) AUTHORIZATION OF APPROPRIATIONS.— 

15 To carry out this subsection, there are authorized to 

16 be appropriated $10,000,000 for fiscal year 2024, 

17 $12,000,000 for fiscal year 2025, $14,000,000 for 

18 fiscal year 2026, $16,000,000 for fiscal year 2027, 

19 and $18,000,000 for fiscal year 2028.’’. 

20 SEC. 302. COMPREHENSIVE OPIOID RECOVERY CENTERS. 

21 Section 552 of the Public Health Service Act (42 

22 U.S.C. 290ee–7) is amended— 

23 (1) in subsection (d)(2)— 

24 (A) in the matter preceding subparagraph 

25 (A), by striking ‘‘and in such manner’’ and inVerDate Sep 11 2014 20:31 Dec 11, 2023 Jkt 049200 PO 00000 Frm 00043 Fmt 6652 Sfmt 6201 E:\BILLS\S3393.IS S3393
44 

•S 3393 IS

1 serting ‘‘, in such manner, and containing such 

2 information and assurances’’; and 

3 (B) in subparagraph (A), by striking ‘‘is 

4 capable of coordinating with other entities to 

5 carry out’’ and inserting ‘‘has the demonstrated 

6 capability to carry out, through referral or con7 tractual arrangements’’; 

8 (2) in subsection (h)— 

9 (A) by redesignating paragraphs (1) 

10 through (4) as subparagraphs (A) through (D), 

11 respectively, and adjusting the margins accord12 ingly; 

13 (B) by striking ‘‘With respect to’’ and in14 serting the following: 

15 ‘‘(1) IN GENERAL.—With respect to’’; and 

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

17 ‘‘(2) ADDITIONAL REPORTING FOR CERTAIN EL18 IGIBLE ENTITIES.—An entity carrying out activities 

19 described in subsection (g) through referral or con20 tractual arrangements shall include in the submis21 sions required under paragraph (1) information re22 lated to the status of such referrals or contractual 

23 arrangements, including an assessment of whether 

24 such referrals or contractual arrangements are supVerDate Sep 11 2014 20:31 Dec 11, 2023 Jkt 049200 PO 00000 Frm 00044 Fmt 6652 Sfmt 6201 E:\BILLS\S3393.IS S3393
45 

•S 3393 IS

1 porting the ability of such entity to carry out such 

2 activities.’’; and 

3 (3) in subsection (j), by striking ‘‘2019 through 

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

5 SEC. 303. BUILDING COMMUNITIES OF RECOVERY. 

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

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

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

9 ‘‘$16,000,000 for each of fiscal years 2024 through 

10 2028’’. 

11 SEC. 304. PEER SUPPORT TECHNICAL ASSISTANCE CEN12 TER. 

13 Section 547A of the Public Health Service Act (42 

14 U.S.C. 290ee–2a) is amended— 

15 (1) in subsection (b)(4), by striking ‘‘building; 

16 and’’ and inserting the following: ‘‘building, such 

17 as— 

18 ‘‘(A) professional development of peer sup19 port specialists; and 

20 ‘‘(B) making recovery support services 

21 available in nonclinical settings; and’’; 

22 (2) by redesignating subsections (d) and (e) as 

23 subsections (e) and (f), respectively; 

24 (3) by inserting after subsection (c) the fol25 lowing: 

46 

•S 3393 IS

1 ‘‘(d) PILOT PROGRAM.— 

2 ‘‘(1) IN GENERAL.—The Secretary shall carry 

3 out a pilot program to establish one regional tech4 nical assistance center (referred to in this subsection 

5 as the ‘Regional Center’) to assist the Center in car6 rying out activities described in subsection (b) within 

7 the geographic region of such Regional Center in a 

8 manner that is tailored to the needs of such region. 

9 ‘‘(2) EVALUATION.—Not later than 4 years 

10 after the date of enactment of the SUPPORT for 

11 Patients and Communities Reauthorization Act, the 

12 Secretary shall evaluate the activities of the Regional 

13 Center and submit to the Committee on Health, 

14 Education, Labor, and Pensions of the Senate and 

15 the Committee on Energy and Commerce of the 

16 House of Representatives a report on the findings of 

17 such evaluation, including— 

18 ‘‘(A) a description of the distinct roles and 

19 responsibilities of the Regional Center and the 

20 Center; 

21 ‘‘(B) available information relating to the 

22 outcomes of the pilot program under this sub23 section, such as any impact the Regional Center 

24 had on the operations and efficiency of the Cen25 ter relating to requests for technical assistance 

47 

•S 3393 IS

1 and support within the region of such Regional 

2 Center; 

3 ‘‘(C) a description of any gaps or areas of 

4 duplication relating to the activities of the Re5 gional Center and the Center within such re6 gion; and 

7 ‘‘(D) recommendations relating to the 

8 modification, expansion, or termination of the 

9 pilot program under this subsection. 

10 ‘‘(3) TERMINATION.—This subsection shall ter11 minate on September 30, 2028.’’; and 

12 (4) in subsection (f), as so redesignated, by 

13 striking ‘‘$1,000,000 for each of fiscal years 2019 

14 through 2023’’ and inserting ‘‘$2,000,000 for each 

15 of fiscal years 2024 through 2028’’. 

16 SEC. 305. CAREER ACT. 

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

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

19 is amended— 

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

21 TREATMENT, RECOVERY, AND WORKFORCE

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

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

24 ‘‘for a period’’; 

25 (3) in subsection (c)— 

48 

•S 3393 IS

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

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

3 ‘‘the average rates for calendar years 2018 

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

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

6 follows: 

7 ‘‘(2) RATES.—The rates described in this para8 graph are the following: 

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

10 rates of drug overdose deaths for calendar years 

11 2018 through 2022 based on data from the 

12 Centers for Disease Control and Prevention, in13 cluding, if necessary, provisional data for cal14 endar year 2022. 

15 ‘‘(B) The highest average rates of unem16 ployment for calendar years 2018 through 2022 

17 based on data provided by the Bureau of Labor 

18 Statistics. 

19 ‘‘(C) The lowest average labor force par20 ticipation rates for calendar years 2018 through 

21 2022 based on data provided by the Bureau of 

22 Labor Statistics.’’; 

23 (4) in subsection (g)— 

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

25 redesignating subparagraphs (A) and (B) as 

49 

•S 3393 IS

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

2 the margins accordingly; 

3 (B) by redesignating paragraphs (1) 

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

5 respectively, and adjusting the margins accord6 ingly; 

7 (C) in the matter preceding subparagraph 

8 (A) (as so redesignated), by striking ‘‘An enti9 ty’’ and inserting the following: 

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

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

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

13 receiving a grant under this section may use not 

14 more than 5 percent of the funds for providing 

15 transportation for individuals to participate in an ac16 tivity supported by a grant under this section, which 

17 transportation shall be to or from a place of work 

18 or a place where the individual is receiving career 

19 and technical education or job training services or 

20 receiving services directly linked to treatment of or 

21 recovery from a substance use disorder. 

22 ‘‘(3) LIMITATION.—The Secretary may not re23 quire an entity to, or give priority to an entity that 

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

50 

•S 3393 IS

1 for activities that are not specified in this sub2 section.’’; 

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

4 shall include employment and earnings outcomes de5 scribed in subclauses (I) and (III) of section 

6 116(b)(2)(A)(i) of the Workforce Innovation and 

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

8 respect to the participation of such individuals with 

9 a substance use disorder in programs and activities 

10 funded by the grant under this section’’ after ‘‘sub11 section (g)’’; 

12 (6) in subsection (j)— 

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

14 grants awarded prior to the date of enactment 

15 of the SUPPORT for Patients and Commu16 nities Reauthorization Act’’ after ‘‘grant period 

17 under this section’’; and 

18 (B) in paragraph (2)— 

19 (i) in the matter preceding subpara20 graph (A), by striking ‘‘2 years after sub21 mitting the preliminary report required 

22 under paragraph (1)’’ and inserting ‘‘Sep23 tember 30, 2028’’; and 

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

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

51 

•S 3393 IS

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

2 for each of fiscal years 2019 through 2023’’ and in3 serting ‘‘$12,000,000 for each of fiscal years 2024 

4 through 2028’’. 

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

6 in section 1(b) of the SUPPORT for Patients and Com7 munities Act (Public Law 115–271; 132 Stat. 3894) is 

8 amended by striking the item relating to section 7183 and 

9 inserting the following: 

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

grants.’’. 

10 SEC. 306. OFFICE OF RECOVERY. 

11 Part A of title V of the Public Health Service Act 

12 (42 U.S.C. 290aa et seq.) is amended by inserting after 

13 section 501C (42 U.S.C. 290aa–0b) the following: 

14 ‘‘SEC. 501D. OFFICE OF RECOVERY. 

15 ‘‘(a) IN GENERAL.—There is established, within the 

16 Substance Abuse and Mental Health Services Administra17 tion, an Office of Recovery (referred to in this section as 

18 the ‘Office’). 

19 ‘‘(b) RESPONSIBILITIES.—The Office shall, taking 

20 into account the perspectives of individuals with dem21 onstrated experience in mental health or substance use 

22 disorder recovery— 

23 ‘‘(1) identify new and emerging challenges re24 lated to the provision of recovery support services; 

52 

•S 3393 IS

1 ‘‘(2) support technical assistance, data analysis, 

2 and evaluation functions in order to assist States, 

3 local governmental entities, Indian Tribes, and Trib4 al organizations in implementing and strengthening 

5 recovery support services, consistent with the needs 

6 of such States, local governmental entities, Indian 

7 Tribes, and Tribal organizations; and 

8 ‘‘(3) ensure coordination of efforts to identify, 

9 disseminate, and evaluate best practices related to— 

10 ‘‘(A) improving the capacity of, and access 

11 to, recovery support services; and 

12 ‘‘(B) supporting the training, education, 

13 professional development, and retention of peer 

14 support specialists. 

15 ‘‘(c) REPORT.—Not later than 4 years after the date 

16 of enactment of the SUPPORT for Patients and Commu17 nities Reauthorization Act, the Assistant Secretary for 

18 Mental Health and Substance Use shall submit to the 

19 Committee on Health, Education, Labor, and Pensions of 

20 the Senate and the Committee on Energy and Commerce 

21 of the House of Representatives a report on the activities 

22 conducted by the Office, including— 

23 ‘‘(1) a description of the specific roles and re24 sponsibilities of the Office; 

53 

•S 3393 IS

1 ‘‘(2) a description of the relationship between 

2 the Office and other relevant components or pro3 grams of the Substance Abuse and Mental Health 

4 Services Administration; 

5 ‘‘(3) the identification of any gaps in the activi6 ties of the Substance Abuse and Mental Health 

7 Services Administration or challenges in coordina8 tion between the Office and such relevant compo9 nents or programs of such agency; and 

10 ‘‘(4) recommendations related to the continued 

11 operations of the Office. 

12 ‘‘(d) SUNSET.—This section shall cease to have force 

13 or effect on September 30, 2028.’’. 

14 TITLE IV—TECHNICAL 

15 AMENDMENTS 

16 SEC. 401. DELIVERY OF A CONTROLLED SUBSTANCE BY A 

17 PHARMACY TO AN ADMINISTERING PRACTI18 TIONER. 

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

20 (21 U.S.C. 829a(a)) is amended by striking paragraph (2) 

21 and inserting the following: 

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

23 schedule III, IV, or V to be administered— 

54 

•S 3393 IS

1 ‘‘(A) by injection or implantation for the 

2 purpose of maintenance or detoxification treat3 ment; or 

4 ‘‘(B) intranasally, subject to risk evalua5 tion and mitigation strategy pursuant to section 

6 505–1 of the Federal Food, Drug, and Cos7 metic Act (21 U.S.C. 355–1), with post-admin8 istration monitoring by a health care profes9 sional;’’. 

10 SEC. 402. TECHNICAL CORRECTION ON CONTROLLED SUB11 STANCES DISPENSING. 

12 Effective as if included in the enactment of Public 

13 Law 117–328— 

14 (1) section 1252(a) of division FF of Public 

15 Law 117–328 (136 Stat. 5681) is amended, in the 

16 matter being inserted into section 302(e) of the Con17 trolled Substances Act, by striking ‘‘303(g)’’ and in18 serting ‘‘303(h)’’; 

19 (2) section 1262 of division FF of Public Law 

20 117–328 (136 Stat. 5681) is amended— 

21 (A) in subsection (a)— 

22 (i) in the matter preceding paragraph 

23 (1), by striking ‘‘303(g)’’ and inserting 

24 ‘‘303(h)’’; 

55 

•S 3393 IS

1 (ii) in the matter being stricken by 

2 subsection (a)(2), by striking ‘‘(g)(1)’’ and 

3 inserting ‘‘(h)(1)’’; and 

4 (iii) in the matter being inserted by 

5 subsection (a)(2), by striking ‘‘(g) Practi6 tioners’’ and inserting ‘‘(h) Practitioners’’; 

7 and 

8 (B) in subsection (b)— 

9 (i) in the matter being stricken by 

10 paragraph (1), by striking ‘‘303(g)(1)’’ 

11 and inserting ‘‘303(h)(1)’’; 

12 (ii) in the matter being inserted by 

13 paragraph (1), by striking ‘‘303(g)’’ and 

14 inserting ‘‘303(h)’’; 

15 (iii) in the matter being stricken by 

16 paragraph (2)(A), by striking ‘‘303(g)(2)’’ 

17 and inserting ‘‘303(h)(2)’’; 

18 (iv) in the matter being stricken by 

19 paragraph (3), by striking ‘‘303(g)(2)(B)’’ 

20 and inserting ‘‘303(h)(2)(B)’’; 

21 (v) in the matter being stricken by 

22 paragraph (5), by striking ‘‘303(g)’’ and 

23 inserting ‘‘303(h)’’; and 

56 

•S 3393 IS

1 (vi) in the matter being stricken by 

2 paragraph (6), by striking ‘‘303(g)’’ and 

3 inserting ‘‘303(h)’’; and 

4 (3) section 1263(b) of division FF of Public 

5 Law 117–328 (136 Stat. 5685) is amended— 

6 (A) by striking ‘‘303(g)(2)’’ and inserting 

7 ‘‘303(h)(2)’’; and 

8 (B) by striking ‘‘(21 U.S.C. 823(g)(2))’’ 

9 and inserting ‘‘(21 U.S.C. 823(h)(2))’’. 

10 SEC. 403. REQUIRED TRAINING FOR PRESCRIBERS OF CON11 TROLLED SUBSTANCES. 

12 (a) IN GENERAL.—Section 303 of the Controlled 

13 Substances Act (21 U.S.C. 823) is amended— 

14 (1) by redesignating the second subsection des15 ignated as subsection (l) as subsection (m); and 

16 (2) in subsection (m)(1), as so redesignated— 

17 (A) in subparagraph (A)— 

18 (i) In clause (iv)— 

19 (I) In subclause (I)— 

20 (aa) by inserting ‘‘the Amer21 ican Academy of Family Physi22 cians, the American Podiatric 

23 Medical Association, the Acad24 emy of General Dentistry,’’ be25 fore ‘‘or any other organization’’; 

57 

•S 3393 IS

1 (bb) by striking ‘‘or the 

2 Commission’’ and inserting ‘‘the 

3 Commission’’; and 

4 (cc) by inserting ‘‘, or the 

5 Council on Podiatric Medical 

6 Education’’ before the semicolon 

7 at the end; and 

8 (II) in subclause (III), by insert9 ing ‘‘or the American Academy of 

10 Family Physicians’’ after ‘‘Associa11 tion’’; and 

12 (ii) in clause (v), in the matter pre13 ceding subclause (I)— 

14 (I) by striking ‘‘osteopathic medi15 cine, dental surgery’’ and inserting 

16 ‘‘osteopathic medicine, podiatric medi17 cine, dental surgery’’; and 

18 (II) by striking ‘‘or dental medi19 cine curriculum’’ and inserting ‘‘or 

20 dental or podiatric medicine cur21 riculum’’; and 

22 (B) in subparagraph (B)— 

23 (i) in clause (i), by inserting ‘‘the 

24 American Pharmacists Association, the Ac25 creditation Council on Pharmacy EduVerDate Sep 11 2014 20:31 Dec 11, 2023 Jkt 049200 PO 00000 Frm 00057 Fmt 6652 Sfmt 6201 E:\BILLS\S3393.IS S3393
58 

•S 3393 IS

1 cation, the American Optometric Associa2 tion, the American Psychiatric Nurses As3 sociation, the American Academy of Nurs4 ing, the American Academy of Family 

5 Physicians’’ before ‘‘, or any other organi6 zation’’; and 

7 (ii) in clause (ii)— 

8 (I) by striking ‘‘or accredited 

9 school’’ and inserting ‘‘, an accredited 

10 school’’; and 

11 (II) by inserting ‘‘, or an accred12 ited school of pharmacy’’ before ‘‘in 

13 the United States’’. 

14 (b) EFFECTIVE DATE.—The amendment made by 

15 subsection (a) shall take effect as if enacted on December 

16 29, 2022. 

Æ