II 

Calendar No. 319 

118TH CONGRESS 

2D 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 

FEBRUARY 1, 2024 

Reported by Mr. SANDERS, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

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’’. 


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

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—PREVENTION 

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 


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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. 

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 


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

2 and heroin’’; and 

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

4 for each of fiscal years 2019 through 2023’’ and in5 serting ‘‘$56,000,000 for each of fiscal years 2024 

6 through 2028’’. 

7 SEC. 102. SURVEILLANCE AND EDUCATION REGARDING IN8 FECTIONS ASSOCIATED WITH ILLICIT DRUG 

9 USE AND OTHER RISK FACTORS. 

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

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

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

13 SEC. 103. PREVENTING OVERDOSES OF CONTROLLED SUB14 STANCES. 

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

16 U.S.C. 280b–1) is amended— 

17 (1) in subsection (a)— 

18 (A) in paragraph (2)— 

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

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

21 the end; and 

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

23 ‘‘opioids’’ and inserting ‘‘substances caus24 ing overdose’’; 

25 (B) in paragraph (3)(A)— 


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1 (i) by inserting ‘‘identify substances 

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

3 (ii) by striking ‘‘abuse, and 

4 overdoses’’ and inserting ‘‘overdoses, and 

5 associated risk factors’’; 

6 (2) in subsection (b)(2)— 

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

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

9 overdoses’’; 

10 (B) in subparagraph (C), by striking ‘‘cod11 ing’’ and inserting ‘‘monitoring and identi12 fying’’; 

13 (C) in subparagraph (E)— 

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

15 health laboratories’’; and 

16 (ii) by inserting ‘‘and other emerging 

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

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

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

20 and 

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

22 for each of fiscal years 2019 through 2023’’ and in23 serting ‘‘$505,579,000 for each of fiscal years 2024 

24 through 2028’’. 


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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)— 


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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 


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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, 


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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— 


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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 


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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. 


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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 


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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)— 


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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 

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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; 


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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 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6401 E:\BILLS\S3393.RS S3393

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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 


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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 


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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, 


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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. 


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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, 


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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— 


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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’’. 


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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. 


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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. 


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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’’. 


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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; 


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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’’; 


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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. 


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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). 


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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). 


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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 


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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 


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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 


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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 


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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 


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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. 


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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 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00038 Fmt 6652 Sfmt 6401 E:\BILLS\S3393.RS S3393

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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 & 


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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— 


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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 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00041 Fmt 6652 Sfmt 6401 E:\BILLS\S3393.RS S3393

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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’’; 


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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 

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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 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00044 Fmt 6652 Sfmt 6401 E:\BILLS\S3393.RS S3393

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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: 


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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 


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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)— 


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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 


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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 


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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 


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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; 


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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; 


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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— 


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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)’’; 


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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 


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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’’; 


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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 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00057 Fmt 6652 Sfmt 6401 E:\BILLS\S3393.RS S3393

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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. 

17 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

19 ‘‘SUPPORT for Patients and Communities Reauthoriza20 tion Act’’. 

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

22 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—PREVENTION 

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. 


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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. 

Sec. 112. Protecting Suicide Prevention Lifeline from cybersecurity incidents. 

Sec. 113. Bruce’s Law. 

Sec. 114. Guidance on at-home drug disposal systems. 

Sec. 115. Review of opioid drugs and actions. 

Sec. 116. Consideration of enriched enrollment randomized withdrawal methodology. 

Sec. 117. Approval of new opioid analgesic drugs. 

Sec. 118. Guidance on developing non-addictive medical products to treat pain 

or addiction. 

Sec. 119. National Chronic Pain Information System. 

Sec. 120. Requirements for electronic-prescribing for controlled substances under 

group health plans and group and individual health insurance 

coverage. 

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. 

Sec. 214. Roundtable on using health information technology to improve mental 

health and substance use care outcomes. 

Sec. 215. Peer-to-peer mental health support. 

Sec. 216. Kid PROOF pilot program. 

TITLE III—RECOVERY 

Sec. 301. Youth prevention and recovery. 

Sec. 302. Comprehensive opioid recovery centers. 

Sec. 303. Building communities of recovery. 


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Sec. 304. Peer support technical assistance center. 

Sec. 305. CAREER Act. 

Sec. 306. Research and recommendations on criminal background check process 

for peer support specialists. 

Sec. 307. Office of Recovery. 

Sec. 308. Review of Grants.gov. 

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. 

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)— 


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

2 and inserting ‘‘opioid, heroin, and other 

3 drug’’; and 

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

5 inserting ‘‘overdose’’; and 

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

7 and heroin’’; and 

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

9 for each of fiscal years 2019 through 2023’’ and in10 serting ‘‘$56,000,000 for each of fiscal years 2024 

11 through 2028’’. 

12 SEC. 102. SURVEILLANCE AND EDUCATION REGARDING IN13 FECTIONS ASSOCIATED WITH ILLICIT DRUG 

14 USE AND OTHER RISK FACTORS. 

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

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

17 2023’’ and inserting ‘‘2024 through 2028’’. 

18 SEC. 103. PREVENTING OVERDOSES OF CONTROLLED SUB19 STANCES. 

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

21 U.S.C. 280b–1) is amended— 

22 (1) in subsection (a)— 

23 (A) in paragraph (2)— 


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

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

3 the end; and 

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

5 ‘‘opioids’’ and inserting ‘‘substances causing 

6 overdose’’; 

7 (B) in paragraph (3)(A)— 

8 (i) by inserting ‘‘identify substances 

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

10 (ii) by striking ‘‘abuse, and overdoses’’ 

11 and inserting ‘‘overdoses, and associated 

12 risk factors’’; 

13 (2) in subsection (b)(2)— 

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

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

16 overdoses’’; 

17 (B) in subparagraph (C), by striking ‘‘cod18 ing’’ and inserting ‘‘monitoring and identi19 fying’’; 

20 (C) in subparagraph (E)— 

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

22 health laboratories’’; and 

23 (ii) by inserting ‘‘and other emerging 

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


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1 (D) in subparagraph (F,) by inserting ‘‘and 

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

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

4 for each of fiscal years 2019 through 2023’’ and in5 serting ‘‘$505,579,000 for each of fiscal years 2024 

6 through 2028’’. 

7 SEC. 104. PILOT PROGRAM FOR PUBLIC HEALTH LABORA8 TORIES TO DETECT FENTANYL AND OTHER 

9 SYNTHETIC OPIOIDS. 

10 Section 7011 of the SUPPORT for Patients and Com11 munities Act (42 U.S.C. 247d–10) is amended by striking 

12 subsection (d). 

13 SEC. 105. PRENATAL AND POSTNATAL HEALTH. 

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

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

16 2023’’ and inserting ‘‘2024 through 2028’’. 

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

18 STRESS INITIATIVE. 

19 Section 582 of the Public Health Service Act (42 

20 U.S.C. 290hh–1) is amended— 

21 (1) in the section heading, by striking ‘‘VIO22 LENCE RELATED STRESS’’ and inserting ‘‘TRAU23 MATIC EVENTS’’; 

24 (2) in subsection (a)— 


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

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

3 ‘‘Tribes and Tribal’’; and 

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

5 dissemination’’ after ‘‘the development’’; 

6 (3) in subsection (b), by inserting ‘‘and dissemi7 nation’’ after ‘‘the development’’; 

8 (4) in subsection (d)— 

9 (A) by striking ‘‘The NCTSI’’ and inserting 

10 the following: 

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

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

13 ‘‘(2) NCTSI GRANTEES.—In carrying out sub14 section (a)(2), NCTSI grantees shall develop trainings 

15 and other resources, as applicable and appropriate, to 

16 support implementation of the evidence-based prac17 tices developed and disseminated under such sub18 section.’’; 

19 (5) in subsection (e)— 

20 (A) by redesignating paragraphs (1) and 

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

22 and adjusting the margins accordingly; 

23 (B) in subparagraph (A), as so redesig24 nated, by inserting ‘‘and implementation’’ after 

25 ‘‘the dissemination’’; 


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1 (C) by striking ‘‘The NCTSI’’ and inserting 

2 the following: 

3 ‘‘(1) COORDINATING CENTER.—’’; and 

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

5 ‘‘(2) NCTSI GRANTEES.—NCTSI grantees shall, 

6 as appropriate, collaborate with other such grantees, 

7 the NCTSI coordinating center, and the Secretary in 

8 carrying out subsections (a)(2) and (d)(2).’’; 

9 (6) by amending subsection (h) to read as fol10 lows: 

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

12 to receive a grant, contract, or cooperative agreement under 

13 subsection (a), a public or nonprofit private entity or an 

14 Indian Tribe or Tribal organization shall submit to the 

15 Secretary an application at such time, in such manner, and 

16 containing such information and assurances as the Sec17 retary may require, including— 

18 ‘‘(1) a plan for the rigorous evaluation of the ac19 tivities funded under the grant, contract, or agree20 ment, including both process and outcomes evalua21 tion, and the submission of an evaluation at the end 

22 of the project period; and 

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

24 Tribe, or Tribal organization will support efforts led 

25 by the Secretary or the NCTSI coordinating center, as 


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1 applicable, to evaluate activities carried out under 

2 this section.’’; and 

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

4 for each of fiscal years 2019 through 2023’’ and in5 serting ‘‘$93,887,000 for each of fiscal years 2024 and 

6 2025, $104,000,000 for fiscal year 2026, $110,000,000 

7 for fiscal year 2027, and $112,661,000 for fiscal year 

8 2028’’. 

9 SEC. 107. SURVEILLANCE AND DATA COLLECTION FOR 

10 CHILD, YOUTH, AND ADULT TRAUMA. 

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

12 Communities Act (42 U.S.C. 242t(e)) is amended by strik13 ing ‘‘2019 through 2023’’ and inserting ‘‘2024 through 

14 2028’’. 

15 SEC. 108. PREVENTING ADVERSE CHILDHOOD EXPERI16 ENCES. 

17 (a) GRANT PROGRAM.— 

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

19 Human Services (referred to in this section as the 

20 ‘‘Secretary’’), acting through the Director of the Cen21 ters for Disease Control and Prevention, may award 

22 grants or cooperative agreements to States, territories, 

23 Indian Tribes and Tribal organizations (as such 

24 terms are defined in section 4 of the Indian Self-De25 termination and Education Assistance Act (25 U.S.C. 


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1 5304)), and local governmental entities for purposes 

2 of carrying out public health activities to improve 

3 health outcomes by preventing or reducing adverse 

4 childhood experiences. 

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

6 under this subsection may use such award to— 

7 (A) identify, implement, and evaluate evi8 dence-based public health activities to prevent or 

9 reduce adverse childhood experiences and im10 prove health outcomes; 

11 (B) improve data collection and analysis 

12 regarding the prevention and reduction of ad13 verse childhood experiences, including any such 

14 data described in section 7131 of the SUPPORT 

15 for Patients and Communities Act (42 U.S.C. 

16 242t), to identify— 

17 (i) any geographic areas or popu18 lations within the jurisdiction of the recipi19 ent of an award that have disproportion20 ately high rates of adverse childhood experi21 ences; 

22 (ii) any types of adverse childhood ex23 periences of high prevalence within such ju24 risdiction; and 


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1 (iii) any short-term health outcomes 

2 and long-term health outcomes associated 

3 with adverse childhood experiences, includ4 ing mental health and substance use dis5 orders; and 

6 (C) leverage such data and analysis to in7 form the identification, implementation, and 

8 evaluation of evidence-based public health activi9 ties under subparagraph (A). 

10 (3) PARTNERSHIPS.—Recipients of an award 

11 under this subsection may identify opportunities to 

12 establish, or strengthen existing, partnerships with 

13 other relevant public and private entities within such 

14 jurisdiction for purposes of carrying out such award. 

15 (4) TECHNICAL ASSISTANCE.—The Secretary 

16 may provide training and technical assistance to re17 cipients of awards under this subsection. 

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

19 the date of enactment of this Act, and annually there20 after, the Secretary shall report to the Committee on 

21 Health, Education, Labor, and Pensions of the Senate 

22 and the Committee on Energy and Commerce of the 

23 House of Representatives on the specific activities 

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1 cluding the effectiveness of such activities in pre2 venting or reducing adverse childhood experiences. 

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

4 conduct research to evaluate public health activities to ad5 dress adverse childhood experiences. 

6 (c) AUTHORIZATION OF APPROPRIATIONS.—To carry 

7 out this section, there is authorized to be appropriated 

8 $7,000,000 for each of fiscal years 2024 through 2028. 

9 SEC. 109. CLARIFICATION OF USE OF FUNDS FOR PROD10 UCTS USED TO PREVENT OVERDOSE DEATHS. 

11 The activities carried out pursuant to section 

12 1003(b)(4)(A) of the 21st Century Cures Act (42 U.S.C. 

13 290ee–3a(b)(4)(A)) may include facilitating access to prod14 ucts used to prevent overdose deaths by detecting the pres15 ence of one or more substances, to the extent the purchase 

16 and possession of such products is consistent with Federal 

17 and State law. 

18 SEC. 110. SUPPORT FOR INDIVIDUALS AND FAMILIES IM19 PACTED BY FETAL ALCOHOL SPECTRUM DIS20 ORDER. 

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

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

23 (1) by amending the part heading to read as fol24 lows: ‘‘FETAL ALCOHOL SPECTRUM DISORDERS

25 PREVENTION AND SERVICES PROGRAM’’; 


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

2 (A) in the section heading, by striking ‘‘ES3 TABLISHMENT OF FETAL ALCOHOL SYN4 DROME PREVENTION’’ and inserting ‘‘FETAL

5 ALCOHOL SPECTRUM DISORDERS PREVEN6 TION, INTERVENTION,’’; 

7 (B) by striking ‘‘Fetal Alcohol Syndrome 

8 and Fetal Alcohol Effect’’ each place it appears 

9 and inserting ‘‘FASD’’; 

10 (C) in subsection (a)— 

11 (i) by amending the heading to read as 

12 follows: ‘‘IN GENERAL’’; 

13 (ii) in the matter preceding paragraph 

14 (1)— 

15 (I) by inserting ‘‘or continue ac16 tivities to support’’ after ‘‘shall estab17 lish’’; 

18 (II) by striking ‘‘FASD’’ (as 

19 amended by subparagraph (B)) and 

20 inserting ‘‘fetal alcohol spectrum dis21 orders (referred to in this section as 

22 ‘FASD’)’’; 

23 (III) by striking ‘‘prevention, 

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1 ness, prevention, identification, inter2 vention,’’; and 

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

4 inserting ‘‘, which may’’; 

5 (iii) in paragraph (1)— 

6 (I) in subparagraph (A)— 

7 (aa) by striking ‘‘medical 

8 schools’’ and inserting ‘‘health 

9 professions schools’’; and 

10 (bb) by inserting ‘‘infants,’’ 

11 after ‘‘provision of services for’’; 

12 and 

13 (II) in subparagraph (D), by 

14 striking ‘‘medical and mental’’ and in15 serting ‘‘agencies providing’’; 

16 (iv) in paragraph (2)— 

17 (I) in the matter preceding sub18 paragraph (A), by striking ‘‘a preven19 tion and diagnosis program to support 

20 clinical studies, demonstrations and 

21 other research as appropriate’’ and in22 serting ‘‘supporting and conducting re23 search on FASD, as appropriate, in24 cluding’’; 

25 (II) in subparagraph (B)— 


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1 (aa) by striking ‘‘prevention 

2 services and interventions for 

3 pregnant, alcohol-dependent 

4 women’’ and inserting ‘‘culturally 

5 and linguistically appropriate 

6 evidence-based or evidence-in7 formed interventions and appro8 priate societal supports for pre9 venting prenatal alcohol exposure, 

10 which may co-occur with exposure 

11 to other substances’’; and 

12 (bb) by striking ‘‘; and’’ and 

13 inserting a semicolon; 

14 (v) by striking paragraph (3) and in15 serting the following: 

16 ‘‘(3) integrating into surveillance a case defini17 tion for FASD and, in collaboration with other Fed18 eral and outside partners, support organizations of 

19 appropriate medical and mental health professionals 

20 in their development and refinement of evidence-based 

21 clinical diagnostic guidelines and criteria for all 

22 FASD; and 

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

24 identification, treatment, and support of individuals 

25 with FASD and their families, which may include— 


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1 ‘‘(A) utilizing and adapting existing Fed2 eral, State, or Tribal programs to include FASD 

3 identification and FASD-informed support; 

4 ‘‘(B) developing and expanding screening 

5 and diagnostic capacity for FASD; 

6 ‘‘(C) developing, implementing, and evalu7 ating targeted FASD-informed intervention pro8 grams for FASD; 

9 ‘‘(D) increasing awareness of FASD; 

10 ‘‘(E) providing training with respect to 

11 FASD for professionals across relevant sectors; 

12 and 

13 ‘‘(F) disseminating information about 

14 FASD and support services to affected individ15 uals and their families.’’; 

16 (D) in subsection (b)— 

17 (i) by striking ‘‘described in section 

18 399I’’; 

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

20 inserting the following: 

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

22 (iii) by adding at the end the fol23 lowing: 


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1 ‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re2 ceive a grant, or enter into a cooperative agreement 

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

4 ‘‘(A) be a State, Indian Tribe or Tribal or5 ganization, local government, scientific or aca6 demic institution, or nonprofit organization; and 

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

8 an application at such time, in such manner, 

9 and containing such information as the Sec10 retary may require, including a description of 

11 the activities that the entity intends to carry out 

12 using amounts received under this section. 

13 ‘‘(3) ADDITIONAL APPLICATION CONTENTS.—The 

14 Secretary may require that an eligible entity include 

15 in the application submitted under paragraph 

16 (2)(B)— 

17 ‘‘(A) a designation of an individual to serve 

18 as a FASD State or Tribal coordinator of activi19 ties such eligible entity proposes to carry out 

20 through a grant, cooperative agreement, or con21 tract under this section; and 

22 ‘‘(B) a description of an advisory committee 

23 the entity will establish to provide guidance for 

24 the entity on developing and implementing a 

25 statewide or Tribal strategic plan to prevent 


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1 FASD and provide for the identification, treat2 ment, and support of individuals with FASD 

3 and their families.’’; and 

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

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

6 ‘‘(c) DEFINITION OF FASD-INFORMED.—For purposes 

7 of this section, the term ‘FASD-informed’, with respect to 

8 support or an intervention program, means that such sup9 port or intervention program uses culturally and linguis10 tically informed evidence-based or practice-based interven11 tions and appropriate societal supports to support an im12 proved quality of life for an individual with FASD and 

13 the family of such individual.’’; and 

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

15 (42 U.S.C. 280f–1, 280f–2, 280f–3) and inserting the 

16 following: 

17 ‘‘SEC. 399I. FETAL ALCOHOL SPECTRUM DISORDERS CEN18 TERS FOR EXCELLENCE. 

19 ‘‘(a) IN GENERAL.—The Secretary shall, as appro20 priate, award grants, cooperative agreements, or contracts 

21 to public or nonprofit private entities with demonstrated 

22 expertise in the prevention of, identification of, and inter23 vention services with respect to, fetal alcohol spectrum dis24 orders (referred to in this section as ‘FASD’) and other re25 lated adverse conditions. Such awards shall be for the purVerDate Sep 11 2014 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00075 Fmt 6652 Sfmt 6203 E:\BILLS\S3393.RS S3393

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1 poses of establishing Fetal Alcohol Spectrum Disorders Cen2 ters for Excellence to build local, Tribal, State, and nation3 wide capacities to prevent the occurrence of FASD and 

4 other related adverse conditions, and to respond to the needs 

5 of individuals with FASD and their families by carrying 

6 out the programs described in subsection (b). 

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

8 subsection (a) may use such award for the following pur9 poses: 

10 ‘‘(1) Initiating or expanding diagnostic capacity 

11 for FASD by increasing screening, assessment, identi12 fication, and diagnosis. 

13 ‘‘(2) Developing and supporting public aware14 ness and outreach activities, including the use of a 

15 range of media and public outreach, to raise public 

16 awareness of the risks associated with alcohol con17 sumption during pregnancy, with the goals of reduc18 ing the prevalence of FASD and improving the devel19 opmental, health (including mental health), and edu20 cational outcomes of individuals with FASD and sup21 porting families caring for individuals with FASD. 

22 ‘‘(3) Acting as a clearinghouse for evidence-based 

23 resources on FASD prevention, identification, and 

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1 based directory on FASD-specific services in States, 

2 Indian Tribes, and local communities, and dissemi3 nating ongoing research and developing resources on 

4 FASD to help inform systems of care for individuals 

5 with FASD across their lifespan. 

6 ‘‘(4) Increasing awareness and understanding of 

7 efficacious, evidence-based screening tools and cul8 turally and linguistically appropriate evidence-based 

9 intervention services and best practices, which may 

10 include by conducting nationwide, regional, State, 

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

12 conferences for training community leaders, medical 

13 and mental health and substance use disorder profes14 sionals, education and disability professionals, fami15 lies, law enforcement personnel, judges, individuals 

16 working in financial assistance programs, social serv17 ice personnel, child welfare professionals, and other 

18 service providers. 

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

20 local affiliates dedicated to FASD awareness, preven21 tion, and identification and family and individual 

22 support programs and services. 

23 ‘‘(6) Providing technical assistance to recipients 

24 of grants, cooperative agreements, or contracts under 

25 section 399H, as appropriate. 


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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 entity 

5 shall submit to the Secretary an application at such time, 

6 in such manner, and containing such information as the 

7 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 and treatment 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, 


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1 Education, Labor, and Pensions of the Senate and the Com2 mittee on Energy and Commerce of the House of Represent3 atives a report on the efforts of the Department of Health 

4 and Human Services to advance public awareness of, and 

5 facilitate the identification of best practices related to, fetal 

6 alcohol spectrum disorders identification, prevention, treat7 ment, 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 a 

17 specific interoperability connection other than to 

18 align with nationally recognized, consensus-based 

19 open standards, such as in accordance with the appli20 cation programming interface (API) requirements 

21 pursuant to sections 3001 and 3004.’’. 


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1 SEC. 112. PROTECTING SUICIDE PREVENTION LIFELINE 

2 FROM CYBERSECURITY INCIDENTS. 

3 (a) NATIONAL SUICIDE PREVENTION LIFELINE PRO4 GRAM.—Section 520E–3(b) of the Public Health Service Act 

5 (42 U.S.C. 290bb–36c(b)) is amended— 

6 (1) in paragraph (4), by striking ‘‘and’’ at the 

7 end; 

8 (2) in paragraph (5), by striking the period at 

9 the end and inserting ‘‘; and’’; and 

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

11 ‘‘(6) taking such steps as may be necessary to en12 sure the suicide prevention hotline is protected from 

13 cybersecurity incidents and eliminates known cyberse14 curity vulnerabilities.’’. 

15 (b) REPORTING.—Section 520E–3 of the Public Health 

16 Service Act (42 U.S.C. 290bb–36c) is amended— 

17 (1) by redesignating subsection (f) as subsection 

18 (g); and 

19 (2) by inserting after subsection (e) the following: 

20 ‘‘(f) CYBERSECURITY REPORTING.— 

21 ‘‘(1) NOTIFICATION.— 

22 ‘‘(A) IN GENERAL.—The program’s network 

23 administrator receiving Federal funding pursu24 ant to subsection (a) shall report to the Assistant 

25 Secretary, in a manner that protects personal 


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1 privacy, consistent with applicable Federal and 

2 State privacy laws— 

3 ‘‘(i) any identified cybersecurity 

4 vulnerabilities to the program within a rea5 sonable amount of time after identification 

6 of such a vulnerability; and 

7 ‘‘(ii) any identified cybersecurity inci8 dents to the program within a reasonable 

9 amount of time after identification of such 

10 incident. 

11 ‘‘(B) LOCAL AND REGIONAL CRISIS CEN12 TERS.—Local and regional crisis centers partici13 pating in the program shall report to the pro14 gram’s network administrator identified under 

15 subparagraph (A), in a manner that protects 

16 personal privacy, consistent with applicable Fed17 eral and State privacy laws— 

18 ‘‘(i) any identified cybersecurity 

19 vulnerabilities to the program within a rea20 sonable amount of time after identification 

21 of such vulnerability; and 

22 ‘‘(ii) any identified cybersecurity inci23 dents to the program within a reasonable 

24 amount of time after identification of such 

25 incident. 


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1 ‘‘(2) NOTIFICATION.—If the program’s network 

2 administrator receiving funding pursuant to sub3 section (a) discovers, or is informed by a local or re4 gional crisis center pursuant to paragraph (1)(B) of, 

5 a cybersecurity vulnerability or incident, within a 

6 reasonable amount of time after such discovery or re7 ceipt of information, such entity shall report the vul8 nerability or incident to the Assistant Secretary. 

9 ‘‘(3) CLARIFICATION.— 

10 ‘‘(A) OVERSIGHT.— 

11 ‘‘(i) LOCAL AND REGIONAL CRISIS CEN12 TERS.—Except as provided in clause (ii), 

13 local and regional crisis centers partici14 pating in the program shall oversee all tech15 nology each center employs in the provision 

16 of services as a participant in the program. 

17 ‘‘(ii) NETWORK ADMINISTRATOR.—The 

18 program’s network administrator receiving 

19 Federal funding pursuant to subsection (a) 

20 shall oversee the technology each crisis cen21 ter employs in the provision of services as 

22 a participant in the program if such over23 sight responsibilities are established in the 

24 applicable network participation agreement. 


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1 ‘‘(B) SUPPLEMENT, NOT SUPPLANT.—The 

2 cybersecurity incident reporting requirements 

3 under this subsection shall supplement, and not 

4 supplant, cybersecurity incident reporting re5 quirements under other provisions of applicable 

6 Federal law that are in effect on the date of the 

7 enactment of the SUPPORT for Patients and 

8 Communities Reauthorization Act.’’. 

9 (c) STUDY.—Not later than 180 days after the date 

10 of the enactment of this Act, the Comptroller General of the 

11 United States shall— 

12 (1) conduct and complete a study that evaluates 

13 cybersecurity risks and vulnerabilities associated with 

14 the 9–8–8 National Suicide Prevention Lifeline; and 

15 (2) submit a report of the findings of such study 

16 to the Committee on Health, Education, Labor, and 

17 Pensions of the Senate and the Committee on Energy 

18 and Commerce of the House of Representatives. 

19 SEC. 113. BRUCE’S LAW. 

20 (a) YOUTH PREVENTION AND RECOVERY.—Section 

21 7102(c) of the SUPPORT for Patients and Communities 

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

23 (1) in paragraph (3)(A)(i), by inserting ‘‘, which 

24 may include strategies to increase education and 

25 awareness of the potency and dangers of synthetic 


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1 opioids (including drugs contaminated with fentanyl) 

2 and, as appropriate, other emerging drug use or mis3 use issues’’ before the semicolon; and 

4 (2) in paragraph (4)(A), by inserting ‘‘and 

5 strategies to increase education and awareness of the 

6 potency and dangers of synthetic opioids (including 

7 drugs contaminated with fentanyl) and, as appro8 priate, emerging drug use or misuse issues’’ before the 

9 semicolon. 

10 (b) INTERDEPARTMENTAL SUBSTANCE USE DIS11 ORDERS COORDINATING COMMITTEE.—Section 7022 of the 

12 SUPPORT for Patients and Communities Act (42 U.S.C. 

13 290aa note) is amended— 

14 (1) by striking subsection (g) and inserting the 

15 following: 

16 ‘‘(g) WORKING GROUPS.— 

17 ‘‘(1) IN GENERAL.—The Committee may estab18 lish working groups for purposes of carrying out the 

19 duties described in subsection (e). Any such working 

20 group shall be composed of members of the Committee 

21 (or the designees of such members) and may hold such 

22 meetings as are necessary to enable the working group 

23 to carry out the duties delegated to the working 

24 group. 


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1 ‘‘(2) ADDITIONAL FEDERAL INTERAGENCY WORK

2 GROUP ON FENTANYL CONTAMINATION OF ILLEGAL

3 DRUGS.— 

4 ‘‘(A) ESTABLISHMENT.—The Secretary, act5 ing through the Committee, shall establish a Fed6 eral Interagency Work Group on Fentanyl Con7 tamination of Illegal Drugs (referred to in this 

8 paragraph as the ‘Work Group’), consisting of 

9 representatives from relevant Federal depart10 ments and agencies on the Committee. 

11 ‘‘(B) CONSULTATION.—The Work Group 

12 shall consult with relevant stakeholders and sub13 ject matter experts, including— 

14 ‘‘(i) State, Tribal, and local subject 

15 matter experts in reducing, preventing, and 

16 responding to drug overdose caused by 

17 fentanyl contamination of illicit drugs; and 

18 ‘‘(ii) family members of both adults 

19 and youth who have overdosed by fentanyl20 contaminated illicit drugs. 

21 ‘‘(C) DUTIES.—The Work Group shall— 

22 ‘‘(i) examine Federal efforts to reduce 

23 and prevent drug overdose by fentanyl-con24 taminated illicit drugs; 


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1 ‘‘(ii) identify strategies to improve 

2 State, Tribal, and local responses to over3 dose by fentanyl-contaminated illicit drugs; 

4 ‘‘(iii) coordinate with the Secretary, as 

5 appropriate, in carrying out activities to 

6 raise public awareness of synthetic opioids 

7 and other emerging drug use and misuse 

8 issues; 

9 ‘‘(iv) make recommendations to Con10 gress for improving Federal programs, in11 cluding with respect to the coordination of 

12 efforts across such programs; and 

13 ‘‘(v) make recommendations for edu14 cating youth on the potency and dangers of 

15 drugs contaminated by fentanyl. 

16 ‘‘(D) ANNUAL REPORT TO SECRETARY.—The 

17 Work Group shall annually prepare and submit 

18 to the Secretary, the Committee on Health, Edu19 cation, Labor, and Pensions of the Senate, and 

20 the Committee on Education and the Workforce 

21 of the House of Representatives, a report on the 

22 activities carried out by the Work Group under 

23 subparagraph (C), including recommendations to 

24 reduce and prevent drug overdose by fentanyl 

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1 lations, and specifically among youth at risk for 

2 substance misuse.’’; and 

3 (2) by striking subsection (i) and inserting the 

4 following: 

5 ‘‘(i) SUNSET.—The Committee shall terminate on Sep6 tember 30, 2028.’’. 

7 SEC. 114. GUIDANCE ON AT-HOME DRUG DISPOSAL SYS8 TEMS. 

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

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

11 Human Services (referred to in this section as the ‘‘Sec12 retary’’), in consultation with the Administrator of the 

13 Drug Enforcement Administration, shall publish guidance 

14 to facilitate the use of at-home safe disposal systems for ap15 plicable drugs, including for such at-home safe disposal sys16 tems that the Secretary may require as a part of a risk 

17 evaluation and mitigation strategy under section 505–1 of 

18 the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355– 

19 1). 

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

21 shall include— 

22 (1) recommended standards for effective at-home 

23 drug disposal systems to meet applicable statutory or 

24 regulatory requirements enforced by the Food and 


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1 Drug Administration and, as appropriate, the Drug 

2 Enforcement Administration; 

3 (2) recommended information to include as in4 structions for use to disseminate with at-home drug 

5 disposal systems; 

6 (3) best practices and educational tools to sup7 port the use of an at-home drug disposal system; and 

8 (4) recommended use of licensed health providers 

9 for the dissemination of education, instruction, and 

10 at-home drug disposal systems. 

11 SEC. 115. REVIEW OF OPIOID DRUGS AND ACTIONS. 

12 Not later than one year after the date of enactment 

13 of this Act, the Secretary of Health and Human Services 

14 (referred to in this section as the ‘‘Secretary’’) shall publish 

15 on the website of the Food and Drug Administration (re16 ferred to in this section as the ‘‘FDA’’) a report that out17 lines a plan for completing a review of opioid analgesic 

18 drugs that are approved under section 505 of the Federal 

19 Food, Drug, and Cosmetic Act (21 U.S.C. 355) that con20 siders the public health effects of such opioid drugs as part 

21 of the benefit-risk assessment, and that addresses the activi22 ties of the FDA that relate to increasing the development 

23 of non-addictive medical products intended to treat pain 

24 or addiction. Such report shall include— 


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1 (1) an opportunity for public input concerning 

2 the regulation by the FDA of opioid analgesic drugs, 

3 including scientific evidence that relates to conditions 

4 of use, safety, or benefit-risk assessment (including 

5 consideration of the public health effects) of such 

6 opioid drugs; 

7 (2) an update on the actions taken by the FDA 

8 to review the effectiveness, safety, benefit-risk profile 

9 (which may include public health effects), and use of 

10 approved opioid analgesic drugs; 

11 (3) a timeline for an assessment of the potential 

12 need, as appropriate, for labeling changes, revised or 

13 additional postmarketing requirements, enforcement 

14 actions, or withdrawals for opioid analgesic drugs; 

15 (4) an overview of the steps that the FDA has 

16 taken to support the development and approval of 

17 non-addictive medical products intended to treat pain 

18 or addiction, and actions planned to further support 

19 the development and approval of such products; and 

20 (5) an overview of the consideration by the FDA 

21 of clinical trial methodologies for analgesic drugs, in22 cluding the enriched enrollment randomized with23 drawal methodology, and the benefits and drawbacks 

24 associated with different trial methodologies for such 


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1 drugs, incorporating any public input received under 

2 paragraph (1). 

3 SEC. 116. CONSIDERATION OF ENRICHED ENROLLMENT 

4 RANDOMIZED WITHDRAWAL METHODOLOGY. 

5 (a) IN GENERAL.—Not later than 2 years after the 

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

7 Human Services (referred to in this section as the ‘‘Sec8 retary’’), acting through the Commissioner of Food and 

9 Drugs, shall convene a meeting of the Anesthetic and An10 algesic Drug Products Advisory Committee and the Drug 

11 Safety and Risk Management Advisory Committee of the 

12 Food and Drug Administration to review the use of the en13 riched enrollment randomized withdrawal methodology in 

14 clinical trials of opioid analgesic drugs and consider and 

15 make recommendations regarding the use of alternative 

16 clinical study methodologies. In conducting such review, the 

17 Secretary shall consider the report issued by the National 

18 Academy of Sciences under subsection (c). 

19 (b) PRESENTATIONS.—If the Secretary allows for for20 mal presentations in support of the use of the enriched en21 rollment randomized withdrawal methodology at the meet22 ing described in subsection (a), the Secretary shall also 

23 allow for equal time at such meeting for presentations that 

24 are critical of such methodology. 


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1 (c) NAS STUDY AND REPORT.—The Secretary shall 

2 seek to enter into a contract with the National Academy 

3 of Sciences under which the National Academy— 

4 (1) conducts a study on the effectiveness of en5 riched enrollment randomized withdrawal method6 ology in demonstrating the efficacy of opioid analge7 sic drugs in treating chronic pain; and 

8 (2) not later than 1 year after the date of enact9 ment of this Act, submits a report on such study to 

10 the Secretary. 

11 (d) REVIEW OF OPIOID ANALGESIC DRUGS.—In con12 nection with the meeting described in subsection (a), the 

13 Anesthetic and Analgesic Drug Products Advisory Com14 mittee and the Drug Safety and Risk Management Advisory 

15 Committee of the Food and Drug Administration shall re16 view the approved labeling and action package for approval 

17 (as described in subsection (l)(2) of section 505 of the Fed18 eral Food, Drug, and Cosmetic Act (21 U.S.C. 355)), on 

19 all opioid analgesic drugs approved using enriched enroll20 ment randomized withdrawal methodology under such sec21 tion 505 as of the date of such meeting. The findings from 

22 such review shall be made publicly available on a website 

23 operated by the Secretary, acting through the Commissioner 

24 of Food and Drugs. 


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1 (e) DEFINITION OF OPIOID ANALGESIC DRUG.—In this 

2 section, the term ‘‘opioid analgesic drug’’ means a drug that 

3 has a labeled indication approved by the Food and Drug 

4 Administration to produce analgesia by acting upon the 

5 body’s opioid receptors. 

6 SEC. 117. APPROVAL OF NEW OPIOID ANALGESIC DRUGS. 

7 Section 505(c) of the Federal Food, Drug, and Cos8 metic Act (21 U.S.C. 355(c)) is amended by adding at the 

9 end the following: 

10 ‘‘(6) Notwithstanding any other provision of this 

11 section, in making a determination to approve or 

12 deny an application submitted under subsection (b) 

13 for an opioid analgesic drug, the Secretary may con14 sider whether such drug provides a substantial im15 provement, in terms of greater safety or greater effec16 tiveness, or major contribution to patient care, com17 pared to an approved opioid analgesic drug. For pur18 poses of this paragraph, the term ‘opioid analgesic 

19 drug’ means a drug that is approved under this sec20 tion to produce analgesia by acting upon the body’s 

21 opioid receptors.’’. 


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1 SEC. 118. GUIDANCE ON DEVELOPING NON-ADDICTIVE MED2 ICAL PRODUCTS TO TREAT PAIN OR ADDIC3 TION. 

4 Not later than 1 year after the date of enactment of 

5 this Act, the Secretary of Health and Human Services shall 

6 issue draft guidance under section 3001(b) of the SUP7 PORT for Patients and Communities Act (21 U.S.C. 355 

8 note) to address non-addictive analgesics for chronic pain, 

9 including the information required to be included in guid10 ance documents under paragraphs (1) through (4) of such 

11 section 3001(b). 

12 SEC. 119. NATIONAL CHRONIC PAIN INFORMATION SYSTEM. 

13 Part P of title III of the Public Health Service Act 

14 (42 U.S.C. 280g et seq.) is amended by adding at the end 

15 the following: 

16 ‘‘SEC. 399V–8. CHRONIC PAIN RESEARCH. 

17 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

18 with the Director of the Centers for Disease Control and 

19 Prevention, the Director of the National Institutes of 

20 Health, and other agencies as the Secretary determines ap21 propriate, shall— 

22 ‘‘(1) utilize available Federal research data to 

23 clarify the incidence and prevalence of chronic pain 

24 from any source, including injuries, operations, and 

25 diseases and conditions; 


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1 ‘‘(2) identify gaps in the available research data 

2 and collect deidentified population research data 

3 using medical claims and survey data to fill gaps in 

4 available research data, such as— 

5 ‘‘(A) incidence and prevalence of specific 

6 pain conditions; 

7 ‘‘(B) demographics and other information, 

8 such as age, race, ethnicity, gender, and geo9 graphic location; 

10 ‘‘(C) the incidence and prevalence of known 

11 chronic pain conditions, as well as diseases and 

12 conditions that include or lead to pain; 

13 ‘‘(D) risk factors that may be associated 

14 with chronic pain conditions, such as genetic 

15 and environmental risk factors and other infor16 mation, as appropriate; 

17 ‘‘(E) diagnosis and progression markers; 

18 ‘‘(F) both direct and indirect costs of illness; 

19 ‘‘(G) the epidemiology of the conditions; 

20 ‘‘(H) the detection, management, and treat21 ment of the conditions; 

22 ‘‘(I) the epidemiology, detection, manage23 ment, and treatment of frequent secondary or co24 occurring conditions, such as depression, anx25 iety, and substance use disorders; 


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1 ‘‘(J) the utilization of medical and social 

2 services by patients with chronic pain condi3 tions, including the direct health care costs of 

4 pain treatment, both traditional and alternative, 

5 and the indirect costs (such as missed work, pub6 lic and private disability, and reduction in pro7 ductivity); and 

8 ‘‘(K) the effectiveness of evidence-based 

9 treatment approaches on chronic pain condi10 tions; 

11 ‘‘(3) develop, in collaboration with individuals 

12 and organizations with appropriate chronic pain ex13 pertise, including patients or patient advocates, epi14 demiologists, representatives of national voluntary 

15 health associations, health information technology ex16 perts, clinicians, and research scientists, standard 

17 definitions and approaches for population research on 

18 chronic pain to efficiently promote greater com19 parability of data; and 

20 ‘‘(4) disseminate, pursuant to the public webpage 

21 under subsection (b), and, as appropriate, to the pub22 lic and to other Federal departments and agencies, 

23 any findings, developed population research stand24 ards, and available Federal data sources related to 

25 chronic pain. 


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1 ‘‘(b) DISSEMINATION.—The Secretary, acting through 

2 the Director of the Centers for Disease Control and Preven3 tion, shall establish a public webpage, to be known as the 

4 Chronic Pain Information Hub, that— 

5 ‘‘(1) aggregates and summarizes available Fed6 eral data sources, indicators, and peer-reviewed re7 search related to chronic pain; 

8 ‘‘(2) includes an up-to-date summary of com9 plete, ongoing, and planned data collection and anal10 ysis related to chronic pain that is conducted and 

11 supported by the Centers for Disease Control and Pre12 vention; and 

13 ‘‘(3) translates research findings into clinical 

14 tools and resources, recommendations for closing re15 search gaps, and recommendations for population re16 search standards for researchers, with recommenda17 tions updated annually to incorporate research find18 ings from the prior year. 

19 ‘‘(c) CONFLICTS OF INTEREST.—If an individual or 

20 organization that collaborates with the Secretary in car21 rying out subsection (a) receives a payment or other trans22 fer of value of a type described in section 

23 1128G(a)(1)(A)(vi) of the Social Security Act from a man24 ufacturer of a drug (including a biological product) or de25 vice that would be required to be disclosed pursuant to secVerDate Sep 11 2014 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00096 Fmt 6652 Sfmt 6203 E:\BILLS\S3393.RS S3393

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1 tion 1128G(a)(1) of the Social Security Act, if the indi2 vidual or organization were a covered recipient or if such 

3 disclosure were required upon request of or by designation 

4 on behalf of a covered recipient pursuant to such section, 

5 the individual or organization shall disclose to the Sec6 retary information regarding such payment or other trans7 fer of value. The Secretary shall make such disclosures pub8 licly available. 

9 ‘‘(d) REPORT.—Not later than 2 years after the date 

10 of the enactment of the SUPPORT for Patients and Com11 munities Reauthorization Act, the Secretary shall submit 

12 a report to the Committee on Health, Education, Labor, 

13 and Pensions of the Senate and the Committee on Energy 

14 and Commerce of the House of Representatives concerning 

15 the implementation of this section. Such report shall include 

16 information on— 

17 ‘‘(1) the development and maintenance of the 

18 Chronic Pain Information Hub; 

19 ‘‘(2) the information made available through the 

20 Chronic Pain Information Hub; 

21 ‘‘(3) the data gaps identified, and planned efforts 

22 to address such gaps; 

23 ‘‘(4) the process established for soliciting feedback 

24 from collaborators; and 

25 ‘‘(5) feedback received from collaborators. 


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1 ‘‘(e) DEFINITION.—In this section, the term ‘chronic 

2 pain’ means persistent or recurrent pain lasting longer 

3 than 3 months. 

4 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To carry 

5 out this section, there is authorized to be appropriated such 

6 sums as may be necessary for each of fiscal years 2024 

7 through 2028.’’. 

8 SEC. 120. REQUIREMENTS FOR ELECTRONIC-PRESCRIBING 

9 FOR CONTROLLED SUBSTANCES UNDER 

10 GROUP HEALTH PLANS AND GROUP AND IN11 DIVIDUAL HEALTH INSURANCE COVERAGE. 

12 (a) PUBLIC HEALTH SERVICE ACT AMENDMENT.— 

13 Section 2799A–7 of the Public Health Service Act (42 

14 U.S.C. 300gg–117) is amended by adding at the end the 

15 following new subsection: 

16 ‘‘(d) REQUIREMENTS FOR ELECTRONIC-PRESCRIBING

17 FOR CONTROLLED SUBSTANCES.— 

18 ‘‘(1) IN GENERAL.—Except as provided pursuant 

19 to paragraph (2), for plan years beginning on or after 

20 January 1, 2026, a group health plan and a health 

21 insurance issuer offering group or individual health 

22 insurance coverage, with respect to a participating 

23 provider, as defined in section 2799–1(a)(3), shall 

24 have in place policies, subject to paragraphs (4) and 

25 (5), that require any prescription for a schedule II, 


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1 III, IV, or V controlled substance (as defined by sec2 tion 202 of the Controlled Substances Act) covered by 

3 the plan or coverage that is transmitted by such a 

4 participating provider for such a participant, bene5 ficiary, or enrollee be electronically transmitted con6 sistent with standards established under paragraph 

7 (3) of section 1860D–4(e) of the Social Security Act, 

8 under an electronic prescription drug program that 

9 meets requirements that are substantially similar (as 

10 jointly determined by the Secretary, the Secretary of 

11 Labor, and the Secretary of the Treasury) to the re12 quirements of paragraph (2) of such section 1860D– 

13 4(e). 

14 ‘‘(2) EXCEPTION FOR CERTAIN CIR15 CUMSTANCES.—The Secretary, the Secretary of Labor, 

16 and the Secretary of the Treasury shall jointly, 

17 through rulemaking, specify circumstances and proc18 esses by which the requirement under paragraph (1) 

19 may be waived, with respect to a schedule II, III, IV, 

20 or V controlled substance that is a prescription drug 

21 covered by a group health plan or group or indi22 vidual health insurance coverage offered by a health 

23 insurance issuer, including in the case of— 


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1 ‘‘(A) a prescription issued when the partici2 pating provider and dispensing pharmacy are 

3 the same entity; 

4 ‘‘(B) a prescription issued that cannot be 

5 transmitted electronically under the most re6 cently implemented version of the National 

7 Council for Prescription Drug Programs 

8 SCRIPT Standard; 

9 ‘‘(C) a prescription issued by a partici10 pating provider who received a waiver (which 

11 may include a waiver obtained pursuant to sec12 tion 1860D–4(e)(7)(B)(iii) of the Social Security 

13 Act) or a renewal thereof for a period of time as 

14 determined by the Secretary, the Secretary of 

15 Labor, and the Secretary of the Treasury, not to 

16 exceed one year, from the requirement to use elec17 tronic prescribing due to demonstrated economic 

18 hardship, technological limitations that are not 

19 reasonably within the control of the partici20 pating provider, or other exceptional cir21 cumstance demonstrated by the participating 

22 provider; 

23 ‘‘(D) a prescription issued by a partici24 pating provider under circumstances in which, 

25 notwithstanding the participating provider’s 


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1 ability to submit a prescription electronically as 

2 required by this subsection, such participating 

3 provider reasonably determines that it would be 

4 impractical for the individual involved to obtain 

5 substances prescribed by electronic prescription 

6 in a timely manner, and such delay would ad7 versely impact the individual involved’s medical 

8 condition involved; 

9 ‘‘(E) a prescription issued by a partici10 pating provider prescribing a drug under a re11 search protocol; 

12 ‘‘(F) a prescription issued by a partici13 pating provider for a drug for which the Food 

14 and Drug Administration requires a prescrip15 tion to contain elements that are not able to be 

16 included in electronic prescribing, such as a drug 

17 with risk evaluation and mitigation strategies 

18 that include elements to assure safe use; 

19 ‘‘(G) a prescription issued for an individual 

20 who receives hospice care or for a resident of a 

21 nursing facility (as defined in section 1919(a) of 

22 the Social Security Act); 

23 ‘‘(H) a prescription issued under cir24 cumstances in which electronic prescribing is not 

25 available due to temporary technological or elecVerDate Sep 11 2014 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00101 Fmt 6652 Sfmt 6203 E:\BILLS\S3393.RS S3393

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1 trical failure, as specified jointly by the Sec2 retary, the Secretary of Labor, and the Secretary 

3 of the Treasury through rulemaking; and 

4 ‘‘(I) a prescription issued by a partici5 pating provider allowing for the dispensing of a 

6 non-patient specific prescription pursuant to a 

7 standing order, approved protocol for drug ther8 apy, collaborative drug management, or com9 prehensive medication management, in response 

10 to a public health emergency or other cir11 cumstances under which the participating pro12 vider may issue a non-patient specific prescrip13 tion. 

14 ‘‘(3) RULES OF CONSTRUCTION.— 

15 ‘‘(A) VERIFICATION.—Nothing in this sub16 section shall be construed as requiring a dis17 penser to verify that a participating provider, 

18 with respect to a prescription for a schedule II, 

19 III, IV, or V controlled substance that is a pre20 scription drug covered by a group health plan or 

21 group or individual health insurance coverage of22 fered by a health insurance issuer, has a waiver 

23 (or is otherwise exempt) under paragraph (2) 

24 from the requirement under paragraph (1). 


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1 ‘‘(B) AUTHORITY TO DISPENSE.—Nothing 

2 in this subsection shall be construed as affecting 

3 the authority of a group health plan or group or 

4 individual health insurance coverage offered by a 

5 health insurance issuer to cover, or the authority 

6 of a dispenser to continue to dispense, a pre7 scription drug if the prescription for such drug 

8 is an otherwise valid written, oral, or fax pre9 scription that is consistent with applicable law. 

10 ‘‘(C) PATIENT CHOICE.—Nothing in this 

11 subsection shall be construed as affecting the 

12 ability of an individual who is a participant, 

13 beneficiary, or enrollee of a group health plan or 

14 group or individual health insurance coverage of15 fered by a health insurance issuer and who is 

16 prescribed a schedule II, III, IV, or V controlled 

17 substance that is a prescription drug covered by 

18 the plan or coverage to designate a particular 

19 dispenser to dispense a prescribed controlled sub20 stance to the extent consistent with the require21 ments under this subsection. 

22 ‘‘(4) REGULATIONS ON POLICY REQUIRE23 MENTS.—The Secretary, the Secretary of Labor, and 

24 the Secretary of the Treasury shall promulgate regu25 lations specifying requirements for the policies estabVerDate Sep 11 2014 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00103 Fmt 6652 Sfmt 6203 E:\BILLS\S3393.RS S3393

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1 lished by group health plans and health insurance 

2 issuers under paragraph (1). Such regulations shall 

3 include requirements for— 

4 ‘‘(A) a uniform process by which plans and 

5 issuers are required to set the e-prescribing re6 quirements; 

7 ‘‘(B) a process by which plans and issuers 

8 are required to grant waivers and exceptions to 

9 participating providers pursuant to paragraph 

10 (2); and 

11 ‘‘(C) a mechanism for plans and issuers to 

12 recognize waivers issued to participating pro13 viders under part D of title XVIII of the Social 

14 Security Act, pursuant to paragraph (2)(C). 

15 ‘‘(5) PROHIBITIONS.—The policies established 

16 pursuant to paragraph (1) by a group health plan or 

17 health insurance issuer offering group or individual 

18 health insurance coverage may not— 

19 ‘‘(A) require dispensers of a schedule II, III, 

20 IV, or V controlled substance to confirm that the 

21 prescription for the controlled substance was elec22 tronically issued by a participating provider in 

23 accordance with such policies, as described in 

24 paragraph (1); 


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1 ‘‘(B) require dispensers of such controlled 

2 substances to submit information or data beyond 

3 what is otherwise required to process a prescrip4 tion drug claim in order to confirm a partici5 pating provider’s compliance with such policies; 

6 ‘‘(C) reject, deny, or recoup reimbursement 

7 for a prescription drug claim based on the for8 mat in which the prescription was issued; or 

9 ‘‘(D) require a participating provider to use 

10 a specific vendor for electronic prescribing or a 

11 specific electronic prescribing product or system. 

12 ‘‘(6) ATTESTATION OF COMPLIANCE.—Beginning 

13 on January 1, 2026, each group health plan and 

14 health insurance issuer offering group or individual 

15 health insurance coverage shall annually submit to 

16 the Secretary, the Secretary of Labor, and the Sec17 retary of the Treasury an attestation of compliance 

18 with the requirements of this subsection. 

19 ‘‘(7) CONSULTATION REQUIREMENT FOR RULE20 MAKING.—In promulgating regulations to carry out 

21 this subsection, the Secretary, the Secretary of the 

22 Labor, and the Secretary of the Treasury shall jointly 

23 consult with dispensers of controlled substances, State 

24 insurance regulators, and health care practitioners.’’. 


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1 (b) EMPLOYEE RETIREMENT INCOME SECURITY ACT

2 OF 1974 AMENDMENT.—Section 722 of the Employee Re3 tirement Income Security Act of 1974 (29 U.S.C. 1185k) 

4 is amended by adding at the end the following new sub5 section: 

6 ‘‘(d) REQUIREMENTS FOR ELECTRONIC-PRESCRIBING

7 FOR CONTROLLED SUBSTANCES.— 

8 ‘‘(1) IN GENERAL.—Except as provided pursuant 

9 to paragraph (2), for plan years beginning on or after 

10 January 1, 2026, a group health plan and a health 

11 insurance issuer offering group health insurance cov12 erage, with respect to a participating provider, as de13 fined in section 716(a)(3), shall have in place poli14 cies, subject to paragraphs (4) and (5), that require 

15 any prescription for a schedule II, III, IV, or V con16 trolled substance (as defined by section 202 of the 

17 Controlled Substances Act) covered by the plan or cov18 erage that is transmitted by such a participating pro19 vider for such a participant or beneficiary be elec20 tronically transmitted consistent with standards es21 tablished under paragraph (3) of section 1860D–4(e) 

22 of the Social Security Act, under an electronic pre23 scription drug program that meets requirements that 

24 are substantially similar (as jointly determined by 

25 the Secretary, the Secretary of Health and Human 


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1 Services, and the Secretary of the Treasury) to the re2 quirements of paragraph (2) of such section 1860D– 

3 4(e). 

4 ‘‘(2) EXCEPTION FOR CERTAIN CIR5 CUMSTANCES.—The Secretary, the Secretary of 

6 Health and Human Services, and the Secretary of the 

7 Treasury shall jointly, through rulemaking, specify 

8 circumstances and processes by which the requirement 

9 under paragraph (1) may be waived, with respect to 

10 a schedule II, III, IV, or V controlled substance that 

11 is a prescription drug covered by a group health plan 

12 or group health insurance coverage offered by a health 

13 insurance issuer, including in the case of— 

14 ‘‘(A) a prescription issued when the partici15 pating provider and dispensing pharmacy are 

16 the same entity; 

17 ‘‘(B) a prescription issued that cannot be 

18 transmitted electronically under the most re19 cently implemented version of the National 

20 Council for Prescription Drug Programs 

21 SCRIPT Standard; 

22 ‘‘(C) a prescription issued by a partici23 pating provider who received a waiver (which 

24 may include a waiver obtained pursuant to sec25 tion 1860D–4(e)(7)(B)(iii) of the Social Security 


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1 Act) or a renewal thereof for a period of time as 

2 determined by the Secretary, the Secretary of 

3 Health and Human Services, and the Secretary 

4 of the Treasury, not to exceed one year, from the 

5 requirement to use electronic prescribing due to 

6 demonstrated economic hardship, technological 

7 limitations that are not reasonably within the 

8 control of the participating provider, or other ex9 ceptional circumstance demonstrated by the par10 ticipating provider; 

11 ‘‘(D) a prescription issued by a partici12 pating provider under circumstances in which, 

13 notwithstanding the participating provider’s 

14 ability to submit a prescription electronically as 

15 required by this subsection, such participating 

16 provider reasonably determines that it would be 

17 impractical for the individual involved to obtain 

18 substances prescribed by electronic prescription 

19 in a timely manner, and such delay would ad20 versely impact the individual’s medical condi21 tion involved; 

22 ‘‘(E) a prescription issued by a partici23 pating provider prescribing a drug under a re24 search protocol; 


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1 ‘‘(F) a prescription issued by a partici2 pating provider for a drug for which the Food 

3 and Drug Administration requires a prescrip4 tion to contain elements that are not able to be 

5 included in electronic prescribing, such as a drug 

6 with risk evaluation and mitigation strategies 

7 that include elements to assure safe use; 

8 ‘‘(G) a prescription issued for an individual 

9 who receives hospice care or for a resident of a 

10 nursing facility (as defined in section 1919(a) of 

11 the Social Security Act); 

12 ‘‘(H) a prescription issued under cir13 cumstances in which electronic prescribing is not 

14 available due to temporary technological or elec15 trical failure, as specified jointly by the Sec16 retary, the Secretary of Health and Human 

17 Services, and the Secretary of the Treasury 

18 through rulemaking; and 

19 ‘‘(I) a prescription issued by a partici20 pating provider allowing for the dispensing of a 

21 non-patient specific prescription pursuant to a 

22 standing order, approved protocol for drug ther23 apy, collaborative drug management, or com24 prehensive medication management, in response 

25 to a public health emergency or other cirVerDate Sep 11 2014 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00109 Fmt 6652 Sfmt 6203 E:\BILLS\S3393.RS S3393

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1 cumstances under which the participating pro2 vider may issue a non-patient specific prescrip3 tion. 

4 ‘‘(3) RULES OF CONSTRUCTION.— 

5 ‘‘(A) VERIFICATION.—Nothing in this sub6 section shall be construed as requiring a dis7 penser to verify that a participating provider, 

8 with respect to a prescription for a schedule II, 

9 III, IV, or V controlled substance that is a pre10 scription drug covered by a group health plan or 

11 group or individual health insurance coverage of12 fered by a health insurance issuer, has a waiver 

13 (or is otherwise exempt) under paragraph (2) 

14 from the requirement under paragraph (1). 

15 ‘‘(B) AUTHORITY TO DISPENSE.—Nothing 

16 in this subsection shall be construed as affecting 

17 the authority of a group health plan or group 

18 health insurance coverage offered by a health in19 surance issuer to cover, or the authority of a dis20 penser to continue to dispense, a prescription 

21 drug if the prescription for such drug is an oth22 erwise valid written, oral, or fax prescription 

23 that is consistent with applicable law. 

24 ‘‘(C) PATIENT CHOICE.—Nothing in this 

25 subsection shall be construed as affecting the 


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1 ability of an individual who is a participant or 

2 beneficiary of a group health plan or group or 

3 individual health insurance coverage offered by a 

4 health insurance issuer and who is prescribed a 

5 schedule II, III, IV, or V controlled substance 

6 that is a prescription drug covered by the plan 

7 or coverage to designate a particular dispenser to 

8 dispense a prescribed controlled substance to the 

9 extent consistent with the requirements under 

10 this subsection. 

11 ‘‘(4) REGULATIONS ON POLICY REQUIRE12 MENTS.—The Secretary, the Secretary of Health and 

13 Human Services, and the Secretary of the Treasury 

14 shall promulgate regulations specifying requirements 

15 for the policies established by group health plans and 

16 health insurance issuers under paragraph (1). Such 

17 regulations shall include requirements for— 

18 ‘‘(A) a uniform process by which plans and 

19 issuers are required to set the e-prescribing re20 quirements; 

21 ‘‘(B) a process by which plans and issuers 

22 are required to grant waivers and exceptions to 

23 participating providers pursuant to paragraph 

24 (2); and 


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1 ‘‘(C) a mechanism for plans and issuers to 

2 recognize waivers issued to participating pro3 viders under part D of title XVIII of the Social 

4 Security Act, pursuant to paragraph (2)(C). 

5 ‘‘(5) PROHIBITIONS.—The policies established 

6 pursuant to paragraph (1) by a group health plan or 

7 health insurance issuer offering group health insur8 ance coverage may not— 

9 ‘‘(A) require dispensers of a schedule II, III, 

10 IV, or V controlled substance to confirm that the 

11 prescription for the controlled substance was elec12 tronically issued by a participating provider in 

13 accordance with such policies, as described in 

14 paragraph (1); 

15 ‘‘(B) require dispensers of such controlled 

16 substances to submit information or data beyond 

17 what is otherwise required to process a prescrip18 tion drug claim in order to confirm a partici19 pating provider’s compliance with such policies; 

20 ‘‘(C) reject, deny, or recoup reimbursement 

21 for a prescription drug claim based on the for22 mat in which the prescription was issued; or 

23 ‘‘(D) require a participating provider to use 

24 a specific vendor for electronic prescribing or a 

25 specific electronic prescribing product or system. 


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1 ‘‘(6) ATTESTATION OF COMPLIANCE.—Beginning 

2 on January 1, 2026, each group health plan and 

3 health insurance issuer offering group health insur4 ance coverage shall annually submit to the Secretary, 

5 the Secretary of Health and Human Services, and the 

6 Secretary of the Treasury an attestation of compli7 ance with the requirements of this subsection. 

8 ‘‘(7) CONSULTATION REQUIREMENT FOR RULE9 MAKING.—In promulgating regulations to carry out 

10 this subsection, the Secretary, the Secretary of Health 

11 and Human Services, and the Secretary of the Treas12 ury shall jointly consult with dispensers of controlled 

13 substances, State insurance regulators, and health 

14 care practitioners.’’. 

15 (c) INTERNAL REVENUE CODE OF 1986 AMEND16 MENT.—Section 9822 of the Internal Revenue Code of 1986 

17 is amended by adding at the end the following new sub18 section: 

19 ‘‘(d) REQUIREMENTS FOR ELECTRONIC-PRESCRIBING

20 FOR CONTROLLED SUBSTANCES.— 

21 ‘‘(1) IN GENERAL.—Except as provided pursuant 

22 to paragraph (2), for plan years beginning on or after 

23 January 1, 2026, a group health plan, with respect 

24 to a participating provider, as defined in section 

25 9816(a)(3), shall have in place policies, subject to 


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1 paragraphs (4) and (5), that require any prescription 

2 for a schedule II, III, IV, or V controlled substance 

3 (as defined by section 202 of the Controlled Sub4 stances Act) covered by the plan that is transmitted 

5 by such a participating provider for such a partici6 pant or beneficiary be electronically transmitted con7 sistent with standards established under paragraph 

8 (3) of section 1860D–4(e) of the Social Security Act, 

9 under an electronic prescription drug program that 

10 meets requirements that are substantially similar (as 

11 jointly determined by the Secretary, the Secretary of 

12 Health and Human Services, and the Secretary of 

13 Labor) to the requirements of paragraph (2) of such 

14 section 1860D–4(e). 

15 ‘‘(2) EXCEPTION FOR CERTAIN CIR16 CUMSTANCES.—The Secretary, the Secretary of 

17 Health and Human Services, and the Secretary of 

18 Labor shall jointly, through rulemaking, specify cir19 cumstances and processes by which the requirement 

20 under paragraph (1) may be waived, with respect to 

21 a schedule II, III, IV, or V controlled substance that 

22 is a prescription drug covered by a group health, in23 cluding in the case of— 


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1 ‘‘(A) a prescription issued when the partici2 pating provider and dispensing pharmacy are 

3 the same entity; 

4 ‘‘(B) a prescription issued that cannot be 

5 transmitted electronically under the most re6 cently implemented version of the National 

7 Council for Prescription Drug Programs 

8 SCRIPT Standard; 

9 ‘‘(C) a prescription issued by a partici10 pating provider who received a waiver (which 

11 may include a waiver obtained pursuant to sec12 tion 1860D–4(e)(7)(B)(iii) of the Social Security 

13 Act) or a renewal thereof for a period of time as 

14 determined by the Secretary, the Secretary of 

15 Health and Human Services, and the Secretary 

16 of Labor, not to exceed one year, from the re17 quirement to use electronic prescribing due to 

18 demonstrated economic hardship, technological 

19 limitations that are not reasonably within the 

20 control of the participating provider, or other ex21 ceptional circumstance demonstrated by the par22 ticipating provider; 

23 ‘‘(D) a prescription issued by a partici24 pating provider under circumstances in which, 

25 notwithstanding the participating provider’s 


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1 ability to submit a prescription electronically as 

2 required by this subsection, such participating 

3 provider reasonably determines that it would be 

4 impractical for the individual involved to obtain 

5 substances prescribed by electronic prescription 

6 in a timely manner, and such delay would ad7 versely impact the individual’s medical condi8 tion involved; 

9 ‘‘(E) a prescription issued by a partici10 pating provider prescribing a drug under a re11 search protocol; 

12 ‘‘(F) a prescription issued by a partici13 pating provider for a drug for which the Food 

14 and Drug Administration requires a prescrip15 tion to contain elements that are not able to be 

16 included in electronic prescribing, such as a drug 

17 with risk evaluation and mitigation strategies 

18 that include elements to assure safe use; 

19 ‘‘(G) a prescription issued for an individual 

20 who receives hospice care or for a resident of a 

21 nursing facility (as defined in section 1919(a) of 

22 the Social Security Act); 

23 ‘‘(H) a prescription issued under cir24 cumstances in which electronic prescribing is not 

25 available due to temporary technological or elecVerDate Sep 11 2014 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00116 Fmt 6652 Sfmt 6203 E:\BILLS\S3393.RS S3393

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1 trical failure, as specified jointly by the Sec2 retary, the Secretary of Health and Human 

3 Services, and the Secretary of Labor through 

4 rulemaking; and 

5 ‘‘(I) a prescription issued by a partici6 pating provider allowing for the dispensing of a 

7 non-patient specific prescription pursuant to a 

8 standing order, approved protocol for drug ther9 apy, collaborative drug management, or com10 prehensive medication management, in response 

11 to a public health emergency or other cir12 cumstances under which the participating pro13 vider may issue a non-patient specific prescrip14 tion. 

15 ‘‘(3) RULES OF CONSTRUCTION.— 

16 ‘‘(A) VERIFICATION.—Nothing in this sub17 section shall be construed as requiring a dis18 penser to verify that a participating provider, 

19 with respect to a prescription for a schedule II, 

20 III, IV, or V controlled substance that is a pre21 scription drug covered by a group health plan, 

22 has a waiver (or is otherwise exempt) under 

23 paragraph (2) from the requirement under para24 graph (1). 


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1 ‘‘(B) AUTHORITY TO DISPENSE.—Nothing 

2 in this subsection shall be construed as affecting 

3 the ability of a group health plan to cover, or the 

4 ability of a dispenser to continue to dispense, a 

5 prescription drug if the prescription for such 

6 drug is an otherwise valid written, oral, or fax 

7 prescription that is consistence with applicable 

8 laws and regulations. 

9 ‘‘(C) PATIENT CHOICE.—Nothing in this 

10 subsection shall be construed as affecting the 

11 ability of an individual who is a participant or 

12 beneficiary of a group health plan and who is 

13 prescribed a schedule II, III, IV, or V controlled 

14 substance that is a prescription drug covered by 

15 the plan to designate a particular dispenser to 

16 dispense a prescribed controlled substance to the 

17 extent consistent with the requirements under 

18 this subsection. 

19 ‘‘(4) REGULATIONS ON POLICY REQUIRE20 MENTS.—The Secretary, the Secretary of Health and 

21 Human Services, and the Secretary of Labor shall 

22 promulgate regulations specifying requirements for 

23 the policies established by group health plans under 

24 paragraph (1). Such regulations shall include require25 ments for— 


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1 ‘‘(A) a uniform process by which plans are 

2 required to set the e-prescribing requirements; 

3 ‘‘(B) a process by which plans are required 

4 to grant waivers and exceptions to participating 

5 providers pursuant to paragraph (2); and 

6 ‘‘(C) a mechanism for plans to recognize 

7 waivers issued to participating providers under 

8 part D of title XVIII of the Public Health Serv9 ice Act, pursuant to paragraph (2)(C). 

10 ‘‘(5) PROHIBITIONS.—The policies established 

11 pursuant to paragraph (1) by a group health plan 

12 may not— 

13 ‘‘(A) require dispensers of a schedule II, III, 

14 IV, or V controlled substance to confirm that the 

15 prescription for the controlled substance was elec16 tronically issued by a participating provider in 

17 accordance with such policies, as described in 

18 paragraph (1); 

19 ‘‘(B) require dispensers of such controlled 

20 substances to submit information or data beyond 

21 what is otherwise required to process a prescrip22 tion drug claim in order to confirm a partici23 pating provider’s compliance with such policies; 


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1 ‘‘(C) reject, deny, or recoup reimbursement 

2 for a prescription drug claim based on the for3 mat in which the prescription was issued; or 

4 ‘‘(D) require a participating provider to use 

5 a specific vendor for electronic prescribing or a 

6 specific electronic prescribing product or system. 

7 ‘‘(6) ATTESTATION OF COMPLIANCE.—Beginning 

8 on January 1, 2026, each group health plan shall an9 nually submit to the Secretary, the Secretary of 

10 Health and Human Services, and the Secretary of 

11 Labor an attestation of compliance with the require12 ments of this subsection. 

13 ‘‘(7) CONSULTATION REQUIREMENT FOR RULE14 MAKING.—In promulgating regulations to carry out 

15 this subsection, the Secretary, the Secretary of Health 

16 and Human Services, and the Secretary of Labor 

17 shall jointly consult with dispensers of controlled sub18 stances, State insurance regulators, and health care 

19 practitioners.’’. 

20 (d) UPDATE OF BIOMETRIC COMPONENT OF MULTI21 FACTOR AUTHENTICATION.—Not later than 1 year after the 

22 date of enactment of this Act, the Attorney General shall 

23 finalize a regulation updating the requirements for the bio24 metric component of multifactor authentication with re25 spect to electronic prescriptions of controlled substances, as 


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1 required under section 2003(c) of the SUPPORT for Pa2 tients and Community Act (Public Law 115–271). 

3 TITLE II—TREATMENT 

4 SEC. 201. RESIDENTIAL TREATMENT PROGRAM FOR PREG5 NANT AND POSTPARTUM WOMEN. 

6 Section 508 of the Public Health Service Act (42 

7 U.S.C. 290bb–1) is amended— 

8 (1) in subsection (d)(11)(C), by striking ‘‘pro9 viding health services’’ and inserting ‘‘providing 

10 health care services’’; 

11 (2) in subsection (g)— 

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

13 ‘‘will provide’’; and 

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

15 ‘‘Such plan may include a description of how 

16 such applicant will target outreach to women 

17 disproportionately impacted by maternal sub18 stance use disorder.’’; and 

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

20 for each of fiscal years 2019 through 2023’’ and in21 serting ‘‘$38,931,000 for each of fiscal years 2024 

22 through 2028’’. 


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1 SEC. 202. LOAN REPAYMENT PROGRAM FOR SUBSTANCE 

2 USE DISORDER TREATMENT WORKFORCE. 

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

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

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

6 ‘‘$50,000,000 for each of fiscal years 2024 through 2028’’. 

7 SEC. 203. REGIONAL CENTERS OF EXCELLENCE IN SUB8 STANCE USE DISORDER EDUCATION. 

9 Section 551 of the Public Health Service Act (42 

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

11 SEC. 204. MENTAL AND BEHAVIORAL HEALTH EDUCATION 

12 AND TRAINING PROGRAM. 

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

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

15 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To carry 

16 out this section, there is authorized to be appropriated the 

17 following: 

18 ‘‘(1) $50,000,000 for fiscal year 2024, to be allo19 cated as follows: 

20 ‘‘(A) For grants described in subsection 

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

22 ‘‘(B) For grants described in subsection 

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

24 ‘‘(C) For grants described in subsection 

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


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1 ‘‘(D) For grants described in subsection 

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

3 ‘‘(2) $55,000,000 for fiscal year 2025, to be allo4 cated as follows: 

5 ‘‘(A) For grants described in subsection 

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

7 ‘‘(B) For grants described in subsection 

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

9 ‘‘(C) For grants described in subsection 

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

11 ‘‘(D) For grants described in subsection 

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

13 ‘‘(3) $60,000,000 for fiscal year 2026, to be allo14 cated as follows: 

15 ‘‘(A) For grants described in subsection 

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

17 ‘‘(B) For grants described in subsection 

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

19 ‘‘(C) For grants described in subsection 

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

21 ‘‘(D) For grants described in subsection 

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

23 ‘‘(4) $65,000,000 for fiscal year 2027, to be allo24 cated as follows: 


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1 ‘‘(A) For grants described in subsection 

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

3 ‘‘(B) For grants described in subsection 

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

5 ‘‘(C) For grants described in subsection 

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

7 ‘‘(D) For grants described in subsection 

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

9 ‘‘(5) $75,000,000 for fiscal year 2028, to be allo10 cated as follows: 

11 ‘‘(A) For grants described in subsection 

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

13 ‘‘(B) For grants described in subsection 

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

15 ‘‘(C) For grants described in subsection 

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

17 ‘‘(D) For grants described in subsection 

18 (a)(4), $15,000,000.’’. 

19 SEC. 205. GRANTS TO ENHANCE ACCESS TO SUBSTANCE 

20 USE DISORDER TREATMENT. 

21 Section 3203 of the SUPPORT for Patients and Com22 munities Act (21 U.S.C. 823 note) is amended— 

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

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

25 and inserting the following: 


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1 ‘‘The Secretary’’. 

2 SEC. 206. GRANTS TO IMPROVE TRAUMA SUPPORT SERV3 ICES AND MENTAL HEALTH CARE FOR CHIL4 DREN AND YOUTH IN EDUCATIONAL SET5 TINGS. 

6 Section 7134 of the SUPPORT for Patients and Com7 munities Act (42 U.S.C. 280h–7) is amended— 

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

9 inserting ‘‘Tribal’’; 

10 (2) in subsection (c)— 

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

12 intervention,’’ after ‘‘screening,’’; 

13 (B) in paragraph (3)— 

14 (i) in the matter preceding subpara15 graph (A), by inserting ‘‘other staff,’’ after 

16 ‘‘support personnel,’’; and 

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

18 ‘‘social and emotional learning’’ and insert19 ing ‘‘developmentally appropriate prac20 tices’’; and 

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

22 stigma associated with mental health care and’’ 

23 after ‘‘efforts to’’; 

24 (3) in subsection (d)— 

25 (A) in paragraph (4)— 


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

2 and’’ and inserting a semicolon; 

3 (ii) in subparagraph (B)— 

4 (I) by striking ‘‘tribal organiza5 tions as appropriate, other school per6 sonnel’’ and inserting ‘‘Tribal organi7 zations as appropriate, other staff’’; 

8 and 

9 (II) by striking the period and in10 serting ‘‘; and’’; and 

11 (iii) by adding at the end the fol12 lowing: 

13 ‘‘(C) parents and guardians will be in14 formed of what trauma support services and 

15 mental health care are available to their students 

16 and what services and care their students receive, 

17 in accordance with the parental consent require18 ments under subsection (h)(2).’’; and 

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

20 ‘‘(7) A plan for sustaining the program following 

21 the end of the award period.’’; 

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

23 shall include a description of how the school obtains 

24 consent from the student’s parent or guardian for the 


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1 provision of trauma support services and mental 

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

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

4 inserting ‘‘Tribal’’; 

5 (6) in subsection (h)— 

6 (A) in the subsection heading, by inserting 

7 ‘‘; APPLICATION OF CERTAIN PROVISIONS’’ after 

8 ‘‘CONSTRUCTION’’; 

9 (B) by striking ‘‘tribal’’ each place it ap10 pears and inserting ‘‘Tribal’’; 

11 (C) by redesignating paragraphs (1) and 

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

13 and adjusting the margins accordingly; 

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

15 and inserting the following: 

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

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

18 ‘‘(2) APPLICATION OF PROVISIONS.— 

19 ‘‘(A) RULES.—Section 4001 of the Elemen20 tary and Secondary Education Act of 1965 (not 

21 including the exception under subsection 

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

23 entity receiving a grant, contract, or cooperative 

24 agreement under this section in the same manner 


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1 as such section 4001 applies to an entity receiv2 ing funding under title IV of such Act. 

3 ‘‘(B) PRIVACY PROTECTIONS.—Any edu4 cation record of a student collected or main5 tained under subsection (c)(4) shall have the pro6 tections required for education records under sec7 tion 444 of the General Education Provisions 

8 Act.’’. 

9 (7) in subsection (k)— 

10 (A) by redesignating paragraphs (5) 

11 through (11) as paragraphs (6) through (12), re12 spectively; and 

13 (B) by inserting after paragraph (4) the fol14 lowing: 

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

16 the meaning given such term in section 8101 of the 

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

18 and 

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

20 2023’’ and inserting ‘‘2024 through 2028’’. 


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1 SEC. 207. DEVELOPMENT AND DISSEMINATION OF MODEL 

2 TRAINING PROGRAMS FOR SUBSTANCE USE 

3 DISORDER PATIENT RECORDS. 

4 Section 7053 of the SUPPORT for Patients and Com5 munities Act (42 U.S.C. 290dd–2 note) is amended by strik6 ing subsection (e). 

7 SEC. 208. TASK FORCE ON BEST PRACTICES FOR TRAUMA8 INFORMED IDENTIFICATION, REFERRAL, AND 

9 SUPPORT. 

10 Section 7132 of the SUPPORT for Patients and Com11 munities Act (Public Law 115–271; 132 Stat. 4046) is 

12 amended— 

13 (1) in subsection (b)(1)— 

14 (A) by redesignating subparagraph (CC) as 

15 subparagraph (DD); and 

16 (B) by inserting after subparagraph (BB) 

17 the following: 

18 ‘‘(CC) The Administration for Community 

19 Living.’’; 

20 (2) in subsection (d)(1), in the matter preceding 

21 subparagraph (A), by inserting ‘‘, developmental dis22 ability service providers’’ before ‘‘, individuals who 

23 are’’; and 

24 (3) in subsection (i), by striking ‘‘2023’’ and in25 serting ‘‘2028’’. 


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1 SEC. 209. PROGRAM TO SUPPORT COORDINATION AND CON2 TINUATION OF CARE FOR DRUG OVERDOSE 

3 PATIENTS. 

4 Section 7081 of the SUPPORT for Patients and Com5 munities Act (42 U.S.C. 290dd–4) is amended by striking 

6 subsection (f). 

7 SEC. 210. REGULATIONS RELATING TO SPECIAL REGISTRA8 TION FOR TELEMEDICINE. 

9 Not later than 1 year after the date of enactment of 

10 this Act, the Attorney General, in consultation with the Sec11 retary of Health and Human Services, shall promulgate the 

12 final regulations required under section 311(h)(2) of the 

13 Controlled Substances Act (21 U.S.C. 831(h)(2)). 

14 SEC. 211. MENTAL HEALTH PARITY. 

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

16 the Inspector General of the Department of Labor, in co17 ordination with the Inspector General of the Department 

18 of Health and Human Services, shall report to the Com19 mittee on Health, Education, Labor, and Pensions of the 

20 Senate and the Committee on Energy and Commerce and 

21 the Committee on Education and the Workforce of the 

22 House of Representatives on the following: 

23 (1) The non-quantitative treatment limit (re24 ferred to in this section as ‘‘NQTL’’) requirements 

25 with respect to mental health and substance use dis26 order benefits under group health plans and health 


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1 insurance issuers under section 2726(a)(8) of the Pub2 lic Health Service Act (42 U.S.C. 300gg–26(a)(8)), 

3 section 712(a)(8) of the Employee Retirement Income 

4 Security Act of 1974 (29 U.S.C. 1185a(a)(8)), and 

5 section 9812(a)(8) of the Internal Revenue Code of 

6 1986 (referred to in this section as the ‘‘NQTL com7 parative analysis requirements’’), and the require8 ments for the Secretary of Health and Human Serv9 ices, the Secretary of Labor, and the Secretary of the 

10 Treasury to issue regulations, a compliance program 

11 guide, and additional guidance documents and tools 

12 providing guidance relating to mental health parity 

13 requirements under section 2726(a) of the Public 

14 Health Service Act (42 U.S.C. 300gg–26(a)), section 

15 712(a) of the Employee Retirement Income Security 

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

17 9812(a) of the Internal Revenue Code of 1986. 

18 (2) With respect to the NQTL comparative anal19 ysis requirements described in paragraph (1), an 

20 analysis of the actions taken by the Secretary of 

21 Labor, the Secretary of the Treasury, and the Sec22 retary of Health and Human Services to provide 

23 guidance to ensure that group health plans and health 

24 insurance issuers can fully comply with mental health 

25 parity requirements under section 2726 of the Public 


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1 Health Service Act (42 U.S.C. 300gg–26), section 712 

2 of the Employee Retirement Income Security Act of 

3 1974 (29 U.S.C. 1185a), and section 9812 of the In4 ternal Revenue Code of 1986 and the NQTL compara5 tive analysis requirements described in paragraph 

6 (1), including an analysis of— 

7 (A) the extent to which the Secretary of 

8 Labor, the Secretary of the Treasury, and the 

9 Secretary of Health and Human Services have 

10 fulfilled the requirement under section 203(b) of 

11 division BB of the Consolidated Appropriations 

12 Act, 2021 (Public Law 116–260) to issue the spe13 cific guidance and regulations pertaining to the 

14 requirements for group health plans and health 

15 insurance issuers to demonstrate compliance 

16 with the NQTL comparative analysis require17 ments; and 

18 (B) whether sufficient guidance and exam19 ples from the Department of Labor and Depart20 ment of Health and Human Services, and the 

21 Department of the Treasury exist to guide and 

22 assist group health plans and health insurance 

23 issuers in complying with the requirements to 

24 demonstrate compliance with mental health par25 ity NQTL comparative analysis requirements/ 


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1 under such sections 2726(a)(8), 712(a)(8), and 

2 9812(a)(8). 

3 (3) A review of the enforcement processes of the 

4 Department of Labor and the Department of Health 

5 and Human Services to evaluate the consistency of 

6 interpretation of the requirements under section 

7 2726(a)(8) of the Public Health Service Act (42 

8 U.S.C. 300gg–26(a)(8)), section 712(a)(8) of the Em9 ployee Retirement Income Security Act of 1974 (29 

10 U.S.C. 1185a(a)(8)), and section 9812(a)(8) of the In11 ternal Revenue Code of 1986, in particular with re12 spect to processes utilized for enforcement, actions or 

13 inactions that constitute noncompliance, and avoid14 ance among the agencies of duplication of enforce15 ment, including an evaluation of compliance with sec16 tion 104 of the Health Insurance Portability and Ac17 countability Act of 1996 (Public Law 104–191). 

18 (4) A review of the implementation, by the De19 partment of Labor, Department of Health and 

20 Human Services, and Department of the Treasury, of 

21 mental health parity requirements under section 2726 

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

23 26), section 712 of the Employee Retirement Income 

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

25 9812 of the Internal Revenue Code of 1986, including 


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1 all such requirements in effect through the enactment 

2 of the Mental Health Parity Act of 1996 (Public Law 

3 104–204), the Paul Wellstone and Pete Domenici 

4 Mental Health Parity and Addiction Equity Act of 

5 2008 (Public Law 110–460), the 21st Century Cures 

6 Act (Public Law 114–255), and the Consolidated Ap7 propriations Act, 2023 (Public Law 117–328) (in8 cluding any amendments made by such Acts), and in9 cluding with respect to the timing of all actions, 

10 delays of any actions, reasons for any such delays, 

11 mandated requirements that were met only once but 

12 not each time such requirements were mandated. 

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

14 health plan’’ and ‘‘health insurance issuer’’ have the mean15 ings given such terms in section 733 of the Employee Retire16 ment Income Security Act of 1974 (29 U.S.C. 1191b). 

17 SEC. 212. STATE GUIDANCE RELATED TO INDIVIDUALS 

18 WITH SERIOUS MENTAL ILLNESS AND CHIL19 DREN WITH SERIOUS EMOTIONAL DISTURB20 ANCE. 

21 (a) REVIEW OF USE OF CERTAIN FUNDING.—Not later 

22 than 1 year after the date of enactment of this Act, the Sec23 retary of Health and Human Services, acting through the 

24 Assistant Secretary for Mental Health and Substance Use, 

25 shall conduct a review of the use by States of funds made 


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1 available under the Community Mental Health Services 

2 Block Grant program under subpart I of part B of title 

3 XIX of the Public Health Service Act (42 U.S.C. 300x et 

4 seq.) for First Episode Psychosis activities. Such review 

5 shall consider the following: 

6 (1) How the States use funds for evidence-based 

7 treatments and services, such as coordinated specialty 

8 care, according to the standard of care for individuals 

9 with early serious mental illness, including the com10 prehensiveness of such treatments to include all as11 pects of the recommended intervention. 

12 (2) How State mental health departments coordi13 nate with State Medicaid departments in the delivery 

14 of the treatments and services described in paragraph 

15 (1). 

16 (3) The percentage of the State funding under 

17 the block grant program that is applied toward early 

18 serious mental illness, and funding in excess of, or 

19 under, 10 percent of the amount of the grant, broken 

20 down by State. 

21 (4) The percentage of funds expended by States 

22 through such block grant program specifically on 

23 First Episode Psychosis, to the extent such informa24 tion is available. 


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

3 per-capita basis. 

4 (6) How the funds are used to reach underserved 

5 populations, including rural populations and racial 

6 and ethnic minority populations. 

7 (b) REPORT AND GUIDANCE.— 

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

9 completion of the review under subsection (a), the Sec10 retary of Health and Human Services, acting through 

11 the Assistant Secretary for Mental Health and Sub12 stance Use, shall submit to the Committee on Appro13 priations, the Committee on Health, Education, 

14 Labor, and Pensions, and the Committee on Finance 

15 of the Senate and to the Committee on Appropria16 tions and the Committee on Energy and Commerce of 

17 the House of Representatives a report on the findings 

18 made as a result of the review conducted under sub19 section (a). Such report shall include any rec20 ommendations with respect to any changes to the 

21 Community Mental Health Services Block Grant pro22 gram under subpart I of part B of title XIX of the 

23 Public Health Service Act (42 U.S.C. 300x et seq.), 

24 including the set-aside required for First Episode 


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1 Psychosis, that would facilitate improved outcomes for 

2 the targeted population involved. 

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

4 date on which the report is submitted under para5 graph (1), the Secretary of Health and Human Serv6 ices, acting through the Assistant Secretary for Men7 tal Health and Substance Use, shall update the guid8 ance provided to States under the Community Mental 

9 Health Services Block Grant program based on the 

10 findings and recommendations of the report. 

11 (c) ADDITIONAL GUIDANCE.—The Director of the Na12 tional Institute of Mental Health shall coordinate with the 

13 Assistant Secretary for Mental Health and Substance Use 

14 in providing guidance to State grantees and provider sub15 grantees about research advances in the delivery of services 

16 for First Episode Psychosis under the Community Mental 

17 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 & MedVerDate Sep 11 2014 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00137 Fmt 6652 Sfmt 6203 E:\BILLS\S3393.RS S3393

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1 icaid Services and the Director of the National Institute 

2 of Mental Health— 

3 (1) shall provide updated guidance to States con4 cerning the manner in which Federal funding pro5 vided to States through programs administered by 

6 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 co11 ordinated specialty care to individuals with serious 

12 mental illness and serious emotional disturbance, and 

13 interventions for individuals with early serious men14 tal illness, including First Episode Psychosis; and 

15 (2) may streamline relevant State reporting re16 quirements if such streamlining would result in mak17 ing it easier for States to coordinate funding under 

18 the programs described in paragraph (1) to improve 

19 treatments for individuals with serious mental illness 

20 and serious emotional disturbance. 

21 SEC. 213. IMPROVING ACCESS TO ADDICTION MEDICINE 

22 PROVIDERS. 

23 Section 597 of the Public Health Service Act (42 

24 U.S.C. 290ll) is amended— 


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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 SEC. 214. ROUNDTABLE ON USING HEALTH INFORMATION 

6 TECHNOLOGY TO IMPROVE MENTAL HEALTH 

7 AND SUBSTANCE USE CARE OUTCOMES. 

8 (a) ROUNDTABLE.—Not later than 180 days after the 

9 date of enactment of this Act, the Office of the National 

10 Coordinator for Health Information Technology shall con11 vene a public roundtable to examine how the expanded use 

12 of electronic health records among mental health and sub13 stance use service providers can improve outcomes for pa14 tients in mental health and substance use settings and how 

15 best to increase electronic health record adoption among 

16 such providers. 

17 (b) PARTICIPANTS.—The National Coordinator for 

18 Health Information Technology shall ensure that the par19 ticipants in the roundtable under subsection (a) include 

20 private and public sector stakeholders, including patients, 

21 providers (including providers of inpatient services and 

22 providers of outpatient services), and representatives of 

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1 mation technology certification organizations, and State 

2 and Federal agencies. 

3 (c) REPORT.—Not later than 180 days after the con4 clusion of the public stakeholder roundtable under sub5 section (a), the Office of the National Coordinator for 

6 Health Information Technology shall submit to the Com7 mittee on Health, Education, Labor, and Pensions of the 

8 Senate and the Committee on Energy and Commerce of the 

9 House of Representatives a report outlining information 

10 gathered from the roundtable under subsection (a). Such re11 port shall include an examination of— 

12 (1) recommendations from the roundtable par13 ticipants; 

14 (2) unique considerations for using electronic 

15 health record systems in mental health and substance 

16 use treatment settings; 

17 (3) unique considerations for developers of health 

18 information technology relating to certification of 

19 electronic health records for use in mental health and 

20 substance use treatment settings where the applicable 

21 health information technology is not currently subject 

22 to certification requirements; 

23 (4) current usage of electronic health records by 

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1 viders, and the scope and magnitude of such providers 

2 that do not use electronic health record systems; 

3 (5) examples of how electronic health record sys4 tems enable coordinated care and care management; 

5 (6) how electronic health record systems further 

6 appropriate patient and provider access to secure, us7 able electronic information exchange; 

8 (7) how electronic health record systems can be 

9 connected to or support existing systems, which may 

10 include the 988 crisis line, mobile crisis response sys11 tems, and co-responder programs, to facilitate 

12 connectivity, response, and integrated care; 

13 (8) any existing programs to support greater 

14 adoption of electronic health record systems among 

15 mental health and substance use service providers; 

16 (9) any limitations to greater adoption of elec17 tronic health record systems among mental health and 

18 substance use service providers; 

19 (10) the costs of adoption of electronic health 

20 record systems by mental health and substance use 

21 disorder service providers; and 

22 (11) best practices implemented by States and by 

23 other entities to support adoption of use of electronic 

24 health records among mental health and substance use 

25 disorder service providers. 


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1 SEC. 215. PEER-TO-PEER MENTAL HEALTH SUPPORT. 

2 (a) IN GENERAL.—The Assistant Secretary for Mental 

3 Health and Substance Use (referred to in this section as 

4 the ‘‘Assistant Secretary’’), in consultation with the Sec5 retary of Education, may, as appropriate and within a rel6 evant existing program, carry out a pilot program and 

7 make awards, on a competitive basis, to eligible entities to 

8 support evidence-based mental health peer support activities 

9 for students enrolled in secondary schools (as such term is 

10 defined in section 8101 of the Elementary and Secondary 

11 Education Act of 1965 (20 U.S.C. 7801)). 

12 (b) ELIGIBILITY.—To be eligible to receive an award 

13 under this section, an entity shall— 

14 (1) be a State, political subdivision of a State, 

15 territory, or Indian Tribe or Tribal organization (as 

16 such terms are defined in section 4 of the Indian Self17 Determination and Education Assistance Act (25 

18 U.S.C. 5304)); and 

19 (2) submit to the Assistant Secretary an applica20 tion at such time, in such manner, and containing 

21 such information as the Assistant Secretary may re22 quire, including a description of how the entity will 

23 measure and evaluate progress of the program in im24 proving student mental health outcomes. 

25 (c) USE OF AMOUNTS.— 


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1 (1) IN GENERAL.—Subject to paragraph (2), an 

2 eligible entity may use amounts provided under this 

3 section to implement or operate evidence-based mental 

4 health peer support activities in 1 or more secondary 

5 schools (as such term is defined in section 8101 of the 

6 Elementary and Secondary Education Act of 1965 

7 (20 U.S.C. 7801)) within the jurisdiction of such eli8 gible entity, which may include providing training, 

9 as appropriate, to students, adult supervisors, and 

10 other appropriate individuals to improve the early 

11 identification of, response to, and recovery supports 

12 for mental health and substance use challenges, reduce 

13 associated risks, and promote resiliency. 

14 (2) PROGRAM OVERSIGHT.—An eligible entity 

15 shall ensure that mental health peer support activities 

16 under paragraph (1) are overseen by a school-based 

17 mental health professional. 

18 (3) FERPA.—Any education records of the stu19 dent collected or maintained under this section shall 

20 have the protections provided in section 444 of the 

21 General Education Provisions Act (20 U.S.C. 1232g). 

22 (d) EVALUATION; REPORT.— 

23 (1) EVALUATION.—The Assistant Secretary shall 

24 carry out an evaluation to measure the efficacy of the 

25 program under this section. The evaluation shall— 


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1 (A) measure participation rates in mental 

2 health peer support activities, including any as3 sociated trends; 

4 (B) describe the specific trainings provided, 

5 or other activities carried out under the pilot 

6 program; 

7 (C) assess whether such mental health peer 

8 support activities impacted mental health out9 comes of participating students; and 

10 (D) measure the effectiveness of the pilot 

11 program in connecting students to professional 

12 mental health services compared to other evi13 dence-based strategies. 

14 (2) REPORT.—The Assistant Secretary shall pre15 pare and submit to the Committee on Health, Edu16 cation, Labor, and Pensions of the Senate and the 

17 Committees on Energy and Commerce and Education 

18 and the Workforce of the House of Representatives a 

19 report containing the results of the evaluation con20 ducted under paragraph (1). 

21 (e) TECHNICAL ASSISTANCE.—The Assistant Sec22 retary, in coordination with the Secretary of Education, 

23 shall provide technical assistance to eligible entities apply24 ing for and receiving an award under this section, includVerDate Sep 11 2014 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00144 Fmt 6652 Sfmt 6203 E:\BILLS\S3393.RS S3393

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1 ing the identification and dissemination of best practices 

2 for mental health peer support programs for students. 

3 (f) RULE OF CONSTRUCTION.—Section 4001 of the Ele4 mentary and Secondary Education Act of 1965 (20 U.S.C. 

5 7101) shall apply to an entity receiving a grant, contract, 

6 or cooperative agreement under this section in the same 

7 manner as such section applies to an entity receiving fund8 ing under title IV of such Act, except that section 

9 4001(a)(2)(B)(i) of such Act shall not apply. 

10 (g) SUNSET.—This section shall terminate on Sep11 tember 30, 2028. 

12 SEC. 216. KID PROOF PILOT PROGRAM. 

13 (a) IN GENERAL.—The Assistant Secretary for Mental 

14 Health and Substance Use (referred to in this section as 

15 the ‘‘Assistant Secretary’’), may, as appropriate and within 

16 a relevant existing program, carry out a pilot program and 

17 make awards, on a competitive basis, to eligible entities to 

18 prevent, or reduce the risk of, suicide and drug overdose 

19 by children, adolescents, and young adults, including by ad20 dressing the misuse of lethal means commonly used in over21 dose or suicide. 

22 (b) ELIGIBILITY.—To be eligible to receive an award 

23 under this section, an entity shall— 

24 (1) be a State, political subdivision of a State, 

25 territory, or Indian Tribe or Tribal organization (as 


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1 such terms are defined in section 4 of the Indian Self2 Determination and Education Assistance Act (25 

3 U.S.C. 5304)); and 

4 (2) submit to the Assistant Secretary an applica5 tion at such time, in such manner, and containing 

6 such information as the Assistant Secretary may re7 quire, including a description of the geographic loca8 tion and settings in which such entity proposes to 

9 carry out activities under such award and the dem10 onstrated need of such geographic location and set11 tings. 

12 (c) USE OF FUNDS.—An eligible entity shall use 

13 amounts provided under this section to implement evidence14 based practices to prevent, or reduce the risk of, overdose 

15 and suicide among children, adolescents, and young adults, 

16 including promoting education and awareness among par17 ents or legal guardians on relevant best practices and pro18 viding appropriate supplies to parents or legal guardians 

19 to prevent, or reduce the risk of, the misuse of lethal means 

20 commonly used in overdose or suicide. 

21 (d) PARTNERSHIPS.—Recipients of funding under this 

22 section may partner with health care facilities to carry out 

23 activities under subsection (c). 

24 (e) EVALUATION; REPORT.— 


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1 (1) EVALUATION.—Not later than 2 years after 

2 the date on which awards under this section are first 

3 issued, the Assistant Secretary shall carry out an 

4 evaluation to measure the efficacy of the program 

5 under this section. The evaluation shall include— 

6 (A) a description of any specific education 

7 and awareness activities carried out through the 

8 pilot program under this section; 

9 (B) the number and types of supplies pro10 vided to parents or legal guardians to prevent, or 

11 reduce the risk of, the misuse of lethal means 

12 commonly used in overdose or suicide; and 

13 (C) an assessment of the efficacy of the pilot 

14 program in preventing, or reducing the risk of, 

15 overdose and suicide. 

16 (2) REPORT.—The Assistant Secretary shall pre17 pare and submit to the Committee on Health, Edu18 cation, Labor, and Pensions of the Senate and the 

19 Committee on Energy and Commerce of the House of 

20 Representatives a report containing the results of the 

21 evaluation conducted under paragraph (1). 

22 (f) SUNSET.—This section shall terminate on Sep23 tember 30, 2028. 


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1 TITLE III—RECOVERY 

2 SEC. 301. YOUTH PREVENTION AND RECOVERY. 

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

4 Communities Act (42 U.S.C. 290bb–7a(c)) (as amended by 

5 section 113(a)) is amended— 

6 (1) in paragraph (2)— 

7 (A) in subparagraph (A)— 

8 (i) in clause (i)— 

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

10 of local educational agencies,’’ after ‘‘a 

11 local educational agency’’; and 

12 (II) by striking ‘‘high schools’’ 

13 and inserting ‘‘secondary schools’’; and 

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

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

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

17 as follows: 

18 ‘‘(E) INDIAN TRIBE; TRIBAL ORGANIZA19 TION.—The terms ‘Indian Tribe’ and ‘Tribal or20 ganization’ have the meanings given such terms 

21 in section 4 of the Indian Self-Determination 

22 and Education Assistance Act (25 U.S.C. 

23 5304).’’; 

24 (C) by redesignating subparagraph (K) as 

25 subparagraph (L); and 


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1 (D) by inserting after subparagraph (J) the 

2 following: 

3 ‘‘(K) SECONDARY SCHOOL.—The term ‘sec4 ondary school’ has the meaning given such term 

5 in section 8101 of the Elementary and Sec6 ondary Education Act of 1965 (20 U.S.C. 

7 7801).’’; 

8 (2) in paragraph (3)(A), in the matter preceding 

9 clause (i)— 

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

11 (B) by inserting ‘‘at increased risk for sub12 stance misuse’’ after ‘‘specific populations’’; 

13 (3) in paragraph (4)— 

14 (A) in the matter preceding subparagraph 

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

16 ‘‘Indian Tribes’’; 

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

18 abuse’’; and 

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

20 mentoring’’ and inserting ‘‘peer-to-peer support’’; 

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

22 inserting ‘‘Tribal’’; 

23 (5) in paragraph (6)(A)— 

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

25 inserting a semicolon; and 


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

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

3 carried out under the grant program, after 

4 the grant program has ended; and’’; 

5 (6) in paragraph (8), by striking ‘‘2022’’ and in6 serting ‘‘2027’’; and 

7 (7) by amending paragraph (9) to read as fol8 lows: 

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

10 carry out this subsection, there are authorized to be 

11 appropriated $10,000,000 for fiscal year 2024, 

12 $12,000,000 for fiscal year 2025, $14,000,000 for fis13 cal year 2026, $16,000,000 for fiscal year 2027, and 

14 $18,000,000 for fiscal year 2028.’’. 

15 SEC. 302. COMPREHENSIVE OPIOID RECOVERY CENTERS. 

16 Section 552 of the Public Health Service Act (42 

17 U.S.C. 290ee–7) is amended— 

18 (1) in subsection (d)(2)— 

19 (A) in the matter preceding subparagraph 

20 (A), by striking ‘‘and in such manner’’ and in21 serting ‘‘, in such manner, and containing such 

22 information and assurances’’; and 

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

24 capable of coordinating with other entities to 

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


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1 capability to carry out, through referral or con2 tractual arrangements’’; 

3 (2) in subsection (h)— 

4 (A) by redesignating paragraphs (1) 

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

6 respectively, and adjusting the margins accord7 ingly; 

8 (B) by striking ‘‘With respect to’’ and in9 serting the following: 

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

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

12 ‘‘(2) ADDITIONAL REPORTING FOR CERTAIN ELI13 GIBLE ENTITIES.—An entity carrying out activities 

14 described in subsection (g) through referral or con15 tractual arrangements shall include in the submis16 sions required under paragraph (1) information re17 lated to the status of such referrals or contractual ar18 rangements, including an assessment of whether such 

19 referrals or contractual arrangements are supporting 

20 the ability of such entity to carry out such activi21 ties.’’; and 

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

23 2023’’ and inserting ‘‘2024 through 2028’’. 


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1 SEC. 303. BUILDING COMMUNITIES OF RECOVERY. 

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

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

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

5 ‘‘$16,000,000 for each of fiscal years 2024 through 2028’’. 

6 SEC. 304. PEER SUPPORT TECHNICAL ASSISTANCE CENTER. 

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

8 U.S.C. 290ee–2a) is amended— 

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

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

11 as— 

12 ‘‘(A) professional development of peer sup13 port specialists; and 

14 ‘‘(B) making recovery support services 

15 available in nonclinical settings; and’’; 

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

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

18 (3) by inserting after subsection (c) the fol19 lowing: 

20 ‘‘(d) PILOT PROGRAM.— 

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

22 out a pilot program to establish one regional technical 

23 assistance center (referred to in this subsection as the 

24 ‘Regional Center’) to assist the Center in carrying out 

25 activities described in subsection (b) within the geoVerDate Sep 11 2014 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00152 Fmt 6652 Sfmt 6203 E:\BILLS\S3393.RS S3393

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1 graphic region of such Regional Center in a manner 

2 that is tailored to the needs of such region. 

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

4 the date of enactment of the SUPPORT for Patients 

5 and Communities Reauthorization Act, the Secretary 

6 shall evaluate the activities of the Regional Center 

7 and submit to the Committee on Health, Education, 

8 Labor, and Pensions of the Senate and the Committee 

9 on Energy and Commerce of the House of Representa10 tives a report on the findings of such evaluation, in11 cluding— 

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

13 responsibilities of the Regional Center and the 

14 Center; 

15 ‘‘(B) available information relating to the 

16 outcomes of the pilot program under this sub17 section, such as any impact the Regional Center 

18 had on the operations and efficiency of the Cen19 ter relating to requests for technical assistance 

20 and support within the region of such Regional 

21 Center; 

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

23 duplication relating to the activities of the Re24 gional Center and the Center within such region; 

25 and 


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1 ‘‘(D) recommendations relating to the modi2 fication, expansion, or termination of the pilot 

3 program under this subsection. 

4 ‘‘(3) TERMINATION.—This subsection shall termi5 nate on September 30, 2028.’’; and 

6 (4) in subsection (f), as so redesignated, by strik7 ing ‘‘$1,000,000 for each of fiscal years 2019 through 

8 2023’’ and inserting ‘‘$2,000,000 for each of fiscal 

9 years 2024 through 2028’’. 

10 SEC. 305. CAREER ACT. 

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

12 Patients and Communities Act (42 U.S.C. 290ee–8) is 

13 amended— 

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

15 TREATMENT, RECOVERY, AND WORKFORCE

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

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

18 ‘‘for a period’’; 

19 (3) in subsection (c)— 

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

21 described in paragraph (2)’’ and inserting ‘‘the 

22 average rates for calendar years 2018 through 

23 2022 described in paragraph (2)’’; and 

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

25 follows: 


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1 ‘‘(2) RATES.—The rates described in this para2 graph are the following: 

3 ‘‘(A) The highest age-adjusted average rates 

4 of drug overdose deaths for calendar years 2018 

5 through 2022 based on data from the Centers for 

6 Disease Control and Prevention, including, if 

7 necessary, provisional data for calendar year 

8 2022. 

9 ‘‘(B) The highest average rates of unemploy10 ment for calendar years 2018 through 2022 

11 based on data provided by the Bureau of Labor 

12 Statistics. 

13 ‘‘(C) The lowest average labor force partici14 pation rates for calendar years 2018 through 

15 2022 based on data provided by the Bureau of 

16 Labor Statistics.’’; 

17 (4) in subsection (g)— 

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

19 redesignating subparagraphs (A) and (B) as 

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

21 the margins accordingly; 

22 (B) by redesignating paragraphs (1) 

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

24 respectively, and adjusting the margins accord25 ingly; 


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1 (C) in the matter preceding subparagraph 

2 (A) (as so redesignated), by striking ‘‘An entity’’ 

3 and inserting the following: 

4 ‘‘(1) IN GENERAL.—An entity’’; and 

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

6 ‘‘(2) TRANSPORTATION SERVICES.—An entity re7 ceiving a grant under this section may use not more 

8 than 5 percent of the funds for providing transpor9 tation for individuals to participate in an activity 

10 supported by a grant under this section, which trans11 portation shall be to or from a place of work or a 

12 place where the individual is receiving career and 

13 technical education or job training services or receiv14 ing services directly linked to treatment of or recovery 

15 from a substance use disorder. 

16 ‘‘(3) LIMITATION.—The Secretary may not re17 quire an entity to, or give priority to an entity that 

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

19 for activities that are not specified in this sub20 section.’’; 

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

22 shall include employment and earnings outcomes de23 scribed in subclauses (I) and (III) of section 

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1 spect to the participation of such individuals with a 

2 substance use disorder in programs and activities 

3 funded by the grant under this section’’ after ‘‘sub4 section (g)’’; 

5 (6) in subsection (j)— 

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

7 grants awarded prior to the date of enactment of 

8 the SUPPORT for Patients and Communities 

9 Reauthorization Act’’ after ‘‘grant period under 

10 this section’’; and 

11 (B) in paragraph (2)— 

12 (i) in the matter preceding subpara13 graph (A), by striking ‘‘2 years after sub14 mitting the preliminary report required 

15 under paragraph (1)’’ and inserting ‘‘Sep16 tember 30, 2028’’; and 

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

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

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

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

21 ‘‘$12,000,000 for each of fiscal years 2024 through 

22 2028’’. 

23 (b) CLERICAL AMENDMENT.—The table of contents in 

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1 ed by striking the item relating to section 7183 and insert2 ing the following: 

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

3 SEC. 306. RESEARCH AND RECOMMENDATIONS ON CRIMI4 NAL BACKGROUND CHECK PROCESS FOR 

5 PEER SUPPORT SPECIALISTS. 

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

7 Human Services (referred to in this section as the ‘‘Sec8 retary’’), in coordination with the Attorney General, shall 

9 develop a report on research and recommendations with re10 spect to criminal background check processes for individuals 

11 becoming peer support specialists. 

12 (b) CONTENTS.—The report under subsection (a) shall 

13 include— 

14 (1) a summary of evidence-based research on the 

15 effectiveness of peer support specialists in improving 

16 the mental health and the substance use disorder re17 covery of other individuals; 

18 (2) a survey of each State’s laws (including reg19 ulations) that contain criminal background check re20 quirements for serving as a peer support specialist, 

21 including— 

22 (A) an analysis of criminal offenses that 

23 are included in State laws (including regula24 tions) that prevent individuals from earning a 


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1 peer support specialist certification or from 

2 practicing as a peer support specialist; 

3 (B) an analysis of requirements (if any) 

4 under the State plan under title XIX of the So5 cial Security Act (42 U.S.C. 1396 et seq.) or 

6 under a waiver of such plan relating to back7 ground checks for providers participating under 

8 such plan or waiver and the extent to which any 

9 such requirements differ from similar require10 ments imposed under State law (including regu11 lations); 

12 (C) an analysis of requirements (if any) of 

13 any State receiving a grant under part B of title 

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

15 300x et seq.) relating to background checks for 

16 providers participating in a program under, or 

17 otherwise providing services supported by, such 

18 grant; 

19 (D) a review of State laws (including regu20 lations) that provide exemptions from prohibi21 tions regarding certification or practice of peer 

22 support specialists; and 

23 (E) an indication of each State that has 

24 gone through the process of amending or other25 wise changing criminal background check laws 


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1 (including regulations) for the certification and 

2 practice of peer support specialists; and 

3 (3) recommendations to States on criminal back4 ground check processes that would reduce barriers to 

5 becoming certified as peer support specialists. 

6 (c) AVAILABILITY.—Not later than 1 year after the 

7 date of enactment of this Act, the Secretary shall— 

8 (1) post the report required under subsection (a) 

9 on the publicly accessible internet website of the Sub10 stance Abuse and Mental Health Services Administra11 tion; and 

12 (2) distribute such report to— 

13 (A) State agencies responsible for certifi14 cation of peer support specialists; 

15 (B) the Centers for Medicare & Medicaid 

16 Services; 

17 (C) State agencies responsible for carrying 

18 out a State plan under title XIX of the Social 

19 Security Act or under a waiver of such plan; 

20 and 

21 (D) State agencies responsible for carrying 

22 out a grant under part B of title XIX of the 

23 Public Health Service Act (42 U.S.C. 300x et 

24 seq.). 

25 (d) DEFINITION OF PEER SUPPORT SPECIALIST.— 


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1 (1) IN GENERAL.—In this section, the term ‘‘peer 

2 support specialist’’ means an individual— 

3 (A)(i) who has lived experience of recovery 

4 from a mental health condition or substance use 

5 disorder and who specializes in supporting indi6 viduals with mental health conditions or sub7 stance use disorders; or 

8 (ii) who has lived experience as a parent or 

9 caregiver of an individual with a mental health 

10 condition or substance use disorder and who spe11 cializes in supporting families navigating men12 tal health or substance use service systems; and 

13 (B) who is certified as qualified to furnish 

14 peer support services, as described in paragraph 

15 (2), under a process that is determined by the 

16 State in which such individual furnishes such 

17 services or determined appropriate by the Sec18 retary. 

19 (2) PEER SUPPORT SERVICES.—The services de20 scribed in this paragraph shall be consistent with the 

21 National Practice Guidelines for Peer Supporters 

22 issued by the National Association of Peer Supporters 

23 (or a successor publication) and inclusive of the Core 

24 Competencies for Peer Workers in Behavioral Health 


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1 Services of the Substance Abuse and Mental Health 

2 Services Administration. 

3 SEC. 307. OFFICE OF RECOVERY. 

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

5 Substance Abuse and Mental Health Services Administra6 tion, an Office of Recovery (referred to in this section as 

7 the ‘‘Office’’). 

8 (b) RESPONSIBILITIES.—The Office shall, taking into 

9 account the perspectives of individuals with demonstrated 

10 experience in mental health or substance use disorder recov11 ery— 

12 (1) identify new and emerging challenges related 

13 to the provision of recovery support services; 

14 (2) support technical assistance, data analysis, 

15 and evaluation functions in order to assist States, 

16 local governmental entities, Indian Tribes, and Tribal 

17 organizations in implementing and strengthening re18 covery support services, consistent with the needs of 

19 such States, local governmental entities, Indian 

20 Tribes, and Tribal organizations; and 

21 (3) ensure coordination of efforts to identify, dis22 seminate, and evaluate best practices related to— 

23 (A) improving the capacity of, and access 

24 to, recovery support services; and 


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1 (B) supporting the training, education, pro2 fessional development, and retention of peer sup3 port specialists. 

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

5 enactment of this Act, the Assistant Secretary for Mental 

6 Health and Substance Use shall submit to the Committee 

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

8 and the Committee on Energy and Commerce of the House 

9 of Representatives a report on the activities conducted by 

10 the Office, including— 

11 (1) a description of the specific roles and respon12 sibilities of the Office; 

13 (2) a description of the relationship between the 

14 Office and other relevant components or programs of 

15 the Substance Abuse and Mental Health Services Ad16 ministration; 

17 (3) the identification of any gaps in the activi18 ties of the Substance Abuse and Mental Health Serv19 ices Administration or challenges in coordination be20 tween the Office and such relevant components or pro21 grams of such agency; and 

22 (4) recommendations related to the continued op23 erations of the Office. 


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1 SEC. 308. REVIEW OF GRANTS.GOV. 

2 (a) IN GENERAL.—Not later than 1 year after the date 

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

4 Human Services (referred to in this section as the ‘‘Sec5 retary’’) shall convene a public meeting for purposes of im6 proving awareness of, and access to, information related to 

7 current and future Federal funding opportunities, includ8 ing Federal funding opportunities related to mental health 

9 and substance use disorder programs. 

10 (b) TOPICS.—The public meeting under subsection (a) 

11 shall include— 

12 (1) opportunities to improve the utility and 

13 functionality of relevant internet websites maintained 

14 by the Secretary, such as Grants.gov; 

15 (2) other models for displaying and dissemi16 nating information related to Federal funding oppor17 tunities, such as interactive dashboards; and 

18 (3) strategies to improve the ability of entities to 

19 apply for Federal funding opportunities, including 

20 entities that have not traditionally applied for pro21 grams administered by the Secretary. 

22 (c) WEBSITE IMPROVEMENTS.—The Secretary shall 

23 implement improvements to Grants.gov based on stake24 holder feedback received at the public meeting under sub25 section (a). 


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1 (d) REPORT.—Not later than 1 year after the date on 

2 which the public meeting under subsection (a) is convened, 

3 the Secretary shall submit to the Committee on Health, 

4 Education, Labor, and Pensions of the Senate and the Com5 mittee on Energy and Commerce of the House of Represent6 atives a report summarizing the findings of such meeting, 

7 including how the Secretary has taken into account the feed8 back received through such meeting and implemented im9 provements to relevant internet websites maintained by the 

10 Secretary and strategies to improve awareness of Federal 

11 funding opportunities. 

12 TITLE IV—TECHNICAL 

13 AMENDMENTS 

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

15 PHARMACY TO AN ADMINISTERING PRACTI16 TIONER. 

17 Section 309A(a) of the Controlled Substances Act (21 

18 U.S.C. 829a(a)) is amended by striking paragraph (2) and 

19 inserting the following: 

20 ‘‘(2) the controlled substance is a drug in sched21 ule III, IV, or V to be administered— 

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

23 purpose of maintenance or detoxification treat24 ment; or 


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1 ‘‘(B) intranasally, subject to risk evaluation 

2 and mitigation strategy pursuant to section 

3 505–1 of the Federal Food, Drug, and Cosmetic 

4 Act (21 U.S.C. 355–1), with post-administration 

5 monitoring by a health care professional;’’. 

6 SEC. 402. TECHNICAL CORRECTION ON CONTROLLED SUB7 STANCES DISPENSING. 

8 Effective as if included in the enactment of Public Law 

9 117–328— 

10 (1) section 1252(a) of division FF of Public Law 

11 117–328 (136 Stat. 5681) is amended, in the matter 

12 being inserted into section 302(e) of the Controlled 

13 Substances Act, by striking ‘‘303(g)’’ and inserting 

14 ‘‘303(h)’’; 

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

16 117–328 (136 Stat. 5681) is amended— 

17 (A) in subsection (a)— 

18 (i) in the matter preceding paragraph 

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

20 ‘‘303(h)’’; 

21 (ii) in the matter being stricken by 

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

23 inserting ‘‘(h)(1)’’; and 

24 (iii) in the matter being inserted by 

25 subsection (a)(2), by striking ‘‘(g) PractiVerDate Sep 11 2014 23:37 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00166 Fmt 6652 Sfmt 6203 E:\BILLS\S3393.RS S3393

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1 tioners’’ and inserting ‘‘(h) Practitioners’’; 

2 and 

3 (B) in subsection (b)— 

4 (i) in the matter being stricken by 

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

6 inserting ‘‘303(h)(1)’’; 

7 (ii) in the matter being inserted by 

8 paragraph (1), by striking ‘‘303(g)’’ and in9 serting ‘‘303(h)’’; 

10 (iii) in the matter being stricken by 

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

12 and inserting ‘‘303(h)(2)’’; 

13 (iv) in the matter being stricken by 

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

15 and inserting ‘‘303(h)(2)(B)’’; 

16 (v) in the matter being stricken by 

17 paragraph (5), by striking ‘‘303(g)’’ and in18 serting ‘‘303(h)’’; and 

19 (vi) in the matter being stricken by 

20 paragraph (6), by striking ‘‘303(g)’’ and in21 serting ‘‘303(h)’’; and 

22 (3) section 1263(b) of division FF of Public Law 

23 117–328 (136 Stat. 5685) is amended— 

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

25 ‘‘303(h)(2)’’; and 


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

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

3 SEC. 403. REQUIRED TRAINING FOR PRESCRIBERS OF CON4 TROLLED SUBSTANCES. 

5 (a) IN GENERAL.—Section 303 of the Controlled Sub6 stances Act (21 U.S.C. 823) is amended— 

7 (1) by redesignating the second subsection des8 ignated as subsection (l) as subsection (m); and 

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

10 (A) in subparagraph (A)— 

11 (i) in clause (iv)— 

12 (I) in subclause (I)— 

13 (aa) by inserting ‘‘the Amer14 ican Academy of Family Physi15 cians, the American Podiatric 

16 Medical Association, the Academy 

17 of General Dentistry, the Amer18 ican Optometric Association,’’ be19 fore ‘‘or any other organization’’; 

20 (bb) by striking ‘‘or the Com21 mission’’ and inserting ‘‘the Com22 mission’’; and 

23 (cc) by inserting ‘‘, or the 

24 Council on Podiatric Medical 


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1 Education’’ before the semicolon 

2 at the end; and 

3 (II) in subclause (III), by insert4 ing ‘‘or the American Academy of 

5 Family Physicians’’ after ‘‘Associa6 tion’’; and 

7 (ii) in clause (v), in the matter pre8 ceding subclause (I)— 

9 (I) by striking ‘‘osteopathic medi10 cine, dental surgery’’ and inserting 

11 ‘‘osteopathic medicine, podiatric medi12 cine, dental surgery’’; and 

13 (II) by striking ‘‘or dental medi14 cine curriculum’’ and inserting ‘‘or 

15 dental or podiatric medicine cur16 riculum’’; and 

17 (B) in subparagraph (B)— 

18 (i) in clause (i)— 

19 (I) by inserting ‘‘the American 

20 Pharmacists Association, the Accredi21 tation Council on Pharmacy Edu22 cation, the American Psychiatric 

23 Nurses Association, the American 

24 Academy of Nursing, the American 


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1 Academy of Family Physicians,’’ before 

2 ‘‘or any other organization’’; and 

3 (II) by inserting ‘‘, the American 

4 Academy of Family Physicians,’’ before 

5 ‘‘or the Accreditation Council’’; and 

6 (ii) in clause (ii)— 

7 (I) by striking ‘‘or accredited 

8 school’’ and inserting ‘‘, an accredited 

9 school’’; and 

10 (II) by inserting ‘‘, or an accred11 ited school of pharmacy’’ before ‘‘in the 

12 United States’’. 

13 (b) EFFECTIVE DATE.—The amendment made by sub14 section (a) shall take effect as if enacted on December 29, 

15 2022. 


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Calendar No. 319 

118TH CONGRESS 

2D SESSION S. 3393 

A BILL 

To reauthorize the SUPPORT for Patients and 

Communities Act, and for other purposes. 

FEBRUARY 1, 2024 

Reported with an amendment 


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