II 

118TH CONGRESS 

2D SESSION S. 3663 

To provide funding for programs and activities under the SUPPORT for 

Patients and Communities Act. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 25, 2024 

Mrs. SHAHEEN (for herself and Ms. HASSAN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To provide funding for programs and activities under the 

SUPPORT for Patients and Communities Act. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Turn the Tide Act’’. 

5 SEC. 2. CONTROLLED SUBSTANCE PROVISIONS OF THE 

6 SUPPORT FOR PATIENTS AND COMMUNITIES 

7 ACT. 

8 (a) GRANTS TO ENHANCE ACCESS TO SUBSTANCE

9 USE DISORDER TREATMENT.—Section 3203(b) of the 

10 Substance Use-Disorder Prevention that Promotes Opioid 


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1 Recovery and Treatment for Patients and Communities 

2 Act (Public Law 115–271) is amended to read as follows: 

3 ‘‘(b) APPROPRIATIONS.—For grants under subsection 

4 (a), there is authorized to be appropriated, and there is 

5 appropriated, out of any monies in the Treasury not other6 wise appropriated, $4,000,000 for each of fiscal years 

7 2024 through 2027.’’. 

8 (b) ACCESS TO INCREASED DRUG DISPOSAL.—Sec9 tion 3260 of the Substance Use-Disorder Prevention that 

10 Promotes Opioid Recovery and Treatment for Patients 

11 and Communities Act (Public Law 115–271) is amended 

12 to read as follows: 

13 ‘‘SEC. 3260. APPROPRIATIONS. 

14 ‘‘To carry out this chapter, there is authorized to be 

15 appropriated, and there is appropriated, out of any monies 

16 in the Treasury not otherwise appropriated, $10,000,000 

17 for each of fiscal years 2024 through 2027.’’. 

18 SEC. 3. PUBLIC HEALTH PROVISIONS OF THE SUPPORT 

19 FOR PATIENTS AND COMMUNITIES ACT. 

20 (a) FIRST RESPONDER TRAINING.—Section 546(h) 

21 of the Public Health Service Act (42 U.S.C. 290ee–1(h)) 

22 is amended to read as follows: 

23 ‘‘(h) APPROPRIATIONS.—To carry out this section, 

24 there is authorized to be appropriated, and there is appro25 priated, out of any monies in the Treasury not otherwise 


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1 appropriated, $56,000,000 for each of fiscal years 2024 

2 through 2027.’’. 

3 (b) PUBLIC HEALTH LABORATORIES PILOT PRO4 GRAM.—Section 7011(d) of the Substance Use-Disorder 

5 Prevention that Promotes Opioid Recovery and Treatment 

6 for Patients and Communities Act (Public Law 115–271) 

7 is amended to read as follows: 

8 ‘‘(d) APPROPRIATIONS.—To carry out this section, 

9 there is authorized to be appropriated, and there is appro10 priated, out of any monies in the Treasury not otherwise 

11 appropriated, $15,000,000 for each of fiscal years 2024 

12 through 2027.’’. 

13 (c) MODEL TRAINING PROGRAMS FOR SUBSTANCE

14 USE DISORDER PATIENT RECORDS.—Section 7053(e) of 

15 the Substance Use-Disorder Prevention that Promotes 

16 Opioid Recovery and Treatment for Patients and Commu17 nities Act (Public Law 115–271) is amended to read as 

18 follows: 

19 ‘‘(e) APPROPRIATIONS.—To carry out this section, 

20 there is authorized to be appropriated, and there is appro21 priated, out of any monies in the Treasury not otherwise 

22 appropriated— 

23 ‘‘(1) $4,000,000 for fiscal year 2024; 

24 ‘‘(2) $2,000,000 for fiscal year 2025; and 


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1 ‘‘(3) $1,000,000 for each of fiscal years 2026 

2 and 2027.’’. 

3 (d) RESIDENTIAL TREATMENT PROGRAMS FOR

4 PREGNANT AND POSTPARTUM WOMEN.—Section 508(s) 

5 of the Public Health Service Act (42 U.S.C. 290bb–1(s)) 

6 is amended by striking the first sentence and inserting the 

7 following: ‘‘To carry out this section, there is authorized 

8 to be appropriated, and there is appropriated, out of any 

9 monies in the Treasury not otherwise appropriated, 

10 $40,000,000 for each of fiscal years 2024 through 2027.’’. 

11 (e) MENTAL AND BEHAVIORAL HEALTH EDUCATION

12 AND TRAINING GRANTS.—Section 756(f) of the Public 

13 Health Service Act (42 U.S.C. 294e–1(f)) is amended to 

14 read as follows: 

15 ‘‘(f) APPROPRIATIONS.—To carry out this section, 

16 there is authorized to be appropriated, and there is appro17 priated, out of any monies in the Treasury not otherwise 

18 appropriated, $75,000,000 for each of fiscal years 2024 

19 through 2027.’’. 

20 (f) COORDINATION AND CONTINUATION OF CARE

21 FOR DRUG OVERDOSE PATIENTS.—Section 7081(f) of the 

22 Substance Use-Disorder Prevention that Promotes Opioid 

23 Recovery and Treatment for Patients and Communities 

24 Act (Public Law 115–271) is amended to read as follows: 


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1 ‘‘(f) APPROPRIATIONS.—To carry out this section, 

2 there is authorized to be appropriated, and there is appro3 priated, out of any monies in the Treasury not otherwise 

4 appropriated, $10,000,000 for each of fiscal years 2024 

5 through 2027.’’. 

6 (g) EMERGENCY DEPARTMENT ALTERNATIVES TO

7 OPIOIDS DEMONSTRATION PROGRAM.—Section 7091(g) 

8 of the Substance Use-Disorder Prevention that Promotes 

9 Opioid Recovery and Treatment for Patients and Commu10 nities Act (Public Law 115–271) is amended to read as 

11 follows: 

12 ‘‘(g) APPROPRIATIONS.—To carry out this section, 

13 there is authorized to be appropriated, and there is appro14 priated, out of any monies in the Treasury not otherwise 

15 appropriated, $10,000,000 for each of fiscal years 2024 

16 through 2027.’’. 

17 (h) REGIONAL CENTERS OF EXCELLENCE IN SUB18 STANCE USE DISORDER EDUCATION.—Section 551(f) of 

19 the Public Health Service Act (42 U.S.C. 290ee–6(f)) is 

20 amended to read as follows: 

21 ‘‘(f) APPROPRIATIONS.—To carry out this section, 

22 there is authorized to be appropriated, and there is appro23 priated, out of any monies in the Treasury not otherwise 

24 appropriated, $4,000,000 for each of fiscal years 2024 

25 through 2027.’’. 


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1 (i) YOUTH PREVENTION AND RECOVERY.—Section 

2 7102(c)(9) of the Substance Use-Disorder Prevention that 

3 Promotes Opioid Recovery and Treatment for Patients 

4 and Communities Act (Public Law 115–271) is amended 

5 to read as follows: 

6 ‘‘(9) APPROPRIATIONS.—To carry out this sub7 section, there is authorized to be appropriated, and 

8 there is appropriated, out of any monies in the 

9 Treasury not otherwise appropriated, $18,000,000 

10 for each of fiscal years 2024 through 2027.’’. 

11 (j) COMPREHENSIVE OPIOID RECOVERY CENTERS.— 

12 Section 552(j) of the Public Health Service Act (42 U.S.C. 

13 290ee–7(j)) is amended to read as follows: 

14 ‘‘(j) APPROPRIATIONS.—To carry out this section, 

15 there is authorized to be appropriated, and there is appro16 priated, out of any monies in the Treasury not otherwise 

17 appropriated, $10,000,000 for each of fiscal years 2024 

18 through 2027.’’. 

19 (k) CDC SURVEILLANCE AND DATA COLLECTION.— 

20 Section 7131(e) of the Substance Use-Disorder Prevention 

21 that Promotes Opioid Recovery and Treatment for Pa22 tients and Communities Act (Public Law 115–271) is 

23 amended to read as follows: 

24 ‘‘(e) APPROPRIATIONS.—To carry out this section, 

25 there is authorized to be appropriated, and there is approVerDate Sep 11 2014 20:28 Jan 29, 2024 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3663.IS S3663

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1 priated, out of any monies in the Treasury not otherwise 

2 appropriated, $2,000,000 for each of fiscal years 2024 

3 through 2027.’’. 

4 (l) NATIONAL CHILD TRAUMATIC STRESS INITIA5 TIVE.—Section 582(j) of the Public Health Service Act 

6 (42 U.S.C. 290hh–1(j)) is amended to read as follows: 

7 ‘‘(j) APPROPRIATIONS.—To carry out this section, 

8 there is authorized to be appropriated, and there is appro9 priated, out of any monies in the Treasury not otherwise 

10 appropriated, $112,000,000 for each of fiscal years 2024 

11 through 2027.’’. 

12 (m) TRAUMA SUPPORT SERVICES AND MENTAL

13 HEALTH CARE.—Section 7134(l) of the Substance Use14 Disorder Prevention that Promotes Opioid Recovery and 

15 Treatment for Patients and Communities Act (Public Law 

16 115–271) is amended to read as follows: 

17 ‘‘(l) APPROPRIATIONS.—To carry out this section, 

18 there is authorized to be appropriated, and there is appro19 priated, out of any monies in the Treasury not otherwise 

20 appropriated, $50,000,000 for each of fiscal years 2024 

21 through 2027.’’. 

22 (n) SURVEILLANCE AND EDUCATION REGARDING IN23 FECTIONS ASSOCIATED WITH ILLICIT DRUG USE AND

24 OTHER RISK FACTORS.—Section 317N(d) of the Public 


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1 Health Service Act (42 U.S.C. 247b–15(d)) is amended 

2 to read as follows: 

3 ‘‘(d) APPROPRIATIONS.—To carry out this section, 

4 there is authorized to be appropriated, and there is appro5 priated, out of any monies in the Treasury not otherwise 

6 appropriated, $40,000,000 for each of fiscal years 2024 

7 through 2027.’’. 

8 (o) BUILDING COMMUNITIES OF RECOVERY.—Sec9 tion 547(f) of the Public Health Service Act (42 U.S.C. 

10 290ee–2(f)) is amended to read as follows: 

11 ‘‘(f) APPROPRIATIONS.—To carry out this section, 

12 there is authorized to be appropriated, and there is appro13 priated, out of any monies in the Treasury not otherwise 

14 appropriated, $16,000,000 for each of fiscal years 2024 

15 through 2027.’’. 

16 (p) PEER SUPPORT TECHNICAL ASSISTANCE CEN17 TER.—Section 547A(e) of the Public Health Service Act 

18 (42 U.S.C. 290ee–2a(e)) is amended to read as follows: 

19 ‘‘(e) APPROPRIATIONS.—To carry out this section, 

20 there is authorized to be appropriated, and there is appro21 priated, out of any monies in the Treasury not otherwise 

22 appropriated, $2,000,000 for each of fiscal years 2024 

23 through 2027.’’. 


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1 (q) PREVENTING OVERDOSES OF CONTROLLED SUB2 STANCES.—Section 392A(d) of the Public Health Service 

3 Act (42 U.S.C. 280b–1(d)) is amended to read as follows: 

4 ‘‘(d) APPROPRIATIONS.—To carry out this section, 

5 there is authorized to be appropriated, and there is appro6 priated, out of any monies in the Treasury not otherwise 

7 appropriated, $506,000,000 for each of fiscal years 2024 

8 through 2027.’’. 

9 (r) CAREER ACT.—Section 7183(k) of the Substance 

10 Use-Disorder Prevention that Promotes Opioid Recovery 

11 and Treatment for Patients and Communities Act (Public 

12 Law 115–271) is amended to read as follows: 

13 ‘‘(k) APPROPRIATIONS.—To carry out this section, 

14 there is authorized to be appropriated, and there is appro15 priated, out of any monies in the Treasury not otherwise 

16 appropriated, $12,000,000 for each of fiscal years 2024 

17 through 2027.’’. 

18 SEC. 4. HOUSING AND DEPARTMENT OF JUSTICE PROVI19 SIONS OF THE SUPPORT FOR PATIENTS AND 

20 COMMUNITIES ACT. 

21 (a) REAUTHORIZATION AND IMPROVEMENT OF RE22 COVERY HOUSING PROGRAM.—Section 8071 of the SUP23 PORT for Patients and Communities Act (42 U.S.C. 5301 

24 note; Public Law 115–271) is amended— 


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1 (1) in subsection (a), by striking ‘‘such sums as 

2 may be necessary for each of fiscal years 2019 

3 through 2023’’ and inserting ‘‘$60,000,000 for each 

4 of fiscal years 2024 through 2029’’; 

5 (2) in subsection (b)— 

6 (A) in paragraph (1), by striking ‘‘date of 

7 enactment of this Act’’ and inserting ‘‘date of 

8 enactment of the Turn the Tide Act’’; and 

9 (B) by striking paragraph (2) and insert10 ing the following: 

11 ‘‘(2) PRIORITY.— 

12 ‘‘(A) IN GENERAL.—The funding formula 

13 required under paragraph (1) shall ensure that 

14 priority for amounts appropriated or otherwise 

15 made available under this section is given to 

16 States with the greatest need, as such need is 

17 determined by the Secretary based on the fol18 lowing factors, and weighting such factors as 

19 described in subparagraph (B): 

20 ‘‘(i) The highest average rates of un21 employment based on data provided by the 

22 Bureau of Labor Statistics for calendar 

23 years 2019 through 2023. 

24 ‘‘(ii) The lowest average labor force 

25 participation rates based on data provided 


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1 by the Bureau of Labor Statistics for cal2 endar years 2019 through 2023. 

3 ‘‘(iii) The highest average age-ad4 justed rates of drug overdose deaths based 

5 on data from the Centers for Disease Con6 trol and Prevention for the 3 most recent 

7 calendar years. 

8 ‘‘(B) WEIGHTING.—The factors described 

9 in subparagraph (A) shall be weighted as fol10 lows: 

11 ‘‘(i) The rate described in subpara12 graph (A)(i) shall be weighted at 15 per13 cent. 

14 ‘‘(ii) The rate described in subpara15 graph (A)(ii) shall be weighted at 15 per16 cent. 

17 ‘‘(iii) The rate described in subpara18 graph (A)(iii) shall be weighted at 70 per19 cent.’’; and 

20 (3) in subsection (c)(1), by striking ‘‘at least 30 

21 percent of such funds within one year’’ and inserting 

22 ‘‘at least 50 percent of such funds within 2 years’’. 

23 (b) BUILDING CAPACITY FOR FAMILY-FOCUSED RES24 IDENTIAL TREATMENT.—Section 8083(c) of the Sub25 stance Use-Disorder Prevention that Promotes Opioid ReVerDate Sep 11 2014 20:28 Jan 29, 2024 Jkt 049200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S3663.IS S3663

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1 covery and Treatment for Patients and Communities Act 

2 (Public Law 115–271) is amended to read as follows: 

3 ‘‘(c) APPROPRIATIONS.—To carry out this section, 

4 there is authorized to be appropriated, and there is appro5 priated, out of any monies in the Treasury not otherwise 

6 appropriated, $20,000,000 for fiscal years 2024, which 

7 shall remain available through fiscal year 2027.’’. 

8 (c) COMPREHENSIVE OPIOID ABUSE GRANT PRO9 GRAM.—Section 1001(a)(27) of title I of the Omnibus 

10 Crime Control and Safe Streets Act of 1968 (34 U.S.C. 

11 10261(a)(27)) is amended to read as follows: 

12 ‘‘(27) To carry out part LL, there is authorized to 

13 be appropriated, and there is appropriated, out of any 

14 monies in the Treasury not otherwise appropriated, 

15 $500,000,000 for each of fiscal years 2024 through 

16 2027.’’. 

17 (d) OFFICE OF NATIONAL DRUG CONTROL POL18 ICY.—Section 714 of the Office of National Drug Control 

19 Policy Reauthorization Act of 1998 (21 U.S.C. 1711) is 

20 amended to read as follows: 

21 ‘‘SEC. 714. AUTHORIZATION OF APPROPRIATIONS; APPRO22 PRIATIONS. 

23 ‘‘To carry out this title, except activities otherwise 

24 specified, there is authorized to be appropriated, and there 

25 is appropriated, out of any monies in the Treasury not 


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1 otherwise appropriated, $50,000,000 for each of fiscal 

2 years 2024 through 2027, to remain available until ex3 pended.’’. 

4 (e) DRUG-FREE COMMUNITIES PROGRAM.—Section 

5 1024 of the Anti-Drug Abuse Act of 1988 (21 U.S.C. 

6 1524) is amended— 

7 (1) in the heading, by inserting ‘‘; APPRO8 PRIATIONS’’ after ‘‘AUTHORIZATION OF APPRO9 PRIATIONS’’; and 

10 (2) by striking subsection (a) and inserting the 

11 following: 

12 ‘‘(a) IN GENERAL.—To carry out this chapter, there 

13 is authorized to be appropriated to the Office of National 

14 Drug Control Policy, and there is appropriated, out of any 

15 monies in the Treasury not otherwise appropriated, 

16 $175,000,000 for each of fiscal years 2024 through 

17 2027.’’. 

18 (f) HIGH-INTENSITY DRUG TRAFFICKING AREA PRO19 GRAM.—Section 707(p) of the Office of National Drug 

20 Control Policy Reauthorization Act of 1988 (21 U.S.C. 

21 1706(p)) is amended— 

22 (1) by redesignating paragraphs (1) through 

23 (6) as subparagraphs (A) through (F), respectively, 

24 and adjusting the margins accordingly; 


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1 (2) by striking ‘‘There is authorized’’ and in2 serting the following: 

3 ‘‘(1) IN GENERAL.—There is authorized’’; 

4 (3) in paragraph (1), as so designated— 

5 (A) in subparagraph (E), as so redesig6 nated, by striking ‘‘each of’’; and 

7 (B) in subparagraph (F), as so redesig8 nated, by striking ‘‘2018 through 2023’’ and in9 serting ‘‘2024 through 2027’’; and 

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

11 ‘‘(2) APPROPRIATIONS.—To carry out this sec12 tion, there is authorized to be appropriated to the 

13 Office of National Drug Control Policy, and there is 

14 appropriated, out of any monies in the Treasury not 

15 otherwise appropriated, $350,000,000 for each of 

16 fiscal years 2024 through 2027.’’. 

17 (g) DRUG COURT PROGRAM.—Section 

18 1001(a)(25)(A) of title I of the Omnibus Crime Control 

19 and Safe Streets Act of 1968 (34 U.S.C. 

20 10261(a)(25)(A)) is amended to read as follows: 

21 ‘‘(25)(A) Except as provided in subparagraph (C), to 

22 carry out part EE, there is authorized to be appropriated, 

23 and there is appropriated, out of any monies in the Treas24 ury not otherwise appropriated, $125,000,000 for each of 

25 fiscal years 2024 through 2027.’’. 


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1 (h) DRUG COURT TRAINING AND TECHNICAL AS2 SISTANCE.—Section 705(e)(2) of the Office of National 

3 Drug Control Policy Reauthorization Act of 1988 (21 

4 U.S.C. 1704(e)(2)) is amended to read as follows: 

5 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS; AP6 PROPRIATIONS.—To carry out this subsection, there 

7 is authorized to be appropriated, and there is appro8 priated, out of any monies in the Treasury not oth9 erwise appropriated, $5,000,000 for each of fiscal 

10 years 2024 through 2027.’’. 

11 (i) ADMINISTRATION OF THE OFFICE OF NATIONAL

12 DRUG CONTROL POLICY.—Section 704(i)(2) of the Office 

13 of National Drug Control Policy Reauthorization Act of 

14 1998 (21 U.S.C. 1703(i)(2)) is amended to read as fol15 lows: 

16 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS; AP17 PROPRIATIONS.—To carry out this subsection, there 

18 is authorized to be appropriated, and there is appro19 priated, out of any monies in the Treasury not oth20 erwise appropriated, $1,750,000 for each of fiscal 

21 years 2024 through 2027.’’. 

22 (j) EMERGING THREATS COMMITTEE, PLAN, AND

23 MEDIA CAMPAIGN.—Section 709(g) of the Office of Na24 tional Drug Control Policy Reauthorization Act of 1998 

25 (21 U.S.C. 1708(g)) is amended to read as follows: 


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1 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS; APPRO2 PRIATIONS.—To carry out this section, there is authorized 

3 to be appropriated to the Office, and there is appropriated, 

4 out of any monies in the Treasury not otherwise appro5 priated, $35,000,000 for each of fiscal years 2024 through 

6 2027.’’. 

7 SEC. 5. BOLSTERING COMMITMENTS TO STATE GRANTS 

8 FOR SUBSTANCE USE DISORDER TREATMENT 

9 AND PREVENTION. 

10 (a) STATE OPIOID RESPONSE GRANTS.— 

11 (1) IN GENERAL.—To carry out activities under 

12 section 1003 of the 21st Century Cures Act (42 

13 U.S.C. 290ee–3 note) relating to opioids by the 

14 State agency responsible for administering the sub15 stance abuse prevention and treatment block grant 

16 under subpart II of part B of title XIX of the Public 

17 Health Service Act (42 U.S.C. 300x–21 et seq.), 

18 there is authorized to be appropriated, and there is 

19 appropriated, $5,500,000,000 for each of fiscal 

20 years 2024 through 2028. 

21 (2) FLEXIBILITY IN USE OF FUNDS.—Section 

22 1003(b) of the 21st Century Cures Act (42 U.S.C. 

23 290ee–3 note) is amended by adding at the end the 

24 following: 


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1 ‘‘(3) FLEXIBILITY.—States and Indian tribes 

2 may use amounts provided under grants under this 

3 subsection to support substance use disorder treat4 ment care and related services regardless of whether 

5 the patient involved has a primary diagnosis of 

6 opioid use disorder, so long as the individual has a 

7 substance use disorder diagnosis. 

8 ‘‘(4) RULE OF CONSTRUCTION.—Nothing in 

9 this subsection shall be construed to prohibit States 

10 from using grant funds under this subsection to allo11 cate amounts to local governments to establish sub12 grantee awards in such localities.’’. 

13 (3) SUBSTANCE ABUSE PREVENTION AND

14 TREATMENT BLOCK GRANTS.—Section 1935(a) of 

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

16 35(a)) is amended to read as follows: 

17 ‘‘(a) APPROPRIATIONS.—To carry out this subpart, 

18 subpart III, and section 505(d), there is authorized to be 

19 appropriated, and there is appropriated, out of any monies 

20 in the Treasury not otherwise appropriated, 

21 $3,000,000,000 for each of fiscal years 2024 through 

22 2028, and $2,500,000,000 for each of fiscal years 2029 

23 through 2033.’’. 

24 (b) REQUIREMENTS.—For the purposes of carrying 

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1 tion (and the amendment made by this section), the Sec2 retary of Health and Human Services shall ensure that 

3 the following requirements are complied with: 

4 (1) Of the amount appropriated for each fiscal 

5 year under subsection (a) (and the amendment made 

6 by such subsection), $50,000,000 shall be made 

7 available to Indian Tribes or tribal organizations. 

8 (2) Of such remaining amounts for each such 

9 fiscal year, 15 percent shall be made available to the 

10 States with the highest mortality rate related to 

11 opioid use disorders. For purposes of allocating such 

12 funds, the Secretary shall develop a formula that 

13 avoids a significant cliff between States with similar 

14 mortality rates to prevent unusually large changes in 

15 certain States when compared to prior year alloca16 tions, including consideration of new formula meth17 odologies to avoid such funding cliffs. 

18 (3) Of the amount made available for each fis19 cal year under subsections (a)(1) for State Opioid 

20 Response Grants, not more than 2 percent of such 

21 amount shall be available for Federal administrative 

22 expenses, training, technical assistance, and evalua23 tion. 

24 (4) Of the amounts not reserved under para25 graphs (1) through (3), the Secretary shall make alVerDate Sep 11 2014 20:28 Jan 29, 2024 Jkt 049200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\S3663.IS S3663

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1 locations to States, territories, and the District of 

2 Columbia according to a formula using national sur3 vey results that the Secretary determines are the 

4 most objective and reliable measure of drug use and 

5 drug-related deaths. 

6 (5) The formula methodology under paragraph 

7 (4) shall be submitted to the Committees on Appro8 priations of the House of Representatives and the 

9 Committee on Appropriations of the Senate not less 

10 than 15 days prior to publishing a Funding Oppor11 tunity Announcement. 

12 (6) The prevention and treatment activities 

13 funded through grants under this section may in14 clude education, treatment (including the provision 

15 of medication), behavioral health services for individ16 uals in treatment programs, referral to treatment 

17 services, recovery support, and medical screening as18 sociated with such treatment. 

19 (7) Each State, including the District of Co20 lumbia, shall receive not less than $4,000,000 under 

21 grants under this section. 

22 (8) In addition to amounts appropriated under 

23 this section (and the amendment made by this sec24 tion), the following amounts shall be available under 


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1 section 241 of the Public Health Service Act (42 

2 U.S.C. 238j): 

3 (A) $79,200,000 to carry out subpart II of 

4 part B of title XIX of the Public Health Service 

5 Act to fund section 1935(b) (42 U.S.C. 300x– 

6 35) (relating to technical assistance, national 

7 data, data collection and evaluation activities) 

8 and the total available under this Act for activi9 ties under such section 1935(b) shall not exceed 

10 5 percent of the amounts appropriated for such 

11 subpart II of part B of title XIX. 

12 (B) $2,000,000 to evaluate substance 

13 abuse treatment programs. 

14 (9) None of the funds provided for under sec15 tion 1921 of the Public Health Service Act (42 

16 U.S.C. 300x–21) or State Opioid Response Grants 

17 under section 1003 of the 21st Century Cures Act 

18 (42 U.S.C. 290ee–3 note) shall be subject to section 

19 241 of such Act (42 U.S.C. 238j). 

20 SEC. 6. ELIMINATING INSURANCE BARRIERS TO MEDICA21 TION-ASSISTED TREATMENT. 

22 (a) PROHIBITION.—Section 1903(i) of the Social Se23 curity Act (42 U.S.C. 1396b(i)) is amended— 

24 (1) in paragraph (26), by striking ‘‘; or’’ and 

25 inserting a semicolon; 


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1 (2) in paragraph (27), by striking the period at 

2 the end and inserting ‘‘; or’’; and 

3 (3) by inserting after paragraph (27) the fol4 lowing new paragraph: 

5 ‘‘(28) with respect to any amount expended for 

6 medical assistance for medication-assisted treatment 

7 (as defined in section 1905(ee)) if the State imposes 

8 any utilization control policies or procedures (as de9 fined by the Secretary), including any prior author10 ization requirements, with respect to the provision of 

11 such assistance; or’’. 

12 (b) CONFORMING AMENDMENT.—Section 

13 1905(a)(29) of the Social Security Act (42 U.S.C. 

14 1396d(a)(29)) is amended by inserting ‘‘and section 

15 1903(i)(28)’’ after ‘‘subsection (ee)’’. 

16 (c) EFFECTIVE DATE.—The amendments made by 

17 this subsection take effect on October 1, 2024. 

18 SEC. 7. LIMITATIONS ON COST-SHARING FOR OPIOID OVER19 DOSE REVERSAL MEDICATIONS. 

20 (a) LIMITATIONS ON COST-SHARING.— 

21 (1) PUBLIC HEALTH SERVICE ACT.—Part D of 

22 title XXVII of the Public Health Service Act (42 

23 U.S.C. 300gg–111 et seq.) is amended by adding at 

24 the end the following: 


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1 ‘‘SEC. 2799A–11. LIMITATIONS ON COST-SHARING FOR 

2 OPIOID OVERDOSE REVERSAL AGENTS. 

3 ‘‘(a) IN GENERAL.—A group health plan or a health 

4 insurance issuer offering group or individual health insur5 ance coverage shall provide coverage for, and shall not im6 pose any cost-sharing requirement under the plan or cov7 erage with respect to at least one formulation of an opioid 

8 overdose reversal agent. 

9 ‘‘(b) UTILIZATION CONTROL POLICIES; MEDICAL

10 MANAGEMENT.—A group health plan or health insurance 

11 issuer offering group or individual health insurance cov12 erage shall not impose any utilization control policies or 

13 procedures (as defined by the Secretary), including prior 

14 authorization requirements, with respect to opioid over15 dose reversal agents covered under the plan or coverage. 

16 Such a plan or issuer may apply medical management 

17 practices in providing the benefits described in subsection 

18 (a). 

19 ‘‘(c) DEFINITION.—In this section, the term ‘opioid 

20 overdose reversal agent’ means a drug or biological prod21 uct approved by the Food and Drug Administration for 

22 one of the following uses (or a similar use): 

23 ‘‘(1) Complete or partial reversal of opioid de24 pression, including respiratory depression, induced 

25 by opioids. 


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1 ‘‘(2) Emergency treatment of a known or sus2 pected opioid overdose, as manifested by respiratory 

3 or central nervous system depression.’’. 

4 (2) EMPLOYEE RETIREMENT INCOME SECURITY

5 ACT OF 1974.— 

6 (A) IN GENERAL.—Subpart B of part 7 of 

7 subtitle B of title I of the Employee Retirement 

8 Income Security Act of 1974 (29 U.S.C. 1185 

9 et seq.) is amend by adding at the end the fol10 lowing: 

11 ‘‘SEC. 726. LIMITATIONS ON COST-SHARING FOR OPIOID 

12 OVERDOSE REVERSAL AGENTS. 

13 ‘‘(a) IN GENERAL.—A group health plan or a health 

14 insurance issuer offering group health insurance coverage 

15 shall provide coverage for, and shall not impose any cost16 sharing requirement under the plan or coverage with re17 spect to at least one formulation of an opioid overdose re18 versal agent. 

19 ‘‘(b) UTILIZATION CONTROL POLICIES; MEDICAL

20 MANAGEMENT.—A group health plan or health insurance 

21 issuer offering group health insurance coverage shall not 

22 impose any utilization control policies or procedures (as 

23 defined by the Secretary), including prior authorization re24 quirements, with respect to opioid overdose reversal agents 

25 covered under the plan or coverage. Such a plan or issuer 


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1 may apply medical management practices in providing the 

2 benefits described in subsection (a). 

3 ‘‘(c) DEFINITION.—In this section, the term ‘opioid 

4 overdose reversal agent’ means a drug or biological prod5 uct approved by the Food and Drug Administration for 

6 one of the following uses (or a similar use): 

7 ‘‘(1) Complete or partial reversal of opioid de8 pression, including respiratory depression, induced 

9 by opioids. 

10 ‘‘(2) Emergency treatment of a known or sus11 pected opioid overdose, as manifested by respiratory 

12 or central nervous system depression.’’. 

13 (B) CLERICAL AMENDMENT.—The table of 

14 contents in section 1 of the Employee Retire15 ment Income Security Act of 1974 (29 U.S.C. 

16 1001 et seq.) is amended by inserting after the 

17 item relating to section 725 the following new 

18 item: 

‘‘Sec. 726. Limitations on cost-sharing for opioid overdose reversal agents.’’. 

19 (3) INTERNAL REVENUE CODE OF 1986.— 

20 (A) IN GENERAL.—Subchapter B of chap21 ter 100 of the Internal Revenue Code of 1986 

22 is amended by adding at the end the following: 


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1 ‘‘SEC. 9826. LIMITATIONS ON COST-SHARING FOR OPIOID 

2 OVERDOSE REVERSAL AGENTS. 

3 ‘‘(a) IN GENERAL.—A group health plan shall pro4 vide coverage for, and shall not impose any cost-sharing 

5 requirement under the plan with respect to at least one 

6 formulation of an opioid overdose reversal agent. 

7 ‘‘(b) UTILIZATION CONTROL POLICIES; MEDICAL

8 MANAGEMENT.—A group health plan shall not impose any 

9 utilization control policies or procedures (as defined by the 

10 Secretary), including prior authorization requirements, 

11 with respect to opioid overdose reversal agents covered 

12 under the plan. Such a plan may apply medical manage13 ment practices in providing the benefits described in sub14 section (a). 

15 ‘‘(c) DEFINITION.—In this section, the term ‘opioid 

16 overdose reversal agent’ means a drug or biological prod17 uct approved by the Food and Drug Administration for 

18 one of the following uses (or a similar use): 

19 ‘‘(1) Complete or partial reversal of opioid de20 pression, including respiratory depression, induced 

21 by opioids. 

22 ‘‘(2) Emergency treatment of a known or sus23 pected opioid overdose, as manifested by respiratory 

24 or central nervous system depression.’’. 

25 (B) CLERICAL AMENDMENT.—The table of 

26 sections for subchapter B of chapter 100 of the 


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1 Internal Revenue Code of 1986 is amended by 

2 adding at the end the following new item: 

‘‘Sec. 9826. Limitations on cost-sharing for opioid overdose reversal agents.’’. 

3 (4) EFFECTIVE DATE.—The amendments made 

4 by this subsection shall apply to plan years begin5 ning on or after January 1, 2025. 

6 (b) SAFE HARBOR FOR ABSENCE OF DEDUCTIBLE

7 FOR OPIOID OVERDOSE REVERSAL AGENTS.— 

8 (1) IN GENERAL.—Paragraph (2) of section 

9 223(c) of the Internal Revenue Code of 1986 is 

10 amended by adding at the end the following new 

11 subparagraph: 

12 ‘‘(H) SAFE HARBOR FOR ABSENCE OF DE13 DUCTIBLE FOR OPIOID OVERDOSE REVERSAL

14 AGENTS.—A plan shall not fail to be treated as 

15 a high deductible health plan by reason of fail16 ing to have a deductible for opioid overdose re17 versal agents (as defined in section 9826(c)).’’. 

18 (2) EFFECTIVE DATE.—The amendment made 

19 by this section shall apply to plan years beginning 

20 on or after January 1, 2025. 

21 (c) LIMITATIONS ON COST-SHARING UNDER MEDI22 CARE PART D.— 

23 (1) IN GENERAL.—Section 1860D–2 of the So24 cial Security Act (42 U.S.C. 1395w–102) is amend25 ed— 


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1 (A) in subsection (b)— 

2 (i) in paragraph (1)(A), in the matter 

3 preceding clause (i), by striking ‘‘and (9)’’ 

4 and inserting ‘‘, (9), and (10)’’; 

5 (ii) in paragraph (2)(A), in the matter 

6 preceding clause (i), by striking ‘‘and (9)’’ 

7 and inserting ‘‘, (9), and (10)’’; and 

8 (iii) by adding at the end the fol9 lowing new paragraph: 

10 ‘‘(10) LIMITATIONS ON COST-SHARING FOR

11 OPIOID OVERDOSE REVERSAL AGENTS.— 

12 ‘‘(A) IN GENERAL.—For plan year 2025 

13 and each subsequent plan year, each prescrip14 tion drug plan and MA–PD plan shall not im15 pose any cost-sharing requirement under the 

16 plan with respect to at least one brand or ge17 neric version of an opioid overdose reversal 

18 agent (as defined in section 2799A–11 of the 

19 Public Health Service Act). The requirement 

20 under the preceding sentence shall also apply to 

21 cost-sharing applicable to subsidy eligible indi22 viduals under section 1814D–14. 

23 ‘‘(B) COST-SHARING.—For purposes of 

24 subparagraph (A), the elimination of cost-shar25 ing shall include the following: 


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1 ‘‘(i) NO APPLICATION OF DEDUCT2 IBLE.—The waiver of the deductible under 

3 paragraph (1). 

4 ‘‘(ii) NO APPLICATION OF COINSUR5 ANCE.—The waiver of coinsurance under 

6 paragraph (2).’’; and 

7 (B) in subsection (c), by adding at the end 

8 the following new paragraph: 

9 ‘‘(7) TREATMENT OF COST-SHARING FOR

10 OPIOID OVERDOSE REVERSAL AGENTS.—The cov11 erage is provided in accordance with subsection 

12 (b)(10).’’. 

13 (2) CONFORMING AMENDMENTS TO COST-SHAR14 ING FOR LOW-INCOME INDIVIDUALS.—Section 

15 1860D–14(a) of the Social Security Act (42 U.S.C. 

16 1395w–114(a)) is amended— 

17 (A) in paragraph (1), in the matter pre18 ceding subparagraph (A), by striking ‘‘In the 

19 case’’ and inserting ‘‘Subject to section 1860D– 

20 2(b)(10), in the case’’; and 

21 (B) in paragraph (2), in the matter pre22 ceding subparagraph (A), by striking ‘‘In the 

23 case’’ and inserting ‘‘Subject to section 1860D– 

24 2(b)(10), in the case’’. 


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1 SEC. 8. TARGETING HEALTH WORKFORCE LOAN REPAY2 MENT ASSISTANCE TO HARDEST-HIT STATES. 

3 (a) LOAN REPAYMENT PROGRAM FOR SUBSTANCE

4 USE DISORDER TREATMENT WORKFORCE.—Section 781 

5 of the Public Health Service Act (42 U.S.C. 295h) is 

6 amended— 

7 (1) in subsection (b), by adding at the end the 

8 following: 

9 ‘‘(3) TAX LIABILITY.—The amount of a pay10 ment made under this section on behalf of an indi11 vidual shall not be considered income for any pur12 pose under the Internal Revenue Code of 1986.’’; 

13 and 

14 (2) in subsection (j), by striking ‘‘$25,000,000 

15 for each of fiscal years 2019 through 2023’’ and in16 serting ‘‘$50,000,000 for each of fiscal years 2024 

17 through 2028’’. 

18 (b) TRAINING DEMONSTRATION PROGRAM.—Section 

19 760(g) of the Public Health Service Act (42 U.S.C. 

20 294k(g)) is amended to read as follows: 

21 ‘‘(g) APPROPRIATIONS.— 

22 ‘‘(1) IN GENERAL.—To carry out this section 

23 (other than paragraph (2)), there is authorized to be 

24 appropriated, and there is appropriated, out of any 

25 monies in the Treasury not otherwise appropriated, 


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1 $10,000,000 for each of fiscal years 2024 through 

2 2027. 

3 ‘‘(2) STATES WITH HIGHEST DRUG OVERDOSE

4 DEATH RATES.— 

5 ‘‘(A) IN GENERAL.—To carry out the pro6 gram under this section with respect to grant7 ees located in States described in subparagraph 

8 (B), there is authorized to be appropriated, and 

9 there is appropriated, out of any monies in the 

10 Treasury not otherwise appropriated, 

11 $20,000,000 for each of fiscal years 2024 

12 through 2027. 

13 ‘‘(B) STATES DESCRIBED.—A State de14 scribed in this subparagraph is a State that is 

15 among the top 10 States in terms of highest 

16 per capita drug poisoning deaths in each of cal17 endar years 2019, 2020, and 2021, based on 

18 the most recent data available from the Centers 

19 for Disease Control and Prevention. 

20 ‘‘(C) APPLICATION OF SECTION.—Except 

21 as provided in this paragraph, the requirements 

22 of this section otherwise applicable to grantees 

23 under this section shall apply to grantees re24 ceiving assistance under this paragraph.’’. 


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1 SEC. 9. MEDICAID PAYMENTS FOR BEHAVIORAL HEALTH 

2 AND MENTAL HEALTH PROVIDERS. 

3 (a) IN GENERAL.— 

4 (1) FEE-FOR-SERVICE.—Section 1902 of the 

5 Social Security Act (42 U.S.C. 1396a) is amended— 

6 (A) in subsection (a)(13)— 

7 (i) by striking ‘‘and’’ at the end of 

8 subparagraph (B); 

9 (ii) by adding ‘‘and’’ at the end of 

10 subparagraph (C); and 

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

13 ‘‘(D) payment for mental health and be14 havioral health services (as defined in sub15 section (uu)(1)) furnished on or after October 

16 1, 2024, and before October 1, 2028, by a phy17 sician or applicable professional (as defined in 

18 subsection (uu)(2)) at a rate that is not less 

19 than 100 percent of the payment rate that ap20 plies to such services and physician or applica21 ble professional under part B of title XVIII (or, 

22 if greater, the payment rate that would be ap23 plicable under such part if the conversion factor 

24 under section 1848(d) for the year involved 

25 were the conversion factor under such section 

26 for 2024, and, if such services are not covered 


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1 under such part, the reasonable and customary 

2 rate the Secretary determines would apply to 

3 such services and physician or applicable profes4 sional);’’; and 

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

6 subsection: 

7 ‘‘(uu) MENTAL HEALTH AND BEHAVIORAL HEALTH

8 SERVICES.—For purposes of subsection (a)(13)(D): 

9 ‘‘(1) MENTAL HEALTH AND BEHAVIORAL

10 HEALTH SERVICES.— 

11 ‘‘(A) IN GENERAL.—The term ‘mental 

12 health and behavioral health services’ means the 

13 following services, when provided to a patient 

14 with a diagnosis of substance use disorder (as 

15 defined in subparagraph (B)) as a part of the 

16 management or treatment of the patient’s sub17 stance use disorder (as determined in accord18 ance with regulations promulgated by the Sec19 retary under subparagraph (C)): 

20 ‘‘(i) Evaluation and management serv21 ices that are procedure codes (for services 

22 covered under title XVIII) for services in 

23 the category designated Evaluation and 

24 Management in the Healthcare Common 

25 Procedure Coding System (established by 


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1 the Secretary under section 1848(c)(5) as 

2 of December 31, 2020, and as subse3 quently modified). 

4 ‘‘(ii) Counseling services, as defined 

5 by the Secretary. 

6 ‘‘(iii) Payment codes established by 

7 the Secretary for opioid use disorder treat8 ment services under section 1866F. 

9 ‘‘(iv) Any other services the Secretary 

10 determines are necessary for the manage11 ment or treatment of a patient with a di12 agnosis of substance use disorder. 

13 ‘‘(B) PATIENT WITH A DIAGNOSIS OF SUB14 STANCE USE DISORDER.—For purposes of sub15 paragraph (A), the term ‘patient with a diag16 nosis of substance use disorder’ means an indi17 vidual who has been diagnosed with 1 or more 

18 diagnosis codes within the code set entitled the 

19 ‘Mental health and behavioral disorders due to 

20 psychoactive substance use’ under the 10th re21 vision of the International Statistical Classifica22 tion of Diseases and Related Health Problems. 

23 ‘‘(C) REGULATIONS.—Not later than 90 

24 days after the enactment of this subsection, the 

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1 ing when services are sufficiently related to part 

2 of the management or treatment of a patient’s 

3 substance use disorder. 

4 ‘‘(2) APPLICABLE PROFESSIONAL.—The term 

5 ‘applicable professional’ means— 

6 ‘‘(A) a clinical psychologist (as defined for 

7 purposes of section 1861(ii)); 

8 ‘‘(B) a clinical social worker (as defined in 

9 section 1861(hh)(1)); 

10 ‘‘(C) a medical professional approved to 

11 furnish medication-assisted treatment under 

12 section 303(g)(2) of the Controlled Substances 

13 Act; or 

14 ‘‘(D) a medical professional that is author15 ized under the State plan or under a waiver of 

16 such plan to furnish mental and behavioral 

17 health services (as defined in paragraph (1)).’’. 

18 (2) MANAGED CARE.—Section 1932(f) of such 

19 Act (42 U.S.C. 1396u–2(f)) is amended— 

20 (A) in the subsection heading, by inserting 

21 ‘‘AND MENTAL HEALTH AND BEHAVIORAL

22 HEALTH SERVICES’’ after ‘‘CARE SERVICES’’; 

23 and 

24 (B) by inserting before the period at the 

25 end the following: ‘‘, and, in the case of mental 


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1 health and behavioral health services described 

2 in section 1902(a)(13)(D), consistent with the 

3 minimum payment rates specified in such sec4 tion (regardless of the manner in which such 

5 payments are made, including in the form of 

6 capitation or partial capitation)’’. 

7 (b) INCREASED FMAP FOR ADDITIONAL COSTS.— 

8 Section 1905 of the Social Security Act (42 U.S.C. 1396d) 

9 is amended— 

10 (1) in subsection (b), by striking ‘‘and (ii)’’ and 

11 inserting ‘‘(ii), and (jj)’’; and 

12 (2) by adding at the end the following new sub13 section: 

14 ‘‘(jj) INCREASED FMAP FOR ADDITIONAL EXPENDI15 TURES FOR MENTAL HEALTH AND BEHAVIORAL HEALTH

16 SERVICES.— 

17 ‘‘(1) IN GENERAL.—Notwithstanding subsection 

18 (b), with respect to the portion of the amounts ex19 pended for medical assistance for services described 

20 in section 1902(a)(13)(D) furnished on or after Oc21 tober 1, 2024, and before October 1, 2028, that is 

22 attributable to the amount by which the minimum 

23 payment rate required under such section (or, by ap24 plication, section 1932(f)) exceeds the payment rate 

25 applicable to such services under the State plan or 


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1 a waiver of such plan as of July 1, 2024, the Fed2 eral medical assistance percentage for a State shall 

3 be equal to 100 percent. The preceding sentence 

4 shall not be construed as prohibiting the payment of 

5 Federal financial participation based on the Federal 

6 medical assistance percentage for the portion of the 

7 amounts expended for medical assistance for such 

8 services that is attributable to the amount (if any) 

9 by which the payment rate applicable to such serv10 ices under the State plan or waiver exceeds such 

11 minimum payment rate. 

12 ‘‘(2) DISREGARD OF ENHANCED PAYMENTS FOR

13 PURPOSES OF TERRITORIAL LIMITS.—The amount of 

14 any payment made for expenditures on medical as15 sistance that is attributable to the application of the 

16 Federal medical assistance percentage described in 

17 paragraph (1) shall not be taken into account for 

18 purposes of applying payment limits under sub19 sections (f) and (g) of section 1108.’’. 

20 SEC. 10. CMI DEMONSTRATION TO TEST THE PROVISION OF 

21 RECOVERY HOUSING FOR INDIVIDUALS WITH 

22 OPIOID USE DISORDER UNDER MEDICAID. 

23 Section 1115A of the Social Security Act (42 U.S.C. 

24 1315a) is amended— 


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1 (1) in subsection (b)(2)(A), by adding at the 

2 end the following new sentence: ‘‘The models se3 lected under this subparagraph shall include the 

4 demonstration described in subsection (h) (which 

5 shall be implemented not later than 18 months after 

6 the date of enactment of such subsection).’’; and 

7 (2) by adding at the end the following new sub8 section: 

9 ‘‘(h) DEMONSTRATION TO TEST THE PROVISION OF

10 RECOVERY HOUSING FOR INDIVIDUALS WITH OPIOID

11 USE DISORDER UNDER MEDICAID.— 

12 ‘‘(1) IN GENERAL.—The CMI, in consultation 

13 with the Secretary of Housing and Urban Develop14 ment and other agencies, as the Secretary deter15 mines appropriate, shall conduct a demonstration 

16 project (referred to in this subsection as the ‘dem17 onstration’) to test whether providing Medicaid man18 aged care entities with an elevated global capitated 

19 budget for eligible Medicaid beneficiaries, paired 

20 with flexibilities to allow States to provide medical 

21 assistance for recovery housing for such bene22 ficiaries, would result in reduced emergency depart23 ment visits, hospitalizations, and program expendi24 tures under per beneficiary, or improve quality of 

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1 penditures under the Medicaid program under title 

2 XIX. 

3 ‘‘(2) DEMONSTRATION REQUIREMENTS.— 

4 ‘‘(A) IN GENERAL.—Under the demonstra5 tion, each eligible State that is selected by the 

6 CMI to participate in the demonstration shall 

7 enter into an agreement with a Medicaid man8 aged care entity under which the entity agrees 

9 to provide services (including recovery housing) 

10 to eligible Medicaid beneficiaries under a pay11 ment model that meets the requirements of sub12 paragraph (B). 

13 ‘‘(B) CAPITATED PAYMENTS.— 

14 ‘‘(i) IN GENERAL.—The CMI shall es15 tablish a capitated payments system for 

16 Medicaid managed care entities under the 

17 demonstration that is based on the dem18 onstration budget determined under clause 

19 (ii). 

20 ‘‘(ii) DEMONSTRATION BUDGET.— 

21 ‘‘(I) IN GENERAL.—For purposes 

22 of clause (i), the demonstration budg23 et of a Medicaid managed care entity 

24 for each year of a demonstration pe25 riod shall be determined by the CMI 


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1 based on the number of eligible Med2 icaid beneficiaries enrolled with the 

3 entity and the average annual spend4 ing under title XIX in the State in5 volved on individuals who are enrolled 

6 in the State plan under such title (or 

7 a waiver of such plan) and who— 

8 ‘‘(aa) have a diagnosis of 

9 opioid use disorder; 

10 ‘‘(bb) are in the top quartile 

11 of per beneficiary spending for 

12 such plan or waiver for the most 

13 recent year; and 

14 ‘‘(cc) have attained age 21 

15 but have not attained age 65. 

16 ‘‘(II) RISK ADJUSTMENT.—The 

17 CMI may adjust the demonstration 

18 budget determined for a Medicaid 

19 managed care entity and a year under 

20 this clause using a risk adjustment 

21 model selected by the CMI to account 

22 for differences in age and clinical con23 ditions of the eligible Medicaid bene24 ficiaries enrolled with the entity com25 pared to the overall population upon 


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1 which the demonstration budget is 

2 based. 

3 ‘‘(C) SELECTION OF ELIGIBLE STATES.— 

4 Not later than 1 year after the date of enact5 ment of this subsection, the CMI shall select 

6 not less than 2 eligible States to participate in 

7 the demonstration. 

8 ‘‘(3) ADDITIONAL WAIVER AUTHORITY.—In ad9 dition to the authority described in subsection 

10 (d)(1), the Secretary may waive such requirements 

11 of title XIX as necessary to carry out the dem12 onstration. 

13 ‘‘(4) DEFINITIONS.—In this subsection: 

14 ‘‘(A) ELIGIBLE MEDICAID BENEFICIARY.— 

15 The term ‘eligible Medicaid beneficiary’ means 

16 an individual who— 

17 ‘‘(i) is eligible for medical assistance 

18 under a State plan under title XIX or a 

19 waiver of such a plan; 

20 ‘‘(ii) has a diagnosis of opioid use dis21 order; 

22 ‘‘(iii) does not have a permanent resi23 dence (as certified by the individual); 

24 ‘‘(iv) is currently receiving medication25 assisted treatment or completed a course 


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1 of medication-assisted treatment during 

2 the 3-month period preceding the individ3 ual’s participation in the demonstration; 

4 and 

5 ‘‘(v) has attained age 21 but has not 

6 attained age 65. 

7 ‘‘(B) ELIGIBLE STATE.— 

8 ‘‘(i) IN GENERAL.—The term ‘eligible 

9 State’ means a State that— 

10 ‘‘(I) makes medical assistance 

11 available to all individuals described in 

12 section 1902(a)(10)(A)(i)(VIII); and 

13 ‘‘(II) agrees to participate in the 

14 demonstration. 

15 ‘‘(ii) SELECTION OF ELIGIBLE

16 STATES.—In selecting eligible States to 

17 participate in the demonstration, the CMI 

18 shall give priority to States that are— 

19 ‘‘(I) among the top 10 States in 

20 terms of highest per capita drug poi21 soning deaths in each of calendar 

22 years 2019, 2020, and 2021, based on 

23 the most recent data available from 

24 the Centers for Disease Control and 

25 Prevention; and 


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1 ‘‘(II) among the 10 States with 

2 the lowest physician reimbursement 

3 rates for services furnished under title 

4 XIX (as determined by the Secretary) 

5 in each of calendar years 2019, 2020, 

6 and 2021. 

7 ‘‘(C) MANAGED CARE ENTITY.—The term 

8 ‘managed care entity’ means a medicaid man9 aged care organization described in section 

10 1932(a)(1)(B)(i). 

11 ‘‘(D) RECOVERY HOUSING.—The term ‘re12 covery housing’ means a shared living environ13 ment free from alcohol and illicit drug use and 

14 centered on peer support and connection to 

15 services that promote sustained recovery from 

16 substance use disorders. 

17 ‘‘(E) STATE.—The term ‘State’ includes 

18 the 50 States and the District of Columbia.’’. 

19 SEC. 11. EXTENSION OF MEDICAID DELIVERY SYSTEM RE20 FORM AND INCENTIVE PAYMENT WAIVERS. 

21 (a) EXTENSION OF WAIVERS.—In the case of a Med22 icaid section 1115 waiver described in subsection (b), not 

23 later than 60 days after the date of enactment of this Act, 

24 the Secretary of Health and Human Services shall— 


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1 (1) extend the termination date for the waiver 

2 to December 31, 2026 (or such earlier date as the 

3 State conducting the waiver may elect); 

4 (2) apply the same annual dollar allotment for 

5 the period for which the waiver is extended under 

6 paragraph (1) as the annual dollar allotment that 

7 applied to the waiver period in effect on the date of 

8 enactment of this Act; and 

9 (3) allow any State with such a waiver to use 

10 funds provided during the period for which the waiv11 er is extended under paragraph (1) to support the 

12 training of direct service workers that provide home 

13 and community-based services. 

14 (b) MEDICAID SECTION 1115 WAIVER DESCRIBED.— 

15 The Medicaid section 1115 waiver described in this sub16 section is a waiver approved under section 1115 of the 

17 Social Security Act (42 U.S.C. 1315) relating to delivery 

18 system reform incentive payments that— 

19 (1) as of the date of enactment of this Act, is 

20 to terminate on or before December 31, 2024; 

21 (2) was in effect as of January 1, 2022; and 

22 (3) was approved for any State that is among 

23 the top 10 States in terms of highest per capita 

24 drug poisoning deaths in each of calendar years 

25 2019, 2020, and 2021, based on the most recent 


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1 data available from the Centers for Disease Control 

2 and Prevention. 

3 SEC. 12. EXPANDING DRUG-FREE COMMUNITIES SUPPORT 

4 GRANTS. 

5 Section 1032 of the Anti-Drug Abuse Act of 1988 

6 (21 U.S.C. 1532) is amended— 

7 (1) in subsection (b)— 

8 (A) in paragraph (3)— 

9 (i) in subparagraph (A), by striking 

10 ‘‘subparagraph (F)’’ and inserting ‘‘sub11 paragraph (H)’’; 

12 (ii) by redesignating subparagraphs 

13 (D), (E), and (F) as subparagraphs (F), 

14 (G), and (H), respectively; 

15 (iii) by inserting after subparagraph 

16 (C) the following: 

17 ‘‘(D) SUBSEQUENT ADDITIONAL

18 GRANTS.—Subject to subparagraph (H), the 

19 Administrator may award a subsequent addi20 tional grant to a grant recipient under subpara21 graph (A), for each fiscal year during the 4-fis22 cal-year period following the fiscal year for 

23 which the initial additional grant under sub24 paragraph (A) is awarded, in an amount not to 

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1 cluding in-kind contributions, raised by the 

2 grant recipient for the fiscal year for which the 

3 subsequent additional grant is awarded. 

4 ‘‘(E) RENEWAL GRANTS.—Subject to sub5 paragraph (H), the Administrator may award a 

6 renewal grant to a grant recipient under sub7 paragraph (D), for the first fiscal year following 

8 the 4-fiscal-year period for which the subse9 quent additional grant under subparagraph (D) 

10 is awarded, in an amount not to exceed the 

11 amount of non-Federal funds, including in-kind 

12 contributions, raised by the grant recipient for 

13 the fiscal year for which the renewal grant is 

14 awarded.’’; and 

15 (iv) in subparagraph (F), as so redes16 ignated— 

17 (I) in the subparagraph heading, 

18 by striking ‘‘RENEWAL’’ and inserting 

19 ‘‘SUBSEQUENT RENEWAL’’; and 

20 (II) in the matter preceding 

21 clause (i)— 

22 (aa) by striking ‘‘clause 

23 (iv)’’ and inserting ‘‘subpara24 graph (H)’’; 


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1 (bb) by striking ‘‘renewal 

2 grant to a grant recipient under 

3 this subparagraph’’ and inserting 

4 ‘‘subsequent renewal grant to a 

5 grant recipient under subpara6 graph (E)’’; and 

7 (cc) by striking ‘‘initial addi8 tional grant’’ and inserting ‘‘re9 newal grant under subparagraph 

10 (E)’’; and 

11 (B) in paragraph (4), by striking ‘‘(3)(E)’’ 

12 and inserting ‘‘(3)(G)’’; 

13 (2) in subsection (d)— 

14 (A) by striking ‘‘In awarding’’ and insert15 ing the following: 

16 ‘‘(1) PRIORITY FOR ECONOMICALLY DISADVAN17 TAGED AREAS.—In awarding’’; and 

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

19 ‘‘(2) PRIORITY FOR STATES DEMONSTRATING

20 HIGH MORTALITY RATES RELATING TO OPIOID USE

21 DISORDER.— 

22 ‘‘(A) GRANTS TO MORE THAN 1 ELIGIBLE

23 COALITION REPRESENTING A COMMUNITY.—In 

24 awarding grants under subsection (b)(1)(B)(ii), 

25 the Administrator shall give priority to eligible 


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1 coalitions that serve 1 or more communities in 

2 a State that has a high mortality rate relating 

3 to opioid use disorder. 

4 ‘‘(B) SUBSEQUENT ADDITIONAL

5 GRANTS.—In awarding subsequent additional 

6 grants under subsection (b)(3)(D), the Admin7 istrator shall give priority to an eligible coali8 tion that serves 1 or more communities in a 

9 State that has a high mortality rate relating to 

10 opioid use disorder.’’; and 

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

12 ‘‘(e) LIMITATION ON SUBSEQUENT RENEWAL

13 GRANTS.—A recipient of a subsequent renewal grant 

14 awarded under subsection (b)(3)(F) may not be awarded 

15 any further grant under this section.’’. 

16 SEC. 13. SUPPORT FOR LAW ENFORCEMENT MENTAL 

17 HEALTH AND WELLNESS. 

18 There is authorized to be appropriated, and there is 

19 appropriated, out of any monies in the Treasury not other20 wise appropriated, $15,000,000 for each of fiscal years 

21 2024 through 2027 for grants under section 1701(b)(23) 

22 of title I of the Omnibus Crime Control and Safe Streets 

23 Act of 1968 (34 U.S.C. 10381(b)(23)) to establish peer 

24 mentoring mental health and wellness pilot programs 

25 within State, Tribal, and local law enforcement agencies. 


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1 SEC. 14. ADVERSE CHILDHOOD EXPERIENCES RESPONSE 

2 TEAM GRANT PROGRAM. 

3 (a) IN GENERAL.—Title I of the Omnibus Crime 

4 Control and Safe Streets Act of 1968 (34 U.S.C. 10101 

5 et seq.) is amended by adding at the end the following: 

6 ‘‘PART PP—ADVERSE CHILDHOOD EXPERIENCES 

7 RESPONSE TEAM GRANT PROGRAM 

8 ‘‘SEC. 3061. GRANTS FOR ADVERSE CHILDHOOD EXPERI9 ENCES RESPONSE TEAMS. 

10 ‘‘(a) GRANTS AUTHORIZED.—From amounts made 

11 available to carry out this section, the Attorney General, 

12 in coordination with the Secretary of Health and Human 

13 Services, shall make grants to States, units of local gov14 ernment, Indian Tribes, and neighborhood or community15 based organizations to address adverse childhood experi16 ences associated with exposure to trauma. 

17 ‘‘(b) USE OF FUNDS.—Amounts received under a 

18 grant under this section may be used to establish an ad19 verse childhood experiences response team, including by— 

20 ‘‘(1) establishing protocols to follow when en21 countering a child or youth exposed to trauma to fa22 cilitate access to services; 

23 ‘‘(2) developing referral partnership agreements 

24 with behavioral health providers, substance treat25 ment facilities, and recovery services for family 

26 members of children exposed to trauma; 


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1 ‘‘(3) integrating law enforcement, mental 

2 health, and crisis services to respond to situations 

3 where children have been exposed to trauma; 

4 ‘‘(4) implementing comprehensive programs and 

5 practices to support children exposed to trauma; 

6 ‘‘(5) identifying barriers for children to access 

7 trauma-informed care in their communities; 

8 ‘‘(6) providing training in trauma-informed care 

9 to emergency response providers, victim service pro10 viders, child protective service professionals, edu11 cational institutions, and other community partners; 

12 ‘‘(7) supporting cross-system planning and col13 laboration among officers and employees who work 

14 in law enforcement, court systems, child welfare 

15 services, correctional reentry programs, emergency 

16 medical services, health care services, public health, 

17 and substance abuse treatment and recovery sup18 port; and 

19 ‘‘(8) providing technical assistance to commu20 nities, organizations, and public agencies on how to 

21 prevent and mitigate the impact of exposure to trau22 ma and violence. 

23 ‘‘(c) APPLICATION.—A State, unit of local govern24 ment, Indian Tribe, or neighborhood or community-based 

25 organization desiring a grant under this section shall subVerDate Sep 11 2014 20:28 Jan 29, 2024 Jkt 049200 PO 00000 Frm 00049 Fmt 6652 Sfmt 6201 E:\BILLS\S3663.IS S3663

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1 mit to the Attorney General an application in such form, 

2 and containing such information, as the Attorney General 

3 may reasonably require.’’. 

4 (b) AUTHORIZATION OF APPROPRIATIONS.—Section 

5 1001(a) of title I of the Omnibus Crime Control and Safe 

6 Streets Act of 1968 (34 U.S.C. 10261(a)) is amended by 

7 adding at the end the following: 

8 ‘‘(29) There are authorized to be appropriated to 

9 carry out part PP $10,000,000 for each of fiscal years 

10 2024 through 2027.’’. 

Æ 


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