117TH CONGRESS 

1ST SESSION H. R. 2379 

AN ACT 

To amend the 21st Century Cures Act to reauthorize and 

expand a grant program for State response to the opioid 

use disorders crisis, 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, 
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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘State Opioid Response 

3 Grant Authorization Act of 2021’’. 

4 SEC. 2. GRANT PROGRAM FOR STATE AND TRIBAL RE5 SPONSE TO OPIOID AND STIMULANT USE AND 

6 MISUSE. 

7 Section 1003 of the 21st Century Cures Act (42 

8 U.S.C. 290ee–3 note) is amended to read as follows: 

9 ‘‘SEC. 1003. GRANT PROGRAM FOR STATE AND TRIBAL RE10 SPONSE TO OPIOID AND STIMULANT USE AND 

11 MISUSE. 

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

13 Human Services (referred to in this section as the ‘Sec14 retary’) shall carry out the grant program described in 

15 subsection (b) for purposes of addressing opioid and stim16 ulant use and misuse, within States, Indian Tribes, and 

17 populations served by Tribal organizations and Urban In18 dian organizations. 

19 ‘‘(b) GRANTS PROGRAM.— 

20 ‘‘(1) IN GENERAL.—Subject to the availability 

21 of appropriations, the Secretary shall award grants 

22 to States, Indian Tribes, Tribal organizations, and 

23 Urban Indian organizations for the purpose of ad24 dressing opioid and stimulant use and misuse, within 

25 such States, such Indian Tribes, and populations 

26 served by such Tribal organizations and Urban In-
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1 dian organizations, in accordance with paragraph 

2 (2). 

3 ‘‘(2) MINIMUM ALLOCATIONS; PREFERENCE.— 

4 In determining grant amounts for each recipient of 

5 a grant under paragraph (1), the Secretary shall— 

6 ‘‘(A) ensure that each State receives not 

7 less than $4,000,000; and 

8 ‘‘(B) give preference to States, Indian 

9 Tribes, Tribal organizations, and Urban Indian 

10 organizations whose populations have an inci11 dence or prevalence of opioid use disorders or 

12 stimulant use or misuse that is substantially 

13 higher relative to the populations of other 

14 States, other Indian Tribes, Tribal organiza15 tions, or Urban Indian organizations, as appli16 cable. 

17 ‘‘(3) FORMULA METHODOLOGY.— 

18 ‘‘(A) IN GENERAL.—Before publishing a 

19 funding opportunity announcement with respect 

20 to grants under this section, the Secretary 

21 shall— 

22 ‘‘(i) develop a formula methodology to 

23 be followed in allocating grant funds 

24 awarded under this section among grant-
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1 ees, which includes performance assess2 ments for continuation awards; and 

3 ‘‘(ii) not later than 30 days after de4 veloping the formula methodology under 

5 clause (i), submit the formula methodology 

6 to— 

7 ‘‘(I) the Committee on Energy 

8 and Commerce and the Committee on 

9 Appropriations of the House of Rep10 resentatives; and 

11 ‘‘(II) the Committee on Health, 

12 Education, Labor, and Pensions and 

13 the Committee on Appropriations of 

14 the Senate. 

15 ‘‘(B) REPORT.—Not later than two years 

16 after the date of the enactment of the State 

17 Opioid Response Grant Authorization Act of 

18 2021, the Comptroller General of the United 

19 States shall submit to the Committee on 

20 Health, Education, Labor, and Pensions of the 

21 Senate and the Committee on Energy and Com22 merce of the House of Representatives a report 

23 that— 

24 ‘‘(i) assesses how grant funding is al25 located to States under this section and 
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1 how such allocations have changed over 

2 time; 

3 ‘‘(ii) assesses how any changes in 

4 funding under this section have affected 

5 the efforts of States to address opioid or 

6 stimulant use or misuse; and 

7 ‘‘(iii) assesses the use of funding pro8 vided through the grant program under 

9 this section and other similar grant pro10 grams administered by the Substance 

11 Abuse and Mental Health Services Admin12 istration. 

13 ‘‘(4) USE OF FUNDS.—Grants awarded under 

14 this subsection shall be used for carrying out activi15 ties that supplement activities pertaining to opioid 

16 and stimulant use and misuse, undertaken by the 

17 State agency responsible for administering the sub18 stance abuse prevention and treatment block grant 

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

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

21 which may include public health-related activities 

22 such as the following: 

23 ‘‘(A) Implementing prevention activities, 

24 and evaluating such activities to identify effec-
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1 tive strategies to prevent substance use dis2 orders. 

3 ‘‘(B) Establishing or improving prescrip4 tion drug monitoring programs. 

5 ‘‘(C) Training for health care practitioners, 

6 such as best practices for prescribing opioids, 

7 pain management, recognizing potential cases 

8 of substance use disorders, referral of patients 

9 to treatment programs, preventing diversion of 

10 controlled substances, and overdose prevention. 

11 ‘‘(D) Supporting access to health care 

12 services, including— 

13 ‘‘(i) services provided by federally cer14 tified opioid treatment programs; 

15 ‘‘(ii) outpatient and residential sub16 stance use disorder treatment services that 

17 utilize medication-assisted treatment, as 

18 appropriate; or 

19 ‘‘(iii) other appropriate health care 

20 providers to treat substance use disorders. 

21 ‘‘(E) Recovery support services, includ22 ing— 

23 ‘‘(i) community-based services that in24 clude peer supports; 
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1 ‘‘(ii) mutual aid recovery programs 

2 that support medication-assisted treat3 ment; or 

4 ‘‘(iii) services to address housing 

5 needs and family issues. 

6 ‘‘(F) Other public health-related activities, 

7 as the State, Indian Tribe, Tribal organization, 

8 or Urban Indian organization determines appro9 priate, related to addressing substance use dis10 orders within the State, Indian Tribe, Tribal or11 ganization, or Urban Indian organization, in12 cluding directing resources in accordance with 

13 local needs related to substance use disorders. 

14 ‘‘(c) ACCOUNTABILITY AND OVERSIGHT.—A State re15 ceiving a grant under subsection (b) shall include in re16 porting related to substance use disorders submitted to the 

17 Secretary pursuant to section 1942 of the Public Health 

18 Service Act (42 U.S.C. 300x–52), a description of— 

19 ‘‘(1) the purposes for which the grant funds re20 ceived by the State under such subsection for the 

21 preceding fiscal year were expended and a descrip22 tion of the activities of the State under the grant; 

23 ‘‘(2) the ultimate recipients of amounts pro24 vided to the State; and 
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1 ‘‘(3) the number of individuals served through 

2 the grant. 

3 ‘‘(d) LIMITATIONS.—Any funds made available pur4 suant to subsection (i)— 

5 ‘‘(1) shall not be used for any purpose other 

6 than the grant program under subsection (b); and 

7 ‘‘(2) shall be subject to the same requirements 

8 as substance use disorders prevention and treatment 

9 programs under titles V and XIX of the Public 

10 Health Service Act (42 U.S.C. 290aa et seq., 300w 

11 et seq.). 

12 ‘‘(e) INDIAN TRIBES, TRIBAL ORGANIZATIONS, AND

13 URBAN INDIAN ORGANIZATIONS.—The Secretary, in con14 sultation with Indian Tribes, Tribal organizations, and 

15 Urban Indian organizations, shall identify and establish 

16 appropriate mechanisms for Indian Tribes, Tribal organi17 zations, and Urban Indian organizations to demonstrate 

18 or report the information as required under subsections 

19 (b), (c), and (d). 

20 ‘‘(f) REPORT TO CONGRESS.—Not later than Sep21 tember 30, 2024, and biennially thereafter, the Secretary 

22 shall submit to the Committee on Health, Education, 

23 Labor, and Pensions of the Senate and the Committee on 

24 Energy and Commerce of the House of Representatives, 

25 and the Committees on Appropriations of the House of 
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1 Representatives and the Senate, a report that includes a 

2 summary of the information provided to the Secretary in 

3 reports made pursuant to subsections (c) and (e), includ4 ing— 

5 ‘‘(1) the purposes for which grant funds are 

6 awarded under this section; 

7 ‘‘(2) the activities of the grant recipients; and 

8 ‘‘(3) for each State, Indian Tribe, Tribal orga9 nization, and Urban Indian organization that re10 ceives a grant under this section, the funding level 

11 provided to such recipient. 

12 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary, in13 cluding through the Tribal Training and Technical Assist14 ance Center of the Substance Abuse and Mental Health 

15 Services Administration, shall provide States, Indian 

16 Tribes, Tribal organizations, and Urban Indian organiza17 tions, as applicable, with technical assistance concerning 

18 grant application and submission procedures under this 

19 section, award management activities, and enhancing out20 reach and direct support to rural and underserved commu21 nities and providers in addressing substance use disorders. 

22 ‘‘(h) DEFINITIONS.—In this section: 

23 ‘‘(1) INDIAN TRIBE.—The term ‘Indian Tribe’ 

24 has the meaning given the term ‘Indian tribe’ in sec-
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1 tion 4 of the Indian Self-Determination and Edu2 cation Assistance Act (25 U.S.C. 5304). 

3 ‘‘(2) TRIBAL ORGANIZATION.—The term ‘Tribal 

4 organization’ has the meaning given the term ‘tribal 

5 organization’ in such section 4. 

6 ‘‘(3) STATE.—The term ‘State’ has the mean7 ing given such term in section 1954(b) of the Public 

8 Health Service Act (42 U.S.C. 300x–64(b)). 

9 ‘‘(4) URBAN INDIAN ORGANIZATION.—The term 

10 ‘Urban Indian organization’ has the meaning given 

11 such term in section 4 of the Indian Health Care 

12 Improvement Act. 

13 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 

14 ‘‘(1) IN GENERAL.—For purposes of carrying 

15 out the grant program under subsection (b), there is 

16 authorized to be appropriated $1,750,000,000 for 

17 each of fiscal years 2022 through 2027, to remain 

18 available until expended. 

19 ‘‘(2) FEDERAL ADMINISTRATIVE EXPENSES.— 

20 Of the amounts made available for each fiscal year 

21 to award grants under subsection (b), the Secretary 

22 shall not use more than 20 percent for Federal ad23 ministrative expenses, training, technical assistance, 

24 and evaluation. 
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1 ‘‘(3) SET ASIDE.—Of the amounts made avail2 able for each fiscal year to award grants under sub3 section (b) for a fiscal year, the Secretary shall— 

4 ‘‘(A) award 5 percent to Indian Tribes, 

5 Tribal organizations, and Urban Indian organi6 zations; and 

7 ‘‘(B) of the amount remaining after appli8 cation of subparagraph (A), set aside up to 15 

9 percent for awards to States with the highest 

10 age-adjusted rate of drug overdose death based 

11 on the ordinal ranking of States according to 

12 the Director of the Centers for Disease Control 

13 and Prevention.’’. 

Passed the House of Representatives October 20, 

2021. 

Attest: 

Clerk. 
117TH CONGRESS 

1ST SESSION H. R. 2379 

AN ACT 

To amend the 21st Century Cures Act to reauthorother purposes. sponse to the opioid use disorders crisis, and for ize and expand a grant program for State re-