II 

115TH CONGRESS 

2D SESSION S. 2437 

To reauthorize and improve the 21st Century Cures opioid grant program. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 15, 2018 

Ms. BALDWIN (for herself, Mrs. SHAHEEN, Ms. SMITH, Ms. HEITKAMP, Mr. 

BROWN, Ms. HASSAN, Mr. MANCHIN, Ms. WARREN, Ms. KLOBUCHAR, 

Ms. STABENOW, Mr. NELSON, Mr. KING, Mr. CARDIN, Mr. TESTER, Mr. 

KAINE, and Mr. UDALL) introduced the following bill; which was read 

twice and referred to the Committee on Health, Education, Labor, and 

Pensions 

A BILL 

To reauthorize and improve the 21st Century Cures opioid 

grant program. 

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 ‘‘Opioid Response En5 hancement Act’’. 

6 SEC. 2. OPIOID GRANT PROGRAM REAUTHORIZATION. 

7 (a) IN GENERAL.—Section 1003 of the 21st Century 

8 Cures Act (42 U.S.C. 290ee–3 note) is amended— 

9 (1) in subsection (b)— 


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1 (A) in paragraph (2)(A), by adding at the 

2 end the following: 

3 ‘‘(iii) For each of fiscal years 2019 

4 through 2023, $2,000,000,000.’’; and 

5 (B) in paragraph (3)— 

6 (i) in subparagraph (A)— 

7 (I) by striking ‘‘2017 and 2018’’ 

8 and inserting ‘‘2019 through 2023’’; 

9 and 

10 (II) by inserting after ‘‘para11 graph (2)(A),’’ the following: ‘‘and in 

12 each of the fiscal years 2019 through 

13 2023, there is authorized to be appro14 priated from the Account to the Sec15 retary, for the grant program de16 scribed in subsection (c)(3), 

17 $400,000,000,’’; and 

18 (ii) in subparagraph (B), by striking 

19 ‘‘2017 and 2018’’ and inserting ‘‘2019 

20 through 2023’’; 

21 (2) in subsection (c)— 

22 (A) in paragraph (1)— 

23 (i) by inserting ‘‘and Tribal entities’’ 

24 after ‘‘grants to States’’; 


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1 (ii) by inserting ‘‘and Tribal entities’’ 

2 after ‘‘preference to States’’; and 

3 (iii) by inserting ‘‘or Tribal entities’’ 

4 before the period at the end; 

5 (B) in paragraph (2)— 

6 (i) in the matter preceding subpara7 graph (A)— 

8 (I) by inserting ‘‘, including ac9 tivities supported by community-based 

10 organizations and counties,’’ after 

11 ‘‘carrying out activities’’; and 

12 (II) by striking ‘‘to a State’’; 

13 (ii) in subparagraph (E), by inserting 

14 ‘‘or Tribal entity’’ after ‘‘State’’ each place 

15 that such term appears; and 

16 (iii) by adding at the end the fol17 lowing: 

18 ‘‘(F) In addition to carrying out activities 

19 related to addressing the opioid epidemic, a 

20 State or Tribal entity may use grants awarded 

21 under this section for carrying out public-health 

22 activities related to addressing other substance 

23 abuse, as determined appropriate and as deter24 mined to be a substantial or similar public 


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1 health threat as the opioid epidemic by the 

2 State or Tribal entity.’’; and 

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

4 ‘‘(3) TARGETED RESPONSE ENHANCEMENT

5 GRANTS.— 

6 ‘‘(A) IN GENERAL.—Subject to the avail7 ability of appropriations, the Secretary shall use 

8 50 percent of the amount transferred under 

9 subsection (b)(2)(A)(iii) in each fiscal year to 

10 award supplemental funding grants to at least 

11 10 States and Tribal entities, to expand and en12 hance grant activities required under this sub13 section. In awarding such grants, the Secretary 

14 shall give preference to areas of greatest need, 

15 including as indicated by higher mortality rates 

16 associated with opioid overdoses. 

17 ‘‘(B) USE OF FUNDS.—Grants awarded to 

18 a State or Tribal entity under this paragraph 

19 shall be used for carrying out activities to sup20 plement activities otherwise carried out under 

21 this subsection to expand and enhance preven22 tion, treatment, and recovery support efforts in 

23 States and Tribal entities hardest hit by the 

24 opioid epidemic, which may include public 

25 health-related activities such as the following: 


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1 ‘‘(i) Expansion of evidence-based 

2 strategies for the provision of prevention, 

3 treatment, and recovery support services 

4 for individuals with opioid use disorders. 

5 ‘‘(ii) Expansion and enhancement of 

6 integrated systems of care, including the 

7 co-location of services to address the pri8 mary and behavioral healthcare needs of 

9 individuals with opioid use disorders. 

10 ‘‘(iii) Expansion of efforts to dis11 tribute overdose reversal drugs and edu12 cate first responders and other relevant 

13 community members on the use of such 

14 drugs to prevent overdose-related deaths. 

15 ‘‘(iv) Expansion of any activity au16 thorized under the State or Tribal entity 

17 grant under paragraph (1) to address the 

18 State’s or Tribal entity’s specific needs re19 lated to combatting the opioid crisis. 

20 ‘‘(4) SET ASIDE.—Of the amount made avail21 able for each fiscal year to award grants under para22 graph (1), not less than 10 percent of such amount 

23 in each such fiscal year shall be provided to Tribal 

24 entities.’’; 


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1 (3) by redesignating subsections (d) through (f) 

2 as subsections (e) through (g), respectively; 

3 (4) by inserting after subsection (c), the fol4 lowing: 

5 ‘‘(d) TECHNICAL ASSISTANCE.—The Secretary shall 

6 provide State agencies and Tribal entities, as applicable 

7 through the Tribal Training and Technical Assistance 

8 Center, with technical assistance concerning— 

9 ‘‘(1) application and submission procedures and 

10 award management activities; 

11 ‘‘(2) enhancing outreach and direct support to 

12 rural and underserved communities and providers in 

13 addressing the opioid crisis; and 

14 ‘‘(3) strengthening data collection data sharing 

15 activities to help improve surveillance.’’; 

16 (5) in subsection (e) (as so redesignated), by in17 serting ‘‘shall prioritize providing such funds directly 

18 to local communities and counties to address the 

19 opioid crisis in areas of unmet need and’’ after ‘‘sub20 section (c)’’; and 

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

22 ‘‘(h) TRIBAL ENTITY.—In this section, the term 

23 ‘Tribal entity’ means an Indian tribe (as defined in section 

24 4 of the Indian Self-Determination and Education Assist25 ance Act (25 U.S.C. 5304)), a tribal organization (as deVerDate Sep 11 2014 21:10 Feb 23, 2018 Jkt 079200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2437.IS S2437

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1 fined in such section), or a consortium of such a tribe and 

2 organization.’’. 

3 (b) ADDITIONAL AMOUNTS FOR FISCAL YEAR

4 2018.—In addition to amounts otherwise made available 

5 for grants under section 1003(c) of the 21st Century 

6 Cures Act (42 U.S.C. 290ee–3 note) for fiscal year 2018, 

7 there are appropriated $1,500,000,000 for such grants in 

8 such fiscal year, of which, $500,000,000 shall be used for 

9 grants under section 1003(c)(3) of such Act. 

Æ 


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