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[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 1410 Introduced in Senate (IS)]

114th CONGRESS
  1st Session
                                S. 1410

To amend the Public Health Service Act to provide grants to improve the 
                 treatment of substance use disorders.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                              May 21, 2015

  Mr. Markey introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL

 
To amend the Public Health Service Act to provide grants to improve the 
                 treatment of substance use disorders.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Treatment and Recovery Investment 
Act''.

SEC. 2. OPIOID TREATMENT AND RECOVERY INITIATIVE.

    Subpart 1 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb et seq.) is amended--
            (1) by redesignating the second section 514 relating to the 
        methamphetamine and amphetamine treatment initiative (42 U.S.C. 
        290bb-9) as section 514B; and
            (2) by adding at the end the following:

``SEC. 514C. OPIOID TREATMENT AND RECOVERY INITIATIVE.

    ``(a) Grants.--
            ``(1) Authority to make grants.--The Director of the Center 
        for Substance Abuse Treatment may award grants to the State 
        agencies responsible for administering funds received under the 
        substance abuse prevention and treatment block grant program 
        under title XIX, units of local government that have a high 
        rate, or have had a rapid increase, in the use of, or death 
        related to the use of, heroin or other opioids, including 
        prescription opioids, and Indian tribes or tribal organizations 
        (as defined in section 4 of the Indian Health Care Improvement 
        Act), in order to permit such entities to expand evidence-based 
        treatment activities and related recovery services in the 
        specific geographical areas of such entities where there exists 
        a need to address the use of, or death related to the use of, 
        heroin or other opioids.
            ``(2) Recipients.--Grants awarded under paragraph (1) shall 
        be directed to the substance abuse directors of the States and 
        the appropriate tribal government authorities of the Indian 
        tribes.
            ``(3) Nature of activities.--Grant funds awarded under 
        paragraph (1) shall be used for activities that are based on 
        reliable scientific evidence of efficacy in the treatment of 
        problems related to the use or misuse of heroin or other 
        opioids.
    ``(b) Geographic Distribution.--The Director shall ensure that 
grants awarded under subsection (a) are distributed equitably among the 
various regions of the United States and among rural, urban, and 
suburban areas that are affected by the use of heroin or other opioids.
    ``(c) Evaluation and Reporting.--A State agency, unit of local 
government, or Indian tribe or tribal organization receiving a grant 
under subsection (a) shall provide the Director with aggregate data and 
other information determined by the Director to be necessary to enable 
the Director--
            ``(1) to evaluate the success of the grant program involved 
        in achieving its purposes; and
            ``(2) to prepare and submit the report to Congress on an 
        annual basis.
    ``(d) Additional Activities.--In carrying out this section, the 
Director shall--
            ``(1) disseminate widely such findings derived from the 
        evaluation conducted under subsection (c) as the Director 
        considers appropriate;
            ``(2) provide States, Indian tribes, and tribal 
        organizations, and health care providers with technical 
        assistance in connection with the provision of evidence-based 
        treatment for problems related to heroin and other opioids; and
            ``(3) give priority to applications for grants under this 
        section that support recovery and related services as a 
        critical component of the grant program, including 
        comprehensive social services that assist with housing, 
        employment, or education.
    ``(e) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $27,000,000 for fiscal year 2016, 
        and such sums as may be necessary for each of fiscal years 2016 
        through 2020.
            ``(2) Use of certain funds.--Of the funds appropriated to 
        carry out this section in any fiscal year under paragraph (1), 
        the lesser of 5 percent of such funds or $1,000,000 shall be 
        available to the Director for purposes of carrying out 
        subsection (c).''.

SEC. 3. GRANTS FOR ENHANCING PRIMARY CARE ACCESS FOR OPIOID DEPENDENT 
              PREGNANT AND PARENTING WOMEN.

    Subpart 1 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb et seq.), as amended by section 2, is further amended by 
adding at the end the following:

``SEC. 514D. GRANTS FOR ENHANCING PRIMARY CARE ACCESS FOR OPIOID 
              DEPENDENT PREGNANT AND PARENTING WOMEN.

    ``(a) In General.--The Director of the Center for Substance Abuse 
Treatment shall award grants to State substance abuse agencies, Indian 
tribes or tribal organizations (as defined in section 4 of the Indian 
Health Care Improvement Act), and public nonprofit entities for the 
purpose of enhancing access to primary care and related services for 
pregnant and parenting women diagnosed with opioid dependence.
    ``(b) Use of Funds.--Amount awarded under a grant under subsection 
(a) may be used to assist health care providers or facilities caring 
for pregnant and parenting opioid dependent women to provide the 
following services:
            ``(1) Clinically appropriate trauma informed gender-
        specific services that are based on reliable scientific 
        evidence of efficacy in the treatment of problems related to 
        substance use disorder.
            ``(2) Prenatal and postpartum care.
            ``(3) Child care for infants and other children under the 
        age of 18 of the opioid dependent woman.
            ``(4) Prevention and wellness services, including nutrition 
        education, exercise instruction, and training in other life and 
        coping skills.
            ``(5) Developmental and therapeutic services for children 
        of opioid dependent woman.
            ``(6) Domestic violence services.
            ``(7) Educational services for women on proper care for 
        newborns with neonatal abstinence syndrome and other clinical 
        indications for newborns related to substance use during 
        pregnancy.
            ``(8) Parenting courses.
            ``(9) HIV/AIDS and Hepatitis C care and services.
            ``(10) Dental services.
            ``(11) Recovery coaches and mentors that can assist in 
        supporting the opioid dependent woman in achieving long term 
        recovery according to the needs of the woman.
            ``(12) Case management services, including assistance in 
        establishing eligibility for public programs, housing 
        assistance, job training, educational or vocational 
        opportunities, transportation, and other related activities.
    ``(c) Length of Grant.--Each grant awarded under subsection (a) 
shall be for a period of 5 years.
    ``(d) Additional Activities.--The Director shall--
            ``(1) collect and evaluate data regarding activities 
        supported by grants awarded under subsection (a);
            ``(2) give priority in awarding grants to applicants that 
        are meeting a geographical need for substance use disorder 
        services for pregnant, postpartum or parenting women; and
            ``(3) give priority in awarding grants to entities that are 
        collaborating with State health care, public health, criminal 
        justice, and child welfare agencies as well as local Federally 
        qualified health centers for the purpose of enhancing access to 
        primary care and related services for pregnant and parenting 
        women diagnosed with opioid dependence.
    ``(e) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $15,000,000 for fiscal year 2016, 
        and such sums as may be necessary for each of fiscal years 2016 
        through 2020.
            ``(2) Use of certain funds.--Of the funds appropriated to 
        carry out this section in any fiscal year, the lesser of 5 
        percent of such funds or $1,000,000 shall be available to the 
        Director for purposes of carrying out subsection (d).''.

SEC. 4. ADOLESCENT TREATMENT PROGRAMS.

    Subpart 1 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb et seq.), as amended by section 3, is further amended by 
adding at the end the following:

``SEC. 514E. GRANTS TO IMPROVE ACCESS TO TREATMENT AND RECOVERY FOR 
              ADOLESCENTS.

    ``(a) In General.--The Secretary, acting through the Director of 
the Center for Substance Abuse Treatment, shall award grants, 
contracts, or cooperative agreements to eligible State substance abuse 
agencies and other entities determined appropriate by the Director for 
the purpose of increasing the capacity of substance use disorder 
treatment and recovery services for adolescents.
    ``(b) Eligibility.--To be eligible to receive a grant, contract, or 
cooperative agreement under subsection (a) an entity shall--
            ``(1) prepare and submit to the Director an application at 
        such time, in such manner, and contain such information as the 
        Director may require, including a plan for the evaluation of 
        any activities carried out with the funds provided under this 
        section;
            ``(2) ensure that all entities receiving support under the 
        grant, contract, or cooperative agreement comply with all 
        applicable State licensure or certification requirements 
        regarding the provision of the services involved; and
            ``(3) provide the Director with periodic evaluations of the 
        progress of the activities funded under this section and an 
        evaluation at the completion of such activities, as the 
        Director determines to be appropriate.
    ``(c) Priority.--In awarding grants, contracts, and cooperative 
agreements under subsection (a), the Director shall give priority to 
applicants who propose to fill a demonstrated geographic need for 
adolescent specific residential treatment services.
    ``(d) Use of Funds.--Amounts awarded under grants, contracts, or 
cooperative agreements under this section may be used to enable health 
care providers or facilities that provide treatment and recovery 
assistance for adolescents with a substance use disorder to provide the 
following services:
            ``(1) Individualized patient centered care that is specific 
        to circumstances of the individual patient.
            ``(2) Clinically appropriate, trauma-informed, gender-
        specific and age appropriate treatment services that are based 
        on reliable scientific evidence of efficacy in the treatment of 
        problems related to substance use disorders.
            ``(3) Clinically appropriate care to address treatment for 
        substance use and any co-occurring physical and mental health 
        disorders at the same location, and through access to primary 
        care services.
            ``(4) Coordination of treatment services with recovery and 
        other social support, including educational, vocational 
        training, assistance with the juvenile justice system, child 
        welfare, and mental health agencies.
            ``(5) Aftercare and long-term recovery support, including 
        peer support services.
    ``(e) Duration of Assistance.--Grants, contracts, and cooperative 
agreements awarded under subsection (a) shall be for a period of not to 
exceed 5 years.
    ``(f) Additional Activities.--The Director shall--
            ``(1) collect and evaluate the activities carried out with 
        amount received under subsection (a);
            ``(2) disseminate widely such significant information 
        derived from the evaluation as the Secretary considers 
        appropriate.
    ``(g) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $25,000,000 for fiscal year 2016, 
        and such sums as may be necessary for each of fiscal years 2016 
        through 2020.
            ``(2) Use of certain funds.--Of the funds appropriated to 
        carry out this section in any fiscal year, the lesser of 5 
        percent of such funds or $1,000,000 shall be available to the 
        Director for purposes of carrying out subsection (f).''.

SEC. 5. GRANTS TO ENHANCE AND EXPAND RECOVERY SUPPORT SERVICES.

    Subpart 1 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb et seq.), as amended by section 4, is further amended by 
adding at the end the following:

``SEC. 514F. GRANTS TO ENHANCE AND EXPAND RECOVERY SUPPORT SERVICES.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Substance Abuse and Mental Health Services Administration, shall 
award grants to State substance abuse agencies and non-profit 
organizations to develop, expand, and enhance recovery support services 
for individuals with substance use disorders.
    ``(b) Eligible Entities.--In the case of an applicant that is not a 
State substance abuse agency, to be eligible to receive a grant under 
this section, the entity shall--
            ``(1) prepare and submit to the Secretary an application at 
        such time, in such manner, and contain such information as the 
        Secretary may require, including a plan for the evaluation of 
        any activities carried out with the funds provided under this 
        section;
            ``(2) demonstrate the inclusion of individuals in recovery 
        from a substance use disorder in leadership levels or governing 
        bodies of the entity;
            ``(3) have as a primary mission the provision of long-term 
        recovery support for substance use disorders; and
            ``(4) be accredited by the Council on the Accreditation of 
        Peer Recovery Support Services or meet any applicable State 
        certification requirements regarding the provision of the 
        recovery services involved.
    ``(c) Use of Funds.--Amounts awarded under a grant under this 
section shall be used to provide for the following activities:
            ``(1) Educating and mentoring that assists individuals and 
        families with substance use disorders in navigating systems of 
        care.
            ``(2) Peer recovery support services which include peer 
        coaching and mentoring.
            ``(3) Recovery-focused community education and outreach 
        programs, including training on the use of all forms of opioid 
        overdose antagonists used to counter the effects of an 
        overdose.
            ``(4) Training, mentoring, and education to develop and 
        enhance peer mentoring and coaching.
            ``(5) Programs aimed at identifying and reducing stigma and 
        discriminatory practices that serve as barriers to substance 
        use disorder recovery and treatment of these disorders.
            ``(6) Developing partnerships between networks that support 
        recovery and other community organizations and services, 
        including--
                    ``(A) public and private substance use disorder 
                treatment programs and systems;
                    ``(B) health care providers;
                    ``(C) recovery-focused addiction and recovery 
                professionals;
                    ``(D) faith-based organizations;
                    ``(E) organizations focused on criminal justice 
                reform;
                    ``(F) schools; and
                    ``(G) social service agencies in the community, 
                including educational, juvenile justice, child welfare, 
                housing and mental health agencies.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $7,000,000 for fiscal year 
2016, and such sums as may be necessary for each of fiscal years 2016 
through 2020.''.

SEC. 6. INCREASING THE AUTHORIZATION OF THE SUBSTANCE ABUSE PREVENTION 
              AND TREATMENT BLOCK GRANT.

    Section 1935(a) of the Public Health Service Act (42 U.S.C. 300x-
35(a)) is amended by striking ``$2,000,000,000 for fiscal year 2001, 
and such sums as may be necessary for each of the fiscal years 2002 and 
2003'' and inserting ``$2,270,000,000 for fiscal year 2016. For each 
fiscal year beginning with fiscal year 2017, there are authorized to be 
so appropriated, an amount equal to the amount authorized for the 
previous fiscal year under this subsection increased by the annual 
percentage increase in the Consumer Price Index for such year''.

SEC. 7. STUDY ON TREATMENT INFRASTRUCTURE.

    Not later than one year after the date of enactment of this Act, 
the Comptroller General of the United States shall initiate an 
evaluation, and submit to Congress a report, of the in-patient and 
outpatient treatment capacity, availability, and needs of the United 
States, which shall include--
            (1) the capacity of acute residential or inpatient 
        detoxification programs;
            (2) the capacity of inpatient clinical stabilization 
        programs, transitional residential support services, and 
        residential rehabilitation programs;
            (3) the capacity of demographic specific residential or 
        inpatient treatment programs, such as those designed for 
        pregnant women or adolescents;
            (4) geographical differences of the availability of 
        residential and outpatient treatment and recovery options for 
        substance use disorders across the continuum of care;
            (5) the availability of residential and outpatient 
        treatment programs that offer treatment options based on 
        reliable scientific evidence of efficacy for the treatment of 
        substance use disorders, including the use of Food and Drug 
        Administration-approved medicines and evidence-based 
        nonpharmacological therapies;
            (6) the number of patients in residential and specialty 
        outpatient treatment services for substance use disorders; and
            (7) an assessment of the need for residential and 
        outpatient treatment for substance use disorders across the 
        continuum of care.
                                 <all>
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