II 

117TH CONGRESS 

1ST SESSION S. 2238 

To amend the Public Health Service Act to reauthorize and extend the 

Fetal Alcohol Spectrum Disorders Prevention and Services program, and 

for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 24, 2021 

Ms. MURKOWSKI (for herself and Ms. KLOBUCHAR) 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 reauthorize and 

extend the Fetal Alcohol Spectrum Disorders Prevention 

and Services program, and for other purposes. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Advancing FASD Re5 search, Services and Prevention Act’’ or the ‘‘FASD Re6 spect Act’’. 

7 SEC. 2. FINDINGS. 

8 Congress finds as follows: 


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1 (1) Fetal Alcohol Spectrum Disorders (referred 

2 to in this section as ‘‘FASD’’), is a serious and com3 plex public health issue impacting individuals, fami4 lies, and communities throughout the United States, 

5 regardless of race, sex, culture, or geography. This 

6 Act provides an opportunity for our Nation to ex7 plore strategies to not only prevent the adverse ef8 fects of prenatal alcohol exposure (referred to in this 

9 section as ‘‘PAE’’) but heal individual, historical, 

10 and cultural traumas. 

11 (2) Exposure to alcohol has long-lasting con12 sequences for a developing fetus, which may lead to 

13 a range of life-long physical, mental, social, and 

14 emotional problems. There is no known safe amount 

15 of alcohol use during pregnancy or while trying to 

16 get pregnant. There is also no safe time during 

17 pregnancy to drink. All types of alcohol are equally 

18 harmful, including all wines and beer. 

19 (3) The most recent prevalence study identified 

20 as many as 1 in 20 first graders across the country 

21 are affected by PAE. Given that nearly 45 percent 

22 of pregnancies are unintended and women often 

23 don’t know that they are pregnant until they are 6 

24 weeks along or more, it’s easy to understand how a 

25 woman could drink alcohol while expecting. Research 


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1 shows that solely focusing on individual women’s be2 havior as FASD prevention strategy perpetuates 

3 stigma and blame on biological mothers, individuals 

4 impacted by FASD, and the condition itself. 

5 (4) Although research shows that white, college6 educated, middle- to upper-class women are the most 

7 likely group to drink during pregnancy, one of the 

8 common misnomers about FASD is that it is an ‘‘in9 digenous issue’’. Continued surveillance, stigmatiza10 tion, and stereotyping of Indigenous populations 

11 may contribute to the misbelief that FASD is over12 represented in these communities. 

13 (5) In their recent landmark survey, ‘‘Lay of 

14 the Land: Equality vs Equity’’, the FASD Change15 makers, comprised of young adults with FASD, doc16 umented the social determinants of health that lead 

17 to the detrimental health disparities people with 

18 FASD often endure, including victimization result19 ing in incarceration, homelessness, reduced access to 

20 health care, vulnerabilities to substance misuse, and 

21 unemployment. 

22 (6) The higher prevalence of FASD in criminal 

23 justice and foster care systems has been docu24 mented. Nearly 1 out of 4 children in juvenile cor25 rections has FASD, and prevalence estimates among 


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1 children in the foster care systems range from 23 

2 percent to 60 percent. Prevalence in adult correc3 tions ranges from 11 percent to 25 percent. 

4 (7) The National Academy of Medicine rec5 ommendations for a broad Federal response formed 

6 the basis of the Fetal Alcohol Syndrome and Fetal 

7 Alcohol Effect Prevention and Services Act of 1998 

8 that authorized $27,000,000 for a National Task 

9 Force on Fetal Alcohol Syndrome and grant pro10 grams at the National Institute on Alcohol Abuse 

11 and Alcoholism, the Centers for Disease Control and 

12 Prevention, and the Substance Abuse and Mental 

13 Health Services Administration. 

14 (8) In 2009, the National Task Force on Fetal 

15 Alcohol Syndrome reported FASD diagnostic capac16 ity and FASD-informed services insufficient in the 

17 United States, resulting in countless individuals with 

18 FASD remaining unrecognized or misdiagnosed. 

19 (9) Despite PAE remaining the leading pre20 ventable cause of birth defects and 

21 neurodevelopmental disabilities in the United States, 

22 the authority for the National Task Force on Fetal 

23 Alcohol Syndrome expired, SAMHSA funding for 

24 FASD ended in 2015, and other Federal and State 

25 FASD-related funding declined. 


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1 (10) FASD is preventable. Although there is no 

2 cure for individuals impacted by FASD, research 

3 shows that intervention services and supports that 

4 include social, environmental, and educational strate5 gies can prevent subsequent trauma to the indi6 vidual, the individual’s caregivers, and society. 

7 (11) Building coordinated State and Tribal 

8 FASD systems of care that offer integrated cul9 turally appropriate services and supports grounded 

10 in best practices can mitigate the harms created by 

11 historical and cultural trauma. 

12 SEC. 3. PROGRAMS FOR FETAL ALCOHOL SPECTRUM DIS13 ORDERS. 

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

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

16 by striking section 399H and inserting the following: 

17 ‘‘SEC. 399H. PROGRAMS FOR FETAL ALCOHOL SPECTRUM 

18 DISORDERS. 

19 ‘‘(a) DEFINITION.—In this part— 

20 ‘‘(1) the term ‘fetal alcohol spectrum disorders’ 

21 or ‘FASD’ means diagnosable developmental disabil22 ities of a broad range of neurodevelopmental and 

23 physical effects that result from prenatal exposure to 

24 alcohol. The effects may include lifelong physical, 

25 mental, behavioral, social and learning disabilities, 


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1 and other problems that impact daily functioning 

2 (such as living independently or holding a job), as 

3 well as overall health and well-being; and 

4 ‘‘(2) the terms ‘Indian Tribe’ and ‘Tribal orga5 nization’ have the meanings given the terms ‘Indian 

6 tribe’ and ‘tribal organization’ in section 4 of the In7 dian Self-Determination and Education Assistance 

8 Act. 

9 ‘‘(b) RESEARCH ON FETAL ALCOHOL SPECTRUM

10 DISORDERS AND RELATED CONDITIONS.— 

11 ‘‘(1) IN GENERAL.—The Secretary, acting 

12 through the Director of the National Institutes of 

13 Health, shall— 

14 ‘‘(A) establish a research program for 

15 FASD; and 

16 ‘‘(B) award grants, contracts, or coopera17 tive agreements to public or private nonprofit 

18 entities to pay all or part of carrying out re19 search under such research program. 

20 ‘‘(2) TYPES OF RESEARCH.—In carrying out 

21 paragraph (1), the Secretary, acting through the Di22 rector of the National Institute on Alcohol Abuse 

23 and Alcoholism (referred to in this section as the 

24 ‘Director of the Institute’), shall continue to conduct 

25 and expand national and international research in 


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1 consultation with other Federal agencies and outside 

2 partners that includes— 

3 ‘‘(A) the most promising avenues of re4 search in FASD diagnosis, intervention, and 

5 prevention; 

6 ‘‘(B) factors that may mitigate the effects 

7 of prenatal alcohol and other substance expo8 sure including culturally relevant factors and 

9 social determinants of health; and 

10 ‘‘(C) other research that the Director of 

11 the Institute determines to be appropriate with 

12 respect to conditions that develop as a result of 

13 prenatal alcohol and other substance exposure. 

14 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

15 To carry out this subsection, there is authorized to 

16 be appropriated $30,000,000 for each of fiscal years 

17 2022 through 2027. 

18 ‘‘(c) SURVEILLANCE, PUBLIC HEALTH RESEARCH, 

19 AND PREVENTION ACTIVITIES.— 

20 ‘‘(1) IN GENERAL.—The Secretary, acting 

21 through the Director of the National Center on 

22 Birth Defects and Developmental Disabilities of the 

23 Centers for Disease Control and Prevention, shall 

24 facilitate surveillance, public health research, and 


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1 prevention of FASD in accordance with this sub2 section. 

3 ‘‘(2) SURVEILLANCE, PUBLIC HEALTH RE4 SEARCH AND PREVENTION.—In carrying out this 

5 subsection, the Secretary shall— 

6 ‘‘(A) integrate into surveillance practice an 

7 evidence-based standard case definition for fetal 

8 alcohol syndrome and, in collaboration with 

9 other Federal and outside partners, support or10 ganizations of appropriate medical and mental 

11 health professionals in their development and 

12 refinement of evidence-based clinical diagnostic 

13 guidelines and criteria for all fetal alcohol spec14 trum disorders; 

15 ‘‘(B) disseminate and provide the nec16 essary training and support to appropriate med17 ical and mental health professionals on the 

18 early identification of children with prenatal al19 cohol or other substance exposure as such chil20 dren may require ongoing developmental and 

21 behavioral surveillance by their primary health 

22 care clinician which continues throughout their 

23 lifetime to access ongoing treatment and refer24 ral problems; 


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1 ‘‘(C) support applied public health preven2 tion research to identify culturally-appropriate 

3 or evidence-based strategies for reducing alcohol 

4 and other substance exposed pregnancies in 

5 women at high risk of such pregnancies; 

6 ‘‘(D) disseminate and provide the nec7 essary training and support to implement cul8 turally-appropriate or evidence-based strategies 

9 developed under subparagraph (C) to— 

10 ‘‘(i) hospitals, Federally-qualified 

11 health centers, residential and outpatient 

12 substance disorder treatment programs, 

13 and other appropriate health care pro14 viders; 

15 ‘‘(ii) educational settings; 

16 ‘‘(iii) social work and child protection 

17 service providers; 

18 ‘‘(iv) foster care providers and adop19 tion agencies; 

20 ‘‘(v) State or Tribal offices and other 

21 agencies providing services to individuals 

22 with disabilities; 

23 ‘‘(vi) mental health treatment facili24 ties; 


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1 ‘‘(vii) Indian Tribes and Tribal orga2 nizations; 

3 ‘‘(viii) military medical treatment fa4 cility described in section 1073d(c) of title 

5 10, United States Code, and medical cen6 ters of the Department of Veterans Af7 fairs; and 

8 ‘‘(ix) other entities that the Secretary 

9 determines to be appropriate; 

10 ‘‘(E) conduct activities related to risk fac11 tor surveillance; 

12 ‘‘(F) disseminate and evaluate brief behav13 ioral intervention strategies and referrals aimed 

14 at preventing alcohol and substance-exposed 

15 pregnancies among women of childbearing age 

16 in special settings, including clinical primary 

17 health centers, outpatient clinics, child welfare 

18 agencies, and correctional facilities and recovery 

19 campuses; 

20 ‘‘(G) document the FASD lived experience 

21 and incorporate the perspectives of individuals 

22 and their family members affected by FASD 

23 and birth mothers of individuals with FASD in 

24 the dissemination of information and resources; 


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1 ‘‘(H) disseminate comprehensive alcohol 

2 and pregnancy and FASD information, re3 sources, and services to families and caregivers, 

4 professionals, and the public through an estab5 lished national network of affiliated FASD or6 ganizations and through organizations serving 

7 medical, behavioral health, addiction, disability, 

8 education, legal and other professionals; and 

9 ‘‘(I) coordinate FASD activities with affili10 ated State, Tribal and local systems and organi11 zations with respect to the prevention of alcohol 

12 and other substance-exposed pregnancies. 

13 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

14 To carry out this subsection, there is authorized to 

15 be appropriated $13,000,000 for each of fiscal years 

16 2022 through 2027. 

17 ‘‘(d) BUILDING STATE AND TRIBAL FASD SYS18 TEMS.— 

19 ‘‘(1) IN GENERAL.—The Secretary, acting 

20 through the Administrator of the Health Resources 

21 and Services Administration, shall award grants, 

22 contracts, or cooperative agreements to States and 

23 Indian Tribes for the purpose of establishing ongo24 ing comprehensive and coordinated State and Tribal 

25 FASD multidisciplinary, diverse coalitions to— 


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1 ‘‘(A) develop systems of care for— 

2 ‘‘(i) the prevention of FASD and 

3 other adverse conditions as a result of pre4 natal substance exposure; and 

5 ‘‘(ii) the identification, treatment and 

6 support of individuals with FASD or other 

7 adverse conditions from prenatal substance 

8 exposure and support for their families; 

9 ‘‘(B) provide leadership and support in es10 tablishing, expanding or increasing State and 

11 Tribal systems capacity in addressing FASD 

12 and other adverse conditions as a result of pre13 natal substance exposure; and 

14 ‘‘(C) update or develop implementing and 

15 evaluating State and Tribal FASD strategic 

16 plans to— 

17 ‘‘(i) establish or expand State and 

18 Tribal programs of surveillance, screening, 

19 assessment, diagnosis, prevention of FASD 

20 and other physical or neurodevelopmental 

21 disabilities from prenatal substance expo22 sure; 

23 ‘‘(ii) integrate programs related to 

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1 cohol and other substance exposure into 

2 existing State and Tribal coordinated sys3 tems of care which focus on the social de4 terminants of health, including systemic 

5 racism, access to the Medicare program 

6 under title XVIII of the Social Security 

7 Act or to the Medicaid program under title 

8 XIX of such Act, maternal and early child9 hood health, economic security, food and 

10 housing, education, justice and corrections, 

11 mental health, substance use disorder, 

12 child welfare, developmental disabilities, 

13 and health care; 

14 ‘‘(iii) identify across-the-lifetime 

15 issues for individuals and families related 

16 to FASD and other adverse conditions re17 lated to prenatal substance exposure, in18 cluding historical and cultural trauma, 

19 child abuse and neglect, mental health and 

20 substance use disorder; and 

21 ‘‘(iv) identify systemic and other bar22 riers to the integration of prenatal alcohol 

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1 isting systems of care for individuals and 

2 families. 

3 ‘‘(2) ELIGIBILITY.—To be eligible to receive a 

4 grant, contract, or cooperative agreement under 

5 paragraph (1), a State, an Indian Tribe, a Tribal or6 ganization, or a State-Tribal collaborative (referred 

7 to in this paragraph as an ‘eligible entity’) shall pre8 pare and submit to the Secretary an application at 

9 such time, in such manner, and containing such in10 formation as the Secretary may require, including— 

11 ‘‘(A) evidence that the eligible entity des12 ignated in the application have or will have au13 thority to implement programs described in this 

14 subsection; and 

15 ‘‘(B) evidence of the establishment of a 

16 State or Tribal FASD Advisory Group of State 

17 agencies or Tribal entities and, if available, a 

18 State affiliate of the National Organization on 

19 Fetal Alcohol Syndrome or similar Tribal or 

20 statewide FASD advocacy organization, to pro21 vide the leadership in building State or Tribal 

22 capacity in addressing prenatal alcohol and 

23 other substance exposure, including FASD pre24 vention, identification, and intervention activi25 ties and programming, including— 


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1 ‘‘(i) the formation of a FASD advi2 sory coalition of diverse, public and private 

3 representatives from multiple disciplines 

4 that may include— 

5 ‘‘(I) State agencies or Tribal en6 tities that are responsible for health, 

7 human services, corrections, edu8 cation, housing, developmental disabil9 ities, substance use disorder, child 

10 welfare, juvenile and adult justice sys11 tems, mental health and any other 

12 agency related to the adverse social 

13 impact of prenatal alcohol and other 

14 substance exposures; and 

15 ‘‘(II) public and private sector 

16 stakeholders, including individuals 

17 with FASD and their caretakers and 

18 entities that work with or provide 

19 services or support for individuals 

20 with FASD and their families, such as 

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1 sionals, and other entities that ad2 dress individual, family, community 

3 and society issues related to prenatal 

4 alcohol and other substance exposure 

5 throughout an individual’s lifespan; 

6 and 

7 ‘‘(ii) the development of a State or 

8 Tribal strategic plan that— 

9 ‘‘(I) contains recommendations, 

10 action steps, and deliverables for im11 proving social determinants of health; 

12 ‘‘(II) recommends actions for 

13 prevention of FASD and other condi14 tions related to prenatal substance ex15 posure; 

16 ‘‘(III) integrates culturally-appro17 priate, best practices or evidence18 based practices on screening, identi19 fication and treatment into existing 

20 systems of care; 

21 ‘‘(IV) provides for FASD-in22 formed clinical and therapeutic inter23 ventions; 

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1 ilies and individuals with FASD and 

2 other conditions from prenatal sub3 stance exposure across their lifetimes; 

4 ‘‘(VI) identifies— 

5 ‘‘(aa) existing FASD or 

6 other programs related to pre7 natal substance exposures in the 

8 State or Indian Tribe, includ9 ing— 

10 ‘‘(AA) FASD primary, 

11 secondary and tertiary pre12 vention programs; 

13 ‘‘(BB) prenatal screen14 ing, assessment or diag15 nostic services; and 

16 ‘‘(CC) support and 

17 service programs for individ18 uals with FASD and their 

19 families; 

20 ‘‘(bb) existing State, local, 

21 and Tribal programs, systems, 

22 and funding streams that could 

23 be used to identify and assist in24 dividuals with FASD and other 

25 conditions related to substance 


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1 exposed pregnancies, and prevent 

2 prenatal exposure to alcohol and 

3 other harmful substances; 

4 ‘‘(cc) barriers to providing 

5 FASD diagnostic services or pro6 grams to assist individuals with 

7 FASD or reducing alcohol and 

8 substance exposed pregnancies 

9 for women at risk for alcohol or 

10 other substance exposed preg11 nancies, and recommendations to 

12 reduce or eliminate such barriers; 

13 and 

14 ‘‘(dd) barriers to FASD pre15 vention, screening, assessment, 

16 identification, and treatment pro17 grams and to the provision of 

18 FASD-informed support services 

19 and accommodations across the 

20 lifespan, and recommendations to 

21 reduce or eliminate such barriers; 

22 ‘‘(VII) integrates a public-private 

23 partnership of State, Tribal, and local 

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1 tems of care approach that addresses 

2 social determinants of health, includ3 ing systemic racism on health out4 comes, economic security, food and 

5 housing; education, justice, and health 

6 care challenges experienced by individ7 uals who have been diagnosed with 

8 FASD or other conditions as result of 

9 prenatal substance exposure; 

10 ‘‘(VIII) describes programs of 

11 surveillance, screening, assessment 

12 and diagnosis, prevention, clinical 

13 intervention and therapeutic and other 

14 supports and services for individuals 

15 with FASD and their families; 

16 ‘‘(IX) recognizes the impact of 

17 historical, cultural, and other trauma 

18 of individuals in the design and appli19 cation of all programming; and 

20 ‘‘(X) recognizes the lived experi21 ences of birth mothers and those with 

22 FASD and their families in the design 

23 and application of all programming. 

24 ‘‘(3) RESTRICTIONS ON AND USE OF FUNDS.— 

25 Amounts received under a grant, contract, or cooperVerDate Sep 11 2014 22:21 Jul 15, 2021 Jkt 019200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\S2238.IS S2238

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1 ative agreement under this subsection shall be used 

2 for one or more of the following activities: 

3 ‘‘(A) Establishing or increasing diagnostic 

4 capacity in the State or Indian Tribe to meet 

5 the estimated prevalence needs of the State or 

6 Indian Tribe’s FASD population. 

7 ‘‘(B) Providing educational and supportive 

8 services to individuals with FASD and other 

9 conditions related to prenatal substance expo10 sure and their families. 

11 ‘‘(C) Establishing a FASD statewide sur12 veillance system. 

13 ‘‘(D) Including FASD information in State 

14 medical and mental health care and education 

15 programs at schools of higher education. 

16 ‘‘(E) Collecting, analyzing, and inter17 preting data. 

18 ‘‘(F) Replicating culturally-aware or best 

19 practice FASD prevention programs, including 

20 case-management models for pregnant or par21 enting women with alcohol and other substance 

22 use disorders. 

23 ‘‘(G) Training of primary care and other 

24 providers in screening for prenatal alcohol and 

25 other substance exposure in prenatal, pediatric, 


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1 early childhood or other child or teenage check2 up settings. 

3 ‘‘(H) Developing, implementing, and evalu4 ating population-based and targeted prevention 

5 programs for FASD, including public awareness 

6 campaigns. 

7 ‘‘(I) Increasing capacity of the State or In8 dian Tribe to deliver housing, economic and 

9 food security services to adults impacted by 

10 FASD or other conditions related to prenatal 

11 substance exposure. 

12 ‘‘(J) Referring individuals with FASD and 

13 other conditions related to prenatal substance 

14 exposure to appropriate FASD-informed sup15 port services. 

16 ‘‘(K) Providing for State and Tribal FASD 

17 coordinators. 

18 ‘‘(L) Providing training to health care (in19 cluding mental health care) providers on the 

20 prevention, identification and treatment of 

21 FASD and other conditions related to prenatal 

22 substance exposure across the lifespan. 

23 ‘‘(M) Providing training to education, jus24 tice, and social service system professionals to 


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1 become FASD-informed and FASD-engaged in 

2 their practices. 

3 ‘‘(N) Including FASD in training for 

4 workforce development and disability accessi5 bility. 

6 ‘‘(O) Supporting peer-to-peer certification 

7 programs for individuals with FASD. 

8 ‘‘(P) Developing FASD-informed certifi9 cation programs. 

10 ‘‘(Q) Disseminating information about 

11 FASD and other conditions related to prenatal 

12 substance exposure and the availability of sup13 port services to families and individuals with 

14 FASD and other adverse conditions related to 

15 prenatal substance exposure. 

16 ‘‘(R) Implementing recommendations from 

17 relevant agencies and organizations, including 

18 the State or Tribal FASD advisory group, on 

19 the identification and prevention of FASD, 

20 intervention programs or services for individuals 

21 with FASD and their families. 

22 ‘‘(S) Other activities, as the Secretary de23 termines appropriate or as recommended by the 

24 National Advisory Council on FASD under sec25 tion 399H–1. 


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1 ‘‘(4) OTHER CONTRACTS AND AGREEMENTS.— 

2 A State may carry out activities under paragraph 

3 (3) through contracts or cooperative agreements 

4 with another State or an Indian Tribe, and with 

5 public, private for-profit or nonprofit entities with a 

6 demonstrated expertise in FASD and other condi7 tions related to prenatal substance exposure preven8 tion, screening and diagnosis, or intervention serv9 ices. 

10 ‘‘(5) REPORT TO CONGRESS.—Not later than 2 

11 years after the date on which amounts are first ap12 propriated under paragraph (6), the Secretary shall 

13 prepare and submit to the Committee on Health, 

14 Education, Labor, and Pensions of the Senate and 

15 the Committee on Energy and Commerce of the 

16 House of Representatives a report that contains a 

17 description of programs carried out under this sec18 tion. At a minimum, the report shall contain— 

19 ‘‘(A) information concerning the number of 

20 States receiving grants; 

21 ‘‘(B) State and Tribal FASD diagnostic 

22 capacity and barriers to achieving diagnostic ca23 pacity based on State FASD surveillance data 

24 or the most recent estimated prevalence of 

25 FASD in the United States; 


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1 ‘‘(C) information concerning systemic or 

2 other barriers to screening for prenatal alcohol 

3 and other substance exposure in existing sys4 tems of care, including— 

5 ‘‘(i) the child welfare system; 

6 ‘‘(ii) maternal and early child health 

7 care and alcohol and other substance use 

8 disorder treatment programs; 

9 ‘‘(iii) primary or secondary education 

10 systems; and 

11 ‘‘(iv) juvenile and adult systems of 

12 justice; 

13 ‘‘(D) information concerning existing 

14 State, Tribal, local government or community 

15 programs and systems of care and funding 

16 streams that could be used to identify and as17 sist individuals with FASD and other conditions 

18 related to substance exposed pregnancies and 

19 the degree to which such programs are FASD20 informed or to which there are systemic or 

21 other barriers preventing their use; and 

22 ‘‘(E) information concerning existing 

23 State, Tribal, local government or community 

24 primary, tertiary, or secondary prevention proVerDate Sep 11 2014 22:21 Jul 15, 2021 Jkt 019200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\S2238.IS S2238

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1 grams on prenatal exposure to alcohol and 

2 other harmful prenatal substances. 

3 ‘‘(6) AUTHORIZATION OF APPROPRIATIONS.— 

4 ‘‘(A) IN GENERAL.—To carry out this sub5 section, there is authorized to be appropriated 

6 $32,000,000 for each of fiscal years 2022 

7 through 2027. 

8 ‘‘(B) ADMINISTRATIVE AND EMPLOYMENT

9 EXPENSES.—Of the amount appropriated for a 

10 fiscal year under subparagraph (A), 

11 $12,000,000 shall be allocated to States and 

12 Indian Tribes for purposes of covering adminis13 trative costs and supporting the employment of 

14 FASD State and Tribal coordinators. 

15 ‘‘(C) TRIBAL SET ASIDE.—Up to 20 per16 cent of the grants, contracts, or cooperative 

17 agreements awarded under this subsection shall 

18 be reserved for Indian Tribes and Tribal orga19 nizations. 

20 ‘‘(e) PROMOTING COMMUNITY PARTNERSHIPS.— 

21 ‘‘(1) IN GENERAL.—The Secretary, acting 

22 through the Administrator of Health Resources and 

23 Services Administration, shall award grants, con24 tracts, or cooperative agreements to eligible entities 

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1 prove community partnerships for the purpose of 

2 collaborating on common objectives and integrating 

3 culturally-appropriate best practice services available 

4 to individuals with FASD and other conditions re5 lated to prenatal substance exposure such as surveil6 lance, screening, assessment, diagnosis, prevention, 

7 treatment, and support services. 

8 ‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re9 ceive a grant, contract, or cooperative agreement 

10 under paragraph (1), an entity shall— 

11 ‘‘(A) be a public or private nonprofit entity 

12 that is— 

13 ‘‘(i) a health care provider or health 

14 professional; 

15 ‘‘(ii) a primary or secondary school; 

16 ‘‘(iii) a social work or child protection 

17 service provider; 

18 ‘‘(iv) an incarceration facility, or 

19 State or local judicial system for juveniles 

20 and adults; 

21 ‘‘(v) an FASD organization, parent22 led group, or other organization that sup23 ports and advocates for individuals with 

24 FASD and their families; 


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1 ‘‘(vi) an Indian Tribe or Tribal orga2 nization; 

3 ‘‘(vii) an early childhood intervention 

4 facility; 

5 ‘‘(viii) any other entity the Secretary 

6 determines to be appropriate; or 

7 ‘‘(ix) a consortium of any of the enti8 ties described in clauses (i) through (viii); 

9 and 

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

11 an application at such time, in such manner, 

12 and containing such information as the Sec13 retary may require, including assurances that 

14 the entity submitting the application does, at 

15 the time of application, or will, within a reason16 able amount of time from the date of applica17 tion, provide evidence of substantive participa18 tion with a broad range of entities that work 

19 with or provide services for individuals with 

20 FASD. 

21 ‘‘(3) ACTIVITIES.—An eligible entity shall use 

22 amounts received under a grant, contract, or cooper23 ative agreement under this subsection to carry out 

24 one or more of the following activities relating to 


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1 FASD and other conditions related to prenatal sub2 stance exposure: 

3 ‘‘(A) Integrating FASD-informed and cul4 turally-appropriate practices into existing pro5 grams and services available in the community. 

6 ‘‘(B) Conducting a needs assessment to 

7 identify services that are not available in a com8 munity. 

9 ‘‘(C) Developing and implementing cul10 turally-appropriate, community-based initiatives 

11 to prevent FASD, and to screen, assess, diag12 nose, treat, and provide FASD-informed sup13 port services to individuals with FASD and 

14 their families. 

15 ‘‘(D) Disseminating information about 

16 FASD and the availability of support services. 

17 ‘‘(E) Developing and implementing a com18 munity-wide public awareness and outreach 

19 campaign focusing on the dangers of drinking 

20 alcohol while pregnant. 

21 ‘‘(F) Providing mentoring or other support 

22 to individuals with FASD and their families. 

23 ‘‘(G) Other activities, as the Secretary de24 termines appropriate, or in consideration of rec25 ommendations from the National Advisory 


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1 Council on FASD established under section 

2 399H–1. 

3 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

4 To carry out this subsection, there is authorized to 

5 be appropriated $5,000,000 for each of fiscal years 

6 2022 through 2027. 

7 ‘‘(f) DEVELOPMENT OF BEST PRACTICES AND MOD8 ELS OF CARE.— 

9 ‘‘(1) IN GENERAL.—The Secretary, in coordina10 tion with the Administrator of Health Resources and 

11 Services Administration, shall award grants to 

12 States, Indian Tribes and Tribal organizations, non13 governmental organizations, and institutions of high14 er education for the establishment of pilot projects 

15 to identify and implement culturally-appropriate best 

16 practices for— 

17 ‘‘(A) providing intervention and education 

18 of children with FASD, including— 

19 ‘‘(i) activities and programs designed 

20 specifically for the identification, treat21 ment, and education of such children; and 

22 ‘‘(ii) curricula development and 

23 credentialing of teachers, administrators, 

24 and social workers who implement such 


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1 programs and provide childhood interven2 tions; 

3 ‘‘(B) educating professionals within the 

4 child welfare, juvenile and adult criminal justice 

5 systems, including judges, attorneys, probation 

6 officers, social workers, child advocates, medical 

7 and mental health professionals, substance 

8 abuse professionals, law enforcement officers, 

9 prison wardens or other incarceration adminis10 trators, and administrators of developmental 

11 disability, mental health and alternative incar12 ceration facilities on how to screen, assess, 

13 identify, treat and support individuals with 

14 FASD or similar conditions related to prenatal 

15 substance exposure within these systems, in16 cluding— 

17 ‘‘(i) programs designed specifically for 

18 the identification, assessment, treatment, 

19 and education of individuals with FASD; 

20 and 

21 ‘‘(ii) curricula development and 

22 credentialing within the adult and juvenile 

23 justice and child welfare systems for indi24 viduals who implement such programs; 


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1 ‘‘(C) educating adoption or foster care 

2 agency officials about available and necessary 

3 services for children with FASD, including— 

4 ‘‘(i) programs designed specifically for 

5 screening, assessment and identification, 

6 treatment, and education of individuals 

7 with FASD; and 

8 ‘‘(ii) ongoing and consistent education 

9 and training for potential adoptive or fos10 ter parents of a child with FASD; 

11 ‘‘(D) educating health and mental health 

12 and substance use providers about available and 

13 necessary services for children with FASD, in14 cluding— 

15 ‘‘(i) programs designed specifically for 

16 screening and identification, and both 

17 health and mental health treatment, of in18 dividuals with FASD; and 

19 ‘‘(ii) curricula development and 

20 credentialing within the health and mental 

21 health and substance abuse systems for in22 dividuals who implement such programs; 

23 and 

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1 ducing alcohol and other substance exposed 

2 pregnancies in women at high risk of such preg3 nancies. 

4 ‘‘(2) APPLICATION.—To be eligible for a grant 

5 under paragraph (1), an entity shall prepare and 

6 submit to the Secretary an application at such time, 

7 in such manner, and containing such information as 

8 the Secretary may require. 

9 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

10 To carry out this subsection, there is authorized to 

11 be appropriated $5,000,000 for each of fiscal years 

12 2022 through 2027. 

13 ‘‘(g) TRANSITIONAL SERVICES.— 

14 ‘‘(1) IN GENERAL.—The Secretary, in coordina15 tion with the Administrator of the Health Resources 

16 and Services Administration and the Administrator 

17 of the Administration for Community Living, shall 

18 award demonstration grants, contracts, and coopera19 tive agreements to States and local units of govern20 ment, Indian Tribes and Tribal organizations, and 

21 nongovernmental organizations for the purpose of 

22 establishing integrated systems for providing cul23 turally-appropriate best practice transitional services 

24 for adults affected by prenatal alcohol or substance 


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1 exposure and evaluating the effectiveness of such 

2 services. 

3 ‘‘(2) APPLICATION.—To be eligible for a grant, 

4 contract, or cooperative agreement under paragraph 

5 (1), an entity shall prepare and submit to the Sec6 retary an application at such time, in such manner, 

7 and containing such information as the Secretary 

8 may reasonably require, including specific creden9 tials relating to education, skills, training, and con10 tinuing educational requirements relating to FASD. 

11 ‘‘(3) ALLOWABLE USES.—An entity shall use 

12 amounts received under a grant, contract, or cooper13 ative agreement under paragraph (1) to carry out 

14 one or more of the following activities: 

15 ‘‘(A) Provide housing assistance to, or spe16 cialized housing for, adults with FASD. 

17 ‘‘(B) Provide FASD-informed vocational 

18 training and placement services for adults with 

19 FASD. 

20 ‘‘(C) Provide medication monitoring serv21 ices for adults with FASD. 

22 ‘‘(D) Provide FASD-informed training and 

23 support to organizations providing family serv24 ices or mental health programs and other orga25 nizations that work with adults with FASD. 


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1 ‘‘(E) Establish and evaluate housing mod2 els specially designed for adults with FASD. 

3 ‘‘(F) Recruit, train and provide mentors 

4 for individuals with FASD. 

5 ‘‘(G) Other services or programs, as the 

6 Secretary determines appropriate. 

7 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

8 To carry out this subsection, there is authorized to 

9 be appropriated $5,000,000 for each of fiscal years 

10 2022 through 2027. 

11 ‘‘(h) SERVICES FOR INDIVIDUALS WITH FETAL AL12 COHOL SPECTRUM DISORDERS.— 

13 ‘‘(1) IN GENERAL.—The Secretary, in coordina14 tion with the Assistant Secretary for Mental Health 

15 and Substance Use, shall make awards of grants, co16 operative agreements, or contracts to public and 

17 nonprofit private entities, including Indian tribes 

18 and tribal organizations, to provide FASD-informed 

19 culturally-appropriate services to individuals with 

20 FASD. 

21 ‘‘(2) USE OF FUNDS.—An award under para22 graph (1) may, subject to paragraph (4), be used 

23 to— 

24 ‘‘(A) screen and test individuals to deter25 mine the type and level of services needed; 


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1 ‘‘(B) develop a FASD-informed com2 prehensive plan for providing services to the in3 dividuals; 

4 ‘‘(C) provide FASD-informed mental 

5 health counseling; 

6 ‘‘(D) provide FASD-informed substance 

7 abuse prevention services and treatment, if 

8 needed; 

9 ‘‘(E) coordinate services with other social 

10 programs including social services, justice sys11 tem, educational services, health services, men12 tal health and substance abuse services, finan13 cial assistance programs, vocational services 

14 and housing assistance programs; 

15 ‘‘(F) provide FASD-informed vocational 

16 services; 

17 ‘‘(G) provide FASD-informed health coun18 seling; 

19 ‘‘(H) provide FASD-informed housing as20 sistance; 

21 ‘‘(I) conduct FASD-informed parenting 

22 skills training; 

23 ‘‘(J) develop and implement overall FASD24 informed case management; 


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1 ‘‘(K) provide supportive services for fami2 lies of individuals with FASD; 

3 ‘‘(L) provide respite care for caretakers of 

4 individuals with FASD; 

5 ‘‘(M) recruit, train and provide mentors 

6 for individuals with FASD; 

7 ‘‘(N) provide FASD-informed educational 

8 and supportive services to families of individ9 uals with FASD; and 

10 ‘‘(O) provide other services and programs, 

11 to the extent authorized by the Secretary after 

12 consideration of recommendations made by the 

13 National Advisory Council on FASD. 

14 ‘‘(3) REQUIREMENTS.—To be eligible to receive 

15 an award under paragraph (1), an applicant shall— 

16 ‘‘(A) demonstrate that the program will be 

17 part of a coordinated, comprehensive system of 

18 care for such individuals; 

19 ‘‘(B) demonstrate an established commu20 nication with other social programs in the com21 munity including social services, justice system, 

22 financial assistance programs, health services, 

23 educational services, mental health and sub24 stance abuse services, vocational services and 

25 housing assistance services; 


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1 ‘‘(C) have a qualified staff of medical, 

2 mental health or other professionals with a his3 tory of working with individuals with FASD; 

4 ‘‘(D) provide assurance that the services 

5 will be provided in a culturally and linguistically 

6 appropriate manner; and 

7 ‘‘(E) provide assurance that at the end of 

8 the 5-year award period, other mechanisms will 

9 be identified to meet the needs of the individ10 uals and families served under such award. 

11 ‘‘(4) RELATIONSHIP TO PAYMENTS UNDER

12 OTHER PROGRAMS.—An award may be made under 

13 paragraph (1) only if the applicant involved agrees 

14 that the award will not be expended to pay the ex15 penses of providing any service under this section to 

16 an individual to the extent that payment has been 

17 made, or can reasonably be expected to be made, 

18 with respect to such expenses— 

19 ‘‘(A) under any State compensation pro20 gram, under an insurance policy, or under any 

21 Federal or State or Tribal health benefits pro22 grams; or 

23 ‘‘(B) by an entity that provides health 

24 services on a prepaid basis. 


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1 ‘‘(5) DURATION OF AWARDS.—With respect to 

2 any award under paragraph (1), the period during 

3 which payments under such award are made to the 

4 recipient may not exceed 5 years. 

5 ‘‘(6) EVALUATION.—The Secretary shall evalu6 ate each project carried out under paragraph (1) 

7 and shall disseminate the findings with respect to 

8 each such evaluation to appropriate public and pri9 vate entities, including the National Advisory Coun10 cil on FASD. 

11 ‘‘(7) FUNDING.— 

12 ‘‘(A) AUTHORIZATION OF APPROPRIA13 TIONS.—For the purpose of carrying out this 

14 subsection, there is authorized to be appro15 priated $10,000,000 for each fiscal years 2022 

16 through 2027. 

17 ‘‘(B) ALLOCATION.—Of the amounts ap18 propriated under subparagraph (A) for a fiscal 

19 year, not more than $300,000 shall, for the 

20 purposes relating to FASD, be made available 

21 for collaborative, coordinated interagency ef22 forts with the National Institute on Alcohol 

23 Abuse and Alcoholism, National Institute on 

24 Mental Health, the Eunice Kennedy Shriver 

25 National Institute of Child Health and Human 


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1 Development, the Health Resources and Serv2 ices Administration, the Agency for Healthcare 

3 Research and Quality, the Administration for 

4 Community Living, the Centers for Disease 

5 Control and Prevention, the Department of 

6 Education, the Department of Justice, and 

7 other agencies, as determined by the Secretary. 

8 Interagency collaborative efforts may include— 

9 ‘‘(i) the evaluation of existing pro10 grams for efficacy; 

11 ‘‘(ii) the development of new evidence12 based or best practice programs for pre13 vention of prenatal alcohol and other sub14 stance exposure, and interventions for indi15 viduals with FASD and their families; 

16 ‘‘(iii) the facilitation of translation 

17 and transition of existing evidence-based, 

18 best practices or culturally-appropriate 

19 prevention and intervention programs into 

20 general and community practice; and 

21 ‘‘(iv) engaging in Tribal consultation 

22 to ensure that Indian Tribes and Tribal or23 ganizations are able to develop culturally24 appropriate services and interventions for 

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1 sure, and interventions for individuals with 

2 FASD and other conditions related to pre3 natal substance exposure and their fami4 lies.’’. 

5 SEC. 4. NATIONAL ADVISORY COUNCIL ON FSAD. 

6 Part O of title III of the Public Health Service Act 

7 (42 U.S.C. 280f et seq.), as amended by section 2, is fur8 ther amended by inserting after section 339H the fol9 lowing: 

10 ‘‘SEC. 399H–1. NATIONAL ADVISORY COUNCIL ON FASD. 

11 ‘‘(a) IN GENERAL.—The Secretary shall establish an 

12 advisory council to be known as the National Advisory 

13 Council on FASD (referred to in this section as the ‘Coun14 cil’) to foster coordination and cooperation among all Fed15 eral and non-Federal members and their constituencies 

16 that conduct or support FASD and other conditions re17 lated to prenatal substance exposure research, programs, 

18 and surveillance, and otherwise meet the general needs of 

19 populations actually or potentially impacted by FASD and 

20 other conditions related to prenatal substance exposure. 

21 ‘‘(b) MEMBERSHIP.—The Council shall be composed 

22 of 23 members as described in paragraphs (1) and (2). 

23 ‘‘(1) FEDERAL MEMBERSHIP.—Members of the 

24 Council shall include representatives of the following 

25 Federal agencies: 


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1 ‘‘(A) The National Institute on Alcohol 

2 Abuse and Alcoholism. 

3 ‘‘(B) The National Institute on Drug 

4 Abuse. 

5 ‘‘(C) The Centers for Disease Control and 

6 Prevention. 

7 ‘‘(D) The Health Resources and Services 

8 Administration. 

9 ‘‘(E) The Substance Abuse and Mental 

10 Health Services Agency. 

11 ‘‘(F) The Office of Special Education and 

12 Rehabilitative Services. 

13 ‘‘(G) The Office of Justice Programs. 

14 ‘‘(H) The Indian Health Service. 

15 ‘‘(I) The Interagency Coordinating Com16 mittee on Fetal Alcohol Spectrum Disorders. 

17 ‘‘(J) The Agency for Healthcare Research 

18 and Quality. 

19 ‘‘(2) NON-FEDERAL MEMBERS.—Additional 

20 non-Federal public and private sector members of 

21 the Council shall be nominated by the Interagency 

22 Coordinating Committee on Fetal Alcohol Spectrum 

23 Disorders and appointed by the Secretary, and shall 

24 be staffed by the Office of the Assistant Secretary 

25 for Planning and Evaluation of the Department of 


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1 Health and Human Services. Such members shall in2 clude— 

3 ‘‘(A) at least one individual with FASD or 

4 a parent or legal guardian of an individual with 

5 FASD; 

6 ‘‘(B) at least one individual or a parent or 

7 legal guardian of an individual with a condition 

8 related to prenatal substance exposure; 

9 ‘‘(C) at least one birth mother of an indi10 vidual with FASD; 

11 ‘‘(D) at least one representative from the 

12 FASD Study Group of the Research Society on 

13 Alcoholism; 

14 ‘‘(E) at least one representative of the Na15 tional Organization on Fetal Alcohol Syndrome; 

16 ‘‘(F) at least one representative of a lead17 ing statewide advocacy and service organization 

18 for individuals with FASD and their families; 

19 ‘‘(G) at least one representative of the 

20 FASD Center for Excellence established under 

21 section 399H–3; 

22 ‘‘(H) at least 2 representatives from State 

23 or Tribal advisory groups receiving an award 

24 under section 399H(d); and 


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1 ‘‘(I) representatives with interest and ex2 pertise in FASD from the private sector of pe3 diatricians, obstetricians and gynecologists, sub4 stance abuse and mental health care providers, 

5 family and juvenile court judges and justice and 

6 corrections programming and services, or spe7 cial education and social work professionals. 

8 ‘‘(3) APPOINTMENT TIMING.—The members of 

9 the Council described in paragraph (2) shall be ap10 pointed by the Secretary not later than 6 months 

11 after the date of enactment of the Advancing FASD 

12 Research, Services and Prevention Act. 

13 ‘‘(c) FUNCTIONS.—The Council shall— 

14 ‘‘(1) advise Federal, State, Tribal and local pro15 grams and research concerning FASD and other 

16 conditions related to prenatal substance exposure, 

17 including programs and research concerning edu18 cation and public awareness for relevant service pro19 viders, reducing the incidence of prenatal alcohol 

20 and other substance exposure in pregnancies, med21 ical and mental diagnosis, interventions for women 

22 at-risk of giving birth with FASD and beneficial 

23 services and supports for individuals with FASD and 

24 their families; 


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1 ‘‘(2) coordinate its efforts with the Interagency 

2 Committee on Fetal Alcohol Spectrum Disorders; 

3 ‘‘(3) develop a summary of advances in FASD 

4 research related to prevention, treatment, screening, 

5 diagnosis, and interventions; 

6 ‘‘(4) make recommendations for the FASD re7 search program to the Director of the National In8 stitute of Alcohol Abuse and Alcoholism; 

9 ‘‘(5) review the 2009 report of the National 

10 Task Force on FAS entitled, ‘A Call to Action’ and 

11 other reports on FASD and the adverse impact of 

12 prenatal substance exposure; 

13 ‘‘(6) develop a summary of advances in practice 

14 and programs relevant to FASD prevention, treat15 ment, early screening, diagnosis, and interventions; 

16 and 

17 ‘‘(7) make recommendations on a national 

18 agenda to reduce the prevalence and the associated 

19 impact of FASD and other conditions related to pre20 natal substance exposure and improve the quality of 

21 life of individuals and families impacted by FASD or 

22 the adverse effects of prenatal substance exposure, 

23 including— 

24 ‘‘(A) proposed Federal budgetary require25 ments for FASD research and related services 


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1 and support activities for individuals with 

2 FASD; 

3 ‘‘(B) recommendations to ensure that 

4 FASD research, and services and support ac5 tivities to the extent practicable, of the Depart6 ment of Health and Human Services and of 

7 other Federal departments and agencies, are 

8 not unnecessarily duplicative; 

9 ‘‘(C) identification of existing Federal pro10 grams that could be used to identify and assist 

11 individuals with FASD and other conditions re12 lated to substance exposed pregnancies; 

13 ‘‘(D) identification of gaps or barriers for 

14 individuals living with, or impacted by, FASD 

15 in accessing diagnostic, early intervention, and 

16 support services; 

17 ‘‘(E) identification of prevention strategies, 

18 including education campaigns and options, 

19 such as product warnings and other mecha20 nisms to raise awareness of the risks associated 

21 with prenatal alcohol consumption; 

22 ‘‘(F) identification of current diagnostic 

23 methods and practices for the identification of 

24 FASD and identify gaps or barriers for achiev25 ing diagnostic capacity throughout the United 


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1 States based on current estimated prevalence of 

2 FASD; 

3 ‘‘(G) recommendations for research or 

4 other measures to increase diagnostic capacity 

5 to meet the needs of the estimated number of 

6 individuals with FASD; 

7 ‘‘(H) identification and enhancement of 

8 culturally-appropriate or best practice ap9 proaches and models of care to reduce the inci10 dence of FASD; and 

11 ‘‘(I) identification and enhancement of best 

12 practice approaches and models of care to in13 crease support and treat individuals with 

14 FASD, and to make recommendations for a 

15 broad model comprehensive community ap16 proach to the overall problem of prenatal alco17 hol and other harmful substance exposure. 

18 ‘‘(d) REPORT TO CONGRESS AND THE PRESIDENT.— 

19 The Council shall submit to Congress and to the Presi20 dent— 

21 ‘‘(1) an update on the summary of advances de22 scribed in paragraphs (3) and (6) of subsection (c), 

23 not later than 2 years after the date of enactment 

24 of the Advancing FASD Research, Services and Pre25 vention Act; 


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1 ‘‘(2) an update to the national agenda described 

2 in subsection (c)(7), including any progress made in 

3 achieving the objectives outlined in such agenda, not 

4 later than 4 years after the date of enactment of 

5 such Act; and 

6 ‘‘(3) a final report that provides a summary of 

7 advances described in paragraphs (3) and (6) of sub8 section (c), and an update to the national agenda 

9 described in subsection (c)(7), not later than Sep10 tember 30, 2027. 

11 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

12 is authorized to be appropriated to carry out this section 

13 $2,000,000 for each of fiscal years 2022 through 2027.’’. 

14 SEC. 5. INTERAGENCY COORDINATING COMMITTEE ON 

15 FETAL ALCOHOL SPECTRUM DISORDERS. 

16 Subpart 14 of part C of title IV of the Public Health 

17 Service Act (42 U.S.C. 285n et seq.) is amended by adding 

18 at the end the following: 

19 ‘‘SEC. 464K. INTERAGENCY COORDINATING COMMITTEE ON 

20 FETAL ALCOHOL SPECTRUM DISORDERS. 

21 ‘‘(a) IN GENERAL.—The Director of the Institute 

22 shall provide for the continuation of the ‘Interagency Co23 ordinating Committee on Fetal Alcohol Spectrum Dis24 orders’ (referred to in this section as the ‘Committee’) so 

25 that such Committee may— 


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1 ‘‘(1) coordinate activities conducted by the Fed2 eral Government on FASD, including convening 

3 meetings, establishing work groups, sharing informa4 tion, and facilitating and promoting collaborative 

5 projects among Federal agencies, the National Advi6 sory Council on FASD established under section 

7 399H–1, and outside partners; 

8 ‘‘(2) support organizations of appropriate med9 ical and mental health professionals in their develop10 ment and refinement of evidence-based clinical diag11 nostic guidelines and criteria for all fetal alcohol 

12 spectrum disorders in collaboration with other Fed13 eral and outside partners, and 

14 ‘‘(3) develop priority areas considering rec15 ommendations from the National Advisory Council 

16 on FASD. 

17 ‘‘(b) MEMBERSHIP.—Members of the Committee 

18 shall include representatives of the following Federal agen19 cies: 

20 ‘‘(1) The National Institute on Alcohol Abuse 

21 and Alcoholism. 

22 ‘‘(2) The Centers for Disease Control and Pre23 vention. 

24 ‘‘(3) The Health Resources and Services Ad25 ministration. 


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1 ‘‘(4) The Office of the Assistant Secretary for 

2 Planning and Evaluation. 

3 ‘‘(5) The Office of Juvenile Justice and Delin4 quency Prevention. 

5 ‘‘(6) Office of Justice Programs of the Depart6 ment of Justice. 

7 ‘‘(7) The Substance Abuse and Mental Health 

8 Services Administration. 

9 ‘‘(8) The Office of Special Education and Reha10 bilitation Services. 

11 ‘‘(9) The National Institute on Drug Abuse. 

12 ‘‘(10) The National Institute of Mental Health. 

13 ‘‘(11) The Indian Health Service. 

14 ‘‘(12) The Eunice Kennedy Shriver National 

15 Institute of Child Health and Human Development. 

16 ‘‘(13) Other Federal agencies with responsibil17 ities related to FASD prevention or treatment or 

18 that interact with individuals with FASD, including 

19 education and correctional systems, alcohol and sub20 stance use disorder prevention and treatment pro21 grams, maternal health, the Medicare and Medicaid 

22 programs under titles XVIII and XIX, respectively, 

23 of the Social Security Act, child health and welfare, 

24 rehabilitative services, and labor and housing grant 

25 or entitlement programs. 


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1 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to carry out this section 

3 $1,000,000 for each of fiscal years 2022 through 2027.’’. 

4 SEC. 6. FASD CENTER FOR EXCELLENCE. 

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

6 Health Service Act (42 U.S.C. 280f et seq.), as amended 

7 by section 4, is further amended by inserting after section 

8 339H–2 the following: 

9 ‘‘SEC. 399H–2. FASD CENTER FOR EXCELLENCE. 

10 ‘‘(a) IN GENERAL.—The Secretary, acting through 

11 the Administrator of the Health Resources and Services 

12 Administration, and in consultation with the Assistant 

13 Secretary for Mental Health and Substance Use, the Di14 rector of the Centers for Disease Control, and the Chair 

15 of the Interagency Coordinating Committee on Fetal Alco16 hol Spectrum Disorders, shall award up to 4 grants, coop17 erative agreements, or contracts to public or nonprofit en18 tities with demonstrated expertise in FASD prevention, 

19 identification, and intervention services and other adverse 

20 conditions related to prenatal substance exposure. Such 

21 awards shall be for the purposes of establishing a FASD 

22 Center for Excellence to build local, Tribal, State, and na23 tional capacities to prevent the occurrence of FASD and 

24 other adverse conditions related to exposure to substances, 

25 and to respond to the needs of individuals with FASD and 


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1 their families by carrying out the programs described in 

2 subsection (b). 

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

4 under subsection (a) may use such award for any of the 

5 following programs: 

6 ‘‘(1) INCREASING FASD DIAGNOSTIC CAPAC7 ITY.—Initiating or expanding diagnostic capacity of 

8 FASD by increasing screening, assessment, identi9 fication, and diagnosis in settings such as clinical 

10 practices, educational settings, child welfare, and ju11 venile out-of-home placement facilities and adult cor12 rectional systems. 

13 ‘‘(2) PUBLIC AWARENESS.—Developing and 

14 supporting national public awareness and outreach 

15 activities, including the use of all types of media and 

16 public outreach, and the formation of a diverse 

17 speakers bureau to raise public awareness of the 

18 risks associated with alcohol consumption during 

19 pregnancy with the purpose of reducing the preva20 lence of FASD and improving the quality of life for 

21 those living with FASD and their families. 

22 ‘‘(3) RESOURCES AND TRAINING.— 

23 ‘‘(A) CLEARINGHOUSE.—Acting as a clear24 inghouse for resources on FASD prevention, 

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1 tices, including the maintenance of a national 

2 data-based directory on FASD-specific services 

3 in States, Indian Tribes, and local communities. 

4 ‘‘(B) INTERNET-BASED CENTER.—Pro5 viding an internet-based center that dissemi6 nates ongoing research and resource develop7 ment on FASD in administering systems of 

8 care for individuals with FASD across their 

9 lifespan. 

10 ‘‘(C) INTERVENTION SERVICES AND BEST

11 PRACTICES.—Increasing awareness and under12 standing of efficacious FASD screening tools 

13 and culturally-appropriate intervention services 

14 and best practices by— 

15 ‘‘(i) maintaining a diverse national 

16 speakers bureau; and 

17 ‘‘(ii) conducting national, regional, 

18 State, Tribal, or peer cross-State webinars, 

19 workshops, or conferences for training 

20 community leaders, medical and mental 

21 health and substance abuse professionals, 

22 education and disability professionals, fam23 ilies, law enforcement personnel, judges, 

24 individuals working in financial assistance 

25 programs, social service personnel, child 


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1 welfare professionals, and other service 

2 providers. 

3 ‘‘(D) BUILDING CAPACITY.—Building ca4 pacity for State, Tribal, and local affiliates 

5 dedicated to FASD awareness, prevention, and 

6 identification and family and individual support 

7 programs and services. 

8 ‘‘(4) TECHNICAL ASSISTANCE.—Providing tech9 nical assistance to— 

10 ‘‘(A) communities for replicating and 

11 adapting exemplary comprehensive systems of 

12 care for individuals with FASD developed under 

13 section 399H(d) and for replicating and adapt14 ing culturally-appropriate best or model projects 

15 of care developed under section 399H(f); 

16 ‘‘(B) States and Indian Tribes in devel17 oping statewide or Tribal FASD strategic 

18 plans, establishing or expanding statewide pro19 grams of surveillance, screening and diagnosis, 

20 prevention, and clinical intervention, and sup21 port for individuals with FASD and their fami22 lies under section 399H(d); and 

23 ‘‘(C) Indian Tribes and Tribal organiza24 tions in engaging in tribal consultation to en25 sure that such Tribes and Tribal organizations 


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1 are able to develop culturally-appropriate serv2 ices and interventions for individuals with 

3 FASD and other conditions related to prenatal 

4 substance exposure and their families. 

5 ‘‘(5) OTHER FUNCTIONS.—Carrying out other 

6 functions, to the extent authorized by the Secretary, 

7 after consideration of recommendations of the Na8 tional Advisory Council on FASD. 

9 ‘‘(c) APPLICATION.—To be eligible for a grant, con10 tract, or cooperative agreement under this section, an enti11 ty shall submit to the Secretary an application at such 

12 time, in such manner, and containing such information as 

13 the Secretary may require, including specific credentials 

14 relating to FASD expertise and experience relevant to the 

15 application’s proposed activity, including development of 

16 FASD public awareness activities and resources; FASD 

17 resource development, dissemination, and training; coordi18 nation of FASD-informed services, technical assistance, 

19 administration of FASD partner networks, and other 

20 FASD-specific expertise. 

21 ‘‘(d) SUBCONTRACTING.—A public or private non22 profit may carry out the activities under subsection (a) 

23 through contracts or cooperative agreements with other 

24 public and private nonprofit entities with demonstrated ex25 pertise in— 


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1 ‘‘(1) FASD prevention activities; 

2 ‘‘(2) FASD screening and identification; 

3 ‘‘(3) FASD resource, development, dissemina4 tion, training and technical assistance, administra5 tion and support of FASD partner networks; and 

6 ‘‘(4) intervention services. 

7 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

8 is authorized to be appropriated to carry out this section 

9 $8,000,000 for each of fiscal years 2022 through 2027.’’. 

10 SEC. 7. DEPARTMENT OF EDUCATION AND DEPARTMENT 

11 OF JUSTICE PROGRAMS. 

12 (a) PREVENTION, IDENTIFICATION, INTERVENTION, 

13 AND SERVICES IN THE EDUCATION SYSTEM.— 

14 (1) GENERAL RULE.—The Secretary of Edu15 cation shall address education-related issues with re16 spect to children with FASD, in accordance with 

17 this subsection. 

18 (2) SPECIFIC RESPONSIBILITIES.—The Sec19 retary of Education shall direct the Office of Special 

20 Education and Rehabilitative Services to— 

21 (A) support the development, collection, 

22 and dissemination (through the internet website 

23 of the Department of Education, at teacher-to24 teacher workshops, through in-service trainings, 

25 and through other means) of culturally approVerDate Sep 11 2014 22:21 Jul 15, 2021 Jkt 019200 PO 00000 Frm 00055 Fmt 6652 Sfmt 6201 E:\BILLS\S2238.IS S2238

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1 priate best practices that are FASD-informed 

2 in the education and support of children with 

3 FASD (including any special techniques on how 

4 to assist these children in both special and tra5 ditional educational settings, and including such 

6 practices that incorporate information con7 cerning the identification, behavioral supports, 

8 teaching, and learning associated with FASD) 

9 to— 

10 (i) education groups such as the Na11 tional Association of School Boards, the 

12 National Education Association, the Amer13 ican Federation of Teachers, the National 

14 Association of Elementary School Prin15 cipals, the National Association of Sec16 ondary School Principals and national 

17 groups of special education teachers; 

18 (ii) recipients of a grant under the 

19 21st Century Community Learning Center 

20 program established under part B of title 

21 IV of the Elementary and Secondary Edu22 cation Act of 1965 (20 U.S.C. 7171 et 

23 seq.) and other after school program per24 sonnel; and 


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1 (iii) parent teacher associations, par2 ent information and training centers, and 

3 other appropriate parent education organi4 zations; 

5 (B) ensure that, in administering the Indi6 viduals with Disabilities Education Act (20 

7 U.S.C. 1400 et seq.), parents, educators, and 

8 advocates for children with disabilities are 

9 aware that children with FASD have the right 

10 to access general curriculum under the least re11 strictive environment; 

12 (C) collaborate with other Federal agencies 

13 to include information or activities relating to 

14 prenatal alcohol and other harmful substance 

15 exposure in programs related to maternal 

16 health and health education; and 

17 (D) support efforts by peer advisory net18 works of adolescents in schools to discourage 

19 the use of alcohol and other harmful substances 

20 while pregnant or when considering getting 

21 pregnant. 

22 (3) DEFINITION.—For purposes of this sub23 section, the term ‘‘FASD’’ has the meaning given 

24 such term in section 399H(a) of the Public Health 

25 Service Act, as added by section 3. 


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1 (4) AUTHORIZATION OF APPROPRIATIONS.— 

2 There are authorized to be appropriated to carry out 

3 this subsection $5,000,000 for each of fiscal years 

4 2022 through 2027. 

5 (b) PREVENTION, IDENTIFICATION, INTERVENTION

6 AND SERVICES IN THE JUSTICE SYSTEM.— 

7 (1) IN GENERAL.—The Attorney General shall 

8 address justice-related issues with respect to youth 

9 and adults with FASD and other 

10 neurodevelopmental conditions as a result of pre11 natal substance exposure, in accordance with this 

12 subsection. 

13 (2) REQUIREMENTS.—The Attorney General, 

14 acting through the Office of Juvenile Justice and 

15 Delinquency Prevention and the Bureau of Justice 

16 Initiatives, shall— 

17 (A) develop screening and assessment pro18 cedures and conduct trainings on demonstration 

19 FASD surveillance projects in adult and juve20 nile correction facilities in collaboration with 

21 the National Center on Birth Defects and De22 velopmental Disabilities and assistance from ap23 propriate medical and mental health profes24 sionals; 


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1 (B) provide culturally appropriate support 

2 and technical assistance to justice systems pro3 fessionals in developing training curricula on 

4 how to most effectively identify and interact 

5 with individuals with FASD or similar 

6 neurodevelopmental disorders in the adult and 

7 juvenile justice systems, and such support may 

8 include providing information about the preven9 tion, assessment, identification and treatment 

10 of these disorders into justice professionals’ 

11 credentialing or continuing education require12 ments; 

13 (C) provide culturally appropriate technical 

14 assistance to adult and juvenile systems in ad15 dressing the integration of prenatal alcohol and 

16 substance exposure history into existing vali17 dated screening and assessment instruments; 

18 (D) provide culturally appropriate tech19 nical assistance and support on the education of 

20 justice system professionals, including judges, 

21 attorneys, probation officers, child advocates, 

22 law enforcement officers, prison wardens and 

23 other incarceration officials, medical and mental 

24 health professionals, and administrators of de25 velopmental disability, mental health and alterVerDate Sep 11 2014 22:21 Jul 15, 2021 Jkt 019200 PO 00000 Frm 00059 Fmt 6652 Sfmt 6201 E:\BILLS\S2238.IS S2238

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1 native incarceration facilities on how to screen, 

2 assess, identify, treat, respond and support in3 dividuals with FASD and other conditions as a 

4 result of substance exposure within the justice 

5 systems, including— 

6 (i) programs designed specifically for 

7 the identification, assessment, treatment, 

8 and education of those with FASD; 

9 (ii) curricula development and 

10 credentialing of teachers, administrators, 

11 and social workers who implement such 

12 programs; and 

13 (iii) how FASD and other 

14 neurodevelopmental disorders impact an 

15 individual’s interaction with law enforce16 ment and whether diversionary sentencing 

17 options are more appropriate for such indi18 viduals; 

19 (E) conduct a study on the practices and 

20 procedures within the criminal justice system 

21 for identifying and treatment of juvenile and 

22 adult offenders with neurodevelopmental dis23 abilities, such as FASD, the impact of FASD 

24 on offenders’ cognitive skills and adaptive func25 tioning, and identify alternative culturally apVerDate Sep 11 2014 22:21 Jul 15, 2021 Jkt 019200 PO 00000 Frm 00060 Fmt 6652 Sfmt 6201 E:\BILLS\S2238.IS S2238

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1 propriate methods of treatment and incarcer2 ation that have been demonstrated to be more 

3 effective for such offenders; and 

4 (F) collaborate with professionals with 

5 FASD expertise and implement FASD-in6 formed transition programs for adults and juve7 niles with FASD who are released from adult 

8 and juvenile correctional facilities. 

9 (3) ACCESS FOR BOP INMATES.—The Attorney 

10 General shall direct the Reentry Services Division at 

11 the Bureau of Prisons to ensure that each inmate 

12 with FASD or a similar neurodevelopmental disorder 

13 who is in the custody of the Bureau of Prisons have 

14 access to FASD-informed culturally appropriate 

15 services upon re-entry, including programs, re16 sources, and activities for adults with FASD, to fa17 cilitate the successful reintegration into their com18 munities upon release. 

19 (4) AUTHORIZATION OF APPROPRIATIONS.—For 

20 the purpose of carrying out this subsection, there 

21 are authorized to be appropriated $2,000,000 for 

22 each of fiscal years 2022 through 2027. 

23 (c) DEFINITION.—For purposes of this section, the 

24 term ‘‘FASD’’ has the meaning given such term in section 


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1 399H(a) of the Public Health Service Act, as amended 

2 by section 3. 

Æ 


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