II

105TH CONGRESS

1ST SESSION S. 1466

To amend the Public Health Service Act to permit faith-based substance

abuse treatment centers to receive Federal assistance, to permit individuals receiving Federal drug treatment assistance to select private and

religiously oriented treatment, and to protect the rights of individuals

from being required to receive religiously oriented treatment.

IN THE SENATE OF THE UNITED STATES

NOVEMBER 8, 1977

Mr. ABRAHAM (for himself, Mr. HUTCHINSON, and Mr. COATS) introduced the

following bill; which was read twice and referred to the Committee on

Labor and Human Resources

A BILL

To amend the Public Health Service Act to permit faithbased substance abuse treatment centers to receive Federal assistance, to permit individuals receiving Federal

drug treatment assistance to select private and religiously oriented treatment, and to protect the rights

of individuals from being required to receive religiously

oriented treatment.

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

2 This Act may be cited as the ‘‘The Effective Sub3 stance Abuse Treatment Act’’.

4 SEC. 2. PREVENTION AND TREATMENT OF SUBSTANCE

5 ABUSE; SERVICES PROVIDED THROUGH RELI6 GIOUS ORGANIZATIONS.

7 Title V of the Public Health Service Act (42 U.S.C.

8 290aa et seq.) is amended by adding at the end the follow9 ing:

10 ‘‘PART G—SERVICES PROVIDED THROUGH RELIGIOUS

11 ORGANIZATIONS

12 ‘‘SEC. 581. APPLICABILITY TO DESIGNATED PROGRAMS.

13 ‘‘(a) DESIGNATED PROGRAMS.—Subject to sub14 section (b), this part applies to each program under this

15 Act that makes awards of Federal financial assistance to

16 public or private entities for the purpose of carrying out

17 activities to prevent or treat substance abuse (in this part

18 referred to as a ‘designated program’). Designated pro19 grams include the program under subpart II of part B

20 of title XIX (relating to formula grants to the States).

21 ‘‘(b) LIMITATION.—This part does not apply to any

22 award of Federal financial assistance under a designated

23 program for a purpose other than the purpose specified

24 in subsection (a).

25 ‘‘(c) DEFINITIONS.—For purposes of this part (and

26 subject to subsection (b)):
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1 ‘‘(1) DESIGNATED AWARD RECIPIENT.—The

2 term ‘designated award recipient’ means a public or

3 private entity that has received an award under a

4 designated program (whether the award is a des5 ignated direct award or a designated subaward).

6 ‘‘(2) DESIGNATED DIRECT AWARD.—The term

7 ‘designated direct award’ means an award under a

8 designated program that is received directly from

9 the Federal Government.

10 ‘‘(3) DESIGNATED SUBAWARD.—The term ‘des11 ignated subaward’ means an award of financial as12 sistance made by a non-Federal entity, which award

13 consists in whole or in part of Federal financial as14 sistance provided through an award under a des15 ignated program.

16 ‘‘(4) DESIGNATED PROGRAM.—The term ‘des17 ignated program’ has the meaning given such term

18 in subsection (a).

19 ‘‘(5) FINANCIAL ASSISTANCE.—The term ‘fi20 nancial assistance’ means a grant, cooperative agree21 ment, contract, or voucherized assistance.

22 ‘‘(6) PROGRAM BENEFICIARY.—The term ‘pro23 gram beneficiary’ means an individual who receives

24 program services.
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1 ‘‘(7) PROGRAM PARTICIPANT.—The term ‘pro2 gram participant’ has the meaning given such term

3 in section 582(a)(2).

4 ‘‘(8) PROGRAM SERVICES.—The term ‘program

5 services’ means treatment for substance abuse, or

6 preventive services regarding such abuse, provided

7 pursuant to an award under a designated program.

8 ‘‘(9) RELIGIOUS ORGANIZATION.—The term ‘re9 ligious organization’ means a nonprofit religious or10 ganization.

11 ‘‘(10) VOUCHERIZED ASSISTANCE.—The term

12 ‘voucherized assistance’ means—

13 ‘‘(A) a system of selecting and reimbursing

14 program services in which—

15 ‘‘(i) the beneficiary is given a docu16 ment or other authorization that may be

17 used to pay for program services;

18 ‘‘(ii) the beneficiary chooses the orga19 nization that will provide services to him or

20 her according to rules specified by the des21 ignated award recipient; and

22 ‘‘(iii) the organization selected by the

23 beneficiary is reimbursed by the designated

24 award recipient for program services pro25 vided; or
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1 ‘‘(B) any other mode of financial assist2 ance to pay for program services in which the

3 program beneficiary determines the allocation

4 of program funds through his or her selection

5 of one service provider from among alternatives.

6 ‘‘SEC. 582. RELIGIOUS ORGANIZATIONS AS PROGRAM PAR7 TICIPANTS.

8 ‘‘(a) IN GENERAL.—

9 ‘‘(1) SCOPE OF AUTHORITY.—Notwithstanding

10 any other provision of law, a religious organiza11 tion—

12 ‘‘(A) may be a designated award recipient;

13 ‘‘(B) may make designated subawards to

14 other public or nonprofit private entities (in15 cluding other religious organizations);

16 ‘‘(C) may provide for the provision of pro17 gram services to program beneficiaries through

18 the use of voucherized assistance; and

19 ‘‘(D) may be a provider of services under

20 a designated program, including a provider that

21 accepts voucherized assistance.

22 ‘‘(2) DEFINITION OF PROGRAM PARTICIPANT.—

23 For purposes of this part, the term ‘program partici24 pant’ means a public or private entity that has re25 ceived a designated direct award, or a designated
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1 subaward, regardless of whether the entity provides

2 program services. Such term includes an entity

3 whose only participation in a designated program is

4 to provide program services pursuant to the accept5 ance of voucherized assistance.

6 ‘‘(b) RELIGIOUS ORGANIZATIONS.—The purpose of

7 this section is to allow religious organizations to be pro8 gram participants on the same basis as any other non9 profit private provider without impairing the religious

10 character of such organizations, and without diminishing

11 the religious freedom of program beneficiaries.

12 ‘‘(c) NONDISCRIMINATION AGAINST RELIGIOUS OR13 GANIZATIONS.—

14 ‘‘(1) FINDINGS.—The Congress finds that the

15 establishment clause of the first amendment to the

16 Constitution of the United States does not require

17 that—

18 ‘‘(A) social-welfare programs discriminate

19 against faith-based providers of services; or

20 ‘‘(B) faith-based providers of services, as a

21 prerequisite to participation in Federal pro22 grams, abandon their religious character and

23 censor their religious expression.

24 ‘‘(2) NONDISCRIMINATION.—Religious organiza25 tions are eligible to be program participants on the
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1 same basis as any other nonprofit private organiza2 tion. Neither the Federal Government nor a State

3 receiving funds under such programs shall discrimi4 nate against an organization that is or applies to be

5 a program participant on the basis that the organi6 zation has a religious character.

7 ‘‘(d) RELIGIOUS CHARACTER AND FREEDOM.—

8 ‘‘(1) RELIGIOUS ORGANIZATIONS.—Except as

9 provided in this section, any religious organization

10 that is a program participant shall retain its inde11 pendence from Federal, State, and local government,

12 including such organization’s control over the defini13 tion, development, practice, and expression of its re14 ligious beliefs.

15 ‘‘(2) ADDITIONAL SAFEGUARDS.—Neither the

16 Federal Government nor a State shall require a reli17 gious organization to—

18 ‘‘(A) alter its form of internal governance;

19 or

20 ‘‘(B) remove religious art, icons, scripture,

21 or other symbols;

22 in order to be a program participant.

23 ‘‘(e) NONDISCRIMINATION IN EMPLOYMENT.—

24 ‘‘(1) IN GENERAL.—Except as provided in para25 graph (2), nothing in this section shall be construed
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1 to modify or affect the provisions of any other Fed2 eral or State law or regulation that relates to dis3 crimination in employment on the basis of religion.

4 ‘‘(2) EXCEPTION.—A religious organization

5 that is a program participant may require that an

6 employee rendering program services adhere to—

7 ‘‘(A) the religious beliefs and practices of

8 such organization; and

9 ‘‘(B) any rules of the organization regard10 ing the use of drugs or alcohol.

11 ‘‘(f) RIGHTS OF PROGRAM BENEFICIARIES.—

12 ‘‘(1) OBJECTIONS REGARDING RELIGIOUS OR13 GANIZATIONS.—With respect to an individual who is

14 a program beneficiary or a prospective program ben15 eficiary, if the individual objects to a program par16 ticipant on the basis that the participant is a reli17 gious organization, the following applies:

18 ‘‘(A) If the organization received a des19 ignated direct award, the organization shall ar20 range for the individual to receive program

21 services through an alternative entity.

22 ‘‘(B) If the organization received a des23 ignated subaward, the non-Federal entity that

24 made the subaward shall arrange for the indi-
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1 vidual to receive the program services through

2 an alternative program participant.

3 ‘‘(C) If the organization is providing serv4 ices pursuant to voucherized assistance, the

5 designated award recipient that operates the

6 voucherized assistance program shall arrange

7 for the individual to receive the program serv8 ices through an alternative provider.

9 ‘‘(D) Arrangements under any of subpara10 graphs (A) through (C) with an alternative en11 tity shall provide for program services the mon12 etary value of which is not less than the mone13 tary value of the program services that the indi14 vidual would have received from the religious

15 organization involved.

16 ‘‘(2) NONDISCRIMINATION.—

17 ‘‘(A) IN GENERAL.—Except as provided in

18 subparagraph (B) or as otherwise provided in

19 law, a religious organization that is a program

20 participant shall not in providing program serv21 ices discriminate against a program beneficiary

22 on the basis of religion or religious belief.

23 ‘‘(B) LIMITATION.—A religious organiza24 tion that is a program participant may require

25 a program beneficiary who has elected in ac-
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1 cordance with paragraph (1) to receive program

2 services from such organization—

3 ‘‘(i) to actively participate in religious

4 practice, worship, and instruction; and

5 ‘‘(ii) to follow rules of behavior de6 vised by the organizations that are reli7 gious in content or origin.

8 ‘‘(g) FISCAL ACCOUNTABILITY.—

9 ‘‘(1) IN GENERAL.—Except as provided in para10 graph (2), any religious organization that is a pro11 gram participant shall be subject to the same regula12 tions as other recipients of awards of Federal finan13 cial assistance to account, in accordance with gen14 erally accepted auditing principles, for the use of the

15 funds provided under such awards.

16 ‘‘(2) LIMITED AUDIT.—With respect to the

17 award involved, if a religious organization that is a

18 program participant maintains the Federal funds in

19 a separate account from non-Federal funds, then

20 only the Federal funds shall be subject to audit.

21 ‘‘(h) COMPLIANCE.—With respect to compliance with

22 this section by an agency, a religious organization may

23 obtain judicial review of agency action in accordance with

24 chapter 7 of title 5, United States Code.
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1 ‘‘SEC. 583. LIMITATIONS ON USE OF FUNDS FOR CERTAIN

2 PURPOSES.

3 ‘‘(a) IN GENERAL.—Except as provided in subsection

4 (b), no funds provided directly to an entity under a des5 ignated program shall be expended for sectarian worship

6 or instruction.

7 ‘‘(b) EXCEPTION.—Subsection (a) shall not apply to

8 assistance provided to or on behalf of a program bene9 ficiary if the beneficiary may choose where such assistance

10 is redeemed or allocated.

11 ‘‘SEC. 584. ADMINISTRATION OF PROGRAM AND TREAT12 MENT OF FUNDS.

13 ‘‘(a) FUNDS NOT AID TO INSTITUTIONS.—Financial

14 assistance under a designated program provided to or on

15 behalf of program beneficiaries is aid to the beneficiary,

16 not to the organization providing program services. The

17 receipt by a program beneficiary of program services at

18 the facilities of the organization shall not constitute Fed19 eral financial assistance to the organization involved.

20 ‘‘(b) PROHIBITION ON STATE DISCRIMINATION IN

21 USE OF FUNDS.—No provision in any State constitution

22 or State law shall be construed to prohibit the expenditure

23 of Federal funds under a designated program in a reli24 gious facility or by a religious organization that is a pro25 gram participant. If a State law or constitution would pre26 vent the expenditure of State or local public funds in such
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1 a facility or by such an organization, then the State or

2 local government shall segregate the Federal funds from

3 State or other public funds for purposes of carrying out

4 the designated program.

5 ‘‘SEC. 585. EDUCATIONAL REQUIREMENTS FOR PERSONNEL

6 IN DRUG TREATMENT PROGRAMS.

7 ‘‘(a) FINDINGS.—The Congress finds that—

8 ‘‘(1) establishing formal educational qualifica9 tion for counselors and other personnel in drug

10 treatment programs may undermine the effective11 ness of such programs; and

12 ‘‘(2) such formal educational requirements for

13 counselors and other personnel may hinder or pre14 vent the provision of needed drug treatment services.

15 ‘‘(b) LIMITATION ON EDUCATIONAL REQUIREMENTS

16 OF PERSONNEL.—

17 ‘‘(1) TREATMENT OF RELIGIOUS EDUCATION.—

18 If any State or local government that is a program

19 participant imposes formal educational qualifications

20 on providers of program services, including religious

21 organizations, such State or local government shall

22 treat religious education and training of personnel

23 as having a critical and positive role in the delivery

24 of program services. In applying educational quali25 fications for personnel in religious organizations,
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1 such State or local government shall give credit for

2 religious education and training equivalent to credit

3 given for secular course work in drug treatment or

4 any other secular subject that is of similar grade

5 level and duration.

6 ‘‘(2) RESTRICTION OF DISCRIMINATION RE7 QUIREMENTS.—

8 ‘‘(A) IN GENERAL.—Subject to paragraph

9 (1), a State or local government that is a pro10 gram participant may establish formal edu11 cational qualifications for personnel in organiza12 tions providing program services that contribute

13 to success in reducing drug use among program

14 beneficiaries.

15 ‘‘(B) EXCEPTION.—The Secretary shall

16 waive the application of any educational quali17 fication imposed under subparagraph (A) for an

18 individual religious organization, if the Sec19 retary determines that—

20 ‘‘(i) the religious organization has a

21 record of prior successful drug treatment

22 for at least the preceding 3 years;

23 ‘‘(ii) the educational qualifications

24 have effectively barred such religious orga-
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1 nization from becoming a program pro2 vider;

3 ‘‘(iii) the organization has applied to

4 the Secretary to waive the qualifications;

5 and

6 ‘‘(iv) the State or local government

7 has failed to demonstrate empirically that

8 the educational qualifications in question

9 are necessary to the successful operation of

10 a drug treatment program.’’.

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