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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5866 Introduced in House (IH)]

<DOC>

118th CONGRESS
  1st Session
                                H. R. 5866

 To ensure comprehensive wraparound services for families impacted by 
            substance use disorders, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            October 2, 2023

  Ms. Lee of California (for herself, Mr. Trone, Mr. Mullin, and Mr. 
   Schiff) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
  Ways and Means, and Education and the Workforce, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL

 
 To ensure comprehensive wraparound services for families impacted by 
            substance use disorders, and for other purposes.

    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 ``Substance Use Disorder and Family 
Engagement in Recovery Act'' or the ``SAFE in Recovery Act''.

SEC. 2. ENSURING CARE AND NO UNDUE FAMILY SEPARATION OF FAMILIES 
              IMPACTED BY SUBSTANCE USE DISORDER.

    (a) In General.--Section 503 of the Social Security Act (42 U.S.C. 
703) is amended by adding at the end the following new subsection:
    ``(d) Limitations on Toxicology Testing To Detect Substance Use.--
            ``(1) In general.--As a condition of receiving payments 
        under this section, each State--
                    ``(A) shall not require the birthing parent of an 
                infant who is identified as being affected by substance 
                abuse or withdrawal symptoms resulting from prenatal 
                drug exposure or a Fetal Alcohol Spectrum Disorder to 
                undergo toxicology testing to detect substance use 
                unless the parent--
                            ``(i) gives clear and informed consent 
                        prior to such testing; and
                            ``(ii) is able to access, if necessary for 
                        purposes of giving such consent, interpretation 
                        services and reasonable accommodations for 
                        disabilities;
                    ``(B) shall ensure that a pregnant or postpartum 
                individual taking a prescription drug, including a 
                prescription drug for the treatment of a substance use 
                disorder, in accordance with the recommendations of the 
                prescribing practitioner, shall not be subject to 
                investigations of child abuse and neglect on the basis 
                that such individual is taking such prescription drug;
                    ``(C) shall ensure that--
                            ``(i) any toxicology testing to detect 
                        substance use that is provided to a pregnant or 
                        postpartum individual taking a prescription 
                        drug, including a prescription drug for the 
                        treatment of a substance use disorder, in 
                        accordance with the recommendations of the 
                        prescribing practitioner is consented to by the 
                        pregnant or postpartum individual in accordance 
                        with subparagraph (A); and
                            ``(ii) such testing (and the results of 
                        such testing) shall not affect the individual's 
                        access to care or public assistance and shall 
                        not be the sole factor in a family separation 
                        determination involving the individual; and
                    ``(D) shall ensure that any health care provider 
                involved in the delivery or care of an infant 
                identified as being affected by substance abuse or 
                withdrawal symptoms resulting from prenatal drug 
                exposure, or a Fetal Alcohol Spectrum Disorder, is not 
                required to notify the child protective services system 
                of the State or any unit of local government of the 
                State of the occurrence of such condition in such 
                infant if such condition is the result of the birthing 
                parent of the infant taking a prescription drug, 
                including a prescription drug for the treatment of a 
                substance use disorder, in accordance with the 
                recommendations of the prescribing practitioner, and 
                such provider has no other reason to suspect that the 
                infant is in imminent danger of abuse or neglect.
            ``(2) Definition of prescription drug.--In this subsection, 
        the term `prescription drug' means a drug approved under 
        section 505 of the Federal Food, Drug, and Cosmetic Act (21 
        U.S.C. 355) or licensed under section 351 of the Public Health 
        Service Act (42 U.S.C. 262) that is subject to section 
        503(b)(1) of the Federal Food, Drug, and Cosmetic Act (21 
        U.S.C. 353(b)(1)).''.
    (b) Effective Date.--The amendment made by this section shall take 
effect on the date that is 2 years after the date of enactment of this 
Act.

SEC. 3. ENSURING A WHOLE-OF-GOVERNMENT APPROACH THROUGH A FEDERAL 
              INTERAGENCY TASK FORCE TO SUPPORT FAMILIES IMPACTED BY 
              SUBSTANCE USE DISORDERS.

    (a) Establishment.--There is established within the Federal 
Government an interagency task force to improve--
            (1) efforts, resources, and services of the Federal 
        Government to support families impacted by substance use 
        disorders;
            (2) the utilization of such efforts, resources, and 
        services; and
            (3) strategies to streamline the provision of comprehensive 
        wraparound care for families impacted by substance use 
        disorders.
    (b) Membership.--
            (1) Composition.--The task force shall be composed of the 
        heads of the following Federal departments and agencies, or 
        their designees:
                    (A) The Centers for Medicare & Medicaid Services.
                    (B) The Substance Abuse and Mental Health Services 
                Administration.
                    (C) The Agency for Healthcare Research and Quality.
                    (D) The Centers for Disease Control and Prevention.
                    (E) The Indian Health Service.
                    (F) The Department of Veterans Affairs.
                    (G) The National Institutes of Health.
                    (H) The Food and Drug Administration.
                    (I) The Health Resources and Services 
                Administration.
                    (J) The Department of Defense.
                    (K) The Office of Minority Health of the Department 
                of Health and Human Services.
                    (L) The Administration for Children and Families.
                    (M) The Office of the Assistant Secretary for 
                Planning and Evaluation of the Department of Health and 
                Human Services.
                    (N) The Office for Civil Rights of the Department 
                of Health and Human Services.
                    (O) The Office of Juvenile Justice and Delinquency 
                Prevention of the Department of Justice.
                    (P) The Office of Community Oriented Policing 
                Services of the Department of Justice.
                    (Q) The National Center for Education Evaluation 
                and Regional Assistance of the Department of Education.
                    (R) The National Center for Special Education 
                Research of the Institute of Education Science.
                    (S) The Office of Elementary and Secondary 
                Education of the Department of Education.
                    (T) The Office for Civil Rights of the Department 
                of Education.
                    (U) The Office of Special Education and 
                Rehabilitative Services of the Department of Education.
                    (V) The Bureau of Indian Affairs of the Department 
                of the Interior.
                    (W) The Veterans Health Administration of the 
                Department of Veterans Affairs.
                    (X) The Office of Special Needs Assistance Programs 
                of the Department of Housing and Urban Development.
                    (Y) The Office of Head Start of the Administration 
                for Children and Families.
                    (Z) The Children's Bureau of the Administration for 
                Children and Families.
                    (AA) The Bureau of Indian Education of the 
                Department of the Interior.
                    (BB) Such other Federal agencies as the Secretaries 
                determine to be appropriate.
            (2) Date of appointments.--The heads of Federal departments 
        and agencies shall appoint the corresponding members of the 
        task force not later than 60 days after the date of enactment 
        of this Act.
            (3) Chairperson.--The task force shall be chaired by the 
        Secretary of Health and Human Services.
    (c) Duties.--The interagency task force shall carry out each of the 
following activities:
            (1) Solicit input from stakeholders, including frontline 
        service providers, educators, mental health professionals, 
        researchers, experts in infant, child, and youth trauma, child 
        welfare professionals, people in recovery, and the public, in 
        order to inform the activities under this subsection.
            (2) Compile a comprehensive list of all Federal Government 
        efforts, resources, and services to support families impacted 
        by substance use disorders.
            (3) Assess the effectiveness of care, services, and 
        resources available to families impacted by substance use 
        disorders.
            (4) Analyze and make recommendations for means of 
        eliminating barriers that prevent individuals with substance 
        use disorders from entering and remaining in care for the 
        disorder involved.
            (5) Analyze and make recommendations for means of 
        eliminating barriers to social services for individuals with 
        substance use disorders and their families.
            (6) Provide recommendations for effectively streamlining 
        the provision of comprehensive wraparound care for families 
        impacted by substance use disorders.
            (7) Recommend a plan for addressing the comprehensive 
        wraparound care needs of families impacted by substance use 
        disorders and specifically address in the plan the needs of 
        populations most disproportionately affected.
            (8) Other activities as determined appropriate by the 
        Secretary.
    (d) Operating Plan.--Not later than 120 days after the date of 
enactment of this Act, the task force shall hold the first meeting. Not 
later than 2 years after such date of enactment, the task force shall 
submit to the Secretary of Education, the Secretary of Health and Human 
Services, the Secretary of Labor, the Secretary of the Interior, the 
Attorney General, and Congress an operating plan for carrying out the 
activities of the task force described in subsection (c). Such 
operating plan shall include--
            (1) a list of specific activities that the task force plans 
        to carry out for purposes of carrying out duties described in 
        subsection (c), which may include public engagement;
            (2) a plan for carrying out the activities under subsection 
        (c);
            (3) a list of members of the task force and other 
        individuals who are not members of the task force that may be 
        consulted to carry out such activities;
            (4) an explanation of Federal agency involvement and 
        coordination needed to carry out such activities, including any 
        statutory or regulatory barriers to such coordination;
            (5) a budget for carrying out such activities;
            (6) a proposed timeline for implementing recommendations 
        and efforts identified under subsection (c); and
            (7) other information that the task force determines 
        appropriate as related to its duties.
    (e) Final Report.--Not later than 3 years after the date of 
enactment of this Act, the Secretary shall submit to Congress and the 
general public a final report that contains the findings and 
recommendations (including the recommended plan described in subsection 
(c)(7)) of the task force.
    (f) Additional Reports.--In addition to the final report under 
subsection (e), the task force shall submit--
            (1) a report to Congress identifying any recommendations 
        identified under subsection (c) that require additional 
        legislative authority to implement; and
            (2) a report to the Governors describing opportunities for 
        local- and State-level partnerships, professional development, 
        or best practices to support families impacted by substance use 
        disorders.
    (g) Sunset.--The task force shall sunset on the date that is 60 
days after the submission of the report under subsection (e), but not 
later than September 30, 2028.
    (h) Definition of Comprehensive Wraparound Care.--In this section, 
the term ``comprehensive wraparound care'' includes clinical, ancillary 
health, mental health, substance use disorder, and social support 
services, to address a substance use disorder.

SEC. 4. INCREASING ACCESS TO BEHAVIORAL HEALTH CARE THROUGH COMMUNITY 
              HEALTH CENTERS.

    (a) Required Primary Health Services.--
            (1) In general.--Section 330(b) of the Public Health 
        Service Act (42 U.S.C. 254b(b)) is amended--
                    (A) in paragraph (1)(A)(i)--
                            (i) in subclause (IV), by striking ``; 
                        and'' and inserting a semicolon;
                            (ii) in subclause (V), by striking the 
                        semicolon and inserting ``; and''; and
                            (iii) by adding at the end the following:
                                    ``(VI) behavioral and mental health 
                                and substance use disorder services;'';
                    (B) in paragraph (1)(A)(ii), by inserting ``, 
                including such referrals to certified community 
                behavioral health centers'' before the semicolon; and
                    (C) in paragraph (2)--
                            (i) by striking subparagraph (A); and
                            (ii) by redesignating subparagraphs (B) 
                        through (D) as subparagraphs (A) through (C), 
                        respectively.
            (2) Funding.--For purposes of assisting health centers in 
        incorporating behavioral and mental health and substance use 
        disorder services into the required primary health services 
        offered by such centers, there is appropriated to the Secretary 
        of Health and Human Services, out of amounts in the Treasury 
        not otherwise appropriated, $500,000,000 for fiscal year 2025, 
        to remain available until expended.
            (3) Report.--Not later than 1 year after the date that is 3 
        years after the date of enactment of this Act, the Secretary of 
        Health and Human Services shall submit a report to Congress 
        on--
                    (A) the impact that the amendments made by 
                paragraph (1) has had on access to behavioral and 
                mental health and substance use disorder services; and
                    (B) employee recruitment and retention for 
                behavioral and mental health and substance use disorder 
                providers, including for health centers, certified 
                community behavioral health centers, and other 
                community care settings.
    (b) Environmental Justice Communities.--Section 10503 of the 
Patient Protection and Affordable Care Act (42 U.S.C. 254b-2) is 
amended--
            (1) in subsection (b)(1)--
                    (A) in subparagraph (E), by striking ``and'' at the 
                end; and
                    (B) by adding at the end the following:
                    ``(G) $130,000,000,000 for the period of fiscal 
                years 2024 through 2028.
    ``(f) Environmental Justice Communities.--The Secretary shall 
ensure that not less than 50 percent of the amounts appropriated under 
subsection (b)(1) for fiscal year 2024 or any fiscal year thereafter 
are awarded to entities for use with respect to projects or sites 
located in or serving communities with significant representation of 
communities of color, low-income communities, or Tribal and Indigenous 
communities that experience, or are at risk of experiencing, higher or 
more adverse human health or environmental effects.
    ``(g) Prohibition.--No amounts made available under this section 
may be used for any activity that is subject to the reporting 
requirements set forth in section 203(a) of the Labor-Management 
Reporting and Disclosure Act of 1959 (29 U.S.C. 433(a)).''.

SEC. 5. IMPROVING OUTCOMES FOR PREGNANT AND POSTPARTUM PATIENTS WITH 
              SUBSTANCE USE DISORDER AND PAYMENTS TO INCENTIVIZE CARE 
              FOR OPIOID USE DISORDER.

    (a) In General.--Section 1866F(b)(1) of the Social Security Act (42 
U.S.C. 1395cc-6(b)(1) is amended by adding at the end the following new 
subparagraph:
                    ``(G) Improves outcomes for pregnant and postpartum 
                individuals with opioid use disorder.''.
    (b) Payments.--Section 1866F(e)(1) of the Social Security Act (42 
U.S.C. 1395cc-6(e)(1)) is amended--
            (1) in subparagraph (A), by inserting ``pregnancy and 
        postpartum services and'' after ``including''; and
            (2) in subparagraph (B)--
                    (A) in clause (iii), by striking ``and'';
                    (B) in clause (iv), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following new clause:
                            ``(v) pay a higher per applicable 
                        beneficiary per month care management fee for 
                        an applicable beneficiary who receives 
                        pregnancy or postpartum services from a 
                        participant.''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on January 1, 2024, and shall apply to services furnished on or 
after that date.

SEC. 6. INCREASING ACCESS TO WRAPAROUND SERVICES FOR CHILDREN FROM 
              FAMILIES IMPACTED BY SUBSTANCE USE DISORDER.

    (a) Grants.--The Head Start Act is amended by inserting after 
section 645A (42 U.S.C. 9840a) the following:

``SEC. 645B. CHILDREN FROM FAMILIES IMPACTED BY SUBSTANCE USE DISORDER.

    ``(a) Grants.--
            ``(1) In general.--The Secretary shall make grants, in 
        accordance with paragraph (2), to Head Start and Early Head 
        Start agencies to enable the agencies to provide comprehensive 
        health, educational, nutritional, social, and other services to 
        children in Head Start and Early Head Start programs, 
        respectively, from families impacted by substance use disorder, 
        or referring the children to such services, to assure best 
        outcomes for the health, wellness, and school readiness of the 
        children.
            ``(2) Formula.--The Secretary shall make those grants, to 
        fund the activities described in paragraph (1) for a fiscal 
        year, by--
                    ``(A) using the amount appropriated under 
                subsection (c) for that fiscal year; and
                    ``(B) distributing that amount in accordance with 
                clauses (i) (with respect to additional funding for the 
                comprehensive services described in paragraph (1)) and 
                (ii) of section 640(a)(4)(C).
    ``(b) Construction.--A reference in this subchapter (other than 
this section) to funds appropriated or provided under this subchapter 
shall not be considered to include funds appropriated or provided under 
this section.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $60,000,000 for fiscal year 2024 
and each subsequent fiscal year.''.
    (b) Conforming Amendment.--Section 639 of the Head Start Act (42 
U.S.C. 9834) is amended by striking ``section 657B'' and inserting 
``sections 645B and 657B''.

SEC. 7. COORDINATING RESEARCH OF THE NATIONAL INSTITUTES OF HEALTH.

    Part A of title IV of the Public Health Service Act (42 U.S.C. 281 
et seq.) is amended by adding at the end the following:

``SEC. 404P. RESEARCH WITH RESPECT TO CO-OCCURRING PREGNANCY AND 
              SUBSTANCE USE DISORDER.

    ``The Director of the National Institutes of Health shall establish 
a consortium on pregnancy, postpartum recovery, and substance use 
disorder research to establish research priorities and steward research 
activities across the national research institutes and national centers 
to understand and mitigate the harms of substance use disorder for 
pregnant and postpartum patients and their children.''.

SEC. 8. ENSURING THE USE OF BEST AVAILABLE MEDICAL PRACTICES THROUGH A 
              GAO REPORT ON CLINICAL GUIDELINES FOR TREATING PREGNANT 
              AND PARENTING PATIENTS WITH SUBSTANCE USE DISORDER AND 
              THEIR CHILDREN.

    The Comptroller General of the United States shall--
            (1) conduct a study assessing--
                    (A) the extent to which clinical guidelines for 
                treating pregnant and parenting patients with substance 
                use disorder and their children are implemented;
                    (B) any systemic and other barriers to ensuring 
                that patients and children described in subparagraph 
                (A) get access to up-to-date care that addresses the 
                complexity of co-occurring substance use disorder and 
                pregnancy; and
                    (C) access to treatment for pregnant and postpartum 
                individuals with substance use disorder and the impacts 
                of interactions with child welfare systems; and
            (2) not later than 2 years after the date of enactment of 
        this Act, submit a report to Congress on the results of such 
        study.
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