I 
117TH CONGRESS 
1ST SESSION H. R. 4151 
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 HOUSE OF REPRESENTATIVES 
JUNE 24, 2021 
Ms. MCCOLLUM (for herself and Mr. YOUNG) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Education and Labor, 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 con-
cerned 
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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Advancing FASD Re-
search, Services, and Prevention Act’’ or the ‘‘FASD Re-
spect Act’’. 
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SEC. 2. FINDINGS. 
Congress finds as follows: 
(1) Fetal Alcohol Spectrum Disorders (referred 
to in this section as ‘‘FASD’’), is a serious and com-
plex public health issue impacting individuals, fami-
lies, and communities throughout the United States, 
regardless of race, sex, culture, or geography. This 
Act provides an opportunity for our Nation to ex-
plore strategies to not only prevent the adverse ef-
fects of prenatal alcohol exposure (referred to in this 
section as ‘‘PAE’’) but heal individual, historical, 
and cultural traumas. 
(2) Exposure to alcohol has long-lasting con-
sequences for a developing fetus, which may lead to 
a range of life-long physical, mental, social, and 
emotional problems. There is no known safe amount 
of alcohol use during pregnancy or while trying to 
get pregnant. There is also no safe time during 
pregnancy to drink. All types of alcohol are equally 
harmful, including all wines and beer. 
(3) The most recent prevalence study identified 
as many as 1 in 20 first graders across the country 
are affected by PAE. Given that nearly 45 percent 
of pregnancies are unintended and women often 
don’t know that they are pregnant until they are 6 
weeks along or more, it’s easy to understand how a 
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woman could drink alcohol while expecting. Research 
shows that solely focusing on individual women’s be-
havior as FASD prevention strategy perpetuates 
stigma and blame on biological mothers, individuals 
impacted by FASD, and the condition itself. 
(4) Although research shows that White, col-
lege-educated, middle- to upper-class women are the 
most likely group to drink during pregnancy, one of 
the common misnomers about FASD is that it is an 
‘‘indigenous issue’’. Continued surveillance, stig-
matization, and stereotyping of Indigenous popu-
lations may contribute to the misbelief that FASD 
is over-represented in these communities. 
(5) In their recent landmark survey, ‘‘Lay of 
the Land: Equality vs. Equity’’, the FASD Change-
makers, comprised of young adults with FASD, doc-
umented the social determinants of health that lead 
to the detrimental health disparities people with 
FASD often endure, including victimization result-
ing in incarceration, homelessness, reduced access to 
health care, vulnerabilities to substance misuse, and 
unemployment. 
(6) The higher prevalence of FASD in criminal 
justice and foster care systems has been docu-
mented. Nearly 1 out of 4 children in juvenile cor-
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rections has FASD, and prevalence estimates among 
children in the foster care systems range from 23 
percent to 60 percent. Prevalence in adult correc-
tions ranges from 11 percent to 25 percent. 
(7) The National Academy of Medicine rec-
ommendations for a broad Federal response formed 
the basis of the Fetal Alcohol Syndrome and Fetal 
Alcohol Effect Prevention and Services Act of 1998 
that authorized $27,000,000 for a National Task 
Force on Fetal Alcohol Syndrome and grant pro-
grams at the National Institute on Alcohol Abuse 
and Alcoholism, the Centers for Disease Control and 
Prevention, and the Substance Abuse and Mental 
Health Services Administration. 
(8) In 2009, the National Task Force on Fetal 
Alcohol Syndrome reported FASD diagnostic capac-
ity and FASD-informed services insufficient in the 
United States, resulting in countless individuals with 
FASD remaining unrecognized or misdiagnosed. 
(9) Despite PAE remaining the leading pre-
ventable cause of birth defects and neurodevelop-
mental disabilities in the United States, the author-
ity for the National Task Force on Fetal Alcohol 
Syndrome expired, SAMHSA funding for FASD 
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ended in 2015, and other Federal and State FASD- 
related funding declined. 
(10) FASD is preventable. Although there is no 
cure for individuals impacted by FASD, research 
shows that intervention services and supports that 
include social, environmental, and educational strate-
gies can prevent subsequent trauma to the indi-
vidual, the individual’s caregivers, and society. 
(11) Building coordinated State and Tribal 
FASD systems of care that offer integrated cul-
turally appropriate services and supports grounded 
in best practices can mitigate the harms created by 
historical and cultural trauma. 
SEC. 3. PROGRAMS FOR FETAL ALCOHOL SPECTRUM DIS-
ORDERS. 
(a) IN GENERAL.—Part O of title III of the Public 
Health Service Act (42 U.S.C. 280f et seq.) is amended 
by striking section 399H and inserting the following: 
‘‘SEC. 399H. PROGRAMS FOR FETAL ALCOHOL SPECTRUM 
DISORDERS. 
‘‘(a) DEFINITION.—In this part— 
‘‘(1) the term ‘fetal alcohol spectrum disorders’ 
or ‘FASD’ means diagnosable developmental disabil-
ities of a broad range of neurodevelopmental and 
physical effects that result from prenatal exposure to 
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alcohol. The effects may include lifelong physical, 
mental, behavioral, social and learning disabilities, 
and other problems that impact daily functioning 
(such as living independently or holding a job), as 
well as overall health and well-being; and 
‘‘(2) the terms ‘Indian Tribe’ and ‘Tribal orga-
nization’ have the meanings given the terms ‘Indian 
tribe’ and ‘tribal organization’ in section 4 of the In-
dian Self-Determination and Education Assistance 
Act. 
‘‘(b) RESEARCH
ON FETAL ALCOHOL SPECTRUM 
DISORDERS AND RELATED CONDITIONS.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the National Institutes of 
Health, shall— 
‘‘(A) establish a research program for 
FASD; and 
‘‘(B) award grants, contracts, or coopera-
tive agreements to public or private nonprofit 
entities to pay all or part of carrying out re-
search under such research program. 
‘‘(2) TYPES
OF
RESEARCH.—In carrying out 
paragraph (1), the Secretary, acting through the Di-
rector of the National Institute on Alcohol Abuse 
and Alcoholism (referred to in this section as the 
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‘Director of the Institute’), shall continue to conduct 
and expand national and international research in 
consultation with other Federal agencies and outside 
partners that includes— 
‘‘(A) the most promising avenues of re-
search in FASD diagnosis, intervention, and 
prevention; 
‘‘(B) factors that may mitigate the effects 
of prenatal alcohol and other substance expo-
sure including culturally relevant factors and 
social determinants of health; and 
‘‘(C) other research that the Director of 
the Institute determines to be appropriate with 
respect to conditions that develop as a result of 
prenatal alcohol and other substance exposure. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this subsection, there is authorized to 
be appropriated $30,000,000 for each of fiscal years 
2022 through 2027. 
‘‘(c) SURVEILLANCE, PUBLIC HEALTH RESEARCH, 
AND PREVENTION ACTIVITIES.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the National Center on 
Birth Defects and Developmental Disabilities of the 
Centers for Disease Control and Prevention, shall 
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facilitate surveillance, public health research, and 
prevention of FASD in accordance with this sub-
section. 
‘‘(2) SURVEILLANCE, 
PUBLIC
HEALTH
RE-
SEARCH
AND
PREVENTION.—In carrying out this 
subsection, the Secretary shall— 
‘‘(A) integrate into surveillance practice an 
evidence-based standard case definition for fetal 
alcohol syndrome and, in collaboration with 
other Federal and outside partners, support or-
ganizations of appropriate medical and mental 
health professionals in their development and 
refinement of evidence-based clinical diagnostic 
guidelines and criteria for all fetal alcohol spec-
trum disorders; 
‘‘(B) disseminate and provide the nec-
essary training and support to appropriate med-
ical and mental health professionals on the 
early identification of children with prenatal al-
cohol or other substance exposure as such chil-
dren may require ongoing developmental and 
behavioral surveillance by their primary health 
care clinician which continues throughout their 
lifetime to access ongoing treatment and refer-
ral problems; 
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‘‘(C) support applied public health preven-
tion research to identify culturally appropriate 
or evidence-based strategies for reducing alcohol 
and other substance exposed pregnancies in 
women at high risk of such pregnancies; 
‘‘(D) disseminate and provide the nec-
essary training and support to implement cul-
turally appropriate or evidence-based strategies 
developed under subparagraph (C) to— 
‘‘(i) 
hospitals, 
federally 
qualified 
health centers, residential and outpatient 
substance disorder treatment programs, 
and other appropriate health care pro-
viders; 
‘‘(ii) educational settings; 
‘‘(iii) social work and child protection 
service providers; 
‘‘(iv) foster care providers and adop-
tion agencies; 
‘‘(v) State or Tribal offices and other 
agencies providing services to individuals 
with disabilities; 
‘‘(vi) mental health treatment facili-
ties; 
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‘‘(vii) Indian Tribes and Tribal orga-
nizations; 
‘‘(viii) military medical treatment fa-
cility described in section 1073d(c) of title 
10, United States Code, and medical cen-
ters of the Department of Veterans Af-
fairs; and 
‘‘(ix) other entities that the Secretary 
determines to be appropriate; 
‘‘(E) conduct activities related to risk fac-
tor surveillance; 
‘‘(F) disseminate and evaluate brief behav-
ioral intervention strategies and referrals aimed 
at preventing alcohol and substance-exposed 
pregnancies among women of childbearing age 
in special settings, including clinical primary 
health centers, outpatient clinics, child welfare 
agencies, and correctional facilities and recovery 
campuses; 
‘‘(G) document the FASD lived experience 
and incorporate the perspectives of individuals 
and their family members affected by FASD 
and birth mothers of individuals with FASD in 
the dissemination of information and resources; 
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‘‘(H) disseminate comprehensive alcohol 
and pregnancy and FASD information, re-
sources, and services to families and caregivers, 
professionals, and the public through an estab-
lished national network of affiliated FASD or-
ganizations and through organizations serving 
medical, behavioral health, addiction, disability, 
education, legal and other professionals; and 
‘‘(I) coordinate FASD activities with affili-
ated State, Tribal and local systems and organi-
zations with respect to the prevention of alcohol 
and other substance-exposed pregnancies. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this subsection, there is authorized to 
be appropriated $13,000,000 for each of fiscal years 
2022 through 2027. 
‘‘(d) BUILDING STATE
AND TRIBAL FASD SYS-
TEMS.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Administrator of the Health Resources 
and Services Administration, shall award grants, 
contracts, or cooperative agreements to States and 
Indian Tribes for the purpose of establishing ongo-
ing comprehensive and coordinated State and Tribal 
FASD multidisciplinary, diverse coalitions to— 
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‘‘(A) develop systems of care for— 
‘‘(i) the prevention of FASD and 
other adverse conditions as a result of pre-
natal substance exposure; and 
‘‘(ii) the identification, treatment and 
support of individuals with FASD or other 
adverse conditions from prenatal substance 
exposure and support for their families; 
‘‘(B) provide leadership and support in es-
tablishing, expanding or increasing State and 
Tribal systems capacity in addressing FASD 
and other adverse conditions as a result of pre-
natal substance exposure; and 
‘‘(C) update or develop implementing and 
evaluating State and Tribal FASD strategic 
plans to— 
‘‘(i) establish or expand State and 
Tribal programs of surveillance, screening, 
assessment, diagnosis, prevention of FASD 
and other physical or neurodevelopmental 
disabilities from prenatal substance expo-
sure; 
‘‘(ii) integrate programs related to 
prevention of FASD and interventions ad-
dressing the adverse effects of prenatal al-
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cohol and other substance exposure into 
existing State and Tribal coordinated sys-
tems of care which focus on the social de-
terminants of health, including systemic 
racism, access to the Medicare program 
under title XVIII of the Social Security 
Act or to the Medicaid program under title 
XIX of such Act, maternal and early child-
hood health, economic security, food and 
housing, education, justice and corrections, 
mental health, substance use disorder, 
child welfare, developmental disabilities, 
and health care; 
‘‘(iii) 
identify 
across-the-lifetime 
issues for individuals and families related 
to FASD and other adverse conditions re-
lated to prenatal substance exposure, in-
cluding historical and cultural trauma, 
child abuse and neglect, mental health and 
substance use disorder; and 
‘‘(iv) identify systemic and other bar-
riers to the integration of prenatal alcohol 
and substance exposure screening, assess-
ment and identification of FASD into ex-
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isting systems of care for individuals and 
families. 
‘‘(2) ELIGIBILITY.—To be eligible to receive a 
grant, contract, or cooperative agreement under 
paragraph (1), a State, an Indian Tribe, a Tribal or-
ganization, or a State-Tribal collaborative (referred 
to in this paragraph as an ‘eligible entity’) shall pre-
pare and submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require, including— 
‘‘(A) evidence that the eligible entity des-
ignated in the application have or will have au-
thority to implement programs described in this 
subsection; 
‘‘(B) evidence of the establishment of a 
State or Tribal FASD Advisory Group of State 
agencies or Tribal entities and, if available, a 
State affiliate of the National Organization on 
Fetal Alcohol Syndrome or similar Tribal or 
statewide FASD advocacy organization, to pro-
vide the leadership in building State or Tribal 
capacity in addressing prenatal alcohol and 
other substance exposure, including FASD pre-
vention, identification, and intervention activi-
ties and programming, including— 
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‘‘(i) the formation of a FASD advi-
sory coalition of diverse, public and private 
representatives from multiple disciplines 
that may include— 
‘‘(I) State agencies or Tribal en-
tities that are responsible for health, 
human 
services, 
corrections, 
edu-
cation, housing, developmental disabil-
ities, substance use disorder, child 
welfare, juvenile and adult justice sys-
tems, mental health and any other 
agency related to the adverse social 
impact of prenatal alcohol and other 
substance exposures; 
‘‘(II) public and private sector 
stakeholders, 
including 
individuals 
with FASD and their caretakers and 
entities that work with or provide 
services or support for individuals 
with FASD and their families, such as 
community-based agencies, law en-
forcement, the judiciary, probation of-
ficers, medical and mental health pro-
viders, substance use disorder coun-
selors, educators, child welfare profes-
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sionals, and other entities that ad-
dress individual, family, community 
and society issues related to prenatal 
alcohol and other substance exposure 
throughout an individual’s lifespan; 
and 
‘‘(ii) the development of a State or 
Tribal strategic plan that— 
‘‘(I) contains recommendations, 
action steps, and deliverables for im-
proving social determinants of health; 
‘‘(II) recommends actions for 
prevention of FASD and other condi-
tions related to prenatal substance ex-
posure; 
‘‘(III) integrates culturally appro-
priate best practices or evidence-based 
practices on screening, identification 
and treatment into existing systems of 
care; 
‘‘(IV) provides for FASD-in-
formed clinical and therapeutic inter-
ventions; 
‘‘(V) 
provides 
for 
FASD-in-
formed supports and services for fam-
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ilies and individuals with FASD and 
other conditions from prenatal sub-
stance exposure across their lifetimes; 
‘‘(VI) identifies— 
‘‘(aa) existing FASD or 
other programs related to pre-
natal substance exposures in the 
State or Indian Tribe, includ-
ing— 
‘‘(AA) FASD primary, 
secondary and tertiary pre-
vention programs; 
‘‘(BB) prenatal screen-
ing, assessment or diag-
nostic services; and 
‘‘(CC) 
support 
and 
service programs for individ-
uals with FASD and their 
families; and 
‘‘(bb) existing State, local, 
and Tribal programs, systems, 
and funding streams that could 
be used to identify and assist in-
dividuals with FASD and other 
conditions related to substance 
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exposed pregnancies, and prevent 
prenatal exposure to alcohol and 
other harmful substances; 
‘‘(cc) barriers to providing 
FASD diagnostic services or pro-
grams to assist individuals with 
FASD or reducing alcohol and 
substance exposed pregnancies 
for women at risk for alcohol or 
other substance exposed preg-
nancies, and recommendations to 
reduce or eliminate such barriers; 
‘‘(dd) barriers to FASD pre-
vention, screening, assessment, 
identification, and treatment pro-
grams and to the provision of 
FASD-informed support services 
and accommodations across the 
lifespan, and recommendations to 
reduce or eliminate such barriers; 
‘‘(VII) integrates a public-private 
partnership of State, Tribal, and local 
communities to develop a comprehen-
sive FASD-informed and engaged sys-
tems of care approach that addresses 
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social determinants of health, includ-
ing systemic racism on health out-
comes, economic security, food and 
housing; education, justice, and health 
care challenges experienced by individ-
uals who have been diagnosed with 
FASD or other conditions as result of 
prenatal substance exposure; 
‘‘(VIII) describes programs of 
surveillance, 
screening, 
assessment 
and diagnosis, prevention, clinical 
intervention and therapeutic and other 
supports and services for individuals 
with FASD and their families; 
‘‘(IX) recognizes the impact of 
historical, cultural, and other trauma 
of individuals in the design and appli-
cation of all programming; and 
‘‘(X) recognizes the lived experi-
ences of birth mothers and those with 
FASD and their families in the design 
and application of all programming. 
‘‘(3) RESTRICTIONS ON AND USE OF FUNDS.— 
Amounts received under a grant, contract, or cooper-
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ative agreement under this subsection shall be used 
for one or more of the following activities: 
‘‘(A) Establishing or increasing diagnostic 
capacity in the State or Indian Tribe to meet 
the estimated prevalence needs of the State or 
Indian Tribe’s FASD population. 
‘‘(B) Providing educational and supportive 
services to individuals with FASD and other 
conditions related to prenatal substance expo-
sure and their families. 
‘‘(C) Establishing a FASD statewide sur-
veillance system. 
‘‘(D) Including FASD information in State 
medical and mental health care and education 
programs at schools of higher education. 
‘‘(E) Collecting, analyzing, and inter-
preting data. 
‘‘(F) Replicating culturally aware or best 
practice FASD prevention programs, including 
case-management models for pregnant or par-
enting women with alcohol and other substance 
use disorders. 
‘‘(G) Training of primary care and other 
providers in screening for prenatal alcohol and 
other substance exposure in prenatal, pediatric, 
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early childhood or other child or teenage check-
up settings. 
‘‘(H) Developing, implementing, and evalu-
ating population-based and targeted prevention 
programs for FASD, including public awareness 
campaigns. 
‘‘(I) Increasing capacity of the State or In-
dian Tribe to deliver housing, economic and 
food security services to adults impacted by 
FASD or other conditions related to prenatal 
substance exposure. 
‘‘(J) Referring individuals with FASD and 
other conditions related to prenatal substance 
exposure to appropriate FASD-informed sup-
port services. 
‘‘(K) Providing for State and Tribal FASD 
coordinators. 
‘‘(L) Providing training to health care (in-
cluding mental health care) providers on the 
prevention, identification and treatment of 
FASD and other conditions related to prenatal 
substance exposure across the lifespan. 
‘‘(M) Providing training to education, jus-
tice, and social service system professionals to 
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become FASD-informed and FASD-engaged in 
their practices. 
‘‘(N) Including FASD in training for 
workforce development and disability accessi-
bility. 
‘‘(O) Supporting peer-to-peer certification 
programs for individuals with FASD. 
‘‘(P) Developing FASD-informed certifi-
cation programs. 
‘‘(Q) Disseminating information about 
FASD and other conditions related to prenatal 
substance exposure and the availability of sup-
port services to families and individuals with 
FASD and other adverse conditions related to 
prenatal substance exposure. 
‘‘(R) Implementing recommendations from 
relevant agencies and organizations, including 
the State or Tribal FASD advisory group, on 
the identification and prevention of FASD, 
intervention programs or services for individuals 
with FASD and their families. 
‘‘(S) Other activities, as the Secretary de-
termines appropriate or as recommended by the 
National Advisory Council on FASD under sec-
tion 399H–1. 
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‘‘(4) OTHER CONTRACTS AND AGREEMENTS.— 
A State may carry out activities under paragraph 
(3) through contracts or cooperative agreements 
with another State or an Indian Tribe, and with 
public, private for-profit or nonprofit entities with a 
demonstrated expertise in FASD and other condi-
tions related to prenatal substance exposure preven-
tion, screening and diagnosis, or intervention serv-
ices. 
‘‘(5) REPORT TO CONGRESS.—Not later than 2 
years after the date on which amounts are first ap-
propriated under paragraph (6), the Secretary shall 
prepare and submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and 
the Committee on Energy and Commerce of the 
House of Representatives a report that contains a 
description of programs carried out under this sec-
tion. At a minimum, the report shall contain— 
‘‘(A) information concerning the number of 
States receiving grants; 
‘‘(B) State and Tribal FASD diagnostic 
capacity and barriers to achieving diagnostic ca-
pacity based on State FASD surveillance data 
or the most recent estimated prevalence of 
FASD in the United States; 
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‘‘(C) information concerning systemic or 
other barriers to screening for prenatal alcohol 
and other substance exposure in existing sys-
tems of care, including— 
‘‘(i) the child welfare system; 
‘‘(ii) maternal and early child health 
care and alcohol and other substance use 
disorder treatment programs; 
‘‘(iii) primary or secondary education 
systems; and 
‘‘(iv) juvenile and adult systems of 
justice; 
‘‘(D) 
information 
concerning 
existing 
State, Tribal, local government or community 
programs and systems of care and funding 
streams that could be used to identify and as-
sist individuals with FASD and other conditions 
related to substance exposed pregnancies and 
the degree to which such programs are FASD- 
informed or to which there are systemic or 
other barriers preventing their use; and 
‘‘(E) 
information 
concerning 
existing 
State, Tribal, local government or community 
primary, tertiary, or secondary prevention pro-
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grams on prenatal exposure to alcohol and 
other harmful prenatal substances. 
‘‘(6) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(A) IN GENERAL.—To carry out this sub-
section, there is authorized to be appropriated 
$32,000,000 for each of fiscal years 2022 
through 2027. 
‘‘(B) ADMINISTRATIVE AND EMPLOYMENT 
EXPENSES.—Of the amount appropriated for a 
fiscal 
year 
under 
subparagraph 
(A), 
$12,000,000 shall be allocated to States and 
Indian Tribes for purposes of covering adminis-
trative costs and supporting the employment of 
FASD State and Tribal coordinators. 
‘‘(C) TRIBAL SET ASIDE.—Up to 20 per-
cent of the grants, contracts, or cooperative 
agreements awarded under this subsection shall 
be reserved for Indian Tribes and Tribal orga-
nizations. 
‘‘(e) PROMOTING COMMUNITY PARTNERSHIPS.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Administrator of Health Resources and 
Services Administration, shall award grants, con-
tracts, or cooperative agreements to eligible entities 
to enable such entities to establish, enhance, or im-
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prove community partnerships for the purpose of 
collaborating on common objectives and integrating 
culturally appropriate best practice services available 
to individuals with FASD and other conditions re-
lated to prenatal substance exposure such as surveil-
lance, screening, assessment, diagnosis, prevention, 
treatment, and support services. 
‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re-
ceive a grant, contract, or cooperative agreement 
under paragraph (1), an entity shall— 
‘‘(A) be a public or private nonprofit entity 
that is— 
‘‘(i) a health care provider or health 
professional; 
‘‘(ii) a primary or secondary school; 
‘‘(iii) a social work or child protection 
service provider; 
‘‘(iv) an incarceration facility, or 
State or local judicial system for juveniles 
and adults; 
‘‘(v) an FASD organization, parent- 
led group, or other organization that sup-
ports and advocates for individuals with 
FASD and their families; 
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‘‘(vi) an Indian Tribe or Tribal orga-
nization; 
‘‘(vii) an early childhood intervention 
facility; 
‘‘(viii) any other entity the Secretary 
determines to be appropriate; or 
‘‘(ix) a consortium of any of the enti-
ties described in clauses (i) through (viii); 
and 
‘‘(B) prepare and submit to the Secretary 
an application at such time, in such manner, 
and containing such information as the Sec-
retary may require, including assurances that 
the entity submitting the application does, at 
the time of application, or will, within a reason-
able amount of time from the date of applica-
tion, provide evidence of substantive participa-
tion with a broad range of entities that work 
with or provide services for individuals with 
FASD. 
‘‘(3) ACTIVITIES.—An eligible entity shall use 
amounts received under a grant, contract, or cooper-
ative agreement under this subsection to carry out 
one or more of the following activities relating to 
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FASD and other conditions related to prenatal sub-
stance exposure: 
‘‘(A) Integrating FASD-informed and cul-
turally appropriate practices into existing pro-
grams and services available in the community. 
‘‘(B) Conducting a needs assessment to 
identify services that are not available in a com-
munity. 
‘‘(C) Developing and implementing cul-
turally appropriate, community-based initiatives 
to prevent FASD, and to screen, assess, diag-
nose, treat, and provide FASD-informed sup-
port services to individuals with FASD and 
their families. 
‘‘(D) Disseminating information about 
FASD and the availability of support services. 
‘‘(E) Developing and implementing a com-
munity-wide public awareness and outreach 
campaign focusing on the dangers of drinking 
alcohol while pregnant. 
‘‘(F) Providing mentoring or other support 
to individuals with FASD and their families. 
‘‘(G) Other activities, as the Secretary de-
termines appropriate, or in consideration of rec-
ommendations from the National Advisory 
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Council on FASD established under section 
399H–1. 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this subsection, there is authorized to 
be appropriated $5,000,000 for each of fiscal years 
2022 through 2027. 
‘‘(f) DEVELOPMENT OF BEST PRACTICES AND MOD-
ELS OF CARE.— 
‘‘(1) IN GENERAL.—The Secretary, in coordina-
tion with the Administrator of Health Resources and 
Services Administration, shall award grants to 
States, Indian Tribes and Tribal organizations, non-
governmental organizations, and institutions of high-
er education for the establishment of pilot projects 
to identify and implement culturally appropriate best 
practices for— 
‘‘(A) providing intervention and education 
of children with FASD, including— 
‘‘(i) activities and programs designed 
specifically for the identification, treat-
ment, and education of such children; and 
‘‘(ii) curricula development and cre-
dentialing of teachers, administrators, and 
social workers who implement such pro-
grams and provide childhood interventions; 
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‘‘(B) educating professionals within the 
child welfare, juvenile and adult criminal justice 
systems, including judges, attorneys, probation 
officers, social workers, child advocates, medical 
and mental health professionals, substance 
abuse professionals, law enforcement officers, 
prison wardens or other incarceration adminis-
trators, and administrators of developmental 
disability, mental health and alternative incar-
ceration facilities on how to screen, assess, 
identify, treat and support individuals with 
FASD or similar conditions related to prenatal 
substance exposure within these systems, in-
cluding— 
‘‘(i) programs designed specifically for 
the identification, assessment, treatment, 
and education of individuals with FASD; 
and 
‘‘(ii) curricula development and cre-
dentialing within the adult and juvenile 
justice and child welfare systems for indi-
viduals who implement such programs; 
‘‘(C) educating adoption or foster care 
agency officials about available and necessary 
services for children with FASD, including— 
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‘‘(i) programs designed specifically for 
screening, assessment and identification, 
treatment, and education of individuals 
with FASD; and 
‘‘(ii) on-going and consistent edu-
cation and training for potential adoptive 
or foster parents of a child with FASD; 
‘‘(D) educating health and mental health 
and substance use providers about available and 
necessary services for children with FASD, in-
cluding— 
‘‘(i) programs designed specifically for 
screening and identification, and both 
health and mental health treatment, of in-
dividuals with FASD; and 
‘‘(ii) 
curricula 
development 
and 
credentialing within the health and mental 
health and substance abuse systems for in-
dividuals who implement such programs; 
and 
‘‘(E) identifying and implementing cul-
turally appropriate best practice models for re-
ducing alcohol and other substance exposed 
pregnancies in women at high risk of such preg-
nancies. 
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‘‘(2) APPLICATION.—To be eligible for a grant 
under paragraph (1), an entity shall prepare and 
submit to the Secretary an application at such time, 
in such manner, and containing such information as 
the Secretary may require. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this subsection, there is authorized to 
be appropriated $5,000,000 for each of fiscal years 
2022 through 2027. 
‘‘(g) TRANSITIONAL SERVICES.— 
‘‘(1) IN GENERAL.—The Secretary, in coordina-
tion with the Administrator of the Health Resources 
and Services Administration and the Administrator 
of the Administration for Community Living, shall 
award demonstration grants, contracts, and coopera-
tive agreements to States and local units of govern-
ment, Indian Tribes and Tribal organizations, and 
nongovernmental organizations for the purpose of 
establishing integrated systems for providing cul-
turally appropriate best practice transitional services 
for adults affected by prenatal alcohol or substance 
exposure and evaluating the effectiveness of such 
services. 
‘‘(2) APPLICATION.—To be eligible for a grant, 
contract, or cooperative agreement under paragraph 
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(1), an entity shall prepare and submit to the Sec-
retary an application at such time, in such manner, 
and containing such information as the Secretary 
may reasonably require, including specific creden-
tials relating to education, skills, training, and con-
tinuing educational requirements relating to FASD. 
‘‘(3) ALLOWABLE USES.—An entity shall use 
amounts received under a grant, contract, or cooper-
ative agreement under paragraph (1) to carry out 
one or more of the following activities: 
‘‘(A) Provide housing assistance to, or spe-
cialized housing for, adults with FASD. 
‘‘(B) Provide FASD-informed vocational 
training and placement services for adults with 
FASD. 
‘‘(C) Provide medication monitoring serv-
ices for adults with FASD. 
‘‘(D) Provide FASD-informed training and 
support to organizations providing family serv-
ices or mental health programs and other orga-
nizations that work with adults with FASD. 
‘‘(E) Establish and evaluate housing mod-
els specially designed for adults with FASD. 
‘‘(F) Recruit, train and provide mentors 
for individuals with FASD. 
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‘‘(G) Other services or programs, as the 
Secretary determines appropriate. 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
To carry out this subsection, there is authorized to 
be appropriated $5,000,000 for each of fiscal years 
2022 through 2027. 
‘‘(h) SERVICES FOR INDIVIDUALS WITH FETAL AL-
COHOL SPECTRUM DISORDERS.— 
‘‘(1) IN GENERAL.—The Secretary, in coordina-
tion the Assistant Secretary for Mental Health and 
Substance Use, shall make awards of grants, cooper-
ative agreements, or contracts to public and non-
profit private entities, including Indian tribes and 
tribal organizations, to provide FASD-informed cul-
turally appropriate services to individuals with 
FASD. 
‘‘(2) USE OF FUNDS.—An award under para-
graph (1) may, subject to paragraph (4), be used 
to— 
‘‘(A) screen and test individuals to deter-
mine the type and level of services needed; 
‘‘(B) develop a FASD-informed com-
prehensive plan for providing services to the in-
dividuals; 
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‘‘(C) 
provide 
FASD-informed 
mental 
health counseling; 
‘‘(D) provide FASD-informed substance 
abuse prevention services and treatment, if 
needed; 
‘‘(E) coordinate services with other social 
programs including social services, justice sys-
tem, educational services, health services, men-
tal health and substance abuse services, finan-
cial assistance programs, vocational services 
and housing assistance programs; 
‘‘(F) provide FASD-informed vocational 
services; 
‘‘(G) provide FASD-informed health coun-
seling; 
‘‘(H) provide FASD-informed housing as-
sistance; 
‘‘(I) conduct FASD-informed parenting 
skills training; 
‘‘(J) develop and implement overall FASD- 
informed case management; 
‘‘(K) provide supportive services for fami-
lies of individuals with FASD; 
‘‘(L) provide respite care for caretakers of 
individuals with FASD; 
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‘‘(M) recruit, train and provide mentors 
for individuals with FASD; 
‘‘(N) provide FASD-informed educational 
and supportive services to families of individ-
uals with FASD; and 
‘‘(O) provide other services and programs, 
to the extent authorized by the Secretary after 
consideration of recommendations made by the 
National Advisory Council on FASD. 
‘‘(3) REQUIREMENTS.—To be eligible to receive 
an award under paragraph (1), an applicant shall— 
‘‘(A) demonstrate that the program will be 
part of a coordinated, comprehensive system of 
care for such individuals; 
‘‘(B) demonstrate an established commu-
nication with other social programs in the com-
munity including social services, justice system, 
financial assistance programs, health services, 
educational services, mental health and sub-
stance abuse services, vocational services and 
housing assistance services; 
‘‘(C) have a qualified staff of medical, 
mental health or other professionals with a his-
tory of working with individuals with FASD; 
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‘‘(D) provide assurance that the services 
will be provided in a culturally and linguistically 
appropriate manner; and 
‘‘(E) provide assurance that at the end of 
the 5-year award period, other mechanisms will 
be identified to meet the needs of the individ-
uals and families served under such award. 
‘‘(4) RELATIONSHIP
TO
PAYMENTS
UNDER 
OTHER PROGRAMS.—An award may be made under 
paragraph (1) only if the applicant involved agrees 
that the award will not be expended to pay the ex-
penses of providing any service under this section to 
an individual to the extent that payment has been 
made, or can reasonably be expected to be made, 
with respect to such expenses— 
‘‘(A) under any State compensation pro-
gram, under an insurance policy, or under any 
Federal or State or Tribal health benefits pro-
grams; or 
‘‘(B) by an entity that provides health 
services on a prepaid basis. 
‘‘(5) DURATION OF AWARDS.—With respect to 
any award under paragraph (1), the period during 
which payments under such award are made to the 
recipient may not exceed 5 years. 
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‘‘(6) EVALUATION.—The Secretary shall evalu-
ate each project carried out under paragraph (1) 
and shall disseminate the findings with respect to 
each such evaluation to appropriate public and pri-
vate entities, including the National Advisory Coun-
cil on FASD. 
‘‘(7) FUNDING.— 
‘‘(A) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.— For the purpose of carrying out this 
subsection, there is authorized to be appro-
priated $10,000,000 for each fiscal years 2022 
through 2027. 
‘‘(B) ALLOCATION.—Of the amounts ap-
propriated under subparagraph (A) for a fiscal 
year, not more than $300,000 shall, for the 
purposes relating to FASD, be made available 
for collaborative, coordinated interagency ef-
forts with the National Institute on Alcohol 
Abuse and Alcoholism, National Institute on 
Mental Health, the Eunice Kennedy Shriver 
National Institute of Child Health and Human 
Development, the Health Resources and Serv-
ices Administration, the Agency for Healthcare 
Research and Quality, the Administration for 
Community Living, the Centers for Disease 
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Control and Prevention, the Department of 
Education, the Department of Justice, and 
other agencies, as determined by the Secretary. 
Interagency collaborative efforts may include— 
‘‘(i) the evaluation of existing pro-
grams for efficacy; 
‘‘(ii) the development of new evidence- 
based or best practice programs for pre-
vention of prenatal alcohol and other sub-
stance exposure, and interventions for indi-
viduals with FASD and their families; 
‘‘(iii) the facilitation of translation 
and transition of existing evidence-based, 
best practices or culturally appropriate 
prevention and intervention programs into 
general and community practice; and 
‘‘(iv) engaging in Tribal consultation 
to ensure that Indian Tribes and Tribal or-
ganizations are able to develop culturally 
appropriate services and interventions for 
prenatal alcohol and other substance expo-
sure, and interventions for individuals with 
FASD and other conditions related to pre-
natal substance exposure and their fami-
lies.’’. 
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SEC. 4. NATIONAL ADVISORY COUNCIL ON FSAD. 
Part O of title III of the Public Health Service Act 
(42 U.S.C. 280f et seq.), as amended by section 2, is fur-
ther amended by inserting after section 339H the fol-
lowing: 
‘‘SEC. 399H–1. NATIONAL ADVISORY COUNCIL ON FASD. 
‘‘(a) IN GENERAL.—The Secretary shall establish an 
advisory council to be known as the National Advisory 
Council on FASD (referred to in this section as the ‘Coun-
cil’) to foster coordination and cooperation among all Fed-
eral and non-Federal members and their constituencies 
that conduct or support FASD and other conditions re-
lated to prenatal substance exposure research, programs, 
and surveillance, and otherwise meet the general needs of 
populations actually or potentially impacted by FASD and 
other conditions related to prenatal substance exposure. 
‘‘(b) MEMBERSHIP.—The Council shall be composed 
of 23 members as described in paragraphs (1) and (2). 
‘‘(1) FEDERAL MEMBERSHIP.—Members of the 
Council shall include representatives of the following 
Federal agencies: 
‘‘(A) The National Institute on Alcohol 
Abuse and Alcoholism. 
‘‘(B) The National Institute on Drug 
Abuse. 
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‘‘(C) The Centers for Disease Control and 
Prevention. 
‘‘(D) The Health Resources and Services 
Administration. 
‘‘(E) The Substance Abuse and Mental 
Health Services Agency. 
‘‘(F) The Office of Special Education and 
Rehabilitative Services. 
‘‘(G) The Office of Justice Programs. 
‘‘(H) The Indian Health Service. 
‘‘(I) The Interagency Coordinating Com-
mittee on Fetal Alcohol Spectrum Disorders. 
‘‘(J) The Agency for Healthcare Research 
and Quality. 
‘‘(2) 
NON-FEDERAL
MEMBERS.—Additional 
non-Federal public and private sector members of 
the Council shall be nominated by the Interagency 
Coordinating Committee on Fetal Alcohol Spectrum 
Disorders and appointed by the Secretary, and shall 
be staffed by the Office of the Assistant Secretary 
for Planning and Evaluation of the Department of 
Health and Human Service. Such members shall in-
clude— 
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‘‘(A) at least one individual with FASD or 
a parent or legal guardian of an individual with 
FASD; 
‘‘(B) at least one individual or a parent or 
legal guardian of an individual with a condition 
related to prenatal substance exposure; 
‘‘(C) at least one birth mother of an indi-
vidual with FASD; 
‘‘(D) at least one representative from the 
FASD Study Group of the Research Society on 
Alcoholism; 
‘‘(E) at least one representative of the Na-
tional Organization on Fetal Alcohol Syndrome; 
‘‘(F) at least one representative of a lead-
ing statewide advocacy and service organization 
for individuals with FASD and their families; 
‘‘(G) at least one representative of the 
FASD Center for Excellence established under 
section 399H–3; 
‘‘(H) at least 2 representatives from State 
or Tribal advisory groups receiving an award 
under section 399H(d); and 
‘‘(I) representatives with interest and ex-
pertise in FASD from the private sector of pe-
diatricians, obstetricians and gynecologists, sub-
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stance abuse and mental health care providers, 
family and juvenile court judges and justice and 
corrections programming and services, or spe-
cial education and social work professionals. 
‘‘(3) APPOINTMENT TIMING.—The members of 
the Council described in paragraph (2) shall be ap-
pointed by the Secretary not later than 6 months 
after the date of enactment of the Advancing FASD 
Research, Services, and Prevention Act. 
‘‘(c) FUNCTIONS.—The Council shall— 
‘‘(1) advise Federal, State, Tribal and local pro-
grams and research concerning FASD and other 
conditions related to prenatal substance exposure, 
including programs and research concerning edu-
cation and public awareness for relevant service pro-
viders, reducing the incidence of prenatal alcohol 
and other substance exposure in pregnancies, med-
ical and mental diagnosis, interventions for women 
at-risk of giving birth with FASD and beneficial 
services and supports for individuals with FASD and 
their families; 
‘‘(2) coordinate its efforts with the Interagency 
Committee on Fetal Alcohol Spectrum Disorders; 
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‘‘(B) recommendations to ensure that 
FASD research, and services and support ac-
tivities to the extent practicable, of the Depart-
ment of Health and Human Services and of 
other Federal departments and agencies, are 
not unnecessarily duplicative; 
‘‘(C) identification of existing Federal pro-
grams that could be used to identify and assist 
individuals with FASD and other conditions re-
lated to substance exposed pregnancies; 
‘‘(D) identification of gaps or barriers for 
individuals living with, or impacted by, FASD 
in accessing diagnostic, early intervention, and 
support services; 
‘‘(E) identification of prevention strategies, 
including education campaigns and options, 
such as product warnings and other mecha-
nisms to raise awareness of the risks associated 
with prenatal alcohol consumption; 
‘‘(F) identification of current diagnostic 
methods and practices for the identification of 
FASD and identify gaps or barriers for achiev-
ing diagnostic capacity throughout the United 
States based on current estimated prevalence of 
FASD; 
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‘‘(G) recommendations for research or 
other measures to increase diagnostic capacity 
to meet the needs of the estimated number of 
individuals with FASD; 
‘‘(H) identification and enhancement of 
culturally appropriate or best practice ap-
proaches and models of care to reduce the inci-
dence of FASD; and 
‘‘(I) identification and enhancement of best 
practice approaches and models of care to in-
crease support and treat individuals with 
FASD, and to make recommendations for a 
broad model comprehensive community ap-
proach to the overall problem of prenatal alco-
hol and other harmful substance exposure. 
‘‘(d) REPORT TO CONGRESS AND THE PRESIDENT.— 
The Council shall submit to Congress and to the Presi-
dent— 
‘‘(1) an update on the summary of advances de-
scribed in paragraphs (3) and (6) of subsection (c), 
not later than 2 years after the date of enactment 
of the Advancing FASD Research, Services, and 
Prevention Act; 
‘‘(2) an update to the national agenda described 
in subsection (c)(7), including any progress made in 
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achieving the objectives outlined in such agenda, not 
later than 4 years after the date of enactment of 
such Act; and 
‘‘(3) a final report that provides a summary of 
advances described in paragraphs (3) and (6) of sub-
section (c), and an update to the national agenda 
described in subsection (c)(7), not later than Sep-
tember 30, 2027. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$2,000,000 for each of fiscal years 2022 through 2027.’’. 
SEC. 5. INTERAGENCY COORDINATING COMMITTEE ON 
FETAL ALCOHOL SPECTRUM DISORDERS. 
Subpart 14 of part C of title IV of the Public Health 
Service Act (42 U.S.C. 285n et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 464K. INTERAGENCY COORDINATING COMMITTEE ON 
FETAL ALCOHOL SPECTRUM DISORDERS. 
‘‘(a) IN GENERAL.—The Director of the Institute 
shall provide for the continuation of the ‘Interagency Co-
ordinating Committee on Fetal Alcohol Spectrum Dis-
orders’ (referred to in this section as the ‘Committee’) so 
that such Committee may— 
‘‘(1) coordinate activities conducted by the Fed-
eral Government on FASD, including convening 
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meetings, establishing work groups, sharing informa-
tion, and facilitating and promoting collaborative 
projects among Federal agencies, the National Advi-
sory Council on FASD established under section 
399H–1, and outside partners; 
‘‘(2) support organizations of appropriate med-
ical and mental health professionals in their develop-
ment and refinement of evidence-based clinical diag-
nostic guidelines and criteria for all fetal alcohol 
spectrum disorders in collaboration with other Fed-
eral and outside partners, and 
‘‘(3) develop priority areas considering rec-
ommendations from the National Advisory Council 
on FASD. 
‘‘(b) MEMBERSHIP.—Members of the Committee 
shall include representatives of the following Federal agen-
cies: 
‘‘(1) The National Institute on Alcohol Abuse 
and Alcoholism. 
‘‘(2) The Centers for Disease Control and Pre-
vention. 
‘‘(3) The Health Resources and Services Ad-
ministration. 
‘‘(4) The Office of the Assistant Secretary for 
Planning and Evaluation. 
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‘‘(5) The Office of Juvenile Justice and Delin-
quency Prevention. 
‘‘(6) Office of Justice Programs of the Depart-
ment of Justice. 
‘‘(7) The Substance Abuse and Mental Health 
Services Administration. 
‘‘(8) The Office of Special Education and Reha-
bilitation Services. 
‘‘(9) The National Institute on Drug Abuse. 
‘‘(10) The National Institute of Mental Health. 
‘‘(11) The Indian Health Service. 
‘‘(12) The Eunice Kennedy Shriver National 
Institute of Child Health and Human Development. 
‘‘(13) Other Federal agencies with responsibil-
ities related to FASD prevention or treatment or 
that interact with individuals with FASD, including 
education and correctional systems, alcohol and sub-
stance use disorder prevention and treatment pro-
grams, maternal health, the Medicare and Medicaid 
programs under titles XVIII and XIX, respectively, 
of the Social Security Act, child health and welfare, 
rehabilitative services, and labor and housing grant 
or entitlement programs. 
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