292 
resentatives and the Committee on Health, Education, 
Labor, and Pensions of the Senate a report on the health 
effects of new psychoactive substances, including synthetic 
drugs, used by adolescents and young adults. 
(b) NEW PSYCHOACTIVE SUBSTANCE DEFINED.—For 
purposes of subsection (a), the term ‘‘new psychoactive sub-
stance’’ means a controlled substance analogue (as defined 
in section 102(32) of the Controlled Substances Act (21 
U.S.C. 802(32)). 
SEC. 7002. FIRST RESPONDER TRAINING. 
Section 546 of the Public Health Service Act (42 
U.S.C. 290ee–1) is amended— 
(1) in subsection (c)— 
(A) in paragraph (2), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (3), by striking the period 
and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(4) train and provide resources for first re-
sponders and members of other key community sectors 
on safety around fentanyl, carfentanil, and other dan-
gerous licit and illicit drugs to protect themselves 
from exposure to such drugs and respond appro-
priately when exposure occurs.’’;
293 
(2) in subsection (d), by striking ‘‘and mecha-
nisms for referral to appropriate treatment for an en-
tity receiving a grant under this section’’ and insert-
ing ‘‘mechanisms for referral to appropriate treat-
ment, and safety around fentanyl, carfentanil, and 
other dangerous licit and illicit drugs’’; 
(3) in subsection (f)— 
(A) in paragraph (3), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (4), by striking the period 
and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(5) the number of first responders and members 
of other key community sectors trained on safety 
around fentanyl, carfentanil, and other dangerous 
licit and illicit drugs.’’; 
(4) by redesignating subsection (g) as subsection 
(h); 
(5) by inserting after subsection (f) the following: 
‘‘(g) OTHER KEY COMMUNITY SECTORS.—In this sec-
tion, the term ‘other key community sectors’ includes sub-
stance use disorder treatment providers, emergency medical 
services agencies, agencies and organizations working with 
prison and jail populations and offender reentry programs, 
health care providers, harm reduction groups, pharmacies,
294 
community health centers, tribal health facilities, and men-
tal health providers.’’; and 
(6) in subsection (h), as so redesignated, by 
striking ‘‘$12,000,000 for each of fiscal years 2017 
through 2021’’ and inserting ‘‘$36,000,000 for each of 
fiscal years 2019 through 2023’’. 
Subtitle B—Pilot Program for Pub-
lic Health Laboratories To De-
tect Fentanyl and Other Syn-
thetic Opioids 
SEC. 7011. PILOT PROGRAM FOR PUBLIC HEALTH LABORA-
TORIES TO DETECT FENTANYL AND OTHER 
SYNTHETIC OPIOIDS. 
(a) GRANTS.—The Secretary of Health and Human 
Services (referred to in this section as the ‘‘Secretary’’) shall 
award grants to, or enter into cooperative agreements with, 
Federal, State, and local agencies to improve coordination 
between public health laboratories and laboratories operated 
by law enforcement agencies, such as Customs and Border 
Protection and the Drug Enforcement Administration, to 
improve detection of synthetic opioids, including fentanyl 
and its analogues, as described in subsection (b). 
(b) DETECTION ACTIVITIES.—The Secretary, in con-
sultation with the Director of the National Institute of 
Standards and Technology, the Director of the Centers for
295 
Disease Control and Prevention, the Attorney General of the 
United States, and the Administrator of the Drug Enforce-
ment Administration, shall, for purposes of this section, de-
velop or identify— 
(1) best practices for safely handling and testing 
synthetic opioids, including fentanyl and its ana-
logues, including with respect to reference materials, 
instrument calibration, and quality control protocols; 
(2) reference materials and quality control 
standards related to synthetic opioids, including 
fentanyl and its analogues, to enhance— 
(A) clinical diagnostics; 
(B) postmortem data collection; and 
(C) portable testing equipment utilized by 
law enforcement and public health officials; and 
(3) procedures for the identification of new and 
emerging synthetic opioid formulations and proce-
dures for reporting those findings to appropriate law 
enforcement agencies and Federal, State, and local 
public health laboratories and health departments, as 
appropriate. 
(c) LABORATORIES.—The Secretary shall require re-
cipients of grants or cooperative agreements under sub-
section (a) to—
296 
(1) follow the best practices established under 
subsection (b) and have the appropriate capabilities 
to provide laboratory testing of controlled substances, 
such as synthetic fentanyl, and biospecimens for the 
purposes of aggregating and reporting public health 
information to Federal, State, and local public health 
officials, laboratories, and other entities the Secretary 
deems appropriate; 
(2) work with law enforcement agencies and pub-
lic health authorities, as practicable; 
(3) provide early warning information to Fed-
eral, State, and local law enforcement agencies and 
public health authorities regarding trends or other 
data related to the supply of synthetic opioids, includ-
ing fentanyl and its analogues; 
(4) provide biosurveillance capabilities with re-
spect to identifying trends in adverse health outcomes 
associated with non-fatal exposures; and 
(5) provide diagnostic testing, as appropriate 
and practicable, for non-fatal exposures of emergency 
personnel, first responders, and other individuals. 
(d) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$15,000,000 for each of fiscal years 2019 through 2023.
297 
Subtitle C—Indexing Narcotics, 
Fentanyl, and Opioids 
SEC. 7021. ESTABLISHMENT OF SUBSTANCE USE DISORDER 
INFORMATION DASHBOARD. 
Title XVII of the Public Health Service Act (42 U.S.C. 
300u et seq.) is amended by adding at the end the following 
new section: 
‘‘SEC. 1711. ESTABLISHMENT OF SUBSTANCE USE DIS-
ORDER INFORMATION DASHBOARD. 
‘‘(a) IN GENERAL.—Not later than 6 months after the 
date of the enactment of this section, the Secretary of Health 
and Human Services shall, in consultation with the Direc-
tor of National Drug Control Policy, establish and periodi-
cally update, on the Internet website of the Department of 
Health and Human Services, a public information dash-
board that— 
‘‘(1) provides links to information on programs 
within the Department of Health and Human Serv-
ices related to the reduction of opioid and other sub-
stance use disorders; 
‘‘(2) provides access, to the extent practicable 
and appropriate, to publicly available data, which 
may include data from agencies within the Depart-
ment of Health and Human Services and— 
‘‘(A) other Federal agencies;
299 
SEC. 7022. INTERDEPARTMENTAL SUBSTANCE USE DIS-
ORDERS COORDINATING COMMITTEE. 
(a) ESTABLISHMENT.—Not later than 3 months after 
the date of the enactment of this Act, the Secretary of Health 
and Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall, in coordination with the Director of Na-
tional Drug Control Policy, establish a committee, to be 
known as the Interdepartmental Substance Use Disorders 
Coordinating Committee (in this section referred to as the 
‘‘Committee’’), to coordinate Federal activities related to 
substance use disorders. 
(b) MEMBERSHIP.— 
(1) FEDERAL MEMBERS.—The Committee shall 
be composed of the following Federal representatives, 
or the designees of such representatives: 
(A) The Secretary, who shall serve as the 
Chair of the Committee. 
(B) The Attorney General of the United 
States. 
(C) The Secretary of Labor. 
(D) The Secretary of Housing and Urban 
Development. 
(E) The Secretary of Education. 
(F) The Secretary of Veterans Affairs. 
(G) The Commissioner of Social Security.
300 
(H) The Assistant Secretary for Mental 
Health and Substance Use. 
(I) The Director of National Drug Control 
Policy. 
(J) Representatives of other Federal agen-
cies that support or conduct activities or pro-
grams related to substance use disorders, as de-
termined appropriate by the Secretary. 
(2) NON-FEDERAL
MEMBERS.—The Committee 
shall include a minimum of 15 non-Federal members 
appointed by the Secretary, of which— 
(A) at least two such members shall be an 
individual who has received treatment for a di-
agnosis of a substance use disorder; 
(B) at least two such members shall be a di-
rector of a State substance abuse agency; 
(C) at least two such members shall be a 
representative of a leading research, advocacy, or 
service organization for adults with substance 
use disorder; 
(D) at least two such members shall— 
(i) be a physician, licensed mental 
health professional, advance practice reg-
istered nurse, or physician assistant; and
301 
(ii) have experience in treating indi-
viduals with substance use disorders; 
(E) at least one such member shall be a sub-
stance use disorder treatment professional who 
provides treatment services at a certified opioid 
treatment program; 
(F) at least one such member shall be a sub-
stance use disorder treatment professional who 
has research or clinical experience in working 
with racial and ethnic minority populations; 
(G) at least one such member shall be a sub-
stance use disorder treatment professional who 
has research or clinical mental health experience 
in working with medically underserved popu-
lations; 
(H) at least one such member shall be a 
State-certified substance use disorder peer sup-
port specialist; 
(I) at least one such member shall be a drug 
court judge or a judge with experience in adjudi-
cating cases related to substance use disorder; 
(J) at least one such member shall be a pub-
lic safety officer with extensive experience in 
interacting with adults with a substance use dis-
order; and
302 
(K) at least one such member shall be an 
individual with experience providing services for 
homeless individuals with a substance use dis-
order. 
(c) TERMS.— 
(1) IN GENERAL.—A member of the Committee 
appointed under subsection (b)(2) shall be appointed 
for a term of 3 years and may be reappointed for one 
or more 3-year terms. 
(2) VACANCIES.—A vacancy on the Committee 
shall be filled in the same manner in which the origi-
nal appointment was made. Any individual ap-
pointed to fill a vacancy for an unexpired term shall 
be appointed for the remainder of such term and may 
serve after the expiration of such term until a suc-
cessor has been appointed. 
(d) MEETINGS.—The Committee shall meet not fewer 
than two times each year. 
(e) DUTIES.—The Committee shall— 
(1) identify areas for improved coordination of 
activities, if any, related to substance use disorders, 
including research, services, supports, and prevention 
activities across all relevant Federal agencies; 
(2) identify and provide to the Secretary rec-
ommendations for improving Federal programs for
303 
the prevention and treatment of, and recovery from, 
substance use disorders, including by expanding ac-
cess to prevention, treatment, and recovery services; 
(3) analyze substance use disorder prevention 
and treatment strategies in different regions of and 
populations in the United States and evaluate the ex-
tent to which Federal substance use disorder preven-
tion and treatment strategies are aligned with State 
and local substance use disorder prevention and treat-
ment strategies; 
(4) make recommendations to the Secretary re-
garding any appropriate changes with respect to the 
activities and strategies described in paragraphs (1) 
through (3); 
(5) make recommendations to the Secretary re-
garding public participation in decisions relating to 
substance use disorders and the process by which pub-
lic feedback can be better integrated into such deci-
sions; and 
(6) make recommendations to ensure that sub-
stance use disorder research, services, supports, and 
prevention activities of the Department of Health and 
Human Services and other Federal agencies are not 
unnecessarily duplicative.
304 
(f) ANNUAL REPORT.—Not later than 1 year after the 
date of the enactment of this Act, and annually thereafter 
for the life of the Committee, the Committee shall publish 
on the Internet website of the Department of Health and 
Human Services, which may include the public information 
dashboard established under section 1711 of the Public 
Health Service Act, as added by section 7021, a report sum-
marizing the activities carried out by the Committee pursu-
ant to subsection (e), including any findings resulting from 
such activities. 
(g) WORKING GROUPS.—The Committee may establish 
working groups for purposes of carrying out the duties de-
scribed in subsection (e). Any such working group shall be 
composed of members of the Committee (or the designees of 
such members) and may hold such meetings as are nec-
essary to enable the working group to carry out the duties 
delegated to the working group. 
(h) FEDERAL ADVISORY COMMITTEE ACT.—The Fed-
eral Advisory Committee Act (5 U.S.C. App.) shall apply 
to the Committee only to the extent that the provisions of 
such Act do not conflict with the requirements of this sec-
tion. 
(i) SUNSET.—The Committee shall terminate on the 
date that is 6 years after the date on which the Committee 
is established under subsection (a).
305 
SEC. 7023. NATIONAL MILESTONES TO MEASURE SUCCESS 
IN CURTAILING THE OPIOID CRISIS. 
(a) IN GENERAL.—Not later than 180 days after the 
date of enactment of this Act, the Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’), in coordination with the Administrator of the 
Drug Enforcement Administration and the Director of the 
Office of National Drug Control Policy, shall develop or 
identify existing national indicators (referred to in this sec-
tion as the ‘‘national milestones’’) to measure success in 
curtailing the opioid crisis, with the goal of significantly 
reversing the incidence and prevalence of opioid misuse and 
abuse, and opioid-related morbidity and mortality in the 
United States within 5 years of such date of enactment. 
(b) NATIONAL MILESTONES TO END THE OPIOID CRI-
SIS.—The national milestones under subsection (a) shall in-
clude the following: 
(1) Not fewer than 10 indicators or metrics to 
accurately and expediently measure progress in meet-
ing the goal described in subsection (a), which shall, 
as appropriate, include, indicators or metrics related 
to— 
(A) the number of fatal and non-fatal 
opioid overdoses; 
(B) the number of emergency room visits re-
lated to opioid misuse and abuse;
306 
(C) the number of individuals in sustained 
recovery from opioid use disorder; 
(D) the number of infections associated with 
illicit drug use, such as HIV, viral hepatitis, and 
infective endocarditis, and available capacity for 
treating such infections; 
(E) the number of providers prescribing 
medication-assisted treatment for opioid use dis-
orders, including in primary care settings, com-
munity health centers, jails, and prisons; 
(F) the number of individuals receiving 
treatment for opioid use disorder; and 
(G) additional indicators or metrics, as ap-
propriate, such as metrics pertaining to specific 
populations, including women and children, 
American Indians and Alaskan Natives, individ-
uals living in rural and non-urban areas, and 
justice-involved populations, that would further 
clarify the progress made in addressing the 
opioid crisis. 
(2) A reasonable goal, such as a percentage de-
crease or other specified metric, that signifies progress 
in meeting the goal described in subsection (a), and 
annual targets to help achieve that goal.
307 
(c) CONSIDERATION OF OTHER SUBSTANCE USE DIS-
ORDERS.—In developing the national milestones under sub-
section (b), the Secretary shall, as appropriate, consider 
other substance use disorders in addition to opioid use dis-
order. 
(d) EXTENSION OF PERIOD.—If the Secretary deter-
mines that the goal described in subsection (a) will not be 
achieved with respect to any indicator or metric established 
under subsection (b)(2) within 5 years of the date of enact-
ment of this Act, the Secretary may extend the timeline for 
meeting such goal with respect to that indicator or metric. 
The Secretary shall include with any such extension a ra-
tionale for why additional time is needed and information 
on whether significant changes are needed in order to 
achieve such goal with respect to the indicator or metric. 
(e) ANNUAL STATUS UPDATE.—Not later than one 
year after the date of enactment of this Act, the Secretary 
shall make available on the Internet website of the Depart-
ment of Health and Human Services, 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, an update on the progress, 
including expected progress in the subsequent year, in 
achieving the goals detailed in the national milestones. 
Each such update shall include the progress made in the
308 
first year or since the previous report, as applicable, in 
meeting each indicator or metric in the national milestones. 
SEC. 7024. STUDY ON PRESCRIBING LIMITS. 
Not later than 2 years after the date of enactment of 
this Act, the Secretary of Health and Human Services, in 
consultation with the Attorney General of the United States, 
shall 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 on 
the impact of Federal and State laws and regulations that 
limit the length, quantity, or dosage of opioid prescriptions. 
Such report shall address— 
(1) the impact of such limits on— 
(A) the incidence and prevalence of overdose 
related to prescription opioids; 
(B) the incidence and prevalence of overdose 
related to illicit opioids; 
(C) the prevalence of opioid use disorders; 
(D) medically appropriate use of, and ac-
cess to, opioids, including any impact on travel 
expenses and pain management outcomes for pa-
tients, whether such limits are associated with 
significantly higher rates of negative health out-
comes, including suicide, and whether the impact
309 
of such limits differs based on the clinical indi-
cation for which opioids are prescribed; 
(2) whether such limits lead to a significant in-
crease in burden for prescribers of opioids or pre-
scribers of treatments for opioid use disorder, includ-
ing any impact on patient access to treatment, and 
whether any such burden is mitigated by any factors 
such as electronic prescribing or telemedicine; and 
(3) the impact of such limits on diversion or 
misuse of any controlled substance in schedule II, III, 
or IV of section 202(c) of the Controlled Substances 
Act (21 U.S.C. 812(c)). 
Subtitle D—Ensuring Access to 
Quality Sober Living 
SEC. 7031. NATIONAL RECOVERY HOUSING BEST PRAC-
TICES. 
Part D of title V of the Public Health Service Act (42 
U.S.C. 290dd et seq.) is amended by adding at the end the 
following new section: 
‘‘SEC. 550. NATIONAL RECOVERY HOUSING BEST PRAC-
TICES. 
‘‘(a) BEST PRACTICES
FOR OPERATING RECOVERY 
HOUSING.— 
‘‘(1) IN GENERAL.—The Secretary, in consulta-
tion with the individuals and entities specified in
310 
paragraph (2), shall identify or facilitate the develop-
ment of best practices, which may include model laws 
for implementing suggested minimum standards, for 
operating recovery housing. 
‘‘(2) CONSULTATION.—In carrying out the ac-
tivities described in paragraph (1), the Secretary 
shall consult with, as appropriate— 
‘‘(A) relevant divisions of the Department of 
Health and Human Services, including the Sub-
stance Abuse and Mental Health Services Ad-
ministration, the Office of Inspector General, the 
Indian Health Service, and the Centers for Medi-
care & Medicaid Services; 
‘‘(B) the Secretary of Housing and Urban 
Development; 
‘‘(C) directors or commissioners, as applica-
ble, of State health departments, tribal health de-
partments, State Medicaid programs, and State 
insurance agencies; 
‘‘(D) representatives of health insurance 
issuers; 
‘‘(E) national accrediting entities and rep-
utable providers of, and analysts of, recovery 
housing services, including Indian tribes, tribal 
organizations, and tribally designated housing
311 
entities that provide recovery housing services, as 
applicable; 
‘‘(F) individuals with a history of substance 
use disorder; and 
‘‘(G) other stakeholders identified by the 
Secretary. 
‘‘(b) IDENTIFICATION
OF FRAUDULENT RECOVERY 
HOUSING OPERATORS.— 
‘‘(1) IN GENERAL.—The Secretary, in consulta-
tion with the individuals and entities described in 
paragraph (2), shall identify or facilitate the develop-
ment of common indicators that could be used to 
identify potentially fraudulent recovery housing oper-
ators. 
‘‘(2) CONSULTATION.—In carrying out the ac-
tivities described in paragraph (1), the Secretary 
shall consult with, as appropriate, the individuals 
and entities specified in subsection (a)(2) and the At-
torney General of the United States. 
‘‘(3) REQUIREMENTS.— 
‘‘(A) PRACTICES FOR IDENTIFICATION AND 
REPORTING.—In carrying out the activities de-
scribed in paragraph (1), the Secretary shall 
consider how law enforcement, public and pri-
312 
vate payers, and the public can best identify and 
report fraudulent recovery housing operators. 
‘‘(B) FACTORS
TO
BE
CONSIDERED.—In 
carrying out the activities described in para-
graph (1), the Secretary shall identify or develop 
indicators, which may include indicators related 
to— 
‘‘(i) unusual billing practices; 
‘‘(ii) average lengths of stays; 
‘‘(iii) excessive levels of drug testing 
(in terms of cost or frequency); and 
‘‘(iv) unusually high levels of recidi-
vism. 
‘‘(c) DISSEMINATION.—The Secretary shall, as appro-
priate, disseminate the best practices identified or developed 
under subsection (a) and the common indicators identified 
or developed under subsection (b) to— 
‘‘(1) State agencies, which may include the pro-
vision of technical assistance to State agencies seeking 
to adopt or implement such best practices; 
‘‘(2) Indian tribes, tribal organizations, and 
tribally designated housing entities; 
‘‘(3) the Attorney General of the United States; 
‘‘(4) the Secretary of Labor;
313 
‘‘(5) the Secretary of Housing and Urban Devel-
opment; 
‘‘(6) State and local law enforcement agencies; 
‘‘(7) health insurance issuers; 
‘‘(8) recovery housing entities; and 
‘‘(9) the public. 
‘‘(d) REQUIREMENTS.—In carrying out the activities 
described in subsections (a) and (b), the Secretary, in con-
sultation with appropriate individuals and entities de-
scribed in subsections (a)(2) and (b)(2), shall consider how 
recovery housing is able to support recovery and prevent 
relapse, recidivism, or overdose (including overdose death), 
including by improving access and adherence to treatment, 
including medication-assisted treatment. 
‘‘(e) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to provide the Secretary with the 
authority to require States to adhere to minimum stand-
ards in the State oversight of recovery housing. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘recovery housing’ means a shared 
living environment free from alcohol and illicit drug 
use and centered on peer support and connection to 
services that promote sustained recovery from sub-
stance use disorders.
314 
‘‘(2) The terms ‘Indian tribe’ and ‘tribal organi-
zation’ have the meanings given those terms in section 
4 of the Indian Self-Determination and Education 
Assistance Act (25 U.S.C. 5304). 
‘‘(3) The term ‘tribally designated housing enti-
ty’ has the meaning given that term in section 4 of 
the Native American Housing Assistance and Self-De-
termination Act of 1996 (25 U.S.C. 4103). 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$3,000,000 for the period of fiscal years 2019 through 
2021.’’. 
Subtitle E—Advancing Cutting 
Edge Research 
SEC. 7041. UNIQUE RESEARCH INITIATIVES. 
Section 402(n)(1) of the Public Health Service Act (42 
U.S.C. 282(n)(1)) is amended— 
(1) in subparagraph (A), by striking ‘‘or’’; 
(2) in subparagraph (B), by striking the period 
and inserting ‘‘; or’’; and 
(3) by adding at the end the following: 
‘‘(C) high impact cutting-edge research that 
fosters scientific creativity and increases funda-
mental biological understanding leading to the 
prevention, diagnosis, or treatment of diseases
315 
and disorders, or research urgently required to 
respond to a public health threat.’’. 
SEC. 7042. PAIN RESEARCH. 
Section 409J(b) of the Public Health Service Act (42 
U.S.C. 284q(b)) is amended— 
(1) in paragraph (5)— 
(A) in subparagraph (A), by striking ‘‘and 
treatment of pain and diseases and disorders as-
sociated with pain’’ and inserting ‘‘treatment, 
and management of pain and diseases and dis-
orders associated with pain, including informa-
tion on best practices for the utilization of non- 
pharmacologic treatments, non-addictive medical 
products, and other drugs or devices approved or 
cleared by the Food and Drug Administration’’; 
(B) in subparagraph (B), by striking ‘‘on 
the symptoms and causes of pain;’’ and inserting 
the following: ‘‘on— 
‘‘(i) the symptoms and causes of pain, 
including the identification of relevant bio-
markers and screening models and the epi-
demiology of acute and chronic pain; 
‘‘(ii) the diagnosis, prevention, treat-
ment, and management of acute and chron-
ic pain, including with respect to non-phar-
316 
macologic treatments, non-addictive medical 
products, and other drugs or devices ap-
proved or cleared by the Food and Drug Ad-
ministration; and 
‘‘(iii) risk factors for, and early warn-
ing signs of, substance use disorders in pop-
ulations with acute and chronic pain; and’’; 
and 
(C) by striking subparagraphs (C) through 
(E) and inserting the following: 
‘‘(C) make recommendations to the Director 
of NIH— 
‘‘(i) to ensure that the activities of the 
National Institutes of Health and other 
Federal agencies are free of unnecessary du-
plication of effort; 
‘‘(ii) on how best to disseminate infor-
mation on pain care and epidemiological 
data related to acute and chronic pain; and 
‘‘(iii) on how to expand partnerships 
between public entities and private entities 
to expand collaborative, cross-cutting re-
search.’’; 
(2) by redesignating paragraph (6) as para-
graph (7); and
317 
(3) by inserting after paragraph (5) the fol-
lowing: 
‘‘(6) REPORT.—The Secretary shall ensure that 
recommendations and actions taken by the Director 
with respect to the topics discussed at the meetings de-
scribed in paragraph (4) are included in appropriate 
reports to Congress.’’. 
Subtitle F—Jessie’s Law 
SEC. 7051. INCLUSION OF OPIOID ADDICTION HISTORY IN 
PATIENT RECORDS. 
(a) BEST PRACTICES.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this Act, the Secretary of 
Health and Human Services (in this section referred 
to as the ‘‘Secretary’’), in consultation with appro-
priate stakeholders, including a patient with a his-
tory of opioid use disorder, an expert in electronic 
health records, an expert in the confidentiality of pa-
tient health information and records, and a health 
care provider, shall identify or facilitate the develop-
ment of best practices regarding— 
(A) the circumstances under which informa-
tion that a patient has provided to a health care 
provider regarding such patient’s history of 
opioid use disorder should, only at the patient’s
318 
request, be prominently displayed in the medical 
records (including electronic health records) of 
such patient; 
(B) what constitutes the patient’s request 
for the purpose described in subparagraph (A); 
and 
(C) the process and methods by which the 
information should be so displayed. 
(2) DISSEMINATION.—The Secretary shall dis-
seminate the best practices developed under para-
graph (1) to health care providers and State agencies. 
(b) REQUIREMENTS.—In identifying or facilitating 
the development of best practices under subsection (a), as 
applicable, the Secretary, in consultation with appropriate 
stakeholders, shall consider the following: 
(1) The potential for addiction relapse or over-
dose, including overdose death, when opioid medica-
tions are prescribed to a patient recovering from 
opioid use disorder. 
(2) The benefits of displaying information about 
a patient’s opioid use disorder history in a manner 
similar to other potentially lethal medical concerns, 
including drug allergies and contraindications. 
(3) The importance of prominently displaying 
information about a patient’s opioid use disorder
319 
when a physician or medical professional is pre-
scribing medication, including methods for avoiding 
alert fatigue in providers. 
(4) The importance of a variety of appropriate 
medical professionals, including physicians, nurses, 
and pharmacists, having access to information de-
scribed in this section when prescribing or dispensing 
opioid medication, consistent with Federal and State 
laws and regulations. 
(5) The importance of protecting patient pri-
vacy, including the requirements related to consent 
for disclosure of substance use disorder information 
under all applicable laws and regulations. 
(6) All applicable Federal and State laws and 
regulations. 
SEC. 7052. COMMUNICATION WITH FAMILIES DURING EMER-
GENCIES. 
(a) PROMOTING AWARENESS OF AUTHORIZED DISCLO-
SURES DURING EMERGENCIES.—The Secretary of Health 
and Human Services shall annually notify health care pro-
viders regarding permitted disclosures under Federal health 
care privacy law during emergencies, including overdoses, 
of certain health information to families, caregivers, and 
health care providers.
320 
(b) USE OF MATERIAL.—For the purposes of carrying 
out subsection (a), the Secretary of Health and Human 
Services may use material produced under section 7053 of 
this Act or section 11004 of the 21st Century Cures Act 
(42 U.S.C. 1320d–2 note). 
SEC. 7053. DEVELOPMENT AND DISSEMINATION OF MODEL 
TRAINING PROGRAMS FOR SUBSTANCE USE 
DISORDER PATIENT RECORDS. 
(a) INITIAL PROGRAMS AND MATERIALS.—Not later 
than 1 year after the date of the enactment of this Act, the 
Secretary of Health and Human Services (in this section 
referred to as the ‘‘Secretary’’), in consultation with appro-
priate experts, shall identify the following model programs 
and materials (or if no such programs or materials exist, 
recognize private or public entities to develop and dissemi-
nate such programs and materials): 
(1) Model programs and materials for training 
health care providers (including physicians, emer-
gency medical personnel, psychiatrists, psychologists, 
counselors, therapists, nurse practitioners, physician 
assistants, behavioral health facilities and clinics, 
care managers, and hospitals, including individuals 
such as general counsels or regulatory compliance 
staff who are responsible for establishing provider pri-
vacy policies) concerning the permitted uses and dis-
321 
closures, consistent with the standards and regula-
tions governing the privacy and security of substance 
use disorder patient records promulgated by the Sec-
retary under section 543 of the Public Health Service 
Act (42 U.S.C. 290dd–2) for the confidentiality of pa-
tient records. 
(2) Model programs and materials for training 
patients and their families regarding their rights to 
protect and obtain information under the standards 
and regulations described in paragraph (1). 
(b) REQUIREMENTS.—The model programs and mate-
rials described in paragraphs (1) and (2) of subsection (a) 
shall address circumstances under which disclosure of sub-
stance use disorder patient records is needed to— 
(1) facilitate communication between substance 
use disorder treatment providers and other health care 
providers to promote and provide the best possible in-
tegrated care; 
(2) avoid inappropriate prescribing that can 
lead to dangerous drug interactions, overdose, or re-
lapse; and 
(3) notify and involve families and caregivers 
when individuals experience an overdose. 
(c) PERIODIC UPDATES.—The Secretary shall—
322 
(1) periodically review and update the model 
program and materials identified or developed under 
subsection (a); and 
(2) disseminate such updated programs and ma-
terials to the individuals described in subsection 
(a)(1). 
(d) INPUT OF CERTAIN ENTITIES.—In identifying, re-
viewing, or updating the model programs and materials 
under this section, the Secretary shall solicit the input of 
relevant stakeholders. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section— 
(1) $4,000,000 for fiscal year 2019; 
(2) $2,000,000 for each of fiscal years 2020 and 
2021; and 
(3) $1,000,000 for each of fiscal years 2022 and 
2023. 
Subtitle G—Protecting Pregnant 
Women and Infants 
SEC. 7061. REPORT ON ADDRESSING MATERNAL AND IN-
FANT HEALTH IN THE OPIOID CRISIS. 
(a) IN GENERAL.—Not later than 18 months after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services, in coordination with the Centers for 
Disease Control and Prevention, the National Institutes of
324 
SEC. 7062. PROTECTING MOMS AND INFANTS. 
(a) REPORT.— 
(1) IN GENERAL.—Not later than 60 days after 
the date of enactment of this Act, the Secretary of 
Health and Human Services (referred to in this sec-
tion as the ‘‘Secretary’’) shall submit to the Com-
mittee on Health, Education, Labor, and Pensions of 
the Senate and the Committee on Energy and Com-
merce of the House of Representatives, and make 
available to the public on the Internet website of the 
Department of Health and Human Services, a report 
regarding the implementation of the recommendations 
in the strategy relating to prenatal opioid use, includ-
ing neonatal abstinence syndrome, developed pursu-
ant to section 2 of the Protecting Our Infants Act of 
2015 (Public Law 114–91). Such report shall in-
clude— 
(A) an update on the implementation of the 
recommendations in the strategy, including in-
formation regarding the agencies involved in the 
implementation; and 
(B) information on additional funding or 
authority the Secretary requires, if any, to im-
plement the strategy, which may include au-
thorities needed to coordinate implementation of
325 
such strategy across the Department of Health 
and Human Services. 
(2) PERIODIC
UPDATES.—The Secretary shall 
periodically update the report under paragraph (1). 
(b) RESIDENTIAL TREATMENT PROGRAMS FOR PREG-
NANT AND POSTPARTUM WOMEN.—Section 508(s) of the 
Public Health Service Act (42 U.S.C. 290bb–1(s)) is amend-
ed by striking ‘‘$16,900,000 for each of fiscal years 2017 
through 2021’’ and inserting ‘‘$29,931,000 for each of fiscal 
years 2019 through 2023’’. 
SEC. 7063. EARLY INTERVENTIONS FOR PREGNANT WOMEN 
AND INFANTS. 
(a) DEVELOPMENT OF EDUCATIONAL MATERIALS BY 
CENTER FOR SUBSTANCE ABUSE PREVENTION.—Section 
515(b) of the Public Health Service Act (42 U.S.C. 290bb– 
21(b)) is amended— 
(1) in paragraph (13), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (14), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(15) in consultation with relevant stakeholders 
and in collaboration with the Director of the Centers 
for Disease Control and Prevention, develop edu-
cational materials for clinicians to use with pregnant
326 
women for shared decision making regarding pain 
management and the prevention of substance use dis-
orders during pregnancy.’’. 
(b) GUIDELINES AND RECOMMENDATIONS BY CENTER 
FOR SUBSTANCE ABUSE TREATMENT.—Section 507(b) of 
the Public Health Service Act (42 U.S.C. 290bb(b)) is 
amended— 
(1) in paragraph (13), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (14), by striking the period at 
the end and inserting a semicolon; and 
(3) by adding at the end the following: 
‘‘(15) in cooperation with the Secretary, imple-
ment and disseminate, as appropriate, the rec-
ommendations in the report entitled ‘Protecting Our 
Infants Act: Final Strategy’ issued by the Depart-
ment of Health and Human Services in 2017; and’’. 
(c) SUPPORT OF PARTNERSHIPS BY CENTER FOR SUB-
STANCE ABUSE TREATMENT.—Section 507(b) of the Public 
Health Service Act (42 U.S.C. 290bb(b)), as amended by 
subsection (b), is further amended by adding at the end the 
following: 
‘‘(16) in cooperation with relevant stakeholders, 
and through public-private partnerships, encourage 
education about substance use disorders for pregnant
327 
women and health care providers who treat pregnant 
women and babies.’’. 
SEC. 7064. PRENATAL AND POSTNATAL HEALTH. 
Section 317L of the Public Health Service Act (42 
U.S.C. 247b–13) is amended— 
(1) in subsection (a)— 
(A) by amending paragraph (1) to read as 
follows: 
‘‘(1) to collect, analyze, and make available data 
on prenatal smoking and alcohol and other substance 
abuse and misuse, including— 
‘‘(A) data on— 
‘‘(i) the incidence, prevalence, and im-
plications of such activities; and 
‘‘(ii) the incidence and prevalence of 
implications and outcomes, including neo-
natal abstinence syndrome and other mater-
nal and child health outcomes associated 
with such activities; and 
‘‘(B) additional information or data, as ap-
propriate, on family health history, medication 
exposures during pregnancy, demographic infor-
mation, such as race, ethnicity, geographic loca-
tion, and family history, and other relevant in-
formation, to inform such analysis;’’;
328 
(B) in paragraph (2)— 
(i) by striking ‘‘prevention of’’ and in-
serting ‘‘prevention and long-term outcomes 
associated with’’; and 
(ii) by striking ‘‘illegal drug use’’ and 
inserting ‘‘other substance abuse and mis-
use’’; 
(C) in paragraph (3), by striking ‘‘and ces-
sation programs; and’’ and inserting ‘‘, treat-
ment, and cessation programs;’’; 
(D) in paragraph (4), by striking ‘‘illegal 
drug use.’’ and inserting ‘‘other substance abuse 
and misuse; and’’; and 
(E) by adding at the end the following: 
‘‘(5) to issue public reports on the analysis of 
data described in paragraph (1), including analysis 
of— 
‘‘(A) long-term outcomes of children affected 
by neonatal abstinence syndrome; 
‘‘(B) health outcomes associated with pre-
natal smoking, alcohol, and substance abuse and 
misuse; and 
‘‘(C) relevant studies, evaluations, or infor-
mation the Secretary determines to be appro-
priate.’’;
329 
(2) in subsection (b), by inserting ‘‘tribal enti-
ties,’’ after ‘‘local governments,’’; 
(3) by redesignating subsection (c) as subsection 
(d); 
(4) by inserting after subsection (b) the fol-
lowing: 
‘‘(c) COORDINATING ACTIVITIES.—To carry out this 
section, the Secretary may— 
‘‘(1) provide technical and consultative assist-
ance to entities receiving grants under subsection (b); 
‘‘(2) ensure a pathway for data sharing between 
States, tribal entities, and the Centers for Disease 
Control and Prevention; 
‘‘(3) ensure data collection under this section is 
consistent with applicable State, Federal, and Tribal 
privacy laws; and 
‘‘(4) coordinate with the National Coordinator 
for Health Information Technology, as appropriate, 
to assist States and Tribes in implementing systems 
that use standards recognized by such National Coor-
dinator, as such recognized standards are available, 
in order to facilitate interoperability between such 
systems and health information technology systems, 
including certified health information technology.’’; 
and
330 
(5) in subsection (d), as so redesignated, by 
striking ‘‘2001 through 2005’’ and inserting ‘‘2019 
through 2023’’. 
SEC. 7065. PLANS OF SAFE CARE. 
(a) IN GENERAL.—Section 105(a) of the Child Abuse 
Prevention and Treatment Act (42 U.S.C. 5106(a)) is 
amended by adding at the end the following: 
‘‘(7) GRANTS TO STATES TO IMPROVE AND CO-
ORDINATE THEIR RESPONSE TO ENSURE THE SAFETY, 
PERMANENCY, AND
WELL-BEING
OF
INFANTS
AF-
FECTED BY SUBSTANCE USE.— 
‘‘(A) PROGRAM
AUTHORIZED.—The Sec-
retary is authorized to make grants to States for 
the purpose of assisting child welfare agencies, 
social services agencies, substance use disorder 
treatment agencies, hospitals with labor and de-
livery units, medical staff, public health and 
mental health agencies, and maternal and child 
health agencies to facilitate collaboration in de-
veloping, updating, implementing, and moni-
toring plans of safe care described in section 
106(b)(2)(B)(iii). Section 112(a)(2) shall not 
apply to the program authorized under this 
paragraph. 
‘‘(B) DISTRIBUTION OF FUNDS.—
331 
‘‘(i) RESERVATIONS.—Of the amounts 
made available to carry out subparagraph 
(A), the Secretary shall reserve— 
‘‘(I) no more than 3 percent for 
the purposes described in subparagraph 
(G); and 
‘‘(II) up to 3 percent for grants to 
Indian Tribes and tribal organizations 
to address the needs of infants born 
with, and identified as being affected 
by, substance abuse or withdrawal 
symptoms resulting from prenatal drug 
exposure or a fetal alcohol spectrum 
disorder and their families or care-
givers, which to the extent practicable, 
shall be consistent with the uses of 
funds described under subparagraph 
(D). 
‘‘(ii) ALLOTMENTS
TO
STATES
AND 
TERRITORIES.—The Secretary shall allot 
the amount made available to carry out 
subparagraph (A) that remains after appli-
cation of clause (i) to each State that ap-
plies for such a grant, in an amount equal 
to the sum of—
332 
‘‘(I) $500,000; and 
‘‘(II) an amount that bears the 
same relationship to any funds made 
available to carry out subparagraph 
(A) and remaining after application of 
clause (i), as the number of live births 
in the State in the previous calendar 
year bears to the number of live births 
in all States in such year. 
‘‘(iii) RATABLE
REDUCTION.—If the 
amount made available to carry out sub-
paragraph (A) is insufficient to satisfy the 
requirements of clause (ii), the Secretary 
shall ratably reduce each allotment to a 
State. 
‘‘(C) APPLICATION.—A State desiring a 
grant under this paragraph shall submit an ap-
plication to the Secretary at such time and in 
such manner as the Secretary may require. Such 
application shall include— 
‘‘(i) a description of— 
‘‘(I) the impact of substance use 
disorder in such State, including with 
respect to the substance or class of sub-
stances with the highest incidence of
333 
abuse in the previous year in such 
State, including— 
‘‘(aa) the prevalence of sub-
stance use disorder in such State; 
‘‘(bb) the aggregate rate of 
births in the State of infants af-
fected by substance abuse or with-
drawal symptoms or a fetal alco-
hol spectrum disorder (as deter-
mined by hospitals, insurance 
claims, claims submitted to the 
State Medicaid program, or other 
records), if available and to the 
extent practicable; and 
‘‘(cc) the number of infants 
identified, for whom a plan of safe 
care was developed, and for whom 
a referral was made for appro-
priate services, as reported under 
section 106(d)(18); 
‘‘(II) the challenges the State faces 
in developing, implementing, and mon-
itoring plans of safe care in accordance 
with section 106(b)(2)(B)(iii);
334 
‘‘(III) the State’s lead agency for 
the grant program and how that agen-
cy will coordinate with relevant State 
entities and programs, including the 
child welfare agency, the substance use 
disorder treatment agency, hospitals 
with labor and delivery units, health 
care providers, the public health and 
mental health agencies, programs fund-
ed by the Substance Abuse and Mental 
Health Services Administration that 
provide substance use disorder treat-
ment for women, the State Medicaid 
program, the State agency admin-
istering the block grant program under 
title V of the Social Security Act (42 
U.S.C. 701 et seq.), the State agency 
administering the programs funded 
under part C of the Individuals with 
Disabilities Education Act (20 U.S.C. 
1431 et seq.), the maternal, infant, and 
early childhood home visiting program 
under section 511 of the Social Secu-
rity Act (42 U.S.C. 711), the State ju-
dicial system, and other agencies, as
335 
determined by the Secretary, and In-
dian Tribes and tribal organizations, 
as appropriate, to implement the ac-
tivities under this paragraph; 
‘‘(IV) how the State will monitor 
local development and implementation 
of plans of safe care, in accordance 
with section 106(b)(2)(B)(iii)(II), in-
cluding how the State will monitor to 
ensure plans of safe care address dif-
ferences between substance use disorder 
and medically supervised substance 
use, including for the treatment of a 
substance use disorder; 
‘‘(V) if applicable, how the State 
plans to utilize funding authorized 
under part E of title IV of the Social 
Security Act (42 U.S.C. 670 et seq.) to 
assist in carrying out any plan of safe 
care, including such funding author-
ized under section 471(e) of such Act 
(as in effect on October 1, 2018) for 
mental health and substance abuse pre-
vention and treatment services and in- 
home parent skill-based programs and
336 
funding authorized under such section 
472(j) (as in effect on October 1, 2018) 
for children with a parent in a li-
censed residential family-based treat-
ment facility for substance abuse; and 
‘‘(VI) an assessment of the treat-
ment and other services and programs 
available in the State to effectively 
carry out any plan of safe care devel-
oped, including identification of needed 
treatment, and other services and pro-
grams to ensure the well-being of 
young children and their families af-
fected by substance use disorder, such 
as programs carried out under part C 
of the Individuals with Disabilities 
Education Act (20 U.S.C. 1431 et seq.) 
and comprehensive early childhood de-
velopment services and programs such 
as Head Start programs; 
‘‘(ii) a description of how the State 
plans to use funds for activities described in 
subparagraph (D) for the purposes of ensur-
ing State compliance with requirements
337 
under clauses (ii) and (iii) of section 
106(b)(2)(B); and 
‘‘(iii) an assurance that the State will 
comply with requirements to refer a child 
identified as substance-exposed to early 
intervention services as required pursuant 
to a grant under part C of the Individuals 
with Disabilities Education Act (20 U.S.C. 
1431 et seq.). 
‘‘(D) USES OF FUNDS.—Funds awarded to 
a State under this paragraph may be used for 
the following activities, which may be carried 
out by the State directly, or through grants or 
subgrants, contracts, or cooperative agreements: 
‘‘(i) Improving State and local systems 
with respect to the development and imple-
mentation of plans of safe care, which— 
‘‘(I) shall include parent and 
caregiver 
engagement, 
as 
required 
under section 106(b)(2)(B)(iii)(I), re-
garding available treatment and serv-
ice options, which may include re-
sources 
available 
for 
pregnant, 
perinatal, and postnatal women; and
338 
‘‘(II) may include activities such 
as— 
‘‘(aa) 
developing 
policies, 
procedures, or protocols for the 
administration or development of 
evidence-based 
and 
validated 
screening tools for infants who 
may be affected by substance use 
withdrawal symptoms or a fetal 
alcohol spectrum disorder and 
pregnant, perinatal, and post-
natal women whose infants may 
be affected by substance use with-
drawal symptoms or a fetal alco-
hol spectrum disorder; 
‘‘(bb) improving assessments 
used to determine the needs of the 
infant and family; 
‘‘(cc) improving ongoing case 
management services; 
‘‘(dd) improving access to 
treatment services, which may be 
prior to the pregnant woman’s de-
livery date; and
339 
‘‘(ee) keeping families safely 
together when it is in the best in-
terest of the child. 
‘‘(ii) Developing policies, procedures, 
or protocols in consultation and coordina-
tion with health professionals, public and 
private health facilities, and substance use 
disorder treatment agencies to ensure that— 
‘‘(I) appropriate notification to 
child protective services is made in a 
timely manner, as required under sec-
tion 106(b)(2)(B)(ii); 
‘‘(II) a plan of safe care is in 
place, in accordance with section 
106(b)(2)(B)(iii), before the infant is 
discharged from the birth or health 
care facility; and 
‘‘(III) such health and related 
agency professionals are trained on 
how to follow such protocols and are 
aware of the supports that may be pro-
vided under a plan of safe care. 
‘‘(iii) Training health professionals 
and health system leaders, child welfare 
workers, substance use disorder treatment
340 
agencies, and other related professionals 
such as home visiting agency staff and law 
enforcement in relevant topics including— 
‘‘(I) State mandatory reporting 
laws 
established 
under 
section 
106(b)(2)(B)(i) and the referral and 
process requirements for notification to 
child protective services when child 
abuse or neglect reporting is not man-
dated; 
‘‘(II) the co-occurrence of preg-
nancy and substance use disorder, and 
implications of prenatal exposure; 
‘‘(III) the clinical guidance about 
treating substance use disorder in 
pregnant and postpartum women; 
‘‘(IV) appropriate screening and 
interventions for infants affected by 
substance use disorder, withdrawal 
symptoms, or a fetal alcohol spectrum 
disorder and the requirements under 
section 106(b)(2)(B)(iii); and 
‘‘(V) 
appropriate 
multigenerational strategies to address
341 
the mental health needs of the parent 
and child together. 
‘‘(iv) Establishing partnerships, agree-
ments, or memoranda of understanding be-
tween the lead agency and other entities 
(including health professionals, health fa-
cilities, child welfare professionals, juvenile 
and family court judges, substance use and 
mental disorder treatment programs, early 
childhood education programs, maternal 
and child health and early intervention pro-
fessionals (including home visiting pro-
viders), peer-to-peer recovery programs such 
as parent mentoring programs, and housing 
agencies) to facilitate the implementation 
of, and compliance with, section 106(b)(2) 
and clause (ii) of this subparagraph, in 
areas which may include— 
‘‘(I) developing a comprehensive, 
multi-disciplinary 
assessment 
and 
intervention process for infants, preg-
nant women, and their families who 
are affected by substance use disorder, 
withdrawal symptoms, or a fetal alco-
hol spectrum disorder, that includes
343 
‘‘(v) Developing and updating systems 
of technology for improved data collection 
and 
monitoring 
under 
section 
106(b)(2)(B)(iii), including existing elec-
tronic medical records, to measure the out-
comes achieved through the plans of safe 
care, including monitoring systems to meet 
the requirements of this Act and submission 
of performance measures. 
‘‘(E) REPORTING.—Each State that receives 
funds under this paragraph, for each year such 
funds are received, shall submit a report to the 
Secretary, disaggregated by geographic location, 
economic status, and major racial and ethnic 
groups, except that such disaggregation shall not 
be required if the results would reveal personally 
identifiable information on, with respect to in-
fants identified under section 106(b)(2)(B)(ii)— 
‘‘(i) the number who experienced re-
moval associated with parental substance 
use; 
‘‘(ii) the number who experienced re-
moval and subsequently are reunified with 
parents, and the length of time between such 
removal and reunification;
344 
‘‘(iii) the number who are referred to 
community providers without a child pro-
tection case; 
‘‘(iv) the number who receive services 
while in the care of their birth parents; 
‘‘(v) the number who receive post-re-
unification services within 1 year after a 
reunification has occurred; and 
‘‘(vi) the number who experienced a re-
turn to out-of-home care within 1 year after 
reunification. 
‘‘(F) 
SECRETARY’S
REPORT
TO
CON-
GRESS.—The Secretary shall submit an annual 
report to the Committee on Health, Education, 
Labor, and Pensions and the Committee on Ap-
propriations of the Senate and the Committee on 
Education and the Workforce and the Committee 
on Appropriations of the House of Representa-
tives that includes the information described in 
subparagraph (E) and recommendations or ob-
servations on the challenges, successes, and les-
sons derived from implementation of the grant 
program. 
‘‘(G) 
ASSISTING
STATES’ 
IMPLEMENTA-
TION.—The Secretary shall use the amount re-
345 
served under subparagraph (B)(i)(I) to provide 
written guidance and technical assistance to sup-
port States in complying with and implementing 
this paragraph, which shall include— 
‘‘(i) technical assistance, including 
programs of in-depth technical assistance, 
to additional States, territories, and Indian 
Tribes and tribal organizations in accord-
ance with the substance-exposed infant ini-
tiative developed by the National Center on 
Substance Abuse and Child Welfare; 
‘‘(ii) guidance on the requirements of 
this Act with respect to infants born with 
and identified as being affected by substance 
use or withdrawal symptoms or fetal alcohol 
spectrum disorder, as described in clauses 
(ii) and (iii) of section 106(b)(2)(B), in-
cluding by— 
‘‘(I) enhancing States’ under-
standing of requirements and flexibili-
ties under the law, including by clari-
fying key terms; 
‘‘(II) addressing state-identified 
challenges 
with 
developing, 
imple-
menting, and monitoring plans of safe
346 
care, including those reported under 
subparagraph (C)(i)(II); 
‘‘(III) disseminating best practices 
on implementation of plans of safe 
care, on such topics as differential re-
sponse, collaboration and coordination, 
and identification and delivery of serv-
ices for different populations, while 
recognizing needs of different popu-
lations and varying community ap-
proaches across States; and 
‘‘(IV) helping States improve the 
long-term safety and well-being of 
young children and their families; 
‘‘(iii) supporting State efforts to de-
velop information technology systems to 
manage plans of safe care; and 
‘‘(iv) preparing the Secretary’s report 
to Congress described in subparagraph (F). 
‘‘(H) SUNSET.—The authority under this 
paragraph shall sunset on September 30, 2023.’’. 
(b) REPEAL.—The Abandoned Infants Assistance Act 
of 1988 (42 U.S.C. 5117aa et seq.) is repealed.
347 
Subtitle H—Substance Use Disorder 
Treatment Workforce 
SEC. 7071. LOAN REPAYMENT PROGRAM FOR SUBSTANCE 
USE DISORDER TREATMENT WORKFORCE. 
Title VII of the Public Health Service Act is amend-
ed— 
(1) by redesignating part F as part G; and 
(2) by inserting after part E (42 U.S.C. 294n et 
seq.) the following: 
‘‘PART F—SUBSTANCE USE DISORDER 
TREATMENT WORKFORCE 
‘‘SEC. 781. LOAN REPAYMENT PROGRAM FOR SUBSTANCE 
USE DISORDER TREATMENT WORKFORCE. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Administrator of the Health Resources and Services Admin-
istration, shall carry out a program under which— 
‘‘(1) the Secretary enters into agreements with 
individuals to make payments in accordance with 
subsection (b) on the principal of and interest on any 
eligible loan; and 
‘‘(2) the individuals each agree to the require-
ments of service in substance use disorder treatment 
employment, as described in subsection (d). 
‘‘(b) PAYMENTS.—For each year of obligated service by 
an individual pursuant to an agreement under subsection
348 
(a), the Secretary shall make a payment to such individual 
as follows: 
‘‘(1) SERVICE IN A SHORTAGE AREA.—The Sec-
retary shall pay— 
‘‘(A) for each year of obligated service by an 
individual pursuant to an agreement under sub-
section (a), 1⁄6 of the principal of and interest on 
each eligible loan of the individual which is out-
standing on the date the individual began service 
pursuant to the agreement; and 
‘‘(B) for completion of the sixth and final 
year of such service, the remainder of such prin-
cipal and interest. 
‘‘(2) MAXIMUM AMOUNT.—The total amount of 
payments under this section to any individual shall 
not exceed $250,000. 
‘‘(c) ELIGIBLE LOANS.—The loans eligible for repay-
ment under this section are each of the following: 
‘‘(1) Any loan for education or training for a 
substance use disorder treatment employment. 
‘‘(2) Any loan under part E of title VIII (relat-
ing to nursing student loans). 
‘‘(3) Any Federal Direct Stafford Loan, Federal 
Direct PLUS Loan, Federal Direct Unsubsidized 
Stafford Loan, or Federal Direct Consolidation Loan
349 
(as such terms are used in section 455 of the Higher 
Education Act of 1965). 
‘‘(4) Any Federal Perkins Loan under part E of 
title I of the Higher Education Act of 1965. 
‘‘(5) Any other Federal loan as determined ap-
propriate by the Secretary. 
‘‘(d) REQUIREMENTS OF SERVICE.—Any individual 
receiving payments under this program as required by an 
agreement under subsection (a) shall agree to an annual 
commitment to full-time employment, with no more than 
1 year passing between any 2 years of covered employment, 
in substance use disorder treatment employment in the 
United States in— 
‘‘(1) a Mental Health Professional Shortage 
Area, as designated under section 332; or 
‘‘(2) a county (or a municipality, if not con-
tained within any county) where the mean drug over-
dose death rate per 100,000 people over the past 3 
years for which official data is available from the 
State, is higher than the most recent available na-
tional average overdose death rate per 100,000 people, 
as reported by the Centers for Disease Control and 
Prevention.
350 
‘‘(e) INELIGIBILITY FOR DOUBLE BENEFITS.—No bor-
rower may, for the same service, receive a reduction of loan 
obligations or a loan repayment under both— 
‘‘(1) this section; and 
‘‘(2) any Federally supported loan forgiveness 
program, including under section 338B, 338I, or 846 
of this Act, or section 428J, 428L, 455(m), or 460 of 
the Higher Education Act of 1965. 
‘‘(f) BREACH.— 
‘‘(1) LIQUIDATED DAMAGES FORMULA.—The Sec-
retary may establish a liquidated damages formula to 
be used in the event of a breach of an agreement en-
tered into under subsection (a). 
‘‘(2) LIMITATION.—The failure by an individual 
to complete the full period of service obligated pursu-
ant to such an agreement, taken alone, shall not con-
stitute a breach of the agreement, so long as the indi-
vidual completed in good faith the years of service for 
which payments were made to the individual under 
this section. 
‘‘(g) ADDITIONAL CRITERIA.—The Secretary— 
‘‘(1) may establish such criteria and rules to 
carry out this section as the Secretary determines are 
needed and in addition to the criteria and rules spec-
ified in this section; and
351 
‘‘(2) shall give notice to the committees specified 
in subsection (h) of any criteria and rules so estab-
lished. 
‘‘(h) REPORT TO CONGRESS.—Not later than 5 years 
after the date of enactment of this section, and every other 
year thereafter, the Secretary shall prepare and submit to 
the Committee on Energy and Commerce of the House of 
Representatives and the Committee on Health, Education, 
Labor, and Pensions of the Senate a report on— 
‘‘(1) the number and location of borrowers who 
have qualified for loan repayments under this section; 
and 
‘‘(2) the impact of this section on the availability 
of substance use disorder treatment employees nation-
ally and in shortage areas and counties described in 
subsection (d). 
‘‘(i) DEFINITION.—In this section: 
‘‘(1) The terms ‘Indian tribe’ and ‘tribal organi-
zation’ have the meanings given those terms in section 
4 of the Indian Self-Determination and Education 
Assistance Act. 
‘‘(2) The term ‘municipality’ means a city, 
town, or other public body created by or pursuant to 
State law, or an Indian tribe.
352 
‘‘(3) The term ‘substance use disorder treatment 
employment’ means full-time employment (including 
a fellowship)— 
‘‘(A) where the primary intent and function 
of the position is the direct treatment or recovery 
support of patients with or in recovery from a 
substance use disorder, including master’s level 
social workers, psychologists, counselors, mar-
riage and family therapists, psychiatric mental 
health practitioners, occupational therapists, 
psychology doctoral interns, and behavioral 
health paraprofessionals and physicians, physi-
cian assistants, and nurses, who are licensed or 
certified in accordance with applicable State and 
Federal laws; and 
‘‘(B) which is located at a substance use 
disorder treatment program, private physician 
practice, hospital or health system-affiliated in-
patient treatment center or outpatient clinic (in-
cluding an academic medical center-affiliated 
treatment program), correctional facility or pro-
gram, youth detention center or program, inpa-
tient psychiatric facility, crisis stabilization 
unit, community health center, community men-
tal health or other specialty community behav-
353 
ioral health center, recovery center, school, com-
munity-based organization, telehealth platform, 
migrant health center, health program or facility 
operated by an Indian tribe or tribal organiza-
tion, Federal medical facility, or any other facil-
ity as determined appropriate for purposes of 
this section by the Secretary. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section 
$25,000,000 for each of fiscal years 2019 through 2023.’’. 
SEC. 
7072. 
CLARIFICATION 
REGARDING 
SERVICE 
IN 
SCHOOLS AND OTHER COMMUNITY-BASED 
SETTINGS. 
Subpart III of part D of title III of the Public Health 
Service Act (42 U.S.C. 254 l et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 
338N. 
CLARIFICATION 
REGARDING 
SERVICE 
IN 
SCHOOLS AND OTHER COMMUNITY-BASED 
SETTINGS. 
‘‘(a) SCHOOLS AND COMMUNITY-BASED SETTINGS.— 
An entity to which a participant in the Scholarship Pro-
gram or the Loan Repayment Program (referred to in this 
section as a ‘participant’) is assigned under section 333 
may direct such participant to provide service as a behav-
ioral or mental health professional at a school or other com-
354 
munity-based setting located in a health professional short-
age area. 
‘‘(b) OBLIGATED SERVICE.— 
‘‘(1) IN GENERAL.—Any service described in sub-
section (a) that a participant provides may count to-
wards such participant’s completion of any obligated 
service requirements under the Scholarship Program 
or the Loan Repayment Program, subject to any limi-
tation imposed under paragraph (2). 
‘‘(2) LIMITATION.—The Secretary may impose a 
limitation on the number of hours of service described 
in subsection (a) that a participant may credit to-
wards completing obligated service requirements, pro-
vided that the limitation allows a member to credit 
service described in subsection (a) for not less than 50 
percent of the total hours required to complete such 
obligated service requirements. 
‘‘(c) RULE
OF CONSTRUCTION.—The authorization 
under subsection (a) shall be notwithstanding any other 
provision of this subpart or subpart II.’’. 
SEC. 7073. PROGRAMS FOR HEALTH CARE WORKFORCE. 
(a) PROGRAM FOR EDUCATION AND TRAINING IN PAIN 
CARE.—Section 759 of the Public Health Service Act (42 
U.S.C. 294i) is amended—
355 
(1) in subsection (a), by striking ‘‘hospices, and 
other public and private entities’’ and inserting ‘‘hos-
pices, tribal health programs (as defined in section 4 
of the Indian Health Care Improvement Act), and 
other public and nonprofit private entities’’; 
(2) in subsection (b)— 
(A) in the matter preceding paragraph (1), 
by striking ‘‘award may be made under sub-
section (a) only if the applicant for the award 
agrees that the program carried out with the 
award will include’’ and inserting ‘‘entity re-
ceiving an award under this section shall develop 
a comprehensive education and training plan 
that includes’’; 
(B) in paragraph (1)— 
(i) by inserting ‘‘preventing,’’ after 
‘‘diagnosing,’’; and 
(ii) by inserting ‘‘non-addictive med-
ical products and non-pharmacologic treat-
ments and’’ after ‘‘including’’; 
(C) in paragraph (2)— 
(i) by inserting ‘‘Federal, State, and 
local’’ after ‘‘applicable’’; and
356 
(ii) by striking ‘‘the degree to which’’ 
and all that follows through ‘‘effective pain 
care’’ and inserting ‘‘opioids’’; 
(D) in paragraph (3), by inserting ‘‘, inte-
grated, evidence-based pain management, and, as 
appropriate, non-pharmacotherapy’’ before the 
semicolon; 
(E) in paragraph (4), by striking ‘‘; and’’ 
and inserting ‘‘;’’; and 
(F) by striking paragraph (5) and inserting 
the following: 
‘‘(5) recent findings, developments, and advance-
ments in pain care research and the provision of pain 
care, which may include non-addictive medical prod-
ucts and non-pharmacologic treatments intended to 
treat pain; and 
‘‘(6) the dangers of opioid abuse and misuse, de-
tection of early warning signs of opioid use disorders 
(which may include best practices related to screening 
for opioid use disorders, training on screening, brief 
intervention, and referral to treatment), and safe dis-
posal options for prescription medications (including 
such options provided by law enforcement or other in-
novative deactivation mechanisms).’’;
357 
(3) in subsection (d), by inserting ‘‘prevention,’’ 
after ‘‘diagnosis,’’; and 
(4) in subsection (e), by striking ‘‘2010 through 
2012’’ and inserting ‘‘2019 through 2023’’. 
(b) MENTAL AND BEHAVIORAL HEALTH EDUCATION 
AND TRAINING PROGRAM.—Section 756 of the Public 
Health Service Act (42 U.S.C. 294e–1) is amended— 
(1) in subsection (a)— 
(A) in paragraph (1), by inserting ‘‘, trau-
ma,’’ after ‘‘focus on child and adolescent mental 
health’’; and 
(B) in paragraphs (2) and (3), by inserting 
‘‘trauma-informed care and’’ before ‘‘substance 
use disorder prevention and treatment services’’; 
and 
(2) in subsection (f), by striking ‘‘2018 through 
2022’’ and inserting ‘‘2019 through 2023’’. 
Subtitle I—Preventing Overdoses 
While in Emergency Rooms 
SEC. 7081. PROGRAM TO SUPPORT COORDINATION AND 
CONTINUATION OF CARE FOR DRUG OVER-
DOSE PATIENTS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
358 
retary’’) shall identify or facilitate the development of best 
practices for— 
(1) emergency treatment of known or suspected 
drug overdose; 
(2) the use of recovery coaches, as appropriate, 
to encourage individuals who experience a non-fatal 
overdose to seek treatment for substance use disorder 
and to support coordination and continuation of care; 
(3) coordination and continuation of care and 
treatment, including, as appropriate, through refer-
rals, of individuals after a drug overdose; and 
(4) the provision or prescribing of overdose rever-
sal medication, as appropriate. 
(b) GRANT ESTABLISHMENT AND PARTICIPATION.— 
(1) IN
GENERAL.—The Secretary shall award 
grants on a competitive basis to eligible entities to 
support implementation of voluntary programs for 
care and treatment of individuals after a drug over-
dose, as appropriate, which may include implementa-
tion of the best practices described in subsection (a). 
(2) ELIGIBLE ENTITY.—In this section, the term 
‘‘eligible entity’’ means— 
(A) a State substance abuse agency; 
(B) an Indian Tribe or tribal organization; 
or
359 
(C) an entity that offers treatment or other 
services for individuals in response to, or fol-
lowing, drug overdoses or a drug overdose, such 
as an emergency department, in consultation 
with a State substance abuse agency. 
(3) APPLICATION.—An eligible entity desiring a 
grant under this section shall submit an application 
to the Secretary, at such time and in such manner as 
the Secretary may require, that includes— 
(A) evidence that such eligible entity carries 
out, or is capable of contracting and coordi-
nating with other community entities to carry 
out, the activities described in paragraph (4); 
(B) evidence that such eligible entity will 
work with a recovery community organization to 
recruit, train, hire, mentor, and supervise recov-
ery coaches and fulfill the requirements described 
in paragraph (4)(A); and 
(C) such additional information as the Sec-
retary may require. 
(4) USE OF GRANT FUNDS.—An eligible entity 
awarded a grant under this section shall use such 
grant funds to— 
(A) hire or utilize recovery coaches to help 
support recovery, including by—
360 
(i) connecting patients to a continuum 
of care services, such as— 
(I) treatment and recovery sup-
port programs; 
(II) programs that provide non- 
clinical recovery support services; 
(III) peer support networks; 
(IV) recovery community organi-
zations; 
(V) health care providers, includ-
ing physicians and other providers of 
behavioral health and primary care; 
(VI) education and training pro-
viders; 
(VII) employers; 
(VIII) housing services; and 
(IX) child welfare agencies; 
(ii) providing education on overdose 
prevention and overdose reversal to patients 
and families, as appropriate; 
(iii) providing follow-up services for 
patients after an overdose to ensure contin-
ued recovery and connection to support 
services;
361 
(iv) collecting and evaluating outcome 
data for patients receiving recovery coach-
ing services; and 
(v) providing other services the Sec-
retary determines necessary to help ensure 
continued connection with recovery support 
services, including culturally appropriate 
services, as applicable; 
(B) establish policies and procedures, pur-
suant to Federal and State law, that address the 
provision of overdose reversal medication, the ad-
ministration of all drugs or devices approved or 
cleared under the Federal Food, Drug, and Cos-
metic Act (21 U.S.C. 301 et seq.) and all biologi-
cal products licensed under section 351 of the 
Public Health Service Act (42 U.S.C. 262) to 
treat substance use disorder, and subsequent con-
tinuation of, or referral to, evidence-based treat-
ment for patients with a substance use disorder 
who have experienced a non-fatal drug overdose, 
in order to support long-term treatment, prevent 
relapse, and reduce recidivism and future over-
dose; and 
(C) establish integrated models of care for 
individuals who have experienced a non-fatal
362 
drug overdose which may include patient assess-
ment, follow up, and transportation to and from 
treatment facilities. 
(5) ADDITIONAL PERMISSIBLE USES.—In addi-
tion to the uses described in paragraph (4), a grant 
awarded under this section may be used, directly or 
through contractual arrangements, to provide— 
(A) all drugs or devices approved or cleared 
under the Federal Food, Drug, and Cosmetic Act 
(21 U.S.C. 301 et seq.) and all biological prod-
ucts licensed under section 351 of the Public 
Health Service Act (42 U.S.C. 262) to treat sub-
stance use disorders or reverse overdose, pursuant 
to Federal and State law; 
(B) withdrawal and detoxification services 
that include patient evaluation, stabilization, 
and preparation for treatment of substance use 
disorder, including treatment described in sub-
paragraph (A), as appropriate; or 
(C) mental health services provided by a 
certified professional who is licensed and quali-
fied by education, training, or experience to as-
sess the psychosocial background of patients, to 
contribute to the appropriate treatment plan for
363 
patients with substance use disorder, and to 
monitor patient progress. 
(6) PREFERENCE.—In awarding grants under 
this section, the Secretary shall give preference to eli-
gible entities that meet any or all of the following cri-
teria: 
(A) The eligible entity is a critical access 
hospital (as defined in section 1861(mm)(1) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395x(mm)(1))), a low volume hospital (as de-
fined in section 1886(d)(12)(C)(i) of such Act 
(42 U.S.C. 1395ww(d)(12)(C)(i))), a sole com-
munity 
hospital 
(as 
defined 
in 
section 
1886(d)(5)(D)(iii) of such Act (42 U.S.C. 
1395ww(d)(5)(D)(iii))), or a hospital that re-
ceives disproportionate share hospital payments 
under section 1886(d)(5)(F) of the Social Secu-
rity Act (42 U.S.C. 1395ww(d)(5)(F)). 
(B) The eligible entity is located in a State 
with an age-adjusted rate of drug overdose deaths 
that is above the national overdose mortality 
rate, as determined by the Director of the Centers 
for Disease Control and Prevention, or under the 
jurisdiction of an Indian Tribe with an age-ad-
justed rate of drug overdose deaths that is above
364 
the national overdose mortality rate, as deter-
mined through appropriate mechanisms as deter-
mined by the Secretary in consultation with In-
dian Tribes. 
(C) The eligible entity demonstrates that re-
covery coaches will be placed in both health care 
settings and community settings. 
(7) PERIOD OF GRANT.—A grant awarded to an 
eligible entity under this section shall be for a period 
of not more than 5 years. 
(c) DEFINITIONS.—In this section: 
(1) INDIAN TRIBE; TRIBAL ORGANIZATION.—The 
terms ‘‘Indian Tribe’’ and ‘‘tribal organization’’ have 
the meanings given the terms ‘‘Indian tribe’’ and 
‘‘tribal organization’’ in section 4 of the Indian Self- 
Determination and Education Assistance Act (25 
U.S.C. 5304). 
(2) RECOVERY
COACH.—the term ‘‘recovery 
coach’’ means an individual— 
(A) with knowledge of, or experience with, 
recovery from a substance use disorder; and 
(B) who has completed training from, and 
is determined to be in good standing by, a recov-
ery services organization capable of conducting 
such training and making such determination.
365 
(3) RECOVERY COMMUNITY ORGANIZATION.—The 
term ‘‘recovery community organization’’ has the 
meaning given such term in section 547(a) of the 
Public Health Service Act (42 U.S.C. 290ee–2(a)). 
(d) REPORTING REQUIREMENTS.— 
(1) REPORTS BY GRANTEES.—Each eligible enti-
ty awarded a grant under this section shall submit to 
the Secretary an annual report for each year for 
which the entity has received such grant that includes 
information on— 
(A) the number of individuals treated by the 
entity for non-fatal overdoses, including the 
number of non-fatal overdoses where overdose re-
versal medication was administered; 
(B) the number of individuals administered 
medication-assisted treatment by the entity; 
(C) the number of individuals referred by 
the entity to other treatment facilities after a 
non-fatal overdose, the types of such other facili-
ties, and the number of such individuals admit-
ted to such other facilities pursuant to such refer-
rals; and 
(D) the frequency and number of patients 
with reoccurrences, including readmissions for
366 
non-fatal overdoses and evidence of relapse re-
lated to substance use disorder. 
(2) REPORT BY SECRETARY.—Not later than 5 
years after the date of enactment of this Act, the Sec-
retary shall submit to Congress a report that includes 
an evaluation of the effectiveness of the grant program 
carried out under this section with respect to long 
term health outcomes of the population of individuals 
who have experienced a drug overdose, the percentage 
of patients treated or referred to treatment by grant-
ees, and the frequency and number of patients who ex-
perienced relapse, were readmitted for treatment, or 
experienced another overdose. 
(e) PRIVACY.—The requirements of this section, includ-
ing with respect to data reporting and program oversight, 
shall be subject to all applicable Federal and State privacy 
laws. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$10,000,000 for each of fiscal years 2019 through 2023. 
Subtitle J—Alternatives to Opioids 
in the Emergency Department 
SEC. 7091. EMERGENCY DEPARTMENT ALTERNATIVES TO 
OPIOIDS DEMONSTRATION PROGRAM. 
(a) DEMONSTRATION PROGRAM GRANTS.—
367 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the 
‘‘Secretary’’) shall carry out a demonstration pro-
gram for purposes of awarding grants to hospitals 
and emergency departments, including freestanding 
emergency departments, to develop, implement, en-
hance, or study alternatives to opioids for pain man-
agement in such settings. 
(2) ELIGIBILITY.—To be eligible to receive a 
grant under paragraph (1), a hospital or emergency 
department shall submit an application to the Sec-
retary at such time, in such manner, and containing 
such information as the Secretary may require. 
(3) GEOGRAPHIC DISTRIBUTION.—In awarding 
grants under this section, the Secretary shall seek to 
ensure geographical distribution among grant recipi-
ents. 
(4) USE OF FUNDS.—Grants under paragraph 
(1) shall be used to— 
(A) target treatment approaches for painful 
conditions frequently treated in such settings; 
(B) train providers and other hospital per-
sonnel on protocols or best practices related to 
the use and prescription of opioids and alter-
368 
natives to opioids for pain management in the 
emergency department; and 
(C) develop or continue strategies to provide 
alternatives to opioids, as appropriate. 
(b) ADDITIONAL
DEMONSTRATION
PROGRAM.—The 
Secretary may carry out a demonstration program similar 
to the program under subsection (a) for other acute care 
settings. 
(c) CONSULTATION.—The Secretary shall implement a 
process for recipients of grants under subsection (a) or (b) 
to share evidence-based and best practices and promote con-
sultation with persons having robust knowledge, including 
emergency departments and physicians that have success-
fully implemented programs that use alternatives to opioids 
for pain management, as appropriate, such as approaches 
studied through the National Center for Complimentary 
and Integrative Health or other institutes and centers at 
the National Institutes of Health, as appropriate. The Sec-
retary shall offer to each recipient of a grant under sub-
section (a) or (b) technical assistance as necessary. 
(d) TECHNICAL ASSISTANCE.—The Secretary shall 
identify or facilitate the development of best practices on 
alternatives to opioids for pain management and provide 
technical assistance to hospitals and other acute care set-
369 
tings on alternatives to opioids for pain management. The 
technical assistance provided shall be for the purpose of— 
(1) utilizing information from recipients of a 
grant under subsection (a) or (b) that have success-
fully implemented alternatives to opioids programs; 
(2) identifying or facilitating the development of 
best practices on the use of alternatives to opioids, 
which may include pain-management strategies that 
involve non-addictive medical products, non-pharma-
cologic treatments, and technologies or techniques to 
identify patients at risk for opioid use disorder; 
(3) identifying or facilitating the development of 
best practices on the use of alternatives to opioids that 
target common painful conditions and include certain 
patient populations, such as geriatric patients, preg-
nant women, and children; and 
(4) disseminating information on the use of al-
ternatives to opioids to providers in acute care set-
tings, which may include emergency departments, 
outpatient clinics, critical access hospitals, Federally 
qualified health centers, Indian Health Service health 
facilities, and tribal hospitals. 
(e) REPORT TO THE SECRETARY.—Each recipient of 
a grant under this section shall submit to the Secretary 
(during the period of such grant) annual reports on the
370 
progress of the program funded through the grant. These 
reports shall include, in accordance with all applicable 
State and Federal privacy laws— 
(1) a description of and specific information 
about the opioid alternative pain management pro-
grams, including the demographic characteristics of 
patients who were treated with an alternative pain 
management protocol, implemented in hospitals, 
emergency departments, and other acute care settings; 
(2) data on the opioid alternative pain manage-
ment strategies used, including the number of opioid 
prescriptions written— 
(A) during a baseline period before the pro-
gram began; or 
(B) at various stages of the program; and 
(3) data on patients who were eventually pre-
scribed opioids after alternative pain management 
protocols and treatments were utilized; and 
(4) any other information the Secretary deter-
mines appropriate. 
(f) REPORT TO CONGRESS.—Not later than 1 year 
after completion of the demonstration program under this 
section, the Secretary shall submit a report to the Congress 
on the results of the demonstration program and include 
in the report—
371 
(1) the number of applications received and the 
number funded; 
(2) a summary of the reports described in sub-
section (e), including data that allows for comparison 
of programs; and 
(3) recommendations for broader implementation 
of pain management strategies that encourage the use 
of alternatives to opioids in hospitals, emergency de-
partments, or other acute care settings. 
(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$10,000,000 for each of fiscal years 2019 through 2021. 
Subtitle K—Treatment, Education, 
and Community Help To Combat 
Addiction 
SEC. 7101. ESTABLISHMENT OF REGIONAL CENTERS OF EX-
CELLENCE IN SUBSTANCE USE DISORDER 
EDUCATION. 
Part D of title V of the Public Health Service Act, as 
amended by section 7031, is further amended by adding at 
the end the following new section: 
‘‘SEC. 551. REGIONAL CENTERS OF EXCELLENCE IN SUB-
STANCE USE DISORDER EDUCATION. 
‘‘(a) IN GENERAL.—The Secretary, in consultation 
with appropriate agencies, shall award cooperative agree-
372 
ments to eligible entities for the designation of such entities 
as Regional Centers of Excellence in Substance Use Dis-
order Education for purposes of improving health profes-
sional training resources with respect to substance use dis-
order prevention, treatment, and recovery. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a coopera-
tive agreement under subsection (a), an entity shall— 
‘‘(1) be an accredited entity that offers education 
to students in various health professions, which may 
include— 
‘‘(A) a teaching hospital; 
‘‘(B) a medical school; 
‘‘(C) a certified behavioral health clinic; or 
‘‘(D) any other health professions school, 
school of public health, or Cooperative Extension 
Program at institutions of higher education, as 
defined in section 101 of the Higher Education 
Act of 1965, engaged in the prevention, treat-
ment, or recovery of substance use disorders; 
‘‘(2) demonstrate community engagement and 
partnerships with community stakeholders, including 
entities that train health professionals, mental health 
counselors, social workers, peer recovery specialists, 
substance use treatment programs, community health 
centers, physician offices, certified behavioral health
373 
clinics, research institutions, and law enforcement; 
and 
‘‘(3) submit to the Secretary an application con-
taining such information, at such time, and in such 
manner, as the Secretary may require. 
‘‘(c) ACTIVITIES.—An entity receiving an award under 
this section shall develop, evaluate, and distribute evidence- 
based resources regarding the prevention and treatment of, 
and recovery from, substance use disorders. Such resources 
may include information on— 
‘‘(1) the neurology and pathology of substance 
use disorders; 
‘‘(2) advancements in the treatment of substance 
use disorders; 
‘‘(3) techniques and best practices to support re-
covery from substance use disorders; 
‘‘(4) strategies for the prevention and treatment 
of, and recovery from substance use disorders across 
patient populations; and 
‘‘(5) other topic areas that are relevant to the ob-
jectives described in subsection (a). 
‘‘(d) GEOGRAPHIC DISTRIBUTION.—In awarding coop-
erative agreements under subsection (a), the Secretary shall 
take into account regional differences among eligible entities 
and shall make an effort to ensure geographic distribution.
375 
the Secretary of Education and other heads of agencies, in-
cluding the Assistant Secretary for Mental Health and Sub-
stance Use and the Administrator of the Health Resources 
and Services Administration, as appropriate, shall estab-
lish a resource center to provide technical support to recipi-
ents of grants under subsection (c). 
(c) YOUTH PREVENTION AND RECOVERY INITIATIVE.— 
(1) IN GENERAL.—The Secretary, in consultation 
with the Secretary of Education, shall administer a 
program to provide support for communities to sup-
port the prevention of, treatment of, and recovery 
from, substance use disorders for children, adolescents, 
and young adults. 
(2) DEFINITIONS.—In this subsection: 
(A) ELIGIBLE ENTITY.—The term ‘‘eligible 
entity’’ means— 
(i) a local educational agency that is 
seeking to establish or expand substance use 
prevention or recovery support services at 
one or more high schools; 
(ii) a State educational agency; 
(iii) an institution of higher education 
(or consortia of such institutions), which 
may include a recovery program at an in-
stitution of higher education;
376 
(iv) a local board or one-stop operator; 
(v) a nonprofit organization with ap-
propriate expertise in providing services or 
programs for children, adolescents, or young 
adults, excluding a school; 
(vi) a State, political subdivision of a 
State, Indian tribe, or tribal organization; 
or 
(vii) a high school or dormitory serv-
ing high school students that receives fund-
ing from the Bureau of Indian Education. 
(B) FOSTER CARE.—The term ‘‘foster care’’ 
has the meaning given such term in section 
1355.20(a) of title 45, Code of Federal Regula-
tions (or any successor regulations). 
(C) HIGH SCHOOL.—The term ‘‘high school’’ 
has the meaning given such term in section 8101 
of the Elementary and Secondary Education Act 
of 1965 (20 U.S.C. 7801). 
(D) HOMELESS YOUTH.—The term ‘‘home-
less youth’’ has the meaning given the term 
‘‘homeless children or youths’’ in section 725 of 
the McKinney-Vento Homeless Assistance Act (42 
U.S.C. 11434a).
377 
(E) INDIAN
TRIBE; 
TRIBAL
ORGANIZA-
TION.—The terms ‘‘Indian tribe’’ and ‘‘tribal or-
ganization’’ have the meanings given such terms 
in section 4 of the Indian Self-Determination 
and Education Assistance Act (25 U.S.C. 5304). 
(F) INSTITUTION OF HIGHER EDUCATION.— 
The term ‘‘institution of higher education’’ has 
the meaning given such term in section 101 of 
the Higher Education Act of 1965 (20 U.S.C. 
1001) and includes a ‘‘postsecondary vocational 
institution’’ as defined in section 102(c) of such 
Act (20 U.S.C. 1002(c)). 
(G) LOCAL
EDUCATIONAL
AGENCY.—The 
term ‘‘local educational agency’’ has the meaning 
given such term in section 8101 of the Elemen-
tary and Secondary Education Act of 1965 (20 
U.S.C. 7801). 
(H) LOCAL BOARD; ONE-STOP OPERATOR.— 
The terms ‘‘local board’’ and ‘‘one-stop operator’’ 
have the meanings given such terms in section 3 
of the Workforce Innovation and Opportunity 
Act (29 U.S.C. 3102). 
(I) OUT-OF-SCHOOL
YOUTH.—The term 
‘‘out-of-school youth’’ has the meaning given such 
term in section 129(a)(1)(B) of the Workforce In-
378 
novation and Opportunity Act (29 U.S.C. 
3164(a)(1)(B)). 
(J) RECOVERY PROGRAM.—The term ‘‘recov-
ery program’’ means a program— 
(i) to help children, adolescents, or 
young adults who are recovering from sub-
stance use disorders to initiate, stabilize, 
and maintain healthy and productive lives 
in the community; and 
(ii) that includes peer-to-peer support 
delivered by individuals with lived experi-
ence in recovery, and communal activities 
to build recovery skills and supportive so-
cial networks. 
(K) STATE
EDUCATIONAL
AGENCY.—The 
term ‘‘State educational agency’’ has the mean-
ing given such term in section 8101 of the Ele-
mentary and Secondary Education Act (20 
U.S.C. 7801). 
(3) BEST PRACTICES.—The Secretary, in con-
sultation with the Secretary of Education, shall— 
(A) identify or facilitate the development of 
evidence-based best practices for prevention of 
substance misuse and abuse by children, adoles-
cents, and young adults, including for specific
379 
populations such as youth in foster care, home-
less youth, out-of-school youth, and youth who 
are at risk of or have experienced trafficking that 
address— 
(i) primary prevention; 
(ii) appropriate recovery support serv-
ices; 
(iii) appropriate use of medication-as-
sisted treatment for such individuals, if ap-
plicable, and ways of overcoming barriers to 
the use of medication-assisted treatment in 
such population; and 
(iv) efficient and effective communica-
tion, which may include the use of social 
media, to maximize outreach efforts; 
(B) disseminate such best practices to State 
educational agencies, local educational agencies, 
schools and dormitories funded by the Bureau of 
Indian Education, institutions of higher edu-
cation, recovery programs at institutions of high-
er education, local boards, one-stop operators, 
family and youth homeless providers, and non-
profit organizations, as appropriate; 
(C) conduct a rigorous evaluation of each 
grant funded under this subsection, particularly
380 
its impact on the indicators described in para-
graph (7)(B); and 
(D) provide technical assistance for grantees 
under this subsection. 
(4) GRANTS
AUTHORIZED.—The Secretary, in 
consultation with the Secretary of Education, shall 
award 3-year grants, on a competitive basis, to eligi-
ble entities to enable such entities, in coordination 
with Indian tribes, if applicable, and State agencies 
responsible for carrying out substance use disorder 
prevention and treatment programs, to carry out evi-
dence-based programs for— 
(A) prevention of substance misuse and 
abuse by children, adolescents, and young adults, 
which may include primary prevention; 
(B) recovery support services for children, 
adolescents, and young adults, which may in-
clude counseling, job training, linkages to com-
munity-based services, family support groups, 
peer mentoring, and recovery coaching; or 
(C) treatment or referrals for treatment of 
substance use disorders, which may include the 
use of medication-assisted treatment, as appro-
priate.
381 
(5) SPECIAL
CONSIDERATION.—In awarding 
grants under this subsection, the Secretary shall give 
special consideration to the unique needs of tribal, 
urban, suburban, and rural populations. 
(6) APPLICATION.—To be eligible for a grant 
under this subsection, an entity shall submit to the 
Secretary an application at such time, in such man-
ner, and containing such information as the Sec-
retary may require. Such application shall include— 
(A) a description of— 
(i) the impact of substance use dis-
orders in the population that will be served 
by the grant program; 
(ii) how the eligible entity has solicited 
input from relevant stakeholders, which 
may include faculty, teachers, staff, fami-
lies, students, and experts in substance use 
disorder prevention, treatment, and recovery 
in developing such application; 
(iii) the goals of the proposed project, 
including the intended outcomes; 
(iv) how the eligible entity plans to use 
grant funds for evidence-based activities, in 
accordance with this subsection to prevent, 
provide recovery support for, or treat sub-
382 
stance use disorders amongst such individ-
uals, or a combination of such activities; 
and 
(v) how the eligible entity will collabo-
rate with relevant partners, which may in-
clude State educational agencies, local edu-
cational agencies, institutions of higher edu-
cation, juvenile justice agencies, prevention 
and recovery support providers, local service 
providers, including substance use disorder 
treatment programs, providers of mental 
health services, youth serving organizations, 
family and youth homeless providers, child 
welfare agencies, and primary care pro-
viders, in carrying out the grant program; 
and 
(B) an assurance that the eligible entity 
will participate in the evaluation described in 
paragraph (3)(C). 
(7) REPORTS TO THE SECRETARY.—Each eligible 
entity awarded a grant under this subsection shall 
submit to the Secretary a report at such time and in 
such manner as the Secretary may require. Such re-
port shall include—
383 
(A) a description of how the eligible entity 
used grant funds, in accordance with this sub-
section, including the number of children, adoles-
cents, and young adults reached through pro-
gramming; and 
(B) a description, including relevant data, 
of how the grant program has made an impact 
on the intended outcomes described in paragraph 
(6)(A)(iii), including— 
(i) indicators of student success, which, 
if the eligible entity is an educational insti-
tution, shall include student well-being and 
academic achievement; 
(ii) substance use disorders amongst 
children, adolescents, and young adults, in-
cluding the number of overdoses and deaths 
amongst children, adolescents, and young 
adults served by the grant during the grant 
period; and 
(iii) other indicators, as the Secretary 
determines appropriate. 
(8) REPORT TO CONGRESS.—The Secretary shall, 
not later than October 1, 2022, submit a report to the 
Committee on Health, Education, Labor, and Pen-
sions of the Senate and the Committee on Energy and
384 
Commerce and the Committee on Education and the 
Workforce of the House of Representatives a report 
summarizing the effectiveness of the grant program 
under this subsection, based on the information sub-
mitted in reports required under paragraph (7). 
(9) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated $10,000,000 to 
carry out this subsection for each of fiscal years 2019 
through 2023. 
Subtitle L—Information From Na-
tional Mental Health and Sub-
stance Use Policy Laboratory 
SEC. 
7111. 
INFORMATION 
FROM 
NATIONAL 
MENTAL 
HEALTH AND SUBSTANCE USE POLICY LAB-
ORATORY. 
Section 501A(b) of the Public Health Service Act (42 
U.S.C. 290aa–0(b)) is amended— 
(1) in paragraph (5)(C), by striking ‘‘; and’’ at 
the end and inserting a semicolon; 
(2) by redesignating paragraph (6) as para-
graph (7); and 
(3) by inserting after paragraph (5) the fol-
lowing: 
‘‘(6) issue and periodically update information 
for entities applying for grants or cooperative agree-
385 
ments from the Substance Abuse and Mental Health 
Services Administration in order to— 
‘‘(A) encourage the implementation and 
replication of evidence-based practices; and 
‘‘(B) provide technical assistance to appli-
cants for funding, including with respect to jus-
tifications for such programs and activities; 
and’’. 
Subtitle M—Comprehensive Opioid 
Recovery Centers 
SEC. 7121. COMPREHENSIVE OPIOID RECOVERY CENTERS. 
(a) IN GENERAL.—Part D of title V of the Public 
Health Service Act (42 U.S.C. 290dd et seq.), as amended 
by sections 7031 and 7101, is further amended by adding 
at the end the following new section: 
‘‘SEC. 552. COMPREHENSIVE OPIOID RECOVERY CENTERS. 
‘‘(a) IN GENERAL.—The Secretary shall award grants 
on a competitive basis to eligible entities to establish or op-
erate a comprehensive opioid recovery center (referred to in 
this section as a ‘Center’). A Center may be a single entity 
or an integrated delivery network. 
‘‘(b) GRANT PERIOD.— 
‘‘(1) IN GENERAL.—A grant awarded under sub-
section (a) shall be for a period of not less than 3 
years and not more than 5 years.
386 
‘‘(2) RENEWAL.—A grant awarded under sub-
section (a) may be renewed, on a competitive basis, 
for additional periods of time, as determined by the 
Secretary. In determining whether to renew a grant 
under this paragraph, the Secretary shall consider the 
data submitted under subsection (h). 
‘‘(c) MINIMUM NUMBER OF CENTERS.—The Secretary 
shall allocate the amounts made available under subsection 
(j) such that not fewer than 10 grants may be awarded. 
Not more than one grant shall be made to entities in a sin-
gle State for any one period. 
‘‘(d) APPLICATION.— 
‘‘(1) ELIGIBLE ENTITY.—An entity is eligible for 
a grant under this section if the entity offers treat-
ment and other services for individuals with a sub-
stance use disorder. 
‘‘(2) SUBMISSION OF APPLICATION.—In order to 
be eligible for a grant under subsection (a), an entity 
shall submit an application to the Secretary at such 
time and in such manner as the Secretary may re-
quire. Such application shall include— 
‘‘(A) evidence that such entity carries out, 
or is capable of coordinating with other entities 
to carry out, the activities described in sub-
section (g); and
387 
‘‘(B) such other information as the Sec-
retary may require. 
‘‘(e) PRIORITY.—In awarding grants under subsection 
(a), the Secretary shall give priority to eligible entities— 
‘‘(1) located in a State with an age-adjusted rate 
of drug overdose deaths that is above the national 
overdose mortality rate, as determined by the Director 
of the Centers for Disease Control and Prevention; or 
‘‘(2) serving an Indian Tribe (as defined in sec-
tion 4 of the Indian Self-Determination and Edu-
cation Assistance Act) with an age-adjusted rate of 
drug overdose deaths that is above the national over-
dose mortality rate, as determined through appro-
priate mechanisms determined by the Secretary in 
consultation with Indian Tribes. 
‘‘(f) PREFERENCE.—In awarding grants under sub-
section (a), the Secretary may give preference to eligible en-
tities utilizing technology-enabled collaborative learning 
and capacity building models, including such models as de-
fined in section 2 of the Expanding Capacity for Health 
Outcomes Act (Public Law 114–270; 130 Stat. 1395), to 
conduct the activities described in this section. 
‘‘(g) CENTER ACTIVITIES.—Each Center shall, at a 
minimum, carry out the following activities directly, 
through referral, or through contractual arrangements,
388 
which may include carrying out such activities through 
technology-enabled collaborative learning and capacity 
building models described in subsection (f): 
‘‘(1) TREATMENT
AND
RECOVERY
SERVICES.— 
Each Center shall— 
‘‘(A) Ensure that intake, evaluations, and 
periodic patient assessments meet the individual-
ized clinical needs of patients, including by re-
viewing patient placement in treatment settings 
to support meaningful recovery. 
‘‘(B) Provide the full continuum of treat-
ment services, including— 
‘‘(i) all drugs and devices approved or 
cleared under the Federal Food, Drug, and 
Cosmetic Act and all biological products li-
censed under section 351 of this Act to treat 
substance use disorders or reverse overdoses, 
pursuant to Federal and State law; 
‘‘(ii) medically supervised withdrawal 
management, that includes patient evalua-
tion, stabilization, and readiness for and 
entry into treatment; 
‘‘(iii) counseling provided by a pro-
gram counselor or other certified profes-
sional who is licensed and qualified by edu-
389 
cation, training, or experience to assess the 
psychological and sociological background of 
patients, to contribute to the appropriate 
treatment plan for the patient, and to mon-
itor patient progress; 
‘‘(iv) treatment, as appropriate, for 
patients with co-occurring substance use 
and mental disorders; 
‘‘(v) testing, as appropriate, for infec-
tions commonly associated with illicit drug 
use; 
‘‘(vi) residential rehabilitation, and 
outpatient and intensive outpatient pro-
grams; 
‘‘(vii) recovery housing; 
‘‘(viii) community-based and peer re-
covery support services; 
‘‘(ix) job training, job placement as-
sistance, and continuing education assist-
ance to support reintegration into the work-
force; and 
‘‘(x) other best practices to provide the 
full continuum of treatment and services, as 
determined by the Secretary.
390 
‘‘(C) Ensure that all programs covered by 
the Center include medication-assisted treatment, 
as appropriate, and do not exclude individuals 
receiving medication-assisted treatment from any 
service. 
‘‘(D) Periodically conduct patient assess-
ments to support sustained and clinically sig-
nificant recovery, as defined by the Assistant 
Secretary for Mental Health and Substance Use. 
‘‘(E) Provide onsite access to medication, as 
appropriate, and toxicology services; for purposes 
of carrying out this section. 
‘‘(F) Operate a secure, confidential, and 
interoperable electronic health information sys-
tem. 
‘‘(G) Offer family support services such as 
child care, family counseling, and parenting 
interventions to help stabilize families impacted 
by substance use disorder, as appropriate. 
‘‘(2) OUTREACH.—Each Center shall carry out 
outreach activities regarding the services offered 
through the Centers, which may include— 
‘‘(A) training and supervising outreach 
staff, as appropriate, to work with State and 
local health departments, health care providers,
391 
the Indian Health Service, State and local edu-
cational agencies, schools funded by the Indian 
Bureau of Education, institutions of higher edu-
cation, State and local workforce development 
boards, State and local community action agen-
cies, public safety officials, first responders, In-
dian Tribes, child welfare agencies, as appro-
priate, and other community partners and the 
public, including patients, to identify and re-
spond to community needs; 
‘‘(B) ensuring that the entities described in 
subparagraph (A) are aware of the services of the 
Center; and 
‘‘(C) disseminating and making publicly 
available, including through the internet, evi-
dence-based resources that educate professionals 
and the public on opioid use disorder and other 
substance use disorders, including co-occurring 
substance use and mental disorders. 
‘‘(h) DATA REPORTING AND PROGRAM OVERSIGHT.— 
With respect to a grant awarded under subsection (a), not 
later than 90 days after the end of the first year of the grant 
period, and annually thereafter for the duration of the 
grant period (including the duration of any renewal period
392 
for such grant), the entity shall submit data, as appro-
priate, to the Secretary regarding— 
‘‘(1) the programs and activities funded by the 
grant; 
‘‘(2) health outcomes of the population of indi-
viduals with a substance use disorder who received 
services from the Center, evaluated by an independent 
program evaluator through the use of outcomes meas-
ures, as determined by the Secretary; 
‘‘(3) the retention rate of program participants; 
and 
‘‘(4) any other information that the Secretary 
may require for the purpose of—ensuring that the 
Center is complying with all the requirements of the 
grant, including providing the full continuum of serv-
ices described in subsection (g)(1)(B). 
‘‘(i) PRIVACY.—The provisions of this section, includ-
ing with respect to data reporting and program oversight, 
shall be subject to all applicable Federal and State privacy 
laws. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated $10,000,000 for each of fiscal 
years 2019 through 2023 for purposes of carrying out this 
section.’’. 
(b) REPORTS TO CONGRESS.—
393 
(1) PRELIMINARY
REPORT.—Not later than 3 
years after the date of the enactment of this Act, the 
Secretary of Health and Human Services shall sub-
mit to Congress a preliminary report that analyzes 
data submitted under section 552(h) of the Public 
Health Service Act, as added by subsection (a). 
(2) FINAL REPORT.—Not later than 2 years after 
submitting the preliminary report required under 
paragraph (1), the Secretary of Health and Human 
Services shall submit to Congress a final report that 
includes— 
(A) an evaluation of the effectiveness of the 
comprehensive services provided by the Centers 
established or operated pursuant to section 552 
of the Public Health Service Act, as added by 
subsection (a), with respect to health outcomes of 
the population of individuals with substance use 
disorder who receive services from the Center, 
which shall include an evaluation of the effective-
ness of services for treatment and recovery sup-
port and to reduce relapse, recidivism, and over-
dose; and 
(B) recommendations, as appropriate, re-
garding ways to improve Federal programs re-
lated to substance use disorders, which may in-
411 
(5) Engaging families and communities in ef-
forts to increase awareness of child and youth trau-
ma, which may include sharing best practices with 
law enforcement regarding trauma-informed care and 
working with mental health professionals to provide 
interventions, as well as longer term coordinated care 
within the community for children and youth who 
have experienced trauma and their families. 
(6) To provide technical assistance to school sys-
tems and mental health agencies. 
(7) To evaluate the effectiveness of the program 
carried out under this section in increasing student 
access to evidence-based trauma support services and 
mental health care. 
(8) To establish partnerships with or provide 
subgrants to Head Start agencies (including Early 
Head Start agencies), public and private preschool 
programs, child care programs (including home-based 
providers), or other entities described in subsection 
(a), to include such entities described in this para-
graph in the evidence-based trauma initiatives, ac-
tivities, support services, and mental health systems 
established under this section in order to provide, de-
velop, or improve prevention, screening, referral, and
648 
‘‘(C) Data sufficient to show the extent of 
prescription drug diversion, trafficking, and 
misuse in the calendar year and each of the pre-
vious 3 calendar years. 
‘‘(D) Any quantifiable measures the Direc-
tor determines to be appropriate to detail 
progress toward the achievement of the goals of 
the National Drug Control Strategy. 
‘‘(g) DEVELOPMENT OF AN ANNUAL NATIONAL DRUG 
CONTROL ASSESSMENT.— 
‘‘(1) TIMING.—Not later than the first Monday 
in February of each year, the Director shall submit 
to the President, Congress, and the appropriate con-
gressional committees, a report assessing the progress 
of each National Drug Control Program Agency to-
ward achieving each goal, objective, and target con-
tained in the National Drug Control Strategy appli-
cable to the prior fiscal year. 
‘‘(2) PROCESS FOR DEVELOPMENT OF THE AN-
NUAL ASSESSMENT.—Not later than November 1 of 
each year, the head of each National Drug Control 
Program Agency shall submit, in accordance with 
guidance issued by the Director, to the Director an 
evaluation of progress by the agency with respect to 
the National Drug Control Strategy goals using the
649 
performance measures for the agency developed under 
this title, including progress with respect to— 
‘‘(A) success in achieving the goals of the 
National Drug Control Strategy; 
‘‘(B) success in reducing domestic and for-
eign sources of illegal drugs; 
‘‘(C) success in expanding access to and in-
creasing the effectiveness of substance use dis-
order treatment; 
‘‘(D) success in protecting the borders of the 
United States (and in particular the South-
western border of the United States) from pene-
tration by illegal narcotics; 
‘‘(E) success in reducing crime associated 
with drug use in the United States; 
‘‘(F) success in reducing the negative health 
and social consequences of drug use in the 
United States; 
‘‘(G) implementation of evidence-based sub-
stance use disorder treatment and prevention 
programs in the United States and improve-
ments in the adequacy and effectiveness of such 
programs; and 
‘‘(H) success in increasing the prevention of 
illicit drug use.
650 
‘‘(3) CONTENTS OF THE ANNUAL ASSESSMENT.— 
The Director shall include in the annual assessment 
required under paragraph (1)— 
‘‘(A) a summary of each evaluation received 
by the Director under paragraph (2); 
‘‘(B) a summary of the progress of each Na-
tional Drug Control Program Agency toward the 
National Drug Control Strategy goals of the 
agency using the performance measures for the 
agency developed under this chapter; 
‘‘(C) an assessment of the effectiveness of 
each National Drug Control Program Agency 
and program in achieving the National Drug 
Control Strategy for the previous year, including 
a specific evaluation of whether the applicable 
goals, measures, objectives, and targets for the 
previous year were met; and 
‘‘(D) the assessments required under this 
subsection shall be based on the Performance 
Measurement System.’’. 
(b) TECHNICAL AND CONFORMING AMENDMENTS.— 
(1) Section 704(b) of the Office of National Drug 
Control Policy Reauthorization Act of 1998 (21 
U.S.C. 1703(b)) is amended—