I 
115TH CONGRESS 
2D SESSION 
H. R. 5736 
To amend the Public Health Service Act to establish a pilot program to 
help individuals in recovery from a substance use disorder transition 
from treatment to independent living and the workforce, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 9, 2018 
Mr. BARR (for himself, Mr. KUSTOFF of Tennessee, Mr. GUTHRIE, Mr. 
MOONEY of West Virginia, Mr. MCKINLEY, Mr. FITZPATRICK, Mr. HAR-
PER, Mr. ROTHFUS, Mr. BUDD, Ms. TENNEY, Mr. CURTIS, Mr. GIBBS, 
Mrs. BLACKBURN, Mr. ROE of Tennessee, and Mrs. WAGNER) introduced 
the following bill; which was referred to the Committee on Education and 
the Workforce, and in addition to the Committees on Energy and Com-
merce, and Financial Services, for a period to be subsequently determined 
by the Speaker, in each case for consideration of such provisions as fall 
within the jurisdiction of the committee concerned 
A BILL 
To amend the Public Health Service Act to establish a pilot 
program to help individuals in recovery from a substance 
use disorder transition from treatment to independent 
living and the workforce, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Comprehensive Addic-
tion Recovery through Effective Employment and Reentry 
Act’’ or the ‘‘CAREER Act’’. 
SEC. 2. PILOT PROGRAM TO HELP INDIVIDUALS IN RECOV-
ERY FROM A SUBSTANCE USE DISORDER 
TRANSITION TO INDEPENDENT LIVING AND 
THE WORKFORCE. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 320B. PILOT PROGRAM TO HELP INDIVIDUALS IN RE-
COVERY FROM A SUBSTANCE USE DISORDER 
TRANSITION TO INDEPENDENT LIVING AND 
THE WORKFORCE. 
‘‘(a) IN GENERAL.—The Secretary shall establish a 
pilot program to award 5-year grants under subsection 
(b)(1) to States, and 1-year grants under subsection 
(b)(2) to States or Indian tribes, for the purpose of mak-
ing subgrants to entities under subsection (c) to help indi-
viduals in recovery from a substance use disorder transi-
tion from treatment to independent living and the work-
force. 
‘‘(b) GRANTS.— 
‘‘(1) 5-YEAR GRANTS.— 
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‘‘(A) IN
GENERAL.—The Secretary shall 
award 5-year grants under this paragraph to 5 
States that submit an application under para-
graph (3). Such States shall be selected— 
‘‘(i) from among the 10 States with 
the highest rate of death due to drug over-
dose per 100,000 people, based on data 
from the Centers for Disease Control and 
Prevention 
for 
calendar 
years 
2013 
through 2017; and 
‘‘(ii) based on the merits of the pro-
posal included in such application and the 
preferences described in subparagraph (B). 
‘‘(B) PREFERENCES.—The Secretary, in 
selecting States for a grant under this para-
graph, shall give priority to States from among 
the States described in subparagraph (A) with 
the combination of— 
‘‘(i) the highest average rates of un-
employment based on data provided by the 
Bureau of Labor Statistics for calendar 
years 2013 through 2017; 
‘‘(ii) the lowest average labor force 
participation rates based on data provided 
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by the Bureau of Labor Statistics for cal-
endar years 2013 through 2017; and 
‘‘(iii) the highest prevalence of opioid 
use disorder based on data provided by the 
Substance Abuse and Mental Health Serv-
ices Administration for calendar years 
2013 through 2017 as may be available. 
‘‘(C) GRANT FUNDS.— 
‘‘(i) IN GENERAL.—The funds from a 
5-year grant awarded under this paragraph 
shall be provided to each of the 5 selected 
States on an annual basis for each of fiscal 
years 2019 through 2023. 
‘‘(ii) CARRY OVER.— 
‘‘(I) IN
GENERAL.—The funds 
awarded under clause (i) for a fiscal 
year shall remain available for the 
State to make subgrants under sub-
section (c) for such fiscal year, except 
a State may carry over (subject to 
subclause (II)) not more than 10 per-
cent of such funds for the following 
fiscal year for such purpose. 
‘‘(II) REQUEST.—A State may 
make a request to the Secretary to 
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carry over more than 10 percent of 
the funds awarded under clause (i) for 
a fiscal year for the following fiscal 
year for such purpose, and the Sec-
retary may grant such request as the 
Secretary determines appropriate. 
‘‘(III) AMOUNT FOR FOLLOWING 
FISCAL
YEAR.—Any amount carried 
over under this clause shall not im-
pact the amount of the funds the Sec-
retary awards the State for such fol-
lowing fiscal year. 
‘‘(iii) RETURN OF FUNDS.—Any funds 
awarded under clause (i) that are not ex-
pended during the fiscal year for which the 
funds are awarded and that are not carried 
over for the following fiscal year under 
clause (ii) shall be returned to the Sec-
retary to carry out this section. Any funds 
returned to the Secretary after fiscal year 
2023 shall be returned to the general fund 
of the Treasury. 
‘‘(2) 1-YEAR GRANTS.— 
‘‘(A) IN GENERAL.—The Secretary shall, 
for each of fiscal years 2019 through 2023, 
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award 1-year grants to States or Indian tribes 
under this paragraph that submit an applica-
tion in accordance with paragraph (3). Such 
States or Indian tribes shall be selected for a 
grant under this paragraph based on criteria 
established by the Secretary. 
‘‘(B) GRANT FUNDS.— 
‘‘(i) IN GENERAL.—The funds award-
ed through a grant under subparagraph 
(A) for a fiscal year shall remain available 
for the State or Indian tribe to make sub-
grants under subsection (c) for such fiscal 
year and may not be carried over for such 
following fiscal year. 
‘‘(ii) RETURN OF FUNDS.—Any funds 
awarded through a grant under subpara-
graph (A) that are not expended during 
the fiscal year of the grant shall be re-
turned to the Secretary to carry out this 
section. Any funds returned to the Sec-
retary after fiscal year 2023 shall be re-
turned to the general fund of the Treas-
ury. 
‘‘(3) APPLICATIONS.— 
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‘‘(A) IN GENERAL.—Each State desiring a 
grant under paragraph (1) and each State or 
Indian tribe desiring a grant under paragraph 
(2) shall submit an application to the Secretary 
at such time and in such manner as the Sec-
retary may reasonably require for such grant. 
‘‘(B) CONTENTS.— 
‘‘(i) IN
GENERAL.—An application 
submitted under subparagraph (A) shall 
contain such information as the Secretary 
may reasonably require, including a pro-
posal for awarding subgrants under sub-
section (c) and a method for evaluating 
such subgrants. 
‘‘(ii) 5-YEAR GRANTS.—An application 
submitted under subparagraph (A) for a 
grant awarded under subsection (b)(1) 
shall include an assurance that not less 
than 50 percent of the funds awarded 
through the grant will be used towards 
making subgrants under subsection (c) to 
the entities applying for such subgrants 
that serve the areas in the State with the 
highest prevalence of substance use dis-
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order, based on data determined appro-
priate by the Secretary. 
‘‘(c) SUBGRANTS.— 
‘‘(1) IN GENERAL.—Each State that receives a 
grant under subsection (b)(1) and each State or In-
dian tribe that receives a grant under subsection 
(b)(2) shall award subgrants on a competitive basis 
to entities that meet the requirements under para-
graphs (2) and (3). 
‘‘(2) SUBGRANT REQUIREMENTS.— 
‘‘(A) APPLICATION.—An entity that de-
sires a subgrant under this subsection shall 
submit an application to the State or Indian 
tribe at such time and in such manner as the 
State or Indian tribe may reasonably require. 
‘‘(B) CONTENTS.—An application sub-
mitted under subparagraph (A) by an entity 
shall contain such information as the State or 
Indian tribe may reasonably require, including 
a demonstration that the entity has one or more 
of the following abilities: 
‘‘(i) The ability to partner with local 
stakeholders, which may include local em-
ployers, community stakeholders, and local 
and State governments, to identify gaps in 
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the workforce due to the prevalence of sub-
stance use disorders. 
‘‘(ii) The ability to partner with local 
stakeholders, which may include local em-
ployers, community stakeholders, and local 
and State governments, to offer transi-
tional services, including employment and 
career counseling or job placement, to help 
individuals in recovery from a substance 
use disorder transition into the workforce. 
‘‘(iii) The ability to partner with local 
stakeholders, which may include local em-
ployers, community stakeholders, and local 
and State governments, to assist employers 
with informing their employees of the re-
sources, such as treatment options for a 
substance use disorder, that are available 
to them. 
‘‘(3) USE OF FUNDS.—An entity receiving a 
subgrant under this subsection shall use the 
subgrant funds for more than one of the following: 
‘‘(A) To hire specialists with an expertise 
in treating substance use disorders, including 
through residential treatment, to assist with the 
treatment provided through a subgrant under 
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this subsection, which may include the use of 
medication-assisted treatment. 
‘‘(B) To provide wrap-around services to 
encourage substance use disorder prevention, 
treatment, recovery, and rehabilitation, with a 
focus on ensuring long-term recovery and symp-
tom remission. 
‘‘(C) To help individuals transition from 
inpatient treatment for a substance use dis-
order to the workforce by providing— 
‘‘(i) career services described in para-
graph (2), and training services described 
in paragraph (3), of section 134(c) of the 
Workforce Innovation and Opportunity Act 
(29 U.S.C. 3174(c)); and 
‘‘(ii) related services described in sec-
tion 134(a)(4)(D) of such Act (42 U.S.C. 
3174(a)(4)(D)). 
‘‘(D) To implement innovative technologies 
to make substance use disorder treatment more 
affordable and accessible, which may include 
the use of telemedicine, and may assist individ-
uals in finding and maintaining employment 
throughout recovery. 
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‘‘(E) To provide ongoing outpatient sub-
stance use disorder treatment programs, includ-
ing peer support meetings, for individuals who 
have recovered or are in recovery from a sub-
stance use disorder while they transition from 
receiving treatment for such disorder to enter-
ing the workforce and maintaining employment. 
‘‘(F) To assist patients, including through 
hiring case managers, care coordinators, or 
trained peer recovery coaches, in recovery from 
a substance use disorder, including through 
programs to provide services to develop daily 
living skills, provide counseling, and provide 
housing assistance, and through other appro-
priate Federal Government assistance pro-
grams. 
‘‘(G) With respect to an entity that pro-
vides the full continuum of substance use dis-
order treatment services, which may include de-
toxification, residential rehabilitation, recovery 
housing, evidence-based treatments (which may 
include the use of medication-assisted treat-
ment), counseling, and recovery supports, to ex-
pand such services to include services that may 
include— 
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‘‘(i) short-term prevocational training 
services, such as the development of learn-
ing skills, communication skills, inter-
viewing skills, punctuality, personal main-
tenance skills, and professional conduct; 
‘‘(ii) vocational training, which shall 
emphasize the skills or knowledge nec-
essary for a particular job function or 
trade; and 
‘‘(iii) care coordination throughout the 
short- and long-term substance use dis-
order recovery process. 
‘‘(H) Any other service determined by the 
Secretary as necessary for achieving the goal of 
transitioning individuals from treatment for 
substance use disorders to independent living 
and the workforce or to encouraging substance 
use disorder prevention in the workforce. 
‘‘(d) CONSULTATION.—The Secretary may, in car-
rying out the pilot program under this section, consult 
with the Assistant Secretary for Substance Use and Men-
tal Health, the Administrator of the Health Resources and 
Services Administration, the Secretary of Labor, the Sec-
retary of Housing and Urban Development, and the Sec-
retary of Education. 
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‘‘(e) REPORTING REQUIREMENTS.— 
‘‘(1) REPORTS TO THE SECRETARY.— 
‘‘(A) 5-YEAR GRANTS.—Not later than De-
cember 31, 2021, each State that has received 
a grant under subsection (b)(1) shall report to 
the Secretary on its progress and effectiveness 
in meeting the objectives of the pilot program 
under this section, including the progress and 
effectiveness of the entities receiving subgrants 
under subsection (c) as demonstrated through 
reports of such progress and effectiveness sub-
mitted to the State by such entities. 
‘‘(B) 1-YEAR GRANTS.—Not later than De-
cember 31 of the fiscal year following the fiscal 
year for which a grant is awarded under sub-
section (b)(2), the State or Indian tribe receiv-
ing such grant shall report to the Secretary on 
its progress and effectiveness in meeting the ob-
jectives of the pilot program under this section, 
including the progress and effectiveness of the 
entities receiving subgrants under subsection 
(c) which may be demonstrated through reports 
of such progress and effectiveness submitted to 
the State or Indian tribe by such entities. 
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‘‘(2) REPORT TO CONGRESS.—Not later than 
December 31, 2024, the Secretary shall submit a re-
port to Congress, including any applicable author-
izing committee of the Senate or House of Rep-
resentatives, evaluating the grants awarded under 
this section. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated $200,000,000, for each 
of fiscal years 2019 through 2023, to carry out this sec-
tion. Out of such amount appropriated for each such fiscal 
year— 
‘‘(1) 75 percent shall be used to make grants 
under subsection (b)(1); and 
‘‘(2) 25 percent shall be used to make grants 
under subsection (b)(2).’’. 
SEC. 3. TRANSITIONAL HOUSING SERVICES. 
(a) IN GENERAL.—Section 105(a) of the Housing 
and Community Development Act of 1974 (42 U.S.C. 
5305(a)) is amended— 
(1) in paragraph (25)(D), by striking ‘‘and’’ at 
the end; 
(2) in paragraph (26), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
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