IIB 
117TH CONGRESS 
1ST SESSION H. R. 2379 
IN THE SENATE OF THE UNITED STATES 
OCTOBER 21, 2021 
Received; read twice and referred to the Committee on Health, Education, 
Labor, and Pensions 
AN ACT 
To amend the 21st Century Cures Act to reauthorize and 
expand a grant program for State response to the opioid 
use disorders crisis, 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 ‘‘State Opioid Response 
Grant Authorization Act of 2021’’. 
SEC. 2. GRANT PROGRAM FOR STATE AND TRIBAL RE-
SPONSE TO OPIOID AND STIMULANT USE AND 
MISUSE. 
Section 1003 of the 21st Century Cures Act (42 
U.S.C. 290ee–3 note) is amended to read as follows: 
‘‘SEC. 1003. GRANT PROGRAM FOR STATE AND TRIBAL RE-
SPONSE TO OPIOID AND STIMULANT USE AND 
MISUSE. 
‘‘(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘Sec-
retary’) shall carry out the grant program described in 
subsection (b) for purposes of addressing opioid and stim-
ulant use and misuse, within States, Indian Tribes, and 
populations served by Tribal organizations and Urban In-
dian organizations. 
‘‘(b) GRANTS PROGRAM.— 
‘‘(1) IN GENERAL.—Subject to the availability 
of appropriations, the Secretary shall award grants 
to States, Indian Tribes, Tribal organizations, and 
Urban Indian organizations for the purpose of ad-
dressing opioid and stimulant use and misuse, within 
such States, such Indian Tribes, and populations 
served by such Tribal organizations and Urban In-
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dian organizations, in accordance with paragraph 
(2). 
‘‘(2) MINIMUM ALLOCATIONS; PREFERENCE.— 
In determining grant amounts for each recipient of 
a grant under paragraph (1), the Secretary shall— 
‘‘(A) ensure that each State receives not 
less than $4,000,000; and 
‘‘(B) give preference to States, Indian 
Tribes, Tribal organizations, and Urban Indian 
organizations whose populations have an inci-
dence or prevalence of opioid use disorders or 
stimulant use or misuse that is substantially 
higher relative to the populations of other 
States, other Indian Tribes, Tribal organiza-
tions, or Urban Indian organizations, as appli-
cable. 
‘‘(3) FORMULA METHODOLOGY.— 
‘‘(A) IN
GENERAL.—Before publishing a 
funding opportunity announcement with respect 
to grants under this section, the Secretary 
shall— 
‘‘(i) develop a formula methodology to 
be followed in allocating grant funds 
awarded under this section among grant-
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‘‘(ii) mutual aid recovery programs 
that support medication-assisted treat-
ment; or 
‘‘(iii) services to address housing 
needs and family issues. 
‘‘(F) Other public health-related activities, 
as the State, Indian Tribe, Tribal organization, 
or Urban Indian organization determines appro-
priate, related to addressing substance use dis-
orders within the State, Indian Tribe, Tribal or-
ganization, or Urban Indian organization, in-
cluding directing resources in accordance with 
local needs related to substance use disorders. 
‘‘(c) ACCOUNTABILITY AND OVERSIGHT.—A State re-
ceiving a grant under subsection (b) shall include in re-
porting related to substance use disorders submitted to the 
Secretary pursuant to section 1942 of the Public Health 
Service Act (42 U.S.C. 300x–52), a description of— 
‘‘(1) the purposes for which the grant funds re-
ceived by the State under such subsection for the 
preceding fiscal year were expended and a descrip-
tion of the activities of the State under the grant; 
‘‘(2) the ultimate recipients of amounts pro-
vided to the State; and 
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‘‘(3) the number of individuals served through 
the grant. 
‘‘(d) LIMITATIONS.—Any funds made available pur-
suant to subsection (i)— 
‘‘(1) shall not be used for any purpose other 
than the grant program under subsection (b); and 
‘‘(2) shall be subject to the same requirements 
as substance use disorders prevention and treatment 
programs under titles V and XIX of the Public 
Health Service Act (42 U.S.C. 290aa et seq., 300w 
et seq.). 
‘‘(e) INDIAN TRIBES, TRIBAL ORGANIZATIONS, AND 
URBAN INDIAN ORGANIZATIONS.—The Secretary, in con-
sultation with Indian Tribes, Tribal organizations, and 
Urban Indian organizations, shall identify and establish 
appropriate mechanisms for Indian Tribes, Tribal organi-
zations, and Urban Indian organizations to demonstrate 
or report the information as required under subsections 
(b), (c), and (d). 
‘‘(f) REPORT TO CONGRESS.—Not later than Sep-
tember 30, 2024, and biennially thereafter, the Secretary 
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, 
and the Committees on Appropriations of the House of 
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Representatives and the Senate, a report that includes a 
summary of the information provided to the Secretary in 
reports made pursuant to subsections (c) and (e), includ-
ing— 
‘‘(1) the purposes for which grant funds are 
awarded under this section; 
‘‘(2) the activities of the grant recipients; and 
‘‘(3) for each State, Indian Tribe, Tribal orga-
nization, and Urban Indian organization that re-
ceives a grant under this section, the funding level 
provided to such recipient. 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary, in-
cluding through the Tribal Training and Technical Assist-
ance Center of the Substance Abuse and Mental Health 
Services Administration, shall provide States, Indian 
Tribes, Tribal organizations, and Urban Indian organiza-
tions, as applicable, with technical assistance concerning 
grant application and submission procedures under this 
section, award management activities, and enhancing out-
reach and direct support to rural and underserved commu-
nities and providers in addressing substance use disorders. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) INDIAN TRIBE.—The term ‘Indian Tribe’ 
has the meaning given the term ‘Indian tribe’ in sec-
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tion 4 of the Indian Self-Determination and Edu-
cation Assistance Act (25 U.S.C. 5304). 
‘‘(2) TRIBAL ORGANIZATION.—The term ‘Tribal 
organization’ has the meaning given the term ‘tribal 
organization’ in such section 4. 
‘‘(3) STATE.—The term ‘State’ has the mean-
ing given such term in section 1954(b) of the Public 
Health Service Act (42 U.S.C. 300x–64(b)). 
‘‘(4) URBAN INDIAN ORGANIZATION.—The term 
‘Urban Indian organization’ has the meaning given 
such term in section 4 of the Indian Health Care 
Improvement Act. 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—For purposes of carrying 
out the grant program under subsection (b), there is 
authorized to be appropriated $1,750,000,000 for 
each of fiscal years 2022 through 2027, to remain 
available until expended. 
‘‘(2) FEDERAL ADMINISTRATIVE EXPENSES.— 
Of the amounts made available for each fiscal year 
to award grants under subsection (b), the Secretary 
shall not use more than 20 percent for Federal ad-
ministrative expenses, training, technical assistance, 
and evaluation. 
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‘‘(3) SET ASIDE.—Of the amounts made avail-
able for each fiscal year to award grants under sub-
section (b) for a fiscal year, the Secretary shall— 
‘‘(A) award 5 percent to Indian Tribes, 
Tribal organizations, and Urban Indian organi-
zations; and 
‘‘(B) of the amount remaining after appli-
cation of subparagraph (A), set aside up to 15 
percent for awards to States with the highest 
age-adjusted rate of drug overdose death based 
on the ordinal ranking of States according to 
the Director of the Centers for Disease Control 
and Prevention.’’. 
Passed the House of Representatives October 20, 
2021. 
Attest: 
CHERYL L. JOHNSON, 
Clerk. 
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