I 
115TH CONGRESS 
2D SESSION 
H. R. 5545 
To provide emergency assistance to States, territories, Tribal nations, and 
local areas affected by the opioid epidemic and to make financial assist-
ance available to States, territories, Tribal nations, local areas, and 
public or private nonprofit entities to provide for the development, organi-
zation, coordination, and operation of more effective and cost efficient 
systems for the delivery of essential services to individuals with substance 
use disorder and their families. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 18, 2018 
Mr. CUMMINGS introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
the Judiciary, and Natural Resources, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To provide emergency assistance to States, territories, Tribal 
nations, and local areas affected by the opioid epidemic 
and to make financial assistance available to States, ter-
ritories, Tribal nations, local areas, and public or private 
nonprofit entities to provide for the development, organi-
zation, coordination, and operation of more effective and 
cost efficient systems for the delivery of essential services 
to individuals with substance use disorder and their fami-
lies. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Comprehensive Addiction Resources Emergency Act of 
2018’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Purpose. 
Sec. 3. Amendment to the Public Health Service Act. 
‘‘TITLE XXXIV—SUBSTANCE USE AND OPIOID HEALTH 
RESOURCES 
‘‘Subtitle A—Substance Use and Opioid Emergency Relief Grant Program 
‘‘Sec. 3401. Establishment of program of grants. 
‘‘Sec. 3402. Planning council. 
‘‘Sec. 3403. Amount of grant and use of amounts. 
‘‘Sec. 3404. Application. 
‘‘Sec. 3405. Technical assistance. 
‘‘Sec. 3406. Authorization of appropriations. 
‘‘Subtitle B—State and Tribal Substance Use Disorder Prevention and 
Intervention Grant Program 
‘‘Sec. 3411. Establishment of program of grants. 
‘‘Sec. 3412. Amount of grant and use of amounts. 
‘‘Sec. 3413. Application and limitation. 
‘‘Sec. 3414. Technical assistance. 
‘‘Sec. 3415. Authorization of appropriations. 
‘‘Subtitle C—Other Grant Program 
‘‘Sec. 3421. Establishment of grant program. 
‘‘Sec. 3422. Use of amounts. 
‘‘Sec. 3423. Technical assistance. 
‘‘Sec. 3424. Planning and development grants. 
‘‘Sec. 3425. Authorization of appropriations. 
‘‘Subtitle D—Miscellaneous Provisions 
‘‘Sec. 3431. Special projects of national significance. 
‘‘Sec. 3432. Education and training centers. 
‘‘Sec. 3433. Other provisions. 
‘‘Sec. 3434. Standards for substance use disorder treatment and recovery 
facilities. 
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‘‘Sec. 3435. Naloxone distribution program. 
‘‘Sec. 3436. Additional funding for the National Institutes of Health. 
‘‘Sec. 3437. Additional funding for improved data collection and prevention 
of infectious disease transmission. 
‘‘Sec. 3438. Definitions. 
Sec. 4. Amendments to the Controlled Substances Act. 
SEC. 2. PURPOSE. 
It is the purpose of this Act to provide emergency 
assistance to States, territories, Tribal nations, and local 
areas that are disproportionately affected by the opioid 
epidemic and to make financial assistance available to 
States, territories, Tribal nations, local areas, and other 
public or private nonprofit entities to provide for the devel-
opment, organization, coordination, and operation of more 
effective and cost efficient systems for the delivery of es-
sential services to individuals and families with substance 
use disorder. 
SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICE 
ACT. 
The Public Health Service Act (42 U.S.C. 201 et 
seq.) is amended by adding at the end the following: 
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‘‘TITLE XXXIV—SUBSTANCE USE 
AND 
OPIOID 
HEALTH 
RE-
SOURCES 
‘‘Subtitle A—Substance Use and 
Opioid Emergency Relief Grant 
Program 
‘‘SEC. 3401. ESTABLISHMENT OF PROGRAM OF GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, in coordination 
with the Director of the Office of National Drug Control 
Policy, shall award grants to eligible localities for the pur-
pose of addressing substance use within such localities. 
‘‘(b) ELIGIBILITY.— 
‘‘(1) IN GENERAL.—To be eligible to receive a 
grant under subsection (a) a locality shall— 
‘‘(A) be— 
‘‘(i) a county that can demonstrate 
that the rate of drug overdose deaths per 
100,000 individuals residing in the county 
during the most recent 3-year period for 
which such data are available was not less 
than the rate of such deaths for the county 
that ranked at the 67th percentile of all 
counties, as determined by the Secretary; 
‘‘(ii) a county that can demonstrate 
that the number of drug overdose deaths 
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during the most recent 3-year period for 
which such data are available was not less 
than the number of such deaths for the 
county that ranked at the 90th percentile 
of all counties, as determined by the Sec-
retary; or 
‘‘(iii) a city that is located within a 
county described in clause (i) or (ii), that 
meets the requirements of paragraph (3); 
and 
‘‘(B) submit to the Secretary an applica-
tion in accordance with section 3404. 
‘‘(2) MULTIPLE
CONTIGUOUS
COUNTIES.—In 
the case of an eligible county that is contiguous to 
one or more other eligible counties within the same 
State, the group of counties shall— 
‘‘(A) be considered as a single eligible 
county for purposes of a grant under this sec-
tion; 
‘‘(B) submit a single application under sec-
tion 3404; 
‘‘(C) form a joint planning council (for the 
purposes of section 3402); and 
‘‘(D) establish, through intergovernmental 
agreements, an administrative mechanism to al-
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quirement. 
Such 
application 
shall 
dem-
onstrate— 
‘‘(i) that the needs of the population 
to be served are distinct or that addressing 
substance use in the service area would be 
best served by the formation of an inde-
pendent council; and 
‘‘(ii) that the city or county or group 
of counties has the capacity to administer 
the funding received under this subtitle. 
‘‘(D) MINIMUM FUNDING.—A city or coun-
ty that meets the requirement of this paragraph 
and receives a grant under section 3401 shall 
be entitled to an amount of funding under the 
grant in an amount that is not less than the 
amount determined under section 3403(a) with 
respect to such city or county. 
‘‘(4) INDEPENDENT CITY.—Independent cities 
that are not located within the territory of a county 
shall be treated as eligible counties for purposes of 
this subtitle. 
‘‘(5) POLITICAL
SUBDIVISIONS.—With respect 
to States that do not have a local county system of 
governance, the Secretary shall determine the local 
political subdivisions within such States that are eli-
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gible to receive a grant under section 3401 and such 
subdivisions shall be treated as eligible counties for 
purposes of this subtitle. 
‘‘(6) DETERMINATIONS
WHERE
THERE
IS
A 
LACK OF DATA.—The Secretary shall establish eligi-
bility and allocation criteria related to the prevalence 
of drug overdose deaths, the mortality rate from 
drug overdoses, and that provides an equivalent 
measure of need for funding for cities and counties 
for which the data described in paragraph (1)(A) or 
(2)(D)(i) is not available. 
‘‘(7) STUDY.—Not later than 3 years after the 
date of enactment of this title, the Comptroller Gen-
eral shall conduct a study to determine whether the 
data utilized for purposes of paragraph (1)(A) pro-
vides the most precise measure of local area need re-
lated to substance use and addiction prevalence and 
whether additional data would provide more precise 
measures of substance use and addiction prevalence 
in local areas. Such study shall identify barriers to 
collecting or analyzing such data, and make rec-
ommendations for revising the indicators used under 
such paragraph to determine eligibility in order to 
direct funds to the local areas in most need of fund-
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ing to provide assistance related to substance use 
and addiction. 
‘‘(8) REFERENCE.—For purposes of this sub-
title, the term ‘eligible local area’ includes— 
‘‘(A) a city or county described in para-
graph (1); 
‘‘(B) multiple contiguous counties de-
scribed in paragraph (2); 
‘‘(C) an independent locality described in 
paragraph (3); 
‘‘(D) an independent city described in 
paragraph (4); and 
‘‘(E) a political subdivision described in 
paragraph (5). 
‘‘(c) ADMINISTRATION.— 
‘‘(1) IN GENERAL.—Assistance made available 
under a grant awarded under this section shall be 
directed to the chief elected official of the eligible 
local area who shall administer the grant funds. 
‘‘(2) MULTIPLE CONTIGUOUS COUNTIES.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), in the case of an eligible 
county described in subsection (b)(2), assist-
ance made available under a grant awarded 
under this section shall be directed to the chief 
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elected official of the particular county des-
ignated in the application submitted for the 
grant under section 3404. Such chief elected of-
ficial shall be the administrator of the grant. 
‘‘(B) STATE
ADMINISTRATION.—Notwith-
standing subparagraph (A), the eligible county 
described in subsection (b)(2) may elect to des-
ignate the chief elected State official of the 
State in which the eligible county is located as 
the administrator of the grant funds. 
‘‘SEC. 3402. PLANNING COUNCIL. 
‘‘(a) ESTABLISHMENT.—To be eligible to receive a 
grant under section 3401, the chief elected official of the 
eligible local area shall establish or designate a substance 
use disorder treatment and services planning council that 
shall, to the maximum extent practicable— 
‘‘(1) be representative of the demographics of 
the population of individuals with substance use dis-
order in the area; and 
‘‘(2) include representatives of— 
‘‘(A) health care providers, including feder-
ally qualified health centers, rural health clinics, 
Indian health programs as defined in section 4 
of the Indian Health Care Improvement Act, 
urban Indian organizations as defined in section 
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4 of the Indian Health Care Improvement Act, 
Native Hawaiian organizations as defined in 
section 12 of the Native Hawaiian Health Care 
Act of 1988, and facilities operated by the De-
partment of Veterans Affairs; 
‘‘(B) community-based health, harm reduc-
tion, or addiction service organizations, includ-
ing, where applicable, representatives of Drug 
Free Communities Coalition grantees; 
‘‘(C) social service providers, including pro-
viders of housing and homelessness services and 
recovery residence providers; 
‘‘(D) mental health care providers; 
‘‘(E) local public health agencies; 
‘‘(F) law enforcement officials, including 
officials from High Intensity Drug Trafficking 
Area program, where applicable; 
‘‘(G) affected communities, including indi-
viduals with substance use disorder or a history 
of substance use disorder, including individuals 
in recovery from substance use disorders; 
‘‘(H) State governments, including the 
State Medicaid agency and the Single State 
Agency for Substance Abuse Services; 
‘‘(I) local governments; 
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‘‘(J) non-elected community leaders; 
‘‘(K) substance use disorder treatment pro-
viders; 
‘‘(L) Indian tribes and tribal organizations 
as defined in section 4 of the Indian Self-Deter-
mination and Education Assistance Act; 
‘‘(M) urban Indians as defined in section 4 
of the Indian Health Care Improvement Act; 
‘‘(N) historically underserved groups and 
subpopulations; 
‘‘(O) individuals who were formerly incar-
cerated; 
‘‘(P) organizations serving individuals who 
are currently or were formerly incarcerated; 
‘‘(Q) representatives of Federal agencies; 
‘‘(R) representatives of organizations that 
provide services to youth at risk of substance 
use; 
‘‘(S) representatives of medical examiners 
or coroners; 
‘‘(T) representatives of labor unions and 
the workplace community; and 
‘‘(U) representatives of local fire depart-
ments and emergency medical services. 
‘‘(b) METHOD OF PROVIDING FOR COUNCIL.— 
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