‘‘SEC. 3413. APPLICATION. 
‘‘(a) APPLICATION.—To be eligible to receive a grant 
under section 3411, a State shall have in effect a State 
plan approved by the Secretary pursuant to section 
1932(b), and shall prepare and submit to the Secretary 
an application in such form, and containing such informa-
tion, as the Secretary shall require, including— 
‘‘(1) a complete accounting of the disbursement 
of any prior grants received under this subtitle by 
the applicant and the results achieved by these ex-
penditures and a demonstration that funds received 
from a grant under this subtitle in the prior year 
were expended in accordance with State priorities; 
‘‘(2) establishment of goals and objectives to be 
achieved with grant funds provided under this sub-
title, including targets and milestones that are in-
tended to be met, the activities that will be under-
taken to achieve those targets, and the number of 
individuals likely to be served by the funds sought, 
including demographic data on the populations to be 
served; 
‘‘(3) a demonstration that the State will use 
funds in a manner that provides substance use dis-
order treatment services in compliance with the evi-
dence-based standards developed in accordance with 
section 3435, including all drugs approved by the 
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Food and Drug Administration for the treatment of 
substance use disorder; 
‘‘(4) a demonstration that resources provided 
under the grant will be allocated in accordance with 
the local demographic incidence of substance use, in-
cluding allocations for services for children, youths, 
and women; 
‘‘(5) an explanation of how income, asset, and 
medical expense criteria will be established and ap-
plied to those who qualify for assistance under the 
program; and 
‘‘(6) for any prior funding received under this 
section, data provided in such form as the Secretary 
shall require detailing, at a minimum, the extent to 
which the activities supported by the funding met 
the goals and objectives specified in the application 
for the funding, the number of individuals who 
accessed medication-assisted treatment by age, gen-
der, race, and other demographic criteria relevant to 
the program, and the effect of the program on over-
dose rates and rates of death due to overdose in the 
region served by the program. 
‘‘(b) REQUIREMENTS REGARDING IMPOSITION
OF 
CHARGES FOR SERVICES.— 
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‘‘(1) IN
GENERAL.—The Secretary may not 
make a grant under section 3411 to a State unless 
the State provides assurances that in the provision 
of services with assistance provided under the 
grant— 
‘‘(A) in the case of individuals with an in-
come less than or equal to 138 percent of the 
official poverty level, the provider will not im-
pose charges on any such individual for the 
services provided under the grant; 
‘‘(B) in the case of individuals with an in-
come greater than 138 percent of the official 
poverty level, the provider will impose a charge 
on each such individual according to a schedule 
of charges made available to the public; 
‘‘(C) in the case of individuals with an in-
come greater than 138 percent of the official 
poverty level but not exceeding 200 percent of 
such poverty level, the provider will not, for an 
calendar year, impose charges in an amount ex-
ceeding 5 percent of the annual gross income of 
the individual; 
‘‘(D) in the case of individuals with an in-
come greater than 200 percent of the official 
poverty level but not exceeding 300 percent of 
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such poverty level, the provider will not, for any 
calendar year, impose charges in an amount ex-
ceeding 7 percent of the annual gross income of 
the individual involved; 
‘‘(E) in the case of individuals with an in-
come greater than 300 percent of the official 
poverty level, the provider will not, for any cal-
endar year, impose charges in an amount ex-
ceeding 15 percent of the annual gross income 
of the individual involved; and 
‘‘(F) in the case of eligible American In-
dian and Alaska Native individuals as defined 
by section 447.50 of title 42, Code of Federal 
Regulations (as in effect on July 1, 2010), the 
provider will not impose any charges for sub-
stance use disorder treatment services, includ-
ing any charges or cost-sharing prohibited by 
section 1402(d) of the Patient Protection and 
Affordable Care Act. 
‘‘(2) CHARGES.—With respect to compliance 
with the assurances made under paragraph (1), a 
State may, in the case of individuals subject to a 
charge— 
‘‘(A) assess the amount of the charge in 
the discretion of the State, including imposing 
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only a nominal charge for the provision of serv-
ices, subject to the provisions of the paragraph 
regarding public schedules and regarding limi-
tations on the maximum amount of charges 
and; 
‘‘(B) take into consideration the total med-
ical expenses of individuals in assessing the 
amount of the charge, subject to such provi-
sions. 
‘‘(3) AGGREGATE
CHARGES.—The Secretary 
may not make a grant under section 3411 to a State 
unless the State agrees that the limitations on 
charges for substance use disorder treatment serv-
ices under this subsection applies to the annual ag-
gregate of charges imposed for such services, how-
ever the charges are characterized, includes enroll-
ment fees, premiums, deductibles, cost sharing, co- 
payments, co-insurance costs, or any other charges. 
‘‘(c) INDIAN TRIBES.—Any application requirements 
applying to grants distributed in accordance with section 
3412(b) shall be developed by the Secretary in consulta-
tion with Indian tribes. 
‘‘SEC. 3414. TECHNICAL ASSISTANCE. 
‘‘The Secretary shall provide technical assistance in 
administering and coordinating the activities authorized 
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under section 3412, including technical assistance for the 
development of State applications for supplementary 
grants authorized in section 3212(a)(2). 
‘‘SEC. 3415. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There is authorized to be appropriated to carry out 
this subtitle— 
‘‘(1) $4,000,000,000 for fiscal year 2020; 
‘‘(2) $4,000,000,000 for fiscal year 2021; 
‘‘(3) $4,000,000,000 for fiscal year 2022; 
‘‘(4) $4,000,000,000 for fiscal year 2023; 
‘‘(5) $4,000,000,000 for fiscal year 2024; 
‘‘(6) $4,000,000,000 for fiscal year 2025; 
‘‘(7) $4,000,000,000 for fiscal year 2026; 
‘‘(8) $4,000,000,000 for fiscal year 2027; 
‘‘(9) $4,000,000,000 for fiscal year 2028; and 
‘‘(10) $4,000,000,000 for fiscal year 2029. 
‘‘Subtitle C—Other Grant Program 
‘‘SEC. 3421. ESTABLISHMENT OF GRANT PROGRAM. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants to public, nonprofit, and Indian entities for the 
purpose of funding prevention services, core medical serv-
ices, recovery and support services, early intervention serv-
ices, harm reduction services, and administrative expenses 
in accordance with this section. 
‘‘(b) ELIGIBILITY.— 
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‘‘(A) minority populations and Indian pop-
ulations; 
‘‘(B) ex-offenders; 
‘‘(C) individuals with comorbidities includ-
ing HIV/AIDS, hepatitis B or C, mental health 
disorder or other behavioral health disorders; 
‘‘(D) low-income populations; 
‘‘(E) inner city populations; and 
‘‘(F) rural populations. 
‘‘(3) APPLICATION.—To be eligible to receive a 
grant under this section, a public or nonprofit entity 
described in this subsection shall prepare and submit 
to the Secretary an application in such form, and 
containing such information, as the Secretary shall 
require, including— 
‘‘(A) a complete accounting of the dis-
bursement of any prior grants received under 
this subtitle by the applicant and the results 
achieved by these expenditures; 
‘‘(B) a comprehensive plan for the use of 
the grant, including— 
‘‘(i) a demonstration of the extent of 
local need for the funds sought; 
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‘‘(ii) a plan for providing substance 
use disorder treatment services that is con-
sistent with local needs; and 
‘‘(iii) goals and objectives to be 
achieved with grant funds provided under 
this section, including targets and mile-
stones that are intended to be met and a 
description of the activities that will be un-
dertaken to achieve those targets; 
‘‘(C) a demonstration that the grantee will 
use funds in a manner that provides substance 
use disorder treatment services compliant with 
the evidence-based standards developed in ac-
cordance with section 3435, including all drugs 
approved by the Food and Drug Administration 
for the treatment of substance use disorder for 
which the applicant offers treatment, in accord-
ance with section 3435(c); 
‘‘(D) information on the number of individ-
uals to be served by the funds sought, including 
demographic data on the populations to be 
served; 
‘‘(E) a demonstration that resources pro-
vided under the grant will be allocated in ac-
cordance with the local demographic incidence 
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of substance use, including allocations for serv-
ices for children, youths, and women; 
‘‘(F) an explanation of how income, asset, 
and medical expense criteria will be established 
and applied to those who qualify for assistance 
under the program; and 
‘‘(G) for any prior funding received under 
this section, data provided in such form as the 
Secretary shall require detailing, at a minimum, 
the extent to which the activities supported by 
the funding met the goals and objectives speci-
fied in the application for the funding, the num-
ber of individuals who accessed medication-as-
sisted treatment by age, gender, race, and other 
demographic criteria relevant to the program, 
and the effect of the program on overdose rates 
and rates of death due to overdose in the region 
served by the program. 
‘‘(4) REQUIREMENT OF STATUS AS MEDICAID 
PROVIDER.— 
‘‘(A) PROVISION OF SERVICE.—Subject to 
subparagraph (B), the Secretary may not make 
a grant under this section for the provision of 
substance use disorder treatment services under 
this section in a State unless, in the case of any 
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such service that is available pursuant to the 
State plan approved under title XIX of the So-
cial Security Act for the State— 
‘‘(i)(I) the applicant for the grant will 
provide the service directly, and the appli-
cant has entered into a participation agree-
ment under the State plan and is qualified 
to receive payments under such plan; or 
‘‘(II) the applicant for the grant will 
enter into an agreement with a public or 
nonprofit private entity under which the 
entity will provide the substance use dis-
order treatment service, and the entity has 
entered into such a participation agree-
ment and is qualified to receive such pay-
ments; and 
‘‘(ii) the applicant ensures that pay-
ment will be sought for each such service 
rendered in accordance with the usual pay-
ment schedule under the State plan. 
‘‘(B) WAIVER.—In the case of an entity 
making an agreement pursuant to subpara-
graph (A) regarding the provision of substance 
use disorder treatment services, the require-
ment established in such paragraph shall be 
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waived by the State if the entity does not, in 
providing such services, impose a charge or ac-
cept reimbursement available from any third- 
party payor, including reimbursement under 
any insurance policy or under any Federal or 
State health benefits program. A waiver under 
this subparagraph shall not be longer than 2 
years in duration and shall not be renewed. 
‘‘(C) DETERMINATION.—A determination 
by the State of whether an entity referred to in 
subparagraph (A) meets the criteria for a waiv-
er under such subparagraph shall be made 
without regard to whether the entity accepts 
voluntary donations for the purpose of pro-
viding services to the public. 
‘‘(5) REQUIRED TERMS FOR EXPANDING AND 
IMPROVING CARE.—A funding agreement for a grant 
under this section is that— 
‘‘(A) funds received under the grant will 
not be utilized to make payments for any item 
or service to the extent that payment has been 
made, or can reasonably be expected to be 
made, with respect to that item or service under 
a State compensation program, under an insur-
ance policy, or under any Federal or State 
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health benefits program (except for a program 
administered by, or providing the services of, 
the Indian Health Service); 
‘‘(B) entities providing substance use dis-
order treatment services with assistance made 
available under the grant shall offer all drugs 
approved by the Food and Drug Administration 
for the treatment of substance use disorder for 
which the applicant offers treatment, in accord-
ance with section 3435(c); 
‘‘(C) substance use disorder treatment 
services provided with assistance made available 
under the grant will be provided without re-
gard— 
‘‘(i) to the ability of the individual to 
pay for such services; and 
‘‘(ii) to the current or past health con-
dition of the individual to be served; 
‘‘(D) substance use disorder treatment 
services will be provided in a setting that is ac-
cessible to low-income individuals with sub-
stance use disorders and to individuals with 
substance use disorders residing in rural areas; 
and 
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‘‘(E) the confidentiality of individuals re-
ceiving substance use disorder treatment serv-
ices will be maintained in a manner not incon-
sistent with applicable law. 
‘‘(c) AMOUNT OF GRANT TO INDIAN ENTITIES.— 
‘‘(1) INDIAN TRIBES.—In this section, the term 
‘Indian Tribe’ has the meaning given such term in 
section 4 of the Indian Self-Determination and Edu-
cation Assistance Act. 
‘‘(2) FORMULA GRANTS.—The Secretary, acting 
through the Indian Health Service, shall use 10 per-
cent of the amount available under section 3435 for 
each fiscal year to provide grants to Indian entities 
in an amount determined pursuant to criteria devel-
oped by the Secretary in consultation with Indian 
Tribes, for the purposes of addressing substance use. 
‘‘(3) USE OF AMOUNTS.—Notwithstanding any 
requirements in this section, Native entities may use 
amounts provided under grants awarded under this 
section for the uses identified in section 3422 and 
any other activities determined appropriate by the 
Secretary, in consultation with Indian Tribes. 
‘‘SEC. 3422. USE OF AMOUNTS. 
‘‘(a) USE OF FUNDS.—An entity shall use amounts 
received under a grant under section 3421 to provide di-
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rect financial assistance to eligible entities for the purpose 
of delivering or enhancing— 
‘‘(1) prevention services described in subsection 
(b); 
‘‘(2) core medical services described in sub-
section (c); 
‘‘(3) recovery and support services described in 
subsection (d); 
‘‘(4) early intervention and engagement services 
described in subsection (e); 
‘‘(5) harm reduction services described in sub-
section (f); and 
‘‘(6) administrative expenses described in sub-
section (g). 
‘‘(b) PREVENTION SERVICES.—For purposes of this 
section, the term ‘prevention services’ means evidence- 
based services, programs, or multi-sector strategies to pre-
vent substance use disorder (including education cam-
paigns, community-based prevention programs, risk iden-
tification programs, opioid diversion, collection and dis-
posal of unused opioids, services to at-risk populations, 
and trauma support services). 
‘‘(c) CORE MEDICAL SERVICES.—For purposes of 
this section, the term ‘core medical services’ means the 
following evidence-based services provided to individuals 
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with substance use disorder or at risk for developing sub-
stance use disorder, including through the use of telemedi-
cine or a hub and spoke model: 
‘‘(1) Substance use disorder treatment, as more 
fully described in section 3439(4), including assess-
ment of disease presence, severity, and co-occurring 
conditions, treatment planning, clinical stabilization 
services, withdrawal management and detoxification, 
intensive inpatient treatment, intensive outpatient 
treatment, outpatient treatment, residential inpa-
tient services, treatment for co-occurring mental 
health and substance use disorders, and all drugs 
approved by the Food and Drug Administration for 
the treatment of substance use disorder. 
‘‘(2) Outpatient and ambulatory health services, 
including those administered by federally qualified 
health centers, rural health clinics, tribal clinics and 
hospitals, urban Indian health facilities, certified 
community behavioral health clinics (as described in 
section 223 of the Protecting Access to Medicare 
Act), and comprehensive opioid recovery centers (as 
described in section 552 of this Act). 
‘‘(3) Hospice services. 
‘‘(4) Mental health services. 
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‘‘(5) Opioid overdose reversal drug products 
procurement, distribution, and training. 
‘‘(6) Pharmaceutical assistance related to the 
management of substance-use disorder and co-mor-
bid conditions. 
‘‘(7) Home and community based health serv-
ices. 
‘‘(8) Comprehensive Case Management and care 
coordination, including substance use disorder treat-
ment adherence services. 
‘‘(9) Health insurance enrollment and cost- 
sharing assistance in accordance with section 3412. 
‘‘(d) RECOVERY AND SUPPORT SERVICES.—For pur-
poses of this section, the term ‘recovery and support serv-
ices’ means services that are provided to individuals with 
substance use disorder, including residential recovery 
housing, mental health services, long term recovery serv-
ices, 24/7 hotline crisis center support, medical transpor-
tation services, respite care for persons caring for individ-
uals with substance use disorder, child care and family 
services while an individual is receiving inpatient treat-
ment services or at the time of outpatient services, out-
reach services, peer recovery services, nutrition services, 
and referrals for job training and career services, housing, 
legal services, and child care and family services. The enti-
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ties through which such services may be provided include 
local and tribal authorities that provide child care, hous-
ing, community development, and other recovery and sup-
port services, so long as they do not exclude individuals 
on the basis that such individuals receive medication-as-
sisted treatment. 
‘‘(e) EARLY INTERVENTION SERVICES.—For pur-
poses of this section, the term ‘early intervention services’ 
means services to provide screening and connection to the 
appropriate level of substance use disorder and mental 
health treatment (including same-day connection), coun-
seling provided to individuals who have misused sub-
stances, who have experienced an overdose, or are at risk 
of developing substance use disorder, the provision of re-
ferrals to facilitate the access of such individuals to core 
medical services or recovery and support services for sub-
stance use disorder, and rapid access to medication-as-
sisted treatment in the setting of recent overdose. The en-
tities through which such services may be provided include 
emergency rooms, fire departments and emergency med-
ical services, detention facilities, prisons and jails homeless 
shelters, law enforcement agencies, health care points of 
entry specified by eligible local areas, federally qualified 
health centers, tribal clinics and hospitals, urban Indian 
health facilities, and rural health clinics. 
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‘‘(f) HARM REDUCTION SERVICES.—For purposes of 
this section, the term ‘harm reduction services’ means evi-
dence-based services provided to individuals engaging in 
substance use that reduce the risk of infectious disease 
transmission, overdose, or death, including by increasing 
access to health care, housing, and recovery and support 
services. 
‘‘(g) ADMINISTRATION AND PLANNING.—An entity 
(not including tribal entities) shall not use in excess of 
10 percent of amounts received under a grant under sec-
tion 3421 for administration, accounting, reporting, and 
program oversight functions, including for the purposes of 
developing systems to improve data collection and data 
sharing. 
‘‘SEC. 3423. TECHNICAL ASSISTANCE. 
‘‘The Secretary may, directly or through grants or 
contracts, provide technical assistance to nonprofit private 
entities and Indian entities regarding the process of sub-
mitting to the Secretary applications for grants under sec-
tion 3421, and may provide technical assistance with re-
spect to the planning, development, and operation of any 
program or service carried out pursuant to such section. 
‘‘SEC. 3424. PLANNING AND DEVELOPMENT GRANTS. 
‘‘(a) IN GENERAL.—The Secretary may provide plan-
ning grants to public, nonprofit private, and Indian enti-
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ties for purposes of assisting such entities in expanding 
their capacity to provide substance use disorder treatment 
services in low-income communities and affected sub-
populations that are underserviced with respect to such 
services. 
‘‘(b) AMOUNT.—A grant under this section may be 
made in an amount not to exceed $150,000. 
‘‘SEC. 3425. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There is authorized to be appropriated to carry out 
this subtitle— 
‘‘(1) $500,000,000 for fiscal year 2020; 
‘‘(2) $500,000,000 for fiscal year 2021; 
‘‘(3) $500,000,000 for fiscal year 2022; 
‘‘(4) $500,000,000 for fiscal year 2023; 
‘‘(5) $500,000,000 for fiscal year 2024; 
‘‘(6) $500,000,000 for fiscal year 2025; 
‘‘(7) $500,000,000 for fiscal year 2026; 
‘‘(8) $500,000,000 for fiscal year 2027; 
‘‘(9) $500,000,000 for fiscal year 2028; and 
‘‘(10) $500,000,000 for fiscal year 2029. 
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‘‘Subtitle D—Innovation, Training, 
and Health Systems Strengthening 
‘‘SEC. 3431. SPECIAL PROJECTS OF NATIONAL SIGNIFI-
CANCE. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants to entities to administer special projects of national 
significance to support the development of innovative and 
original models for the delivery of substance use disorder 
treatment services. 
‘‘(b) GRANTS.—The Secretary shall award grants 
under a project under subsection (a) to entities eligible 
for grants under subtitles A, B, and C based on newly 
emerging needs of individuals receiving assistance under 
this title. 
‘‘(c) REPLICATION.—The Secretary shall make infor-
mation concerning successful models or programs devel-
oped under this section available to grantees under this 
title for the purpose of coordination, replication, and inte-
gration. To facilitate efforts under this section, the Sec-
retary may provide for peer-based technical assistance for 
grantees funded under this section. 
‘‘(d) GRANTS TO TRIBAL GOVERNMENTS.— 
‘‘(1) INDIAN TRIBES.—In this section, the term 
‘Indian tribe’ has the meaning given such term in 
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section 4 of the Indian Self-Determination and Edu-
cation Assistance Act. 
‘‘(2) USE OF FUNDS.—The Secretary, acting 
through the Indian Health Service, shall use 10 per-
cent of the amount available under this section for 
each fiscal year to provide grants to Indian tribes 
for the purposes of supporting the development of 
innovative and original models for the delivery of 
substance use disorder treatment services, including 
the development of culturally-informed care models. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section— 
‘‘(1) $500,000,000 for fiscal year 2020; 
‘‘(2) $500,000,000 for fiscal year 2021; 
‘‘(3) $500,000,000 for fiscal year 2022; 
‘‘(4) $500,000,000 for fiscal year 2023; 
‘‘(5) $500,000,000 for fiscal year 2024; 
‘‘(6) $500,000,000 for fiscal year 2025; 
‘‘(7) $500,000,000 for fiscal year 2026; 
‘‘(8) $500,000,000 for fiscal year 2027; 
‘‘(9) $500,000,000 for fiscal year 2028; and 
‘‘(10) $500,000,000 for fiscal year 2029. 
‘‘SEC. 3432. EDUCATION AND TRAINING CENTERS. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
and enter into contracts to assist public and nonprofit pri-
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100 
vate entities, public and nonprofit schools, and academic 
health centers in meeting the cost of projects— 
‘‘(1) to train health professionals, including 
practitioners in programs under this title and other 
community providers, including physician addiction 
specialists, psychologists, counselors, case managers, 
social workers, peer recovery coaches, harm reduc-
tion workers, public health workers, and community 
health workers, in the diagnosis, treatment, and pre-
vention of substance use disorders, including meas-
ures for the prevention and treatment of co-occur-
ring infectious diseases, mental health disorders, and 
other conditions, and including (as applicable to the 
type of health professional involved), care for 
women, pregnant women, and children; 
‘‘(2) to train the faculty of schools of medicine, 
nursing, public health, osteopathic medicine, den-
tistry, allied health, and mental health practice to 
teach health professions students to screen for and 
provide for the needs of individuals with substance 
use disorders or at risk of substance use; and 
‘‘(3) to develop and disseminate curricula and 
resource materials relating to evidence-based prac-
tices for the screening, prevention, and treatment of 
substance use disorders, including information about 
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combating stigma, prescribing best practices, alter-
native pain therapies, and all drugs approved by the 
Food and Drug Administration for the treatment of 
substance use disorders, including for the purposes 
authorized under the amendments made by section 
3203 of the SUPPORT for Patients and Commu-
nities Act. 
‘‘(b) PREFERENCE IN MAKING GRANTS.—In making 
grants under subsection (a), the Secretary shall give pref-
erence to qualified projects that will— 
‘‘(1) train, or result in the training of, health 
professionals and other community providers de-
scribed in subsection (a)(1), to provide substance 
use disorder treatments for underserved groups, in-
cluding minority individuals and Indians with sub-
stance use disorder and other individuals who are at 
a high risk of substance use; 
‘‘(2) train, or result in the training of, minority 
health professionals and minority allied health pro-
fessionals, to provide substance use disorder treat-
ment for individuals with such disease; 
‘‘(3) train or result in the training of individ-
uals who will provide substance use disorder treat-
ment in rural or other areas that are underserved by 
current treatment structures; 
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‘‘(4) train or result in the training of health 
professionals and allied health professionals, includ-
ing counselors, case managers, social workers, peer 
recovery coaches, and harm reduction workers, pub-
lic health workers, and community health workers, 
to provide treatment for infectious diseases and 
mental health disorders co-occurring with substance 
use disorder; and 
‘‘(5) train or result in the training of health 
professionals and other community providers to pro-
vide substance use disorder treatments for pregnant 
women, children, and adolescents. 
‘‘(c) NATIVE
EDUCATION
AND
TRAINING
CEN-
TERS.—The Secretary shall use 10 percent of the amount 
available under subsection (d) for each fiscal year to pro-
vide grants authorized under this subtitle to— 
‘‘(1) tribal colleges and universities; 
‘‘(2) Indian Health Service grant funded insti-
tutions; and 
‘‘(3) Native partner institutions, including insti-
tutions of higher education with medical training 
programs that partner with one or more Indian 
tribes, tribal organizations, Native Hawaiian organi-
zations, or tribal colleges and universities to train 
Native health professionals that will provide sub-
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stance use disorder treatment services in Native 
communities. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section— 
‘‘(1) $500,000,000 for fiscal year 2020; 
‘‘(2) $500,000,000 for fiscal year 2021; 
‘‘(3) $500,000,000 for fiscal year 2022; 
‘‘(4) $500,000,000 for fiscal year 2023; 
‘‘(5) $500,000,000 for fiscal year 2024; 
‘‘(6) $500,000,000 for fiscal year 2025; 
‘‘(7) $500,000,000 for fiscal year 2026; 
‘‘(8) $500,000,000 for fiscal year 2027; 
‘‘(9) $500,000,000 for fiscal year 2028; and 
‘‘(10) $500,000,000 for fiscal year 2029. 
‘‘SEC. 3433. SUBSTANCE USE DISORDER TREATMENT PRO-
VIDER CAPACITY UNDER THE MEDICAID PRO-
GRAM. 
‘‘(a) IN GENERAL.—The Secretary shall use amounts 
appropriated under this section to provide funding for 
projects in any State or territory to increase substance use 
provider capacity, as provided for in section 1903(aa) of 
the Social Security Act. 
‘‘(b) AMOUNT OF GRANT TO INDIAN ENTITIES.— 
‘‘(1) INDIAN TRIBES.—In this section, the term 
‘Indian tribe’ has the meaning given such term in 
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section 4 of the Indian Self-Determination and Edu-
cation Assistance Act. 
‘‘(2) GRANTS.—The Secretary, acting through 
the Indian Health Service, shall use 10 percent of 
the amount appropriated under this section for each 
fiscal year to award grants to Indian tribes in an 
amount determined pursuant to criteria developed by 
the Secretary in consultation with Indian tribes. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section— 
‘‘(1) $50,000,000 for fiscal year 2020; 
‘‘(2) $50,000,000 for fiscal year 2021; 
‘‘(3) $50,000,000 for fiscal year 2022; 
‘‘(4) $50,000,000 for fiscal year 2023; 
‘‘(5) $50,000,000 for fiscal year 2024; 
‘‘(6) $50,000,000 for fiscal year 2025; 
‘‘(7) $50,000,000 for fiscal year 2026; 
‘‘(8) $50,000,000 for fiscal year 2027; 
‘‘(9) $50,000,000 for fiscal year 2028; and 
‘‘(10) $50,000,000 for fiscal year 2029. 
‘‘SEC. 3434. PROGRAMS TO SUPPORT EMPLOYEES. 
‘‘(a) GRANT PROGRAM FOR WORKERS.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the National Institute for 
Occupational Safety and Health, shall award grants 
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to non-profit entities that meet the requirements of 
this section to fund programs and projects to assist 
workers who are at risk of substance use disorder, 
who have substance use disorder, or who are recov-
ering from substance use disorder to maintain or 
gain employment. 
‘‘(2) GRANTS FOR WORKERS.— 
‘‘(A) IN GENERAL.—The Secretary shall, 
on a competitive basis, award grants for a pe-
riod of not more than 3 years to non-profit en-
tities that submit an application under para-
graph (3) to enable such entities to implement, 
conduct, continue, and expand evidence-based 
programs and projects to assist individuals de-
scribed in subparagraph (G). 
‘‘(B) USE OF AMOUNTS.—An entity may 
use amounts provided under this subsection 
for— 
‘‘(i) prevention services described in 
subparagraph (C), including providing edu-
cation and information to workers regard-
ing the dangers of illicit and licit drug use, 
non-opioid pain management and non-drug 
pain management, or occupational injury 
and illness prevention; 
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‘‘(ii) early intervention services de-
scribed in subparagraph (D) to enable in-
dividuals to maintain or gain employment; 
‘‘(iii) recovery and support services 
described in subparagraph (E) to enable 
individuals to maintain or gain employ-
ment; 
‘‘(iv) harm reduction services de-
scribed in subparagraph (F) to enable indi-
viduals to maintain or gain employment; 
‘‘(v) hiring case managers, care coor-
dinators, and peer support specialists to 
assist employed individuals who are experi-
encing substance use disorder, or who are 
recovering from substance use disorder, in 
accessing substance use disorder treatment 
services; or 
‘‘(vi) providing vocational, life skills, 
and other forms of job training to workers 
who are receiving substance use disorder 
treatment services to enable such workers 
to maintain or gain employment. 
‘‘(C) PREVENTION
SERVICES.—For pur-
poses of this section, the term ‘prevention serv-
ices’ means evidence-based services, programs, 
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or multi-sector strategies to prevent substance 
use disorder (including education campaigns, 
community-based prevention programs, risk 
identification programs, opioid diversion, collec-
tion and disposal of unused opioids, services to 
at-risk populations, and trauma support serv-
ices). 
‘‘(D) RECOVERY
AND
SUPPORT
SERV-
ICES.—For purposes of this section, the term 
‘recovery and support services’ means services 
including residential recovery housing, mental 
health services, long term recovery services, 24/ 
7 hotline crisis center services, medical trans-
portation services, respite care for persons car-
ing for individuals with substance use disorder, 
child care and family services while an indi-
vidual is receiving inpatient treatment services 
or at the time of outpatient services, outreach 
services, peer recovery services, nutrition serv-
ices, and referrals for job training and career 
services, housing, legal services, and child care 
and family services so long as they do not ex-
clude individuals on the basis that such individ-
uals receive medication-assisted treatment. 
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‘‘(E) EARLY INTERVENTION SERVICES.— 
For purposes of this section, the term ‘early 
intervention services’ means services to provide 
screening and connection to the appropriate 
level of substance use disorder and mental 
health treatment (including same-day connec-
tion), counseling provided to individuals who 
have misused substances, who have experienced 
an overdose, or are at risk of developing sub-
stance use disorder, the provision of referrals to 
facilitate the access of such individuals to core 
medical services or recovery and support serv-
ices for substance use disorder, and rapid ac-
cess to medication-assisted treatment in the set-
ting of recent overdose. 
‘‘(F) HARM
REDUCTION
SERVICES.—For 
purposes of this section, the term ‘harm reduc-
tion services’ means evidence-based services 
provided to individuals engaging in substance 
use that reduce the risk of infectious disease 
transmission, overdose, or death, including by 
increasing access to health care, housing, and 
recovery and support services. 
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‘‘(G) INDIVIDUALS
DESCRIBED.—Individ-
uals described in this subparagraph are individ-
uals who— 
‘‘(i)(I) have been employed in the 12- 
month period immediately preceding the 
date on which the determination is being 
made, or who are participating in an em-
ployee training or apprenticeship program; 
and 
‘‘(II) are at high risk of developing 
substance use disorder, including as a re-
sult of employment in industries that expe-
rience high rates of occupational injuries 
and illness; or 
‘‘(ii) are experiencing a substance use 
disorder or are in recovery from a sub-
stance use disorder. 
‘‘(3) APPLICATIONS.—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, including— 
‘‘(A) a complete accounting of the dis-
bursement of any prior grants received under 
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this title by the applicant and the results 
achieved by such expenditures; 
‘‘(B) a description of the population to be 
served with grant funds provided under this 
section, including a description of the unique 
risks the population faces for experiencing occu-
pational injuries or exposure to illicit sub-
stances; 
‘‘(C) the goals and objectives to be 
achieved with grant funds provided under this 
section, including targets and milestones that 
are intended to be met, the activities that will 
be undertaken to achieve those targets, and the 
number of individuals likely to be served by the 
grant funds, including demographic data on the 
populations to be served; 
‘‘(D) a demonstration of the ability of the 
applicant to reach the individuals described in 
paragraph (2)(G) and to provide services de-
scribed in paragraph (2)(B) included in the ap-
plicant’s 
grant 
application, 
including 
by 
partnering with local stakeholders; 
‘‘(E) for any prior funding received under 
this subsection, data provided in such form as 
the Secretary shall require detailing, at a min-
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imum, the extent to which the activities sup-
ported by the funding met the goals, objectives, 
targets, and milestones specified in the applica-
tion for the funding, and the number of individ-
uals with and without substance use disorder 
who received services supported by the funding, 
including the services provided to these individ-
uals, the industries in which the individuals 
were employed when they received services, and 
whether the individuals were still employed in 
that same industry or in any industry when the 
individuals ceased receiving services supported 
by the funding; and 
‘‘(F) any other information the Secretary 
shall require. 
‘‘(4) DATA REPORTING AND OVERSIGHT.—An 
entity awarded a grant under this subsection shall 
submit to the Secretary an annual report at such 
time and in such manner as the Secretary shall re-
quire. Such report shall include, at a minimum, a 
description of— 
‘‘(A) the activities funded by the grant; 
‘‘(B) the number of individuals with and 
without substance use disorder served through 
activities funded by the grant, including the 
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services provided to those individuals and the 
industries in which those individuals were em-
ployed at the time they received services sup-
ported by the grant; 
‘‘(C) for workers experiencing substance 
use disorder or recovering from substance use 
disorder served by activities funded by the 
grant, the number of individuals who main-
tained employment, the number of individuals 
who gained employment, and the number of in-
dividuals who failed to maintain employment 
over the course of the reporting period; and 
‘‘(D) any other information required by the 
Secretary. 
‘‘(5) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection— 
‘‘(A) $40,000,000 for fiscal year 2020; 
‘‘(B) $40,000,000 for fiscal year 2021; 
‘‘(C) $40,000,000 for fiscal year 2022; 
‘‘(D) $40,000,000 for fiscal year 2023; 
‘‘(E) $40,000,000 for fiscal year 2024; 
‘‘(F) $40,000,000 for fiscal year 2025; 
‘‘(G) $40,000,000 for fiscal year 2026; 
‘‘(H) $40,000,000 for fiscal year 2027; 
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‘‘(I) $40,000,000 for fiscal year 2028; and 
‘‘(J) $40,000,000 for fiscal year 2029. 
‘‘(b) RESEARCH ON THE IMPACT OF SUBSTANCE USE 
DISORDER IN THE WORKPLACE AND ON DIRECT SERVICE 
PROVIDERS.— 
‘‘(1) RISKS OF SUBSTANCE USE DISORDER.— 
The Secretary, in consultation with the Director of 
the National Institute for Occupational Safety and 
Health, shall conduct (directly or through grants or 
contracts) research, experiments, and demonstra-
tions, and publish studies relating to— 
‘‘(A) the risks faced by employees in var-
ious occupations of developing substance use 
disorder and of drug overdose deaths and non- 
fatal drug overdoses, and the formulation of 
prevention activities tailored to the risks identi-
fied in these occupations, including occupational 
injury and illness prevention; 
‘‘(B) the prevalence of substance use dis-
order among employees in various occupations; 
‘‘(C) efforts that employers may undertake 
to assist employees who are undergoing sub-
stance use disorder treatment services in main-
taining employment while ensuring workplaces 
are safe and healthful; 
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‘‘(D) risks of occupational exposure to 
opioids and other illicit substances and the for-
mulation of prevention activities tailored to the 
risks identified; and 
‘‘(E) other subjects related to substance 
use disorder in the workplace as the Secretary 
determines. 
‘‘(2) DIRECT SERVICE PROVIDERS.—The Sec-
retary shall conduct (directly or through grants or 
contracts) research, experiments, and demonstra-
tions, and publish studies relating to the occupa-
tional health and safety, recruitment, and retention 
of behavioral health providers who, as part of their 
job responsibilities, provide direct services to individ-
uals who are at risk of experiencing substance use 
disorder or who are experiencing or recovering from 
substance use disorder, including— 
‘‘(A) identifying factors that the Secretary 
believes may endanger the health or safety of 
such workers, including factors that affect the 
risks such workers face of developing substance 
use disorder; 
‘‘(B) motivational and behavioral factors 
relating to the field of behavioral health pro-
viders; 
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‘‘(C) strategies to support the recruitment 
and retention of behavioral health providers; 
and 
‘‘(D) other subjects related to behavioral 
health providers engaged in direct provision of 
substance use disorder prevention and treat-
ment services as the Secretary determines ap-
propriate. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection— 
‘‘(A) $10,000,000 for fiscal year 2020; 
‘‘(B) $10,000,000 for fiscal year 2021; 
‘‘(C) $10,000,000 for fiscal year 2022; 
‘‘(D) $10,000,000 for fiscal year 2023; 
‘‘(E) $10,000,000 for fiscal year 2024; 
‘‘(F) $10,000,000 for fiscal year 2025; 
‘‘(G) $10,000,000 for fiscal year 2026; 
‘‘(H) $10,000,000 for fiscal year 2027; 
‘‘(I) $10,000,000 for fiscal year 2028; and 
‘‘(J) $10,000,000 for fiscal year 2029. 
‘‘SEC. 3435. IMPROVING AND EXPANDING CARE. 
‘‘(a) LEVEL OF CARE STANDARDS FOR SUBSTANCE 
USE DISORDER TREATMENT SERVICES.— 
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‘‘(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this title, the Secretary, in 
consultation with the American Society of Addiction 
Medicine and with State and tribal officials as the 
Secretary determines necessary, shall promulgate 
model standards for the regulation of substance use 
disorder treatment services. 
‘‘(2) SUBSTANCE USE DISORDER TREATMENT 
SERVICES.—The 
model 
standards 
promulgated 
under paragraph (1) shall, at a minimum— 
‘‘(A) identify the types of substance use 
disorder treatment services intended to be cov-
ered without regard to whether they participate 
in any Federal health care program (as defined 
in section 1128B(f) of the Social Security Act) 
and shall not include— 
‘‘(i) a private practitioner who is al-
ready licensed by a State licensing board 
and whose practice is limited to non-inten-
sive outpatient care; or 
‘‘(ii) any substance use disorder treat-
ment service provided on a non-intensive 
outpatient basis in the office of a private 
practitioner who is licensed by a State li-
censing board; 
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‘‘(d) TRIBAL EPIDEMIOLOGY CENTERS.—There shall 
be made available to the Indian Health Service for the 
purpose of funding efforts by Indian tribes and tribal epi-
demiology centers to improve data on drug overdose 
deaths and non-fatal drug overdoses, surveillance related 
to addiction and substance use disorder, and prevention 
of childhood trauma, not less than 1.5 percent of the total 
amount appropriated under this section for each fiscal 
year. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section— 
‘‘(1) $500,000,000 for fiscal year 2020; 
‘‘(2) $500,000,000 for fiscal year 2021; 
‘‘(3) $500,000,000 for fiscal year 2022; 
‘‘(4) $500,000,000 for fiscal year 2023; 
‘‘(5) $500,000,000 for fiscal year 2024; 
‘‘(6) $500,000,000 for fiscal year 2025; 
‘‘(7) $500,000,000 for fiscal year 2026; 
‘‘(8) $500,000,000 for fiscal year 2027; 
‘‘(9) $500,000,000 for fiscal year 2028; and 
‘‘(10) $500,000,000 for fiscal year 2029. 
‘‘SEC. 3439. DEFINITIONS. 
‘‘In this title: 
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