394 
clude dissemination of best practices for the 
treatment of substance use disorders to health 
care professionals. 
Subtitle N—Trauma-Informed Care 
SEC. 7131. CDC SURVEILLANCE AND DATA COLLECTION FOR 
CHILD, YOUTH, AND ADULT TRAUMA. 
(a) DATA COLLECTION.—The Director of the Centers 
for Disease Control and Prevention (referred to in this sec-
tion as the ‘‘Director’’) may, in cooperation with the States, 
collect and report data on adverse childhood experiences 
through the Behavioral Risk Factor Surveillance System, 
the Youth Risk Behavior Surveillance System, and other 
relevant public health surveys or questionnaires. 
(b) TIMING.—The collection of data under subsection 
(a) may occur biennially. 
(c) DATA FROM RURAL AREAS.—The Director shall 
encourage each State that participates in collecting and re-
porting data under subsection (a) to collect and report data 
from rural areas within such State, in order to generate 
a statistically reliable representation of such areas. 
(d) DATA FROM TRIBAL AREAS.—The Director may, 
in cooperation with Indian Tribes (as defined in section 
4 of the Indian Self-Determination and Education Assist-
ance Act) and pursuant to a written request from an In-
dian Tribe, provide technical assistance to such Indian
395 
Tribe to collect and report data on adverse childhood experi-
ences through the Behavioral Risk Factor Surveillance Sys-
tem, the Youth Risk Behavior Surveillance System, or an-
other relevant public health survey or questionnaire. 
(e) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$2,000,000 for each of fiscal years 2019 through 2023. 
SEC. 7132. TASK FORCE TO DEVELOP BEST PRACTICES FOR 
TRAUMA-INFORMED IDENTIFICATION, REFER-
RAL, AND SUPPORT. 
(a) ESTABLISHMENT.—There is established a task 
force, to be known as the Interagency Task Force on Trau-
ma-Informed Care (in this section referred to as the ‘‘task 
force’’) that shall identify, evaluate, and make recommenda-
tions regarding— 
(1) best practices with respect to children and 
youth, and their families as appropriate, who have 
experienced or are at risk of experiencing trauma; 
and 
(2) ways in which Federal agencies can better 
coordinate to improve the Federal response to families 
impacted by substance use disorders and other forms 
of trauma. 
(b) MEMBERSHIP.—
396 
(1) COMPOSITION.—The task force shall be com-
posed of the heads of the following Federal depart-
ments and agencies, or their designees: 
(A) The Centers for Medicare & Medicaid 
Services. 
(B) The Substance Abuse and Mental 
Health Services Administration. 
(C) The Agency for Healthcare Research 
and Quality. 
(D) The Centers for Disease Control and 
Prevention. 
(E) The Indian Health Service. 
(F) The Department of Veterans Affairs. 
(G) The National Institutes of Health. 
(H) The Food and Drug Administration. 
(I) The Health Resources and Services Ad-
ministration. 
(J) The Department of Defense. 
(K) The Office of Minority Health of the 
Department of Health and Human Services. 
(L) The Administration for Children and 
Families. 
(M) The Office of the Assistant Secretary 
for Planning and Evaluation of the Department 
of Health and Human Services.
397 
(N) The Office for Civil Rights of the De-
partment of Health and Human Services. 
(O) The Office of Juvenile Justice and De-
linquency Prevention of the Department of Jus-
tice. 
(P) The Office of Community Oriented Po-
licing Services of the Department of Justice. 
(Q) The Office on Violence Against Women 
of the Department of Justice. 
(R) The National Center for Education 
Evaluation and Regional Assistance of the De-
partment of Education. 
(S) The National Center for Special Edu-
cation Research of the Institute of Education 
Science. 
(T) The Office of Elementary and Sec-
ondary Education of the Department of Edu-
cation. 
(U) The Office for Civil Rights of the De-
partment of Education. 
(V) The Office of Special Education and 
Rehabilitative Services of the Department of 
Education. 
(W) The Bureau of Indian Affairs of the 
Department of the Interior.
398 
(X) The Veterans Health Administration of 
the Department of Veterans Affairs. 
(Y) The Office of Special Needs Assistance 
Programs of the Department of Housing and 
Urban Development. 
(Z) The Office of Head Start of the Admin-
istration for Children and Families. 
(AA) The Children’s Bureau of the Admin-
istration for Children and Families. 
(BB) The Bureau of Indian Education of 
the Department of the Interior. 
(CC) Such other Federal agencies as the 
Secretaries determine to be appropriate. 
(2) DATE OF APPOINTMENTS.—The heads of Fed-
eral departments and agencies shall appoint the cor-
responding members of the task force not later than 
60 days after the date of enactment of this Act. 
(3) CHAIRPERSON.—The task force shall be 
chaired by the Assistant Secretary for Mental Health 
and Substance Use, or the Assistant Secretary’s des-
ignee. 
(c) TASK FORCE DUTIES.—The task force shall— 
(1) solicit input from stakeholders, including 
frontline service providers, educators, mental health 
professionals, researchers, experts in infant, child, and
399 
youth trauma, child welfare professionals, and the 
public, in order to inform the activities under para-
graph (2); and 
(2) identify, evaluate, make recommendations, 
and update such recommendations not less than an-
nually, to the general public, the Secretary of Edu-
cation, the Secretary of Health and Human Services, 
the Secretary of Labor, the Secretary of the Interior, 
the Attorney General, and other relevant cabinet Sec-
retaries, and Congress regarding— 
(A) a set of evidence-based, evidence-in-
formed, and promising best practices with re-
spect to— 
(i) prevention strategies for individuals 
at risk of experiencing or being exposed to 
trauma, including trauma as a result of ex-
posure to substance use; 
(ii) the identification of infants, chil-
dren and youth, and their families as ap-
propriate, who have experienced or are at 
risk of experiencing trauma; 
(iii) the expeditious referral to and im-
plementation of trauma-informed practices 
and supports that prevent and mitigate the 
effects of trauma, which may include whole-
400 
family and multi-generational approaches; 
and 
(iv) 
community 
based 
or 
multi- 
generational practices that support children 
and their families; 
(B) a national strategy on how the task 
force and member agencies will collaborate, 
prioritize options for, and implement a coordi-
nated approach, which may include— 
(i) data sharing; 
(ii) providing support to infants, chil-
dren, and youth, and their families as ap-
propriate, who have experienced or are at 
risk of experiencing trauma; 
(iii) identifying options for coordi-
nating existing grants that support infants, 
children, and youth, and their families as 
appropriate, who have experienced, or are 
at risk of experiencing, exposure to sub-
stance use or other trauma, including trau-
ma related to substance use; and 
(iv) other ways to improve coordina-
tion, planning, and communication within 
and across Federal agencies, offices, and 
programs, to better serve children and fami-
401 
lies impacted by substance use disorders; 
and 
(C) existing Federal authorities at the De-
partment of Education, Department of Health 
and Human Services, Department of Justice, 
Department of Labor, Department of the Inte-
rior, and other relevant agencies, and specific 
Federal grant programs to disseminate best 
practices on, provide training in, or deliver serv-
ices through, trauma-informed practices, and 
disseminate such information— 
(i) in writing to relevant program of-
fices at such agencies to encourage grant 
applicants in writing to use such funds, 
where appropriate, for trauma-informed 
practices; and 
(ii) to the general public through the 
internet website of the task force. 
(d) BEST PRACTICES.—In identifying, evaluating, 
and recommending the set of best practices under subsection 
(c), the task force shall— 
(1) include guidelines for providing professional 
development and education for front-line services pro-
viders, including school personnel, early childhood 
education program providers, providers from child- or
402 
youth-serving organizations, housing and homeless 
providers, primary and behavioral health care pro-
viders, child welfare and social services providers, ju-
venile and family court personnel, health care pro-
viders, individuals who are mandatory reporters of 
child abuse or neglect, trained nonclinical providers 
(including peer mentors and clergy), and first re-
sponders, in— 
(A) understanding and identifying early 
signs and risk factors of trauma in infants, chil-
dren, and youth, and their families as appro-
priate, including through screening processes and 
services; 
(B) providing practices to prevent and 
mitigate the impact of trauma, including by fos-
tering safe and stable environments and relation-
ships; and 
(C) developing and implementing policies, 
procedures, or systems that— 
(i) are designed to quickly refer in-
fants, children, youth, and their families as 
appropriate, who have experienced or are at 
risk of experiencing trauma to the appro-
priate trauma-informed screening and sup-
port and age-appropriate treatment, and to
403 
ensure such infants, children, youth, and 
family members receive such support; 
(ii) utilize and develop partnerships 
with early childhood education programs, 
local social services organizations, such as 
organizations serving youth, and clinical 
mental health or other health care providers 
with expertise in providing support services 
and age-appropriate trauma-informed and 
evidence-based treatment aimed at pre-
venting or mitigating the effects of trauma; 
(iii) educate children and youth to— 
(I) understand and identify the 
signs, effects, or symptoms of trauma; 
and 
(II) build the resilience and cop-
ing skills to mitigate the effects of expe-
riencing trauma; 
(iv) 
promote 
and 
support 
multi- 
generational practices that assist parents, 
foster parents, and kinship and other care-
givers in accessing resources related to, and 
developing environments conducive to, the 
prevention and mitigation of trauma; and
404 
(v) collect and utilize data from 
screenings, referrals, or the provision of 
services and supports to evaluate outcomes 
and improve processes for trauma-informed 
services and supports that are culturally 
sensitive, linguistically appropriate, and 
specific to age ranges and sex, as applicable; 
(2) recommend best practices that are designed 
to avoid unwarranted custody loss or criminal pen-
alties for parents or guardians in connection with in-
fants, children, and youth who have experienced or 
are at risk of experiencing trauma; and 
(3) recommend opportunities for local- and 
State-level partnerships that— 
(A) are designed to quickly identify and 
refer children and families, as appropriate, who 
have experienced or are at risk of experiencing 
exposure to trauma, including related to sub-
stance use; 
(B) utilize and develop partnerships with 
early childhood education programs, local social 
services organizations, and health care services 
aimed at preventing or mitigating the effects of 
exposure to trauma, including related to sub-
stance use;
405 
(C) offer community-based prevention ac-
tivities, including educating families and chil-
dren on the effects of exposure to trauma, such 
as trauma related to substance use, and how to 
build resilience and coping skills to mitigate 
those effects; 
(D) in accordance with Federal privacy 
protections, 
utilize 
non-personally-identifiable 
data from screenings, referrals, or the provision 
of services and supports to evaluate and improve 
processes addressing exposure to trauma, includ-
ing related to substance use; and 
(E) are designed to prevent separation and 
support reunification of families if in the best 
interest of the child. 
(e) OPERATING PLAN.—Not later than 120 days after 
the date of enactment of this Act, the task force shall hold 
the first meeting. Not later than 2 years after such date 
of enactment, the task force shall submit to the Secretary 
of Education, Secretary of Health and Human Services, 
Secretary of Labor, Secretary of the Interior, the Attorney 
General, and Congress an operating plan for carrying out 
the activities of the task force described in subsection (c)(2). 
Such operating plan shall include—
406 
(1) a list of specific activities that the task force 
plans to carry out for purposes of carrying out duties 
described in subsection (c)(2), which may include 
public engagement; 
(2) a plan for carrying out the activities under 
subsection (c)(2); 
(3) a list of members of the task force and other 
individuals who are not members of the task force 
that may be consulted to carry out such activities; 
(4) an explanation of Federal agency involve-
ment and coordination needed to carry out such ac-
tivities, including any statutory or regulatory bar-
riers to such coordination; 
(5) a budget for carrying out such activities; 
(6) a proposed timeline for implementing rec-
ommendations and efforts identified under subsection 
(c); and 
(7) other information that the task force deter-
mines appropriate as related to its duties. 
(f) FINAL REPORT.—Not later than 3 years after the 
date of the first meeting of the task force, the task force shall 
submit to the general public, Secretary of Education, Sec-
retary of Health and Human Services, Secretary of Labor, 
Secretary of the Interior, the Attorney General, other rel-
evant cabinet Secretaries, the Committee on Energy and
407 
Commerce and the Committee on Education and the Work-
force of the House of Representatives and the Committee 
on Health, Education, Labor, and Pensions of the Senate, 
and Congress, a final report containing all of the findings 
and recommendations required under this section, and shall 
make such report available online in an accessible format. 
(g) ADDITIONAL REPORTS.—In addition to the final 
report under subsection (f). the task force shall submit— 
(1) a report to Congress identifying any rec-
ommendations identified under subsection (c) that re-
quire additional legislative authority to implement; 
and 
(2) a report to the Governors describing the op-
portunities for local- and State-level partnerships, 
professional development, or best practices rec-
ommended under subsection (d)(3). 
(h) DEFINITIONS.—In this section— 
(1) the term ‘‘early childhood education pro-
gram’’ has the meaning given such term in section 
103 of the Higher Education Act of 1965 (20 U.S.C. 
1003); 
(2) The term ‘‘Governor’’ means the chief execu-
tive officer of a State; and 
(3) the term ‘‘State’’ means each of the several 
States, the District of Columbia, the Commonwealth
408 
of Puerto Rico, the Virgin Islands, Guam, American 
Samoa, and the Commonwealth of the Northern Mar-
iana Islands. 
(i) SUNSET.—The task force shall sunset on the date 
that is 60 days after the submission of the final report 
under subsection (f), but not later than September 30, 2023. 
SEC. 7133. NATIONAL CHILD TRAUMATIC STRESS INITIA-
TIVE. 
Section 582(j) of the Public Health Service Act (42 
U.S.C. 290hh–1(j)) (relating to grants to address the prob-
lems of persons who experience violence-related stress) is 
amended by striking ‘‘$46,887,000 for each of fiscal years 
2018 through 2022’’ and inserting ‘‘$63,887,000 for each 
of fiscal years 2019 through 2023’’. 
SEC. 7134. GRANTS TO IMPROVE TRAUMA SUPPORT SERV-
ICES AND MENTAL HEALTH CARE FOR CHIL-
DREN AND YOUTH IN EDUCATIONAL SET-
TINGS. 
(a) GRANTS, CONTRACTS, AND COOPERATIVE AGREE-
MENTS AUTHORIZED.—The Secretary, in coordination with 
the Assistant Secretary for Mental Health and Substance 
Use, is authorized to award grants to, or enter into con-
tracts or cooperative agreements with, State educational 
agencies, local educational agencies, Indian Tribes (as de-
fined in section 4 of the Indian Self-Determination and
409 
Education Assistance Act) or their tribal educational agen-
cies, a school operated by the Bureau of Indian Education, 
a Regional Corporation, or a Native Hawaiian educational 
organization, for the purpose of increasing student access 
to evidence-based trauma support services and mental 
health care by developing innovative initiatives, activities, 
or programs to link local school systems with local trauma- 
informed support and mental health systems, including 
those under the Indian Health Service. 
(b) DURATION.—With respect to a grant, contract, or 
cooperative agreement awarded or entered into under this 
section, the period during which payments under such 
grant, contract or agreement are made to the recipient may 
not exceed 4 years. 
(c) USE OF FUNDS.—An entity that receives a grant, 
contract, or cooperative agreement under this section shall 
use amounts made available through such grant, contract, 
or cooperative agreement for evidence-based activities, 
which shall include any of the following: 
(1) Collaborative efforts between school-based 
service systems and trauma-informed support and 
mental health service systems to provide, develop, or 
improve prevention, screening, referral, and treatment 
and support services to students, such as providing
410 
trauma screenings to identify students in need of spe-
cialized support. 
(2) To implement schoolwide positive behavioral 
interventions and supports, or other trauma-informed 
models of support. 
(3) To provide professional development to teach-
ers, teacher assistants, school leaders, specialized in-
structional support personnel, and mental health pro-
fessionals that— 
(A) fosters safe and stable learning environ-
ments that prevent and mitigate the effects of 
trauma, including through social and emotional 
learning; 
(B) improves school capacity to identify, 
refer, and provide services to students in need of 
trauma support or behavioral health services; or 
(C) reflects the best practices for trauma-in-
formed identification, referral, and support de-
veloped by the Task Force under section 7132. 
(4) Services at a full-service community school 
that focuses on trauma-informed supports, which may 
include a full-time site coordinator, or other activities 
consistent with section 4625 of the Elementary and 
Secondary Education Act of 1965 (20 U.S.C. 7275).
412 
treatment and support services to young children and 
their families. 
(d) APPLICATIONS.—To be eligible to receive a grant, 
contract, or cooperative agreement under this section, an 
entity described in subsection (a) shall submit an applica-
tion to the Secretary at such time, in such manner, and 
containing such information as the Secretary may reason-
ably require, which shall include the following: 
(1) A description of the innovative initiatives, 
activities, or programs to be funded under the grant, 
contract, or cooperative agreement, including how 
such program will increase access to evidence-based 
trauma support services and mental health care for 
students, and, as applicable, the families of such stu-
dents. 
(2) A description of how the program will pro-
vide linguistically appropriate and culturally com-
petent services. 
(3) A description of how the program will sup-
port students and the school in improving the school 
climate in order to support an environment conducive 
to learning. 
(4) An assurance that—
413 
(A) persons providing services under the 
grant, contract, or cooperative agreement are 
adequately trained to provide such services; and 
(B) teachers, school leaders, administrators, 
specialized instructional support personnel, rep-
resentatives of local Indian Tribes or tribal orga-
nizations as appropriate, other school personnel, 
and parents or guardians of students partici-
pating in services under this section will be en-
gaged and involved in the design and implemen-
tation of the services. 
(5) A description of how the applicant will sup-
port and integrate existing school-based services with 
the program in order to provide mental health serv-
ices for students, as appropriate. 
(6) A description of the entities in the commu-
nity with which the applicant will partner or to 
which the applicant will provide subgrants in accord-
ance with subsection (c)(8). 
(e) INTERAGENCY AGREEMENTS.— 
(1) LOCAL INTERAGENCY AGREEMENTS.—To en-
sure the provision of the services described in sub-
section (c), a recipient of a grant, contract, or cooper-
ative agreement under this section, or their designee, 
shall establish a local interagency agreement among
414 
local educational agencies, agencies responsible for 
early childhood education programs, Head Start 
agencies (including Early Head Start agencies), juve-
nile justice authorities, mental health agencies, child 
welfare agencies, and other relevant agencies, authori-
ties, or entities in the community that will be in-
volved in the provision of such services. 
(2) CONTENTS.—In ensuring the provision of the 
services described in subsection (c), the local inter-
agency agreement shall specify with respect to each 
agency, authority, or entity that is a party to such 
agreement— 
(A) the financial responsibility for the serv-
ices; 
(B) the conditions and terms of responsi-
bility for the services, including quality, account-
ability, and coordination of the services; and 
(C) the conditions and terms of reimburse-
ment among such agencies, authorities, or enti-
ties, including procedures for dispute resolution. 
(f) EVALUATION.—The Secretary shall reserve not 
more than 3 percent of the funds made available under sub-
section (l) for each fiscal year to— 
(1) conduct a rigorous, independent evaluation 
of the activities funded under this section; and
415 
(2) disseminate and promote the utilization of 
evidence-based practices regarding trauma support 
services and mental health care. 
(g) DISTRIBUTION OF AWARDS.—The Secretary shall 
ensure that grants, contracts, and cooperative agreements 
awarded or entered into under this section are equitably 
distributed among the geographical regions of the United 
States and among tribal, urban, suburban, and rural popu-
lations. 
(h) RULE OF CONSTRUCTION.—Nothing in this section 
shall be construed— 
(1) to prohibit an entity involved with a pro-
gram carried out under this section from reporting a 
crime that is committed by a student to appropriate 
authorities; or 
(2) to prevent Federal, State, and tribal law en-
forcement and judicial authorities from exercising 
their responsibilities with regard to the application of 
Federal, tribal, and State law to crimes committed by 
a student. 
(i) SUPPLEMENT, NOT SUPPLANT.—Any services pro-
vided through programs carried out under this section shall 
supplement, and not supplant, existing mental health serv-
ices, including any special education and related services
416 
provided under the Individuals with Disabilities Education 
Act (20 U.S.C. 1400 et seq.). 
(j) CONSULTATION WITH INDIAN TRIBES.—In car-
rying out subsection (a), the Secretary shall, in a timely 
manner, meaningfully consult with Indian Tribes and their 
representatives to ensure notice of eligibility. 
(k) DEFINITIONS.—In this section: 
(1) ELEMENTARY SCHOOL.—The term ‘‘elemen-
tary school’’ has the meaning given such term in sec-
tion 8101 of the Elementary and Secondary Edu-
cation Act of 1965 (20 U.S.C. 7801). 
(2) EVIDENCE-BASED.—The term ‘‘evidence- 
based’’ has the meaning given such term in section 
8101(21)(A)(i) of the Elementary and Secondary 
Education Act of 1965 (20 U.S.C. 7801(21)(A)(i)). 
(3) NATIVE HAWAIIAN EDUCATIONAL ORGANIZA-
TION.—The term ‘‘Native Hawaiian educational or-
ganization’’ has the meaning given such term in sec-
tion 6207 of the Elementary and Secondary Edu-
cation Act of 1965 (20 U.S.C. 7517). 
(4) LOCAL
EDUCATIONAL
AGENCY.—The term 
‘‘local educational agency’’ has the meaning given 
such term in section 8101 of the Elementary and Sec-
ondary Education Act of 1965 (20 U.S.C. 7801).
417 
(5) REGIONAL
CORPORATION.—The term ‘‘Re-
gional Corporation’’ has the meaning given the term 
in section 3 of the Alaska Native Claims Settlement 
Act (43 U.S.C. 1602)). 
(6) SCHOOL.—The term ‘‘school’’ means a public 
elementary school or public secondary school. 
(7) SCHOOL LEADER.—The term ‘‘school leader’’ 
has the meaning given such term in section 8101 of 
the Elementary and Secondary Education Act of 
1965 (20 U.S.C. 7801). 
(8) SECONDARY SCHOOL.—The term ‘‘secondary 
school’’ has the meaning given such term in section 
8101 of the Elementary and Secondary Education 
Act of 1965 (20 U.S.C. 7801). 
(9) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Education. 
(10) SPECIALIZED
INSTRUCTIONAL
SUPPORT 
PERSONNEL.—The term ‘‘specialized instructional 
support personnel’’ has the meaning given such term 
in section 8101 of the Elementary and Secondary 
Education Act of 1965 (20 U.S.C. 7801). 
(11) STATE
EDUCATIONAL
AGENCY.—The term 
‘‘State educational agency’’ has the meaning given 
such term in section 8101 of the Elementary and Sec-
ondary Education Act of 1965 (20 U.S.C. 7801).
418 
(l) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$50,000,000 for each of fiscal years 2019 through 2023. 
SEC. 7135. RECOGNIZING EARLY CHILDHOOD TRAUMA RE-
LATED TO SUBSTANCE ABUSE. 
(a) DISSEMINATION OF INFORMATION.—The Secretary 
of Health and Human Services shall disseminate informa-
tion, resources, and, if requested, technical assistance to 
early childhood care and education providers and profes-
sionals working with young children on— 
(1) ways to properly recognize children who may 
be impacted by trauma, including trauma related to 
substance use by a family member or other adult; and 
(2) how to respond appropriately in order to 
provide for the safety and well-being of young chil-
dren and their families. 
(b) GOALS.—The information, resources, and technical 
assistance provided under subsection (a) shall— 
(1) educate early childhood care and education 
providers and professionals working with young chil-
dren on understanding and identifying the early 
signs and risk factors of children who might be im-
pacted by trauma, including trauma due to exposure 
to substance use;
419 
(2) suggest age-appropriate communication tools, 
procedures, and practices for trauma-informed care, 
including ways to prevent or mitigate the effects of 
trauma; 
(3) provide options for responding to children 
impacted by trauma, including due to exposure to 
substance use, that consider the needs of the child and 
family, including recommending resources and refer-
rals for evidence-based services to support such fam-
ily; and 
(4) promote whole-family and multi-generational 
approaches to keep families safely together when it is 
in the best interest of the child. 
(c) COORDINATION.—The Secretary of Health and 
Human Services shall coordinate with the task force to de-
velop best practices for trauma-informed identification, re-
ferral, and support authorized under section 7132 in dis-
seminating the information, resources, and technical assist-
ance described under subsection (b). 
(d) RULE OF CONSTRUCTION.—Such information, re-
sources, and if applicable, technical assistance, shall not be 
construed to amend the requirements under— 
(1) the Child Care and Development Block Grant 
Act of 1990 (42 U.S.C. 9858 et seq.);
420 
(2) the Head Start Act (42 U.S.C. 9831 et seq.); 
or 
(3) the Individuals with Disabilities Education 
Act (20 U.S.C. 1400 et seq.). 
Subtitle O—Eliminating Opioid 
Related Infectious Diseases 
SEC. 7141. REAUTHORIZATION AND EXPANSION OF PRO-
GRAM OF SURVEILLANCE AND EDUCATION 
REGARDING INFECTIONS ASSOCIATED WITH 
ILLICIT DRUG USE AND OTHER RISK FAC-
TORS. 
Section 317N of the Public Health Service Act (42 
U.S.C. 247b–15) is amended to read as follows: 
‘‘SEC. 317N. SURVEILLANCE AND EDUCATION REGARDING 
INFECTIONS 
ASSOCIATED 
WITH 
ILLICIT 
DRUG USE AND OTHER RISK FACTORS. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, 
may (directly or through grants to public and nonprofit 
private entities) provide for programs for the following: 
‘‘(1) To cooperate with States and Indian tribes 
in implementing or maintaining a national system to 
determine the incidence of infections commonly asso-
ciated with illicit drug use, such as viral hepatitis, 
human immunodeficiency virus, and infective endo-
421 
carditis, and to assist the States in determining the 
prevalence of such infections, which may include the 
reporting of cases of such infections. 
‘‘(2) To identify, counsel, and offer testing to in-
dividuals who are at risk of infections described in 
paragraph (1) resulting from illicit drug use, receiv-
ing blood transfusions prior to July 1992, or other 
risk factors. 
‘‘(3) To provide appropriate referrals for coun-
seling, testing, and medical treatment of individuals 
identified under paragraph (2) and to ensure, to the 
extent practicable, the provision of appropriate fol-
low-up services. 
‘‘(4) To develop and disseminate public informa-
tion and education programs for the detection and 
control of infections described in paragraph (1), with 
priority given to high-risk populations as determined 
by the Secretary. 
‘‘(5) To improve the education, training, and 
skills of health professionals in the detection and con-
trol of infections described in paragraph (1), includ-
ing to improve coordination of treatment of substance 
use disorders and infectious diseases, with priority 
given to substance use disorder treatment providers, 
pediatricians and other primary care providers, ob-
422 
stetrician-gynecologists, and infectious disease clini-
cians, including HIV clinicians. 
‘‘(b) LABORATORY PROCEDURES.—The Secretary may 
(directly or through grants to public and nonprofit private 
entities) carry out programs to provide for improvements 
in the quality of clinical-laboratory procedures regarding 
infections described in subsection (a)(1). 
‘‘(c) DEFINITION.—In this section, the term ‘Indian 
tribe’ has the meaning given that term in section 4 of the 
Indian Self-Determination and Education Assistance Act. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $40,000,000 for each of the fiscal years 
2019 through 2023.’’. 
Subtitle P—Peer Support 
Communities of Recovery 
SEC. 7151. BUILDING COMMUNITIES OF RECOVERY. 
Section 547 of the Public Health Service Act (42 
U.S.C. 290ee–2) is amended to read as follows: 
‘‘SEC. 547. BUILDING COMMUNITIES OF RECOVERY. 
‘‘(a) DEFINITION.—In this section, the term ‘recovery 
community organization’ means an independent nonprofit 
organization that— 
‘‘(1) mobilizes resources within and outside of 
the recovery community, which may include through
423 
a peer support network, to increase the prevalence 
and quality of long-term recovery from substance use 
disorders; and 
‘‘(2) is wholly or principally governed by people 
in recovery for substance use disorders who reflect the 
community served. 
‘‘(b) GRANTS
AUTHORIZED.—The Secretary shall 
award grants to recovery community organizations to en-
able such organizations to develop, expand, and enhance re-
covery services. 
‘‘(c) FEDERAL SHARE.—The Federal share of the costs 
of a program funded by a grant under this section may 
not exceed 85 percent. 
‘‘(d) USE OF FUNDS.—Grants awarded under sub-
section (b)— 
‘‘(1) shall be used to develop, expand, and en-
hance community and statewide recovery support 
services; and 
‘‘(2) may be used to— 
‘‘(A) build connections between recovery net-
works, including between recovery community 
organizations and peer support networks, and 
with other recovery support services, including— 
‘‘(i) behavioral health providers;
424 
‘‘(ii) primary care providers and phy-
sicians; 
‘‘(iii) 
educational 
and 
vocational 
schools; 
‘‘(iv) employers; 
‘‘(v) housing services; 
‘‘(vi) child welfare agencies; and 
‘‘(vii) other recovery support services 
that facilitate recovery from substance use 
disorders, including non-clinical commu-
nity services; 
‘‘(B) reduce stigma associated with sub-
stance use disorders; and 
‘‘(C) conduct outreach on issues relating to 
substance use disorders and recovery, includ-
ing— 
‘‘(i) identifying the signs of substance 
use disorder; 
‘‘(ii) the resources available to individ-
uals with substance use disorder and to 
families of an individual with a substance 
use disorder, including programs that men-
tor and provide support services to children; 
‘‘(iii) the resources available to help 
support individuals in recovery; and
425 
‘‘(iv) related medical outcomes of sub-
stance use disorders, the potential of acquir-
ing an infection commonly associated with 
illicit drug use, and neonatal abstinence 
syndrome among infants exposed to opioids 
during pregnancy. 
‘‘(e) SPECIAL CONSIDERATION.—In carrying out this 
section, the Secretary shall give special consideration to the 
unique needs of rural areas, including areas with an age- 
adjusted rate of drug overdose deaths that is above the na-
tional average and areas with a shortage of prevention and 
treatment services. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2019 through 2023.’’. 
SEC. 7152. PEER SUPPORT TECHNICAL ASSISTANCE CEN-
TER. 
Title V of the Public Health Service Act (42 U.S.C. 
290dd et seq.) is amended by inserting after section 547 
the following: 
‘‘SEC. 547A. PEER SUPPORT TECHNICAL ASSISTANCE CEN-
TER. 
‘‘(a) ESTABLISHMENT.—The Secretary, acting through 
the Assistant Secretary, shall establish or operate a Na-
tional Peer-Run Training and Technical Assistance Center
426 
for Addiction Recovery Support (referred to in this section 
as the ‘Center’). 
‘‘(b) FUNCTIONS.—The Center established under sub-
section (a) shall provide technical assistance and support 
to recovery community organizations and peer support net-
works, including such assistance and support related to— 
‘‘(1) training on identifying— 
‘‘(A) signs of substance use disorder; 
‘‘(B) resources to assist individuals with a 
substance use disorder, or resources for families 
of an individual with a substance use disorder; 
and 
‘‘(C) best practices for the delivery of recov-
ery support services; 
‘‘(2) the provision of translation services, inter-
pretation, or other such services for clients with lim-
ited English speaking proficiency; 
‘‘(3) data collection to support research, includ-
ing for translational research; 
‘‘(4) capacity building; and 
‘‘(5) evaluation and improvement, as necessary, 
of the effectiveness of such services provided by recov-
ery community organizations. 
‘‘(c) BEST PRACTICES.—The Center established under 
subsection (a) shall periodically issue best practices for use
427 
by recovery community organizations and peer support net-
works. 
‘‘(d) RECOVERY COMMUNITY ORGANIZATION.—In this 
section, the term ‘recovery community organization’ has the 
meaning given such term in section 547. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$1,000,000 for each of fiscal years 2019 through 2023.’’. 
Subtitle Q—Creating Opportunities 
That Necessitate New and En-
hanced Connections That Im-
prove Opioid Navigation Strate-
gies 
SEC. 7161. PREVENTING OVERDOSES OF CONTROLLED SUB-
STANCES. 
(a) IN GENERAL.—Part J of title III of the Public 
Health Service Act (42 U.S.C. 280b et seq.) is amended by 
inserting after section 392 (42 U.S.C. 280b–1) the following: 
‘‘SEC. 392A. PREVENTING OVERDOSES OF CONTROLLED 
SUBSTANCES. 
‘‘(a) EVIDENCE-BASED PREVENTION GRANTS.— 
‘‘(1) IN GENERAL.—The Director of the Centers 
for Disease Control and Prevention may—
428 
‘‘(A) to the extent practicable, carry out and 
expand any evidence-based prevention activities 
described in paragraph (2); 
‘‘(B) provide training and technical assist-
ance to States, localities, and Indian tribes for 
purposes of carrying out such activity; and 
‘‘(C) award grants to States, localities, and 
Indian tribes for purposes of carrying out such 
activity. 
‘‘(2) 
EVIDENCE-BASED
PREVENTION
ACTIVI-
TIES.—An evidence-based prevention activity de-
scribed in this paragraph is any of the following ac-
tivities: 
‘‘(A) Improving the efficiency and use of a 
new or currently operating prescription drug 
monitoring program, including by— 
‘‘(i) encouraging all authorized users 
(as specified by the State or other entity) to 
register with and use the program; 
‘‘(ii) enabling such users to access any 
updates to information collected by the pro-
gram in as close to real-time as possible; 
‘‘(iii) improving the ease of use of such 
program;
429 
‘‘(iv) providing for a mechanism for 
the program to notify authorized users of 
any potential misuse or abuse of controlled 
substances and any detection of inappro-
priate prescribing or dispensing practices 
relating to such substances; 
‘‘(v) encouraging the analysis of pre-
scription drug monitoring data for purposes 
of providing de-identified, aggregate reports 
based on such analysis to State public 
health agencies, State substance abuse agen-
cies, State licensing boards, and other ap-
propriate State agencies, as permitted 
under applicable Federal and State law and 
the policies of the prescription drug moni-
toring program and not containing any 
protected health information, to prevent in-
appropriate prescribing, drug diversion, or 
abuse and misuse of controlled substances, 
and to facilitate better coordination among 
agencies; 
‘‘(vi) enhancing interoperability be-
tween the program and any health informa-
tion technology (including certified health
430 
information technology), including by inte-
grating program data into such technology; 
‘‘(vii) updating program capabilities 
to respond to technological innovation for 
purposes of appropriately addressing the oc-
currence and evolution of controlled sub-
stance overdoses; 
‘‘(viii) facilitating and encouraging 
data exchange between the program and the 
prescription drug monitoring programs of 
other States; 
‘‘(ix) enhancing data collection and 
quality, 
including 
improving 
patient 
matching and proactively monitoring data 
quality; 
‘‘(x) providing prescriber and dis-
penser practice tools, including prescriber 
practice insight reports for practitioners to 
review their prescribing patterns in com-
parison to such patterns of other practi-
tioners in the specialty; and 
‘‘(xi) meeting the purpose of the pro-
gram established under section 399O, as de-
scribed in section 399O(a).
431 
‘‘(B) Promoting community or health sys-
tem interventions. 
‘‘(C) Evaluating interventions to prevent 
controlled substance overdoses. 
‘‘(D) Implementing projects to advance an 
innovative prevention approach with respect to 
new and emerging public health crises and op-
portunities to address such crises, such as en-
hancing public education and awareness on the 
risks associated with opioids. 
‘‘(3) ADDITIONAL GRANTS.—The Director may 
award grants to States, localities, and Indian 
Tribes— 
‘‘(A) to carry out innovative projects for 
grantees to rapidly respond to controlled sub-
stance misuse, abuse, and overdoses, including 
changes in patterns of controlled substance use; 
and 
‘‘(B) for any other evidence-based activity 
for preventing controlled substance misuse, abuse, 
and overdoses as the Director determines appro-
priate. 
‘‘(4) RESEARCH.—The Director, in coordination 
with the Assistant Secretary for Mental Health and 
Substance Use and the National Mental Health and
432 
Substance Use Policy Laboratory established under 
section 501A, as appropriate and applicable, may 
conduct studies and evaluations to address substance 
use disorders, including preventing substance use dis-
orders or other related topics the Director determines 
appropriate. 
‘‘(b) ENHANCED CONTROLLED SUBSTANCE OVERDOSE 
DATA
COLLECTION, 
ANALYSIS, 
AND
DISSEMINATION 
GRANTS.— 
‘‘(1) IN GENERAL.—The Director of the Centers 
for Disease Control and Prevention may— 
‘‘(A) to the extent practicable, carry out any 
controlled substance overdose data collection ac-
tivities described in paragraph (2); 
‘‘(B) provide training and technical assist-
ance to States, localities, and Indian tribes for 
purposes of carrying out such activity; 
‘‘(C) award grants to States, localities, and 
Indian tribes for purposes of carrying out such 
activity; and 
‘‘(D) coordinate with the Assistant Sec-
retary for Mental Health and Substance Use to 
collect data pursuant to section 505(d)(1)(A) (re-
lating to the number of individuals admitted to
433 
emergency departments as a result of the abuse 
of alcohol or other drugs). 
‘‘(2) CONTROLLED SUBSTANCE OVERDOSE DATA 
COLLECTION AND ANALYSIS ACTIVITIES.—A controlled 
substance overdose data collection, analysis, and dis-
semination activity described in this paragraph is 
any of the following activities: 
‘‘(A) Improving the timeliness of reporting 
data to the public, including data on fatal and 
nonfatal overdoses of controlled substances. 
‘‘(B) Enhancing the comprehensiveness of 
controlled substance overdose data by collecting 
information on such overdoses from appropriate 
sources such as toxicology reports, autopsy re-
ports, death scene investigations, and emergency 
departments. 
‘‘(C) Modernizing the system for coding 
causes of death related to controlled substance 
overdoses to use an electronic-based system. 
‘‘(D) Using data to help identify risk fac-
tors 
associated 
with 
controlled 
substance 
overdoses. 
‘‘(E) Supporting entities involved in pro-
viding information on controlled substance 
overdoses, such as coroners, medical examiners,
434 
and public health laboratories to improve accu-
rate testing and standardized reporting of causes 
and contributing factors to controlled substances 
overdoses and analysis of various opioid ana-
logues to controlled substance overdoses. 
‘‘(F) Working to enable and encourage the 
access, exchange, and use of information regard-
ing controlled substance overdoses among data 
sources and entities. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) CONTROLLED SUBSTANCE.—The term ‘con-
trolled substance’ has the meaning given that term in 
section 102 of the Controlled Substances Act. 
‘‘(2) INDIAN TRIBE.—The term ‘Indian tribe’ has 
the meaning given that term in section 4 of the In-
dian Self-Determination and Education Assistance 
Act. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For pur-
poses of carrying out this section, section 399O of this Act, 
and section 102 of the Comprehensive Addiction and Recov-
ery Act of 2016 (Public Law 114–198), there is authorized 
to be appropriated $496,000,000 for each of fiscal years 
2019 through 2023.’’.
435 
(b) EDUCATION AND AWARENESS.—Section 102 of the 
Comprehensive Addiction and Recovery Act of 2016 (Public 
Law 114–198) is amended— 
(1) by amending subsection (a) to read as fol-
lows: 
‘‘(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Director of the Centers 
for Disease Control and Prevention and in coordination 
with the heads of other departments and agencies, shall ad-
vance education and awareness regarding the risks related 
to misuse and abuse of opioids, as appropriate, which may 
include developing or improving existing programs, con-
ducting activities, and awarding grants that advance the 
education and awareness of— 
‘‘(1) the public, including patients and con-
sumers— 
‘‘(A) generally; and 
‘‘(B) regarding such risks related to unused 
opioids and the dispensing options under section 
309(f) of the Controlled Substances Act, as appli-
cable; and 
‘‘(2) providers, which may include— 
‘‘(A) providing for continuing education on 
appropriate prescribing practices;
436 
‘‘(B) education related to applicable State 
or local prescriber limit laws, information on the 
use of non-addictive alternatives for pain man-
agement, and the use of overdose reversal drugs, 
as appropriate; 
‘‘(C) disseminating and improving the use 
of evidence-based opioid prescribing guidelines 
across relevant health care settings, as appro-
priate, and updating guidelines as necessary; 
‘‘(D) implementing strategies, such as best 
practices, to encourage and facilitate the use of 
prescriber guidelines, in accordance with State 
and local law; 
‘‘(E) disseminating information to pro-
viders about prescribing options for controlled 
substances, including such options under section 
309(f) of the Controlled Substances Act, as appli-
cable; and 
‘‘(F) disseminating information, as appro-
priate, on the National Pain Strategy developed 
by or in consultation with the Assistant Sec-
retary for Health; and 
‘‘(3) other appropriate entities.’’; and 
(2) in subsection (b)—
437 
(A) by striking ‘‘opioid abuse’’ each place 
such term appears and inserting ‘‘opioid misuse 
and abuse’’; and 
(B) in paragraph (2), by striking ‘‘safe dis-
posal of prescription medications and other’’ and 
inserting ‘‘non-addictive treatment options, safe 
disposal options for prescription medications, 
and other applicable’’. 
SEC. 7162. PRESCRIPTION DRUG MONITORING PROGRAM. 
Section 399O of the Public Health Service Act (42 
U.S.C. 280g–3) is amended to read as follows: 
‘‘SEC. 399O. PRESCRIPTION DRUG MONITORING PROGRAM. 
‘‘(a) PROGRAM.— 
‘‘(1) IN GENERAL.—Each fiscal year, the Sec-
retary, acting through the Director of the Centers for 
Disease Control and Prevention, in coordination with 
the heads of other departments and agencies as appro-
priate, shall support States or localities for the pur-
pose of improving the efficiency and use of PDMPs, 
including— 
‘‘(A) establishment and implementation of a 
PDMP; 
‘‘(B) maintenance of a PDMP; 
‘‘(C) improvements to a PDMP by—
438 
‘‘(i) enhancing functional components 
to work toward— 
‘‘(I) universal use of PDMPs 
among providers and their delegates, to 
the extent that State laws allow; 
‘‘(II) more timely inclusion of 
data within a PDMP; 
‘‘(III) active management of the 
PDMP, in part by sending proactive 
or unsolicited reports to providers to 
inform prescribing; and 
‘‘(IV) ensuring the highest level of 
ease in use of and access to PDMPs by 
providers and their delegates, to the ex-
tent that State laws allow; 
‘‘(ii) in consultation with the Office of 
the National Coordinator for Health Infor-
mation Technology, improving the intra-
state interoperability of PDMPs by— 
‘‘(I) making PDMPs more action-
able by integrating PDMPs within 
electronic health records and health in-
formation technology infrastructure; 
and
439 
‘‘(II) linking PDMP data to other 
data systems within the State, includ-
ing— 
‘‘(aa) the data of pharmacy 
benefit managers, medical exam-
iners 
and 
coroners, 
and 
the 
State’s Medicaid program; 
‘‘(bb) worker’s compensation 
data; and 
‘‘(cc) prescribing data of pro-
viders of the Department of Vet-
erans Affairs and the Indian 
Health Service within the State; 
‘‘(iii) in consultation with the Office of 
the National Coordinator for Health Infor-
mation Technology, improving the inter-
state interoperability of PDMPs through— 
‘‘(I) sharing of dispensing data in 
near-real time across State lines; and 
‘‘(II) integration of automated 
queries for multistate PDMP data and 
analytics into clinical workflow to im-
prove the use of such data and ana-
lytics by practitioners and dispensers; 
or
440 
‘‘(iv) improving the ability to include 
treatment availability resources and referral 
capabilities within the PDMP. 
‘‘(2) LEGISLATION.—As a condition on the re-
ceipt of support under this section, the Secretary shall 
require a State or locality to demonstrate that it has 
enacted legislation or regulations— 
‘‘(A) to provide for the implementation of 
the PDMP; and 
‘‘(B) to permit the imposition of appro-
priate penalties for the unauthorized use and 
disclosure of information maintained by the 
PDMP. 
‘‘(b) PDMP STRATEGIES.—The Secretary shall en-
courage a State or locality, in establishing, improving, or 
maintaining a PDMP, to implement strategies that im-
prove— 
‘‘(1) the reporting of dispensing in the State or 
locality of a controlled substance to an ultimate user 
so the reporting occurs not later than 24 hours after 
the dispensing event; 
‘‘(2) the consultation of the PDMP by each pre-
scribing practitioner, or their designee, in the State 
or locality before initiating treatment with a con-
trolled substance, or any substance as required by the
441 
State to be reported to the PDMP, and over the course 
of ongoing treatment for each prescribing event; 
‘‘(3) the consultation of the PDMP before dis-
pensing a controlled substance, or any substance as 
required by the State to be reported to the PDMP; 
‘‘(4) the proactive notification to a practitioner 
when patterns indicative of controlled substance mis-
use by a patient, including opioid misuse, are de-
tected; 
‘‘(5) the availability of data in the PDMP to 
other States, as allowable under State law; and 
‘‘(6) the availability of nonidentifiable informa-
tion to the Centers for Disease Control and Preven-
tion for surveillance, epidemiology, statistical re-
search, or educational purposes. 
‘‘(c) DRUG MISUSE AND ABUSE.—In consultation with 
practitioners, dispensers, and other relevant and interested 
stakeholders, a State receiving support under this section— 
‘‘(1) shall establish a program to notify practi-
tioners and dispensers of information that will help 
to identify and prevent the unlawful diversion or mis-
use of controlled substances; 
‘‘(2) may, to the extent permitted under State 
law, notify the appropriate authorities responsible for 
carrying out drug diversion investigations if the State
442 
determines that information in the PDMP main-
tained by the State indicates an unlawful diversion 
or abuse of a controlled substance; 
‘‘(3) may conduct analyses of controlled sub-
stance program data for purposes of providing appro-
priate State agencies with aggregate reports based on 
such analyses in as close to real-time as practicable, 
regarding prescription patterns flagged as potentially 
presenting a risk of misuse, abuse, addiction, over-
dose, and other aggregate information, as appropriate 
and in compliance with applicable Federal and State 
laws and provided that such reports shall not include 
protected health information; and 
‘‘(4) may access information about prescriptions, 
such as claims data, to ensure that such prescribing 
and dispensing history is updated in as close to real- 
time as practicable, in compliance with applicable 
Federal and State laws and provided that such infor-
mation shall not include protected health information. 
‘‘(d) EVALUATION AND REPORTING.—As a condition 
on receipt of support under this section, the State shall re-
port on interoperability with PDMPs of other States and 
Federal agencies, where appropriate, intrastate interoper-
ability with health information technology systems such as 
electronic health records, health information exchanges, and
443 
e-prescribing, where appropriate, and whether or not the 
State provides automatic, up-to-date, or daily information 
about a patient when a practitioner (or the designee of a 
practitioner, where permitted) requests information about 
such patient. 
‘‘(e) EVALUATION AND REPORTING.—A State receiving 
support under this section shall provide the Secretary with 
aggregate nonidentifiable information, as permitted by 
State law, to enable the Secretary— 
‘‘(1) to evaluate the success of the State’s pro-
gram in achieving the purpose described in subsection 
(a); or 
‘‘(2) to prepare and submit to the Congress the 
report required by subsection (i)(2). 
‘‘(f) EDUCATION AND ACCESS TO THE MONITORING 
SYSTEM.—A State receiving support under this section 
shall take steps to— 
‘‘(1) facilitate prescribers and dispensers, and 
their delegates, as permitted by State law, to use the 
PDMP, to the extent practicable; and 
‘‘(2) educate prescribers and dispensers, and 
their delegates on the benefits of the use of PDMPs. 
‘‘(g) ELECTRONIC FORMAT.—The Secretary may issue 
guidelines specifying a uniform electronic format for the re-
porting, sharing, and disclosure of information pursuant
444 
to PDMPs. To the extent possible, such guidelines shall be 
consistent with standards recognized by the Office of the Na-
tional Coordinator for Health Information Technology. 
‘‘(h) RULES OF CONSTRUCTION.— 
‘‘(1) FUNCTIONS
OTHERWISE
AUTHORIZED
BY 
LAW.—Nothing in this section shall be construed to 
restrict the ability of any authority, including any 
local, State, or Federal law enforcement, narcotics 
control, licensure, disciplinary, or program authority, 
to perform functions otherwise authorized by law. 
‘‘(2) ADDITIONAL PRIVACY PROTECTIONS.—Noth-
ing in this section shall be construed as preempting 
any State from imposing any additional privacy pro-
tections. 
‘‘(3) FEDERAL PRIVACY REQUIREMENTS.—Noth-
ing in this section shall be construed to supersede any 
Federal privacy or confidentiality requirement, in-
cluding the regulations promulgated under section 
264(c) of the Health Insurance Portability and Ac-
countability Act of 1996 (Public Law 104–191; 110 
Stat. 2033) and section 543 of this Act. 
‘‘(4) NO FEDERAL PRIVATE CAUSE OF ACTION.— 
Nothing in this section shall be construed to create a 
Federal private cause of action.
445 
‘‘(i) PROGRESS REPORT.—Not later than 3 years after 
the date of enactment of this section, the Secretary shall— 
‘‘(1) complete a study that— 
‘‘(A) determines the progress of grantees in 
establishing and implementing PDMPs con-
sistent with this section; 
‘‘(B) provides an analysis of the extent to 
which the operation of PDMPs has— 
‘‘(i) reduced inappropriate use, abuse, 
diversion of, and overdose with, controlled 
substances; 
‘‘(ii) established or strengthened initia-
tives to ensure linkages to substance use dis-
order treatment services; or 
‘‘(iii) affected patient access to appro-
priate care in States operating PDMPs; 
‘‘(C) determine the progress of grantees in 
achieving interstate interoperability and intra-
state interoperability of PDMPs, including an 
assessment of technical, legal, and financial bar-
riers to such progress and recommendations for 
addressing these barriers; 
‘‘(D) determines the progress of grantees in 
implementing near real-time electronic PDMPs;
446 
‘‘(E) provides an analysis of the privacy 
protections in place for the information reported 
to the PDMP in each State or locality receiving 
support under this section and any recommenda-
tions of the Secretary for additional Federal or 
State requirements for protection of this infor-
mation; 
‘‘(F) determines the progress of States or lo-
calities in implementing technological alter-
natives to centralized data storage, such as peer- 
to-peer file sharing or data pointer systems, in 
PDMPs and the potential for such alternatives to 
enhance the privacy and security of individually 
identifiable data; and 
‘‘(G) evaluates the penalties that States or 
localities have enacted for the unauthorized use 
and disclosure of information maintained in 
PDMPs, and the criteria used by the Secretary 
to determine whether such penalties qualify as 
appropriate for purposes of subsection (a)(2); 
and 
‘‘(2) submit a report to the Congress on the re-
sults of the study. 
‘‘(j) ADVISORY COUNCIL.—
447 
‘‘(1) ESTABLISHMENT.—A State or locality may 
establish an advisory council to assist in the estab-
lishment, improvement, or maintenance of a PDMP 
consistent with this section. 
‘‘(2) LIMITATION.—A State or locality may not 
use Federal funds for the operations of an advisory 
council to assist in the establishment, improvement, 
or maintenance of a PDMP. 
‘‘(3) SENSE OF CONGRESS.—It is the sense of the 
Congress that, in establishing an advisory council to 
assist in the establishment, improvement, or mainte-
nance of a PDMP, a State or locality should consult 
with appropriate professional boards and other inter-
ested parties. 
‘‘(k) DEFINITIONS.—For purposes of this section: 
‘‘(1) The term ‘controlled substance’ means a 
controlled substance (as defined in section 102 of the 
Controlled Substances Act) in schedule II, III, or IV 
of section 202 of such Act. 
‘‘(2) The term ‘dispense’ means to deliver a con-
trolled substance to an ultimate user by, or pursuant 
to the lawful order of, a practitioner, irrespective of 
whether the dispenser uses the Internet or other means 
to effect such delivery.
448 
‘‘(3) The term ‘dispenser’ means a physician, 
pharmacist, or other person that dispenses a con-
trolled substance to an ultimate user. 
‘‘(4) The term ‘interstate interoperability’ with 
respect to a PDMP means the ability of the PDMP 
to electronically share reported information with an-
other State if the information concerns either the dis-
pensing of a controlled substance to an ultimate user 
who resides in such other State, or the dispensing of 
a controlled substance prescribed by a practitioner 
whose principal place of business is located in such 
other State. 
‘‘(5) The term ‘intrastate interoperability’ with 
respect to a PDMP means the integration of PDMP 
data within electronic health records and health infor-
mation technology infrastructure or linking of a 
PDMP to other data systems within the State, includ-
ing the State’s Medicaid program, workers’ compensa-
tion programs, and medical examiners or coroners. 
‘‘(6) The term ‘nonidentifiable information’ 
means information that does not identify a practi-
tioner, dispenser, or an ultimate user and with re-
spect to which there is no reasonable basis to believe 
that the information can be used to identify a practi-
tioner, dispenser, or an ultimate user.
449 
‘‘(7) The term ‘PDMP’ means a prescription 
drug monitoring program that is State-controlled. 
‘‘(8) The term ‘practitioner’ means a physician, 
dentist, veterinarian, scientific investigator, phar-
macy, hospital, or other person licensed, registered, or 
otherwise permitted, by the United States or the juris-
diction in which the individual practices or does re-
search, to distribute, dispense, conduct research with 
respect to, administer, or use in teaching or chemical 
analysis, a controlled substance in the course of pro-
fessional practice or research. 
‘‘(9) The term ‘State’ means each of the 50 
States, the District of Columbia, and any common-
wealth or territory of the United States. 
‘‘(10) The term ‘ultimate user’ means a person 
who has obtained from a dispenser, and who pos-
sesses, a controlled substance for the person’s own use, 
for the use of a member of the person’s household, or 
for the use of an animal owned by the person or by 
a member of the person’s household. 
‘‘(11) The term ‘clinical workflow’ means the in-
tegration of automated queries for prescription drug 
monitoring programs data and analytics into health 
information technologies such as electronic health 
record systems, health information exchanges, and/or
450 
pharmacy dispensing software systems, thus stream-
lining provider access through automated queries.’’. 
Subtitle R—Review of Substance 
Use Disorder Treatment Pro-
viders Receiving Federal Fund-
ing 
SEC. 7171. REVIEW OF SUBSTANCE USE DISORDER TREAT-
MENT 
PROVIDERS 
RECEIVING 
FEDERAL 
FUNDING. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall conduct a review of entities that receive Fed-
eral funding for the provision of substance use disorder 
treatment services. The review shall include: 
(1) The length of time the entity has provided 
substance use disorder treatment services and the geo-
graphic area served by the entity. 
(2) A detailed analysis of the patient population 
served by the entity, including but not limited to the 
number of patients, types of diagnosed substance use 
disorders and the demographic information of such 
patients, including sex, race, ethnicity, and socio-
economic status. 
(3) Detailed information on the types of sub-
stance use disorders for which the entity has the expe-
451 
rience, capability, and capacity to provide such serv-
ices. 
(4) An analysis of how the entity handles pa-
tients requiring treatment for a substance use dis-
order that the organization is not able to treat. 
(5) An analysis of what is needed in order to 
improve the entity’s ability to meet the addiction 
treatment needs of the communities served by that en-
tity. 
(6) Based on the identified needs of the commu-
nities served, a description of unmet needs and inad-
equate services and how such needs and services could 
be better addressed to treat individuals with meth-
amphetamine, cocaine, including crack cocaine, her-
oin, opioid, and other substance use disorders. 
(b) REPORT.—Not later than 2 years after the date 
of the enactment of this Act, the Secretary shall develop and 
submit to Congress a plan to direct appropriate resources 
to entities that provide substance use disorder treatment 
services in order to address inadequacies in services or 
funding identified through the survey described in sub-
section (a).
452 
Subtitle S—Other Health Provisions 
SEC. 7181. STATE RESPONSE TO THE OPIOID ABUSE CRISIS. 
(a) IN GENERAL.—Section 1003 of the 21st Century 
Cures Act (Public Law 114–255) is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘the authorization of appro-
priations under subsection (b) to carry out the 
grant program described in subsection (c)’’ and 
inserting ‘‘subsection (h) to carry out the grant 
program described in subsection (b)’’; and 
(B) by inserting ‘‘and Indian Tribes’’ after 
‘‘States’’; 
(2) by striking subsection (b); 
(3) by redesignating subsections (c) through (e) 
as subsections (b) through (d), respectively; 
(4) by redesignating subsection (f) as subsection 
(j); 
(5) in subsection (b), as so redesignated— 
(A) in paragraph (1)— 
(i) in the paragraph heading, by in-
serting ‘‘AND TRIBAL’’ after ‘‘STATE’’; 
(ii) by striking ‘‘States for the purpose 
of addressing the opioid abuse crisis within 
such States’’ and inserting ‘‘States and In-
dian Tribes for the purpose of addressing
453 
the opioid abuse crisis within such States 
and Indian Tribes’’; 
(iii) by inserting ‘‘or Indian Tribes’’ 
after ‘‘preference to States’’; and 
(iv) by inserting before the period of 
the second sentence ‘‘or other Indian Tribes, 
as applicable’’; and 
(B) in paragraph (2)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘to a State’’; 
(ii) in subparagraph (A), by striking 
‘‘Improving State’’ and inserting ‘‘Estab-
lishing or improving’’; 
(iii) in subparagraph (C), by inserting 
‘‘preventing diversion of controlled sub-
stances,’’ after ‘‘treatment programs,’’; and 
(iv) in subparagraph (E), by striking 
‘‘as the State determines appropriate, re-
lated to addressing the opioid abuse crisis 
within the State’’ and inserting ‘‘as the 
State or Indian Tribe determines appro-
priate, related to addressing the opioid 
abuse crisis within the State or Indian 
Tribe, including directing resources in ac-
454 
cordance with local needs related to sub-
stance use disorders’’; 
(6) in subsection (c), as so redesignated, by strik-
ing ‘‘subsection (c)’’ and inserting ‘‘subsection (b)’’; 
(7) in subsection (d), as so redesignated— 
(A) in the matter preceding paragraph (1), 
by striking ‘‘the authorization of appropriations 
under subsection (b)’’ and inserting ‘‘subsection 
(h)’’; and 
(B) in paragraph (1), by striking ‘‘sub-
section (c)’’ and inserting ‘‘subsection (b)’’; and 
(8) by inserting after subsection (d), as so redes-
ignated, the following: 
‘‘(e) INDIAN TRIBES.— 
‘‘(1) DEFINITION.—For purposes of this section, 
the term ‘Indian Tribe’ has the meaning given the 
term ‘Indian tribe’ in section 4 of the Indian Self-De-
termination and Education Assistance Act (25 U.S.C. 
5304). 
‘‘(2) 
APPROPRIATE
MECHANISMS.—The 
Sec-
retary, in consultation with Indian Tribes, shall 
identify and establish appropriate mechanisms for 
Tribes to demonstrate or report the information as re-
quired under subsections (b), (c), and (d).
455 
‘‘(f) REPORT TO CONGRESS.—Not later than 1 year 
after the date on which amounts are first awarded after 
the date of enactment of this subsection, pursuant to sub-
section (b), and annually thereafter, the Secretary shall sub-
mit 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 summa-
rizing the information provided to the Secretary in reports 
made pursuant to subsection (c), including the purposes for 
which grant funds are awarded under this section and the 
activities of such grant recipients. 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary, includ-
ing through the Tribal Training and Technical Assistance 
Center of the Substance Abuse and Mental Health Services 
Administration, shall provide State agencies and Indian 
Tribes, 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 the opioid crisis. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For pur-
poses of carrying out the grant program under subsection 
(b), there is authorized to be appropriated $500,000,000 for 
each of fiscal years 2019 through 2021, to remain available 
until expended.
456 
‘‘(i) SET ASIDE.—Of the amounts made available for 
each fiscal year to award grants under subsection (b) for 
a fiscal year, 5 percent of such amount for such fiscal year 
shall be made available to Indian Tribes, and up to 15 per-
cent of such amount for such fiscal year may be set aside 
for States with the highest age-adjusted rate of drug over-
dose death based on the ordinal ranking of States according 
to the Director of the Centers for Disease Control and Pre-
vention.’’. 
(b) CONFORMING AMENDMENT.—Section 1004(c) of the 
21st Century Cures Act (Public Law 114–255) is amended 
by striking ‘‘, the FDA Innovation Account, or the Account 
For the State Response to the Opioid Abuse Crisis’’ and 
inserting ‘‘or the FDA Innovation Account’’. 
SEC. 7182. REPORT ON INVESTIGATIONS REGARDING PAR-
ITY IN MENTAL HEALTH AND SUBSTANCE USE 
DISORDER BENEFITS. 
(a) IN GENERAL.—Section 13003 of the 21st Century 
Cures Act (Public Law 114–255) is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘with findings of any seri-
ous violation regarding’’ and inserting ‘‘con-
cerning’’; and
457 
(B) by inserting ‘‘and the Committee on 
Education and the Workforce’’ after ‘‘Energy 
and Commerce’’; and 
(2) in subsection (b)(1)— 
(A) by inserting ‘‘complaints received and 
number of’’ before ‘‘closed’’; and 
(B) by inserting before the period ‘‘, and, 
for each such investigation closed, which agency 
conducted the investigation, whether the health 
plan that is the subject of the investigation is 
fully insured or not fully insured and a sum-
mary of any coordination between the applicable 
State regulators and the Department of Labor, 
the Department of Health and Human Services, 
or the Department of the Treasury, and ref-
erences to any guidance provided by the agencies 
addressing the category of violation committed’’. 
(b) APPLICABILITY.—The amendments made by sub-
section (a) shall apply with respect to the second annual 
report required under such section 13003 and each such an-
nual report thereafter. 
SEC. 7183. CAREER ACT. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’), in consultation with the Secretary of Labor, shall
458 
continue or establish a program to support individuals in 
substance use disorder treatment and recovery to live inde-
pendently and participate in the workforce. 
(b) GRANTS AUTHORIZED.—In carrying out the ac-
tivities under this section, the Secretary shall, on a competi-
tive basis, award grants for a period of not more than 5 
years to entities to enable such entities to carry out evi-
dence-based programs to help individuals in substance use 
disorder treatment and recovery to live independently and 
participate in the workforce. Such entities shall coordinate, 
as applicable, with Indian tribes or tribal organizations (as 
applicable), State boards and local boards (as defined in 
section 3 of the Workforce Innovation and Opportunity Act 
(29 U.S.C. 3102), lead State agencies with responsibility 
for a workforce investment activity (as defined in such sec-
tion 3), and State agencies responsible for carrying out sub-
stance use disorder prevention and treatment programs. 
(c) PRIORITY.— 
(1) IN
GENERAL.—In awarding grants under 
this section, the Secretary shall give priority based on 
the State in which the entity is located. Priority shall 
be given among States according to a formula based 
on the rates described in paragraph (2) and weighted 
as described in paragraph (3).
459 
(2) RATES.—The rates described in this para-
graph are the following: 
(A) The amount by which the rate of drug 
overdose deaths in the State, adjusted for age, is 
above the national overdose mortality rate, as de-
termined by the Director of the Centers for Dis-
ease Control and Prevention. 
(B) The amount by which the rate of unem-
ployment for the State, based on data provided 
by the Bureau of Labor Statistics for the pre-
ceding 5 calendar years for which there is avail-
able data, is above the national average. 
(C) The amount by which rate of labor force 
participation in the State, based on data pro-
vided by the Bureau of Labor Statistics for the 
preceding 5 calendar years for which there is 
available data, is below the national average. 
(3) WEIGHTING.—The rates described in para-
graph (2) shall be weighted as follows: 
(A) The rate described in paragraph (2)(A) 
shall be weighted 70 percent. 
(B) The rate described in paragraph (2)(B) 
shall be weighted 15 percent. 
(C) The rate described in paragraph (2)(C) 
shall be weighted 15 percent.
460 
(d) PREFERENCE.—In awarding grants under this 
section, the Secretary shall give preference to entities located 
in areas within States with the greatest need, with such 
need based on the highest mortality rate related to substance 
use disorder. 
(e) DEFINITIONS.—In this section: 
(1) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means an entity that offers treatment or recovery 
services for individuals with substance use disorders, 
and partners with one or more local or State stake-
holders, which may include local employers, commu-
nity organizations, the local workforce development 
board, local and State governments, and Indian 
Tribes or tribal organizations, to support recovery, 
independent living, and participation in the work-
force. 
(2) INDIAN TRIBES; 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). 
(3) STATE.—The term ‘‘State’’ includes only the 
several States and the District of Columbia.
461 
(f) APPLICATIONS.—An eligible entity shall submit an 
application at such time and in such manner as the Sec-
retary may require. In submitting an application, the enti-
ty shall demonstrate the ability to partner with local stake-
holders, which may include local employers, community 
stakeholders, the local workforce development board, local 
and State governments, and Indian Tribes or tribal organi-
zations, as applicable, to— 
(1) identify gaps in the workforce due to the 
prevalence of substance use disorders; 
(2) in coordination with statewide employment 
and training activities, including coordination and 
alignment of activities carried out by entities pro-
vided grant funds under section 8041, help individ-
uals in recovery from a substance use disorder transi-
tion into the workforce, including by providing career 
services, training services as described in paragraph 
(2) of section 134(c) of the Workforce Innovation and 
Opportunity Act (29 U.S.C. 3174(c)), and related 
services described in section 134(a)(3) of such Act (42 
U.S.C. 3174(a)); and 
(3) assist employers with informing their em-
ployees of the resources, such as resources related to 
substance use disorders that are available to their em-
ployees.
462 
(g) USE OF FUNDS.—An entity receiving a grant 
under this section shall use the funds to conduct one or more 
of the following activities: 
(1) Hire case managers, care coordinators, pro-
viders of peer recovery support services, as described 
in section 547(a) of the Public Health Service Act (42 
U.S.C. 290ee–2(a)), or other professionals, as appro-
priate, to provide services that support treatment, re-
covery, and rehabilitation, and prevent relapse, re-
cidivism, and overdose, including by encouraging— 
(A) the development and strengthening of 
daily living skills; and 
(B) the use of counseling, care coordination, 
and other services, as appropriate, to support re-
covery from substance use disorders. 
(2) Implement or utilize innovative technologies, 
which may include the use of telemedicine. 
(3) In coordination with the lead State agency 
with responsibility for a workforce investment activ-
ity or local board described in subsection (b), pro-
vide— 
(A) short-term prevocational training serv-
ices; and
463 
(B) training services that are directly 
linked to the employment opportunities in the 
local area or the planning region. 
(h) SUPPORT FOR STATE STRATEGY.—An eligible en-
tity shall include in its application under subsection (f) in-
formation describing how the services and activities pro-
posed in such application are aligned with the State, out-
lying area, or Tribal strategy, as applicable, for addressing 
issues described in such application and how such entity 
will coordinate with existing systems to deliver services as 
described in such application. 
(i) DATA REPORTING AND PROGRAM OVERSIGHT.— 
Each eligible entity awarded a grant under this section 
shall submit to the Secretary a report at such time and 
in such manner as the Secretary may require. Such report 
shall include a description of— 
(1) the programs and activities funded by the 
grant; 
(2) outcomes of the population of individuals 
with a substance use disorder the grantee served 
through activities described in subsection (g); and 
(3) any other information that the Secretary 
may require for the purpose of ensuring that the 
grantee is complying with all of the requirements of 
the grant.
464 
(j) REPORTS TO CONGRESS.— 
(1) PRELIMINARY
REPORT.—Not later than 2 
years after the end of the first year of the grant pe-
riod under this section, the Secretary shall submit to 
Congress a preliminary report that analyzes reports 
submitted under subsection (i). 
(2) FINAL REPORT.—Not later than 2 years after 
submitting the preliminary report required under 
paragraph (1), the Secretary shall submit to Congress 
a final report that includes— 
(A) a description of how the grant funding 
was used, including the number of individuals 
who received services under subsection (g)(3) and 
an evaluation of the effectiveness of the activities 
conducted by the grantee with respect to out-
comes of the population of individuals with sub-
stance use disorder who receive services from the 
grantee; and 
(B) recommendations related to best prac-
tices for health care professionals to support in-
dividuals in substance use disorder treatment or 
recovery to live independently and participate in 
the workforce. 
(k) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated $5,000,000 for each of fiscal
465 
years 2019 through 2023 for purposes of carrying out this 
section. 
TITLE VIII—MISCELLANEOUS 
Subtitle A—Synthetics Trafficking 
and Overdose Prevention 
SEC. 8001. SHORT TITLE. 
This subtitle may be cited as the ‘‘Synthetics Traf-
ficking and Overdose Prevention Act of 2018’’ or ‘‘STOP 
Act of 2018’’. 
SEC. 8002. CUSTOMS FEES. 
(a) IN GENERAL.—Section 13031(b)(9) of the Consoli-
dated Omnibus Budget Reconciliation Act of 1985 (19 
U.S.C. 58c(b)(9)) is amended by adding at the end the fol-
lowing: 
‘‘(D)(i) With respect to the processing of items 
that are sent to the United States through the inter-
national postal network by ‘Inbound Express Mail 
service’ or ‘Inbound EMS’ (as that service is described 
in the mail classification schedule referred to in sec-
tion 3631 of title 39, United States Code), the fol-
lowing payments are required: 
‘‘(I) $1 per Inbound EMS item. 
‘‘(II) If an Inbound EMS item is formally 
entered, the fee provided for under subsection 
(a)(9), if applicable.
466 
‘‘(ii) Notwithstanding section 451 of the Tariff 
Act of 1930 (19 U.S.C. 1451), the payments required 
by clause (i), as allocated pursuant to clause (iii)(I), 
shall be the only payments required for reimburse-
ment of U.S. Customs and Border Protection for cus-
toms services provided in connection with the proc-
essing of an Inbound EMS item. 
‘‘(iii)(I) The payments required by clause (i)(I) 
shall be allocated as follows: 
‘‘(aa) 50 percent of the amount of the pay-
ments shall be paid on a quarterly basis by the 
United States Postal Service to the Commis-
sioner of U.S. Customs and Border Protection in 
accordance with regulations prescribed by the 
Secretary of the Treasury to reimburse U.S. Cus-
toms and Border Protection for customs services 
provided in connection with the processing of In-
bound EMS items. 
‘‘(bb) 50 percent of the amount of the pay-
ments shall be retained by the Postal Service to 
reimburse the Postal Service for services provided 
in connection with the customs processing of In-
bound EMS items. 
‘‘(II) Payments received by U.S. Customs and 
Border Protection under subclause (I)(aa) shall, in
467 
accordance with section 524 of the Tariff Act of 1930 
(19 U.S.C. 1524), be deposited in the Customs User 
Fee Account and used to directly reimburse each ap-
propriation for the amount paid out of that appro-
priation for the costs incurred in providing services 
to international mail facilities. Amounts deposited in 
accordance with the preceding sentence shall be avail-
able until expended for the provision of such services. 
‘‘(III) Payments retained by the Postal Service 
under subclause (I)(bb) shall be used to directly reim-
burse the Postal Service for the costs incurred in pro-
viding services in connection with the customs proc-
essing of Inbound EMS items. 
‘‘(iv) Beginning in fiscal year 2021, the Sec-
retary, in consultation with the Postmaster General, 
may adjust, not more frequently than once each fiscal 
year, the amount described in clause (i)(I) to an 
amount commensurate with the costs of services pro-
vided in connection with the customs processing of In-
bound EMS items, consistent with the obligations of 
the United States under international agreements.’’. 
(b) CONFORMING AMENDMENTS.—Section 13031(a) of 
the Consolidated Omnibus Budget Reconciliation Act of 
1985 (19 U.S.C. 58c(a)) is amended—
468 
(1) in paragraph (6), by inserting ‘‘(other than 
an item subject to a fee under subsection (b)(9)(D))’’ 
after ‘‘customs officer’’; and 
(2) in paragraph (10)— 
(A) in subparagraph (C), in the matter pre-
ceding clause (i), by inserting ‘‘(other than In-
bound EMS items described in subsection 
(b)(9)(D))’’ after ‘‘release’’; and 
(B) in the flush at the end, by inserting ‘‘or 
of Inbound EMS items described in subsection 
(b)(9)(D),’’ after ‘‘(C),’’. 
(c) EFFECTIVE DATE.—The amendments made by this 
section shall take effect on January 1, 2020. 
SEC. 8003. MANDATORY ADVANCE ELECTRONIC INFORMA-
TION FOR POSTAL SHIPMENTS. 
(a) MANDATORY ADVANCE ELECTRONIC INFORMA-
TION.— 
(1) IN GENERAL.—Section 343(a)(3)(K) of the 
Trade Act of 2002 (Public Law 107–210; 19 U.S.C. 
2071 note) is amended to read as follows: 
‘‘(K)(i) The Secretary shall prescribe regu-
lations requiring the United States Postal Serv-
ice to transmit the information described in 
paragraphs (1) and (2) to the Commissioner of 
U.S. Customs and Border Protection for inter-
469 
national mail shipments by the Postal Service 
(including shipments to the Postal Service from 
foreign postal operators that are transported by 
private carrier) consistent with the requirements 
of this subparagraph. 
‘‘(ii) In prescribing regulations under 
clause (i), the Secretary shall impose require-
ments for the transmission to the Commissioner 
of information described in paragraphs (1) and 
(2) for mail shipments described in clause (i) 
that are comparable to the requirements for the 
transmission of such information imposed on 
similar non-mail shipments of cargo, taking into 
account the parameters set forth in subpara-
graphs (A) through (J). 
‘‘(iii) The regulations prescribed under 
clause (i) shall require the transmission of the 
information described in paragraphs (1) and (2) 
with respect to a shipment as soon as practicable 
in relation to the transportation of the shipment, 
consistent with subparagraph (H). 
‘‘(iv) Regulations prescribed under clause 
(i) shall allow for the requirements for the trans-
mission to the Commissioner of information de-
scribed in paragraphs (1) and (2) for mail ship-
470 
ments described in clause (i) to be implemented 
in phases, as appropriate, by— 
‘‘(I) setting incremental targets for in-
creasing the percentage of such shipments 
for which information is required to be 
transmitted to the Commissioner; and 
‘‘(II) taking into consideration— 
‘‘(aa) the risk posed by such ship-
ments; 
‘‘(bb) the volume of mail shipped 
to the United States by or through a 
particular country; and 
‘‘(cc) the capacities of foreign 
postal operators to provide that infor-
mation to the Postal Service. 
‘‘(v)(I) Notwithstanding clause (iv), the 
Postal Service shall, not later than December 31, 
2018, arrange for the transmission to the Com-
missioner of the information described in para-
graphs (1) and (2) for not less than 70 percent 
of the aggregate number of mail shipments, in-
cluding 100 percent of mail shipments from the 
People’s Republic of China, described in clause 
(i).
471 
‘‘(II) If the requirements of subclause (I) 
are not met, the Comptroller General of the 
United States shall submit to the appropriate 
congressional committees, not later than June 
30, 2019, a report— 
‘‘(aa) assessing the reasons for the fail-
ure to meet those requirements; and 
‘‘(bb) identifying recommendations to 
improve the collection by the Postal Service 
of the information described in paragraphs 
(1) and (2). 
‘‘(vi)(I) Notwithstanding clause (iv), the 
Postal Service shall, not later than December 31, 
2020, arrange for the transmission to the Com-
missioner of the information described in para-
graphs (1) and (2) for 100 percent of the aggre-
gate number of mail shipments described in 
clause (i). 
‘‘(II) The Commissioner, in consultation 
with the Postmaster General, may determine to 
exclude a country from the requirement described 
in subclause (I) to transmit information for mail 
shipments described in clause (i) from the coun-
try if the Commissioner determines that the 
country—
472 
‘‘(aa) does not have the capacity to col-
lect and transmit such information; 
‘‘(bb) represents a low risk for mail 
shipments that violate relevant United 
States laws and regulations; and 
‘‘(cc) accounts for low volumes of mail 
shipments that can be effectively screened 
for compliance with relevant United States 
laws and regulations through an alternate 
means. 
‘‘(III) The Commissioner shall, at a min-
imum on an annual basis, re-evaluate any deter-
mination made under subclause (II) to exclude a 
country from the requirement described in sub-
clause (I). If, at any time, the Commissioner de-
termines that a country no longer meets the re-
quirements under subclause (II), the Commis-
sioner may not further exclude the country from 
the requirement described in subclause (I). 
‘‘(IV) The Commissioner shall, on an an-
nual basis, submit to the appropriate congres-
sional committees— 
‘‘(aa) a list of countries with respect to 
which the Commissioner has made a deter-
mination under subclause (II) to exclude the
473 
countries from the requirement described in 
subclause (I); and 
‘‘(bb) information used to support such 
determination with respect to such coun-
tries. 
‘‘(vii)(I) The Postmaster General shall, in 
consultation with the Commissioner, refuse any 
shipments received after December 31, 2020, for 
which the information described in paragraphs 
(1) and (2) is not transmitted as required under 
this subparagraph, except as provided in sub-
clause (II). 
‘‘(II) If remedial action is warranted in 
lieu of refusal of shipments pursuant to sub-
clause (I), the Postmaster General and the Com-
missioner shall take remedial action with respect 
to the shipments, including destruction, seizure, 
controlled delivery or other law enforcement ini-
tiatives, or correction of the failure to provide 
the information described in paragraphs (1) and 
(2) with respect to the shipments. 
‘‘(viii) Nothing in this subparagraph shall 
be construed to limit the authority of the Sec-
retary to obtain information relating to inter-
474 
national mail shipments from private carriers or 
other appropriate parties. 
‘‘(ix) In this subparagraph, the term ‘ap-
propriate congressional committees’ means— 
‘‘(I) the Committee on Finance and the 
Committee on Homeland Security and Gov-
ernmental Affairs of the Senate; and 
‘‘(II) the Committee on Ways and 
Means, the Committee on Oversight and 
Government Reform, and the Committee on 
Homeland Security of the House of Rep-
resentatives.’’. 
(2) JOINT STRATEGIC PLAN ON MANDATORY AD-
VANCE INFORMATION.—Not later than 60 days after 
the date of the enactment of this Act, the Secretary of 
Homeland Security and the Postmaster General shall 
develop and submit to the appropriate congressional 
committees a joint strategic plan detailing specific 
performance measures for achieving— 
(A) the transmission of information as re-
quired by section 343(a)(3)(K) of the Trade Act 
of 2002, as amended by paragraph (1); and 
(B) the presentation by the Postal Service to 
U.S. Customs and Border Protection of all mail
475 
targeted by U.S. Customs and Border Protection 
for inspection. 
(b) CAPACITY BUILDING.— 
(1) IN GENERAL.—Section 343(a) of the Trade 
Act of 2002 (Public Law 107–210; 19 U.S.C. 2071 
note) is amended by adding at the end the following: 
‘‘(5) CAPACITY BUILDING.— 
‘‘(A) IN GENERAL.—The Secretary, with the 
concurrence of the Secretary of State, and in co-
ordination with the Postmaster General and the 
heads of other Federal agencies, as appropriate, 
may provide technical assistance, equipment, 
technology, and training to enhance the capacity 
of foreign postal operators— 
‘‘(i) to gather and provide the informa-
tion required by paragraph (3)(K); and 
‘‘(ii) to otherwise gather and provide 
postal shipment information related to— 
‘‘(I) terrorism; 
‘‘(II) items the importation or in-
troduction of which into the United 
States is prohibited or restricted, in-
cluding controlled substances; and 
‘‘(III) such other concerns as the 
Secretary determines appropriate.
476 
‘‘(B) PROVISION OF EQUIPMENT AND TECH-
NOLOGY.—With respect to the provision of equip-
ment and technology under subparagraph (A), 
the Secretary may lease, loan, provide, or other-
wise assist in the deployment of such equipment 
and technology under such terms and conditions 
as the Secretary may prescribe, including nonre-
imbursable loans or the transfer of ownership of 
equipment and technology.’’. 
(2) JOINT STRATEGIC PLAN ON CAPACITY BUILD-
ING.—Not later than 1 year after the date of the en-
actment of this Act, the Secretary of Homeland Secu-
rity and the Postmaster General shall, in consultation 
with the Secretary of State, jointly develop and sub-
mit to the appropriate congressional committees a 
joint strategic plan— 
(A) detailing the extent to which U.S. Cus-
toms and Border Protection and the United 
States Postal Service are engaged in capacity 
building efforts under section 343(a)(5) of the 
Trade Act of 2002, as added by paragraph (1); 
(B) describing plans for future capacity 
building efforts; and 
(C) assessing how capacity building has in-
creased the ability of U.S. Customs and Border
477 
Protection and the Postal Service to advance the 
goals of this subtitle and the amendments made 
by this subtitle. 
(c) REPORT AND CONSULTATIONS BY SECRETARY OF 
HOMELAND SECURITY AND POSTMASTER GENERAL.— 
(1) REPORT.—Not later than 180 days after the 
date of the enactment of this Act, and annually there-
after until 3 years after the Postmaster General has 
met the requirement under clause (vi) of subpara-
graph (K) of section 343(a)(3) of the Trade Act of 
2002, as amended by subsection (a)(1), the Secretary 
of Homeland Security and the Postmaster General 
shall, in consultation with the Secretary of State, 
jointly submit to the appropriate congressional com-
mittees a report on compliance with that subpara-
graph that includes the following: 
(A) An assessment of the status of the regu-
lations required to be promulgated under that 
subparagraph. 
(B) An update regarding new and existing 
agreements reached with foreign postal operators 
for the transmission of the information required 
by that subparagraph. 
(C) A summary of deliberations between the 
United States Postal Service and foreign postal
478 
operators with respect to issues relating to the 
transmission of that information. 
(D) A summary of the progress made in 
achieving the transmission of that information 
for the percentage of shipments required by that 
subparagraph. 
(E) An assessment of the quality of that in-
formation being received by foreign postal opera-
tors, as determined by the Secretary of Home-
land Security, and actions taken to improve the 
quality of that information. 
(F) A summary of policies established by 
the Universal Postal Union that may affect the 
ability of the Postmaster General to obtain the 
transmission of that information. 
(G) A summary of the use of technology to 
detect illicit synthetic opioids and other illegal 
substances in international mail parcels and 
planned acquisitions and advancements in such 
technology. 
(H) Such other information as the Sec-
retary of Homeland Security and the Postmaster 
General consider appropriate with respect to ob-
taining the transmission of information required 
by that subparagraph.
479 
(2) CONSULTATIONS.—Not later than 180 days 
after the date of the enactment of this Act, and every 
180 days thereafter until the Postmaster General has 
met the requirement under clause (vi) of section 
343(a)(3)(K) of the Trade Act of 2002, as amended by 
subsection (a)(1), to arrange for the transmission of 
information with respect to 100 percent of the aggre-
gate number of mail shipments described in clause (i) 
of that section, the Secretary of Homeland Security 
and the Postmaster General shall provide briefings to 
the appropriate congressional committees on the 
progress made in achieving the transmission of that 
information for that percentage of shipments. 
(d) GOVERNMENT
ACCOUNTABILITY
OFFICE
RE-
PORT.—Not later than June 30, 2019, the Comptroller Gen-
eral of the United States shall submit to the appropriate 
congressional committees a report— 
(1) assessing the progress of the United States 
Postal Service in achieving the transmission of the 
information required by subparagraph (K) of section 
343(a)(3) of the Trade Act of 2002, as amended by 
subsection (a)(1), for the percentage of shipments re-
quired by that subparagraph;
480 
(2) assessing the quality of the information re-
ceived from foreign postal operators for targeting pur-
poses; 
(3) assessing the specific percentage of targeted 
mail presented by the Postal Service to U.S. Customs 
and Border Protection for inspection; 
(4) describing the costs of collecting the informa-
tion required by such subparagraph (K) from foreign 
postal operators and the costs of implementing the use 
of that information; 
(5) assessing the benefits of receiving that infor-
mation with respect to international mail shipments; 
(6) assessing the feasibility of assessing a cus-
toms fee under section 13031(b)(9) of the Consolidated 
Omnibus Budget Reconciliation Act of 1985, as 
amended by section 8002, on international mail ship-
ments other than Inbound Express Mail service in a 
manner consistent with the obligations of the United 
States under international agreements; and 
(7) identifying recommendations, including rec-
ommendations for legislation, to improve the compli-
ance of the Postal Service with such subparagraph 
(K), including an assessment of whether the detection 
of illicit synthetic opioids in the international mail 
would be improved by—
481 
(A) requiring the Postal Service to serve as 
the consignee for international mail shipments 
containing goods; or 
(B) designating a customs broker to act as 
an importer of record for international mail 
shipments containing goods. 
(e) TECHNICAL CORRECTION.—Section 343 of the 
Trade Act of 2002 (Public Law 107–210; 19 U.S.C. 2071 
note) is amended in the section heading by striking ‘‘AD-
VANCED’’ and inserting ‘‘ADVANCE’’. 
(f) APPROPRIATE CONGRESSIONAL COMMITTEES DE-
FINED.—In this section, the term ‘‘appropriate congres-
sional committees’’ means— 
(1) the Committee on Finance and the Com-
mittee on Homeland Security and Governmental Af-
fairs of the Senate; and 
(2) the Committee on Ways and Means, the Com-
mittee on Oversight and Government Reform, and the 
Committee on Homeland Security of the House of 
Representatives. 
SEC. 8004. INTERNATIONAL POSTAL AGREEMENTS. 
(a) EXISTING AGREEMENTS.— 
(1) IN GENERAL.—In the event that any provi-
sion of this subtitle, or any amendment made by this 
subtitle, is determined to be in violation of obligations
482 
of the United States under any postal treaty, conven-
tion, or other international agreement related to 
international postal services, or any amendment to 
such an agreement, the Secretary of State should ne-
gotiate to amend the relevant provisions of the agree-
ment so that the United States is no longer in viola-
tion of the agreement. 
(2) RULE OF CONSTRUCTION.—Nothing in this 
subsection shall be construed to permit delay in the 
implementation of this subtitle or any amendment 
made by this subtitle. 
(b) FUTURE AGREEMENTS.— 
(1) CONSULTATIONS.—Before entering into, on 
or after the date of the enactment of this Act, any 
postal treaty, convention, or other international 
agreement related to international postal services, or 
any amendment to such an agreement, that is related 
to the ability of the United States to secure the provi-
sion of advance electronic information by foreign 
postal operators, the Secretary of State should consult 
with the appropriate congressional committees (as de-
fined in section 8003(f)). 
(2) EXPEDITED NEGOTIATION OF NEW AGREE-
MENT.—To the extent that any new postal treaty, 
convention, or other international agreement related
483 
to international postal services would improve the 
ability of the United States to secure the provision of 
advance electronic information by foreign postal oper-
ators as required by regulations prescribed under sec-
tion 343(a)(3)(K) of the Trade Act of 2002, as 
amended by section 8003(a)(1), the Secretary of State 
should expeditiously conclude such an agreement. 
SEC. 8005. COST RECOUPMENT. 
(a) IN GENERAL.—The United States Postal Service 
shall, to the extent practicable and otherwise recoverable by 
law, ensure that all costs associated with complying with 
this subtitle and amendments made by this subtitle are 
charged directly to foreign shippers or foreign postal opera-
tors. 
(b) COSTS NOT CONSIDERED REVENUE.—The recovery 
of costs under subsection (a) shall not be deemed revenue 
for purposes of subchapter I and II of chapter 36 of title 
39, United States Code, or regulations prescribed under that 
chapter. 
SEC. 8006. DEVELOPMENT OF TECHNOLOGY TO DETECT IL-
LICIT NARCOTICS. 
(a) IN GENERAL.—The Postmaster General and the 
Commissioner of U.S. Customs and Border Protection, in 
coordination with the heads of other agencies as appro-
priate, shall collaborate to identify and develop technology
484 
for the detection of illicit fentanyl, other synthetic opioids, 
and other narcotics and psychoactive substances entering 
the United States by mail. 
(b) OUTREACH TO PRIVATE SECTOR.—The Postmaster 
General and the Commissioner shall conduct outreach to 
private sector entities to gather information regarding the 
current state of technology to identify areas for innovation 
relating to the detection of illicit fentanyl, other synthetic 
opioids, and other narcotics and psychoactive substances en-
tering the United States. 
SEC. 8007. CIVIL PENALTIES FOR POSTAL SHIPMENTS. 
Section 436 of the Tariff Act of 1930 (19 U.S.C. 1436) 
is amended by adding at the end the following new sub-
section: 
‘‘(e) CIVIL PENALTIES FOR POSTAL SHIPMENTS.— 
‘‘(1) CIVIL PENALTY.—A civil penalty shall be 
imposed against the United States Postal Service if 
the Postal Service accepts a shipment in violation of 
section 343(a)(3)(K)(vii)(I) of the Trade Act of 2002. 
‘‘(2) MODIFICATION OF CIVIL PENALTY.— 
‘‘(A) IN GENERAL.—U.S. Customs and Bor-
der Protection shall reduce or dismiss a civil 
penalty imposed pursuant to paragraph (1) if 
U.S. Customs and Border Protection determines 
that the United States Postal Service—
485 
‘‘(i) has a low error rate in compliance 
with section 343(a)(3)(K) of the Trade Act 
of 2002; 
‘‘(ii) is cooperating with U.S. Customs 
and Border Protection with respect to the 
violation of section 343(a)(3)(K)(vii)(I) of 
the Trade Act of 2002; or 
‘‘(iii) has taken remedial action to pre-
vent 
future 
violations 
of 
section 
343(a)(3)(K)(vii)(I) of the Trade Act of 
2002. 
‘‘(B) WRITTEN
NOTIFICATION.—U.S. Cus-
toms and Border Protection shall issue a written 
notification to the Postal Service with respect to 
each exercise of the authority of subparagraph 
(A) to reduce or dismiss a civil penalty imposed 
pursuant to paragraph (1). 
‘‘(3) ONGOING LACK OF COMPLIANCE.—If U.S. 
Customs and Border Protection determines that the 
United States Postal Service— 
‘‘(A) has repeatedly committed violations of 
section 343(a)(3)(K)(vii)(I) of the Trade Act of 
2002, 
‘‘(B) has failed to cooperate with U.S. Cus-
toms and Border Protection with respect to vio-
486 
lations of section 343(a)(3)(K)(vii)(I) of the 
Trade Act of 2002, and 
‘‘(C) has an increasing error rate in com-
pliance with section 343(a)(3)(K) of the Trade 
Act of 2002, 
civil penalties may be imposed against the United 
States Postal Service until corrective action, satisfac-
tory to U.S. Customs and Border Protection, is 
taken.’’. 
SEC. 8008. REPORT ON VIOLATIONS OF ARRIVAL, REPORT-
ING, 
ENTRY, 
AND 
CLEARANCE 
REQUIRE-
MENTS AND FALSITY OR LACK OF MANIFEST. 
(a) IN GENERAL.—The Commissioner of U.S. Customs 
and Border Protection shall submit to the appropriate con-
gressional committees an annual report that contains the 
information described in subsection (b) with respect to each 
violation of section 436 of the Tariff Act of 1930 (19 U.S.C. 
1436), as amended by section 8007, and section 584 of such 
Act (19 U.S.C. 1584) that occurred during the previous 
year. 
(b) INFORMATION DESCRIBED.—The information de-
scribed in this subsection is the following: 
(1) The name and address of the violator. 
(2) The specific violation that was committed.
487 
(3) The location or port of entry through which 
the items were transported. 
(4) An inventory of the items seized, including 
a description of the items and the quantity seized. 
(5) The location from which the items originated. 
(6) The entity responsible for the apprehension 
or seizure, organized by location or port of entry. 
(7) The amount of penalties assessed by U.S. 
Customs and Border Protection, organized by name of 
the violator and location or port of entry. 
(8) The amount of penalties that U.S. Customs 
and Border Protection could have levied, organized by 
name of the violator and location or port of entry. 
(9) The rationale for negotiating lower penalties, 
organized by name of the violator and location or 
port of entry. 
(c) APPROPRIATE CONGRESSIONAL COMMITTEES DE-
FINED.—In this section, the term ‘‘appropriate congres-
sional committees’’ means— 
(1) the Committee on Finance and the Com-
mittee on Homeland Security and Governmental Af-
fairs of the Senate; and 
(2) the Committee on Ways and Means, the Com-
mittee on Oversight and Government Reform, and the
488 
Committee on Homeland Security of the House of 
Representatives. 
SEC. 8009. EFFECTIVE DATE; REGULATIONS. 
(a) EFFECTIVE DATE.—This subtitle and the amend-
ments made by this subtitle (other than the amendments 
made by section 8002) shall take effect on the date of the 
enactment of this Act. 
(b) REGULATIONS.—Not later than 1 year after the 
date of the enactment of this Act, such regulations as are 
necessary to carry out this subtitle and the amendments 
made by this subtitle shall be prescribed. 
Subtitle B—Opioid Addiction 
Recovery Fraud Prevention 
SEC. 8021. SHORT TITLE. 
This subtitle may be cited as the ‘‘Opioid Addiction 
Recovery Fraud Prevention Act of 2018’’. 
SEC. 8022. DEFINITIONS. 
For purposes of this subtitle only, and not be construed 
or applied as to challenge or affect the characterization, def-
inition, or treatment under any other statute, regulation, 
or rule: 
(1) SUBSTANCE
USE
DISORDER
TREATMENT 
PRODUCT.—The term ‘‘substance use disorder treat-
ment product’’ means a product for use or marketed
489 
for use in the treatment, cure, or prevention of a sub-
stance use disorder, including an opioid use disorder. 
(2) SUBSTANCE
USE
DISORDER
TREATMENT 
SERVICE.—The term ‘‘substance use disorder treat-
ment service’’ means a service that purports to pro-
vide referrals to treatment, treatment, or recovery 
housing for people diagnosed with, having, or pur-
porting to have a substance use disorder, including an 
opioid use disorder. 
SEC. 8023. UNFAIR OR DECEPTIVE ACTS OR PRACTICES 
WITH RESPECT TO SUBSTANCE USE DIS-
ORDER TREATMENT SERVICE AND PROD-
UCTS. 
(a) UNLAWFUL ACTIVITY.—It is unlawful to engage in 
an unfair or deceptive act or practice with respect to any 
substance use disorder treatment service or substance use 
disorder treatment product. 
(b) ENFORCEMENT BY THE FEDERAL TRADE COMMIS-
SION.— 
(1) UNFAIR
OR
DECEPTIVE
ACTS
OR
PRAC-
TICES.—A violation of subsection (a) shall be treated 
as a violation of a rule under section 18 of the Fed-
eral Trade Commission Act (15 U.S.C. 57a) regard-
ing unfair or deceptive acts or practices.
490 
(2) POWERS OF THE FEDERAL TRADE COMMIS-
SION.— 
(A) IN GENERAL.—The Federal Trade Com-
mission shall enforce this section in the same 
manner, by the same means, and with the same 
jurisdiction, powers, and duties as though all ap-
plicable terms and provisions of the Federal 
Trade Commission Act (15 U.S.C. 41 et seq.) 
were incorporated into and made a part of this 
section. 
(B) PRIVILEGES
AND
IMMUNITIES.—Any 
person who violates subsection (a) shall be sub-
ject to the penalties and entitled to the privileges 
and immunities provided in the Federal Trade 
Commission Act as though all applicable terms 
and provisions of the Federal Trade Commission 
Act (15 U.S.C. 41 et seq.) were incorporated and 
made part of this section. 
(c) AUTHORITY PRESERVED.—Nothing in this subtitle 
shall be construed to limit the authority of the Federal 
Trade Commission or the Food and Drug Administration 
under any other provision of law.
491 
Subtitle C—Addressing Economic 
and Workforce Impacts of the 
Opioid Crisis 
SEC. 8041. ADDRESSING ECONOMIC AND WORKFORCE IM-
PACTS OF THE OPIOID CRISIS. 
(a) DEFINITIONS.—Except as otherwise expressly pro-
vided, in this section: 
(1) WIOA DEFINITIONS.—The terms ‘‘core pro-
gram’’, ‘‘individual with a barrier to employment’’, 
‘‘local area’’, ‘‘local board’’, ‘‘one-stop operator’’, ‘‘out-
lying area’’, ‘‘State’’, ‘‘State board’’, and ‘‘supportive 
services’’ have the meanings given the terms in section 
3 of the Workforce Innovation and Opportunity Act 
(29 U.S.C. 3102). 
(2) EDUCATION
PROVIDER.—The term ‘‘edu-
cation provider’’ means— 
(A) an institution of higher education, as 
defined in section 101 of the Higher Education 
Act of 1965 (20 U.S.C. 1001); or 
(B) a postsecondary vocational institution, 
as defined in section 102(c) of such Act (20 
U.S.C. 1002(c)). 
(3) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means— 
(A) a State workforce agency;
492 
(B) an outlying area; or 
(C) a Tribal entity. 
(4) PARTICIPATING
PARTNERSHIP.—The term 
‘‘participating partnership’’ means a partnership— 
(A) evidenced by a written contract or 
agreement; and 
(B) including, as members of the partner-
ship, a local board receiving a subgrant under 
subsection (d) and 1 or more of the following: 
(i) The eligible entity. 
(ii) A treatment provider. 
(iii) An employer or industry organi-
zation. 
(iv) An education provider. 
(v) A legal service or law enforcement 
organization. 
(vi) A faith-based or community-based 
organization. 
(vii) Other State or local agencies, in-
cluding counties or local governments. 
(viii) Other organizations, as deter-
mined to be necessary by the local board. 
(ix) Indian Tribes or tribal organiza-
tions.
493 
(5) PROGRAM
PARTICIPANT.—The term ‘‘pro-
gram participant’’ means an individual who— 
(A) is a member of a population of workers 
described in subsection (e)(2) that is served by a 
participating partnership through the pilot pro-
gram under this section; and 
(B) enrolls with the applicable partici-
pating partnership to receive any of the services 
described in subsection (e)(3). 
(6) PROVIDER
OF
PEER
RECOVERY
SUPPORT 
SERVICES.—The term ‘‘provider of peer recovery sup-
port services’’ means a provider that delivers peer re-
covery support services through an organization de-
scribed in section 547(a) of the Public Health Service 
Act (42 U.S.C. 290ee–2(a)). 
(7) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Labor. 
(8) STATE
WORKFORCE
AGENCY.—The term 
‘‘State workforce agency’’ means the lead State agency 
with responsibility for the administration of a pro-
gram under chapter 2 or 3 of subtitle B of title I of 
the Workforce Innovation and Opportunity Act (29 
U.S.C. 3161 et seq., 3171 et seq.). 
(9) SUBSTANCE USE DISORDER.—The term ‘‘sub-
stance use disorder’’ has the meaning given such term
494 
by the Assistant Secretary for Mental Health and 
Substance Use. 
(10) TREATMENT PROVIDER.—The term ‘‘treat-
ment provider’’— 
(A) means a health care provider that— 
(i) offers services for treating substance 
use disorders and is licensed in accordance 
with applicable State law to provide such 
services; and 
(ii) accepts health insurance for such 
services, including coverage under title XIX 
of the Social Security Act (42 U.S.C. 1396 
et seq.); and 
(B) may include— 
(i) a nonprofit provider of peer recov-
ery support services; 
(ii) a community health care provider; 
(iii) a Federally qualified health center 
(as defined in section 1861(aa) of the Social 
Security Act (42 U.S.C. 1395x)); 
(iv) an Indian health program (as de-
fined in section 3 of the Indian Health Care 
Improvement Act (25 U.S.C. 1603)), includ-
ing an Indian health program that serves
495 
an urban center (as defined in such sec-
tion); and 
(v) a Native Hawaiian health center 
(as defined in section 12 of the Native Ha-
waiian Health Care Improvement Act (42 
U.S.C. 11711)). 
(11) TRIBAL ENTITY.—The term ‘‘Tribal entity’’ 
includes any Indian Tribe, tribal organization, In-
dian-controlled organization serving Indians, Native 
Hawaiian organization, or Alaska Native entity, as 
such terms are defined or used in section 166 of the 
Workforce Innovation and Opportunity Act (29 
U.S.C. 3221). 
(b) PILOT PROGRAM AND GRANTS AUTHORIZED.— 
(1) IN GENERAL.—The Secretary, in consultation 
with the Secretary of Health and Human Services, 
shall carry out a pilot program to address economic 
and workforce impacts associated with a high rate of 
a substance use disorder. In carrying out the pilot 
program, the Secretary shall make grants, on a com-
petitive basis, to eligible entities to enable such enti-
ties to make subgrants to local boards to address the 
economic and workforce impacts associated with a 
high rate of a substance use disorder.
496 
(2) GRANT AMOUNTS.—The Secretary shall make 
each such grant in an amount that is not less than 
$500,000, and not more than $5,000,000, for a fiscal 
year. 
(c) GRANT APPLICATIONS.— 
(1) IN GENERAL.—An eligible entity applying 
for a grant under this section shall submit an appli-
cation to the Secretary at such time and in such form 
and manner as the Secretary may reasonably require, 
including the information described in this sub-
section. 
(2) SIGNIFICANT
IMPACT
ON
COMMUNITY
BY 
OPIOID
AND
SUBSTANCE
USE
DISORDER-RELATED 
PROBLEMS.— 
(A) DEMONSTRATION.—An eligible entity 
shall include in the application— 
(i) information that demonstrates sig-
nificant impact on the community by prob-
lems related to opioid abuse or another sub-
stance use disorder, by— 
(I) identifying the counties, com-
munities, regions, or local areas that 
have been significantly impacted and 
will be served through the grant (each
497 
referred to in this section as a ‘‘service 
area’’); and 
(II) demonstrating for each such 
service area, an increase equal to or 
greater than the national increase in 
such problems, between— 
(aa) 1999; and 
(bb) 2016 or the latest year 
for which data are available; and 
(ii) a description of how the eligible 
entity will prioritize support for signifi-
cantly impacted service areas described in 
clause (i)(I). 
(B) INFORMATION.—To meet the require-
ments described in subparagraph (A)(i)(II), the 
eligible entity may use information including 
data on— 
(i) the incidence or prevalence of 
opioid abuse and other substance use dis-
orders; 
(ii) the age-adjusted rate of drug over-
dose deaths, as determined by the Director 
of the Centers for Disease Control and Pre-
vention;
498 
(iii) the rate of non-fatal hospitaliza-
tions related to opioid abuse or other sub-
stance use disorders; 
(iv) the number of arrests or convic-
tions, or a relevant law enforcement sta-
tistic, that reasonably shows an increase in 
opioid abuse or another substance use dis-
order; or 
(v) in the case of an eligible entity de-
scribed in subsection (a)(3)(C), other alter-
native relevant data as determined appro-
priate by the Secretary. 
(C) SUPPORT FOR STATE STRATEGY.—The 
eligible entity may include in the application in-
formation describing how the proposed services 
and activities are aligned with the State, out-
lying area, or Tribal strategy, as applicable, for 
addressing problems described in subparagraph 
(A) in specific service areas or across the State, 
outlying area, or Tribal land. 
(3) ECONOMIC
AND
EMPLOYMENT
CONDITIONS 
DEMONSTRATE ADDITIONAL FEDERAL SUPPORT NEED-
ED.— 
(A) DEMONSTRATION.—An eligible entity 
shall include in the application information that
499 
demonstrates that a high rate of a substance use 
disorder has caused, or is coincident to— 
(i) an economic or employment down-
turn in the service area; or 
(ii) persistent economically depressed 
conditions in such service area. 
(B) INFORMATION.—To meet the require-
ments of subparagraph (A), an eligible entity 
may use information including— 
(i) documentation of any layoff, an-
nounced future layoff, legacy industry de-
cline, decrease in an employment or labor 
market participation rate, or economic im-
pact, whether or not the result described in 
this clause is overtly related to a high rate 
of a substance use disorder; 
(ii) documentation showing decreased 
economic activity related to, caused by, or 
contributing to a high rate of a substance 
use disorder, including a description of how 
the service area has been impacted, or will 
be impacted, by such a decrease; 
(iii) information on economic indica-
tors, labor market analyses, information
500 
from public announcements, and demo-
graphic and industry data; 
(iv) information on rapid response ac-
tivities (as defined in section 3 of the Work-
force Innovation and Opportunity Act (29 
U.S.C. 3102)) that have been or will be con-
ducted, including demographic data gath-
ered by employer or worker surveys or 
through other methods; 
(v) data or documentation, beyond an-
ecdotal evidence, showing that employers 
face challenges filling job vacancies due to a 
lack of skilled workers able to pass a drug 
test; or 
(vi) any additional relevant data or 
information on the economy, workforce, or 
another aspect of the service area to support 
the application. 
(d) SUBGRANT AUTHORIZATION
AND APPLICATION 
PROCESS.— 
(1) SUBGRANTS AUTHORIZED.— 
(A) IN GENERAL.—An eligible entity receiv-
ing a grant under subsection (b)—
501 
(i) may use not more than 5 percent of 
the grant funds for the administrative costs 
of carrying out the grant; 
(ii) in the case of an eligible entity de-
scribed in subparagraph (A) or (B) of sub-
section (a)(3), shall use the remaining grant 
funds to make subgrants to local entities in 
the service area to carry out the services 
and activities described in subsection (e); 
and 
(iii) in the case of an eligible entity 
described in subsection (a)(3)(C), shall use 
the remaining grant funds to carry out the 
services and activities described in sub-
section (e). 
(B) EQUITABLE DISTRIBUTION.—In making 
subgrants under this subsection, an eligible enti-
ty shall ensure, to the extent practicable, the eq-
uitable distribution of subgrants, based on— 
(i) geography (such as urban and rural 
distribution); and 
(ii) 
significantly 
impacted 
service 
areas as described in subsection (c)(2). 
(C) TIMING OF SUBGRANT FUNDS DISTRIBU-
TION.—An eligible entity making subgrants
502 
under this subsection shall disburse subgrant 
funds to a local board receiving a subgrant from 
the eligible entity by the later of— 
(i) the date that is 90 days after the 
date on which the Secretary makes the 
funds available to the eligible entity; or 
(ii) the date that is 15 days after the 
date that the eligible entity makes the 
subgrant under subparagraph (A)(ii). 
(2) SUBGRANT APPLICATION.— 
(A) IN GENERAL.—A local board desiring to 
receive a subgrant under this subsection from an 
eligible entity shall submit an application at 
such time and in such manner as the eligible en-
tity may reasonably require, including the infor-
mation described in this paragraph. 
(B) 
CONTENTS.—Each 
application 
de-
scribed in subparagraph (A) shall include— 
(i) an analysis of the estimated per-
formance of the local board in carrying out 
the proposed services and activities under 
the subgrant— 
(I) based on— 
(aa) primary indicators of 
performance described in section
503 
116(c)(1)(A)(i) of the Workforce 
Innovation and Opportunity Act 
(29 U.S.C. 3141(c)(1)(A)(i), to as-
sess estimated effectiveness of the 
proposed services and activities, 
including the estimated number of 
individuals with a substance use 
disorder who may be served by the 
proposed services and activities; 
(bb) the record of the local 
board in serving individuals with 
a barrier to employment; and 
(cc) the ability of the local 
board to establish a participating 
partnership; and 
(II) which may include or uti-
lize— 
(aa) data from the National 
Center for Health Statistics of the 
Centers for Disease Control and 
Prevention; 
(bb) data from the Center for 
Behavioral Health Statistics and 
Quality of the Substance Abuse
504 
and Mental Health Services Ad-
ministration; 
(cc) State vital statistics; 
(dd) municipal police de-
partment records; 
(ee) reports from local coro-
ners; or 
(ff) other relevant data; and 
(ii) in the case of a local board pro-
posing to serve a population described in 
subsection (e)(2)(B), a demonstration of the 
workforce shortage in the professional area 
to be addressed under the subgrant (which 
may include substance use disorder treat-
ment and related services, non-addictive 
pain therapy and pain management serv-
ices, mental health care treatment services, 
emergency response services, or mental 
health care), which shall include informa-
tion that can demonstrate such a shortage, 
such as— 
(I) the distance between— 
(aa) communities affected by 
opioid abuse or another substance 
use disorder; and
505 
(bb) facilities or professionals 
offering services in the profes-
sional area; or 
(II) the maximum capacity of fa-
cilities or professionals to serve indi-
viduals in an affected community, or 
increases in arrests related to opioid or 
another substance use disorder, over-
dose deaths, or nonfatal overdose emer-
gencies in the community. 
(e) SUBGRANT SERVICES AND ACTIVITIES.— 
(1) IN GENERAL.—Each local board that receives 
a subgrant under subsection (d) shall carry out the 
services and activities described in this subsection 
through a participating partnership. 
(2) 
SELECTION
OF
POPULATION
TO
BE 
SERVED.—A participating partnership shall elect to 
provide services and activities under the subgrant to 
one or both of the following populations of workers: 
(A) Workers, including dislocated workers, 
individuals with barriers to employment, new 
entrants in the workforce, or incumbent workers 
(employed or underemployed), each of whom— 
(i) is directly or indirectly affected by 
a high rate of a substance use disorder; and
506 
(ii) voluntarily confirms that the work-
er, or a friend or family member of the 
worker, has a history of opioid abuse or an-
other substance use disorder. 
(B) Workers, including dislocated workers, 
individuals with barriers to employment, new 
entrants in the workforce, or incumbent workers 
(employed or underemployed), who— 
(i) seek to transition to professions that 
support individuals with a substance use 
disorder or at risk for developing such dis-
order, such as professions that provide— 
(I) substance use disorder treat-
ment and related services; 
(II) services offered through pro-
viders of peer recovery support services; 
(III) non-addictive pain therapy 
and pain management services; 
(IV) emergency response services; 
or 
(V) mental health care; and 
(ii) need new or upgraded skills to bet-
ter serve such a population of struggling or 
at-risk individuals.
507 
(3) SERVICES AND ACTIVITIES.—Each partici-
pating partnership shall use funds available through 
a subgrant under this subsection to carry out 1 or 
more of the following: 
(A) 
ENGAGING
EMPLOYERS.—Engaging 
with employers to— 
(i) learn about the skill and hiring re-
quirements of employers; 
(ii) learn about the support needed by 
employers to hire and retain program par-
ticipants, and other individuals with a sub-
stance use disorder, and the support needed 
by such employers to obtain their commit-
ment to testing creative solutions to employ-
ing program participants and such individ-
uals; 
(iii) connect employers and workers to 
on-the-job or customized training programs 
before or after layoff to help facilitate reem-
ployment; 
(iv) connect employers with an edu-
cation provider to develop classroom in-
struction to complement on-the-job learning 
for program participants and such individ-
uals;
508 
(v) help employers develop the cur-
riculum design of a work-based learning 
program for program participants and such 
individuals; 
(vi) help employers employ program 
participants or such individuals engaging 
in a work-based learning program for a 
transitional period before hiring such a pro-
gram participant or individual for full-time 
employment of not less than 30 hours a 
week; or 
(vii) connect employers to program 
participants receiving concurrent outpatient 
treatment and job training services. 
(B) 
SCREENING
SERVICES.—Providing 
screening services, which may include— 
(i) using an evidence-based screening 
method to screen each individual seeking 
participation in the pilot program to deter-
mine whether the individual has a sub-
stance use disorder; 
(ii) conducting an assessment of each 
such individual to determine the services 
needed for such individual to obtain or re-
509 
tain employment, including an assessment 
of strengths and general work readiness; or 
(iii) accepting walk-ins or referrals 
from employers, labor organizations, or 
other entities recommending individuals to 
participate in such program. 
(C) INDIVIDUAL TREATMENT AND EMPLOY-
MENT
PLAN.—Developing an individual treat-
ment and employment plan for each program 
participant— 
(i) in coordination, as appropriate, 
with other programs serving the participant 
such as the core programs within the work-
force development system under the Work-
force Innovation and Opportunity Act (29 
U.S.C. 3101 et seq.); and 
(ii) which shall include providing a 
case manager to work with each participant 
to develop the plan, which may include— 
(I) identifying employment and 
career goals; 
(II) exploring career pathways 
that lead to in-demand industries and 
sectors, as determined by the State 
board and the head of the State work-
510 
force agency or, as applicable, the 
Tribal entity; 
(III) setting appropriate achieve-
ment objectives to attain the employ-
ment and career goals identified under 
subclause (I); or 
(IV) developing the appropriate 
combination of services to enable the 
participant to achieve the employment 
and career goals identified under sub-
clause (I). 
(D) OUTPATIENT TREATMENT AND RECOV-
ERY CARE.—In the case of a participating part-
nership serving program participants described 
in paragraph (2)(A) with a substance use dis-
order, providing individualized and group out-
patient treatment and recovery services for such 
program participants that are offered during the 
day and evening, and on weekends. Such treat-
ment and recovery services— 
(i) shall be based on a model that uti-
lizes combined behavioral interventions and 
other evidence-based or evidence-informed 
interventions; and
511 
(ii) may include additional services 
such as— 
(I) health, mental health, addic-
tion, or other forms of outpatient treat-
ment that may impact a substance use 
disorder and co-occurring conditions; 
(II) drug testing for a current 
substance use disorder prior to enroll-
ment in career or training services or 
prior to employment; 
(III) linkages to community serv-
ices, including services offered by part-
ner organizations designed to support 
program participants; or 
(IV) referrals to health care, in-
cluding referrals to substance use dis-
order treatment and mental health 
services. 
(E) 
SUPPORTIVE
SERVICES.—Providing 
supportive services, which shall include services 
such as— 
(i) coordinated wraparound services to 
provide maximum support for program 
participants to assist the program partici-
pants in maintaining employment and re-
512 
covery for not less than 12 months, as ap-
propriate; 
(ii) assistance in establishing eligi-
bility for assistance under Federal, State, 
Tribal, and local programs providing health 
services, mental health services, vocational 
services, housing services, transportation 
services, social services, or services through 
early childhood education programs (as de-
fined in section 103 of the Higher Edu-
cation Act of 1965 (20 U.S.C. 1003)); 
(iii) services offered through providers 
of peer recovery support services; 
(iv) networking and mentorship oppor-
tunities; or 
(v) any supportive services determined 
necessary by the local board. 
(F) CAREER
AND
JOB
TRAINING
SERV-
ICES.—Offering career services and training 
services, and related services, concurrently or se-
quentially with the services provided under sub-
paragraphs (B) through (E). Such services shall 
include the following:
513 
(i) Services provided to program par-
ticipants who are in a pre-employment 
stage of the program, which may include— 
(I) initial education and skills as-
sessments; 
(II) traditional classroom train-
ing funded through individual training 
accounts under chapter 3 of subtitle B 
of title I of the Workforce Innovation 
and Opportunity Act (29 U.S.C. 3171 
et seq.); 
(III) services to promote employ-
ability skills such as punctuality, per-
sonal maintenance skills, and profes-
sional conduct; 
(IV) in-depth interviewing and 
evaluation to identify employment bar-
riers and to develop individual em-
ployment plans; 
(V) career planning that in-
cludes— 
(aa) career pathways leading 
to in-demand, high-wage jobs; and 
(bb) job coaching, job match-
ing, and job placement services;
514 
(VI) provision of payments and 
fees for employment and training-re-
lated applications, tests, and certifi-
cations; or 
(VII) any other appropriate ca-
reer service or training service de-
scribed in section 134(c) of the Work-
force Innovation and Opportunity Act 
(29 U.S.C. 3174(c)). 
(ii) Services provided to program par-
ticipants during their first 6 months of em-
ployment to ensure job retention, which 
may include— 
(I) case management and support 
services, including a continuation of 
the services described in clause (i); 
(II) a continuation of skills train-
ing, and career and technical edu-
cation, described in clause (i) that is 
conducted in collaboration with the 
employers of such participants; 
(III) mentorship services and job 
retention support for such partici-
pants; or
515 
(IV) targeted training for man-
agers and workers working with such 
participants (such as mentors), and 
human resource representatives in the 
business in which such participants 
are employed. 
(iii) Services to assist program partici-
pants in maintaining employment for not 
less than 12 months, as appropriate. 
(G) PROVEN AND PROMISING PRACTICES.— 
Leading efforts in the service area to identify 
and promote proven and promising strategies 
and initiatives for meeting the needs of employ-
ers and program participants. 
(4) LIMITATIONS.—A participating partnership 
may not use— 
(A) more than 10 percent of the funds re-
ceived under a subgrant under subsection (d) for 
the administrative costs of the partnership; 
(B) more than 10 percent of the funds re-
ceived under such subgrant for the provision of 
treatment and recovery services, as described in 
paragraph (3)(D); and 
(C) more than 10 percent of the funds re-
ceived under such subgrant for the provision of
516 
supportive services described in paragraph 
(3)(E) to program participants. 
(f) PERFORMANCE ACCOUNTABILITY.— 
(1) REPORTS.—The Secretary shall establish 
quarterly reporting requirements for recipients of 
grants and subgrants under this section that, to the 
extent practicable, are based on the performance ac-
countability system under section 116 of the Work-
force Innovation and Opportunity Act (29 U.S.C. 
3141) and, in the case of a grant awarded to an eligi-
ble entity described in subsection (a)(3)(C), section 
166(h) of such Act (29 U.S.C. 3221(h)), including the 
indicators described in subsection (c)(1)(A)(i) of such 
section 116 and the requirements for local area per-
formance reports under subsection (d) of such section 
116. 
(2) EVALUATIONS.— 
(A) AUTHORITY
TO
ENTER
INTO
AGREE-
MENTS.—The Secretary shall ensure that an 
independent evaluation is conducted on the pilot 
program carried out under this section to deter-
mine the impact of the program on employment 
of individuals with substance use disorders. The 
Secretary shall enter into an agreement with eli-
517 
gible entities receiving grants under this section 
to pay for all or part of such evaluation. 
(B) METHODOLOGIES
TO
BE
USED.—The 
independent evaluation required under this 
paragraph shall use experimental designs using 
random assignment or, when random assignment 
is not feasible, other reliable, evidence-based re-
search methodologies that allow for the strongest 
possible causal inferences. 
(g) FUNDING.— 
(1) COVERED FISCAL YEAR.—In this subsection, 
the term ‘‘covered fiscal year’’ means any of fiscal 
years 2019 through 2023. 
(2) USING FUNDING FOR NATIONAL DISLOCATED 
WORKER GRANTS.—Subject to paragraph (4) and not-
withstanding section 132(a)(2)(A) and subtitle D of 
the Workforce Innovation and Opportunity Act (29 
U.S.C. 3172(a)(2)(A), 3221 et seq.), the Secretary 
may use, to carry out the pilot program under this 
section for a covered fiscal year— 
(A) funds made available to carry out sec-
tion 170 of such Act (29 U.S.C. 3225) for that 
fiscal year;
518 
(B) funds made available to carry out sec-
tion 170 of such Act that remain available for 
that fiscal year; and 
(C) funds that remain available under sec-
tion 172(f) of such Act (29 U.S.C. 3227(f)). 
(3) AVAILABILITY
OF
FUNDS.—Funds appro-
priated under section 136(c) of such Act (29 U.S.C. 
3181(c)) and made available to carry out section 170 
of such Act for a fiscal year shall remain available 
for use under paragraph (2) for a subsequent fiscal 
year until expended. 
(4) LIMITATION.—The Secretary may not use 
more than $100,000,000 of the funds described in 
paragraph (2) for any covered fiscal year under this 
section. 
Subtitle D—Peer Support Coun-
seling Program for Women Vet-
erans 
SEC. 8051. PEER SUPPORT COUNSELING PROGRAM FOR 
WOMEN VETERANS. 
(a) IN GENERAL.—Section 1720F(j) of title 38, United 
States Code, is amended by adding at the end the following 
new paragraph: 
‘‘(4)(A) As part of the counseling program under this 
subsection, the Secretary shall emphasize appointing peer
519 
support counselors for women veterans. To the degree prac-
ticable, the Secretary shall seek to recruit women peer sup-
port counselors with expertise in— 
‘‘(i) female gender-specific issues and services; 
‘‘(ii) the provision of information about services 
and benefits provided under laws administered by the 
Secretary; or 
‘‘(iii) employment mentoring. 
‘‘(B) To the degree practicable, the Secretary shall em-
phasize facilitating peer support counseling for women vet-
erans who are eligible for counseling and services under sec-
tion 1720D of this title, have post-traumatic stress disorder 
or suffer from another mental health condition, are homeless 
or at risk of becoming homeless, or are otherwise at in-
creased risk of suicide, as determined by the Secretary. 
‘‘(C) The Secretary shall conduct outreach to inform 
women veterans about the program and the assistance 
available under this paragraph. 
‘‘(D) In carrying out this paragraph, the Secretary 
shall coordinate with such community organizations, State 
and local governments, institutions of higher education, 
chambers of commerce, local business organizations, organi-
zations that provide legal assistance, and other organiza-
tions as the Secretary considers appropriate.
520 
‘‘(E) In carrying out this paragraph, the Secretary 
shall provide adequate training for peer support counselors, 
including training carried out under the national program 
of training required by section 304(c) of the Caregivers and 
Veterans Omnibus Health Services Act of 2010 (38 U.S.C. 
1712A note).’’. 
(b) FUNDING.—The Secretary of Veterans Affairs shall 
carry out paragraph (4) of section 1720F(j) of title 38, 
United States Code, as added by subsection (a), using funds 
otherwise made available to the Secretary. No additional 
funds are authorized to be appropriated by reason of such 
paragraph. 
(c) REPORT TO CONGRESS.—Not later than 2 years 
after the date of the enactment of this Act, the Secretary 
of Veterans Affairs shall submit to the Committees on Vet-
erans’ Affairs of the Senate and House of Representatives 
a report on the peer support counseling program under sec-
tion 1720F(j) of title 38, United States Code, as amended 
by this section. Such report shall include— 
(1) the number of peer support counselors in the 
program; 
(2) an assessment of the effectiveness of the pro-
gram; and 
(3) a description of the oversight of the program.
521 
Subtitle E—Treating Barriers to 
Prosperity 
SEC. 8061. SHORT TITLE. 
This subtitle may be cited as the ‘‘Treating Barriers 
to Prosperity Act of 2018’’. 
SEC. 8062. DRUG ABUSE MITIGATION INITIATIVE. 
(a) IN GENERAL.—Chapter 145 of title 40, United 
States Code, is amended by inserting after section 14509 
the following: 
‘‘§ 14510. Drug abuse mitigation initiative 
‘‘(a) IN GENERAL.—The Appalachian Regional Com-
mission may provide technical assistance to, make grants 
to, enter into contracts with, or otherwise provide amounts 
to individuals or entities in the Appalachian region for 
projects and activities to address drug abuse, including 
opioid abuse, in the region, including projects and activi-
ties— 
‘‘(1) to facilitate the sharing of best practices 
among States, counties, and other experts in the re-
gion with respect to reducing such abuse; 
‘‘(2) to initiate or expand programs designed to 
eliminate or reduce the harm to the workforce and 
economic growth of the region that results from such 
abuse;
522 
‘‘(3) to attract and retain relevant health care 
services, businesses, and workers; and 
‘‘(4) to develop relevant infrastructure, including 
broadband infrastructure that supports the use of tele-
medicine. 
‘‘(b) LIMITATION ON AVAILABLE AMOUNTS.—Of the 
cost of any activity eligible for a grant under this section— 
‘‘(1) not more than 50 percent may be provided 
from amounts appropriated to carry out this section; 
and 
‘‘(2) notwithstanding paragraph (1)— 
‘‘(A) in the case of a project to be carried 
out in a county for which a distressed county 
designation is in effect under section 14526, not 
more than 80 percent may be provided from 
amounts appropriated to carry out this section; 
and 
‘‘(B) in the case of a project to be carried 
out in a county for which an at-risk designation 
is in effect under section 14526, not more than 
70 percent may be provided from amounts ap-
propriated to carry out this section. 
‘‘(c) SOURCES OF ASSISTANCE.—Subject to subsection 
(b), a grant provided under this section may be provided
523 
from amounts made available to carry out this section in 
combination with amounts made available— 
‘‘(1) under any other Federal program (subject 
to the availability of subsequent appropriations); or 
‘‘(2) from any other source. 
‘‘(d) FEDERAL SHARE.—Notwithstanding any provi-
sion of law limiting the Federal share under any other Fed-
eral program, amounts made available to carry out this sec-
tion may be used to increase that Federal share, as the Ap-
palachian Regional Commission determines to be appro-
priate.’’. 
(b) CLERICAL AMENDMENT.—The analysis for chapter 
145 of title 40, United States Code, is amended by inserting 
after the item relating to section 14509 the following: 
‘‘14510. Drug abuse mitigation initiative.’’. 
Subtitle F—Pilot Program to Help 
Individuals in Recovery From a 
Substance Use Disorder Become 
Stably Housed 
SEC. 8071. PILOT PROGRAM TO HELP INDIVIDUALS IN RE-
COVERY FROM A SUBSTANCE USE DISORDER 
BECOME STABLY HOUSED. 
(a) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated under this section such sums 
as may be necessary for each of fiscal years 2019 through 
2023 for assistance to States to provide individuals in re-
524 
covery from a substance use disorder stable, temporary 
housing for a period of not more than 2 years or until the 
individual secures permanent housing, whichever is earlier. 
(b) ALLOCATION OF APPROPRIATED AMOUNTS.— 
(1) IN GENERAL.—The amounts appropriated or 
otherwise made available to States under this section 
shall be allocated based on a funding formula estab-
lished by the Secretary of Housing and Urban Devel-
opment (referred to in this section as the ‘‘Secretary’’) 
not later than 60 days after the date of enactment of 
this Act. 
(2) CRITERIA.— 
(A) IN GENERAL.—The funding formula re-
quired under paragraph (1) shall ensure that 
any amounts appropriated or otherwise made 
available under this section are allocated to 
States with an age-adjusted rate of drug overdose 
deaths that is above the national overdose mor-
tality rate, according to the Centers for Disease 
Control and Prevention. 
(B) PRIORITY.— 
(i) IN GENERAL.—Among such States, 
priority shall be given to States with the 
greatest need, as such need is determined by 
the Secretary based on the following factors,
525 
and weighting such factors as described in 
clause (ii): 
(I) The highest average rates of 
unemployment 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 pro-
vided by the Bureau of Labor Statis-
tics for calendar years 2013 through 
2017. 
(III) The highest age-adjusted 
rates of drug overdose deaths based on 
data from the Centers for Disease Con-
trol and Prevention. 
(ii) 
WEIGHTING.—The 
factors 
de-
scribed in clause (i) shall be weighted as fol-
lows: 
(I) The rate described in clause 
(i)(I) shall be weighted at 15 percent. 
(II) The rate described in clause 
(i)(II) shall be weighted at 15 percent. 
(III) The rate described in clause 
(i)(III) shall be weighted at 70 percent.
526 
(3) DISTRIBUTION.—Amounts appropriated or 
otherwise made available under this section shall be 
distributed according to the funding formula estab-
lished by the Secretary under paragraph (1) not later 
than 30 days after the establishment of such formula. 
(c) USE OF FUNDS.— 
(1) IN
GENERAL.—Any State that receives 
amounts pursuant to this section shall expend at least 
30 percent of such funds within one year of the date 
funds become available to the grantee for obligation. 
(2) PRIORITY.—Any State that receives amounts 
pursuant to this section shall distribute such amounts 
giving priority to entities with the greatest need and 
ability to deliver effective assistance in a timely man-
ner. 
(3) ADMINISTRATIVE COSTS.—Any State that re-
ceives amounts pursuant to this section may use up 
to 5 percent of any grant for administrative costs. 
(d) RULES OF CONSTRUCTION.— 
(1) IN GENERAL.—Except as otherwise provided 
by this section, amounts appropriated, or amounts 
otherwise made available to States under this section 
shall be treated as though such funds were community 
development block grant funds under title I of the
527 
Housing and Community Development Act of 1974 
(42 U.S.C. 5301 et seq.). 
(2) NO MATCH.—No matching funds shall be re-
quired in order for a State to receive any amounts 
under this section. 
(e) AUTHORITY TO WAIVE OR SPECIFY ALTERNATIVE 
REQUIREMENTS.— 
(1) 
IN
GENERAL.—In 
administering 
any 
amounts appropriated or otherwise made available 
under this section, the Secretary may waive or specify 
alternative requirements to any provision under title 
I of the Housing and Community Development Act of 
1974 (42 U.S.C. 5301 et seq.) except for requirements 
related to fair housing, nondiscrimination, labor 
standards, the environment, and requirements that 
activities benefit persons of low- and moderate-in-
come, upon a finding that such a waiver is necessary 
to expedite or facilitate the use of such funds. 
(2) NOTICE
OF
INTENT.—The Secretary shall 
provide written notice of its intent to exercise the au-
thority to specify alternative requirements under 
paragraph (1) to the Committee on Banking, Hous-
ing, and Urban Affairs of the Senate and the Com-
mittee on Financial Services of the House of Rep-
528 
resentatives not later than 15 business days before 
such exercise of authority occurs. 
(3) NOTICE
TO
THE
PUBLIC.—The Secretary 
shall provide written notice of its intent to exercise 
the authority to specify alternative requirements 
under paragraph (1) to the public via notice, on the 
internet website of the Department of Housing and 
Urban Development, and by other appropriate means, 
not later than 15 business days before such exercise of 
authority occurs. 
(f) TECHNICAL ASSISTANCE.—For the 2-year period 
following the date of enactment of this Act, the Secretary 
may use not more than 2 percent of the funds made avail-
able under this section for technical assistance to grantees. 
(g) STATE.—For purposes of this section the term 
‘‘State’’ includes any State as defined in section 102 of the 
Housing and Community Development Act of 1974 (42 
U.S.C. 5302) and the District of Columbia. 
Subtitle G—Human Services 
SEC. 8081. SUPPORTING FAMILY-FOCUSED RESIDENTIAL 
TREATMENT. 
(a) DEFINITIONS.—In this section: 
(1) FAMILY-FOCUSED RESIDENTIAL TREATMENT 
PROGRAM.—The 
term 
‘‘family-focused 
residential 
treatment program’’ means a trauma-informed resi-
529 
dential program primarily for substance use disorder 
treatment for pregnant and postpartum women and 
parents and guardians that allows children to reside 
with such women or their parents or guardians dur-
ing treatment to the extent appropriate and applica-
ble. 
(2) MEDICAID PROGRAM.—The term ‘‘Medicaid 
program’’ means the program established under title 
XIX of the Social Security Act (42 U.S.C. 1396 et 
seq.). 
(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(4) TITLE IV–E PROGRAM.—The term ‘‘title IV– 
E program’’ means the program for foster care, pre-
vention, and permanency established under part E of 
title IV of the Social Security Act (42 U.S.C. 670 et 
seq.). 
(b) GUIDANCE
ON FAMILY-FOCUSED RESIDENTIAL 
TREATMENT PROGRAMS.— 
(1) IN GENERAL.—Not later than 180 days after 
the date of enactment of this Act, the Secretary, in 
consultation with divisions of the Department of 
Health and Human Services administering substance 
use disorder or child welfare programs, shall develop 
and issue guidance to States identifying opportunities
530 
to support family-focused residential treatment pro-
grams for the provision of substance use disorder 
treatment. Before issuing such guidance, the Secretary 
shall solicit input from representatives of States, 
health care providers with expertise in addiction med-
icine, obstetrics and gynecology, neonatology, child 
trauma, and child development, health plans, recipi-
ents of family-focused treatment services, and other 
relevant stakeholders. 
(2) ADDITIONAL REQUIREMENTS.—The guidance 
required under paragraph (1) shall include descrip-
tions of the following: 
(A) Existing opportunities and flexibilities 
under the Medicaid program, including under 
waivers authorized under section 1115 or 1915 of 
the Social Security Act (42 U.S.C. 1315, 1396n), 
for States to receive Federal Medicaid funding 
for the provision of substance use disorder treat-
ment for pregnant and postpartum women and 
parents and guardians and, to the extent appli-
cable, their children, in family-focused residen-
tial treatment programs. 
(B) How States can employ and coordinate 
funding provided under the Medicaid program, 
the title IV-E program, and other programs ad-
531 
ministered by the Secretary to support the provi-
sion of treatment and services provided by a 
family-focused residential treatment facility such 
as substance use disorder treatment and services, 
including medication-assisted treatment, family, 
group, and individual counseling, case manage-
ment, parenting education and skills develop-
ment, the provision, assessment, or coordination 
of care and services for children, including nec-
essary assessments and appropriate interven-
tions, non-emergency transportation for nec-
essary care provided at or away from a program 
site, transitional services and supports for fami-
lies leaving treatment, and other services. 
(C) How States can employ and coordinate 
funding provided under the Medicaid program 
and the title IV–E program (including as 
amended by the Family First Prevention Serv-
ices Act enacted under title VII of division E of 
Public Law 115–123, and particularly with re-
spect to the authority under subsections (a)(2)(C) 
and (j) of section 472 and section 474(a)(1) of 
the Social Security Act (42 U.S.C. 672, 
674(a)(1)) (as amended by section 50712 of Pub-
lic Law 115–123) to provide foster care mainte-
532 
nance payments for a child placed with a parent 
who is receiving treatment in a licensed residen-
tial family-based treatment facility for a sub-
stance use disorder) to support placing children 
with their parents in family-focused residential 
treatment programs. 
SEC. 8082. IMPROVING RECOVERY AND REUNIFYING FAMI-
LIES. 
(a) FAMILY RECOVERY AND REUNIFICATION PROGRAM 
REPLICATION PROJECT.—Section 435 of the Social Secu-
rity Act (42 U.S.C. 629e) is amended by adding at the end 
the following: 
‘‘(e) FAMILY RECOVERY
AND REUNIFICATION PRO-
GRAM REPLICATION PROJECT.— 
‘‘(1) PURPOSE.—The purpose of this subsection 
is to provide resources to the Secretary to support the 
conduct and evaluation of a family recovery and re-
unification program replication project (referred to in 
this subsection as the ‘project’) and to determine the 
extent to which such programs may be appropriate 
for use at different intervention points (such as when 
a child is at risk of entering foster care or when a 
child is living with a guardian while a parent is in 
treatment). The family recovery and reunification 
program conducted under the project shall use a re-
533 
covery coach model that is designed to help reunify 
families and protect children by working with parents 
or guardians with a substance use disorder who have 
temporarily lost custody of their children. 
‘‘(2) PROGRAM COMPONENTS.—The family recov-
ery and reunification program conducted under the 
project shall adhere closely to the elements and pro-
tocol determined to be most effective in other recovery 
coaching programs that have been rigorously evalu-
ated and shown to increase family reunification and 
protect children and, consistent with such elements 
and protocol, shall provide such items and services 
as— 
‘‘(A) assessments to evaluate the needs of the 
parent or guardian; 
‘‘(B) assistance in receiving the appropriate 
benefits to aid the parent or guardian in recov-
ery; 
‘‘(C) services to assist the parent or guard-
ian in prioritizing issues identified in assess-
ments, establishing goals for resolving such issues 
that are consistent with the goals of the treat-
ment provider, child welfare agency, courts, and 
other agencies involved with the parent or guard-
534 
ian or their children, and making a coordinated 
plan for achieving such goals; 
‘‘(D) home visiting services coordinated 
with the child welfare agency and treatment pro-
vider involved with the parent or guardian or 
their children; 
‘‘(E) case management services to remove 
barriers for the parent or guardian to partici-
pate and continue in treatment, as well as to re- 
engage a parent or guardian who is not partici-
pating or progressing in treatment; 
‘‘(F) access to services needed to monitor the 
parent’s or guardian’s compliance with program 
requirements; 
‘‘(G) frequent reporting between the treat-
ment provider, child welfare agency, courts, and 
other agencies involved with the parent or guard-
ian or their children to ensure appropriate infor-
mation on the parent’s or guardian’s status is 
available to inform decision-making; and 
‘‘(H) assessments and recommendations 
provided by a recovery coach to the child welfare 
caseworker responsible for documenting the par-
ent’s or guardian’s progress in treatment and re-
covery as well as the status of other areas identi-
535 
fied in the treatment plan for the parent or 
guardian, including a recommendation regard-
ing the expected safety of the child if the child 
is returned to the custody of the parent or guard-
ian that can be used by the caseworker and a 
court to make permanency decisions regarding 
the child. 
‘‘(3) RESPONSIBILITIES OF THE SECRETARY.— 
‘‘(A) IN
GENERAL.—The Secretary shall, 
through a grant or contract with 1 or more enti-
ties, conduct and evaluate the family recovery 
and reunification program under the project. 
‘‘(B) REQUIREMENTS.—In identifying 1 or 
more entities to conduct the evaluation of the 
family recovery and reunification program, the 
Secretary shall— 
‘‘(i) determine that the area or areas 
in which the program will be conducted 
have sufficient substance use disorder treat-
ment providers and other resources (other 
than those provided with funds made avail-
able to carry out the project) to successfully 
conduct the program; 
‘‘(ii) determine that the area or areas 
in which the program will be conducted
536 
have enough potential program partici-
pants, and will serve a sufficient number of 
parents or guardians and their children, so 
as to allow for the formation of a control 
group, evaluation results to be adequately 
powered, and preliminary results of the 
evaluation to be available within 4 years of 
the program’s implementation; 
‘‘(iii) provide the entity or entities 
with technical assistance for the program 
design, including by working with 1 or 
more entities that are or have been involved 
in recovery coaching programs that have 
been rigorously evaluated and shown to in-
crease family reunification and protect chil-
dren so as to make sure the program con-
ducted under the project adheres closely to 
the elements and protocol determined to be 
most effective in such other recovery coach-
ing programs; 
‘‘(iv) assist the entity or entities in se-
curing adequate coaching, treatment, child 
welfare, court, and other resources needed to 
successfully conduct the family recovery and
538 
reunification program under the project to en-
sure— 
‘‘(i) the program’s implementation ad-
heres closely to the elements and protocol de-
termined to be most effective in other recov-
ery coaching programs that have been rigor-
ously evaluated and shown to increase fam-
ily reunification and protect children; and 
‘‘(ii) random assignment of parents or 
guardians and their children to be partici-
pants in the program or to be part of the 
program’s control group is being carried 
out. 
‘‘(C) IMPACT
STUDY.—The impact study 
component of the evaluation shall determine the 
impacts of the family recovery and reunification 
program conducted under the project on the par-
ents and guardians and their children partici-
pating in the program. The impact study compo-
nent shall— 
‘‘(i) be conducted using an experi-
mental design that uses a random assign-
ment research methodology; 
‘‘(ii) consistent with previous studies of 
other recovery coaching programs that have
539 
been rigorously evaluated and shown to in-
crease family reunification and protect chil-
dren, measure outcomes for parents and 
guardians and their children over multiple 
time periods, including for a period of 5 
years; and 
‘‘(iii) include measurements of family 
stability and parent, guardian, and child 
safety for program participants and the 
program control group that are consistent 
with measurements of such factors for par-
ticipants and control groups from previous 
studies of other recovery coaching programs 
so as to allow results of the impact study to 
be compared with the results of such prior 
studies, including with respect to compari-
sons between program participants and the 
program control group regarding— 
‘‘(I) safe family reunification; 
‘‘(II) time to reunification; 
‘‘(III) 
permanency 
(such 
as 
through 
measures 
of 
reunification, 
adoption, or placement with guard-
ians);
540 
‘‘(IV) safety (such as through 
measures of subsequent maltreatment); 
‘‘(V) parental or guardian treat-
ment persistence and engagement; 
‘‘(VI) parental or guardian sub-
stance use; 
‘‘(VII) juvenile delinquency; 
‘‘(VIII) cost; and 
‘‘(IX) other measurements agreed 
upon by the Secretary and the entity 
or entities operating the family recov-
ery and reunification program under 
the project. 
‘‘(D) IMPLEMENTATION STUDY.—The imple-
mentation study component of the evaluation 
shall be conducted concurrently with the conduct 
of the impact study component and shall include, 
in addition to such other information as the Sec-
retary may determine, descriptions and analyses 
of— 
‘‘(i) the adherence of the family recov-
ery and reunification program conducted 
under the project to other recovery coaching 
programs that have been rigorously evalu-
541 
ated and shown to increase family reunifi-
cation and protect children; and 
‘‘(ii) the difference in services received 
or proposed to be received by the program 
participants and the program control 
group. 
‘‘(E) REPORT.—The Secretary shall publish 
on an internet website maintained by the Sec-
retary the following information: 
‘‘(i) A report on the pilot phase compo-
nent of the evaluation. 
‘‘(ii) A report on the impact study 
component of the evaluation. 
‘‘(iii) A report on the implementation 
study component of the evaluation. 
‘‘(iv) A report that includes— 
‘‘(I) analyses of the extent to 
which the program has resulted in in-
creased reunifications, increased per-
manency, case closures, net savings to 
the State or States involved (taking 
into account both costs borne by States 
and the Federal government), or other 
outcomes, or if the program did not 
produce such outcomes, an analysis of
542 
why the replication of the program did 
not yield such results; 
‘‘(II) if, based on such analyses, 
the Secretary determines the program 
should be replicated, a replication 
plan; and 
‘‘(III) such recommendations for 
legislation and administrative action 
as the Secretary determines appro-
priate. 
‘‘(5) APPROPRIATION.—In addition to any 
amounts otherwise made available to carry out this 
subpart, out of any money in the Treasury of the 
United States not otherwise appropriated, there are 
appropriated $15,000,000 for fiscal year 2019 to 
carry out the project, which shall remain available 
through fiscal year 2026.’’. 
(b) CLARIFICATION OF PAYER OF LAST RESORT AP-
PLICATION TO CHILD WELFARE PREVENTION AND FAMILY 
SERVICES.—Section 471(e)(10) of the Social Security Act 
(42 U.S.C. 671(e)(10)), as added by section 50711(a)(2) of 
division E of Public Law 115–123, is amended— 
(1) in subparagraph (A), by inserting ‘‘, nor 
shall the provision of such services or programs be 
construed to permit the State to reduce medical or
543 
other assistance available to a recipient of such serv-
ices or programs’’ after ‘‘under this Act’’; and 
(2) by adding at the end the following: 
‘‘(C) PAYER OF LAST RESORT.—In carrying 
out its responsibilities to ensure access to services 
or programs under this subsection, the State 
agency shall not be considered to be a legally lia-
ble third party for purposes of satisfying a fi-
nancial commitment for the cost of providing 
such services or programs with respect to any in-
dividual for whom such cost would have been 
paid for from another public or private source 
but for the enactment of this subsection (except 
that whenever considered necessary to prevent a 
delay in the receipt of appropriate early inter-
vention services by a child or family in a timely 
fashion, funds provided under section 474(a)(6) 
may be used to pay the provider of services or 
programs pending reimbursement from the pub-
lic or private source that has ultimate responsi-
bility for the payment).’’. 
(c) EFFECTIVE DATE.—The amendments made by sub-
section (b) shall take effect as if included in section 50711 
of division E of Public Law 115–123.
544 
SEC. 8083. BUILDING CAPACITY FOR FAMILY-FOCUSED RES-
IDENTIAL TREATMENT. 
(a) DEFINITIONS.—In this section: 
(1) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means a State, county, local, or tribal health or 
child welfare agency, a private nonprofit organiza-
tion, a research organization, a treatment service pro-
vider, an institution of higher education (as defined 
under section 101 of the Higher Education Act of 
1965 (20 U.S.C. 1001)), or another entity specified by 
the Secretary. 
(2) FAMILY-FOCUSED RESIDENTIAL TREATMENT 
PROGRAM.—The 
term 
‘‘family-focused 
residential 
treatment program’’ means a trauma-informed resi-
dential program primarily for substance use disorder 
treatment for pregnant and postpartum women and 
parents and guardians that allows children to reside 
with such women or their parents or guardians dur-
ing treatment to the extent appropriate and applica-
ble. 
(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(b) SUPPORT FOR THE DEVELOPMENT OF EVIDENCE- 
BASED FAMILY-FOCUSED RESIDENTIAL TREATMENT PRO-
GRAMS.—
545 
(1) AUTHORITY TO AWARD GRANTS.—The Sec-
retary shall award grants to eligible entities for pur-
poses of developing, enhancing, or evaluating family- 
focused residential treatment programs to increase the 
availability of such programs that meet the require-
ments for promising, supported, or well-supported 
practices specified in section 471(e)(4)(C) of the So-
cial Security Act (42 U.S.C. 671(e)(4)(C))) (as added 
by the Family First Prevention Services Act enacted 
under title VII of division E of Public Law 115–123). 
(2) EVALUATION REQUIREMENT.—The Secretary 
shall require any evaluation of a family-focused resi-
dential treatment program by an eligible entity that 
uses funds awarded under this section for all or part 
of the costs of the evaluation be designed to assist in 
the determination of whether the program may qual-
ify as a promising, supported, or well-supported prac-
tice in accordance with the requirements of such sec-
tion 471(e)(4)(C). 
(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to the Secretary to carry out 
this section, $20,000,000 for fiscal year 2019, which shall 
remain available through fiscal year 2023.
546 
Subtitle H—Reauthorizing and Ex-
tending 
Grants 
for 
Recovery 
From Opioid Use Programs 
SEC. 8091. SHORT TITLE. 
This subtitle may be cited as the ‘‘Reauthorizing and 
Extending Grants for Recovery from Opioid Use Programs 
Act of 2018’’ or the ‘‘REGROUP Act of 2018’’. 
SEC. 8092. REAUTHORIZATION OF THE COMPREHENSIVE 
OPIOID ABUSE GRANT PROGRAM. 
Section 1001(a)(27) of the Omnibus Crime Control 
and Safe Streets Act of 1968 (34 U.S.C. 10261(a)(27)) is 
amended by striking ‘‘through 2021’’ and inserting ‘‘and 
2018, and $330,000,000 for each of fiscal years 2019 
through 2023’’. 
Subtitle I—Fighting Opioid Abuse 
in Transportation 
SEC. 8101. SHORT TITLE. 
This subtitle may be cited as the ‘‘Fighting Opioid 
Abuse in Transportation Act’’. 
SEC. 8102. ALCOHOL AND CONTROLLED SUBSTANCE TEST-
ING OF MECHANICAL EMPLOYEES. 
(a) IN GENERAL.—Not later than 2 years after the 
date of enactment of this Act, the Secretary of Transpor-
tation shall publish a rule in the Federal Register revising 
the regulations promulgated under section 20140 of title 49,
547 
United States Code, to cover all employees of railroad car-
riers who perform mechanical activities. 
(b) DEFINITION
OF MECHANICAL ACTIVITIES.—For 
the purposes of the rule under subsection (a), the Secretary 
shall define the term ‘‘mechanical activities’’ by regulation. 
SEC. 8103. DEPARTMENT OF TRANSPORTATION PUBLIC 
DRUG AND ALCOHOL TESTING DATABASE. 
(a) IN GENERAL.—Subject to subsection (c), the Sec-
retary of Transportation shall— 
(1) not later than March 31, 2019, establish and 
make publicly available on its website a database of 
the drug and alcohol testing data reported by employ-
ers for each mode of transportation; and 
(2) update the database annually. 
(b) CONTENTS.—The database under subsection (a) 
shall include, for each mode of transportation— 
(1) the total number of drug and alcohol tests by 
type of substance tested; 
(2) the drug and alcohol test results by type of 
substance tested; 
(3) the reason for the drug or alcohol test, such 
as pre-employment, random, post-accident, reasonable 
suspicion or cause, return-to-duty, or follow-up, by 
type of substance tested; and
548 
(4) the number of individuals who refused test-
ing. 
(c) COMMERCIALLY SENSITIVE DATA.—The Depart-
ment of Transportation shall not release any commercially 
sensitive data or personally identifiable data furnished by 
an employer under this section unless the data is aggregated 
or otherwise in a form that does not identify the employer 
providing the data. 
(d) SAVINGS CLAUSE.—Nothing in this section may 
be construed as limiting or otherwise affecting the require-
ments of the Secretary of Transportation to adhere to re-
quirements applicable to confidential business information 
and sensitive security information, consistent with applica-
ble law. 
SEC. 8104. GAO REPORT ON DEPARTMENT OF TRANSPOR-
TATION’S COLLECTION AND USE OF DRUG 
AND ALCOHOL TESTING DATA. 
(a) IN GENERAL.—Not later than 2 years after the 
date the Department of Transportation public drug and al-
cohol testing database is established under section 8103, the 
Comptroller General of the United States shall— 
(1) review the Department of Transportation 
Drug and Alcohol Testing Management Information 
System; and
549 
(2) submit to the Committee on Commerce, 
Science, and Transportation of the Senate and the 
Committee on Transportation and Infrastructure of 
the House of Representatives a report on the review, 
including recommendations under subsection (c). 
(b) CONTENTS.—The report under subsection (a) shall 
include— 
(1) a description of the process the Department 
of Transportation uses to collect and record drug and 
alcohol testing data submitted by employers for each 
mode of transportation; 
(2) an assessment of whether and, if so, how the 
Department of Transportation uses the data described 
in paragraph (1) in carrying out its responsibilities; 
and 
(3) an assessment of the Department of Trans-
portation public drug and alcohol testing database 
under section 8103. 
(c) RECOMMENDATIONS.—The report under subsection 
(a) may include recommendations regarding— 
(1) how the Department of Transportation can 
best use the data described in subsection (b)(1); 
(2) any improvements that could be made to the 
process described in subsection (b)(1);
550 
(3) whether and, if so, how the Department of 
Transportation public drug and alcohol testing data-
base under section 8103 could be made more effective; 
and 
(4) such other recommendations as the Comp-
troller General considers appropriate. 
SEC. 8105. TRANSPORTATION WORKPLACE DRUG AND AL-
COHOL TESTING PROGRAM; ADDITION OF 
FENTANYL AND OTHER SUBSTANCES. 
(a) MANDATORY GUIDELINES FOR FEDERAL WORK-
PLACE DRUG TESTING PROGRAMS.— 
(1) IN GENERAL.—Not later than 180 days after 
the date of enactment of this Act, the Secretary of 
Health and Human Services shall— 
(A) determine whether a revision of the 
Mandatory Guidelines for Federal Workplace 
Drug Testing Programs to expand the opiate cat-
egory on the list of authorized substance testing 
to include fentanyl is justified, based on the reli-
ability and cost-effectiveness of available testing; 
and 
(B) consider whether to include with the de-
termination under subparagraph (A) a separate 
determination on whether a revision of the Man-
datory Guidelines for Federal Workplace Drug
551 
Testing Programs to expand the list of sub-
stances authorized for testing to include any 
other drugs or other substances listed in schedule 
I and II of section 202 of the Controlled Sub-
stances Act (21 U.S.C. 812) is justified based on 
the criteria described in subparagraph (A). 
(2) REVISION OF GUIDELINES.—If an expansion 
of the substance list is determined to be justified 
under paragraph (1), the Secretary of Health and 
Human Services shall— 
(A) notify the Committee on Commerce, 
Science, and Transportation of the Senate and 
the Committee on Transportation and Infra-
structure of the House of Representatives of the 
determination; and 
(B) publish in the Federal Register, not 
later than 18 months after the date of the deter-
mination under that paragraph, a final notice of 
the revision of the Mandatory Guidelines for 
Federal Workplace Drug Testing Programs to ex-
pand the list of substances authorized to be tested 
to include the substance or substances determined 
to be justified for inclusion. 
(3) REPORT.—If an expansion of the substance 
list is determined not to be justified under paragraph
552 
(1), the Secretary of Health and Human Services 
shall submit to the Committee on Commerce, Science, 
and Transportation of the Senate and the Committee 
on Transportation and Infrastructure of the House of 
Representatives a report explaining, in detail, the 
reasons the expansion of the list of authorized sub-
stances is not justified. 
(b) DEPARTMENT OF TRANSPORTATION DRUG-TESTING 
PANEL.—If an expansion is determined to be justified 
under subsection (a)(1), the Secretary of Transportation 
shall publish in the Federal Register, not later than 18 
months after the date the final notice is published under 
subsection (a)(2), a final rule revising part 40 of title 49, 
Code of Federal Regulations, to include such substances in 
the Department of Transportation’s drug-testing panel, con-
sistent with the Mandatory Guidelines for Federal Work-
place Drug Testing Programs as revised by the Secretary 
of Health and Human Services under subsection (a). 
(c) SAVINGS PROVISION.—Nothing in this section may 
be construed as— 
(1) delaying the publication of the notices de-
scribed in sections 8106 and 8107 of this Act until the 
Secretary of Health and Human Services makes a de-
termination or publishes a notice under this section; 
or
553 
(2) limiting or otherwise affecting any authority 
of the Secretary of Health and Human Services or the 
Secretary of Transportation to expand the list of au-
thorized substance testing to include an additional 
substance. 
SEC. 8106. STATUS REPORTS ON HAIR TESTING GUIDE-
LINES. 
(a) IN GENERAL.—Not later than 60 days after the 
date of enactment of this Act, and annually thereafter until 
the date that the Secretary of Health and Human Services 
publishes in the Federal Register a final notice of scientific 
and technical guidelines for hair testing in accordance with 
section 5402(b) of the Fixing America’s Surface Transpor-
tation Act (Public Law 114-94; 129 Stat. 1312), the Sec-
retary of Health and Human Services shall submit to the 
Committee on Commerce, Science, and Transportation of 
the Senate and the Committee on Transportation and In-
frastructure of the House of Representatives a report on— 
(1) the status of the hair testing guidelines; 
(2) an explanation for why the hair testing 
guidelines have not been issued; and 
(3) an estimated date of completion of the hair 
testing guidelines. 
(b) REQUIREMENT.—To the extent practicable and 
consistent with the objective of the hair testing described in
554 
subsection (a) to detect illegal or unauthorized use of sub-
stances by the individual being tested, the final notice of 
scientific and technical guidelines under that subsection, as 
determined by the Secretary of Health and Human Serv-
ices, shall eliminate the risk of positive test results, of the 
individual being tested, caused solely by the drug use of oth-
ers and not caused by the drug use of the individual being 
tested. 
SEC. 8107. MANDATORY GUIDELINES FOR FEDERAL WORK-
PLACE DRUG TESTING PROGRAMS USING 
ORAL FLUID. 
(a) DEADLINE.—Not later than December 31, 2018, the 
Secretary of Health and Human Services shall publish in 
the Federal Register a final notice of the Mandatory Guide-
lines for Federal Workplace Drug Testing Programs using 
Oral Fluid, based on the notice of proposed mandatory 
guidelines published in the Federal Register on May 15, 
2015 (94 FR 28054). 
(b) REQUIREMENT.—To the extent practicable and 
consistent with the objective of the testing described in sub-
section (a) to detect illegal or unauthorized use of substances 
by the individual being tested, the final notice of scientific 
and technical guidelines under that subsection, as deter-
mined by the Secretary of Health and Human Services, 
shall eliminate the risk of positive test results, of the indi-
555 
vidual being tested, caused solely by the drug use of others 
and not caused by the drug use of the individual being test-
ed. 
(c) RULE OF CONSTRUCTION.—Nothing in this section 
may be construed as requiring the Secretary of Health and 
Human Services to reissue a notice of proposed mandatory 
guidelines to carry out subsection (a). 
SEC. 8108. ELECTRONIC RECORDKEEPING. 
(a) DEADLINE.—Not later than 1 year after the date 
of enactment of this Act, the Secretary of Health and 
Human Services shall— 
(1) ensure that each certified laboratory that re-
quests approval for the use of completely paperless 
electronic Federal Drug Testing Custody and Control 
Forms from the National Laboratory Certification 
Program’s Electronic Custody and Control Form sys-
tems receives approval for those completely paperless 
electronic forms instead of forms that include any 
combination of electronic traditional handwritten sig-
natures executed on paper forms; and 
(2) establish a deadline for a certified laboratory 
to request approval under paragraph (1). 
(b) SAVINGS CLAUSE.—Nothing in this section may be 
construed as limiting or otherwise affecting any authority 
of the Secretary of Health and Human Services to grant
556 
approval to a certified laboratory for use of completely 
paperless electronic Federal Drug Testing Custody and 
Control Forms, including to grant approval outside of the 
process under subsection (a). 
(c) ELECTRONIC SIGNATURES.—Not later than 18 
months after the date of the deadline under subsection 
(a)(2), the Secretary of Transportation shall issue a final 
rule revising part 40 of title 49, Code of Federal Regula-
tions, to authorize, to the extent practicable, the use of elec-
tronic signatures or digital signatures executed to electronic 
forms instead of traditional handwritten signatures exe-
cuted on paper forms. 
SEC. 8109. STATUS REPORTS ON COMMERCIAL DRIVER’S LI-
CENSE 
DRUG 
AND 
ALCOHOL 
CLEARING-
HOUSE. 
(a) IN GENERAL.—Not later than 60 days after the 
date of enactment of this Act, and annually thereafter until 
the compliance date, the Administrator of the Federal Motor 
Carrier Safety Administration shall submit to the Com-
mittee on Commerce, Science, and Transportation of the 
Senate and the Committee on Transportation and Infra-
structure of the House of Representatives a status report 
on implementation of the final rule for the Commercial 
Driver’s License Drug and Alcohol Clearinghouse (81 FR 
87686), including—
557 
(1) an updated schedule, including benchmarks, 
for implementing the final rule as soon as practicable, 
but not later than the compliance date; and 
(2) a description of each action the Federal 
Motor Carrier Safety Administration is taking to im-
plement the final rule before the compliance date. 
(b) DEFINITION OF COMPLIANCE DATE.—In this sec-
tion, the term ‘‘compliance date’’ means the earlier of— 
(1) January 6, 2020; or 
(2) the date that the national clearinghouse re-
quired under section 31306a of title 49, United States 
Code, is operational. 
Subtitle J—Eliminating Kickbacks 
in Recovery 
SEC. 8121. SHORT TITLE. 
This subtitle may be cited as the ‘‘Eliminating Kick-
backs in Recovery Act of 2018’’. 
SEC. 8122. CRIMINAL PENALTIES. 
(a) IN GENERAL.—Chapter 11 of title 18, United 
States Code, is amended by inserting after section 219 the 
following:
558 
‘‘§ 220. Illegal remunerations for referrals to recovery 
homes, clinical treatment facilities, and 
laboratories 
‘‘(a) OFFENSE.—Except as provided in subsection (b), 
whoever, with respect to services covered by a health care 
benefit program, in or affecting interstate or foreign com-
merce, knowingly and willfully— 
‘‘(1) solicits or receives any remuneration (in-
cluding any kickback, bribe, or rebate) directly or in-
directly, overtly or covertly, in cash or in kind, in re-
turn for referring a patient or patronage to a recov-
ery home, clinical treatment facility, or laboratory; or 
‘‘(2) pays or offers any remuneration (including 
any kickback, bribe, or rebate) directly or indirectly, 
overtly or covertly, in cash or in kind— 
‘‘(A) to induce a referral of an individual 
to a recovery home, clinical treatment facility, or 
laboratory; or 
‘‘(B) in exchange for an individual using 
the services of that recovery home, clinical treat-
ment facility, or laboratory, 
shall be fined not more than $200,000, imprisoned not more 
than 10 years, or both, for each occurrence. 
‘‘(b) APPLICABILITY.—Subsection (a) shall not apply 
to—
559 
‘‘(1) a discount or other reduction in price ob-
tained by a provider of services or other entity under 
a health care benefit program if the reduction in price 
is properly disclosed and appropriately reflected in 
the costs claimed or charges made by the provider or 
entity; 
‘‘(2) a payment made by an employer to an em-
ployee or independent contractor (who has a bona fide 
employment or contractual relationship with such em-
ployer) for employment, if the employee’s payment is 
not determined by or does not vary by— 
‘‘(A) the number of individuals referred to 
a particular recovery home, clinical treatment 
facility, or laboratory; 
‘‘(B) the number of tests or procedures per-
formed; or 
‘‘(C) the amount billed to or received from, 
in part or in whole, the health care benefit pro-
gram from the individuals referred to a par-
ticular recovery home, clinical treatment facility, 
or laboratory; 
‘‘(3) a discount in the price of an applicable 
drug of a manufacturer that is furnished to an appli-
cable beneficiary under the Medicare coverage gap
560 
discount program under section 1860D–14A(g) of the 
Social Security Act (42 U.S.C. 1395w–114a(g)); 
‘‘(4) a payment made by a principal to an agent 
as compensation for the services of the agent under a 
personal services and management contract that meets 
the requirements of section 1001.952(d) of title 42, 
Code of Federal Regulations, as in effect on the date 
of enactment of this section; 
‘‘(5) a waiver or discount (as defined in section 
1001.952(h)(5) of title 42, Code of Federal Regula-
tions, or any successor regulation) of any coinsurance 
or copayment by a health care benefit program if— 
‘‘(A) the waiver or discount is not routinely 
provided; and 
‘‘(B) the waiver or discount is provided in 
good faith; 
‘‘(6) 
a 
remuneration 
described 
in 
section 
1128B(b)(3)(I) of the Social Security Act (42 U.S.C. 
1320a–7b(b)(3)(I)); 
‘‘(7) a remuneration made pursuant to an alter-
native payment model (as defined in section 
1833(z)(3)(C) of the Social Security Act) or pursuant 
to a payment arrangement used by a State, health in-
surance issuer, or group health plan if the Secretary 
of Health and Human Services has determined that
561 
such arrangement is necessary for care coordination 
or value-based care; or 
‘‘(8) any other payment, remuneration, discount, 
or reduction as determined by the Attorney General, 
in consultation with the Secretary of Health and 
Human Services, by regulation. 
‘‘(c) REGULATIONS.—The Attorney General, in con-
sultation with the Secretary of Health and Human Serv-
ices, may promulgate regulations to clarify the exceptions 
described in subsection (b). 
‘‘(d) PREEMPTION.— 
‘‘(1) FEDERAL
LAW.—This section shall not 
apply to conduct that is prohibited under section 
1128B of the Social Security Act (42 U.S.C. 1320a– 
7b). 
‘‘(2) STATE LAW.—Nothing in this section shall 
be construed to occupy the field in which any provi-
sions of this section operate to the exclusion of State 
laws on the same subject matter. 
‘‘(e) DEFINITIONS.—In this section— 
‘‘(1) the terms ‘applicable beneficiary’ and ‘ap-
plicable drug’ have the meanings given those terms in 
section 1860D–14A(g) of the Social Security Act (42 
U.S.C. 1395w–114a(g));
562 
‘‘(2) the term ‘clinical treatment facility’ means 
a medical setting , other than a hospital, that pro-
vides detoxification, risk reduction, outpatient treat-
ment and care, residential treatment, or rehabilita-
tion for substance use, pursuant to licensure or cer-
tification under State law; 
‘‘(3) the term ‘health care benefit program’ has 
the meaning given the term in section 24(b); 
‘‘(4) the term ‘laboratory’ has the meaning given 
the term in section 353 of the Public Health Service 
Act (42 U.S.C. 263a); and 
‘‘(5) the term ‘recovery home’ means a shared 
living environment that is, or purports to be, free 
from alcohol and illicit drug use and centered on peer 
support and connection to services that promote sus-
tained recovery from substance use disorders.’’. 
(b) CLERICAL AMENDMENT.—The table of sections for 
chapter 11 of title 18, United States Code, is amended by 
inserting after the item related to section 219 the following: 
‘‘220. Illegal remunerations for referrals to recovery homes, clinical treatment fa-
cilities, and laboratories.’’. 
Subtitle K—Substance Abuse 
Prevention 
SEC. 8201. SHORT TITLE. 
This subtitle may be cited as the ‘‘Substance Abuse 
Prevention Act of 2018’’.
563 
SEC. 8202. REAUTHORIZATION OF THE OFFICE OF NA-
TIONAL DRUG CONTROL POLICY. 
(a) OFFICE OF NATIONAL DRUG CONTROL POLICY RE-
AUTHORIZATION ACT OF 1998.— 
(1) IN GENERAL.—The Office of National Drug 
Control Policy Reauthorization Act of 1998 (21 
U.S.C. 1701 et seq.), as in effect on September 29, 
2003, and as amended by the laws described in para-
graph (2), is revived and restored. 
(2) LAWS DESCRIBED.—The laws described in 
this paragraph are: 
(A) The Office of National Drug Control 
Policy Reauthorization Act of 2006 (Public Law 
109–469; 120 Stat. 3502). 
(B) The Presidential Appointment Effi-
ciency and Streamlining Act of 2011 (Public 
Law 112–166; 126 Stat. 1283). 
(b) REAUTHORIZATION.— 
(1) IN GENERAL.—Section 714 of the Office of 
National Drug Control Policy Reauthorization Act of 
1998 (21 U.S.C. 1711) is amended by striking ‘‘such 
sums as may be necessary for each of fiscal years 
2006 through 2010’’ and inserting ‘‘$18,400,000 for 
each of fiscal years 2018 through 2023’’. 
(2) REPEAL
OF
TERMINATION.—The Office of 
National Drug Control Policy Reauthorization Act of
564 
1998 (21 U.S.C. 1701 et seq.) is amended by striking 
section 715 (21 U.S.C. 1712). 
SEC. 8203. REAUTHORIZATION OF THE DRUG-FREE COMMU-
NITIES PROGRAM. 
(a) REVIVAL OF NATIONAL NARCOTICS LEADERSHIP 
ACT OF 1988.— 
(1) IN
GENERAL.—Chapter 2 of the National 
Narcotics Leadership Act of 1988 (21 U.S.C. 1521 et 
seq.), except for subchapter II (21 U.S.C. 1541 et 
seq.), as in effect on September 29, 1997, and as 
amended by the laws described in paragraph (2), is 
revived and restored. 
(2) LAWS DESCRIBED.—The laws described in 
this paragraph are: 
(A) Public Law 107–82 (115 Stat. 814). 
(B) The Office of National Drug Control 
Policy Reauthorization Act of 2006 (Public Law 
109–469: 120 Stat. 3502), as amended by para-
graph (4). 
(3) AMENDMENT TO TERMINATION PROVISION.— 
Section 1009 of the National Narcotics Leadership 
Act of 1988 (21 U.S.C. 1056) is amended by inserting 
‘‘and sections 1021 through 1035’’ after ‘‘section 
1007’’. 
(4) TECHNICAL CORRECTION.—
565 
(A) IN GENERAL.—Title VIII of the Office 
of National Drug Control Policy Reauthorization 
Act of 2006 (Public Law 109–469; 120 Stat. 
3535) is amended by striking ‘‘Drug-Free Com-
munities Act of 1997’’ each place it appears and 
inserting ‘‘National Narcotics Leadership Act of 
1988’’. 
(B) EFFECTIVE
DATE.—The amendments 
made by subparagraph (A) shall take effect as 
though enacted as part of the Office of National 
Drug Control Policy Reauthorization Act of 
2006 (Public Law 109–469; 120 Stat. 3502). 
(b) AMENDMENT TO NATIONAL NARCOTICS LEADER-
SHIP ACT OF 1988.—Chapter 2 of subtitle A of title I of 
the National Narcotics Leadership Act of 1988 (21 U.S.C. 
1521 et seq.) is amended— 
(1) in section 1022 (21 U.S.C. 1522), by striking 
‘‘substance abuse’’ each place it appears and inserting 
‘‘substance use and misuse’’; 
(2) in section 1023 (21 U.S.C. 1523), by striking 
paragraph (9) and inserting the following: 
‘‘(9) SUBSTANCE USE AND MISUSE.—The term 
‘substance use and misuse’ means— 
‘‘(A) the illegal use or misuse of drugs, in-
cluding substances for which a listing is effect
566 
under any of schedules I through V under section 
202 of the Controlled Substances Act (21 U.S.C. 
812); 
‘‘(B) the misuse of inhalants or over-the- 
counter drugs; or 
‘‘(C) the use of alcohol, tobacco, or other re-
lated product as such use is prohibited by State 
or local law.’’; 
(3) in section 1024 (21 U.S.C. 1524), by striking 
subsections (a) and (b) and inserting the following: 
‘‘(a) IN GENERAL.—There is authorized to be appro-
priated to the Office of National Drug Control Policy to 
carry out this chapter $99,000,000 for each of fiscal years 
2018 through 2023. 
‘‘(b) ADMINISTRATIVE COSTS.—Not more than 8 per-
cent of the funds appropriated to carry out this chapter 
may be used by the Office of National Drug Control Policy 
to pay administrative costs associated with the responsibil-
ities of the Office under this chapter.’’; 
(4) in subchapter I (21 U.S.C. 1531 et seq.)— 
(A) by striking ‘‘substance abuse’’ each 
place it appears and inserting ‘‘substance use 
and misuse’’; and
567 
(B) in section 1032(b)(1)(A) (21 U.S.C. 
1532(b)(1)(A)), by striking clause (iii) and in-
serting the following: 
‘‘(iii) RENEWAL
GRANTS.—Subject to 
clause (iv), the Administrator may award a 
renewal grant to a grant recipient under 
this subparagraph for each fiscal year of the 
4-fiscal-year period following the first fiscal 
year for which the initial additional grant 
is awarded in an amount not to exceed the 
following: 
‘‘(I) For the first and second fiscal 
years of the 4-fiscal-year period, the 
amount of the non-Federal funds, in-
cluding in-kind contributions, raised 
by the coalition for the applicable fis-
cal year is not less than 125 percent of 
the amount awarded. 
‘‘(II) For the third and fourth fis-
cal tears of the 4-fiscal-year period, the 
amount of the non-Federal funds, in-
cluding in-kind contributions, raised 
by the coalition for the applicable fis-
cal year is not less than 150 percent of 
the amount awarded.’’; and
568 
(5) by striking subchapter II (21 U.S.C. 1541 et 
seq.). 
SEC. 8204. REAUTHORIZATION OF THE NATIONAL COMMU-
NITY ANTI-DRUG COALITION INSTITUTE. 
Section 4 of Public Law 107–82 (21 U.S.C. 1521 note) 
is amended to read as follows: 
‘‘SEC. 4. AUTHORIZATION FOR NATIONAL COMMUNITY 
ANTIDRUG COALITION INSTITUTE. 
‘‘(a) IN GENERAL.—The Director shall, using amounts 
authorized to be appropriated by subsection (d), make a 
competitive grant to provide for the continuation of the Na-
tional Community Anti-drug Coalition Institute. 
‘‘(b) ELIGIBLE ORGANIZATIONS.—An organization eli-
gible for the grant under subsection (a) is any national non-
profit organization that represents, provides technical as-
sistance and training to, and has special expertise and 
broad, national-level experience in community antidrug 
coalitions under this subchapter. 
‘‘(c) USE OF GRANT AMOUNT.—The organization that 
receives the grant under subsection (a) shall continue a Na-
tional Community Anti-Drug Coalition Institute to— 
‘‘(1) provide education, training, and technical 
assistance for coalition leaders and community teams, 
with emphasis on the development of coalitions serv-
ing economically disadvantaged areas;
569 
‘‘(2) develop and disseminate evaluation tools, 
mechanisms, and measures to better assess and docu-
ment coalition performance measures and outcomes; 
and 
‘‘(3) bridge the gap between research and prac-
tice by translating knowledge from research into prac-
tical information. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—The Di-
rector shall, using amounts authorized to be appropriated 
by section 1032 of the National Narcotics Leadership Act 
of 1988 (15 U.S.C. 1532), make a grant of $2 million under 
subsection (a), for each of the fiscal years 2018 through 
2023.’’. 
SEC. 8205. REAUTHORIZATION OF THE HIGH-INTENSITY 
DRUG TRAFFICKING AREA PROGRAM. 
Section 707 of the Office of National Drug Control Pol-
icy Reauthorization Act of 1998 (21 U.S.C. 1706) is amend-
ed— 
(1) in subsection (f), by striking ‘‘no Federal’’ 
and all that follows through ‘‘programs.’’ and insert-
ing the following: ‘‘not more than a total of 5 percent 
of Federal funds appropriated for the Program are 
expended for substance use disorder treatment pro-
grams and drug prevention programs.’’; 
(2) in subsection (p)—
570 
(A) in paragraph (4), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (5), by striking the period 
at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(6) $280,000,000 for each of fiscal years 2018 
through 2023.’’; and 
(3) in subsection (q)— 
(A) by striking paragraph (2) and inserting 
the following: 
‘‘(2) REQUIRED USES.—The funds used under 
paragraph (1) shall be used to ensure the safety of 
neighborhoods and the protection of communities, in-
cluding the prevention of the intimidation of wit-
nesses of illegal drug distribution and related activi-
ties and the establishment of, or support for, pro-
grams that provide protection or assistance to wit-
nesses in court proceedings.’’; and 
(B) by adding at the end the following: 
‘‘(3) BEST
PRACTICE
MODELS.—The Director 
shall work with HIDTAs to develop and maintain 
best practice models to assist State, local, and Tribal 
governments in addressing witness safety, relocation, 
financial and housing assistance, or any other serv-
ices related to witness protection or assistance in
571 
cases of illegal drug distribution and related activi-
ties. The Director shall ensure dissemination of the 
best practice models to each HIDTA.’’. 
SEC. 8206. REAUTHORIZATION OF DRUG COURT PROGRAM. 
Section 1001(a)(25)(A) of title I of the Omnibus Crime 
Control and Safe Streets Act of 1968 (34 U.S.C. 
10261(a)(25)(A)) is amended by striking ‘‘Except as pro-
vided’’ and all that follows and inserting the following: 
‘‘Except as provided in subparagraph (C), there is author-
ized to be appropriated to carry out part EE $75,000,000 
for each of fiscal years 2018 through 2023.’’. 
SEC. 8207. DRUG COURT TRAINING AND TECHNICAL ASSIST-
ANCE. 
Section 705 of the Office of National Drug Control Pol-
icy Reauthorization Act of 1998 (21 U.S.C. 1704) is amend-
ed by adding at the end the following: 
‘‘(e) DRUG COURT TRAINING AND TECHNICAL ASSIST-
ANCE PROGRAM.— 
‘‘(1) GRANTS AUTHORIZED.—The Director may 
make a grant to a nonprofit organization for the pur-
pose of providing training and technical assistance to 
drug courts. 
‘‘(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out
572 
this subsection $2,000,000 for each of fiscal years 
2018 through 2023.’’. 
SEC. 8208. DRUG OVERDOSE RESPONSE STRATEGY. 
Section 707 of the Office of National Drug Control Pol-
icy Reauthorization Act of 1998 (21 U.S.C. 1706) is amend-
ed by adding at the end the following: 
‘‘(r) DRUG OVERDOSE RESPONSE STRATEGY IMPLE-
MENTATION.—The Director may use funds appropriated to 
carry out this section to implement a drug overdose re-
sponse strategy in high intensity drug trafficking areas on 
a nationwide basis by— 
‘‘(1) coordinating multi-disciplinary efforts to 
prevent, reduce, and respond to drug overdoses, in-
cluding the uniform reporting of fatal and non-fatal 
overdoses to public health and safety officials; 
‘‘(2) increasing data sharing among public safe-
ty and public health officials concerning drug-related 
abuse trends, including new psychoactive substances, 
and related crime; and 
‘‘(3) enabling collaborative deployment of preven-
tion, intervention, and enforcement resources to ad-
dress substance use addiction and narcotics traf-
ficking.’’.
573 
SEC. 8209. PROTECTING LAW ENFORCEMENT OFFICERS 
FROM ACCIDENTAL EXPOSURE. 
Section 707 of the Office of National Drug Control Pol-
icy Reauthorization Act of 1998 (21 U.S.C. 1706), as 
amended by section 8208, is amended by adding at the end 
the following: 
‘‘(s) SUPPLEMENTAL GRANTS.—The Director is au-
thorized to use not more than $10,000,000 of the amounts 
otherwise appropriated to carry out this section to provide 
supplemental competitive grants to high intensity drug 
trafficking areas that have experienced high seizures of 
fentanyl and new psychoactive substances for the purposes 
of— 
‘‘(1) purchasing portable equipment to test for 
fentanyl and other substances; 
‘‘(2) training law enforcement officers and other 
first responders on best practices for handling 
fentanyl and other substances; and 
‘‘(3) purchasing protective equipment, including 
overdose reversal drugs.’’. 
SEC. 8210. COPS ANTI-METH PROGRAM. 
Section 1701 of title I of the Omnibus Crime Control 
and Safe Streets Act of 1968 (34 U.S.C. 10381) is amend-
ed— 
(1) by redesignating subsection (k) as subsection 
(l); and
574 
(2) by inserting after subsection (j) the following: 
‘‘(k) COPS ANTI-METH PROGRAM.—The Attorney 
General shall use amounts otherwise appropriated to carry 
out this section for a fiscal year (beginning with fiscal year 
2019) to make competitive grants, in amounts of not less 
than $1,000,000 for such fiscal year, to State law enforce-
ment agencies with high seizures of precursor chemicals, fin-
ished methamphetamine, laboratories, and laboratory dump 
seizures for the purpose of locating or investigating illicit 
activities, such as precursor diversion, laboratories, or 
methamphetamine traffickers.’’. 
SEC. 8211. COPS ANTI-HEROIN TASK FORCE PROGRAM. 
Section 1701 of title I of the Omnibus Crime Control 
and Safe Streets Act of 1968 (34 U.S.C. 10381) is amend-
ed— 
(1) by redesignating subsection (l), as so redesig-
nated by section 8210, as subsection (m); and 
(2) by inserting after subsection (k), as added by 
section 8210, the following: 
‘‘(l) COPS ANTI-HEROIN TASK FORCE PROGRAM.—The 
Attorney General shall use amounts otherwise appropriated 
to carry out this section, or other amounts as appropriated, 
for a fiscal year (beginning with fiscal year 2019) to make 
competitive grants to State law enforcement agencies in 
States with high per capita rates of primary treatment ad-
575 
missions, for the purpose of locating or investigating illicit 
activities, through Statewide collaboration, relating to the 
distribution of heroin, fentanyl, or carfentanil or relating 
to the unlawful distribution of prescription opioids.’’. 
SEC. 8212. COMPREHENSIVE ADDICTION AND RECOVERY 
ACT EDUCATION AND AWARENESS. 
Title VII of the Comprehensive Addiction and Recov-
ery Act of 2016 (Public Law 114–198; 130 Stat. 735) is 
amended by adding at the end the following: 
‘‘SEC. 709. SERVICES FOR FAMILIES AND PATIENTS IN CRI-
SIS. 
‘‘(a) IN GENERAL.—The Secretary of Health and 
Human Services may make grants to entities that focus on 
addiction and substance use disorders and specialize in 
family and patient services, advocacy for patients and fam-
ilies, and educational information. 
‘‘(b) ALLOWABLE USES.—A grant awarded under this 
section may be used for nonprofit national, State, or local 
organizations that engage in the following activities: 
‘‘(1) Expansion of resource center services with 
professional, clinical staff that provide, for families 
and individuals impacted by a substance use dis-
order, support, access to treatment resources, brief as-
sessments, medication and overdose prevention edu-
cation, compassionate listening services, recovery sup-
576 
port or peer specialists, bereavement and grief sup-
port, and case management. 
‘‘(2) Continued development of health informa-
tion technology systems that leverage new and upcom-
ing technology and techniques for prevention, inter-
vention, and filling resource gaps in communities 
that are underserved. 
‘‘(3) Enhancement and operation of treatment 
and recovery resources, easy-to-read scientific and evi-
dence-based education on addiction and substance use 
disorders, and other informational tools for families 
and individuals impacted by a substance use disorder 
and community stakeholders, such as law enforcement 
agencies. 
‘‘(4) Provision of training and technical assist-
ance to State and local governments, law enforcement 
agencies, health care systems, research institutions, 
and other stakeholders. 
‘‘(5) Expanding upon and implementing edu-
cational information using evidence-based informa-
tion on substance use disorders. 
‘‘(6) Expansion of training of community stake-
holders, law enforcement officers, and families across 
a broad-range of addiction, health, and related topics
577 
on substance use disorders, local issues and commu-
nity-specific issues related to the drug epidemic. 
‘‘(7) Program evaluation.’’. 
SEC. 8213. REIMBURSEMENT OF SUBSTANCE USE DISORDER 
TREATMENT PROFESSIONALS. 
Not later than January 1, 2020, the Comptroller Gen-
eral of the United States shall submit to Congress a report 
examining how substance use disorder services are reim-
bursed. 
SEC. 8214. SOBRIETY TREATMENT AND RECOVERY TEAMS 
(START). 
Title V of the Public Health Service Act (42 U.S.C. 
290dd et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 550. SOBRIETY TREATMENT AND RECOVERY TEAMS. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
to States, units of local government, or tribal governments 
to establish or expand Sobriety Treatment And Recovery 
Team (referred to in this section as ‘START’) or other simi-
lar programs to determine the effectiveness of pairing social 
workers or mentors with families that are struggling with 
a substance use disorder and child abuse or neglect in order 
to help provide peer support, intensive treatment, and child 
welfare services to such families.
578 
‘‘(b) ALLOWABLE USES.—A grant awarded under this 
section may be used for one or more of the following activi-
ties: 
‘‘(1) Training eligible staff, including social 
workers, social services coordinators, child welfare 
specialists, substance use disorder treatment profes-
sionals, and mentors. 
‘‘(2) Expanding access to substance use disorder 
treatment services and drug testing. 
‘‘(3) Enhancing data sharing with law enforce-
ment agencies, child welfare agencies, substance use 
disorder treatment providers, judges, and court per-
sonnel. 
‘‘(4) Program evaluation and technical assist-
ance. 
‘‘(c) PROGRAM REQUIREMENTS.—A State, unit of 
local government, or tribal government receiving a grant 
under this section shall— 
‘‘(1) serve only families for which— 
‘‘(A) there is an open record with the child 
welfare agency; and 
‘‘(B) substance use disorder was a reason 
for the record or finding described in paragraph 
(1); and
579 
‘‘(2) coordinate any grants awarded under this 
section with any grant awarded under section 437(f) 
of the Social Security Act focused on improving out-
comes for children affected by substance abuse. 
‘‘(d) TECHNICAL ASSISTANCE.—The Secretary may re-
serve not more than 5 percent of funds provided under this 
section to provide technical assistance on the establishment 
or expansion of programs funded under this section from 
the National Center on Substance Abuse and Child Wel-
fare.’’. 
SEC. 8215. PROVIDER EDUCATION. 
Not later than 60 days after the date of enactment of 
this Act, the Attorney General, in consultation with the Sec-
retary of Health and Human Services, shall complete the 
plan related to medical registration coordination required 
by Senate Report 114–239, which accompanied the Veterans 
Care Financial Protection Act of 2017 (Public Law 115– 
131; 132 Stat. 334). 
SEC. 8216. DEFINITIONS. 
Section 702 of the Office of National Drug Control Pol-
icy Reauthorization Act of 1998 (21 U.S.C. 1701) is amend-
ed— 
(1) by striking paragraphs (5), (12), and (13); 
(2) by redesignating paragraph (11) as para-
graph (17);
580 
(3) by redesignating paragraphs (9) and (10) as 
paragraphs (14) and (15), respectively; 
(4) by redesignating paragraphs (6), (7), and (8) 
as paragraphs (10), (11), and (12), respectively; 
(5) by redesignating paragraphs (1), (2), (3), 
and (4) as paragraphs (3), (4), (5), and (6), respec-
tively; 
(6) by inserting before paragraph (3), as so re-
designated, the following: 
‘‘(1) AGENCY.—The term ‘agency’ has the mean-
ing given the term ‘executive agency’ in section 102 
of title 31, United States Code. 
‘‘(2) APPROPRIATE
CONGRESSIONAL
COMMIT-
TEES.— 
‘‘(A) IN GENERAL.—The term ‘appropriate 
congressional committees’ means— 
‘‘(i) the Committee on the Judiciary, 
the Committee on Appropriations, and the 
Committee on Health, Education, Labor, 
and Pensions of the Senate; and 
‘‘(ii) the Committee on Oversight and 
Government Reform, the Committee on the 
Judiciary, the Committee on Energy and 
Commerce, and the Committee on Appro-
priations of the House of Representatives.
581 
‘‘(B) SUBMISSION TO CONGRESS.—Any sub-
mission to Congress shall mean submission to the 
appropriate congressional committees.’’; 
(7) by amending paragraph (3), as so redesig-
nated, to read as follows: 
‘‘(3) DEMAND REDUCTION.—The term ‘demand 
reduction’ means any activity conducted by a Na-
tional Drug Control Program Agency, other than an 
enforcement activity, that is intended to reduce or 
prevent the use of drugs or support, expand, or pro-
vide treatment and recovery efforts, including— 
‘‘(A) education about the dangers of illicit 
drug use; 
‘‘(B) services, programs, or strategies to pre-
vent substance use disorder, including evidence- 
based education campaigns, community-based 
prevention programs, collection and disposal of 
unused prescription drugs, and services to at-risk 
populations to prevent or delay initial use of an 
illicit drug; 
‘‘(C) substance use disorder treatment; 
‘‘(D) support for long-term recovery from 
substance use disorders; 
‘‘(E) drug-free workplace programs;
582 
‘‘(F) drug testing, including the testing of 
employees; 
‘‘(G) interventions for illicit drug use and 
dependence; 
‘‘(H) expanding availability of access to 
health care services for the treatment of substance 
use disorders; 
‘‘(I) international drug control coordination 
and cooperation with respect to activities de-
scribed in this paragraph; 
‘‘(J) pre- and post-arrest criminal justice 
interventions such as diversion programs, drug 
courts, and the provision of evidence-based treat-
ment to individuals with substance use disorders 
who are arrested or under some form of criminal 
justice supervision, including medication assisted 
treatment; 
‘‘(K) other coordinated and joint initiatives 
among Federal, State, local, and Tribal agencies 
to promote comprehensive drug control strategies 
designed to reduce the demand for, and the avail-
ability of, illegal drugs; 
‘‘(L) international illicit drug use edu-
cation, prevention, treatment, recovery, research,