Title: CAREER Act
Policy area: Health

Summary:
Comprehensive Addiction Recovery through Effective Employment and Reentry Act or the CAREER Act
This bill amends the Public Health Service Act to require the Department of Health and Human Services (HHS) to establish a pilot program to award grants to states in order to assist individuals with the transition from substance use disorder treatment programs to independent living and the workforce. Eligible grant activities include outpatient treatment programs, care coordination services, and vocational training. HHS may award five-year grants to up to five states (based in part on specified unemployment and overdose data) and one-year grants to states and Indian tribes (based on criteria determined by HHS).
Additionally, the bill amends the Housing and Community Development Act of 1974 to include temporary housing services for individuals transitioning from substance use disorder treatment programs as qualifying activities for which states may use federal funds. The bill also amends the Workforce Innovation and Opportunity Act and the Rehabilitation Act of 1973 to allow states to use federal funds for career and training services for such individuals, including career counseling, employee assistance programs, and educational resources for employers.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2730 Introduced in Senate (IS)]

<DOC>






115th CONGRESS
  2d Session
                                S. 2730

To amend the Public Health Service Act to establish a pilot program to 
 help individuals in recovery from a substance use disorder transition 
 from treatment to independent living and the workforce, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 23, 2018

 Mr. McConnell introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to establish a pilot program to 
 help individuals in recovery from a substance use disorder transition 
 from treatment to independent living and the workforce, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Comprehensive Addiction Recovery 
through Effective Employment and Reentry Act'' or the ``CAREER Act''.

SEC. 2. PILOT PROGRAM TO HELP INDIVIDUALS IN RECOVERY FROM A SUBSTANCE 
              USE DISORDER TRANSITION TO INDEPENDENT LIVING AND THE 
              WORKFORCE.

    Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by adding at the end the following:

``SEC. 320B. PILOT PROGRAM TO HELP INDIVIDUALS IN RECOVERY FROM A 
              SUBSTANCE USE DISORDER TRANSITION TO INDEPENDENT LIVING 
              AND THE WORKFORCE.

    ``(a) In General.--The Secretary shall establish a pilot program to 
award 5-year grants under subsection (b)(1) to States, and 1-year 
grants under subsection (b)(2) to States or Indian tribes, for the 
purpose of making subgrants to entities under subsection (c) to help 
individuals in recovery from a substance use disorder transition from 
treatment to independent living and the workforce.
    ``(b) Grants.--
            ``(1) 5-year grants.--
                    ``(A) In general.--The Secretary shall award 5-year 
                grants under this paragraph to 5 States that submit an 
                application under paragraph (3). Such States shall be 
                selected--
                            ``(i) from among the 10 States with the 
                        highest rate of death due to drug overdose per 
                        100,000 people, based on data from the Centers 
                        for Disease Control and Prevention for calendar 
                        years 2013 through 2017; and
                            ``(ii) based on the merits of the proposal 
                        included in such application and the 
                        preferences described in subparagraph (B).
                    ``(B) Preferences.--The Secretary, in selecting 
                States for a grant under this paragraph, shall give 
                priority to States from among the States described in 
                subparagraph (A) with the combination of--
                            ``(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 provided by 
                        the Bureau of Labor Statistics for calendar 
                        years 2013 through 2017; and
                            ``(iii) the highest prevalence of opioid 
                        use disorder based on data provided by the 
                        Substance Abuse and Mental Health Services 
                        Administration for calendar years 2013 through 
                        2017 as may be available.
                    ``(C) Grant funds.--
                            ``(i) In general.--The funds from a 5-year 
                        grant awarded under this paragraph shall be 
                        provided to each of the 5 selected States on an 
                        annual basis for each of fiscal years 2019 
                        through 2023.
                            ``(ii) Carry over.--
                                    ``(I) In general.--The funds 
                                awarded under clause (i) for a fiscal 
                                year shall remain available for the 
                                State to make subgrants under 
                                subsection (c) for such fiscal year, 
                                except a State may carry over (subject 
                                to subclause (II)) not more than 10 
                                percent of such funds for the following 
                                fiscal year for such purpose.
                                    ``(II) Request.--A State may make a 
                                request to the Secretary to carry over 
                                more than 10 percent of the funds 
                                awarded under clause (i) for a fiscal 
                                year for the following fiscal year for 
                                such purpose, and the Secretary may 
                                grant such request as the Secretary 
                                determines appropriate.
                                    ``(III) Amount for following fiscal 
                                year.--Any amount carried over under 
                                this clause shall not impact the amount 
                                of the funds the Secretary awards the 
                                State for such following fiscal year.
                            ``(iii) Return of funds.--Any funds awarded 
                        under clause (i) that are not expended during 
                        the fiscal year for which the funds are awarded 
                        and that are not carried over for the following 
                        fiscal year under clause (ii) shall be returned 
                        to the Secretary to carry out this section. Any 
                        funds returned to the Secretary after fiscal 
                        year 2023 shall be returned to the general fund 
                        of the Treasury.
            ``(2) 1-year grants.--
                    ``(A) In general.--The Secretary shall, for each of 
                fiscal years 2019 through 2023, award 1-year grants to 
                States or Indian tribes under this paragraph that 
                submit an application in accordance with paragraph (3). 
                Such States or Indian tribes shall be selected for a 
                grant under this paragraph based on criteria 
                established by the Secretary.
                    ``(B) Grant funds.--
                            ``(i) In general.--The funds awarded 
                        through a grant under subparagraph (A) for a 
                        fiscal year shall remain available for the 
                        State or Indian tribe to make subgrants under 
                        subsection (c) for such fiscal year and may not 
                        be carried over for such following fiscal year.
                            ``(ii) Return of funds.--Any funds awarded 
                        through a grant under subparagraph (A) that are 
                        not expended during the fiscal year of the 
                        grant shall be returned to the Secretary to 
                        carry out this section. Any funds returned to 
                        the Secretary after fiscal year 2023 shall be 
                        returned to the general fund of the Treasury.
            ``(3) Applications.--
                    ``(A) In general.--Each State desiring a grant 
                under paragraph (1) and each State or Indian tribe 
                desiring a grant under paragraph (2) shall submit an 
                application to the Secretary at such time and in such 
                manner as the Secretary may reasonably require for such 
                grant.
                    ``(B) Contents.--
                            ``(i) In general.--An application submitted 
                        under subparagraph (A) shall contain such 
                        information as the Secretary may reasonably 
                        require, including a proposal for awarding 
                        subgrants under subsection (c) and a method for 
                        evaluating such subgrants.
                            ``(ii) 5-year grants.--An application 
                        submitted under subparagraph (A) for a grant 
                        awarded under subsection (b)(1) shall include 
                        an assurance that not less than 50 percent of 
                        the funds awarded through the grant will be 
                        used towards making subgrants under subsection 
                        (c) to the entities applying for such subgrants 
                        that serve the areas in the State with the 
                        highest prevalence of substance use disorder, 
                        based on data determined appropriate by the 
                        Secretary.
    ``(c) Subgrants.--
            ``(1) In general.--Each State that receives a grant under 
        subsection (b)(1) and each State or Indian tribe that receives 
        a grant under subsection (b)(2) shall award subgrants on a 
        competitive basis to entities that meet the requirements under 
        paragraphs (2) and (3).
            ``(2) Subgrant requirements.--
                    ``(A) Application.--An entity that desires a 
                subgrant under this subsection shall submit an 
                application to the State or Indian tribe at such time 
                and in such manner as the State or Indian tribe may 
                reasonably require.
                    ``(B) Contents.--An application submitted under 
                subparagraph (A) by an entity shall contain such 
                information as the State or Indian tribe may reasonably 
                require, including a demonstration that the entity has 
                one or more of the following abilities:
                            ``(i) The ability to partner with local 
                        stakeholders, which may include local 
                        employers, community stakeholders, and local 
                        and State governments, to identify gaps in the 
                        workforce due to the prevalence of substance 
                        use disorders.
                            ``(ii) The ability to partner with local 
                        stakeholders, which may include local 
                        employers, community stakeholders, and local 
                        and State governments, to offer transitional 
                        services, including employment and career 
                        counseling or job placement, to help 
                        individuals in recovery from a substance use 
                        disorder transition into the workforce.
                            ``(iii) The ability to partner with local 
                        stakeholders, which may include local 
                        employers, community stakeholders, and local 
                        and State governments, to assist employers with 
                        informing their employees of the resources, 
                        such as treatment options for a substance use 
                        disorder, that are available to them.
            ``(3) Use of funds.--An entity receiving a subgrant under 
        this subsection shall use the subgrant funds for more than one 
        of the following:
                    ``(A) To hire specialists with an expertise in 
                treating substance use disorders, including through 
                residential treatment, to assist with the treatment 
                provided through a subgrant under this subsection, 
                which may include the use of medication-assisted 
                treatment.
                    ``(B) To provide wrap-around services to encourage 
                substance use disorder prevention, treatment, recovery, 
                and rehabilitation, with a focus on ensuring long-term 
                recovery and symptom remission.
                    ``(C) To help individuals transition from inpatient 
                treatment for a substance use disorder to the workforce 
                by providing--
                            ``(i) career services described in 
                        paragraph (2), and training services described 
                        in paragraph (3), of section 134(c) of the 
                        Workforce Innovation and Opportunity Act (29 
                        U.S.C. 3174(c)); and
                            ``(ii) related services described in 
                        section 134(a)(4)(D) of such Act (42 U.S.C. 
                        3174(a)(4)(D)).
                    ``(D) To implement innovative technologies to make 
                substance use disorder treatment more affordable and 
                accessible, which may include the use of telemedicine, 
                and may assist individuals in finding and maintaining 
                employment throughout recovery.
                    ``(E) To provide ongoing outpatient substance use 
                disorder treatment programs, including peer support 
                meetings, for individuals who have recovered or are in 
                recovery from a substance use disorder while they 
                transition from receiving treatment for such disorder 
                to entering the workforce and maintaining employment.
                    ``(F) To assist patients, including through hiring 
                case managers, care coordinators, or trained peer 
                recovery coaches, in recovery from a substance use 
                disorder, including through programs to provide 
                services to develop daily living skills, provide 
                counseling, and provide housing assistance, and through 
                other appropriate Federal Government assistance 
                programs.
                    ``(G) With respect to an entity that provides the 
                full continuum of substance use disorder treatment 
                services, which may include detoxification, residential 
                rehabilitation, recovery housing, evidence-based 
                treatments (which may include the use of medication-
                assisted treatment), counseling, and recovery supports, 
                to expand such services to include services that may 
                include--
                            ``(i) short-term prevocational training 
                        services, such as the development of learning 
                        skills, communication skills, interviewing 
                        skills, punctuality, personal maintenance 
                        skills, and professional conduct;
                            ``(ii) vocational training, which shall 
                        emphasize the skills or knowledge necessary for 
                        a particular job function or trade; and
                            ``(iii) care coordination throughout the 
                        short- and long-term substance use disorder 
                        recovery process.
                    ``(H) Any other service determined by the Secretary 
                as necessary for achieving the goal of transitioning 
                individuals from treatment for substance use disorders 
                to independent living and the workforce or to 
                encouraging substance use disorder prevention in the 
                workforce.
    ``(d) Consultation.--The Secretary may, in carrying out the pilot 
program under this section, consult with the Assistant Secretary for 
Substance Use and Mental Health, the Administrator of the Health 
Resources and Services Administration, the Secretary of Labor, the 
Secretary of Housing and Urban Development, and the Secretary of 
Education.
    ``(e) Reporting Requirements.--
            ``(1) Reports to the secretary.--
                    ``(A) 5-year grants.--Not later than December 31, 
                2021, each State that has received a grant under 
                subsection (b)(1) shall report to the Secretary on its 
                progress and effectiveness in meeting the objectives of 
                the pilot program under this section, including the 
                progress and effectiveness of the entities receiving 
                subgrants under subsection (c) as demonstrated through 
                reports of such progress and effectiveness submitted to 
                the State by such entities.
                    ``(B) 1-year grants.--Not later than December 31 of 
                the fiscal year following the fiscal year for which a 
                grant is awarded under subsection (b)(2), the State or 
                Indian tribe receiving such grant shall report to the 
                Secretary on its progress and effectiveness in meeting 
                the objectives of the pilot program under this section, 
                including the progress and effectiveness of the 
                entities receiving subgrants under subsection (c) which 
                may be demonstrated through reports of such progress 
                and effectiveness submitted to the State or Indian 
                tribe by such entities.
            ``(2) Report to congress.--Not later than December 31, 
        2024, the Secretary shall submit a report to Congress, 
        including any applicable authorizing committee of the Senate or 
        House of Representatives, evaluating the grants awarded under 
        this section.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated $200,000,000, for each of fiscal years 2019 through 2023, 
to carry out this section. Out of such amount appropriated for each 
such fiscal year--
            ``(1) 75 percent shall be used to make grants under 
        subsection (b)(1); and
            ``(2) 25 percent shall be used to make grants under 
        subsection (b)(2).''.

SEC. 3. TRANSITIONAL HOUSING SERVICES.

    (a) In General.--Section 105(a) of the Housing and Community 
Development Act of 1974 (42 U.S.C. 5305(a)) is amended--
            (1) in paragraph (25)(D), by striking ``and'' at the end;
            (2) in paragraph (26), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following:
            ``(27) providing temporary housing services to individuals 
        who are transitioning out of substance abuse treatment programs 
        for--
                    ``(A) a period of not more than 24 months or until 
                the individual secures permanent housing, whichever is 
                earlier; or
                    ``(B) such longer period as the Secretary 
                determines necessary.''.
    (b) Additional CDBG Authorization of Appropriations.--
            (1) Definition of covered entity.--In this subsection, the 
        term ``covered entity'' means--
                    (A) a State (as defined in section 102(a) of the 
                Housing and Community Development Act of 1974 (42 
                U.S.C. 5302(a))) that is among the 10 States with the 
                highest rate of death due to drug overdose per 100,000 
                people, based on data from the Centers for Disease 
                Control and Prevention for calendar years 2013 through 
                2017; and
                    (B) any entitlement community located in a State 
                described in subparagraph (A).
            (2) Authorization of appropriations.--In addition to any 
        amounts appropriated for the community development block grant 
        program under title I of the Housing and Community Development 
        Act of 1974 (42 U.S.C. 5301 et seq.), there are authorized to 
        be appropriated $25,000,000 for each of fiscal years 2019 
        through 2023, to be allocated by the Secretary of Housing and 
        Urban Development on a competitive basis to covered entities to 
        carry out the activity described in paragraph (27) of section 
        105(a) of such Act (42 U.S.C. 5305(a)), as added by subsection 
        (a).
            (3) Preferences.--In allocating amounts authorized to be 
        appropriated under paragraph (2), the Secretary of Housing and 
        Urban Development shall give priority to--
                    (A) States from among the States described in 
                paragraph (1)(A) with a combination of--
                            (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 provided by 
                        the Bureau of Labor Statistics for calendar 
                        years 2013 through 2017; and
                            (iii) the highest prevalence of opioid use 
                        disorder based on data provided by the 
                        Substance Abuse and Mental Health Services 
                        Administration for calendar years 2013 through 
                        2017 as may be available; and
                    (B) entitlement communities located in a State 
                described in clause (i), (ii), or (iii) of subparagraph 
                (A).

SEC. 4. SUBSTANCE USE DISORDER TRANSITION ACTIVITIES.

    (a) Reservations for State Activities.--Section 133(a)(1) of the 
Workforce Innovation and Opportunity Act (29 U.S.C. 3173(a)(1)) is 
amended--
            (1) by striking ``The Governor'' and inserting the 
        following:
                    ``(A) In general.--The Governor''; and
            (2) by adding at the end the following:
                    ``(B) Substance use disorder transition 
                activities.--
                            ``(i) Adult and dislocated funds.--Of the 
                        funds reserved as required under section 
                        128(a)(1) and subparagraph (A), the Governor of 
                        a State with an application approved under 
                        section 134(a)(4) may reserve a sum of not more 
                        than 5 percent of each of the amounts allotted 
                        to the State under paragraphs (1)(B) and (2)(B) 
                        of section 132(b) for a fiscal year for 
                        substance use disorder transition activities 
                        described in section 134(a)(4). Notwithstanding 
                        sections 128(a)(2), 129(b), and 134(a), the 
                        Governor may not use an amount allotted under 
                        section 127(b)(1)(C) for those activities.
                            ``(ii) Vocational rehabilitation funds.--
                        The Governor of a State with such an approved 
                        application may reserve funds as described in 
                        section 110(e) of the Rehabilitation Act of 
                        1973 (29 U.S.C. 730(e)) for substance use 
                        disorder transition activities described in 
                        section 134(a)(4).''.
    (b) Statewide Employment and Training Activities.--
            (1) In general.--Section 134(a)(1) of the Workforce 
        Innovation and Opportunity Act (29 U.S.C. 3174(a)(1)) is 
        amended--
                    (A) in subparagraph (A), by striking ``and'' at the 
                end;
                    (B) in subparagraph (B), in the matter following 
                clause (ii), by striking the period and inserting ``; 
                and''; and
                    (C) by adding at the end the following:
                    ``(C) as described in section 133(a)(1)(B), may be 
                used for substance use disorder transition activities 
                as described in paragraph (4), regardless of whether 
                the funds were allotted to the State under paragraph 
                (1) or (2) of section 132(b).''.
            (2) Substance use disorder transition activities.--Section 
        134(a) of the Workforce Innovation and Opportunity Act (29 
        U.S.C. 3174(a)) is amended by adding at the end the following:
            ``(4) Substance use disorder transition activities.--
                    ``(A) Definitions.--In this paragraph:
                            ``(i) Appropriate secretary.--The term 
                        `appropriate Secretary' means--
                                    ``(I) except as provided in 
                                subclause (II), the Secretary of Labor; 
                                or
                                    ``(II) if the application involves 
                                funds reserved under section 110(e) of 
                                the Rehabilitation Act of 1973 (29 
                                U.S.C. 730(e)), the Secretary of Labor 
                                and the Secretary of Education.
                            ``(ii) Substance use disorder.--The term 
                        `substance use disorder' means such a disorder 
                        within the meaning of the term in title V of 
                        the Public Health Service Act (42 U.S.C. 290aa 
                        et seq.).
                            ``(iii) Substance use disorder transition 
                        activities.--The term `substance use disorder 
                        transition activities' means activities 
                        authorized under subparagraph (D) or (E).
                    ``(B) Eligible states.--To be eligible to use the 
                funds reserved under clause (i) or (ii) of section 
                133(a)(1)(B) for substance use disorder transition 
                activities described in this paragraph, a State shall--
                            ``(i) submit to the appropriate Secretary 
                        an application seeking flexibility to use the 
                        reserved funds for such activities, and submit 
                        the application at such time, in such manner, 
                        and containing such information as the 
                        appropriate Secretary may require, including an 
                        assurance that the State will award subgrants 
                        to entities on the basis of the ability of the 
                        entities to provide the substance use disorder 
                        transition activities involved, including any 
                        programs that the entities propose to provide 
                        that lead to recognized postsecondary 
                        credentials; and
                            ``(ii) obtain approval of the application.
                    ``(C) Subgrants.--An eligible State may use the 
                funds reserved under clause (i) or (ii) of section 
                133(a)(1)(B) to make subgrants to one-stop operators 
                and nonprofit organizations, to provide services under 
                subparagraph (D) and (at the election of the State) 
                subparagraph (E).
                    ``(D) Career services.--An entity that receives a 
                subgrant under subparagraph (C) shall use the subgrant 
                funds to assist individuals in recovery from a 
                substance use disorder in transitioning to the 
                workforce, by providing career services (such as the 
                services described in section 134(c)(2)) and related 
                services, which may include one or more of--
                            ``(i) providing ongoing career counseling, 
                        both before and after job placement, with a 
                        focus on individual employment preferences 
                        while weighing the skill needs of industries in 
                        the local area;
                            ``(ii) promoting systemic job development, 
                        by facilitating voluntary programs and 
                        relationships between participants and local 
                        employers to create potential employment 
                        opportunities;
                            ``(iii) providing benefits counseling--
                                    ``(I) to ensure participants 
                                receive accurate information regarding 
                                how employment will affect access to 
                                various Federal programs, such as the 
                                Medicaid program established under 
                                title XIX of the Social Security Act 
                                (42 U.S.C. 1396 et seq.) and the 
                                supplemental security income program 
                                established under title XVI of that Act 
                                (42 U.S.C. 1381 et seq.); and
                                    ``(II) to advise participants on 
                                ways to transition away from the 
                                programs described in subclause (I) 
                                through maintaining employment;
                            ``(iv) creating voluntary programs with 
                        employers to establish a work and treatment 
                        arrangement, such as an Employee Assistance 
                        Program, for employees in recovery from a 
                        substance use disorder;
                            ``(v) providing educational materials or 
                        training to employers to enable the employers 
                        to inform their employees of the resources, 
                        such as treatment options for a substance use 
                        disorder, that are available to them; and
                            ``(vi) any other career services that are 
                        determined to be necessary by the appropriate 
                        Secretary and that would assist individuals in 
                        recovery from a substance use disorder in 
                        transitioning to the workforce.
                    ``(E) Training services.--An entity that receives a 
                subgrant under subparagraph (C) shall (at the election 
                of the State) use the subgrant funds to assist 
                individuals in recovery from a substance use disorder 
                in transitioning to the workforce, by providing 
                training services.''.
    (c) Administration.--Section 181 of the Workforce Innovation and 
Opportunity Act (29 U.S.C. 3241) is amended--
            (1) by redesignating subsection (g) as subsection (h); and
            (2) by inserting after subsection (f) the following:
    ``(g) Relationship to Other Laws.--
            ``(1) Disability nondiscrimination law.--Subject to 
        paragraph (2), an employer that employs, or considers for 
        employment, any individual who receives services under this 
        section or under section 320B of the Public Health Service Act 
        shall have an absolute defense to any claim (including a 
        charge) of unlawful discrimination on the basis of disability 
        under a covered law, that alleges that the employer 
        discriminated against that individual (which may include 
        refusing to hire or terminating the employment of the 
        individual) based on alcohol addiction or past substance use 
        disorder for which the individual receives such services.
            ``(2) Rule of construction.--Nothing in paragraph (1) shall 
        be construed to eliminate the duty of the employer, to an 
        employee who is an individual who receives such services, to 
        provide a reasonable accommodation for an alcohol disorder, or 
        a past substance use disorder, that is a disability under a 
        covered law.
            ``(3) Definitions.--In this subsection:
                    ``(A) Covered law.--The term `covered law' means 
                title I of the Americans with Disabilities Act of 1990 
                (42 U.S.C. 12111 et seq.), title V of the 
                Rehabilitation Act of 1973 (29 U.S.C. 791 et seq.), or 
                a State law (including local law), that prohibits 
                discrimination on the basis of disability in 
                employment.
                    ``(B) Substance use disorder.--The term `substance 
                use disorder' means such a disorder within the meaning 
                of the term in title V of the Public Health Service Act 
                (42 U.S.C. 290aa et seq.).''.
    (d) Other Core Programs.--Section 110 of the Rehabilitation Act of 
1973 (29 U.S.C. 730) is amended by adding at the end the following:
    ``(e)(1) In the case of a transition State, from any State 
allotment under subsection (a) for a fiscal year, the State may reserve 
not more than 5 percent of the allotted funds for substance use 
disorder transition activities described in section 134(a)(4) of the 
Workforce Innovation and Opportunity Act (29 U.S.C. 3174(a)(4)).
    ``(2) In this section, the term `transition State' means a State 
with an application approved under section 134(a)(4) of the Workforce 
Innovation and Opportunity Act.''.
                                 <all>