II 117th CONGRESS 2d Session S. 4301 IN THE SENATE OF THE UNITED STATES May 25, 2022 Ms. Hassan (for herself, Ms. Murkowski , and Mr. Luján ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To reauthorize and improve the block grants for prevention and treatment of substance abuse.

1. Short title This Act may be cited as the Substance Use Prevention, Treatment, and Recovery Act . 2. Other amendments to the block Grants for Prevention and Treatment of Substance Abuse (a) Certain allocations (1) Allocations regarding recovery Section 1922 of the Public Health Service Act ( 42 U.S.C. 300x–22 ) is amended by adding at the end the following: (c) Allocations regarding recovery (1) In general A funding agreement for this grant under section 1921 is that, in expending the grant, the State involved will expend not less than 10 percent each fiscal year for programs for community-based and peer recovery support services for individuals with a substance use disorder. (2) Special rule for 2023 Notwithstanding paragraph (1), for fiscal year 2023, a State shall expend not less than 7 percent for programs described in such paragraph, provided that, in fiscal year 2024, the State expends for such programs an amount equal to any difference between 10 percent of the grant amount for fiscal year 2023 and the amount actually expended for such programs in fiscal year 2023, in addition to meeting the requirements of paragraph (1) with respect to grant amounts for fiscal year 2024. . (2) Technical amendment Effective as if included in the enactment of the Children's Health Act of 2000 ( Public Law 106–310 ), section 3303(f)(2)(A) of the Children's Health Act of 2000 ( Public Law 106–310 ; 114 Stat. 1211) is amended by striking section 1922(c) of the Public Health Service Act ( 42 U.S.C. 300x–22(c) ) and inserting section 1922(b) of the Public Health Service Act, as amended by section 3303(a), . (b) Public health promotion for recovery (1) Formula grants Section 1921(b) of the Public Health Service Act ( 42 U.S.C. 300x–21(b) ) is amended— (A) by inserting , including measures for infrastructure, education, or outreach to prevent overdose or other health risks, after substance use disorders ; and (B) by inserting evidence-based or evidence-informed after evaluating . (2) Certain restrictions on expenditures Section 1931(a)(1) of the Public Health Service Act ( 42 U.S.C. 300x–31(a)(1) ) is amended— (A) in subparagraph (E), by striking ; or and inserting a semicolon; (B) in subparagraph (F), by striking the period and inserting ; or ; and (C) by adding at the end the following: (G) in a manner that excludes individuals on the basis that such individuals receive drugs approved by the Food and Drug Administration for the treatment of substance use disorders. . (c) Restrictions on expenditure of grant Section 1931(a) of the Public Health Service Act ( 42 U.S.C. 300x–31(a) ) is amended— (1) in paragraph (1)(F), by inserting , except that the State may use such grant to provide support to programs that include infrastructure, education, or outreach services before the period; and (2) by amending paragraph (3) to read as follows: (3) Limitation regarding penal and correctional institutions A funding agreement for this grant under section 1921 is that, in expending the grant, the State involved will expend not more than such a percentage of the block grant treatment budget, between 5 and 10 percent, as the Secretary may specify, for the purpose of providing treatment services in penal or correctional institutions of the State. . (d) Study on assessment for use in distribution of limited State resources (1) In general The Secretary of Health and Human Services (referred to in this section as the Secretary ), acting through the Assistant Secretary for Mental Health and Substance Use, in consultation with States and other local entities providing prevention, treatment, or recovery support services related to substance use, shall conduct a study to develop a model needs assessment process for States to consider to help determine how best to allocate block grant funding received under subpart II of part B of title XIX of the Public Health Service Act ( 42 U.S.C. 300x–21 et seq. ) to provide services to substance use disorder prevention, treatment, and recovery support. The study shall include cost estimates with each model needs assessment process. (2) Report Not later than 1 year after the date of the enactment of this Act, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report on the results of the study conducted under paragraph (1). (e) Funding Section 1935(a) of the Public Health Service Act ( 42 U.S.C. 300x–35(a) ) is amended by striking $1,858,079,000 for each of fiscal years 2018 through 2022. and inserting $3,200,000,000 for each of fiscal years 2023 through 2027 . 3. Eliminating stigmatizing language relating to substance use (a) Block Grants for Prevention and Treatment of Substance Use Part B of title XIX of the Public Health Service Act ( 42 U.S.C. 300x et seq. ) is amended— (1) in the part heading, by striking Substance Abuse and inserting Substance Use ; (2) in section 1922(a) ( 42 U.S.C. 300x–22(a) )— (A) in paragraph (1), in the matter preceding subparagraph (A), by striking substance abuse and inserting substance use disorders ; and (B) by striking such abuse each place it appears in paragraphs (1) and (2) and inserting such use ; (3) in section 1923 ( 42 U.S.C. 300x–23 )— (A) in the section heading, by striking Substance Abuse and inserting Substance Use ; and (B) by striking drug abuse each place it appears in subsections (a) and (b) and inserting substance use disorders ; (4) in section 1925(a)(1) ( 42 U.S.C. 300x–25(a)(1) ), by striking alcohol or drug abuse and inserting alcohol or other substance use disorders ; (5) in section 1926(b)(2)(B) ( 42 U.S.C. 300x–26(b)(2)(B) ), by striking substance abuse ; (6) in section 1931(b)(2) ( 42 U.S.C. 300x–31(b)(2) ), by striking substance abuse and inserting substance use disorders ; (7) in section 1933(d)(1) ( 42 U.S.C. 300x–33(d) ), in the matter following subparagraph (B), by striking abuse of alcohol and other drugs and inserting use of substances ; (8) by amending paragraph (4) of section 1934 ( 42 U.S.C. 300x–34 ) to read as follows: (4) The term substance use disorder means the recurrent use of alcohol or other drugs that causes clinically significant impairment. ; (9) in section 1935 ( 42 U.S.C. 300x–35 )— (A) in subsection (a), by striking substance abuse and inserting substance use disorders ; and (B) in subsection (b)(1), by striking substance abuse each place it appears and inserting substance use disorders ; (10) in section 1949 ( 42 U.S.C. 300x–59 ), by striking substance abuse each place it appears in subsections (a) and (d) and inserting substance use disorders ; (11) in section 1954(b)(4) ( 42 U.S.C. 300x–64(b)(4) )— (A) by striking substance abuse each place it appears and inserting substance use disorders ; and (B) by striking such abuse and inserting such disorders ; (12) in section 1955 ( 42 U.S.C. 300x–65 ), by striking substance abuse each place it appears and inserting substance use disorder ; and (13) in section 1956 ( 42 U.S.C. 300x–66 ), by striking substance abuse each place it appears and inserting substance use disorders . (b) Certain programs regarding mental health and substance abuse Part C of title XIX of the Public Health Service Act ( 42 U.S.C. 300y et seq. ) is amended— (1) in the part heading, by striking Substance Abuse and inserting Substance Use ; (2) in section 1971 ( 42 U.S.C. 300y ), by striking substance abuse each place it appears in subsections (a), (b), and (f) and inserting substance use ; and (3) in section 1976 ( 42 U.S.C. 300y–11 ), by striking intravenous abuse and inserting intravenous use .