[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2901 Introduced in Senate (IS)]
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117th CONGRESS
1st Session
S. 2901
To amend title V of the Public Health Service Act to provide for
increased oversight of recovery housing, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 29, 2021
Mr. Whitehouse (for himself and Mr. Portman) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend title V of the Public Health Service Act to provide for
increased oversight of recovery housing, 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 ``Excellence in Recovery Housing
Act''.
SEC. 2. CLARIFYING THE ROLE OF SAMHSA IN PROMOTING THE AVAILABILITY OF
HIGH-QUALITY RECOVERY HOUSING.
Section 501(d) of the Public Health Service Act (42 U.S.C. 290aa)
is amended--
(1) in paragraph (24)(E), by striking ``and'' at the end;
(2) in paragraph (25), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(26) collaborate with national accrediting entities and
reputable providers and analysts of recovery housing services
and all relevant Federal agencies, including the Centers for
Medicare & Medicaid Services, the Health Resources and Services
Administration, other offices and agencies within the
Department of Health and Human Services, the Office of National
Drug Control Policy, the Department of Justice, the Department
of Housing and Urban Development, and the Department of
Agriculture, to promote the availability of high-quality
recovery housing for individuals with a substance use
disorder.''.
SEC. 3. DEVELOPING GUIDELINES FOR STATES TO PROMOTE THE AVAILABILITY OF
HIGH-QUALITY RECOVERY HOUSING.
Title V of the Public Health Service Act is amended by inserting
after section 550 of such Act (42 U.S.C. 290ee-5) the following:
``SEC. 550A. DEVELOPING GUIDELINES FOR STATES TO PROMOTE THE
AVAILABILITY OF HIGH-QUALITY RECOVERY HOUSING.
``(a) In General.--Not later than 1 year after the date of
enactment of this section, the Secretary, acting through the Assistant
Secretary, shall develop, and publish on the website of the Substance
Abuse and Mental Health Services Administration, consensus-based
guidelines and nationally recognized standards for States to promote
the availability of high-quality recovery housing for individuals with
a substance use disorder. Such guidelines shall--
``(1) be developed in consultation with national
accrediting entities, reputable providers and analysts of
recovery housing services, and States and be consistent with
the best practices developed under section 550; and
``(2) to the extent practicable, build on existing best
practices and suggested guidelines developed previously by the
Substance Abuse and Mental Health Services Administration.
``(b) Public Comment Period.--Before finalizing guidelines under
subsection (a), the Secretary shall provide for a public comment
period.
``(c) Exclusion of Guideline on Treatment Services.--In developing
the guidelines under subsection (a), the Secretary may not include any
guideline or standard with respect to substance use disorder treatment
services.
``(d) Substance Use Disorder Treatment Services.--In this section,
the term `substance use disorder treatment services' means items or
services furnished for the treatment of a substance use disorder,
including--
``(1) medications approved by the Food and Drug
Administration for use in such treatment, excluding each such
medication used to prevent or treat a drug overdose;
``(2) the administering of such medications;
``(3) recommendations for such treatment;
``(4) clinical assessments and referrals;
``(5) counseling with a physician, psychologist, or mental
health professional (including individual and group therapy);
and
``(6) toxicology testing.''.
SEC. 4. COORDINATION OF FEDERAL ACTIVITIES TO PROMOTE THE AVAILABILITY
OF HIGH-QUALITY RECOVERY HOUSING.
Section 550 of the Public Health Service Act (42 U.S.C. 290ee-5) is
amended--
(1) by redesignating subsections (e), (f), and (g) as
subsections (g), (h), and (i), respectively; and
(2) by inserting after subsection (d) the following:
``(e) Coordination of Federal Activities To Promote the
Availability of High-Quality Recovery Housing for Individuals With a
Substance Use Disorder.--
``(1) In general.--The Secretary, acting through the
Assistant Secretary, and the Secretary of Housing and Urban
Development shall convene an interagency working group, co-
chaired by the Assistant Secretary and the Secretary of Housing
and Urban Development and comprised of representatives of each
of the Federal agencies described in paragraph (2) (referred to
in this section as the `working group') for the following
purposes:
``(A) To increase collaboration, cooperation, and
consultation among such Federal agencies, with respect
to promoting the availability of high-quality recovery
housing.
``(B) To align the efforts of such agencies and
avoid duplication of such efforts by such agencies.
``(C) To develop objectives, priorities, and a
long-term plan for supporting State, Tribal, and local
efforts with respect to the operation of high-quality
recovery housing that is consistent with the best
practices developed under this section.
``(D) To coordinate inspection and enforcement
among Federal and State agencies.
``(E) To coordinate data collection on the quality
of recovery housing.
``(2) Federal agencies described.--The Federal agencies
described in this paragraph are the following:
``(A) The Department of Health and Human Services,
including--
``(i) the Centers for Medicare & Medicaid
Services;
``(ii) the Substance Abuse and Mental
Health Services Administration;
``(iii) the Health Resources and Services
Administration; and
``(iv) the Indian Health Service.
``(B) The Department of Housing and Urban
Development.
``(C) The Department of Agriculture.
``(D) The Department of Justice.
``(E) The Office of National Drug Control Policy.
``(F) The Bureau of Indian Affairs.
``(G) The Department of Labor.
``(H) Any other Federal agency as the co-chairs
determine appropriate.
``(3) Meetings.--The working group shall meet on a
quarterly basis.
``(4) Reports to congress.--Beginning not later than 1 year
after the date of enactment of this section and annually
thereafter, the working group shall submit to the Committee on
Energy and Commerce, the Committee on Ways and Means, the
Committee on Agriculture, and the Committee on Financial
Services of the House of Representatives and the Committee on
Health, Education, Labor, and Pensions, the Committee on
Agriculture, Nutrition, and Forestry, and the Committee on
Finance of the Senate a report describing the work of the
working group and any recommendations of the working group to
improve Federal, State, or local policy with respect to
recovery housing operations.
``(5) Authorization of appropriations.--To carry out this
subsection, there are authorized to be appropriated such sums
as may be necessary for fiscal years 2022 through 2027.''.
SEC. 5. NAS STUDY AND REPORT.
(a) In General.--Not later than 60 days after the date of enactment
of this Act, the Secretary of Health and Human Services, acting through
the Assistant Secretary for Mental Health and Substance Use, shall
enter into an arrangement with the National Academies of Sciences,
Engineering, and Medicine to conduct a study, which may include a
literature review and case studies as appropriate, on--
(1) the quality and effectiveness of recovery housing in
the United States, including the availability in the United
States of high-quality recovery housing and whether that
availability meets the demand for such housing in the United
States; and
(2) State, Tribal, and local regulation and oversight of
recovery housing.
(b) Topics.--The study under subsection (a) shall include a
literature review of studies that--
(1) examine the quality of, and effectiveness outcomes for,
the types and characteristics of covered recovery housing
programs listed in subsection (c); and
(2) identify the research and data gaps that must be filled
to better report on the quality of, and effectiveness outcomes
related to, covered recovery housing.
(c) Type and Characteristics.--The types and characteristics of
covered recovery housing programs referred to in subsection (b) consist
of the following:
(1) Nonprofit and for-profit covered recovery housing.
(2) Private and public covered recovery housing.
(3) Covered recovery housing programs that provide services
to--
(A) residents on a voluntary basis; and
(B) residents pursuant to a judicial order.
(4) Number of clients served, disaggregated to the extent
possible by covered recovery housing serving--
(A) 6 or fewer recovering residents;
(B) 10 to 13 recovering residents; and
(C) 18 or more recovering residents.
(5) Bedroom occupancy in a house, disaggregated to the
extent possible by--
(A) single room occupancy;
(B) 2 residents occupying 1 room; and
(C) more than 2 residents occupying 1 room.
(6) Duration of services received by clients, disaggregated
to the extent possible according to whether the services were--
(A) 30 days or fewer;
(B) 31 to 90 days;
(C) more than 90 days and fewer than 6 months; or
(D) 6 months or more.
(7) Certification levels of staff.
(8) Fraudulent and abusive practices by operators of
covered recovery housing and inpatient and outpatient treatment
facilities, both individually and in concert, including--
(A) deceptive or misleading marketing practices,
including--
(i) inaccurate outcomes-based marketing;
and
(ii) marketing based on non-evidence-based
practices;
(B) illegal patient brokering;
(C) third-party recruiters;
(D) deceptive or misleading marketing practices of
treatment facility and recovery housing online
aggregators; and
(E) the impact of such practices on health care
costs and recovery rates.
(d) Report.--The arrangement under subsection (a) shall require, by
not later than 18 months after the date of entering into the
agreement--
(1) completing the study under such subsection; and
(2) making publicly available (including through
publication on the internet) a report that contains--
(A) the results of the study;
(B) the National Academy's recommendations for
Federal, State, and local policies to promote the
availability of high-quality recovery housing in the
United States;
(C) research and data gaps;
(D) recommendations for recovery housing quality
and effectiveness metrics;
(E) recommended mechanisms to collect data on those
metrics, including with respect to research and data
gaps;
(F) recommendations to eliminate restrictions by
recovery housing that exclude individuals who take
prescribed medications for opioid use disorder; and
(G) a summary of allegations, assertions, or formal
legal actions on the State and local levels by
governments and nongovernmental organizations with
respect to the opening and operation of recovery
housing.
(e) Definitions.--In this subsection:
(1) The term ``covered recovery housing'' means recovery
housing that utilizes compensated or volunteer onsite staff who
are not health care professionals to support residents.
(2) The term ``effectiveness outcomes'' may include
decreased substance use, reduced probability of relapse or
reoccurrence, lower rates of incarceration, higher income,
increased employment, and improved family functioning.
(3) The term ``health care professional'' means an
individual who is licensed or otherwise authorized by the State
to provide health care services.
(4) The term ``recovery housing'' means a shared living
environment that is or purports to be--
(A) free from alcohol and use of nonprescribed
drugs; and
(B) centered on connection to services that promote
sustained recovery from substance use disorders.
(f) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $1,500,000 for fiscal year 2022.
SEC. 6. FILLING RESEARCH AND DATA GAPS.
Not later than 60 days after the completion of the study under
section 5, the Secretary of Health and Human Services shall enter into
an agreement with an appropriate entity to conduct such research as may
be necessary to fill the research and data gaps identified in reporting
pursuant to such section.
SEC. 7. GRANTS FOR STATES TO PROMOTE THE AVAILABILITY OF HIGH QUALITY
RECOVERY HOUSING.
Section 550 of the Public Health Service Act (42 U.S.C. 290ee-5),
as amended by section 4, is further amended by inserting after
subsection (e) (as inserted by section 4) the following:
``(f) Grants for Implementing National Recovery Housing Best
Practices.--
``(1) In general.--The Secretary shall award grants to
States (and political subdivisions of States), Tribes, and
territories--
``(A) for the provision of technical assistance by
national accrediting entities and reputable providers
and analysts of recovery housing services to implement
the guidelines, nationally recognized standards, and
recommendations developed under section 3 of the
Excellence in Recovery Housing Act and this section;
and
``(B) to promote the availability of high-quality
recovery housing for individuals with a substance use
disorder and practices to maintain housing quality long
term.
``(2) State enforcement plans.--Beginning not later than 90
days after the date of enactment of this paragraph and every 2
years thereafter, as a condition on the receipt of a grant
under paragraph (1), each State (or political subdivision of a
State), Tribe, or territory receiving such a grant shall submit
to the Secretary, and make publicly available on a publicly
accessible website of the State (or political subdivision of
the State), Tribe, or territory--
``(A) the plan of the State (or political
subdivision of a State), Tribe, or territory, with
respect to the promotion of high-quality recovery
housing for individuals with a substance use disorder
located within the jurisdiction of such State (or
political subdivision of a State), Tribe, or territory;
and
``(B) a description of how such plan is consistent
with the best practices developed under this section
and guidelines developed under section 550A.
``(3) Review of accrediting entities.--The Secretary shall
periodically review, by developing a rubric to evaluate
accreditation, the accrediting entities providing technical
assistance pursuant to paragraph (1)(A).
``(4) Authorization of appropriations.--To carry out this
subsection, there is authorized to be appropriated $10,000,000
for each of fiscal years 2023 through 2027.''.
SEC. 8. AUTHORIZATION OF APPROPRIATIONS.
Section 550 of the Public Health Service Act (42 U.S.C. 290ee-5),
as amended by sections 4 and 7, is further amended by amending
subsection (i) (as redesignated by such section 4) to read as follows:
``(i) Authorization of Appropriations.--
``(1) In general.--To carry out this section, there is
authorized to be appropriated--
``(A) $2,000,000 for fiscal year 2022; and
``(B) $11,000,000 for each of fiscal years 2023
through 2027.
``(2) Reservations of funds.--For each of fiscal years 2022
through 2027, of the amounts appropriated under paragraph (1)
for such fiscal year, the Secretary shall reserve--
``(A) not less than $1,000,000 to carry out
subsection (e); and
``(B) not less than $10,000,000 to award grants
under paragraphs (1) and (2) of subsection (f).''.
SEC. 9. REPUTABLE PROVIDERS AND ANALYSTS OF RECOVERY HOUSING SERVICES
DEFINITION.
Section 550(h) of the Public Health Service Act (42 U.S.C. 290ee-
5(i)), as redesignated by section 4, is amended by adding at the end
the following:
``(4) The term `reputable providers and analysts of
recovery housing services' means recovery housing service
providers and analysts that--
``(A) use evidence-based approaches;
``(B) act in accordance with guidelines issued by
the Assistant Secretary;
``(C) have not been found guilty of health care
fraud, patient brokering, or false advertising by the
Department of Justice, the Department of Health and
Human Services, or a Medicaid Fraud Control Unit;
``(D) have not been found to have violated Federal,
State, or local codes of conduct with respect to
recovery housing for individuals with a substance use
disorder; and
``(E) do not employ individuals with a past
conviction of criminal, domestic, or sexual violence,
or significant drug distribution, in the care or
supervision of individuals.''.
SEC. 10. TECHNICAL CORRECTION.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.)
is amended--
(1) by redesignating section 550 (relating to Sobriety
Treatment and Recovery Teams) (42 U.S.C. 290ee-10), as added by
section 8214 of Public Law 115-271, as section 550B; and
(2) moving such section so it appears after section 550A
(added by section 3 of this Act).
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