[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 4839 Introduced in Senate (IS)]
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117th CONGRESS
2d Session
S. 4839
To reauthorize and expand a grant program for State and Tribal response
to opioid and stimulant use and misuse, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 13, 2022
Ms. Baldwin (for herself and Mrs. Shaheen) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To reauthorize and expand a grant program for State and Tribal response
to opioid and stimulant use and misuse, 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 ``State Opioid Response Grant
Authorization Act of 2022''.
SEC. 2. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID AND
STIMULANT USE AND MISUSE.
Section 1003 of the 21st Century Cures Act (42 U.S.C. 290ee3 note)
is amended to read as follows:
``SEC. 1003. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID AND
STIMULANT USE AND MISUSE.
``(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the `Secretary') shall carry out the
grant program described in subsection (b) for purposes of addressing
opioid use disorder and stimulant misuse and use disorders, within
States, Indian Tribes, and populations served by Tribal organizations
and Urban Indian organizations.
``(b) Grants Program.--
``(1) In general.--Subject to the availability of
appropriations, the Secretary shall award grants to States,
Indian Tribes, Tribal organizations, and Urban Indian
organizations for the purpose of addressing opioid use disorder
and stimulant use and misuse, within such States, such Indian
Tribes, and populations served by such Tribal organizations and
Urban Indian organizations, in accordance with paragraph (2).
``(2) Minimum allocations; preference.--In determining
grant amounts for each recipient of a grant under paragraph
(1), the Secretary shall--
``(A) ensure that each State receives not less than
$12,000,000; and
``(B) give preference to States, Indian Tribes,
Tribal organizations, and Urban Indian organizations--
``(i) whose populations have an incidence
or prevalence of opioid use disorder that is
substantially higher relative to the
populations of other States, Indian Tribes,
Tribal organizations, or Urban Indian
organizations, as applicable; or
``(ii) whose areas are more rural relative
to the populations of other States, Indian
Tribes, Tribal organizations, or Urban Indian
organizations, as applicable.
``(3) Formula methodology.--
``(A) In general.--At least 30 days before
publishing a funding opportunity announcement with
respect to grants under this section, the Secretary
shall--
``(i) develop a formula methodology,
consistent with paragraph (2), to be followed
in allocating grant funds awarded under this
section among grantees, which includes
performance assessments for continuation
awards; and
``(ii) not later than 30 days after
developing the formula methodology under clause
(i), submit the formula methodology to--
``(I) the Committee on Health,
Education, Labor, and Pensions and the
Committee on Appropriations of the
Senate; and
``(II) the Committee on Energy and
Commerce and the Committee on
Appropriations of the House of
Representatives.
``(B) Transition period for new formula
methodology.--The Secretary shall set a 2-year
transition period for the implementation of any new
formula methodology if such new formula methodology
would reduce the allocation of any State by more than
10 percent.
``(C) Consideration.--The Secretary shall ensure
that the formula developed under subparagraph (A)
avoids a significant cliff between States with similar
mortality rates related to opioid use disorders to
prevent unusually large funding changes in States when
compared to prior year allocations.
``(D) Report.--Not later than 2 years after the
date of the enactment of the State Opioid Response
Grant Authorization Act of 2022, the Comptroller
General of the United States 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 that assesses--
``(i) how grant funding is allocated to
States under this section and how such
allocations have changed over time;
``(ii) how any changes within the specified
2-year period after the date of enactment of
the State Opioid Response Grant Authorization
Act of 2022 have affected the efforts of States
to address opioid use disorder or stimulant use
and misuse; and
``(iii) the use of funding provided through
the grant program under this section and other
similar grant programs administered by the
Substance Abuse and Mental Health Services
Administration.
``(4) Use of funds.--Grants awarded under this subsection
shall be used for carrying out activities that supplement
activities pertaining to opioid use disorder and stimulant use
and misuse, undertaken by the State agency responsible for
administering the substance abuse prevention and treatment
block grant under subpart II of part B of title XIX of the
Public Health Service Act (42 U.S.C. 300x-21 et seq.), which
may include public health-related activities such as the
following:
``(A) Implementing substance use disorder and
overdose prevention activities and evaluating such
activities to identify effective strategies to prevent
substance use disorders and overdoses.
``(B) Establishing or improving prescription drug
monitoring programs.
``(C) Training for health care practitioners, such
as best practices for prescribing opioids and
stimulants, pain management, recognizing potential
cases of substance use disorders, referral of patients
to treatment programs, preventing diversion of
controlled substances, and overdose prevention.
``(D) Supporting access to health care services,
including--
``(i) services provided by federally-
certified opioid or stimulant treatment
programs;
``(ii) outpatient and residential substance
use disorder treatment services that utilize,
or refer patients to, medication-assisted
treatment, where clinically appropriate;
``(iii) services to treat substance use
disorders provided by other appropriate health
care providers and at other locations; or
``(iv) overdose prevention programs and
services, including drugs or devices approved,
cleared, or otherwise legally marketed under
the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected
overdose.
``(E) Recovery support services, including--
``(i) community-based services that include
peer supports;
``(ii) mutual aid recovery programs that
support medication-assisted treatment;
``(iii) services to address housing needs,
transportation needs, food insecurity, and
employment issues; or
``(iv) resources or programs that support
families that include an individual with a
substance use disorder, including education,
training, outreach, and peer support services.
``(F) Other public health-related activities, as
the grant recipient determines appropriate, related to
addressing substance use disorders within the State,
Indian Tribe, Tribal organization, or Urban Indian
organization, including directing resources in
accordance with local needs related to substance use
disorders.
``(c) Accountability and Oversight.--A State receiving a grant
under subsection (b) shall include in reporting related to substance
use disorders submitted to the Secretary pursuant to section 1942 of
the Public Health Service Act (42 U.S.C. 300x-52), a description of--
``(1) the purposes for which the grant funds received by
the State under such subsection for the preceding fiscal year
were expended and a description of the activities of the State
under the grant;
``(2) the ultimate recipients of amounts provided to the
State; and
``(3) the number of individuals served through each of the
activities of the State under the grant and the total number of
individuals served through the grant.
``(d) Limitations.--Any funds made available pursuant to subsection
(i)--
``(1) notwithstanding any transfer authority in any
appropriations Act, shall not be used for any purpose other
than the grant program under subsection (b); and
``(2) shall be subject to the same requirements as
substance use disorders prevention and treatment programs under
titles V and XIX of the Public Health Service Act (42 U.S.C.
290aa et seq., 300w et seq.).
``(e) Indian Tribes, Tribal Organizations, and Urban Indian
Organizations.--The Secretary, in consultation with Indian Tribes,
Tribal organizations, and Urban Indian organizations, shall identify
and establish appropriate mechanisms for Indian Tribes, Tribal
organizations, and Urban Indian organizations to demonstrate or report
information as required under subsections (b), (c), and (d).
``(f) Report to Congress.--Not later than September 30, 2024, and
biennially thereafter, the Secretary shall submit to the Committee on
Health, Education, Labor, and Pensions and the Committee on
Appropriations of the Senate and the Committee on Energy and Commerce
and the Committee on Appropriations of the House of Representatives a
report that includes a summary of the information provided to the
Secretary in reports made pursuant to subsections (c) and (e),
including--
``(1) the purposes for which grant funds are awarded under
this section;
``(2) the activities of the grant recipients; and
``(3) for each State, Indian Tribe, Tribal organization,
and Urban Indian organization that receives a grant under this
section, the funding level provided to such recipient.
``(g) Technical Assistance.--The Secretary, acting, as appropriate,
through the Tribal Training and Technical Assistance Center of the
Substance Abuse and Mental Health Services Administration, shall
provide States, Indian Tribes, Tribal organizations, and Urban Indian
organizations, as applicable, with--
``(1) technical assistance concerning grant application and
submission procedures under this section;
``(2) award management activities; and
``(3) enhancement of outreach and direct support to rural
and underserved communities and providers in addressing
substance use disorders.
``(h) Definitions.--In this section:
``(1) Indian tribe; tribal organization.--The terms `Indian
Tribe' and `Tribal organization' have the meanings given such
terms in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 5304).
``(2) State.--The term `State' has the meaning given such
term in section 1954(b) of the Public Health Service Act (42
U.S.C. 300x-64(b)).
``(3) Urban indian organization.--The term `Urban Indian
organization' has the meaning given such term in section 4 of
the Indian Health Care Improvement Act (25 U.S.C. 1603).
``(i) Authorization of Appropriations.--
``(1) In general.--For purposes of carrying out the grant
program under subsection (b), there is authorized to be
appropriated $2,700,000,000 for each of fiscal years 2023
through 2027, to remain available until expended.
``(2) Federal administrative expenses.--Of the amounts made
available for each fiscal year to award grants under subsection
(b), the Secretary shall use not more than 2 percent for
Federal administrative expenses, training, technical
assistance, and evaluation.
``(3) Set aside.--Of the amounts made available for each
fiscal year to award grants under subsection (b) for a fiscal
year, the Secretary shall--
``(A) award 5 percent to Indian Tribes, Tribal
organizations, and Urban Indian organizations; and
``(B) award up to 15 percent to States with the
highest age-adjusted rates of drug overdose death over
the most recent 2-year period, according to the
Director of the Centers for Disease Control and
Prevention.''.
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