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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public">
	<metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>115 S2437 IS: Opioid Response Enhancement Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2018-02-15</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
<form>
		<distribution-code display="yes">II</distribution-code>
		<congress>115th CONGRESS</congress><session>2d Session</session>
		<legis-num>S. 2437</legis-num>
		<current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber>
		<action>
			<action-date date="20180215">February 15, 2018</action-date>
			<action-desc><sponsor name-id="S354">Ms. Baldwin</sponsor> (for herself, <cosponsor name-id="S324">Mrs. Shaheen</cosponsor>, <cosponsor name-id="S394">Ms. Smith</cosponsor>, <cosponsor name-id="S360">Ms. Heitkamp</cosponsor>, <cosponsor name-id="S307">Mr. Brown</cosponsor>, <cosponsor name-id="S388">Ms. Hassan</cosponsor>, <cosponsor name-id="S338">Mr. Manchin</cosponsor>, <cosponsor name-id="S366">Ms. Warren</cosponsor>, <cosponsor name-id="S311">Ms. Klobuchar</cosponsor>, <cosponsor name-id="S284">Ms. Stabenow</cosponsor>, <cosponsor name-id="S282">Mr. Nelson</cosponsor>, <cosponsor name-id="S363">Mr. King</cosponsor>, <cosponsor name-id="S308">Mr. Cardin</cosponsor>, <cosponsor name-id="S314">Mr. Tester</cosponsor>, <cosponsor name-id="S362">Mr. Kaine</cosponsor>, and <cosponsor name-id="S326">Mr. Udall</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions</committee-name></action-desc>
		</action>
		<legis-type>A BILL</legis-type>
		<official-title>To reauthorize and improve the 21st Century Cures opioid grant program.</official-title>
	</form>
	<legis-body>
		<section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header>
 <text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Opioid Response Enhancement Act</short-title></quote>.</text>
		</section><section id="id7FD40F8CA726419D86B523CC5A525FDE"><enum>2.</enum><header>Opioid grant program reauthorization</header>
 <subsection id="id11E2E591F1EE4890B1182325BD756A90"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1003 of the 21st Century Cures Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290ee-3">42 U.S.C. 290ee–3</external-xref> note) is amended—</text> <paragraph id="id2D9F3F64CFEA47D7AC968F2198E80DCD"><enum>(1)</enum><text>in subsection (b)—</text>
 <subparagraph id="id441BA76420B24BAEA90EE3720E1193B4"><enum>(A)</enum><text>in paragraph (2)(A), by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="id720CC5C57C554FD3B3EC05033CFCDD09" style="OLC"> <clause id="idCF19A295CEF442E0812B0B258C48A846"><enum>(iii)</enum><text>For each of fiscal years 2019 through 2023, $2,000,000,000.</text></clause><after-quoted-block>; and</after-quoted-block></quoted-block>
 </subparagraph><subparagraph id="id5060B80892E54F0989E696BAA9063864"><enum>(B)</enum><text>in paragraph (3)—</text> <clause id="id0ACE1FE5389B46BCA4602D3AF5845C2F"><enum>(i)</enum><text>in subparagraph (A)—</text>
 <subclause id="idE16370086DE14ED99ACB7633453F7075"><enum>(I)</enum><text>by striking <quote>2017 and 2018</quote> and inserting <quote>2019 through 2023</quote>; and</text> </subclause><subclause id="id0B3DF5C3FD8F4AC99B899F9524FA890B"><enum>(II)</enum><text>by inserting after <quote>paragraph (2)(A),</quote> the following: <quote>and in each of the fiscal years 2019 through 2023, there is authorized to be appropriated from the Account to the Secretary, for the grant program described in subsection (c)(3), $400,000,000,</quote>; and</text>
 </subclause></clause><clause id="id6A70A5D0AB474564800DA4E4FF2A91C6"><enum>(ii)</enum><text>in subparagraph (B), by striking <quote>2017 and 2018</quote> and inserting <quote>2019 through 2023</quote>;</text> </clause></subparagraph></paragraph><paragraph id="id88A31D92B92948FEADE6376CBBBB7DC8"><enum>(2)</enum><text>in subsection (c)—</text>
 <subparagraph id="id2DAE8DCCCF7B444F9FF1A25D59DD92E8"><enum>(A)</enum><text>in paragraph (1)—</text> <clause id="idCAC9727A8A304B0E9E829ECE50D4C68F"><enum>(i)</enum><text>by inserting <quote>and Tribal entities</quote> after <quote>grants to States</quote>;</text>
 </clause><clause id="id10BD6A7A2B9E450AB8DE9ABFCE339D8C"><enum>(ii)</enum><text>by inserting <quote>and Tribal entities</quote> after <quote>preference to States</quote>; and</text> </clause><clause id="id87B428F19B764E23996471078FB3D0F6"><enum>(iii)</enum><text>by inserting <quote>or Tribal entities</quote> before the period at the end;</text>
 </clause></subparagraph><subparagraph id="id3C58F433E4BB485E948BA1C161F4AACB"><enum>(B)</enum><text>in paragraph (2)—</text> <clause id="idAB323CAB793C4ADFA9C22AE23DF8D7AF"><enum>(i)</enum><text>in the matter preceding subparagraph (A)—</text>
 <subclause id="idBA4136604D564B439EC15647516FF5D9"><enum>(I)</enum><text>by inserting <quote>, including activities supported by community-based organizations and counties,</quote> after <quote>carrying out activities</quote>; and</text> </subclause><subclause id="idD2883A1A602644C5BE8F2D58BEF342E9"><enum>(II)</enum><text>by striking <quote>to a State</quote>;</text>
 </subclause></clause><clause id="id5621089649C64EAA91F7850295F7CA81"><enum>(ii)</enum><text>in subparagraph (E), by inserting <quote>or Tribal entity</quote> after <quote>State</quote> each place that such term appears; and</text> </clause><clause id="id71CBE4E7B05647C8A040D7A50202BED9"><enum>(iii)</enum><text>by adding at the end the following:</text>
							<quoted-block display-inline="no-display-inline" id="id088843FB425F4AE3BCF0BFBB5110B388" style="OLC">
 <subparagraph id="idD151F3F0BC37483DA51955F76868046F"><enum>(F)</enum><text>In addition to carrying out activities related to addressing the opioid epidemic, a State or Tribal entity may use grants awarded under this section for carrying out public-health activities related to addressing other substance abuse, as determined appropriate and as determined to be a substantial or similar public health threat as the opioid epidemic by the State or Tribal entity.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
 </clause></subparagraph><subparagraph id="idBF9B46E42C654EA09752FCD0CDA0BA2A"><enum>(C)</enum><text>by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="id066313CBE79A44B382EB9AC5AEF8A0BC" style="OLC"> <paragraph id="id2C56A6EE9CE549EFA630D60B213476D0"><enum>(3)</enum><header>Targeted response enhancement grants</header> <subparagraph id="id6391E53118D64C0DBA02F8111402D51D"><enum>(A)</enum><header>In general</header><text>Subject to the availability of appropriations, the Secretary shall use 50 percent of the amount transferred under subsection (b)(2)(A)(iii) in each fiscal year to award supplemental funding grants to at least 10 States and Tribal entities, to expand and enhance grant activities required under this subsection. In awarding such grants, the Secretary shall give preference to areas of greatest need, including as indicated by higher mortality rates associated with opioid overdoses.</text>
 </subparagraph><subparagraph id="id9a43906c2ce74a5caeb60d59ee0fc428"><enum>(B)</enum><header>Use of funds</header><text>Grants awarded to a State or Tribal entity under this paragraph shall be used for carrying out activities to supplement activities otherwise carried out under this subsection to expand and enhance prevention, treatment, and recovery support efforts in States and Tribal entities hardest hit by the opioid epidemic, which may include public health-related activities such as the following:</text>
 <clause id="id3d0431f362e44525a0213dbd1a2822a5"><enum>(i)</enum><text>Expansion of evidence-based strategies for the provision of prevention, treatment, and recovery support services for individuals with opioid use disorders.</text>
 </clause><clause id="id0f0c933b6cc34ea7848fe021e41c7de3"><enum>(ii)</enum><text>Expansion and enhancement of integrated systems of care, including the co-location of services to address the primary and behavioral healthcare needs of individuals with opioid use disorders.</text>
 </clause><clause id="id66706b7fcc7d43a296943b5a7c2bc302"><enum>(iii)</enum><text>Expansion of efforts to distribute overdose reversal drugs and educate first responders and other relevant community members on the use of such drugs to prevent overdose-related deaths.</text>
 </clause><clause id="id4692fc1ca5194e7189e1915b92f83bfb"><enum>(iv)</enum><text>Expansion of any activity authorized under the State or Tribal entity grant under paragraph (1) to address the State's or Tribal entity's specific needs related to combatting the opioid crisis.</text>
 </clause></subparagraph></paragraph><paragraph id="idA265A191B4334B459112345B1B4C0363"><enum>(4)</enum><header>Set aside</header><text>Of the amount made available for each fiscal year to award grants under paragraph (1), not less than 10 percent of such amount in each such fiscal year shall be provided to Tribal entities.</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
 </subparagraph></paragraph><paragraph id="id8CC6947C0238404E9D73A01409BA0E7B"><enum>(3)</enum><text>by redesignating subsections (d) through (f) as subsections (e) through (g), respectively;</text> </paragraph><paragraph id="id88B25A2A577044E287AA326860F72376"><enum>(4)</enum><text>by inserting after subsection (c), the following:</text>
					<quoted-block display-inline="no-display-inline" id="id107E203DD0B44A909A4DB0A82146AD1F" style="OLC">
 <subsection id="idfd27300f33384e1090adcf5c4e156591"><enum>(d)</enum><header>Technical assistance</header><text>The Secretary shall provide State agencies and Tribal entities, as applicable through the Tribal Training and Technical Assistance Center, with technical assistance concerning—</text>
 <paragraph id="id2930307B50654991A7CA85198B3E2340"><enum>(1)</enum><text>application and submission procedures and award management activities;</text> </paragraph><paragraph id="ida8c5443f8b8641a4ba6d0389af89f4b0"><enum>(2)</enum><text>enhancing outreach and direct support to rural and underserved communities and providers in addressing the opioid crisis; and</text>
 </paragraph><paragraph id="id2b8433e6b1de4d9caa254e75a926a735"><enum>(3)</enum><text>strengthening data collection data sharing activities to help improve surveillance.</text></paragraph></subsection><after-quoted-block>; </after-quoted-block></quoted-block> </paragraph><paragraph id="idBC188DD5A82742ACAB61601879930E6B"><enum>(5)</enum><text>in subsection (e) (as so redesignated), by inserting <quote>shall prioritize providing such funds directly to local communities and counties to address the opioid crisis in areas of unmet need and</quote> after <quote>subsection (c)</quote>; and</text>
 </paragraph><paragraph id="id1859BB571B334AF4B94270C7B96166FE"><enum>(6)</enum><text>by adding at the end the following:</text> <quoted-block display-inline="no-display-inline" id="idEFF71241BC0747348DC0343C32FF69CA" style="OLC"> <subsection id="idF99569430CAB4802A1DB16FC4B67F341"><enum>(h)</enum><header>Tribal entity</header><text>In this section, the term <term>Tribal entity</term> means an Indian tribe (as defined in section 4 of the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>)), a tribal organization (as defined in such section), or a consortium of such a tribe and organization.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
 </paragraph></subsection><subsection id="idD82F7475705E417BB2619D2DC7519AE9"><enum>(b)</enum><header>Additional amounts for fiscal year 2018</header><text>In addition to amounts otherwise made available for grants under section 1003(c) of the 21st Century Cures Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290ee-3">42 U.S.C. 290ee–3</external-xref> note) for fiscal year 2018, there are appropriated $1,500,000,000 for such grants in such fiscal year, of which, $500,000,000 shall be used for grants under section 1003(c)(3) of such Act.</text></subsection></section></legis-body>
</bill>


