[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4899 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 4899

To amend the Public Health Service Act to provide grants for treatment 
           of heroin, opioids, cocaine, methamphetamine, 3,4-
methylenedioxymethamphetamine (ecstasy), and phencyclidine (PCP) abuse, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 30, 2018

Mr. Cartwright (for himself, Mr. Payne, and Ms. Norton) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to provide grants for treatment 
           of heroin, opioids, cocaine, methamphetamine, 3,4-
methylenedioxymethamphetamine (ecstasy), and phencyclidine (PCP) abuse, 
                        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 ``Access to Substance Abuse Treatment 
Act of 2018''.

SEC. 2. PURPOSE.

    It is the purpose of this Act to--
            (1) reduce crime and improve public safety by making 
        treatment for heroin, opioids, cocaine, methamphetamine, 3,4-
        methylenedioxymethamphetamine (ecstasy), and phencyclidine 
        (PCP) abuse available to every American who needs it;
            (2) keep families together by encouraging alternatives to 
        incarceration for nonviolent drug law offenses;
            (3) help identify root causes and most effective treatment 
        methods for heroin, opioids, cocaine, methamphetamine, 3,4-
        methylenedioxymethamphetamine, and phencyclidine abuse; and
            (4) expand research into cutting-edge treatment methods for 
        stimulant abuse.

SEC. 3. HEROIN, OPIOIDS, COCAINE, METHAMPHETAMINE, 3,4-
              METHYLENEDIOXYMETHAMPHETAMINE (ECSTASY), AND 
              PHENCYCLIDINE (PCP) TREATMENT AND WRAP-AROUND PROGRAMS.

    Subpart 1 of part B of title V of the Public Health Service Act is 
amended by inserting after section 514B (42 U.S.C. 290bb-10) the 
following new sections:

``SEC. 514C. INITIATIVE TO INCREASE HEROIN, OPIOIDS, COCAINE, 
              METHAMPHETAMINE, ECSTASY, AND PCP TREATMENT CAPACITY.

    ``(a) In General.--The Secretary may make grants to State, local, 
and tribal governments for the purpose of increasing the availability 
of treatment for heroin, opioids, cocaine, methamphetamine, 3,4-
methylenedioxymethamphetamine (ecstasy), and phencyclidine (PCP) abuse.
    ``(b) Requirements.--
            ``(1) In general.--To seek a grant under subsection (a), a 
        State, local, or tribal government shall submit an application 
        to the Secretary at such time, in such manner, and containing 
        such information and assurances as the Secretary may require.
            ``(2) Use of grant funds.--The grants made under subsection 
        (a) may only be used to--
                    ``(A) build treatment centers;
                    ``(B) expand existing treatment centers;
                    ``(C) hire treatment professionals;
                    ``(D) provide training and education to substance 
                abuse professionals, medical professionals, and 
                educators related to the treatment of heroin, opioids, 
                cocaine, methamphetamine, 3,4-
                methylenedioxymethamphetamine, and phencyclidine abuse; 
                and
                    ``(E) engage in other activities that the Secretary 
                has determined are relevant to the purpose of the 
                grants under subsection (a).
    ``(c) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section 
for fiscal years 2019 through 2023.

``SEC. 514D. HEROIN, OPIOIDS, COCAINE, METHAMPHETAMINE, ECSTASY, AND 
              PCP ABUSE TREATMENT VOUCHERS FOR UNDERSERVED POPULATIONS.

    ``(a) In General.--The Secretary may make grants to State, local, 
and tribal governments and nonprofit entities to provide vouchers to 
individuals in underserved populations for authorized services related 
to the treatment of such individuals for heroin, opioids, cocaine, 
methamphetamine, 3,4-methylenedioxymethamphetamine (ecstasy), and 
phencyclidine (PCP) abuse.
    ``(b) Requirements.--
            ``(1) Application.--To seek a grant under subsection (a), a 
        State, local, or tribal government or a nonprofit entity shall 
        submit an application to the Secretary at such time, in such 
        manner, and containing such information and assurances as the 
        Secretary may require, including a description of the method 
        that such State, government, or entity will use--
                    ``(A) to identify individuals who would benefit 
                from treatment for heroin, opioids, cocaine, 
                methamphetamine, 3,4-methylenedioxymethamphetamine, or 
                phencyclidine abuse;
                    ``(B) to identify if such individuals are in 
                underserved populations; and
                    ``(C) to provide vouchers to such individuals in 
                such populations.
            ``(2) Preservation of choice.--A recipient of a grant under 
        this section may not restrict the ability of an individual 
        receiving a voucher under this section to use the voucher to 
        pay for authorized services furnished by any provider of 
        authorized services, so long as the provider of such services 
        meets all applicable State licensure or certification 
        requirements regarding the provision of such services.
            ``(3) Duration of award.--With respect to a grant under 
        this section, the period during which payments under such grant 
        are made to the grant recipient may not exceed five years.
            ``(4) Matching funds.--The Secretary may require that 
        recipients of grants under this section provide non-Federal 
        matching funds, as determined appropriate by the Secretary, to 
        ensure the commitment of the grant recipients to the provision 
        of vouchers for treatment to individuals who use heroin, 
        opioids, cocaine, methamphetamine, 3,4-
        methylenedioxymethamphetamine, or phencyclidine. Such non-
        Federal matching funds may be provided directly or through 
        donations from public or private entities and may be in cash or 
        in-kind, fairly evaluated, including property, equipment, or 
        services.
            ``(5) Maintenance of effort.--The Secretary may require 
        that grant recipients under this section agree to maintain 
        expenditures of non-Federal amounts for authorized services 
        related to the treatment of heroin, opioids, cocaine, 
        methamphetamine, 3,4-methylenedioxymethamphetamine, and 
        phencyclidine abuse at a level that is not less than the level 
        of such expenditures maintained by the recipient for the fiscal 
        year preceding the fiscal year for which the entity receives 
        such a grant.
    ``(c) Report.--
            ``(1) In general.--Not later than December 1, 2019, and 
        annually thereafter, the Secretary shall submit a report to the 
        Congress on the grants under subsection (a).
            ``(2) Contents of report.--The report under paragraph (1) 
        shall contain an evaluation of the effectiveness of the grants 
        made under subsection (a) in improving access to heroin, 
        opioids, cocaine, methamphetamine, 3,4-
        methylenedioxymethamphetamine, and phencyclidine treatment for 
        underserved populations.
    ``(d) Definitions.--For purposes of this section:
            ``(1) Authorized services.--The term `authorized services' 
        means--
                    ``(A) treatment for heroin, opioids, cocaine, 
                methamphetamine, 3,4-methylenedioxymethamphetamine, or 
                phencyclidine abuse, including individual, group, and 
                family counseling regarding such abuse;
                    ``(B) follow-up services to prevent an individual 
                from relapsing into such abuse;
                    ``(C) wrap-around services, as such term is defined 
                in section 514E(e)(4); and
                    ``(D) any additional services specified by the 
                Secretary.
            ``(2) Underserved population.--The term `underserved 
        population' means a population of individuals who cannot access 
        appropriate substance abuse treatment (including comprehensive 
        substance abuse treatment) due to financial, geographical, 
        language, socioeconomic, or cultural barriers.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section 
for fiscal years 2019 through 2023.

``SEC. 514E. COMPREHENSIVE WRAP-AROUND HEROIN, OPIOIDS, COCAINE, 
              METHAMPHETAMINE, 3,4-METHYLENEDIOXYMETHAMPHETAMINE 
              (ECSTASY), AND PHENCYCLIDINE (PCP) TREATMENT SERVICES.

    ``(a) In General.--The Secretary may make grants to public, 
private, and nonprofit entities, Indian tribes, and tribal 
organizations to establish programs to provide for and coordinate the 
provision of wrap-around services to heroin, opioids, cocaine, 
methamphetamine, 3,4-methylenedioxymethamphetamine, or phencyclidine-
affected individuals.
    ``(b) Minimum Qualifications for Receipt of Award.--To seek a grant 
under subsection (a), a public, private, or nonprofit entity, an Indian 
tribe, or a tribal organization shall submit an application to the 
Secretary at such time, in such manner, and containing such information 
and assurances as the Secretary may require, including assurances to 
the satisfaction of the Secretary that--
            ``(1) the applicant has the capacity to carry out a program 
        described in subsection (a);
            ``(2) the applicant has entered into agreements with 
        entities in the community involved, through which the applicant 
        will provide wrap-around services; and
            ``(3) the applicant, or any entity through which the 
        applicant will provide such services, meets all applicable 
        State licensure or certification requirements regarding the 
        provision of such services.
    ``(c) Priority for Grant Distribution.--In making grants under this 
section, the Secretary shall give priority to applications for programs 
that serve communities with a high or increasing rate of heroin, 
opioids, cocaine, methamphetamine, 3,4-methylenedioxymethamphetamine, 
or phencyclidine abuse or addiction, as specified by the Secretary.
    ``(d) Reports.--For each year that a public, private, or nonprofit 
entity, Indian tribe, or tribal organization receives a grant under 
subsection (a) for a program, such entity, tribe, or organization shall 
submit to the Secretary a report on the results and effectiveness of 
the program.
    ``(e) Definitions.--For purposes of this section:
            ``(1) Heroin, opioids, cocaine, methamphetamine, 3,4-
        methylenedioxymethamphetamine, or phencyclidine-affected 
        individual.--The term `heroin, opioids, cocaine, 
        methamphetamine, 3,4-methylenedioxymethamphetamine, or 
        phencyclidine-affected individual' means an individual who--
                    ``(A)(i) resided in a residential inpatient 
                treatment facility for the treatment of heroin, 
                opioids, cocaine, methamphetamine, 3,4-
                methylenedioxymethamphetamine, or phencyclidine abuse 
                or addiction; or
                    ``(ii) received treatment for heroin, opioids, 
                cocaine, methamphetamine, 3,4-
                methylenedioxymethamphetamine, or phencyclidine abuse 
                or addiction from an intensive outpatient treatment 
                facility; and
                    ``(B) after successful completion of such treatment 
                reenters the community.
            ``(2) Intensive outpatient treatment facility.--The term 
        `intensive outpatient treatment facility' means a facility that 
        provides treatment for substance abuse and that, with respect 
        to an individual receiving such treatment--
                    ``(A) provides a minimum of seven hours of 
                treatment for substance abuse during a week;
                    ``(B) provides regularly scheduled treatment 
                sessions within a structured program; and
                    ``(C) ensures that the treatment sessions are led 
                by health professionals or clinicians.
            ``(3) Residential inpatient treatment facility.--The term 
        `residential inpatient treatment facility' means a facility 
        that provides treatment for substance abuse in which health 
        professionals and clinicians provide a planned regimen of 24-
        hour professionally directed evaluation, care, and treatment 
        for such substance abuse in an inpatient setting, including 24-
        hour observation and monitoring.
            ``(4) Wrap-around services.--The term `wrap-around 
        services' means, with respect to a heroin, opioids, cocaine, 
        methamphetamine, 3,4-methylenedioxymethamphetamine, or 
        phencyclidine-affected individual, the following services:
                    ``(A) Medical services.
                    ``(B) Dental services.
                    ``(C) Mental health services.
                    ``(D) Child care services.
                    ``(E) Job training services.
                    ``(F) Housing assistance.
                    ``(G) Training in parenting.
                    ``(H) Prevention services for family members, with 
                respect to heroin, opioids, cocaine, methamphetamine, 
                3,4-methylenedioxymethamphetamine, and phencyclidine 
                abuse or addiction.
                    ``(I) Transportation assistance services for 
                purposes of participation in the services listed in 
                subparagraphs (A) through (H).
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section 
for fiscal years 2019 through 2023.''.

SEC. 4. EXTENSION AND EXPANSION OF RESIDENTIAL TREATMENT PROGRAM FOR 
              PREGNANT AND POSTPARTUM WOMEN TO INCLUDE CAREGIVER 
              PARENTS.

    Section 508 of the Public Health Service Act (42 U.S.C. 290bb-1) is 
amended--
            (1) in the heading, by striking ``pregnant and postpartum 
        women'' and inserting ``caregiver parents, including pregnant 
        women'';
            (2) in subsection (a)--
                    (A) in the matter preceding paragraph (1)--
                            (i) by inserting ``, Indian tribes, and 
                        tribal organizations'' after ``nonprofit 
                        private entities''; and
                            (ii) by striking ``pregnant and postpartum 
                        women treatment for substance abuse'' and 
                        inserting ``caregiver parents, including 
                        pregnant women, treatment for substance abuse 
                        (including treatment for addiction to heroin, 
                        opioids, cocaine, methamphetamine, 3,4-
                        methylenedioxymethamphetamine (ecstasy), or 
                        phencyclidine (PCP))'';
                    (B) in each of paragraphs (1), (2), and (3), by 
                striking ``the women'' and inserting ``such parents'' 
                each place it appears; and
                    (C) in paragraph (3), by inserting ``supplemental'' 
                before ``services'';
            (3) in subsection (b)--
                    (A) in paragraph (1), by inserting ``, Indian 
                tribes, or tribal organizations'' after ``nonprofit 
                private entities''; and
                    (B) in paragraph (2)--
                            (i) by striking ``the services'' and 
                        inserting ``such services''; and
                            (ii) by striking ``woman'' and inserting 
                        ``caregiver parent'';
            (4) in subsection (c)--
                    (A) in paragraph (1), by striking ``eligible 
                woman'' and inserting ``eligible caregiver parent''; 
                and
                    (B) by striking ``the women'' and ``the woman'' 
                each place either term appears and inserting ``such 
                parent'';
            (5) in subsection (d)--
                    (A) in the matter proceeding paragraph (1), by 
                striking ``woman'' and inserting ``caregiver parent'';
                    (B) in paragraphs (3) and (4), by striking ``the 
                woman'' and inserting ``such parent'' each place it 
                appears;
                    (C) in paragraph (9)--
                            (i) by striking ``the women'' and inserting 
                        ``such parent'' each place it appears;
                            (ii) by striking ``units'' and inserting 
                        ``unit''; and
                            (iii) by striking ``of parents'' and 
                        inserting ``of the parents of such parent'';
                    (D) in paragraph (10), by inserting ``, Indian 
                tribes, or tribal organizations'' after ``entities''; 
                and
                    (E) in paragraph (11)--
                            (i) by striking ``the women'' and inserting 
                        ``such parent''; and
                            (ii) by striking ``their children'' and 
                        inserting ``the children of such parent'';
            (6) in subsection (f)(1), in the matter proceeding 
        subparagraph (A) by inserting ``, Indian tribes, or tribal 
        organizations'' after ``public or private entities'';
            (7) in subsection (g)--
                    (A) by striking ``identify women'' and inserting 
                ``identify caregiver parents''; and
                    (B) by striking ``the women'' and inserting ``such 
                parents'';
            (8) in subsection (h)(1), by striking ``pregnant and 
        postpartum women'' and inserting ``caregiver parents'';
            (9) in subsection (j)--
                    (A) in the matter proceeding paragraph (1)--
                            (i) by striking ``to on behalf'' and 
                        inserting ``to or on behalf''; and
                            (ii) by striking ``woman'' and inserting 
                        ``caregiver parent'';
                    (B) in paragraph (2), by striking ``the woman'' and 
                inserting ``such parent''; and
                    (C) in paragraph (3), by striking ``woman'' and 
                inserting ``parent'';
            (10) in subsection (k)(2), by striking ``women'' and 
        inserting ``caregiver parents'';
            (11) in subsection (l), by striking ``such agreements'' and 
        inserting ``the funding agreements under this section'';
            (12) by amending subsection (m) to read as follows:
    ``(m) Use of Funds; Priority for Certain Areas Served.--
            ``(1) Use of funds.--A funding agreement for an award under 
        subsection (a) for an applicant is that funds awarded under 
        subsection (a) to such applicant shall be used for programs 
        according to the following order of priority:
                    ``(A) For a program that provides services to 
                caregiver parents who are pregnant and postpartum 
                women.
                    ``(B) For a program that provides services to 
                caregiver parents who are single parents and the sole 
                caregivers with respect to their children.
                    ``(C) For a program that provides services to any 
                caregiver parents.
            ``(2) Priority for certain areas served.--In making awards 
        under subsection (a), the Director shall give priority to any 
        entity, tribe, or organization that agrees to use the award for 
        a program serving an area that--
                    ``(A) is an area determined by the Director to have 
                a shortage of family-based substance abuse treatment 
                options; or
                    ``(B) is determined by the Director to have high 
                rates of addiction to heroin, opioids, cocaine, 
                methamphetamine, 3,4-methylenedioxymethamphetamine, or 
                phencyclidine.'';
            (13) in subsection (p)--
                    (A) by striking ``October 1, 1994'' and inserting 
                ``January 1, 2019'';
                    (B) by striking ``Committee on Labor and Human 
                Resources'' and inserting ``Committee on Health, 
                Education, Labor, and Pensions''; and
                    (C) by striking the third sentence;
            (14) in subsection (q)--
                    (A) by redesignating paragraphs (2), (3), (4), and 
                (5) as paragraphs (3), (4), (5), and (6), respectively;
                    (B) by inserting after paragraph (1) the following 
                new paragraph:
            ``(2) The term `caregiver parent' means, with respect to a 
        child, a parent or legal guardian with whom the child resides, 
        and includes a pregnant woman.''; and
                    (C) by amending paragraph (3), as redesignated by 
                subparagraph (A) of this paragraph, to read as follows:
            ``(3) The term `eligible caregiver parent' means a 
        caregiver parent who has been admitted to a program operated 
        pursuant to subsection (a).''; and
            (15) in subsection (r), by striking ``to fiscal years 2001 
        through 2003'' and inserting  ``for fiscal years 2019 through 
        2023''.

SEC. 5. EFFECTIVENESS OF STIMULANT TREATMENT METHODS.

    (a) Research.--The Director of the National Institute on Drug Abuse 
shall conduct research, directly or through contract with another 
entity, on the effectiveness of the use of agonist and antagonist drugs 
to reduce the problems associated with stimulant abuse, including 
cocaine and methamphetamine abuse.
    (b) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section 
for fiscal years 2019 through 2023.

SEC. 6. IOM STUDY ON DRUG TREATMENTS FOR STIMULANT ABUSE.

    (a) Report.--The Secretary of Health and Human Services shall seek 
to enter into a contract with the Institute of Medicine of the National 
Academies to complete a literature review and submit a report to 
Congress on the effectiveness of agonist and antagonist drugs for the 
treatment of stimulant abuse, including cocaine and methamphetamine 
abuse.
    (b) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section 
for fiscal years 2019 through 2023.

SEC. 7. GAO EVALUATION OF THE IMPACT OF THIS LEGISLATION.

    (a) Study on the Level of Funding for Treatment.--The Comptroller 
General of the United States shall conduct a study on--
            (1) the impact of the programs authorized by this Act 
        (including the amendments made by this Act) on the 
        effectiveness and availability of treatment for heroin, 
        opioids, cocaine, methamphetamine, 3,4-
        methylenedioxymethamphetamine, and phencyclidine abuse;
            (2) whether the level of Federal funding available for the 
        treatment of heroin, opioids, cocaine, methamphetamine, 3,4-
        methylenedioxymethamphetamine, and phencyclidine abuse meets, 
        exceeds, or is less than the amount necessary to provide 
        adequate treatment for such abuse; and
            (3) the impact of effective treatment of heroin, opioids, 
        cocaine, methamphetamine, 3,4-methylenedioxymethamphetamine, 
        and phencyclidine abuse on cost savings due to the reduced need 
        for criminal justice and other services.
    (b) Reports.--
            (1) Interim report.--Not later than the last day of the 
        two-year period beginning on the date of enactment of this Act, 
        the Comptroller General shall submit to Congress a report on 
        the interim findings of the study under subsection (a).
            (2) Final report.--Not later than 3 years after the date on 
        which the report under paragraph (1) is submitted to Congress, 
        the Comptroller General shall submit to Congress a report on 
        the findings of the study under subsection (a).

SEC. 8. NO ADDITIONAL APPROPRIATIONS.

    This Act, and the amendments made by this Act, shall not be 
construed to increase the amount of appropriations that are authorized 
to be approved for any fiscal year.
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