[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6 Engrossed Amendment Senate (EAS)]

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                  In the Senate of the United States,

                                                    September 17, 2018.
    Resolved, That the bill from the House of Representatives (H.R. 6) 
entitled ``An Act to provide for opioid use disorder prevention, 
recovery, and treatment, and for other purposes.'', do pass with the 
following

                               AMENDMENT:

            Strike all after the enacting clause and insert the 
      following:

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Opioid Crisis 
Response Act of 2018''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.

                  TITLE I--OPIOID CRISIS RESPONSE ACT

Sec. 1001. Definitions.

              Subtitle A--Reauthorization of Cures Funding

Sec. 1101. State response to the opioid abuse crisis.

                  Subtitle B--Research and Innovation

Sec. 1201. Advancing cutting-edge research.
Sec. 1202. Pain research.
Sec. 1203. Report on synthetic drug use.

     Subtitle C--Medical Products and Controlled Substances Safety

Sec. 1301. Clarifying FDA regulation of non-addictive pain products.
Sec. 1302. Clarifying FDA packaging authorities.
Sec. 1303. Strengthening FDA and CBP coordination and capacity.
Sec. 1304. Clarifying FDA post-market authorities.
Sec. 1305. Restricting entrance of illicit drugs.
Sec. 1306. First responder training.
Sec. 1307. Disposal of controlled substances of hospice patients.
Sec. 1308. GAO study and report on hospice safe drug management.
Sec. 1309. Delivery of a controlled substance by a pharmacy to be 
                            administered by injection or implantation.

                   Subtitle D--Treatment and Recovery

Sec. 1401. Comprehensive opioid recovery centers.
Sec. 1402. Program to support coordination and continuation of care for 
                            drug overdose patients.
Sec. 1403. Alternatives to opioids.
Sec. 1404. Building communities of recovery.
Sec. 1405. Peer support technical assistance center.
Sec. 1406. Medication-assisted treatment for recovery from addiction.
Sec. 1407. Grant program.
Sec. 1408. Allowing for more flexibility with respect to medication-
                            assisted treatment for opioid use 
                            disorders.
Sec. 1409. National recovery housing best practices.
Sec. 1410. Addressing economic and workforce impacts of the opioid 
                            crisis.
Sec. 1411. Career Act.
Sec. 1412. Pilot program to help individuals in recovery from a 
                            substance use disorder become stably 
                            housed.
Sec. 1413. Youth prevention and recovery.
Sec. 1414. Plans of safe care.
Sec. 1415. Regulations relating to special registration for 
                            telemedicine.
Sec. 1416. National Health Service Corps behavioral and mental health 
                            professionals providing obligated service 
                            in schools and other community-based 
                            settings.
Sec. 1417. Loan repayment for substance use disorder treatment 
                            providers.
Sec. 1418. Protecting moms and infants.
Sec. 1419. Early interventions for pregnant women and infants.
Sec. 1420. Report on investigations regarding parity in mental health 
                            and substance use disorder benefits.

                         Subtitle E--Prevention

Sec. 1501. Study on prescribing limits.
Sec. 1502. Programs for health care workforce.
Sec. 1503. Education and awareness campaigns.
Sec. 1504. Enhanced controlled substance overdoses data collection, 
                            analysis, and dissemination.
Sec. 1505. Preventing overdoses of controlled substances.
Sec. 1506. CDC surveillance and data collection for child, youth, and 
                            adult trauma.
Sec. 1507. Reauthorization of NASPER.
Sec. 1508. Jessie's law.
Sec. 1509. Development and dissemination of model training programs for 
                            substance use disorder patient records.
Sec. 1510. Communication with families during emergencies.
Sec. 1511. Prenatal and postnatal health.
Sec. 1512. Surveillance and education regarding infections associated 
                            with illicit drug use and other risk 
                            factors.
Sec. 1513. Task force to develop best practices for trauma-informed 
                            identification, referral, and support.
Sec. 1514. Grants to improve trauma support services and mental health 
                            care for children and youth in educational 
                            settings.
Sec. 1515. National Child Traumatic Stress Initiative.
Sec. 1516. National milestones to measure success in curtailing the 
                            opioid crisis.

                           TITLE II--FINANCE

Sec. 2001. Short title.

                          Subtitle A--Medicare

Sec. 2101. Medicare opioid safety education.
Sec. 2102. Expanding the use of telehealth services for the treatment 
                            of opioid use disorder and other substance 
                            use disorders.
Sec. 2103. Comprehensive screenings for seniors.
Sec. 2104. Every prescription conveyed securely.
Sec. 2105. Standardizing electronic prior authorization for safe 
                            prescribing.
Sec. 2106. Strengthening partnerships to prevent opioid abuse.
Sec. 2107. Commit to opioid medical prescriber accountability and 
                            safety for seniors.
Sec. 2108. Fighting the opioid epidemic with sunshine.
Sec. 2109. Demonstration testing coverage of certain services furnished 
                            by opioid treatment programs.
Sec. 2110. Encouraging appropriate prescribing under Medicare for 
                            victims of opioid overdose.
Sec. 2111. Automatic escalation to external review under a Medicare 
                            part D drug management program for at-risk 
                            beneficiaries.
Sec. 2112. Testing of incentive payments for behavioral health 
                            providers for adoption and use of certified 
                            electronic health record technology.
Sec. 2113. Medicare Improvement Fund.

                          Subtitle B--Medicaid

Sec. 2201. Caring recovery for infants and babies.
Sec. 2202. Peer support enhancement and evaluation review.
Sec. 2203. Medicaid substance use disorder treatment via telehealth.
Sec. 2204. Enhancing patient access to non-opioid treatment options.
Sec. 2205. Assessing barriers to opioid use disorder treatment.
Sec. 2206. Help for moms and babies.
Sec. 2207. Securing flexibility to treat substance use disorders.
Sec. 2208. MACPAC study and report on MAT utilization controls under 
                            State Medicaid programs.
Sec. 2209. Opioid addiction treatment programs enhancement.
Sec. 2210. Better data sharing to combat the opioid crisis.
Sec. 2211. Mandatory reporting with respect to adult behavioral health 
                            measures.
Sec. 2212. Report on innovative State initiatives and strategies to 
                            provide housing-related services and 
                            supports to individuals struggling with 
                            substance use disorders under Medicaid.
Sec. 2213. Technical assistance and support for innovative State 
                            strategies to provide housing-related 
                            supports under Medicaid.

                       Subtitle C--Human Services

Sec. 2301. Supporting family-focused residential treatment.
Sec. 2302. Improving recovery and reunifying families.
Sec. 2303. Building capacity for family-focused residential treatment.

       Subtitle D--Synthetics Trafficking and Overdose Prevention

Sec. 2401. Short title.
Sec. 2402. Customs fees.
Sec. 2403. Mandatory advance electronic information for postal 
                            shipments.
Sec. 2404. International postal agreements.
Sec. 2405. Cost recoupment.
Sec. 2406. Development of technology to detect illicit narcotics.
Sec. 2407. Civil penalties for postal shipments.
Sec. 2408. Report on violations of arrival, reporting, entry, and 
                            clearance requirements and falsity or lack 
                            of manifest.
Sec. 2409. Effective date; regulations.

                          TITLE III--JUDICIARY

             Subtitle A--Access to Increased Drug Disposal

Sec. 3101. Short title.
Sec. 3102. Definitions.
Sec. 3103. Authority to make grants.
Sec. 3104. Application.
Sec. 3105. Use of grant funds.
Sec. 3106. Eligibility for grant.
Sec. 3107. Duration of grants.
Sec. 3108. Accountability and oversight.
Sec. 3109. Duration of program.
Sec. 3110. Authorization of appropriations.

           Subtitle B--Using Data To Prevent Opioid Diversion

Sec. 3201. Short title.
Sec. 3202. Purpose.
Sec. 3203. Amendments.
Sec. 3204. Report.

                 Subtitle C--Substance Abuse Prevention

Sec. 3301. Short title.
Sec. 3302. Reauthorization of the Office of National Drug Control 
                            Policy.
Sec. 3303. Reauthorization of the Drug-Free Communities Program.
Sec. 3304. Reauthorization of the National Community Anti-Drug 
                            Coalition Institute.
Sec. 3305. Reauthorization of the High-Intensity Drug Trafficking Area 
                            Program.
Sec. 3306. Reauthorization of drug court program.
Sec. 3307. Drug court training and technical assistance.
Sec. 3308. Drug overdose response strategy.
Sec. 3309. Protecting law enforcement officers from accidental 
                            exposure.
Sec. 3310. COPS Anti-Meth Program.
Sec. 3311. COPS anti-heroin task force program.
Sec. 3312. Comprehensive Addiction and Recovery Act education and 
                            awareness.
Sec. 3313. Protecting children with addicted parents.
Sec. 3314. Reimbursement of substance use disorder treatment 
                            professionals.
Sec. 3315. Sobriety Treatment and Recovery Teams (START).
Sec. 3316. Provider education.
Sec. 3317. Demand reduction.
Sec. 3318. Anti-drug media campaign.
Sec. 3319. Technical corrections to the office of national drug control 
                            policy reauthorization act of 1998.

      Subtitle D--Synthetic Abuse and Labeling of Toxic Substances

Sec. 3401. Short title.
Sec. 3402. Controlled substance analogues.

                    Subtitle E--Opioid Quota Reform

Sec. 3501. Short title.
Sec. 3502. Strengthening considerations for DEA opioid quotas.

                 Subtitle F--Preventing Drug Diversion

Sec. 3601. Short title.
Sec. 3602. Improvements to prevent drug diversion.

                     Subtitle G--Sense of Congress

Sec. 3701. Sense of Congress.

                           TITLE IV--COMMERCE

          Subtitle A--Fighting Opioid Abuse in Transportation

Sec. 4101. Short title.
Sec. 4102. Rail mechanical employee controlled substances and alcohol 
                            testing.
Sec. 4103. Rail yardmaster controlled substances and alcohol testing.
Sec. 4104. Department of Transportation public drug and alcohol testing 
                            database.
Sec. 4105. GAO report on Department of Transportation's collection and 
                            use of drug and alcohol testing data.
Sec. 4106. Transportation Workplace Drug and Alcohol Testing Program; 
                            addition of fentanyl.
Sec. 4107. Status reports on hair testing guidelines.
Sec. 4108. Mandatory Guidelines for Federal Workplace Drug Testing 
                            Programs Using Oral Fluid.
Sec. 4109. Electronic recordkeeping.
Sec. 4110. Status reports on Commercial Driver's License Drug and 
                            Alcohol Clearinghouse.

         Subtitle B--Opioid Addiction Recovery Fraud Prevention

Sec. 4201. Short title.
Sec. 4202. Definitions.
Sec. 4203. False or misleading representations with respect to opioid 
                            treatment programs and products.

                  TITLE I--OPIOID CRISIS RESPONSE ACT

SEC. 1001. DEFINITIONS.

    In this title--
            (1) the terms ``Indian Tribe'' and ``tribal organization'' 
        have the meanings given the terms ``Indian tribe'' and ``tribal 
        organization'' in section 4 of the Indian Self-Determination 
        and Education Assistance Act (25 U.S.C. 5304); and
            (2) the term ``Secretary'' means the Secretary of Health 
        and Human Services, unless otherwise specified.

              Subtitle A--Reauthorization of Cures Funding

SEC. 1101. STATE RESPONSE TO THE OPIOID ABUSE CRISIS.

    (a) In General.--Section 1003 of the 21st Century Cures Act (Public 
Law 114-255) is amended--
            (1) in subsection (a)--
                    (A) by striking ``the authorization of 
                appropriations under subsection (b) to carry out the 
                grant program described in subsection (c)'' and 
                inserting ``subsection (h) to carry out the grant 
                program described in subsection (b)''; and
                    (B) by inserting ``and Indian Tribes'' after 
                ``States'';
            (2) by striking subsection (b);
            (3) by redesignating subsections (c) through (e) as 
        subsections (b) through (d), respectively;
            (4) by redesignating subsection (f) as subsection (j);
            (5) in subsection (b), as so redesignated--
                    (A) in paragraph (1)--
                            (i) in the paragraph heading, by inserting 
                        ``and indian tribe'' after ``State'';
                            (ii) by striking ``States for the purpose 
                        of addressing the opioid abuse crisis within 
                        such States'' and inserting ``States and Indian 
                        Tribes for the purpose of addressing the opioid 
                        abuse crisis within such States and Indian 
                        Tribes'';
                            (iii) by inserting ``or Indian Tribes'' 
                        after ``preference to States''; and
                            (iv) by inserting before the period of the 
                        second sentence ``or other Indian Tribes, as 
                        applicable'';
                    (B) in paragraph (2)--
                            (i) in the matter preceding subparagraph 
                        (A), by striking ``to a State'';
                            (ii) in subparagraph (A), by striking 
                        ``State'';
                            (iii) in subparagraph (C), by inserting 
                        ``preventing diversion of controlled 
                        substances,'' after ``treatment programs,''; 
                        and
                            (iv) in subparagraph (E), by striking ``as 
                        the State determines appropriate, related to 
                        addressing the opioid abuse crisis within the 
                        State'' and inserting ``as the State or Indian 
                        Tribe determines appropriate, related to 
                        addressing the opioid abuse crisis within the 
                        State, including directing resources in 
                        accordance with local needs related to 
                        substance use disorders'';
            (6) in subsection (c), as so redesignated, by striking 
        ``subsection (c)'' and inserting ``subsection (b)'';
            (7) in subsection (d), as so redesignated--
                    (A) in the matter preceding paragraph (1), by 
                striking ``the authorization of appropriations under 
                subsection (b)'' and inserting ``subsection (h)''; and
                    (B) in paragraph (1), by striking ``subsection 
                (c)'' and inserting ``subsection (b)''; and
            (8) by inserting after subsection (d), as so redesignated, 
        the following:
    ``(e) Indian Tribes.--
            ``(1) Definition.--For purposes of this section, the term 
        `Indian Tribe' has the meaning given the term `Indian tribe' in 
        section 4 of the Indian Self-Determination and Education 
        Assistance Act (25 U.S.C. 5304).
            ``(2) Appropriate mechanisms.--The Secretary, in 
        consultation with Indian Tribes, shall identify and establish 
        appropriate mechanisms for Tribes to demonstrate or report the 
        information as required under subsections (b), (c), and (d).
    ``(f) Report to Congress.--Not later than 1 year after the date on 
which amounts are first awarded after the date of enactment of the 
Opioid Crisis Response Act of 2018, pursuant to subsection (b), and 
annually thereafter, 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 
summarizing the information provided to the Secretary in reports made 
pursuant to subsection (c), including the purposes for which grant 
funds are awarded under this section and the activities of such grant 
recipients.
    ``(g) Technical Assistance.--The Secretary, including through the 
Tribal Training and Technical Assistance Center of the Substance Abuse 
and Mental Health Services Administration, shall provide State agencies 
and Indian Tribes, as applicable, with technical assistance concerning 
grant application and submission procedures under this section, award 
management activities, and enhancing outreach and direct support to 
rural and underserved communities and providers in addressing the 
opioid crisis.
    ``(h) Authorization of Appropriations.--For purposes of carrying 
out the grant program under subsection (b), there is authorized to be 
appropriated $500,000,000 for each of fiscal years 2019 through 2021, 
to remain available until expended.
    ``(i) Set Aside.--Of the amounts made available for each fiscal 
year to award grants under subsection (b) for a fiscal year, 5 percent 
of such amount for such fiscal year shall be made available to Indian 
Tribes, and up to 15 percent of such amount for such fiscal year may be 
set aside for States with the highest age-adjusted rate of drug 
overdose death based on the ordinal ranking of States according to the 
Director of the Centers for Disease Control and Prevention.''.
    (b) Conforming Amendment.--Section 1004(c) of the 21st Century 
Cures Act (Public Law 114-255) is amended by striking ``, the FDA 
Innovation Account, or the Account For the State Response to the Opioid 
Abuse Crisis'' and inserting ``or the FDA Innovation Account''.

                  Subtitle B--Research and Innovation

SEC. 1201. ADVANCING CUTTING-EDGE RESEARCH.

    Section 402(n)(1) of the Public Health Service Act (42 U.S.C. 
282(n)(1)) is amended--
            (1) in subparagraph (A), by striking ``or'';
            (2) in subparagraph (B), by striking the period and 
        inserting ``; or''; and
            (3) by adding at the end the following:
                    ``(C) high impact cutting-edge research that 
                fosters scientific creativity and increases fundamental 
                biological understanding leading to the prevention, 
                diagnosis, or treatment of diseases and disorders, or 
                research urgently required to respond to a public 
                health threat.''.

SEC. 1202. PAIN RESEARCH.

    Section 409J(b) of the Public Health Service Act (42 U.S.C. 
284q(b)) is amended--
            (1) in paragraph (5)--
                    (A) in subparagraph (A), by striking ``and 
                treatment of pain and diseases and disorders associated 
                with pain'' and inserting ``treatment, and management 
                of pain and diseases and disorders associated with 
                pain, including information on best practices for 
                utilization of non-pharmacologic treatments, non-
                addictive medical products, and other drugs or devices 
                approved or cleared by the Food and Drug 
                Administration'';
                    (B) in subparagraph (B), by striking ``on the 
                symptoms and causes of pain;'' and inserting the 
                following: ``on--
                            ``(i) the symptoms and causes of pain, 
                        including the identification of relevant 
                        biomarkers and screening models and the 
                        epidemiology of acute and chronic pain;
                            ``(ii) the diagnosis, prevention, 
                        treatment, and management of acute or chronic 
                        pain, including with respect to non-
                        pharmacologic treatments, non-addictive medical 
                        products, and other drugs or devices approved 
                        or cleared by the Food and Drug Administration; 
                        and
                            ``(iii) risk factors for, and early warning 
                        signs of, substance use disorders; and''; and
                    (C) by striking subparagraphs (C) through (E) and 
                inserting the following:
                    ``(C) make recommendations to the Director of NIH--
                            ``(i) to ensure that the activities of the 
                        National Institutes of Health and other Federal 
                        agencies are free of unnecessary duplication of 
                        effort;
                            ``(ii) on how best to disseminate 
                        information on pain care and epidemiological 
                        data related to acute and chronic pain; and
                            ``(iii) on how to expand partnerships 
                        between public entities and private entities to 
                        expand collaborative, cross-cutting 
                        research.'';
            (2) by redesignating paragraph (6) as paragraph (7); and
            (3) by inserting after paragraph (5) the following:
            ``(6) Report.--The Director of NIH shall ensure that 
        recommendations and actions taken by the Director with respect 
        to the topics discussed at the meetings described in paragraph 
        (4) are included in appropriate reports to Congress.''.

SEC. 1203. REPORT ON SYNTHETIC DRUG USE.

    (a) In General.--Not later than 3 years 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 
health effects of new psychoactive substances, including synthetic 
drugs, by adolescents and young adults.
    (b) New Psychoactive Substance Defined.--For purposes of subsection 
(a), the term ``new psychoactive substance'' means a controlled 
substance analogue (as defined in section 102(32) of the Controlled 
Substances Act (21 U.S.C. 802(32))).

     Subtitle C--Medical Products and Controlled Substances Safety

SEC. 1301. CLARIFYING FDA REGULATION OF NON-ADDICTIVE PAIN PRODUCTS.

    (a) Public Meetings.--Not later than one year after the date of 
enactment of this Act, the Secretary, acting through the Commissioner 
of Food and Drugs, shall hold not less than one public meeting to 
address the challenges and barriers of developing non-addictive medical 
products intended to treat pain or addiction, which may include--
            (1) the manner by which the Secretary may incorporate the 
        risks of misuse and abuse of a controlled substance (as defined 
        in section 102 of the Controlled Substances Act (21 U.S.C. 802) 
        into the risk benefit assessments under subsections (d) and (e) 
        of section 505 of the Federal Food, Drug, and Cosmetic Act (21 
        U.S.C. 355), section 510(k) of such Act (21 U.S.C. 360(k)), or 
        section 515(c) of such Act (21 U.S.C. 360e(c)), as applicable;
            (2) the application of novel clinical trial designs 
        (consistent with section 3021 of the 21st Century Cures Act 
        (Public Law 114-255)), use of real world evidence (consistent 
        with section 505F of the Federal Food, Drug, and Cosmetic Act 
        (21 U.S.C. 355g)), and use of patient experience data 
        (consistent with section 569C of the Federal Food, Drug, and 
        Cosmetic Act (21 U.S.C. 360bbb-8c)) for the development of non-
        addictive medical products intended to treat pain or addiction;
            (3) the evidentiary standards and the development of opioid 
        sparing data for inclusion in the labeling of medical products; 
        and
            (4) the application of eligibility criteria under sections 
        506 and 515B of the Federal Food, Drug, and Cosmetic Act (21 
        U.S.C. 356, 360e-3) for non-addictive medical products intended 
        to treat pain or addiction.
    (b) Guidance.--Not less than one year after the public meetings are 
conducted under subsection (a) the Secretary shall issue one or more 
final guidance documents, or update existing guidance documents, to 
help address challenges to developing non-addictive medical products to 
treat pain or addiction. Such guidance documents shall include 
information regarding--
            (1) how the Food and Drug Administration may apply sections 
        506 and 515B of the Federal Food, Drug, and Cosmetic Act (21 
        U.S.C. 356, 360e-3) to non-addictive medical products intended 
        to treat pain or addiction, including the circumstances under 
        which the Secretary--
                    (A) may apply the eligibility criteria under such 
                sections 506 and 515B to non-addictive medical products 
                intended to treat pain or addiction;
                    (B) considers the risk of addiction of controlled 
                substances approved to treat pain when establishing 
                unmet medical need; and
                    (C) considers pain, pain control, or pain 
                management in assessing whether a disease or condition 
                is a serious or life-threatening disease or condition;
            (2) the methods by which sponsors may evaluate acute and 
        chronic pain, endpoints for non-addictive medical products 
        intended to treat pain, the manner in which endpoints and 
        evaluations of efficacy will be applied across and within 
        review divisions, taking into consideration the etiology of the 
        underlying disease, and the manner in which sponsors may use 
        surrogate endpoints, intermediate endpoints, and real world 
        evidence;
            (3) the manner in which the Food and Drug Administration 
        will assess evidence to support the inclusion of opioid sparing 
        data in the labeling of non-addictive medical products intended 
        to treat pain, including--
                    (A) data collection methodologies, including the 
                use of novel clinical trial designs (consistent with 
                section 3021 of the 21st Century Cures Act (Public Law 
                114-255)) and real world evidence (consistent with 
                section 505F of the Federal Food, Drug, and Cosmetic 
                Act (21 U.S.C. 355g)), as appropriate, to support 
                product labeling;
                    (B) ethical considerations of exposing subjects to 
                controlled substances in clinical trials to develop 
                opioid sparing data and considerations on data 
                collection methods that reduce harm, which may include 
                the reduction of opioid use as a clinical benefit;
                    (C) endpoints, including primary, secondary, and 
                surrogate endpoints, to evaluate the reduction of 
                opioid use;
                    (D) best practices for communication between 
                sponsors and the agency on the development of data 
                collection methods, including the initiation of data 
                collection; and
                    (E) the appropriate format in which to submit such 
                data results to the Secretary; and
            (4) the circumstances under which the Food and Drug 
        Administration considers misuse and abuse of a controlled 
        substance (as defined in section 102 of the Controlled 
        Substances Act (21 U.S.C. 802) in making the risk benefit 
        assessment under paragraphs (2) and (4) of subsection (d) of 
        section 505 of the Federal Food, Drug, and Cosmetic Act (21 
        U.S.C. 355) and in finding that a drug is unsafe under 
        paragraph (1) or (2) of subsection (e) of such section.
    (c) Definitions.--In this section--
            (1) the term ``medical product'' means a drug (as defined 
        in section 201(g)(1) of the Federal Food, Drug, and Cosmetic 
        Act (21 U.S.C. 321(g)(1))), biological product (as defined in 
        section 351(i) of the Public Health Service Act (42 U.S.C. 
        262(i))), or device (as defined in section 201(h) of the 
        Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(h))); and
            (2) the term ``opioid sparing'' means reducing, replacing, 
        or avoiding the use of opioids or other controlled substances.

SEC. 1302. CLARIFYING FDA PACKAGING AUTHORITIES.

    (a) Additional Potential Elements of Strategy.--Section 505-1(e) of 
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355-1(e)) is 
amended by adding at the end the following:
            ``(4) Packaging and disposal.--The Secretary may require a 
        risk evaluation mitigation strategy for a drug for which there 
        is a serious risk of an adverse drug experience described in 
        subparagraph (B) or (C) of subsection (b)(1), taking into 
        consideration the factors described in subparagraphs (C) and 
        (D) of subsection (f)(2) and in consultation with other 
        relevant Federal agencies with authorities over drug packaging, 
        which may include requiring that--
                    ``(A) the drug be made available for dispensing to 
                certain patients in unit dose packaging, packaging that 
                provides a set duration, or another packaging system 
                that the Secretary determines may mitigate such serious 
                risk; or
                    ``(B) the drug be dispensed to certain patients 
                with a safe disposal packaging or safe disposal system 
                for purposes of rendering drugs non-retrievable (as 
                defined in section 1300.05 of title 21, Code of Federal 
                Regulations (or any successor regulation)) if the 
                Secretary has determines that such safe disposal 
                packaging or system may mitigate such serious risk and 
                exists in sufficient quantities.''.
    (b) Assuring Access and Minimizing Burden.--Section 505-1(f)(2)(C) 
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355-1(f)(2)(C)) 
is amended--
            (1) in clause (i) by striking ``and'' at the end; and
            (2) by adding at the end the following:
                            ``(iii) patients with functional needs; 
                        and''.
    (c) Application to Abbreviated New Drug Applications.--Section 505-
1(i) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355-1(i)) 
is amended--
            (1) in paragraph (1)--
                    (A) by redesignating subparagraph (B) as 
                subparagraph (C); and
                    (B) inserting after subparagraph (A) the following:
                    ``(B) A packaging or disposal requirement, if 
                required under subsection (e)(4) for the applicable 
                listed drug.''; and
            (2) in paragraph (2)--
                    (A) in subparagraph (A), by striking ``and'' at the 
                end;
                    (B) by redesignating subparagraph (B) as 
                subparagraph (C); and
                    (C) by inserting after subparagraph (A) the 
                following:
                    ``(B) shall permit packaging systems and safe 
                disposal packaging or safe disposal systems that are 
                different from those required for the applicable listed 
                drug under subsection (e)(4); and''.

SEC. 1303. STRENGTHENING FDA AND CBP COORDINATION AND CAPACITY.

    (a) In General.--The Secretary, acting through the Commissioner of 
Food and Drugs, shall coordinate with the Secretary of Homeland 
Security to carry out activities related to customs and border 
protection and response to illegal controlled substances and drug 
imports, including at sites of import (such as international mail 
facilities). Such Secretaries may carry out such activities through a 
memorandum of understanding between the Food and Drug Administration 
and the U.S. Customs and Border Protection.
    (b) FDA Import Facilities and Inspection Capacity.--
            (1) In general.--In carrying out this section, the 
        Secretary shall, in collaboration with the Secretary of 
        Homeland Security and the Postmaster General of the United 
        States Postal Service, provide that import facilities in which 
        the Food and Drug Administration operates or carries out 
        activities related to drug imports within the international 
        mail facilities include--
                    (A) facility upgrades and improved capacity in 
                order to increase and improve inspection and detection 
                capabilities, which may include, as the Secretary 
                determines appropriate--
                            (i) improvements to facilities, such as 
                        upgrades or renovations, and support for the 
                        maintenance of existing import facilities and 
                        sites to improve coordination between Federal 
                        agencies;
                            (ii) the construction of, or upgrades to, 
                        laboratory capacity for purposes of detection 
                        and testing of imported goods;
                            (iii) upgrades to the security of import 
                        facilities; and
                            (iv) innovative technology and equipment to 
                        facilitate improved and near-real-time 
                        information sharing between the Food and Drug 
                        Administration, the Department of Homeland 
                        Security, and the United States Postal Service; 
                        and
                    (B) innovative technology, including controlled 
                substance detection and testing equipment and other 
                applicable technology, in order to collaborate with the 
                U.S. Customs and Border Protection to share near-real-
                time information, including information about test 
                results, as appropriate.
            (2) Innovative technology.--Any technology used in 
        accordance with paragraph (1)(B) shall be interoperable with 
        technology used by other relevant Federal agencies, including 
        the U.S. Customs and Border Protection, as the Secretary 
        determines appropriate.
    (c) Report.--Not later than 6 months after the date of enactment of 
this Act, the Secretary, in consultation with the Secretary of Homeland 
Security and the Postmaster General of the United States Postal 
Service, shall report to the relevant committees of Congress on the 
implementation of this section, including a summary of progress made 
towards near-real-time information sharing and the interoperability of 
such technologies.
    (d) Authorization of Appropriations.--Out of amounts otherwise 
available to the Secretary, the Secretary may allocate such sums as may 
be necessary for purposes of carrying out this section.

SEC. 1304. CLARIFYING FDA POST-MARKET AUTHORITIES.

    Section 505-1(b)(1)(E) of the Federal Food, Drug, and Cosmetic Act 
(21 U.S.C. 355-1(b)(1)(E)) is amended by striking ``of the drug'' and 
inserting ``of the drug, which may include reduced effectiveness under 
the conditions of use prescribed in the labeling of such drug, but 
which may not include reduced effectiveness that is in accordance with 
such labeling''.

SEC. 1305. RESTRICTING ENTRANCE OF ILLICIT DRUGS.

    (a) In General.--The Secretary, acting through the Commissioner of 
Food and Drugs, upon discovering or receiving, in a package being 
offered for import, a controlled substance that is offered for import 
in violation of any requirement of the Controlled Substances Act (21 
U.S.C. 801 et seq.), the Controlled Substances Import and Export Act 
(21 U.S.C. 951 et seq.), the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 301 et seq.), or any other applicable law, shall transfer such 
package to the U.S. Customs and Border Protection. If the Secretary 
identifies additional packages that appear to be the same as such 
package containing a controlled substance, such additional packages may 
also be transferred to U.S. Customs and Border Protection. The U.S. 
Customs and Border Protection shall receive such packages consistent 
with the requirements of the Controlled Substances Act (21 U.S.C. 801 
et seq.).
    (b) Debarment, Temporary Denial of Approval, and Suspension.--
            (1) In general.--Section 306(b) of the Federal Food, Drug, 
        and Cosmetic Act (21 U.S.C. 335a(b)) is amended--
                    (A) in paragraph (1)--
                            (i) in the matter preceding subparagraph 
                        (A), by inserting ``or (3)'' after ``paragraph 
                        (2)'';
                            (ii) in subparagraph (A), by striking the 
                        comma at the end and inserting a semicolon;
                            (iii) in subparagraph (B), by striking ``, 
                        or'' and inserting a semicolon;
                            (iv) in subparagraph (C), by striking the 
                        period and inserting ``; or''; and
                            (v) by adding at the end the following:
                    ``(D) a person from importing or offering for 
                import into the United States a drug.''; and
                    (B) in paragraph (3)--
                            (i) in the heading, by striking ``Food'';
                            (ii) in subparagraph (A), by striking ``; 
                        or'' and inserting a semicolon;
                            (iii) in subparagraph (B), by striking the 
                        period and inserting a semicolon; and
                            (iv) by adding at the end the following:
                    ``(C) the person has been convicted of a felony for 
                conduct relating to the importation into the United 
                States of any drug or controlled substance (as defined 
                in section 102 of the Controlled Substances Act);
                    ``(D) the person has engaged in a pattern of 
                importing or offering for import--
                            ``(i) controlled substances that are 
                        prohibited from importation under section 
                        401(m) of the Tariff Act of 1930 (19 U.S.C. 
                        1401(m)); or
                            ``(ii) adulterated or misbranded drugs that 
                        are--
                                    ``(I) not designated in an 
                                authorized electronic data interchange 
                                system as a product that is regulated 
                                by the Secretary; or
                                    ``(II) knowingly or intentionally 
                                falsely designated in an authorized 
                                electronic data interchange system as a 
                                product that is regulated by the 
                                Secretary.''.
            (2) Prohibited act.--Section 301(cc) of the Federal Food, 
        Drug, and Cosmetic Act (21 U.S.C. 331(cc)) is amended by 
        inserting ``or a drug'' after ``food''.
    (c) Imports and Exports.--Section 801(a) of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 381(a)) is amended--
            (1) by striking the second sentence;
            (2) by striking ``If it appears'' and inserting ``Subject 
        to subsection (b), if it appears'';
            (3) by striking ``regarding such article, then such article 
        shall be refused'' and inserting the following: ``regarding 
        such article, or (5) such article is being imported or offered 
        for import in violation of section 301(cc), then any such 
        article described in any of clauses (1) through (5) may be 
        refused admission. If it appears from the examination of such 
        samples or otherwise that the article is a counterfeit drug, 
        such article shall be refused admission.'';
            (4) by striking ``this Act, then such article shall be 
        refused admission'' and inserting ``this Act, then such article 
        may be refused admission''; and
            (5) by striking ``Clause (2) of the third sentence'' and 
        all that follows through the period at the end and inserting 
        the following: ``Neither clause (2) nor clause (5) of the 
        second sentence of this subsection shall be construed to 
        prohibit the admission of narcotic drugs, the importation of 
        which is permitted under the Controlled Substances Import and 
        Export Act.''.
    (d) Certain Illicit Articles.--Section 801 of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 381) is amended by adding at the end 
the following--
    ``(t) Illicit Articles Containing Active Pharmaceutical 
Ingredients.--
            ``(1) In general.--For purposes of this section, an article 
        that is being imported or offered for import into the United 
        States may be treated by the Secretary as a drug if the 
        article--
                    ``(A) is not--
                            ``(i) accompanied by an electronic import 
                        entry for such article submitted using an 
                        authorized electronic data interchange system; 
                        and
                            ``(ii) designated in such a system as an 
                        article regulated by the Secretary (which may 
                        include regulation as a drug, a device, or a 
                        dietary supplement; and
                    ``(B) is an ingredient that presents significant 
                public health concern and is, or contains--
                            ``(i) an active ingredient in a drug--
                                    ``(I) that is approved under 
                                section 505 or licensed under section 
                                351 of the Public Health Service Act; 
                                or
                                    ``(II) for which--
                                            ``(aa) an investigational 
                                        use exemption is in effect 
                                        under section 505(i) of this 
                                        Act or section 351(a) of the 
                                        Public Health Service Act; and
                                            ``(bb) a substantial 
                                        clinical investigation has been 
                                        instituted, and such 
                                        investigation has been made 
                                        public; or
                            ``(ii) a substance that has a chemical 
                        structure that is substantially similar to the 
                        chemical structure of an active ingredient in a 
                        drug or biological product described in 
                        subclause (I) or (II) of clause (i).
            ``(2) Effect.--This subsection shall not be construed to 
        bear upon any determination of whether an article is a drug 
        within the meaning of section 201(g), other than for the 
        purposes described in paragraph (1).''.

SEC. 1306. FIRST RESPONDER TRAINING.

    Section 546 of the Public Health Service Act (42 U.S.C. 290ee-1) is 
amended--
            (1) in subsection (c)--
                    (A) in paragraph (2), by striking ``and'' at the 
                end;
                    (B) in paragraph (3), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following:
            ``(4) train and provide resources for first responders and 
        members of other key community sectors on safety around 
        fentanyl, carfentanil, and other dangerous licit and illicit 
        drugs to protect themselves from exposure to such drugs and 
        respond appropriately when exposure occurs.'';
            (2) in subsection (d), by striking ``and mechanisms for 
        referral to appropriate treatment for an entity receiving a 
        grant under this section'' and inserting ``mechanisms for 
        referral to appropriate treatment, and safety around fentanyl, 
        carfentanil, and other dangerous licit and illicit drugs'';
            (3) in subsection (f)--
                    (A) in paragraph (3), by striking ``and'' at the 
                end;
                    (B) in paragraph (4), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following:
            ``(5) the number of first responders and members of other 
        key community sectors trained on safety around fentanyl, 
        carfentanil, and other dangerous licit and illicit drugs.'';
            (4) by redesignating subsection (g) as subsection (h);
            (5) by inserting after subsection (f) the following:
    ``(g) Other Key Community Sectors.--In this section, the term 
`other key community sectors' includes substance abuse treatment 
providers, emergency medical services agencies, agencies and 
organizations working with prison and jail populations and offender 
reentry programs, health care providers, harm reduction groups, 
pharmacies, community health centers, tribal health facilities, and 
mental health providers.''; and
            (6) in subsection (h), as so redesignated, by striking 
        ``$12,000,000 for each of fiscal years 2017 through 2021'' and 
        inserting ``$36,000,000 for each of fiscal years 2019 through 
        2023''.

SEC. 1307. DISPOSAL OF CONTROLLED SUBSTANCES OF HOSPICE PATIENTS.

    (a) In General.--Section 302(g) of the Controlled Substances Act 
(21 U.S.C. 822(g)) is amended by adding at the end the following:
    ``(5)(A) An employee of a qualified hospice program acting within 
the scope of employment may handle, in the place of residence of a 
hospice patient, any controlled substance that was lawfully dispensed 
to the hospice patient, for the purpose of assisting in the disposal of 
the controlled substance--
            ``(i) after the hospice patient's death;
            ``(ii) if the controlled substance is expired; or
            ``(iii) if--
                    ``(I) the employee is--
                            ``(aa) the physician of the hospice 
                        patient; and
                            ``(bb) registered under section 303(f); and
                    ``(II) the hospice patient no longer requires the 
                controlled substance because the plan of care of the 
                hospice patient has been modified.
    ``(B) In this paragraph:
            ``(i) The term `employee of a qualified hospice program' 
        means a physician, physician assistant, registered nurse, or 
        nurse practitioner who--
                    ``(I) is employed by, or is acting pursuant to 
                arrangements made with, a qualified hospice program; 
                and
                    ``(II) is licensed or certified to perform such 
                employment, or such activities arranged by the 
                qualified hospice program, in accordance with 
                applicable State law.
            ``(ii) The terms `hospice care' and `hospice program' have 
        the meanings given those terms in section 1861(dd) of the 
        Social Security Act (42 U.S.C. 1395x(dd)).
            ``(iii) The term `hospice patient' means an individual 
        receiving hospice care.
            ``(iv) The term `qualified hospice program' means a hospice 
        program that--
                    ``(I) has written policies and procedures for 
                employees of the hospice program to use when assisting 
                in the disposal of the controlled substances of a 
                hospice patient in a circumstance described in clause 
                (i), (ii), or (iii) of subparagraph (A);
                    ``(II) at the time when the controlled substances 
                are first ordered--
                            ``(aa) provides a copy of the written 
                        policies and procedures to the hospice patient 
                        or hospice patient representative and the 
                        family of the hospice patient;
                            ``(bb) discusses the policies and 
                        procedures with the hospice patient or hospice 
                        patient's representative and the hospice 
                        patient's family in a language and manner that 
                        such individuals understand to ensure that such 
                        individuals are informed regarding the safe 
                        disposal of controlled substances; and
                            ``(cc) documents in the clinical record of 
                        the hospice patient that the written policies 
                        and procedures were provided and discussed with 
                        the hospice patient or hospice patient's 
                        representative; and
                    ``(III) at the time when an employee of the hospice 
                program assists in the disposal of controlled 
                substances of a hospice patient, documents in the 
                clinical record of the hospice patient a list of all 
                controlled substances disposed of.
    ``(C) The Attorney General may, by regulation, include additional 
types of licensed medical professionals in the definition of the term 
`employee of a qualified hospice program' under subparagraph (B).''.
    (b) No Registration Required.--Section 302(c) of the Controlled 
Substances Act (21 U.S.C. 822(c)) is amended by adding at the end the 
following:
            ``(4) An employee of a qualified hospice program for the 
        purpose of assisting in the disposal of a controlled substance 
        in accordance with subsection (g)(5), except as provided in 
        subparagraph (A)(iii) of that subsection.''.
    (c) Guidance.--The Attorney General may issue guidance to qualified 
hospice programs to assist the programs in satisfying the requirements 
under paragraph (5) of section 302(g) of the Controlled Substances Act 
(21 U.S.C. 822(g)), as added by subsection (a).
    (d) State and Local Authority.--Nothing in this section or the 
amendments made by this section shall be construed to prevent a State 
or local government from imposing additional controls or restrictions 
relating to the regulation of the disposal of controlled substances in 
hospice care or hospice programs.

SEC. 1308. GAO STUDY AND REPORT ON HOSPICE SAFE DRUG MANAGEMENT.

    (a) Study.--
            (1) In general.--The Comptroller General of the United 
        States (in this section referred to as the ``Comptroller 
        General'') shall conduct a study on the requirements applicable 
        to and challenges of hospice programs with regard to the 
        management and disposal of controlled substances in the home of 
        an individual.
            (2) Contents.--In conducting the study under paragraph (1), 
        the Comptroller General shall include--
                    (A) an overview of challenges encountered by 
                hospice programs regarding the disposal of controlled 
                substances, such as opioids, in a home setting, 
                including any key changes in policies, procedures, or 
                best practices for the disposal of controlled 
                substances over time; and
                    (B) a description of Federal requirements, 
                including requirements under the Medicare program, for 
                hospice programs regarding the disposal of controlled 
                substances in a home setting, and oversight of 
                compliance with those requirements.
    (b) Report.--Not later than 18 months after the date of enactment 
of this Act, the Comptroller General shall submit to Congress a report 
containing the results of the study conducted under subsection (a), 
together with recommendations, if any, for such legislation and 
administrative action as the Comptroller General determines 
appropriate.

SEC. 1309. DELIVERY OF A CONTROLLED SUBSTANCE BY A PHARMACY TO BE 
              ADMINISTERED BY INJECTION OR IMPLANTATION.

    (a) In General.--The Controlled Substances Act is amended by 
inserting after section 309 (21 U.S.C. 829) the following:

``delivery of a controlled substance by a pharmacy to an administering 
                              practitioner

    ``Sec. 309A.  (a) In General.--Notwithstanding section 102(10), a 
pharmacy may deliver a controlled substance to a practitioner in 
accordance with a prescription that meets the requirements of this 
title and the regulations issued by the Attorney General under this 
title, for the purpose of administering the controlled substance by the 
practitioner if--
            ``(1) the controlled substance is delivered by the pharmacy 
        to the prescribing practitioner or the practitioner 
        administering the controlled substance, as applicable, at the 
        location listed on the practitioner's certificate of 
        registration issued under this title;
            ``(2) in the case of administering of the controlled 
        substance for the purpose of maintenance or detoxification 
        treatment under section 303(g)(2)--
                    ``(A) the practitioner who issued the prescription 
                is a qualifying practitioner authorized under, and 
                acting within the scope of that section; and
                    ``(B) the controlled substance is to be 
                administered by injection or implantation;
            ``(3) the pharmacy and the practitioner are authorized to 
        conduct the activities specified in this section under the law 
        of the State in which such activities take place;
            ``(4) the prescription is not issued to supply any 
        practitioner with a stock of controlled substances for the 
        purpose of general dispensing to patients;
            ``(5) except as provided in subsection (b), the controlled 
        substance is to be administered only to the patient named on 
        the prescription not later than 14 days after the date of 
        receipt of the controlled substance by the practitioner; and
            ``(6) notwithstanding any exceptions under section 307, the 
        prescribing practitioner, and the practitioner administering 
        the controlled substance, as applicable, maintain complete and 
        accurate records of all controlled substances delivered, 
        received, administered, or otherwise disposed of under this 
        section, including the persons to whom controlled substances 
        were delivered and such other information as may be required by 
        regulations of the Attorney General.
    ``(b) Modification of Number of Days Before Which Controlled 
Substance Shall Be Administered.--
            ``(1) Initial 2-year period.--During the 2-year period 
        beginning on the date of enactment of this section, the 
        Attorney General, in coordination with the Secretary, may 
        reduce the number of days described in subsection (a)(5) if the 
        Attorney General determines that such reduction will--
                    ``(A) reduce the risk of diversion; or
                    ``(B) protect the public health.
            ``(2) Modifications after submission of report.--After the 
        date on which the report described in subsection (c) is 
        submitted, the Attorney General, in coordination with the 
        Secretary, may modify the number of days described in 
        subsection (a)(5).
            ``(3) Minimum number of days.--Any modification under this 
        subsection shall be for a period of not less than 7 days.''.
    (b) Study and Report.--Not later than 2 years after the date of 
enactment of this section, the Comptroller General of the United States 
shall conduct a study and submit to Congress a report on access to and 
potential diversion of controlled substances administered by injection 
or implantation.
    (c) Technical and Conforming Amendment.--The table of contents for 
the Comprehensive Drug Abuse Prevention and Control Act of 1970 is 
amended by inserting after the item relating to section 309 the 
following:

``Sec. 309A. Delivery of a controlled substance by a pharmacy to an 
                            administering practitioner.''.

                   Subtitle D--Treatment and Recovery

SEC. 1401. COMPREHENSIVE OPIOID RECOVERY CENTERS.

    (a) In General.--The Secretary shall award grants on a competitive 
basis to eligible entities to establish or operate a comprehensive 
opioid recovery center (referred to in this section as a ``Center''). A 
Center may be a single entity or an integrated delivery network.
    (b) Grant Period.--
            (1) In general.--A grant awarded under subsection (a) shall 
        be for a period not more than 5 years.
            (2) Renewal.--A grant awarded under subsection (a) may be 
        renewed, on a competitive basis, for additional periods of 
        time, as determined by the Secretary. In determining whether to 
        renew a grant under this paragraph, the Secretary shall 
        consider the data submitted under subsection (h).
    (c) Minimum Number of Grants.--The Secretary shall allocate the 
amounts made available under subsection (j) such that not fewer than 10 
grants may be awarded. Not more than one grant shall be made to 
entities in a single State for any one period.
    (d) Application.--
            (1) Eligible entity.--An entity is eligible for a grant 
        under this section if the entity offers treatment and other 
        services for individuals with a substance use disorder.
            (2) Submission of application.--In order to be eligible for 
        a grant under subsection (a), an entity shall submit an 
        application to the Secretary at such time and in such manner as 
        the Secretary may require. Such application shall include--
                    (A) evidence that such entity carries out, or is 
                capable of coordinating with other entities to carry 
                out, the activities described in subsection (g); and
                    (B) such other information as the Secretary may 
                require.
    (e) Priority.--In awarding grants under subsection (a), the 
Secretary shall give priority to eligible entities located in a State 
or Indian Tribe with an age-adjusted rate of drug overdose deaths that 
is above the national overdose mortality rate, as determined by the 
Director of the Centers for Disease Control and Prevention.
    (f) Preference.--In awarding grants under subsection (a), the 
Secretary may give preference to eligible entities utilizing 
technology-enabled collaborative learning and capacity building models, 
including such models as defined in section 2 of the Expanding Capacity 
for Health Outcomes Act (Public Law 114-270; 130 Stat. 1395), to 
conduct the activities described in this section.
    (g) Center Activities.--Each Center shall, at a minimum, carry out 
the following activities directly, through referral, or through 
contractual arrangements, which may include carrying out such 
activities through technology-enabled collaborative learning and 
capacity building models described in subsection (f):
            (1) Treatment and recovery services.--Each Center shall--
                    (A) ensure that intake and evaluations meet the 
                individualized clinical needs of patients, including by 
                offering assessments for services and care 
                recommendations through independent, evidence-based 
                verification processes for reviewing patient placement 
                in treatment settings;
                    (B) provide the full continuum of treatment 
                services, including--
                            (i) all drugs approved by the Food and Drug 
                        Administration to treat substance use 
                        disorders, pursuant to Federal and State law;
                            (ii) medically supervised withdrawal 
                        management that includes patient evaluation, 
                        stabilization, and readiness for and entry into 
                        treatment;
                            (iii) counseling provided by a program 
                        counselor or other certified professional who 
                        is licensed and qualified by education, 
                        training, or experience to assess the 
                        psychological and sociological background of 
                        patients, to contribute to the appropriate 
                        treatment plan for the patient, and to monitor 
                        patient progress;
                            (iv) treatment, as appropriate, for 
                        patients with co-occurring substance use and 
                        mental disorders;
                            (v) testing, as appropriate, for infections 
                        commonly associated with illicit drug use;
                            (vi) residential rehabilitation, and 
                        outpatient and intensive outpatient programs;
                            (vii) recovery housing;
                            (viii) community-based and peer recovery 
                        support services;
                            (ix) job training, job placement 
                        assistance, and continuing education assistance 
                        to support reintegration into the workforce; 
                        and
                            (x) other best practices to provide the 
                        full continuum of treatment and services, as 
                        determined by the Secretary;
                    (C) ensure that all programs covered by the Center 
                include medication-assisted treatment, as appropriate, 
                and do not exclude individuals receiving medication-
                assisted treatment from any service;
                    (D) periodically conduct patient assessments to 
                support sustained and clinically significant recovery, 
                as defined by the Assistant Secretary for Mental Health 
                and Substance Use;
                    (E) administer an onsite pharmacy and provide 
                toxicology services, for purposes of carrying out this 
                section; and
                    (F) operate a secure, confidential, and 
                interoperable electronic health information system.
            (2) Outreach.--Each Center shall carry out outreach 
        activities to publicize the services offered through the 
        Centers, which may include--
                    (A) training and supervising outreach staff, as 
                appropriate, to work with State and local health 
                departments, health care providers, the Indian Health 
                Service, State and local educational agencies, schools 
                funded by the Indian Bureau of Education, institutions 
                of higher education, State and local workforce 
                development boards, State and local community action 
                agencies, public safety officials, first responders, 
                Indian Tribes, child welfare agencies, as appropriate, 
                and other community partners and the public, including 
                patients, to identify and respond to community needs;
                    (B) ensuring that the entities described in 
                subparagraph (A) are aware of the services of the 
                Center; and
                    (C) disseminating and making publicly available, 
                including through the internet, evidence-based 
                resources that educate professionals and the public on 
                opioid use disorder and other substance use disorders, 
                including co-occurring substance use and mental 
                disorders.
    (h) Data Reporting and Program Oversight.--With respect to a grant 
awarded under subsection (a), not later than 90 days after the end of 
the first year of the grant period, and annually thereafter for the 
duration of the grant period (including the duration of any renewal 
period for such grant), the entity shall submit data, as appropriate, 
to the Secretary regarding--
            (1) the programs and activities funded by the grant;
            (2) health outcomes of the population of individuals with a 
        substance use disorder who received services from the Center, 
        evaluated by an independent program evaluator through the use 
        of outcomes measures, as determined by the Secretary;
            (3) the retention rate of program participants; and
            (4) any other information that the Secretary may require 
        for the purpose of ensuring that the Center is complying with 
        all the requirements of the grant, including providing the full 
        continuum of services described in subsection (g)(1)(B).
    (i) Privacy.--The provisions of this section, including with 
respect to data reporting and program oversight, shall be subject to 
all applicable Federal and State privacy laws.
    (j) Authorization of Appropriations.--There is authorized to be 
appropriated $10,000,000 for each of fiscal years 2019 through 2023 for 
purposes of carrying out this section.
    (k) Reports to Congress.--
            (1) Preliminary report.--Not later than 3 years after the 
        date of the enactment of this Act, the Secretary shall submit 
        to Congress a preliminary report that analyzes data submitted 
        under subsection (h).
            (2) Final report.--Not later than 2 years after submitting 
        the preliminary report required under paragraph (1), the 
        Secretary shall submit to Congress a final report that 
        includes--
                    (A) an evaluation of the effectiveness of the 
                comprehensive services provided by the Centers 
                established or operated pursuant to this section with 
                respect to health outcomes of the population of 
                individuals with substance use disorder who receive 
                services from the Center, which shall include an 
                evaluation of the effectiveness of services for 
                treatment and recovery support and to reduce relapse, 
                recidivism, and overdose; and
                    (B) recommendations, as appropriate, regarding ways 
                to improve Federal programs related to substance use 
                disorders, which may include dissemination of best 
                practices for the treatment of substance use disorders 
                to health care professionals.

SEC. 1402. PROGRAM TO SUPPORT COORDINATION AND CONTINUATION OF CARE FOR 
              DRUG OVERDOSE PATIENTS.

    (a) In General.--The Secretary shall identify or facilitate the 
development of best practices for--
            (1) emergency treatment of known or suspected drug 
        overdose;
            (2) the use of recovery coaches, as appropriate, to 
        encourage individuals who experience a non-fatal overdose to 
        seek treatment for substance use disorder and to support 
        coordination and continuation of care;
            (3) coordination and continuation of care and treatment, 
        including, as appropriate, through referrals, of individuals 
        after an opioid overdose; and
            (4) the provision of overdose reversal medication, as 
        appropriate.
    (b) Grant Establishment and Participation.--
            (1) In general.--The Secretary shall award grants on a 
        competitive basis to eligible entities to support 
        implementation of voluntary programs for care and treatment of 
        individuals after an opioid overdose, as appropriate, which may 
        include implementation of the best practices described in 
        subsection (a).
            (2) Eligible entity.--In this section, the term ``eligible 
        entity'' means--
                    (A) a State alcohol or drug agency;
                    (B) an Indian Tribe or tribal organization; or
                    (C) an entity that offers treatment or other 
                services for individuals in response to, or following, 
                drug overdoses or a drug overdose, in consultation with 
                a State alcohol and drug agency.
            (3) Application.--An eligible entity desiring a grant under 
        this section shall submit an application to the Secretary, at 
        such time and in such manner as the Secretary may require, that 
        includes--
                    (A) evidence that such eligible entity carries out, 
                or is capable of contracting and coordinating with 
                other community entities to carry out, the activities 
                described in paragraph (4);
                    (B) evidence that such eligible entity will work 
                with a recovery community organization to recruit, 
                train, hire, mentor, and supervise recovery coaches and 
                fulfill the requirements described in paragraph (4)(A); 
                and
                    (C) such additional information as the Secretary 
                may require.
            (4) Use of grant funds.--An eligible entity awarded a grant 
        under this section shall use such grant funds to--
                    (A) hire or utilize recovery coaches to help 
                support recovery, including by--
                            (i) connecting patients to a continuum of 
                        care services, such as--
                                    (I) treatment and recovery support 
                                programs;
                                    (II) programs that provide non-
                                clinical recovery support services;
                                    (III) peer support networks;
                                    (IV) recovery community 
                                organizations;
                                    (V) health care providers, 
                                including physicians and other 
                                providers of behavioral health and 
                                primary care;
                                    (VI) education and training 
                                providers;
                                    (VII) employers;
                                    (VIII) housing services; and
                                    (IX) child welfare agencies;
                            (ii) providing education on overdose 
                        prevention and overdose reversal to patients 
                        and families, as appropriate;
                            (iii) providing follow-up services for 
                        patients after an overdose to ensure continued 
                        recovery and connection to support services;
                            (iv) collecting and evaluating outcome data 
                        for patients receiving recovery coaching 
                        services; and
                            (v) providing other services the Secretary 
                        determines necessary to help ensure continued 
                        connection with recovery support services, 
                        including culturally appropriate services, as 
                        applicable;
                    (B) establish policies and procedures, pursuant to 
                Federal and State law, that address the provision of 
                overdose reversal medication, the administration of all 
                drugs approved by the Food and Drug Administration to 
                treat substance use disorder, and subsequent 
                continuation of, or referral to, evidence-based 
                treatment for patients with a substance use disorder 
                who have experienced a non-fatal drug overdose, in 
                order to support long-term treatment, prevent relapse, 
                and reduce recidivism and future overdose; and
                    (C) establish integrated models of care for 
                individuals who have experienced a non-fatal drug 
                overdose which may include patient assessment, follow 
                up, and transportation to and from treatment 
                facilities.
            (5) Additional permissible uses.--In addition to the uses 
        described in paragraph (4), a grant awarded under this section 
        may be used, directly or through contractual arrangements, to 
        provide--
                    (A) all drugs approved by the Food and Drug 
                Administration to treat substance use disorders, 
                pursuant to Federal and State law;
                    (B) withdrawal and detoxification services that 
                include patient evaluation, stabilization, and 
                preparation for treatment of substance use disorder, 
                including treatment described in subparagraph (A), as 
                appropriate; or
                    (C) mental health services provided by a program 
                counselor, social worker, therapist, or other certified 
                professional who is licensed and qualified by 
                education, training, or experience to assess the 
                psychosocial background of patients, to contribute to 
                the appropriate treatment plan for patients with 
                substance use disorder, and to monitor patient 
                progress.
            (6) Preference.--In awarding grants under this section, the 
        Secretary shall give preference to eligible entities that meet 
        any or all of the following criteria:
                    (A) The eligible entity is a critical access 
                hospital (as defined in section 1861(mm)(1) of the 
                Social Security Act (42 U.S.C. 1395x(mm)(1))), a low 
                volume hospital (as defined in section 
                1886(d)(12)(C)(i) of such Act (42 U.S.C. 
                1395ww(d)(12)(C)(i))), or a sole community hospital (as 
                defined in section 1886(d)(5)(D)(iii) of such Act (42 
                U.S.C. 1395ww(d)(5)(D)(iii))).
                    (B) The eligible entity is located in a State, or 
                under the jurisdiction of an Indian Tribe, with an age-
                adjusted rate of drug overdose deaths that is above the 
                national overdose mortality rate, as determined by the 
                Director of the Centers for Disease Control and 
                Prevention.
                    (C) The eligible entity demonstrates that recovery 
                coaches will be placed in both health care settings and 
                community settings.
            (7) Period of grant.--A grant awarded to an eligible entity 
        under this section shall be for a period of not more than 5 
        years.
    (c) Definitions.--In this section:
            (1) Recovery coach.--the term ``recovery coach'' means an 
        individual--
                    (A) with knowledge of, or experience with, recovery 
                from a substance use disorder; and
                    (B) who has completed training from, and is 
                determined to be in good standing by, a recovery 
                services organization capable of conducting such 
                training and making such determination.
            (2) Recovery community organization.--The term ``recovery 
        community organization'' has the meaning given such term in 
        section 547(a) of the Public Health Service Act (42 U.S.C. 
        290ee-2(a)).
            (3) State alcohol and drug agency.--The term ``State 
        alcohol and drug agency'' means the principal agency of a State 
        that is responsible for carrying out the block grant for 
        prevention and treatment of substance abuse under subpart II of 
        part B of title XIX of the Public Health Service Act (42 U.S.C. 
        300x-21 et seq.)
    (d) Reporting Requirements.--
            (1) Reports by grantees.--Each eligible entity awarded a 
        grant under this section shall submit to the Secretary an 
        annual report for each year for which the entity has received 
        such grant that includes information on--
                    (A) the number of individuals treated by the entity 
                for non-fatal overdoses, including the number of non-
                fatal overdoses where overdose reversal medication was 
                administered;
                    (B) the number of individuals administered 
                medication-assisted treatment by the entity;
                    (C) the number of individuals referred by the 
                entity to other treatment facilities after a non-fatal 
                overdose, the types of such other facilities, and the 
                number of such individuals admitted to such other 
                facilities pursuant to such referrals; and
                    (D) the frequency and number of patients with 
                reoccurrences, including readmissions for non-fatal 
                overdoses and evidence of relapse related to substance 
                use disorder.
            (2) Report by secretary.--Not later than 5 years after the 
        date of enactment of this Act, the Secretary shall submit to 
        Congress a report that includes an evaluation of the 
        effectiveness of the grant program carried out under this 
        section with respect to long term health outcomes of the 
        population of individuals who have experienced a drug overdose, 
        the percentage of patients treated or referred to treatment by 
        grantees, and the frequency and number of patients who 
        experienced relapse, were readmitted for treatment, or 
        experienced another overdose.
    (e) Privacy.--The requirements of this section, including with 
respect to data reporting and program oversight, shall be subject to 
all applicable Federal and State privacy laws.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2019 through 2023.

SEC. 1403. ALTERNATIVES TO OPIOIDS.

    (a) In General.--The Secretary shall, directly or through grants 
to, or contracts with, public and private entities, provide technical 
assistance to hospitals and other acute care settings on alternatives 
to opioids for pain management. The technical assistance provided shall 
be for the purpose of--
            (1) utilizing information from acute care providers 
        including emergency departments and other providers that have 
        successfully implemented alternatives to opioids programs, 
        promoting non-addictive protocols and medications while 
        appropriately limiting the use of opioids;
            (2) identifying or facilitating the development of best 
        practices on the use of alternatives to opioids, which may 
        include pain-management strategies that involve non-addictive 
        medical products, non-pharmacologic treatments, and 
        technologies or techniques to identify patients at risk for 
        opioid use disorder;
            (3) identifying or facilitating the development of best 
        practices on the use of alternatives to opioids that target 
        common painful conditions and include certain patient 
        populations, such as geriatric patients, pregnant women, and 
        children;
            (4) disseminating information on the use of alternatives to 
        opioids to providers in acute care settings, which may include 
        emergency departments, outpatient clinics, critical access 
        hospitals, Federally qualified health centers, Indian Health 
        Service health facilities, and tribal hospitals; and
            (5) collecting data and reporting on health outcomes 
        associated with the use of alternatives to opioids.
    (b) Pain Management and Funding.--
            (1) In general.--The Secretary shall award grants to 
        hospitals and other acute care settings relating to 
        alternatives to opioids for pain management.
            (2) Authorization of appropriations.--There is authorized 
        to be appropriated $5,000,000 for each of fiscal years 2019 
        through 2023 for purposes of carrying out this section.

SEC. 1404. BUILDING COMMUNITIES OF RECOVERY.

    Section 547 of the Public Health Service Act (42 U.S.C. 290ee-2) is 
amended to read as follows:

``SEC. 547. BUILDING COMMUNITIES OF RECOVERY.

    ``(a) Definition.--In this section, the term `recovery community 
organization' means an independent nonprofit organization that--
            ``(1) mobilizes resources within and outside of the 
        recovery community, which may include through a peer support 
        network, to increase the prevalence and quality of long-term 
        recovery from substance use disorders; and
            ``(2) is wholly or principally governed by people in 
        recovery for substance use disorders who reflect the community 
        served.
    ``(b) Grants Authorized.--The Secretary shall award grants to 
recovery community organizations to enable such organizations to 
develop, expand, and enhance recovery services.
    ``(c) Federal Share.--The Federal share of the costs of a program 
funded by a grant under this section may not exceed 85 percent.
    ``(d) Use of Funds.--Grants awarded under subsection (b)--
            ``(1) shall be used to develop, expand, and enhance 
        community and statewide recovery support services; and
            ``(2) may be used to--
                    ``(A) build connections between recovery networks, 
                including between recovery community organizations and 
                peer support networks, and with other recovery support 
                services, including--
                            ``(i) behavioral health providers;
                            ``(ii) primary care providers and 
                        physicians;
                            ``(iii) educational and vocational schools;
                            ``(iv) employers;
                            ``(v) housing services;
                            ``(vi) child welfare agencies; and
                            ``(vii) other recovery support services 
                        that facilitate recovery from substance use 
                        disorders, including non-clinical community 
                        services;
                    ``(B) reduce the stigma associated with substance 
                use disorders; and
                    ``(C) conduct outreach on issues relating to 
                substance use disorders and recovery, including--
                            ``(i) identifying the signs of substance 
                        use disorder;
                            ``(ii) the resources available to 
                        individuals with substance use disorder and to 
                        families of an individual with a substance use 
                        disorder, including programs that mentor and 
                        provide support services to children;
                            ``(iii) the resources available to help 
                        support individuals in recovery; and
                            ``(iv) related medical outcomes of 
                        substance use disorders, the potential of 
                        acquiring an infection commonly associated with 
                        illicit drug use, and neonatal abstinence 
                        syndrome among infants exposed to opioids 
                        during pregnancy.
    ``(e) Special Consideration.--In carrying out this section, the 
Secretary shall give special consideration to the unique needs of rural 
areas, including areas with an age-adjusted rate of drug overdose 
deaths that is above the national average and areas with a shortage of 
prevention and treatment services.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2019 through 2023.''.

SEC. 1405. PEER SUPPORT TECHNICAL ASSISTANCE CENTER.

    (a) Establishment.--The Secretary, acting through the Assistant 
Secretary for Mental Health and Substance Abuse, shall establish or 
operate a National Peer-Run Training and Technical Assistance Center 
for Addiction Recovery Support (referred to in this subsection as the 
``Center'').
    (b) Functions.--The Center established under subsection (a) shall 
provide technical assistance and support to recovery community 
organizations and peer support networks, including such assistance and 
support related to--
            (1) training on identifying--
                    (A) signs of substance use disorder;
                    (B) resources to assist individuals with a 
                substance use disorder, or resources for families of an 
                individual with a substance use disorder; and
                    (C) best practices for the delivery of recovery 
                support services;
            (2) the provision of translation services, interpretation, 
        or other such services for clients with limited English 
        speaking proficiency;
            (3) data collection to support research, including for 
        translational research;
            (4) capacity building; and
            (5) evaluation and improvement, as necessary, of the 
        effectiveness of such services provided by recovery community 
        organizations (as defined in section 547 of the Public Health 
        Service Act).
    (c) Best Practices.--The Center established under subsection (a) 
shall periodically issue best practices for use by recovery community 
organizations and peer support networks.
    (d) Recovery Community Organization.--In this section, the term 
``recovery community organization'' has the meaning given such term in 
section 547 of the Public Health Service Act.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2019 through 2023.

SEC. 1406. MEDICATION-ASSISTED TREATMENT FOR RECOVERY FROM ADDICTION.

    (a) Waivers for Maintenance Treatment or Detoxification.--Section 
303(g)(2)(G)(ii) of the Controlled Substances Act (21 U.S.C. 
823(g)(2)(G)(ii)) is amended by adding at the end the following:
                    ``(VIII) The physician graduated in good standing 
                from an accredited school of allopathic medicine or 
                osteopathic medicine in the United States during the 5-
                year period immediately preceding the date on which the 
                physician submits to the Secretary a written 
                notification under subparagraph (B) and successfully 
                completed a comprehensive allopathic or osteopathic 
                medicine curriculum or accredited medical residency 
                that--
                            ``(aa) included not less than 24 hours of 
                        training on treating and managing opioid-
                        dependent patients; and
                            ``(bb) included, at a minimum--
                                    ``(AA) the training described in 
                                items (aa) through (gg) of subclause 
                                (IV); and
                                    ``(BB) training with respect to any 
                                other best practice the Secretary 
                                determines should be included in the 
                                curriculum, which may include training 
                                on pain management, including 
                                assessment and appropriate use of 
                                opioid and non-opioid alternatives.''.
    (b) Treatment for Children.--The Secretary shall consider ways to 
ensure that an adequate number of physicians who meet the requirements 
under the amendment made by subsection (a) and have a specialty in 
pediatrics, or the treatment of children or of adolescents, are granted 
a waiver under section 303(g)(2) of the Controlled Substances Act (21 
U.S.C. 823(g)(2)) to treat children and adolescents with substance use 
disorders.
    (c) Technical Amendment.--Section 102(24) of the Controlled 
Substances Act (21 U.S.C. 802(24)) is amended by striking ``Health, 
Education, and Welfare'' and inserting ``Health and Human Services''.

SEC. 1407. GRANT PROGRAM.

    (a) In General.--The Secretary shall establish a grant program 
under which the Secretary may make grants to accredited schools of 
allopathic medicine or osteopathic medicine and teaching hospitals 
located in the United States to support the development of curricula 
that meet the requirements under subclause (VIII) of section 
303(g)(2)(G)(ii) of the Controlled Substances Act, as added by section 
1406(a) of this Act.
    (b) Authorization of Appropriations.--There is authorized to be 
appropriated for grants under subsection (a), $4,000,000 for each of 
fiscal years 2019 through 2023.

SEC. 1408. ALLOWING FOR MORE FLEXIBILITY WITH RESPECT TO MEDICATION-
              ASSISTED TREATMENT FOR OPIOID USE DISORDERS.

    Subclause (II) of section 303(g)(2)(B)(iii) of the Controlled 
Substances Act (21 U.S.C. 823(g)(2)(B)(iii)) is amended to read as 
follows:
            ``(II) The applicable number is--
                    ``(aa) 100 if, not sooner than 1 year after the 
                date on which the practitioner submitted the initial 
                notification, the practitioner submits a second 
                notification to the Secretary of the need and intent of 
                the practitioner to treat up to 100 patients; or
                    ``(bb) 275 if the practitioner meets the 
                requirements specified in section 8.610 of title 42, 
                Code of Federal Regulations (or successor 
                regulations).''.

SEC. 1409. NATIONAL RECOVERY HOUSING BEST PRACTICES.

    (a) Best Practices for Operating Recovery Housing.--
            (1) In general.--The Secretary, in consultation with the 
        individuals and entities described in paragraph (2), shall 
        identify or facilitate the development of best practices, which 
        may include model laws for implementing suggested minimum 
        standards, for operating recovery housing.
            (2) Consultation.--In carrying out the activities described 
        in paragraph (1) the Secretary shall consult with, as 
        appropriate--
                    (A) relevant divisions of the Department of Health 
                and Human Services, including the Substance Abuse and 
                Mental Health Services Administration, the Office of 
                Inspector General, the Indian Health Service, and the 
                Centers for Medicare & Medicaid Services;
                    (B) the Secretary of Housing and Urban Development;
                    (C) directors or commissioners, as applicable, of 
                State health departments, tribal health departments, 
                State Medicaid programs, and State insurance agencies;
                    (D) representatives of health insurance issuers;
                    (E) national accrediting entities and reputable 
                providers of, and analysts of, recovery housing 
                services, including Indian Tribes, tribal 
                organizations, and tribally designated housing entities 
                that provide recovery housing services, as applicable;
                    (F) individuals with a history of substance use 
                disorder; and
                    (G) other stakeholders identified by the Secretary.
    (b) Identification of Fraudulent Recovery Housing Operators.--
            (1) In general.--The Secretary, in consultation with the 
        individuals and entities described in paragraph (2), shall 
        identify or facilitate the development of common indicators 
        that could be used to identify potentially fraudulent recovery 
        housing operators.
            (2) Consultation.--In carrying out the activities described 
        in paragraph (1), the Secretary shall consult with, as 
        appropriate--
                    (A) relevant divisions of the Department of Health 
                and Human Services, including the Substance Abuse and 
                Mental Health Services Administration, the Office of 
                Inspector General, the Indian Health Service, and the 
                Centers for Medicare & Medicaid Services;
                    (B) the Attorney General;
                    (C) the Secretary of Housing and Urban Development;
                    (D) directors or commissioners, as applicable, of 
                State health departments, tribal health departments, 
                State Medicaid programs, and State insurance agencies;
                    (E) representatives of health insurance issuers;
                    (F) national accrediting entities and reputable 
                providers of, and analysts of, recovery housing 
                services, including Indian Tribes, tribal 
                organizations, and tribally designated housing entities 
                that provide recovery housing services, as applicable;
                    (G) individuals with a history of substance use 
                disorder; and
                    (H) other stakeholders identified by the Secretary.
            (3) Requirements.--
                    (A) Practices for identification and reporting.--In 
                carrying out the activities described in this 
                subsection, the Secretary shall consider how law 
                enforcement, public and private payers, and the public 
                can best identify and report fraudulent recovery 
                housing operators.
                    (B) Factors to be considered.--In carrying out the 
                activities described in this subsection, the Secretary 
                shall consider identifying or developing indicators 
                regarding--
                            (i) unusual billing practices;
                            (ii) average lengths of stays;
                            (iii) excessive levels of drug testing (in 
                        terms of cost or frequency);
                            (iv) unusually high levels of recidivism; 
                        and
                            (v) any other factors identified by the 
                        Secretary.
    (c) Dissemination.--The Secretary shall, as appropriate, 
disseminate the best practices identified or developed under subsection 
(a), and the common indicators identified or developed under subsection 
(b), to--
            (1) State agencies, which may include the provision of 
        technical assistance to State agencies seeking to adopt or 
        implement such best practices;
            (2) Indian Tribes, tribal organizations, and tribally 
        designated housing entities;
            (3) the Attorney General;
            (4) the Secretary of Labor;
            (5) the Secretary of Housing and Urban Development;
            (6) State and local law enforcement agencies;
            (7) health insurance issuers;
            (8) recovery housing entities; and
            (9) the public.
    (d) Requirements.--In carrying out the activities under subsections 
(a) and (b), the Secretary, in consultation with appropriate 
stakeholders as described in each such subsection, shall consider how 
recovery housing is able to support recovery and prevent relapse, 
recidivism, or overdose (including overdose death), including by 
improving access and adherence to treatment, including medication-
assisted treatment.
    (e) Rule of Construction.--Nothing in this section shall be 
construed to provide the Secretary with the authority to require States 
to adhere to minimum standards in the State oversight of recovery 
housing.
    (f) Definitions.--In this section--
            (1) the term ``recovery housing'' means a shared living 
        environment free from alcohol and illicit drug use and centered 
        on peer support and connection to services that promote 
        sustained recovery from substance use disorders; and
            (2) the term ``tribally designated housing entity'' has the 
        meaning given such term in section 4 of the Native American 
        Housing Assistance and Self-Determination Act of 1996 (25 
        U.S.C. 4103).

SEC. 1410. ADDRESSING ECONOMIC AND WORKFORCE IMPACTS OF THE OPIOID 
              CRISIS.

    (a) Definitions.--Except as otherwise expressly provided, in this 
section:
            (1) WIOA definitions.--The terms ``core program'', 
        ``individual with a barrier to employment'', ``local area'', 
        ``local board'', ``one-stop operator'', ``outlying area'', 
        ``State'', ``State board'', and ``supportive services'' have 
        the meanings given the terms in section 3 of the Workforce 
        Innovation and Opportunity Act (29 U.S.C. 3102).
            (2) Education provider.--The term ``education provider'' 
        means--
                    (A) an institution of higher education, as defined 
                in section 101 of the Higher Education Act of 1965 (20 
                U.S.C. 1001); or
                    (B) a postsecondary vocational institution, as 
                defined in section 102(c) of such Act (20 U.S.C. 
                1002(c)).
            (3) Eligible entity.--The term ``eligible entity'' means--
                    (A) a State workforce agency;
                    (B) an outlying area; or
                    (C) a Tribal entity.
            (4) Participating partnership.--The term ``participating 
        partnership'' means a partnership--
                    (A) evidenced by a written contract or agreement; 
                and
                    (B) including, as members of the partnership, a 
                local board receiving a subgrant under subsection (d) 
                and 1 or more of the following:
                            (i) The eligible entity.
                            (ii) A treatment provider.
                            (iii) An employer or industry organization.
                            (iv) An education provider.
                            (v) A legal service or law enforcement 
                        organization.
                            (vi) A faith-based or community-based 
                        organization.
                            (vii) Other State or local agencies, 
                        including counties or local governments.
                            (viii) Other organizations, as determined 
                        to be necessary by the local board.
                            (ix) Indian Tribes or tribal organizations.
            (5) Program participant.--The term ``program participant'' 
        means an individual who--
                    (A) is a member of a population of workers 
                described in subsection (e)(2) that is served by a 
                participating partnership through the pilot program 
                under this section; and
                    (B) enrolls with the applicable participating 
                partnership to receive any of the services described in 
                subsection (e)(3).
            (6) Provider of peer recovery support services.--The term 
        ``provider of peer recovery support services'' means a provider 
        that delivers peer recovery support services through an 
        organization described in section 547(a) of the Public Health 
        Service Act (42 U.S.C. 290ee-2(a)).
            (7) Secretary.--The term ``Secretary'' means the Secretary 
        of Labor.
            (8) State workforce agency.--The term ``State workforce 
        agency'' means the lead State agency with responsibility for 
        the administration of a program under chapter 2 or 3 of 
        subtitle B of title I of the Workforce Innovation and 
        Opportunity Act (29 U.S.C. 3161 et seq., 3171 et seq.).
            (9) Substance use disorder.--The term ``substance use 
        disorder'' has the meaning given such term by the Assistant 
        Secretary for Mental Health and Substance Use.
            (10) Treatment provider.--The term ``treatment provider''--
                    (A) means a health care provider that--
                            (i) offers services for treating substance 
                        use disorders and is licensed in accordance 
                        with applicable State law to provide such 
                        services; and
                            (ii) accepts health insurance for such 
                        services, including coverage under title XIX of 
                        the Social Security Act (42 U.S.C. 1396 et 
                        seq.); and
                    (B) may include--
                            (i) a nonprofit provider of peer recovery 
                        support services;
                            (ii) a community health care provider;
                            (iii) a Federally qualified health center 
                        (as defined in section 1861(aa) of the Social 
                        Security Act (42 U.S.C. 1395x));
                            (iv) an Indian health program (as defined 
                        in section 3 of the Indian Health Care 
                        Improvement Act (25 U.S.C. 1603)), including an 
                        Indian health program that serves an urban 
                        center (as defined in such section); and
                            (v) a Native Hawaiian health center (as 
                        defined in section 12 of the Native Hawaiian 
                        Health Care Improvement Act (42 U.S.C. 11711)).
            (11) Tribal entity.--The term ``Tribal entity'' includes 
        any Indian Tribe, tribal organization, Indian-controlled 
        organization serving Indians, Native Hawaiian organization, or 
        Alaska Native entity, as such terms are defined or used in 
        section 166 of the Workforce Innovation and Opportunity Act (29 
        U.S.C. 3221).
    (b) Pilot Program and Grants Authorized.--
            (1) In general.--The Secretary, in consultation with the 
        Secretary of Health and Human Services, shall carry out a pilot 
        program to address economic and workforce impacts associated 
        with a high rate of a substance use disorder. In carrying out 
        the pilot program, the Secretary shall make grants, on a 
        competitive basis, to eligible entities to enable such entities 
        to make subgrants to local boards to address the economic and 
        workforce impacts associated with a high rate of a substance 
        use disorder.
            (2) Grant amounts.--The Secretary shall make each such 
        grant in an amount that is not less than $500,000, and not more 
        than $5,000,000, for a fiscal year.
    (c) Grant Applications.--
            (1) In general.--An eligible entity applying for a grant 
        under this section shall submit an application to the Secretary 
        at such time and in such form and manner as the Secretary may 
        reasonably require, including the information described in this 
        subsection.
            (2) Significant impact on community by opioid and substance 
        use disorder-related problems.--
                    (A) Demonstration.--An eligible entity shall 
                include in the application--
                            (i) information that demonstrates 
                        significant impact on the community by problems 
                        related to opioid abuse or another substance 
                        use disorder, by--
                                    (I) identifying the counties, 
                                communities, regions, or local areas 
                                that have been significantly impacted 
                                and will be served through the grant 
                                (each referred to in this section as a 
                                ``service area''); and
                                    (II) demonstrating for each such 
                                service area, an increase equal to or 
                                greater than the national increase in 
                                such problems, between--
                                            (aa) 1999; and
                                            (bb) 2016 or the latest 
                                        year for which data are 
                                        available; and
                            (ii) a description of how the eligible 
                        entity will prioritize support for 
                        significantly impacted service areas described 
                        in clause (i)(I).
                    (B) Information.--To meet the requirements 
                described in subparagraph (A)(i)(II), the eligible 
                entity may use information including data on--
                            (i) the incidence or prevalence of opioid 
                        abuse and other substance use disorders;
                            (ii) the age-adjusted rate of drug overdose 
                        deaths, as determined by the Director of the 
                        Centers for Disease Control and Prevention;
                            (iii) the rate of non-fatal 
                        hospitalizations related to opioid abuse or 
                        other substance use disorders;
                            (iv) the number of arrests or convictions, 
                        or a relevant law enforcement statistic, that 
                        reasonably shows an increase in opioid abuse or 
                        another substance use disorder; or
                            (v) in the case of an eligible entity 
                        described in subsection (a)(3)(C), other 
                        alternative relevant data as determined 
                        appropriate by the Secretary.
                    (C) Support for state strategy.--The eligible 
                entity may include in the application information 
                describing how the proposed services and activities are 
                aligned with the State, outlying area, or Tribal 
                strategy, as applicable, for addressing problems 
                described in subparagraph (A) in specific service areas 
                or across the State, outlying area, or Tribal land.
            (3) Economic and employment conditions demonstrate 
        additional federal support needed.--
                    (A) Demonstration.--An eligible entity shall 
                include in the application information that 
                demonstrates that a high rate of a substance use 
                disorder has caused, or is coincident to--
                            (i) an economic or employment downturn in 
                        the service area; or
                            (ii) persistent economically depressed 
                        conditions in such service area.
                    (B) Information.--To meet the requirements of 
                subparagraph (A), an eligible entity may use 
                information including--
                            (i) documentation of any layoff, announced 
                        future layoff, legacy industry decline, 
                        decrease in an employment or labor market 
                        participation rate, or economic impact, whether 
                        or not the result described in this clause is 
                        overtly related to a high rate of a substance 
                        use disorder;
                            (ii) documentation showing decreased 
                        economic activity related to, caused by, or 
                        contributing to a high rate of a substance use 
                        disorder, including a description of how the 
                        service area has been impacted, or will be 
                        impacted, by such a decrease;
                            (iii) information on economic indicators, 
                        labor market analyses, information from public 
                        announcements, and demographic and industry 
                        data;
                            (iv) information on rapid response 
                        activities (as defined in section 3 of the 
                        Workforce Innovation and Opportunity Act (29 
                        U.S.C. 3102)) that have been or will be 
                        conducted, including demographic data gathered 
                        by employer or worker surveys or through other 
                        methods;
                            (v) data or documentation, beyond anecdotal 
                        evidence, showing that employers face 
                        challenges filling job vacancies due to a lack 
                        of skilled workers able to pass a drug test; or
                            (vi) any additional relevant data or 
                        information on the economy, workforce, or 
                        another aspect of the service area to support 
                        the application.
    (d) Subgrant Authorization and Application Process.--
            (1) Subgrants authorized.--
                    (A) In general.--An eligible entity receiving a 
                grant under subsection (b)--
                            (i) may use not more than 5 percent of the 
                        grant funds for the administrative costs of 
                        carrying out the grant;
                            (ii) in the case of an eligible entity 
                        described in subparagraph (A) or (B) of 
                        subsection (a)(3), shall use the remaining 
                        grant funds to make subgrants to local entities 
                        in the service area to carry out the services 
                        and activities described in subsection (e); and
                            (iii) in the case of an eligible entity 
                        described in subsection (a)(3)(C), shall use 
                        the remaining grant funds to carry out the 
                        services and activities described in subsection 
                        (e).
                    (B) Equitable distribution.--In making subgrants 
                under this subsection, an eligible entity shall ensure, 
                to the extent practicable, the equitable distribution 
                of subgrants, based on--
                            (i) geography (such as urban and rural 
                        distribution); and
                            (ii) significantly impacted service areas 
                        as described in subsection (c)(2).
                    (C) Timing of subgrant funds distribution.--An 
                eligible entity making subgrants under this subsection 
                shall disburse subgrant funds to a local board 
                receiving a subgrant from the eligible entity by the 
                later of--
                            (i) the date that is 90 days after the date 
                        on which the Secretary makes the funds 
                        available to the eligible entity; or
                            (ii) the date that is 15 days after the 
                        date that the eligible entity makes the 
                        subgrant under subparagraph (A)(ii).
            (2) Subgrant application.--
                    (A) In general.--A local board desiring to receive 
                a subgrant under this subsection from an eligible 
                entity shall submit an application at such time and in 
                such manner as the eligible entity may reasonably 
                require, including the information described in this 
                paragraph.
                    (B) Contents.--Each application described in 
                subparagraph (A) shall include--
                            (i) an analysis of the estimated 
                        performance of the local board in carrying out 
                        the proposed services and activities under the 
                        subgrant--
                                    (I) based on--
                                            (aa) primary indicators of 
                                        performance described in 
                                        section 116(c)(1)(A)(i) of the 
                                        Workforce Innovation and 
                                        Opportunity Act (29 U.S.C. 
                                        3141(c)(1)(A)(i), to assess 
                                        estimated effectiveness of the 
                                        proposed services and 
                                        activities, including the 
                                        estimated number of individuals 
                                        with a substance use disorder 
                                        who may be served by the 
                                        proposed services and 
                                        activities;
                                            (bb) the record of the 
                                        local board in serving 
                                        individuals with a barrier to 
                                        employment; and
                                            (cc) the ability of the 
                                        local board to establish a 
                                        participating partnership; and
                                    (II) which may include or utilize--
                                            (aa) data from the National 
                                        Center for Health Statistics of 
                                        the Centers for Disease Control 
                                        and Prevention;
                                            (bb) data from the Center 
                                        for Behavioral Health 
                                        Statistics and Quality of the 
                                        Substance Abuse and Mental 
                                        Health Services Administration;
                                            (cc) State vital 
                                        statistics;
                                            (dd) municipal police 
                                        department records;
                                            (ee) reports from local 
                                        coroners; or
                                            (ff) other relevant data; 
                                        and
                            (ii) in the case of a local board proposing 
                        to serve a population described in subsection 
                        (e)(2)(B), a demonstration of the workforce 
                        shortage in the professional area to be 
                        addressed under the subgrant (which may include 
                        substance use disorder treatment and related 
                        services, non-addictive pain therapy and pain 
                        management services, mental health care 
                        treatment services, emergency response 
                        services, or mental health care), which shall 
                        include information that can demonstrate such a 
                        shortage, such as--
                                    (I) the distance between--
                                            (aa) communities affected 
                                        by opioid abuse or another 
                                        substance use disorder; and
                                            (bb) facilities or 
                                        professionals offering services 
                                        in the professional area; or
                                    (II) the maximum capacity of 
                                facilities or professionals to serve 
                                individuals in an affected community, 
                                or increases in arrests related to 
                                opioid or another substance use 
                                disorder, overdose deaths, or nonfatal 
                                overdose emergencies in the community.
    (e) Subgrant Services and Activities.--
            (1) In general.--Each local board that receives a subgrant 
        under subsection (d) shall carry out the services and 
        activities described in this subsection through a participating 
        partnership.
            (2) Selection of population to be served.--A participating 
        partnership shall elect to provide services and activities 
        under the subgrant to one or both of the following populations 
        of workers:
                    (A) Workers, including dislocated workers, 
                individuals with barriers to employment, new entrants 
                in the workforce, or incumbent workers (employed or 
                underemployed), each of whom--
                            (i) is directly or indirectly affected by a 
                        high rate of a substance use disorder; and
                            (ii) voluntarily confirms that the worker, 
                        or a friend or family member of the worker, has 
                        a history of opioid abuse or another substance 
                        use disorder.
                    (B) Workers, including dislocated workers, 
                individuals with barriers to employment, new entrants 
                in the workforce, or incumbent workers (employed or 
                underemployed), who--
                            (i) seek to transition to professions that 
                        support individuals with a substance use 
                        disorder or at risk for developing such 
                        disorder, such as professions that provide--
                                    (I) substance use disorder 
                                treatment and related services;
                                    (II) services offered through 
                                providers of peer recovery support 
                                services;
                                    (III) non-addictive pain therapy 
                                and pain management services;
                                    (IV) emergency response services; 
                                or
                                    (V) mental health care; and
                            (ii) need new or upgraded skills to better 
                        serve such a population of struggling or at-
                        risk individuals.
            (3) Services and activities.--Each participating 
        partnership shall use funds available through a subgrant under 
        this subsection to carry out 1 or more of the following:
                    (A) Engaging employers.--Engaging with employers 
                to--
                            (i) learn about the skill and hiring 
                        requirements of employers;
                            (ii) learn about the support needed by 
                        employers to hire and retain program 
                        participants, and other individuals with a 
                        substance use disorder, and the support needed 
                        by such employers to obtain their commitment to 
                        testing creative solutions to employing program 
                        participants and such individuals;
                            (iii) connect employers and workers to on-
                        the-job or customized training programs before 
                        or after layoff to help facilitate 
                        reemployment;
                            (iv) connect employers with an education 
                        provider to develop classroom instruction to 
                        complement on-the-job learning for program 
                        participants and such individuals;
                            (v) help employers develop the curriculum 
                        design of a work-based learning program for 
                        program participants and such individuals;
                            (vi) help employers employ program 
                        participants or such individuals engaging in a 
                        work-based learning program for a transitional 
                        period before hiring such a program participant 
                        or individual for full-time employment of not 
                        less than 30 hours a week; or
                            (vii) connect employers to program 
                        participants receiving concurrent outpatient 
                        treatment and job training services.
                    (B) Screening services.--Providing screening 
                services, which may include--
                            (i) using an evidence-based screening 
                        method to screen each individual seeking 
                        participation in the pilot program to determine 
                        whether the individual has a substance use 
                        disorder;
                            (ii) conducting an assessment of each such 
                        individual to determine the services needed for 
                        such individual to obtain or retain employment, 
                        including an assessment of strengths and 
                        general work readiness; or
                            (iii) accepting walk-ins or referrals from 
                        employers, labor organizations, or other 
                        entities recommending individuals to 
                        participate in such program.
                    (C) Individual treatment and employment plan.--
                Developing an individual treatment and employment plan 
                for each program participant--
                            (i) in coordination, as appropriate, with 
                        other programs serving the participant such as 
                        the core programs within the workforce 
                        development system under the Workforce 
                        Innovation and Opportunity Act (29 U.S.C. 3101 
                        et seq.); and
                            (ii) which shall include providing a case 
                        manager to work with each participant to 
                        develop the plan, which may include--
                                    (I) identifying employment and 
                                career goals;
                                    (II) exploring career pathways that 
                                lead to in-demand industries and 
                                sectors, as determined by the State 
                                board and the head of the State 
                                workforce agency or, as applicable, the 
                                Tribal entity;
                                    (III) setting appropriate 
                                achievement objectives to attain the 
                                employment and career goals identified 
                                under subclause (I); or
                                    (IV) developing the appropriate 
                                combination of services to enable the 
                                participant to achieve the employment 
                                and career goals identified under 
                                subclause (I).
                    (D) Outpatient treatment and recovery care.--In the 
                case of a participating partnership serving program 
                participants described in paragraph (2)(A) with a 
                substance use disorder, providing individualized and 
                group outpatient treatment and recovery services for 
                such program participants that are offered during the 
                day and evening, and on weekends. Such treatment and 
                recovery services--
                            (i) shall be based on a model that utilizes 
                        combined behavioral interventions and other 
                        evidence-based or evidence-informed 
                        interventions; and
                            (ii) may include additional services such 
                        as--
                                    (I) health, mental health, 
                                addiction, or other forms of outpatient 
                                treatment that may impact a substance 
                                use disorder and co-occurring 
                                conditions;
                                    (II) drug testing for a current 
                                substance use disorder prior to 
                                enrollment in career or training 
                                services or prior to employment;
                                    (III) linkages to community 
                                services, including services offered by 
                                partner organizations designed to 
                                support program participants; or
                                    (IV) referrals to health care, 
                                including referrals to substance use 
                                disorder treatment and mental health 
                                services.
                    (E) Supportive services.--Providing supportive 
                services, which shall include services such as--
                            (i) coordinated wraparound services to 
                        provide maximum support for program 
                        participants to assist the program participants 
                        in maintaining employment and recovery for not 
                        less than 12 months, as appropriate;
                            (ii) assistance in establishing eligibility 
                        for assistance under Federal, State, Tribal, 
                        and local programs providing health services, 
                        mental health services, vocational services, 
                        housing services, transportation services, 
                        social services, or services through early 
                        childhood education programs (as defined in 
                        section 103 of the Higher Education Act of 1965 
                        (20 U.S.C. 1003));
                            (iii) services offered through providers of 
                        peer recovery support services;
                            (iv) networking and mentorship 
                        opportunities; or
                            (v) any supportive services determined 
                        necessary by the local board.
                    (F) Career and job training services.--Offering 
                career services and training services, and related 
                services, concurrently or sequentially with the 
                services provided under subparagraphs (B) through (E). 
                Such services shall include the following:
                            (i) Services provided to program 
                        participants who are in a pre-employment stage 
                        of the program, which may include--
                                    (I) initial education and skills 
                                assessments;
                                    (II) traditional classroom training 
                                funded through individual training 
                                accounts under chapter 3 of subtitle B 
                                of title I of the Workforce Innovation 
                                and Opportunity Act (29 U.S.C. 3171 et 
                                seq.);
                                    (III) services to promote 
                                employability skills such as 
                                punctuality, personal maintenance 
                                skills, and professional conduct;
                                    (IV) in-depth interviewing and 
                                evaluation to identify employment 
                                barriers and to develop individual 
                                employment plans;
                                    (V) career planning that includes--
                                            (aa) career pathways 
                                        leading to in-demand, high-wage 
                                        jobs; and
                                            (bb) job coaching, job 
                                        matching, and job placement 
                                        services;
                                    (VI) provision of payments and fees 
                                for employment and training-related 
                                applications, tests, and 
                                certifications; or
                                    (VII) any other appropriate career 
                                service or training service described 
                                in section 134(c) of the Workforce 
                                Innovation and Opportunity Act (29 
                                U.S.C. 3174(c)).
                            (ii) Services provided to program 
                        participants during their first 6 months of 
                        employment to ensure job retention, which may 
                        include--
                                    (I) case management and support 
                                services, including a continuation of 
                                the services described in clause (i);
                                    (II) a continuation of skills 
                                training, and career and technical 
                                education, described in clause (i) that 
                                is conducted in collaboration with the 
                                employers of such participants;
                                    (III) mentorship services and job 
                                retention support for such 
                                participants; or
                                    (IV) targeted training for managers 
                                and workers working with such 
                                participants (such as mentors), and 
                                human resource representatives in the 
                                business in which such participants are 
                                employed.
                            (iii) Services to assist program 
                        participants in maintaining employment for not 
                        less than 12 months, as appropriate.
                    (G) Proven and promising practices.--Leading 
                efforts in the service area to identify and promote 
                proven and promising strategies and initiatives for 
                meeting the needs of employers and program 
                participants.
            (4) Limitations.--A participating partnership may not use--
                    (A) more than 10 percent of the funds received 
                under a subgrant under subsection (d) for the 
                administrative costs of the partnership;
                    (B) more than 10 percent of the funds received 
                under such subgrant for the provision of treatment and 
                recovery services, as described in paragraph (3)(D); 
                and
                    (C) more than 10 percent of the funds received 
                under such subgrant for the provision of supportive 
                services described in paragraph (3)(E) to program 
                participants.
    (f) Performance Accountability.--
            (1) Reports.--The Secretary shall establish quarterly 
        reporting requirements for recipients of grants and subgrants 
        under this section that, to the extent practicable, are based 
        on the performance accountability system under section 116 of 
        the Workforce Innovation and Opportunity Act (29 U.S.C. 3141) 
        and, in the case of a grant awarded to an eligible entity 
        described in subsection (a)(3)(C), section 166(h) of such Act 
        (29 U.S.C. 3221(h)), including the indicators described in 
        subsection (c)(1)(A)(i) of such section 116 and the 
        requirements for local area performance reports under 
        subsection (d) of such section 116.
            (2) Evaluations.--
                    (A) Authority to enter into agreements.--The 
                Secretary shall ensure that an independent evaluation 
                is conducted on the pilot program carried out under 
                this section to determine the impact of the program on 
                employment of individuals with substance use disorders. 
                The Secretary shall enter into an agreement with 
                eligible entities receiving grants under this section 
                to pay for all or part of such evaluation.
                    (B) Methodologies to be used.--The independent 
                evaluation required under this paragraph shall use 
                experimental designs using random assignment or, when 
                random assignment is not feasible, other reliable, 
                evidence-based research methodologies that allow for 
                the strongest possible causal inferences.
    (g) Funding.--
            (1) Covered fiscal year.--In this subsection, the term 
        ``covered fiscal year'' means any of fiscal years 2018 through 
        2023.
            (2) Using funding for national dislocated worker grants.--
        Subject to paragraph (4) and notwithstanding section 
        132(a)(2)(A) and subtitle D of the Workforce Innovation and 
        Opportunity Act (29 U.S.C. 3172(a)(2)(A), 3221 et seq.), the 
        Secretary may use, to carry out the pilot program under this 
        section for a covered fiscal year--
                    (A) funds made available to carry out section 170 
                of such Act (29 U.S.C. 3225) for that fiscal year;
                    (B) funds made available to carry out section 170 
                of such Act that remain available for that fiscal year; 
                and
                    (C) funds that remain available under section 
                172(f) of such Act (29 U.S.C. 3227(f)).
            (3) Availability of funds.--Funds appropriated under 
        section 136(c) of such Act (29 U.S.C. 3181(c)) and made 
        available to carry out section 170 of such Act for a fiscal 
        year shall remain available for use under paragraph (2) for a 
        subsequent fiscal year until expended.
            (4) Limitation.--The Secretary may not use more than 
        $100,000,000 of the funds described in paragraph (2) for any 
        covered fiscal year under this section.

SEC. 1411. CAREER ACT.

    (a) In General.--The Secretary, in consultation with the Secretary 
of Labor, shall continue or establish a program to support individuals 
in recovery from a substance use disorder transition to independent 
living and the workforce.
    (b) Grants Authorized.--In carrying out the activities under this 
section, the Secretary shall, on a competitive basis, award grants for 
a period of not more than 5 years to entities to enable such entities 
to carry out evidence-based programs to help individuals in recovery 
from a substance use disorder transition from treatment to independent 
living and the workforce. Such entities shall coordinate, as 
applicable, with Indian tribes or tribal organizations (as applicable), 
State boards and local boards (as defined in section 3 of the Workforce 
Innovation and Opportunity Act (29 U.S.C. 3102), lead State agencies 
with responsibility for a workforce investment activity (as defined in 
such section 3), and State agencies responsible for carrying out 
substance use disorder prevention and treatment programs.
    (c) Priority.--In awarding grants under this section, the Secretary 
shall give priority to entities located in a State with--
            (1) an age-adjusted rate of drug overdose deaths that is 
        above the national overdose mortality rate, as determined by 
        the Director of the Centers for Disease Control and Prevention;
            (2) a rate of unemployment, based on data provided by the 
        Bureau of Labor Statistics for calendar years 2013 through 
        2017, that is above the national average; and
            (3) a rate of labor force participation, based on data 
        provided by the Bureau of Labor Statistics for calendar years 
        2013 through 2017, that is below the national average.
    (d) Preference.--In awarding grants under this section, the 
Secretary shall, as appropriate, give preference to entities located in 
an area with an age-adjusted rate of drug overdose deaths that is above 
the national overdose mortality rate.
    (e) Applications.--An eligible entity shall submit an application 
at such time and in such manner as the Secretary may require. In 
submitting an application, the entity shall demonstrate the ability to 
partner with local stakeholders, which may include local employers, 
community stakeholders, the local workforce development board, and 
local and State governments, to--
            (1) identify gaps in the workforce due to the prevalence of 
        substance use disorders;
            (2) in coordination with statewide employment and training 
        activities, including coordination and alignment of activities 
        carried out by entities provided grant funds under section 
        1410, help individuals in recovery from a substance use 
        disorder transition into the workforce, including by providing 
        career services, training services as described in paragraph 
        (2) of section 134(c) of the Workforce Innovation and 
        Opportunity Act (29 U.S.C. 3174(c)), and related services 
        described in section 134(a)(3) of such Act (42 U.S.C. 3174(a)); 
        and
            (3) assist employers with informing their employees of the 
        resources, such as resources related to substance use disorders 
        that are available to their employees.
    (f) Use of Funds.--An entity receiving a grant under this section 
shall use the funds to conduct one or more of the following activities:
            (1) Hire case managers, care coordinators, providers of 
        peer recovery support services, as described in section 547(a) 
        of the Public Health Service Act (42 U.S.C. 290ee-2(a)), or 
        other professionals, as appropriate, to provide services that 
        support treatment, recovery, and rehabilitation, and prevent 
        relapse, recidivism, and overdose, including by encouraging--
                    (A) the development of daily living skills; and
                    (B) the use of counseling, care coordination, and 
                other services, as appropriate, to support recovery 
                from substance use disorders.
            (2) Implement or utilize innovative technologies, which may 
        include the use of telemedicine.
            (3) In coordination with the lead State agency with 
        responsibility for a workforce investment activity or local 
        board described in subsection (b), provide--
                    (A) short-term prevocational training services; and
                    (B) training services that are directly linked to 
                the employment opportunities in the local area or the 
                planning region.
    (g) Support for State Strategy.--An eligible entity shall include 
in its application under subsection (e) information describing how the 
services and activities proposed in such application are aligned with 
the State, outlying area, or Tribal strategy, as applicable, for 
addressing issues described in such application and how such entity 
will coordinate with existing systems to deliver services as described 
in such application.
    (h) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary for each of fiscal years 
2019 through 2023 for purposes of carrying out this section.

SEC. 1412. PILOT PROGRAM TO HELP INDIVIDUALS IN RECOVERY FROM A 
              SUBSTANCE USE DISORDER BECOME STABLY HOUSED.

    (a) Authorization of Appropriations.--There is authorized to be 
appropriated under this section such sums as may be necessary for each 
of fiscal years 2019 through 2023 for assistance to States to provide 
individuals in recovery from a substance use disorder stable, temporary 
housing for a period of not more than 2 years or until the individual 
secures permanent housing, whichever is earlier.
    (b) Allocation of Appropriated Amounts.--
            (1) In general.--The amounts appropriated or otherwise made 
        available to States under this section shall be allocated based 
        on a funding formula established by the Secretary of Housing 
        and Urban Development (referred to in this section as the 
        ``Secretary'') not later than 60 days after the date of 
        enactment of this Act.
            (2) Criteria.--The funding formula required under paragraph 
        (1) shall ensure that any amounts appropriated or otherwise 
        made available under this section are allocated to States with 
        an age-adjusted rate of drug overdose deaths that is above the 
        national overdose mortality rate, according to the Centers for 
        Disease Control and Prevention. Among such States, priority 
        shall be given to States with the greatest need, as such need 
        is determined by the Secretary based on--
                    (A) the highest average rates of unemployment based 
                on data provided by the Bureau of Labor Statistics for 
                calendar years 2013 through 2017;
                    (B) the lowest average labor force participation 
                rates based on data provided by the Bureau of Labor 
                Statistics for calendar years 2013 through 2017; and
                    (C) the highest prevalence of opioid use disorder 
                based on data provided by the Substance Abuse and 
                Mental Health Services Administration for calendar 
                years 2013 through 2017.
            (3) Distribution.--Amounts appropriated or otherwise made 
        available under this section shall be distributed according to 
        the funding formula established by the Secretary under 
        paragraph (1) not later than 30 days after the establishment of 
        such formula.
    (c) Use of Funds.--
            (1) In general.--Any State that receives amounts pursuant 
        to this section shall expend at least 30 percent of such funds 
        within one year of the date funds become available to the 
        grantee for obligation.
            (2) Priority.--Any State that receives amounts pursuant to 
        this section shall distribute such amounts giving priority to 
        entities with the greatest need and ability to deliver 
        effective assistance in a timely manner.
            (3) Administrative costs.--Any State that receives amounts 
        pursuant to this section may use up to 5 percent of any grant 
        for administrative costs.
    (d) Rules of Construction.--
            (1) In general.--Except as otherwise provided by this 
        section, amounts appropriated, or amounts otherwise made 
        available to States under this section shall be treated as 
        though such funds were community development block grant funds 
        under title I of the Housing and Community Development Act of 
        1974 (42 U.S.C. 5301 et seq.).
            (2) No match.--No matching funds shall be required in order 
        for a State to receive any amounts under this section.
    (e) Authority to Waive or Specify Alternative Requirements.--
            (1) In general.--In administering any amounts appropriated 
        or otherwise made available under this section, the Secretary 
        may waive or specify alternative requirements for any provision 
        of any statute or regulation in connection with the obligation 
        by the Secretary or the use of funds except for requirements 
        related to fair housing, nondiscrimination, labor standards, 
        and the environment, upon a finding that such a waiver is 
        necessary to expedite or facilitate the use of such funds.
            (2) Notice.--The Secretary shall provide written notice of 
        its intent to exercise the authority to specify alternative 
        requirements under paragraph (1) to the Committee on Banking, 
        Housing, and Urban Affairs of the Senate and the Committee on 
        Financial Services of the House of Representatives not later 
        than 5 business days before such exercise of authority occurs.
    (f) Technical Assistance.--For the 2-year period following the date 
of enactment of this Act, the Secretary may use not more than 2 percent 
of the funds made available under this section for technical assistance 
to grantees.
    (g) State.--For purposes of this section the term ``State'' 
includes any State as defined in section 102 of the Housing and 
Community Development Act of 1974 (42 U.S.C. 5302) and the District of 
Columbia.

SEC. 1413. YOUTH PREVENTION AND RECOVERY.

    (a)  Substance Abuse Treatment Services for Children, Adolescents, 
and Young Adults.--Section 514 of the Public Health Service Act (42 
U.S.C. 290bb-7) is amended--
            (1) in the section heading, by striking ``children and 
        adolescents'' and inserting ``children, adolescents, and young 
        adults'';
            (2) in subsection (a)(2), by striking ``children, 
        including'' and inserting ``children, adolescents, and young 
        adults, including''; and
            (3) by striking ``children and adolescents'' each place it 
        appears and inserting ``children, adolescents, and young 
        adults''.
    (b) Resource Center.--The Secretary, acting through the Assistant 
Secretary for Mental Health and Substance Use and, as appropriate, in 
consultation with the Secretary of Education and other agencies, shall 
establish a resource center to provide technical support to recipients 
of grants under subsection (c).
    (c) Youth Prevention and Recovery Initiative.--
            (1) In general.--The Secretary, in consultation with the 
        Secretary of Education, shall administer a program to provide 
        support for communities to support the prevention of, treatment 
        of, and recovery from, substance use disorders for children, 
        adolescents, and young adults.
            (2) Definitions.--In this subsection:
                    (A) Eligible entity.--The term ``eligible entity'' 
                means--
                            (i) a local educational agency that is 
                        seeking to establish or expand substance use 
                        prevention or recovery support services at one 
                        or more high schools;
                            (ii) a State educational agency;
                            (iii) an institution of higher education 
                        (or consortia of such institutions), which may 
                        include a recovery program at an institution of 
                        higher education;
                            (iv) a local board or one-stop operator;
                            (v) a nonprofit organization with 
                        appropriate expertise in providing services or 
                        programs for children, adolescents, or young 
                        adults, excluding a school;
                            (vi) a State, political subdivision of a 
                        State, Indian Tribe, or tribal organization; or
                            (vii) a high school or dormitory serving 
                        high school students that receives funding from 
                        the Bureau of Indian Education.
                    (B) Evidence-based.--The term ``evidence-based'' 
                has the meaning given such term in section 8101 of the 
                Elementary and Secondary Education Act (20 U.S.C. 
                7801).
                    (C) Foster care.--The term ``foster care'' has the 
                meaning given such term in section 1355.20(a) of title 
                45, Code of Federal Regulations (or any successor 
                regulations).
                    (D) High school.--The term ``high school'' has the 
                meaning given such term in section 8101 of the 
                Elementary and Secondary Education Act of 1965 (20 
                U.S.C. 7801).
                    (E) Homeless youth.--The term ``homeless youth'' 
                has the meaning given the term ``homeless children or 
                youths'' in section 725 of the McKinney-Vento Homeless 
                Assistance Act (42 U.S.C. 11434a);
                    (F) Institution of higher education.--The term 
                ``institution of higher education'' has the meaning 
                given such term in section 101 of the Higher Education 
                Act of 1965 (20 U.S.C. 1001) and includes a 
                ``postsecondary vocational institution'' as defined in 
                section 102(c) of such Act (20 U.S.C. 1002(c)).
                    (G) Local educational agency.--The term ``local 
                educational agency'' has the meaning given the term in 
                section 8101 of the Elementary and Secondary Education 
                Act of 1965 (20 U.S.C. 7801).
                    (H) Local board; one-stop operator.--The terms 
                ``local board'' and ``one-stop operator'' have the 
                meanings given such terms in section 3 of the Workforce 
                Innovation and Opportunity Act (29 U.S.C. 3102).
                    (I) Out of school youth.--The term ``out-of-school 
                youth'' has the meaning given such term in section 
                129(a)(1)(B) of the Workforce Innovation and 
                Opportunity Act (29 U.S.C. 3164(a)(1)(B)).
                    (J) Recovery program.--The term ``recovery 
                program'' means a program--
                            (i) to help children, adolescents, or young 
                        adults who are recovering from substance use 
                        disorders to initiate, stabilize, and maintain 
                        healthy and productive lives in the community; 
                        and
                            (ii) that includes peer-to-peer support 
                        delivered by individuals with lived experience 
                        in recovery, and communal activities to build 
                        recovery skills and supportive social networks.
                    (K) State educational agency.--The term ``State 
                educational agency'' has the meaning given the term in 
                section 8101 of the Elementary and Secondary Education 
                Act (20 U.S.C. 7801).
            (3) Best practices.--The Secretary, in consultation with 
        the Secretary of Education, shall--
                    (A) identify or facilitate the development of 
                evidence-based best practices for prevention of 
                substance misuse and abuse by children, adolescents, 
                and young adults, including for specific populations 
                such as youth in foster care, homeless youth, out-of-
                school youth, and youth who are at risk of or have 
                experienced trafficking that address--
                            (i) primary prevention;
                            (ii) appropriate recovery support services;
                            (iii) appropriate use of medication-
                        assisted treatment for such individuals, if 
                        applicable, and ways of overcoming barriers to 
                        the use of medication-assisted treatment in 
                        such population; and
                            (iv) efficient and effective communication, 
                        which may include the use of social media, to 
                        maximize outreach efforts;
                    (B) disseminate such best practices to State 
                educational agencies, local educational agencies, 
                schools and dormitories funded by the Bureau of Indian 
                Education, institutions of higher education, recovery 
                programs at institutions of higher education, local 
                boards, one-stop operators, family and youth homeless 
                providers, and nonprofit organizations, as appropriate;
                    (C) conduct a rigorous evaluation of each grant 
                funded under this subsection, particularly its impact 
                on the indicators described in paragraph (8)(B); and
                    (D) provide technical assistance for grantees under 
                this subsection.
            (4) Grants authorized.--The Secretary, in consultation with 
        the Secretary of Education, shall award 3-year grants, on a 
        competitive basis, to eligible entities to enable such 
        entities, in coordination with Indian Tribes, if applicable, 
        and State agencies responsible for carrying out substance use 
        disorder prevention and treatment programs, to carry out 
        evidence-based programs for--
                    (A) prevention of substance misuse and abuse by 
                children, adolescents, and young adults, which may 
                include primary prevention;
                    (B) recovery support services for children, 
                adolescents, and young adults, which may include 
                counseling, job training, linkages to community-based 
                services, family support groups, peer mentoring, and 
                recovery coaching; or
                    (C) treatment or referrals for treatment of 
                substance use disorders, which may include the use of 
                medication-assisted treatment, as appropriate.
            (5) Special consideration.--In awarding grants under this 
        subsection, the Secretary shall give special consideration to 
        the unique needs of tribal, urban, suburban, and rural 
        populations.
            (6) Application.--To be eligible for a grant under this 
        subsection, an entity shall submit to the Secretary an 
        application at such time, in such manner, and containing such 
        information as the Secretary may require. Such application 
        shall include--
                    (A) a description of--
                            (i) the impact of substance use disorders 
                        in the population that will be served by the 
                        grant program;
                            (ii) how the eligible entity has solicited 
                        input from relevant stakeholders, which may 
                        include faculty, teachers, staff, families, 
                        students, and experts in substance use 
                        prevention and treatment in developing such 
                        application;
                            (iii) the goals of the proposed project, 
                        including the intended outcomes;
                            (iv) how the eligible entity plans to use 
                        grant funds for evidence-based activities, in 
                        accordance with this subsection to prevent, 
                        provide recovery support for, or treat 
                        substance use disorders amongst such 
                        individuals, or a combination of such 
                        activities; and
                            (v) how the eligible entity will 
                        collaborate with relevant partners, which may 
                        include State educational agencies, local 
                        educational agencies, institutions of higher 
                        education, juvenile justice agencies, 
                        prevention and recovery support providers, 
                        local service providers, including substance 
                        use disorder treatment programs, providers of 
                        mental health services, youth serving 
                        organizations, family and youth homeless 
                        providers, child welfare agencies, and primary 
                        care providers, in carrying out the grant 
                        program; and
                    (B) an assurance that the eligible entity will 
                participate in the evaluation described in paragraph 
                (3)(C).
            (7) Priority.--In awarding grants under this subsection, 
        the Secretary shall give priority to eligible entities that 
        propose to use grant funds for activities that meet the 
        criteria described in subclauses (I) and (II) of section 
        8101(21)(A)(i) of the Elementary and Secondary Education Act 
        (20 U.S.C. 7801(21)(A)(i)).
            (8) Reports to the secretary.--Each eligible entity awarded 
        a grant under this subsection shall submit to the Secretary a 
        report at such time and in such manner as the Secretary may 
        require. Such report shall include--
                    (A) a description of how the eligible entity used 
                grant funds, in accordance with this subsection, 
                including the number of children, adolescents, and 
                young adults reached through programming; and
                    (B) a description, including relevant data, of how 
                the grant program has made an impact on the intended 
                outcomes described in paragraph (6)(A)(iii), 
                including--
                            (i) indicators of student success, which, 
                        if the eligible entity is an educational 
                        institution, shall include student well-being 
                        and academic achievement;
                            (ii) substance use disorders amongst 
                        children, adolescents, and young adults, 
                        including the number of overdoses and deaths 
                        amongst children, adolescents, and young adults 
                        during the grant period; and
                            (iii) other indicators, as the Secretary 
                        determines appropriate.
            (9) Report to congress.--The Secretary shall, not later 
        than October 1, 2022, submit a report to the Committee on 
        Health, Education, Labor, and Pensions of the Senate, and the 
        Committee on Energy and Commerce and the Committee on Education 
        and the Workforce of the House of Representatives, a report 
        summarizing the effectiveness of the grant program under this 
        subsection, based on the information submitted in reports 
        required under paragraph (8).
            (10) Authorization of appropriations.--There is authorized 
        to be appropriated such sums as may be necessary to carry out 
        this subsection for each of fiscal years 2019 through 2023.

SEC. 1414. PLANS OF SAFE CARE.

    Section 105(a) of the Child Abuse Prevention and Treatment Act (42 
U.S.C. 5106(a)) is amended by adding at the end the following:
            ``(7) Grants to states to improve and coordinate their 
        response to ensure the safety, permanency, and well-being of 
        infants affected by substance use.--
                    ``(A) Program authorized.--The Secretary shall make 
                grants to States for the purpose of assisting child 
                welfare agencies, social services agencies, substance 
                use disorder treatment agencies, hospitals with labor 
                and delivery units, medical staff, public health and 
                mental health agencies, and maternal and child health 
                agencies to facilitate collaboration in developing, 
                updating, implementing, and monitoring plans of safe 
                care described in section 106(b)(2)(B)(iii).
                    ``(B) Distribution of funds.--
                            ``(i) Reservations.--Of the amounts 
                        appropriated under subparagraph (H), the 
                        Secretary shall reserve--
                                    ``(I) no more than 3 percent for 
                                the purposes described in subparagraph 
                                (G); and
                                    ``(II) up to 3 percent for grants 
                                to Indian Tribes and tribal 
                                organizations to address the needs of 
                                infants born with, and identified as 
                                being affected by, substance abuse or 
                                withdrawal symptoms resulting from 
                                prenatal drug exposure or a fetal 
                                alcohol spectrum disorder and their 
                                families or caregivers, which to the 
                                extent practicable, shall be consistent 
                                with the uses of funds described under 
                                subparagraph (D).
                            ``(ii) Allotments to states and 
                        territories.--The Secretary shall allot the 
                        amount appropriated under subparagraph (H) that 
                        remains after application of clause (i) to each 
                        State that applies for such a grant, in an 
                        amount equal to the sum of--
                                    ``(I) $500,000; and
                                    ``(II) an amount that bears the 
                                same relationship to any funds 
                                appropriated under subparagraph (H) and 
                                remaining after application of clause 
                                (i), as the number of live births in 
                                the State in the previous calendar year 
                                bears to the number of live births in 
                                all States in such year.
                            ``(iii) Ratable reduction.--If the amount 
                        appropriated under subparagraph (H) is 
                        insufficient to satisfy the requirements of 
                        clause (ii), the Secretary shall ratably reduce 
                        each allotment to a State.
                    ``(C) Application.--A State desiring a grant under 
                this paragraph shall submit an application to the 
                Secretary at such time and in such manner as the 
                Secretary may require. Such application shall include--
                            ``(i) a description of--
                                    ``(I) the impact of substance use 
                                disorder in such State, including with 
                                respect to the substance or class of 
                                substances with the highest incidence 
                                of abuse in the previous year in such 
                                State, including--
                                            ``(aa) the prevalence of 
                                        substance use disorder in such 
                                        State;
                                            ``(bb) the aggregate rate 
                                        of births in the State of 
                                        infants affected by substance 
                                        abuse or withdrawal symptoms or 
                                        a fetal alcohol spectrum 
                                        disorder (as determined by 
                                        hospitals, insurance claims, 
                                        claims submitted to the State 
                                        Medicaid program, or other 
                                        records), if available and to 
                                        the extent practicable; and
                                            ``(cc) the number of 
                                        infants identified, for whom a 
                                        plan of safe care was 
                                        developed, and for whom a 
                                        referral was made for 
                                        appropriate services, as 
                                        reported under section 
                                        106(d)(18);
                                    ``(II) the challenges the State 
                                faces in developing, implementing, and 
                                monitoring plans of safe care in 
                                accordance with section 
                                106(b)(2)(B)(iii);
                                    ``(III) the State's lead agency for 
                                the grant program and how that agency 
                                will coordinate with relevant State 
                                entities and programs, including the 
                                child welfare agency, the substance use 
                                disorder treatment agency, hospitals 
                                with labor and delivery units, health 
                                care providers, the public health and 
                                mental health agencies, programs funded 
                                by the Substance Abuse and Mental 
                                Health Services Administration that 
                                provide substance use disorder 
                                treatment for women, the State Medicaid 
                                program, the State agency administering 
                                the block grant program under title V 
                                of the Social Security Act (42 U.S.C. 
                                701 et seq.), the State agency 
                                administering the programs funded under 
                                part C of the Individuals with 
                                Disabilities Education Act (20 U.S.C. 
                                1431 et seq.), the maternal, infant, 
                                and early childhood home visiting 
                                program under section 511 of the Social 
                                Security Act (42 U.S.C. 711), the State 
                                judicial system, and other agencies, as 
                                determined by the Secretary, and Indian 
                                Tribes and tribal organizations, as 
                                appropriate;
                                    ``(IV) how the State will monitor 
                                local development and implementation of 
                                plans of safe care, in accordance with 
                                section 106(b)(2)(B)(iii)(II), 
                                including how the State will monitor to 
                                ensure plans of safe care address 
                                differences between substance use 
                                disorder and medically supervised 
                                substance use, including for the 
                                treatment of a substance use disorder;
                                    ``(V) how the State meets the 
                                requirements of section 1927 of the 
                                Public Health Service Act (42 U.S.C. 
                                300x-27);
                                    ``(VI) how the State plans to 
                                utilize funding authorized under part E 
                                of title IV of the Social Security Act 
                                (42 U.S.C. 670 et seq.) to assist in 
                                carrying out any plan of safe care, 
                                including such funding authorized under 
                                section 471(e) of such Act (as in 
                                effect on October 1, 2018) for mental 
                                health and substance abuse prevention 
                                and treatment services and in-home 
                                parent skill-based programs and funding 
                                authorized under such section 472(j) 
                                (as in effect on October 1, 2018) for 
                                children with a parent in a licensed 
                                residential family-based treatment 
                                facility for substance abuse; and
                                    ``(VII) an assessment of the 
                                treatment and other services and 
                                programs available in the State, to 
                                effectively carry out any plan of safe 
                                care developed, including 
                                identification of needed treatment, and 
                                other services and programs to ensure 
                                the well-being of young children and 
                                their families affected by substance 
                                use disorder, such as programs carried 
                                out under part C of the Individuals 
                                with Disabilities Education Act and 
                                comprehensive early childhood 
                                development services and programs such 
                                as Head Start programs;
                            ``(ii) a description of how the State plans 
                        to use funds for activities described in 
                        subparagraph (D) for the purposes of ensuring 
                        State compliance with requirements under 
                        clauses (ii) and (iii) of section 106(b)(2)(B); 
                        and
                            ``(iii) an assurance that the State will--
                                    ``(I) comply with this Act and 
                                parts B and E of title IV of the Social 
                                Security Act (42 U.S.C. 621 et seq., 
                                670 et seq.); and
                                    ``(II) comply with requirements to 
                                refer a child identified as substance-
                                exposed to early intervention services 
                                as required pursuant to a grant under 
                                part C of the Individuals with 
                                Disabilities Education Act (20 U.S.C. 
                                1431 et seq.).
                    ``(D) Uses of funds.--Funds awarded to a State 
                under this paragraph may be used for the following 
                activities, which may be carried out by the State 
                directly, or through grants or subgrants, contracts, or 
                cooperative agreements:
                            ``(i) Improving State and local systems 
                        with respect to the development and 
                        implementation of plans of safe care, which--
                                    ``(I) shall include parent and 
                                caregiver engagement, as required under 
                                section 106(b)(2)(B)(iii)(I), regarding 
                                available treatment and service 
                                options, which may include resources 
                                available for pregnant, perinatal, and 
                                postnatal women; and
                                    ``(II) may include activities such 
                                as--
                                            ``(aa) developing policies, 
                                        procedures, or protocols for 
                                        the administration or 
                                        development of evidence-based 
                                        and validated screening tools 
                                        for infants who may be affected 
                                        by substance use withdrawal 
                                        symptoms or a fetal alcohol 
                                        spectrum disorder and pregnant, 
                                        perinatal, and postnatal women 
                                        whose infants may be affected 
                                        by substance use withdrawal 
                                        symptoms or a fetal alcohol 
                                        spectrum disorder;
                                            ``(bb) improving 
                                        assessments used to determine 
                                        the needs of the infant and 
                                        family;
                                            ``(cc) improving ongoing 
                                        case management services; and
                                            ``(dd) improving access to 
                                        treatment services, which may 
                                        be prior to the pregnant 
                                        woman's delivery date.
                            ``(ii) Developing policies, procedures, or 
                        protocols in consultation and coordination with 
                        health professionals, public and private health 
                        facilities, and substance use disorder 
                        treatment agencies to ensure that--
                                    ``(I) appropriate notification to 
                                child protective services is made in a 
                                timely manner;
                                    ``(II) a plan of safe care is in 
                                place, in accordance with section 
                                106(b)(2)(B)(iii), before the infant is 
                                discharged from the birth or health 
                                care facility; and
                                    ``(III) such health and related 
                                agency professionals are trained on how 
                                to follow such protocols and are aware 
                                of the supports that may be provided 
                                under a plan of safe care.
                            ``(iii) Training health professionals and 
                        health system leaders, child welfare workers, 
                        substance use disorder treatment agencies, and 
                        other related professionals such as home 
                        visiting agency staff and law enforcement in 
                        relevant topics including--
                                    ``(I) State mandatory reporting 
                                laws and the referral and process 
                                requirements for notification to child 
                                protective services when child abuse or 
                                neglect reporting is not mandated;
                                    ``(II) the co-occurrence of 
                                pregnancy and substance use disorder, 
                                and implications of prenatal exposure;
                                    ``(III) the clinical guidance about 
                                treating substance use disorder in 
                                pregnant and postpartum women;
                                    ``(IV) appropriate screening and 
                                interventions for infants affected by 
                                substance use disorder, withdrawal 
                                symptoms, or a fetal alcohol spectrum 
                                disorder and the requirements under 
                                section 106(b)(2)(B)(iii); and
                                    ``(V) appropriate multigenerational 
                                strategies to address the mental health 
                                needs of the parent and child together.
                            ``(iv) Establishing partnerships, 
                        agreements, or memoranda of understanding 
                        between the lead agency and health 
                        professionals, health facilities, child welfare 
                        professionals, juvenile and family court 
                        judges, substance use and mental disorder 
                        treatment programs, early childhood education 
                        programs, and maternal and child health and 
                        early intervention professionals, including 
                        home visiting providers, peer-to-peer recovery 
                        programs such as parent mentoring programs, and 
                        housing agencies to facilitate the 
                        implementation of, and compliance with section 
                        106(b)(2) and clause (ii) of this subparagraph, 
                        in areas which may include--
                                    ``(I) developing a comprehensive, 
                                multi-disciplinary assessment and 
                                intervention process for infants, 
                                pregnant women, and their families who 
                                are affected by substance use disorder, 
                                withdrawal symptoms, or a fetal alcohol 
                                spectrum disorder, that includes 
                                meaningful engagement with and takes 
                                into account the unique needs of each 
                                family and addresses differences 
                                between medically supervised substance 
                                use, including for the treatment of 
                                substance use disorder, and substance 
                                use disorder;
                                    ``(II) ensuring that treatment 
                                approaches for serving infants, 
                                pregnant women, and perinatal and 
                                postnatal women whose infants may be 
                                affected by substance use, withdrawal 
                                symptoms, or a fetal alcohol spectrum 
                                disorder, are designed to, where 
                                appropriate, keep infants with their 
                                mothers during both inpatient and 
                                outpatient treatment; and
                                    ``(III) increasing access to all 
                                evidence-based medication-assisted 
                                treatment approved by the Food and Drug 
                                Administration, behavioral therapy, and 
                                counseling services for the treatment 
                                of substance use disorders, as 
                                appropriate.
                            ``(v) Developing and updating systems of 
                        technology for improved data collection and 
                        monitoring under section 106(b)(2)(B)(iii), 
                        including existing electronic medical records, 
                        to measure the outcomes achieved through the 
                        plans of safe care, including monitoring 
                        systems to meet the requirements of this Act 
                        and submission of performance measures.
                    ``(E) Reporting.--Each State that receives funds 
                under this paragraph, for each year such funds are 
                received, shall submit a report to the Secretary, 
                disaggregated by geographic location, economic status, 
                and major racial and ethnic groups, except that such 
                disaggregation shall not be required if the results 
                would reveal personally identifiable information on, 
                with respect to infants identified under section 
                106(b)(2)(B)(ii)--
                            ``(i) the number who experienced removal 
                        associated with parental substance use;
                            ``(ii) the number who experienced removal 
                        and subsequently are reunified with parents, 
                        and the length of time between such removal and 
                        reunification;
                            ``(iii) the number who are referred to 
                        community providers without a child protection 
                        case;
                            ``(iv) the number who receive services 
                        while in the care of their birth parents;
                            ``(v) the number who receive post-
                        reunification services within 1 year after a 
                        reunification has occurred; and
                            ``(vi) the number who experienced a return 
                        to out-of-home care within 1 year after 
                        reunification.
                    ``(F) Secretary's report to congress.--The 
                Secretary shall submit an annual report to the 
                Committee on Health, Education, Labor, and Pensions and 
                the Committee on Appropriations of the Senate and the 
                Committee on Education and the Workforce and the 
                Committee on Appropriations of the House of 
                Representatives that includes the information described 
                in subparagraph (E) and recommendations or observations 
                on the challenges, successes, and lessons derived from 
                implementation of the grant program.
                    ``(G) Reservation of funds.--The Secretary shall 
                use the amount reserved under subparagraph (B)(i)(I) 
                for the purposes of--
                            ``(i) providing technical assistance, 
                        including programs of in-depth technical 
                        assistance, to additional States, territories, 
                        and Indian Tribes and tribal organizations in 
                        accordance with the substance-exposed infant 
                        initiative developed by the National Center on 
                        Substance Abuse and Child Welfare;
                            ``(ii) issuing guidance on the requirements 
                        of this Act with respect to infants born with 
                        and identified as being affected by substance 
                        use or withdrawal symptoms or fetal alcohol 
                        spectrum disorder, as described in clauses (ii) 
                        and (iii) of section 106(b)(2)(B), including 
                        by--
                                    ``(I) clarifying key terms; and
                                    ``(II) disseminating best practices 
                                on implementation of plans of safe 
                                care, on such topics as differential 
                                response, collaboration and 
                                coordination, and identification and 
                                delivery of services for different 
                                populations;
                            ``(iii) supporting State efforts to develop 
                        information technology systems to manage plans 
                        of safe care; and
                            ``(iv) preparing the Secretary's report to 
                        Congress described in subparagraph (F).
                    ``(H) Authorization of appropriations.--To carry 
                out the program under this paragraph, there is 
                authorized to be appropriated $60,000,000 for each of 
                fiscal years 2019 through 2023.''.

SEC. 1415. REGULATIONS RELATING TO SPECIAL REGISTRATION FOR 
              TELEMEDICINE.

    Section 311(h) of the Controlled Substances Act (21 U.S.C. 831(h)) 
is amended by striking paragraph (2) and inserting the following:
            ``(2) Regulations.--
                    ``(A) In general.--Not later than 1 year after the 
                date of enactment of the Opioid Crisis Response Act of 
                2018, in consultation with the Secretary, and in 
                accordance with the procedure described in subparagraph 
                (B), the Attorney General shall promulgate final 
                regulations specifying--
                            ``(i) the limited circumstances in which a 
                        special registration under this subsection may 
                        be issued; and
                            ``(ii) the procedure for obtaining a 
                        special registration under this subsection.
                    ``(B) Procedure.--In promulgating final regulations 
                under subparagraph (A), the Attorney General shall--
                            ``(i) issue a notice of proposed rulemaking 
                        that includes a copy of the proposed 
                        regulations;
                            ``(ii) provide a period of not less than 60 
                        days for comments on the proposed regulations;
                            ``(iii) finalize the proposed regulation 
                        not later than 6 months after the close of the 
                        comment period; and
                            ``(iv) publish the final regulations not 
                        later than 30 days before the effective date of 
                        the final regulations.''.

SEC. 1416. NATIONAL HEALTH SERVICE CORPS BEHAVIORAL AND MENTAL HEALTH 
              PROFESSIONALS PROVIDING OBLIGATED SERVICE IN SCHOOLS AND 
              OTHER COMMUNITY-BASED SETTINGS.

    Subpart III of part D of title III of the Public Health Service Act 
(42 U.S.C. 254l et seq.) is amended by adding at the end the following:

``SEC. 338N. BEHAVIORAL AND MENTAL HEALTH PROFESSIONALS PROVIDING 
              OBLIGATED SERVICE IN SCHOOLS AND OTHER COMMUNITY-BASED 
              SETTINGS.

    ``(a) Schools and Community-based Settings.--An entity to which a 
participant in the Scholarship Program or the Loan Repayment Program 
(referred to in this section as a `participant') is assigned under 
section 333 may direct such participant to provide service as a 
behavioral or mental health professional at a school or other 
community-based setting located in a health professional shortage area.
    ``(b) Obligated Service.--
            ``(1) In general.--Any service described in subsection (a) 
        that a participant provides may count towards such 
        participant's completion of any obligated service requirements 
        under the Scholarship Program or the Loan Repayment Program, 
        subject to any limitation imposed under paragraph (2).
            ``(2) Limitation.--The Secretary may impose a limitation on 
        the number of hours of service described in subsection (a) that 
        a participant may credit towards completing obligated service 
        requirements, provided that the limitation allows a member to 
        credit service described in subsection (a) for not less than 50 
        percent of the total hours required to complete such obligated 
        service requirements.
    ``(c) Rule of Construction.--The authorization under subsection (a) 
shall be notwithstanding any other provision of this subpart or subpart 
II.''.

SEC. 1417. LOAN REPAYMENT FOR SUBSTANCE USE DISORDER TREATMENT 
              PROVIDERS.

    (a) Loan Repayment for Substance Use Treatment Providers.--The 
Secretary shall enter into contracts under section 338B of the Public 
Health Service Act (42 U.S.C. 254l-1) with eligible health 
professionals providing substance use disorder treatment services in 
substance use disorder treatment facilities, as defined by the 
Secretary.
    (b) Provision of Substance Use Disorder Treatment.--In carrying out 
the activities described in subsection (a)--
            (1) each such facility shall be located in or serving a 
        mental health professional shortage area designated under 
        section 332 of the Public Health Service Act (42 U.S.C. 254e), 
        or, as the Secretary determines appropriate, an area with an 
        age-adjusted rate of drug overdose deaths that is above the 
        national overdose mortality rate;
            (2) section 331(a)(3)(D) of such Act (42 U.S.C. 
        254d(a)(3)(D)) shall be applied as if the term ``primary health 
        services'' includes health services regarding substance use 
        disorder treatment and infections associated with illicit drug 
        use;
            (3) section 331(a)(3)(E)(i) of such Act (42 U.S.C. 
        254d(a)(3)(E)(i)) shall be applied as if the term ``behavioral 
        and mental health professionals'' includes master's level, 
        licensed substance use disorder treatment counselors, and other 
        relevant professionals or paraprofessionals, as the Secretary 
        determines appropriate; and
            (4) such professionals and facilities shall provide--
                    (A) directly, or through the use of telehealth 
                technology, and pursuant to Federal and State law, 
                counseling by a program counselor or other certified 
                professional who is licensed and qualified by 
                education, training, or experience to assess the 
                psychological and sociological background of patients, 
                to contribute to the appropriate treatment plan for the 
                patient, and to monitor progress; and
                    (B) medication-assisted treatment, including, to 
                the extent practicable, all drugs approved by the Food 
                and Drug Administration to treat substance use 
                disorders, pursuant to Federal and State law.
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $25,000,000 for each of fiscal 
years 2019 through 2023.

SEC. 1418. PROTECTING MOMS AND INFANTS.

    (a) Report.--
            (1) In general.--Not later than 60 days after the date of 
        enactment of this Act, the Secretary shall submit to the 
        appropriate committees of Congress and make available to the 
        public on the internet website of the Department of Health and 
        Human Services a report regarding the implementation of the 
        recommendations in the strategy relating to prenatal opioid 
        use, including neonatal abstinence syndrome, developed pursuant 
        to section 2 of the Protecting Our Infants Act of 2015 (Public 
        Law 114-91). Such report shall include--
                    (A) an update on the implementation of the 
                recommendations in the strategy, including information 
                regarding the agencies involved in the implementation; 
                and
                    (B) information on additional funding or authority 
                the Secretary requires, if any, to implement the 
                strategy, which may include authorities needed to 
                coordinate implementation of such strategy across the 
                Department of Health and Human Services.
            (2) Periodic updates.--The Secretary shall periodically 
        update the report under paragraph (1).
    (b) Residential Treatment Programs for Pregnant and Postpartum 
Women.--Section 508(s) of the Public Health Service Act (42 U.S.C. 
290bb-1(s)) is amended by striking ``$16,900,000 for each of fiscal 
years 2017 through 2021'' and inserting ``$29,931,000 for each of 
fiscal years 2019 through 2023''.

SEC. 1419. EARLY INTERVENTIONS FOR PREGNANT WOMEN AND INFANTS.

    (a) Development of Educational Materials by Center for Substance 
Abuse Prevention.--Section 515(b) of the Public Health Service Act (42 
U.S.C. 290bb-21(b)) is amended--
            (1) in paragraph (13), by striking ``and'' at the end;
            (2) in paragraph (14), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following:
            ``(15) in cooperation with relevant stakeholders and the 
        Director of the Centers for Disease Control and Prevention, 
        develop educational materials for clinicians to use with 
        pregnant women for shared decisionmaking regarding pain 
        management during pregnancy.''.
    (b) Guidelines and Recommendations by Center for Substance Abuse 
Treatment.--Section 507(b) of the Public Health Service Act (42 U.S.C. 
290bb(b)) is amended--
            (1) in paragraph (13), by striking ``and'' at the end;
            (2) in paragraph (14), by striking the period at the end 
        and inserting a semicolon; and
            (3) by adding at the end the following:
            ``(15) in cooperation with the Secretary, implement and 
        disseminate, as appropriate, the recommendations in the report 
        entitled `Protecting Our Infants Act: Final Strategy' issued by 
        the Department of Health and Human Services in 2017; and''.
    (c) Support of Partnerships by Center for Substance Abuse 
Treatment.--Section 507(b) of the Public Health Service Act (42 U.S.C. 
290bb(b)), as amended by subsection (b), is further amended by adding 
at the end the following:
            ``(16) in cooperation with relevant stakeholders, support 
        public-private partnerships to assist with education about, and 
        support with respect to, substance use disorder for pregnant 
        women and health care providers who treat pregnant women and 
        babies.''.

SEC. 1420. REPORT ON INVESTIGATIONS REGARDING PARITY IN MENTAL HEALTH 
              AND SUBSTANCE USE DISORDER BENEFITS.

    (a) In General.--Section 13003 of the 21st Century Cures Act 
(Public Law 114-255) is amended--
            (1) in subsection (a), by striking ``with findings of any 
        serious violation regarding'' and inserting ``concerning''; and
            (2) in subsection (b)(1)--
                    (A) by inserting ``complaints received and number 
                of'' before ``closed''; and
                    (B) by inserting before the period ``, and, for 
                each such investigation closed, which agency conducted 
                the investigation, whether the health plan that is the 
                subject of the investigation is fully insured or not 
                fully insured and a summary of any coordination between 
                the applicable State regulators and the Department of 
                Labor, the Department of Health and Human Services, or 
                the Department of the Treasury, and references to any 
                guidance provided by the agencies addressing the 
                category of violation committed''.
    (b) Applicability.--The amendments made by subsection (a) shall 
apply with respect to the second annual report required under such 
section 13003 and each such annual report thereafter.

                         Subtitle E--Prevention

SEC. 1501. STUDY ON PRESCRIBING LIMITS.

    Not later than 2 years after the date of enactment of this Act, the 
Secretary, in consultation with the Attorney General, 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 impact of Federal and State laws and 
regulations that limit the length, quantity, or dosage of opioid 
prescriptions. Such report shall address--
            (1) the impact of such limits on--
                    (A) the incidence and prevalence of overdose 
                related to prescription opioids;
                    (B) the incidence and prevalence of overdose 
                related to illicit opioids;
                    (C) the prevalence of opioid use disorders;
                    (D) medically appropriate use of, and access to, 
                opioids, including any impact on travel expenses and 
                pain management outcomes for patients, whether such 
                limits are associated with significantly higher rates 
                of negative health outcomes, including suicide, and 
                whether the impact of such limits differs based on the 
                clinical indication for which opioids are prescribed;
            (2) whether such limits lead to a significant increase in 
        burden for prescribers of opioids or prescribers of treatments 
        for opioid use disorder, including any impact on patient access 
        to treatment, and whether any such burden is mitigated by any 
        factors such as electronic prescribing or telemedicine; and
            (3) the impact of such limits on diversion or misuse of any 
        controlled substance in schedule II, III, or IV of section 
        202(c) of the Controlled Substances Act (21 U.S.C. 812(c)).

SEC. 1502. PROGRAMS FOR HEALTH CARE WORKFORCE.

    (a) Program for Education and Training in Pain Care.--Section 759 
of the Public Health Service Act (42 U.S.C. 294i) is amended--
            (1) in subsection (a), by striking ``hospices, and other 
        public and private entities'' and inserting ``hospices, tribal 
        health programs (as defined in section 4 of the Indian Health 
        Care Improvement Act), and other public and nonprofit private 
        entities'';
            (2) in subsection (b)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``award may be made under subsection (a) only 
                if the applicant for the award agrees that the program 
                carried out with the award will include'' and inserting 
                ``entity receiving an award under this section shall 
                develop a comprehensive education and training plan 
                that includes'';
                    (B) in paragraph (1)--
                            (i) by inserting ``preventing,'' after 
                        ``diagnosing,''; and
                            (ii) by inserting ``non-addictive medical 
                        products and non-pharmacologic treatments and'' 
                        after ``including'';
                    (C) in paragraph (2)--
                            (i) by inserting ``Federal, State, and 
                        local'' after ``applicable''; and
                            (ii) by striking ``the degree to which'' 
                        and all that follows through ``effective pain 
                        care'' and inserting ``opioids'';
                    (D) in paragraph (3), by inserting ``, integrated, 
                evidence-based pain management, and, as appropriate, 
                non-pharmacotherapy'' before the semicolon;
                    (E) in paragraph (4), by striking ``; and'' and 
                inserting ``;''; and
                    (F) by striking paragraph (5) and inserting the 
                following:
            ``(5) recent findings, developments, and advancements in 
        pain care research and the provision of pain care, which may 
        include non-addictive medical products and non-pharmacologic 
        treatments intended to treat pain; and
            ``(6) the dangers of opioid abuse and misuse, detection of 
        early warning signs of opioid use disorders (which may include 
        best practices related to screening for opioid use disorders, 
        training on screening, brief intervention, and referral to 
        treatment), and safe disposal options for prescription 
        medications (including such options provided by law enforcement 
        or other innovative deactivation mechanisms).'';
            (3) in subsection (d), by inserting ``prevention,'' after 
        ``diagnosis,''; and
            (4) in subsection (e), by striking ``2010 through 2012'' 
        and inserting ``2019 through 2023''.
    (b) Mental and Behavioral Health Education and Training Program.--
Section 756(a) of the Public Health Service Act (42 U.S.C. 294e-1(a)) 
is amended--
            (1) in paragraph (1), by inserting ``, trauma,'' after 
        ``focus on child and adolescent mental health''; and
            (2) in paragraphs (2) and (3), by inserting ``trauma-
        informed care and'' before ``substance use disorder prevention 
        and treatment services''.

SEC. 1503. EDUCATION AND AWARENESS CAMPAIGNS.

    Section 102 of the Comprehensive Addiction and Recovery Act of 2016 
(Public Law 114-198) is amended--
            (1) by amending subsection (a) to read as follows:
    ``(a) In General.--The Secretary of Health and Human Services, 
acting through the Director of the Centers for Disease Control and 
Prevention and in coordination with the heads of other departments and 
agencies, shall advance education and awareness regarding the risks 
related to misuse and abuse of opioids, as appropriate, which may 
include developing or improving existing programs, conducting 
activities, and awarding grants that advance the education and 
awareness of--
            ``(1) the public, including patients and consumers;
            ``(2) patients, consumers, and other appropriate members of 
        the public, regarding such risks related to unused opioids and 
        the dispensing options under section 309(f) of the Controlled 
        Substances Act, as applicable;
            ``(3) providers, which may include--
                    ``(A) providing for continuing education on 
                appropriate prescribing practices;
                    ``(B) education related to applicable State or 
                local prescriber limit laws, information on the use of 
                non-addictive alternatives for pain management, and the 
                use of overdose reversal drugs, as appropriate;
                    ``(C) disseminating and improving the use of 
                evidence-based opioid prescribing guidelines across 
                relevant health care settings, as appropriate, and 
                updating guidelines as necessary;
                    ``(D) implementing strategies, such as best 
                practices, to encourage and facilitate the use of 
                prescriber guidelines, in accordance with State and 
                local law;
                    ``(E) disseminating information to providers about 
                prescribing options for controlled substances, 
                including such options under section 309(f) of the 
                Controlled Substances Act, as applicable; and
                    ``(F) disseminating information, as appropriate, on 
                the National Pain Strategy developed by or in 
                consultation with the Assistant Secretary for Health; 
                and
            ``(4) other appropriate entities.''; and
            (2) in subsection (b)--
                    (A) by striking ``opioid abuse'' each place such 
                term appears and inserting ``opioid misuse and abuse''; 
                and
                    (B) in paragraph (2), by striking ``safe disposal 
                of prescription medications and other'' and inserting 
                ``non-addictive treatment options, safe disposal 
                options for prescription medications, and other 
                applicable''.

SEC. 1504. ENHANCED CONTROLLED SUBSTANCE OVERDOSES DATA COLLECTION, 
              ANALYSIS, AND DISSEMINATION.

    Part J of title III of the Public Health Service Act is amended by 
inserting after section 392 (42 U.S.C. 280b-1) the following:

``SEC. 392A. ENHANCED CONTROLLED SUBSTANCE OVERDOSES DATA COLLECTION, 
              ANALYSIS, AND DISSEMINATION.

    ``(a) In General.--The Director of the Centers for Disease Control 
and Prevention, using the authority provided to the Director under 
section 392, may--
            ``(1) to the extent practicable, carry out and expand any 
        controlled substance overdose data collection, analysis, and 
        dissemination activity described in subsection (b);
            ``(2) provide training and technical assistance to States, 
        localities, and Indian Tribes for the purpose of carrying out 
        any such activity; and
            ``(3) award grants to States, localities, and Indian Tribes 
        for the purpose of carrying out any such activity.
    ``(b) Controlled Substance Overdose Data Collection and Analysis 
Activities.--A controlled substance overdose data collection, analysis, 
and dissemination activity described in this subsection is any of the 
following activities:
            ``(1) Improving the timeliness of reporting aggregate data 
        to the public, including data on fatal and nonfatal controlled 
        substance overdoses.
            ``(2) Enhancing the comprehensiveness of controlled 
        substance overdose data by collecting information on such 
        overdoses from appropriate sources such as toxicology reports, 
        autopsy reports, death scene investigations, and emergency 
        department services.
            ``(3) Modernizing the system for coding causes of death 
        related to controlled substance overdoses to use an electronic-
        based system.
            ``(4) Using data to help identify risk factors associated 
        with controlled substance overdoses, including the delivery of 
        certain health care services.
            ``(5) Supporting entities involved in reporting information 
        on controlled substance overdoses, such as coroners and medical 
        examiners, to improve accurate testing and standardized 
        reporting of causes and contributing factors of such overdoses, 
        and analysis of various opioid analogues to controlled 
        substance overdoses.
            ``(6) Working to enable and encourage the access, exchange, 
        and use of data regarding controlled substances overdoses among 
        data sources and entities.
    ``(c) Definitions.--In this section--
            ``(1) the term `controlled substance' has the meaning given 
        that term in section 102 of the Controlled Substances Act; and
            ``(2) the term `Indian Tribe' has the meaning given the 
        term `Indian tribe' in section 4 of the Indian Self-
        Determination and Education Assistance Act.''.

SEC. 1505. PREVENTING OVERDOSES OF CONTROLLED SUBSTANCES.

    Part J of title III of the Public Health Service Act (42 U.S.C. 
280b et seq.), as amended by section 504, is further amended by 
inserting after section 392A the following:

``SEC. 392B. PREVENTING OVERDOSES OF CONTROLLED SUBSTANCES.

    ``(a) Prevention Activities.--
            ``(1) In general.--The Director of the Centers for Disease 
        Control and Prevention (referred to in this section as the 
        `Director'), using the authority provided to the Director under 
        section 392, may--
                    ``(A) to the extent practicable, carry out and 
                expand any prevention activity described in paragraph 
                (2);
                    ``(B) provide training and technical assistance to 
                States, localities, and Indian Tribes to carry out any 
                such activity; and
                    ``(C) award grants to States, localities, and 
                Indian Tribes for the purpose of carrying out any such 
                activity.
            ``(2) Prevention activities.--A prevention activity 
        described in this paragraph is an activity to improve the 
        efficiency and use of a new or currently operating prescription 
        drug monitoring program, such as--
                    ``(A) encouraging all authorized users (as 
                specified by the State or other entity) to register 
                with and use the program;
                    ``(B) enabling such users to access any data 
                updates in as close to real-time as practicable;
                    ``(C) providing for a mechanism for the program to 
                notify authorized users of any potential misuse or 
                abuse of controlled substances and any detection of 
                inappropriate prescribing or dispensing practices 
                relating to such substances;
                    ``(D) encouraging the analysis of prescription drug 
                monitoring data for purposes of providing de-
                identified, aggregate reports based on such analysis to 
                State public health agencies, State alcohol and drug 
                agencies, State licensing boards, and other appropriate 
                State agencies, as permitted under applicable Federal 
                and State law and the policies of the prescription drug 
                monitoring program and not containing any protected 
                health information, to prevent inappropriate 
                prescribing, drug diversion, or abuse and misuse of 
                controlled substances, and to facilitate better 
                coordination among agencies;
                    ``(E) enhancing interoperability between the 
                program and any health information technology 
                (including certified health information technology), 
                including by integrating program data into such 
                technology;
                    ``(F) updating program capabilities to respond to 
                technological innovation for purposes of appropriately 
                addressing the occurrence and evolution of controlled 
                substance overdoses;
                    ``(G) developing or enhancing data exchange with 
                other sources such as the Medicaid agency, the Medicare 
                program, pharmacy benefit managers, coroners' reports, 
                and workers' compensation data;
                    ``(H) facilitating and encouraging data exchange 
                between the program and the prescription drug 
                monitoring programs of other States;
                    ``(I) enhancing data collection and quality, 
                including improving patient matching and proactively 
                monitoring data quality; and
                    ``(J) providing prescriber and dispenser practice 
                tools, including prescriber practice insight reports 
                for practitioners to review their prescribing patterns 
                in comparison to such patters of other practitioners in 
                the specialty.
    ``(b) Additional Grants.--The Director may award grants to States, 
localities, and Indian Tribes--
            ``(1) to carry out innovative projects for grantees to 
        rapidly respond to controlled substance misuse, abuse, and 
        overdoses, including changes in patterns of controlled 
        substance use; and
            ``(2) for any other evidence-based activity for preventing 
        controlled substance misuse, abuse, and overdoses as the 
        Director determines appropriate.
    ``(c) Research.--The Director, in coordination with the Assistant 
Secretary for Mental Health and Substance Use and the National Mental 
Health and Substance Use Policy Laboratory established under section 
501A, as appropriate and applicable, may conduct studies and 
evaluations to address substance use disorders, including preventing 
substance use disorders or other related topics the Director determines 
appropriate.
    ``(d) Public and Prescriber Education.--Pursuant to section 102 of 
the Comprehensive Addiction and Recovery Act of 2016, the Director may 
advance the education and awareness of prescribers and the public 
regarding the risk of abuse and misuse of prescription opioids.
    ``(e) Definitions.--In this section--
            ``(1) the term `controlled substance' has the meaning given 
        that term in section 102 of the Controlled Substances Act; and
            ``(2) the term `Indian Tribe' has the meaning given the 
        term `Indian tribe' in section 4 of the Indian Self-
        Determination and Education Assistance Act.
    ``(f) Authorization of Appropriations.--For purposes of carrying 
out this section, section 392A of this Act, and section 102 of the 
Comprehensive Addiction and Recovery Act of 2016, there is authorized 
to be appropriated $486,000,000 for each of fiscal years 2019 through 
2024.''.

SEC. 1506. CDC SURVEILLANCE AND DATA COLLECTION FOR CHILD, YOUTH, AND 
              ADULT TRAUMA.

    (a) Data Collection.--The Director of the Centers for Disease 
Control and Prevention (referred to in this section as the 
``Director'') may, in cooperation with the States, collect and report 
data on adverse childhood experiences through the Behavioral Risk 
Factor Surveillance System, the Youth Risk Behavior Surveillance 
System, and other relevant public health surveys or questionnaires.
    (b) Timing.--The collection of data under subsection (a) may occur 
in fiscal year 2019 and every 2 years thereafter.
    (c) Data From Rural Areas.--The Director shall encourage each State 
that participates in collecting and reporting data under subsection (a) 
to collect and report data from tribal and rural areas within such 
State, in order to generate a statistically reliable representation of 
such areas.
    (d) Data From Tribal Areas.--The Director may, in cooperation with 
Indian Tribes and pursuant to a written request from an Indian Tribe, 
provide technical assistance to such Indian Tribe to collect and report 
data on adverse childhood experiences through the Behavioral Risk 
Factor Surveillance System, the Youth Risk Behavior Surveillance 
System, or another relevant public health survey or questionnaire.
    (e) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated such sums as may be necessary 
for the period of fiscal years 2019 through 2021.

SEC. 1507. REAUTHORIZATION OF NASPER.

    Section 399O of the Public Health Service Act (42 U.S.C. 280g-3) is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), in the matter preceding 
                subparagraph (A), by striking ``in consultation with 
                the Administrator of the Substance Abuse and Mental 
                Health Services Administration and Director of the 
                Centers for Disease Control and Prevention'' and 
                inserting ``in coordination with the Director of the 
                Centers for Disease Control and the heads of other 
                departments and agencies as appropriate''; and
                    (B) by adding at the end the following:
            ``(4) States and local governments.--
                    ``(A) In general.--In the case of a State that does 
                not have a prescription drug monitoring program, a 
                county or other unit of local government within the 
                State that has a prescription drug monitoring program 
                shall be treated as a State for purposes of this 
                section, including for purposes of eligibility for 
                grants under paragraph (1).
                    ``(B) Plan for interoperability.--For purposes of 
                meeting the interoperability requirements under 
                subsection (c)(3), a county or other unit of local 
                government shall submit a plan outlining the methods 
                such county or unit of local government will use to 
                ensure the capability of data sharing with other 
                counties and units of local government within the State 
                and with other States, as applicable.'';
            (2) in subsection (c)--
                    (A) in paragraph (1)(A)(iii)--
                            (i) by inserting ``as such standards become 
                        available,'' after ``interoperability 
                        standards,''; and
                            (ii) by striking ``generated or identified 
                        by the Secretary or his or her designee'' and 
                        inserting ``recognized by the Office of the 
                        National Coordinator for Health Information 
                        Technology''; and
                    (B) in paragraph (3)(A), by inserting ``including 
                electronic health records,'' after ``technology 
                systems,'';
            (3) in subsection (d)(1), by striking ``not later than 1 
        week after the date of such dispensing'' and inserting ``in as 
        close to real time as practicable'';
            (4) in subsection (f)--
                    (A) in paragraph (1)(D), by striking ``medicaid'' 
                and inserting ``Medicaid''; and
                    (B) in paragraph (2)--
                            (i) in subparagraph (A), by striking 
                        ``and'' at the end;
                            (ii) in subparagraph (B), by striking the 
                        period and inserting a semicolon; and
                            (iii) by adding at the end the following:
                    ``(C) may conduct analyses of controlled substance 
                program data for purposes of providing appropriate 
                State agencies with aggregate reports based on such 
                analyses in as close to real-time as practicable, 
                regarding prescription patterns flagged as potentially 
                presenting a risk of misuse, abuse, addiction, 
                overdose, and other aggregate information, as 
                appropriate and in compliance with applicable Federal 
                and State laws and provided that such reports shall not 
                include protected health information; and
                    ``(D) may access information about prescriptions, 
                such as claims data, to ensure that such prescribing 
                and dispensing history is updated in as close to real-
                time as practicable, in compliance with applicable 
                Federal and State laws and provided that such 
                information shall not include protected health 
                information.'';
            (5) in subsection (i), by inserting ``, in collaboration 
        with the National Coordinator for Health Information Technology 
        and the Director of the National Institute of Standards and 
        Technology,'' after ``The Secretary''; and
            (6) in subsection (n), by striking ``2021'' and inserting 
        ``2026''.

SEC. 1508. JESSIE'S LAW.

    (a) Best Practices.--
            (1) In general.--Not later than 1 year after the date of 
        enactment of this Act, the Secretary, in consultation with 
        appropriate stakeholders, including a patient with a history of 
        opioid use disorder, an expert in electronic health records, an 
        expert in the confidentiality of patient health information and 
        records, and a health care provider, shall identify or 
        facilitate the development of best practices regarding--
                    (A) the circumstances under which information that 
                a patient has provided to a health care provider 
                regarding such patient's history of opioid use disorder 
                should, only at the patient's request, be prominently 
                displayed in the medical records (including electronic 
                health records) of such patient;
                    (B) what constitutes the patient's request for the 
                purpose described in subparagraph (A); and
                    (C) the process and methods by which the 
                information should be so displayed.
            (2) Dissemination.--The Secretary shall disseminate the 
        best practices developed under paragraph (1) to health care 
        providers and State agencies.
    (b) Requirements.--In identifying or facilitating the development 
of best practices under subsection (a), as applicable, the Secretary, 
in consultation with appropriate stakeholders, shall consider the 
following:
            (1) The potential for addiction relapse or overdose, 
        including overdose death, when opioid medications are 
        prescribed to a patient recovering from opioid use disorder.
            (2) The benefits of displaying information about a 
        patient's opioid use disorder history in a manner similar to 
        other potentially lethal medical concerns, including drug 
        allergies and contraindications.
            (3) The importance of prominently displaying information 
        about a patient's opioid use disorder when a physician or 
        medical professional is prescribing medication, including 
        methods for avoiding alert fatigue in providers.
            (4) The importance of a variety of appropriate medical 
        professionals, including physicians, nurses, and pharmacists, 
        having access to information described in this section when 
        prescribing or dispensing opioid medication, consistent with 
        Federal and State laws and regulations.
            (5) The importance of protecting patient privacy, including 
        the requirements related to consent for disclosure of substance 
        use disorder information under all applicable laws and 
        regulations.
            (6) All applicable Federal and State laws and regulations.

SEC. 1509. DEVELOPMENT AND DISSEMINATION OF MODEL TRAINING PROGRAMS FOR 
              SUBSTANCE USE DISORDER PATIENT RECORDS.

    (a) Initial Programs and Materials.--Not later than 1 year after 
the date of the enactment of this Act, the Secretary, in consultation 
with appropriate experts, shall identify the following model programs 
and materials (or if no such programs or materials exist, recognize 
private or public entities to develop and disseminate such programs and 
materials):
            (1) Model programs and materials for training health care 
        providers (including physicians, emergency medical personnel, 
        psychiatrists, psychologists, counselors, therapists, nurse 
        practitioners, physician assistants, behavioral health 
        facilities and clinics, care managers, and hospitals, including 
        individuals such as general counsels or regulatory compliance 
        staff who are responsible for establishing provider privacy 
        policies) concerning the permitted uses and disclosures, 
        consistent with the standards and regulations governing the 
        privacy and security of substance use disorder patient records 
        promulgated by the Secretary under section 543 of the Public 
        Health Service Act (42 U.S.C. 290dd-2) for the confidentiality 
        of patient records.
            (2) Model programs and materials for training patients and 
        their families regarding their rights to protect and obtain 
        information under the standards and regulations described in 
        paragraph (1).
    (b) Requirements.--The model programs and materials described in 
paragraphs (1) and (2) of subsection (a) shall address circumstances 
under which disclosure of substance use disorder patient records is 
needed to--
            (1) facilitate communication between substance use disorder 
        treatment providers and other health care providers to promote 
        and provide the best possible integrated care;
            (2) avoid inappropriate prescribing that can lead to 
        dangerous drug interactions, overdose, or relapse; and
            (3) notify and involve families and caregivers when 
        individuals experience an overdose.
    (c) Periodic Updates.--The Secretary shall--
            (1) periodically review and update the model program and 
        materials identified or developed under subsection (a); and
            (2) disseminate such updated programs and materials to the 
        individuals described in subsection (a)(1).
    (d) Input of Certain Entities.--In identifying, reviewing, or 
updating the model programs and materials under this section, the 
Secretary shall solicit the input of relevant stakeholders.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2019 through 2023.

SEC. 1510. COMMUNICATION WITH FAMILIES DURING EMERGENCIES.

    (a) Promoting Awareness of Authorized Disclosures During 
Emergencies.--The Secretary shall annually notify health care providers 
regarding permitted disclosures during emergencies, including 
overdoses, of certain health information to families and caregivers 
under Federal health care privacy laws and regulations.
    (b) Use of Material.--For the purposes of carrying out subsection 
(a), the Secretary may use material produced under section 1509 of this 
Act or under section 11004 of the 21st Century Cures Act (42 U.S.C. 
1320d-2 note).

SEC. 1511. PRENATAL AND POSTNATAL HEALTH.

    Section 317L of the Public Health Service Act (42 U.S.C. 247b-13) 
is amended--
            (1) in subsection (a)--
                    (A) by amending paragraph (1) to read as follows:
            ``(1) to collect, analyze, and make available data on 
        prenatal smoking and alcohol and substance abuse and misuse, 
        including--
                    ``(A) data on--
                            ``(i) the incidence, prevalence, and 
                        implications of such activities; and
                            ``(ii) the incidence and prevalence of 
                        implications and outcomes, including neonatal 
                        abstinence syndrome and other maternal and 
                        child health outcomes associated with such 
                        activities; and
                    ``(B) to inform such analysis, additional 
                information or data on family health history, 
                medication exposures during pregnancy, demographic 
                information, such as race, ethnicity, geographic 
                location, and family history, and other relevant 
                information, as appropriate;'';
                    (B) in paragraph (2)--
                            (i) by striking ``prevention of'' and 
                        inserting ``prevention and long-term outcomes 
                        associated with''; and
                            (ii) by striking ``illegal drug use'' and 
                        inserting ``substance abuse and misuse'';
                    (C) in paragraph (3), by striking ``and cessation 
                programs; and'' and inserting ``, treatment, and 
                cessation programs;'';
                    (D) in paragraph (4), by striking ``illegal drug 
                use.'' and inserting ``substance abuse and misuse; 
                and''; and
                    (E) by adding at the end the following:
            ``(5) to issue public reports on the analysis of data 
        described in paragraph (1), including analysis of--
                    ``(A) long-term outcomes of children affected by 
                neonatal abstinence syndrome;
                    ``(B) health outcomes associated with prenatal 
                smoking, alcohol, and substance abuse and misuse; and
                    ``(C) relevant studies, evaluations, or information 
                the Secretary determines to be appropriate.'';
            (2) in subsection (b), by inserting ``tribal entities,'' 
        after ``local governments,'';
            (3) by redesignating subsection (c) as subsection (d);
            (4) by inserting after subsection (b) the following:
    ``(c) Coordinating Activities.--To carry out this section, the 
Secretary may--
            ``(1) provide technical and consultative assistance to 
        entities receiving grants under subsection (b);
            ``(2) ensure a pathway for data sharing between States, 
        tribal entities, and the Centers for Disease Control and 
        Prevention;
            ``(3) ensure data collection under this section is 
        consistent with applicable State, Federal, and Tribal privacy 
        laws; and
            ``(4) coordinate with the National Coordinator for Health 
        Information Technology, as appropriate, to assist States and 
        Tribes in implementing systems that use standards recognized by 
        such National Coordinator, as such recognized standards are 
        available, in order to facilitate interoperability between such 
        systems and health information technology systems, including 
        certified health information technology.''; and
            (5) in subsection (d), as so redesignated, by striking 
        ``2001 through 2005'' and inserting ``2019 through 2023''.

SEC. 1512. SURVEILLANCE AND EDUCATION REGARDING INFECTIONS ASSOCIATED 
              WITH ILLICIT DRUG USE AND OTHER RISK FACTORS.

    Section 317N of the Public Health Service Act (42 U.S.C. 247b-15) 
is amended--
            (1) by amending the section heading to read as follows: 
        ``surveillance and education regarding infections associated 
        with illicit drug use and other risk factors'';
            (2) in subsection (a)--
                    (A) in the matter preceding paragraph (1), by 
                inserting ``activities'' before the colon;
                    (B) in paragraph (1)--
                            (i) by inserting ``or maintaining'' after 
                        ``implementing'';
                            (ii) by striking ``hepatitis C virus 
                        infection (in this section referred to as `HCV 
                        infection')'' and inserting ``infections 
                        commonly associated with illicit drug use, 
                        which may include viral hepatitis, human 
                        immunodeficiency virus, and infective 
                        endocarditis,''; and
                            (iii) by striking ``such infection'' and 
                        all that follows through the period at the end 
                        and inserting ``such infections, which may 
                        include the reporting of cases of such 
                        infections.'';
                    (C) in paragraph (2), by striking ``HCV infection'' 
                and all that follows through the period at the end and 
                inserting ``infections as a result of illicit drug use, 
                receiving blood transfusions prior to July 1992, or 
                other risk factors.'';
                    (D) in paragraphs (4) and (5), by striking ``HCV 
                infection'' each place such term appears and inserting 
                ``infections described in paragraph (1)''; and
                    (E) in paragraph (5), by striking ``pediatricians 
                and other primary care physicians, and obstetricians 
                and gynecologists'' and inserting ``substance use 
                disorder treatment providers, pediatricians, other 
                primary care providers, and obstetrician-
                gynecologists'';
            (3) in subsection (b)--
                    (A) by striking ``directly and'' and inserting 
                ``directly or''; and
                    (B) by striking ``hepatitis C,'' and all that 
                follows through the period at the end and inserting 
                ``infections described in subsection (a)(1).''; and
            (4) in subsection (c), by striking ``such sums as may be 
        necessary for each of the fiscal years 2001 through 2005'' and 
        inserting ``$40,000,000 for each of fiscal years 2019 through 
        2023''.

SEC. 1513. TASK FORCE TO DEVELOP BEST PRACTICES FOR TRAUMA-INFORMED 
              IDENTIFICATION, REFERRAL, AND SUPPORT.

    (a) Establishment.--There is established a task force, to be known 
as the Interagency Task Force on Trauma-Informed Care (in this section 
referred to as the ``task force'') that shall identify, evaluate, and 
make recommendations regarding best practices with respect to children 
and youth, and their families as appropriate, who have experienced or 
are at risk of experiencing trauma.
    (b) Membership.--
            (1) Composition.--The task force shall be composed of the 
        heads of the following Federal departments and agencies, or 
        their designees:
                    (A) The Centers for Medicare & Medicaid Services.
                    (B) The Substance Abuse and Mental Health Services 
                Administration.
                    (C) The Agency for Healthcare Research and Quality.
                    (D) The Centers for Disease Control and Prevention.
                    (E) The Indian Health Service.
                    (F) The Department of Veterans Affairs.
                    (G) The National Institutes of Health.
                    (H) The Food and Drug Administration.
                    (I) The Health Resources and Services 
                Administration.
                    (J) The Department of Defense.
                    (K) The Office of Minority Health.
                    (L) The Administration for Children and Families.
                    (M) The Office of the Assistant Secretary for 
                Planning and Evaluation.
                    (N) The Office for Civil Rights of the Department 
                of Health and Human Services.
                    (O) The Office of Juvenile Justice and Delinquency 
                Prevention of the Department of Justice.
                    (P) The Office of Community Oriented Policing 
                Services of the Department of Justice.
                    (Q) The Office on Violence Against Women of the 
                Department of Justice.
                    (R) The National Center for Education Evaluation 
                and Regional Assistance of the Department of Education.
                    (S) The National Center for Special Education 
                Research of the Institute of Education Science.
                    (T) The Office of Elementary and Secondary 
                Education of the Department of Education.
                    (U) The Office for Civil Rights of the Department 
                of Education.
                    (V) The Office of Special Education and 
                Rehabilitative Services of the Department of Education.
                    (W) The Bureau of Indian Affairs of the Department 
                of the Interior.
                    (X) The Veterans Health Administration of the 
                Department of Veterans Affairs.
                    (Y) The Office of Special Needs Assistance Programs 
                of the Department of Housing and Urban Development.
                    (Z) The Office of Head Start of the Administration 
                for Children and Families.
                    (AA) The Children's Bureau of the Administration 
                for Children and Families.
                    (BB) The Bureau of Indian Education of the 
                Department of the Interior.
                    (CC) Such other Federal agencies as the Secretaries 
                determine to be appropriate.
            (2) Date of appointments.--The heads of Federal departments 
        and agencies shall appoint the corresponding members of the 
        task force not later than 6 months after the date of enactment 
        of this Act.
            (3) Chairperson.--The task force shall be chaired by the 
        Assistant Secretary for Mental Health and Substance Use.
    (c) Task Force Duties.--The task force shall--
            (1) solicit input from stakeholders, including frontline 
        service providers, educators, mental health professionals, 
        researchers, experts in infant, child, and youth trauma, child 
        welfare professionals, and the public, in order to inform the 
        activities under paragraph (2); and
            (2) identify, evaluate, make recommendations, and update 
        such recommendations not less than annually, to the general 
        public, the Secretary of Education, the Secretary of Health and 
        Human Services, the Secretary of Labor, the Secretary of the 
        Interior, the Attorney General, and other relevant cabinet 
        Secretaries, and Congress regarding--
                    (A) a set of evidence-based, evidence-informed, and 
                promising best practices with respect to--
                            (i) the identification of infants, children 
                        and youth, and their families as appropriate, 
                        who have experienced or are at risk of 
                        experiencing trauma; and
                            (ii) the expeditious referral to and 
                        implementation of trauma-informed practices and 
                        supports that prevent and mitigate the effects 
                        of trauma;
                    (B) a national strategy on how the task force and 
                member agencies will collaborate, prioritize options 
                for, and implement a coordinated approach which may 
                include data sharing and the awarding of grants that 
                support infants, children, and youth, and their 
                families as appropriate, who have experienced or are at 
                risk of experiencing trauma; and
                    (C) existing Federal authorities at the Department 
                of Education, Department of Health and Human Services, 
                Department of Justice, Department of Labor, Department 
                of the Interior, and other relevant agencies, and 
                specific Federal grant programs to disseminate best 
                practices on, provide training in, or deliver services 
                through, trauma-informed practices, and disseminate 
                such information--
                            (i) in writing to relevant program offices 
                        at such agencies to encourage grant applicants 
                        in writing to use such funds, where 
                        appropriate, for trauma-informed practices; and
                            (ii) to the general public through the 
                        internet website of the task force.
    (d) Best Practices.--In identifying, evaluating, and recommending 
the set of best practices under subsection (c), the task force shall--
            (1) include guidelines for providing professional 
        development for front-line services providers, including school 
        personnel, early childhood education program providers, 
        providers from child- or youth-serving organizations, housing 
        and homeless providers, primary and behavioral health care 
        providers, child welfare and social services providers, 
        juvenile and family court personnel, health care providers, 
        individuals who are mandatory reporters of child abuse or 
        neglect, trained nonclinical providers (including peer mentors 
        and clergy), and first responders, in--
                    (A) understanding and identifying early signs and 
                risk factors of trauma in infants, children, and youth, 
                and their families as appropriate, including through 
                screening processes;
                    (B) providing practices to prevent and mitigate the 
                impact of trauma, including by fostering safe and 
                stable environments and relationships; and
                    (C) developing and implementing policies, 
                procedures, or systems that--
                            (i) are designed to quickly refer infants, 
                        children, youth, and their families as 
                        appropriate, who have experienced or are at 
                        risk of experiencing trauma to the appropriate 
                        trauma-informed screening and support, 
                        including age-appropriate treatment, and to 
                        ensure such infants, children, youth, and 
                        family members receive such support;
                            (ii) utilize and develop partnerships with 
                        early childhood education programs, local 
                        social services organizations, such as 
                        organizations serving youth, and clinical 
                        mental health or health care service providers 
                        with expertise in providing support services 
                        (including age-appropriate trauma-informed and 
                        evidence-based treatment) aimed at preventing 
                        or mitigating the effects of trauma;
                            (iii) educate children and youth to--
                                    (I) understand and identify the 
                                signs, effects, or symptoms of trauma; 
                                and
                                    (II) build the resilience and 
                                coping skills to mitigate the effects 
                                of experiencing trauma;
                            (iv) promote and support multi-generational 
                        practices that assist parents, foster parents, 
                        and kinship and other caregivers in accessing 
                        resources related to, and developing 
                        environments conducive to, the prevention and 
                        mitigation of trauma; and
                            (v) collect and utilize data from 
                        screenings, referrals, or the provision of 
                        services and supports to evaluate and improve 
                        processes for trauma-informed support and 
                        outcomes that are culturally sensitive, 
                        linguistically appropriate, and specific to age 
                        ranges and sex, as applicable; and
            (2) recommend best practices that are designed to avoid 
        unwarranted custody loss or criminal penalties for parents or 
        guardians in connection with infants, children, and youth who 
        have experienced or are at risk of experiencing trauma.
    (e) Operating Plan.--Not later than 1 year after the date of 
enactment of this Act, the task force shall hold the first meeting. Not 
later than 2 years after such date of enactment, the task force shall 
submit to the Secretary of Education, Secretary of Health and Human 
Services, Secretary of Labor, Secretary of the Interior, the Attorney 
General, and Congress an operating plan for carrying out the activities 
of the task force described in subsection (c)(2). Such operating plan 
shall include--
            (1) a list of specific activities that the task force plans 
        to carry out for purposes of carrying out duties described in 
        subsection (c)(2), which may include public engagement;
            (2) a plan for carrying out the activities under subsection 
        (c)(2);
            (3) a list of members of the task force and other 
        individuals who are not members of the task force that may be 
        consulted to carry out such activities;
            (4) an explanation of Federal agency involvement and 
        coordination needed to carry out such activities, including any 
        statutory or regulatory barriers to such coordination;
            (5) a budget for carrying out such activities; and
            (6) other information that the task force determines 
        appropriate.
    (f) Final Report.--Not later than 3 years after the date of the 
first meeting of the task force, the task force shall submit to the 
general public, Secretary of Education, Secretary of Health and Human 
Services, Secretary of Labor, Secretary of the Interior, the Attorney 
General, and other relevant cabinet Secretaries, and Congress, a final 
report containing all of the findings and recommendations required 
under this section.
    (g) Definition.--In this section, the term ``early childhood 
education program'' has the meaning given such term in section 103 of 
the Higher Education Act of 1965 (20 U.S.C. 1003).
    (h) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2019 through 2022.
    (i) Sunset.--The task force shall on the date that is 60 days after 
the submission of the final report under subsection (f), but not later 
than September 30, 2022.

SEC. 1514. GRANTS TO IMPROVE TRAUMA SUPPORT SERVICES AND MENTAL HEALTH 
              CARE FOR CHILDREN AND YOUTH IN EDUCATIONAL SETTINGS.

    (a) Grants, Contracts, and Cooperative Agreements Authorized.--The 
Secretary, in coordination with the Assistant Secretary for Mental 
Health and Substance Use, is authorized to award grants to, or enter 
into contracts or cooperative agreements with, State educational 
agencies, local educational agencies, Head Start agencies (including 
Early Head Start agencies), State or local agencies that administer 
public preschool programs, Indian Tribes or their tribal educational 
agencies, a school operated by the Bureau of Indian Education, a 
Regional Corporation (as defined in section 3 of the Alaska Native 
Claims Settlement Act (43 U.S.C. 1602)), or a Native Hawaiian 
educational organization (as defined in section 6207 of the Elementary 
and Secondary Education Act of 1965 (20 U.S.C. 7517)), for the purpose 
of increasing student access to evidence-based trauma support services 
and mental health care by developing innovative initiatives, 
activities, or programs to link local school systems with local trauma-
informed support and mental health systems, including those under the 
Indian Health Service.
    (b) Duration.--With respect to a grant, contract, or cooperative 
agreement awarded or entered into under this section, the period during 
which payments under such grant, contract or agreement are made to the 
recipient may not exceed 4 years.
    (c) Use of Funds.--An entity that receives a grant, contract, or 
cooperative agreement under this section shall use amounts made 
available through such grant, contract, or cooperative agreement for 
evidence-based activities, which shall include any of the following:
            (1) Collaborative efforts between school-based service 
        systems and trauma-informed support and mental health service 
        systems to provide, develop, or improve prevention, screening, 
        referral, and treatment and support services to students, such 
        as by providing universal trauma screenings to identify 
        students in need of specialized support.
            (2) To implement schoolwide multi-tiered positive 
        behavioral interventions and supports, or other trauma-informed 
        models of support.
            (3) To provide professional development to teachers, 
        teacher assistants, school leaders, specialized instructional 
        support personnel, and mental health professionals that--
                    (A) fosters safe and stable learning environments 
                that prevent and mitigate the effects of trauma, 
                including through social and emotional learning;
                    (B) improves school capacity to identify, refer, 
                and provide services to students in need of trauma 
                support or behavioral health services; or
                    (C) reflects the best practices developed by the 
                Interagency Task Force on Trauma-Informed Care 
                established under section 513.
            (4) To create or enhance services at a full-service 
        community school that focuses on trauma-informed supports, 
        which may include establishing a school-site advisory team, 
        managing, coordinating, or delivering pipeline services, hiring 
        a full-time site coordinator, or other activities consistent 
        with section 4625 of the Elementary and Secondary Education Act 
        of 1965 (20 U.S.C. 7275).
            (5) Engaging families and communities in efforts to 
        increase awareness of child and youth trauma, which may include 
        sharing best practices with law enforcement regarding trauma-
        informed care and working with mental health professionals to 
        provide interventions, as well as longer term coordinated care 
        within the community for children and youth who have 
        experienced trauma and their families.
            (6) To provide technical assistance to school systems and 
        mental health agencies.
            (7) To evaluate the effectiveness of the program carried 
        out under this section in increasing student access to 
        evidence-based trauma support services and mental health care.
    (d) Applications.--To be eligible to receive a grant, contract, or 
cooperative agreement under this section, an entity described in 
subsection (a) shall submit an application to the Secretary at such 
time, in such manner, and containing such information as the Secretary 
may reasonably require, which shall include the following:
            (1) A description of the innovative initiatives, 
        activities, or programs to be funded under the grant, contract, 
        or cooperative agreement, including how such program will 
        increase access to evidence-based trauma support services and 
        mental health care for students, and, as applicable, the 
        families of such students.
            (2) A description of how the program will provide 
        linguistically appropriate and culturally competent services.
            (3) A description of how the program will support students 
        and the school in improving the school climate in order to 
        support an environment conducive to learning.
            (4) An assurance that--
                    (A) persons providing services under the grant, 
                contract, or cooperative agreement are adequately 
                trained to provide such services; and
                    (B) teachers, school leaders, administrators, 
                specialized instructional support personnel, 
                representatives of local Indian Tribes or tribal 
                organizations as appropriate, other school personnel, 
                and parents or guardians of students participating in 
                services under this section will be engaged and 
                involved in the design and implementation of the 
                services.
            (5) A description of how the applicant will support and 
        integrate existing school-based services with the program in 
        order to provide mental health services for students, as 
        appropriate.
    (e) Interagency Agreements.--
            (1) Designation of lead agency.--A recipient of a grant, 
        contract, or cooperative agreement under this section shall 
        designate a lead agency to direct the establishment of an 
        interagency agreement among local educational agencies, 
        agencies responsible for early childhood education programs, 
        juvenile justice authorities, mental health agencies, child 
        welfare agencies, and other relevant entities in the State or 
        Indian Tribe, in collaboration with local entities.
            (2) Contents.--The interagency agreement shall ensure the 
        provision of the services described in subsection (c), 
        specifying with respect to each agency, authority, or entity--
                    (A) the financial responsibility for the services;
                    (B) the conditions and terms of responsibility for 
                the services, including quality, accountability, and 
                coordination of the services; and
                    (C) the conditions and terms of reimbursement among 
                the agencies, authorities, or entities that are parties 
                to the interagency agreement, including procedures for 
                dispute resolution.
    (f) Evaluation.--The Secretary shall reserve not to exceed 3 
percent of the funds made available under subsection (l) for each 
fiscal year to--
            (1) conduct a rigorous, independent evaluation of the 
        activities funded under this section; and
            (2) disseminate and promote the utilization of evidence-
        based practices regarding trauma support services and mental 
        health care.
    (g) Distribution of Awards.--The Secretary shall ensure that 
grants, contracts, and cooperative agreements awarded or entered into 
under this section are equitably distributed among the geographical 
regions of the United States and among tribal, urban, suburban, and 
rural populations.
    (h) Rule of Construction.--Nothing in this section shall be 
construed--
            (1) to prohibit an entity involved with a program carried 
        out under this section from reporting a crime that is committed 
        by a student to appropriate authorities; or
            (2) to prevent Federal, State, and tribal law enforcement 
        and judicial authorities from exercising their responsibilities 
        with regard to the application of Federal, tribal, and State 
        law to crimes committed by a student.
    (i) Supplement, Not Supplant.--Any services provided through 
programs carried out under this section shall supplement, and not 
supplant, existing mental health services, including any special 
education and related services provided under the Individuals with 
Disabilities Education Act (20 U.S.C. 1400 et seq.).
    (j) Consultation With Indian Tribes.--In carrying out subsection 
(a), the Secretary shall, in a timely manner, meaningfully consult, 
engage, and cooperate with Indian Tribes and their representatives to 
ensure notice of eligibility.
    (k) Definitions.--In this section:
            (1) Elementary or secondary school.--The term ``elementary 
        or secondary school'' means a public elementary and secondary 
        school as such term is defined in section 8101 of the 
        Elementary and Secondary Education Act of 1965 (20 U.S.C. 
        7801).
            (2) Evidence-based.--The term ``evidence-based'' has the 
        meaning given such term in section 8101(21)(A)(i) of the 
        Elementary and Secondary Education Act of 1965 (20 U.S.C. 
        7801(21)(A)(i)).
            (3) Native hawaiian educational organization.--The term 
        ``Native Hawaiian educational organization'' has the meaning 
        given such term in section 6207 of the Elementary and Secondary 
        Education Act of 1965 (20 U.S.C. 7517).
            (4) Pipeline services.--The term ``pipeline services'' has 
        the meaning given such term in section 4622 of the Elementary 
        and Secondary Education Act of 1965 (20 U.S.C. 7517).
            (5) School leader.--The term ``school leader'' has the 
        meaning given such term in section 8101 of the Elementary and 
        Secondary Education Act of 1965 (20 U.S.C. 7801).
            (6) Secretary.--The term ``Secretary'' means the Secretary 
        of Education.
            (7) Specialized instructional support personnel.--The term 
        ``specialized instructional support personnel'' has the meaning 
        given such term in section 8101 of the Elementary and Secondary 
        Education Act of 1965 (20 U.S.C. 7801).
    (l) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2019 through 2023.

SEC. 1515. NATIONAL CHILD TRAUMATIC STRESS INITIATIVE.

    Section 582(j) of the Public Health Service Act (42 U.S.C. 290hh-
1(j)) (relating to grants to address the problems of persons who 
experience violence-related stress) is amended by striking 
``$46,887,000 for each of fiscal years 2018 through 2022'' and 
inserting ``$53,887,000 for each of fiscal years 2019 through 2023''.

SEC. 1516. NATIONAL MILESTONES TO MEASURE SUCCESS IN CURTAILING THE 
              OPIOID CRISIS.

    (a) In General.--Not later than 180 days after the date of 
enactment of this Act, the Secretary, in consultation with the 
Administrator of the Drug Enforcement Administration and the Director 
of the Office of National Drug Control Policy, shall develop or 
identify existing national indicators (referred to in this section as 
the ``national milestones'') to measure success in curtailing the 
opioid crisis, with the goal of significantly reversing the incidence 
and prevalence of opioid misuse and abuse, and opioid-related morbidity 
and mortality in the United States within 5 years of such date of 
enactment.
    (b) National Milestones to End the Opioid Crisis.--The national 
milestones under subsection (a) shall include the following:
            (1) Not fewer than 10 indicators or metrics to accurately 
        and expediently measure progress in meeting the goal described 
        in subsection (a), which shall, as appropriate, include, 
        indicators or metrics related to--
                    (A) the number of fatal and non-fatal opioid 
                overdoses;
                    (B) the number of emergency room visits related to 
                opioid misuse and abuse;
                    (C) the number of individuals in sustained recovery 
                from opioid use disorder;
                    (D) the number of infections associated with 
                illicit drug use, such as HIV, viral hepatitis, and 
                infective endocarditis, and available capacity for 
                treating such infections;
                    (E) the number of providers prescribing medication 
                assisted treatment for opioid use disorders, including 
                in primary care settings, community health centers, 
                jails, and prisons;
                    (F) the number of individuals receiving treatment 
                for opioid use disorder; and
                    (G) additional indicators or metrics, as 
                appropriate, such as metrics pertaining to specific 
                populations, including women and children, American 
                Indians and Alaskan Natives, individuals living in 
                rural and non-urban areas, and justice-involved 
                populations, that would further clarify the progress 
                made in addressing the opioid misuse and abuse crisis.
            (2) A reasonable goal, such as a percentage decrease or 
        other specified metric, that signifies progress in meeting the 
        goal described in subsection (a), and annual targets to help 
        achieve that goal.
    (c) Consideration of Other Substance Use Disorders.--In developing 
the national milestones under subsection (b), the Secretary shall, as 
appropriate, consider other substance use disorders in addition to 
opioid use disorder.
    (d) Extension of Period.--If the Secretary determines that the goal 
described in subsection (a) will not be achieved with respect to any 
indicator or metric established under subsection (b)(2) within 5 years 
of the date of enactment of this Act, the Secretary may extend the 
timeline for meeting such goal with respect to that indicator or 
metric. The Secretary shall include with any such extension a rationale 
for why additional time is needed and information on whether 
significant changes are needed in order to achieve such goal with 
respect to the indicator or metric.
    (e) Annual Status Update.--Not later than one year after the 
enactment of this Act, the Secretary shall make available on the 
internet website of the Department of Health and Human Services, and 
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, an update on the progress, including expected progress 
in the subsequent year, in achieving the goals detailed in the national 
milestones. Each such update shall include the progress made in the 
first year or since the previous report, as applicable, in meeting each 
indicator or metric in the national milestones.

                           TITLE II--FINANCE

SEC. 2001. SHORT TITLE.

    This title may be cited as the ``Helping to End Addiction and 
Lessen Substance Use Disorders Act of 2018'' or the ``HEAL Act of 
2018''.

                          Subtitle A--Medicare

SEC. 2101. MEDICARE OPIOID SAFETY EDUCATION.

    (a) In General.--Section 1804 of the Social Security Act (42 U.S.C. 
1395b-2) is amended by adding at the end the following new subsection:
    ``(d) The notice provided under subsection (a) shall include--
            ``(1) references to educational resources regarding opioid 
        use and pain management;
            ``(2) a description of categories of alternative, non-
        opioid pain management treatments covered under this title; and
            ``(3) a suggestion for the beneficiary to talk to a 
        physician regarding opioid use and pain management.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to notices distributed prior to each Medicare open enrollment 
period beginning after January 1, 2019.

SEC. 2102. EXPANDING THE USE OF TELEHEALTH SERVICES FOR THE TREATMENT 
              OF OPIOID USE DISORDER AND OTHER SUBSTANCE USE DISORDERS.

    (a) In General.--Section 1834(m) of the Social Security Act (42 
U.S.C. 1395m(m)) is amended--
            (1) in paragraph (2)(B)--
                    (A) in clause (i), in the matter preceding 
                subclause (I), by striking ``clause (ii)'' and 
                inserting ``clause (ii) and paragraph (6)(C)''; and
                    (B) in clause (ii), in the heading, by striking 
                ``for home dialysis therapy'';
            (2) in paragraph (4)(C)--
                    (A) in clause (i), by striking ``paragraph (6)'' 
                and inserting ``paragraphs (5), (6), and (7)''; and
                    (B) in clause (ii)(X), by inserting ``or telehealth 
                services described in paragraph (7)'' before the period 
                at the end; and
            (3) by adding at the end the following new paragraph:
            ``(7) Treatment of substance use disorder services 
        furnished through telehealth.--The geographic requirements 
        described in paragraph (4)(C)(i) shall not apply with respect 
        to telehealth services furnished on or after January 1, 2019, 
        to an eligible telehealth individual with a substance use 
        disorder diagnosis for purposes of treatment of such disorder, 
        as determined by the Secretary, at an originating site 
        described in paragraph (4)(C)(ii) (other than an originating 
        site described in subclause (IX) of such paragraph).''.
    (b) Implementation.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') may implement the 
amendments made by this section by interim final rule.
    (c) Report.--Not later than 5 years after the date of the enactment 
of this Act, the Secretary shall submit to Congress a report on the 
impact of the implementation of the amendments made by this section 
with respect to telehealth services under section 1834(m) of the Social 
Security Act (42 U.S.C. 1395m(m)) on--
            (1) the utilization of health care items and services under 
        title XVIII of such Act (42 U.S.C. 1395 et seq.) related to 
        substance use disorders, including emergency department visits; 
        and
            (2) health outcomes related to substance use disorders, 
        such as opioid overdose deaths.

SEC. 2103. COMPREHENSIVE SCREENINGS FOR SENIORS.

    (a) Initial Preventive Physical Examination.--Section 1861(ww) of 
the Social Security Act (42 U.S.C. 1395x(ww)) is amended--
            (1) in paragraph (1)--
                    (A) by striking ``paragraph (2) and'' and inserting 
                ``paragraph (2),''; and
                    (B) by inserting ``and the furnishing of a review 
                of any current opioid prescriptions (as defined in 
                paragraph (4)),'' after ``upon the agreement with the 
                individual,''; and
            (2) in paragraph (2)--
                    (A) by redesignating subparagraph (N) as 
                subparagraph (O); and
                    (B) by inserting after subparagraph (M) the 
                following new subparagraph:
                    ``(N) Screening for potential substance use 
                disorders.''; and
            (3) by adding at the end the following new paragraph:
    ``(4) For purposes of paragraph (1), the term `a review of any 
current opioid prescriptions' means, with respect to an individual 
determined to have a current prescription for opioids--
            ``(A) a review of the potential risk factors to the 
        individual for opioid use disorder;
            ``(B) an evaluation of the individual's severity of pain 
        and current treatment plan;
            ``(C) the provision of information on non-opioid treatment 
        options; and
            ``(D) a referral to a pain management specialist, as 
        appropriate.''.
    (b) Annual Wellness Visit.--Section 1861(hhh)(2) of the Social 
Security Act (42 U.S.C. 1395x(hhh)(2)) is amended--
            (1) by redesignating subparagraph (G) as subparagraph (I); 
        and
            (2) by inserting after subparagraph (F) the following new 
        subparagraphs:
                    ``(G) Screening for potential substance use 
                disorders and referral for treatment as appropriate.
                    ``(H) The furnishing of a review of any current 
                opioid prescriptions (as defined in subsection 
                (ww)(4)).''.
    (c) Effective Date.--The amendments made by this section shall 
apply to examinations and visits furnished on or after January 1, 2019.

SEC. 2104. EVERY PRESCRIPTION CONVEYED SECURELY.

    (a) In General.--Section 1860D-4(e) of the Social Security Act (42 
U.S.C. 1395w-104(e)) is amended by adding at the end the following:
            ``(7) Requirement of e-prescribing for controlled 
        substances.--
                    ``(A) In general.--Subject to subparagraph (B), a 
                prescription for a covered part D drug under a 
                prescription drug plan (or under an MA-PD plan) for a 
                schedule II, III, IV, or V controlled substance shall 
                be transmitted by a health care practitioner 
                electronically in accordance with an electronic 
                prescription drug program that meets the requirements 
                of paragraph (2).
                    ``(B) Exception for certain circumstances.--The 
                Secretary shall, through rulemaking, specify 
                circumstances and processes by which the Secretary may 
                waive the requirement under subparagraph (A), with 
                respect to a covered part D drug, including in the case 
                of--
                            ``(i) a prescription issued when the 
                        practitioner and dispensing pharmacy are the 
                        same entity;
                            ``(ii) a prescription issued that cannot be 
                        transmitted electronically under the most 
                        recently implemented version of the National 
                        Council for Prescription Drug Programs SCRIPT 
                        Standard;
                            ``(iii) a prescription issued by a 
                        practitioner who received a waiver or a renewal 
                        thereof for a period of time as determined by 
                        the Secretary, not to exceed one year, from the 
                        requirement to use electronic prescribing due 
                        to demonstrated economic hardship, 
                        technological limitations that are not 
                        reasonably within the control of the 
                        practitioner, or other exceptional circumstance 
                        demonstrated by the practitioner;
                            ``(iv) a prescription issued by a 
                        practitioner under circumstances in which, 
                        notwithstanding the practitioner's ability to 
                        submit a prescription electronically as 
                        required by this subsection, such practitioner 
                        reasonably determines that it would be 
                        impractical for the individual involved to 
                        obtain substances prescribed by electronic 
                        prescription in a timely manner, and such delay 
                        would adversely impact the individual's medical 
                        condition involved;
                            ``(v) a prescription issued by a 
                        practitioner prescribing a drug under a 
                        research protocol;
                            ``(vi) a prescription issued by a 
                        practitioner for a drug for which the Food and 
                        Drug Administration requires a prescription to 
                        contain elements that are not able to be 
                        included in electronic prescribing such as, a 
                        drug with risk evaluation and mitigation 
                        strategies that include elements to assure safe 
                        use;
                            ``(vii) a prescription issued by a 
                        practitioner--
                                    ``(I) for an individual who 
                                receives hospice care under this title; 
                                and
                                    ``(II) that is not covered under 
                                the hospice benefit under this title; 
                                and
                            ``(viii) a prescription issued by a 
                        practitioner for an individual who is--
                                    ``(I) a resident of a nursing 
                                facility (as defined in section 
                                1919(a)); and
                                    ``(II) dually eligible for benefits 
                                under this title and title XIX.
                    ``(C) Dispensing.--(i) Nothing in this paragraph 
                shall be construed as requiring a sponsor of a 
                prescription drug plan under this part, MA organization 
                offering an MA-PD plan under part C, or a pharmacist to 
                verify that a practitioner, with respect to a 
                prescription for a covered part D drug, has a waiver 
                (or is otherwise exempt) under subparagraph (B) from 
                the requirement under subparagraph (A).
                    ``(ii) Nothing in this paragraph shall be construed 
                as affecting the ability of the plan to cover or the 
                pharmacists' ability to continue to dispense covered 
                part D drugs from otherwise valid written, oral or fax 
                prescriptions that are consistent with laws and 
                regulations.
                    ``(iii) Nothing in this paragraph shall be 
                construed as affecting the ability of an individual who 
                is being prescribed a covered part D drug to designate 
                a particular pharmacy to dispense the covered part D 
                drug to the extent consistent with the requirements 
                under subsection (b)(1) and under this paragraph.
                    ``(D) Enforcement.--The Secretary shall, through 
                rulemaking, have authority to enforce and specify 
                appropriate penalties for non-compliance with the 
                requirement under subparagraph (A).''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to coverage of drugs prescribed on or after January 1, 2021.

SEC. 2105. STANDARDIZING ELECTRONIC PRIOR AUTHORIZATION FOR SAFE 
              PRESCRIBING.

    Section 1860D-4(e)(2) of the Social Security Act (42 U.S.C. 1395w-
104(e)(2)) is amended by adding at the end the following new 
subparagraph:
                    ``(E) Electronic prior authorization.--
                            ``(i) In general.--Not later than January 
                        1, 2021, the program shall provide for the 
                        secure electronic transmittal of--
                                    ``(I) a prior authorization request 
                                from the prescribing health care 
                                professional for coverage of a covered 
                                part D drug for a part D eligible 
                                individual enrolled in a part D plan 
                                (as defined in section 1860D-23(a)(5)) 
                                to the PDP sponsor or Medicare 
                                Advantage organization offering such 
                                plan; and
                                    ``(II) a response, in accordance 
                                with this subparagraph, from such PDP 
                                sponsor or Medicare Advantage 
                                organization, respectively, to such 
                                professional.
                            ``(ii) Electronic transmission.--
                                    ``(I) Exclusions.--For purposes of 
                                this subparagraph, a facsimile, a 
                                proprietary payer portal that does not 
                                meet standards specified by the 
                                Secretary, or an electronic form shall 
                                not be treated as an electronic 
                                transmission described in clause (i).
                                    ``(II) Standards.--In order to be 
                                treated, for purposes of this 
                                subparagraph, as an electronic 
                                transmission described in clause (i), 
                                such transmission shall comply with 
                                technical standards adopted by the 
                                Secretary in consultation with the 
                                National Council for Prescription Drug 
                                Programs, other standard setting 
                                organizations determined appropriate by 
                                the Secretary, and stakeholders 
                                including PDP sponsors, Medicare 
                                Advantage organizations, health care 
                                professionals, and health information 
                                technology software vendors.
                                    ``(III) Application.--
                                Notwithstanding any other provision of 
                                law, for purposes of this subparagraph, 
                                the Secretary may require the use of 
                                such standards adopted under subclause 
                                (II) in lieu of any other applicable 
                                standards for an electronic 
                                transmission described in clause (i) 
                                for a covered part D drug for a part D 
                                eligible individual.''.

SEC. 2106. STRENGTHENING PARTNERSHIPS TO PREVENT OPIOID ABUSE.

    (a) In General.--Section 1859 of the Social Security Act (42 U.S.C. 
1395w-28) is amended by adding at the end the following new subsection:
    ``(i) Program Integrity Transparency Measures.--
            ``(1) Program integrity portal.--
                    ``(A) In general.--Not later than 2 years after the 
                date of the enactment of this subsection, the Secretary 
                shall, after consultation with stakeholders, establish 
                a secure Internet website portal that would allow a 
                secure path for communication between the Secretary, MA 
                plans under this part, prescription drug plans under 
                part D, and an eligible entity with a contract under 
                section 1893 (such as a Medicare drug integrity 
                contractor or any successor entity to a Medicare drug 
                integrity contractor), in accordance with subsection 
                (j)(3) of such section, for the purpose of enabling 
                through such portal--
                            ``(i) the referral by such plans of 
                        suspicious activities of a provider of services 
                        (including a prescriber) or supplier related to 
                        fraud, waste, and abuse for initiating or 
                        assisting investigations conducted by the 
                        eligible entity; and
                            ``(ii) data sharing among such MA plans, 
                        prescription drug plans, and the Secretary.
                    ``(B) Required uses of portal.--The Secretary shall 
                disseminate the following information to MA plans under 
                this part and prescription drug plans under part D 
                through the secure Internet website portal established 
                under subparagraph (A):
                            ``(i) Providers of services and suppliers 
                        that have been referred pursuant to 
                        subparagraph (A)(i) during the previous 12-
                        month period.
                            ``(ii) Providers of services and suppliers 
                        who are the subject of an active exclusion 
                        under section 1128 or who are subject to a 
                        suspension of payment under this title pursuant 
                        to section 1862(o) or otherwise.
                            ``(iii) Providers of services and suppliers 
                        who are the subject of an active revocation of 
                        participation under this title, including for 
                        not satisfying conditions of participation.
                            ``(iv) In the case of such a plan that 
                        makes a referral under subparagraph (A)(i) 
                        through the portal with respect to suspicious 
                        activities of a provider of services (including 
                        a prescriber) or supplier, if such provider (or 
                        prescriber) or supplier has been the subject of 
                        an administrative action under this title or 
                        title XI with respect to similar activities, a 
                        notification to such plan of such action so 
                        taken.
                    ``(C) Rulemaking.--For purposes of this paragraph, 
                the Secretary shall, through rulemaking, specify what 
                constitutes suspicious activities related to fraud, 
                waste, and abuse, using guidance such as what is 
                provided in the Medicare Program Integrity Manual 
                4.7.1.
            ``(2) Quarterly reports.--Beginning not later than 2 years 
        after the date of the enactment of this subsection, the 
        Secretary shall make available to MA plans under this part and 
        prescription drug plans under part D in a timely manner (but no 
        less frequently than quarterly) and using information submitted 
        to an entity described in paragraph (1) through the portal 
        described in such paragraph or pursuant to section 1893, 
        information on fraud, waste, and abuse schemes and trends in 
        identifying suspicious activity. Information included in each 
        such report shall--
                    ``(A) include administrative actions, pertinent 
                information related to opioid overprescribing, and 
                other data determined appropriate by the Secretary in 
                consultation with stakeholders; and
                    ``(B) be anonymized information submitted by plans 
                without identifying the source of such information.
            ``(3) Clarification.--Nothing in this subsection shall 
        preclude or otherwise affect referrals to the Inspector General 
        of the Department of Health and Human Services or other law 
        enforcement entities.''.
    (b) Contract Requirement to Communicate Plan Corrective Actions 
Against Opioids Over-prescribers.--Section 1857(e)(4)(C) of the Social 
Security Act (42 U.S.C. 1395w-27(e)(4)(C)) is amended by adding at the 
end the following new paragraph:
            ``(5) Communicating plan corrective actions against opioids 
        over-prescribers.--
                    ``(A) In general.--Beginning with plan years 
                beginning on or after January 1, 2021, a contract under 
                this section with an MA organization shall require the 
                organization to submit to the Secretary, through the 
                process established under subparagraph (B), information 
                on credible evidence of suspicious activities of a 
                provider of services (including a prescriber) or 
                supplier related to fraud and other actions taken by 
                such plans related to inappropriate prescribing of 
                opioids.
                    ``(B) Process.--Not later than January 1, 2021, the 
                Secretary shall, in consultation with stakeholders, 
                establish a process under which MA plans and 
                prescription drug plans shall submit to the Secretary 
                information described in subparagraph (A).
                    ``(C) Regulations.--For purposes of this paragraph, 
                including as applied under section 1860D-12(b)(3)(D), 
                the Secretary shall, pursuant to rulemaking--
                            ``(i) specify a definition for the term 
                        `inappropriate prescribing of opioids' and a 
                        method for determining if a provider of 
                        services prescribes such a high volume; and
                            ``(ii) establish the process described in 
                        subparagraph (B) and the types of information 
                        that may be submitted through such process.''.
    (c) Reference Under Part D to Program Integrity Transparency 
Measures.--Section 1860D-4 of the Social Security Act (42 U.S.C. 1395w-
104) is amended by adding at the end the following new subsection:
    ``(m) Program Integrity Transparency Measures.--For program 
integrity transparency measures applied with respect to prescription 
drug plan and MA plans, see section 1859(i).''.

SEC. 2107. COMMIT TO OPIOID MEDICAL PRESCRIBER ACCOUNTABILITY AND 
              SAFETY FOR SENIORS.

    Section 1860D-4(c)(4) of the Social Security Act (42 U.S.C. 1395w-
104(c)(4)) is amended by adding at the end the following new 
subparagraph:
                    ``(D) Notification and additional requirements with 
                respect to statistical outlier prescribers of 
                opioids.--
                            ``(i) Notification.--Not later than January 
                        1, 2021, the Secretary shall, in the case of a 
                        prescriber identified by the Secretary under 
                        clause (ii) to be a statistical outlier 
                        prescriber of opioids, provide, subject to 
                        clause (iv), an annual notification to such 
                        prescriber that such prescriber has been so 
                        identified that includes resources on proper 
                        prescribing methods and other information as 
                        specified in accordance with clause (iii).
                            ``(ii) Identification of statistical 
                        outlier prescribers of opioids.--
                                    ``(I) In general.--The Secretary 
                                shall, subject to subclause (III), 
                                using the valid prescriber National 
                                Provider Identifiers included pursuant 
                                to subparagraph (A) on claims for 
                                covered part D drugs for part D 
                                eligible individuals enrolled in 
                                prescription drug plans under this part 
                                or MA-PD plans under part C and based 
                                on the thresholds established under 
                                subclause (II), identify prescribers 
                                that are statistical outlier opioids 
                                prescribers for a period of time 
                                specified by the Secretary.
                                    ``(II) Establishment of 
                                thresholds.--For purposes of subclause 
                                (I) and subject to subclause (III), the 
                                Secretary shall, after consultation 
                                with stakeholders, establish 
                                thresholds, based on prescriber 
                                specialty and, as determined 
                                appropriate by the Secretary, 
                                geographic area, for identifying 
                                whether a prescriber in a specialty and 
                                geographic area is a statistical 
                                outlier prescriber of opioids as 
                                compared to other prescribers of 
                                opioids within such specialty and area.
                                    ``(III) Exclusions.--The following 
                                shall not be included in the analysis 
                                for identifying statistical outlier 
                                prescribers of opioids under this 
                                clause:
                                            ``(aa) Claims for covered 
                                        part D drugs for part D 
                                        eligible individuals who are 
                                        receiving hospice care under 
                                        this title.
                                            ``(bb) Claims for covered 
                                        part D drugs for part D 
                                        eligible individuals who are 
                                        receiving oncology services 
                                        under this title.
                                            ``(cc) Prescribers who are 
                                        the subject of an investigation 
                                        by the Centers for Medicare & 
                                        Medicaid Services or the 
                                        Inspector General of the 
                                        Department of Health and Human 
                                        Services.
                            ``(iii) Contents of notification.--The 
                        Secretary shall include the following 
                        information in the notifications provided under 
                        clause (i):
                                    ``(I) Information on how such 
                                prescriber compares to other 
                                prescribers within the same specialty 
                                and, if determined appropriate by the 
                                Secretary, geographic area.
                                    ``(II) Information on opioid 
                                prescribing guidelines, based on input 
                                from stakeholders, that may include the 
                                Centers for Disease Control and 
                                Prevention guidelines for prescribing 
                                opioids for chronic pain and guidelines 
                                developed by physician organizations.
                                    ``(III) Other information 
                                determined appropriate by the 
                                Secretary.
                            ``(iv) Modifications and expansions.--
                                    ``(I) Frequency.--Beginning 5 years 
                                after the date of the enactment of this 
                                subparagraph, the Secretary may change 
                                the frequency of the notifications 
                                described in clause (i) based on 
                                stakeholder input and changes in opioid 
                                prescribing utilization and trends.
                                    ``(II) Expansion to other 
                                prescriptions.--The Secretary may 
                                expand notifications under this 
                                subparagraph to include identifications 
                                and notifications with respect to 
                                concurrent prescriptions of covered 
                                Part D drugs used in combination with 
                                opioids that are considered to have 
                                adverse side effects when so used in 
                                such combination, as determined by the 
                                Secretary.
                            ``(v) Additional requirements for 
                        persistent statistical outlier prescribers.--In 
                        the case of a prescriber who the Secretary 
                        determines is persistently identified under 
                        clause (ii) as a statistical outlier prescriber 
                        of opioids, the following shall apply:
                                    ``(I) The Secretary shall provide 
                                an opportunity for such prescriber to 
                                receive technical assistance or 
                                educational resources on opioid 
                                prescribing guidelines (such as the 
                                guidelines described in clause 
                                (iii)(II)) from an entity that 
                                furnishes such assistance or resources, 
                                which may include a quality improvement 
                                organization under part B of title XI, 
                                as available and appropriate.
                                    ``(II) Such prescriber may be 
                                required to enroll in the program under 
                                this title under section 1866(j) if 
                                such prescriber is not otherwise 
                                required to enroll. The Secretary shall 
                                determine the length of the period for 
                                which such prescriber is required to 
                                maintain such enrollment.
                                    ``(III) Not less frequently than 
                                annually (and in a form and manner 
                                determined appropriate by the 
                                Secretary), the Secretary shall 
                                communicate information on such 
                                prescribers to sponsors of a 
                                prescription drug plan and Medicare 
                                Advantage organizations offering an MA-
                                PD plan.
                            ``(vi) Public availability of 
                        information.--The Secretary shall make 
                        aggregate information under this subparagraph 
                        available on the Internet website of the 
                        Centers for Medicare & Medicaid Services. Such 
                        information shall be in a form and manner 
                        determined appropriate by the Secretary and 
                        shall not identify any specific prescriber. In 
                        carrying out this clause, the Secretary shall 
                        consult with interested stakeholders.
                            ``(vii) Opioids defined.--For purposes of 
                        this subparagraph, the term `opioids' has such 
                        meaning as specified by the Secretary.
                            ``(viii) Other activities.--Nothing in this 
                        subparagraph shall preclude the Secretary from 
                        conducting activities that provide prescribers 
                        with information as to how they compare to 
                        other prescribers that are in addition to the 
                        activities under this subparagraph, including 
                        activities that were being conducted as of the 
                        date of the enactment of this subparagraph.''.

SEC. 2108. FIGHTING THE OPIOID EPIDEMIC WITH SUNSHINE.

    (a) Inclusion of Information Regarding Payments to Advance Practice 
Nurses.--
            (1) In general.--Section 1128G(e)(6) of the Social Security 
        Act (42 U.S.C. 1320a-7h(e)(6)) is amended--
                    (A) in subparagraph (A), by adding at the end the 
                following new clauses:
                            ``(iii) A physician assistant, nurse 
                        practitioner, or clinical nurse specialist (as 
                        such terms are defined in section 1861(aa)(5)).
                            ``(iv) A certified registered nurse 
                        anesthetist (as defined in section 
                        1861(bb)(2)).
                            ``(v) A certified nurse-midwife (as defined 
                        in section 1861(gg)(2)).''; and
                    (B) in subparagraph (B), by inserting ``, physician 
                assistant, nurse practitioner, clinical nurse 
                specialist, certified nurse anesthetist, or certified 
                nurse-midwife'' after ``physician''.
            (2) Effective date.--The amendments made by this subsection 
        shall apply with respect to information required to be 
        submitted under section 1128G of the Social Security Act (42 
        U.S.C. 1320a-7h) on or after January 1, 2022.
    (b) Sunset of Exclusion of National Provider Identifier of Covered 
Recipient in Information Made Publicly Available.--Section 
1128G(c)(1)(C)(viii) of the Social Security Act (42 U.S.C. 1320a-
7h(c)(1)(C)(viii))) is amended by striking ``does not contain'' and 
inserting ``in the case of information made available under this 
subparagraph prior to January 1, 2022, does not contain''.
    (c) Administration.--Chapter 35 of title 44, United States Code, 
shall not apply to this section or the amendments made by this section.

SEC. 2109. DEMONSTRATION TESTING COVERAGE OF CERTAIN SERVICES FURNISHED 
              BY OPIOID TREATMENT PROGRAMS.

    Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is 
amended by inserting after section 1866E the following:

   ``demonstration testing coverage of certain services furnished by 
                       opioid treatment programs

    ``Sec. 1866F.  (a) Establishment.--
            ``(1) In general.--The Secretary shall conduct a 
        demonstration (in this section referred to as the 
        `demonstration') to test coverage of and payment for opioid use 
        disorder treatment services (as defined in paragraph (2)(B)) 
        furnished by opioid treatment programs (as defined in paragraph 
        (2)(A)) to individuals under part B using a bundled payment as 
        described in paragraph (3).
            ``(2) Definitions.--In this section:
                    ``(A) Opioid treatment program.--The term `opioid 
                treatment program' means an entity that is an opioid 
                treatment program (as defined in section 8.2 of title 
                42 of the Code of Federal Regulations, or any successor 
                regulation) that--
                            ``(i) is selected for participation in the 
                        demonstration;
                            ``(ii) has in effect a certification by the 
                        Substance Abuse and Mental Health Services 
                        Administration for such a program;
                            ``(iii) is accredited by an accrediting 
                        body approved by the Substance Abuse and Mental 
                        Health Services Administration;
                            ``(iv) submits to the Secretary data and 
                        information needed to monitor the quality of 
                        services furnished and conduct the evaluation 
                        described in subsection (c); and
                            ``(v) meets such additional requirements as 
                        the Secretary may find necessary.
                    ``(B) Opioid use disorder treatment services.--The 
                term `opioid use disorder treatment services' means 
                items and services that are furnished by an opioid 
                treatment program for the treatment of opioid use 
                disorder, including--
                            ``(i) opioid agonist and antagonist 
                        treatment medications (including oral, 
                        injected, or implanted versions) that are 
                        approved by the Food and Drug Administration 
                        under section 505 of the Federal Food, Drug and 
                        Cosmetic Act for use in the treatment of opioid 
                        use disorder;
                            ``(ii) dispensing and administration of 
                        such medications, if applicable;
                            ``(iii) substance use counseling by a 
                        professional to the extent authorized under 
                        State law to furnish such services;
                            ``(iv) individual and group therapy with a 
                        physician or psychologist (or other mental 
                        health professional to the extent authorized 
                        under State law);
                            ``(v) toxicology testing; and
                            ``(vi) other items and services that the 
                        Secretary determines are appropriate (but in no 
                        case to include meals or transportation).
            ``(3) Bundled payment under part b.--
                    ``(A) In general.--The Secretary shall pay, from 
                the Federal Supplementary Medical Insurance Trust Fund 
                under section 1841, to an opioid treatment program 
                participating in the demonstration a bundled payment as 
                determined by the Secretary for opioid use disorder 
                treatment services that are furnished by such treatment 
                program to an individual under part B during an episode 
                of care (as defined by the Secretary).
                    ``(B) Considerations.--The Secretary may implement 
                this paragraph through one or more bundles based on the 
                type of medication provided (such as buprenorphine, 
                methadone, naltrexone, or a new innovative drug), the 
                frequency of services furnished, the scope of services 
                furnished, characteristics of the individuals furnished 
                such services, or other factors as the Secretary 
                determines appropriate. In developing such bundles, the 
                Secretary may consider payment rates paid to opioid 
                treatment programs for comparable services under State 
                plans under title XIX or under the TRICARE program 
                under chapter 55 of title 10 of the United States Code.
    ``(b) Implementation.--
            ``(1) Duration.--The demonstration shall be conducted for a 
        period of 5 years, beginning not later than January 1, 2021.
            ``(2) Scope.--In carrying out the demonstration, the 
        Secretary shall limit the number of beneficiaries that may 
        participate at any one time in the demonstration to 2,000.
            ``(3) Waiver.--The Secretary may waive such provisions of 
        this title and title XI as the Secretary determines necessary 
        in order to implement the demonstration.
            ``(4) Administration.--Chapter 35 of title 44, United 
        States Code, shall not apply to this section.
    ``(c) Evaluation and Report.--
            ``(1) Evaluation.--The Secretary shall conduct an 
        evaluation of the demonstration. Such evaluation shall include 
        analyses of--
                    ``(A) the impact of the demonstration on--
                            ``(i) utilization of health care items and 
                        services related to opioid use disorder, 
                        including hospitalizations and emergency 
                        department visits;
                            ``(ii) beneficiary health outcomes related 
                        to opioid use disorder, including opioid 
                        overdose deaths; and
                            ``(iii) overall expenditures under this 
                        title; and
                    ``(B) the performance of opioid treatment programs 
                participating in the demonstration with respect to 
                applicable quality and cost metrics, including whether 
                any additional quality measures related to opioid use 
                disorder treatment are needed with respect to such 
                programs under this title.
            ``(2) Report.--Not later than 2 years after the completion 
        of the demonstration, the Secretary shall submit to Congress a 
        report containing the results of the evaluation conducted under 
        paragraph (1), together with recommendations for such 
        legislation and administrative action as the Secretary 
        determines appropriate.
    ``(d) Funding.--For purposes of administering and carrying out the 
demonstration, in addition to funds otherwise appropriated, there shall 
be transferred to the Secretary for the Center for Medicare & Medicaid 
Services Program Management Account from the Federal Supplementary 
Medical Insurance Trust Fund under section 1841 $5,000,000, to remain 
available until expended.''.

SEC. 2110. ENCOURAGING APPROPRIATE PRESCRIBING UNDER MEDICARE FOR 
              VICTIMS OF OPIOID OVERDOSE.

    Section 1860D-4(c)(5)(C) of the Social Security Act (42 U.S.C. 
1395w-104(c)(5)(C)) is amended--
            (1) in clause (i), in the matter preceding subclause (I), 
        by striking ``For purposes'' and inserting ``Except as provided 
        in clause (v), for purposes''; and
            (2) by adding at the end the following new clause:
                            ``(v) Treatment of enrollees with a history 
                        of opioid-related overdose.--
                                    ``(I) In general.--For plan years 
                                beginning not later than January 1, 
                                2021, a part D eligible individual who 
                                is not an exempted individual described 
                                in clause (ii) and who is identified 
                                under this clause as a part D eligible 
                                individual with a history of opioid-
                                related overdose (as defined by the 
                                Secretary) shall be included as a 
                                potentially at-risk beneficiary for 
                                prescription drug abuse under the drug 
                                management program under this 
                                paragraph.
                                    ``(II) Identification and notice.--
                                For purposes of this clause, the 
                                Secretary shall--
                                            ``(aa) identify part D 
                                        eligible individuals with a 
                                        history of opioid-related 
                                        overdose (as so defined); and
                                            ``(bb) notify the PDP 
                                        sponsor of the prescription 
                                        drug plan in which such an 
                                        individual is enrolled of such 
                                        identification.''.

SEC. 2111. AUTOMATIC ESCALATION TO EXTERNAL REVIEW UNDER A MEDICARE 
              PART D DRUG MANAGEMENT PROGRAM FOR AT-RISK BENEFICIARIES.

    (a) In General.--Section 1860D-4(c)(5) of the Social Security Act 
(42 U.S.C. 1395ww-10(c)(5)) is amended--
            (1) in subparagraph (B), in each of clauses (ii)(III) and 
        (iii)(IV), by striking ``and the option of an automatic 
        escalation to external review'' and inserting ``, including 
        notice that if on reconsideration a PDP sponsor affirms its 
        denial, in whole or in part, the case shall be automatically 
        forwarded to the independent, outside entity contracted with 
        the Secretary for review and resolution''; and
            (2) in subparagraph (E), by striking ``and the option'' and 
        all that follows and inserting the following: ``and if on 
        reconsideration a PDP sponsor affirms its denial, in whole or 
        in part, the case shall be automatically forwarded to the 
        independent, outside entity contracted with the Secretary for 
        review and resolution.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply beginning not later January 1, 2021.

SEC. 2112. TESTING OF INCENTIVE PAYMENTS FOR BEHAVIORAL HEALTH 
              PROVIDERS FOR ADOPTION AND USE OF CERTIFIED ELECTRONIC 
              HEALTH RECORD TECHNOLOGY.

    Section 1115A(b)(2)(B) of the Social Security Act (42 U.S.C. 
1315a(b)(2)(B)) is amended by adding at the end the following new 
clause:
                            ``(xxv) Providing incentive payments to 
                        behavioral health providers for the adoption 
                        and use of certified electronic health record 
                        technology (as defined in section 1848(o)(4)) 
                        to improve the quality and coordination of care 
                        through the electronic documentation and 
                        exchange of health information. Behavioral 
                        health providers may include--
                                    ``(I) psychiatric hospitals (as 
                                defined in section 1861(f));
                                    ``(II) community mental health 
                                centers (as defined in section 
                                1861(ff)(3)(B));
                                    ``(III) clinical psychologists (as 
                                defined in section 1861(ii));
                                    ``(IV) clinical social workers (as 
                                defined in section 1861(hh)(1)); and
                                    ``(V) hospitals, treatment 
                                facilities, and mental health or 
                                substance use disorder providers that 
                                participate in a State plan under title 
                                XIX or a waiver of such plan.''.

SEC. 2113. MEDICARE IMPROVEMENT FUND.

    Section 1898(b)(1) of the Social Security Act (42 U.S.C. 
1395iii(b)(1)) is amended by striking ``fiscal year 2021, $0'' and 
inserting ``fiscal year 2024, $65,000,000''.

                          Subtitle B--Medicaid

SEC. 2201. CARING RECOVERY FOR INFANTS AND BABIES.

    (a) State Plan Amendment.--Section 1902(a) of the Social Security 
Act (42 U.S.C. 1396a(a)) is amended--
            (1) in paragraph (82), by striking ``and'' after the 
        semicolon;
            (2) in paragraph (83), by striking the period at the end 
        and inserting ``; and''; and
            (3) by inserting after paragraph (83), the following new 
        paragraph:
            ``(84) provide, at the option of the State, for making 
        medical assistance available on an inpatient or outpatient 
        basis at a residential pediatric recovery center (as defined in 
        subsection (nn)) to infants with neonatal abstinence 
        syndrome.''.
    (b) Residential Pediatric Recovery Center Defined.--Section 1902 of 
such Act (42 U.S.C. 1396a) is amended by adding at the end the 
following new subsection:
    ``(nn) Residential Pediatric Recovery Center Defined.--
            ``(1) In general.--For purposes of section 1902(a)(84), the 
        term `residential pediatric recovery center' means a center or 
        facility that furnishes items and services for which medical 
        assistance is available under the State plan to infants with 
        the diagnosis of neonatal abstinence syndrome without any other 
        significant medical risk factors.
            ``(2) Counseling and services.--A residential pediatric 
        recovery center may offer counseling and other services to 
        mothers (and other appropriate family members and caretakers) 
        of infants receiving treatment at such centers if such services 
        are otherwise covered under the State plan under this title or 
        under a waiver of such plan. Such other services may include 
        the following:
                    ``(A) Counseling or referrals for services.
                    ``(B) Activities to encourage caregiver-infant 
                bonding.
                    ``(C) Training on caring for such infants.''.
    (c) Effective Date.--The amendments made by this section take 
effect on the date of enactment of this Act and shall apply to medical 
assistance furnished on or after that date, without regard to final 
regulations to carry out such amendments being promulgated as of such 
date.

SEC. 2202. PEER SUPPORT ENHANCEMENT AND EVALUATION REVIEW.

    (a) In General.--Not later than 2 years after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Committee on Energy and Commerce of the House of 
Representatives, the Committee on Finance of the Senate, and the 
Committee on Health, Education, Labor, and Pensions of the Senate a 
report on the provision of peer support services under the Medicaid 
program.
    (b) Content of Report.--
            (1) In general.--The report required under subsection (a) 
        shall include the following information:
                    (A) Information on State coverage of peer support 
                services under Medicaid, including--
                            (i) the mechanisms through which States may 
                        provide such coverage, including through 
                        existing statutory authority or through 
                        waivers;
                            (ii) the populations to which States have 
                        provided such coverage;
                            (iii) the payment models, including any 
                        alternative payment models, used by States to 
                        pay providers of such services; and
                            (iv) where available, information on 
                        Federal and State spending under Medicaid for 
                        peer support services.
                    (B) Information on selected State experiences in 
                providing medical assistance for peer support services 
                under State Medicaid plans and whether States measure 
                the effects of providing such assistance with respect 
                to--
                            (i) improving access to behavioral health 
                        services;
                            (ii) improving early detection, and 
                        preventing worsening, of behavioral health 
                        disorders;
                            (iii) reducing chronic and comorbid 
                        conditions; and
                            (iv) reducing overall health costs.
            (2) Recommendations.--The report required under subsection 
        (a) shall include recommendations, including recommendations 
        for such legislative and administrative actions related to 
        improving services, including peer support services, and access 
        to peer support services under Medicaid as the Comptroller 
        General of the United States determines appropriate.

SEC. 2203. MEDICAID SUBSTANCE USE DISORDER TREATMENT VIA TELEHEALTH.

    (a) Definitions.--In this section:
            (1) Comptroller general.--The term ``Comptroller General'' 
        means the Comptroller General of the United States.
            (2) School-based health center.--The term ``school-based 
        health center'' has the meaning given that term in section 
        2110(c)(9) of the Social Security Act (42 U.S.C. 1397jj(c)(9)).
            (3) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (4) Teleheath services.--The term ``telehealth services'' 
        includes remote patient monitoring and other key modalities 
        such as live video or synchronous telehealth, store-and-forward 
        or asynchronous telehealth, mobile health, telephonic 
        consultation, and electronic consult including provider-to-
        provider e-consults.
            (5) Underserved area.--The term ``underserved area'' means 
        a health professional shortage area (as defined in section 
        332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 
        254e(a)(1)(A))) and a medically underserved area (according to 
        a designation under section 330(b)(3)(A) of the Public Health 
        Service Act (42 U.S.C. 254b(b)(3)(A))).
    (b) Guidance to States Regarding Federal Reimbursement for 
Furnishing Services and Treatment for Substance Use Disorders Under 
Medicaid Using Telehealth Services, Including in School-based Health 
Centers.--Not later than 1 year after the date of enactment of this 
Act, the Secretary, acting through the Administrator of the Centers for 
Medicare & Medicaid Services, shall issue guidance to States on the 
following:
            (1) State options for Federal reimbursement of expenditures 
        under Medicaid for furnishing services and treatment for 
        substance use disorders, including assessment, medication-
        assisted treatment, counseling, and medication management, 
        using telehealth services. Such guidance shall also include 
        guidance on furnishing services and treatments that address the 
        needs of high risk individuals, including at least the 
        following groups:
                    (A) American Indians and Alaska Natives.
                    (B) Adults under the age of 40.
                    (C) Individuals with a history of nonfatal 
                overdose.
            (2) State options for Federal reimbursement of expenditures 
        under Medicaid for education directed to providers serving 
        Medicaid beneficiaries with substance use disorders using the 
        hub and spoke model, through contracts with managed care 
        entities, through administrative claiming for disease 
        management activities, and under Delivery System Reform 
        Incentive Payment (``DSRIP'') programs.
            (3) State options for Federal reimbursement of expenditures 
        under Medicaid for furnishing services and treatment for 
        substance use disorders for individuals enrolled in Medicaid in 
        a school-based health center using telehealth services.
    (c) GAO Evaluation of Children's Access to Services and Treatment 
for Substance Use Disorders Under Medicaid.--
            (1) Study.--The Comptroller General shall evaluate 
        children's access to services and treatment for substance use 
        disorders under Medicaid. The evaluation shall include an 
        analysis of State options for improving children's access to 
        such services and treatment and for improving outcomes, 
        including by increasing the number of Medicaid providers who 
        offer services or treatment for substance use disorders in a 
        school-based health center using telehealth services, 
        particularly in rural and underserved areas. The evaluation 
        shall include an analysis of Medicaid provider reimbursement 
        rates for services and treatment for substance use disorders.
            (2) Report.--Not later than 1 year after the date of 
        enactment of this Act, the Comptroller General shall submit to 
        Congress a report containing the results of the evaluation 
        conducted under paragraph (1), together with recommendations 
        for such legislation and administrative action as the 
        Comptroller General determines appropriate.
    (d) Report on Reducing Barriers to Using Telehealth Services and 
Remote Patient Monitoring for Pediatric Populations Under Medicaid.--
            (1) In general.--Not later than 1 year after the date of 
        enactment of this Act, the Secretary, acting through the 
        Administrator of the Centers for Medicare & Medicaid Services, 
        shall issue a report to the Committee on Finance of the Senate 
        and the Committee on Energy and Commerce of the House of 
        Representative identifying best practices and potential 
        solutions for reducing barriers to using telehealth services to 
        furnish services and treatment for substance use disorders 
        among pediatric populations under Medicaid. The report shall 
        include--
                    (A) analyses of the best practices, barriers, and 
                potential solutions for using telehealth services to 
                diagnose and provide services and treatment for 
                children with substance use disorders, including opioid 
                use disorder; and
                    (B) identification and analysis of the differences, 
                if any, in furnishing services and treatment for 
                children with substance use disorders using telehealth 
                services and using services delivered in person, such 
                as, and to the extent feasible, with respect to--
                            (i) utilization rates;
                            (ii) costs;
                            (iii) avoidable inpatient admissions and 
                        readmissions;
                            (iv) quality of care; and
                            (v) patient, family, and provider 
                        satisfaction.
            (2) Publication.--The Secretary shall publish the report 
        required under paragraph (1) on a public Internet website of 
        the Department of Health and Human Services.

SEC. 2204. ENHANCING PATIENT ACCESS TO NON-OPIOID TREATMENT OPTIONS.

    Not later than January 1, 2019, the Secretary of Health and Human 
Services, acting through the Administrator of the Centers for Medicare 
& Medicaid Services, shall issue 1 or more final guidance documents, or 
update existing guidance documents, to States regarding mandatory and 
optional items and services that may be provided under a State plan 
under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), or 
under a waiver of such a plan, for non-opioid treatment and management 
of pain, including, but not limited to, evidence-based non-opioid 
pharmacological therapies and non-pharmacological therapies.

SEC. 2205. ASSESSING BARRIERS TO OPIOID USE DISORDER TREATMENT.

    (a) Study.--
            (1) In general.--The Comptroller General of the United 
        States (in this section referred to as the ``Comptroller 
        General'') shall conduct a study regarding the barriers to 
        providing medication used in the treatment of substance use 
        disorders under Medicaid distribution models such as the ``buy-
        and-bill'' model, and options for State Medicaid programs to 
        remove or reduce such barriers. The study shall include 
        analyses of each of the following models of distribution of 
        substance use disorder treatment medications, particularly 
        buprenorphine, naltrexone, and buprenorphine-naloxone 
        combinations:
                    (A) The purchasing, storage, and administration of 
                substance use disorder treatment medications by 
                providers.
                    (B) The dispensing of substance use disorder 
                treatment medications by pharmacists.
                    (C) The ordering, prescribing, and obtaining 
                substance use disorder treatment medications on demand 
                from specialty pharmacies by providers.
            (2) Requirements.--For each model of distribution specified 
        in paragraph (1), the Comptroller General shall evaluate how 
        each model presents barriers or could be used by selected State 
        Medicaid programs to reduce the barriers related to the 
        provision of substance use disorder treatment by examining what 
        is known about the effects of the model of distribution on--
                    (A) Medicaid beneficiaries' access to substance use 
                disorder treatment medications;
                    (B) the differential cost to the program between 
                each distribution model for medication assisted 
                treatment; and
                    (C) provider willingness to provide or prescribe 
                substance use disorder treatment medications.
    (b) Report.--Not later than 15 months after the date of the 
enactment of this Act, the Comptroller General shall submit to Congress 
a report containing the results of the study conducted under subsection 
(a), together with recommendations for such legislation and 
administrative action as the Comptroller General determines 
appropriate.

SEC. 2206. HELP FOR MOMS AND BABIES.

    (a) Medicaid State Plan.--Section 1905(a) of the Social Security 
Act (42 U.S.C. 1396d(a)) is amended by adding at the end the following 
new sentence: ``In the case of a woman who is eligible for medical 
assistance on the basis of being pregnant (including through the end of 
the month in which the 60-day period beginning on the last day of her 
pregnancy ends), who is a patient in an institution for mental diseases 
for purposes of receiving treatment for a substance use disorder, and 
who was enrolled for medical assistance under the State plan 
immediately before becoming a patient in an institution for mental 
diseases or who becomes eligible to enroll for such medical assistance 
while such a patient, the exclusion from the definition of `medical 
assistance' set forth in the subdivision (B) following paragraph (29) 
of the first sentence of this subsection shall not be construed as 
prohibiting Federal financial participation for medical assistance for 
items or services that are provided to the woman outside of the 
institution.''.
    (b) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendment made by subsection (a) shall take effect on the date 
        of enactment of this Act.
            (2) Rule for changes requiring state legislation.--In the 
        case of a State plan under title XIX of the Social Security Act 
        which the Secretary of Health and Human Services determines 
        requires State legislation (other than legislation 
        appropriating funds) in order for the plan to meet the 
        additional requirements imposed by the amendment made by 
        subsection (a), the State plan shall not be regarded as failing 
        to comply with the requirements of such title solely on the 
        basis of its failure to meet these additional requirements 
        before the first day of the first calendar quarter beginning 
        after the close of the first regular session of the State 
        legislature that begins after the date of the enactment of this 
        Act. For purposes of the previous sentence, in the case of a 
        State that has a 2-year legislative session, each year of such 
        session shall be deemed to be a separate regular session of the 
        State legislature.

SEC. 2207. SECURING FLEXIBILITY TO TREAT SUBSTANCE USE DISORDERS.

    Section 1903(m) of the Social Security Act (42 U.S.C. 1396b(m)) is 
amended by adding at the end the following new paragraph:
    ``(7) Payment shall be made under this title to a State for 
expenditures for capitation payments described in section 438.6(e) of 
title 42, Code of Federal Regulations (or any successor regulation).''.

SEC. 2208. MACPAC STUDY AND REPORT ON MAT UTILIZATION CONTROLS UNDER 
              STATE MEDICAID PROGRAMS.

    (a) Study.--The Medicaid and CHIP Payment and Access Commission 
shall conduct a study and analysis of utilization control policies 
applied to medication-assisted treatment for substance use disorders 
under State Medicaid programs, including policies and procedures 
applied both in fee-for-service Medicaid and in risk-based managed care 
Medicaid, which shall--
            (1) include an inventory of such utilization control 
        policies and related protocols for ensuring access to medically 
        necessary treatment;
            (2) determine whether managed care utilization control 
        policies and procedures for medication assisted treatment for 
        substance use disorders are consistent with section 
        438.210(a)(4)(ii) of title 42, Code of Federal Regulations; and
            (3) identify policies that--
                    (A) limit an individual's access to medication-
                assisted treatment for a substance use disorder by 
                limiting the quantity of medication-assisted treatment 
                prescriptions, or the number of refills for such 
                prescriptions, available to the individual as part of a 
                prior authorization process or similar utilization 
                protocols; and
                    (B) apply without evaluating individual instances 
                of fraud, waste, or abuse.
    (b) Report.--Not later than 1 year after the date of the enactment 
of this Act, the Medicaid and CHIP Payment and Access Commission shall 
make publicly available a report containing the results of the study 
conducted under subsection (a).

SEC. 2209. OPIOID ADDICTION TREATMENT PROGRAMS ENHANCEMENT.

    (a) T-MSIS Substance Use Disorder Data Book.--
            (1) In general.--Not later than the date that is 12 months 
        after the date of enactment of this Act, the Secretary of 
        Health and Human Services (in this section referred to as the 
        ``Secretary'') shall publish on the public website of the 
        Centers for Medicare & Medicaid Services a report with 
        comprehensive data on the prevalence of substance use disorders 
        in the Medicaid beneficiary population and services provided 
        for the treatment of substance use disorders under Medicaid.
            (2) Content of report.--The report required under paragraph 
        (1) shall include, at a minimum, the following data for each 
        State (including, to the extent available, for the District of 
        Columbia, Puerto Rico, the Virgin Islands, Guam, the Northern 
        Mariana Islands, and American Samoa):
                    (A) The number and percentage of individuals 
                enrolled in the State Medicaid plan or waiver of such 
                plan in each of the major enrollment categories (as 
                defined in a public letter from the Medicaid and CHIP 
                Payment and Access Commission to the Secretary) who 
                have been diagnosed with a substance use disorder and 
                whether such individuals are enrolled under the State 
                Medicaid plan or a waiver of such plan, including the 
                specific waiver authority under which they are 
                enrolled, to the extent available.
                    (B) A list of the substance use disorder treatment 
                services by each major type of service, such as 
                counseling, medication assisted treatment, peer 
                support, residential treatment, and inpatient care, for 
                which beneficiaries in each State received at least 1 
                service under the State Medicaid plan or a waiver of 
                such plan.
                    (C) The number and percentage of individuals with a 
                substance use disorder diagnosis enrolled in the State 
                Medicaid plan or waiver of such plan who received 
                substance use disorder treatment services under such 
                plan or waiver by each major type of service under 
                subparagraph (B) within each major setting type, such 
                as outpatient, inpatient, residential, and other home 
                and community-based settings.
                    (D) The number of services provided under the State 
                Medicaid plan or waiver of such plan per individual 
                with a substance use disorder diagnosis enrolled in 
                such plan or waiver for each major type of service 
                under subparagraph (B).
                    (E) The number and percentage of individuals 
                enrolled in the State Medicaid plan or waiver, by major 
                enrollment category, who received substance use 
                disorder treatment through--
                            (i) a medicaid managed care entity (as 
                        defined in section 1932(a)(1)(B) of the Social 
                        Security Act (42 U.S.C. 1396u-2(a)(1)(B))), 
                        including the number of such individuals who 
                        received such assistance through a prepaid 
                        inpatient health plan or a prepaid ambulatory 
                        health plan;
                            (ii) a fee-for-service payment model; or
                            (iii) an alternative payment model, to the 
                        extent available.
                    (F) The number and percentage of individuals with a 
                substance use disorder who receive substance use 
                disorder treatment services in an outpatient or home 
                and community-based setting after receiving treatment 
                in an inpatient or residential setting, and the number 
                of services received by such individuals in the 
                outpatient or home and community-based setting.
            (3) Annual updates.--The Secretary shall issue an updated 
        version of the report required under paragraph (1) not later 
        than January 1 of each calendar year through 2024.
            (4) Use of t-msis data.--The report required under 
        paragraph (1) and updates required under paragraph (3) shall--
                    (A) use data and definitions from the Transformed 
                Medicaid Statistical Information System (``T-MSIS'') 
                data set that is no more than 12 months old on the date 
                that the report or update is published; and
                    (B) as appropriate, include a description with 
                respect to each State of the quality and completeness 
                of the data and caveats describing the limitations of 
                the data reported to the Secretary by the State that is 
                sufficient to communicate the appropriate uses for the 
                information.
    (b) Making T-MSIS Data on Substance Use Disorders Available to 
Researchers.--
            (1) In general.--The Secretary shall publish in the Federal 
        Register a system of records notice for the data specified in 
        paragraph (2) for the Transformed Medicaid Statistical 
        Information System, in accordance with section 552a(e)(4) of 
        title 5, United States Code. The notice shall outline policies 
        that protect the security and privacy of the data that, at a 
        minimum, meet the security and privacy policies of SORN 09-70-
        0541 for the Medicaid Statistical Information System.
            (2) Required data.--The data covered by the systems of 
        records notice required under paragraph (1) shall be sufficient 
        for researchers and States to analyze the prevalence of 
        substance use disorders in the Medicaid beneficiary population 
        and the treatment of substance use disorders under Medicaid 
        across all States (including the District of Columbia, Puerto 
        Rico, the Virgin Islands, Guam, the Northern Mariana Islands, 
        and American Samoa), forms of treatment, and treatment 
        settings.
            (3) Initiation of data-sharing activities.--Not later than 
        January 1, 2019, the Secretary shall initiate the data-sharing 
        activities outlined in the notice required under paragraph (1).

SEC. 2210. BETTER DATA SHARING TO COMBAT THE OPIOID CRISIS.

    (a) In General.--Section 1903(m) of the Social Security Act (42 
U.S.C. 1396b(m)), as amended by section 2207, is amended by adding at 
the end the following new paragraph:
    ``(8)(A) The State agency administering the State plan under this 
title may have reasonable access, as determined by the State, to 1 or 
more prescription drug monitoring program databases administered or 
accessed by the State to the extent the State agency is permitted to 
access such databases under State law.
    ``(B) Such State agency may facilitate reasonable access, as 
determined by the State, to 1 or more prescription drug monitoring 
program databases administered or accessed by the State, to same extent 
that the State agency is permitted under State law to access such 
databases, for--
            ``(i) any provider enrolled under the State plan to provide 
        services to Medicaid beneficiaries; and
            ``(ii) any managed care entity (as defined under section 
        1932(a)(1)(B)) that has a contract with the State under this 
        subsection or under section 1905(t)(3).
    ``(C) Such State agency may share information in such databases, to 
the same extent that the State agency is permitted under State law to 
share information in such databases, with--
            ``(i) any provider enrolled under the State plan to provide 
        services to Medicaid beneficiaries; and
            ``(ii) any managed care entity (as defined under section 
        1932(a)(1)(B)) that has a contract with the State under this 
        subsection or under section 1905(t)(3).''.
    (b) Security and Privacy.--All applicable State and Federal 
security and privacy protections and laws shall apply to any State 
agency, individual, or entity accessing 1 or more prescription drug 
monitoring program databases or obtaining information in such databases 
in accordance with section 1903(m)(8) of the Social Security Act (42 
U.S.C. 1396b(m)(8)) (as added by subsection (a)).
    (c) Effective Date.--The amendment made by subsection (a) shall 
take effect on the date of enactment of this Act.

SEC. 2211. MANDATORY REPORTING WITH RESPECT TO ADULT BEHAVIORAL HEALTH 
              MEASURES.

    Section 1139B of the Social Security Act (42 U.S.C. 1320b-9b) is 
amended--
            (1) in subsection (b)--
                    (A) in paragraph (3)--
                            (i) by striking ``Not later than January 1, 
                        2013'' and inserting the following:
                    ``(A) Voluntary reporting.--Not later than January 
                1, 2013''; and
                            (ii) by adding at the end the following:
                    ``(B) Mandatory reporting with respect to 
                behavioral health measures.--Beginning with the State 
                report required under subsection (d)(1) for 2024, the 
                Secretary shall require States to use all behavioral 
                health measures included in the core set of adult 
                health quality measures and any updates or changes to 
                such measures to report information, using the 
                standardized format for reporting information and 
                procedures developed under subparagraph (A), regarding 
                the quality of behavioral health care for Medicaid 
                eligible adults.'';
                    (B) in paragraph (5), by adding at the end the 
                following new subparagraph:
                    ``(C) Behavioral health measures.--Beginning with 
                respect to State reports required under subsection 
                (d)(1) for 2024, the core set of adult health quality 
                measures maintained under this paragraph (and any 
                updates or changes to such measures) shall include 
                behavioral health measures.''; and
            (2) in subsection (d)(1)(A)--
                    (A) by striking ``the such plan'' and inserting 
                ``such plan''; and
                    (B) by striking ``subsection (a)(5)'' and inserting 
                ``subsection (b)(5) and, beginning with the report for 
                2024, all behavioral health measures included in the 
                core set of adult health quality measures maintained 
                under such subsection (b)(5) and any updates or changes 
                to such measures (as required under subsection 
                (b)(3))''.

SEC. 2212. REPORT ON INNOVATIVE STATE INITIATIVES AND STRATEGIES TO 
              PROVIDE HOUSING-RELATED SERVICES AND SUPPORTS TO 
              INDIVIDUALS STRUGGLING WITH SUBSTANCE USE DISORDERS UNDER 
              MEDICAID.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Secretary of Health and Human Services shall issue a 
report to Congress describing innovative State initiatives and 
strategies for providing housing-related services and supports under a 
State Medicaid program to individuals with substance use disorders who 
are experiencing or at risk of experiencing homelessness.
    (b) Content of Report.--The report required under subsection (a) 
shall describe the following:
            (1) Existing methods and innovative strategies developed 
        and adopted by State Medicaid programs that have achieved 
        positive outcomes in increasing housing stability among 
        Medicaid beneficiaries with substance use disorders who are 
        experiencing or at risk of experiencing homelessness, including 
        Medicaid beneficiaries with substance use disorders who are--
                    (A) receiving treatment for substance use disorders 
                in inpatient, residential, outpatient, or home and 
                community-based settings;
                    (B) transitioning between substance use disorder 
                treatment settings; or
                    (C) living in supportive housing or another model 
                of affordable housing.
            (2) Strategies employed by Medicaid managed care 
        organizations, primary care case managers, hospitals, 
        accountable care organizations, and other care coordination 
        providers to deliver housing-related services and supports and 
        to coordinate services provided under State Medicaid programs 
        across different treatment settings.
            (3) Innovative strategies and lessons learned by States 
        with Medicaid waivers approved under section 1115 or 1915 of 
        the Social Security Act (42 U.S.C. 1315, 1396n), including--
                    (A) challenges experienced by States in designing, 
                securing, and implementing such waivers or plan 
                amendments;
                    (B) how States developed partnerships with other 
                organizations such as behavioral health agencies, State 
                housing agencies, housing providers, health care 
                services agencies and providers, community-based 
                organizations, and health insurance plans to implement 
                waivers or State plan amendments; and
                    (C) how and whether States plan to provide Medicaid 
                coverage for housing-related services and supports in 
                the future, including by covering such services and 
                supports under State Medicaid plans or waivers.
            (4) Existing opportunities for States to provide housing-
        related services and supports through a Medicaid waiver under 
        sections 1115 or 1915 of the Social Security Act (42 U.S.C. 
        1315, 1396n) or through a State Medicaid plan amendment, such 
        as the Assistance in Community Integration Service pilot 
        program, which promotes supportive housing and other housing-
        related supports under Medicaid for individuals with substance 
        use disorders and for which Maryland has a waiver approved 
        under such section 1115 to conduct the program.
            (5) Innovative strategies and partnerships developed and 
        implemented by State Medicaid programs or other entities to 
        identify and enroll eligible individuals with substance use 
        disorders who are experiencing or at risk of experiencing 
        homelessness in State Medicaid programs.

SEC. 2213. TECHNICAL ASSISTANCE AND SUPPORT FOR INNOVATIVE STATE 
              STRATEGIES TO PROVIDE HOUSING-RELATED SUPPORTS UNDER 
              MEDICAID.

    (a) In General.--The Secretary of Health and Human Services shall 
provide technical assistance and support to States regarding the 
development and expansion of innovative State strategies (including 
through State Medicaid demonstration projects) to provide housing-
related supports and services and care coordination services under 
Medicaid to individuals with substance use disorders.
    (b) Report.--Not later than 180 days after the date of enactment of 
this Act, the Secretary shall issue a report to Congress detailing a 
plan of action to carry out the requirements of subsection (a).

                       Subtitle C--Human Services

SEC. 2301. SUPPORTING FAMILY-FOCUSED RESIDENTIAL TREATMENT.

    (a) Definitions.--In this section:
            (1) Family-focused residential treatment program.--The term 
        ``family-focused residential treatment program'' means a 
        trauma-informed residential program primarily for substance use 
        disorder treatment for pregnant and postpartum women and 
        parents and guardians that allows children to reside with such 
        women or their parents or guardians during treatment to the 
        extent appropriate and applicable.
            (2) Medicaid program.--The term ``Medicaid program'' means 
        the program established under title XIX of the Social Security 
        Act (42 U.S.C. 1396 et seq.).
            (3) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (4) Title iv-e program.--The term ``title IV-E program'' 
        means the program for foster care, prevention, and permanency 
        established under part E of title IV of the Social Security Act 
        (42 U.S.C. 670 et seq.).
    (b) Guidance on Family-focused Residential Treatment Programs.--
            (1) In general.--Not later than 180 days after the date of 
        enactment of this Act, the Secretary, in consultation with 
        divisions of the Department of Health and Human Services 
        administering substance use disorder or child welfare programs, 
        shall develop and issue guidance to States identifying 
        opportunities to support family-focused residential treatment 
        programs for the provision of substance use disorder treatment. 
        Before issuing such guidance, the Secretary shall solicit input 
        from representatives of States, health care providers with 
        expertise in addiction medicine, obstetrics and gynecology, 
        neonatology, child trauma, and child development, health plans, 
        recipients of family-focused treatment services, and other 
        relevant stakeholders.
            (2) Additional requirements.--The guidance required under 
        paragraph (1) shall include descriptions of the following:
                    (A) Existing opportunities and flexibilities under 
                the Medicaid program, including under waivers 
                authorized under section 1115 or 1915 of the Social 
                Security Act (42 U.S.C. 1315, 1396n), for States to 
                receive Federal Medicaid funding for the provision of 
                substance use disorder treatment for pregnant and 
                postpartum women and parents and guardians and, to the 
                extent applicable, their children, in family-focused 
                residential treatment programs.
                    (B) How States can employ and coordinate funding 
                provided under the Medicaid program, the title IV-E 
                program, and other programs administered by the 
                Secretary to support the provision of treatment and 
                services provided by a family-focused residential 
                treatment facility such as substance use disorder 
                treatment and services, including medication-assisted 
                treatment, family, group, and individual counseling, 
                case management, parenting education and skills 
                development, the provision, assessment, or coordination 
                of care and services for children, including necessary 
                assessments and appropriate interventions, non-
                emergency transportation for necessary care provided at 
                or away from a program site, transitional services and 
                supports for families leaving treatment, and other 
                services.
                    (C) How States can employ and coordinate funding 
                provided under the Medicaid program and the title IV-E 
                program (including as amended by the Family First 
                Prevention Services Act enacted under title VII of 
                division E of Public Law 115-123, and particularly with 
                respect to the authority under subsections (a)(2)(C) 
                and (j) of section 472 and section 474(a)(1) of the 
                Social Security Act (42 U.S.C. 672, 674(a)(1)) (as 
                amended by section 50712 of Public Law 115-123) to 
                provide foster care maintenance payments for a child 
                placed with a parent who is receiving treatment in a 
                licensed residential family-based treatment facility 
                for a substance use disorder) to support placing 
                children with their parents in family-focused 
                residential treatment programs.

SEC. 2302. IMPROVING RECOVERY AND REUNIFYING FAMILIES.

    (a) Family Recovery and Reunification Program Replication 
Project.--Section 435 of the Social Security Act (42 U.S.C. 629e) is 
amended by adding at the end the following:
    ``(e) Family Recovery and Reunification Program Replication 
Project.--
            ``(1) Purpose.--The purpose of this subsection is to 
        provide resources to the Secretary to support the conduct and 
        evaluation of a family recovery and reunification program 
        replication project (referred to in this subsection as the 
        `project') and to determine the extent to which such programs 
        may be appropriate for use at different intervention points 
        (such as when a child is at risk of entering foster care or 
        when a child is living with a guardian while a parent is in 
        treatment). The family recovery and reunification program 
        conducted under the project shall use a recovery coach model 
        that is designed to help reunify families and protect children 
        by working with parents or guardians with a substance use 
        disorder who have temporarily lost custody of their children.
            ``(2) Program components.--The family recovery and 
        reunification program conducted under the project shall adhere 
        closely to the elements and protocol determined to be most 
        effective in other recovery coaching programs that have been 
        rigorously evaluated and shown to increase family reunification 
        and protect children and, consistent with such elements and 
        protocol, shall provide such items and services as--
                    ``(A) assessments to evaluate the needs of the 
                parent or guardian;
                    ``(B) assistance in receiving the appropriate 
                benefits to aid the parent or guardian in recovery;
                    ``(C) services to assist the parent or guardian in 
                prioritizing issues identified in assessments, 
                establishing goals for resolving such issues that are 
                consistent with the goals of the treatment provider, 
                child welfare agency, courts, and other agencies 
                involved with the parent or guardian or their children, 
                and making a coordinated plan for achieving such goals;
                    ``(D) home visiting services coordinated with the 
                child welfare agency and treatment provider involved 
                with the parent or guardian or their children;
                    ``(E) case management services to remove barriers 
                for the parent or guardian to participate and continue 
                in treatment, as well as to re-engage a parent or 
                guardian who is not participating or progressing in 
                treatment;
                    ``(F) access to services needed to monitor the 
                parent's or guardian's compliance with program 
                requirements;
                    ``(G) frequent reporting between the treatment 
                provider, child welfare agency, courts, and other 
                agencies involved with the parent or guardian or their 
                children to ensure appropriate information on the 
                parent's or guardian's status is available to inform 
                decision-making; and
                    ``(H) assessments and recommendations provided by a 
                recovery coach to the child welfare caseworker 
                responsible for documenting the parent's or guardian's 
                progress in treatment and recovery as well as the 
                status of other areas identified in the treatment plan 
                for the parent or guardian, including a recommendation 
                regarding the expected safety of the child if the child 
                is returned to the custody of the parent or guardian 
                that can be used by the caseworker and a court to make 
                permanency decisions regarding the child.
            ``(3) Responsibilities of the secretary.--
                    ``(A) In general.--The Secretary shall, through a 
                grant or contract with 1 or more entities, conduct and 
                evaluate the family recovery and reunification program 
                under the project.
                    ``(B) Requirements.--In identifying 1 or more 
                entities to conduct the evaluation of the family 
                recovery and reunification program, the Secretary 
                shall--
                            ``(i) determine that the area or areas in 
                        which the program will be conducted have 
                        sufficient substance use disorder treatment 
                        providers and other resources (other than those 
                        provided with funds made available to carry out 
                        the project) to successfully conduct the 
                        program;
                            ``(ii) determine that the area or areas in 
                        which the program will be conducted have enough 
                        potential program participants, and will serve 
                        a sufficient number of parents or guardians and 
                        their children, so as to allow for the 
                        formation of a control group, evaluation 
                        results to be adequately powered, and 
                        preliminary results of the evaluation to be 
                        available within 4 years of the program's 
                        implementation;
                            ``(iii) provide the entity or entities with 
                        technical assistance for the program design, 
                        including by working with 1 or more entities 
                        that are or have been involved in recovery 
                        coaching programs that have been rigorously 
                        evaluated and shown to increase family 
                        reunification and protect children so as to 
                        make sure the program conducted under the 
                        project adheres closely to the elements and 
                        protocol determined to be most effective in 
                        such other recovery coaching programs;
                            ``(iv) assist the entity or entities in 
                        securing adequate coaching, treatment, child 
                        welfare, court, and other resources needed to 
                        successfully conduct the family recovery and 
                        reunification program under the project; and
                            ``(v) ensure the entity or entities will be 
                        able to monitor the impacts of the program in 
                        the area or areas in which it is conducted for 
                        at least 5 years after parents or guardians and 
                        their children are randomly assigned to 
                        participate in the program or to be part of the 
                        program's control group.
            ``(4) Evaluation requirements.--
                    ``(A) In general.--The Secretary, in consultation 
                with the entity or entities conducting the family 
                recovery and reunification program under the project, 
                shall conduct an evaluation to determine whether the 
                program has been implemented effectively and resulted 
                in improvements for children and families. The 
                evaluation shall have 3 components: a pilot phase, an 
                impact study, and an implementation study.
                    ``(B) Pilot phase.--The pilot phase component of 
                the evaluation shall consist of the Secretary providing 
                technical assistance to the entity or entities 
                conducting the family recovery and reunification 
                program under the project to ensure--
                            ``(i) the program's implementation adheres 
                        closely to the elements and protocol determined 
                        to be most effective in other recovery coaching 
                        programs that have been rigorously evaluated 
                        and shown to increase family reunification and 
                        protect children; and
                            ``(ii) random assignment of parents or 
                        guardians and their children to be participants 
                        in the program or to be part of the program's 
                        control group is being carried out.
                    ``(C) Impact study.--The impact study component of 
                the evaluation shall determine the impacts of the 
                family recovery and reunification program conducted 
                under the project on the parents and guardians and 
                their children participating in the program. The impact 
                study component shall--
                            ``(i) be conducted using an experimental 
                        design that uses a random assignment research 
                        methodology;
                            ``(ii) consistent with previous studies of 
                        other recovery coaching programs that have been 
                        rigorously evaluated and shown to increase 
                        family reunification and protect children, 
                        measure outcomes for parents and guardians and 
                        their children over multiple time periods, 
                        including for a period of 5 years; and
                            ``(iii) include measurements of family 
                        stability and parent, guardian, and child 
                        safety for program participants and the program 
                        control group that are consistent with 
                        measurements of such factors for participants 
                        and control groups from previous studies of 
                        other recovery coaching programs so as to allow 
                        results of the impact study to be compared with 
                        the results of such prior studies, including 
                        with respect to comparisons between program 
                        participants and the program control group 
                        regarding--
                                    ``(I) safe family reunification;
                                    ``(II) time to reunification;
                                    ``(III) permanency (such as through 
                                measures of reunification, adoption, or 
                                placement with guardians);
                                    ``(IV) safety (such as through 
                                measures of subsequent maltreatment);
                                    ``(V) parental or guardian 
                                treatment persistence and engagement;
                                    ``(VI) parental or guardian 
                                substance use;
                                    ``(VII) juvenile delinquency;
                                    ``(VIII) cost; and
                                    ``(IX) other measurements agreed 
                                upon by the Secretary and the entity or 
                                entities operating the family recovery 
                                and reunification program under the 
                                project.
                    ``(D) Implementation study.--The implementation 
                study component of the evaluation shall be conducted 
                concurrently with the conduct of the impact study 
                component and shall include, in addition to such other 
                information as the Secretary may determine, 
                descriptions and analyses of--
                            ``(i) the adherence of the family recovery 
                        and reunification program conducted under the 
                        project to other recovery coaching programs 
                        that have been rigorously evaluated and shown 
                        to increase family reunification and protect 
                        children; and
                            ``(ii) the difference in services received 
                        or proposed to be received by the program 
                        participants and the program control group.
                    ``(E) Report.--The Secretary shall publish on an 
                internet website maintained by the Secretary the 
                following information:
                            ``(i) A report on the pilot phase component 
                        of the evaluation.
                            ``(ii) A report on the impact study 
                        component of the evaluation.
                            ``(iii) A report on the implementation 
                        study component of the evaluation.
                            ``(iv) A report that includes--
                                    ``(I) analyses of the extent to 
                                which the program has resulted in 
                                increased reunifications, increased 
                                permanency, case closures, net savings 
                                to the State or States involved (taking 
                                into account both costs borne by States 
                                and the Federal government), or other 
                                outcomes, or if the program did not 
                                produce such outcomes, an analysis of 
                                why the replication of the program did 
                                not yield such results;
                                    ``(II) if, based on such analyses, 
                                the Secretary determines the program 
                                should be replicated, a replication 
                                plan; and
                                    ``(III) such recommendations for 
                                legislation and administrative action 
                                as the Secretary determines 
                                appropriate.
            ``(5) Appropriation.--In addition to any amounts otherwise 
        made available to carry out this subpart, out of any money in 
        the Treasury of the United States not otherwise appropriated, 
        there are appropriated $15,000,000 for fiscal year 2019 to 
        carry out the project, which shall remain available through 
        fiscal year 2026.''.
    (b) Clarification of Payer of Last Resort Application to Child 
Welfare Prevention and Family Services.--Section 471(e)(10) of the 
Social Security Act (42 U.S.C. 671(e)(10)), as added by section 
50711(a)(2) of division E of Public Law 115-123, is amended--
            (1) in subparagraph (A), by inserting ``, nor shall the 
        provision of such services or programs be construed to permit 
        the State to reduce medical or other assistance available to a 
        recipient of such services or programs'' after ``under this 
        Act''; and
            (2) by adding at the end the following:
                    ``(C) Payer of last resort.--In carrying out its 
                responsibilities to ensure access to services or 
                programs under this subsection, the State agency shall 
                not be considered to be a legally liable third party 
                for purposes of satisfying a financial commitment for 
                the cost of providing such services or programs with 
                respect to any individual for whom such cost would have 
                been paid for from another public or private source but 
                for the enactment of this subsection (except that 
                whenever considered necessary to prevent a delay in the 
                receipt of appropriate early intervention services by a 
                child or family in a timely fashion, funds provided 
                under section 474(a)(6) may be used to pay the provider 
                of services or programs pending reimbursement from the 
                public or private source that has ultimate 
                responsibility for the payment).''.
    (c) Effective Date.--The amendments made by subsection (b) shall 
take effect as if included in section 50711 of division E of Public Law 
115-123.

SEC. 2303. BUILDING CAPACITY FOR FAMILY-FOCUSED RESIDENTIAL TREATMENT.

    (a) Definitions.--In this section:
            (1) Eligible entity.--The term ``eligible entity'' means a 
        State, county, local, or tribal health or child welfare agency, 
        a private nonprofit organization, a research organization, a 
        treatment service provider, an institution of higher education 
        (as defined under section 101 of the Higher Education Act of 
        1965 (20 U.S.C. 1001)), or another entity specified by the 
        Secretary.
            (2) Family-focused residential treatment program.--The term 
        ``family-focused residential treatment program'' means a 
        trauma-informed residential program primarily for substance use 
        disorder treatment for pregnant and postpartum women and 
        parents and guardians that allows children to reside with such 
        women or their parents or guardians during treatment to the 
        extent appropriate and applicable.
            (3) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
    (b) Support for the Development of Evidence-based Family-focused 
Residential Treatment Programs.--
            (1) Authority to award grants.--The Secretary shall award 
        grants to eligible entities for purposes of developing, 
        enhancing, or evaluating family-focused residential treatment 
        programs to increase the availability of such programs that 
        meet the requirements for promising, supported, or well-
        supported practices specified in section 471(e)(4)(C) of the 
        Social Security Act (42 U.S.C. 671(e)(4)(C))) (as added by the 
        Family First Prevention Services Act enacted under title VII of 
        division E of Public Law 115-123).
            (2) Evaluation requirement.--The Secretary shall require 
        any evaluation of a family-focused residential treatment 
        program by an eligible entity that uses funds awarded under 
        this section for all or part of the costs of the evaluation be 
        designed to assist in the determination of whether the program 
        may qualify as a promising, supported, or well-supported 
        practice in accordance with the requirements of such section 
        471(e)(4)(C).
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary to carry out this section, $20,000,000 
for fiscal year 2019, which shall remain available through fiscal year 
2023.

       Subtitle D--Synthetics Trafficking and Overdose Prevention

SEC. 2401. SHORT TITLE.

    This subtitle may be cited as the ``Synthetics Trafficking and 
Overdose Prevention Act of 2018'' or ``STOP Act of 2018''.

SEC. 2402. CUSTOMS FEES.

    (a) In General.--Section 13031(b)(9) of the Consolidated Omnibus 
Budget Reconciliation Act of 1985 (19 U.S.C. 58c(b)(9)) is amended by 
adding at the end the following:
            ``(D)(i) With respect to the processing of items that are 
        sent to the United States through the international postal 
        network by `Inbound Express Mail service' or `Inbound EMS' (as 
        that service is described in the mail classification schedule 
        referred to in section 3631 of title 39, United States Code), 
        the following payments are required:
                    ``(I) $1 per Inbound EMS item.
                    ``(II) If an Inbound EMS item is formally entered, 
                the fee provided for under subsection (a)(9), if 
                applicable.
            ``(ii) Notwithstanding section 451 of the Tariff Act of 
        1930 (19 U.S.C. 1451), the payments required by clause (i), as 
        allocated pursuant to clause (iii)(I), shall be the only 
        payments required for reimbursement of U.S. Customs and Border 
        Protection for customs services provided in connection with the 
        processing of an Inbound EMS item.
            ``(iii)(I) The payments required by clause (i)(I) shall be 
        allocated as follows:
                    ``(aa) 50 percent of the amount of the payments 
                shall be paid on a quarterly basis by the United States 
                Postal Service to the Commissioner of U.S. Customs and 
                Border Protection in accordance with regulations 
                prescribed by the Secretary of the Treasury to 
                reimburse U.S. Customs and Border Protection for 
                customs services provided in connection with the 
                processing of Inbound EMS items.
                    ``(bb) 50 percent of the amount of the payments 
                shall be retained by the Postal Service to reimburse 
                the Postal Service for services provided in connection 
                with the customs processing of Inbound EMS items.
            ``(II) Payments received by U.S. Customs and Border 
        Protection under subclause (I)(aa) shall, in accordance with 
        section 524 of the Tariff Act of 1930 (19 U.S.C. 1524), be 
        deposited in the Customs User Fee Account and used to directly 
        reimburse each appropriation for the amount paid out of that 
        appropriation for the costs incurred in providing services to 
        international mail facilities. Amounts deposited in accordance 
        with the preceding sentence shall be available until expended 
        for the provision of such services.
            ``(III) Payments retained by the Postal Service under 
        subclause (I)(bb) shall be used to directly reimburse the 
        Postal Service for the costs incurred in providing services in 
        connection with the customs processing of Inbound EMS items.
            ``(iv) Beginning in fiscal year 2021, the Secretary, in 
        consultation with the Postmaster General, may adjust, not more 
        frequently than once each fiscal year, the amount described in 
        clause (i)(I) to an amount commensurate with the costs of 
        services provided in connection with the customs processing of 
        Inbound EMS items, consistent with the obligations of the 
        United States under international agreements.''.
    (b) Conforming Amendments.--Section 13031(a) of the Consolidated 
Omnibus Budget Reconciliation Act of 1985 (19 U.S.C. 58c(a)) is 
amended--
            (1) in paragraph (6), by inserting ``(other than an item 
        subject to a fee under subsection (b)(9)(D))'' after ``customs 
        officer''; and
            (2) in paragraph (10)--
                    (A) in subparagraph (C), in the matter preceding 
                clause (i), by inserting ``(other than Inbound EMS 
                items described in subsection (b)(9)(D))'' after 
                ``release''; and
                    (B) in the flush at the end, by inserting ``or of 
                Inbound EMS items described in subsection (b)(9)(D),'' 
                after ``(C),''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on January 1, 2020.

SEC. 2403. MANDATORY ADVANCE ELECTRONIC INFORMATION FOR POSTAL 
              SHIPMENTS.

    (a) Mandatory Advance Electronic Information.--
            (1) In general.--Section 343(a)(3)(K) of the Trade Act of 
        2002 (Public Law 107-210; 19 U.S.C. 2071 note) is amended to 
        read as follows:
                    ``(K)(i) The Secretary shall prescribe regulations 
                requiring the United States Postal Service to transmit 
                the information described in paragraphs (1) and (2) to 
                the Commissioner of U.S. Customs and Border Protection 
                for international mail shipments by the Postal Service 
                (including shipments to the Postal Service from foreign 
                postal operators that are transported by private 
                carrier) consistent with the requirements of this 
                subparagraph.
                    ``(ii) In prescribing regulations under clause (i), 
                the Secretary shall impose requirements for the 
                transmission to the Commissioner of information 
                described in paragraphs (1) and (2) for mail shipments 
                described in clause (i) that are comparable to the 
                requirements for the transmission of such information 
                imposed on similar non-mail shipments of cargo, taking 
                into account the parameters set forth in subparagraphs 
                (A) through (J).
                    ``(iii) The regulations prescribed under clause (i) 
                shall require the transmission of the information 
                described in paragraphs (1) and (2) with respect to a 
                shipment as soon as practicable in relation to the 
                transportation of the shipment, consistent with 
                subparagraph (H).
                    ``(iv) Regulations prescribed under clause (i) 
                shall allow for the requirements for the transmission 
                to the Commissioner of information described in 
                paragraphs (1) and (2) for mail shipments described in 
                clause (i) to be implemented in phases, as appropriate, 
                by--
                            ``(I) setting incremental targets for 
                        increasing the percentage of such shipments for 
                        which information is required to be transmitted 
                        to the Commissioner; and
                            ``(II) taking into consideration--
                                    ``(aa) the risk posed by such 
                                shipments;
                                    ``(bb) the volume of mail shipped 
                                to the United States by or through a 
                                particular country; and
                                    ``(cc) the capacities of foreign 
                                postal operators to provide that 
                                information to the Postal Service.
                    ``(v)(I) Notwithstanding clause (iv), the Postal 
                Service shall, not later than December 31, 2018, 
                arrange for the transmission to the Commissioner of the 
                information described in paragraphs (1) and (2) for not 
                less than 70 percent of the aggregate number of mail 
                shipments, including 100 percent of mail shipments from 
                the People's Republic of China, described in clause 
                (i).
                    ``(II) If the requirements of subclause (I) are not 
                met, the Comptroller General of the United States shall 
                submit to the appropriate congressional committees, not 
                later than June 30, 2019, a report--
                            ``(aa) assessing the reasons for the 
                        failure to meet those requirements; and
                            ``(bb) identifying recommendations to 
                        improve the collection by the Postal Service of 
                        the information described in paragraphs (1) and 
                        (2).
                    ``(vi)(I) Notwithstanding clause (iv), the Postal 
                Service shall, not later than December 31, 2020, 
                arrange for the transmission to the Commissioner of the 
                information described in paragraphs (1) and (2) for 100 
                percent of the aggregate number of mail shipments 
                described in clause (i).
                    ``(II) The Commissioner, in consultation with the 
                Postmaster General, may determine to exclude a country 
                from the requirement described in subclause (I) to 
                transmit information for mail shipments described in 
                clause (i) from the country if the Commissioner 
                determines that the country--
                            ``(aa) does not have the capacity to 
                        collect and transmit such information;
                            ``(bb) represents a low risk for mail 
                        shipments that violate relevant United States 
                        laws and regulations; and
                            ``(cc) accounts for low volumes of mail 
                        shipments that can be effectively screened for 
                        compliance with relevant United States laws and 
                        regulations through an alternate means.
                    ``(III) The Commissioner shall, at a minimum on an 
                annual basis, re-evaluate any determination made under 
                subclause (II) to exclude a country from the 
                requirement described in subclause (I). If, at any 
                time, the Commissioner determines that a country no 
                longer meets the requirements under subclause (II), the 
                Commissioner may not further exclude the country from 
                the requirement described in subclause (I).
                    ``(IV) The Commissioner shall, on an annual basis, 
                submit to the appropriate congressional committees--
                            ``(aa) a list of countries with respect to 
                        which the Commissioner has made a determination 
                        under subclause (II) to exclude the countries 
                        from the requirement described in subclause 
                        (I); and
                            ``(bb) information used to support such 
                        determination with respect to such countries.
                    ``(vii)(I) The Postmaster General shall, in 
                consultation with the Commissioner, refuse any 
                shipments received after December 31, 2020, for which 
                the information described in paragraphs (1) and (2) is 
                not transmitted as required under this subparagraph, 
                except as provided in subclause (II).
                    ``(II) If remedial action is warranted in lieu of 
                refusal of shipments pursuant to subclause (I), the 
                Postmaster General and the Commissioner shall take 
                remedial action with respect to the shipments, 
                including destruction, seizure, controlled delivery or 
                other law enforcement initiatives, or correction of the 
                failure to provide the information described in 
                paragraphs (1) and (2) with respect to the shipment.
                    ``(viii) Nothing in this subparagraph shall be 
                construed to limit the authority of the Secretary to 
                obtain information relating to international mail 
                shipments from private carriers or other appropriate 
                parties.
                    ``(ix) In this subparagraph, the term `appropriate 
                congressional committees' means--
                            ``(I) the Committee on Finance and the 
                        Committee on Homeland Security and Governmental 
                        Affairs of the Senate; and
                            ``(II) the Committee on Ways and Means, the 
                        Committee on Oversight and Government Reform, 
                        and the Committee on Homeland Security of the 
                        House of Representatives.''.
            (2) Joint strategic plan on mandatory advance 
        information.--Not later than 60 days after the date of the 
        enactment of this Act, the Secretary of Homeland Security and 
        the Postmaster General shall develop and submit to the 
        appropriate congressional committees a joint strategic plan 
        detailing specific performance measures for achieving--
                    (A) the transmission of information as required by 
                section 343(a)(3)(K) of the Trade Act of 2002, as 
                amended by paragraph (1); and
                    (B) the presentation by the Postal Service to U.S. 
                Customs and Border Protection of all mail targeted by 
                U.S. Customs and Border Protection for inspection.
    (b) Capacity Building.--
            (1) In general.--Section 343(a) of the Trade Act of 2002 
        (Public Law 107-210; 19 U.S.C. 2071 note) is amended by adding 
        at the end the following:
            ``(5) Capacity building.--
                    ``(A) In general.--The Secretary, with the 
                concurrence of the Secretary of State, and in 
                coordination with the Postmaster General and the heads 
                of other Federal agencies, as appropriate, may provide 
                technical assistance, equipment, technology, and 
                training to enhance the capacity of foreign postal 
                operators--
                            ``(i) to gather and provide the information 
                        required by paragraph (3)(K); and
                            ``(ii) to otherwise gather and provide 
                        postal shipment information related to--
                                    ``(I) terrorism;
                                    ``(II) items the importation or 
                                introduction of which into the United 
                                States is prohibited or restricted, 
                                including controlled substances; and
                                    ``(III) such other concerns as the 
                                Secretary determines appropriate.
                    ``(B) Provision of equipment and technology.--With 
                respect to the provision of equipment and technology 
                under subparagraph (A), the Secretary may lease, loan, 
                provide, or otherwise assist in the deployment of such 
                equipment and technology under such terms and 
                conditions as the Secretary may prescribe, including 
                nonreimbursable loans or the transfer of ownership of 
                equipment and technology.''.
            (2) Joint strategic plan on capacity building.--Not later 
        than one year after the date of the enactment of this Act, the 
        Secretary of Homeland Security and the Postmaster General 
        shall, in consultation with the Secretary of State, jointly 
        develop and submit to the appropriate congressional committees 
        a joint strategic plan--
                    (A) detailing the extent to which U.S. Customs and 
                Border Protection and the United States Postal Service 
                are engaged in capacity building efforts under section 
                343(a)(5) of the Trade Act of 2002, as added by 
                paragraph (1);
                    (B) describing plans for future capacity building 
                efforts; and
                    (C) assessing how capacity building has increased 
                the ability of U.S. Customs and Border Protection and 
                the Postal Service to advance the goals of this 
                subtitle and the amendments made by this subtitle.
    (c) Report and Consultations by Secretary of Homeland Security and 
Postmaster General.--
            (1) Report.--Not later than 180 days after the date of the 
        enactment of this Act, and annually thereafter until 3 years 
        after the Postmaster General has met the requirement under 
        clause (vi) of subparagraph (K) of section 343(a)(3) of the 
        Trade Act of 2002, as amended by subsection (a)(1), the 
        Secretary of Homeland Security and the Postmaster General 
        shall, in consultation with the Secretary of State, jointly 
        submit to the appropriate congressional committees a report on 
        compliance with that subparagraph that includes the following:
                    (A) An assessment of the status of the regulations 
                required to be promulgated under that subparagraph.
                    (B) An update regarding new and existing agreements 
                reached with foreign postal operators for the 
                transmission of the information required by that 
                subparagraph.
                    (C) A summary of deliberations between the United 
                States Postal Service and foreign postal operators with 
                respect to issues relating to the transmission of that 
                information.
                    (D) A summary of the progress made in achieving the 
                transmission of that information for the percentage of 
                shipments required by that subparagraph.
                    (E) An assessment of the quality of that 
                information being received by foreign postal operators, 
                as determined by the Secretary of Homeland Security, 
                and actions taken to improve the quality of that 
                information.
                    (F) A summary of policies established by the 
                Universal Postal Union that may affect the ability of 
                the Postmaster General to obtain the transmission of 
                that information.
                    (G) A summary of the use of technology to detect 
                illicit synthetic opioids and other illegal substances 
                in international mail parcels and planned acquisitions 
                and advancements in such technology.
                    (H) Such other information as the Secretary of 
                Homeland Security and the Postmaster General consider 
                appropriate with respect to obtaining the transmission 
                of information required by that subparagraph.
            (2) Consultations.--Not later than 180 days after the date 
        of the enactment of this Act, and every 180 days thereafter 
        until the Postmaster General has met the requirement under 
        clause (vi) of section 343(a)(3)(K) of the Trade Act of 2002, 
        as amended by subsection (a)(1), to arrange for the 
        transmission of information with respect to 100 percent of the 
        aggregate number of mail shipments described in clause (i) of 
        that section, the Secretary of Homeland Security and the 
        Postmaster General shall provide briefings to the appropriate 
        congressional committees on the progress made in achieving the 
        transmission of that information for that percentage of 
        shipments.
    (d) Government Accountability Office Report.--Not later than June 
30, 2019, the Comptroller General of the United States shall submit to 
the appropriate congressional committees a report--
            (1) assessing the progress of the United States Postal 
        Service in achieving the transmission of the information 
        required by subparagraph (K) of section 343(a)(3) of the Trade 
        Act of 2002, as amended by subsection (a)(1), for the 
        percentage of shipments required by that subparagraph;
            (2) assessing the quality of the information received from 
        foreign postal operators for targeting purposes;
            (3) assessing the specific percentage of targeted mail 
        presented by the Postal Service to U.S. Customs and Border 
        Protection for inspection;
            (4) describing the costs of collecting the information 
        required by such subparagraph (K) from foreign postal operators 
        and the costs of implementing the use of that information;
            (5) assessing the benefits of receiving that information 
        with respect to international mail shipments;
            (6) assessing the feasibility of assessing a customs fee 
        under section 13031(b)(9) of the Consolidated Omnibus Budget 
        Reconciliation Act of 1985, as amended by section 2402, on 
        international mail shipments other than Inbound Express Mail 
        service in a manner consistent with the obligations of the 
        United States under international agreements; and
            (7) identifying recommendations, including recommendations 
        for legislation, to improve the compliance of the Postal 
        Service with such subparagraph (K), including an assessment of 
        whether the detection of illicit synthetic opioids in the 
        international mail would be improved by--
                    (A) requiring the Postal Service to serve as the 
                consignee for international mail shipments containing 
                goods; or
                    (B) designating a customs broker to act as an 
                importer of record for international mail shipments 
                containing goods.
    (e) Technical Correction.--Section 343 of the Trade Act of 2002 
(Public Law 107-210; 19 U.S.C. 2071 note) is amended in the section 
heading by striking ``advanced'' and inserting ``advance''.
    (f) Appropriate Congressional Committees Defined.--In this section, 
the term ``appropriate congressional committees'' means--
            (1) the Committee on Finance and the Committee on Homeland 
        Security and Governmental Affairs of the Senate; and
            (2) the Committee on Ways and Means, the Committee on 
        Oversight and Government Reform, and the Committee on Homeland 
        Security of the House of Representatives.

SEC. 2404. INTERNATIONAL POSTAL AGREEMENTS.

    (a) Existing Agreements.--
            (1) In general.--In the event that any provision of this 
        subtitle, or any amendment made by this subtitle, is determined 
        to be in violation of obligations of the United States under 
        any postal treaty, convention, or other international agreement 
        related to international postal services, or any amendment to 
        such an agreement, the Secretary of State should negotiate to 
        amend the relevant provisions of the agreement so that the 
        United States is no longer in violation of the agreement.
            (2) Rule of construction.--Nothing in this subsection shall 
        be construed to permit delay in the implementation of this 
        subtitle or any amendment made by this subtitle.
    (b) Future Agreements.--
            (1) Consultations.--Before entering into, on or after the 
        date of the enactment of this Act, any postal treaty, 
        convention, or other international agreement related to 
        international postal services, or any amendment to such an 
        agreement, that is related to the ability of the United States 
        to secure the provision of advance electronic information by 
        foreign postal operators, the Secretary of State should consult 
        with the appropriate congressional committees (as defined in 
        section 2403(f)).
            (2) Expedited negotiation of new agreement.--To the extent 
        that any new postal treaty, convention, or other international 
        agreement related to international postal services would 
        improve the ability of the United States to secure the 
        provision of advance electronic information by foreign postal 
        operators as required by regulations prescribed under section 
        343(a)(3)(K) of the Trade Act of 2002, as amended by section 
        2403(a)(1), the Secretary of State should expeditiously 
        conclude such an agreement.

SEC. 2405. COST RECOUPMENT.

    (a) In General.--The United States Postal Service shall, to the 
extent practicable and otherwise recoverable by law, ensure that all 
costs associated with complying with this subtitle and amendments made 
by this subtitle are charged directly to foreign shippers or foreign 
postal operators.
    (b) Costs Not Considered Revenue.--The recovery of costs under 
subsection (a) shall not be deemed revenue for purposes of subchapter I 
and II of chapter 36 of title 39, United States Code, or regulations 
prescribed under that chapter.

SEC. 2406. DEVELOPMENT OF TECHNOLOGY TO DETECT ILLICIT NARCOTICS.

    (a) In General.--The Postmaster General and the Commissioner of 
U.S. Customs and Border Protection, in coordination with the heads of 
other agencies as appropriate, shall collaborate to identify and 
develop technology for the detection of illicit fentanyl, other 
synthetic opioids, and other narcotics and psychoactive substances 
entering the United States by mail.
    (b) Outreach to Private Sector.--The Postmaster General and the 
Commissioner shall conduct outreach to private sector entities to 
gather information regarding the current state of technology to 
identify areas for innovation relating to the detection of illicit 
fentanyl, other synthetic opioids, and other narcotics and psychoactive 
substances entering the United States.

SEC. 2407. CIVIL PENALTIES FOR POSTAL SHIPMENTS.

    Section 436 of the Tariff Act of 1930 (19 U.S.C. 1436) is amended 
by adding at the end the following new subsection:
    ``(e) Civil Penalties for Postal Shipments.--
            ``(1) Civil penalty.--A civil penalty shall be imposed 
        against the United States Postal Service if the Postal Service 
        accepts a shipment in violation of section 343(a)(3)(K)(vii)(I) 
        of the Trade Act of 2002.
            ``(2) Modification of civil penalty.--
                    ``(A) In general.--U.S. Customs and Border 
                Protection shall reduce or dismiss a civil penalty 
                imposed pursuant to paragraph (1) if U.S. Customs and 
                Border Protection determines that the United States 
                Postal Service--
                            ``(i) has a low error rate in compliance 
                        with section 343(a)(3)(K) of the Trade Act of 
                        2002;
                            ``(ii) is cooperating with U.S. Customs and 
                        Border Protection with respect to the violation 
                        of section 343(a)(3)(K)(vii)(I) of the Trade 
                        Act of 2002; or
                            ``(iii) has taken remedial action to 
                        prevent future violations of section 
                        343(a)(3)(K)(vii)(I) of the Trade Act of 2002.
                    ``(B) Written notification.--U.S. Customs and 
                Border Protection shall issue a written notification to 
                the Postal Service with respect to each exercise of the 
                authority of subparagraph (A) to reduce or dismiss a 
                civil penalty imposed pursuant to paragraph (1).
            ``(3) Ongoing lack of compliance.--If U.S. Customs and 
        Border Protection determines that the United States Postal 
        Service--
                    ``(A) has repeatedly committed violations of 
                section 343(a)(3)(K)(vii)(I) of the Trade Act of 2002,
                    ``(B) has failed to cooperate with U.S. Customs and 
                Border Protection with respect to violations of section 
                343(a)(3)(K)(vii)(I) of the Trade Act of 2002, and
                    ``(C) has an increasing error rate in compliance 
                with section 343(a)(3)(K) of the Trade Act of 2002,
        civil penalties may be imposed against the United States Postal 
        Service until corrective action, satisfactory to U.S. Customs 
        and Border Protection, is taken.''.

SEC. 2408. REPORT ON VIOLATIONS OF ARRIVAL, REPORTING, ENTRY, AND 
              CLEARANCE REQUIREMENTS AND FALSITY OR LACK OF MANIFEST.

    (a) In General.--The Commissioner of U.S. Customs and Border 
Protection shall submit to the appropriate congressional committees an 
annual report that contains the information described in subsection (b) 
with respect to each violation of section 436 of the Tariff Act of 1930 
(19 U.S.C. 1436), as amended by section 7, and section 584 of such Act 
(19 U.S.C. 1584) that occurred during the previous year.
    (b) Information Described.--The information described in this 
subsection is the following:
            (1) The name and address of the violator.
            (2) The specific violation that was committed.
            (3) The location or port of entry through which the items 
        were transported.
            (4) An inventory of the items seized, including a 
        description of the items and the quantity seized.
            (5) The location from which the items originated.
            (6) The entity responsible for the apprehension or seizure, 
        organized by location or port of entry.
            (7) The amount of penalties assessed by U.S. Customs and 
        Border Protection, organized by name of the violator and 
        location or port of entry.
            (8) The amount of penalties that U.S. Customs and Border 
        Protection could have levied, organized by name of the violator 
        and location or port of entry.
            (9) The rationale for negotiating lower penalties, 
        organized by name of the violator and location or port of 
        entry.
    (c) Appropriate Congressional Committees Defined.--In this section, 
the term ``appropriate congressional committees'' means--
            (1) the Committee on Finance and the Committee on Homeland 
        Security and Governmental Affairs of the Senate; and
            (2) the Committee on Ways and Means, the Committee on 
        Oversight and Government Reform, and the Committee on Homeland 
        Security of the House of Representatives.

SEC. 2409. EFFECTIVE DATE; REGULATIONS.

    (a) Effective Date.--This subtitle and the amendments made by this 
subtitle (other than the amendments made by section 2402) shall take 
effect on the date of the enactment of this Act.
    (b) Regulations.--Not later than one year after the date of the 
enactment of this Act, such regulations as are necessary to carry out 
this subtitle and the amendments made by this subtitle shall be 
prescribed.

                          TITLE III--JUDICIARY

             Subtitle A--Access to Increased Drug Disposal

SEC. 3101. SHORT TITLE.

    This subtitle may be cited as the ``Access to Increased Drug 
Disposal Act of 2018''.

SEC. 3102. DEFINITIONS.

    In this subtitle--
            (1) the term ``Attorney General'' means the Attorney 
        General, acting through the Assistant Attorney General for the 
        Office of Justice Programs;
            (2) the term ``authorized collector'' means a narcotic 
        treatment program, a hospital or clinic with an on-site 
        pharmacy, a retail pharmacy, or a reverse distributor, that is 
        authorized as a collector under section 1317.40 of title 21, 
        Code of Federal Regulations (or any successor regulation);
            (3) the term ``covered grant'' means a grant awarded under 
        section 3003; and
            (4) the term ``eligible collector'' means a person who is 
        eligible to be an authorized collector.

SEC. 3103. AUTHORITY TO MAKE GRANTS.

    The Attorney General shall award grants to States to enable the 
States to increase the participation of eligible collectors as 
authorized collectors.

SEC. 3104. APPLICATION.

    A State desiring a covered grant shall submit to the Attorney 
General an application that, at a minimum--
            (1) identifies the single State agency that oversees 
        pharmaceutical care and will be responsible for complying with 
        the requirements of the grant;
            (2) details a plan to increase participation rates of 
        eligible collectors as authorized collectors; and
            (3) describes how the State will select eligible collectors 
        to be served under the grant.

SEC. 3105. USE OF GRANT FUNDS.

    A State that receives a covered grant, and any subrecipient of the 
grant, may use the grant amounts only for the costs of installation, 
maintenance, training, purchasing, and disposal of controlled 
substances associated with the participation of eligible collectors as 
authorized collectors.

SEC. 3106. ELIGIBILITY FOR GRANT.

    The Attorney General shall award a covered grant to 5 States, not 
less than 3 of which shall be States in the lowest quartile of States 
based on the participation rate of eligible collectors as authorized 
collectors, as determined by the Attorney General.

SEC. 3107. DURATION OF GRANTS.

    The Attorney General shall determine the period of years for which 
a covered grant is made to a State.

SEC. 3108. ACCOUNTABILITY AND OVERSIGHT.

    A State that receives a covered grant shall submit to the Attorney 
General a report, at such time and in such manner as the Attorney 
General may reasonably require, that--
            (1) lists the ultimate recipients of the grant amounts;
            (2) describes the activities undertaken by the State using 
        the grant amounts; and
            (3) contains performance measures relating to the 
        effectiveness of the grant, including changes in the 
        participation rate of eligible collectors as authorized 
        collectors.

SEC. 3109. DURATION OF PROGRAM.

    The Attorney General may award covered grants for each of the first 
5 fiscal years beginning after the date of enactment of this Act.

SEC. 3110. AUTHORIZATION OF APPROPRIATIONS.

    There is authorized to be appropriated to the Attorney General such 
sums as may be necessary to carry out this subtitle.

           Subtitle B--Using Data To Prevent Opioid Diversion

SEC. 3201. SHORT TITLE.

    This subtitle may be cited as the ``Using Data to Prevent Opioid 
Diversion Act of 2018''.

SEC. 3202. PURPOSE.

    (a) In General.--The purpose of this subtitle is to provide drug 
manufacturers and distributors with access to anonymized information 
through the Automated Reports and Consolidated Orders System to help 
drug manufacturers and distributors identify, report, and stop 
suspicious orders of opioids and reduce diversion rates.
    (b) Rule of Construction.--Nothing in this subtitle should be 
construed to absolve a drug manufacturer, drug distributor, or other 
Drug Enforcement Administration registrant from the responsibility of 
the manufacturer, distributor, or other registrant to--
            (1) identify, stop, and report suspicious orders; or
            (2) maintain effective controls against diversion in 
        accordance with section 303 of the Controlled Substances Act 
        (21 U.S.C. 823) or any successor law or associated regulation.

SEC. 3203. AMENDMENTS.

    (a) Records and Reports of Registrants.--Section 307 of the 
Controlled Substances Act (21 U.S.C. 827) is amended--
            (1) by redesignating subsections (f), (g), and (h) as 
        subsections (g), (h), and (i), respectively;
            (2) by inserting after subsection (e) the following:
    ``(f)(1) The Attorney General shall, not less frequently than 
quarterly, make the following information available to manufacturer and 
distributor registrants through the Automated Reports and Consolidated 
Orders System, or any subsequent automated system developed by the Drug 
Enforcement Administration to monitor selected controlled substances:
            ``(A) The total number of distributor registrants that 
        distribute controlled substances to a pharmacy or practitioner 
        registrant, aggregated by the name and address of each pharmacy 
        and practitioner registrant.
            ``(B) The total quantity and type of opioids distributed, 
        listed by Administration Controlled Substances Code Number, to 
        each pharmacy and practitioner registrant described in 
        subparagraph (A).
    ``(2) The information required to be made available under paragraph 
(1) shall be made available not later than the 15th day of the first 
month following the quarter to which the information relates.
    ``(3)(A) All registered manufacturers and distributors shall be 
responsible for reviewing the information made available by the 
Attorney General under this subsection.
    ``(B) In determining whether to initiate proceedings under this 
title against a registered manufacturer or distributor based on the 
failure of the registrant to maintain effective controls against 
diversion or otherwise comply with the requirements of this title or 
the regulations issued thereunder, the Attorney General may take into 
account that the information made available under this subsection was 
available to the registrant.''; and
            (3) by inserting after subsection (i), as so redesignated, 
        the following:
    ``(j) All of the reports required under this section shall be 
provided in an electronic format.''.
    (b) Cooperative Arrangements.--Section 503 of the Controlled 
Substances Act (21 U.S.C. 873) is amended--
            (1) by striking subsection (c) and inserting the following:
    ``(c)(1) The Attorney General shall, once every 6 months, prepare 
and make available to regulatory, licensing, attorneys general, and law 
enforcement agencies of States a standardized report containing 
descriptive and analytic information on the actual distribution 
patterns, as gathered through the Automated Reports and Consolidated 
Orders System, or any subsequent automated system, pursuant to section 
307 and which includes detailed amounts, outliers, and trends of 
distributor and pharmacy registrants, in such States for the controlled 
substances contained in schedule II, which, in the discretion of the 
Attorney General, are determined to have the highest abuse.
    ``(2) If the Attorney General publishes the report described in 
paragraph (1) once every 6 months as required under paragraph (1), 
nothing in this subsection shall be construed to bring an action in any 
court to challenge the sufficiency of the information or to compel the 
Attorney General to produce any documents or reports referred to in 
this subsection.''.
    (c) Civil and Criminal Penalties.--Section 402 of the Controlled 
Substances Act (21 U.S.C. 842) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (15), by striking ``or'' at the 
                end;
                    (B) in paragraph (16), by striking the period at 
                the end and inserting ``; or''; and
                    (C) by inserting after paragraph (16) the 
                following:
            ``(17) in the case of a registered manufacturer or 
        distributor of opioids, to fail to review the most recent 
        information, directly related to the customers of the 
        manufacturer or distributor, made available by the Attorney 
        General in accordance with section 307(f).''; and
            (2) in subsection (c)--
                    (A) in paragraph (1), by striking subparagraph (B) 
                and inserting the following:
    ``(B)(i) Except as provided in clause (ii), in the case of a 
violation of paragraph (5), (10), or (17) of subsection (a), the 
penalty shall not exceed $10,000.
    ``(ii) In the case of a violation described in clause (i) committed 
by a registered manufacturer or distributor of opioids and related to 
the reporting of suspicious orders for opioids, failing to maintain 
effective controls against diversion of opioids, or failing to review 
the most recent information made available by the Attorney General in 
accordance with section 307(f), the penalty shall not exceed 
$100,000.''; and
                    (B) in paragraph (2)--
                            (i) in subparagraph (A), by inserting ``or 
                        (D)'' after ``subparagraph (B)''; and
                            (ii) by adding at the end the following:
    ``(D) In the case of a violation described in subparagraph (A) that 
was a violation of paragraph (5), (10), or (17) of subsection (a) 
committed by a registered manufacturer or distributor of opioids that 
relates to the reporting of suspicious orders for opioids, failing to 
maintain effective controls against diversion of opioids, or failing to 
review the most recent information made available by the Attorney 
General in accordance with section 307(f), the criminal fine under 
title 18, United States Code, shall not exceed $500,000.''.

SEC. 3204. REPORT.

    Not later than 1 year after the date of enactment of this Act, the 
Attorney General shall submit to Congress a report that provides 
information about how the Attorney General is using data in the 
Automation of Reports and Consolidated Orders System to identify and 
stop suspicious activity, including whether the Attorney General is 
looking at aggregate orders from individual pharmacies to multiple 
distributors that in total are suspicious, even if no individual order 
rises to the level of a suspicious order to a given distributor.

                 Subtitle C--Substance Abuse Prevention

SEC. 3301. SHORT TITLE.

    This subtitle may be cited as the ``Substance Abuse Prevention Act 
of 2018''.

SEC. 3302. REAUTHORIZATION OF THE OFFICE OF NATIONAL DRUG CONTROL 
              POLICY.

    (a) Office of National Drug Control Policy Reauthorization Act of 
1998.--
            (1) In general.--The Office of National Drug Control Policy 
        Reauthorization Act of 1998 (21 U.S.C. 1701 et seq.), as in 
        effect on September 29, 2003, and as amended by the laws 
        described in paragraph (2), is revived and restored.
            (2) Laws described.--The laws described in this paragraph 
        are:
                    (A) The Office of National Drug Control Policy 
                Reauthorization Act of 2006 (Public Law 109-469; 120 
                Stat. 3502).
                    (B) The Presidential Appointment Efficiency and 
                Streamlining Act of 2011 (Public Law 112-166; 126 Stat. 
                1283).
    (b) Reauthorization.--Section 715(a) of the Office of National Drug 
Control Policy Reauthorization Act of 1998 (21 U.S.C. 1712(a)) is 
amended by striking ``2010'' and inserting ``2022''.

SEC. 3303. REAUTHORIZATION OF THE DRUG-FREE COMMUNITIES PROGRAM.

    Section 1024 of the National Narcotics Leadership Act of 1988 (21 
U.S.C. 1524(a)) is amended by striking subsections (a) and (b) and 
inserting the following:
    ``(a) In General.--There is authorized to be appropriated to the 
Office of National Drug Control Policy to carry out this chapter 
$99,000,000 for each of fiscal years 2018 through 2022.
    ``(b) Administrative Costs.--Not more than 8 percent of the funds 
appropriated to carry out this chapter may be used by the Office of 
National Drug Control Policy to pay administrative costs associated 
with the responsibilities of the Office under this chapter.''.

SEC. 3304. REAUTHORIZATION OF THE NATIONAL COMMUNITY ANTI-DRUG 
              COALITION INSTITUTE.

    Section 4(c)(4) of Public Law 107-82 (21 U.S.C. 1521 note) is 
amended by striking ``2008 through 2012'' and inserting ``2018 through 
2022''.

SEC. 3305. REAUTHORIZATION OF THE HIGH-INTENSITY DRUG TRAFFICKING AREA 
              PROGRAM.

    Section 707(p) of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1706(p)) is amended--
            (1) in paragraph (4), by striking ``and'' at the end;
            (2) in paragraph (5), by striking the period at the end and 
        inserting ``; and''; and
            (3) by adding at the end the following:
            ``(6) $280,000,000 for each of fiscal years 2018 through 
        2022.''.

SEC. 3306. REAUTHORIZATION OF DRUG COURT PROGRAM.

    Section 1001(a)(25)(A) of title I of the Omnibus Crime Control and 
Safe Streets Act of 1968 (34 U.S.C. 10261(a)(25)(A)) is amended by 
striking ``Except as provided'' and all that follows and inserting the 
following: ``Except as provided in subparagraph (C), there is 
authorized to be appropriated to carry out part EE $75,000,000 for each 
of fiscal years 2018 through 2022.''.

SEC. 3307. DRUG COURT TRAINING AND TECHNICAL ASSISTANCE.

    Section 705 of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1704) is amended by adding at 
the end the following--
    ``(e) Drug Court Training and Technical Assistance Program.--Using 
funds appropriated to carry out this title, the Director may make 
grants to nonprofit organizations for the purpose of providing training 
and technical assistance to drug courts.''.

SEC. 3308. DRUG OVERDOSE RESPONSE STRATEGY.

    Section 707 of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1706) is amended by adding at 
the end the following:
    ``(r) Drug Overdose Response Strategy Implementation.--The Director 
may use funds appropriated to carry out this section to implement a 
drug overdose response strategy in high intensity drug trafficking 
areas on a nationwide basis by--
            ``(1) coordinating multi-disciplinary efforts to prevent, 
        reduce, and respond to drug overdoses, including the uniform 
        reporting of fatal and non-fatal overdoses to public health and 
        safety officials;
            ``(2) increasing data sharing among public safety and 
        public health officials concerning drug-related abuse trends, 
        including new psychoactive substances, and related crime; and
            ``(3) enabling collaborative deployment of prevention, 
        intervention, and enforcement resources to address substance 
        use addiction and narcotics trafficking.''.

SEC. 3309. PROTECTING LAW ENFORCEMENT OFFICERS FROM ACCIDENTAL 
              EXPOSURE.

    Section 707 of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1706), as amended by section 
3308, is amended by adding at the end the following:
    ``(s) Supplemental Grants.--The Director is authorized to use not 
more than $10,000,000 of the amounts otherwise appropriated to carry 
out this section to provide supplemental competitive grants to high 
intensity drug trafficking areas that have experienced high seizures of 
fentanyl and new psychoactive substances for the purposes of--
            ``(1) purchasing portable equipment to test for fentanyl 
        and other substances;
            ``(2) training law enforcement officers and other first 
        responders on best practices for handling fentanyl and other 
        substances; and
            ``(3) purchasing protective equipment, including overdose 
        reversal drugs.''.

SEC. 3310. COPS ANTI-METH PROGRAM.

    Section 1701 of title I of the Omnibus Crime Control and Safe 
Streets Act of 1968 (34 U.S.C. 10381) is amended--
            (1) by redesignating subsection (k) as subsection (l); and
            (2) by inserting after subsection (j) the following:
    ``(k) COPS Anti-Meth Program.--The Attorney General shall use 
amounts otherwise appropriated to carry out this section to make 
competitive grants, in amounts of not less than $1,000,000 for a fiscal 
year, to State law enforcement agencies with high seizures of precursor 
chemicals, finished methamphetamine, laboratories, and laboratory dump 
seizures for the purpose of locating or investigating illicit 
activities, such as precursor diversion, laboratories, or 
methamphetamine traffickers.''.

SEC. 3311. COPS ANTI-HEROIN TASK FORCE PROGRAM.

    Section 1701 of title I of the Omnibus Crime Control and Safe 
Streets Act of 1968 (34 U.S.C. 10381) is amended--
            (1) by redesignating subsection (l), as so redesignated by 
        section 3310, as subsection (m); and
            (2) by inserting after subsection (k), as added by section 
        3310, the following:
    ``(l) Cops Anti-heroin Task Force Program.--The Attorney General 
shall use amounts otherwise appropriated to carry out this section, or 
other amounts as appropriated, to make competitive grants to State law 
enforcement agencies in States with high per capita rates of primary 
treatment admissions, for the purpose of locating or investigating 
illicit activities, through Statewide collaboration, relating to the 
distribution of heroin, fentanyl, or carfentanil or relating to the 
unlawful distribution of prescription opioids.''.

SEC. 3312. COMPREHENSIVE ADDICTION AND RECOVERY ACT EDUCATION AND 
              AWARENESS.

    Title VII of the Comprehensive Addiction and Recovery Act of 2016 
(Public Law 114-198; 130 Stat. 735) is amended by adding at the end the 
following:

``SEC. 709. SERVICES FOR FAMILIES AND PATIENTS IN CRISIS.

    ``(a) In General.--The Attorney General may make grants to entities 
that focus on addiction and substance use disorders and specialize in 
family and patient services, advocacy for patients and families, and 
educational information.
    ``(b) Allowable Uses.--A grant awarded under this section may be 
used for private, nonprofit national organizations that engage in all 
of the following activities:
            ``(1) Expansion of phone line or call center services with 
        professional, clinical staff that provide, for families and 
        individuals impacted by a substance use disorder, support, 
        access to treatment resources, brief assessments, medication 
        and overdose prevention education, compassionate listening 
        services, recovery support or peer specialists, bereavement and 
        grief support, and case management.
            ``(2) Continued development of health information 
        technology systems that leverage new and upcoming technology 
        and techniques for prevention, intervention, and filling 
        resource gaps in communities that are underserved.
            ``(3) Enhancement and operation of treatment and recovery 
        resources, easy-to-read scientific and evidence-based education 
        on addiction and substance use disorders, and other 
        informational tools for families and individuals impacted by a 
        substance use disorder and community stakeholders, such as law 
        enforcement agencies.
            ``(4) Provision of training and technical assistance to 
        State and local governments, law enforcement agencies, health 
        care systems, research institutions, and other stakeholders.
            ``(5) Expanding upon and implementing educational 
        information using evidence-based information on substance use 
        disorders.
            ``(6) Expansion of training of community stakeholders, law 
        enforcement officers, and families across a broad-range of 
        addiction, health, and related topics on substance use 
        disorders, local issues and community-specific issues related 
        to the drug epidemic.
            ``(7) Program evaluation.
    ``(c) Authorization of Appropriations.--For each of fiscal years 
2018 through 2022, the Attorney General is authorized to award not more 
than $10,000,000 of amounts otherwise appropriated to the Attorney 
General for comprehensive opioid abuse reduction activities for 
purposes of carrying out this section.''.

SEC. 3313. PROTECTING CHILDREN WITH ADDICTED PARENTS.

    Part D of title V of the Public Health Service Act (42 U.S.C. 290dd 
et seq.) is amended by adding at the end the following:

``SEC. 550. PROTECTING CHILDREN WITH ADDICTED PARENTS.

    ``(a) Best Practices.--The Secretary, acting through the Assistant 
Secretary and in cooperation with the Commissioner of the 
Administration on Children, Youth and Families, shall collect and 
disseminate best practices for States regarding interventions and 
strategies to keep families affected by a substance use disorder 
together, when it can be done safely. Such best practices shall--
            ``(1) utilize comprehensive family-centered approaches;
            ``(2) ensure that families have access to drug screening, 
        substance use disorder treatment, medication-assisted treatment 
        approved by the Food and Drug Administration, and parental 
        support; and
            ``(3) build upon lessons learned from--
                    ``(A) programs such as the maternal, infant, and 
                early childhood home visiting program under section 511 
                of the Social Security Act; and
                    ``(B) identifying substance abuse prevention and 
                treatment services that meet the requirements for 
                promising, supported, or well-supported practices 
                specified in section 471(e)(4)(C) of the Social 
                Security Act (as such section shall be in effect 
                beginning on October 1, 2018).
    ``(b) Grant Program.--The Secretary shall award grants to States, 
units of local government, and tribal governments to--
            ``(1) develop programs and models designed to keep pregnant 
        and post-partum women who have a substance use disorder 
        together with their newborns, including programs and models 
        that provide for screenings of pregnant and post-partum women 
        for substance use disorders, treatment interventions, 
        supportive housing, nonpharmacological interventions for 
        children born with neonatal abstinence syndrome, medication 
        assisted treatment, and other recovery supports; and
            ``(2) support the attendance of children who have a family 
        member living with a substance use disorder at therapeutic 
        camps or other therapeutic programs aimed at addiction 
        prevention education and delaying the onset of first use, 
        providing trusted mentors and education on coping strategies 
        that these children can use in their daily lives, and family 
        support initiatives aimed at keeping these families 
        together.''.

SEC. 3314. REIMBURSEMENT OF SUBSTANCE USE DISORDER TREATMENT 
              PROFESSIONALS.

    Not later than January 1, 2020, the Comptroller General of the 
United States shall submit to Congress a report examining how substance 
use disorder services are reimbursed.

SEC. 3315. SOBRIETY TREATMENT AND RECOVERY TEAMS (START).

    Title V of the Public Health Service Act (42 U.S.C. 290dd et seq.), 
as amended by section 3313, is further amended by adding at the end the 
following:

``SEC. 551. SOBRIETY TREATMENT AND RECOVERY TEAMS.

    ``(a) In General.--The Secretary may make grants to States, units 
of local government, or tribal governments to establish or expand 
Sobriety Treatment And Recovery Team (referred to in this section as 
`START') or other similar programs to determine the effectiveness of 
pairing social workers or mentors with families that are struggling 
with a substance use disorder and child abuse or neglect in order to 
help provide peer support, intensive treatment, and child welfare 
services to such families.
    ``(b) Allowable Uses.--A grant awarded under this section may be 
used for one or more of the following activities:
            ``(1) Training eligible staff, including social workers, 
        social services coordinators, child welfare specialists, 
        substance use disorder treatment professionals, and mentors.
            ``(2) Expanding access to substance use disorder treatment 
        services and drug testing.
            ``(3) Enhancing data sharing with law enforcement agencies, 
        child welfare agencies, substance use disorder treatment 
        providers, judges, and court personnel.
            ``(4) Program evaluation and technical assistance.
    ``(c) Program Requirements.--A State, unit of local government, or 
tribal government receiving a grant under this section shall--
            ``(1) serve only families for which--
                    ``(A) there is an open record with the child 
                welfare agency; and
                    ``(B) substance use disorder was a reason for the 
                record or finding described in paragraph (1); and
            ``(2) coordinate any grants awarded under this section with 
        any grant awarded under section 437(f) of the Social Security 
        Act focused on improving outcomes for children affected by 
        substance abuse.
    ``(d) Technical Assistance.--The Secretary may reserve not more 
than 5 percent of funds provided under this section to provide 
technical assistance on the establishment or expansion of programs 
funded under this section from the National Center on Substance Abuse 
and Child Welfare.
    ``(e) Authorization of Appropriations.--For each of fiscal years 
2018 through 2022, the Secretary is authorized to award not more than 
$10,000,000 of amounts otherwise appropriated to the Secretary for 
comprehensive opioid abuse reduction activities for purposes of 
carrying out this section.''.

SEC. 3316. PROVIDER EDUCATION.

    Not later than 60 days after the date of enactment of this Act, the 
Attorney General, in consultation with the Secretary of Health and 
Human Services, shall complete the plan related to medical registration 
coordination required by Senate Report 114-239, which accompanied the 
Veterans Care Financial Protection Act of 2017 (Public Law 115-131; 132 
Stat. 334).

SEC. 3317. DEMAND REDUCTION.

    Section 702(1) of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1701(1)) is amended--
            (1) by redesignating subparagraphs (F) through (J) as 
        subparagraphs (G) through (K), respectively; and
            (2) by inserting after subparagraph (E) the following:
                    ``(F) support for long-term recovery from substance 
                use disorders;''.

SEC. 3318. ANTI-DRUG MEDIA CAMPAIGN.

    Section 709 of the Office of National Drug Control Policy 
Reauthorization Act of 1998 (21 U.S.C. 1708) is amended--
            (1) in the section heading, by striking ``youth'';
            (2) in subsection (a)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``youth'';
                    (B) in paragraph (1), by striking ``young'';
                    (C) in paragraph (2), by striking ``of adults of 
                the impact of drug abuse on young people'' and 
                inserting ``among the population about the impact of 
                drug abuse''; and
                    (D) in paragraph (3), by striking ``parents and 
                other interested adults to discuss with young people'' 
                and inserting ``interested persons to discuss''; and
            (3) in subsection (b)(2)(C)(ii), by striking ``among 
        youth''.

SEC. 3319. TECHNICAL CORRECTIONS TO THE OFFICE OF NATIONAL DRUG CONTROL 
              POLICY REAUTHORIZATION ACT OF 1998.

    The Office of National Drug Control Policy Reauthorization Act of 
1998 (21 U.S.C. 1701 et seq.) is amended--
            (1) in section 703(b)(3)(E) (21 U.S.C. 1702(b)(3)(E))--
                    (A) in clause (i), by adding ``and'' at the end;
                    (B) in clause (ii), by striking ``; and'' and 
                inserting a period; and
                    (C) by striking clause (iii);
            (2) in section 704 (21 U.S.C. 1703)--
                    (A) in subsection (c)(3)(C)--
                            (i) in clause (v), by adding ``and'' at the 
                        end;
                            (ii) in clause (vi), by striking ``; and'' 
                        and inserting a period; and
                            (iii) by striking clause (vii); and
                    (B) in subsection (f)--
                            (i) by striking the first paragraph (5); 
                        and
                            (ii) by striking the second paragraph (4);
            (3) in section 706(a)(2)(A) (21 U.S.C. 1705(a)(2)(A))--
                    (A) by striking clause (ix); and
                    (B) by redesignating clauses (x) through (xiv) as 
                clauses (ix) through (xiii), respectively; and
            (4) by striking section 708 (21 U.S.C. 1707).

      Subtitle D--Synthetic Abuse and Labeling of Toxic Substances

SEC. 3401. SHORT TITLE.

    This subtitle may be cited as the ``Synthetic Abuse and Labeling of 
Toxic Substances Act of 2017'' or the ``SALTS Act''.

SEC. 3402. CONTROLLED SUBSTANCE ANALOGUES.

    Section 203 of the Controlled Substances Act (21 U.S.C. 813) is 
amended--
            (1) by striking ``A controlled'' and inserting ``(a) In 
        General.--A controlled''; and
            (2) by adding at the end the following:
    ``(b) Determination.--In determining whether a controlled substance 
analogue was intended for human consumption under subsection (a), 
evidence related to the following factors may be considered, along with 
all other relevant evidence:
            ``(1) The marketing, advertising, and labeling of the 
        substance.
            ``(2) The known efficacy or usefulness of the substance for 
        the marketed, advertised, or labeled purpose.
            ``(3) The difference between the price at which the 
        substance is sold and the price at which the substance it is 
        purported to be or advertised as is normally sold.
            ``(4) The diversion of the substance from legitimate 
        channels and the clandestine importation, manufacture, or 
        distribution of the substance.
            ``(5) Whether the defendant knew or should have known the 
        substance was intended to be consumed by injection, inhalation, 
        ingestion, or any other immediate means.
    ``(c) Limitation.--For purposes of this section, the existence of 
evidence that a substance was not marketed, advertised, or labeled for 
human consumption shall not preclude the Government from establishing, 
based on all the evidence, that the substance was intended for human 
consumption.''.

                    Subtitle E--Opioid Quota Reform

SEC. 3501. SHORT TITLE.

    This subtitle may be cited as the ``Opioid Quota Reform Act''.

SEC. 3502. STRENGTHENING CONSIDERATIONS FOR DEA OPIOID QUOTAS.

    (a) In General.--Section 306 of the Controlled Substances Act (21 
U.S.C. 826) is amended--
            (1) in subsection (a)--
                    (A) by inserting ``(1)'' after ``(a)'';
                    (B) in the second sentence, by striking 
                ``Production'' and inserting ``Except as provided in 
                paragraph (2), production''; and
                    (C) by adding at the end the following:
    ``(2) The Attorney General may, if the Attorney General determines 
it will assist in avoiding the overproduction, shortages, or diversion 
of a controlled substance, establish an aggregate or individual 
production quota under this subsection, or a procurement quota 
established by the Attorney General by regulation, in terms of 
pharmaceutical dosage forms prepared from or containing the controlled 
substance.'';
            (2) in subsection (b), in the first sentence, by striking 
        ``production'' and inserting ``manufacturing'';
            (3) in subsection (c), by striking ``October'' and 
        inserting ``December''; and
            (4) by adding at the end the following:
    ``(i)(1)(A) In establishing any quota under this section, or any 
procurement quota established by the Attorney General by regulation, 
for fentanyl, oxycodone, hydrocodone, oxymorphone, or hydromorphone (in 
this subsection referred to as a `covered controlled substance'), the 
Attorney General shall estimate the amount of diversion of the covered 
controlled substance that occurs in the United States.
    ``(B) In estimating diversion under this paragraph, the Attorney 
General--
            ``(i) shall consider information the Attorney General, in 
        consultation with the Secretary of Health and Human Services, 
        determines reliable on rates of overdose deaths and abuse and 
        overall public health impact related to the covered controlled 
        substance in the United States; and
            ``(ii) may take into consideration whatever other sources 
        of information the Attorney General determines reliable.
    ``(C) After estimating the amount of diversion of a covered 
controlled substance, the Attorney General shall make appropriate quota 
reductions, as determined by the Attorney General, from the quota the 
Attorney General would have otherwise established had such diversion 
not been considered.
    ``(2)(A) For any year for which the approved aggregate production 
quota for a covered controlled substance is higher than the approved 
aggregate production quota for the covered controlled substance for the 
previous year, the Attorney General shall include in the final order an 
explanation of why the public health benefits of increasing the quota 
clearly outweigh the consequences of having an increased volume of the 
covered controlled substance available for sale, and potential 
diversion, in the United States.
    ``(B) Not later than 1 year after the date of enactment of this 
subsection, and every year thereafter, the Attorney General shall 
submit to the Caucus on International Narcotics Control, the Committee 
on the Judiciary, the Committee on Health, Education, Labor, and 
Pensions, and the Committee on Appropriations of the Senate and the 
Committee on the Judiciary, the Committee on Energy and Commerce, and 
the Committee on Appropriations of the House of Representatives the 
following information with regard to each covered controlled substance:
            ``(i) An anonymized count of the total number of 
        manufacturers issued individual manufacturing quotas that year 
        for the covered controlled substance.
            ``(ii) An anonymized count of how many such manufacturers 
        were issued an approved manufacturing quota that was higher 
        than the quota issued to that manufacturer for the covered 
        controlled substance in the previous year.
    ``(3) Not later than 1 year after the date of enactment of this 
subsection, the Attorney General shall submit to Congress a report on 
how the Attorney General, when fixing and adjusting production and 
manufacturing quotas under this section for covered controlled 
substances, will--
            ``(A) take into consideration changes in the accepted 
        medical use of the covered controlled substances; and
            ``(B) work with the Secretary of Health and Human Services 
        on methods to appropriately and anonymously estimate the type 
        and amount of covered controlled substances that are submitted 
        for collection from approved drug collection receptacles, mail-
        back programs, and take-back events.''.
    (b) Conforming Change.--The Law Revision Counsel is directed to 
amend the heading for subsection (b) of section 826 of title 21, United 
States Code, by striking ``Production'' and inserting 
``Manufacturing''.

                 Subtitle F--Preventing Drug Diversion

SEC. 3601. SHORT TITLE.

    This subtitle may be cited as the ``Preventing Drug Diversion Act 
of 2018''.

SEC. 3602. IMPROVEMENTS TO PREVENT DRUG DIVERSION.

    (a) Definition.--Section 102 of the Controlled Substances Act (21 
U.S.C. 802) is amended by adding at the end the following:
            ``(57) The term `suspicious order' includes--
                    ``(A) an order of a controlled substance of unusual 
                size;
                    ``(B) an order of a controlled substance deviating 
                substantially from a normal pattern;
                    ``(C) orders of controlled substances of unusual 
                frequency; and
                    ``(D) an order having any characteristic that would 
                indicate to a reasonable registrant that it is 
                suspicious or not legitimate.''.
    (b) Suspicious Orders.--Part C of the Controlled Substances Act (21 
U.S.C. 821 et seq.) is amended by adding at the end the following:

``SEC. 312. SUSPICIOUS ORDERS.

    ``(a) Reporting.--Each registrant shall--
            ``(1) design and operate a system to identify suspicious 
        orders for the registrant;
            ``(2) ensure that the system designed and operated under 
        paragraph (1) by the registrant complies with applicable 
        Federal and State privacy laws; and
            ``(3) upon discovering a suspicious order or series of 
        orders, notify the Administrator of the Drug Enforcement 
        Administration and the Special Agent in Charge of the Division 
        Office of the Drug Enforcement Administration for the area in 
        which the registrant is located or conducts business.
    ``(b) Suspicious Order Database.--
            ``(1) In general.--Not later than 1 year after the date of 
        enactment of this section, the Attorney General shall establish 
        a centralized database for collecting reports of suspicious 
        orders.
            ``(2) Satisfaction of reporting requirements.--If a 
        registrant reports a suspicious order to the centralized 
        database established under paragraph (1), the registrant shall 
        be considered to have complied with the requirement under 
        subsection (a)(3) to notify the Administrator of the Drug 
        Enforcement Administration and the Special Agent in Charge of 
        the Division Office of the Drug Enforcement Administration for 
        the area in which the registrant is located or conducts 
        business.
    ``(c) Sharing Information With the States.--
            ``(1) In general.--The Attorney General shall prepare and 
        make available information regarding suspicious orders in a 
        State, including information in the database established under 
        subsection (b)(1), to the point of contact for purposes of 
        administrative, civil, and criminal oversight relating to the 
        diversion of controlled substances for the State, as designated 
        by the Governor or chief executive officer of the State.
            ``(2) Timing.--The Attorney General shall provide 
        information in accordance with paragraph (1) within a 
        reasonable period of time after obtaining the information.
            ``(3) Coordination.--In establishing the process for the 
        provision of information under this subsection, the Attorney 
        General shall coordinate with States to ensure that the 
        Attorney General has access to information, as permitted under 
        State law, possessed by the States relating to prescriptions 
        for controlled substances that will assist in enforcing Federal 
        law.''.
    (c) Reports to Congress.--
            (1) Definition.--In this subsection, the term ``suspicious 
        order'' has the meaning given that term in section 102 of the 
        Controlled Substances Act, as amended by this subtitle.
            (2) One time report.--Not later than 1 year after the date 
        of enactment of this Act, the Attorney General shall submit to 
        Congress a report on the reporting of suspicious orders, which 
        shall include--
                    (A) a description of the centralized database 
                established under section 312 of the Controlled 
                Substances Act, as added by this section, to collect 
                reports of suspicious orders;
                    (B) a description of the system and reports 
                established under section 312 of the Controlled 
                Substances Act, as added by this section, to share 
                information with States;
                    (C) information regarding how the Attorney General 
                used reports of suspicious orders before the date of 
                enactment of this Act and after the date of enactment 
                of this Act, including how the Attorney General 
                received the reports and what actions were taken in 
                response to the reports; and
                    (D) descriptions of the data analyses conducted on 
                reports of suspicious orders to identify, analyze, and 
                stop suspicious activity.
            (3) Additional reports.--Not later than 1 year after the 
        date of enactment of this Act, and annually thereafter until 
        the date that is 5 years after the date of enactment of this 
        Act, the Attorney General shall submit to Congress a report 
        providing, for the previous year--
                    (A) the number of reports of suspicious orders;
                    (B) a summary of actions taken in response to 
                reports, in the aggregate, of suspicious orders; and
                    (C) a description of the information shared with 
                States based on reports of suspicious orders.
            (4) One time gao report.--Not later than 1 year after the 
        date of enactment of this Act, the Comptroller General of the 
        United States, in consultation with the Administrator of the 
        Drug Enforcement Administration, shall submit to Congress a 
        report on the reporting of suspicious orders, which shall 
        include an evaluation of the utility of real-time reporting of 
        potential suspicious orders of opioids on a national level 
        using computerized algorithms, including the extent to which 
        such algorithms--
                    (A) would help ensure that potentially suspicious 
                orders are more accurately captured, identified, and 
                reported in real-time to suppliers before orders are 
                filled;
                    (B) may produce false positives of suspicious order 
                reports that could result in market disruptions for 
                legitimate orders of opioids; and
                    (C) would reduce the overall length of an 
                investigation that prevents the diversion of suspicious 
                orders of opioids.

                     Subtitle G--Sense of Congress

SEC. 3701. SENSE OF CONGRESS.

    It is the sense of Congress that:
            (1) Americans with substance use disorders often seek 
        treatment through recovery homes and clinical treatment 
        facilities that offer detoxification, risk reduction, 
        outpatient treatment, residential treatment, or rehabilitation 
        for substance use. Most of those facilities provide a critical 
        function in addressing substance misuse and abuse, particularly 
        as the incidence and prevalence of substance use disorders, and 
        drug overdose numbers continue to rise.
            (2) Despite the necessity of such treatment facilities and 
        the important services most provide, there are some bad actors 
        in the industry who, through telemarketing and other schemes, 
        actively recruit patients with private insurance so that 
        programs can bill the insurers without providing the necessary 
        treatment services. Often these ``patient brokers'' are paid 
        for each patient successfully recruited. Payments are also made 
        as a percentage of billings, which incentivizes brokers to 
        recommend patients even at low risk levels to the most 
        aggressive and most expensive treatment programs.
            (3) Unless the patient is enrolled in a Federal health care 
        program, a gap in Federal law exists with respect to patient 
        brokers who are improperly recruiting unsuspecting patients to 
        defraud insurance companies.
            (4) It is important that Congress provide a mechanism to 
        penalize these bad actors, while minding legitimate entities 
        who continue to help patients find reputable treatment 
        programs.

                           TITLE IV--COMMERCE

          Subtitle A--Fighting Opioid Abuse in Transportation

SEC. 4101. SHORT TITLE.

    This subtitle may be cited as the ``Fighting Opioid Abuse in 
Transportation Act''.

SEC. 4102. RAIL MECHANICAL EMPLOYEE CONTROLLED SUBSTANCES AND ALCOHOL 
              TESTING.

    (a) Rail Mechanical Employees.--Not later than 2 years after the 
date of enactment of this Act, the Secretary of Transportation shall 
publish a final rule in the Federal Register revising the regulations 
promulgated under section 20140 of title 49, United States Code, to 
designate a rail mechanical employee as a railroad employee responsible 
for safety-sensitive functions for purposes of that section.
    (b) Definition of Rail Mechanical Employee.--The Secretary shall 
define the term ``rail mechanical employee'' by regulation under 
subsection (a).
    (c) Savings Clause.--Nothing in this section may be construed as 
limiting or otherwise affecting the discretion of the Secretary of 
Transportation to set different requirements by railroad size or other 
factors, consistent with applicable law.

SEC. 4103. RAIL YARDMASTER CONTROLLED SUBSTANCES AND ALCOHOL TESTING.

    (a) Yardmasters.--Not later than 2 years after the date of 
enactment of this Act, the Secretary of Transportation shall publish a 
final rule in the Federal Register revising the regulations promulgated 
under section 20140 of title 49, United States Code, to designate a 
yardmaster as a railroad employee responsible for safety-sensitive 
functions for purposes of that section.
    (b) Definition of Yardmaster.--The Secretary shall define the term 
``yardmaster'' by regulation under subsection (a).
    (c) Savings Clause.--Nothing in this section may be construed as 
limiting or otherwise affecting the discretion of the Secretary of 
Transportation to set different requirements by railroad size or other 
factors, consistent with applicable law.

SEC. 4104. DEPARTMENT OF TRANSPORTATION PUBLIC DRUG AND ALCOHOL TESTING 
              DATABASE.

    (a) In General.--Subject to subsection (c), the Secretary of 
Transportation shall--
            (1) not later than March 31, 2019, establish and make 
        publicly available on its website a database of the drug and 
        alcohol testing data reported by employers for each mode of 
        transportation; and
            (2) update the database annually.
    (b) Contents.--The database under subsection (a) shall include, for 
each mode of transportation--
            (1) the total number of drug and alcohol tests by type of 
        substance tested;
            (2) the drug and alcohol test results by type of substance 
        tested;
            (3) the reason for the drug or alcohol test, such as pre-
        employment, random, post-accident, reasonable suspicion or 
        cause, return-to-duty, or follow-up, by type of substance 
        tested; and
            (4) the number of individuals who refused testing.
    (c) Commercially Sensitive Data.--The Department of Transportation 
shall not release any commercially sensitive data furnished by an 
employer under this section unless the data is aggregated or otherwise 
in a form that does not identify the employer providing the data.
    (d) Savings Clause.--Nothing in this section may be construed as 
limiting or otherwise affecting the requirements of the Secretary of 
Transportation to adhere to requirements applicable to confidential 
business information and sensitive security information, consistent 
with applicable law.

SEC. 4105. GAO REPORT ON DEPARTMENT OF TRANSPORTATION'S COLLECTION AND 
              USE OF DRUG AND ALCOHOL TESTING DATA.

    (a) In General.--Not later than 2 years after the date the 
Department of Transportation public drug and alcohol testing database 
is established under section 4104, the Comptroller General of the 
United States shall--
            (1) review the Department of Transportation Drug and 
        Alcohol Testing Management Information System; and
            (2) submit to the Committee on Commerce, Science, and 
        Transportation of the Senate and the Committee on 
        Transportation and Infrastructure of the House of 
        Representatives a report on the review, including 
        recommendations under subsection (c).
    (b) Contents.--The report under subsection (a) shall include--
            (1) a description of the process the Department of 
        Transportation uses to collect and record drug and alcohol 
        testing data submitted by employers for each mode of 
        transportation;
            (2) an assessment of whether and, if so, how the Department 
        of Transportation uses the data described in paragraph (1) in 
        carrying out its responsibilities; and
            (3) an assessment of the Department of Transportation 
        public drug and alcohol testing database under section 4104.
    (c) Recommendations.--The report under subsection (a) may include 
recommendations regarding--
            (1) how the Department of Transportation can best use the 
        data described in subsection (b)(1);
            (2) any improvements that could be made to the process 
        described in subsection (b)(1);
            (3) whether and, if so, how the Department of 
        Transportation public drug and alcohol testing database under 
        section 4104 could be made more effective; and
            (4) such other recommendations as the Comptroller General 
        considers appropriate.

SEC. 4106. TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAM; 
              ADDITION OF FENTANYL.

    (a) Mandatory Guidelines for Federal Workplace Drug Testing 
Programs.--
            (1) In general.--Not later than 180 days after the date of 
        enactment of this Act, the Secretary of Health and Human 
        Services shall determine whether a revision of the Mandatory 
        Guidelines for Federal Workplace Drug Testing Programs to 
        expand the opioid category on the list of authorized drug 
        testing to include fentanyl is justified, based on the 
        reliability and cost-effectiveness of available testing.
            (2) Revision of guidelines.--If the expansion of the opioid 
        category is determined to be justified under paragraph (1), the 
        Secretary of Health and Human Services shall--
                    (A) notify the Committee on Commerce, Science, and 
                Transportation of the Senate and the Committee on 
                Transportation and Infrastructure of the House of 
                Representatives of the determination; and
                    (B) publish in the Federal Register, not later than 
                18 months after the date of the determination under 
                that paragraph, a final notice of the revision of the 
                Mandatory Guidelines for Federal Workplace Drug Testing 
                Programs to expand the opioid category on the list of 
                authorized drug testing to include fentanyl.
            (3) Report.--If the expansion of the opioid category is 
        determined not to be justified under paragraph (1), the 
        Secretary of Health and Human Services shall submit to the 
        Committee on Commerce, Science, and Transportation of the 
        Senate and the Committee on Transportation and Infrastructure 
        of the House of Representatives a report explaining, in detail, 
        the reasons the expansion of the opioid category on the list of 
        authorized drugs to include fentanyl is not justified.
    (b) Department of Transportation Drug-testing Panel.--If the 
expansion of the opioid category is determined to be justified under 
subsection (a)(1), the Secretary of Transportation shall publish in the 
Federal Register, not later than 18 months after the date the final 
notice is published under subsection (a)(2), a final rule revising part 
40 of title 49, Code of Federal Regulations, to include fentanyl in the 
Department of Transportation's drug-testing panel, consistent with the 
Mandatory Guidelines for Federal Workplace Drug Testing Programs as 
revised by the Secretary of Health and Human Services under subsection 
(a).
    (c) Savings Provision.--Nothing in this section may be construed 
as--
            (1) delaying the publication of the notices described in 
        sections 4107 and 4108 until the Secretary of Health and Human 
        Services makes a determination or publishes a notice under this 
        section; or
            (2) limiting or otherwise affecting any authority of the 
        Secretary of Health and Human Services or the Secretary of 
        Transportation to expand the list of authorized drug testing to 
        include an additional substance.

SEC. 4107. STATUS REPORTS ON HAIR TESTING GUIDELINES.

    (a) In General.--Not later than 30 days after the date of enactment 
of this Act, and every 180 days thereafter until the date that the 
Secretary of Health and Human Services publishes in the Federal 
Register a final notice of scientific and technical guidelines for hair 
testing in accordance with section 5402(b) of the Fixing America's 
Surface Transportation Act (Public Law 114-94; 129 Stat. 1312), the 
Secretary of Health and Human Services shall submit to the Committee on 
Commerce, Science, and Transportation of the Senate and the Committee 
on Transportation and Infrastructure of the House of Representatives a 
report on--
            (1) the status of the hair testing guidelines;
            (2) an explanation for why the hair testing guidelines have 
        not been issued;
            (3) a schedule, including benchmarks, for the completion of 
        the hair testing guidelines; and
            (4) an estimated date of completion of the hair testing 
        guidelines.
    (b) Requirement.--To the extent practicable and consistent with the 
objective of the hair testing described in subsection (a) to detect 
illegal or unauthorized use of substances by the individual being 
tested, the final notice of scientific and technical guidelines under 
that subsection, as determined by the Secretary of Health and Human 
Services, shall eliminate the risk of positive test results of the 
individual being tested caused solely by the drug use of others and not 
caused by the drug use of the individual being tested.

SEC. 4108. MANDATORY GUIDELINES FOR FEDERAL WORKPLACE DRUG TESTING 
              PROGRAMS USING ORAL FLUID.

    (a) Deadline.--Not later than December 31, 2018, the Secretary of 
Health and Human Services shall publish in the Federal Register a final 
notice of the Mandatory Guidelines for Federal Workplace Drug Testing 
Programs using Oral Fluid, based on the notice of proposed mandatory 
guidelines published in the Federal Register on May 15, 2015 (80 Fed. 
Reg. 28054).
    (b) Requirement.--To the extent practicable and consistent with the 
objective of the testing described in subsection (a) to detect illegal 
or unauthorized use of substances by the individual being tested, the 
final notice of scientific and technical guidelines under that 
subsection, as determined by the Secretary of Health and Human 
Services, shall eliminate the risk of positive test results of the 
individual being tested caused solely by the drug use of others and not 
caused by the drug use of the individual being tested.
    (c) Rule of Construction.--Nothing in this section may be construed 
as requiring the Secretary of Health and Human Services to reissue a 
notice of proposed mandatory guidelines to carry out subsection (a).

SEC. 4109. ELECTRONIC RECORDKEEPING.

    (a) Deadline.--Not later than 1 year after the date of enactment of 
this Act, the Secretary of Health and Human Services shall--
            (1) ensure that each certified laboratory that requests 
        approval for the use of completely paperless electronic Federal 
        Drug Testing Custody and Control Forms from the National 
        Laboratory Certification Program's Electronic Custody and 
        Control Form systems receives approval for those completely 
        paperless electronic forms instead of forms that include any 
        combination of electronic traditional handwritten signatures 
        executed on paper forms; and
            (2) establish a deadline for a certified laboratory to 
        request approval under paragraph (1).
    (b) Savings Clause.--Nothing in this section may be construed as 
limiting or otherwise affecting any authority of the Secretary of 
Health and Human Services to grant approval to a certified laboratory 
for use of completely paperless electronic Federal Drug Testing Custody 
and Control Forms, including to grant approval outside of the process 
under subsection (a).
    (c) Electronic Signatures.--Not later than 18 months after the date 
of the deadline under subsection (a)(2), the Secretary of 
Transportation shall issue a final rule revising part 40 of title 49, 
Code of Federal Regulations, to authorize, to the extent practicable, 
the use of electronic signatures or digital signatures executed to 
electronic forms instead of traditional handwritten signatures executed 
on paper forms.

SEC. 4110. STATUS REPORTS ON COMMERCIAL DRIVER'S LICENSE DRUG AND 
              ALCOHOL CLEARINGHOUSE.

    (a) In General.--Not later than 180 days after the date of 
enactment of this Act, and biannually thereafter until the compliance 
date, the Administrator of the Federal Motor Carrier Safety 
Administration shall submit to the Committee on Commerce, Science, and 
Transportation of the Senate and the Committee on Transportation and 
Infrastructure of the House of Representatives a status report on 
implementation of the final rule for the Commercial Driver's License 
Drug and Alcohol Clearinghouse (81 Fed. Reg. 87686), including--
            (1) an updated schedule, including benchmarks, for 
        implementing the final rule as soon as practicable, but not 
        later than the compliance date; and
            (2) a description of each action the Federal Motor Carrier 
        Safety Administration is taking to implement the final rule 
        before the compliance date.
    (b) Definition of Compliance Date.--In this section, the term 
``compliance date'' means the earlier of--
            (1) January 6, 2020; or
            (2) the date that the national clearinghouse required under 
        section 31306a of title 49, United States Code, is operational.

         Subtitle B--Opioid Addiction Recovery Fraud Prevention

SEC. 4201. SHORT TITLE.

    This subtitle may be cited as the ``Opioid Addiction Recovery Fraud 
Prevention Act of 2018''.

SEC. 4202. DEFINITIONS.

    In this subtitle:
            (1) Opioid treatment product.--The term ``opioid treatment 
        product'' means a product, including any supplement or 
        medication, for use or marketed for use in the treatment, cure, 
        or prevention of an opioid use disorder.
            (2) Opioid treatment program.--The term ``opioid treatment 
        program'' means a program that provides treatment for people 
        diagnosed with, having, or purporting to have an opioid use 
        disorder.
            (3) Opioid use disorder.--The term ``opioid use disorder'' 
        means a cluster of cognitive, behavioral, or physiological 
        symptoms in which the individual continues use of opioids 
        despite significant opioid-induced problems, such as adverse 
        health effects.

SEC. 4203. FALSE OR MISLEADING REPRESENTATIONS WITH RESPECT TO OPIOID 
              TREATMENT PROGRAMS AND PRODUCTS.

    (a) Unlawful Activity.--It is unlawful to make any deceptive 
representation with respect to the cost, price, efficacy, performance, 
benefit, risk, or safety of any opioid treatment program or opioid 
treatment product.
    (b) Enforcement by the Federal Trade Commission.--
            (1) Unfair or deceptive acts or practices.--A violation of 
        subsection (a) shall be treated as a violation of a rule under 
        section 18 of the Federal Trade Commission Act (15 U.S.C. 57a) 
        regarding unfair or deceptive acts or practices.
            (2) Powers of the federal trade commission.--
                    (A) In general.--The Federal Trade Commission shall 
                enforce this section in the same manner, by the same 
                means, and with the same jurisdiction, powers, and 
                duties as though all applicable terms and provisions of 
                the Federal Trade Commission Act (15 U.S.C. 41 et seq.) 
                were incorporated into and made a part of this section.
                    (B) Privileges and immunities.--Any person who 
                violates subsection (a) shall be subject to the 
                penalties and entitled to the privileges and immunities 
                provided in the Federal Trade Commission Act as though 
                all applicable terms and provisions of the Federal 
                Trade Commission Act (15 U.S.C. 41 et seq.) were 
                incorporated and made part of this section.
    (c) Enforcement by States.--
            (1) In general.--Except as provided in paragraph (4), in 
        any case in which the attorney general of a State has reason to 
        believe that an interest of the residents of the State has been 
        or is threatened or adversely affected by any person who 
        violates subsection (a), the attorney general of the State, as 
        parens patriae, may bring a civil action on behalf of the 
        residents of the State in an appropriate district court of the 
        United States to obtain appropriate relief.
            (2) Rights of federal trade commission.--
                    (A) Notice to federal trade commission.--
                            (i) In general.--Except as provided in 
                        clause (iii), the attorney general of a State 
                        shall notify the Federal Trade Commission in 
                        writing that the attorney general intends to 
                        bring a civil action under paragraph (1) before 
                        initiating the civil action.
                            (ii) Contents.--The notification required 
                        by clause (i) with respect to a civil action 
                        shall include a copy of the complaint to be 
                        filed to initiate the civil action.
                            (iii) Exception.--If it is not feasible for 
                        the attorney general of a State to provide the 
                        notification required by clause (i) before 
                        initiating a civil action under paragraph (1), 
                        the attorney general shall notify the Federal 
                        Trade Commission immediately upon instituting 
                        the civil action.
                    (B) Intervention by federal trade commission.--The 
                Federal Trade Commission may--
                            (i) intervene in any civil action brought 
                        by the attorney general of a State under 
                        paragraph (1); and
                            (ii) upon intervening--
                                    (I) be heard on all matters arising 
                                in the civil action; and
                                    (II) file petitions for appeal.
            (3) Investigatory powers.--Nothing in this subsection shall 
        be construed to prevent the attorney general of a State from 
        exercising the powers conferred on the attorney general by the 
        laws of the State to conduct investigations, to administer 
        oaths or affirmations, or to compel the attendance of witnesses 
        or the production of documentary or other evidence.
            (4) Preemptive action by federal trade commission.--If the 
        Federal Trade Commission or the Attorney General on behalf of 
        the Commission institutes a civil action, or the Federal Trade 
        Commission institutes an administrative action, with respect to 
        a violation of subsection (a), the attorney general of a State 
        may not, during the pendency of that action, bring a civil 
        action under paragraph (1) against any defendant or respondent 
        named in the complaint of the Commission for the violation with 
        respect to which the Commission instituted such action.
            (5) Venue; service of process.--
                    (A) Venue.--Any action brought under paragraph (1) 
                may be brought in any district court of the United 
                States that meets applicable requirements relating to 
                venue under section 1391 of title 28, United States 
                Code.
                    (B) Service of process.--In an action brought under 
                paragraph (1), process may be served in any district in 
                which the defendant--
                            (i) is an inhabitant; or
                            (ii) may be found.
            (6) Actions by other state officials.--In addition to civil 
        actions brought by attorneys general under paragraph (1), any 
        other consumer protection officer of a State who is authorized 
        by the State to do so may bring a civil action under paragraph 
        (1), subject to the same requirements and limitations that 
        apply under this subsection to civil actions brought by 
        attorneys general.
    (d) Authority Preserved.--Nothing in this title shall be construed 
to limit the authority of the Federal Trade Commission or the Food and 
Drug Administration under any other provision of law.

            Attest:

                                                             Secretary.
115th CONGRESS

  2d Session

                                 H.R. 6

_______________________________________________________________________

                               AMENDMENT