[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2680 Reported in Senate (RS)]

<DOC>





                                                       Calendar No. 398
115th CONGRESS
  2d Session
                                S. 2680

                     To address the opioid crisis.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 16, 2018

Mr. Alexander (for himself, Mrs. Murray, Mr. Isakson, Mr. Cassidy, Mr. 
Heller, Mr. Manchin, Ms. Baldwin, Mr. Kaine, Ms. Heitkamp, Mrs. Capito, 
Mr. Jones, Ms. Murkowski, Mr. Hatch, Ms. Smith, Ms. Collins, Mr. Rubio, 
Mr. Casey, and Mrs. McCaskill) introduced the following bill; which was 
 read twice and referred to the Committee on Health, Education, Labor, 
                              and Pensions

                              May 7, 2018

              Reported by Mr. Alexander, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
                     To address the opioid crisis.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE; TABLE OF CONTENTS.</DELETED>

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

<DELETED>Sec. 1. Short title; table of contents.
           <DELETED>TITLE I--REAUTHORIZATION OF CURES FUNDING

<DELETED>Sec. 101. State response to the opioid abuse crisis.
               <DELETED>TITLE II--RESEARCH AND INNOVATION

<DELETED>Sec. 201. Advancing cutting-edge research.
<DELETED>Sec. 202. Pain research.
 <DELETED>TITLE III--MEDICAL PRODUCTS AND CONTROLLED SUBSTANCES SAFETY

<DELETED>Sec. 301. Clarifying FDA regulation of non-addictive pain 
                            products.
<DELETED>Sec. 302. Clarifying FDA packaging authorities.
<DELETED>Sec. 303. Strengthening FDA and CBP coordination and capacity.
<DELETED>Sec. 304. Clarifying FDA post-market authorities.
<DELETED>Sec. 305. First responder training.
<DELETED>Sec. 306. Disposal of controlled substances of a deceased 
                            hospice patient by employees of a hospice 
                            program.
<DELETED>Sec. 307. GAO study and report on hospice safe drug 
                            management.
<DELETED>Sec. 308. Delivery of a controlled substance by a pharmacy to 
                            be administered by injection, implantation, 
                            or intrathecal pump.
               <DELETED>TITLE IV--TREATMENT AND RECOVERY

<DELETED>Sec. 401. Comprehensive opioid recovery centers.
<DELETED>Sec. 402. Program to support coordination and continuation of 
                            care for drug overdose patients.
<DELETED>Sec. 403. Alternatives to opioids.
<DELETED>Sec. 404. Peer support technical assistance.
<DELETED>Sec. 405. Medication-assisted treatment for recovery from 
                            addiction.
<DELETED>Sec. 406. National recovery housing best practices.
<DELETED>Sec. 407. Addressing economic and workforce impacts of the 
                            opioid crisis.
<DELETED>Sec. 408. Youth prevention and recovery.
<DELETED>Sec. 409. Plans of safe care.
<DELETED>Sec. 410. Regulations relating to special registration for 
                            telemedicine.
<DELETED>Sec. 411. National Health Service Corps behavioral and mental 
                            health professionals providing obligated 
                            service in schools and other community-
                            based settings.
<DELETED>Sec. 412. Loan repayment for substance use disorder treatment 
                            providers.
<DELETED>Sec. 413. Improving treatment for pregnant and postpartum 
                            women.
<DELETED>Sec. 414. Early interventions for pregnant women and infants.
                      <DELETED>TITLE V--PREVENTION

<DELETED>Sec. 501. Study on prescribing limits.
<DELETED>Sec. 502. Programs for health care workforce.
<DELETED>Sec. 503. Education and awareness campaigns.
<DELETED>Sec. 504. Enhanced controlled substance overdoses data 
                            collection, analysis, and dissemination.
<DELETED>Sec. 505. Preventing overdoses of controlled substances.
<DELETED>Sec. 506. CDC surveillance and data collection for child, 
                            youth, and adult trauma.
<DELETED>Sec. 507. Reauthorization of NASPER.
<DELETED>Sec. 508. Jessie's Law.
<DELETED>Sec. 509. Development and dissemination of model training 
                            programs for substance use disorder patient 
                            records.
<DELETED>Sec. 510. Communication with families during emergencies.
<DELETED>Sec. 511. Prenatal and postnatal health.
<DELETED>Sec. 512. Surveillance and education regarding infections 
                            associated with injection drug use and 
                            other risk factors.
<DELETED>Sec. 513. Task force to develop best practices for trauma-
                            informed identification, referral, and 
                            support.
<DELETED>Sec. 514. Grants to improve trauma support services and mental 
                            health care for children and youth in 
                            educational settings.
<DELETED>Sec. 515. National Child Traumatic Stress Initiative.

      <DELETED>TITLE I--REAUTHORIZATION OF CURES FUNDING</DELETED>

<DELETED>SEC. 101. STATE RESPONSE TO THE OPIOID ABUSE CRISIS.</DELETED>

<DELETED>    (a) In General.--Section 1003 of the 21st Century Cures 
Act (Public Law 114-255) is amended--</DELETED>
        <DELETED>    (1) in subsection (a)--</DELETED>
                <DELETED>    (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</DELETED>
                <DELETED>    (B) by inserting after ``and Indian 
                tribes'' after ``States'';</DELETED>
        <DELETED>    (2) by striking subsection (b);</DELETED>
        <DELETED>    (3) by redesignating subsections (c) through (e) 
        as subsections (b) through (d), respectively;</DELETED>
        <DELETED>    (4) by redesignating subsection (f) as subsection 
        (j);</DELETED>
        <DELETED>    (5) in subsection (b), as so redesignated--
        </DELETED>
                <DELETED>    (A) in paragraph (1)--</DELETED>
                        <DELETED>    (i) in the paragraph heading, by 
                        inserting ``and indian tribe'' after 
                        ``State'';</DELETED>
                        <DELETED>    (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'';</DELETED>
                        <DELETED>    (iii) by inserting ``or Indian 
                        tribes'' after ``preference to States''; 
                        and</DELETED>
                        <DELETED>    (iv) by inserting before the 
                        period of the second sentence ``or other Indian 
                        tribes, as applicable''; and</DELETED>
                <DELETED>    (B) in paragraph (2)--</DELETED>
                        <DELETED>    (i) in the matter preceding 
                        subparagraph (A), by striking ``to a 
                        State'';</DELETED>
                        <DELETED>    (ii) in subparagraph (A), by 
                        striking ``State'';</DELETED>
                        <DELETED>    (iii) in subparagraph (C), by 
                        inserting ``preventing diversion of controlled 
                        substances,'' after ``treatment programs,''; 
                        and</DELETED>
                        <DELETED>    (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'';</DELETED>
        <DELETED>    (6) in subsection (c), as so redesignated, by 
        striking ``subsection (c)'' and inserting ``subsection 
        (b)'';</DELETED>
        <DELETED>    (7) in subsection (d), as so redesignated--
        </DELETED>
                <DELETED>    (A) in the matter preceding paragraph (1), 
                by striking ``the authorization of appropriations under 
                subsection (b)'' and inserting ``subsection (h)''; 
                and</DELETED>
                <DELETED>    (B) in paragraph (1), by striking 
                ``subsection (c)'' and inserting ``subsection (b)''; 
                and</DELETED>
        <DELETED>    (8) by inserting after subsection (d), as so 
        redesignated, the following:</DELETED>
<DELETED>    ``(e) Indian Tribes.--</DELETED>
        <DELETED>    ``(1) Definition.--For purposes of this section, 
        the term `Indian tribe' has the meaning given such term in 
        section 4 of the Indian Self-Determination and Education 
        Assistance Act (25 U.S.C. 5304).</DELETED>
        <DELETED>    ``(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).</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(h) Authorization of Appropriations.--For purposes of 
carrying out the grant program under subsection (b), there are 
authorized to be appropriated $500,000,000 for each of fiscal years 
2019 through 2021, to remain available until expended.</DELETED>
<DELETED>    ``(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 mortality 
rate associated with opioid use disorders based on the ordinal ranking 
of States according to the age-adjusted overdose mortality rates of the 
Centers for Disease Control and Prevention.''.</DELETED>
<DELETED>    (b) Previously Appropriated Amounts.--</DELETED>
        <DELETED>    (1) Appropriation of amounts remaining in 
        account.--Any unobligated amounts remaining, on the date of 
        enactment of this Act, in the Account For the State Response to 
        the Opioid Abuse Crisis established under section 1003(b) of 
        the 21st Century Cures Act (Public Law 114-255) (as in effect 
        on the day before the date of enactment of this Act) are hereby 
        appropriated to the Secretary of Health and Human Services for 
        purposes of carrying out the grant program under subsection (b) 
        of section 1003 of the 21st Century Cures Act (Public Law 114-
        255) (as redesignated by subsection (a)(3) of this 
        section).</DELETED>
        <DELETED>    (2) Available until expended.--Amounts 
        appropriated under paragraph (1) of this subsection or section 
        1003(b)(3) of the 21st Century Cures Act (as in effect on the 
        day before the date of enactment of this Act) shall remain 
        available until expended.</DELETED>
<DELETED>    (c) 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''.</DELETED>

          <DELETED>TITLE II--RESEARCH AND INNOVATION</DELETED>

<DELETED>SEC. 201. ADVANCING CUTTING-EDGE RESEARCH.</DELETED>

<DELETED>    Section 402(n)(1) of the Public Health Service Act (42 
U.S.C. 282(n)(1)) is amended--</DELETED>
        <DELETED>    (1) in subparagraph (A), by striking 
        ``or'';</DELETED>
        <DELETED>    (2) in subparagraph (B), by striking the period 
        and inserting ``; or''; and</DELETED>
        <DELETED>    (3) by adding at the end the following:</DELETED>
                <DELETED>    ``(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.''.</DELETED>

<DELETED>SEC. 202. PAIN RESEARCH.</DELETED>

<DELETED>    Section 409J(b) of the Public Health Service Act (42 
U.S.C. 284q(b)) is amended--</DELETED>
        <DELETED>    (1) in paragraph (5)--</DELETED>
                <DELETED>    (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 approved, 
                or devices approved or cleared, by the Food and Drug 
                Administration'';</DELETED>
                <DELETED>    (B) in subparagraph (B), by striking ``on 
                the symptoms and causes of pain;'' and inserting the 
                following: ``on--</DELETED>
                        <DELETED>    ``(i) the symptoms and causes of 
                        pain;</DELETED>
                        <DELETED>    ``(ii) the diagnosis, prevention, 
                        treatment, and management of pain; 
                        and</DELETED>
                        <DELETED>    ``(iii) risk factors for, and 
                        early warning signs of, substance use 
                        disorders; and'';</DELETED>
                <DELETED>    (C) by striking subparagraphs (C) through 
                (E) and inserting the following:</DELETED>
                <DELETED>    ``(C) make recommendations to the Director 
                of NIH--</DELETED>
                        <DELETED>    ``(i) to ensure that the 
                        activities of the National Institutes of Health 
                        and other Federal agencies are free of 
                        unnecessary duplication of effort;</DELETED>
                        <DELETED>    ``(ii) on how best to disseminate 
                        information on pain care; and</DELETED>
                        <DELETED>    ``(iii) on how to expand 
                        partnerships between public entities and 
                        private entities to expand collaborative, 
                        cross-cutting research.'';</DELETED>
        <DELETED>    (2) by redesignating paragraph (6) as paragraph 
        (7); and</DELETED>
        <DELETED>    (3) by inserting after paragraph (5) the 
        following:</DELETED>
        <DELETED>    ``(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.''.</DELETED>

    <DELETED>TITLE III--MEDICAL PRODUCTS AND CONTROLLED SUBSTANCES 
                            SAFETY</DELETED>

<DELETED>SEC. 301. CLARIFYING FDA REGULATION OF NON-ADDICTIVE PAIN 
              PRODUCTS.</DELETED>

<DELETED>    (a) Public Meetings.--Not later than 1 year after the date 
of enactment of this Act, the Secretary of Health and Human Services 
(referred to in this section as 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--</DELETED>
        <DELETED>    (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 assessment 
        under section 505(e) of the Federal Food, Drug, and Cosmetic 
        Act (21 U.S.C. 355(e)), 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;</DELETED>
        <DELETED>    (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;</DELETED>
        <DELETED>    (3) the evidentiary standards and the development 
        of opioid sparing data for inclusion in the labeling of medical 
        products; and</DELETED>
        <DELETED>    (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.</DELETED>
<DELETED>    (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--</DELETED>
        <DELETED>    (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--</DELETED>
                <DELETED>    (A) may apply the eligibility criteria 
                under such sections 506 and 515B to non-opioid or non-
                addictive medical products intended to treat pain or 
                addiction;</DELETED>
                <DELETED>    (B) considers the risk of addiction of 
                controlled substances approved to treat pain when 
                establishing unmet medical need; and</DELETED>
                <DELETED>    (C) considers pain, pain control, or pain 
                management in assessing whether a disease or condition 
                is a serious or life-threatening disease or 
                condition;</DELETED>
        <DELETED>    (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;</DELETED>
        <DELETED>    (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--</DELETED>
                <DELETED>    (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;</DELETED>
                <DELETED>    (B) ethical considerations of exposuring 
                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;</DELETED>
                <DELETED>    (C) endpoints, including primary, 
                secondary, and surrogate endpoints, to evaluate the 
                reduction of opioid use;</DELETED>
                <DELETED>    (D) best practices for communication 
                between sponsors and the agency on the development of 
                data collection methods, including the initiation of 
                data collection; and</DELETED>
                <DELETED>    (E) the appropriate format to submit such 
                data results to the Secretary; and</DELETED>
        <DELETED>    (4) the circumstances under which the Food and 
        Drug Administration considers misuse and abuse of drugs in 
        making determinations of safety 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.</DELETED>
<DELETED>    (c) Definitions.--In this section--</DELETED>
        <DELETED>    (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</DELETED>
        <DELETED>    (2) the term ``opioid sparing'' means reducing, 
        replacing, or avoiding the use of opioids or other controlled 
        substances.</DELETED>

<DELETED>SEC. 302. CLARIFYING FDA PACKAGING AUTHORITIES.</DELETED>

<DELETED>    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:</DELETED>
        <DELETED>    ``(4) Serious adverse drug experience.--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), which may 
        include requiring that--</DELETED>
                <DELETED>    ``(A) the drug be made available for 
                dispensing to certain patients in unit dose packaging, 
                packaging that provides a set duration, or other 
                packaging system that the Secretary determines may help 
                mitigate such serious risk; or</DELETED>
                <DELETED>    ``(B) the drug be dispensed to certain 
                patients with a safe disposal packaging or safe 
                disposal system for purposes of rendering unused 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 help mitigate 
                such serious risk and exists in sufficient quantities, 
                in consultation with other relevant Federal agencies 
                with authorities over drug packaging.''.</DELETED>

<DELETED>SEC. 303. STRENGTHENING FDA AND CBP COORDINATION AND 
              CAPACITY.</DELETED>

<DELETED>    (a) In General.--The Secretary of Health and Human 
Services (referred to in this section as 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 United States Customs and Border 
Protection.</DELETED>
<DELETED>    (b) FDA Import Facilities and Inspection Capacity.--In 
carrying out this section, the Secretary shall--</DELETED>
        <DELETED>    (1) 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--</DELETED>
                <DELETED>    (A) facility upgrades and improved 
                capacity in order to increase and improve inspection 
                and detection capabilities, which may include, as the 
                Secretary determines appropriate--</DELETED>
                        <DELETED>    (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;</DELETED>
                        <DELETED>    (ii) the construction of, or 
                        upgrades to, laboratory capacity for purposes 
                        of detection and testing of imported 
                        goods;</DELETED>
                        <DELETED>    (iii) upgrades to the security of 
                        import facilities; and</DELETED>
                        <DELETED>    (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</DELETED>
                <DELETED>    (B) provide import facilities in which the 
                Food and Drug Administration operates or carries out 
                activities related to drug imports within the 
                international mail facilities with innovative 
                technology, including controlled substance detection 
                and testing equipment and other applicable technology, 
                and collaborate with United States Customs and Border 
                Protection to share near-real-time information, 
                including information about test results, as 
                appropriate, provided that such technology is 
                interoperable with technology used by other relevant 
                Federal agencies, including the United States Customs 
                and Border Protection, as applicable, and is used in 
                the time and manner that the Secretary determines 
                appropriate.</DELETED>
<DELETED>    (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.</DELETED>
<DELETED>    (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.</DELETED>

<DELETED>SEC. 304. CLARIFYING FDA POST-MARKET AUTHORITIES.</DELETED>

<DELETED>    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 that is not in accordance with the labeling of such 
drug''.</DELETED>

<DELETED>SEC. 305. FIRST RESPONDER TRAINING.</DELETED>

<DELETED>    Section 546 of the Public Health Service Act (42 U.S.C. 
290ee-1) is amended--</DELETED>
        <DELETED>    (1) in subsection (c)--</DELETED>
                <DELETED>    (A) in paragraph (2), by striking ``and'' 
                at the end;</DELETED>
                <DELETED>    (B) in paragraph (3), by striking the 
                period and inserting ``; and''; and</DELETED>
                <DELETED>    (C) by adding at the end the 
                following:</DELETED>
        <DELETED>    ``(4) train and provide resources for first 
        responders and members of other key community sectors on safety 
        around fentanyl and other dangerous illicit drugs to protect 
        themselves from exposure to fentanyl and respond appropriately 
        when exposure occurs.'';</DELETED>
        <DELETED>    (2) in subsection (d), by inserting ``, and safety 
        around fentanyl and other dangerous illicit drugs'' before the 
        period;</DELETED>
        <DELETED>    (3) in subsection (f)--</DELETED>
                <DELETED>    (A) in paragraph (3), by striking ``and'' 
                at the end;</DELETED>
                <DELETED>    (B) in paragraph (4), by striking the 
                period and inserting a semicolon; and</DELETED>
                <DELETED>    (C) by adding at the end the 
                following:</DELETED>
        <DELETED>    ``(5) the number of first responders and members 
        of other key community sectors trained on safety around 
        fentanyl and other dangerous illicit drugs.''; and</DELETED>
        <DELETED>    (4) in subsection (g), 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''.</DELETED>

<DELETED>SEC. 306. DISPOSAL OF CONTROLLED SUBSTANCES OF A DECEASED 
              HOSPICE PATIENT BY EMPLOYEES OF A HOSPICE 
              PROGRAM.</DELETED>

<DELETED>    (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:</DELETED>
<DELETED>    ``(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 after the hospice patient's death.</DELETED>
<DELETED>    ``(B) In this paragraph:</DELETED>
        <DELETED>    ``(i) The term `employee of a qualified hospice 
        program' means a physician, physician assistant, or nurse who--
        </DELETED>
                <DELETED>    ``(I) is employed by, or is acting 
                pursuant to arrangements made with, a qualified hospice 
                program; and</DELETED>
                <DELETED>    ``(II) is licensed or certified to perform 
                such employment or acts in accordance with applicable 
                State law.</DELETED>
        <DELETED>    ``(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)).</DELETED>
        <DELETED>    ``(iii) The term `hospice patient' means an 
        individual receiving hospice care.</DELETED>
        <DELETED>    ``(iv) The term `qualified hospice program' means 
        a hospice program that--</DELETED>
                <DELETED>    ``(I) has written policies and procedures 
                for employees of the hospice program to use assisting 
                in the disposal of the controlled substances of a 
                hospice patient after the hospice patient's 
                death;</DELETED>
                <DELETED>    ``(II) at the time when the controlled 
                substances are first ordered--</DELETED>
                        <DELETED>    ``(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;</DELETED>
                        <DELETED>    ``(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</DELETED>
                        <DELETED>    ``(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</DELETED>
                <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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).''.</DELETED>
<DELETED>    (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:</DELETED>
        <DELETED>    ``(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).''.</DELETED>
<DELETED>    (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).</DELETED>
<DELETED>    (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.</DELETED>

<DELETED>SEC. 307. GAO STUDY AND REPORT ON HOSPICE SAFE DRUG 
              MANAGEMENT.</DELETED>

<DELETED>    (a) Study.--</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (2) Contents.--In conducting the study under 
        paragraph (1), the Comptroller General shall include--
        </DELETED>
                <DELETED>    (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</DELETED>
                <DELETED>    (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.</DELETED>
<DELETED>    (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.</DELETED>

<DELETED>SEC. 308. DELIVERY OF A CONTROLLED SUBSTANCE BY A PHARMACY TO 
              BE ADMINISTERED BY INJECTION, IMPLANTATION, OR 
              INTRATHECAL PUMP.</DELETED>

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

   <DELETED>``delivery of a controlled substance by a pharmacy to an 
                  administering practitioner</DELETED>

<DELETED>    ``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 of the 
controlled substance by the practitioner if--</DELETED>
        <DELETED>    ``(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;</DELETED>
        <DELETED>    ``(2)(A) in the case of administering of the 
        controlled substance for the purpose of maintenance or 
        detoxification treatment under section 303(g)(2)--</DELETED>
                <DELETED>    ``(i) the practitioner who issued the 
                prescription is a qualifying practitioner authorized 
                under, and acting within the scope of that section; 
                and</DELETED>
                <DELETED>    ``(ii) the controlled substance is to be 
                administered by injection or implantation; or</DELETED>
        <DELETED>    ``(B) in the case of administering of the 
        controlled substance for a purpose other than maintenance or 
        detoxification treatment, the controlled substance is to be 
        administered by a practitioner through use of an intrathecal 
        pump;</DELETED>
        <DELETED>    ``(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;</DELETED>
        <DELETED>    ``(4) the prescription is not issued to supply any 
        practitioner with a stock of controlled substances for the 
        purpose of general dispensing to patients;</DELETED>
        <DELETED>    ``(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</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(b) Modification of Number of Days Before Which 
Controlled Substance Shall Be Administered.--</DELETED>
        <DELETED>    ``(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--
        </DELETED>
                <DELETED>    ``(A) reduce the risk of diversion; 
                or</DELETED>
                <DELETED>    ``(B) protect the public health.</DELETED>
        <DELETED>    ``(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).</DELETED>
        <DELETED>    ``(3) Minimum number of days.--Any modification 
        under this subsection shall be for a period of not less than 7 
        days.''.</DELETED>
<DELETED>    (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, implantation, or through the use of an intrathecal 
pump.</DELETED>
<DELETED>    (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:</DELETED>

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

          <DELETED>TITLE IV--TREATMENT AND RECOVERY</DELETED>

<DELETED>SEC. 401. COMPREHENSIVE OPIOID RECOVERY CENTERS.</DELETED>

<DELETED>    (a) In General.--Part D of title V of the Public Health 
Service Act is amended by adding at the end the following new 
section:</DELETED>

<DELETED>``SEC. 550. COMPREHENSIVE OPIOID RECOVERY CENTERS.</DELETED>

<DELETED>    ``(a) In General.--The Secretary, acting through the 
Assistant Secretary for Mental Health and Substance Use, 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.</DELETED>
<DELETED>    ``(b) Grant Period.--</DELETED>
        <DELETED>    ``(1) In general.--A grant awarded under 
        subsection (a) shall be for a period not more than 5 
        years.</DELETED>
        <DELETED>    ``(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).</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(d) 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--</DELETED>
        <DELETED>    ``(1) evidence that such entity carries out, or is 
        capable of coordinating with other entities to carry out, the 
        activities described in subsection (g); and</DELETED>
        <DELETED>    ``(2) such other information as the Secretary may 
        require.</DELETED>
<DELETED>    ``(e) Priority.--In awarding grants under subsection (a), 
the Secretary shall give priority to eligible entities located in a 
State with an overdose mortality rate that is above the national 
overdose mortality rate, as determined by the Director of the Centers 
for Disease Control and Prevention.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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):</DELETED>
        <DELETED>    ``(1) Treatment and recovery services.--Each 
        Center shall--</DELETED>
                <DELETED>    ``(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;</DELETED>
                <DELETED>    ``(B) provide the full continuum of 
                treatment services, including--</DELETED>
                        <DELETED>    ``(i) all drugs approved by the 
                        Food and Drug Administration to treat substance 
                        use disorders;</DELETED>
                        <DELETED>    ``(ii) medically supervised 
                        withdrawal management that includes patient 
                        evaluation, stabilization, and readiness for 
                        and entry into treatment;</DELETED>
                        <DELETED>    ``(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;</DELETED>
                        <DELETED>    ``(iv) treatment, as appropriate, 
                        for patients with co-occurring substance use 
                        and mental health disorders;</DELETED>
                        <DELETED>    ``(v) residential rehabilitation, 
                        and outpatient and intensive outpatient 
                        programs;</DELETED>
                        <DELETED>    ``(vi) recovery housing;</DELETED>
                        <DELETED>    ``(vii) community-based and peer 
                        recovery support services;</DELETED>
                        <DELETED>    ``(viii) job training, job 
                        placement assistance, and continuing education 
                        assistance to support reintegration into the 
                        workforce; and</DELETED>
                        <DELETED>    ``(ix) other best practices to 
                        provide the full continuum of treatment and 
                        services, as determined by the 
                        Secretary;</DELETED>
                <DELETED>    ``(C) periodically conduct patient 
                assessments to support sustained and clinically 
                significant recovery, as defined by the Assistant 
                Secretary for Mental Health and Substance 
                Use;</DELETED>
                <DELETED>    ``(D) administer an onsite pharmacy and 
                provide toxicology services, for purposes of carrying 
                out this section; and</DELETED>
                <DELETED>    ``(E) operate a secure, confidential, and 
                interoperable electronic health information 
                system.</DELETED>
        <DELETED>    ``(2) Outreach.--Each Center shall carry out 
        outreach activities to publicize the services offered through 
        the Centers, which may include--</DELETED>
                <DELETED>    ``(A) training and supervising outreach 
                staff, as appropriate, to work with State and local 
                health departments, health care providers, State and 
                local education agencies, institutions of higher 
                education, State and local workforce development 
                boards, State and local community action agencies, 
                public safety officials, first responders, child 
                welfare agencies, as appropriate, and other community 
                partners and the public, including patients, to 
                identify and respond to community needs, and ensuring 
                that such entities are aware of the services of the 
                Center; and</DELETED>
                <DELETED>    ``(B) 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 health disorders.</DELETED>
<DELETED>    ``(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--</DELETED>
        <DELETED>    ``(1) the programs and activities funded by the 
        grant;</DELETED>
        <DELETED>    ``(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;</DELETED>
        <DELETED>    ``(3) the retention rate of program participants; 
        and</DELETED>
        <DELETED>    ``(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).</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.''.</DELETED>
<DELETED>    (b) Reports to Congress.--</DELETED>
        <DELETED>    (1) Preliminary report.--Not later than 3 years 
        after the date of the enactment of this Act, the Secretary of 
        Health and Human Services shall submit to Congress a 
        preliminary report that analyzes data submitted under section 
        550(h) of the Public Health Service Act, as added by subsection 
        (a).</DELETED>
        <DELETED>    (2) Final report.--Not later than 2 years after 
        submitting the preliminary report required under paragraph (1), 
        the Secretary of Health and Human Services shall submit to 
        Congress a final report that includes--</DELETED>
                <DELETED>    (A) an evaluation of the effectiveness of 
                the comprehensive services provided by the Centers 
                established or operated pursuant to section 550 of the 
                Public Health Service Act, as added by subsection (a), 
                on 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</DELETED>
                <DELETED>    (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.</DELETED>

<DELETED>SEC. 402. PROGRAM TO SUPPORT COORDINATION AND CONTINUATION OF 
              CARE FOR DRUG OVERDOSE PATIENTS.</DELETED>

<DELETED>    (a) In General.--The Secretary of Health and Human 
Services (referred to in this section as the ``Secretary'') shall 
identify or facilitate the development of best practices for--
</DELETED>
        <DELETED>    (1) emergency treatment of known or suspected drug 
        overdose;</DELETED>
        <DELETED>    (2) coordination and continuation of care and 
        treatment, including, as appropriate, through referrals, of 
        individuals after an opioid overdose; and</DELETED>
        <DELETED>    (3) the provision of overdose reversal medication, 
        as appropriate.</DELETED>
<DELETED>    (b) Grant Establishment and Participation.--</DELETED>
        <DELETED>    (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).</DELETED>
        <DELETED>    (2) Eligible entity.--In this section, the term 
        ``eligible entity'' means an entity that offers treatment or 
        other services for individuals in response to, or following, 
        drug overdoses or a drug overdose.</DELETED>
        <DELETED>    (3) Application.--An eligible entity desiring a 
        grant under this section, in consultation with the principal 
        agency of a State in which such entity offers treatment or 
        other services 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.), shall submit an application to 
        the Secretary, at such time and in such manner as the Secretary 
        may require, that includes--</DELETED>
                <DELETED>    (A) evidence that such eligible entity 
                carries out, or is capable of coordinating with other 
                entities to carry out, the activities described in 
                paragraph (4); and</DELETED>
                <DELETED>    (B) such additional information as the 
                Secretary may require.</DELETED>
        <DELETED>    (4) Use of grant funds.--An eligible entity 
        awarded a grant under this section shall use such grant funds 
        to--</DELETED>
                <DELETED>    (A) hire or utilize recovery coaches to 
                help support recovery, including by--</DELETED>
                        <DELETED>    (i) connecting patients to a 
                        continuum of care services, such as--</DELETED>
                                <DELETED>    (I) treatment and recovery 
                                support programs;</DELETED>
                                <DELETED>    (II) programs that provide 
                                non-clinical recovery support 
                                services;</DELETED>
                                <DELETED>    (III) peer support 
                                networks;</DELETED>
                                <DELETED>    (IV) recovery community 
                                organizations;</DELETED>
                                <DELETED>    (V) health care providers, 
                                including physicians and other 
                                providers of behavioral health and 
                                primary care;</DELETED>
                                <DELETED>    (VI) educational and 
                                vocational schools;</DELETED>
                                <DELETED>    (VII) employers;</DELETED>
                                <DELETED>    (VIII) housing services; 
                                and</DELETED>
                                <DELETED>    (IX) child welfare 
                                agencies;</DELETED>
                        <DELETED>    (ii) providing education on 
                        overdose prevention to patients; and</DELETED>
                        <DELETED>    (iii) providing other services the 
                        Secretary determines necessary to help ensure 
                        continued connection with recovery support 
                        services;</DELETED>
                <DELETED>    (B) establish policies and procedures 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 prevent relapse, and reduce 
                recidivism and future overdose;</DELETED>
                <DELETED>    (C) develop or implement best practices 
                for treating non-fatal drug overdoses, including, with 
                respect to care coordination and integrated care 
                models, for long term treatment and recovery options 
                for individuals with a substance use disorder who have 
                experienced a non-fatal drug overdose; and</DELETED>
                <DELETED>    (D) 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.</DELETED>
        <DELETED>    (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--</DELETED>
                <DELETED>    (A) all drugs approved by the Food and 
                Drug Administration to treat substance use disorders, 
                pursuant to Federal and State law;</DELETED>
                <DELETED>    (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</DELETED>
                <DELETED>    (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.</DELETED>
        <DELETED>    (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:</DELETED>
                <DELETED>    (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))).</DELETED>
                <DELETED>    (B) The eligible entity is located in a 
                State with an overdose mortality rate that is above the 
                national overdose mortality rate, as determined by the 
                Director of the Centers for Disease Control and 
                Prevention.</DELETED>
                <DELETED>    (C) The eligible entity demonstrates that 
                recovery coaches will be placed in both health care 
                settings and community settings.</DELETED>
        <DELETED>    (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.</DELETED>
<DELETED>    (c) Definition.--In this section, the term ``recovery 
coach'' means an individual--</DELETED>
        <DELETED>    (1) with knowledge of, or experience with, 
        recovery from a substance use disorder; and</DELETED>
        <DELETED>    (2) 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.</DELETED>
<DELETED>    (d) Reporting Requirements.--</DELETED>
        <DELETED>    (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--
        </DELETED>
                <DELETED>    (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;</DELETED>
                <DELETED>    (B) the number of individuals administered 
                medication-assisted treatment by the entity;</DELETED>
                <DELETED>    (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</DELETED>
                <DELETED>    (D) the frequency and number of patients 
                with reoccurrences, including readmissions for non-
                fatal overdoses and evidence of relapse related to 
                substance abuse disorder.</DELETED>
        <DELETED>    (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.</DELETED>
<DELETED>    (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.</DELETED>
<DELETED>    (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.</DELETED>

<DELETED>SEC. 403. ALTERNATIVES TO OPIOIDS.</DELETED>

<DELETED>    (a) In General.--The Secretary of Health and Human 
Services 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--</DELETED>
        <DELETED>    (1) utilizing information from acute care 
        providers including emergency departments and other providers 
        that have successfully implemented alternatives to opioids 
        programs, promoting non-opioid protocols and medications while 
        appropriately limiting the use of opioids;</DELETED>
        <DELETED>    (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;</DELETED>
        <DELETED>    (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;</DELETED>
        <DELETED>    (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, and Federally qualified health 
        centers; and</DELETED>
        <DELETED>    (5) collecting data and reporting on health 
        outcomes associated with the use of alternatives to 
        opioids.</DELETED>
<DELETED>    (b) 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.</DELETED>

<DELETED>SEC. 404. PEER SUPPORT TECHNICAL ASSISTANCE.</DELETED>

<DELETED>    (a) Technical Assistance for Peer Support Services.--The 
Secretary of Health and Human Services (referred to in this section as 
the ``Secretary''), acting through the Assistant Secretary for Mental 
Health and Substance Abuse, shall provide technical assistance and 
support to organizations providing peer support services related to 
substance use disorder, including technical assistance and support 
related to--</DELETED>
        <DELETED>    (1) training on identifying--</DELETED>
                <DELETED>    (A) signs of substance use 
                disorder;</DELETED>
                <DELETED>    (B) resources to assist individuals with a 
                substance use disorder, or resources for families of an 
                individual with a substance use disorder; and</DELETED>
                <DELETED>    (C) best practices for the delivery of 
                recovery support services;</DELETED>
        <DELETED>    (2) the provision of translation services, 
        interpretation, or other such services for clients with limited 
        English speaking proficiency;</DELETED>
        <DELETED>    (3) capacity building; and</DELETED>
        <DELETED>    (4) evaluation and improvement, as necessary, of 
        the effectiveness of such peer support services.</DELETED>
<DELETED>    (b) Best Practices.--The Secretary shall periodically 
issue best practices related to peer support services for use by 
organizations that provide peer support services.</DELETED>
<DELETED>    (c) 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.</DELETED>

<DELETED>SEC. 405. MEDICATION-ASSISTED TREATMENT FOR RECOVERY FROM 
              ADDICTION.</DELETED>

<DELETED>    (a) Repeal of Requirement To Update Regulations.--Section 
303 of the Comprehensive Addiction and Recovery Act of 2016 (Public Law 
114-198; 130 Stat. 720) is amended by striking subsection 
(c).</DELETED>
<DELETED>    (b) Codification of Expansion of Maximum Number of 
Patients for Medication-Assisted Treatment.--Section 
303(g)(2)(B)(iii)(II) of the Controlled Substances Act (21 U.S.C. 
(g)(2)(B)(iii)(II)) is amended by striking ``100'' each place it 
appears and inserting ``275''.</DELETED>

<DELETED>SEC. 406. NATIONAL RECOVERY HOUSING BEST PRACTICES.</DELETED>

<DELETED>    (a) Best Practices.--The Secretary of Health and Human 
Services (referred to in this section as the ``Secretary''), in 
consultation with the Secretary for Housing and Urban Development, 
patients with a history of opioid use disorder, and other stakeholders, 
which may include State accrediting entities and reputable providers 
of, and analysts of, recovery housing services, shall identify or 
facilitate the development of best practices, which may include model 
laws for implementing suggested minimum standards, for operating 
recovery housing.</DELETED>
<DELETED>    (b) Dissemination.--The Secretary shall disseminate the 
best practices identified or developed under subsection (a) to--
</DELETED>
        <DELETED>    (1) State agencies, which may include the 
        provision of technical assistance to State agencies seeking to 
        adopt or implement such best practices;</DELETED>
        <DELETED>    (2) recovery housing entities; and</DELETED>
        <DELETED>    (3) the public, as appropriate.</DELETED>
<DELETED>    (c) Requirements.--In identifying or facilitating the 
development of best practices under subsection (a), the Secretary, in 
consultation with appropriate stakeholders, shall consider how recovery 
housing is able to (including by improving access and adherence to 
treatment) support recovery and prevent relapse, recidivism, or 
overdose, including overdose death.</DELETED>
<DELETED>    (d) Rule of Construction.--Nothing in this section shall 
be construed to provide the Secretary with the ability to require 
States to adhere to minimum standards in the State oversight of 
recovery housing.</DELETED>
<DELETED>    (e) Definition.--In this section, 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.</DELETED>

<DELETED>SEC. 407. ADDRESSING ECONOMIC AND WORKFORCE IMPACTS OF THE 
              OPIOID CRISIS.</DELETED>

<DELETED>    (a) Definitions.--Except as otherwise expressly provided, 
in this section:</DELETED>
        <DELETED>    (1) Education provider.--The term ``education 
        provider'' means--</DELETED>
                <DELETED>    (A) an institution of higher education, as 
                defined in section 101 of the Higher Education Act of 
                1965 (20 U.S.C. 1001); or</DELETED>
                <DELETED>    (B) a postsecondary vocational 
                institution, as defined in section 102(c) of such Act 
                (20 U.S.C. 1002(c)).</DELETED>
        <DELETED>    (2) Eligible entity.--The term ``eligible entity'' 
        means--</DELETED>
                <DELETED>    (A) a State workforce agency;</DELETED>
                <DELETED>    (B) a State board;</DELETED>
                <DELETED>    (C) an outlying area, as defined in 
                section 3 of the Workforce Innovation and Opportunity 
                Act (29 U.S.C. 3102); or</DELETED>
                <DELETED>    (D) a Tribal entity.</DELETED>
        <DELETED>    (3) Local area; local board; one-stop operator.--
        The terms ``local area'', ``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).</DELETED>
        <DELETED>    (4) Local entity.--The term ``local entity'' means 
        a local board or one-stop operator.</DELETED>
        <DELETED>    (5) Participating partnership.--The term 
        ``participating partnership'' means a partnership established 
        under subsection (e)(1) by a local entity receiving a subgrant 
        under subsection (d).</DELETED>
        <DELETED>    (6) Program participant.--The term ``program 
        participant'' means an individual who--</DELETED>
                <DELETED>    (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</DELETED>
                <DELETED>    (B) enrolls with the applicable 
                participating partnership to receive any of the 
                services described in subsection (e)(3).</DELETED>
        <DELETED>    (7) Secretary.--The term ``Secretary'' means the 
        Secretary of Labor.</DELETED>
        <DELETED>    (8) State board.--The term ``State board'' has the 
        meaning given the term in section 3 of the Workforce Innovation 
        and Opportunity Act (29 U.S.C. 3102).</DELETED>
        <DELETED>    (9) 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.).</DELETED>
        <DELETED>    (10) Substance use disorder.--The term ``substance 
        use disorder'' means such a disorder within the meaning of 
        title V of the Public Health Service Act (42 U.S.C. 290aa et 
        seq.).</DELETED>
        <DELETED>    (11) Supportive services.--The term ``supportive 
        services'' has the meaning given such term in section 3 of the 
        Workforce Innovation and Opportunity Act (29 U.S.C. 
        3102).</DELETED>
        <DELETED>    (12) Treatment provider.--The term ``treatment 
        provider''--</DELETED>
                <DELETED>    (A) means a health care provider that 
                offers services for treating substance use disorders 
                and is licensed in accordance with applicable State law 
                to provide such services;</DELETED>
                <DELETED>    (B) accepts health insurance for such 
                services, including coverage under title XIX of the 
                Social Security Act (42 U.S.C. 1396 et seq.); 
                and</DELETED>
                <DELETED>    (C) may include--</DELETED>
                        <DELETED>    (i) a nonprofit provider of peer 
                        recovery support services, as defined by the 
                        State involved in regulation or 
                        guidance;</DELETED>
                        <DELETED>    (ii) a community health care 
                        provider; or</DELETED>
                        <DELETED>    (iii) a Federally qualified health 
                        center (as defined in section 1861(aa) of the 
                        Social Security Act (42 U.S.C. 
                        1395x)).</DELETED>
        <DELETED>    (13) 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).</DELETED>
<DELETED>    (b) Pilot Program and Grants Authorized.--</DELETED>
        <DELETED>    (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 and one-stop 
        operators to address the economic and workforce impacts 
        associated with a high rate of a substance use 
        disorder.</DELETED>
        <DELETED>    (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.</DELETED>
<DELETED>    (c) Grant Applications.--</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (2) Significant impact on community by opioid 
        abuse and substance use disorder-related problems.--</DELETED>
                <DELETED>    (A) Demonstration.--An eligible entity 
                shall include in the application information that 
                demonstrates significant impact on the community by 
                problems related to opioid abuse or another substance 
                use disorder, by--</DELETED>
                        <DELETED>    (i) identifying the communities, 
                        regions, or local areas that will be served 
                        through the grant (each referred to in this 
                        section as a ``service area''); and</DELETED>
                        <DELETED>    (ii) showing, for each such 
                        service area, an increase equal to or greater 
                        than the national increase in such problems, 
                        between--</DELETED>
                                <DELETED>    (I) 1999; and</DELETED>
                                <DELETED>    (II) 2016 or the latest 
                                year for which data are 
                                available.</DELETED>
                <DELETED>    (B) Information.--In making the showing 
                described in subparagraph (A)(ii), the eligible entity 
                may use information including data on--</DELETED>
                        <DELETED>    (i) the incidence or prevalence of 
                        opioid abuse and other substance use 
                        disorders;</DELETED>
                        <DELETED>    (ii) the per capita drug overdose 
                        mortality rate, as determined by the Director 
                        of the Centers for Disease Control and 
                        Prevention;</DELETED>
                        <DELETED>    (iii) the rate of non-fatal 
                        hospitalizations related to opioid abuse or 
                        another substance use disorder; or</DELETED>
                        <DELETED>    (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.</DELETED>
                <DELETED>    (C) Support for state strategy.--The 
                eligible entity shall also include in the application 
                information describing how the proposed services and 
                activities support the State's strategy for addressing 
                problems described in subparagraph (A) in specific 
                regions or across the State, outlaying area, or Tribal 
                entity.</DELETED>
        <DELETED>    (3) Economic and employment conditions demonstrate 
        additional federal support needed.--</DELETED>
                <DELETED>    (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, an economic 
                or employment downturn in the service area.</DELETED>
                <DELETED>    (B) Information.--In making the 
                demonstration described in subparagraph (A), the 
                eligible entity may use information including--
                </DELETED>
                        <DELETED>    (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;</DELETED>
                        <DELETED>    (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;</DELETED>
                        <DELETED>    (iii) in particular, information 
                        on economic indicators, labor market analyses, 
                        information from public announcements, and 
                        demographic and industry data;</DELETED>
                        <DELETED>    (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;</DELETED>
                        <DELETED>    (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</DELETED>
                        <DELETED>    (vi) any additional relevant data 
                        or information on the economy, workforce, or 
                        another aspect of the service area to support 
                        the application.</DELETED>
        <DELETED>    (4) Workforce shortage related to treatment 
        workforce.--</DELETED>
                <DELETED>    (A) In general.--An eligible entity may 
                include in the application a demonstration of the 
                workforce shortage in a professional area to be 
                addressed under the grant. Such professional areas may 
                include--</DELETED>
                        <DELETED>    (i) substance use disorder 
                        treatment and related services;</DELETED>
                        <DELETED>    (ii) non-opioid pain therapy and 
                        pain management services; or</DELETED>
                        <DELETED>    (iii) mental health care treatment 
                        services.</DELETED>
                <DELETED>    (B) Information to be included.--An 
                eligible entity demonstrating a workforce shortage 
                under subparagraph (A) shall demonstrate the workforce 
                shortage through information that may include--
                </DELETED>
                        <DELETED>    (i) the distance between--
                        </DELETED>
                                <DELETED>    (I) communities affected 
                                by opioid abuse or another substance 
                                use disorder; and</DELETED>
                                <DELETED>    (II) facilities or 
                                professionals offering services in the 
                                professional area;</DELETED>
                        <DELETED>    (ii) the maximum capacity of 
                        facilities or professionals to serve 
                        individuals in an affected community, or 
                        increases in arrests related to opioid abuse or 
                        another substance use disorder, overdose 
                        deaths, or nonfatal overdose emergencies in the 
                        community; or</DELETED>
                        <DELETED>    (iii) other information that can 
                        demonstrate such a shortage.</DELETED>
<DELETED>    (d) Subgrant Authorization and Application Process.--
</DELETED>
        <DELETED>    (1) Subgrants authorized.--</DELETED>
                <DELETED>    (A) In general.--An eligible entity 
                receiving a grant under subsection (b)--</DELETED>
                        <DELETED>    (i) may use not more than 5 
                        percent of the grant funds for the 
                        administrative costs of carrying out the grant; 
                        and</DELETED>
                        <DELETED>    (ii) shall use the remaining grant 
                        funds to make subgrants to local entities in 
                        the area served by the eligible entity to carry 
                        out the services and activities described in 
                        subsection (e).</DELETED>
                <DELETED>    (B) Geographic distribution.--In making 
                subgrants under this subsection, an eligible entity 
                shall ensure, to the extent practicable, the equitable 
                geographic distribution (such as urban and rural 
                distribution) of areas receiving subgrant 
                funds.</DELETED>
        <DELETED>    (2) Subgrant application.--</DELETED>
                <DELETED>    (A) In general.--A local entity desiring 
                to receive a subgrant under this subsection shall 
                submit an application at such time and in such and 
                manner as the eligible entity may reasonably require, 
                including the information described in this 
                paragraph.</DELETED>
                <DELETED>    (B) Contents.--Each application described 
                in subparagraph (A) shall include an analysis of the 
                estimated performance of the local entity in carrying 
                out the proposed services and activities under the 
                subgrant that--</DELETED>
                        <DELETED>    (i) uses 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;</DELETED>
                        <DELETED>    (ii) analyzes the record of the 
                        local entity in serving individuals with a 
                        barrier to employment; and</DELETED>
                        <DELETED>    (iii) analyzes the ability of the 
                        local entity to establish the partnership 
                        described in subsection (e)(1).</DELETED>
                <DELETED>    (C) Analysis.--The analysis described in 
                subparagraph (B) may include or utilize--</DELETED>
                        <DELETED>    (i) data from the National Center 
                        for Health Statistics of the Centers for 
                        Disease Control and Prevention;</DELETED>
                        <DELETED>    (ii) data from the Center for 
                        Behavioral Health Statistics and Quality of the 
                        Substance Abuse and Mental Health Services 
                        Administration;</DELETED>
                        <DELETED>    (iii) State vital 
                        statistics;</DELETED>
                        <DELETED>    (iv) municipal police department 
                        records;</DELETED>
                        <DELETED>    (v) reports from local coroners; 
                        or</DELETED>
                        <DELETED>    (vi) other relevant 
                        data.</DELETED>
<DELETED>    (e) Subgrant Services and Activities.--</DELETED>
        <DELETED>    (1) Formation of partnership.--</DELETED>
                <DELETED>    (A) In general.--Each local entity that 
                receives a subgrant under subsection (d) shall form a 
                partnership, established through a written contract or 
                other agreement, with members described in subparagraph 
                (B), and shall carry out the services and activities 
                described in this subsection through the 
                partnership.</DELETED>
                <DELETED>    (B) Members of the partnership.--A 
                partnership described in subparagraph (A) shall include 
                1 or more of the following:</DELETED>
                        <DELETED>    (i) The eligible entity.</DELETED>
                        <DELETED>    (ii) A treatment 
                        provider.</DELETED>
                        <DELETED>    (iii) An employer or industry 
                        organization.</DELETED>
                        <DELETED>    (iv) An education 
                        provider.</DELETED>
                        <DELETED>    (v) A justice or law enforcement 
                        organization.</DELETED>
                        <DELETED>    (vi) A faith-based or community-
                        based organization.</DELETED>
                        <DELETED>    (vii) Other State or local 
                        agencies.</DELETED>
                        <DELETED>    (viii) Other organizations, as 
                        determined to be necessary by the local 
                        entity.</DELETED>
        <DELETED>    (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:</DELETED>
                <DELETED>    (A) Workers, including dislocated workers, 
                new entrants in the workforce, or incumbent workers 
                (employed or underemployed), who are directly or 
                indirectly affected by a high rate of a substance use 
                disorder and each of whom is--</DELETED>
                        <DELETED>    (i) an individual who voluntarily 
                        confirms that the individual, or a friend or 
                        family member of the individual, has a history 
                        of opioid abuse or another substance use 
                        disorder; or</DELETED>
                        <DELETED>    (ii) an individual who works or 
                        resides in a community substantially impacted 
                        by a high rate of a substance use disorder or 
                        can otherwise demonstrate job loss as a result 
                        of a high rate of a substance use 
                        disorder.</DELETED>
                <DELETED>    (B) Workers, including dislocated workers, 
                new entrants in the workforce, or incumbent workers 
                (employed or underemployed), who--</DELETED>
                        <DELETED>    (i) seek to transition to 
                        professions that support individuals struggling 
                        with a substance use disorder or at risk for 
                        developing such disorder, such as professions 
                        that provide--</DELETED>
                                <DELETED>    (I) substance use disorder 
                                treatment and related 
                                services;</DELETED>
                                <DELETED>    (II) peer recovery support 
                                services described in subsection 
                                (a)(12)(C)(i);</DELETED>
                                <DELETED>    (III) non-opioid pain 
                                therapy and pain management services; 
                                or</DELETED>
                                <DELETED>    (IV) mental health care; 
                                and</DELETED>
                        <DELETED>    (ii) need new or upgraded skills 
                        to better serve such a population of struggling 
                        or at-risk individuals.</DELETED>
        <DELETED>    (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:</DELETED>
                <DELETED>    (A) Engaging employers.--Engaging with 
                employers to--</DELETED>
                        <DELETED>    (i) learn about the skill and 
                        hiring requirements of employers;</DELETED>
                        <DELETED>    (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;</DELETED>
                        <DELETED>    (iii) connect employers and 
                        workers to on-the-job or customized training 
                        programs before or after layoff to help 
                        facilitate reemployment;</DELETED>
                        <DELETED>    (iv) connect employers with an 
                        education provider to develop classroom 
                        instruction to complement on-the-job learning 
                        for program participants and such 
                        individuals;</DELETED>
                        <DELETED>    (v) help employers develop the 
                        curriculum design of a work-based learning 
                        program for program participants and such 
                        individuals; or</DELETED>
                        <DELETED>    (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.</DELETED>
                <DELETED>    (B) Screening services.--Providing 
                screening services, which may include--</DELETED>
                        <DELETED>    (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;</DELETED>
                        <DELETED>    (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; 
                        and</DELETED>
                        <DELETED>    (iii) accepting walk-ins or 
                        referrals from employers, labor organizations, 
                        or other entities recommending individuals to 
                        participate in such program.</DELETED>
                <DELETED>    (C) Individual treatment and employment 
                plan.--Developing an individual treatment and 
                employment plan for each program participant, which 
                shall include providing a case manager to work with 
                each participant to develop the plan, which may 
                include--</DELETED>
                        <DELETED>    (i) identifying employment and 
                        career goals;</DELETED>
                        <DELETED>    (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;</DELETED>
                        <DELETED>    (iii) setting appropriate 
                        achievement objectives to attain the employment 
                        and career goals identified under clause (i); 
                        or</DELETED>
                        <DELETED>    (iv) developing the appropriate 
                        combination of services to enable the 
                        participant to achieve the employment and 
                        career goals.</DELETED>
                <DELETED>    (D) Outpatient treatment and recovery 
                care.--In the case of a participating partnership 
                serving program participants described in paragraph 
                (2)(A)(i) 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--
                </DELETED>
                        <DELETED>    (i) shall be based on a model that 
                        utilizes combined behavioral interventions and 
                        other evidence-based or evidence-informed 
                        interventions; and</DELETED>
                        <DELETED>    (ii) may include additional 
                        services such as--</DELETED>
                                <DELETED>    (I) health, mental health, 
                                addiction, or other forms of outpatient 
                                treatment that may impact a substance 
                                use disorder and co-occurring 
                                conditions;</DELETED>
                                <DELETED>    (II) drug testing for a 
                                current substance use disorder prior to 
                                enrollment in career or training 
                                services or prior to 
                                employment;</DELETED>
                                <DELETED>    (III) linkages to 
                                community services, including services 
                                offered by partner organizations 
                                designed to support program 
                                participants; and</DELETED>
                                <DELETED>    (IV) referrals to health 
                                care, including referrals to substance 
                                use disorder treatment and mental 
                                health services.</DELETED>
                <DELETED>    (E) Supportive services.--Providing 
                supportive services, which shall include services such 
                as--</DELETED>
                        <DELETED>    (i) coordinated wraparound 
                        services to provide maximum support for program 
                        participants to ensure that the program 
                        participants maintain employment and recovery 
                        for not less than 12 months, as 
                        appropriate;</DELETED>
                        <DELETED>    (ii) assistance in establishing 
                        eligibility for assistance under Federal, 
                        State, and local programs providing health 
                        services, mental health services, housing 
                        services, transportation services, or social 
                        services;</DELETED>
                        <DELETED>    (iii) peer recovery support 
                        services described in subsection 
                        (a)(12)(C)(i);</DELETED>
                        <DELETED>    (iv) networking and mentorship 
                        opportunities; or</DELETED>
                        <DELETED>    (v) any supportive services 
                        determined necessary by the local 
                        entity.</DELETED>
                <DELETED>    (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:</DELETED>
                        <DELETED>    (i) Services provided to program 
                        participants who are in a pre-employment stage 
                        of the program. Such services may include--
                        </DELETED>
                                <DELETED>    (I) initial education and 
                                skills assessments;</DELETED>
                                <DELETED>    (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.);</DELETED>
                                <DELETED>    (III) services to promote 
                                employability skills such as 
                                punctuality, personal maintenance 
                                skills, and professional 
                                conduct;</DELETED>
                                <DELETED>    (IV) in-depth interviewing 
                                and evaluation to identify employment 
                                barriers and to develop individual 
                                employment plans;</DELETED>
                                <DELETED>    (V) career planning that 
                                includes--</DELETED>
                                        <DELETED>    (aa) career 
                                        pathways leading to in-demand, 
                                        high-wage jobs; and</DELETED>
                                        <DELETED>    (bb) job coaching, 
                                        job matching, and job placement 
                                        services;</DELETED>
                                <DELETED>    (VI) provision of payments 
                                and fees for employment and training-
                                related applications, tests, and 
                                certifications; or</DELETED>
                                <DELETED>    (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)).</DELETED>
                        <DELETED>    (ii) Services provided to program 
                        participants during their first 6 months of 
                        employment to ensure job retention, which may 
                        include--</DELETED>
                                <DELETED>    (I) case management and 
                                support services, including a 
                                continuation of the services described 
                                in clause (i);</DELETED>
                                <DELETED>    (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;</DELETED>
                                <DELETED>    (III) mentorship services 
                                and job retention support for such 
                                participants; or</DELETED>
                                <DELETED>    (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.</DELETED>
                        <DELETED>    (iii) Services to assist program 
                        participants in maintaining employment for not 
                        less than 12 months, as appropriate.</DELETED>
                <DELETED>    (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.</DELETED>
        <DELETED>    (4) Limitations.--A participating partnership may 
        not use--</DELETED>
                <DELETED>    (A) more than 5 percent of the funds 
                received under a subgrant under subsection (d) for the 
                administrative costs of the partnership;</DELETED>
                <DELETED>    (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); or</DELETED>
                <DELETED>    (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.</DELETED>
<DELETED>    (f) Performance Accountability.--</DELETED>
        <DELETED>    (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), including the indicators described in subsection 
        (c)(1)(A)(i) of such section and the requirements for local 
        area performance reports under subsection (d) of such 
        section.</DELETED>
        <DELETED>    (2) Evaluations.--</DELETED>
                <DELETED>    (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.</DELETED>
                <DELETED>    (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.</DELETED>
<DELETED>    (g) Funding.--</DELETED>
        <DELETED>    (1) Covered fiscal year.--In this subsection, the 
        term ``covered fiscal year'' means any of fiscal years 2018 
        through 2023.</DELETED>
        <DELETED>    (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.) or any 
        other provision of law, the Secretary may use, to carry out the 
        pilot program under this section for a covered fiscal year--
        </DELETED>
                <DELETED>    (A) funds made available to carry out 
                section 170 of such Act (29 U.S.C. 3225) for that 
                fiscal year;</DELETED>
                <DELETED>    (B) funds made available to carry out 
                section 170 of such Act that remain available for that 
                fiscal year; and</DELETED>
                <DELETED>    (C) funds that remain available under 
                section 172(f) of such Act (29 U.S.C. 
                3227(f)).</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (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.</DELETED>

<DELETED>SEC. 408. YOUTH PREVENTION AND RECOVERY.</DELETED>

<DELETED>    (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--</DELETED>
        <DELETED>    (1) in the section heading, by striking ``children 
        and adolescents'' and inserting ``children, adolescents, and 
        young adults'';</DELETED>
        <DELETED>    (2) in subsection (a)(2), by striking ``children, 
        including'' and inserting ``children, adolescents, and young 
        adults, including''; and</DELETED>
        <DELETED>    (3) by striking ``children and adolescents'' each 
        place it appears and inserting ``children, adolescents, and 
        young adults''.</DELETED>
<DELETED>    (b) Youth Prevention and Recovery Initiative.--</DELETED>
        <DELETED>    (1) Definitions.--In this subsection:</DELETED>
                <DELETED>    (A) Eligible entity.--The term ``eligible 
                entity'' means--</DELETED>
                        <DELETED>    (i) a local educational agency 
                        that is seeking to establish or expand 
                        substance use prevention and recovery support 
                        services at one or more high schools;</DELETED>
                        <DELETED>    (ii) an institution of higher 
                        education;</DELETED>
                        <DELETED>    (iii) a recovery program at an 
                        institution of higher education;</DELETED>
                        <DELETED>    (iv) a local board or one-stop 
                        operator; or</DELETED>
                        <DELETED>    (v) a nonprofit organization, 
                        excluding a school.</DELETED>
                <DELETED>    (B) 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).</DELETED>
                <DELETED>    (C) 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)).</DELETED>
                <DELETED>    (D) Local education agency.--The term 
                ``local educational agency'' has the meaning given the 
                term in section 8101 of the Elementary and Secondary 
                Education Act of 1965.</DELETED>
                <DELETED>    (E) 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).</DELETED>
                <DELETED>    (F) Recovery program.--The term ``recovery 
                program'' means a program--</DELETED>
                        <DELETED>    (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</DELETED>
                        <DELETED>    (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.</DELETED>
                <DELETED>    (G) Secretary.--The term ``Secretary'' 
                means the Secretary of Health and Human Services, 
                except as otherwise specified.</DELETED>
        <DELETED>    (2) Best practices.--The Secretary, in 
        consultation with the Secretary of Education, shall--</DELETED>
                <DELETED>    (A) identify or facilitate the development 
                of evidence-based best practices for prevention of 
                substance misuse and abuse by children, adolescents, 
                and young adults, for appropriate recovery support 
                services, and for appropriate use of medication-
                assisted treatment for such individuals, if 
                applicable;</DELETED>
                <DELETED>    (B) disseminate such best practices to 
                local educational agencies, institutions of higher 
                education, recovery programs at institutions of higher 
                education, local boards, one-stop operators, and 
                nonprofit organizations, as appropriate;</DELETED>
                <DELETED>    (C) conduct a rigorous, independent 
                evaluation of each grant funded under this subsection, 
                particularly its impact on the indicators described in 
                paragraph (5)(B); and</DELETED>
                <DELETED>    (D) provide technical assistance for 
                grantees under this subsection.</DELETED>
        <DELETED>    (3) 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 State agencies 
        responsible for carrying out substance use disorder prevention 
        and treatment programs, to carry out evidence-based or 
        promising programs for--</DELETED>
                <DELETED>    (A) prevention of substance abuse and 
                misuse by children, adolescents, and young 
                adults;</DELETED>
                <DELETED>    (B) recovery support services for 
                children, adolescents, and young adults, which may 
                include counseling, job training, linkages to 
                community-based services, family support groups, and 
                recovery coaching; and</DELETED>
                <DELETED>    (C) treatment or referrals for treatment 
                of substance use disorders, as appropriate.</DELETED>
        <DELETED>    (4) 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--</DELETED>
                <DELETED>    (A) a description of the impact of 
                substance use disorders on children, adolescents, and 
                young adults enrolled in the local educational agency, 
                one-stop operator, local board, or institution of 
                higher education;</DELETED>
                <DELETED>    (B) a description of how the eligible 
                entity has solicited input from faculty, teachers, 
                staff, families, students, and experts in substance use 
                prevention and treatment in developing such 
                application;</DELETED>
                <DELETED>    (C) how the eligible entity plans to use 
                grant funds for evidence-based or promising activities, 
                in accordance with this subsection to prevent, provide 
                recovery support for, and treat substance use disorders 
                amongst such individuals;</DELETED>
                <DELETED>    (D) an assurance that the eligible entity 
                will participate in the evaluation described in 
                paragraph (2)(C); and</DELETED>
                <DELETED>    (E) a description of how the eligible 
                entity will collaborate with local service providers, 
                including substance use disorder treatment programs, 
                providers of mental health services, and primary care 
                providers, in carrying out the grant program.</DELETED>
        <DELETED>    (5) Report.--Each eligible entity awarded a grant 
        under this section shall submit to the appropriate committees 
        of Congress, a report at such time and in such manner as the 
        Secretary may require. Such report shall include--</DELETED>
                <DELETED>    (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</DELETED>
                <DELETED>    (B) a description of how the grant program 
                has made an impact on--</DELETED>
                        <DELETED>    (i) indicators of student success, 
                        including student well-being and academic 
                        achievement; and</DELETED>
                        <DELETED>    (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.</DELETED>
        <DELETED>    (6) Authorization of appropriations.--There is 
        authorized to be appropriated, such sums as may be necessary to 
        carry out this subsection.</DELETED>

<DELETED>SEC. 409. PLANS OF SAFE CARE.</DELETED>

<DELETED>    (a) In General.--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:</DELETED>
        <DELETED>    ``(7) Grants to states to improve and coordinate 
        their response to ensure the safety, permanency, and well-being 
        of infants affected by substance use.--</DELETED>
                <DELETED>    ``(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, 
                public health and mental health agencies, and maternal 
                and child health agencies to facilitate collaboration 
                in developing, updating, and implementing plans of safe 
                care described in section 106(b)(2)(B)(iii).</DELETED>
                <DELETED>    ``(B) Distribution of funds.--</DELETED>
                        <DELETED>    ``(i) Reservations.--Of the 
                        amounts appropriated under subparagraph (H), 
                        the Secretary shall reserve--</DELETED>
                                <DELETED>    ``(I) no more than 3 
                                percent for the purposes described in 
                                subparagraph (G); and</DELETED>
                                <DELETED>    ``(II) up to 3 percent for 
                                grants to Indian Tribes and tribal 
                                organizations for purposes consistent 
                                with this section, as the Secretary 
                                determines appropriate.</DELETED>
                        <DELETED>    ``(ii) Allotments to states and 
                        territories.--The Secretary shall allot the 
                        amount appropriated under subparagraph (H) that 
                        remains after application of clause (i) on a 
                        competitive basis to States that apply for such 
                        a grant.</DELETED>
                        <DELETED>    ``(iii) Selection criteria.--The 
                        Secretary shall allot funds to States that 
                        demonstrate a strong need for such funds, and a 
                        strong commitment to using such funds, to meet 
                        the purposes described in subparagraph (A) in 
                        accordance with subparagraph (D).</DELETED>
                <DELETED>    ``(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--
                </DELETED>
                        <DELETED>    ``(i) a description of--</DELETED>
                                <DELETED>    ``(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--</DELETED>
                                        <DELETED>    ``(aa) the 
                                        prevalence of substance use 
                                        disorder in such 
                                        State;</DELETED>
                                        <DELETED>    ``(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</DELETED>
                                        <DELETED>    ``(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);</DELETED>
                                <DELETED>    ``(II) the challenges the 
                                State faces in developing and 
                                implementing plans of safe care in 
                                accordance with section 
                                106(b)(2)(B)(iii);</DELETED>
                                <DELETED>    ``(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, the public health and mental 
                                health agencies, programs funded by the 
                                Residential Treatment for Pregnant and 
                                Postpartum Women grant program of the 
                                Substance Abuse and Mental Health 
                                Services Administration under section 
                                508 of the Public Health Service Act 
                                (42 U.S.C. 290bb-1), 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;</DELETED>
                                <DELETED>    ``(IV) how the State will 
                                monitor local implementation of plans 
                                of safe care, in accordance with 
                                section 
                                106(b)(2)(B)(iii)(II);</DELETED>
                                <DELETED>    ``(V) how the State meets 
                                the requirements of section 1927 of the 
                                Public Health Service Act (42 U.S.C. 
                                300x-27);</DELETED>
                                <DELETED>    ``(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</DELETED>
                                <DELETED>    ``(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 wellbeing 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;</DELETED>
                        <DELETED>    ``(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</DELETED>
                        <DELETED>    ``(iii) an assurance that the 
                        State will--</DELETED>
                                <DELETED>    ``(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</DELETED>
                                <DELETED>    ``(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.).</DELETED>
                <DELETED>    ``(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:</DELETED>
                        <DELETED>    ``(i) Improving State and local 
                        systems with respect to the development and 
                        implementation of plans of safe care, which--
                        </DELETED>
                                <DELETED>    ``(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</DELETED>
                                <DELETED>    ``(II) may include 
                                activities such as--</DELETED>
                                        <DELETED>    ``(aa) developing 
                                        policies, procedures, or 
                                        protocols for the 
                                        administration 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;</DELETED>
                                        <DELETED>    ``(bb) improving 
                                        assessments used to determine 
                                        the needs of the infant and 
                                        family;</DELETED>
                                        <DELETED>    ``(cc) improving 
                                        ongoing case management 
                                        services; and</DELETED>
                                        <DELETED>    ``(dd) improving 
                                        access to treatment services, 
                                        which may be prior to the 
                                        pregnant woman's delivery 
                                        date.</DELETED>
                        <DELETED>    ``(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--</DELETED>
                                <DELETED>    ``(I) appropriate 
                                notification to child protective 
                                services is made in a timely 
                                manner;</DELETED>
                                <DELETED>    ``(II) a plan of safe care 
                                is in place, where needed, before the 
                                infant is discharged from the birth or 
                                health care facility; and</DELETED>
                                <DELETED>    ``(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.</DELETED>
                        <DELETED>    ``(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--</DELETED>
                                <DELETED>    ``(I) State mandatory 
                                reporting laws and the referral and 
                                notification process;</DELETED>
                                <DELETED>    ``(II) the co-occurrence 
                                of pregnancy and substance use 
                                disorder;</DELETED>
                                <DELETED>    ``(III) the clinical 
                                guidance about treating substance use 
                                disorder in pregnant and postpartum 
                                women;</DELETED>
                                <DELETED>    ``(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</DELETED>
                                <DELETED>    ``(V) appropriate 
                                strategies to address the mental health 
                                needs of the parent and child 
                                together.</DELETED>
                        <DELETED>    ``(iv) Establishing partnerships, 
                        agreements, or memoranda of understanding 
                        between the lead agency and health 
                        professionals, health facilities, child welfare 
                        professionals, substance use disorder and 
                        mental health 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--</DELETED>
                                <DELETED>    ``(I) developing a 
                                comprehensive, multi-disciplinary 
                                assessment and intervention process for 
                                infants 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 legal, medically supervised 
                                substance use, and substance use 
                                disorder;</DELETED>
                                <DELETED>    ``(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</DELETED>
                                <DELETED>    ``(III) increasing access 
                                to 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.</DELETED>
                        <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(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 
                the following:</DELETED>
                        <DELETED>    ``(i) The number of the infants 
                        identified under section 106(b)(2)(B)(ii) who 
                        experienced removal due to parental substance 
                        use concerns who are reunified with parents, 
                        and the length of time between such removal and 
                        reunification.</DELETED>
                        <DELETED>    ``(ii) The number of the infants 
                        identified under section 106(b)(2)(B)(ii) who 
                        experienced substantiated reports of child 
                        abuse or neglect and received differential 
                        response while in the care of their birth 
                        parents or within 1 year after a reunification 
                        has occurred.</DELETED>
                        <DELETED>    ``(iii) The number of the infants 
                        identified under section 106(b)(2)(B)(ii) who 
                        experienced a return to out-of-home care within 
                        one year after reunification.</DELETED>
                <DELETED>    ``(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.</DELETED>
                <DELETED>    ``(G) Reservation of funds.--The Secretary 
                shall use the amount reserved under subparagraph 
                (B)(i)(I) for the purposes of--</DELETED>
                        <DELETED>    ``(i) providing technical 
                        assistance, including programs of in-depth 
                        technical assistance, to additional States, 
                        territories, and Indian tribes in accordance 
                        with the substance-exposed infant initiative 
                        developed by the National Center on Substance 
                        Abuse and Child Welfare;</DELETED>
                        <DELETED>    ``(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--</DELETED>
                                <DELETED>    ``(I) clarifying key 
                                terms; and</DELETED>
                                <DELETED>    ``(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;</DELETED>
                        <DELETED>    ``(iii) supporting State efforts 
                        to develop information technology systems to 
                        manage plans of safe care; and</DELETED>
                        <DELETED>    ``(iv) preparing the Secretary's 
                        report to Congress described in subparagraph 
                        (F).</DELETED>
                <DELETED>    ``(H) Authorization of appropriations.--To 
                carry out the program under this paragraph, there are 
                authorized to be appropriated $60,000,000 for each of 
                fiscal years 2019 through 2023.''.</DELETED>
<DELETED>    (b) Definition.--Section 3 of the Child Abuse Prevention 
and Treatment Act (42 U.S.C. 5101 note) is amended--</DELETED>
        <DELETED>    (1) in paragraph (7), by striking ``; and'' and 
        inserting a semicolon;</DELETED>
        <DELETED>    (2) by redesignating paragraph (8) as paragraph 
        (9); and</DELETED>
        <DELETED>    (3) by inserting after paragraph (7) the 
        following:</DELETED>
        <DELETED>    ``(8) the term `substance use disorder' means the 
        abuse of alcohol or other drugs; and''.</DELETED>

<DELETED>SEC. 410. REGULATIONS RELATING TO SPECIAL REGISTRATION FOR 
              TELEMEDICINE.</DELETED>

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

<DELETED>SEC. 411. NATIONAL HEALTH SERVICE CORPS BEHAVIORAL AND MENTAL 
              HEALTH PROFESSIONALS PROVIDING OBLIGATED SERVICE IN 
              SCHOOLS AND OTHER COMMUNITY-BASED SETTINGS.</DELETED>

<DELETED>    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:</DELETED>

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

<DELETED>    ``(a) Schools and Community-Based Settings.--An entity to 
which a Corps member is assigned under section 333 may direct such 
Corps member to provide service as a behavioral and mental health 
professional at a school or other community-based setting located in a 
health professional shortage area.</DELETED>
<DELETED>    ``(b) Obligated Service.--</DELETED>
        <DELETED>    ``(1) In general.--Any service described in 
        subsection (a) that a Corps member provides may count towards 
        such Corps member's completion of any obligated service 
        requirements under the Scholarship Program or the Loan 
        Repayment Program, subject to any limitation imposed under 
        paragraph (2).</DELETED>
        <DELETED>    ``(2) Limitation.--The Secretary may impose a 
        limitation on the number of hours of service described in 
        subsection (a) that a Corps member 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.</DELETED>
<DELETED>    ``(c) Rule of Construction.--The authorization under 
subsection (a) shall be notwithstanding any other provision of this 
subpart or subpart II.''.</DELETED>

<DELETED>SEC. 412. LOAN REPAYMENT FOR SUBSTANCE USE DISORDER TREATMENT 
              PROVIDERS.</DELETED>

<DELETED>    (a) Loan Repayment for Substance Use Treatment 
Providers.--The Secretary of Health and Human Services (referred to in 
this section as 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.</DELETED>
<DELETED>    (b) Provision of Substance Use Disorder Treatment.--In 
carrying out the activities described in subsection (a)--</DELETED>
        <DELETED>    (1) such facilities shall be located in mental 
        health professional shortage areas designated under section 332 
        of the Public Health Service Act (42 U.S.C. 254e);</DELETED>
        <DELETED>    (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;</DELETED>
        <DELETED>    (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 masters level, 
        licensed substance use disorder treatment counselors; 
        and</DELETED>
        <DELETED>    (4) such professionals and facilities shall 
        provide--</DELETED>
                <DELETED>    (A) 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</DELETED>
                <DELETED>    (B) all drugs approved by the Food and 
                Drug Administration to treat substance use 
                disorders.</DELETED>
<DELETED>    (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.</DELETED>

<DELETED>SEC. 413. IMPROVING TREATMENT FOR PREGNANT AND POSTPARTUM 
              WOMEN.</DELETED>

<DELETED>    (a) Report.--</DELETED>
        <DELETED>    (1) In general.--Not later than 60 days after the 
        date of enactment of this Act, the Secretary of Health and 
        Human Services (referred to in this subsection as 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--</DELETED>
                <DELETED>    (A) an update on the implementation of the 
                recommendations in the strategy, including information 
                regarding the agencies involved in the implementation; 
                and</DELETED>
                <DELETED>    (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.</DELETED>
        <DELETED>    (2) Periodic updates.--The Secretary shall 
        periodically update the report under paragraph (1).</DELETED>
<DELETED>    (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''.</DELETED>

<DELETED>SEC. 414. EARLY INTERVENTIONS FOR PREGNANT WOMEN AND 
              INFANTS.</DELETED>

<DELETED>    (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--</DELETED>
        <DELETED>    (1) in paragraph (13), by striking ``and'' at the 
        end;</DELETED>
        <DELETED>    (2) in paragraph (14), by striking the period at 
        the end and inserting ``; and''; and</DELETED>
        <DELETED>    (3) by adding at the end the following:</DELETED>
        <DELETED>    ``(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.''.</DELETED>
<DELETED>    (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--</DELETED>
        <DELETED>    (1) in paragraph (13), by striking ``and'' at the 
        end;</DELETED>
        <DELETED>    (2) in paragraph (14), by striking the period at 
        the end and inserting a semicolon; and</DELETED>
        <DELETED>    (3) by adding at the end the following:</DELETED>
        <DELETED>    ``(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''.</DELETED>
<DELETED>    (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:</DELETED>
        <DELETED>    ``(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.''.</DELETED>

                 <DELETED>TITLE V--PREVENTION</DELETED>

<DELETED>SEC. 501. STUDY ON PRESCRIBING LIMITS.</DELETED>

<DELETED>    Not later than 2 years after the date of enactment of this 
Act, the Secretary of Health and Human Services, 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--</DELETED>
        <DELETED>    (1) the impact of such limits on--</DELETED>
                <DELETED>    (A) the incidence and prevalence of 
                overdose related to prescription opioids;</DELETED>
                <DELETED>    (B) the incidence and prevalence of 
                overdose related to illicit opioids;</DELETED>
                <DELETED>    (C) the prevalence of opioid use 
                disorders; and</DELETED>
                <DELETED>    (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 clinical indication for which opioids are 
                prescribed;</DELETED>
        <DELETED>    (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; 
        and</DELETED>
        <DELETED>    (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)).</DELETED>

<DELETED>SEC. 502. PROGRAMS FOR HEALTH CARE WORKFORCE.</DELETED>

<DELETED>    (a) Program for Education and Training in Pain Care.--
Section 759 of the Public Health Service Act (42 U.S.C. 294i) is 
amended--</DELETED>
        <DELETED>    (1) in subsection (a), by inserting ``nonprofit'' 
        after ``private'';</DELETED>
        <DELETED>    (2) in subsection (b)--</DELETED>
                <DELETED>    (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'';</DELETED>
                <DELETED>    (B) in paragraph (1)--</DELETED>
                        <DELETED>    (i) by inserting ``preventing,'' 
                        after ``diagnosing,''; and</DELETED>
                        <DELETED>    (ii) by inserting ``non-addictive 
                        medical products and non-pharmacologic 
                        treatments and'' after ``including'';</DELETED>
                <DELETED>    (C) in paragraph (2)--</DELETED>
                        <DELETED>    (i) by inserting ``Federal, State, 
                        and local'' after ``applicable''; and</DELETED>
                        <DELETED>    (ii) by striking ``the degree to 
                        which'' and all that follows through 
                        ``effective pain care'' and inserting 
                        ``opioids'';</DELETED>
                <DELETED>    (D) in paragraph (3), by inserting ``and, 
                as appropriate, non-pharmacotherapy'' before the 
                semicolon;</DELETED>
                <DELETED>    (E) in paragraph (4)--</DELETED>
                        <DELETED>    (i) by inserting ``any'' before 
                        ``cultural''; and</DELETED>
                        <DELETED>    (ii) by striking ``; and'' and 
                        inserting ``;'';</DELETED>
                <DELETED>    (F) in paragraph (5), by striking 
                ``provision of pain care.'' and inserting ``scientific 
                basis of pain and the provision of pain care, including 
                through non-addictive medical products and non-
                pharmacologic treatments; and''; and</DELETED>
                <DELETED>    (G) by adding at the end the 
                following:</DELETED>
        <DELETED>    ``(6) the dangers of opioid abuse, detection of 
        early warning signs of opioid use disorders, and safe disposal 
        options for prescription medications, including such options 
        provided by law enforcement, or other innovative deactivation 
        mechanisms.'';</DELETED>
        <DELETED>    (3) in subsection (d), by inserting 
        ``prevention,'' after ``diagnosis,''; and</DELETED>
        <DELETED>    (4) in subsection (e), by striking ``2010 through 
        2012'' and inserting ``2019 through 2023''.</DELETED>
<DELETED>    (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--</DELETED>
        <DELETED>    (1) in paragraph (1), by inserting ``, trauma,'' 
        after ``focus on child and adolescent mental health''; 
        and</DELETED>
        <DELETED>    (2) in paragraphs (2) and (3), by inserting 
        ``trauma-informed care and'' before ``substance use disorder 
        prevention and treatment services''.</DELETED>

<DELETED>SEC. 503. EDUCATION AND AWARENESS CAMPAIGNS.</DELETED>

<DELETED>    Section 102 of the Comprehensive Addiction and Recovery 
Act of 2016 (Public Law 114-198) is amended--</DELETED>
        <DELETED>    (1) by amending subsection (a) to read as 
        follows:</DELETED>
<DELETED>    ``(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--</DELETED>
        <DELETED>    ``(1) the public, including patients and 
        consumers;</DELETED>
        <DELETED>    ``(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;</DELETED>
        <DELETED>    ``(3) providers, which may include--</DELETED>
                <DELETED>    ``(A) providing for continuing education 
                on appropriate prescribing practices;</DELETED>
                <DELETED>    ``(B) education related to applicable 
                State or local prescriber limit laws, information on 
                the use of non-addictive or non-opioid alternatives for 
                pain management, and the use of overdose reversal 
                drugs, as appropriate;</DELETED>
                <DELETED>    ``(C) disseminating and improving the use 
                of evidence-based opioid prescribing guidelines across 
                relevant health care settings, as appropriate, and 
                updating guidelines as necessary;</DELETED>
                <DELETED>    ``(D) implementing strategies, such as 
                best practices, to encourage and facilitate the use of 
                prescriber guidelines, in accordance with State and 
                local law; and</DELETED>
                <DELETED>    ``(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</DELETED>
        <DELETED>    ``(4) other appropriate entities.''; and</DELETED>
        <DELETED>    (2) in subsection (b)--</DELETED>
                <DELETED>    (A) by striking ``opioid abuse'' each 
                place such term appears and inserting ``opioid misuse 
                and abuse''; and</DELETED>
                <DELETED>    (B) in paragraph (2), by striking ``safe 
                disposal of prescription medications and other'' and 
                inserting ``non-addictive or non-opioid treatment 
                options, safe disposal options for prescription 
                medications, and other applicable''.</DELETED>

<DELETED>SEC. 504. ENHANCED CONTROLLED SUBSTANCE OVERDOSES DATA 
              COLLECTION, ANALYSIS, AND DISSEMINATION.</DELETED>

<DELETED>    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:</DELETED>

<DELETED>``SEC. 392A. ENHANCED CONTROLLED SUBSTANCE OVERDOSES DATA 
              COLLECTION, ANALYSIS, AND DISSEMINATION.</DELETED>

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

<DELETED>SEC. 505. PREVENTING OVERDOSES OF CONTROLLED 
              SUBSTANCES.</DELETED>

<DELETED>    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:</DELETED>

<DELETED>``SEC. 392B. PREVENTING OVERDOSES OF CONTROLLED 
              SUBSTANCES.</DELETED>

<DELETED>    ``(a) Prevention Activities.--</DELETED>
        <DELETED>    ``(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--</DELETED>
                <DELETED>    ``(A) to the extent practicable, carry out 
                and expand any prevention activity described in 
                paragraph (2);</DELETED>
                <DELETED>    ``(B) provide training and technical 
                assistance to States, localities, and Indian tribes to 
                carrying out any such activity; and</DELETED>
                <DELETED>    ``(C) award grants to States, localities, 
                and tribes for the purpose of carrying out any such 
                activity.</DELETED>
        <DELETED>    ``(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--</DELETED>
                <DELETED>    ``(A) encouraging all authorized users (as 
                specified by the State or other entity) to register 
                with and use the program;</DELETED>
                <DELETED>    ``(B) enabling such users to access any 
                data updates in as close to real-time as 
                practicable;</DELETED>
                <DELETED>    ``(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 practices 
                relating to such substances;</DELETED>
                <DELETED>    ``(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 
                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;</DELETED>
                <DELETED>    ``(E) enhancing interoperability between 
                the program and any health information technology 
                (including certified health information technology), 
                including by integrating program data into such 
                technology;</DELETED>
                <DELETED>    ``(F) updating program capabilities to 
                respond to technological innovation for purposes of 
                appropriately addressing the occurrence and evolution 
                of controlled substance overdoses; and</DELETED>
                <DELETED>    ``(G) facilitating and encouraging data 
                exchange between the program and the prescription drug 
                monitoring programs of other States.</DELETED>
<DELETED>    ``(b) Additional Grants.--The Director may award grants to 
States, localities, and Indian tribes--</DELETED>
        <DELETED>    ``(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</DELETED>
        <DELETED>    ``(2) for any other evidence-based activity for 
        preventing controlled substance misuse, abuse, and overdoses as 
        the Director determines appropriate.</DELETED>
<DELETED>    ``(c) Research.--The Director may conduct studies and 
evaluations to address substance use disorders, including preventing 
substance use disorders or other related topics the Director determines 
appropriate.</DELETED>
<DELETED>    ``(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 of prescription 
opioids.</DELETED>
<DELETED>    ``(e) Controlled Substance Defined.--In this section, the 
term `controlled substance' has the meaning given that term in section 
102 of the Controlled Substances Act.</DELETED>
<DELETED>    ``(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.''.</DELETED>

<DELETED>SEC. 506. CDC SURVEILLANCE AND DATA COLLECTION FOR CHILD, 
              YOUTH, AND ADULT TRAUMA.</DELETED>

<DELETED>    (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.</DELETED>
<DELETED>    (b) Timing.--The collection of data under subsection (a) 
may occur in fiscal year 2019 and every 2 years thereafter.</DELETED>
<DELETED>    (c) Data From Tribal and 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.</DELETED>
<DELETED>    (d) Authorization of Appropriations.--To carry out this 
section, there are authorized to be appropriated such sums as may be 
necessary for the period of fiscal years 2019 through 2021.</DELETED>

<DELETED>SEC. 507. REAUTHORIZATION OF NASPER.</DELETED>

<DELETED>    Section 399O of the Public Health Service Act (42 U.S.C. 
280g-3) is amended--</DELETED>
        <DELETED>    (1) in subsection (a)--</DELETED>
                <DELETED>    (A) in paragraph (1), in the matter 
                preceding subparagraph (A), by striking ``Administrator 
                of the Substance Abuse and Mental Health Services 
                Administration and Director of the Centers for Disease 
                Control and Prevention'' and inserting ``Director of 
                the Centers for Disease Control and Prevention and the 
                Assistant Secretary for Mental Health and Substance Use 
                Disorders''; and</DELETED>
                <DELETED>    (B) by adding at the end the 
                following:</DELETED>
        <DELETED>    ``(4) States and local governments.--</DELETED>
                <DELETED>    ``(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).</DELETED>
                <DELETED>    ``(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.'';</DELETED>
        <DELETED>    (2) in subsection (c)--</DELETED>
                <DELETED>    (A) in paragraph (1)(A)(iii)--</DELETED>
                        <DELETED>    (i) by inserting ``as such 
                        standards become available,'' after 
                        ``interoperability standards,''; and</DELETED>
                        <DELETED>    (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</DELETED>
                <DELETED>    (B) in paragraph (3)(A), by inserting 
                ``including electronic health records,'' after 
                ``technology systems,'';</DELETED>
        <DELETED>    (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'';</DELETED>
        <DELETED>    (4) in subsection (f)(1)(D), by striking 
        ``medicaid'' and inserting ``Medicaid'';</DELETED>
        <DELETED>    (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</DELETED>
        <DELETED>    (6) in subsection (n), by striking ``2021'' and 
        inserting ``2026''.</DELETED>

<DELETED>SEC. 508. JESSIE'S LAW.</DELETED>

<DELETED>    (a) Best Practices.--</DELETED>
        <DELETED>    (1) In general.--Not later than 1 year after the 
        date of enactment of this Act, the Secretary of Health and 
        Human Services (referred to in this section as 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--</DELETED>
                <DELETED>    (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;</DELETED>
                <DELETED>    (B) what constitutes the patient's request 
                for the purpose described in subparagraph (A); 
                and</DELETED>
                <DELETED>    (C) the process and methods by which the 
                information should be so displayed.</DELETED>
        <DELETED>    (2) Dissemination.--The Secretary shall 
        disseminate the best practices developed under paragraph (1) to 
        health care providers and State agencies.</DELETED>
<DELETED>    (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:</DELETED>
        <DELETED>    (1) The potential for addiction relapse or 
        overdose, including overdose death, when opioid medications are 
        prescribed to a patient recovering from opioid use 
        disorder.</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (6) All applicable Federal and State laws and 
        regulations.</DELETED>

<DELETED>SEC. 509. DEVELOPMENT AND DISSEMINATION OF MODEL TRAINING 
              PROGRAMS FOR SUBSTANCE USE DISORDER PATIENT 
              RECORDS.</DELETED>

<DELETED>    (a) Initial Programs and Materials.--Not later than 1 year 
after the date of the enactment of this Act, the Secretary of Health 
and Human Services (referred to in this section as 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):</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (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).</DELETED>
<DELETED>    (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--</DELETED>
        <DELETED>    (1) facilitate communication between substance use 
        disorder treatment providers and other health care providers to 
        promote and provide the best possible integrated 
        care;</DELETED>
        <DELETED>    (2) avoid inappropriate prescribing that can lead 
        to dangerous drug interactions, overdose, or relapse; 
        and</DELETED>
        <DELETED>    (3) notify and involve families and caregivers 
        when individuals experience an overdose.</DELETED>
<DELETED>    (c) Periodic Updates.--The Secretary shall--</DELETED>
        <DELETED>    (1) periodically review and update the model 
        program and materials identified or developed under subsection 
        (a); and</DELETED>
        <DELETED>    (2) disseminate such updated programs and 
        materials to the individuals described in subsection 
        (a)(1).</DELETED>
<DELETED>    (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.</DELETED>
<DELETED>    (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.</DELETED>

<DELETED>SEC. 510. COMMUNICATION WITH FAMILIES DURING 
              EMERGENCIES.</DELETED>

<DELETED>    (a) Promoting Awareness of Authorized Disclosures During 
Emergencies.--The Secretary of Health and Human Services 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.</DELETED>
<DELETED>    (b) Use of Material.--For the purposes of carrying out 
subsection (a), the Secretary of Health and Human Services may use 
material produced under section 509 of this Act or under section 11004 
of the 21st Century Cures Act (42 U.S.C. 1320d-2 note).</DELETED>

<DELETED>SEC. 511. PRENATAL AND POSTNATAL HEALTH.</DELETED>

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

<DELETED>SEC. 512. SURVEILLANCE AND EDUCATION REGARDING INFECTIONS 
              ASSOCIATED WITH INJECTION DRUG USE AND OTHER RISK 
              FACTORS.</DELETED>

<DELETED>    Section 317N of the Public Health Service Act (42 U.S.C. 
247b-15) is amended--</DELETED>
        <DELETED>    (1) by amending the section heading to read as 
        follows: ``surveillance and education regarding infections 
        associated with injection drug use and other risk 
        factors'';</DELETED>
        <DELETED>    (2) in subsection (a)--</DELETED>
                <DELETED>    (A) in the matter preceding paragraph (1), 
                by inserting ``activities'' before the colon;</DELETED>
                <DELETED>    (B) in paragraph (1)--</DELETED>
                        <DELETED>    (i) by inserting ``or 
                        maintaining'' after ``implementing'';</DELETED>
                        <DELETED>    (ii) by striking ``hepatitis C 
                        virus infection (in this section referred to as 
                        `HCV infection')'' and inserting ``infections 
                        commonly associated with injection drug use, 
                        including viral hepatitis and human 
                        immunodeficiency virus,''; and</DELETED>
                        <DELETED>    (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.'';</DELETED>
                <DELETED>    (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 
                injection drug use, receiving blood transfusions prior 
                to July 1992, or other risk factors.'';</DELETED>
                <DELETED>    (D) in paragraphs (4) and (5), by striking 
                ``HCV infection'' each place such term appears and 
                inserting ``infections described in paragraph (1)''; 
                and</DELETED>
                <DELETED>    (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'';</DELETED>
        <DELETED>    (3) in subsection (b)--</DELETED>
                <DELETED>    (A) by striking ``directly and'' and 
                inserting ``directly or''; and</DELETED>
                <DELETED>    (B) by striking ``hepatitis C,'' and all 
                that follows through the period at the end and 
                inserting ``infections described in subsection 
                (a)(1).'';</DELETED>
        <DELETED>    (4) by redesignating subsection (c) as subsection 
        (d);</DELETED>
        <DELETED>    (5) by inserting after subsection (b) the 
        following:</DELETED>
<DELETED>    ``(c) Definition.--In this section, the term `injection 
drug use' means--</DELETED>
        <DELETED>    ``(1) intravenous administration of a substance in 
        schedule I of section 202(c) of the Controlled Substances 
        Act;</DELETED>
        <DELETED>    ``(2) intravenous administration of a substance in 
        schedule II, III, IV, or V of section 202(c) of the Controlled 
        Substances Act that has not been approved for intravenous use 
        under section 505 of the Federal Food, Drug and Cosmetic Act or 
        section 351 of the Public Health Service Act; or</DELETED>
        <DELETED>    ``(3) intravenous administration of a substance in 
        schedule II, III, IV, or V of section 202(c) of the Controlled 
        Substances Act that has not been prescribed to the person using 
        the substance.''; and</DELETED>
        <DELETED>    (6) in subsection (d), as so redesignated, 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''.</DELETED>

<DELETED>SEC. 513. TASK FORCE TO DEVELOP BEST PRACTICES FOR TRAUMA-
              INFORMED IDENTIFICATION, REFERRAL, AND SUPPORT.</DELETED>

<DELETED>    (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.</DELETED>
<DELETED>    (b) Membership.--</DELETED>
        <DELETED>    (1) Composition.--The task force shall be composed 
        of the heads of the following Federal departments and agencies, 
        or their designees:</DELETED>
                <DELETED>    (A) The Centers for Medicare & Medicaid 
                Services.</DELETED>
                <DELETED>    (B) The Substance Abuse and Mental Health 
                Services Administration.</DELETED>
                <DELETED>    (C) The Agency for Healthcare Research and 
                Quality.</DELETED>
                <DELETED>    (D) The Centers for Disease Control and 
                Prevention.</DELETED>
                <DELETED>    (E) The Indian Health Service.</DELETED>
                <DELETED>    (F) The Department of Veterans 
                Affairs.</DELETED>
                <DELETED>    (G) The National Institutes of 
                Health.</DELETED>
                <DELETED>    (H) The Food and Drug 
                Administration.</DELETED>
                <DELETED>    (I) The Health Resources and Services 
                Administration.</DELETED>
                <DELETED>    (J) The Department of Defense.</DELETED>
                <DELETED>    (K) The Office of Minority 
                Health.</DELETED>
                <DELETED>    (L) The Administration for Children and 
                Families.</DELETED>
                <DELETED>    (M) The Office of the Assistant Secretary 
                for Planning and Evaluation.</DELETED>
                <DELETED>    (N) The Office for Civil Rights at the 
                Department of Health and Human Services.</DELETED>
                <DELETED>    (O) The Office of Juvenile Justice and 
                Delinquency Prevention of the Department of 
                Justice.</DELETED>
                <DELETED>    (P) The Office of Community Oriented 
                Policing Services of the Department of 
                Justice.</DELETED>
                <DELETED>    (Q) The Office on Violence Against Women 
                of the Department of Justice.</DELETED>
                <DELETED>    (R) The National Center for Education 
                Evaluation and Regional Assistance of the Department of 
                Education.</DELETED>
                <DELETED>    (S) The National Center for Special 
                Education Research of the Institute of Education 
                Science.</DELETED>
                <DELETED>    (T) The Office of Elementary and Secondary 
                Education of the Department of Education.</DELETED>
                <DELETED>    (U) The Office for Civil Rights at the 
                Department of Education.</DELETED>
                <DELETED>    (V) The Office of Special Education and 
                the Rehabilitative Services of the Department of 
                Education.</DELETED>
                <DELETED>    (W) the Bureau of Indian Affairs of the 
                Department of the Interior.</DELETED>
                <DELETED>    (X) The Veterans Health Administration of 
                the Department of Veterans Affairs.</DELETED>
                <DELETED>    (Y) The Office of Special Needs Assistance 
                Programs of the Department of Housing and Urban 
                Development.</DELETED>
                <DELETED>    (Z) The Office of Head Start of the 
                Administration for Children and Families.</DELETED>
                <DELETED>    (AA) The Children's Bureau of the 
                Administration for Children and Families.</DELETED>
                <DELETED>    (BB) The Bureau of Indian Education of the 
                Department of the Interior.</DELETED>
                <DELETED>    (CC) Such other Federal agencies as the 
                Secretaries determine to be appropriate.</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (3) Chairperson.--The task force shall be chaired 
        by the Assistant Secretary for Mental Health and Substance 
        Use.</DELETED>
<DELETED>    (c) Task Force Duties.--The task force shall--</DELETED>
        <DELETED>    (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</DELETED>
        <DELETED>    (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--
        </DELETED>
                <DELETED>    (A) a set of evidence-based, evidence-
                informed, and promising best practices with respect 
                to--</DELETED>
                        <DELETED>    (i) the identification of infants, 
                        children and youth, and their families as 
                        appropriate, who have experienced or are at 
                        risk of experiencing trauma; and</DELETED>
                        <DELETED>    (ii) the expeditious referral to 
                        and implementation of trauma-informed practices 
                        and supports that prevent and mitigate the 
                        effects of trauma;</DELETED>
                <DELETED>    (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 children and their families as 
                appropriate, who have experienced or are at risk of 
                experiencing trauma; and</DELETED>
                <DELETED>    (C) existing Federal authorities at the 
                Department of Education, Department of Health and Human 
                Services, Department of Justice, Department of Labor, 
                Department of 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--</DELETED>
                        <DELETED>    (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</DELETED>
                        <DELETED>    (ii) to the general public through 
                        the internet website of the task 
                        force.</DELETED>
<DELETED>    (d) Best Practices.--In identifying, evaluating, and 
recommending the set of best practices under subsection (c), the task 
force shall--</DELETED>
        <DELETED>    (1) include guidelines for providing professional 
        development for front-line services providers, including school 
        personnel, providers from child- or youth-serving 
        organizations, primary and behavioral health care providers, 
        child welfare and social services providers, family and 
        juvenile court judges and attorneys, 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--</DELETED>
                <DELETED>    (A) understanding and identifying early 
                signs and risk factors of trauma in children and youth, 
                and their families as appropriate, including through 
                screening processes;</DELETED>
                <DELETED>    (B) providing practices to prevent and 
                mitigate the impact of trauma, including by fostering 
                safe and stable environments and relationships; 
                and</DELETED>
                <DELETED>    (C) developing and implementing procedures 
                or systems that--</DELETED>
                        <DELETED>    (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 treatment appropriate to the age of 
                        the child, and to ensure such infants, 
                        children, youth, and family members receive 
                        such support;</DELETED>
                        <DELETED>    (ii) utilize and develop 
                        partnerships with 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 trauma-
                        informed and evidence-based treatment 
                        appropriate to the age of the child) aimed at 
                        preventing or mitigating the effects of 
                        trauma;</DELETED>
                        <DELETED>    (iii) educate children and youth 
                        to--</DELETED>
                                <DELETED>    (I) understand and 
                                identify the signs, effects, or 
                                symptoms of trauma; and</DELETED>
                                <DELETED>    (II) build the resilience 
                                and coping skills to mitigate the 
                                effects of experiencing 
                                trauma;</DELETED>
                        <DELETED>    (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</DELETED>
                        <DELETED>    (v) collect and utilize data from 
                        screenings, referrals, or the provision of 
                        services and supports, conducted in the covered 
                        settings, 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</DELETED>
        <DELETED>    (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.</DELETED>
<DELETED>    (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 paragraphs (2) and (3) of 
subsection (c). Such operating plan shall include--</DELETED>
        <DELETED>    (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;</DELETED>
        <DELETED>    (2) a plan for carrying out the activities under 
        paragraphs (2) and (3) of subsection (c);</DELETED>
        <DELETED>    (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;</DELETED>
        <DELETED>    (4) an explanation of Federal agency involvement 
        and coordination needed to carry out such activities, including 
        any statutory or regulatory barriers to such 
        coordination;</DELETED>
        <DELETED>    (5) a budget for carrying out such activities; 
        and</DELETED>
        <DELETED>    (6) other information that the task force 
        determines appropriate.</DELETED>
<DELETED>    (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.</DELETED>
<DELETED>    (g) Authorization of Appropriations.--To carry out this 
section, there are authorized to be appropriated such sums as may be 
necessary for each of fiscal years 2019 through 2022.</DELETED>
<DELETED>    (h) 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.</DELETED>

<DELETED>SEC. 514. GRANTS TO IMPROVE TRAUMA SUPPORT SERVICES AND MENTAL 
              HEALTH CARE FOR CHILDREN AND YOUTH IN EDUCATIONAL 
              SETTINGS.</DELETED>

<DELETED>    (a) Grants, Contracts, and Cooperative Agreements 
Authorized.--The Secretary, in coordination with the Director of 
Substance Abuse and Mental Health Services Administration, 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.</DELETED>
<DELETED>    (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.</DELETED>
<DELETED>    (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 or promising activities, which shall include any of 
the following:</DELETED>
        <DELETED>    (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 services to students, such 
        as by providing universal trauma screenings to identify 
        students in need of specialized support.</DELETED>
        <DELETED>    (2) To implement multi-tiered positive behavioral 
        interventions and supports, or other trauma-informed models of 
        support.</DELETED>
        <DELETED>    (3) To provide professional development to 
        teachers, teacher assistants, school leaders, specialized 
        instructional support personnel, and mental health 
        professionals that--</DELETED>
                <DELETED>    (A) fosters safe and stable learning 
                environments that prevent and mitigate the effects of 
                trauma, including through social and emotional 
                learning;</DELETED>
                <DELETED>    (B) improves school capacity to identify, 
                refer, and provide services to students in need of 
                trauma support or behavioral health services; 
                or</DELETED>
                <DELETED>    (C) reflects the best practices developed 
                by the Interagency Task Force on Trauma-Informed Care 
                established under section 513.</DELETED>
        <DELETED>    (4) 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.</DELETED>
        <DELETED>    (5) To provide technical assistance to school 
        systems and mental health agencies.</DELETED>
        <DELETED>    (6) 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.</DELETED>
<DELETED>    (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:</DELETED>
        <DELETED>    (1) A description of the program 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 the students.</DELETED>
        <DELETED>    (2) A description of how the program will provide 
        linguistically appropriate and culturally competent 
        services.</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (4) An assurance that--</DELETED>
                <DELETED>    (A) persons providing services under the 
                grant, contract, or cooperative agreement are 
                adequately trained to provide such services; 
                and</DELETED>
                <DELETED>    (B) teachers, school leaders, 
                administrators, specialized instructional support 
                personnel, representatives of local Indian tribes 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.</DELETED>
        <DELETED>    (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.</DELETED>
<DELETED>    (e) Interagency Agreements.--</DELETED>
        <DELETED>    (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, 
        juvenile justice authorities, mental health agencies, child 
        welfare agencies, and other relevant entities in the State, in 
        collaboration with local entities, such as Indian 
        tribes.</DELETED>
        <DELETED>    (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--</DELETED>
                <DELETED>    (A) the financial responsibility for the 
                services;</DELETED>
                <DELETED>    (B) the conditions and terms of 
                responsibility for the services, including quality, 
                accountability, and coordination of the services; 
                and</DELETED>
                <DELETED>    (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.</DELETED>
<DELETED>    (f) Evaluation.--The Secretary shall reserve not to exceed 
3 percent of the funds made available under subsection (l) for each 
fiscal year to--</DELETED>
        <DELETED>    (1) conduct a rigorous, independent evaluation of 
        the activities funded under this section; and</DELETED>
        <DELETED>    (2) disseminate and promote the utilization of 
        evidence-based practices regarding trauma support services and 
        mental health care.</DELETED>
<DELETED>    (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.</DELETED>
<DELETED>    (h) Rule of Construction.--Nothing in this section shall 
be construed--</DELETED>
        <DELETED>    (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</DELETED>
        <DELETED>    (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.</DELETED>
<DELETED>    (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.</DELETED>
<DELETED>    (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.</DELETED>
<DELETED>    (k) Definitions.--In this section:</DELETED>
        <DELETED>    (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).</DELETED>
        <DELETED>    (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)).</DELETED>
        <DELETED>    (3) 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).</DELETED>
        <DELETED>    (4) Secretary.--The term ``Secretary'' means the 
        Secretary of Education.</DELETED>
        <DELETED>    (5) Specialized instructional support personnel.--
        The term ``specialized instructional support personnel'' has 
        the meaning given such term in 8101 of the Elementary and 
        Secondary Education Act of 1965 (20 U.S.C. 7801).</DELETED>
<DELETED>    (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.</DELETED>

<DELETED>SEC. 515. NATIONAL CHILD TRAUMATIC STRESS 
              INITIATIVE.</DELETED>

<DELETED>    Section 582(j) of the Public Health Service Act (42 U.S.C. 
290hh-1(j)) 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''.</DELETED>

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 of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Definitions.

               TITLE I--REAUTHORIZATION OF CURES FUNDING

Sec. 101. State response to the opioid abuse crisis.

                   TITLE II--RESEARCH AND INNOVATION

Sec. 201. Advancing cutting-edge research.
Sec. 202. Pain research.

      TITLE III--MEDICAL PRODUCTS AND CONTROLLED SUBSTANCES SAFETY

Sec. 301. Clarifying FDA regulation of non-addictive pain products.
Sec. 302. Clarifying FDA packaging authorities.
Sec. 303. Strengthening FDA and CBP coordination and capacity.
Sec. 304. Clarifying FDA post-market authorities.
Sec. 305. Restricting entrance of illicit drugs.
Sec. 306. First responder training.
Sec. 307. Disposal of controlled substances of hospice patients.
Sec. 308. GAO study and report on hospice safe drug management.
Sec. 309. Delivery of a controlled substance by a pharmacy to be 
                            administered by injection or implantation.

                    TITLE IV--TREATMENT AND RECOVERY

Sec. 401. Comprehensive opioid recovery centers.
Sec. 402. Program to support coordination and continuation of care for 
                            drug overdose patients.
Sec. 403. Alternatives to opioids.
Sec. 404. Building communities of recovery.
Sec. 405. Peer support technical assistance center.
Sec. 406. Medication-assisted treatment for recovery from addiction.
Sec. 407. Grant program.
Sec. 408. Allowing for more flexibility with respect to medication-
                            assisted treatment for opioid use 
                            disorders.
Sec. 409. National recovery housing best practices.
Sec. 410. Addressing economic and workforce impacts of the opioid 
                            crisis.
Sec. 411. Youth prevention and recovery.
Sec. 412. Plans of safe care.
Sec. 413. Regulations relating to special registration for 
                            telemedicine.
Sec. 414. National Health Service Corps behavioral and mental health 
                            professionals providing obligated service 
                            in schools and other community-based 
                            settings.
Sec. 415. Loan repayment for substance use disorder treatment 
                            providers.
Sec. 416. Protecting moms and infants.
Sec. 417. Early interventions for pregnant women and infants.
Sec. 418. Report on investigations regarding parity in mental health 
                            and substance use disorder benefits.

                          TITLE V--PREVENTION

Sec. 501. Study on prescribing limits.
Sec. 502. Programs for health care workforce.
Sec. 503. Education and awareness campaigns.
Sec. 504. Enhanced controlled substance overdoses data collection, 
                            analysis, and dissemination.
Sec. 505. Preventing overdoses of controlled substances.
Sec. 506. CDC surveillance and data collection for child, youth, and 
                            adult trauma.
Sec. 507. Reauthorization of NASPER.
Sec. 508. Jessie's law.
Sec. 509. Development and dissemination of model training programs for 
                            substance use disorder patient records.
Sec. 510. Communication with families during emergencies.
Sec. 511. Prenatal and postnatal health.
Sec. 512. Surveillance and education regarding infections associated 
                            with illicit drug use and other risk 
                            factors.
Sec. 513. Task force to develop best practices for trauma-informed 
                            identification, referral, and support.
Sec. 514. Grants to improve trauma support services and mental health 
                            care for children and youth in educational 
                            settings.
Sec. 515. National Child Traumatic Stress Initiative.

SEC. 2. DEFINITIONS.

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

               TITLE I--REAUTHORIZATION OF CURES FUNDING

SEC. 101. 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 such term 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 are 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''.

                   TITLE II--RESEARCH AND INNOVATION

SEC. 201. 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. 202. 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 approved, 
                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;
                            ``(ii) the diagnosis, prevention, 
                        treatment, and management of pain; 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
                            ``(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.''.

      TITLE III--MEDICAL PRODUCTS AND CONTROLLED SUBSTANCES SAFETY

SEC. 301. CLARIFYING FDA REGULATION OF NON-ADDICTIVE PAIN PRODUCTS.

    (a) Public Meetings.--Not later than 1 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 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. 302. 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. 303. 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 United States 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 
                United States 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 United States 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. 304. 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. 305. 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 ``; or''; and
                            (iv) and 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).''.
            (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.''.

SEC. 306. 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.''; 
        and
            (4) in subsection (g), 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. 307. 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. 308. 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. 309. 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 of 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.''.

                    TITLE IV--TREATMENT AND RECOVERY

SEC. 401. 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 
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 year 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 on 
                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. 402. 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; or
                    (B) 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) educational and vocational 
                                schools;
                                    (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;
                    (B) establish policies and procedures 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 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. 403. 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, and Federally qualified health centers; 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. 404. 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 are authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2019 through 2023.''.

SEC. 405. 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. 406. MEDICATION-ASSISTED TREATMENT FOR RECOVERY FROM ADDICTION.

    (a) Waivers for Maintenance or Detoxification Treatment.--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 opiate-
                        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. 407. 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 
406(a) of this Act.
    (b) Authorization of Appropriations.--There are authorized to be 
appropriated for grants under subsection (a), $4,000,000 for each of 
fiscal years 2019 through 2023.

SEC. 408. 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. 409. NATIONAL RECOVERY HOUSING BEST PRACTICES.

    (a) Best Practices.--The Secretary, in consultation with the 
Secretary for Housing and Urban Development, patients with a history of 
opioid use disorder, and other stakeholders, which may include State 
accrediting entities and reputable providers of, and analysts of, 
recovery housing services, shall identify or facilitate the development 
of best practices, which may include model laws for implementing 
suggested minimum standards, for operating recovery housing.
    (b) Dissemination.--The Secretary shall disseminate the best 
practices identified or developed under subsection (a) 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 and tribally designated housing entities;
            (3) recovery housing entities; and
            (4) the public, as appropriate.
    (c) Requirements.--In identifying or facilitating the development 
of best practices under subsection (a), the Secretary, in consultation 
with appropriate stakeholders, 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.
    (d) 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.
    (e) 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 the section 4 of the Native American 
        Housing Assistance and Self-Determination Act of 1996 (25 
        U.S.C. 4103).

SEC. 410. 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 government.
                            (viii) Other organizations, as determined 
                        to be necessary by the local board.
            (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 
                        another substance use disorder;
                            (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 and 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) are 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. 411. 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) Youth Prevention and Recovery Initiative.--
            (1) In general.--The Secretary, in consultation with 
        Secretary of Education, shall administer a program to provide 
        support for communities to support the prevention, treatment, 
        and recovery of 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. 412. 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 
                        States 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 wellbeing 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 and 
                                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 are 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 received 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 are 
                authorized to be appropriated $60,000,000 for each of 
                fiscal years 2019 through 2023.''.

SEC. 413. 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. 414. 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. 415. 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 masters 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. 416. 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. 417. 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. 418. 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.

                          TITLE V--PREVENTION

SEC. 501. 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 
                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. 502. 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. 503. 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. 504. 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 
        substances 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 that 
        term in section 4 of the Indian Self-Determination and 
        Education Assistance Act.''.

SEC. 505. 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 carrying 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 
                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 that 
        term 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. 506. 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 Tribal and 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) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for the period of fiscal years 2019 through 2021.

SEC. 507. 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. 508. 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. 509. 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. 510. 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 509 of this 
Act or under section 11004 of the 21st Century Cures Act (42 U.S.C. 
1320d-2 note).

SEC. 511. 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, 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. 512. 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. 513. 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 at 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 at 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 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 are 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. 514. 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) 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.
            (5) To provide technical assistance to school systems and 
        mental health agencies.
            (6) 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) 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).
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of Education.
            (6) Specialized instructional support personnel.--The term 
        ``specialized instructional support personnel'' has the meaning 
        given such term in 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. 515. 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''.
                                                       Calendar No. 398

115th CONGRESS

  2d Session

                                S. 2680

_______________________________________________________________________

                                 A BILL

                     To address the opioid crisis.

_______________________________________________________________________

                              May 7, 2018

                       Reported with an amendment