[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2789 Introduced in Senate (IS)]

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115th CONGRESS
  2d Session
                                S. 2789

  To prevent substance abuse and reduce demand for illicit narcotics.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 26, 2018

 Mr. Cornyn (for himself and Mrs. Feinstein) introduced the following 
    bill; which was read twice and referred to the Committee on the 
                               Judiciary

_______________________________________________________________________

                                 A BILL


 
  To prevent substance abuse and reduce demand for illicit narcotics.

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

SECTION 1. SHORT TITLE.

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

SEC. 2. REAUTHORIZATION OF THE OFFICE OF NATIONAL DRUG CONTROL POLICY.

    (a) Office of National Drug Control Policy Reauthorization Act of 
1998.--
            (1) In general.--The Office of National Drug Control Policy 
        Reauthorization Act of 1998 (21 U.S.C. 1701 et seq.), as in 
        effect on September 29, 2003, and as amended by the laws 
        described in paragraph (2), is revived and restored.
            (2) Laws described.--The laws described in this paragraph 
        are:
                    (A) The Office of National Drug Control Policy 
                Reauthorization Act of 2006 (Public Law 109-469; 125 
                Stat. 3502).
                    (B) The Presidential Appointment Efficiency and 
                Streamlining Act of 2011 (Public Law 112-166; 126 Stat. 
                1283).
    (b) Reauthorization.--Section 715(a) of the Office of National Drug 
Control Policy Reauthorization Act of 1998 (21 U.S.C. 1712(a)) is 
amended by striking ``2010'' and inserting ``2022''.

SEC. 3. REAUTHORIZATION OF THE DRUG-FREE COMMUNITIES PROGRAM.

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

SEC. 4. REAUTHORIZATION OF THE NATIONAL COMMUNITY ANTI-DRUG COALITION 
              INSTITUTE.

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

SEC. 5. REAUTHORIZATION OF THE HIGH-INTENSITY DRUG TRAFFICKING AREA 
              PROGRAM.

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

SEC. 6. REAUTHORIZATION OF DRUG COURT PROGRAM.

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

SEC. 7. DRUG COURT TRAINING AND TECHNICAL ASSISTANCE.

    Section 1034 of the National Narcotics Leadership Act of 1988 (21 
U.S.C. 1534) is amended by adding at the end the following--
    ``(c) Drug Court Training and Technical Assistance Program.--Using 
funds appropriated to carry out this chapter, the Director may make 
grants to nonprofit organizations for the purpose of providing training 
and technical assistance to drug courts.''.

SEC. 8. DRUG OVERDOSE RESPONSE STRATEGY.

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

SEC. 9. PROTECTING LAW ENFORCEMENT OFFICERS FROM ACCIDENTAL EXPOSURE.

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

SEC. 10. DEA 360 STRATEGY.

    (a) In General.--For each of fiscal years 2018 through 2022, the 
Attorney General, acting through the Director of the Drug Enforcement 
Administration, and in coordination with the Director of the Office of 
National Drug Control Policy and the Secretary of Health and Human 
Services, may implement a DEA 360 Strategy in pilot cities across the 
United States as a response to growing demand for heroin and opioids in 
the United States.
    (b) Program Goals.--The goals of the DEA 360 Strategy authorized 
under subsection (a) shall be--
            (1) preventing the deadly cycle of drug abuse, including 
        heroin and opioid abuse, by targeting drug trafficking 
        organizations and street gangs responsible for increasing the 
        supply of narcotics in communities;
            (2) partnering with the healthcare community to raise 
        awareness of the dangers of heroin abuse and prescription 
        opioid abuse; and
            (3) strengthening community organizations that provide 
        long-term assistance and support for the reduction of drug 
        abuse in the community.
    (c) Program Specifications.--In carrying out the DEA 360 strategy 
authorized under subsection (a), the Attorney General shall--
            (1) issue an implementation strategy for each pilot city 
        that is tailored to the unique drug abuse problems of the 
        particular city, details specific measures that will be taken 
        to address the problems, identifies key community partners, and 
        sets specific objectives for success;
            (2) provide dedicated funding for coordinated law 
        enforcement actions against drug trafficking organizations, 
        involving Federal, State, and local law enforcement officials, 
        including the United States Attorney's office for the relevant 
        district;
            (3) conduct diversion control enforcement actions against 
        registrants with the Drug Enforcement Administration who are 
        unlawfully distributing controlled substances;
            (4) create partnerships with pharmaceutical drug 
        manufacturers, wholesalers, pharmacies, and medical 
        practitioners to develop strategies that reduce heroin and 
        opioid abuse, including specific efforts to reduce demand for 
        these substances;
            (5) increase resources for community partnerships with 
        nongovernmental organizations that specialize in drug abuse 
        prevention, awareness, or treatment; and
            (6) conduct training and educational campaigns on best 
        practices for reducing heroin and opioid abuse for governmental 
        agencies and nongovernmental organizations in pilot cities.
    (d) Reports.--For each fiscal year in which the Attorney General 
carries out the DEA 360 Strategy authorized under subsection (a) in a 
pilot city, the Attorney General shall issue a public report that 
details the results of the program in that particular city, including 
quantitative measures to show whether or not the program succeeded in 
achieving the objectives for success required under subsection (c)(1).
    (e) Additional Resources.--The Director of the Office of National 
Drug Control Policy and the Secretary of Health and Human Services may 
use funds otherwise appropriated for purposes consistent with this 
section to assist in the implementation of the DEA 360 Strategy 
authorized under subsection (a) in pilot cities.

SEC. 11. COPS ANTI-METH PROGRAM.

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

SEC. 12. COMPREHENSIVE ADDICTION AND RECOVERY ACT EDUCATION AND 
              AWARENESS.

    (a) Amendment to CARA.--Section 102(a) of the Comprehensive 
Addiction and Recovery Act of 2016 (Public Law 114-198; 130 Stat. 698) 
is amended by inserting ``including the Office of National Drug Control 
Policy,'' after ``agencies,''.
    (b) Use of Funds.--Subchapter I of chapter 2 of the National 
Narcotics Leadership Act of 1988 (21 U.S.C. 1531 et seq.) is amended by 
adding at the end the following:

``SEC. 1036. COMPREHENSIVE ADDICTION AND RECOVERY ACT EDUCATION AND 
              AWARENESS.

    ``The Director may use funds made available to carry out this 
chapter for the purpose of administering, participating in, or 
expanding awareness campaigns and prevention efforts authorized under 
section 102 of the Comprehensive Addiction and Recovery Act of 2016 
(Public Law 114-198; 130 Stat. 698).''.

SEC. 13. PROTECTING CHILDREN WITH ADDICTED PARENTS.

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

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

    ``(a) Best Practices.--The Secretary, acting through the Assistant 
Secretary for Mental Health and Substance Use and in cooperation with 
the Commissioner of the Administration on Children, Youth and Families, 
shall collect and disseminate best practices for States regarding 
interventions and strategies to keep families affected by substance use 
disorder together, when it can be done safely. Such best practices 
shall--
            ``(1) utilize comprehensive family-centered approaches;
            ``(2) ensure that families have access to drug screening, 
        substance use treatment, medication-assisted treatment approved 
        by the Food and Drug Administration, and parental support; and
            ``(3) build upon lessons learned from programs such as the 
        Maternal, Infant, and Early Childhood Home Visiting programs 
        under section 511 of the Social Security Act.
    ``(b) Grant Program.--The Secretary, acting through the Assistant 
Secretary for Mental Health and Substance Use, shall award grants for 
the development of programs and models designed to keep pregnant and 
post-partum women who have a substance use disorder together with their 
newborns, including programs and models that provide for screenings of 
pregnant and post-partum women for substance use disorders, treatment 
interventions, supportive housing, nonpharmacological interventions for 
children born with neonatal abstinence syndrome, medication assisted 
treatment, and other recovery supports.''.

SEC. 14. REIMBURSEMENT OF SUBSTANCE USE DISORDER TREATMENT 
              PROFESSIONALS.

    (a) GAO Report.--Not later than January 1, 2020, the Comptroller 
General of the United States shall submit to Congress a report 
examining how substance use disorder services are reimbursed.
    (b) CMS Recommendations.--Not later than January 1, 2019, the 
Administrator of the Centers for Medicare & Medicaid Services shall 
examine how substance use disorder services are reimbursed and shall 
make recommendations to Congress (taking into consideration the 
findings made by the Comptroller General of the United States in the 
report required under subsection (a)) as to how to reimburse the 
treatment of substance use disorders at a higher rate in order to 
attract a more talented work force.
    (c) Grants to States To Explore Ways To Increase Medicaid 
Reimbursement.--The Secretary of Health and Human Services is 
authorized to make grants to States for the purpose of exploring ways 
to increase reimbursement of substance use disorder services under the 
Medicaid program under title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.).
    (d) Grants to States To Supplement Medicaid Reimbursement to 
Credentialed Substance Use Disorder Professionals.--The Secretary of 
Health and Human Services is authorized to make grants to States for 
the purpose of supplementing the reimbursement paid to credentialed 
substance use disorder professionals (as defined by the Secretary) 
under the Medicaid program under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.).

SEC. 15. TESTING EVIDENCE-BASED MOBILE APPLICATIONS FOR THE TREATMENT 
              OF SUBSTANCE USE DISORDERS.

    Section 1115A(b)(2) of the Social Security Act (42 U.S.C. 
1315a(b)(2)) is amended--
            (1) in subparagraph (A), by adding at the end the following 
        new sentence: ``The models selected under this subparagraph 
        shall include the model described in subparagraph (D), which 
        shall be implemented by not later than January 1, 2020.''; and
            (2) by adding at the end the following new subparagraph:
                    ``(D) Evidence-based mobile applications for 
                treatment of substance use disorders.--The model 
                described in this subparagraph is a model to test the 
                use of evidence-based mobile applications for the 
                treatment of substance use disorders.''.

SEC. 16. MEDICARE HOSPITAL REQUIREMENT TO PROVIDE NALOXONE AS PART OF 
              THE DISCHARGE PROTOCOL TO INDIVIDUALS BEING DISCHARGED 
              AFTER SUFFERING AN OPIOID OVERDOSE.

    (a) In General.--Section 1866(a)(1) of the Social Security Act (42 
U.S.C. 1395cc(a)(1)) is amended--
            (1) in subparagraph (X), by striking ``and'' at the end;
            (2) in subparagraph (Y), by striking the period at the end 
        and inserting ``, and''; and
            (3) by inserting after subparagraph (Y), the following new 
        subparagraph:
            ``(Z) in the case of a hospital or critical access 
        hospital, to provide naloxone and treatment referral options as 
        part of the discharge protocol to individuals being discharged 
        after suffering an opioid overdose.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to contracts entered into or renewed on or after the date of the 
enactment of this Act.

SEC. 17. EDUCATIONAL OUTREACH AND ACCESS TO ABUSE-DETERRENT OPIOIDS.

    (a) Access to Abuse-Deterrent Opioids.--
            (1) Access under medicare part d.--Section 1860D-4(c) of 
        the Social Security Act (42 U.S.C. 1395w-104(c)) is amended by 
        adding at the end the following new paragraph:
            ``(7) Access to abuse-deterrent opioids.--
                    ``(A) In general.--The Secretary shall work with 
                PDP sponsors of prescription drug plans to--
                            ``(i) ensure appropriate access to abuse-
                        deterrent opioids on plan formularies;
                            ``(ii) provide advanced abuse-deterrent 
                        opioid targeting (as determined by the 
                        Secretary) for beneficiaries identified as at-
                        risk for opioid abuse under the drug management 
                        program under paragraph (5) or any other opioid 
                        risk management program established by the 
                        sponsor; and
                            ``(iii) encourage access to non-opioid 
                        alternatives when medically appropriate.
                    ``(B) Prohibition on requiring fail first 
                schemes.--The Secretary shall prohibit PDP sponsors 
                from requiring fail first schemes, also known as step 
                therapy, with respect to abuse-deterrent opioids.
                    ``(C) Encouraging equal access.--The Secretary 
                shall encourage plans to provide equal access to abuse-
                deterrent opioids on formulary tiers and patient cost-
                sharing.
                    ``(D) Abuse-deterrent opioid defined.--In this 
                paragraph, the term `abuse-deterrent opioid' means an 
                abuse-deterrent formulation of an opioid, as determined 
                by the Secretary.''.
            (2) Access under private health plans.--Subpart II of title 
        XXVII of the Public Health Service Act (42 U.S.C. 300gg-11 et 
        seq.) is amended by adding at the end the following:

``SEC. 2729. ACCESS TO ABUSE-DETERRENT OPIOIDS.

    ``(a) In General.--A group health plan and a health insurance 
issuer offering group or individual health insurance coverage shall--
            ``(1) ensure appropriate access to abuse-deterrent opioids 
        as a prescription drug health benefit under such plan or 
        coverage;
            ``(2) provide advanced abuse-deterrent opioid targeting (as 
        determined by the Secretary) for enrollees in the plan or 
        coverage who are identified as at-risk for opioid abuse; and
            ``(3) encourage access to non-opioid alternatives when 
        medically appropriate.
    ``(b) Prohibition on Requiring Fail First Schemes.--The Secretary 
shall prohibit a group health plan and a health insurance issuer 
offering group or individual health insurance coverage from requiring 
fail first schemes, also known as step therapy, with respect to abuse-
deterrent opioids.
    ``(c) Abuse-Deterrent Opioid Defined.--In this section, the term 
`abuse-deterrent opioid' means an abuse-deterrent formulation of an 
opioid, as determined by the Secretary.''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply with respect to plan years beginning on or after 
        January 1, 2019.
    (b) Educational Outreach.--The Secretary of Health and Human 
Services shall educate health insurance issuers, Medicare Advantage 
plans under part C of title XVIII of the Social Security Act (42 U.S.C. 
1395w-21 et seq.), and prescription drug plans under part D of such 
title (42 U.S.C. 1395w-101 et seq.) on opioid abuse prevention, 
including the use of abuse-deterrent opioids (as such term is defined 
in section 2729 of the Public Health Service Act, as added by 
subsection (a)(2)).

SEC. 18. GRANT PROGRAM TO PROVIDE SUPPORT FOR MEDICATION ASSISTED 
              TREATMENT.

    (a) Training Grants.--The Secretary of Health and Human Services 
shall award grants to States for the purpose of training non-physician 
health care professionals in the use of medication-assisted treatment 
approved by the Food and Drug Administration and related best 
practices.
    (b) Referral System Grants.--The Secretary of Health and Human 
Services shall award grants to States for the purpose of improving 
referral systems and ensuring that such systems are current and 
accurate, in order to better enable practitioners to refer patients who 
are prescribed medication assisted treatment to cognitive therapy.

SEC. 19. SOBRIETY TREATMENT AND RECOVERY TEAMS (START).

    Title III of the Comprehensive Addiction and Recovery Act of 2016 
(Public Law 114-198; 130 Stat. 717) is amended by adding at the end the 
following:

``SEC. 304. SOBRIETY TREATMENT AND RECOVERY TEAMS.

    ``(a) In General.--The Director of the Office of National Drug 
Control Policy, in coordination with the Secretary of Health and Human 
Services, may make grants to States, units of local government, or 
tribal governments to establish or expand Sobriety Treatment And 
Recovery Team (referred to in this section as `START') programs to 
determine the effectiveness of pairing social workers and mentors with 
families that are struggling with substance abuse and child abuse or 
neglect in order to help provide peer support, intensive treatment, and 
child welfare services.
    ``(b) Allowable Uses.--A grant awarded under this section may be 
used for one or more of the following activities:
            ``(1) Training eligible staff, including social workers, 
        social services coordinators, child welfare specialists, 
        substance use disorder treatment professionals, and mentors.
            ``(2) Expanding access to substance use disorder treatment 
        services and drug testing.
            ``(3) Enhancing data sharing with law enforcement agencies 
        and child welfare agencies.
            ``(4) Program evaluation.
    ``(c) Program Requirements.--A family may be eligible to 
participate in a START program that receives funding under this section 
only if--
            ``(1) there is a substantiated record or finding of child 
        abuse or neglect within the family; and
            ``(2) substance abuse was the primary reason for the record 
        or finding described in paragraph (1).
    ``(d) Authorization of Appropriations.--For each of fiscal years 
2018 through 2022, the Director of the Office of National Drug Control 
Policy, in consultation with the Secretary of Health and Human 
Services, is authorized to award not more than $10,000,000 of amounts 
otherwise appropriated for comprehensive opioid abuse reduction 
activities for purposes of carrying out this section.''.

SEC. 20. PROVIDER EDUCATION.

    Not later than 90 days after the date of enactment of this Act, the 
Attorney General, in consultation with the Secretary of Health and 
Human Services, shall complete the plan related to medical registration 
coordination required by Senate Report 114-239, which accompanied the 
Veterans Care Financial Protection Act of 2017 (Public Law 115-131; 132 
Stat. 334), including through the issuance of necessary rules or 
regulations.
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