[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2901 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  1st Session
                                S. 2901

   To amend title V of the Public Health Service Act to provide for 
    increased oversight of recovery housing, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 29, 2021

 Mr. Whitehouse (for himself and Mr. Portman) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To amend title V of the Public Health Service Act to provide for 
    increased oversight of recovery housing, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Excellence in Recovery Housing 
Act''.

SEC. 2. CLARIFYING THE ROLE OF SAMHSA IN PROMOTING THE AVAILABILITY OF 
              HIGH-QUALITY RECOVERY HOUSING.

    Section 501(d) of the Public Health Service Act (42 U.S.C. 290aa) 
is amended--
            (1) in paragraph (24)(E), by striking ``and'' at the end;
            (2) in paragraph (25), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following:
            ``(26) collaborate with national accrediting entities and 
        reputable providers and analysts of recovery housing services 
        and all relevant Federal agencies, including the Centers for 
        Medicare & Medicaid Services, the Health Resources and Services 
        Administration, other offices and agencies within the 
        Department of Health and Human Services, the Office of National 
        Drug Control Policy, the Department of Justice, the Department 
        of Housing and Urban Development, and the Department of 
        Agriculture, to promote the availability of high-quality 
        recovery housing for individuals with a substance use 
        disorder.''.

SEC. 3. DEVELOPING GUIDELINES FOR STATES TO PROMOTE THE AVAILABILITY OF 
              HIGH-QUALITY RECOVERY HOUSING.

    Title V of the Public Health Service Act is amended by inserting 
after section 550 of such Act (42 U.S.C. 290ee-5) the following:

``SEC. 550A. DEVELOPING GUIDELINES FOR STATES TO PROMOTE THE 
              AVAILABILITY OF HIGH-QUALITY RECOVERY HOUSING.

    ``(a) In General.--Not later than 1 year after the date of 
enactment of this section, the Secretary, acting through the Assistant 
Secretary, shall develop, and publish on the website of the Substance 
Abuse and Mental Health Services Administration, consensus-based 
guidelines and nationally recognized standards for States to promote 
the availability of high-quality recovery housing for individuals with 
a substance use disorder. Such guidelines shall--
            ``(1) be developed in consultation with national 
        accrediting entities, reputable providers and analysts of 
        recovery housing services, and States and be consistent with 
        the best practices developed under section 550; and
            ``(2) to the extent practicable, build on existing best 
        practices and suggested guidelines developed previously by the 
        Substance Abuse and Mental Health Services Administration.
    ``(b) Public Comment Period.--Before finalizing guidelines under 
subsection (a), the Secretary shall provide for a public comment 
period.
    ``(c) Exclusion of Guideline on Treatment Services.--In developing 
the guidelines under subsection (a), the Secretary may not include any 
guideline or standard with respect to substance use disorder treatment 
services.
    ``(d) Substance Use Disorder Treatment Services.--In this section, 
the term `substance use disorder treatment services' means items or 
services furnished for the treatment of a substance use disorder, 
including--
            ``(1) medications approved by the Food and Drug 
        Administration for use in such treatment, excluding each such 
        medication used to prevent or treat a drug overdose;
            ``(2) the administering of such medications;
            ``(3) recommendations for such treatment;
            ``(4) clinical assessments and referrals;
            ``(5) counseling with a physician, psychologist, or mental 
        health professional (including individual and group therapy); 
        and
            ``(6) toxicology testing.''.

SEC. 4. COORDINATION OF FEDERAL ACTIVITIES TO PROMOTE THE AVAILABILITY 
              OF HIGH-QUALITY RECOVERY HOUSING.

    Section 550 of the Public Health Service Act (42 U.S.C. 290ee-5) is 
amended--
            (1) by redesignating subsections (e), (f), and (g) as 
        subsections (g), (h), and (i), respectively; and
            (2) by inserting after subsection (d) the following:
    ``(e) Coordination of Federal Activities To Promote the 
Availability of High-Quality Recovery Housing for Individuals With a 
Substance Use Disorder.--
            ``(1) In general.--The Secretary, acting through the 
        Assistant Secretary, and the Secretary of Housing and Urban 
        Development shall convene an interagency working group, co-
        chaired by the Assistant Secretary and the Secretary of Housing 
        and Urban Development and comprised of representatives of each 
        of the Federal agencies described in paragraph (2) (referred to 
        in this section as the `working group') for the following 
        purposes:
                    ``(A) To increase collaboration, cooperation, and 
                consultation among such Federal agencies, with respect 
                to promoting the availability of high-quality recovery 
                housing.
                    ``(B) To align the efforts of such agencies and 
                avoid duplication of such efforts by such agencies.
                    ``(C) To develop objectives, priorities, and a 
                long-term plan for supporting State, Tribal, and local 
                efforts with respect to the operation of high-quality 
                recovery housing that is consistent with the best 
                practices developed under this section.
                    ``(D) To coordinate inspection and enforcement 
                among Federal and State agencies.
                    ``(E) To coordinate data collection on the quality 
                of recovery housing.
            ``(2) Federal agencies described.--The Federal agencies 
        described in this paragraph are the following:
                    ``(A) The Department of Health and Human Services, 
                including--
                            ``(i) the Centers for Medicare & Medicaid 
                        Services;
                            ``(ii) the Substance Abuse and Mental 
                        Health Services Administration;
                            ``(iii) the Health Resources and Services 
                        Administration; and
                            ``(iv) the Indian Health Service.
                    ``(B) The Department of Housing and Urban 
                Development.
                    ``(C) The Department of Agriculture.
                    ``(D) The Department of Justice.
                    ``(E) The Office of National Drug Control Policy.
                    ``(F) The Bureau of Indian Affairs.
                    ``(G) The Department of Labor.
                    ``(H) Any other Federal agency as the co-chairs 
                determine appropriate.
            ``(3) Meetings.--The working group shall meet on a 
        quarterly basis.
            ``(4) Reports to congress.--Beginning not later than 1 year 
        after the date of enactment of this section and annually 
        thereafter, the working group shall submit to the Committee on 
        Energy and Commerce, the Committee on Ways and Means, the 
        Committee on Agriculture, and the Committee on Financial 
        Services of the House of Representatives and the Committee on 
        Health, Education, Labor, and Pensions, the Committee on 
        Agriculture, Nutrition, and Forestry, and the Committee on 
        Finance of the Senate a report describing the work of the 
        working group and any recommendations of the working group to 
        improve Federal, State, or local policy with respect to 
        recovery housing operations.
            ``(5) Authorization of appropriations.--To carry out this 
        subsection, there are authorized to be appropriated such sums 
        as may be necessary for fiscal years 2022 through 2027.''.

SEC. 5. NAS STUDY AND REPORT.

    (a) In General.--Not later than 60 days after the date of enactment 
of this Act, the Secretary of Health and Human Services, acting through 
the Assistant Secretary for Mental Health and Substance Use, shall 
enter into an arrangement with the National Academies of Sciences, 
Engineering, and Medicine to conduct a study, which may include a 
literature review and case studies as appropriate, on--
            (1) the quality and effectiveness of recovery housing in 
        the United States, including the availability in the United 
        States of high-quality recovery housing and whether that 
        availability meets the demand for such housing in the United 
        States; and
            (2) State, Tribal, and local regulation and oversight of 
        recovery housing.
    (b) Topics.--The study under subsection (a) shall include a 
literature review of studies that--
            (1) examine the quality of, and effectiveness outcomes for, 
        the types and characteristics of covered recovery housing 
        programs listed in subsection (c); and
            (2) identify the research and data gaps that must be filled 
        to better report on the quality of, and effectiveness outcomes 
        related to, covered recovery housing.
    (c) Type and Characteristics.--The types and characteristics of 
covered recovery housing programs referred to in subsection (b) consist 
of the following:
            (1) Nonprofit and for-profit covered recovery housing.
            (2) Private and public covered recovery housing.
            (3) Covered recovery housing programs that provide services 
        to--
                    (A) residents on a voluntary basis; and
                    (B) residents pursuant to a judicial order.
            (4) Number of clients served, disaggregated to the extent 
        possible by covered recovery housing serving--
                    (A) 6 or fewer recovering residents;
                    (B) 10 to 13 recovering residents; and
                    (C) 18 or more recovering residents.
            (5) Bedroom occupancy in a house, disaggregated to the 
        extent possible by--
                    (A) single room occupancy;
                    (B) 2 residents occupying 1 room; and
                    (C) more than 2 residents occupying 1 room.
            (6) Duration of services received by clients, disaggregated 
        to the extent possible according to whether the services were--
                    (A) 30 days or fewer;
                    (B) 31 to 90 days;
                    (C) more than 90 days and fewer than 6 months; or
                    (D) 6 months or more.
            (7) Certification levels of staff.
            (8) Fraudulent and abusive practices by operators of 
        covered recovery housing and inpatient and outpatient treatment 
        facilities, both individually and in concert, including--
                    (A) deceptive or misleading marketing practices, 
                including--
                            (i) inaccurate outcomes-based marketing; 
                        and
                            (ii) marketing based on non-evidence-based 
                        practices;
                    (B) illegal patient brokering;
                    (C) third-party recruiters;
                    (D) deceptive or misleading marketing practices of 
                treatment facility and recovery housing online 
                aggregators; and
                    (E) the impact of such practices on health care 
                costs and recovery rates.
    (d) Report.--The arrangement under subsection (a) shall require, by 
not later than 18 months after the date of entering into the 
agreement--
            (1) completing the study under such subsection; and
            (2) making publicly available (including through 
        publication on the internet) a report that contains--
                    (A) the results of the study;
                    (B) the National Academy's recommendations for 
                Federal, State, and local policies to promote the 
                availability of high-quality recovery housing in the 
                United States;
                    (C) research and data gaps;
                    (D) recommendations for recovery housing quality 
                and effectiveness metrics;
                    (E) recommended mechanisms to collect data on those 
                metrics, including with respect to research and data 
                gaps;
                    (F) recommendations to eliminate restrictions by 
                recovery housing that exclude individuals who take 
                prescribed medications for opioid use disorder; and
                    (G) a summary of allegations, assertions, or formal 
                legal actions on the State and local levels by 
                governments and nongovernmental organizations with 
                respect to the opening and operation of recovery 
                housing.
    (e) Definitions.--In this subsection:
            (1) The term ``covered recovery housing'' means recovery 
        housing that utilizes compensated or volunteer onsite staff who 
        are not health care professionals to support residents.
            (2) The term ``effectiveness outcomes'' may include 
        decreased substance use, reduced probability of relapse or 
        reoccurrence, lower rates of incarceration, higher income, 
        increased employment, and improved family functioning.
            (3) The term ``health care professional'' means an 
        individual who is licensed or otherwise authorized by the State 
        to provide health care services.
            (4) The term ``recovery housing'' means a shared living 
        environment that is or purports to be--
                    (A) free from alcohol and use of nonprescribed 
                drugs; and
                    (B) centered on connection to services that promote 
                sustained recovery from substance use disorders.
    (f) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $1,500,000 for fiscal year 2022.

SEC. 6. FILLING RESEARCH AND DATA GAPS.

    Not later than 60 days after the completion of the study under 
section 5, the Secretary of Health and Human Services shall enter into 
an agreement with an appropriate entity to conduct such research as may 
be necessary to fill the research and data gaps identified in reporting 
pursuant to such section.

SEC. 7. GRANTS FOR STATES TO PROMOTE THE AVAILABILITY OF HIGH QUALITY 
              RECOVERY HOUSING.

    Section 550 of the Public Health Service Act (42 U.S.C. 290ee-5), 
as amended by section 4, is further amended by inserting after 
subsection (e) (as inserted by section 4) the following:
    ``(f) Grants for Implementing National Recovery Housing Best 
Practices.--
            ``(1) In general.--The Secretary shall award grants to 
        States (and political subdivisions of States), Tribes, and 
        territories--
                    ``(A) for the provision of technical assistance by 
                national accrediting entities and reputable providers 
                and analysts of recovery housing services to implement 
                the guidelines, nationally recognized standards, and 
                recommendations developed under section 3 of the 
                Excellence in Recovery Housing Act and this section; 
                and
                    ``(B) to promote the availability of high-quality 
                recovery housing for individuals with a substance use 
                disorder and practices to maintain housing quality long 
                term.
            ``(2) State enforcement plans.--Beginning not later than 90 
        days after the date of enactment of this paragraph and every 2 
        years thereafter, as a condition on the receipt of a grant 
        under paragraph (1), each State (or political subdivision of a 
        State), Tribe, or territory receiving such a grant shall submit 
        to the Secretary, and make publicly available on a publicly 
        accessible website of the State (or political subdivision of 
        the State), Tribe, or territory--
                    ``(A) the plan of the State (or political 
                subdivision of a State), Tribe, or territory, with 
                respect to the promotion of high-quality recovery 
                housing for individuals with a substance use disorder 
                located within the jurisdiction of such State (or 
                political subdivision of a State), Tribe, or territory; 
                and
                    ``(B) a description of how such plan is consistent 
                with the best practices developed under this section 
                and guidelines developed under section 550A.
            ``(3) Review of accrediting entities.--The Secretary shall 
        periodically review, by developing a rubric to evaluate 
        accreditation, the accrediting entities providing technical 
        assistance pursuant to paragraph (1)(A).
            ``(4) Authorization of appropriations.--To carry out this 
        subsection, there is authorized to be appropriated $10,000,000 
        for each of fiscal years 2023 through 2027.''.

SEC. 8. AUTHORIZATION OF APPROPRIATIONS.

    Section 550 of the Public Health Service Act (42 U.S.C. 290ee-5), 
as amended by sections 4 and 7, is further amended by amending 
subsection (i) (as redesignated by such section 4) to read as follows:
    ``(i) Authorization of Appropriations.--
            ``(1) In general.--To carry out this section, there is 
        authorized to be appropriated--
                    ``(A) $2,000,000 for fiscal year 2022; and
                    ``(B) $11,000,000 for each of fiscal years 2023 
                through 2027.
            ``(2) Reservations of funds.--For each of fiscal years 2022 
        through 2027, of the amounts appropriated under paragraph (1) 
        for such fiscal year, the Secretary shall reserve--
                    ``(A) not less than $1,000,000 to carry out 
                subsection (e); and
                    ``(B) not less than $10,000,000 to award grants 
                under paragraphs (1) and (2) of subsection (f).''.

SEC. 9. REPUTABLE PROVIDERS AND ANALYSTS OF RECOVERY HOUSING SERVICES 
              DEFINITION.

    Section 550(h) of the Public Health Service Act (42 U.S.C. 290ee-
5(i)), as redesignated by section 4, is amended by adding at the end 
the following:
            ``(4) The term `reputable providers and analysts of 
        recovery housing services' means recovery housing service 
        providers and analysts that--
                    ``(A) use evidence-based approaches;
                    ``(B) act in accordance with guidelines issued by 
                the Assistant Secretary;
                    ``(C) have not been found guilty of health care 
                fraud, patient brokering, or false advertising by the 
                Department of Justice, the Department of Health and 
                Human Services, or a Medicaid Fraud Control Unit;
                    ``(D) have not been found to have violated Federal, 
                State, or local codes of conduct with respect to 
                recovery housing for individuals with a substance use 
                disorder; and
                    ``(E) do not employ individuals with a past 
                conviction of criminal, domestic, or sexual violence, 
                or significant drug distribution, in the care or 
                supervision of individuals.''.

SEC. 10. TECHNICAL CORRECTION.

    Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) 
is amended--
            (1) by redesignating section 550 (relating to Sobriety 
        Treatment and Recovery Teams) (42 U.S.C. 290ee-10), as added by 
        section 8214 of Public Law 115-271, as section 550B; and
            (2) moving such section so it appears after section 550A 
        (added by section 3 of this Act).
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