[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 4839 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  2d Session
                                S. 4839

To reauthorize and expand a grant program for State and Tribal response 
    to opioid and stimulant use and misuse, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 13, 2022

  Ms. Baldwin (for herself and Mrs. Shaheen) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To reauthorize and expand a grant program for State and Tribal response 
    to opioid and stimulant use and misuse, 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 ``State Opioid Response Grant 
Authorization Act of 2022''.

SEC. 2. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID AND 
              STIMULANT USE AND MISUSE.

    Section 1003 of the 21st Century Cures Act (42 U.S.C. 290ee3 note) 
is amended to read as follows:

``SEC. 1003. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID AND 
              STIMULANT USE AND MISUSE.

    ``(a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the `Secretary') shall carry out the 
grant program described in subsection (b) for purposes of addressing 
opioid use disorder and stimulant misuse and use disorders, within 
States, Indian Tribes, and populations served by Tribal organizations 
and Urban Indian organizations.
    ``(b) Grants Program.--
            ``(1) In general.--Subject to the availability of 
        appropriations, the Secretary shall award grants to States, 
        Indian Tribes, Tribal organizations, and Urban Indian 
        organizations for the purpose of addressing opioid use disorder 
        and stimulant use and misuse, within such States, such Indian 
        Tribes, and populations served by such Tribal organizations and 
        Urban Indian organizations, in accordance with paragraph (2).
            ``(2) Minimum allocations; preference.--In determining 
        grant amounts for each recipient of a grant under paragraph 
        (1), the Secretary shall--
                    ``(A) ensure that each State receives not less than 
                $12,000,000; and
                    ``(B) give preference to States, Indian Tribes, 
                Tribal organizations, and Urban Indian organizations--
                            ``(i) whose populations have an incidence 
                        or prevalence of opioid use disorder that is 
                        substantially higher relative to the 
                        populations of other States, Indian Tribes, 
                        Tribal organizations, or Urban Indian 
                        organizations, as applicable; or
                            ``(ii) whose areas are more rural relative 
                        to the populations of other States, Indian 
                        Tribes, Tribal organizations, or Urban Indian 
                        organizations, as applicable.
            ``(3) Formula methodology.--
                    ``(A) In general.--At least 30 days before 
                publishing a funding opportunity announcement with 
                respect to grants under this section, the Secretary 
                shall--
                            ``(i) develop a formula methodology, 
                        consistent with paragraph (2), to be followed 
                        in allocating grant funds awarded under this 
                        section among grantees, which includes 
                        performance assessments for continuation 
                        awards; and
                            ``(ii) not later than 30 days after 
                        developing the formula methodology under clause 
                        (i), submit the formula methodology to--
                                    ``(I) the Committee on Health, 
                                Education, Labor, and Pensions and the 
                                Committee on Appropriations of the 
                                Senate; and
                                    ``(II) the Committee on Energy and 
                                Commerce and the Committee on 
                                Appropriations of the House of 
                                Representatives.
                    ``(B) Transition period for new formula 
                methodology.--The Secretary shall set a 2-year 
                transition period for the implementation of any new 
                formula methodology if such new formula methodology 
                would reduce the allocation of any State by more than 
                10 percent.
                    ``(C) Consideration.--The Secretary shall ensure 
                that the formula developed under subparagraph (A) 
                avoids a significant cliff between States with similar 
                mortality rates related to opioid use disorders to 
                prevent unusually large funding changes in States when 
                compared to prior year allocations.
                    ``(D) Report.--Not later than 2 years after the 
                date of the enactment of the State Opioid Response 
                Grant Authorization Act of 2022, the Comptroller 
                General of the United States 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 that assesses--
                            ``(i) how grant funding is allocated to 
                        States under this section and how such 
                        allocations have changed over time;
                            ``(ii) how any changes within the specified 
                        2-year period after the date of enactment of 
                        the State Opioid Response Grant Authorization 
                        Act of 2022 have affected the efforts of States 
                        to address opioid use disorder or stimulant use 
                        and misuse; and
                            ``(iii) the use of funding provided through 
                        the grant program under this section and other 
                        similar grant programs administered by the 
                        Substance Abuse and Mental Health Services 
                        Administration.
            ``(4) Use of funds.--Grants awarded under this subsection 
        shall be used for carrying out activities that supplement 
        activities pertaining to opioid use disorder and stimulant use 
        and misuse, undertaken by the State agency responsible for 
        administering the substance abuse prevention and treatment 
        block grant under subpart II of part B of title XIX of the 
        Public Health Service Act (42 U.S.C. 300x-21 et seq.), which 
        may include public health-related activities such as the 
        following:
                    ``(A) Implementing substance use disorder and 
                overdose prevention activities and evaluating such 
                activities to identify effective strategies to prevent 
                substance use disorders and overdoses.
                    ``(B) Establishing or improving prescription drug 
                monitoring programs.
                    ``(C) Training for health care practitioners, such 
                as best practices for prescribing opioids and 
                stimulants, pain management, recognizing potential 
                cases of substance use disorders, referral of patients 
                to treatment programs, preventing diversion of 
                controlled substances, and overdose prevention.
                    ``(D) Supporting access to health care services, 
                including--
                            ``(i) services provided by federally-
                        certified opioid or stimulant treatment 
                        programs;
                            ``(ii) outpatient and residential substance 
                        use disorder treatment services that utilize, 
                        or refer patients to, medication-assisted 
                        treatment, where clinically appropriate;
                            ``(iii) services to treat substance use 
                        disorders provided by other appropriate health 
                        care providers and at other locations; or
                            ``(iv) overdose prevention programs and 
                        services, including drugs or devices approved, 
                        cleared, or otherwise legally marketed under 
                        the Federal Food, Drug, and Cosmetic Act for 
                        emergency treatment of known or suspected 
                        overdose.
                    ``(E) Recovery support services, including--
                            ``(i) community-based services that include 
                        peer supports;
                            ``(ii) mutual aid recovery programs that 
                        support medication-assisted treatment;
                            ``(iii) services to address housing needs, 
                        transportation needs, food insecurity, and 
                        employment issues; or
                            ``(iv) resources or programs that support 
                        families that include an individual with a 
                        substance use disorder, including education, 
                        training, outreach, and peer support services.
                    ``(F) Other public health-related activities, as 
                the grant recipient determines appropriate, related to 
                addressing substance use disorders within the State, 
                Indian Tribe, Tribal organization, or Urban Indian 
                organization, including directing resources in 
                accordance with local needs related to substance use 
                disorders.
    ``(c) Accountability and Oversight.--A State receiving a grant 
under subsection (b) shall include in reporting related to substance 
use disorders submitted to the Secretary pursuant to section 1942 of 
the Public Health Service Act (42 U.S.C. 300x-52), a description of--
            ``(1) the purposes for which the grant funds received by 
        the State under such subsection for the preceding fiscal year 
        were expended and a description of the activities of the State 
        under the grant;
            ``(2) the ultimate recipients of amounts provided to the 
        State; and
            ``(3) the number of individuals served through each of the 
        activities of the State under the grant and the total number of 
        individuals served through the grant.
    ``(d) Limitations.--Any funds made available pursuant to subsection 
(i)--
            ``(1) notwithstanding any transfer authority in any 
        appropriations Act, shall not be used for any purpose other 
        than the grant program under subsection (b); and
            ``(2) shall be subject to the same requirements as 
        substance use disorders prevention and treatment programs under 
        titles V and XIX of the Public Health Service Act (42 U.S.C. 
        290aa et seq., 300w et seq.).
    ``(e) Indian Tribes, Tribal Organizations, and Urban Indian 
Organizations.--The Secretary, in consultation with Indian Tribes, 
Tribal organizations, and Urban Indian organizations, shall identify 
and establish appropriate mechanisms for Indian Tribes, Tribal 
organizations, and Urban Indian organizations to demonstrate or report 
information as required under subsections (b), (c), and (d).
    ``(f) Report to Congress.--Not later than September 30, 2024, and 
biennially thereafter, the Secretary shall submit to the Committee on 
Health, Education, Labor, and Pensions and the Committee on 
Appropriations of the Senate and the Committee on Energy and Commerce 
and the Committee on Appropriations of the House of Representatives a 
report that includes a summary of the information provided to the 
Secretary in reports made pursuant to subsections (c) and (e), 
including--
            ``(1) the purposes for which grant funds are awarded under 
        this section;
            ``(2) the activities of the grant recipients; and
            ``(3) for each State, Indian Tribe, Tribal organization, 
        and Urban Indian organization that receives a grant under this 
        section, the funding level provided to such recipient.
    ``(g) Technical Assistance.--The Secretary, acting, as appropriate, 
through the Tribal Training and Technical Assistance Center of the 
Substance Abuse and Mental Health Services Administration, shall 
provide States, Indian Tribes, Tribal organizations, and Urban Indian 
organizations, as applicable, with--
            ``(1) technical assistance concerning grant application and 
        submission procedures under this section;
            ``(2) award management activities; and
            ``(3) enhancement of outreach and direct support to rural 
        and underserved communities and providers in addressing 
        substance use disorders.
    ``(h) Definitions.--In this section:
            ``(1) Indian tribe; tribal organization.--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).
            ``(2) State.--The term `State' has the meaning given such 
        term in section 1954(b) of the Public Health Service Act (42 
        U.S.C. 300x-64(b)).
            ``(3) Urban indian organization.--The term `Urban Indian 
        organization' has the meaning given such term in section 4 of 
        the Indian Health Care Improvement Act (25 U.S.C. 1603).
    ``(i) Authorization of Appropriations.--
            ``(1) In general.--For purposes of carrying out the grant 
        program under subsection (b), there is authorized to be 
        appropriated $2,700,000,000 for each of fiscal years 2023 
        through 2027, to remain available until expended.
            ``(2) Federal administrative expenses.--Of the amounts made 
        available for each fiscal year to award grants under subsection 
        (b), the Secretary shall use not more than 2 percent for 
        Federal administrative expenses, training, technical 
        assistance, and evaluation.
            ``(3) Set aside.--Of the amounts made available for each 
        fiscal year to award grants under subsection (b) for a fiscal 
        year, the Secretary shall--
                    ``(A) award 5 percent to Indian Tribes, Tribal 
                organizations, and Urban Indian organizations; and
                    ``(B) award up to 15 percent to States with the 
                highest age-adjusted rates of drug overdose death over 
                the most recent 2-year period, according to the 
                Director of the Centers for Disease Control and 
                Prevention.''.
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