[Congressional Record Volume 162, Number 39 (Thursday, March 10, 2016)]
[Senate]
[Pages S1403-S1416]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
COMPREHENSIVE ADDICTION AND RECOVERY ACT OF 2015
The PRESIDING OFFICER. Under the previous order, the Senate will
resume consideration of S. 524, which the clerk will report.
The legislative clerk read as follows:
A bill (S. 524) to authorize the Attorney General to award
grants to address the national epidemics of prescription
opioid abuse and heroin use.
The PRESIDING OFFICER. Under the previous order, the time until 11:30
a.m. will be equally divided between the two managers or their
designees.
The Senator from Mississippi.
Filling the Supreme Court Vacancy
Mr. WICKER. Madam President, I understand we are on the bill, but
there are no speakers presently here, so I would like to address the
Chair and my colleagues for a few moments about the matter my colleague
from Wyoming was discussing just now, and that is the very serious
matter of how we will fill the vacancy of Justice Scalia.
I want to read to my colleagues a message I got from one of my
constituents in Columbus, MS. As you can imagine, we have all received
quite a bit of opinion from the people who put us in office, but I
think this constituent really hits it on the head when she says: ``The
next appointment is probably the most crucial in our history and will
have ramifications on future generations.''
I really agree with that, and I think it is such a profound decision
that we ought to feel comfortable, as the Senator from Wyoming just
said, in letting the people decide. We are in the midst of a great
debate about the direction our country will take, the executive branch
will take, over the next 4 and possibly 8 years.
The Court has been relatively balanced, with a slight 5-4 tilt toward
the conservative side. Clearly there is an effort in this city and on
the part of some of my friends on the other side of the aisle to shift
that balance. I think it is reasonable to conclude, with so much
involved and with the ramifications on future generations, as my
constituent has said, that it is very appropriate that this be a matter
of debate in this Presidential election and, frankly, in the Senate
elections also. And I realize there is a lot of heat and light on this
issue, but I would simply suggest that we are on the right track in
letting the American people speak to this.
There is another matter in this regard that I have been reluctant to
bring to the attention of my colleagues until today, but I think it has
gotten to the point where we need to be reminded that there are rules
of decorum that apply to this debate and to all debates we have on the
Senate floor. I would direct the Chair's attention and the attention of
my colleagues to rule XIX of the Standing Rules of the Senate.
Paragraph 2 of that rule states: ``No Senator in debate shall, directly
or indirectly, by any form of words impute to another Senator or to
other Senators any conduct or motive unworthy or unbecoming a
Senator.''
I read that paragraph in its entirety because it is quite obvious to
me, to my colleagues on this side of the aisle, and I think to
objective observers, that what has ensued over the last week or two has
been a concerted effort to impugn the reputation and honor of the
chairman of the Judiciary Committee, the distinguished Senator from
Iowa, Mr. Grassley.
I would just suggest to my colleagues on both sides of the aisle and
particularly to my friend the distinguished minority leader that in
reviewing some of the statements that have been made on this floor--and
I have them in my hand, although I will not read them again to the
Chair because they are in the Record--particularly those statements
coming from the very top leadership of the other side of the aisle,
there has been statement after statement that crosses the line, that is
prohibited under the rules. It is a breach of our rules to suggest
about any other Senator motives unworthy or unbecoming of a Senator.
I hope we can continue this debate, and certainly we will, but I hope
we will confine it to the merits of the issue, and there are merits on
both sides. This is not the place to conduct an election or reelection
campaign--the floor of the Senate is not that place--and it seems to me
that in recent days that line has been crossed and crossed repeatedly.
I will get back to my original point. We are prepared to let the
American people speak on this issue, and it is of vital importance not
just for the next 4 years but perhaps for the next decade, two decades,
or three decades. And I would ask us to dial the rhetoric back, dial
the heat back, and stay on the issues. We are comfortable making the
case that this is a decision that should be left to the American
people.
I thank the Chair for giving me the time.
Mr. GRASSLEY. Madam President, I want to take a few minutes to
describe the funding that my substitute amendment for S. 524, the
Comprehensive Addiction and Recovery Act of 2016, is intended to
authorize.
Section 202 of the amendment authorizes SAMHSA's grants to prevent
prescription drug/opioid overdose-related deaths. These grants were
appropriated $12 million in H.R. 2029, the Consolidated Appropriations
Act of 2016. The specific appropriating language is located on page 50
of the Departments of Labor, Health and Human Services, and Education
report to H.R. 2029.
Section 204 authorizes the COPS Anti-Heroin Task Force and Anti-
Methamphetamine Task Force. These two task forces were appropriated $7
million each in H.R. 2029, for a total of $14 million. The specific
appropriating language is located in paragraphs three and four under
the section entitled ``Community Oriented Policing Services'', on page
70 of H.R. 2029.
Section 301 authorizes SAMHSA's grants for targeted capacity
expansion--medicated assisted treatments.
[[Page S1404]]
Grants under this program were appropriated $25 million in H.R. 2029.
The specific appropriating language for this program is located in the
Departments of Labor, Health and Human Services, and Education report
to H.R. 2029, on page 47.
Section 501 authorizes SAMHSA's Services Grant Program for
Residential Treatment for Pregnant & Postpartum Women. This grant
program was appropriated $15.9 million in H.R. 2029. The specific
appropriating language for this program is located in the Departments
of Labor, Health and Human Services, and Education report to H.R. 2029,
on page 46.
Finally, some of the other sections in CARA are being authorized
through 42 U.S.C. section 3797cc, which was appropriated $11 million in
H.R. 2029. The specific appropriating language is located in paragraph
one under the section entitled ``Community Oriented Policing
Services'', on page 69 of H.R. 2029. Therefore, the managers' amendment
authorizes a total of $77.9 million in total.
Mr. WICKER. Madam President, I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. COTTON. Madam President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. COTTON. I yield back.
The PRESIDING OFFICER. Under the previous order, all postcloture time
has expired.
The bill was ordered to be engrossed for a third reading and was read
the third time.
The PRESIDING OFFICER. The bill having been read the third time, the
question is, Shall it pass?
Ms. AYOTTE. I ask for the yeas and nays.
The PRESIDING OFFICER. Is there a sufficient second?
There appears to be a sufficient second.
The clerk will call the roll.
The bill clerk called the roll.
Mr. CORNYN. The following Senators are necessarily absent: the
Senator from Texas (Mr. Cruz), the Senator from Utah (Mr. Lee), and the
Senator from Florida (Mr. Rubio).
Further, if present and voting, the Senator from Utah (Mr. Lee) would
have voted ``nay.''
Mr. DURBIN. I announce that the Senator from Missouri (Mrs.
McCaskill) and the Senator from Vermont (Mr. Sanders) are necessarily
absent.
The PRESIDING OFFICER. Are there any other Senators in the Chamber
desiring to vote?
The result was announced--yeas 94, nays 1, as follows:
[Rollcall Vote No. 34 Leg.]
YEAS--94
Alexander
Ayotte
Baldwin
Barrasso
Bennet
Blumenthal
Blunt
Booker
Boozman
Boxer
Brown
Burr
Cantwell
Capito
Cardin
Carper
Casey
Cassidy
Coats
Cochran
Collins
Coons
Corker
Cornyn
Cotton
Crapo
Daines
Donnelly
Durbin
Enzi
Ernst
Feinstein
Fischer
Flake
Franken
Gardner
Gillibrand
Graham
Grassley
Hatch
Heinrich
Heitkamp
Heller
Hirono
Hoeven
Inhofe
Isakson
Johnson
Kaine
King
Kirk
Klobuchar
Lankford
Leahy
Manchin
Markey
McCain
McConnell
Menendez
Merkley
Mikulski
Moran
Murkowski
Murphy
Murray
Nelson
Paul
Perdue
Peters
Portman
Reed
Reid
Risch
Roberts
Rounds
Schatz
Schumer
Scott
Sessions
Shaheen
Shelby
Stabenow
Sullivan
Tester
Thune
Tillis
Toomey
Udall
Vitter
Warner
Warren
Whitehouse
Wicker
Wyden
NAYS--1
Sasse
NOT VOTING--5
Cruz
Lee
McCaskill
Rubio
Sanders
The bill (S. 524), as amended, was passed, as follows:
S. 524
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the
``Comprehensive Addiction and Recovery Act of 2016''.
(b) Table of Contents.--The table of contents for this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Definitions.
TITLE I--PREVENTION AND EDUCATION
Sec. 101. Development of best practices for the prescribing of
prescription opioids.
Sec. 102. Awareness campaigns.
Sec. 103. Community-based coalition enhancement grants to address local
drug crises.
TITLE II--LAW ENFORCEMENT AND TREATMENT
Sec. 201. Treatment alternative to incarceration programs.
Sec. 202. First responder training for the use of drugs and devices
that rapidly reverse the effects of opioids.
Sec. 203. Prescription drug take back expansion.
Sec. 204. Heroin and methamphetamine task forces.
TITLE III--TREATMENT AND RECOVERY
Sec. 301. Evidence-based prescription opioid and heroin treatment and
interventions demonstration.
Sec. 302. Criminal justice medication assisted treatment and
interventions demonstration.
Sec. 303. National youth recovery initiative.
Sec. 304. Building communities of recovery.
TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES
Sec. 401. Correctional education demonstration grant program.
Sec. 402. National Task Force on Recovery and Collateral Consequences.
TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND
VETERANS
Sec. 501. Improving treatment for pregnant and postpartum women.
Sec. 502. Report on grants for family-based substance abuse treatment.
Sec. 503. Veterans' treatment courts.
TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS
PRESCRIPTION OPIOID AND HEROIN ABUSE
Sec. 601. State demonstration grants for comprehensive opioid abuse
response.
TITLE VII--MISCELLANEOUS
Sec. 701. GAO report on IMD exclusion.
Sec. 702. Funding.
Sec. 703. Conforming amendments.
Sec. 704. Grant accountability.
Sec. 705. Programs to prevent prescription drug abuse under the
Medicare program.
TITLE VIII--TRANSNATIONAL DRUG TRAFFICKING ACT
Sec. 801. Short title.
Sec. 802. Possession, manufacture or distribution for purposes of
unlawful importations.
Sec. 803. Trafficking in counterfeit goods or services.
SEC. 2. FINDINGS.
Congress finds the following:
(1) The abuse of heroin and prescription opioid painkillers
is having a devastating effect on public health and safety in
communities across the United States. According to the
Centers for Disease Control and Prevention, drug overdose
deaths now surpass traffic accidents in the number of deaths
caused by injury in the United States. In 2014, an average of
more than 120 people in the United States died from drug
overdoses every day.
(2) According to the National Institute on Drug Abuse
(commonly known as ``NIDA''), the number of prescriptions for
opioids increased from approximately 76,000,000 in 1991 to
nearly 207,000,000 in 2013, and the United States is the
biggest consumer of opioids globally, accounting for almost
100 percent of the world total for hydrocodone and 81 percent
for oxycodone.
(3) Opioid pain relievers are the most widely misused or
abused controlled prescription drugs (commonly referred to as
``CPDs'') and are involved in most CPD-related overdose
incidents. According to the Drug Abuse Warning Network
(commonly known as ``DAWN''), the estimated number of
emergency department visits involving nonmedical use of
prescription opiates or opioids increased by 112 percent
between 2006 and 2010, from 84,671 to 179,787.
(4) The use of heroin in the United States has also spiked
sharply in recent years. According to the most recent
National Survey on Drug Use and Health, more than 900,000
people in the United States reported using heroin in 2014,
nearly a 35 percent increase from the previous year. Heroin
overdose deaths more than tripled from 2010 to 2014.
(5) The supply of cheap heroin available in the United
States has increased dramatically as well, largely due to the
activity of Mexican drug trafficking organizations. The Drug
Enforcement Administration (commonly known as the ``DEA'')
estimates that heroin seizures at the Mexican border have
more than doubled since 2010, and heroin production in Mexico
increased 62 percent from 2013 to 2014. While only 8 percent
of State and local law enforcement officials across the
United States identified heroin as the greatest drug threat
in their area in 2008, that number rose to 38 percent in
2015.
[[Page S1405]]
(6) Law enforcement officials and treatment experts
throughout the country report that many people who have
misused prescription opioids have turned to heroin as a
cheaper or more easily obtained alternative to prescription
opioids.
(7) According to a report by the National Association of
State Alcohol and Drug Abuse Directors (commonly referred to
as ``NASADAD''), 37 States reported an increase in admissions
to treatment for heroin use during the past 2 years, while
admissions to treatment for prescription opiates increased
500 percent from 2000 to 2012.
(8) Research indicates that combating the opioid crisis,
including abuse of prescription painkillers and,
increasingly, heroin, requires a multipronged approach that
involves prevention, education, monitoring, law enforcement
initiatives, reducing drug diversion and the supply of
illicit drugs, expanding delivery of existing treatments
(including medication assisted treatments), expanding access
to overdose medications and interventions, and the
development of new medications for pain that can augment the
existing treatment arsenal.
(9) Substance use disorders are a treatable disease.
Discoveries in the science of addiction have led to advances
in the treatment of substance use disorders that help people
stop abusing drugs and prescription medications and resume
their productive lives.
(10) According to the National Survey on Drug Use and
Health, approximately 22,700,000 people in the United States
needed substance use disorder treatment in 2013, but only
2,500,000 people received it. Furthermore, current treatment
services are not adequate to meet demand. According to a
report commissioned by the Substance Abuse and Mental Health
Services Administration (commonly known as ``SAMHSA''), there
are approximately 32 providers for every 1,000 individuals
needing substance use disorder treatment. In some States, the
ratio is much lower.
(11) The overall cost of drug abuse, from health care- and
criminal justice-related costs to lost productivity, is
steep, totaling more than $700,000,000,000 a year, according
to NIDA. Effective substance abuse prevention can yield major
economic dividends.
(12) According to NIDA, when schools and communities
properly implement science-validated substance abuse
prevention programs, abuse of alcohol, tobacco, and illicit
drugs is reduced. Such programs help teachers, parents, and
healthcare professionals shape the perceptions of youths
about the risks of drug abuse.
(13) Diverting certain individuals with substance use
disorders from criminal justice systems into community-based
treatment can save billions of dollars and prevent sizeable
numbers of crimes, arrests, and re-incarcerations over the
course of those individuals' lives.
(14) According to the DEA, more than 2,700 tons of expired,
unwanted prescription medications have been collected since
the enactment of the Secure and Responsible Drug Disposal Act
of 2010 (Public Law 111-273; 124 Stat. 2858).
(15) Faith-based, holistic, or drug-free models can provide
a critical path to successful recovery for a number of people
in the United States. The 2015 membership survey conducted by
Alcoholics Anonymous (commonly known as ``AA'') found that 73
percent of AA members were sober longer than 1 year and
attended 2.5 meetings per week.
(16) Research shows that combining treatment medications
with behavioral therapy is an effective way to facilitate
success for some patients. Treatment approaches must be
tailored to address the drug abuse patterns and drug-related
medical, psychiatric, and social problems of each individual.
Different types of medications may be useful at different
stages of treatment or recovery to help a patient stop using
drugs, stay in treatment, and avoid relapse. Patients have a
range of options regarding their path to recovery and many
have also successfully addressed drug abuse through the use
of faith-based, holistic, or drug-free models.
(17) Individuals with mental illness, especially severe
mental illness, are at considerably higher risk for substance
abuse than the general population, and the presence of a
mental illness complicates recovery from substance abuse.
(18) Rural communities are especially susceptible to heroin
and opioid abuse. Individuals in rural counties have higher
rates of drug poisoning deaths, including deaths from
opioids. According to the American Journal of Public Health,
``[O]pioid poisonings in nonmetropolitan counties have
increased at a rate greater than threefold the increase in
metropolitan counties.'' According to a February 19, 2016,
report from the Maine Rural Health Research Center,
``[M]ultiple studies document a higher prevalence [of abuse]
among specific vulnerable rural populations, particularly
among youth, women who are pregnant or experiencing partner
violence, and persons with co-occurring disorders.''
SEC. 3. DEFINITIONS.
In this Act--
(1) the term ``first responder'' includes a firefighter,
law enforcement officer, paramedic, emergency medical
technician, or other individual (including an employee of a
legally organized and recognized volunteer organization,
whether compensated or not), who, in the course of
professional duties, responds to fire, medical, hazardous
material, or other similar emergencies;
(2) the term ``medication assisted treatment'' means the
use, for problems relating to heroin and other opioids, of
medications approved by the Food and Drug Administration in
combination with counseling and behavioral therapies;
(3) the term ``opioid'' means any drug having an addiction-
forming or addiction-sustaining liability similar to morphine
or being capable of conversion into a drug having such
addiction-forming or addiction-sustaining liability; and
(4) the term ``State'' means any State of the United
States, the District of Columbia, the Commonwealth of Puerto
Rico, and any territory or possession of the United States.
TITLE I--PREVENTION AND EDUCATION
SEC. 101. DEVELOPMENT OF BEST PRACTICES FOR THE PRESCRIBING
OF PRESCRIPTION OPIOIDS.
(a) Definitions.--In this section--
(1) the term ``Secretary'' means the Secretary of Health
and Human Services; and
(2) the term ``task force'' means the Pain Management Best
Practices Interagency Task Force convened under subsection
(b).
(b) Interagency Task Force.--Not later than December 14,
2018, the Secretary, in cooperation with the Secretary of
Veterans Affairs, the Secretary of Defense, and the
Administrator of the Drug Enforcement Administration, shall
convene a Pain Management Best Practices Interagency Task
Force to review, modify, and update, as appropriate, best
practices for pain management (including chronic and acute
pain) and prescribing pain medication.
(c) Membership.--The task force shall be comprised of--
(1) representatives of--
(A) the Department of Health and Human Services;
(B) the Department of Veterans Affairs;
(C) the Food and Drug Administration;
(D) the Department of Defense;
(E) the Drug Enforcement Administration;
(F) the Centers for Disease Control and Prevention;
(G) the National Academy of Medicine;
(H) the National Institutes of Health;
(I) the Office of National Drug Control Policy; and
(J) the Office of Rural Health Policy of the Department of
Health and Human Services;
(2) physicians, dentists, and nonphysician prescribers;
(3) pharmacists;
(4) experts in the fields of pain research and addiction
research;
(5) representatives of--
(A) pain management professional organizations;
(B) the mental health treatment community;
(C) the addiction treatment community;
(D) pain advocacy groups; and
(E) groups with expertise around overdose reversal; and
(6) other stakeholders, as the Secretary determines
appropriate.
(d) Duties.--The task force shall--
(1) not later than 180 days after the date on which the
task force is convened under subsection (b), review, modify,
and update, as appropriate, best practices for pain
management (including chronic and acute pain) and prescribing
pain medication, taking into consideration--
(A) existing pain management research;
(B) recommendations from relevant conferences and existing
relevant evidence-based guidelines;
(C) ongoing efforts at the State and local levels and by
medical professional organizations to develop improved pain
management strategies, including consideration of
alternatives to opioids to reduce opioid monotherapy in
appropriate cases;
(D) the management of high-risk populations, other than
populations who suffer pain, who--
(i) may use or be prescribed benzodiazepines, alcohol, and
diverted opioids; or
(ii) receive opioids in the course of medical care; and
(E) the Proposed 2016 Guideline for Prescribing Opioids for
Chronic Pain issued by the Centers for Disease Control and
Prevention (80 Fed. Reg. 77351 (December 14, 2015)) and any
final guidelines issued by the Centers for Disease Control
and Prevention;
(2) solicit and take into consideration public comment on
the practices developed under paragraph (1), amending such
best practices if appropriate; and
(3) develop a strategy for disseminating information about
the best practices to stakeholders, as appropriate.
(e) Limitation.--The task force shall not have rulemaking
authority.
(f) Report.--Not later than 270 days after the date on
which the task force is convened under subsection (b), the
task force shall submit to Congress a report that includes--
(1) the strategy for disseminating best practices for pain
management (including chronic and acute pain) and prescribing
pain medication, as reviewed, modified, or updated under
subsection (d); and
(2) recommendations for effectively applying the best
practices described in paragraph (1) to improve prescribing
practices at medical facilities, including medical facilities
of the Veterans Health Administration.
SEC. 102. AWARENESS CAMPAIGNS.
(a) In General.--The Secretary of Health and Human
Services, in coordination with the Attorney General, shall
advance the education and awareness of the public, providers,
patients, consumers, and other appropriate entities regarding
the risk of abuse of
[[Page S1406]]
prescription opioid drugs if such products are not taken as
prescribed, including opioid and methadone abuse. Such
education and awareness campaigns shall include information
on the dangers of opioid abuse, how to prevent opioid abuse
including through safe disposal of prescription medications
and other safety precautions, and detection of early warning
signs of addiction.
(b) Drug-Free Media Campaign.--
(1) In general.--The Office of National Drug Control
Policy, in coordination with the Secretary of Health and
Human Services and the Attorney General, shall establish a
national drug awareness campaign.
(2) Requirements.--The national drug awareness campaign
required under paragraph (1) shall--
(A) take into account the association between prescription
opioid abuse and heroin use;
(B) emphasize the similarities between heroin and
prescription opioids and the effects of heroin and
prescription opioids on the human body; and
(C) bring greater public awareness to the dangerous effects
of fentanyl when mixed with heroin or abused in a similar
manner.
SEC. 103. COMMUNITY-BASED COALITION ENHANCEMENT GRANTS TO
ADDRESS LOCAL DRUG CRISES.
Part II of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3797cc et seq.) is amended by
striking section 2997 and inserting the following:
``SEC. 2997. COMMUNITY-BASED COALITION ENHANCEMENT GRANTS TO
ADDRESS LOCAL DRUG CRISES.
``(a) Definitions.--In this section--
``(1) the term `Drug-Free Communities Act of 1997' means
chapter 2 of the National Narcotics Leadership Act of 1988
(21 U.S.C. 1521 et seq.);
``(2) the term `eligible entity' means an organization
that--
``(A) on or before the date of submitting an application
for a grant under this section, receives or has received a
grant under the Drug-Free Communities Act of 1997; and
``(B) has documented, using local data, rates of abuse of
opioids or methamphetamines at levels that are--
``(i) significantly higher than the national average as
determined by the Secretary (including appropriate
consideration of the results of the Monitoring the Future
Survey published by the National Institute on Drug Abuse and
the National Survey on Drug Use and Health published by the
Substance Abuse and Mental Health Services Administration);
or
``(ii) higher than the national average, as determined by
the Secretary (including appropriate consideration of the
results of the surveys described in clause (i)), over a
sustained period of time;
``(3) the term `local drug crisis' means, with respect to
the area served by an eligible entity--
``(A) a sudden increase in the abuse of opioids or
methamphetamines, as documented by local data;
``(B) the abuse of prescription medications, specifically
opioids or methamphetamines, that is significantly higher
than the national average, over a sustained period of time,
as documented by local data; or
``(C) a sudden increase in opioid-related deaths, as
documented by local data;
``(4) the term `opioid' means any drug having an addiction-
forming or addiction-sustaining liability similar to morphine
or being capable of conversion into a drug having such
addiction-forming or addiction-sustaining liability; and
``(5) the term `Secretary' means the Secretary of Health
and Human Services.
``(b) Program Authorized.--The Secretary, in coordination
with the Director of the Office of National Drug Control
Policy, may make grants to eligible entities to implement
comprehensive community-wide strategies that address local
drug crises within the area served by the eligible entity.
``(c) Application.--
``(1) In general.--An eligible entity seeking a grant under
this section shall submit an application to the Secretary at
such time, in such manner, and accompanied by such
information as the Secretary may require.
``(2) Criteria.--As part of an application for a grant
under this section, the Secretary shall require an eligible
entity to submit a detailed, comprehensive, multisector plan
for addressing the local drug crisis within the area served
by the eligible entity.
``(d) Use of Funds.--An eligible entity shall use a grant
received under this section--
``(1) for programs designed to implement comprehensive
community-wide prevention strategies to address the local
drug crisis in the area served by the eligible entity, in
accordance with the plan submitted under subsection (c)(2);
and
``(2) to obtain specialized training and technical
assistance from the organization funded under section 4 of
Public Law 107-82 (21 U.S.C. 1521 note).
``(e) Supplement Not Supplant.--An eligible entity shall
use Federal funds received under this section only to
supplement the funds that would, in the absence of those
Federal funds, be made available from other Federal and non-
Federal sources for the activities described in this section,
and not to supplant those funds.
``(f) Evaluation.--A grant under this section shall be
subject to the same evaluation requirements and procedures as
the evaluation requirements and procedures imposed on the
recipient of a grant under the Drug-Free Communities Act of
1997, and may also include an evaluation of the effectiveness
at reducing abuse of opioids, methadone, or methamphetamines.
``(g) Limitation on Administrative Expenses.--Not more than
8 percent of the amounts made available to carry out this
section for a fiscal year may be used by the Secretary to pay
for administrative expenses.''.
TITLE II--LAW ENFORCEMENT AND TREATMENT
SEC. 201. TREATMENT ALTERNATIVE TO INCARCERATION PROGRAMS.
(a) Definitions.--In this section:
(1) Eligible entity.--The term ``eligible entity'' means a
State, unit of local government, Indian tribe, or nonprofit
organization.
(2) Eligible participant.--The term ``eligible
participant'' means an individual who--
(A) comes into contact with the juvenile justice system or
criminal justice system or is arrested or charged with an
offense that is not--
(i) a crime of violence, as defined under applicable State
law or section 3156 of title 18, United States Code; or
(ii) a serious drug offense, as defined under section
924(e)(2)(A) of title 18, United States Code;
(B) has been screened by a qualified mental health
professional and determined to suffer from a substance use
disorder, or co-occurring mental illness and substance use
disorder, that there is a reasonable basis to believe is
related to the commission of the offense; and
(C) has been, after consideration of any potential risk of
violence to any person in the program or the public if the
individual were selected to participate in the program,
unanimously approved for participation in a program funded
under this section by, as applicable depending on the stage
of the criminal justice process--
(i) the relevant law enforcement agency;
(ii) the prosecuting attorney;
(iii) the defense attorney;
(iv) the pretrial, probation, or correctional officer;
(v) the judge; and
(vi) a representative from the relevant mental health or
substance abuse agency.
(b) Program Authorized.--The Secretary of Health and Human
Services, in coordination with the Attorney General, may make
grants to eligible entities to--
(1) develop, implement, or expand a treatment alternative
to incarceration program for eligible participants,
including--
(A) pre-booking, including pre-arrest, treatment
alternative to incarceration programs, including--
(i) law enforcement training on substance use disorders and
co-occurring mental illness and substance use disorders;
(ii) receiving centers as alternatives to incarceration of
eligible participants;
(iii) specialized response units for calls related to
substance use disorders and co-occurring mental illness and
substance use disorders; and
(iv) other pre-arrest or pre-booking treatment alternative
to incarceration models; and
(B) post-booking treatment alternative to incarceration
programs, including--
(i) specialized clinical case management;
(ii) pretrial services related to substance use disorders
and co-occurring mental illness and substance use disorders;
(iii) prosecutor and defender based programs;
(iv) specialized probation;
(v) programs utilizing the American Society of Addiction
Medicine patient placement criteria;
(vi) treatment and rehabilitation programs and recovery
support services; and
(vii) drug courts, DWI courts, and veterans treatment
courts; and
(2) facilitate or enhance planning and collaboration
between State criminal justice systems and State substance
abuse systems in order to more efficiently and effectively
carry out programs described in paragraph (1) that address
problems related to the use of heroin and misuse of
prescription drugs among eligible participants.
(c) Application.--
(1) In general.--An eligible entity seeking a grant under
this section shall submit an application to the Secretary of
Health and Human Services--
(A) that meets the criteria under paragraph (2); and
(B) at such time, in such manner, and accompanied by such
information as the Secretary of Health and Human Services may
require.
(2) Criteria.--An eligible entity, in submitting an
application under paragraph (1), shall--
(A) provide extensive evidence of collaboration with State
and local government agencies overseeing health, community
corrections, courts, prosecution, substance abuse, mental
health, victims services, and employment services, and with
local law enforcement agencies;
(B) demonstrate consultation with the Single State
Authority for Substance Abuse (as defined in section 201(e)
of the Second Chance Act of 2007 (42 U.S.C. 17521(e)));
(C) demonstrate consultation with the Single State criminal
justice planning agency;
(D) demonstrate that evidence-based treatment practices,
including if applicable the use of medication assisted
treatment, will be utilized; and
[[Page S1407]]
(E) demonstrate that evidenced-based screening and
assessment tools will be utilized to place participants in
the treatment alternative to incarceration program.
(d) Requirements.--Each eligible entity awarded a grant for
a treatment alternative to incarceration program under this
section shall--
(1) determine the terms and conditions of participation in
the program by eligible participants, taking into
consideration the collateral consequences of an arrest,
prosecution, or criminal conviction;
(2) ensure that each substance abuse and mental health
treatment component is licensed and qualified by the relevant
jurisdiction;
(3) for programs described in subsection (b)(2), organize
an enforcement unit comprised of appropriately trained law
enforcement professionals under the supervision of the State,
tribal, or local criminal justice agency involved, the duties
of which shall include--
(A) the verification of addresses and other contacts of
each eligible participant who participates or desires to
participate in the program; and
(B) if necessary, the location, apprehension, arrest, and
return to court of an eligible participant in the program who
has absconded from the facility of a treatment provider or
has otherwise violated the terms and conditions of the
program, consistent with Federal and State confidentiality
requirements;
(4) notify the relevant criminal justice entity if any
eligible participant in the program absconds from the
facility of the treatment provider or otherwise violates the
terms and conditions of the program, consistent with Federal
and State confidentiality requirements;
(5) submit periodic reports on the progress of treatment or
other measured outcomes from participation in the program of
each eligible participant in the program to the relevant
State, tribal, or local criminal justice agency;
(6) describe the evidence-based methodology and outcome
measurements that will be used to evaluate the program, and
specifically explain how such measurements will provide valid
measures of the impact of the program; and
(7) describe how the program could be broadly replicated if
demonstrated to be effective.
(e) Use of Funds.--An eligible entity shall use a grant
received under this section for expenses of a treatment
alternative to incarceration program, including--
(1) salaries, personnel costs, equipment costs, and other
costs directly related to the operation of the program,
including the enforcement unit;
(2) payments for treatment providers that are approved by
the relevant State or tribal jurisdiction and licensed, if
necessary, to provide needed treatment to eligible
participants in the program, including medication assisted
treatment, aftercare supervision, vocational training,
education, and job placement;
(3) payments to public and nonprofit private entities that
are approved by the State or tribal jurisdiction and
licensed, if necessary, to provide alcohol and drug addiction
treatment and mental health treatment to eligible
participants in the program; and
(4) salaries, personnel costs, and other costs related to
strategic planning among State and local government agencies.
(f) Supplement Not Supplant.--An eligible entity shall use
Federal funds received under this section only to supplement
the funds that would, in the absence of those Federal funds,
be made available from other Federal and non-Federal sources
for the activities described in this section, and not to
supplant those funds.
(g) Geographic Distribution.--The Secretary of Health and
Human Services shall ensure that, to the extent practicable,
the geographical distribution of grants under this section is
equitable and includes a grant to an eligible entity in--
(1) each State;
(2) rural, suburban, and urban areas; and
(3) tribal jurisdictions.
(h) Priority Consideration With Respect to States.--In
awarding grants to States under this section, the Secretary
of Health and Human Services shall give priority to--
(1) a State that submits a joint application from the
substance abuse agencies and criminal justice agencies of the
State that proposes to use grant funds to facilitate or
enhance planning and collaboration between the agencies,
including coordination to better address the needs of
incarcerated populations; and
(2) a State that--
(A) provides civil liability protection for first
responders, health professionals, and family members who have
received appropriate training in the administration of
naloxone in administering naloxone to counteract opioid
overdoses; and
(B) submits to the Secretary a certification by the
attorney general of the State that the attorney general has--
(i) reviewed any applicable civil liability protection law
to determine the applicability of the law with respect to
first responders, health care professionals, family members,
and other individuals who--
(I) have received appropriate training in the
administration of naloxone; and
(II) may administer naloxone to individuals reasonably
believed to be suffering from opioid overdose; and
(ii) concluded that the law described in subparagraph (A)
provides adequate civil liability protection applicable to
such persons.
(i) Reports and Evaluations.--
(1) In general.--Each fiscal year, each recipient of a
grant under this section during that fiscal year shall submit
to the Secretary of Health and Human Services a report on the
outcomes of activities carried out using that grant in such
form, containing such information, and on such dates as the
Secretary of Health and Human Services shall specify.
(2) Contents.--A report submitted under paragraph (1)
shall--
(A) describe best practices for treatment alternatives; and
(B) identify training requirements for law enforcement
officers who participate in treatment alternative to
incarceration programs.
(j) Funding.--During the 5-year period beginning on the
date of enactment of this Act, the Secretary of Health and
Human Services may carry out this section using not more than
$5,000,000 each fiscal year of amounts appropriated to the
Substance Abuse and Mental Health Services Administration for
Criminal Justice Activities. No additional funds are
authorized to be appropriated to carry out this section.
SEC. 202. FIRST RESPONDER TRAINING FOR THE USE OF DRUGS AND
DEVICES THAT RAPIDLY REVERSE THE EFFECTS OF
OPIOIDS.
Part II of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by
section 103, is amended by adding at the end the following:
``SEC. 2998. FIRST RESPONDER TRAINING FOR THE USE OF DRUGS
AND DEVICES THAT RAPIDLY REVERSE THE EFFECTS OF
OPIOIDS.
``(a) Definition.--In this section--
``(1) the terms `drug' and `device' have the meanings given
those terms in section 201 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 321);
``(2) the term `eligible entity' means a State, a unit of
local government, or an Indian tribal government;
``(3) the term `first responder' includes a firefighter,
law enforcement officer, paramedic, emergency medical
technician, or other individual (including an employee of a
legally organized and recognized volunteer organization,
whether compensated or not), who, in the course of
professional duties, responds to fire, medical, hazardous
material, or other similar emergencies;
``(4) the term `opioid' means any drug having an addiction-
forming or addiction-sustaining liability similar to morphine
or being capable of conversion into a drug having such
addiction-forming or addiction-sustaining liability; and
``(5) the term `Secretary' means the Secretary of Health
and Human Services.
``(b) Program Authorized.--The Secretary, in coordination
with the Attorney General, may make grants to eligible
entities to allow appropriately trained first responders to
administer an opioid overdose reversal drug to an individual
who has--
``(1) experienced a prescription opioid or heroin overdose;
or
``(2) been determined to have likely experienced a
prescription opioid or heroin overdose.
``(c) Application.--
``(1) In general.--An eligible entity seeking a grant under
this section shall submit an application to the Secretary--
``(A) that meets the criteria under paragraph (2); and
``(B) at such time, in such manner, and accompanied by such
information as the Secretary may require.
``(2) Criteria.--An eligible entity, in submitting an
application under paragraph (1), shall--
``(A) describe the evidence-based methodology and outcome
measurements that will be used to evaluate the program funded
with a grant under this section, and specifically explain how
such measurements will provide valid measures of the impact
of the program;
``(B) describe how the program could be broadly replicated
if demonstrated to be effective;
``(C) identify the governmental and community agencies that
the program will coordinate; and
``(D) describe how law enforcement agencies will coordinate
with their corresponding State substance abuse and mental
health agencies to identify protocols and resources that are
available to overdose victims and families, including
information on treatment and recovery resources.
``(d) Use of Funds.--An eligible entity shall use a grant
received under this section to--
``(1) make such opioid overdose reversal drugs or devices
that are approved by the Food and Drug Administration, such
as naloxone, available to be carried and administered by
first responders;
``(2) train and provide resources for first responders on
carrying an opioid overdose reversal drug or device approved
by the Food and Drug Administration, such as naloxone, and
administering the drug or device to an individual who has
experienced, or has been determined to have likely
experienced, a prescription opioid or heroin overdose; and
``(3) establish processes, protocols, and mechanisms for
referral to appropriate treatment, which may include an
outreach coordinator or team to connect individuals receiving
opioid overdose reversal drugs to follow-up services.
[[Page S1408]]
``(e) Technical Assistance Grants.--The Secretary shall
make a grant for the purpose of providing technical
assistance and training on the use of an opioid overdose
reversal drug, such as naloxone, to respond to an individual
who has experienced, or has been determined to have likely
experienced, a prescription opioid or heroin overdose, and
mechanisms for referral to appropriate treatment for an
eligible entity receiving a grant under this section.
``(f) Evaluation.--The Secretary shall conduct an
evaluation of grants made under this section to determine--
``(1) the number of first responders equipped with
naloxone, or another opioid overdose reversal drug, for the
prevention of fatal opioid and heroin overdose;
``(2) the number of opioid and heroin overdoses reversed by
first responders receiving training and supplies of naloxone,
or another opioid overdose reversal drug, through a grant
received under this section;
``(3) the number of calls for service related to opioid and
heroin overdose;
``(4) the extent to which overdose victims and families
receive information about treatment services and available
data describing treatment admissions; and
``(5) the research, training, and naloxone, or another
opioid overdose reversal drug, supply needs of first
responder agencies, including those agencies that are not
receiving grants under this section.
``(g) Rural Areas With Limited Access to Emergency Medical
Services.--In making grants under this section, the Secretary
shall ensure that not less than 25 percent of grant funds are
awarded to eligible entities that are not located in
metropolitan statistical areas, as defined by the Office of
Management and Budget.''.
SEC. 203. PRESCRIPTION DRUG TAKE BACK EXPANSION.
(a) Definition of Covered Entity.--In this section, the
term ``covered entity'' means--
(1) a State, local, or tribal law enforcement agency;
(2) a manufacturer, distributor, or reverse distributor of
prescription medications;
(3) a retail pharmacy;
(4) a registered narcotic treatment program;
(5) a hospital or clinic with an onsite pharmacy;
(6) an eligible long-term care facility; or
(7) any other entity authorized by the Drug Enforcement
Administration to dispose of prescription medications.
(b) Program Authorized.--The Attorney General, in
coordination with the Administrator of the Drug Enforcement
Administration, the Secretary of Health and Human Services,
and the Director of the Office of National Drug Control
Policy, shall coordinate with covered entities in expanding
or making available disposal sites for unwanted prescription
medications.
SEC. 204. HEROIN AND METHAMPHETAMINE TASK FORCES.
Part II of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by
section 202, is amended by adding at the end the following:
``SEC. 2999. HEROIN AND METHAMPHETAMINE TASK FORCES.
``(a) Definition of Opioid.--In this section, the term
`opioid' means any drug having an addiction-forming or
addiction-sustaining liability similar to morphine or being
capable of conversion into a drug having such addiction-
forming or addiction-sustaining liability.
``(b) Authority.--The Attorney General may make grants to
State law enforcement agencies for investigative purposes--
``(1) to locate or investigate illicit activities through
statewide collaboration, including activities related to--
``(A) the distribution of heroin or fentanyl, or the
unlawful distribution of prescription opioids; or
``(B) unlawful heroin, fentanyl, and prescription opioid
traffickers; and
``(2) to locate or investigate illicit activities,
including precursor diversion, laboratories, or
methamphetamine traffickers.''.
TITLE III--TREATMENT AND RECOVERY
SEC. 301. EVIDENCE-BASED PRESCRIPTION OPIOID AND HEROIN
TREATMENT AND INTERVENTIONS DEMONSTRATION.
Part II of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by
section 204, is amended by adding at the end the following:
``SEC. 2999A. EVIDENCE-BASED PRESCRIPTION OPIOID AND HEROIN
TREATMENT AND INTERVENTIONS DEMONSTRATION.
``(a) Definitions.--In this section--
``(1) the terms `Indian tribe' and `tribal organization'
have the meaning given those terms in section 4 of the Indian
Health Care Improvement Act (25 U.S.C. 1603));
``(2) the term `medication assisted treatment' means the
use, for problems relating to heroin and other opioids, of
medications approved by the Food and Drug Administration in
combination with counseling and behavioral therapies;
``(3) the term `opioid' means any drug having an addiction-
forming or addiction-sustaining liability similar to morphine
or being capable of conversion into a drug having such
addiction-forming or addiction-sustaining liability;
``(4) the term `Secretary' means the Secretary of Health
and Human Services; and
``(5) the term `State substance abuse agency' means the
agency of a State responsible for the State prevention,
treatment, and recovery system, including management of 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.).
``(b) Grants.--
``(1) Authority to make grants.--The Secretary, acting
through the Director of the Center for Substance Abuse
Treatment of the Substance Abuse and Mental Health Services
Administration, and in coordination with the Attorney General
and other departments or agencies, as appropriate, may award
grants to State substance abuse agencies, units of local
government, nonprofit organizations, and Indian tribes or
tribal organizations that have a high rate, or have had a
rapid increase, in the use of heroin or other opioids, in
order to permit such entities to expand activities, including
an expansion in the availability of medication assisted
treatment and other clinically appropriate services, with
respect to the treatment of addiction in the specific
geographical areas of such entities where there is a high
rate or rapid increase in the use of heroin or other opioids.
``(2) Nature of activities.--The grant funds awarded under
paragraph (1) shall be used for activities that are based on
reliable scientific evidence of efficacy in the treatment of
problems related to heroin or other opioids.
``(c) Geographic Distribution.--The Secretary shall ensure
that grants awarded under subsection (b) are distributed
equitably among the various regions of the United States and
among rural, urban, and suburban areas that are affected by
the use of heroin or other opioids.
``(d) Additional Activities.--In administering grants under
subsection (b), the Secretary shall--
``(1) evaluate the activities supported by grants awarded
under subsection (b);
``(2) disseminate information, as appropriate, derived from
the evaluation as the Secretary considers appropriate;
``(3) provide States, Indian tribes and tribal
organizations, and providers with technical assistance in
connection with the provision of treatment of problems
related to heroin and other opioids; and
``(4) fund only those applications that specifically
support recovery services as a critical component of the
grant program.''.
SEC. 302. CRIMINAL JUSTICE MEDICATION ASSISTED TREATMENT AND
INTERVENTIONS DEMONSTRATION.
(a) Definitions.--In this section--
(1) the term ``criminal justice agency'' means a State,
local, or tribal--
(A) court;
(B) prison;
(C) jail; or
(D) other agency that performs the administration of
criminal justice, including prosecution, pretrial services,
and community supervision;
(2) the term ``eligible entity'' means a State, unit of
local government, or Indian tribe; and
(3) the term ``Secretary'' means the Secretary of Health
and Human Services.
(b) Program Authorized.--The Secretary, in coordination
with the Attorney General, may make grants to eligible
entities to implement medication assisted treatment programs
through criminal justice agencies.
(c) Application.--
(1) In general.--An eligible entity seeking a grant under
this section shall submit an application to the Secretary--
(A) that meets the criteria under paragraph (2); and
(B) at such time, in such manner, and accompanied by such
information as the Secretary may require.
(2) Criteria.--An eligible entity, in submitting an
application under paragraph (1), shall--
(A) certify that each medication assisted treatment program
funded with a grant under this section has been developed in
consultation with the Single State Authority for Substance
Abuse (as defined in section 201(e) of the Second Chance Act
of 2007 (42 U.S.C. 17521(e))); and
(B) describe how data will be collected and analyzed to
determine the effectiveness of the program described in
subparagraph (A).
(d) Use of Funds.--An eligible entity shall use a grant
received under this section for expenses of--
(1) a medication assisted treatment program, including the
expenses of prescribing medications recognized by the Food
and Drug Administration for opioid treatment in conjunction
with psychological and behavioral therapy;
(2) training criminal justice agency personnel and
treatment providers on medication assisted treatment;
(3) cross-training personnel providing behavioral health
and health services, administration of medicines, and other
administrative expenses, including required reports; and
(4) the provision of recovery coaches who are responsible
for providing mentorship and transition plans to individuals
reentering society following incarceration or alternatives to
incarceration.
(e) Priority Consideration With Respect to States.--In
awarding grants to States under this section, the Secretary
shall give priority to a State that--
(1) provides civil liability protection for first
responders, health professionals, and
[[Page S1409]]
family members who have received appropriate training in the
administration of naloxone in administering naloxone to
counteract opioid overdoses; and
(2) submits to the Secretary a certification by the
attorney general of the State that the attorney general has--
(A) reviewed any applicable civil liability protection law
to determine the applicability of the law with respect to
first responders, health care professionals, family members,
and other individuals who--
(i) have received appropriate training in the
administration of naloxone; and
(ii) may administer naloxone to individuals reasonably
believed to be suffering from opioid overdose; and
(B) concluded that the law described in subparagraph (A)
provides adequate civil liability protection applicable to
such persons.
(f) Technical Assistance.--The Secretary, in coordination
with the Director of the National Institute on Drug Abuse and
the Attorney General, shall provide technical assistance and
training for an eligible entity receiving a grant under this
section.
(g) Reports.--
(1) In general.--An eligible entity receiving a grant under
this section shall submit a report to the Secretary on the
outcomes of each grant received under this section for
individuals receiving medication assisted treatment, based
on--
(A) the recidivism of the individuals;
(B) the treatment outcomes of the individuals, including
maintaining abstinence from illegal, unauthorized, and
unprescribed or undispensed opioids and heroin;
(C) a comparison of the cost of providing medication
assisted treatment to the cost of incarceration or other
participation in the criminal justice system;
(D) the housing status of the individuals; and
(E) the employment status of the individuals.
(2) Contents and timing.--Each report described in
paragraph (1) shall be submitted annually in such form,
containing such information, and on such dates as the
Secretary shall specify.
(h) Funding.--During the 5-year period beginning on the
date of enactment of this Act, the Secretary may carry out
this section using not more than $5,000,000 each fiscal year
of amounts appropriated to the Substance Abuse and Mental
Health Services Administration for Criminal Justice
Activities. No additional funds are authorized to be
appropriated to carry out this section.
SEC. 303. NATIONAL YOUTH RECOVERY INITIATIVE.
Part II of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by
section 301, is amended by adding at the end the following:
``SEC. 2999B. NATIONAL YOUTH RECOVERY INITIATIVE.
``(a) Definitions.--In this section:
``(1) Eligible entity.--The term `eligible entity' means--
``(A) a high school that has been accredited as a recovery
high school by the Association of Recovery Schools;
``(B) an accredited high school that is seeking to
establish or expand recovery support services;
``(C) an institution of higher education;
``(D) a recovery program at a nonprofit collegiate
institution; or
``(E) a nonprofit organization.
``(2) Institution of higher education.--The term
`institution of higher education' has the meaning given the
term in section 101 of the Higher Education Act of 1965 (20
U.S.C. 1001).
``(3) Recovery program.--The term `recovery program'--
``(A) means a program to help individuals who are
recovering from substance use disorders to initiate,
stabilize, and maintain healthy and productive lives in the
community; and
``(B) includes peer-to-peer support and communal activities
to build recovery skills and supportive social networks.
``(b) Grants Authorized.--The Secretary of Health and Human
Services, in coordination with the Secretary of Education,
may award grants to eligible entities to enable the entities
to--
``(1) provide substance use disorder recovery support
services to young people in high school and enrolled in
institutions of higher education;
``(2) help build communities of support for young people in
recovery through a spectrum of activities such as counseling
and health- and wellness-oriented social activities; and
``(3) encourage initiatives designed to help young people
achieve and sustain recovery from substance use disorders.
``(c) Use of Funds.--Grants awarded under subsection (b)
may be used for activities to develop, support, and maintain
youth recovery support services, including--
``(1) the development and maintenance of a dedicated
physical space for recovery programs;
``(2) dedicated staff for the provision of recovery
programs;
``(3) health- and wellness-oriented social activities and
community engagement;
``(4) establishment of recovery high schools;
``(5) coordination of recovery programs with--
``(A) substance use disorder treatment programs and
systems;
``(B) providers of mental health services;
``(C) primary care providers and physicians;
``(D) the criminal justice system, including the juvenile
justice system;
``(E) employers;
``(F) housing services;
``(G) child welfare services;
``(H) high schools and institutions of higher education;
and
``(I) other programs or services related to the welfare of
an individual in recovery from a substance use disorder;
``(6) the development of peer-to-peer support programs or
services; and
``(7) additional activities that help youths and young
adults to achieve recovery from substance use disorders.''.
SEC. 304. BUILDING COMMUNITIES OF RECOVERY.
Part II of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by
section 303, is amended by adding at the end the following:
``SEC. 2999C. 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 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 of Health and Human
Services may 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
50 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) advocate for individuals in recovery from substance
use disorders;
``(B) build connections between recovery networks, between
recovery community organizations, and with other recovery
support services, including--
``(i) substance use disorder treatment programs and
systems;
``(ii) providers of mental health services;
``(iii) primary care providers and physicians;
``(iv) the criminal justice system;
``(v) employers;
``(vi) housing services;
``(vii) child welfare agencies; and
``(viii) other recovery support services that facilitate
recovery from substance use disorders;
``(C) reduce the stigma associated with substance use
disorders;
``(D) conduct public education and outreach on issues
relating to substance use disorders and recovery, including--
``(i) how to identify the signs of addiction;
``(ii) the resources that are available to individuals
struggling with addiction and families who have a family
member struggling with or being treated for addiction,
including programs that mentor and provide support services
to children;
``(iii) the resources that are available to help support
individuals in recovery; and
``(iv) information on the medical consequences of substance
use disorders, including neonatal abstinence syndrome and
potential infection with human immunodeficiency virus and
viral hepatitis; and
``(E) carry out other activities that strengthen the
network of community support for individuals in recovery.''.
TITLE IV--ADDRESSING COLLATERAL CONSEQUENCES
SEC. 401. CORRECTIONAL EDUCATION DEMONSTRATION GRANT PROGRAM.
Part II of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by
section 304, is amended by adding at the end the following:
``SEC. 2999D. CORRECTIONAL EDUCATION DEMONSTRATION GRANT
PROGRAM.
``(a) Definition.--In this section, the term `eligible
entity' means a State, unit of local government, nonprofit
organization, or Indian tribe.
``(b) Grant Program Authorized.--The Attorney General may
make grants to eligible entities to design, implement, and
expand educational programs for offenders in prisons, jails,
and juvenile facilities, including to pay for--
``(1) basic education, secondary level academic education,
high school equivalency examination preparation, career
technical education, and English language learner instruction
at the basic, secondary, or post-secondary levels, for adult
and juvenile populations;
``(2) screening and assessment of inmates to assess
education level and needs, occupational interest or aptitude,
risk level, and other needs, and case management services;
``(3) hiring and training of instructors and aides,
reimbursement of non-corrections staff and experts,
reimbursement of stipends paid to inmate tutors or aides, and
the costs of training inmate tutors and aides;
``(4) instructional supplies and equipment, including
occupational program supplies and
[[Page S1410]]
equipment to the extent that the supplies and equipment are
used for instructional purposes;
``(5) partnerships and agreements with community colleges,
universities, and career technology education program
providers;
``(6) certification programs providing recognized high
school equivalency certificates and industry recognized
credentials; and
``(7) technology solutions to--
``(A) meet the instructional, assessment, and information
needs of correctional populations; and
``(B) facilitate the continued participation of
incarcerated students in community-based education programs
after the students are released from incarceration.
``(c) Application.--An eligible entity seeking a grant
under this section shall submit to the Attorney General an
application in such form and manner, at such time, and
accompanied by such information as the Attorney General
specifies.
``(d) Priority Considerations.--In awarding grants under
this section, the Attorney General shall give priority to
applicants that--
``(1) assess the level of risk and need of inmates,
including by--
``(A) assessing the need for English language learner
instruction;
``(B) conducting educational assessments; and
``(C) assessing occupational interests and aptitudes;
``(2) target educational services to assessed needs,
including academic and occupational at the basic, secondary,
or post-secondary level;
``(3) target career and technology education programs to--
``(A) areas of identified occupational demand; and
``(B) employment opportunities in the communities in which
students are reasonably expected to reside post-release;
``(4) include a range of appropriate educational
opportunities at the basic, secondary, and post-secondary
levels;
``(5) include opportunities for students to attain industry
recognized credentials;
``(6) include partnership or articulation agreements
linking institutional education programs with community sited
programs provided by adult education program providers and
accredited institutions of higher education, community
colleges, and vocational training institutions; and
``(7) explicitly include career pathways models offering
opportunities for incarcerated students to develop academic
skills, in-demand occupational skills and credentials,
occupational experience in institutional work programs or
work release programs, and linkages with employers in the
community, so that incarcerated students have opportunities
to embark on careers with strong prospects for both post-
release employment and advancement in a career ladder over
time.
``(e) Requirements.--An eligible entity seeking a grant
under this section shall--
``(1) describe the evidence-based methodology and outcome
measurements that will be used to evaluate each program
funded with a grant under this section, and specifically
explain how such measurements will provide valid measures of
the impact of the program; and
``(2) describe how each program described in paragraph (1)
could be broadly replicated if demonstrated to be effective.
``(f) Control of Internet Access.--An entity that receives
a grant under this section may restrict access to the
Internet by prisoners, as appropriate and in accordance with
Federal and State law, to ensure public safety.''.
SEC. 402. NATIONAL TASK FORCE ON RECOVERY AND COLLATERAL
CONSEQUENCES.
(a) Definition.--In this section, the term ``collateral
consequence'' means a penalty, disability, or disadvantage
imposed on an individual who is in recovery for a substance
use disorder (including by an administrative agency,
official, or civil court ) as a result of a Federal or State
conviction for a drug-related offense but not as part of the
judgment of the court that imposes the conviction.
(b) Establishment.--
(1) In general.--Not later than 30 days after the date of
enactment of this Act, the Attorney General shall establish a
bipartisan task force to be known as the Task Force on
Recovery and Collateral Consequences (in this section
referred to as the ``Task Force'').
(2) Membership.--
(A) Total number of members.--The Task Force shall include
10 members, who shall be appointed by the Attorney General in
accordance with subparagraphs (B) and (C).
(B) Members of the task force.--The Task Force shall
include--
(i) members who have national recognition and significant
expertise in areas such as health care, housing, employment,
substance use disorders, mental health, law enforcement, and
law;
(ii) not fewer than 2 members--
(I) who have personally experienced a substance abuse
disorder or addiction and are in recovery; and
(II) not fewer than 1 of whom has benefitted from
medication assisted treatment; and
(iii) to the extent practicable, members who formerly
served as elected officials at the State and Federal levels.
(C) Timing.--The Attorney General shall appoint the members
of the Task Force not later than 60 days after the date on
which the Task Force is established under paragraph (1).
(3) Chairperson.--The Task Force shall select a chairperson
or co-chairpersons from among the members of the Task Force.
(c) Duties of the Task Force.--
(1) In general.--The Task Force shall--
(A) identify collateral consequences for individuals with
Federal or State convictions for drug-related offenses who
are in recovery for substance use disorder; and
(B) examine any policy basis for the imposition of
collateral consequences identified under subparagraph (A) and
the effect of the collateral consequences on individuals in
recovery in resuming their personal and professional
activities.
(2) Recommendations.--Not later than 180 days after the
date of the first meeting of the Task Force, the Task Force
shall develop recommendations, as it considers appropriate,
for proposed legislative and regulatory changes related to
the collateral consequences identified under paragraph (1).
(3) Collection of information.--The Task Force shall hold
hearings, require the testimony and attendance of witnesses,
and secure information from any department or agency of the
United States in performing the duties under paragraphs (1)
and (2).
(4) Report.--
(A) Submission to executive branch.--Not later than 1 year
after the date of the first meeting of the Task Force, the
Task Force shall submit a report detailing the findings and
recommendations of the Task Force to--
(i) the head of each relevant department or agency of the
United States;
(ii) the President; and
(iii) the Vice President.
(B) Submission to congress.--The individuals who receive
the report under subparagraph (A) shall submit to Congress
such legislative recommendations, if any, as those
individuals consider appropriate based on the report.
TITLE V--ADDICTION AND TREATMENT SERVICES FOR WOMEN, FAMILIES, AND
VETERANS
SEC. 501. IMPROVING TREATMENT FOR PREGNANT AND POSTPARTUM
WOMEN.
(a) In General.--Section 508 of the Public Health Service
Act (42 U.S.C. 290bb-1) is amended--
(1) in subsection (a), by inserting ``(referred to in this
section as the `Director')'' after ``Director of the Center
for Substance Abuse Treatment''; and
(2) in subsection (p), in the first sentence--
(A) by striking ``Committee on Labor and Human Resources''
and inserting ``Committee on Health, Education, Labor, and
Pensions''; and
(B) by inserting ``(other than subsection (r))'' after
``this section''.
(b) Pilot Program Grants for State Substance Abuse
Agencies.--Section 508 of the Public Health Service Act (42
U.S.C. 290bb-1) is amended--
(1) by striking subsection (r); and
(2) by inserting after subsection (q) the following:
``(r) Pilot Program for State Substance Abuse Agencies.--
``(1) In general.--The Director shall carry out a pilot
program under which the Director makes competitive grants to
State substance abuse agencies to--
``(A) enhance flexibility in the use of funds designed to
support family-based services for pregnant and postpartum
women with a primary diagnosis of a substance use disorder,
including opioid use disorders;
``(B) help State substance abuse agencies address
identified gaps in services furnished to such women along the
continuum of care, including services provided to women in
non-residential based settings; and
``(C) promote a coordinated, effective, and efficient State
system managed by State substance abuse agencies by
encouraging new approaches and models of service delivery
that are evidence-based, including effective family-based
programs for women involved with the criminal justice system.
``(2) Requirements.--In carrying out the pilot program
under this subsection, the Director--
``(A) shall require State substance abuse agencies to
submit to the Director applications, in such form and manner
and containing such information as specified by the Director,
to be eligible to receive a grant under the program;
``(B) shall identify, based on such submitted applications,
State substance abuse agencies that are eligible for such
grants;
``(C) shall require services proposed to be furnished
through such a grant to support family-based treatment and
other services for pregnant and postpartum women with a
primary diagnosis of a substance use disorder, including
opioid use disorders;
``(D) notwithstanding subsection (a)(1), shall not require
that services furnished through such a grant be provided
solely to women that reside in facilities; and
``(E) shall not require that grant recipients under the
program make available all services described in subsection
(d).
``(3) Required services.--
``(A) In general.--The Director shall specify minimum
services required to be made available to eligible women
through a grant awarded under the pilot program under this
subsection. Such minimum services--
``(i) shall include the requirements described in
subsection (c);
``(ii) may include any of the services described in
subsection (d);
``(iii) may include other services, as appropriate; and
[[Page S1411]]
``(iv) shall be based on the recommendations submitted
under subparagraph (B)
``(B) Stakeholder input.--The Director shall convene and
solicit recommendations from stakeholders, including State
substance abuse agencies, health care providers, persons in
recovery from a substance use disorder, and other appropriate
individuals, for the minimum services described in
subparagraph (A).
``(4) Duration.--The pilot program under this subsection
shall not exceed 5 years.
``(5) Evaluation and report to congress.--
``(A) In general.--Out of amounts made available to the
Center for Behavioral Health Statistics and Quality, the
Director of the Center for Behavioral Health Statistics and
Quality, in cooperation with the recipients of grants under
this subsection, shall conduct an evaluation of the pilot
program under this subsection, beginning 1 year after the
date on which a grant is first awarded under this subsection.
The Director of the Center for Behavioral Health Statistics
and Quality, in coordination with the Director of the Center
for Substance Abuse Treatment, not later than 120 days after
completion of such evaluation, shall submit to the relevant
Committees of the Senate and the House of Representatives a
report on such evaluation.
``(B) Contents.--The report to Congress under subparagraph
(A) shall include, at a minimum, outcomes information from
the pilot program, including any resulting reductions in the
use of alcohol and other drugs, engagement in treatment
services, retention in the appropriate level and duration of
services, increased access to the use of drugs approved by
the Food and Drug Administration for the treatment of
substance use disorders in combination with counseling, and
other appropriate measures.
``(6) Definition of state substance abuse agency.--For
purposes of this subsection, the term `State substance abuse
agency' means, with respect to a State, the agency in such
State that manages the substance abuse prevention and
treatment block grant program under part B of title XIX.
``(s) Funding.--
``(1) In general.--For the purpose of carrying out this
section, there are authorized to be appropriated $15,900,000
for each of fiscal years 2016 through 2020.
``(2) Limitation.--Of the amounts made available under
paragraph (1) to carry out this section, not more than 25
percent may be used each fiscal year to carry out subsection
(r).''.
SEC. 502. REPORT ON GRANTS FOR FAMILY-BASED SUBSTANCE ABUSE
TREATMENT.
Section 2925 of the Omnibus Crime Control and Safe Streets
Act of 1968 (42 U.S.C. 3797s-4) is amended--
(1) by striking ``An entity'' and inserting ``(a) Entity
Reports.--An entity''; and
(2) by adding at the end the following:
``(b) Attorney General Report on Family-Based Substance
Abuse Treatment.--The Attorney General shall submit to
Congress an annual report that describes the number of grants
awarded under section 2921(1) and how such grants are used by
the recipients for family-based substance abuse treatment
programs that serve as alternatives to incarceration for
custodial parents to receive treatment and services as a
family.''.
SEC. 503. VETERANS' TREATMENT COURTS.
Section 2991(j)(1)(B)(ii) of title I of the Omnibus Crime
Control and Safe Streets Act of 1968 (42 U.S.C.
3797aa(j)(1)(B)(ii)), as amended by the Comprehensive Justice
and Mental Health Act of 2015 (S. 993, 114th Congress), is
amended--
(1) by inserting ``(I)'' after ``(ii)'';
(2) in subclause (I), as so designated, by striking the
period and inserting ``; or''; and
(3) by adding at the end the following:
``(II) was discharged or released from such service under
dishonorable conditions, if the reason for that discharge or
release, if known, is attributable to a substance use
disorder.''.
TITLE VI--INCENTIVIZING STATE COMPREHENSIVE INITIATIVES TO ADDRESS
PRESCRIPTION OPIOID AND HEROIN ABUSE
SEC. 601. STATE DEMONSTRATION GRANTS FOR COMPREHENSIVE OPIOID
ABUSE RESPONSE.
(a) Definitions.--In this section--
(1) the term ``dispenser'' has the meaning given the term
in section 102 of the Controlled Substances Act (21 U.S.C.
802);
(2) the term ``prescriber'' means a dispenser who
prescribes a controlled substance, or the agent of such a
dispenser;
(3) the term ``prescriber of a schedule II, III, or IV
controlled substance'' does not include a prescriber of a
schedule II, III, or IV controlled substance that dispenses
the substance--
(A) for use on the premises on which the substance is
dispensed;
(B) in a hospital emergency room, when the substance is in
short supply;
(C) for a certified opioid treatment program; or
(D) in other situations as the Attorney General may
reasonably determine; and
(4) the term ``schedule II, III, or IV controlled
substance'' means a controlled substance that is listed on
schedule II, schedule III, or schedule IV of section 202(c)
of the Controlled Substances Act (21 U.S.C. 812(c)).
(b) Planning and Implementation Grants.--
(1) In general.--The Attorney General, in coordination with
the Secretary of Health and Human Services and in
consultation with the Director of the Office of National Drug
Control Policy, may award grants to States, and combinations
thereof, to prepare a comprehensive plan for and implement an
integrated opioid abuse response initiative.
(2) Purposes.--A State receiving a grant under this section
shall establish a comprehensive response to opioid abuse,
which shall include--
(A) prevention and education efforts around heroin and
opioid use, treatment, and recovery, including education of
residents, medical students, and physicians and other
prescribers of schedule II, III, or IV controlled substances
on relevant prescribing guidelines and the prescription drug
monitoring program of the State;
(B) a comprehensive prescription drug monitoring program to
track dispensing of schedule II, III, or IV controlled
substances, which shall--
(i) provide for data sharing with other States by statute,
regulation, or interstate agreement; and
(ii) allow for access to all individuals authorized by the
State to write prescriptions for schedule II, III, or IV
controlled substances on the prescription drug monitoring
program of the State;
(C) developing, implementing, or expanding prescription
drug and opioid addiction treatment programs by--
(i) expanding programs for medication assisted treatment of
prescription drug and opioid addiction, including training
for treatment and recovery support providers;
(ii) developing, implementing, or expanding programs for
behavioral health therapy for individuals who are in
treatment for prescription drug and opioid addiction;
(iii) developing, implementing, or expanding programs to
screen individuals who are in treatment for prescription drug
and opioid addiction for hepatitis C and HIV, and provide
treatment for those individuals if clinically appropriate; or
(iv) developing, implementing, or expanding programs that
provide screening, early intervention, and referral to
treatment (commonly known as ``SBIRT'') to teenagers and
young adults in primary care, middle schools, high schools,
universities, school-based health centers, and other
community-based health care settings frequently accessed by
teenagers or young adults; and
(D) developing, implementing, and expanding programs to
prevent overdose death from prescription medications and
opioids.
(3) Planning grant applications.--
(A) Application.--
(i) In general.--A State seeking a planning grant under
this section to prepare a comprehensive plan for an
integrated opioid abuse response initiative shall submit to
the Attorney General an application in such form, and
containing such information, as the Attorney General may
require.
(ii) Requirements.--An application for a planning grant
under this section shall, at a minimum, include--
(I) a budget and a budget justification for the activities
to be carried out using the grant;
(II) a description of the activities proposed to be carried
out using the grant, including a schedule for completion of
such activities;
(III) outcome measures that will be used to measure the
effectiveness of the programs and initiatives to address
opioids; and
(IV) a description of the personnel necessary to complete
such activities.
(B) Period; nonrenewability.--A planning grant under this
section shall be for a period of 1 year. A State may not
receive more than 1 planning grant under this section.
(C) Strategic plan and program implementation plan.--A
State receiving a planning grant under this section shall
develop a strategic plan and a program implementation plan.
(4) Implementation grants.--
(A) Application.--A State seeking an implementation grant
under this section to implement a comprehensive strategy for
addressing opioid abuse shall submit to the Attorney General
an application in such form, and containing such information,
as the Attorney General may require.
(B) Use of funds.--A State that receives an implementation
grant under this section shall use the grant for the cost of
carrying out an integrated opioid abuse response program in
accordance with this section, including for technical
assistance, training, and administrative expenses.
(C) Requirements.--An integrated opioid abuse response
program carried out using an implementation grant under this
section shall--
(i) require that each prescriber of a schedule II, III, or
IV controlled substance in the State--
(I) registers with the prescription drug monitoring program
of the State; and
(II) consults the prescription drug monitoring program
database of the State before prescribing a schedule II, III,
or IV controlled substance;
(ii) require that each dispenser of a schedule II, III, or
IV controlled substance in the State--
(I) registers with the prescription drug monitoring program
of the State;
(II) consults the prescription drug monitoring program
database of the State before dispensing a schedule II, III,
or IV controlled substance; and
(III) reports to the prescription drug monitoring program
of the State, at a minimum, each instance in which a schedule
II, III, or
[[Page S1412]]
IV controlled substance is dispensed, with limited
exceptions, as defined by the State, which shall indicate the
prescriber by name and National Provider Identifier;
(iii) require that, not fewer than 4 times each year, the
State agency or agencies that administer the prescription
drug monitoring program of the State prepare and provide to
each prescriber of a schedule II, III, or IV controlled
substance an informational report that shows how the
prescribing patterns of the prescriber compare to prescribing
practices of the peers of the prescriber and expected norms;
(iv) if informational reports provided to a prescriber
under clause (iii) indicate that the prescriber is repeatedly
falling outside of expected norms or standard practices for
the prescriber's field, direct the prescriber to educational
resources on appropriate prescribing of controlled
substances;
(v) ensure that the prescriber licensing board of the State
receives a report describing any prescribers that repeatedly
fall outside of expected norms or standard practices for the
prescriber's field, as described in clause (iii);
(vi) require consultation with the Single State Authority
for Substance Abuse (as defined in section 201(e) of the
Second Chance Act of 2007 (42 U.S.C. 17521(e))); and
(vii) establish requirements for how data will be collected
and analyzed to determine the effectiveness of the program.
(D) Period.--An implementation grant under this section
shall be for a period of 2 years.
(5) Priority considerations.--In awarding planning and
implementation grants under this section, the Attorney
General shall give priority to a State that--
(A)(i) provides civil liability protection for first
responders, health professionals, and family members who have
received appropriate training in the administration of
naloxone in administering naloxone to counteract opioid
overdoses; and
(ii) submits to the Attorney General a certification by the
attorney general of the State that the attorney general has--
(I) reviewed any applicable civil liability protection law
to determine the applicability of the law with respect to
first responders, health care professionals, family members,
and other individuals who--
(aa) have received appropriate training in the
administration of naloxone; and
(bb) may administer naloxone to individuals reasonably
believed to be suffering from opioid overdose; and
(II) concluded that the law described in subclause (I)
provides adequate civil liability protection applicable to
such persons;
(B) has in effect legislation or implements a policy under
which the State shall not terminate, but may suspend,
enrollment under the State plan for medical assistance under
title XIX of the Social Security Act (42 U.S.C. 1396 et seq.)
for an individual who is incarcerated for a period of fewer
than 2 years;
(C) has a process for enrollment in services and benefits
necessary by criminal justice agencies to initiate or
continue treatment in the community, under which an
individual who is incarcerated may, while incarcerated,
enroll in services and benefits that are necessary for the
individual to continue treatment upon release from
incarceration;
(D) ensures the capability of data sharing with other
States, such as by making data available to a prescription
monitoring hub;
(E) ensures that data recorded in the prescription drug
monitoring program database of the State is available within
24 hours, to the extent possible; and
(F) ensures that the prescription drug monitoring program
of the State notifies prescribers and dispensers of schedule
II, III, or IV controlled substances when overuse or misuse
of such controlled substances by patients is suspected.
(c) Authorization of Funding.--For each of fiscal years
2016 through 2020, the Attorney General may use, from any
unobligated balances made available under the heading
``GENERAL ADMINISTRATION'' to the Department of Justice in an
appropriation Act, such amounts as are necessary to carry out
this section, not to exceed $5,000,000 per fiscal year.
TITLE VII--MISCELLANEOUS
SEC. 701. GAO REPORT ON IMD EXCLUSION.
(a) Definition.--In this section, the term ``Medicaid
Institutions for Mental Disease exclusion'' means the
prohibition on Federal matching payments under Medicaid for
patients who have attained age 22, but have not attained age
65, in an institution for mental diseases under subparagraph
(B) of the matter following subsection (a) of section 1905 of
the Social Security Act (42 U.S.C. 1396d) and subsection (i)
of such section.
(b) Report Required.--Not later than 1 year after the date
of enactment of this Act, the Comptroller General of the
United States shall submit to Congress a report on the impact
that the Medicaid Institutions for Mental Disease exclusion
has on access to treatment for individuals with a substance
use disorder.
(c) Elements.--The report required under subsection (b)
shall include a review of what is known regarding--
(1) Medicaid beneficiary access to substance use disorder
treatments in institutions for mental disease; and
(2) the quality of care provided to Medicaid beneficiaries
treated in and outside of institutions for mental disease for
substance use disorders.
SEC. 702. FUNDING.
Part II of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3797cc et seq.), as amended by
section 401, is amended by adding at the end the following:
``SEC. 2999E. FUNDING.
``There are authorized to be appropriated to the Attorney
General and the Secretary of Health and Human Services to
carry out this part $62,000,000 for each of fiscal years 2016
through 2020.''.
SEC. 703. CONFORMING AMENDMENTS.
Part II of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3797cc et seq.) is amended--
(1) in the part heading, by striking ``confronting use of
methamphetamine'' and inserting ``comprehensive addiction and
recovery''; and
(2) in section 2996(a)(1), by striking ``this part'' and
inserting ``this section''.
SEC. 704. GRANT ACCOUNTABILITY.
(a) Grants Under Part II of Title I of the Omnibus Crime
Control and Safe Streets Act of 1968.--Part II of title I of
the Omnibus Crime Control and Safe Streets Act of 1968 (42
U.S.C. 3797cc et seq.); as amended by section 702, is amended
by adding at the end the following:
``SEC. 2999F. GRANT ACCOUNTABILITY.
``(a) Definitions.--In this section--
``(1) the term `applicable committees'--
``(A) with respect to the Attorney General and any other
official of the Department of Justice, means--
``(i) the Committee on the Judiciary of the Senate; and
``(ii) the Committee on the Judiciary of the House of
Representatives; and
``(B) with respect to the Secretary of Health and Human
Services and any other official of the Department of Health
and Human Services, means--
``(i) the Committee on Health, Education, Labor, and
Pensions of the Senate; and
``(ii) the Committee on Energy and Commerce of the House of
Representatives;
``(2) the term `covered agency' means--
``(A) the Department of Justice; and
``(B) the Department of Health and Human Services; and
``(3) the term `covered official' means--
``(A) the Attorney General; and
``(B) the Secretary of Health and Human Services.
``(b) Accountability.--All grants awarded by a covered
official under this part shall be subject to the following
accountability provisions:
``(1) Audit requirement.--
``(A) Definition.--In this paragraph, the term `unresolved
audit finding' means a finding in the final audit report of
the Inspector General of a covered agency that the audited
grantee has utilized grant funds for an unauthorized
expenditure or otherwise unallowable cost that is not closed
or resolved within 12 months after the date on which the
final audit report is issued.
``(B) Audit.--Beginning in the first fiscal year beginning
after the date of enactment of this section, and in each
fiscal year thereafter, the Inspector General of a covered
agency shall conduct audits of recipients of grants awarded
by the applicable covered official under this part to prevent
waste, fraud, and abuse of funds by grantees. The Inspector
General shall determine the appropriate number of grantees to
be audited each year.
``(C) Mandatory exclusion.--A recipient of grant funds
under this part that is found to have an unresolved audit
finding shall not be eligible to receive grant funds under
this part during the first 2 fiscal years beginning after the
end of the 12-month period described in subparagraph (A).
``(D) Priority.--In awarding grants under this part, a
covered official shall give priority to eligible applicants
that did not have an unresolved audit finding during the 3
fiscal years before submitting an application for a grant
under this part.
``(E) Reimbursement.--If an entity is awarded grant funds
under this part during the 2-fiscal-year period during which
the entity is barred from receiving grants under subparagraph
(C), the covered official that awarded the grant funds
shall--
``(i) deposit an amount equal to the amount of the grant
funds that were improperly awarded to the grantee into the
General Fund of the Treasury; and
``(ii) seek to recoup the costs of the repayment to the
fund from the grant recipient that was erroneously awarded
grant funds.
``(2) Nonprofit organization requirements.--
``(A) Definition.--For purposes of this paragraph and the
grant programs under this part, the term `nonprofit
organization' means an organization that is described in
section 501(c)(3) of the Internal Revenue Code of 1986 and is
exempt from taxation under section 501(a) of such Code.
``(B) Prohibition.--A covered official may not award a
grant under this part to a nonprofit organization that holds
money in offshore accounts for the purpose of avoiding paying
the tax described in section 511(a) of the Internal Revenue
Code of 1986.
``(C) Disclosure.--Each nonprofit organization that is
awarded a grant under this part and uses the procedures
prescribed in regulations to create a rebuttable presumption
of reasonableness for the compensation of its officers,
directors, trustees, and key employees, shall disclose to the
applicable covered official, in the application for the
grant, the process for determining such compensation,
including the independent persons involved in reviewing and
approving such
[[Page S1413]]
compensation, the comparability data used, and
contemporaneous substantiation of the deliberation and
decision. Upon request, a covered official shall make the
information disclosed under this subparagraph available for
public inspection.
``(3) Conference expenditures.--
``(A) Limitation.--No amounts made available to a covered
official under this part may be used by the covered official,
or by any individual or entity awarded discretionary funds
through a cooperative agreement under this part, to host or
support any expenditure for conferences that uses more than
$20,000 in funds made available by the covered official,
unless the covered official provides prior written
authorization that the funds may be expended to host the
conference.
``(B) Written authorization.--Written authorization under
subparagraph (A) shall include a written estimate of all
costs associated with the conference, including the cost of
all food, beverages, audio-visual equipment, honoraria for
speakers, and entertainment.
``(C) Report.--
``(i) Department of justice.--The Deputy Attorney General
shall submit to the applicable committees an annual report on
all conference expenditures approved by the Attorney General
under this paragraph.
``(ii) Department of health and human services.--The Deputy
Secretary of Health and Human Services shall submit to the
applicable committees an annual report on all conference
expenditures approved by the Secretary of Health and Human
Services under this paragraph.
``(4) Annual certification.--Beginning in the first fiscal
year beginning after the date of enactment of this section,
each covered official shall submit to the applicable
committees an annual certification--
``(A) indicating whether--
``(i) all audits issued by the Office of the Inspector
General of the applicable agency under paragraph (1) have
been completed and reviewed by the appropriate Assistant
Attorney General or Director, or the appropriate official of
the Department of Health and Human Services, as applicable;
``(ii) all mandatory exclusions required under paragraph
(1)(C) have been issued; and
``(iii) all reimbursements required under paragraph (1)(E)
have been made; and
``(B) that includes a list of any grant recipients excluded
under paragraph (1) from the previous year.
``(c) Preventing Duplicative Grants.--
``(1) In general.--Before a covered official awards a grant
to an applicant under this part, the covered official shall
compare potential grant awards with other grants awarded
under this part by the covered official to determine if
duplicate grant awards are awarded for the same purpose.
``(2) Report.--If a covered official awards duplicate
grants to the same applicant for the same purpose, the
covered official shall submit to the applicable committees a
report that includes--
``(A) a list of all duplicate grants awarded, including the
total dollar amount of any duplicate grants awarded; and
``(B) the reason the covered official awarded the duplicate
grants.''.
(b) Other Grants.--
(1) Definitions.--In this subsection--
(A) the term ``applicable committees''--
(i) with respect to the Attorney General and any other
official of the Department of Justice, means--
(I) the Committee on the Judiciary of the Senate; and
(II) the Committee on the Judiciary of the House of
Representatives; and
(ii) with respect to the Secretary of Health and Human
Services and any other official of the Department of Health
and Human Services, means--
(I) the Committee on Health, Education, Labor, and Pensions
of the Senate; and
(II) the Committee on Energy and Commerce of the House of
Representatives;
(B) the term ``covered agency'' means--
(i) the Department of Justice; and
(ii) the Department of Health and Human Services;
(C) the term ``covered grant'' means a grant under section
201, 302, or 601 of this Act or section 508 of the Public
Health Service Act (42 U.S.C. 290bb-1) (as amended by section
501 of this Act); and
(D) the term ``covered official'' means--
(i) the Attorney General; and
(ii) the Secretary of Health and Human Services.
(2) Accountability.--All covered grants awarded by a
covered official shall be subject to the following
accountability provisions:
(A) Audit requirement.--
(i) Definition.--In this subparagraph, the term
``unresolved audit finding'' means a finding in the final
audit report of the Inspector General of a covered agency
that the audited grantee has utilized grant funds for an
unauthorized expenditure or otherwise unallowable cost that
is not closed or resolved within 12 months after the date on
which the final audit report is issued.
(ii) Audit.--Beginning in the first fiscal year beginning
after the date of enactment of this Act, and in each fiscal
year thereafter, the Inspector General of a covered agency
shall conduct audits of recipients of covered grants awarded
by the applicable covered official to prevent waste, fraud,
and abuse of funds by grantees. The Inspector General shall
determine the appropriate number of grantees to be audited
each year.
(iii) Mandatory exclusion.--A recipient of covered grant
funds that is found to have an unresolved audit finding shall
not be eligible to receive covered grant funds during the
first 2 fiscal years beginning after the end of the 12-month
period described in clause (i).
(iv) Priority.--In awarding covered grants, a covered
official shall give priority to eligible applicants that did
not have an unresolved audit finding during the 3 fiscal
years before submitting an application for a covered grant.
(v) Reimbursement.--If an entity is awarded covered grant
funds during the 2-fiscal-year period during which the entity
is barred from receiving grants under clause (iii), the
covered official that awarded the funds shall--
(I) deposit an amount equal to the amount of the grant
funds that were improperly awarded to the grantee into the
General Fund of the Treasury; and
(II) seek to recoup the costs of the repayment to the fund
from the grant recipient that was erroneously awarded grant
funds.
(B) Nonprofit organization requirements.--
(i) Definition.--For purposes of this subparagraph and the
covered grant programs, the term ``nonprofit organization''
means an organization that is described in section 501(c)(3)
of the Internal Revenue Code of 1986 and is exempt from
taxation under section 501(a) of such Code.
(ii) Prohibition.--A covered official may not award a
covered grant to a nonprofit organization that holds money in
offshore accounts for the purpose of avoiding paying the tax
described in section 511(a) of the Internal Revenue Code of
1986.
(iii) Disclosure.--Each nonprofit organization that is
awarded a covered grant and uses the procedures prescribed in
regulations to create a rebuttable presumption of
reasonableness for the compensation of its officers,
directors, trustees, and key employees, shall disclose to the
applicable covered official, in the application for the
grant, the process for determining such compensation,
including the independent persons involved in reviewing and
approving such compensation, the comparability data used, and
contemporaneous substantiation of the deliberation and
decision. Upon request, a covered official shall make the
information disclosed under this clause available for public
inspection.
(C) Conference expenditures.--
(i) Limitation.--No amounts made available to a covered
official under a covered grant program may be used by the
covered official, or by any individual or entity awarded
discretionary funds through a cooperative agreement under a
covered grant program, to host or support any expenditure for
conferences that uses more than $20,000 in funds made
available by the covered official, unless the covered
official provides prior written authorization that the funds
may be expended to host the conference.
(ii) Written authorization.--Written authorization under
clause (i) shall include a written estimate of all costs
associated with the conference, including the cost of all
food, beverages, audio-visual equipment, honoraria for
speakers, and entertainment.
(iii) Report.--
(I) Department of justice.--The Deputy Attorney General
shall submit to the applicable committees an annual report on
all conference expenditures approved by the Attorney General
under this subparagraph.
(II) Department of health and human services.--The Deputy
Secretary of Health and Human Services shall submit to the
applicable committees an annual report on all conference
expenditures approved by the Secretary of Health and Human
Services under this subparagraph.
(D) Annual certification.--Beginning in the first fiscal
year beginning after the date of enactment of this Act, each
covered official shall submit to the applicable committees an
annual certification--
(i) indicating whether--
(I) all audits issued by the Office of the Inspector
General of the applicable agency under subparagraph (A) have
been completed and reviewed by the appropriate Assistant
Attorney General or Director, or the appropriate official of
the Department of Health and Human Services, as applicable;
(II) all mandatory exclusions required under subparagraph
(A)(iii) have been issued; and
(III) all reimbursements required under subparagraph (A)(v)
have been made; and
(ii) that includes a list of any grant recipients excluded
under subparagraph (A) from the previous year.
(3) Preventing duplicative grants.--
(A) In general.--Before a covered official awards a covered
grant to an applicant, the covered official shall compare
potential grant awards with other covered grants awarded by
the covered official to determine if duplicate grant awards
are awarded for the same purpose.
(B) Report.--If a covered official awards duplicate grants
to the same applicant for the same purpose, the covered
official shall submit to the applicable committees a report
that includes--
(i) a list of all duplicate grants awarded, including the
total dollar amount of any duplicate grants awarded; and
(ii) the reason the covered official awarded the duplicate
grants.
SEC. 705. PROGRAMS TO PREVENT PRESCRIPTION DRUG ABUSE UNDER
THE MEDICARE PROGRAM.
(a) Drug Management Program for At-Risk Beneficiaries.--
[[Page S1414]]
(1) In general.--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:
``(5) Drug management program for at-risk beneficiaries.--
``(A) Authority to establish.--A PDP sponsor may establish
a drug management program for at-risk beneficiaries under
which, subject to subparagraph (B), the PDP sponsor may, in
the case of an at-risk beneficiary for prescription drug
abuse who is an enrollee in a prescription drug plan of such
PDP sponsor, limit such beneficiary's access to coverage for
frequently abused drugs under such plan to frequently abused
drugs that are prescribed for such beneficiary by a
prescriber (or prescribers) selected under subparagraph (D),
and dispensed for such beneficiary by a pharmacy (or
pharmacies) selected under such subparagraph.
``(B) Requirement for notices.--
``(i) In general.--A PDP sponsor may not limit the access
of an at-risk beneficiary for prescription drug abuse to
coverage for frequently abused drugs under a prescription
drug plan until such sponsor--
``(I) provides to the beneficiary an initial notice
described in clause (ii) and a second notice described in
clause (iii); and
``(II) verifies with the providers of the beneficiary that
the beneficiary is an at-risk beneficiary for prescription
drug abuse, as described in subparagraph (C)(iv).
``(ii) Initial notice.--An initial written notice described
in this clause is a notice that provides to the beneficiary--
``(I) notice that the PDP sponsor has identified the
beneficiary as potentially being an at-risk beneficiary for
prescription drug abuse;
``(II) information, when possible, describing State and
Federal public health resources that are designed to address
prescription drug abuse to which the beneficiary may have
access, including substance use disorder treatment services,
addiction treatment services, mental health services, and
other counseling services;
``(III) a request for the beneficiary to submit to the PDP
sponsor preferences for which prescribers and pharmacies the
beneficiary would prefer the PDP sponsor to select under
subparagraph (D) in the case that the beneficiary is
identified as an at-risk beneficiary for prescription drug
abuse as described in clause (iii)(I);
``(IV) an explanation of the meaning and consequences of
the identification of the beneficiary as potentially being an
at-risk beneficiary for prescription drug abuse, including an
explanation of the drug management program established by the
PDP sponsor pursuant to subparagraph (A);
``(V) clear instructions that explain how the beneficiary
can contact the PDP sponsor in order to submit to the PDP
sponsor the preferences described in subclause (IV) and any
other communications relating to the drug management program
for at-risk beneficiaries established by the PDP sponsor;
``(VI) contact information for other organizations that can
provide the beneficiary with information regarding drug
management program for at-risk beneficiaries (similar to the
information provided by the Secretary in other standardized
notices to part D eligible individuals enrolled in
prescription drug plans under this part); and
``(VII) notice that the beneficiary has a right to an
appeal pursuant to subparagraph (E).
``(iii) Second notice.--A second written notice described
in this clause is a notice that provides to the beneficiary
notice--
``(I) that the PDP sponsor has identified the beneficiary
as an at-risk beneficiary for prescription drug abuse;
``(II) that such beneficiary has been sent, or informed of,
such identification in the initial notice and is now subject
to the requirements of the drug management program for at-
risk beneficiaries established by such PDP sponsor for such
plan;
``(III) of the prescriber and pharmacy selected for such
individual under subparagraph (D);
``(IV) of, and information about, the right of the
beneficiary to a reconsideration and an appeal under
subsection (h) of such identification and the prescribers and
pharmacies selected;
``(V) that the beneficiary can, in the case that the
beneficiary has not previously submitted to the PDP sponsor
preferences for which prescribers and pharmacies the
beneficiary would prefer the PDP sponsor select under
subparagraph (D), submit such preferences to the PDP sponsor;
and
``(VI) that includes clear instructions that explain how
the beneficiary can contact the PDP sponsor in order to
submit to the PDP sponsor the preferences described in
subclause (V).
``(iv) Timing of notices.--
``(I) In general.--Subject to subclause (II), a second
written notice described in clause (iii) shall be provided to
the beneficiary on a date that is not less than 30 days after
an initial notice described in clause (ii) is provided to the
beneficiary.
``(II) Exception.--In the case that the PDP sponsor, in
conjunction with the Secretary, determines that concerns
identified through rulemaking by the Secretary regarding the
health or safety of the beneficiary or regarding significant
drug diversion activities require the PDP sponsor to provide
a second notice described in clause (iii) to the beneficiary
on a date that is earlier than the date described in
subclause (II), the PDP sponsor may provide such second
notice on such earlier date.
``(III) Form of notice.--The written notices under clauses
(ii) and (iii) shall be in a format determined appropriate by
the Secretary, taking into account beneficiary preferences.
``(C) At-risk beneficiary for prescription drug abuse.--
``(i) In general.--For purposes of this paragraph, the term
`at-risk beneficiary for prescription drug abuse' means a
part D eligible individual who is not an exempted individual
described in clause (ii) and--
``(I) who is identified through criteria developed by the
Secretary in consultation with PDP sponsors and other
stakeholders described in subsection section __(g)(2)(A) of
the Comprehensive Addiction and Recovery Act of 2016 based on
clinical factors indicating misuse or abuse of prescription
drugs described in subparagraph (G), including dosage,
quantity, duration of use, number of and reasonable access to
prescribers, and number of and reasonable access to
pharmacies used to obtain such drug; or
``(II) with respect to whom the PDP sponsor of a
prescription drug plan, upon enrolling such individual in
such plan, received notice from the Secretary that such
individual was identified under this paragraph to be an at-
risk beneficiary for prescription drug abuse under a
prescription drug plan in which such individual was
previously enrolled and such identification has not been
terminated under subparagraph (F).
``(ii) Exempted individual described.--An exempted
individual described in this clause is an individual who--
``(I) receives hospice care under this title;
``(II) resides in a long-term care facility, a facility
described in section 1905(d), or other facility under
contract with a single pharmacy; or
``(III) the Secretary elects to treat as an exempted
individual for purposes of clause (i).
``(iii) Program size.--The Secretary shall establish
policies, including the criteria developed under clause
(i)(I) and the exemptions under clause (ii)(III), to ensure
that the population of enrollees in a drug management program
for at-risk beneficiaries operated by a prescription drug
plan can be effectively managed by such plans.
``(iv) Clinical contact.--With respect to each at-risk
beneficiary for prescription drug abuse enrolled in a
prescription drug plan offered by a PDP sponsor, the PDP
sponsor shall contact the beneficiary's providers who have
prescribed frequently abused drugs regarding whether
prescribed medications are appropriate for such beneficiary's
medical conditions.
``(D) Selection of prescribers.--
``(i) In general.--With respect to each at-risk beneficiary
for prescription drug abuse enrolled in a prescription drug
plan offered by such sponsor, a PDP sponsor shall, based on
the preferences submitted to the PDP sponsor by the
beneficiary pursuant to clauses (ii)(III) and (iii)(V) of
subparagraph (B) if applicable, select--
``(I) one, or, if the PDP sponsor reasonably determines it
necessary to provide the beneficiary with reasonable access
under clause (ii), more than one, individual who is
authorized to prescribe frequently abused drugs (referred to
in this paragraph as a `prescriber') who may write
prescriptions for such drugs for such beneficiary; and
``(II) one, or, if the PDP sponsor reasonably determines it
necessary to provide the beneficiary with reasonable access
under clause (ii), more than one, pharmacy that may dispense
such drugs to such beneficiary.
``(ii) Reasonable access.--In making the selection under
this subparagraph, a PDP sponsor shall ensure, taking into
account geographic location, beneficiary preference, impact
on cost-sharing, and reasonable travel time, that the
beneficiary continues to have reasonable access to drugs
described in subparagraph (G), including--
``(I) for individuals with multiple residences; and
``(II) in the case of natural disasters and similar
emergency situations.
``(iii) Beneficiary preferences.--
``(I) In general.--If an at-risk beneficiary for
prescription drug abuse submits preferences for which in-
network prescribers and pharmacies the beneficiary would
prefer the PDP sponsor select in response to a notice under
subparagraph (B), the PDP sponsor shall--
``(aa) review such preferences;
``(bb) select or change the selection of a prescriber or
pharmacy for the beneficiary based on such preferences; and
``(cc) inform the beneficiary of such selection or change
of selection.
``(II) Exception.--In the case that the PDP sponsor
determines that a change to the selection of a prescriber or
pharmacy under item (bb) by the PDP sponsor is contributing
or would contribute to prescription drug abuse or drug
diversion by the beneficiary, the PDP sponsor may change the
selection of a prescriber or pharmacy for the beneficiary. If
the PDP sponsor changes the selection pursuant to the
preceding sentence, the PDP sponsor shall provide the
beneficiary with--
``(aa) at least 30 days written notice of the change of
selection; and
``(bb) a rationale for the change.
``(III) Timing.--An at-risk beneficiary for prescription
drug abuse may choose to express their prescriber and
pharmacy preference and communicate such preference to their
PDP sponsor at any date while enrolled
[[Page S1415]]
in the program, including after a second notice under
subparagraph (B)(iii) has been provided.
``(iv) Confirmation.--Before selecting a prescriber or
pharmacy under this subparagraph, a PDP sponsor must notify
the prescriber and pharmacy that the beneficiary involved has
been identified for inclusion in the drug management program
for at-risk beneficiaries and that the prescriber and
pharmacy has been selected as the beneficiary's designated
prescriber and pharmacy.
``(E) Appeals.--The identification of an individual as an
at-risk beneficiary for prescription drug abuse under this
paragraph, a coverage determination made under a drug
management program for at-risk beneficiaries, and the
selection of a prescriber or pharmacy under subparagraph (D)
with respect to such individual shall be subject to an
expedited reconsideration and appeal pursuant to subsection
(h).
``(F) Termination of identification.--
``(i) In general.--The Secretary shall develop standards
for the termination of identification of an individual as an
at-risk beneficiary for prescription drug abuse under this
paragraph. Under such standards such identification shall
terminate as of the earlier of--
``(I) the date the individual demonstrates that the
individual is no longer likely, in the absence of the
restrictions under this paragraph, to be an at-risk
beneficiary for prescription drug abuse described in
subparagraph (C)(i); or
``(II) the end of such maximum period of identification as
the Secretary may specify.
``(ii) Rule of construction.--Nothing in clause (i) shall
be construed as preventing a plan from identifying an
individual as an at-risk beneficiary for prescription drug
abuse under subparagraph (C)(i) after such termination on the
basis of additional information on drug use occurring after
the date of notice of such termination.
``(G) Frequently abused drug.--For purposes of this
subsection, the term `frequently abused drug' means a drug
that is determined by the Secretary to be frequently abused
or diverted and that is--
``(i) a Controlled Drug Substance in Schedule CII; or
``(ii) within the same class or category of drugs as a
Controlled Drug Substance in Schedule CII, as determined
through notice and comment rulemaking.
``(H) Data disclosure.--
``(i) Data on decision to impose limitation.--In the case
of an at-risk beneficiary for prescription drug abuse (or an
individual who is a potentially at-risk beneficiary for
prescription drug abuse) whose access to coverage for
frequently abused drugs under a prescription drug plan has
been limited by a PDP sponsor under this paragraph, the
Secretary shall establish rules and procedures to require
such PDP sponsor to disclose data, including necessary
individually identifiable health information, about the
decision to impose such limitations and the limitations
imposed by the PDP sponsor under this part.
``(ii) Data to reduce fraud, abuse, and waste.--The
Secretary shall establish rules and procedures to require PDP
sponsors operating a drug management program for at-risk
beneficiaries under this paragraph to provide the Secretary
with such data as the Secretary determines appropriate for
purposes of identifying patterns of prescription drug
utilization for plan enrollees that are outside normal
patterns and that may indicate fraudulent, medically
unnecessary, or unsafe use.
``(I) Sharing of information for subsequent plan
enrollments.--The Secretary shall establish procedures under
which PDP sponsors who offer prescription drug plans shall
share information with respect to individuals who are at-risk
beneficiaries for prescription drug abuse (or individuals who
are potentially at-risk beneficiaries for prescription drug
abuse) and enrolled in a prescription drug plan and who
subsequently disenroll from such plan and enroll in another
prescription drug plan offered by another PDP sponsor.
``(J) Privacy issues.--Prior to the implementation of the
rules and procedures under this paragraph, the Secretary
shall clarify privacy requirements, including requirements
under the regulations promulgated pursuant to section 264(c)
of the Health Insurance Portability and Accountability Act of
1996 (42 U.S.C. 1320d-2 note), related to the sharing of data
under subparagraphs (H) and (I) by PDP sponsors. Such
clarification shall provide that the sharing of such data
shall be considered to be protected health information in
accordance with the requirements of the regulations
promulgated pursuant to such section 264(c).
``(K) Education.--The Secretary shall provide education to
enrollees in prescription drug plans of PDP sponsors and
providers regarding the drug management program for at-risk
beneficiaries described in this paragraph, including
education--
``(i) provided through the improper payment outreach and
education program described in section 1874A(h); and
``(ii) through current education efforts (such as State
health insurance assistance programs described in subsection
(a)(1)(A) of section 119 of the Medicare Improvements for
Patients and Providers Act of 2008 (42 U.S.C. 1395b-3 note))
and materials directed toward such enrollees.
``(L) CMS compliance review.--The Secretary shall ensure
that existing plan sponsor compliance reviews and audit
processes include the drug management programs for at-risk
beneficiaries under this paragraph, including appeals
processes under such programs.''.
(2) Information for consumers.--Section 1860D-4(a)(1)(B) of
the Social Security Act (42 U.S.C. 1395w-104(a)(1)(B)) is
amended by adding at the end the following:
``(v) The drug management program for at-risk beneficiaries
under subsection (c)(5).''.
(3) Dual eligibles.--Section 1860D-1(b)(3)(D) of the Social
Security Act (42 U.S.C. 1395w-101(b)(3)(D)) is amended by
inserting ``, subject to such limits as the Secretary may
establish for individuals identified pursuant to section
1860D-4(c)(5)'' after ``the Secretary''.
(b) Utilization Management Programs.--Section 1860D-4(c) of
the Social Security Act (42 U.S.C. 1395w-104(c)), as amended
by subsection (a)(1), is amended--
(1) in paragraph (1), by inserting after subparagraph (D)
the following new subparagraph:
``(E) A utilization management tool to prevent drug abuse
(as described in paragraph (5)(A)).''; and
(2) by adding at the end the following new paragraph:
``(6) Utilization management tool to prevent drug abuse.--
``(A) In general.--A tool described in this paragraph is
any of the following:
``(i) A utilization tool designed to prevent the abuse of
frequently abused drugs by individuals and to prevent the
diversion of such drugs at pharmacies.
``(ii) Retrospective utilization review to identify--
``(I) individuals that receive frequently abused drugs at a
frequency or in amounts that are not clinically appropriate;
and
``(II) providers of services or suppliers that may
facilitate the abuse or diversion of frequently abused drugs
by beneficiaries.
``(iii) Consultation with the contractor described in
subparagraph (B) to verify if an individual enrolling in a
prescription drug plan offered by a PDP sponsor has been
previously identified by another PDP sponsor as an individual
described in clause (ii)(I).
``(B) Reporting.--A PDP sponsor offering a prescription
drug plan in a State shall submit to the Secretary and the
Medicare drug integrity contractor with which the Secretary
has entered into a contract under section 1893 with respect
to such State a report, on a monthly basis, containing
information on--
``(i) any provider of services or supplier described in
subparagraph (A)(ii)(II) that is identified by such plan
sponsor during the 30-day period before such report is
submitted; and
``(ii) the name and prescription records of individuals
described in paragraph (5)(C).
``(C) CMS compliance review.--The Secretary shall ensure
that plan sponsor annual compliance reviews and program
audits include a certification that utilization management
tools under this paragraph are in compliance with the
requirements for such tools.''.
(c) Treatment of Certain Complaints for Purposes of Quality
or Performance Assessment.--Section 1860D-42 of the Social
Security Act (42 U.S.C. 1395w-152) is amended by adding at
the end the following new subsection:
``(d) Treatment of Certain Complaints for Purposes of
Quality or Performance Assessment.--In conducting a quality
or performance assessment of a PDP sponsor, the Secretary
shall develop or utilize existing screening methods for
reviewing and considering complaints that are received from
enrollees in a prescription drug plan offered by such PDP
sponsor and that are complaints regarding the lack of access
by the individual to prescription drugs due to a drug
management program for at-risk beneficiaries.''.
(d) Sense of Congress Regarding Use of Technology Tools To
Combat Fraud.--It is the sense of Congress that MA
organizations and PDP sponsors should consider using e-
prescribing and other health information technology tools to
support combating fraud under MA-PD plans and prescription
drug plans under parts C and D of the Medicare Program.
(e) GAO Study and Report.--
(1) Study.--The Comptroller General of the United States
shall conduct a study on the implementation of the amendments
made by this section, including the effectiveness of the at-
risk beneficiaries for prescription drug abuse drug
management programs authorized by section 1860D-4(c)(5) of
the Social Security Act (42 U.S.C. 1395w-10(c)(5)), as added
by subsection (a)(1). Such study shall include an analysis
of--
(A) the impediments, if any, that impair the ability of
individuals described in subparagraph (C) of such section
1860D-4(c)(5) to access clinically appropriate levels of
prescription drugs;
(B) the effectiveness of the reasonable access protections
under subparagraph (D)(ii) of such section 1860D-4(c)(5),
including the impact on beneficiary access and health;
(C) how best to define the term ``designated pharmacy'',
including whether the definition of such term should include
an entity that is comprised of a number of locations that are
under common ownership and that electronically share a real-
time, online database and whether such a definition would
help to protect and improve beneficiary access;
(D) the types of--
(i) individuals who, in the implementation of such section,
are determined to be individuals described in such
subparagraph; and
[[Page S1416]]
(ii) prescribers and pharmacies that are selected under
subparagraph (D) of such section;
(E) the extent of prescription drug abuse beyond Controlled
Drug Substances in Schedule CII in parts C and D of the
Medicare program; and
(F) other areas determined appropriate by the Comptroller
General.
(2) Report.--Not later than July 1, 2019, the Comptroller
General of the United States shall submit to the appropriate
committees of jurisdiction of Congress a report on the study
conducted under paragraph (1), together with recommendations
for such legislation and administrative action as the
Comptroller General determines to be appropriate.
(f) Report by Secretary.--
(1) In general.--Not later than 12 months after the date of
the enactment of this Act, the Secretary of Health and Human
Services shall submit to the appropriate committees of
jurisdiction of Congress a report on ways to improve upon the
appeals process for Medicare beneficiaries with respect to
prescription drug coverage under part D of title XVIII of the
Social Security Act. Such report shall include an analysis
comparing appeals processes under parts C and D of such title
XVIII.
(2) Feedback.--In development of the report described in
paragraph (1), the Secretary of Health and Human Services
shall solicit feedback on the current appeals process from
stakeholders, such as beneficiaries, consumer advocates, plan
sponsors, pharmacy benefit managers, pharmacists, providers,
independent review entity evaluators, and pharmaceutical
manufacturers.
(g) Effective Date.--
(1) In general.--Except as provided in subsection (d)(2),
the amendments made by this section shall apply to
prescription drug plans for plan years beginning on or after
January 1, 2018.
(2) Stakeholder meetings prior to effective date.--
(A) In general.--Not later than January 1, 2017, the
Secretary of Health and Human Services shall convene
stakeholders, including individuals entitled to benefits
under part A of title XVIII of the Social Security Act or
enrolled under part B of such title of such Act, advocacy
groups representing such individuals, clinicians, plan
sponsors, pharmacists, retail pharmacies, entities delegated
by plan sponsors, and biopharmaceutical manufacturers for
input regarding the topics described in subparagraph (B). The
input described in the preceding sentence shall be provided
to the Secretary in sufficient time in order for the
Secretary to take such input into account in promulgating the
regulations pursuant to subparagraph (C).
(B) Topics described.--The topics described in this
subparagraph are the topics of--
(i) the impact on cost-sharing and ensuring accessibility
to prescription drugs for enrollees in prescription drug
plans of PDP sponsors who are at-risk beneficiaries for
prescription drug abuse (as defined in paragraph (5)(C) of
section 1860D-4(c) of the Social Security Act (42 U.S.C.
1395w-10(c)));
(ii) the use of an expedited appeals process under which
such an enrollee may appeal an identification of such
enrollee as an at-risk beneficiary for prescription drug
abuse under such paragraph (similar to the processes
established under the Medicare Advantage program under part C
of title XVIII of the Social Security Act);
(iii) the types of enrollees that should be treated as
exempted individuals, as described in clause (ii) of such
paragraph;
(iv) the manner in which terms and definitions in paragraph
(5) of such section 1860D-4(c) should be applied, such as the
use of clinical appropriateness in determining whether an
enrollee is an at-risk beneficiary for prescription drug
abuse as defined in subparagraph (C) of such paragraph (5);
(v) the information to be included in the notices described
in subparagraph (B) of such section and the standardization
of such notices;
(vi) with respect to a PDP sponsor that establishes a drug
management program for at-risk beneficiaries under such
paragraph (5), the responsibilities of such PDP sponsor with
respect to the implementation of such program;
(vii) notices for plan enrollees at the point of sale that
would explain why an at-risk beneficiary has been prohibited
from receiving a prescription at a location outside of the
designated pharmacy;
(viii) evidence-based prescribing guidelines for opiates;
and
(ix) the sharing of claims data under parts A and B with
PDP sponsors.
(C) Rulemaking.--The Secretary of Health and Human Services
shall, taking into account the input gathered pursuant to
subparagraph (A) and after providing notice and an
opportunity to comment, promulgate regulations to carry out
the provisions of, and amendments made by subsections (a) and
(b).
TITLE VIII--TRANSNATIONAL DRUG TRAFFICKING ACT
SEC. 801. SHORT TITLE.
This title may be cited as the ``Transnational Drug
Trafficking Act of 2015''.
SEC. 802. POSSESSION, MANUFACTURE OR DISTRIBUTION FOR
PURPOSES OF UNLAWFUL IMPORTATIONS.
Section 1009 of the Controlled Substances Import and Export
Act (21 U.S.C. 959) is amended--
(1) by redesignating subsections (b) and (c) as subsections
(c) and (d), respectively; and
(2) in subsection (a), by striking ``It shall'' and all
that follows and inserting the following: ``It shall be
unlawful for any person to manufacture or distribute a
controlled substance in schedule I or II or flunitrazepam or
a listed chemical intending, knowing, or having reasonable
cause to believe that such substance or chemical will be
unlawfully imported into the United States or into waters
within a distance of 12 miles of the coast of the United
States.
``(b) It shall be unlawful for any person to manufacture or
distribute a listed chemical--
``(1) intending or knowing that the listed chemical will be
used to manufacture a controlled substance; and
``(2) intending, knowing, or having reasonable cause to
believe that the controlled substance will be unlawfully
imported into the United States.''.
SEC. 803. TRAFFICKING IN COUNTERFEIT GOODS OR SERVICES.
Chapter 113 of title 18, United States Code, is amended--
(1) in section 2318(b)(2), by striking ``section 2320(e)''
and inserting ``section 2320(f)''; and
(2) in section 2320--
(A) in subsection (a), by striking paragraph (4) and
inserting the following:
``(4) traffics in a drug and knowingly uses a counterfeit
mark on or in connection with such drug,'';
(B) in subsection (b)(3), in the matter preceding
subparagraph (A), by striking ``counterfeit drug'' and
inserting ``drug that uses a counterfeit mark on or in
connection with the drug''; and
(C) in subsection (f), by striking paragraph (6) and
inserting the following:
``(6) the term `drug' means a drug, as defined in section
201 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
321).''.
The PRESIDING OFFICER. The majority leader.
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