[Congressional Record Volume 164, Number 68 (Thursday, April 26, 2018)]
[Senate]
[Pages S2487-S2490]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CORNYN (for himself and Mrs. Feinstein):
  S. 2789. A bill to prevent substance abuse and reduce demand for 
illicit narcotics; to the Committee on the Judiciary.
  Mr. CORNYN. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2789

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

     SECTION 1. SHORT TITLE.

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

[[Page S2488]]

  


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

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

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

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

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

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

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

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

     SEC. 6. REAUTHORIZATION OF DRUG COURT PROGRAM.

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

     SEC. 7. DRUG COURT TRAINING AND TECHNICAL ASSISTANCE.

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

     SEC. 8. DRUG OVERDOSE RESPONSE STRATEGY.

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

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

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

     SEC. 10. DEA 360 STRATEGY.

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

     SEC. 11. COPS ANTI-METH PROGRAM.

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

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

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

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

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

     SEC. 13. PROTECTING CHILDREN WITH ADDICTED PARENTS.

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

[[Page S2489]]

  


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

       ``(a) In General.--The Director of the Office of National 
     Drug Control Policy, in coordination with the Secretary of 
     Health and Human Services, may make grants to States, units 
     of local government, or tribal governments to establish or 
     expand Sobriety Treatment And Recovery Team (referred to in 
     this section as `START') programs to determine the 
     effectiveness of pairing social workers and mentors with 
     families that are struggling with substance abuse and child 
     abuse or neglect in order to help provide peer support, 
     intensive treatment, and child welfare services.
       ``(b) Allowable Uses.--A grant awarded under this section 
     may be used for 1 or more of the following activities:
       ``(1) Training eligible staff, including social workers, 
     social services coordinators, child welfare specialists, 
     substance use disorder treatment professionals, and mentors.
       ``(2) Expanding access to substance use disorder treatment 
     services and drug testing.
       ``(3) Enhancing data sharing with law enforcement agencies 
     and child welfare agencies.
       ``(4) Program evaluation.
       ``(c) Program Requirements.--A family may be eligible to 
     participate in a START program that receives funding under 
     this section only if--
       ``(1) there is a substantiated record or finding of child 
     abuse or neglect within the family; and

[[Page S2490]]

       ``(2) substance abuse was the primary reason for the record 
     or finding described in paragraph (1).
       ``(d) Authorization of Appropriations.--For each of fiscal 
     years 2018 through 2022, the Director of the Office of 
     National Drug Control Policy, in consultation with the 
     Secretary of Health and Human Services, is authorized to 
     award not more than $10,000,000 of amounts otherwise 
     appropriated for comprehensive opioid abuse reduction 
     activities for purposes of carrying out this section.''.

     SEC. 20. PROVIDER EDUCATION.

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

                          ____________________