[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.
____________________