[Congressional Record Volume 168, Number 158 (Thursday, September 29, 2022)]
[Senate]
[Pages S5652-S5658]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 6098. Ms. MURKOWSKI (for herself and Ms. Klobuchar) submitted an
amendment intended to be proposed to amendment SA 5499 submitted by Mr.
Reed (for himself and Mr. Inhofe) and intended to be proposed to the
bill H.R. 7900, to authorize appropriations for fiscal year 2023 for
military activities of the Department of Defense, for military
construction, and for defense activities of the Department of Energy,
to prescribe military personnel strengths for such fiscal year, and for
other purposes; which was ordered to lie on the table; as follows:
At the appropriate place, insert the following:
SEC. __. PROGRAMS FOR FETAL ALCOHOL SPECTRUM DISORDERS.
(a) In General.--Part O of title III of the Public Health
Service Act (42 U.S.C. 280f et seq.) is amended by striking
section 399H and inserting the following:
``SEC. 399H. PROGRAMS FOR FETAL ALCOHOL SPECTRUM DISORDERS.
``(a) Definition.--In this part--
``(1) the term `fetal alcohol spectrum disorders' or `FASD'
means diagnosable developmental disabilities of a broad range
of neurodevelopmental and physical effects that result from
prenatal exposure to alcohol. The effects may include
lifelong physical, mental, behavioral, social and learning
disabilities, and other problems that impact daily
functioning (such as living independently or holding a job),
as well as overall health and well-being; and
``(2) the terms `Indian Tribe' and `Tribal organization'
have the meanings given the terms `Indian tribe' and `tribal
organization' in section 4 of the Indian Self-Determination
and Education Assistance Act.
``(b) Research on Fetal Alcohol Spectrum Disorders and
Related Conditions.--
``(1) In general.--The Secretary, acting through the
Director of the National Institutes of Health, shall--
``(A) establish a research program for FASD; and
``(B) award grants, contracts, or cooperative agreements to
public or private nonprofit entities to pay all or part of
carrying out research under such research program.
``(2) Types of research.--In carrying out paragraph (1),
the Secretary, acting through
[[Page S5653]]
the Director of the National Institute on Alcohol Abuse and
Alcoholism (referred to in this section as the `Director of
the Institute'), shall continue to conduct and expand
national and international research in consultation with
other Federal agencies and outside partners that includes--
``(A) the most promising avenues of research in FASD
diagnosis, intervention, and prevention;
``(B) factors that may mitigate the effects of prenatal
alcohol and other substance exposure including culturally
relevant factors and social determinants of health; and
``(C) other research that the Director of the Institute
determines to be appropriate with respect to conditions that
develop as a result of prenatal alcohol and other substance
exposure.
``(3) Authorization of appropriations.--To carry out this
subsection, there is authorized to be appropriated
$30,000,000 for each of fiscal years 2023 through 2028.
``(c) Surveillance, Public Health Research, and Prevention
Activities.--
``(1) In general.--The Secretary, acting through the
Director of the National Center on Birth Defects and
Developmental Disabilities of the Centers for Disease Control
and Prevention, shall facilitate surveillance, public health
research, and prevention of FASD in accordance with this
subsection.
``(2) Surveillance, public health research and
prevention.--In carrying out this subsection, the Secretary
shall--
``(A) integrate into surveillance practice an evidence-
based standard case definition for fetal alcohol syndrome
and, in collaboration with other Federal and outside
partners, support organizations of appropriate medical and
mental health professionals in their development and
refinement of evidence-based clinical diagnostic guidelines
and criteria for all fetal alcohol spectrum disorders;
``(B) disseminate and provide the necessary training and
support to appropriate medical and mental health
professionals on the early identification of children with
prenatal alcohol or other substance exposure as such children
may require ongoing developmental and behavioral surveillance
by their primary health care clinician which continues
throughout their lifetime to access ongoing treatment and
referral problems;
``(C) support applied public health prevention research to
identify culturally-appropriate or evidence-based strategies
for reducing alcohol and other substance exposed pregnancies
in women at high risk of such pregnancies;
``(D) disseminate and provide the necessary training and
support to implement culturally-appropriate or evidence-based
strategies developed under subparagraph (C) to--
``(i) hospitals, Federally-qualified health centers,
residential and outpatient substance disorder treatment
programs, and other appropriate health care providers;
``(ii) educational settings;
``(iii) social work and child protection service providers;
``(iv) foster care providers and adoption agencies;
``(v) State or Tribal offices and other agencies providing
services to individuals with disabilities;
``(vi) mental health treatment facilities;
``(vii) Indian Tribes and Tribal organizations;
``(viii) military medical treatment facility described in
section 1073d(c) of title 10, United States Code, and medical
centers of the Department of Veterans Affairs; and
``(ix) other entities that the Secretary determines to be
appropriate;
``(E) conduct activities related to risk factor
surveillance;
``(F) disseminate and evaluate brief behavioral
intervention strategies and referrals aimed at preventing
alcohol and substance-exposed pregnancies among women of
childbearing age in special settings, including clinical
primary health centers, outpatient clinics, child welfare
agencies, and correctional facilities and recovery campuses;
``(G) document the FASD lived experience and incorporate
the perspectives of individuals and their family members
affected by FASD and birth mothers of individuals with FASD
in the dissemination of information and resources;
``(H) disseminate comprehensive alcohol and pregnancy and
FASD information, resources, and services to families and
caregivers, professionals, and the public through an
established national network of affiliated FASD organizations
and through organizations serving medical, behavioral health,
addiction, disability, education, legal and other
professionals; and
``(I) coordinate FASD activities with affiliated State,
Tribal and local systems and organizations with respect to
the prevention of alcohol and other substance-exposed
pregnancies.
``(3) Authorization of appropriations.--To carry out this
subsection, there is authorized to be appropriated
$13,000,000 for each of fiscal years 2023 through 2028.
``(d) Building State and Tribal FASD Systems.--
``(1) In general.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration, shall award grants, contracts, or cooperative
agreements to States and Indian Tribes for the purpose of
establishing ongoing comprehensive and coordinated State and
Tribal FASD multidisciplinary, diverse coalitions to--
``(A) develop systems of care for--
``(i) the prevention of FASD and other adverse conditions
as a result of prenatal substance exposure; and
``(ii) the identification, treatment and support of
individuals with FASD or other adverse conditions from
prenatal substance exposure and support for their families;
``(B) provide leadership and support in establishing,
expanding or increasing State and Tribal systems capacity in
addressing FASD and other adverse conditions as a result of
prenatal substance exposure; and
``(C) update or develop implementing and evaluating State
and Tribal FASD strategic plans to--
``(i) establish or expand State and Tribal programs of
surveillance, screening, assessment, diagnosis, prevention of
FASD and other physical or neurodevelopmental disabilities
from prenatal substance exposure;
``(ii) integrate programs related to prevention of FASD and
interventions addressing the adverse effects of prenatal
alcohol and other substance exposure into existing State and
Tribal coordinated systems of care which focus on the social
determinants of health, including systemic racism, access to
the Medicare program under title XVIII of the Social Security
Act or to the Medicaid program under title XIX of such Act,
maternal and early childhood health, economic security, food
and housing, education, justice and corrections, mental
health, substance use disorder, child welfare, developmental
disabilities, and health care;
``(iii) identify across-the-lifetime issues for individuals
and families related to FASD and other adverse conditions
related to prenatal substance exposure, including historical
and cultural trauma, child abuse and neglect, mental health
and substance use disorder; and
``(iv) identify systemic and other barriers to the
integration of prenatal alcohol and substance exposure
screening, assessment and identification of FASD into
existing systems of care for individuals and families.
``(2) Eligibility.--To be eligible to receive a grant,
contract, or cooperative agreement under paragraph (1), a
State, an Indian Tribe, a Tribal organization, or a State-
Tribal collaborative (referred to in this paragraph as an
`eligible entity') shall prepare and submit to the Secretary
an application at such time, in such manner, and containing
such information as the Secretary may require, including--
``(A) evidence that the eligible entity designated in the
application have or will have authority to implement programs
described in this subsection;
``(B) evidence of the establishment of a State or Tribal
FASD Advisory Group of State agencies or Tribal entities and,
if available, a State affiliate of the National Organization
on Fetal Alcohol Syndrome or similar Tribal or statewide FASD
advocacy organization, to provide the leadership in building
State or Tribal capacity in addressing prenatal alcohol and
other substance exposure, including FASD prevention,
identification, and intervention activities and programming,
including--
``(i) the formation of a FASD advisory coalition of
diverse, public and private representatives from multiple
disciplines that may include--
``(I) State agencies or Tribal entities that are
responsible for health, human services, corrections,
education, housing, developmental disabilities, substance use
disorder, child welfare, juvenile and adult justice systems,
mental health and any other agency related to the adverse
social impact of prenatal alcohol and other substance
exposures;
``(II) public and private sector stakeholders, including
individuals with FASD and their caretakers and entities that
work with or provide services or support for individuals with
FASD and their families, such as community-based agencies,law
enforcement, the judiciary, probation officers, medical and
mental health providers, substance use disorder counselors,
educators, child welfare professionals, and other entities
that address individual, family, community and society issues
related to prenatal alcohol and other substance exposure
throughout an individual's lifespan; and
``(ii) the development of a State or Tribal strategic plan
that--
``(I) contains recommendations, action steps, and
deliverables for improving social determinants of health;
``(II) recommends actions for prevention of FASD and other
conditions related to prenatal substance exposure;
``(III) integrates culturally-appropriate, best practices
or evidence-based practices on screening, identification and
treatment into existing systems of care;
``(IV) provides for FASD-informed clinical and therapeutic
interventions;
``(V) provides for FASD-informed supports and services for
families and individuals with FASD and other conditions from
prenatal substance exposure across their lifetimes;
``(VI) identifies--
``(aa) existing FASD or other programs related to prenatal
substance exposures in the State or Indian Tribe, including--
``(AA) FASD primary, secondary and tertiary prevention
programs;
``(BB) prenatal screening, assessment or diagnostic
services; and
``(CC) support and service programs for individuals with
FASD and their families; and
``(bb) existing State, local, and Tribal programs, systems,
and funding streams that could be used to identify and assist
individuals with FASD and other conditions related
[[Page S5654]]
to substance exposed pregnancies, and prevent prenatal
exposure to alcohol and other harmful substances;
``(cc) barriers to providing FASD diagnostic services or
programs to assist individuals with FASD or reducing alcohol
and substance exposed pregnancies for women at risk for
alcohol or other substance exposed pregnancies, and
recommendations to reduce or eliminate such barriers;
``(dd) barriers to FASD prevention, screening, assessment,
identification, and treatment programs and to the provision
of FASD-informed support services and accommodations across
the lifespan, and recommendations to reduce or eliminate such
barriers;
``(VII) integrates a public-private partnership of State,
Tribal, and local communities to develop a comprehensive
FASD-informed and engaged systems of care approach that
addresses social determinants of health, including systemic
racism on health outcomes, economic security, food and
housing; education, justice, and health care challenges
experienced by individuals who have been diagnosed with FASD
or other conditions as result of prenatal substance exposure;
``(VIII) describes programs of surveillance, screening,
assessment and diagnosis, prevention, clinical intervention
and therapeutic and other supports and services for
individuals with FASD and their families;
``(IX) recognizes the impact of historical, cultural, and
other trauma of individuals in the design and application of
all programming; and
``(X) recognizes the lived experiences of birth mothers and
those with FASD and their families in the design and
application of all programming.
``(3) Restrictions on and use of funds.--Amounts received
under a grant, contract, or cooperative agreement under this
subsection shall be used for one or more of the following
activities:
``(A) Establishing or increasing diagnostic capacity in the
State or Indian Tribe to meet the estimated prevalence needs
of the State or Indian Tribe's FASD population.
``(B) Providing educational and supportive services to
individuals with FASD and other conditions related to
prenatal substance exposure and their families.
``(C) Establishing a FASD statewide surveillance system.
``(D) Including FASD information in State medical and
mental health care and education programs at schools of
higher education.
``(E) Collecting, analyzing, and interpreting data.
``(F) Replicating culturally-aware or best practice FASD
prevention programs, including case-management models for
pregnant or parenting women with alcohol and other substance
use disorders.
``(G) Training of primary care and other providers in
screening for prenatal alcohol and other substance exposure
in prenatal, pediatric, early childhood or other child or
teenage checkup settings.
``(H) Developing, implementing, and evaluating population-
based and targeted prevention programs for FASD, including
public awareness campaigns.
``(I) Increasing capacity of the State or Indian Tribe to
deliver housing, economic and food security services to
adults impacted by FASD or other conditions related to
prenatal substance exposure.
``(J) Referring individuals with FASD and other conditions
related to prenatal substance exposure to appropriate FASD-
informed support services.
``(K) Providing for State and Tribal FASD coordinators.
``(L) Providing training to health care (including mental
health care) providers on the prevention, identification and
treatment of FASD and other conditions related to prenatal
substance exposure across the lifespan.
``(M) Providing training to education, justice, and social
service system professionals to become FASD-informed and
FASD-engaged in their practices.
``(N) Including FASD in training for workforce development
and disability accessibility.
``(O) Supporting peer-to-peer certification programs for
individuals with FASD.
``(P) Developing FASD-informed certification programs.
``(Q) Disseminating information about FASD and other
conditions related to prenatal substance exposure and the
availability of support services to families and individuals
with FASD and other adverse conditions related to prenatal
substance exposure.
``(R) Implementing recommendations from relevant agencies
and organizations, including the State or Tribal FASD
advisory group, on the identification and prevention of FASD,
intervention programs or services for individuals with FASD
and their families.
``(S) Other activities, as the Secretary determines
appropriate or as recommended by the National Advisory
Council on FASD under section 399H-1.
``(4) Other contracts and agreements.--A State may carry
out activities under paragraph (3) through contracts or
cooperative agreements with another State or an Indian Tribe,
and with public, private for-profit or nonprofit entities
with a demonstrated expertise in FASD and other conditions
related to prenatal substance exposure prevention, screening
and diagnosis, or intervention services.
``(5) Report to congress.--Not later than 2 years after the
date on which amounts are first appropriated under paragraph
(6), the Secretary shall prepare and submit to the Committee
on Health, Education, Labor, and Pensions of the Senate and
the Committee on Energy and Commerce of the House of
Representatives a report that contains a description of
programs carried out under this section. At a minimum, the
report shall contain--
``(A) information concerning the number of States receiving
grants;
``(B) State and Tribal FASD diagnostic capacity and
barriers to achieving diagnostic capacity based on State FASD
surveillance data or the most recent estimated prevalence of
FASD in the United States;
``(C) information concerning systemic or other barriers to
screening for prenatal alcohol and other substance exposure
in existing systems of care, including--
``(i) the child welfare system;
``(ii) maternal and early child health care and alcohol and
other substance use disorder treatment programs;
``(iii) primary or secondary education systems; and
``(iv) juvenile and adult systems of justice;
``(D) information concerning existing State, Tribal, local
government or community programs and systems of care and
funding streams that could be used to identify and assist
individuals with FASD and other conditions related to
substance exposed pregnancies and the degree to which such
programs are FASD-informed or to which there are systemic or
other barriers preventing their use; and
``(E) information concerning existing State, Tribal, local
government or community primary, tertiary, or secondary
prevention programs on prenatal exposure to alcohol and other
harmful prenatal substances.
``(6) Authorization of appropriations.--
``(A) In general.--To carry out this subsection, there is
authorized to be appropriated $32,000,000 for each of fiscal
years 2023 through 2028.
``(B) Administrative and employment expenses.--Of the
amount appropriated for a fiscal year under subparagraph (A),
$12,000,000 shall be allocated to States and Indian Tribes
for purposes of covering administrative costs and supporting
the employment of FASD State and Tribal coordinators.
``(C) Tribal set aside.--Up to 20 percent of the grants,
contracts, or cooperative agreements awarded under this
subsection shall be reserved for Indian Tribes and Tribal
organizations.
``(e) Promoting Community Partnerships.--
``(1) In general.--The Secretary, acting through the
Administrator of Health Resources and Services
Administration, shall award grants, contracts, or cooperative
agreements to eligible entities to enable such entities to
establish, enhance, or improve community partnerships for the
purpose of collaborating on common objectives and integrating
culturally-appropriate best practice services available to
individuals with FASD and other conditions related to
prenatal substance exposure such as surveillance, screening,
assessment, diagnosis, prevention, treatment, and support
services.
``(2) Eligible entities.--To be eligible to receive a
grant, contract, or cooperative agreement under paragraph
(1), an entity shall--
``(A) be a public or private nonprofit entity that is--
``(i) a health care provider or health professional;
``(ii) a primary or secondary school;
``(iii) a social work or child protection service provider;
``(iv) an incarceration facility, or State or local
judicial system for juveniles and adults;
``(v) an FASD organization, parent-led group, or other
organization that supports and advocates for individuals with
FASD and their families;
``(vi) an Indian Tribe or Tribal organization;
``(vii) an early childhood intervention facility;
``(viii) any other entity the Secretary determines to be
appropriate; or
``(ix) a consortium of any of the entities described in
clauses (i) through (viii); and
``(B) prepare and submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may require, including assurances that the
entity submitting the application does, at the time of
application, or will, within a reasonable amount of time from
the date of application, provide evidence of substantive
participation with a broad range of entities that work with
or provide services for individuals with FASD.
``(3) Activities.--An eligible entity shall use amounts
received under a grant, contract, or cooperative agreement
under this subsection to carry out one or more of the
following activities relating to FASD and other conditions
related to prenatal substance exposure:
``(A) Integrating FASD-informed and culturally-appropriate
practices into existing programs and services available in
the community.
``(B) Conducting a needs assessment to identify services
that are not available in a community.
[[Page S5655]]
``(C) Developing and implementing culturally-appropriate,
community-based initiatives to prevent FASD, and to screen,
assess, diagnose, treat, and provide FASD-informed support
services to individuals with FASD and their families.
``(D) Disseminating information about FASD and the
availability of support services.
``(E) Developing and implementing a community-wide public
awareness and outreach campaign focusing on the dangers of
drinking alcohol while pregnant.
``(F) Providing mentoring or other support to individuals
with FASD and their families.
``(G) Other activities, as the Secretary determines
appropriate, or in consideration of recommendations from the
National Advisory Council on FASD established under section
399H-1.
``(4) Authorization of appropriations.--To carry out this
subsection, there is authorized to be appropriated $5,000,000
for each of fiscal years 2023 through 2028.
``(f) Development of Best Practices and Models of Care.--
``(1) In general.--The Secretary, in coordination with the
Administrator of Health Resources and Services
Administration, shall award grants to States, Indian Tribes
and Tribal organizations, nongovernmental organizations, and
institutions of higher education for the establishment of
pilot projects to identify and implement culturally-
appropriate best practices for--
``(A) providing intervention and education of children with
FASD, including--
``(i) activities and programs designed specifically for the
identification, treatment, and education of such children;
and
``(ii) curricula development and credentialing of teachers,
administrators, and social workers who implement such
programs and provide childhood interventions;
``(B) educating professionals within the child welfare,
juvenile and adult criminal justice systems, including
judges, attorneys, probation officers, social workers, child
advocates, medical and mental health professionals, substance
abuse professionals, law enforcement officers, prison wardens
or other incarceration administrators, and administrators of
developmental disability, mental health and alternative
incarceration facilities on how to screen, assess, identify,
treat and support individuals with FASD or similar conditions
related to prenatal substance exposure within these systems,
including--
``(i) programs designed specifically for the
identification, assessment, treatment, and education of
individuals with FASD; and
``(ii) curricula development and credentialing within the
adult and juvenile justice and child welfare systems for
individuals who implement such programs;
``(C) educating adoption or foster care agency officials
about available and necessary services for children with
FASD, including--
``(i) programs designed specifically for screening,
assessment and identification, treatment, and education of
individuals with FASD; and
``(ii) on-going and consistent education and training for
potential adoptive or foster parents of a child with FASD;
``(D) educating health and mental health and substance use
providers about available and necessary services for children
with FASD, including--
``(i) programs designed specifically for screening and
identification, and both health and mental health treatment,
of individuals with FASD; and
``(ii) curricula development and credentialing within the
health and mental health and substance abuse systems for
individuals who implement such programs; and
``(E) identifying and implementing culturally-appropriate
best practice models for reducing alcohol and other substance
exposed pregnancies in women at high risk of such
pregnancies.
``(2) Application.--To be eligible for a grant under
paragraph (1), an entity shall prepare and submit to the
Secretary an application at such time, in such manner, and
containing such information as the Secretary may require.
``(3) Authorization of appropriations.--To carry out this
subsection, there is authorized to be appropriated $5,000,000
for each of fiscal years 2023 through 2028.
``(g) Transitional Services.--
``(1) In general.--The Secretary, in coordination with the
Administrator of the Health Resources and Services
Administration and the Administrator of the Administration
for Community Living, shall award demonstration grants,
contracts, and cooperative agreements to States and local
units of government, Indian Tribes and Tribal organizations,
and nongovernmental organizations for the purpose of
establishing integrated systems for providing culturally-
appropriate best practice transitional services for adults
affected by prenatal alcohol or substance exposure and
evaluating the effectiveness of such services.
``(2) Application.--To be eligible for a grant, contract,
or cooperative agreement under paragraph (1), an entity shall
prepare and submit to the Secretary an application at such
time, in such manner, and containing such information as the
Secretary may reasonably require, including specific
credentials relating to education, skills, training, and
continuing educational requirements relating to FASD.
``(3) Allowable uses.--An entity shall use amounts received
under a grant, contract, or cooperative agreement under
paragraph (1) to carry out one or more of the following
activities:
``(A) Provide housing assistance to, or specialized housing
for, adults with FASD.
``(B) Provide FASD-informed vocational training and
placement services for adults with FASD.
``(C) Provide medication monitoring services for adults
with FASD.
``(D) Provide FASD-informed training and support to
organizations providing family services or mental health
programs and other organizations that work with adults with
FASD.
``(E) Establish and evaluate housing models specially
designed for adults with FASD.
``(F) Recruit, train and provide mentors for individuals
with FASD.
``(G) Other services or programs, as the Secretary
determines appropriate.
``(4) Authorization of appropriations.--To carry out this
subsection, there is authorized to be appropriated $5,000,000
for each of fiscal years 2023 through 2028.
``(h) Services for Individuals With Fetal Alcohol Spectrum
Disorders.--
``(1) In general.--The Secretary, in coordination the
Assistant Secretary for Mental Health and Substance Use,
shall make awards of grants, cooperative agreements, or
contracts to public and nonprofit private entities, including
Indian tribes and tribal organizations, to provide FASD-
informed culturally-appropriate services to individuals with
FASD.
``(2) Use of funds.--An award under paragraph (1) may,
subject to paragraph (4), be used to--
``(A) screen and test individuals to determine the type and
level of services needed;
``(B) develop a FASD-informed comprehensive plan for
providing services to the individuals;
``(C) provide FASD-informed mental health counseling;
``(D) provide FASD-informed substance abuse prevention
services and treatment, if needed;
``(E) coordinate services with other social programs
including social services, justice system, educational
services, health services, mental health and substance abuse
services, financial assistance programs, vocational services
and housing assistance programs;
``(F) provide FASD-informed vocational services;
``(G) provide FASD-informed health counseling;
``(H) provide FASD-informed housing assistance;
``(I) conduct FASD-informed parenting skills training;
``(J) develop and implement overall FASD-informed case
management;
``(K) provide supportive services for families of
individuals with FASD;
``(L) provide respite care for caretakers of individuals
with FASD;
``(M) recruit, train and provide mentors for individuals
with FASD;
``(N) provide FASD-informed educational and supportive
services to families of individuals with FASD; and
``(O) provide other services and programs, to the extent
authorized by the Secretary after consideration of
recommendations made by the National Advisory Council on
FASD.
``(3) Requirements.--To be eligible to receive an award
under paragraph (1), an applicant shall--
``(A) demonstrate that the program will be part of a
coordinated, comprehensive system of care for such
individuals;
``(B) demonstrate an established communication with other
social programs in the community including social services,
justice system, financial assistance programs, health
services, educational services, mental health and substance
abuse services, vocational services and housing assistance
services;
``(C) have a qualified staff of medical, mental health or
other professionals with a history of working with
individuals with FASD;
``(D) provide assurance that the services will be provided
in a culturally and linguistically appropriate manner; and
``(E) provide assurance that at the end of the 5-year award
period, other mechanisms will be identified to meet the needs
of the individuals and families served under such award.
``(4) Relationship to payments under other programs.--An
award may be made under paragraph (1) only if the applicant
involved agrees that the award will not be expended to pay
the expenses of providing any service under this section to
an individual to the extent that payment has been made, or
can reasonably be expected to be made, with respect to such
expenses--
``(A) under any State compensation program, under an
insurance policy, or under any Federal or State or Tribal
health benefits programs; or
``(B) by an entity that provides health services on a
prepaid basis.
``(5) Duration of awards.--With respect to any award under
paragraph (1), the period during which payments under such
award are made to the recipient may not exceed 5 years.
``(6) Evaluation.--The Secretary shall evaluate each
project carried out under paragraph (1) and shall disseminate
the findings
[[Page S5656]]
with respect to each such evaluation to appropriate public
and private entities, including the National Advisory Council
on FASD.
``(7) Funding.--
``(A) Authorization of appropriations.-- For the purpose of
carrying out this subsection, there is authorized to be
appropriated $10,000,000 for each fiscal years 2023 through
2028.
``(B) Allocation.--Of the amounts appropriated under
subparagraph (A) for a fiscal year, not more than $300,000
shall, for the purposes relating to FASD, be made available
for collaborative, coordinated interagency efforts with the
National Institute on Alcohol Abuse and Alcoholism, National
Institute on Mental Health, the Eunice Kennedy Shriver
National Institute of Child Health and Human Development, the
Health Resources and Services Administration, the Agency for
Healthcare Research and Quality, the Administration for
Community Living, the Centers for Disease Control and
Prevention, the Department of Education, the Department of
Justice, and other agencies, as determined by the Secretary.
Interagency collaborative efforts may include--
``(i) the evaluation of existing programs for efficacy;
``(ii) the development of new evidence-based or best
practice programs for prevention of prenatal alcohol and
other substance exposure, and interventions for individuals
with FASD and their families;
``(iii) the facilitation of translation and transition of
existing evidence-based, best practices or culturally-
appropriate prevention and intervention programs into general
and community practice; and
``(iv) engaging in Tribal consultation to ensure that
Indian Tribes and Tribal organizations are able to develop
culturally-appropriate services and interventions for
prenatal alcohol and other substance exposure, and
interventions for individuals with FASD and other conditions
related to prenatal substance exposure and their families.''.
(b) National Advisory Council on FSAD.--Part O of title III
of the Public Health Service Act (42 U.S.C. 280f et seq.), as
amended by subsection (a), is further amended by inserting
after section 339H the following:
``SEC. 399H-1. NATIONAL ADVISORY COUNCIL ON FASD.
``(a) In General.--The Secretary shall establish an
advisory council to be known as the National Advisory Council
on FASD (referred to in this section as the `Council') to
foster coordination and cooperation among all Federal and
non-Federal members and their constituencies that conduct or
support FASD and other conditions related to prenatal
substance exposure research, programs, and surveillance, and
otherwise meet the general needs of populations actually or
potentially impacted by FASD and other conditions related to
prenatal substance exposure.
``(b) Membership.--The Council shall be composed of 23
members as described in paragraphs (1) and (2).
``(1) Federal membership.--Members of the Council shall
include representatives of the following Federal agencies:
``(A) The National Institute on Alcohol Abuse and
Alcoholism.
``(B) The National Institute on Drug Abuse.
``(C) The Centers for Disease Control and Prevention.
``(D) The Health Resources and Services Administration.
``(E) The Substance Abuse and Mental Health Services
Agency.
``(F) The Office of Special Education and Rehabilitative
Services.
``(G) The Office of Justice Programs.
``(H) The Indian Health Service.
``(I) The Interagency Coordinating Committee on Fetal
Alcohol Spectrum Disorders.
``(J) The Agency for Healthcare Research and Quality.
``(2) Non-federal members.--Additional non-Federal public
and private sector members of the Council shall be nominated
by the Interagency Coordinating Committee on Fetal Alcohol
Spectrum Disorders and appointed by the Secretary, and shall
be staffed by the Office of the Assistant Secretary for
Planning and Evaluation of the Department of Health and Human
Service. Such members shall include--
``(A) at least one individual with FASD or a parent or
legal guardian of an individual with FASD;
``(B) at least one individual or a parent or legal guardian
of an individual with a condition related to prenatal
substance exposure;
``(C) at least one birth mother of an individual with FASD;
``(D) at least one representative from the FASD Study Group
of the Research Society on Alcoholism;
``(E) at least one representative of the National
Organization on Fetal Alcohol Syndrome;
``(F) at least one representative of a leading statewide
advocacy and service organization for individuals with FASD
and their families;
``(G) at least one representative of the FASD Center for
Excellence established under section 399H-3;
``(H) at least 2 representatives from State or Tribal
advisory groups receiving an award under section 399H(d); and
``(I) representatives with interest and expertise in FASD
from the private sector of pediatricians, obstetricians and
gynecologists, substance abuse and mental health care
providers, family and juvenile court judges and justice and
corrections programming and services, or special education
and social work professionals.
``(3) Appointment timing.--The members of the Council
described in paragraph (2) shall be appointed by the
Secretary not later than 6 months after the date of enactment
of this section.
``(c) Functions.--The Council shall--
``(1) advise Federal, State, Tribal and local programs and
research concerning FASD and other conditions related to
prenatal substance exposure, including programs and research
concerning education and public awareness for relevant
service providers, reducing the incidence of prenatal alcohol
and other substance exposure in pregnancies, medical and
mental diagnosis, interventions for women at-risk of giving
birth with FASD and beneficial services and supports for
individuals with FASD and their families;
``(2) coordinate its efforts with the Interagency Committee
on Fetal Alcohol Spectrum Disorders;
``(3) develop a summary of advances in FASD research
related to prevention, treatment, screening, diagnosis, and
interventions;
``(4) make recommendations for the FASD research program to
the Director of the National Institute of Alcohol Abuse and
Alcoholism;
``(5) review the 2009 report of the National Task Force on
FAS entitled, `A Call to Action' and other reports on FASD
and the adverse impact of prenatal substance exposure;
``(6) develop a summary of advances in practice and
programs relevant to FASD prevention, treatment, early
screening, diagnosis, and interventions;
``(7) make recommendations on a national agenda to reduce
the prevalence and the associated impact of FASD and other
conditions related to prenatal substance exposure and improve
the quality of life of individuals and families impacted by
FASD or the adverse effects of prenatal substance exposure,
including--
``(A) proposed Federal budgetary requirements for FASD
research and related services and support activities for
individuals with FASD;
``(B) recommendations to ensure that FASD research, and
services and support activities to the extent practicable, of
the Department of Health and Human Services and of other
Federal departments and agencies, are not unnecessarily
duplicative;
``(C) identification of existing Federal programs that
could be used to identify and assist individuals with FASD
and other conditions related to substance exposed
pregnancies;
``(D) identification of gaps or barriers for individuals
living with, or impacted by, FASD in accessing diagnostic,
early intervention, and support services;
``(E) identification of prevention strategies, including
education campaigns and options, such as product warnings and
other mechanisms to raise awareness of the risks associated
with prenatal alcohol consumption;
``(F) identification of current diagnostic methods and
practices for the identification of FASD and identify gaps or
barriers for achieving diagnostic capacity throughout the
United States based on current estimated prevalence of FASD;
``(G) recommendations for research or other measures to
increase diagnostic capacity to meet the needs of the
estimated number of individuals with FASD;
``(H) identification and enhancement of culturally-
appropriate or best practice approaches and models of care to
reduce the incidence of FASD; and
``(I) identification and enhancement of best practice
approaches and models of care to increase support and treat
individuals with FASD, and to make recommendations for a
broad model comprehensive community approach to the overall
problem of prenatal alcohol and other harmful substance
exposure.
``(d) Report to Congress and the President.--The Council
shall submit to Congress and to the President--
``(1) an update on the summary of advances described in
paragraphs (3) and (6) of subsection (c), not later than 2
years after the date of enactment of this section;
``(2) an update to the national agenda described in
subsection (c)(7), including any progress made in achieving
the objectives outlined in such agenda, not later than 4
years after the date of enactment of such Act; and
``(3) a final report that provides a summary of advances
described in paragraphs (3) and (6) of subsection (c), and an
update to the national agenda described in subsection (c)(7),
not later than September 30, 2027.
``(e) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $2,000,000 for
each of fiscal years 2023 through 2028.''.
(c) Interagency Coordinating Committee on Fetal Alcohol
Spectrum Disorders.--Subpart 14 of part C of title IV of the
Public Health Service Act (42 U.S.C. 285n et seq.) is amended
by adding at the end the following:
``SEC. 464K. INTERAGENCY COORDINATING COMMITTEE ON FETAL
ALCOHOL SPECTRUM DISORDERS.
``(a) In General.--The Director of the Institute shall
provide for the continuation of the `Interagency Coordinating
Committee on Fetal Alcohol Spectrum Disorders' (referred to
in this section as the `Committee') so that such Committee
may--
``(1) coordinate activities conducted by the Federal
Government on FASD, including convening meetings,
establishing work
[[Page S5657]]
groups, sharing information, and facilitating and promoting
collaborative projects among Federal agencies, the National
Advisory Council on FASD established under section 399H-1,
and outside partners;
``(2) support organizations of appropriate medical and
mental health professionals in their development and
refinement of evidence-based clinical diagnostic guidelines
and criteria for all fetal alcohol spectrum disorders in
collaboration with other Federal and outside partners, and
``(3) develop priority areas considering recommendations
from the National Advisory Council on FASD.
``(b) Membership.--Members of the Committee shall include
representatives of the following Federal agencies:
``(1) The National Institute on Alcohol Abuse and
Alcoholism.
``(2) The Centers for Disease Control and Prevention.
``(3) The Health Resources and Services Administration.
``(4) The Office of the Assistant Secretary for Planning
and Evaluation.
``(5) The Office of Juvenile Justice and Delinquency
Prevention.
``(6) Office of Justice Programs of the Department of
Justice.
``(7) The Substance Abuse and Mental Health Services
Administration.
``(8) The Office of Special Education and Rehabilitation
Services.
``(9) The National Institute on Drug Abuse.
``(10) The National Institute of Mental Health.
``(11) The Indian Health Service.
``(12) The Eunice Kennedy Shriver National Institute of
Child Health and Human Development.
``(13) Other Federal agencies with responsibilities related
to FASD prevention or treatment or that interact with
individuals with FASD, including education and correctional
systems, alcohol and substance use disorder prevention and
treatment programs, maternal health, the Medicare and
Medicaid programs under titles XVIII and XIX, respectively,
of the Social Security Act, child health and welfare,
rehabilitative services, and labor and housing grant or
entitlement programs.
``(c) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section
$1,000,000 for each of fiscal years 2023 through 2028.''.
(d) FASD Center for Excellence.--
(1) In general.--Part O of title III of the Public Health
Service Act (42 U.S.C. 280f et seq.), as amended by
subsection (b), is further amended by inserting after section
339H-2 the following:
``SEC. 399H-2. FASD CENTER FOR EXCELLENCE.
``(a) In General.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration, and in consultation with the Assistant
Secretary for Mental Health and Substance Use, the Director
of the Centers for Disease Control, and the Chair of the
Interagency Coordinating Committee on Fetal Alcohol Spectrum
Disorders, shall award up to 4 grants, cooperative
agreements, or contracts to public or nonprofit entities with
demonstrated expertise in FASD prevention, identification,
and intervention services and other adverse conditions
related to prenatal substance exposure. Such awards shall be
for the purposes of establishing a FASD Center for Excellence
to build local, Tribal, State, and national capacities to
prevent the occurrence of FASD and other adverse conditions
related to exposure to substances, and to respond to the
needs of individuals with FASD and their families by carrying
out the programs described in subsection (b).
``(b) Programs.--An entity receiving an award under
subsection (a) may use such award for any of the following
programs:
``(1) Increasing fasd diagnostic capacity.--Initiating or
expanding diagnostic capacity of FASD by increasing
screening, assessment, identification, and diagnosis in
settings such as clinical practices, educational settings,
child welfare, and juvenile out-of-home placement facilities
and adult correctional systems.
``(2) Public awareness.--Developing and supporting national
public awareness and outreach activities, including the use
of all types of media and public outreach, and the formation
of a diverse speakers bureau to raise public awareness of the
risks associated with alcohol consumption during pregnancy
with the purpose of reducing the prevalence of FASD and
improving the quality of life for those living with FASD and
their families.
``(3) Resources and training.--
``(A) Clearinghouse.--Acting as a clearinghouse for
resources on FASD prevention, identification, and culturally-
aware best practices, including the maintenance of a national
data-based directory on FASD-specific services in States,
Indian Tribes, and local communities.
``(B) Internet-based center.--Providing an internet-based
center that disseminates ongoing research and resource
development on FASD in administering systems of care for
individuals with FASD across their lifespan.
``(C) Intervention services and best practices.--Increasing
awareness and understanding of efficacious FASD screening
tools and culturally-appropriate intervention services and
best practices by--
``(i) maintaining a diverse national speakers bureau; and
``(ii) conducting national, regional, State, Tribal, or
peer cross-State webinars, workshops, or conferences for
training community leaders, medical and mental health and
substance abuse professionals, education and disability
professionals, families, law enforcement personnel, judges,
individuals working in financial assistance programs, social
service personnel, child welfare professionals, and other
service providers.
``(D) Building capacity.--Building capacity for State,
Tribal, and local affiliates dedicated to FASD awareness,
prevention, and identification and family and individual
support programs and services.
``(4) Technical assistance.--Providing technical assistance
to--
``(A) communities for replicating and adapting exemplary
comprehensive systems of care for individuals with FASD
developed under section 399H(d) and for replicating and
adapting culturally-appropriate best or model projects of
care developed under section 399H(f);
``(B) States and Indian Tribes in developing statewide or
Tribal FASD strategic plans, establishing or expanding
statewide programs of surveillance, screening and diagnosis,
prevention, and clinical intervention, and support for
individuals with FASD and their families under section
399H(d); and
``(C) Indian Tribes and Tribal organizations in engaging in
tribal consultation to ensure that such Tribes and Tribal
organizations are able to develop culturally-appropriate
services and interventions for individuals with FASD and
other conditions related to prenatal substance exposure and
their families.
``(5) Other functions.--Carrying out other functions, to
the extent authorized by the Secretary, after consideration
of recommendations of the National Advisory Council on FASD.
``(c) Application.--To be eligible for a grant, contract,
or cooperative agreement under this section, an entity shall
submit to the Secretary an application at such time, in such
manner, and containing such information as the Secretary may
require, including specific credentials relating to FASD
expertise and experience relevant to the application's
proposed activity, including development of FASD public
awareness activities and resources; FASD resource
development, dissemination, and training; coordination of
FASD-informed services, technical assistance, administration
of FASD partner networks, and other FASD-specific expertise.
``(d) Subcontracting.--A public or private nonprofit may
carry out the activities under subsection (a) through
contracts or cooperative agreements with other public and
private nonprofit entities with demonstrated expertise in--
``(1) FASD prevention activities;
``(2) FASD screening and identification;
``(3) FASD resource, development, dissemination, training
and technical assistance, administration and support of FASD
partner networks; and
``(4) intervention services.
``(e) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $8,000,000 for
each of fiscal years 2023 through 2028.''.
(e) Department of Education and Department of Justice
Programs.--
(1) Prevention, identification, intervention, and services
in the education system.--
(A) General rule.--The Secretary of Education shall address
education-related issues with respect to children with FASD,
in accordance with this paragraph.
(B) Specific responsibilities.--The Secretary of Education
shall direct the Office of Special Education and
Rehabilitative Services to--
(i) support the development, collection, and dissemination
(through the internet website of the Department of Education,
at teacher-to-teacher workshops, through in-service
trainings, and through other means) of culturally-appropriate
best practices that are FASD-informed in the education and
support of children with FASD (including any special
techniques on how to assist these children in both special
and traditional educational settings, and including such
practices that incorporate information concerning the
identification, behavioral supports, teaching, and learning
associated with FASD) to--
(I) education groups such as the National Association of
School Boards, the National Education Association, the
American Federation of Teachers, the National Association of
Elementary School Principals, the National Association of
Secondary School Principals and national groups of special
education teachers;
(II) recipients of a grant under the 21st Century Community
Learning Center program established under part B of title IV
of the Elementary and Secondary Education Act of 1965 (20
U.S.C. 7171 et seq.) and other after school program
personnel; and
(III) parent teacher associations, parent information and
training centers, and other appropriate parent education
organizations;
(ii) ensure that, in administering the Individuals with
Disabilities Education Act (20 U.S.C. 1400 et seq.), parents,
educators, and advocates for children with disabilities are
aware that children with FASD have the right to access
general curriculum under the least restrictive environment;
(iii) collaborate with other Federal agencies to include
information or activities relating to prenatal alcohol and
other harmful substance exposure in programs related to
maternal health and health education; and
[[Page S5658]]
(iv) support efforts by peer advisory networks of
adolescents in schools to discourage the use of alcohol and
other harmful substances while pregnant or when considering
getting pregnant.
(C) Definition.--For purposes of this paragraph, the term
``FASD'' has the meaning given such term in section 399H(a)
of the Public Health Service Act, as added by subsection (a).
(D) Authorization of appropriations.--There are authorized
to be appropriated to carry out this paragraph $5,000,000 for
each of fiscal years 2023 through 2028.
(2) Prevention, identification, intervention and services
in the justice system.--
(A) In general.--The Attorney General shall address
justice-related issues with respect to youth and adults with
FASD and other neurodevelopmental conditions as a result of
prenatal substance exposure, in accordance with this
paragraph.
(B) Requirements.--The Attorney General, acting through the
Office of Juvenile Justice and Delinquency Prevention and the
Bureau of Justice Initiatives, shall--
(i) develop screening and assessment procedures and conduct
trainings on demonstration FASD surveillance projects in
adult and juvenile correction facilities in collaboration
with the National Center on Birth Defects and Developmental
Disabilities and assistance from appropriate medical and
mental health professionals;
(ii) provide culturally appropriate support and technical
assistance to justice systems professionals in developing
training curricula on how to most effectively identify and
interact with individuals with FASD or similar
neurodevelopmental disorders in the adult and juvenile
justice systems, and such support may include providing
information about the prevention, assessment, identification
and treatment of these disorders into justice professionals'
credentialing or continuing education requirements;
(iii) provide culturally appropriate technical assistance
to adult and juvenile systems in addressing the integration
of prenatal alcohol and substance exposure history into
existing validated screening and assessment instruments;
(iv) provide culturally appropriate technical assistance
and support on the education of justice system professionals,
including judges, attorneys, probation officers, child
advocates, law enforcement officers, prison wardens and other
incarceration officials, medical and mental health
professionals, and administrators of developmental
disability, mental health and alternative incarceration
facilities on how to screen, assess, identify, treat, respond
and support individuals with FASD and other conditions as a
result of substance exposure within the justice systems,
including--
(I) programs designed specifically for the identification,
assessment, treatment, and education of those with FASD;
(II) curricula development and credentialing of teachers,
administrators, and social workers who implement such
programs; and
(III) how FASD and other neurodevelopmental disorders
impact an individual's interaction with law enforcement and
whether diversionary sentencing options are more appropriate
for such individuals;
(v) conduct a study on the practices and procedures within
the criminal justice system for identifying and treatment of
juvenile and adult offenders with neurodevelopmental
disabilities, such as FASD, the impact of FASD on offenders'
cognitive skills and adaptive functioning, and identify
alternative culturally-appropriate methods of treatment and
incarceration that have been demonstrated to be more
effective for such offenders; and
(vi) collaborate with professionals with FASD expertise and
implement FASD-informed transition programs for adults and
juveniles with FASD who are released from adult and juvenile
correctional facilities.
(C) Access for bop inmates.--The Attorney General shall
direct the Reentry Services Division at the Bureau of Prisons
to ensure that each inmate with FASD or a similar
neurodevelopmental disorder who is in the custody of the
Bureau of Prisons have access to FASD-informed culturally
appropriate services upon re-entry, including programs,
resources, and activities for adults with FASD, to facilitate
the successful reintegration into their communities upon
release.
(D) Authorization of appropriations.--For the purpose of
carrying out this paragraph, there are authorized to be
appropriated $2,000,000 for each of fiscal years 2023 through
2028.
(3) Definition.--For purposes of this subsection, the term
``FASD'' has the meaning given such term in section 399H(a)
of the Public Health Service Act, as amended by subsection
(a).
______