[Congressional Record Volume 171, Number 43 (Thursday, March 6, 2025)]
[Senate]
[Pages S1610-S1615]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 1232. Ms. HASSAN submitted an amendment intended to be proposed by 
her to the bill S. 331, to amend the Controlled Substances Act with 
respect to the scheduling of fentanyl-related substances, and for other 
purposes; which was ordered to lie on the table; as follows:

       At the appropriate place, insert the following:

                 TITLE II--SUPPORT ACT REAUTHORIZATION

     SEC. 201. SHORT TITLE.

       This title may be cited as the ``SUPPORT for Patients and 
     Communities Reauthorization Act of 2025''.

                         Subtitle A--Prevention

     SEC. 211. PRENATAL AND POSTNATAL HEALTH.

       Section 317L(d) of the Public Health Service Act (42 U.S.C. 
     247b-13(d)) is amended by striking ``such sums as may be 
     necessary for each of the fiscal years 2019 through 2023'' 
     and inserting ``$4,250,000 for each of fiscal years 2025 
     through 2029''.

[[Page S1611]]

  


     SEC. 212. MONITORING AND EDUCATION REGARDING INFECTIONS 
                   ASSOCIATED WITH ILLICIT DRUG USE AND OTHER RISK 
                   FACTORS.

       Section 317N(d) of the Public Health Service Act (42 U.S.C. 
     247b-15(d)) is amended by striking ``fiscal years 2019 
     through 2023'' and inserting ``fiscal years 2025 through 
     2029''.

     SEC. 213. PREVENTING OVERDOSES OF CONTROLLED SUBSTANCES.

       (a) In General.--Section 392A of the Public Health Service 
     Act (42 U.S.C. 280b-1) is amended--
       (1) in subsection (a)(2)--
       (A) in subparagraph (C), by inserting ``and associated 
     risks'' before the period at the end; and
       (B) in subparagraph (D), by striking ``opioids'' and 
     inserting ``substances causing overdose''; and
       (2) in subsection (b)(2)--
       (A) in subparagraph (B), by inserting ``, and associated 
     risk factors,'' after ``such overdoses'';
       (B) in subparagraph (C), by striking ``coding'' and 
     inserting ``monitoring and identifying'';
       (C) in subparagraph (E)--
       (i) by inserting a comma after ``public health 
     laboratories''; and
       (ii) by inserting ``and other emerging substances related'' 
     after ``analogues''; and
       (D) in subparagraph (F), by inserting ``and associated risk 
     factors'' after ``overdoses''.
       (b) Additional Grants.--Section 392A(a)(3) of the Public 
     Health Service Act (42 U.S.C. 280b-1(a)(3)) is amended--
       (1) in the matter preceding subparagraph (A), by striking 
     ``and Indian Tribes--'' and inserting ``and Indian Tribes for 
     the following purposes:'';
       (2) by amending subparagraph (A) to read as follows:
       ``(A) To carry out innovative projects for grantees to 
     detect, identify, and rapidly respond to controlled substance 
     misuse, abuse, and overdoses, and associated risk factors, 
     including changes in patterns of such controlled substance 
     use. Such projects may include the use of innovative, 
     evidence-based strategies for detecting such patterns, such 
     as wastewater surveillance, if proven to support actionable 
     prevention strategies, in a manner consistent with applicable 
     Federal and State privacy laws.''; and
       (3) in subparagraph (B), by striking ``for any'' and 
     inserting ``For any''.
       (c) Authorization of Appropriations.--Section 392A(e) of 
     the Public Health Service Act (42 U.S.C. 280b-1(e)) is 
     amended by striking ``$496,000,000 for each of fiscal years 
     2019 through 2023'' and inserting ``$505,579,000 for each of 
     fiscal years 2025 through 2029''.

     SEC. 214. SUPPORT FOR INDIVIDUALS AND FAMILIES IMPACTED BY 
                   FETAL ALCOHOL SPECTRUM DISORDER.

       (a) In General.--Part O of title III of the Public Health 
     Service Act (42 U.S.C. 280f et seq.) is amended to read as 
     follows:

    ``PART O--FETAL ALCOHOL SYNDROME PREVENTION AND SERVICES PROGRAM

     ``SEC. 399H. FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION, 
                   INTERVENTION, AND SERVICES DELIVERY PROGRAM.

       ``(a) In General.--The Secretary shall establish or 
     continue activities to support a comprehensive fetal alcohol 
     spectrum disorders (referred to in this section as `FASD') 
     education, prevention, identification, intervention, and 
     services delivery program, which may include--
       ``(1) an education and public awareness program to support, 
     conduct, and evaluate the effectiveness of--
       ``(A) educational programs targeting health professions 
     schools, social and other supportive services, educators and 
     counselors and other service providers in all phases of 
     childhood development, and other relevant service providers, 
     concerning the prevention, identification, and provision of 
     services for infants, children, adolescents and adults with 
     FASD;
       ``(B) strategies to educate school-age children, including 
     pregnant and high-risk youth, concerning FASD;
       ``(C) public and community awareness programs concerning 
     FASD; and
       ``(D) strategies to coordinate information and services 
     across affected community agencies, including agencies 
     providing social services such as foster care, adoption, and 
     social work, agencies providing health services, and agencies 
     involved in education, vocational training and civil and 
     criminal justice;
       ``(2) supporting and conducting research on FASD, as 
     appropriate, including to--
       ``(A) develop appropriate medical diagnostic methods for 
     identifying FASD; and
       ``(B) develop effective culturally and linguistically 
     appropriate evidence-based or evidence-informed interventions 
     and appropriate supports for preventing prenatal alcohol 
     exposure, which may co-occur with exposure to other 
     substances;
       ``(3) building State and Tribal capacity for the 
     identification, treatment, and support of individuals with 
     FASD and their families, which may include--
       ``(A) utilizing and adapting existing Federal, State, or 
     Tribal programs to include FASD identification and FASD-
     informed support;
       ``(B) developing and expanding screening and diagnostic 
     capacity for FASD;
       ``(C) developing, implementing, and evaluating targeted 
     FASD-informed intervention programs for FASD;
       ``(D) providing training with respect to FASD for 
     professionals across relevant sectors; and
       ``(E) disseminating information about FASD and support 
     services to affected individuals and their families; and
       ``(4) an applied research program concerning intervention 
     and prevention to support and conduct service demonstration 
     projects, clinical studies and other research models 
     providing advocacy, educational and vocational training, 
     counseling, medical and mental health, and other supportive 
     services, as well as models that integrate and coordinate 
     such services, that are aimed at the unique challenges facing 
     individuals with Fetal Alcohol Syndrome or Fetal Alcohol 
     Effect and their families.
       ``(b) Grants and Technical Assistance.--
       ``(1) In general.--The Secretary may award grants, 
     cooperative agreements and contracts and provide technical 
     assistance to eligible entities to carry out subsection (a).
       ``(2) Eligible entities.--To be eligible to receive a 
     grant, or enter into a cooperative agreement or contract, 
     under this section, an entity shall--
       ``(A) be a State, Indian Tribe or Tribal organization, 
     local government, scientific or academic institution, or 
     nonprofit organization; 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 a description of the 
     activities that the entity intends to carry out using amounts 
     received under this section.
       ``(3) Additional application contents.--The Secretary may 
     require that an eligible entity include in the application 
     submitted under paragraph (2)(B)--
       ``(A) a designation of an individual to serve as a FASD 
     State or Tribal coordinator of activities such eligible 
     entity proposes to carry out through a grant, cooperative 
     agreement, or contract under this section; and
       ``(B) a description of an advisory committee the entity 
     will establish to provide guidance for the entity on 
     developing and implementing a statewide or Tribal strategic 
     plan to prevent FASD and provide for the identification, 
     treatment, and support of individuals with FASD and their 
     families.
       ``(c) Definition of FASD-informed.--For purposes of this 
     section, the term `FASD-informed', with respect to support or 
     an intervention program, means that such support or 
     intervention program uses culturally and linguistically 
     informed evidence-based or practice-based interventions and 
     appropriate resources to support an improved quality of life 
     for an individual with FASD and the family of such 
     individual.

     ``SEC. 399I. STRENGTHENING CAPACITY AND EDUCATION FOR FETAL 
                   ALCOHOL SPECTRUM DISORDERS.

       ``(a) In General.--The Secretary shall award grants, 
     contracts, or cooperative agreements, as the Secretary 
     determines appropriate, to public or nonprofit private 
     entities with demonstrated expertise in the field of fetal 
     alcohol spectrum disorders (referred to in this section as 
     `FASD'). Such awards shall be for the purposes of building 
     local, Tribal, State, and nationwide capacities to prevent 
     the occurrence of FASD by carrying out the programs described 
     in subsection (b).
       ``(b) Programs.--An entity receiving an award under 
     subsection (a) may use such award for the following purposes:
       ``(1) Developing and supporting public education and 
     outreach activities to raise public awareness of the risks 
     associated with alcohol consumption during pregnancy.
       ``(2) Acting as a clearinghouse for evidence-based 
     resources on FASD prevention, identification, and culturally 
     and linguistically appropriate best practices to help inform 
     systems of care for individuals with FASD across their 
     lifespan.
       ``(3) Increasing awareness and understanding of 
     efficacious, evidence-based screening tools and culturally 
     and linguistically appropriate evidence-based intervention 
     services and best practices, which may include improving the 
     capacity for State, Tribal, and local affiliates.
       ``(4) Providing technical assistance to recipients of 
     grants, cooperative agreements, or contracts under section 
     399H, as appropriate.
       ``(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.
       ``(d) Subcontracting.--A public or private nonprofit entity 
     may carry out the following activities required under this 
     section through contracts or cooperative agreements with 
     other public and private nonprofit entities with demonstrated 
     expertise in FASD:
       ``(1) Resource development and dissemination.
       ``(2) Intervention services.
       ``(3) Training and technical assistance.

     ``SEC. 399J. AUTHORIZATION OF APPROPRIATIONS.

       ``There are authorized to be appropriated to carry out this 
     part $12,500,000 for each of fiscal years 2025 through 
     2029.''.
       (b) Report.--Not later than 4 years after the date of 
     enactment of this Act, and every year thereafter, the 
     Secretary of Health and Human Services 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 
     containing--
       (1) a review of the activities carried out pursuant to 
     sections 399H and 399I of the

[[Page S1612]]

     Public Health Service Act, as amended, to advance public 
     education and awareness of fetal alcohol spectrum disorders 
     (referred to in this section as ``FASD'');
       (2) a description of--
       (A) the activities carried out pursuant to such sections 
     399H and 399I to identify, prevent, and treat FASD; and
       (B) methods used to evaluate the outcomes of such 
     activities; and
       (3) an assessment of activities carried out pursuant to 
     such sections 399H and 399I to support individuals with FASD.

     SEC. 215. PROMOTING STATE CHOICE IN PDMP SYSTEMS.

       Section 399O(h) of the Public Health Service Act (42 U.S.C. 
     280g-3(h)) is amended by adding at the end the following:
       ``(5) Promoting state choice.--Nothing in this section 
     shall be construed to authorize the Secretary to require 
     States to use a specific vendor or a specific 
     interoperability connection other than to align with 
     nationally recognized, consensus-based open standards, such 
     as in accordance with sections 3001 and 3004.''.

     SEC. 216. FIRST RESPONDER TRAINING PROGRAM.

       Section 546 of the Public Health Service Act (42 U.S.C. 
     290ee-1) is amended--
       (1) in subsection (a), by striking ``tribes and tribal'' 
     and inserting ``Tribes and Tribal'';
       (2) in subsections (a), (c), and (d)--
       (A) by striking ``approved or cleared'' each place it 
     appears and inserting ``approved, cleared, or otherwise 
     legally marketed''; and
       (B) by striking ``opioid'' each place it appears;
       (3) in subsection (f)--
       (A) by striking ``approved or cleared'' each place it 
     appears and inserting ``approved, cleared, or otherwise 
     legally marketed'';
       (B) in paragraph (1), by striking ``opioid'';
       (C) in paragraph (2)--
       (i) by striking ``opioid and heroin'' and inserting 
     ``opioid, heroin, and other drug''; and
       (ii) by striking ``opioid overdose'' and inserting 
     ``overdose''; and
       (D) in paragraph (3), by striking ``opioid and heroin''; 
     and
       (4) in subsection (h), by striking ``$36,000,000 for each 
     of fiscal years 2019 through 2023'' and inserting 
     ``$56,000,000 for each of fiscal years 2025 through 2029''.

     SEC. 217. DONALD J. COHEN NATIONAL CHILD TRAUMATIC STRESS 
                   INITIATIVE.

       (a) Technical Amendment.--The second part G of title V of 
     the Public Health Service Act (42 U.S.C. 290kk et seq.), as 
     added by section 144 of the Community Renewal Tax Relief Act 
     (Public Law 106-554), is amended--
       (1) by redesignating such part as part J; and
       (2) by redesignating sections 581 through 584 as sections 
     596 through 596C, respectively.
       (b) In General.--Section 582 of the Public Health Service 
     Act (42 U.S.C. 290hh-1) is amended--
       (1) in the section heading, by striking ``violence related 
     stress'' and inserting ``traumatic events'';
       (2) in subsection (a)--
       (A) in the matter preceding paragraph (1), by striking 
     ``tribes and tribal'' and inserting ``Tribes and Tribal''; 
     and
       (B) in paragraph (2), by inserting ``and dissemination'' 
     after ``the development'';
       (3) in subsection (b), by inserting ``and dissemination'' 
     after ``the development'';
       (4) in subsection (d)--
       (A) by striking ``The NCTSI'' and inserting the following:
       ``(1) Coordinating center.--The NCTSI''; and
       (B) by adding at the end the following:
       ``(2) Nctsi grantees.--In carrying out subsection (a)(2), 
     NCTSI grantees shall develop trainings and other resources, 
     as applicable and appropriate, to support implementation of 
     the evidence-based practices developed and disseminated under 
     such subsection.'';
       (5) in subsection (e)--
       (A) by redesignating paragraphs (1) and (2) as 
     subparagraphs (A) and (B), respectively, and adjusting the 
     margins accordingly;
       (B) in subparagraph (A), as so redesignated, by inserting 
     ``and implementation'' after ``the dissemination'';
       (C) by striking ``The NCTSI'' and inserting the following:
       ``(1) Coordinating center.--The NCTSI''; and
       (D) by adding at the end the following:
       ``(2) Nctsi grantees.--NCTSI grantees shall, as 
     appropriate, collaborate with other such grantees, the NCTSI 
     coordinating center, and the Secretary in carrying out 
     subsections (a)(2) and (d)(2).'';
       (6) by amending subsection (h) to read as follows:
       ``(h) Application and Evaluation.--To be eligible to 
     receive a grant, contract, or cooperative agreement under 
     subsection (a), a public or nonprofit private entity or an 
     Indian Tribe or Tribal organization shall submit to the 
     Secretary an application at such time, in such manner, and 
     containing such information and assurances as the Secretary 
     may require, including--
       ``(1) a plan for the evaluation of the activities funded 
     under the grant, contract, or agreement, including both 
     process and outcomes evaluation, and the submission of an 
     evaluation at the end of the project period; and
       ``(2) a description of how such entity, Indian Tribe, or 
     Tribal organization will support efforts led by the Secretary 
     or the NCTSI coordinating center, as applicable, to evaluate 
     activities carried out under this section.''; and
       (7) by amending subsection (j) to read as follows:
       ``(j) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section--
       ``(1) $93,887,000 for fiscal year 2025;
       ``(2) $95,000,000 for fiscal year 2026;
       ``(3) $97,000,000 for fiscal year 2027;
       ``(4) $100,000,000 for fiscal year 2028; and
       ``(5) $100,000,000 for fiscal year 2029.''.

     SEC. 218. PROTECTING SUICIDE PREVENTION LIFELINE FROM 
                   CYBERSECURITY INCIDENTS.

       (a) National Suicide Prevention Lifeline Program.--Section 
     520E-3(b) of the Public Health Service Act (42 U.S.C. 290bb-
     36c(b)) 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) taking such steps as may be necessary to ensure the 
     suicide prevention hotline is protected from cybersecurity 
     incidents and eliminates known cybersecurity 
     vulnerabilities.''.
       (b) Reporting.--Section 520E-3 of the Public Health Service 
     Act (42 U.S.C. 290bb-36c) is amended--
       (1) by redesignating subsection (f) as subsection (g); and
       (2) by inserting after subsection (e) the following:
       ``(f) Cybersecurity Reporting.--
       ``(1) Notification.--
       ``(A) In general.--The program's network administrator 
     receiving Federal funding pursuant to subsection (a) shall 
     report to the Assistant Secretary, in a manner that protects 
     personal privacy, consistent with applicable Federal and 
     State privacy laws--
       ``(i) any identified cybersecurity vulnerabilities to the 
     program within a reasonable amount of time after 
     identification of such a vulnerability; and
       ``(ii) any identified cybersecurity incidents to the 
     program within a reasonable amount of time after 
     identification of such incident.
       ``(B) Local and regional crisis centers.--Local and 
     regional crisis centers participating in the program shall 
     report to the program's network administrator identified 
     under subparagraph (A), in a manner that protects personal 
     privacy, consistent with applicable Federal and State privacy 
     laws--
       ``(i) any identified cybersecurity vulnerabilities to the 
     program within a reasonable amount of time after 
     identification of such vulnerability; and
       ``(ii) any identified cybersecurity incidents to the 
     program within a reasonable amount of time after 
     identification of such incident.
       ``(2) Notification.--If the program's network administrator 
     receiving funding pursuant to subsection (a) discovers, or is 
     informed by a local or regional crisis center pursuant to 
     paragraph (1)(B) of, a cybersecurity vulnerability or 
     incident, within a reasonable amount of time after such 
     discovery or receipt of information, such entity shall report 
     the vulnerability or incident to the Assistant Secretary.
       ``(3) Clarification.--
       ``(A) Oversight.--
       ``(i) Local and regional crisis centers.--Except as 
     provided in clause (ii), local and regional crisis centers 
     participating in the program shall oversee all technology 
     each center employs in the provision of services as a 
     participant in the program.
       ``(ii) Network administrator.--The program's network 
     administrator receiving Federal funding pursuant to 
     subsection (a) shall oversee the technology each crisis 
     center employs in the provision of services as a participant 
     in the program if such oversight responsibilities are 
     established in the applicable network participation 
     agreement.
       ``(B) Supplement, not supplant.--The cybersecurity incident 
     reporting requirements under this subsection shall 
     supplement, and not supplant, cybersecurity incident 
     reporting requirements under other provisions of applicable 
     Federal law that are in effect on the date of the enactment 
     of the SUPPORT for Patients and Communities Reauthorization 
     Act of 2025.''.
       (c) Study.--Not later than 180 days after the date of the 
     enactment of this Act, the Comptroller General of the United 
     States shall--
       (1) conduct and complete a study that evaluates 
     cybersecurity risks and vulnerabilities associated with the 
     9-8-8 National Suicide Prevention Lifeline; and
       (2) submit a report on the findings of such study to the 
     Committee on Health, Education, Labor, and Pensions of the 
     Senate and the Committee on Energy and Commerce of the House 
     of Representatives.

     SEC. 219. BRUCE'S LAW.

       (a) Youth Prevention and Recovery.--Section 7102(c) of the 
     SUPPORT for Patients and Communities Act (42 U.S.C. 290bb-
     7a(c)) is amended--
       (1) in paragraph (3)(A)(i), by inserting ``, which may 
     include strategies to increase education and awareness of the 
     potency and dangers of synthetic opioids (including drugs 
     contaminated with fentanyl) and, as appropriate, other 
     emerging drug use or misuse issues'' before the semicolon; 
     and
       (2) in paragraph (4)(A), by inserting ``and strategies to 
     increase education and awareness of the potency and dangers 
     of synthetic opioids (including drugs contaminated with 
     fentanyl) and, as appropriate, emerging drug use or misuse 
     issues'' before the semicolon.
       (b) Interdepartmental Substance Use Disorders Coordinating 
     Committee.--Section 7022 of the SUPPORT for Patients and

[[Page S1613]]

     Communities Act (42 U.S.C. 290aa note) is amended--
       (1) by striking subsection (g) and inserting the following:
       ``(g) Working Groups.--
       ``(1) In general.--The Committee may establish working 
     groups for purposes of carrying out the duties described in 
     subsection (e). Any such working group shall be composed of 
     members of the Committee (or the designees of such members) 
     and may hold such meetings as are necessary to carry out the 
     duties delegated to the working group.
       ``(2) Additional federal interagency work group on fentanyl 
     contamination of illegal drugs.--
       ``(A) Establishment.--The Secretary, acting through the 
     Committee, shall establish a Federal Interagency Work Group 
     on Fentanyl Contamination of Illegal Drugs (referred to in 
     this paragraph as the `Work Group') consisting of 
     representatives from relevant Federal departments and 
     agencies on the Committee.
       ``(B) Consultation.--The Work Group shall consult with 
     relevant stakeholders and subject matter experts, including--
       ``(i) State, Tribal, and local subject matter experts in 
     reducing, preventing, and responding to drug overdose caused 
     by fentanyl contamination of illicit drugs; and
       ``(ii) family members of both adults and youth who have 
     overdosed by fentanyl contaminated illicit drugs.
       ``(C) Duties.--The Work Group shall--
       ``(i) examine Federal efforts to reduce and prevent drug 
     overdose by fentanyl-contaminated illicit drugs;
       ``(ii) identify strategies to improve State, Tribal, and 
     local responses to overdose by fentanyl-contaminated illicit 
     drugs;
       ``(iii) coordinate with the Secretary, as appropriate, in 
     carrying out activities to raise public awareness of 
     synthetic opioids and other emerging drug use and misuse 
     issues;
       ``(iv) make recommendations to Congress for improving 
     Federal programs, including with respect to the coordination 
     of efforts across such programs; and
       ``(v) make recommendations for educating youth on the 
     potency and dangers of drugs contaminated by fentanyl.
       ``(D) Annual report to secretary.--The Work Group shall 
     annually prepare and submit to the Secretary, the Committee 
     on Health, Education, Labor, and Pensions of the Senate, and 
     the Committee on Energy and Commerce and the Committee on 
     Education and the Workforce of the House of Representatives, 
     a report on the activities carried out by the Work Group 
     under subparagraph (C), including recommendations to reduce 
     and prevent drug overdose by fentanyl contamination of 
     illegal drugs, in all populations, and specifically among 
     youth at risk for substance misuse.''; and
       (2) by striking subsection (i) and inserting the following:
       ``(i) Sunset.--The Committee shall terminate on September 
     30, 2029.''.

     SEC. 220. GUIDANCE ON AT-HOME DRUG DISPOSAL SYSTEMS.

       (a) In General.--Not later than one year after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services, in consultation with the Administrator of the Drug 
     Enforcement Administration, shall publish guidance to 
     facilitate the use of at-home safe disposal systems for 
     applicable drugs.
       (b) Contents.--The guidance under subsection (a) shall 
     include--
       (1) recommended standards for effective at-home drug 
     disposal systems to meet applicable requirements enforced by 
     the Food and Drug Administration;
       (2) recommended information to include as instructions for 
     use to disseminate with at-home drug disposal systems;
       (3) best practices and educational tools to support the use 
     of an at-home drug disposal system, as appropriate; and
       (4) recommended use of licensed health providers for the 
     dissemination of education, instruction, and at-home drug 
     disposal systems, as appropriate.

     SEC. 221. ASSESSMENT OF OPIOID DRUGS AND ACTIONS.

       (a) In General.--Not later than one year after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services (referred to in this section as the ``Secretary'') 
     shall publish on the website of the Food and Drug 
     Administration (referred to in this section as the ``FDA'') a 
     report that outlines a plan for assessing opioid analgesic 
     drugs that are approved under section 505 of the Federal 
     Food, Drug, and Cosmetic Act (21 U.S.C. 355) that addresses 
     the public health effects of such opioid analgesic drugs as 
     part of the benefit-risk assessment and the activities of the 
     FDA that relate to facilitating the development of 
     nonaddictive medical products intended to treat pain or 
     addiction. Such report shall include--
       (1) an update on the actions taken by the FDA to consider 
     the effectiveness, safety, benefit-risk profile, and use of 
     approved opioid analgesic drugs;
       (2) a timeline for an assessment of the potential need, as 
     appropriate, for labeling changes, revised or additional 
     postmarketing requirements, enforcement actions, or 
     withdrawals for opioid analgesic drugs;
       (3) an overview of the steps that the FDA has taken to 
     support the development and approval of nonaddictive medical 
     products intended to treat pain or addiction, and actions 
     planned to further support the development and approval of 
     such products; and
       (4) an overview of the consideration by the FDA of clinical 
     trial methodologies for analgesic drugs, including the 
     enriched enrollment randomized withdrawal methodology, and 
     the benefits and drawbacks associated with different trial 
     methodologies for such drugs, incorporating any public input 
     received under subsection (b).
       (b) Public Input.--In carrying out subsection (a), the 
     Secretary shall provide an opportunity for public input 
     concerning the regulation by the FDA of opioid analgesic 
     drugs, including scientific evidence that relates to 
     conditions of use, safety, or benefit-risk assessment 
     (including consideration of the public health effects) of 
     such opioid analgesic drugs.

     SEC. 222. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO 
                   OPIOID USE DISORDERS.

       The activities carried out pursuant to section 
     1003(b)(4)(A) of the 21st Century Cures Act (42 U.S.C. 290ee-
     3a(b)(4)(A)) may include facilitating access to products used 
     to prevent overdose deaths by detecting the presence of one 
     or more substances, such as fentanyl and xylazine test 
     strips, to the extent the purchase and possession of such 
     products is consistent with Federal and State law.

                         Subtitle B--Treatment

     SEC. 231. RESIDENTIAL TREATMENT PROGRAM FOR PREGNANT AND 
                   POSTPARTUM WOMEN.

       Section 508 of the Public Health Service Act (42 U.S.C. 
     290bb-1) is amended--
       (1) in subsection (d)(11)(C), by striking ``providing 
     health services'' and inserting ``providing health care 
     services'';
       (2) in subsection (g)--
       (A) by inserting ``a plan describing'' after ``will 
     provide''; and
       (B) by adding at the end the following: ``Such plan may 
     include a description of how such applicant will target 
     outreach to women disproportionately impacted by maternal 
     substance use disorder.''; and
       (3) in subsection (s), by striking ``$29,931,000 for each 
     of fiscal years 2019 through 2023'' and inserting 
     ``$38,931,000 for each of fiscal years 2025 through 2029''.

     SEC. 232. IMPROVING ACCESS TO ADDICTION MEDICINE PROVIDERS.

       Section 597 of the Public Health Service Act (42 U.S.C. 
     290ll) is amended--
       (1) in subsection (a)(1), by inserting ``diagnosis,'' after 
     ``related to''; and
       (2) in subsection (b), by inserting ``addiction medicine,'' 
     after ``psychiatry,''.

     SEC. 233. MENTAL AND BEHAVIORAL HEALTH EDUCATION AND TRAINING 
                   GRANTS.

       Section 756(f) of the Public Health Service Act (42 U.S.C. 
     294e-1(f)) is amended by striking ``fiscal years 2023 through 
     2027'' and inserting ``fiscal years 2025 through 2029''.

     SEC. 234. LOAN REPAYMENT PROGRAM FOR SUBSTANCE USE DISORDER 
                   TREATMENT WORKFORCE.

       Section 781(j) of the Public Health Service Act (42 U.S.C. 
     295h(j)) is amended by striking ``$25,000,000 for each of 
     fiscal years 2019 through 2023'' and inserting ``$40,000,000 
     for each of fiscal years 2025 through 2029''.

     SEC. 235. DEVELOPMENT AND DISSEMINATION OF MODEL TRAINING 
                   PROGRAMS FOR SUBSTANCE USE DISORDER PATIENT 
                   RECORDS.

       Section 7053 of the SUPPORT for Patients and Communities 
     Act (42 U.S.C. 290dd-2 note) is amended by striking 
     subsection (e).

     SEC. 236. TASK FORCE ON BEST PRACTICES FOR TRAUMA-INFORMED 
                   IDENTIFICATION, REFERRAL, AND SUPPORT.

       Section 7132 of the SUPPORT for Patients and Communities 
     Act (Public Law 115-271; 132 Stat. 4046) is amended--
       (1) in subsection (b)(1)--
       (A) by redesignating subparagraph (CC) as subparagraph 
     (DD); and
       (B) by inserting after subparagraph (BB) the following:
       ``(CC) The Administration for Community Living.'';
       (2) in subsection (d)(1), in the matter preceding 
     subparagraph (A), by inserting ``, developmental disability 
     service providers'' before ``, individuals who are''; and
       (3) in subsection (i), by striking ``2023'' and inserting 
     ``2029''.

     SEC. 237. GRANTS TO ENHANCE ACCESS TO SUBSTANCE USE DISORDER 
                   TREATMENT.

       Section 3203 of the SUPPORT for Patients and Communities 
     Act (21 U.S.C. 823 note) is amended--
       (1) by striking subsection (b); and
       (2) by striking ``(a) In General.--The Secretary'' and 
     inserting the following: ``The Secretary''.

     SEC. 238. STATE GUIDANCE RELATED TO INDIVIDUALS WITH SERIOUS 
                   MENTAL ILLNESS AND CHILDREN WITH SERIOUS 
                   EMOTIONAL DISTURBANCE.

       (a) Review of Use of Certain Funding.--Not later than 1 
     year after the date of enactment of this Act, the Secretary 
     of Health and Human Services (referred to in this section as 
     the ``Secretary''), acting through the Assistant Secretary 
     for Mental Health and Substance Use, shall conduct a review 
     of State use of funds made available under the Community 
     Mental Health Services Block Grant program under subpart I of 
     part B of title XIX of the Public Health Service Act (42 
     U.S.C. 300x et seq.) (referred to in this section as the 
     ``block grant program'') for first episode psychosis 
     activities. Such review shall consider the following:
       (1) How States use funds for evidence-based treatments and 
     services according to the standard of care for individuals 
     with early serious mental illness and children with a serious 
     emotional disturbance.

[[Page S1614]]

       (2) The percentages of the State funding under the block 
     grant program expended on early serious mental illness and 
     first episode psychosis, and the number of individuals served 
     under such funds.
       (b) Report and Guidance.--
       (1) Report.--Not later than 180 days after the completion 
     of the review under subsection (a), the Secretary shall 
     submit to the Committee on Health, Education, Labor, and 
     Pensions and the Committee on Appropriations of the Senate 
     and the Committee on Energy and Commerce and the Committee on 
     Appropriations of the House of Representatives a report 
     describing--
       (A) the findings of the review under subsection (a); and
       (B) any recommendations for changes to the block grant 
     program that would facilitate improved outcomes for 
     individuals with serious mental illness and children with 
     serious emotional disturbance.
       (2) Guidance.--Not later than 1 year after the date on 
     which the report is submitted under paragraph (1), the 
     Secretary shall update the guidance provided to States under 
     the block grant program on coordinated specialty care and 
     other evidence-based mental health care services for 
     individuals with serious mental illness and children with a 
     serious emotional disturbance, based on the findings and 
     recommendations of such report.

     SEC. 239. REVIEWING THE SCHEDULING OF APPROVED PRODUCTS 
                   CONTAINING A COMBINATION OF BUPRENORPHINE AND 
                   NALOXONE.

       (a) Secretary of Hhs.--The Secretary of Health and Human 
     Services shall, consistent with the requirements and 
     procedures set forth in sections 201 and 202 of the 
     Controlled Substances Act (21 U.S.C. 811, 812)--
       (1) review the relevant data pertaining to the scheduling 
     of products containing a combination of buprenorphine and 
     naloxone that have been approved under section 505 of the 
     Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355); and
       (2) if appropriate, request that the Attorney General 
     initiate rulemaking proceedings to revise the schedules 
     accordingly with respect to such products.
       (b) Attorney General.--The Attorney General shall review 
     any request made by the Secretary of Health and Human 
     Services under subsection (a)(2) and determine whether to 
     initiate proceedings to revise the schedules in accordance 
     with the criteria set forth in sections 201 and 202 of the 
     Controlled Substances Act (21 U.S.C. 811, 812).

                          Subtitle C--Recovery

     SEC. 241. BUILDING COMMUNITIES OF RECOVERY.

       Section 547(f) of the Public Health Service Act (42 U.S.C. 
     290ee-2(f)) is amended by striking ``$5,000,000 for each of 
     fiscal years 2019 through 2023'' and inserting ``$16,000,000 
     for each of fiscal years 2025 through 2029''.

     SEC. 242. PEER SUPPORT TECHNICAL ASSISTANCE CENTER.

       Section 547A of the Public Health Service Act (42 U.S.C. 
     290ee-2a) is amended--
       (1) in subsection (b)(4), by striking ``building; and'' and 
     inserting the following: ``building, such as--
       ``(A) professional development of peer support specialists; 
     and
       ``(B) making recovery support services available in 
     nonclinical settings; and'';
       (2) by redesignating subsections (d) and (e) as subsections 
     (e) and (f), respectively;
       (3) by inserting after subsection (c) the following:
       ``(d) Regional Centers.--
       ``(1) In general.--The Secretary may establish one regional 
     technical assistance center (referred to in this subsection 
     as the `Regional Center'), with existing resources, to assist 
     the Center in carrying out activities described in subsection 
     (b) within the geographic region of such Regional Center in a 
     manner that is tailored to the needs of such region.
       ``(2) Evaluation.--Not later than 4 years after the date of 
     enactment of the SUPPORT for Patients and Communities 
     Reauthorization Act of 2025, the Secretary shall evaluate the 
     activities of the Regional Center 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 on the findings of such evaluation, 
     including--
       ``(A) a description of the distinct roles and 
     responsibilities of the Regional Center and the Center;
       ``(B) available information relating to the outcomes of the 
     Regional Center under this subsection, such as any impact on 
     the operations and efficiency of the Center relating to 
     requests for technical assistance and support within the 
     region of such Regional Center;
       ``(C) a description of any gaps or areas of duplication 
     relating to the activities of the Regional Center and the 
     Center within such region; and
       ``(D) recommendations relating to the modification, 
     expansion, or termination of the Regional Center under this 
     subsection.
       ``(3) Termination.--This subsection shall terminate on 
     September 30, 2029.''; and
       (4) in subsection (f), as so redesignated, by striking 
     ``$1,000,000 for each of fiscal years 2019 through 2023'' and 
     inserting ``$2,000,000 for each of fiscal years 2025 through 
     2029''.

     SEC. 243. COMPREHENSIVE OPIOID RECOVERY CENTERS.

       Section 552 of the Public Health Service Act (42 U.S.C. 
     290ee-7) is amended--
       (1) in subsection (d)(2)--
       (A) in the matter preceding subparagraph (A), by striking 
     ``and in such manner'' and inserting ``, in such manner, and 
     containing such information and assurances, including 
     relevant documentation,''; and
       (B) in subparagraph (A), by striking ``is capable of 
     coordinating with other entities to carry out'' and inserting 
     ``has the demonstrated capability to carry out, through 
     referral or contractual arrangements'';
       (2) in subsection (h)--
       (A) by redesignating paragraphs (1) through (4) as 
     subparagraphs (A) through (D), respectively, and adjusting 
     the margins accordingly;
       (B) by striking ``With respect to'' and inserting the 
     following:
       ``(1) In general.--With respect to''; and
       (C) by adding at the end the following:
       ``(2) Additional reporting for certain eligible entities.--
     An entity carrying out activities described in subsection (g) 
     through referral or contractual arrangements shall include in 
     the submissions required under paragraph (1) information 
     related to the status of such referrals or contractual 
     arrangements, including an assessment of whether such 
     referrals or contractual arrangements are supporting the 
     ability of such entity to carry out such activities.''; and
       (3) in subsection (j), by striking ``2019 through 2023'' 
     and inserting ``2025 through 2029''.

     SEC. 244. YOUTH PREVENTION AND RECOVERY.

       Section 7102(c) of the SUPPORT for Patients and Communities 
     Act (42 U.S.C. 290bb-7a(c)) (as amended by section 210(a)) is 
     amended--
       (1) in paragraph (2)--
       (A) in subparagraph (A)--
       (i) in clause (i)--

       (I) by inserting ``, or a consortium of local educational 
     agencies,'' after ``a local educational agency''; and
       (II) by striking ``high schools'' and inserting ``secondary 
     schools''; and

       (ii) in clause (vi), by striking ``tribe, or tribal'' and 
     inserting ``Tribe, or Tribal'';
       (B) by amending subparagraph (E) to read as follows:
       ``(E) Indian tribe; tribal organization.--The terms `Indian 
     Tribe' and `Tribal organization' have the meanings given such 
     terms in section 4 of the Indian Self-Determination and 
     Education Assistance Act (25 U.S.C. 5304).'';
       (C) by redesignating subparagraph (K) as subparagraph (L); 
     and
       (D) by inserting after subparagraph (J) the following:
       ``(K) Secondary school.--The term `secondary school' has 
     the meaning given such term in section 8101 of the Elementary 
     and Secondary Education Act of 1965 (20 U.S.C. 7801).'';
       (2) in paragraph (3)(A), in the matter preceding clause 
     (i)--
       (A) by striking ``and abuse''; and
       (B) by inserting ``at increased risk for substance misuse'' 
     after ``specific populations'';
       (3) in paragraph (4)--
       (A) in the matter preceding subparagraph (A), by striking 
     ``Indian tribes'' and inserting ``Indian Tribes'';
       (B) in subparagraph (A), by striking ``and abuse''; and
       (C) in subparagraph (B), by striking ``peer mentoring'' and 
     inserting ``peer-to-peer support'';
       (4) in paragraph (5), by striking ``tribal'' and inserting 
     ``Tribal'';
       (5) in paragraph (6)(A)--
       (A) in clause (iv), by striking ``; and'' and inserting a 
     semicolon; and
       (B) by adding at the end the following:
       ``(vi) a plan to sustain the activities carried out under 
     the grant program, after the grant program has ended; and'';
       (6) in paragraph (8), by striking ``2022'' and inserting 
     ``2027''; and
       (7) by amending paragraph (9) to read as follows:
       ``(9) Authorization of appropriations.--To carry out this 
     subsection, there are authorized to be appropriated--
       ``(A) $10,000,000 for fiscal year 2025;
       ``(B) $12,000,000 for fiscal year 2026;
       ``(C) $13,000,000 for fiscal year 2027;
       ``(D) $14,000,000 for fiscal year 2028; and
       ``(E) $15,000,000 for fiscal year 2029.''.

     SEC. 245. CAREER ACT.

       (a) In General.--Section 7183 of the SUPPORT for Patients 
     and Communities Act (42 U.S.C. 290ee-8) is amended--
       (1) in the section heading, by inserting ``; treatment, 
     recovery, and workforce support grants'' after ``career 
     act'';
       (2) in subsection (b), by inserting ``each'' before ``for a 
     period'';
       (3) in subsection (c)--
       (A) in paragraph (1), by striking ``the rates described in 
     paragraph (2)'' and inserting ``the average rates for 
     calendar years 2018 through 2022 described in paragraph 
     (2)''; and
       (B) by amending paragraph (2) to read as follows:
       ``(2) Rates.--The rates described in this paragraph are the 
     following:
       ``(A) The highest age-adjusted average rates of drug 
     overdose deaths for calendar years 2018 through 2022 based on 
     data from the Centers for Disease Control and Prevention, 
     including, if necessary, provisional data for calendar year 
     2022.
       ``(B) The highest average rates of unemployment for 
     calendar years 2018 through 2022 based on data provided by 
     the Bureau of Labor Statistics.
       ``(C) The lowest average labor force participation rates 
     for calendar years 2018 through 2022 based on data provided 
     by the Bureau of Labor Statistics.'';

[[Page S1615]]

       (4) in subsection (g)--
       (A) in each of paragraphs (1) and (3), by redesignating 
     subparagraphs (A) and (B) as clauses (i) and (ii), 
     respectively, and adjusting the margins accordingly;
       (B) by redesignating paragraphs (1) through (3) as 
     subparagraphs (A) through (C), respectively, and adjusting 
     the margins accordingly;
       (C) in the matter preceding subparagraph (A) (as so 
     redesignated), by striking ``An entity'' and inserting the 
     following:
       ``(1) In general.--An entity''; and
       (D) by adding at the end the following:
       ``(2) Transportation services.--An entity receiving a grant 
     under this section may use not more than 5 percent of the 
     funds for providing transportation for individuals to 
     participate in an activity supported by a grant under this 
     section, which transportation shall be to or from a place of 
     work or a place where the individual is receiving vocational 
     education or job training services or receiving services 
     directly linked to treatment of or recovery from a substance 
     use disorder.
       ``(3) Limitation.--The Secretary may not require an entity 
     to, or give priority to an entity that plans to, use the 
     funds of a grant under this section for activities that are 
     not specified in this subsection.'';
       (5) in subsection (i)(2), by inserting ``, which shall 
     include employment and earnings outcomes described in 
     subclauses (I) and (III) of section 116(b)(2)(A)(i) of the 
     Workforce Innovation and Opportunity Act (29 U.S.C. 
     3141(b)(2)(A)(i)) with respect to the participation of such 
     individuals with a substance use disorder in programs and 
     activities funded by the grant under this section'' after 
     ``subsection (g)'';
       (6) in subsection (j)--
       (A) in paragraph (1), by inserting ``for grants awarded 
     prior to the date of enactment of the SUPPORT for Patients 
     and Communities Reauthorization Act of 2025'' after ``grant 
     period under this section''; and
       (B) in paragraph (2)--
       (i) in the matter preceding subparagraph (A), by striking 
     ``2 years after submitting the preliminary report required 
     under paragraph (1)'' and inserting ``September 30, 2029''; 
     and
       (ii) in subparagraph (A), by striking ``(g)(3)'' and 
     inserting ``(g)(1)(C)''; and
       (7) in subsection (k), by striking ``$5,000,000 for each of 
     fiscal years 2019 through 2023'' and inserting ``$12,000,000 
     for each of fiscal years 2025 through 2029''.
       (b) Reauthorization of the CAREER Act; Recovery Housing 
     Pilot Program.--
       (1) In general.--Section 8071 of the SUPPORT for Patients 
     and Communities Act (42 U.S.C. 5301 note; Public Law 115-271) 
     is amended--
       (A) by striking the section heading and inserting ``career 
     act; recovery housing pilot program'';
       (B) in subsection (a), by striking ``through 2023'' and 
     inserting ``through 2029'';
       (C) in subsection (b)--
       (i) in paragraph (1), by striking ``not later than 60 days 
     after the date of enactment of this Act'' and inserting ``not 
     later than 60 days after the date of enactment of the SUPPORT 
     for Patients and Communities Reauthorization Act of 2025''; 
     and
       (ii) in paragraph (2)(B)(i)--

       (I) in subclause (I)--

       (aa) by striking ``for calendar years 2013 through 2017''; 
     and
       (bb) by inserting ``for calendar years 2018 through 2022'' 
     after ``rates of unemployment'';

       (II) in subclause (II)--

       (aa) by striking ``for calendar years 2013 through 2017''; 
     and
       (bb) by inserting ``for calendar years 2018 through 2022'' 
     after ``participation rates''; and

       (III) by striking subclause (III) and inserting the 
     following:
       ``(III) The highest age-adjusted average rates of drug 
     overdose deaths for calendar years 2018 through 2022 based on 
     data from the Centers for Disease Control and Prevention, 
     including, if necessary, provisional data for calendar year 
     2022.''; and

       (D) in subsection (f), by striking ``For the 2-year period 
     following the date of enactment of this Act, the'' and 
     inserting ``The''.
       (2) Conforming amendment.--Subtitle F of title VIII of the 
     SUPPORT for Patients and Communities Act (Public Law 115-271; 
     132 Stat. 4095) is amended by striking the subtitle heading 
     and inserting the following: ``Subtitle F--CAREER Act; 
     Recovery Housing Pilot Program'' .
       (c) Clerical Amendments.--The table of contents in section 
     1(b) of the SUPPORT for Patients and Communities Act (Public 
     Law 115-271; 132 Stat. 3894) is amended--
       (1) by striking the item relating to section 7183 and 
     inserting the following:

``Sec. 7183. CAREER Act; treatment, recovery, and workforce support 
              grants.'';
       (2) by striking the item relating to subtitle F of title 
     VIII and inserting the following:

    ``Subtitle F--CAREER Act; Recovery Housing Pilot Program''; and

       (3) by striking the item relating to section 8071 and 
     inserting the following:

``Sec. 8071. CAREER Act; Recovery Housing Pilot Program.''.

     SEC. 246. ADDRESSING ECONOMIC AND WORKFORCE IMPACTS OF THE 
                   OPIOID CRISIS.

       Section 8041(g)(1) of the SUPPORT for Patients and 
     Communities Act (29 U.S.C. 3225a(g)(1)) is amended by 
     striking ``2023'' and inserting ``2029''.

                    Subtitle D--Miscellenous Matters

     SEC. 251. DELIVERY OF A CONTROLLED SUBSTANCE BY A PHARMACY TO 
                   A PRESCRIBING PRACTITIONER.

       Section 309A(a) of the Controlled Substances Act (21 U.S.C. 
     829a(a)) is amended by striking paragraph (2) and inserting 
     the following:
       ``(2) the controlled substance is a drug in schedule III, 
     IV, or V to be administered--
       ``(A) by injection or implantation for the purpose of 
     maintenance or detoxification treatment; or
       ``(B) subject to a risk evaluation and mitigation strategy 
     pursuant to section 505-1 of the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 355-1) that includes elements to 
     assure safe use of the drug described in subsection (f)(3)(E) 
     of such section, including a requirement for post-
     administration monitoring by a health care provider.''.

     SEC. 252. REQUIRED TRAINING FOR PRESCRIBERS OF CONTROLLED 
                   SUBSTANCES.

       (a) In General.--Subsection (m)(1) of section 303 of the 
     Controlled Substances Act (21 U.S.C. 823), as so redesignated 
     by section 3 of this Act, is amended--
       (1) in subparagraph (A)--
       (A) in clause (iv)--
       (i) in subclause (I)--

       (I) by inserting ``the American Academy of Family 
     Physicians, the American Podiatric Medical Association, the 
     Academy of General Dentistry, the American Optometric 
     Association,'' before ``or any other organization'';
       (II) by striking ``or the Commission'' and inserting ``the 
     Commission''; and
       (III) by inserting ``, or the Council on Podiatric Medical 
     Education'' before the semicolon at the end; and

       (ii) in subclause (III), by inserting ``or the American 
     Academy of Family Physicians'' after ``Association''; and
       (B) in clause (v), in the matter preceding subclause (I)--
       (i) by striking ``osteopathic medicine, dental surgery'' 
     and inserting ``osteopathic medicine, podiatric medicine, 
     dental surgery''; and
       (ii) by striking ``or dental medicine curriculum'' and 
     inserting ``or dental or podiatric medicine curriculum''; and
       (2) in subparagraph (B)--
       (A) in clause (i)--
       (i) by inserting ``the American Pharmacists Association, 
     the Accreditation Council on Pharmacy Education, the American 
     Psychiatric Nurses Association, the American Academy of 
     Nursing, the American Academy of Family Physicians,'' before 
     ``or any other organization''; and
       (ii) by inserting ``, the American Academy of Family 
     Physicians,'' before ``or the Accreditation Council''; and
       (B) in clause (ii)--
       (i) by striking ``or accredited school'' and inserting ``, 
     an accredited school''; and
       (ii) by inserting ``, or an accredited school of pharmacy'' 
     before ``in the United States''.
       (b) Effective Date.--Notwithstanding the redesignation made 
     by section 3(a)(1), the amendment made by subsection (a) 
     shall take effect as if enacted on December 29, 2022.
                                 ______