[House Report 116-547]
[From the U.S. Government Publishing Office]


116th Congress   }                                      {       Report
                        HOUSE OF REPRESENTATIVES
 2d Session      }                                      {      116-547

======================================================================



 
           FAMILY SUPPORT SERVICES FOR ADDICTION ACT OF 2020

                                _______
                                

 September 29, 2020.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Pallone, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 5572]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 5572) to establish a grant program for family 
community organizations that provide support for individuals 
struggling with substance use disorder and their families, 
having considered the same, reports favorably thereon with an 
amendment and recommends that the bill as amended do pass.

                                CONTENTS

                                                                   Page
  I. Purpose and Summary..............................................3
 II. Background and Need for the Legislation..........................3
III. Committee Hearings...............................................4
 IV. Committee Consideration..........................................5
  V. Committee Votes..................................................5
 VI. Oversight Findings...............................................5
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures5
VIII.Federal Mandates Statement.......................................6

 IX. Statement of General Performance Goals and Objectives............6
  X. Duplication of Federal Programs..................................6
 XI. Committee Cost Estimate..........................................6
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......6
XIII.Advisory Committee Statement.....................................6

XIV. Applicability to Legislative Branch..............................6
 XV. Section-by-Section Analysis of the Legislation...................6
XVI. Changes in Existing Law Made by the Bill, as Reported............7

    The amendment is as follows:
    Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Family Support Services for Addiction 
Act of 2020''.

SEC. 2. FAMILY SUPPORT SERVICES FOR INDIVIDUALS STRUGGLING WITH 
                    SUBSTANCE USE DISORDER.

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

``SEC. 553. FAMILY SUPPORT SERVICES FOR INDIVIDUALS STRUGGLING WITH 
                    SUBSTANCE USE DISORDER.

  ``(a) Definitions.--In this section--
          ``(1) the term `family community organization' means an 
        independent nonprofit organization that--
                  ``(A) mobilizes resources within and outside of the 
                community of families with individuals living with 
                addiction, to provide a support network, education, and 
                evidence-informed tools for families and loved ones of 
                individuals struggling with substance use disorders; 
                and
                  ``(B) is governed by experts in the field of 
                addiction, which may include--
                          ``(i) experts in evidence-informed 
                        interventions for family members;
                          ``(ii) experts in the impact of addiction on 
                        family systems;
                          ``(iii) families who have experience with 
                        substance use disorders and addiction; and
                          ``(iv) other experts in the field of 
                        addiction; and
          ``(2) the term `family support services' means resources or 
        programs that support families that include an individual with 
        substance use disorder.
  ``(b) Grants Authorized.--The Secretary shall award grants to family 
community organizations to enable such organizations to develop, 
expand, and enhance evidence-informed family support services.
  ``(c) Federal Share.--The Federal share of the costs of a program 
funded by a grant under this section may not exceed 85 percent.
  ``(d) Use of Funds.--Grants awarded under subsection (b)--
          ``(1) shall be used to develop, expand, and enhance community 
        and statewide evidence-informed family support services; and
          ``(2) may be used to--
                  ``(A) build connections between family support 
                networks, including providing technical assistance 
                between family community organizations and peer support 
                networks, and with other family support services, 
                focused on enhancing knowledge of evidence-informed 
                interventions for family members and loved ones of 
                individuals living with substance use disorders and 
                reducing harm by educating service providers on current 
                evidence regarding addiction and the family, 
                including--
                          ``(i) behavioral health providers, including 
                        such providers focused specifically on family 
                        and couples therapy in the context of 
                        addiction;
                          ``(ii) primary care providers;
                          ``(iii) providers of foster care services or 
                        support services for grandparents, guardians, 
                        and other extended family impacted by 
                        addiction; and
                          ``(iv) other family support services that 
                        connect to community resources for individuals 
                        with substance use disorders, including non-
                        clinical community services;
                  ``(B) reduce stigma associated with the family of 
                individuals with substance use disorders by improving 
                knowledge about addiction and its treatment, providing 
                compassionate support, and dispelling myths that 
                perpetuate such stigma;
                  ``(C) conduct outreach on issues relating to 
                substance use disorders and family support, which may 
                include education, training, and resources with respect 
                to--
                          ``(i) building a resilience- and strengths-
                        based approach to prevention of, and living 
                        with, addiction in the family;
                          ``(ii) identifying the signs of substance use 
                        disorder;
                          ``(iii) adopting an approach that minimizes 
                        harm to all family members; and
                          ``(iv) families of individuals with a 
                        substance use disorder, including with respect 
                        to--
                                  ``(I) navigating the treatment and 
                                recovery systems;
                                  ``(II) paying for addiction 
                                treatment;
                                  ``(III) education about substance use 
                                disorder; and
                                  ``(IV) avoiding predatory treatment 
                                programs; and
                  ``(D) connect families to evidence-informed peer 
                support programs.
  ``(e) Data Reporting and Program Oversight.--With respect to a grant 
awarded under subsection (a), not later than 90 days after the end of 
the first year of the grant period, and annually thereafter for the 
duration of the grant period, the entity shall submit data, as 
appropriate and to the extent practicable, to the Secretary regarding--
          ``(1) the programs and activities funded by the grant;
          ``(2) health outcomes of the population of individuals with a 
        substance use disorder who received services through programs 
        supported by the grant, as evaluated by an independent program 
        evaluator through the use of outcomes measures, as determined 
        by the Secretary; and
          ``(3) any other information that the secretary may require 
        for the purpose of ensuring that the grant recipient is 
        complying with all the requirements of the grant.
  ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for each of fiscal 
years 2021 through 2025.''.

                         I. Purpose and Summary

    H.R. 5572, the ``Family Support Services for Addiction Act 
of 2020'', was introduced by Representatives David Trone (D-MD) 
and Daniel Meuser (R-PA) on January 9, 2020. This bill would 
authorize the U.S. Department of Health and Human Services 
(HHS) Secretary (the Secretary) to award grants to support 
family community organizations that develop, expand, and 
enhance evidence-informed support services for families and 
family members living with substance use disorders or 
addiction. The grants may be used to build connections between 
family support networks, with behavioral health and primary 
care providers, and foster care services, among others. The 
grants may also be used to reduce stigma around addiction and 
addiction treatment, offer family support outreach activities, 
and connect families to peer support programs. Grantees are 
required to submit data that tracks the program's activities, 
health outcomes, and any other relevant information required by 
the Secretary. This program is authorized at $5 million for 
each of fiscal years 2021 through 2025.

              II. Background and Need for the Legislation

    According to the 2019 National Survey on Drug Use and 
Health (NSDUH), more than 20 million Americans over the age of 
12 have a substance use disorder.\1\ This survey found, 
however, that only four million individuals received any 
substance use treatment in the past year.\2\ The NSDUH data 
also found that among the individuals who did not receive 
treatment, nearly 18 million did not believe they needed 
treatment, 577,000 believed they needed treatment but did not 
make an effort to get treatment, and 236,000 believed they 
needed treatment and made an effort to get treatment.\3\
---------------------------------------------------------------------------
    \1\Substance Abuse and Mental Health Services Administration. Key 
substance use and mental health indicators in the United States: 
Results from the 2019 National Survey on Drug Use and Health (2020).
    \2\Id.
    \3\Id.
---------------------------------------------------------------------------
    Family can play a significant role in helping an individual 
find treatment, yet there is not a one-size-fits-all solution 
to ensuring family members get the care they need.\4\ In his 
testimony, former director of the White House Office of 
National Drug Control Policy Michael Botticelli stated, ``[w]e 
know that addiction effects more than the individual--it 
impacts families as well. Families struggle with knowing how 
best to be supportive of their loved ones and avoid doing harm. 
We also know that getting evidence-based guidance into the 
hands of family and community support systems can dramatically 
influence the trajectory of an individual's care and 
recovery.''\5\ Patty McCarthy, Chief Executive Officer of Faces 
& Voices of Recovery, also said ``[p]arents, children and other 
family members, including those who have lost loved ones, need 
support groups and they need help navigating the complexity of 
the treatment system.''\6\
---------------------------------------------------------------------------
    \4\Substance Abuse and Mental Health Services Administration, 
Resources for Families (www.samhsa.gov/families/resources) (accessed 
September 17, 2020).
    \5\House Committee on Energy and Commerce, Testimony of Michael P. 
Botticelli, Executive Director, Grayken Center for Addiction, Boston 
Medical Center (March 3, 2020).
    \6\House Committee on Energy and Commerce, Testimony of Patty 
McCarthy, Chief Executive Officer, Faces & Voices of Recovery (March 3, 
2020).
---------------------------------------------------------------------------
    An example of an organization that provides services for 
families is an organization called Not One More Alabama.\7\ 
This organization was established in 2016 to help support 
families who have been affected by addiction.\8\ Among other 
services, the organization hosts community education programs 
and provides information to families on medication-assisted 
treatment and treatment programs.\9\ Not One More Alabama also 
provides information on the opioid overdose reversal drug, 
naloxone, and distributes kits through a partnership with a 
local School of Medicine and School of Pharmacy.\10\ The 
program is supported by community grants and additional Federal 
support would bolster programs such as this nationwide.
---------------------------------------------------------------------------
    \7\Not One More Alabama (www.notonemorealabama.org/) (accessed 
September 18, 2020).
    \8\Not One More Alabama, About (www.notonemorealabama.org/
about.html) (accessed September 18, 2020).
    \9\See note 7.
    \10\See note 8.
---------------------------------------------------------------------------

                        III. Committee Hearings

    For the purposes of section 103(i) of H. Res. 6 of the 
116th Congress, the following hearing was used to develop or 
consider H.R. 5572:
    The Subcommittee on Health held a legislative hearing on 
Tuesday, March 3, 2020, entitled, ``Combatting an Epidemic: 
Legislation to Help Patients with Substance Use Disorders,'' to 
consider H.R. 5572, the ``Family Support Services for Addiction 
Act of 2020'', and other legislation. The Subcommittee received 
testimony from the following witnesses:

Panel I:

           ADM Brett P. Giroir, M.D., Assistant 
        Secretary for Health and Senior Adviser to the 
        Secretary on Opioid Policy, Department of Health and 
        Human Services
           Kimberly Brandt, Principal Deputy 
        Administrator for Policy & Operations, Centers for 
        Medicare & Medicaid Services
           Thomas W. Prevoznik, Deputy Assistant 
        Administrator, Diversion Control Division, Drug 
        Enforcement Administration

Panel II:

           Michael P. Botticelli, Executive Director, 
        Grayken Center for Addiction, Boston Medical Center
           Smita Das, M.D., Ph.D., M.P.H., Addiction 
        Psychiatrist, Dual Diagnosis Clinic, Clinical Assistant 
        Professor, Psychiatry and Behavioral Sciences, Stanford 
        University School of Medicine
           Patty McCarthy, Chief Executive Officer, 
        Faces & Voices of Recovery
           Robert I.L. Morrison, Executive Director/
        Director of Legislative Affairs, National Association 
        of State Alcohol and Drug Abuse Directors
           Margaret B. Rizzo, Executive Director, JSAS 
        HealthCare, Inc.
           Shawn A. Ryan, M.D., M.B.A., Chair, 
        Legislative Advocacy Committee, American Society of 
        Addiction Medicine

                      IV. Committee Consideration

    Representatives Trone (D-MD) and Meuser (R PA) introduced 
H.R. 5572, the ``Family Support Services for Addiction Act of 
2020'', on January 9, 2020, and the bill was referred to the 
Committee on Energy and Commerce. The bill was then referred to 
the Subcommittee on Health on January 10, 2020. A legislative 
hearing was held on the bill on March 3, 2020.
    On September 9, 2020, the Subcommittee on Health was 
discharged from further consideration of H.R. 5572, as the full 
Committee on Energy and Commerce called the bill up for 
consideration. The full Committee met in virtual open markup 
session on September 9, 2020, pursuant to notice, to consider 
H.R. 5572. During consideration of the bill, a manager's 
offered by Ms. Blunt Rochester of Delaware was agreed to by a 
voice vote. Upon conclusion of consideration of the bill, the 
full Committee agreed to a motion on final passage by Mr. 
Pallone, Chairman of the committee, to order H.R. 5572 reported 
favorably to the House, amended, by a voice vote, a quorum 
being present.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. The 
Committee advises that there were no record votes taken on H.R. 
5572, including the motion on final passage.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

 VII. New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.
    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.

                    VIII. Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

       IX. Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to 
establish a grant program for family community organizations 
that provide support for individuals struggling with substance 
use disorder and their families.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 5572 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

                      XI. Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

    XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 5572 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIII. Advisory Committee Statement

    No advisory committee within the meaning of section 5(b) of 
the Federal Advisory Committee Act was created by this 
legislation.

                XIV. Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

           XV. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the short title may be cited as 
the ``Family Support Service for Addiction Act of 2020''.

Sec. 2. Family support services for individuals struggling with 
        substance use disorder

    Section 2 amends the Public Health Service Act to add a new 
section 553. Subsection (a) of section 553 defines the term 
``family community organization'' as an independent nonprofit 
organization that can mobilize resources to provide a support 
network, education, and evidence-informed tools for families 
and loved ones of individuals with substance use disorders. 
These ``family community organizations'' may be governed by 
experts in evidence-informed interventions for family members 
and substance use disorders. Subsection (a) of section 553 also 
defines ``family support services'' as resources or programs 
that support families that include an individual with a 
substance use disorder.
    Subsection (b) of section 553 authorizes the Secretary of 
Health and Human Services to award grants to family community 
organizations to develop, expand, and enhance evidence-informed 
family support services.
    Subsection (c) of section 553 prohibits the Federal share 
of the programs funded under this section from exceeding 85 
percent.
    Subsection (d) of section 553 states the funds shall be 
used for developing, expanding, and enhancing community and 
statewide evidence-informed family support services. Further, 
funds may be used for building connections between family 
support networks, peer support networks, health providers, and 
foster care services; and reducing stigma associated with 
substance use disorders. Further, the funds may be used for 
conducting outreach, education, and training to support 
prevention, identification, and other approaches that support 
families of individuals with a substance use disorder. These 
supports may include navigating the treatment and recovery 
systems, paying for addiction treatment, providing education 
about substance use disorder, and providing information on 
avoiding predatory treatment programs.
    Subsection (e) of section 553 requires grantees to report 
information to the Secretary, including information on: the 
programs and activities funded by the grant; health outcomes of 
the population who received services supported by the grant; 
and any other data the Secretary may require.
    Subsection (f) of section 553 authorizes $5 million for 
each of fiscal years 2020 through 2025.

       XVI. Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italics and existing law in which no change is 
proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE V--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

           *       *       *       *       *       *       *



Part D--Miscellaneous Provisions Relating to Substance Abuse and Mental 
Health

           *       *       *       *       *       *       *



SEC. 553. FAMILY SUPPORT SERVICES FOR INDIVIDUALS STRUGGLING WITH 
                    SUBSTANCE USE DISORDER.

  (a) Definitions.--In this section--
          (1) the term ``family community organization'' means 
        an independent nonprofit organization that--
                  (A) mobilizes resources within and outside of 
                the community of families with individuals 
                living with addiction, to provide a support 
                network, education, and evidence-informed tools 
                for families and loved ones of individuals 
                struggling with substance use disorders; and
                  (B) is governed by experts in the field of 
                addiction, which may include--
                          (i) experts in evidence-informed 
                        interventions for family members;
                          (ii) experts in the impact of 
                        addiction on family systems;
                          (iii) families who have experience 
                        with substance use disorders and 
                        addiction; and
                          (iv) other experts in the field of 
                        addiction; and
          (2) the term ``family support services'' means 
        resources or programs that support families that 
        include an individual with substance use disorder.
  (b) Grants Authorized.--The Secretary shall award grants to 
family community organizations to enable such organizations to 
develop, expand, and enhance evidence-informed family support 
services.
  (c) Federal Share.--The Federal share of the costs of a 
program funded by a grant under this section may not exceed 85 
percent.
  (d) Use of Funds.--Grants awarded under subsection (b)--
          (1) shall be used to develop, expand, and enhance 
        community and statewide evidence-informed family 
        support services; and
          (2) may be used to--
                  (A) build connections between family support 
                networks, including providing technical 
                assistance between family community 
                organizations and peer support networks, and 
                with other family support services, focused on 
                enhancing knowledge of evidence-informed 
                interventions for family members and loved ones 
                of individuals living with substance use 
                disorders and reducing harm by educating 
                service providers on current evidence regarding 
                addiction and the family, including--
                          (i) behavioral health providers, 
                        including such providers focused 
                        specifically on family and couples 
                        therapy in the context of addiction;
                          (ii) primary care providers;
                          (iii) providers of foster care 
                        services or support services for 
                        grandparents, guardians, and other 
                        extended family impacted by addiction; 
                        and
                          (iv) other family support services 
                        that connect to community resources for 
                        individuals with substance use 
                        disorders, including non-clinical 
                        community services;
                  (B) reduce stigma associated with the family 
                of individuals with substance use disorders by 
                improving knowledge about addiction and its 
                treatment, providing compassionate support, and 
                dispelling myths that perpetuate such stigma;
                  (C) conduct outreach on issues relating to 
                substance use disorders and family support, 
                which may include education, training, and 
                resources with respect to--
                          (i) building a resilience- and 
                        strengths-based approach to prevention 
                        of, and living with, addiction in the 
                        family;
                          (ii) identifying the signs of 
                        substance use disorder;
                          (iii) adopting an approach that 
                        minimizes harm to all family members; 
                        and
                          (iv) families of individuals with a 
                        substance use disorder, including with 
                        respect to--
                                  (I) navigating the treatment 
                                and recovery systems;
                                  (II) paying for addiction 
                                treatment;
                                  (III) education about 
                                substance use disorder; and
                                  (IV) avoiding predatory 
                                treatment programs; and
                  (D) connect families to evidence-informed 
                peer support programs.
  (e) Data Reporting and Program Oversight.--With respect to a 
grant awarded under subsection (a), not later than 90 days 
after the end of the first year of the grant period, and 
annually thereafter for the duration of the grant period, the 
entity shall submit data, as appropriate and to the extent 
practicable, to the Secretary regarding--
          (1) the programs and activities funded by the grant;
          (2) health outcomes of the population of individuals 
        with a substance use disorder who received services 
        through programs supported by the grant, as evaluated 
        by an independent program evaluator through the use of 
        outcomes measures, as determined by the Secretary; and
          (3) any other information that the secretary may 
        require for the purpose of ensuring that the grant 
        recipient is complying with all the requirements of the 
        grant.
  (f) Authorization of Appropriations.--There is authorized to 
be appropriated to carry out this section $5,000,000 for each 
of fiscal years 2021 through 2025.

           *       *       *       *       *       *       *


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