State Opioid Response Grant Authorization Act of 2021

IIB 117TH CONGRESS 1ST SESSION H. R. 2379 IN THE SENATE OF THE UNITED STATES OCTOBER 21, 2021 Received; read twice and referred to the Committee on Health, Education, Labor, and Pensions AN ACT To amend the 21st Century Cures Act to reauthorize and expand a grant program for State response to the opioid use disorders crisis, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS 2 HR 2379 RFS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘State Opioid Response 2 Grant Authorization Act of 2021’’. 3 SEC. 2. GRANT PROGRAM FOR STATE AND TRIBAL RE- 4 SPONSE TO OPIOID AND STIMULANT USE AND 5 MISUSE. 6 Section 1003 of the 21st Century Cures Act (42 7 U.S.C. 290ee–3 note) is amended to read as follows: 8 ‘‘SEC. 1003. GRANT PROGRAM FOR STATE AND TRIBAL RE- 9 SPONSE TO OPIOID AND STIMULANT USE AND 10 MISUSE. 11 ‘‘(a) IN GENERAL.—The Secretary of Health and 12 Human Services (referred to in this section as the ‘Sec- 13 retary’) shall carry out the grant program described in 14 subsection (b) for purposes of addressing opioid and stim- 15 ulant use and misuse, within States, Indian Tribes, and 16 populations served by Tribal organizations and Urban In- 17 dian organizations. 18 ‘‘(b) GRANTS PROGRAM.— 19 ‘‘(1) IN GENERAL.—Subject to the availability 20 of appropriations, the Secretary shall award grants 21 to States, Indian Tribes, Tribal organizations, and 22 Urban Indian organizations for the purpose of ad- 23 dressing opioid and stimulant use and misuse, within 24 such States, such Indian Tribes, and populations 25 served by such Tribal organizations and Urban In- 26 VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS 3 HR 2379 RFS dian organizations, in accordance with paragraph 1 (2). 2 ‘‘(2) MINIMUM ALLOCATIONS; PREFERENCE.— 3 In determining grant amounts for each recipient of 4 a grant under paragraph (1), the Secretary shall— 5 ‘‘(A) ensure that each State receives not 6 less than $4,000,000; and 7 ‘‘(B) give preference to States, Indian 8 Tribes, Tribal organizations, and Urban Indian 9 organizations whose populations have an inci- 10 dence or prevalence of opioid use disorders or 11 stimulant use or misuse that is substantially 12 higher relative to the populations of other 13 States, other Indian Tribes, Tribal organiza- 14 tions, or Urban Indian organizations, as appli- 15 cable. 16 ‘‘(3) FORMULA METHODOLOGY.— 17 ‘‘(A) IN GENERAL.—Before publishing a 18 funding opportunity announcement with respect 19 to grants under this section, the Secretary 20 shall— 21 ‘‘(i) develop a formula methodology to 22 be followed in allocating grant funds 23 awarded under this section among grant- 24 VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS 4 HR 2379 RFS ees, which includes performance assess- 1 ments for continuation awards; and 2 ‘‘(ii) not later than 30 days after de- 3 veloping the formula methodology under 4 clause (i), submit the formula methodology 5 to— 6 ‘‘(I) the Committee on Energy 7 and Commerce and the Committee on 8 Appropriations of the House of Rep- 9 resentatives; and 10 ‘‘(II) the Committee on Health, 11 Education, Labor, and Pensions and 12 the Committee on Appropriations of 13 the Senate. 14 ‘‘(B) REPORT.—Not later than two years 15 after the date of the enactment of the State 16 Opioid Response Grant Authorization Act of 17 2021, the Comptroller General of the United 18 States shall submit to the Committee on 19 Health, Education, Labor, and Pensions of the 20 Senate and the Committee on Energy and Com- 21 merce of the House of Representatives a report 22 that— 23 ‘‘(i) assesses how grant funding is al- 24 located to States under this section and 25 VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS 5 HR 2379 RFS how such allocations have changed over 1 time; 2 ‘‘(ii) assesses how any changes in 3 funding under this section have affected 4 the efforts of States to address opioid or 5 stimulant use or misuse; and 6 ‘‘(iii) assesses the use of funding pro- 7 vided through the grant program under 8 this section and other similar grant pro- 9 grams administered by the Substance 10 Abuse and Mental Health Services Admin- 11 istration. 12 ‘‘(4) USE OF FUNDS.—Grants awarded under 13 this subsection shall be used for carrying out activi- 14 ties that supplement activities pertaining to opioid 15 and stimulant use and misuse, undertaken by the 16 State agency responsible for administering the sub- 17 stance abuse prevention and treatment block grant 18 under subpart II of part B of title XIX of the Public 19 Health Service Act (42 U.S.C. 300x–21 et seq.), 20 which may include public health-related activities 21 such as the following: 22 ‘‘(A) Implementing prevention activities, 23 and evaluating such activities to identify effec- 24 VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS 6 HR 2379 RFS tive strategies to prevent substance use dis- 1 orders. 2 ‘‘(B) Establishing or improving prescrip- 3 tion drug monitoring programs. 4 ‘‘(C) Training for health care practitioners, 5 such as best practices for prescribing opioids, 6 pain management, recognizing potential cases 7 of substance use disorders, referral of patients 8 to treatment programs, preventing diversion of 9 controlled substances, and overdose prevention. 10 ‘‘(D) Supporting access to health care 11 services, including— 12 ‘‘(i) services provided by federally cer- 13 tified opioid treatment programs; 14 ‘‘(ii) outpatient and residential sub- 15 stance use disorder treatment services that 16 utilize medication-assisted treatment, as 17 appropriate; or 18 ‘‘(iii) other appropriate health care 19 providers to treat substance use disorders. 20 ‘‘(E) Recovery support services, includ- 21 ing— 22 ‘‘(i) community-based services that in- 23 clude peer supports; 24 VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS 7 HR 2379 RFS ‘‘(ii) mutual aid recovery programs 1 that support medication-assisted treat- 2 ment; or 3 ‘‘(iii) services to address housing 4 needs and family issues. 5 ‘‘(F) Other public health-related activities, 6 as the State, Indian Tribe, Tribal organization, 7 or Urban Indian organization determines appro- 8 priate, related to addressing substance use dis- 9 orders within the State, Indian Tribe, Tribal or- 10 ganization, or Urban Indian organization, in- 11 cluding directing resources in accordance with 12 local needs related to substance use disorders. 13 ‘‘(c) ACCOUNTABILITY AND OVERSIGHT.—A State re- 14 ceiving a grant under subsection (b) shall include in re- 15 porting related to substance use disorders submitted to the 16 Secretary pursuant to section 1942 of the Public Health 17 Service Act (42 U.S.C. 300x–52), a description of— 18 ‘‘(1) the purposes for which the grant funds re- 19 ceived by the State under such subsection for the 20 preceding fiscal year were expended and a descrip- 21 tion of the activities of the State under the grant; 22 ‘‘(2) the ultimate recipients of amounts pro- 23 vided to the State; and 24 VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS 8 HR 2379 RFS ‘‘(3) the number of individuals served through 1 the grant. 2 ‘‘(d) LIMITATIONS.—Any funds made available pur- 3 suant to subsection (i)— 4 ‘‘(1) shall not be used for any purpose other 5 than the grant program under subsection (b); and 6 ‘‘(2) shall be subject to the same requirements 7 as substance use disorders prevention and treatment 8 programs under titles V and XIX of the Public 9 Health Service Act (42 U.S.C. 290aa et seq., 300w 10 et seq.). 11 ‘‘(e) INDIAN TRIBES, TRIBAL ORGANIZATIONS, AND 12 URBAN INDIAN ORGANIZATIONS.—The Secretary, in con- 13 sultation with Indian Tribes, Tribal organizations, and 14 Urban Indian organizations, shall identify and establish 15 appropriate mechanisms for Indian Tribes, Tribal organi- 16 zations, and Urban Indian organizations to demonstrate 17 or report the information as required under subsections 18 (b), (c), and (d). 19 ‘‘(f) REPORT TO CONGRESS.—Not later than Sep- 20 tember 30, 2024, and biennially thereafter, the Secretary 21 shall submit to the Committee on Health, Education, 22 Labor, and Pensions of the Senate and the Committee on 23 Energy and Commerce of the House of Representatives, 24 and the Committees on Appropriations of the House of 25 VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS 9 HR 2379 RFS Representatives and the Senate, a report that includes a 1 summary of the information provided to the Secretary in 2 reports made pursuant to subsections (c) and (e), includ- 3 ing— 4 ‘‘(1) the purposes for which grant funds are 5 awarded under this section; 6 ‘‘(2) the activities of the grant recipients; and 7 ‘‘(3) for each State, Indian Tribe, Tribal orga- 8 nization, and Urban Indian organization that re- 9 ceives a grant under this section, the funding level 10 provided to such recipient. 11 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary, in- 12 cluding through the Tribal Training and Technical Assist- 13 ance Center of the Substance Abuse and Mental Health 14 Services Administration, shall provide States, Indian 15 Tribes, Tribal organizations, and Urban Indian organiza- 16 tions, as applicable, with technical assistance concerning 17 grant application and submission procedures under this 18 section, award management activities, and enhancing out- 19 reach and direct support to rural and underserved commu- 20 nities and providers in addressing substance use disorders. 21 ‘‘(h) DEFINITIONS.—In this section: 22 ‘‘(1) INDIAN TRIBE.—The term ‘Indian Tribe’ 23 has the meaning given the term ‘Indian tribe’ in sec- 24 VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS 10 HR 2379 RFS tion 4 of the Indian Self-Determination and Edu- 1 cation Assistance Act (25 U.S.C. 5304). 2 ‘‘(2) TRIBAL ORGANIZATION.—The term ‘Tribal 3 organization’ has the meaning given the term ‘tribal 4 organization’ in such section 4. 5 ‘‘(3) STATE.—The term ‘State’ has the mean- 6 ing given such term in section 1954(b) of the Public 7 Health Service Act (42 U.S.C. 300x–64(b)). 8 ‘‘(4) URBAN INDIAN ORGANIZATION.—The term 9 ‘Urban Indian organization’ has the meaning given 10 such term in section 4 of the Indian Health Care 11 Improvement Act. 12 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 13 ‘‘(1) IN GENERAL.—For purposes of carrying 14 out the grant program under subsection (b), there is 15 authorized to be appropriated $1,750,000,000 for 16 each of fiscal years 2022 through 2027, to remain 17 available until expended. 18 ‘‘(2) FEDERAL ADMINISTRATIVE EXPENSES.— 19 Of the amounts made available for each fiscal year 20 to award grants under subsection (b), the Secretary 21 shall not use more than 20 percent for Federal ad- 22 ministrative expenses, training, technical assistance, 23 and evaluation. 24 VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS 11 HR 2379 RFS ‘‘(3) SET ASIDE.—Of the amounts made avail- 1 able for each fiscal year to award grants under sub- 2 section (b) for a fiscal year, the Secretary shall— 3 ‘‘(A) award 5 percent to Indian Tribes, 4 Tribal organizations, and Urban Indian organi- 5 zations; and 6 ‘‘(B) of the amount remaining after appli- 7 cation of subparagraph (A), set aside up to 15 8 percent for awards to States with the highest 9 age-adjusted rate of drug overdose death based 10 on the ordinal ranking of States according to 11 the Director of the Centers for Disease Control 12 and Prevention.’’. 13 Passed the House of Representatives October 20, 2021. Attest: CHERYL L. JOHNSON, Clerk. VerDate Sep 11 2014 00:53 Oct 22, 2021 Jkt 029200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2379.RFS H2379 pbinns on DSKJLVW7X2PROD with BILLS