,,ii #aadth ,,congress #ast ,session ,s4 #adaj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #ba1 #bjae ,mr4 ,markey introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act to provide grants to improve the treatment of substance use disorders4 #a4 ,short title ,this ,act may be cited as the ,treatment and ,recovery ,investment ,act4 #b4 ,opioid treatment and recovery initiative ,subpart #a of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq47 is amended-- 7#a7 by redesignating the second section #ead relating to the methamphetamine and amphetamine treatment initiative 7#db ,u4,s4,c4 #bij;bb-#i7 as section #ead;,b2 and 7#b7 by adding at the end the following3 #ead;,c4 ,opioid treatment and recovery initiative 7a7 ,grants 7#a7 ,authority to make grants ,the ,director of the ,center for ,substance ,abuse ,treatment may award grants to the ,state agencies responsible for administering funds received under the substance abuse prevention and treatment block grant program under title ,,xix1 units of local government that have a high rate1 or have had a rapid increase1 in the use of1 or death related to the use of1 heroin or other opioids1 including prescription opioids1 and ,indian tribes or tribal organizations 7as defined in section #d of the ,indian ,health ,care ,improvement ,act71 in order to permit such entities to expand evidence-based treatment activities and related recovery services in the specific geographical areas of such entities where there exists a need to address the use of1 or death related to the use of1 heroin or other opioids4 7#b7 ,recipients ,grants awarded under paragraph 7#a7 shall be directed to the substance abuse directors of the ,states and the appropriate tribal government authorities of the ,indian tribes4 7#c7 ,nature of activities ,grant funds awarded under paragraph 7#a7 shall be used for activities that are based on reliable scientific evidence of efficacy in the treatment of problems related to the use or misuse of heroin or other opioids4 7b7 ,geographic distribution ,the ,director shall ensure that grants awarded under subsection 7a7 are distributed equitably among the various regions of the ,united ,states and among rural1 urban1 and suburban areas that are affected by the use of heroin or other opioids4 7c7 ,evaluation and reporting ,a ,state agency1 unit of local government1 or ,indian tribe or tribal organization receiving a grant under subsection 7a7 shall provide the ,director with aggregate data and other information determined by the ,director to be necessary to enable the ,director-- 7#a7 to evaluate the success of the grant program involved in achieving its purposes2 and 7#b7 to prepare and submit the report to ,congress on an annual basis4 7d7 ,additional activities ,in carrying out this section1 the ,director shall-- 7#a7 disseminate widely such findings derived from the evaluation conducted under subsection 7c7 as the ,director considers appropriate2 7#b7 provide ,states1 ,indian tribes1 and tribal organizations1 and health care providers with technical assistance in connection with the provision of evidence-based treatment for problems related to heroin and other opioids2 and 7#c7 give priority to applications for grants under this section that support recovery and related services as a critical component of the grant program1 including comprehensive social services that assist with housing1 employment1 or education4 7e7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section1 #bg1jjj1jjj for fiscal year #bjaf1 and such sums as may be necessary for each of fiscal years #bjaf through #bjbj4 7#b7 ,use of certain funds ,of the funds appropriated to carry out this section in any fiscal year under paragraph 7#a71 the lesser of #e percent of such funds or #a1jjj1jjj shall be available to the ,director for purposes of carrying out subsection 7c74 4 #c4 ,grants for enhancing primary care access for opioid dependent pregnant and parenting women ,subpart #a of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq471 as amended by section #b1 is further amended by adding at the end the following3 #ead;,d4 ,grants for enhancing primary care access for opioid dependent pregnant and parenting women 7a7 ,in general ,the ,director of the ,center for ,substance ,abuse ,treatment shall award grants to ,state substance abuse agencies1 ,indian tribes or tribal organizations 7as defined in section #d of the ,indian ,health ,care ,improvement ,act71 and public nonprofit entities for the purpose of enhancing access to primary care and related services for pregnant and parenting women diagnosed with opioid dependence4 7b7 ,use of funds ,amount awarded under a grant under subsection 7a7 may be used to assist health care providers or facilities caring for pregnant and parenting opioid dependent women to provide the following services3 7#a7 ,clinically appropriate trauma informed gender-specific services that are based on reliable scientific evidence of efficacy in the treatment of problems related to substance use disorder4 7#b7 ,prenatal and postpartum care4 7#c7 ,child care for infants and other children under the age of #ah of the opioid dependent woman4 7#d7 ,prevention and wellness services1 including nutrition education1 exercise instruction1 and training in other life and coping skills4 7#e7 ,developmental and therapeutic services for children of opioid dependent woman4 7#f7 ,domestic violence services4 7#g7 ,educational services for women on proper care for newborns with neonatal abstinence syndrome and other clinical indications for newborns related to substance use during pregnancy4 7#h7 ,parenting courses4 7#i7 ,,hiv_/,,aids and ,hepatitis ,c care and services4 7#aj7 ,dental services4 7#aa7 ,recovery coaches and mentors that can assist in supporting the opioid dependent woman in achieving long term recovery according to the needs of the woman4 7#ab7 ,case management services1 including assistance in establishing eligibility for public programs1 housing assistance1 job training1 educational or vocational opportunities1 transportation1 and other related activities4 7c7 ,length of grant ,each grant awarded under subsection 7a7 shall be for a period of #e years4 7d7 ,additional activities ,the ,director shall-- 7#a7 collect and evaluate data regarding activities supported by grants awarded under subsection 7a72 7#b7 give priority in awarding grants to applicants that are meeting a geographical need for substance use disorder services for pregnant1 postpartum or parenting women2 and 7#c7 give priority in awarding grants to entities that are collaborating with ,state health care1 public health1 criminal justice1 and child welfare agencies as well as local ,federally qualified health centers for the purpose of enhancing access to primary care and related services for pregnant and parenting women diagnosed with opioid dependence4 7e7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section1 #ae1jjj1jjj for fiscal year #bjaf1 and such sums as may be necessary for each of fiscal years #bjaf through #bjbj4 7#b7 ,use of certain funds ,of the funds appropriated to carry out this section in any fiscal year1 the lesser of #e percent of such funds or #a1jjj1jjj shall be available to the ,director for purposes of carrying out subsection 7d74 4 #d4 ,adolescent treatment programs ,subpart #a of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq471 as amended by section #c1 is further amended by adding at the end the following3 #ead;,e4 ,grants to improve access to treatment and recovery for adolescents 7a7 ,in general ,the ,secretary1 acting through the ,director of the ,center for ,substance ,abuse ,treatment1 shall award grants1 contracts1 or cooperative agreements to eligible ,state substance abuse agencies and other entities determined appropriate by the ,director for the purpose of increasing the capacity of substance use disorder treatment and recovery services for adolescents4 7b7 ,eligibility ,to be eligible to receive a grant1 contract1 or cooperative agreement under subsection 7a7 an entity shall-- 7#a7 prepare and submit to the ,director an application at such time1 in such manner1 and contain such information as the ,director may require1 including a plan for the evaluation of any activities carried out with the funds provided under this section2 7#b7 ensure that all entities receiving support under the grant1 contract1 or cooperative agreement comply with all applicable ,state licensure or certification requirements regarding the provision of the services involved2 and 7#c7 provide the ,director with periodic evaluations of the progress of the activities funded under this section and an evaluation at the completion of such activities1 as the ,director determines to be appropriate4 7c7 ,priority ,in awarding grants1 contracts1 and cooperative agreements under subsection 7a71 the ,director shall give priority to applicants who propose to fill a demonstrated geographic need for adolescent specific residential treatment services4 7d7 ,use of funds ,amounts awarded under grants1 contracts1 or cooperative agreements under this section may be used to enable health care providers or facilities that provide treatment and recovery assistance for adolescents with a substance use disorder to provide the following services3 7#a7 ,individualized patient centered care that is specific to circumstances of the individual patient4 7#b7 ,clinically appropriate1 trauma-informed1 gender-specific and age appropriate treatment services that are based on reliable scientific evidence of efficacy in the treatment of problems related to substance use disorders4 7#c7 ,clinically appropriate care to address treatment for substance use and any co-occurring physical and mental health disorders at the same location1 and through access to primary care services4 7#d7 ,coordination of treatment services with recovery and other social support1 including educational1 vocational training1 assistance with the juvenile justice system1 child welfare1 and mental health agencies4 7#e7 ,aftercare and long-term recovery support1 including peer support services4 7e7 ,duration of assistance ,grants1 contracts1 and cooperative agreements awarded under subsection 7a7 shall be for a period of not to exceed #e years4 7f7 ,additional activities ,the ,director shall-- 7#a7 collect and evaluate the activities carried out with amount received under subsection 7a72 7#b7 disseminate widely such significant information derived from the evaluation as the ,secretary considers appropriate4 7g7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to carry out this section1 #be1jjj1jjj for fiscal year #bjaf1 and such sums as may be necessary for each of fiscal years #bjaf through #bjbj4 7#b7 ,use of certain funds ,of the funds appropriated to carry out this section in any fiscal year1 the lesser of #e percent of such funds or #a1jjj1jjj shall be available to the ,director for purposes of carrying out subsection 7f74 4 #e4 ,grants to enhance and expand recovery support services ,subpart #a of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq471 as amended by section #d1 is further amended by adding at the end the following3 #ead;,f4 ,grants to enhance and expand recovery support services 7a7 ,in general ,the ,secretary1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall award grants to ,state substance abuse agencies and non-profit organizations to develop1 expand1 and enhance recovery support services for individuals with substance use disorders4 7b7 ,eligible entities ,in the case of an applicant that is not a ,state substance abuse agency1 to be eligible to receive a grant under this section1 the entity shall-- 7#a7 prepare and submit to the ,secretary an application at such time1 in such manner1 and contain such information as the ,secretary may require1 including a plan for the evaluation of any activities carried out with the funds provided under this section2 7#b7 demonstrate the inclusion of individuals in recovery from a substance use disorder in leadership levels or governing bodies of the entity2 7#c7 have as a primary mission the provision of long-term recovery support for substance use disorders2 and 7#d7 be accredited by the ,council on the ,accreditation of ,peer ,recovery ,support ,services or meet any applicable ,state certification requirements regarding the provision of the recovery services involved4 7c7 ,use of funds ,amounts awarded under a grant under this section shall be used to provide for the following activities3 7#a7 ,educating and mentoring that assists individuals and families with substance use disorders in navigating systems of care4 7#b7 ,peer recovery support services which include peer coaching and mentoring4 7#c7 ,recovery-focused community education and outreach programs1 including training on the use of all forms of opioid overdose antagonists used to counter the effects of an overdose4 7#d7 ,training1 mentoring1 and education to develop and enhance peer mentoring and coaching4 7#e7 ,programs aimed at identifying and reducing stigma and discriminatory practices that serve as barriers to substance use disorder recovery and treatment of these disorders4 7#f7 ,developing partnerships between networks that support recovery and other community organizations and services1 including-- 7,a7 public and private substance use disorder treatment programs and systems2 7,b7 health care providers2 7,c7 recovery-focused addiction and recovery professionals2 7,d7 faith-based organizations2 7,e7 organizations focused on criminal justice reform2 7,f7 schools2 and 7,g7 social service agencies in the community1 including educational1 juvenile justice1 child welfare1 housing and mental health agencies4 7d7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #g1jjj1jjj for fiscal year #bjaf1 and such sums as may be necessary for each of fiscal years #bjaf through #bjbj4 4 #f4 ,increasing the authorization of the substance abuse prevention and treatment block grant ,section #aice7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#ce7;a77 is amended by striking #b1jjj1jjj1jjj for fiscal year #bjja1 and such sums as may be necessary for each of the fiscal years #bjjb and #bjjc and inserting #b1bgj1jjj1jjj for fiscal year #bjaf4 ,for each fiscal year beginning with fiscal year #bjag1 there are authorized to be so appropriated1 an amount equal to the amount authorized for the previous fiscal year under this subsection increased by the annual percentage increase in the ,consumer ,price ,index for such year4 #g4 ,study on treatment infrastructure ,not later than one year after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall initiate an evaluation1 and submit to ,congress a report1 of the in-patient and outpatient treatment capacity1 availability1 and needs of the ,united ,states1 which shall include-- 7#a7 the capacity of acute residential or inpatient detoxification programs2 7#b7 the capacity of inpatient clinical stabilization programs1 transitional residential support services1 and residential rehabilitation programs2 7#c7 the capacity of demographic specific residential or inpatient treatment programs1 such as those designed for pregnant women or adolescents2 7#d7 geographical differences of the availability of residential and outpatient treatment and recovery options for substance use disorders across the continuum of care2 7#e7 the availability of residential and outpatient treatment programs that offer treatment options based on reliable scientific evidence of efficacy for the treatment of substance use disorders1 including the use of ,food and ,drug ,administration-approved medicines and evidence-based nonpharmacological therapies2 7#f7 the number of patients in residential and specialty outpatient treatment services for substance use disorders2 and 7#g7 an assessment of the need for residential and outpatient treatment for substance use disorders across the continuum of care4