,,ii #aaeth ,,congress #b;d ,session ,s4 #bfhj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,april #af1 #bjah ,mr4 ,alexander 7for himself and ,mrs4 ,murray7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to address the opioid crisis4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,opioid ,crisis ,response ,act of #bjah4 7b7 ,table of contents ,the table of contents of this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4 ,,title ,i--,reauthorization of ,cures funding ,sec4 #aja4 ,state response to the opioid abuse crisis4 ,,title ,,ii--,research and innovation ,sec4 #bja4 ,advancing cutting-edge research4 ,sec4 #bjb4 ,pain research4 ,,title ,,iii--,medical ,products and ,controlled ,substances ,safety ,sec4 #cja4 ,clarifying ,,fda regulation of non-addictive pain products4 ,sec4 #cjb4 ,clarifying ,,fda packaging authorities4 ,sec4 #cjc4 ,strengthening ,,fda and ,,cbp coordination and capacity4 ,sec4 #cjd4 ,clarifying ,,fda post-market authorities4 ,sec4 #cje4 ,first responder training4 ,sec4 #cjf4 ,disposal of controlled substances of a deceased hospice patient by employees of a hospice program4 ,sec4 #cjg4 ,,gao study and report on hospice safe drug management4 ,sec4 #cjh4 ,delivery of a controlled substance by a pharmacy to be administered by injection1 implantation1 or intrathecal pump4 ,,title ,,iv--,treatment and recovery ,sec4 #dja4 ,comprehensive opioid recovery centers4 ,sec4 #djb4 ,program to support coordination and continuation of care for drug overdose patients4 ,sec4 #djc4 ,alternatives to opioids4 ,sec4 #djd4 ,peer support technical assistance4 ,sec4 #dje4 ,medication-assisted treatment for recovery from addiction4 ,sec4 #djf4 ,national recovery housing best practices4 ,sec4 #djg4 ,addressing economic and workforce impacts of the opioid crisis4 ,sec4 #djh4 ,youth prevention and recovery4 ,sec4 #dji4 ,plans of safe care4 ,sec4 #daj4 ,regulations relating to special registration for telemedicine4 ,sec4 #daa4 ,national ,health ,service ,corps behavioral and mental health professionals providing obligated service in schools and other community-based settings4 ,sec4 #dab4 ,loan repayment for substance use disorder treatment providers4 ,sec4 #dac4 ,improving treatment for pregnant and postpartum women4 ,sec4 #dad4 ,early interventions for pregnant women and infants4 ,,title ,v--,prevention ,sec4 #eja4 ,study on prescribing limits4 ,sec4 #ejb4 ,programs for health care workforce4 ,sec4 #ejc4 ,education and awareness campaigns4 ,sec4 #ejd4 ,enhanced controlled substance overdoses data collection1 analysis1 and dissemination4 ,sec4 #eje4 ,preventing overdoses of controlled substances4 ,sec4 #ejf4 ,,cdc surveillance and data collection for child1 youth1 and adult trauma4 ,sec4 #ejg4 ,reauthorization of ,,nasper4 ,sec4 #ejh4 ,jessie's ,law4 ,sec4 #eji4 ,development and dissemination of model training programs for substance use disorder patient records4 ,sec4 #eaj4 ,communication with families during emergencies4 ,sec4 #eaa4 ,prenatal and postnatal health4 ,sec4 #eab4 ,surveillance and education regarding infections associated with injection drug use and other risk factors4 ,sec4 #eac4 ,task force to develop best practices for trauma-informed identification1 referral1 and support4 ,sec4 #ead4 ,grants to improve trauma support services and mental health care for children and youth in educational settings4 ,sec4 #eae4 ,national ,child ,traumatic ,stress ,initiative4 ,i ,reauthorization of ,cures funding #aja4 ,state response to the opioid abuse crisis 7a7 ,in general ,section #ajjc of the #bast ,century ,cures ,act 7,public ,law #aad-bee7 is amended-- 7#a7 in subsection 7a7-- 7,a7 by striking the authorization of appropriations under subsection 7b7 to carry out the grant program described in subsection 7c7 and inserting subsection 7h7 to carry out the grant program described in subsection 7b72 and 7,b7 by inserting after and ,indian tribes after ,states2 7#b7 by striking subsection 7b72 7#c7 by redesignating subsections 7c7 through 7e7 as subsections 7b7 through 7d71 respectively2 7#d7 by redesignating subsection 7f7 as subsection 7j72 7#e7 in subsection 7b71 as so redesignated-- 7,a7 in paragraph 7#a7-- 7i7 in the paragraph heading1 by inserting and ,indian tribe after ,state2 7ii7 by striking ,states for the purpose of addressing the opioid abuse crisis within such ,states and inserting ,states and ,indian tribes for the purpose of addressing the opioid abuse crisis within such ,states and ,indian tribes2 7iii7 by inserting or ,indian tribes after preference to ,states2 and 7iv7 by inserting before the period of the second sentence or other ,indian tribes1 as applicable2 and 7,b7 in paragraph 7#b7-- 7i7 in the matter preceding subparagraph 7,a71 by striking to a ,state2 7ii7 in subparagraph 7,a71 by striking ,state2 7iii7 in subparagraph 7,c71 by inserting preventing diversion of controlled substances1 after treatment programs12 and 7iv7 in subparagraph 7,e71 by striking as the ,state determines appropriate1 related to addressing the opioid abuse crisis within the ,state and inserting as the ,state or ,indian tribe determines appropriate1 related to addressing the opioid abuse crisis within the ,state1 including directing resources in accordance with local needs related to substance use disorders2 7#f7 in subsection 7c71 as so redesignated1 by striking subsection 7c7 and inserting subsection 7b72 7#g7 in subsection 7d71 as so redesignated-- 7,a7 in the matter preceding paragraph 7#a71 by striking the authorization of appropriations under subsection 7b7 and inserting subsection 7h72 and 7,b7 in paragraph 7#a71 by striking subsection 7c7 and inserting subsection 7b72 and 7#h7 by inserting after subsection 7d71 as so redesignated1 the following3 7e7 ,indian tribes 7#a7 ,definition ,for purposes of this section1 the term ,indian tribe has the meaning given such term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#b7 ,appropriate mechanisms ,the ,secretary1 in consultation with ,indian tribes1 shall identify and establish appropriate mechanisms for tribes to demonstrate or report the information as required under subsections 7b71 7c71 and 7d74 7f7 ,report to ,congress ,not later than #a year after the date on which amounts are first awarded1 after the date of enactment of the ,opioid ,crisis ,response ,act of #bjah1 pursuant to subsection 7b71 and annually thereafter1 the ,secretary shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a report summarizing the information provided to the ,secretary in reports made pursuant to subsection 7c71 including the purposes for which grant funds are awarded under this section and the activities of such grant recipients4 7g7 ,technical ,assistance ,the ,secretary1 including through the ,tribal ,training and ,technical ,assistance ,center of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall provide ,state agencies and ,indian tribes1 as applicable1 with technical assistance concerning grant application and submission procedures under this section1 award management activities1 and enhancing outreach and direct support to rural and underserved communities and providers in addressing the opioid crisis4 7h7 ,authorization of appropriations ,for purposes of carrying out the grant program under subsection 7b71 there are authorized to be appropriated #ejj1jjj1jjj for each of fiscal years #bjai through #bjba1 to remain available until expended4 7i7 ,set aside ,of the amounts made available for each fiscal year to award grants under subsection 7b7 for a fiscal year1 #e percent of such amount for such fiscal year shall be made available to ,indian tribes1 and up to #ae percent of such amount for such fiscal year may be set aside for ,states with the highest age-adjusted mortality rate associated with opioid use disorders based on the ordinal ranking of ,states according to the age-adjusted overdose mortality rates of the ,centers for ,disease ,control and ,prevention4 4 7b7 ,previously appropriated amounts 7#a7 ,appropriation of amounts remaining in ,account ,any unobligated amounts remaining1 on the date of enactment of this ,act1 in the ,account ,for the ,state ,response to the ,opioid ,abuse ,crisis established under section #ajjc7;b7 of the #bast ,century ,cures ,act 7,public ,law #aad-bee7 7as in effect on the day before the date of enactment of this ,act7 are hereby appropriated to the ,secretary of ,health and ,human ,services for purposes of carrying out the grant program under subsection 7b7 of section #ajjc of the #bast ,century ,cures ,act 7,public ,law #aad-bee7 7as redesignated by subsection 7a77#c7 of this section74 7#b7 ,available until expended ,amounts appropriated under paragraph 7#a7 of this subsection or section #ajjc7;b77#c7 of the #bast ,century ,cures ,act 7as in effect on the day before the date of enactment of this ,act7 shall remain available until expended4 7c7 ,conforming amendment ,section #ajjd7;c7 of the #bast ,century ,cures ,act 7,public ,law #aad-bee7 is amended by striking 1 the ,,fda ,innovation ,account1 or the ,account ,for the ,state ,response to the ,opioid ,abuse ,crisis and inserting or the ,,fda ,innovation ,account4 ,,ii ,research and innovation #bja4 ,advancing cutting-edge research ,section #djb7n77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhb7n77#a77 is amended-- 7#a7 in subparagraph 7,a71 by striking or2 7#b7 in subparagraph 7,b71 by striking the period and inserting 2 or2 and 7#c7 by adding at the end the following3 7,c7 high impact cutting-edge research that fosters scientific creativity and increases fundamental biological understanding leading to the prevention1 diagnosis1 or treatment of diseases and disorders1 or research urgently required to respond to a public health threat4 4 #bjb4 ,pain research ,section #dji;,j7b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhdq7b77 is amended-- 7#a7 in paragraph 7#e7-- 7,a7 in subparagraph 7,a71 by striking and treatment of pain and diseases and disorders associated with pain and inserting treatment1 and management of pain and diseases and disorders associated with pain1 including information on best practices for utilization of non-pharmacologic treatments1 non-addictive medical products1 and other drugs approved1 or devices approved or cleared1 by the ,food and ,drug ,administration2 7,b7 in subparagraph 7,b71 by striking on the symptoms and causes of pain2 and inserting the following3 8on-- 7i7 the symptoms and causes of pain2 7ii7 the diagnosis1 prevention1 treatment1 and management of pain2 and 7iii7 risk factors for1 and early warning signs of1 substance use disorders2 and 2 7,c7 by striking subparagraphs 7,c7 through 7,e7 and inserting the following3 7,c7 make recommendations to the ,director of ,,nih-- 7i7 to ensure that the activities of the ,national ,institutes of ,health and other ,federal agencies are free of unnecessary duplication of effort2 7ii7 on how best to disseminate information on pain care2 and 7iii7 on how to expand partnerships between public entities and private entities to expand collaborative1 cross-cutting research4 2 7#b7 by redesignating paragraph 7#f7 as paragraph 7#g72 and 7#c7 by inserting after paragraph 7#e7 the following3 7#f7 ,report ,the ,director of ,,nih shall ensure that recommendations and actions taken by the ,director with respect to the topics discussed at the meetings described in paragraph 7#d7 are included in appropriate reports to ,congress4 4 ,,iii ,medical ,products and ,controlled ,substances ,safety #cja4 ,clarifying ,,fda regulation of non-addictive pain products 7a7 ,public ,meetings ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 acting through the ,commissioner of ,food and ,drugs1 shall hold not less than one public meeting to address the challenges and barriers of developing non-addictive medical products intended to treat pain or addiction1 which may include-- 7#a7 the manner by which the ,secretary may incorporate the risks of misuse and abuse of a controlled substance 7as defined in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb7 into the risk benefit assessment under section #eje7;e7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee7;e771 section #eaj7k7 of such ,act 7#ba ,u4,s4,c4 #cfj7k771 or section #eae7;c7 of such ,act 7#ba ,u4,s4,c4 #cfj;e7c771 as applicable2 7#b7 the application of novel clinical trial designs 7consistent with section #cjba of the #bast ,century ,cures ,act 7,public ,law #aad-bee771 use of real world evidence 7consistent with section #eje;,f of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee;g771 and use of patient experience data 7consistent with section #efi;,c of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cfj;bbb-#h;c77 for the development of non-addictive medical products intended to treat pain or addiction2 7#c7 the evidentiary standards and the development of opioid sparing data for inclusion in the labeling of medical products2 and 7#d7 the application of eligibility criteria under sections #ejf and #eae;,b of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cef1 #cfj;e-#c7 for non-addictive medical products intended to treat pain or addiction4 7b7 ,guidance ,not less than one year after the public meetings are conducted under subsection 7a7 the ,secretary shall issue one or more final guidance documents1 or update existing guidance documents1 to help address challenges to developing non-addictive medical products to treat pain or addiction4 ,such guidance documents shall include information regarding-- 7#a7 how the ,food and ,drug ,administration may apply sections #ejf and #eae;,b of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cef1 #cfj;e-#c7 to non-addictive medical products intended to treat pain or addiction1 including the circumstances under which the ,secretary-- 7,a7 may apply the eligibility criteria under such sections #ejf and #eae;,b to non-opioid or non-addictive medical products intended to treat pain or addiction2 7,b7 considers the risk of addiction of controlled substances approved to treat pain when establishing unmet medical need2 and 7,c7 considers pain1 pain control1 or pain management in assessing whether a disease or condition is a serious or life-threatening disease or condition2 7#b7 the methods by which sponsors may evaluate acute and chronic pain1 endpoints for non-addictive medical products intended to treat pain1 the manner in which endpoints and evaluations of efficacy will be applied across and within review divisions1 taking into consideration the etiology of the underlying disease1 and the manner in which sponsors may use surrogate endpoints1 intermediate endpoints1 and real world evidence2 7#c7 the manner in which the ,food and ,drug ,administration will assess evidence to support the inclusion of opioid sparing data in the labeling of non-addictive medical products intended to treat pain1 including-- 7,a7 data collection methodologies1 including the use of novel clinical trial designs 7consistent with section #cjba of the #bast ,century ,cures ,act 7,public ,law #aad-bee771 and real world evidence 7consistent with section #eje;,f of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee;g771 as appropriate1 to support product labeling2 7,b7 ethical considerations of exposuring subjects to controlled substances in clinical trials to develop opioid sparing data and considerations on data collection methods that reduce harm1 which may include the reduction of opioid use as a clinical benefit2 7,c7 endpoints1 including primary1 secondary1 and surrogate endpoints1 to evaluate the reduction of opioid use2 7,d7 best practices for communication between sponsors and the agency on the development of data collection methods1 including the initiation of data collection2 and 7,e7 the appropriate format to submit such data results to the ,secretary2 and 7#d7 the circumstances under which the ,food and ,drug ,administration considers misuse and abuse of drugs in making determinations of safety under paragraphs 7#b7 and 7#d7 of subsection 7d7 of section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee7 and in finding that a drug is unsafe under paragraph 7#a7 or 7#b7 of subsection 7e7 of such section4 7c7 ,definitions ,in this section-- 7#a7 the term medical product means a drug 7as defined in section #bja7;g77#a7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba7;g77#a7771 biological product 7as defined in section #cea7;i7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bfb7;i7771 or device 7as defined in section #bja7;h7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba7;h7772 and 7#b7 the term opioid sparing means reducing1 replacing1 or avoiding the use of opioids or other controlled substances4 #cjb4 ,clarifying ,,fda packaging authorities ,section #eje-a7;e7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee-a7;e77 is amended by adding at the end the following3 7#d7 ,serious adverse drug experience ,the ,secretary may require a risk evaluation mitigation strategy for a drug for which there is a serious risk of an adverse drug experience described in subparagraph 7,b7 or 7,c7 of subsection 7b77#a71 taking into consideration the factors described in subparagraphs 7,c7 and 7,d7 of subsection 7f77#b71 which may include requiring that-- 7,a7 the drug be made available for dispensing to certain patients in unit dose packaging1 packaging that provides a set duration1 or other packaging system that the ,secretary determines may help mitigate such serious risk2 or 7,b7 the drug be dispensed to certain patients with a safe disposal packaging or safe disposal system for purposes of rendering unused drugs non-retrievable 7as defined in section #acjj4je of title #ba1 ,code of ,federal ,regulations 7or any successor regulation77 if the ,secretary has determines that such safe disposal packaging or system may help mitigate such serious risk and exists in sufficient quantities1 in consultation with other relevant ,federal agencies with authorities over drug packaging4 4 #cjc4 ,strengthening ,,fda and ,,cbp coordination and capacity 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 acting through the ,commissioner of ,food and ,drugs1 shall coordinate with the ,secretary of ,homeland ,security to carry out activities related to customs and border protection and response to illegal controlled substances and drug imports1 including at sites of import 7such as international mail facilities74 ,such ,secretaries may carry out such activities through a memorandum of understanding between the ,food and ,drug ,administration and the ,united ,states ,customs and ,border ,protection4 7b7 ,,fda import facilities and inspection capacity ,in carrying out this section1 the ,secretary shall-- 7#a7 in collaboration with the ,secretary of ,homeland ,security and the ,postmaster ,general of the ,united ,states ,postal ,service1 provide that import facilities in which the ,food and ,drug ,administration operates or carries out activities related to drug imports within the international mail facilities include-- 7,a7 facility upgrades and improved capacity in order to increase and improve inspection and detection capabilities1 which may include1 as the ,secretary determines appropriate-- 7i7 improvements to facilities1 such as upgrades or renovations1 and support for the maintenance of existing import facilities and sites to improve coordination between ,federal agencies2 7ii7 the construction of1 or upgrades to1 laboratory capacity for purposes of detection and testing of imported goods2 7iii7 upgrades to the security of import facilities2 and 7iv7 innovative technology and equipment to facilitate improved and near-real-time information sharing between the ,food and ,drug ,administration1 the ,department of ,homeland ,security1 and the ,united ,states ,postal ,service2 and 7,b7 provide import facilities in which the ,food and ,drug ,administration operates or carries out activities related to drug imports within the international mail facilities with innovative technology1 including controlled substance detection and testing equipment and other applicable technology1 and collaborate with ,united ,states ,customs and ,border ,protection to share near-real-time information1 including information about test results1 as appropriate1 provided that such technology is interoperable with technology used by other relevant ,federal agencies1 including the ,united ,states ,customs and ,border ,protection1 as applicable1 and is used in the time and manner that the ,secretary determines appropriate4 7c7 ,report ,not later than #f months after the date of enactment of this ,act1 the ,secretary1 in consultation with the ,secretary of ,homeland ,security and the ,postmaster ,general of the ,united ,states ,postal ,service1 shall report to the relevant committees of ,congress on the implementation of this section1 including a summary of progress made towards near-real-time information sharing and the interoperability of such technologies4 7d7 ,authorization of appropriations ,out of amounts otherwise available to the ,secretary1 the ,secretary may allocate such sums as may be necessary for purposes of carrying out this section4 #cjd4 ,clarifying ,,fda post-market authorities ,section #eje-a7;b77#a77;,e7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee-a7;b77#a77;,e77 is amended by striking of the drug and inserting of the drug1 which may include reduced effectiveness that is not in accordance with the labeling of such drug4 #cje4 ,first responder training ,section #edf of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#a7 is amended-- 7#a7 in subsection 7c7-- 7,a7 in paragraph 7#b71 by striking and at the end2 7,b7 in paragraph 7#c71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following3 7#d7 train and provide resources for first responders and members of other key community sectors on safety around fentanyl and other dangerous illicit drugs to protect themselves from exposure to fentanyl and respond appropriately when exposure occurs4 2 7#b7 in subsection 7d71 by inserting 1 and safety around fentanyl and other dangerous illicit drugs before the period2 7#c7 in subsection 7f7-- 7,a7 in paragraph 7#c71 by striking and at the end2 7,b7 in paragraph 7#d71 by striking the period and inserting a semicolon2 and 7,c7 by adding at the end the following3 7#e7 the number of first responders and members of other key community sectors trained on safety around fentanyl and other dangerous illicit drugs4 2 and 7#d7 in subsection 7g71 by striking #ab1jjj1jjj for each of fiscal years #bjag through #bjba and inserting #cf1jjj1jjj for each of fiscal years #bjai through #bjbc4 #cjf4 ,disposal of controlled substances of a deceased hospice patient by employees of a hospice program 7a7 ,in general ,section #cjb7;g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbb7;g77 is amended by adding at the end the following3 7#e7 7,a7 ,an employee of a qualified hospice program acting within the scope of employment may handle1 in the place of residence of a hospice patient1 any controlled substance that was lawfully dispensed to the hospice patient1 for the purpose of assisting in the disposal of the controlled substance after the hospice patient's death4 7,b7 ,in this paragraph3 7i7 ,the term employee of a qualified hospice program means a physician1 physician assistant1 or nurse who-- 7,i7 is employed by1 or is acting pursuant to arrangements made with1 a qualified hospice program2 and 7,,ii7 is licensed or certified to perform such employment or acts in accordance with applicable ,state law4 7ii7 ,the terms hospice care and hospice program have the meanings given those terms in section #ahfa7;dd7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7dd774 7iii7 ,the term hospice patient means an individual receiving hospice care4 7iv7 ,the term qualified hospice program means a hospice program that-- 7,i7 has written policies and procedures for employees of the hospice program to use assisting in the disposal of the controlled substances of a hospice patient after the hospice patient's death2 7,,ii7 at the time when the controlled substances are first ordered-- 7aa7 provides a copy of the written policies and procedures to the hospice patient or hospice patient representative and the family of the hospice patient2 7bb7 discusses the policies and procedures with the hospice patient or hospice patient's representative and the hospice patient's family in a language and manner that such individuals understand to ensure that such individuals are informed regarding the safe disposal of controlled substances2 and 7cc7 documents in the clinical record of the hospice patient that the written policies and procedures were provided and discussed with the hospice patient or hospice patient's representative2 and 7,,iii7 at the time when an employee of the hospice program assists in the disposal of controlled substances of a hospice patient1 documents in the clinical record of the hospice patient a list of all controlled substances disposed of4 7,c7 ,the ,attorney ,general may1 by regulation1 include additional types of licensed medical professionals in the definition of the term employee of a qualified hospice program under subparagraph 7,b74 4 7b7 ,no registration required ,section #cjb7;c7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbb7;c77 is amended by adding at the end the following3 7#d7 ,an employee of a qualified hospice program for the purpose of assisting in the disposal of a controlled substance in accordance with subsection 7g77#e74 4 7c7 ,guidance ,the ,attorney ,general may issue guidance to qualified hospice programs to assist the programs in satisfying the requirements under paragraph 7#e7 of section #cjb7;g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbb7;g771 as added by subsection 7a74 7d7 ,state and local authority ,nothing in this section or the amendments made by this section shall be construed to prevent a ,state or local government from imposing additional controls or restrictions relating to the regulation of the disposal of controlled substances in hospice care or hospice programs4 #cjg4 ,,gao study and report on hospice safe drug management 7a7 ,study 7#a7 ,in general ,the ,comptroller ,general of the ,united ,states 7in this section referred to as the ,comptroller ,general7 shall conduct a study on the requirements applicable to and challenges of hospice programs with regard to the management and disposal of controlled substances in the home of an individual4 7#b7 ,contents ,in conducting the study under paragraph 7#a71 the ,comptroller ,general shall include-- 7,a7 an overview of challenges encountered by hospice programs regarding the disposal of controlled substances1 such as opioids1 in a home setting1 including any key changes in policies1 procedures1 or best practices for the disposal of controlled substances over time2 and 7,b7 a description of ,federal requirements1 including requirements under the ,medicare program1 for hospice programs regarding the disposal of controlled substances in a home setting1 and oversight of compliance with those requirements4 7b7 ,report ,not later than #ah months after the date of enactment of this ,act1 the ,comptroller ,general shall submit to ,congress a report containing the results of the study conducted under subsection 7a71 together with recommendations1 if any1 for such legislation and administrative action as the ,comptroller ,general determines appropriate4 #cjh4 ,delivery of a controlled substance by a pharmacy to be administered by injection1 implantation1 or intrathecal pump 7a7 ,in general ,the ,controlled ,substances ,act is amended by inserting after section #cji 7#ba ,u4,s4,c4 #hbi7 the following3 #cji;,a4 ,delivery of a controlled substance by a pharmacy to an administering practitioner 7a7 ,in general ,notwithstanding section #ajb7aj71 a pharmacy may deliver a controlled substance to a practitioner in accordance with a prescription that meets the requirements of this title and the regulations issued by the ,attorney ,general under this title1 for the purpose of administering of the controlled substance by the practitioner if-- 7#a7 the controlled substance is delivered by the pharmacy to the prescribing practitioner or the practitioner administering the controlled substance1 as applicable1 at the location listed on the practitioner's certificate of registration issued under this title2 7#b7 7,a7 in the case of administering of the controlled substance for the purpose of maintenance or detoxification treatment under section #cjc7;g77#b7-- 7i7 the practitioner who issued the prescription is a qualifying practitioner authorized under1 and acting within the scope of that section2 and 7ii7 the controlled substance is to be administered by injection or implantation2 or 7,b7 in the case of administering of the controlled substance for a purpose other than maintenance or detoxification treatment1 the controlled substance is to be administered by a practitioner through use of an intrathecal pump2 7#c7 the pharmacy and the practitioner are authorized to conduct the activities specified in this section under the law of the ,state in which such activities take place2 7#d7 the prescription is not issued to supply any practitioner with a stock of controlled substances for the purpose of general dispensing to patients2 7#e7 except as provided in subsection 7b71 the controlled substance is to be administered only to the patient named on the prescription not later than #ad days after the date of receipt of the controlled substance by the practitioner2 and 7#f7 notwithstanding any exceptions under section #cjg1 the prescribing practitioner1 and the practitioner administering the controlled substance1 as applicable1 maintain complete and accurate records of all controlled substances delivered1 received1 administered1 or otherwise disposed of under this section1 including the persons to whom controlled substances were delivered and such other information as may be required by regulations of the ,attorney ,general4 7b7 ,modification of number of days before which controlled substance shall be administered 7#a7 ,initial #b-year period ,during the #b-year period beginning on the date of enactment of this section1 the ,attorney ,general1 in coordination with the ,secretary1 may reduce the number of days described in subsection 7a77#e7 if the ,attorney ,general determines that such reduction will-- 7,a7 reduce the risk of diversion2 or 7,b7 protect the public health4 7#b7 ,modifications after submission of report ,after the date on which the report described in subsection 7c7 is submitted1 the ,attorney ,general1 in coordination with the ,secretary1 may modify the number of days described in subsection 7a77#e74 7#c7 ,minimum number of days ,any modification under this subsection shall be for a period of not less than #g days4 4 7b7 ,study and report ,not later than #b years after the date of enactment of this section1 the ,comptroller ,general of the ,united ,states shall conduct a study and submit to ,congress a report on access to and potential diversion of controlled substances administered by injection1 implantation1 or through the use of an intrathecal pump4 7c7 ,technical and conforming amendment ,the table of contents for the ,comprehensive ,drug ,abuse ,prevention and ,control ,act of #aigj is amended by inserting after the item relating to section #cji the following3 ,sec4 #cji;,a4 ,delivery of a controlled substance by a pharmacy to an administering practitioner4 4 ,,iv ,treatment and recovery #dja4 ,comprehensive opioid recovery centers 7a7 ,in general ,part ,d of title ,v of the ,public ,health ,service ,act is amended by adding at the end the following new section3 #eej4 ,comprehensive opioid recovery centers 7a7 ,in general ,the ,secretary1 acting through the ,assistant ,secretary for ,mental ,health and ,substance ,use1 shall award grants on a competitive basis to eligible entities to establish or operate a comprehensive opioid recovery center 7referred to in this section as a ,center74 ,a ,center may be a single entity or an integrated delivery network4 7b7 ,grant period 7#a7 ,in general ,a grant awarded under subsection 7a7 shall be for a period not more than #e years4 7#b7 ,renewal ,a grant awarded under subsection 7a7 may be renewed1 on a competitive basis1 for additional periods of time1 as determined by the ,secretary4 ,in determining whether to renew a grant under this paragraph1 the ,secretary shall consider the data submitted under subsection 7h74 7c7 ,minimum number of grants ,the ,secretary shall allocate the amounts made available under subsection 7j7 such that not fewer than #aj grants may be awarded4 ,not more than one grant shall be made to entities in a single ,state for any one period4 7d7 ,application ,in order to be eligible for a grant under subsection 7a71 an entity shall submit an application to the ,secretary at such time and in such manner as the ,secretary may require4 ,such application shall include-- 7#a7 evidence that such entity carries out1 or is capable of coordinating with other entities to carry out1 the activities described in subsection 7g72 and 7#b7 such other information as the ,secretary may require4 7e7 ,priority ,in awarding grants under subsection 7a71 the ,secretary shall give priority to eligible entities located in a ,state with an overdose mortality rate that is above the national overdose mortality rate1 as determined by the ,director of the ,centers for ,disease ,control and ,prevention4 7f7 ,preference ,in awarding grants under subsection 7a71 the ,secretary may give preference to eligible entities utilizing technology-enabled collaborative learning and capacity building models1 including such models as defined in section #b of the ,expanding ,capacity for ,health ,outcomes ,act 7,public ,law #aad-bgj2 #acj ,stat4 #acie71 to conduct the activities described in this section4 7g7 ,center activities ,each ,center shall1 at a minimum1 carry out the following activities directly1 through referral1 or through contractual arrangements1 which may include carrying out such activities through technology-enabled collaborative learning and capacity building models described in subsection 7f73 7#a7 ,treatment and recovery services ,each ,center shall-- 7,a7 ensure that intake and evaluations meet the individualized clinical needs of patients1 including by offering assessments for services and care recommendations through independent1 evidence-based verification processes for reviewing patient placement in treatment settings2 7,b7 provide the full continuum of treatment services1 including-- 7i7 all drugs approved by the ,food and ,drug ,administration to treat substance use disorders2 7ii7 medically supervised withdrawal management that includes patient evaluation1 stabilization1 and readiness for and entry into treatment2 7iii7 counseling provided by a program counselor or other certified professional who is licensed and qualified by education1 training1 or experience to assess the psychological and sociological background of patients1 to contribute to the appropriate treatment plan for the patient1 and to monitor patient progress2 7iv7 treatment1 as appropriate1 for patients with co-occurring substance use and mental health disorders2 7v7 residential rehabilitation1 and outpatient and intensive outpatient programs2 7vi7 recovery housing2 7vii7 community-based and peer recovery support services2 7viii7 job training1 job placement assistance1 and continuing education assistance to support reintegration into the workforce2 and 7ix7 other best practices to provide the full continuum of treatment and services1 as determined by the ,secretary2 7,c7 periodically conduct patient assessments to support sustained and clinically significant recovery1 as defined by the ,assistant ,secretary for ,mental ,health and ,substance ,use2 7,d7 administer an onsite pharmacy and provide toxicology services1 for purposes of carrying out this section2 and 7,e7 operate a secure1 confidential1 and interoperable electronic health information system4 7#b7 ,outreach ,each ,center shall carry out outreach activities to publicize the services offered through the ,centers1 which may include-- 7,a7 training and supervising outreach staff1 as appropriate1 to work with ,state and local health departments1 health care providers1 ,state and local education agencies1 institutions of higher education1 ,state and local workforce development boards1 ,state and local community action agencies1 public safety officials1 first responders1 child welfare agencies1 as appropriate1 and other community partners and the public1 including patients1 to identify and respond to community needs1 and ensuring that such entities are aware of the services of the ,center2 and 7,b7 disseminating and making publicly available1 including through the internet1 evidence-based resources that educate professionals and the public on opioid use disorder and other substance use disorders1 including co-occurring substance use and mental health disorders4 7h7 ,data reporting and program oversight ,with respect to a grant awarded under subsection 7a71 not later than #ij days after the end of the first year of the grant period1 and annually thereafter for the duration of the grant period 7including the duration of any renewal period for such grant71 the entity shall submit data1 as appropriate1 to the ,secretary regarding-- 7#a7 the programs and activities funded by the grant2 7#b7 health outcomes of the population of individuals with a substance use disorder who received services from the ,center1 evaluated by an independent program evaluator through the use of outcomes measures1 as determined by the ,secretary2 7#c7 the retention rate of program participants2 and 7#d7 any other information that the ,secretary may require for the purpose of ensuring that the ,center is complying with all the requirements of the grant1 including providing the full continuum of services described in subsection 7g77#a77;,b74 7i7 ,privacy ,the provisions of this section1 including with respect to data reporting and program oversight1 shall be subject to all applicable ,federal and ,state privacy laws4 7j7 ,authorization of appropriations ,there is authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjai through #bjbc for purposes of carrying out this section4 4 7b7 ,reports to ,congress 7#a7 ,preliminary report ,not later than #c years after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall submit to ,congress a preliminary report that analyzes data submitted under section #eej7;h7 of the ,public ,health ,service ,act1 as added by subsection 7a74 7#b7 ,final report ,not later than #b years after submitting the preliminary report required under paragraph 7#a71 the ,secretary of ,health and ,human ,services shall submit to ,congress a final report that includes-- 7,a7 an evaluation of the effectiveness of the comprehensive services provided by the ,centers established or operated pursuant to section #eej of the ,public ,health ,service ,act1 as added by subsection 7a71 on health outcomes of the population of individuals with substance use disorder who receive services from the ,center1 which shall include an evaluation of the effectiveness of services for treatment and recovery support and to reduce relapse1 recidivism1 and overdose2 and 7,b7 recommendations1 as appropriate1 regarding ways to improve ,federal programs related to substance use disorders1 which may include dissemination of best practices for the treatment of substance use disorders to health care professionals4 #djb4 ,program to support coordination and continuation of care for drug overdose patients 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary7 shall identify or facilitate the development of best practices for-- 7#a7 emergency treatment of known or suspected drug overdose2 7#b7 coordination and continuation of care and treatment1 including1 as appropriate1 through referrals1 of individuals after an opioid overdose2 and 7#c7 the provision of overdose reversal medication1 as appropriate4 7b7 ,grant establishment and participation 7#a7 ,in general ,the ,secretary shall award grants on a competitive basis to eligible entities to support implementation of voluntary programs for care and treatment of individuals after an opioid overdose1 as appropriate1 which may include implementation of the best practices described in subsection 7a74 7#b7 ,eligible entity ,in this section1 the term eligible entity means an entity that offers treatment or other services for individuals in response to1 or following1 drug overdoses or a drug overdose4 7#c7 ,application ,an eligible entity desiring a grant under this section1 in consultation with the principal agency of a ,state in which such entity offers treatment or other services that is responsible for carrying out the block grant for prevention and treatment of substance abuse under subpart ,,ii of part ,b of title ,,xix of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#ba et seq471 shall submit an application to the ,secretary1 at such time and in such manner as the ,secretary may require1 that includes-- 7,a7 evidence that such eligible entity carries out1 or is capable of coordinating with other entities to carry out1 the activities described in paragraph 7#d72 and 7,b7 such additional information as the ,secretary may require4 7#d7 ,use of grant funds ,an eligible entity awarded a grant under this section shall use such grant funds to-- 7,a7 hire or utilize recovery coaches to help support recovery1 including by-- 7i7 connecting patients to a continuum of care services1 such as-- 7,i7 treatment and recovery support programs2 7,,ii7 programs that provide non-clinical recovery support services2 7,,iii7 peer support networks2 7,,iv7 recovery community organizations2 7,v7 health care providers1 including physicians and other providers of behavioral health and primary care2 7,,vi7 educational and vocational schools2 7,,vii7 employers2 7,,viii7 housing services2 and 7,,ix7 child welfare agencies2 7ii7 providing education on overdose prevention to patients2 and 7iii7 providing other services the ,secretary determines necessary to help ensure continued connection with recovery support services2 7,b7 establish policies and procedures that address the provision of overdose reversal medication1 the administration of all drugs approved by the ,food and ,drug ,administration to treat substance use disorder1 and subsequent continuation of1 or referral to1 evidence-based treatment for patients with a substance use disorder who have experienced a non-fatal drug overdose1 in order to prevent relapse1 and reduce recidivism and future overdose2 7,c7 develop or implement best practices for treating non-fatal drug overdoses1 including1 with respect to care coordination and integrated care models1 for long term treatment and recovery options for individuals with a substance use disorder who have experienced a non-fatal drug overdose2 and 7,d7 establish integrated models of care for individuals who have experienced a non-fatal drug overdose which may include patient assessment1 follow up1 and transportation to and from treatment facilities4 7#e7 ,additional permissible uses ,in addition to the uses described in paragraph 7#d71 a grant awarded under this section may be used1 directly or through contractual arrangements1 to provide-- 7,a7 all drugs approved by the ,food and ,drug ,administration to treat substance use disorders1 pursuant to ,federal and ,state law2 7,b7 withdrawal and detoxification services that include patient evaluation1 stabilization1 and preparation for treatment of substance use disorder1 including treatment described in subparagraph 7,a71 as appropriate2 or 7,c7 mental health services provided by a program counselor1 social worker1 therapist1 or other certified professional who is licensed and qualified by education1 training1 or experience to assess the psychosocial background of patients1 to contribute to the appropriate treatment plan for patients with substance use disorder1 and to monitor patient progress4 7#f7 ,preference ,in awarding grants under this section1 the ,secretary shall give preference to eligible entities that meet any or all of the following criteria3 7,a7 ,the eligible entity is a critical access hospital 7as defined in section #ahfa7mm77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7mm77#a7771 a low volume hospital 7as defined in section #ahhf7;d77#ab77;,c77i7 of such ,act 7#db ,u4,s4,c4 #acieww7d77#ab77;,c77i7771 or a sole community hospital 7as defined in section #ahhf7;d77#e77;,d77iii7 of such ,act 7#db ,u4,s4,c4 #acieww7d77#e77;,d77iii7774 7,b7 ,the eligible entity is located in a ,state with an overdose mortality rate that is above the national overdose mortality rate1 as determined by the ,director of the ,centers for ,disease ,control and ,prevention4 7,c7 ,the eligible entity demonstrates that recovery coaches will be placed in both health care settings and community settings4 7#g7 ,period of grant ,a grant awarded to an eligible entity under this section shall be for a period of not more than #e years4 7c7 ,definition ,in this section1 the term recovery coach means an individual-- 7#a7 with knowledge of1 or experience with1 recovery from a substance use disorder2 and 7#b7 who has completed training from1 and is determined to be in good standing by1 a recovery services organization capable of conducting such training and making such determination4 7d7 ,reporting requirements 7#a7 ,reports by grantees ,each eligible entity awarded a grant under this section shall submit to the ,secretary an annual report for each year for which the entity has received such grant that includes information on-- 7,a7 the number of individuals treated by the entity for non-fatal overdoses1 including the number of non-fatal overdoses where overdose reversal medication was administered2 7,b7 the number of individuals administered medication-assisted treatment by the entity2 7,c7 the number of individuals referred by the entity to other treatment facilities after a non-fatal overdose1 the types of such other facilities1 and the number of such individuals admitted to such other facilities pursuant to such referrals2 and 7,d7 the frequency and number of patients with reoccurrences1 including readmissions for non-fatal overdoses and evidence of relapse related to substance abuse disorder4 7#b7 ,report by ,secretary ,not later than #e years after the date of enactment of this ,act1 the ,secretary shall submit to ,congress a report that includes an evaluation of the effectiveness of the grant program carried out under this section with respect to long term health outcomes of the population of individuals who have experienced a drug overdose1 the percentage of patients treated or referred to treatment by grantees1 and the frequency and number of patients who experienced relapse1 were readmitted for treatment1 or experienced another overdose4 7e7 ,privacy ,the requirements of this section1 including with respect to data reporting and program oversight1 shall be subject to all applicable ,federal and ,state privacy laws4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years #bjai through #bjbc4 #djc4 ,alternatives to opioids 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall1 directly or through grants to1 or contracts with1 public and private entities1 provide technical assistance to hospitals and other acute care settings on alternatives to opioids for pain management4 ,the technical assistance provided shall be for the purpose of-- 7#a7 utilizing information from acute care providers including emergency departments and other providers that have successfully implemented alternatives to opioids programs1 promoting non-opioid protocols and medications while appropriately limiting the use of opioids2 7#b7 identifying or facilitating the development of best practices on the use of alternatives to opioids1 which may include pain-management strategies that involve non-addictive medical products1 non-pharmacologic treatments1 and technologies or techniques to identify patients at-risk for opioid use disorder2 7#c7 identifying or facilitating the development of best practices on the use of alternatives to opioids that target common painful conditions and include certain patient populations1 such as geriatric patients1 pregnant women1 and children2 7#d7 disseminating information on the use of alternatives to opioids to providers in acute care settings1 which may include emergency departments1 outpatient clinics1 critical access hospitals1 and ,federally qualified health centers2 and 7#e7 collecting data and reporting on health outcomes associated with the use of alternatives to opioids4 7b7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years #bjai through #bjbc4 #djd4 ,peer support technical assistance 7a7 ,technical assistance for peer support services ,the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 acting through the ,assistant ,secretary for ,mental ,health and ,substance ,abuse1 shall provide technical assistance and support to organizations providing peer support services related to substance use disorder1 including technical assistance and support related to-- 7#a7 training on identifying-- 7,a7 signs of substance use disorder2 7,b7 resources to assist individuals with a substance use disorder1 or resources for families of an individual with a substance use disorder2 and 7,c7 best practices for the delivery of recovery support services2 7#b7 the provision of translation services1 interpretation1 or other such services for clients with limited ,english speaking proficiency2 7#c7 capacity building2 and 7#d7 evaluation and improvement1 as necessary1 of the effectiveness of such peer support services4 7b7 ,best practices ,the ,secretary shall periodically issue best practices related to peer support services for use by organizations that provide peer support services4 7c7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years #bjai through #bjbc4 #dje4 ,medication-assisted treatment for recovery from addiction 7a7 ,repeal of requirement ,to ,update ,regulations ,section #cjc of the ,comprehensive ,addiction and ,recovery ,act of #bjaf 7,public ,law #aad-aih2 #acj ,stat4 #gbj7 is amended by striking subsection 7c74 7b7 ,codification of expansion of maximum number of patients for medication-,assisted treatment ,section #cjc7;g77#b77;,b77iii77,,ii7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 7g77#b77;,b77iii77,,ii77 is amended by striking #ajj each place it appears and inserting #bge4 #djf4 ,national recovery housing best practices 7a7 ,best practices ,the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 in consultation with the ,secretary for ,housing and ,urban ,development1 patients with a history of opioid use disorder1 and other stakeholders1 which may include ,state accrediting entities and reputable providers of1 and analysts of1 recovery housing services1 shall identify or facilitate the development of best practices1 which may include model laws for implementing suggested minimum standards1 for operating recovery housing4 7b7 ,dissemination ,the ,secretary shall disseminate the best practices identified or developed under subsection 7a7 to-- 7#a7 ,state agencies1 which may include the provision of technical assistance to ,state agencies seeking to adopt or implement such best practices2 7#b7 recovery housing entities2 and 7#c7 the public1 as appropriate4 7c7 ,requirements ,in identifying or facilitating the development of best practices under subsection 7a71 the ,secretary1 in consultation with appropriate stakeholders1 shall consider how recovery housing is able to 7including by improving access and adherence to treatment7 support recovery and prevent relapse1 recidivism1 or overdose1 including overdose death4 7d7 ,rule of construction ,nothing in this section shall be construed to provide the ,secretary with the ability to require ,states to adhere to minimum standards in the ,state oversight of recovery housing4 7e7 ,definition ,in this section1 the term recovery housing means a shared living environment free from alcohol and illicit drug use and centered on peer support and connection to services that promote sustained recovery from substance use disorders4 #djg4 ,addressing economic and workforce impacts of the opioid crisis 7a7 ,definitions ,except as otherwise expressly provided1 in this section3 7#a7 ,education provider ,the term education provider means-- 7,a7 an institution of higher education1 as defined in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja72 or 7,b7 a postsecondary vocational institution1 as defined in section #ajb7;c7 of such ,act 7#bj ,u4,s4,c4 #ajjb7;c774 7#b7 ,eligible entity ,the term eligible entity means-- 7,a7 a ,state workforce agency2 7,b7 a ,state board2 7,c7 an outlying area1 as defined in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb72 or 7,d7 a ,tribal entity4 7#c7 ,local area2 local board2 one-stop operator ,the terms local area1 local board1 and one-stop operator have the meanings given such terms in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb74 7#d7 ,local entity ,the term local entity means a local board or one-stop operator4 7#e7 ,participating partnership ,the term participating partnership means a partnership established under subsection 7e77#a7 by a local entity receiving a subgrant under subsection 7d74 7#f7 ,program participant ,the term program participant means an individual who-- 7,a7 is a member of a population of workers described in subsection 7e77#b7 that is served by a participating partnership through the pilot program under this section2 and 7,b7 enrolls with the applicable participating partnership to receive any of the services described in subsection 7e77#c74 7#g7 ,secretary ,the term ,secretary means the ,secretary of ,labor4 7#h7 ,state board ,the term ,state board has the meaning given the term in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb74 7#i7 ,state workforce agency ,the term ,state workforce agency means the lead ,state agency with responsibility for the administration of a program under chapter #b or #c of subtitle ,b of title ,i of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cafa et seq41 #caga et seq474 7#aj7 ,substance use disorder ,the term substance use disorder means such a disorder within the meaning of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa et seq474 7#aa7 ,supportive services ,the term supportive services has the meaning given such term in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb74 7#ab7 ,treatment provider ,the term treatment provider-- 7,a7 means a health care provider that offers services for treating substance use disorders and is licensed in accordance with applicable ,state law to provide such services2 7,b7 accepts health insurance for such services1 including coverage under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq472 and 7,c7 may include-- 7i7 a nonprofit provider of peer recovery support services1 as defined by the ,state involved in regulation or guidance2 7ii7 a community health care provider2 or 7iii7 a ,federally qualified health center 7as defined in section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex774 7#ac7 ,tribal entity ,the term ,tribal entity includes any ,indian tribe1 tribal organization1 ,indian-controlled organization serving ,indians1 ,native ,hawaiian organization1 or ,alaska ,native entity1 as such terms are defined or used in section #aff of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cbba74 7b7 ,pilot program and grants authorized 7#a7 ,in general ,the ,secretary1 in consultation with the ,secretary of ,health and ,human ,services1 shall carry out a pilot program to address economic and workforce impacts associated with a high rate of a substance use disorder4 ,in carrying out the pilot program1 the ,secretary shall make grants1 on a competitive basis1 to eligible entities to enable such entities to make subgrants to local boards and one-stop operators to address the economic and workforce impacts associated with a high rate of a substance use disorder4 7#b7 ,grant amounts ,the ,secretary shall make each such grant in an amount that is not less than #ejj1jjj1 and not more than #e1jjj1jjj1 for a fiscal year4 7c7 ,grant applications 7#a7 ,in general ,an eligible entity applying for a grant under this section shall submit an application to the ,secretary at such time and in such form and manner as the ,secretary may reasonably require1 including the information described in this subsection4 7#b7 ,significant impact on community by opioid abuse and substance use disorder-related problems 7,a7 ,demonstration ,an eligible entity shall include in the application information that demonstrates significant impact on the community by problems related to opioid abuse or another substance use disorder1 by-- 7i7 identifying the communities1 regions1 or local areas that will be served through the grant 7each referred to in this section as a service area72 and 7ii7 showing1 for each such service area1 an increase equal to or greater than the national increase in such problems1 between-- 7,i7 #aiii2 and 7,,ii7 #bjaf or the latest year for which data are available4 7,b7 ,information ,in making the showing described in subparagraph 7,a77ii71 the eligible entity may use information including data on-- 7i7 the incidence or prevalence of opioid abuse and other substance use disorders2 7ii7 the per capita drug overdose mortality rate1 as determined by the ,director of the ,centers for ,disease ,control and ,prevention2 7iii7 the rate of non-fatal hospitalizations related to opioid abuse or another substance use disorder2 or 7iv7 the number of arrests or convictions1 or a relevant law enforcement statistic1 that reasonably shows an increase in opioid abuse or another substance use disorder4 7,c7 ,support for ,state strategy ,the eligible entity shall also include in the application information describing how the proposed services and activities support the ,state's strategy for addressing problems described in subparagraph 7,a7 in specific regions or across the ,state1 outlaying area1 or ,tribal entity4 7#c7 ,economic and employment conditions demonstrate additional ,federal support needed 7,a7 ,demonstration ,an eligible entity shall include in the application information that demonstrates that a high rate of a substance use disorder has caused1 or is coincident to1 an economic or employment downturn in the service area4 7,b7 ,information ,in making the demonstration described in subparagraph 7,a71 the eligible entity may use information including-- 7i7 documentation of any layoff1 announced future layoff1 legacy industry decline1 decrease in an employment or labor market participation rate1 or economic impact1 whether or not the result described in this clause is overtly related to a high rate of a substance use disorder2 7ii7 documentation showing decreased economic activity related to1 caused by1 or contributing to a high rate of a substance use disorder1 including a description of how the service area has been impacted1 or will be impacted1 by such a decrease2 7iii7 in particular1 information on economic indicators1 labor market analyses1 information from public announcements1 and demographic and industry data2 7iv7 information on rapid response activities 7as defined in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb77 that have been or will be conducted1 including demographic data gathered by employer or worker surveys or through other methods2 7v7 data or documentation1 beyond anecdotal evidence1 showing that employers face challenges filling job vacancies due to a lack of skilled workers able to pass a drug test2 or 7vi7 any additional relevant data or information on the economy1 workforce1 or another aspect of the service area to support the application4 7#d7 ,workforce shortage related to treatment workforce 7,a7 ,in general ,an eligible entity may include in the application a demonstration of the workforce shortage in a professional area to be addressed under the grant4 ,such professional areas may include-- 7i7 substance use disorder treatment and related services2 7ii7 non-opioid pain therapy and pain management services2 or 7iii7 mental health care treatment services4 7,b7 ,information to be included ,an eligible entity demonstrating a workforce shortage under subparagraph 7,a7 shall demonstrate the workforce shortage through information that may include-- 7i7 the distance between-- 7,i7 communities affected by opioid abuse or another substance use disorder2 and 7,,ii7 facilities or professionals offering services in the professional area2 7ii7 the maximum capacity of facilities or professionals to serve individuals in an affected community1 or increases in arrests related to opioid abuse or another substance use disorder1 overdose deaths1 or nonfatal overdose emergencies in the community2 or 7iii7 other information that can demonstrate such a shortage4 7d7 ,subgrant authorization and application process 7#a7 ,subgrants authorized 7,a7 ,in general ,an eligible entity receiving a grant under subsection 7b7-- 7i7 may use not more than #e percent of the grant funds for the administrative costs of carrying out the grant2 and 7ii7 shall use the remaining grant funds to make subgrants to local entities in the area served by the eligible entity to carry out the services and activities described in subsection 7e74 7,b7 ,geographic distribution ,in making subgrants under this subsection1 an eligible entity shall ensure1 to the extent practicable1 the equitable geographic distribution 7such as urban and rural distribution7 of areas receiving subgrant funds4 7#b7 ,subgrant application 7,a7 ,in general ,a local entity desiring to receive a subgrant under this subsection shall submit an application at such time and in such and manner as the eligible entity may reasonably require1 including the information described in this paragraph4 7,b7 ,contents ,each application described in subparagraph 7,a7 shall include an analysis of the estimated performance of the local entity in carrying out the proposed services and activities under the subgrant that-- 7i7 uses primary indicators of performance described in section #aaf7;c77#a77;,a77i7 of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cada7;c77#a77;,a77i771 to assess estimated effectiveness of the proposed services and activities1 including the estimated number of individuals with a substance use disorder who may be served by the proposed services and activities2 7ii7 analyzes the record of the local entity in serving individuals with a barrier to employment2 and 7iii7 analyzes the ability of the local entity to establish the partnership described in subsection 7e77#a74 7,c7 ,analysis ,the analysis described in subparagraph 7,b7 may include or utilize-- 7i7 data from the ,national ,center for ,health ,statistics of the ,centers for ,disease ,control and ,prevention2 7ii7 data from the ,center for ,behavioral ,health ,statistics and ,quality of the ,substance ,abuse and ,mental ,health ,services ,administration2 7iii7 ,state vital statistics2 7iv7 municipal police department records2 7v7 reports from local coroners2 or 7vi7 other relevant data4 7e7 ,subgrant services and activities 7#a7 ,formation of partnership 7,a7 ,in general ,each local entity that receives a subgrant under subsection 7d7 shall form a partnership1 established through a written contract or other agreement1 with members described in subparagraph 7,b71 and shall carry out the services and activities described in this subsection through the partnership4 7,b7 ,members of the partnership ,a partnership described in subparagraph 7,a7 shall include #a or more of the following3 7i7 ,the eligible entity4 7ii7 ,a treatment provider4 7iii7 ,an employer or industry organization4 7iv7 ,an education provider4 7v7 ,a justice or law enforcement organization4 7vi7 ,a faith-based or community-based organization4 7vii7 ,other ,state or local agencies4 7viii7 ,other organizations1 as determined to be necessary by the local entity4 7#b7 ,selection of ,population to be served ,a participating partnership shall elect to provide services and activities under the subgrant to one or both of the following populations of workers3 7,a7 ,workers1 including dislocated workers1 new entrants in the workforce1 or incumbent workers 7employed or underemployed71 who are directly or indirectly affected by a high rate of a substance use disorder and each of whom is-- 7i7 an individual who voluntarily confirms that the individual1 or a friend or family member of the individual1 has a history of opioid abuse or another substance use disorder2 or 7ii7 an individual who works or resides in a community substantially impacted by a high rate of a substance use disorder or can otherwise demonstrate job loss as a result of a high rate of a substance use disorder4 7,b7 ,workers1 including dislocated workers1 new entrants in the workforce1 or incumbent workers 7employed or underemployed71 who-- 7i7 seek to transition to professions that support individuals struggling with a substance use disorder or at risk for developing such disorder1 such as professions that provide-- 7,i7 substance use disorder treatment and related services2 7,,ii7 peer recovery support services described in subsection 7a77#ab77;,c77i72 7,,iii7 non-opioid pain therapy and pain management services2 or 7,,iv7 mental health care2 and 7ii7 need new or upgraded skills to better serve such a population of struggling or at-risk individuals4 7#c7 ,services and activities ,each participating partnership shall use funds available through a subgrant under this subsection to carry out #a or more of the following3 7,a7 ,engaging employers ,engaging with employers to-- 7i7 learn about the skill and hiring requirements of employers2 7ii7 learn about the support needed by employers to hire and retain program participants1 and other individuals with a substance use disorder1 and the support needed by such employers to obtain their commitment to testing creative solutions to employing program participants and such individuals2 7iii7 connect employers and workers to on-the-job or customized training programs before or after layoff to help facilitate reemployment2 7iv7 connect employers with an education provider to develop classroom instruction to complement on-the-job learning for program participants and such individuals2 7v7 help employers develop the curriculum design of a work-based learning program for program participants and such individuals2 or 7vi7 help employers employ program participants or such individuals engaging in a work-based learning program for a transitional period before hiring such a program participant or individual for full-time employment of not less than #cj hours a week4 7,b7 ,screening services ,providing screening services1 which may include-- 7i7 using an evidence-based screening method to screen each individual seeking participation in the pilot program to determine whether the individual has a substance use disorder2 7ii7 conducting an assessment of each such individual to determine the services needed for such individual to obtain or retain employment1 including an assessment of strengths and general work readiness2 and 7iii7 accepting walk-ins or referrals from employers1 labor organizations1 or other entities recommending individuals to participate in such program4 7,c7 ,individual treatment and employment plan ,developing an individual treatment and employment plan for each program participant1 which shall include providing a case manager to work with each participant to develop the plan1 which may include-- 7i7 identifying employment and career goals2 7ii7 exploring career pathways that lead to in-demand industries and sectors as determined by the ,state board and the head of the ,state workforce agency2 7iii7 setting appropriate achievement objectives to attain the employment and career goals identified under clause 7i72 or 7iv7 developing the appropriate combination of services to enable the participant to achieve the employment and career goals4 7,d7 ,outpatient treatment and recovery care ,in the case of a participating partnership serving program participants described in paragraph 7#b77;,a77i7 with a substance use disorder1 providing individualized and group outpatient treatment and recovery services for such program participants that are offered during the day and evening1 and on weekends4 ,such treatment and recovery services-- 7i7 shall be based on a model that utilizes combined behavioral interventions and other evidence-based or evidence-informed interventions2 and 7ii7 may include additional services such as-- 7,i7 health1 mental health1 addiction1 or other forms of outpatient treatment that may impact a substance use disorder and co-occurring conditions2 7,,ii7 drug testing for a current substance use disorder prior to enrollment in career or training services or prior to employment2 7,,iii7 linkages to community services1 including services offered by partner organizations designed to support program participants2 and 7,,iv7 referrals to health care1 including referrals to substance use disorder treatment and mental health services4 7,e7 ,supportive services ,providing supportive services1 which shall include services such as-- 7i7 coordinated wraparound services to provide maximum support for program participants to ensure that the program participants maintain employment and recovery for not less than #ab months1 as appropriate2 7ii7 assistance in establishing eligibility for assistance under ,federal1 ,state1 and local programs providing health services1 mental health services1 housing services1 transportation services1 or social services2 7iii7 peer recovery support services described in subsection 7a77#ab77;,c77i72 7iv7 networking and mentorship opportunities2 or 7v7 any supportive services determined necessary by the local entity4 7,f7 ,career and job training services ,offering career services and training services1 and related services1 concurrently or sequentially with the services provided under subparagraphs 7,b7 through 7,e74 ,such services shall include the following3 7i7 ,services provided to program participants who are in a pre-employment stage of the program4 ,such services may include-- 7,i7 initial education and skills assessments2 7,,ii7 traditional classroom training funded through individual training accounts under chapter #c of subtitle ,b of title ,i of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #caga et seq472 7,,iii7 services to promote employability skills such as punctuality1 personal maintenance skills1 and professional conduct2 7,,iv7 in-depth interviewing and evaluation to identify employment barriers and to develop individual employment plans2 7,v7 career planning that includes-- 7aa7 career pathways leading to in-demand1 high-wage jobs2 and 7bb7 job coaching1 job matching1 and job placement services2 7,,vi7 provision of payments and fees for employment and training-related applications1 tests1 and certifications2 or 7,,vii7 any other appropriate career service or training service described in section #acd7;c7 of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cagd7;c774 7ii7 ,services provided to program participants during their first #f months of employment to ensure job retention1 which may include-- 7,i7 case management and support services1 including a continuation of the services described in clause 7i72 7,,ii7 a continuation of skills training1 and career and technical education1 described in clause 7i7 that is conducted in collaboration with the employers of such participants2 7,,iii7 mentorship services and job retention support for such participants2 or 7,,iv7 targeted training for managers and workers working with such participants 7such as mentors71 and human resource representatives in the business in which such participants are employed4 7iii7 ,services to assist program participants in maintaining employment for not less than #ab months1 as appropriate4 7,g7 ,proven and promising practices ,leading efforts in the service area to identify and promote proven and promising strategies and initiatives for meeting the needs of employers and program participants4 7#d7 ,limitations ,a participating partnership may not use-- 7,a7 more than #e percent of the funds received under a subgrant under subsection 7d7 for the administrative costs of the partnership2 7,b7 more than #aj percent of the funds received under such subgrant for the provision of treatment and recovery services1 as described in paragraph 7#c77;,d72 or 7,c7 more than #aj percent of the funds received under such subgrant for the provision of supportive services described in paragraph 7#c77;,e7 to program participants4 7f7 ,performance accountability 7#a7 ,reports ,the ,secretary shall establish quarterly reporting requirements for recipients of grants and subgrants under this section that1 to the extent practicable1 are based on the performance accountability system under section #aaf of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cada71 including the indicators described in subsection 7c77#a77;,a77i7 of such section and the requirements for local area performance reports under subsection 7d7 of such section4 7#b7 ,evaluations 7,a7 ,authority to enter into agreements ,the ,secretary shall ensure that an independent evaluation is conducted on the pilot program carried out under this section to determine the impact of the program on employment of individuals with substance use disorders4 ,the ,secretary shall enter into an agreement with eligible entities receiving grants under this section to pay for all or part of such evaluation4 7,b7 ,methodologies to be used ,the independent evaluation required under this paragraph shall use experimental designs using random assignment or1 when random assignment is not feasible1 other reliable1 evidence-based research methodologies that allow for the strongest possible causal inferences4 7g7 ,funding 7#a7 ,covered fiscal year ,in this subsection1 the term covered fiscal year means any of fiscal years #bjah through #bjbc4 7#b7 ,using funding for national dislocated worker grants ,subject to paragraph 7#d7 and notwithstanding section #acb7;a77#b77;,a7 and subtitle ,d of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cagb7;a77#b77;,a71 #cbba et seq47 or any other provision of law1 the ,secretary may use1 to carry out the pilot program under this section for a covered fiscal year-- 7,a7 funds made available to carry out section #agj of such ,act 7#bi ,u4,s4,c4 #cbbe7 for that fiscal year2 7,b7 funds made available to carry out section #agj of such ,act that remain available for that fiscal year2 and 7,c7 funds that remain available under section #agb7;f7 of such ,act 7#bi ,u4,s4,c4 #cbbg7;f774 7#c7 ,availability of funds ,funds appropriated under section #acf7;c7 of such ,act 7#bi ,u4,s4,c4 #caha7;c77 and made available to carry out section #agj of such ,act for a fiscal year shall remain available for use under paragraph 7#b7 for a subsequent fiscal year until expended4 7#d7 ,limitation ,the ,secretary may not use more than #ajj1jjj1jjj of the funds described in paragraph 7#b7 for any covered fiscal year under this section4 #djh4 ,youth prevention and recovery 7a7 ,substance abuse treatment services for children1 adolescents1 and young adults ,section #ead of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#g7 is amended-- 7#a7 in the section heading1 by striking children and adolescents and inserting children1 adolescents1 and young adults2 7#b7 in subsection 7a77#b71 by striking children1 including and inserting children1 adolescents1 and young adults1 including2 and 7#c7 by striking children and adolescents each place it appears and inserting children1 adolescents1 and young adults4 7b7 ,youth prevention and recovery initiative 7#a7 ,definitions ,in this subsection3 7,a7 ,eligible entity ,the term eligible entity means-- 7i7 a local educational agency that is seeking to establish or expand substance use prevention and recovery support services at one or more high schools2 7ii7 an institution of higher education2 7iii7 a recovery program at an institution of higher education2 7iv7 a local board or one-stop operator2 or 7v7 a nonprofit organization1 excluding a school4 7,b7 ,high school ,the term high school has the meaning given such term in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7,c7 ,institution of higher education ,the term institution of higher education has the meaning given such term in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja7 and includes a postsecondary vocational institution as defined in section #ajb7;c7 of such ,act 7#bj ,u4,s4,c4 #ajjb7;c774 7,d7 ,local education agency ,the term local educational agency has the meaning given the term in section #haja of the ,elementary and ,secondary ,education ,act of #aife4 7,e7 ,local board2 one-stop operator ,the terms local board and one-stop operator have the meanings given such terms in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb74 7,f7 ,recovery program ,the term recovery program means a program-- 7i7 to help children1 adolescents1 or young adults who are recovering from substance use disorders to initiate1 stabilize1 and maintain healthy and productive lives in the community2 and 7ii7 that includes peer-to-peer support delivered by individuals with lived experience in recovery1 and communal activities to build recovery skills and supportive social networks4 7,g7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services1 except as otherwise specified4 7#b7 ,best practices ,the ,secretary1 in consultation with the ,secretary of ,education1 shall-- 7,a7 identify or facilitate the development of evidence-based best practices for prevention of substance misuse and abuse by children1 adolescents1 and young adults1 for appropriate recovery support services1 and for appropriate use of medication-assisted treatment for such individuals1 if applicable2 7,b7 disseminate such best practices to local educational agencies1 institutions of higher education1 recovery programs at institutions of higher education1 local boards1 one-stop operators1 and nonprofit organizations1 as appropriate2 7,c7 conduct a rigorous1 independent evaluation of each grant funded under this subsection1 particularly its impact on the indicators described in paragraph 7#e77;,b72 and 7,d7 provide technical assistance for grantees under this subsection4 7#c7 ,grants authorized ,the ,secretary1 in consultation with the ,secretary of ,education1 shall award #c-year grants1 on a competitive basis1 to eligible entities to enable such entities1 in coordination with ,state agencies responsible for carrying out substance use disorder prevention and treatment programs1 to carry out evidence-based or promising programs for-- 7,a7 prevention of substance abuse and misuse by children1 adolescents1 and young adults2 7,b7 recovery support services for children1 adolescents1 and young adults1 which may include counseling1 job training1 linkages to community-based services1 family support groups1 and recovery coaching2 and 7,c7 treatment or referrals for treatment of substance use disorders1 as appropriate4 7#d7 ,application ,to be eligible for a grant under this subsection1 an entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 ,such application shall include-- 7,a7 a description of the impact of substance use disorders on children1 adolescents1 and young adults enrolled in the local educational agency1 one-stop operator1 local board1 or institution of higher education2 7,b7 a description of how the eligible entity has solicited input from faculty1 teachers1 staff1 families1 students1 and experts in substance use prevention and treatment in developing such application2 7,c7 how the eligible entity plans to use grant funds for evidence-based or promising activities1 in accordance with this subsection to prevent1 provide recovery support for1 and treat substance use disorders amongst such individuals2 7,d7 an assurance that the eligible entity will participate in the evaluation described in paragraph 7#b77;,c72 and 7,e7 a description of how the eligible entity will collaborate with local service providers1 including substance use disorder treatment programs1 providers of mental health services1 and primary care providers1 in carrying out the grant program4 7#e7 ,report ,each eligible entity awarded a grant under this section shall submit to the appropriate committees of ,congress1 a report at such time and in such manner as the ,secretary may require4 ,such report shall include-- 7,a7 a description of how the eligible entity used grant funds1 in accordance with this subsection1 including the number of children1 adolescents1 and young adults reached through programming2 and 7,b7 a description of how the grant program has made an impact on-- 7i7 indicators of student success1 including student well-being and academic achievement2 and 7ii7 substance use disorders amongst children1 adolescents1 and young adults1 including the number of overdoses and deaths amongst children1 adolescents1 and young adults during the grant period4 7#f7 ,authorization of appropriations ,there is authorized to be appropriated1 such sums as may be necessary to carry out this subsection4 #dji4 ,plans of safe care 7a7 ,in general ,section #aje7;a7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajf7;a77 is amended by adding at the end the following3 7#g7 ,grants to ,states to improve and coordinate their response to ensure the safety1 permanency1 and well-being of infants affected by substance use 7,a7 ,program authorized ,the ,secretary shall make grants to ,states for the purpose of assisting child welfare agencies1 social services agencies1 substance use disorder treatment agencies1 public health and mental health agencies1 and maternal and child health agencies to facilitate collaboration in developing1 updating1 and implementing plans of safe care described in section #ajf7;b77#b77;,b77iii74 7,b7 ,distribution of funds 7i7 ,reservations ,of the amounts appropriated under subparagraph 7,h71 the ,secretary shall reserve-- 7,i7 no more than #c percent for the purposes described in subparagraph 7,g72 and 7,,ii7 up to #c percent for grants to ,indian ,tribes and tribal organizations for purposes consistent with this section1 as the ,secretary determines appropriate4 7ii7 ,allotments to ,states and territories ,the ,secretary shall allot the amount appropriated under subparagraph 7,h7 that remains after application of clause 7i7 on a competitive basis to ,states that apply for such a grant4 7iii7 ,selection criteria ,the ,secretary shall allot funds to ,states that demonstrate a strong need for such funds1 and a strong commitment to using such funds1 to meet the purposes described in subparagraph 7,a7 in accordance with subparagraph 7,d74 7,c7 ,application ,a ,state desiring a grant under this paragraph shall submit an application to the ,secretary at such time and in such manner as the ,secretary may require4 ,such application shall include-- 7i7 a description of-- 7,i7 the impact of substance use disorder in such ,state1 including with respect to the substance or class of substances with the highest incidence of abuse in the previous year in such ,state1 including-- 7aa7 the prevalence of substance use disorder in such ,state2 7bb7 the aggregate rate of births in the ,state of infants affected by substance abuse or withdrawal symptoms or a fetal alcohol spectrum disorder 7as determined by hospitals1 insurance claims1 claims submitted to the ,state ,medicaid program1 or other records71 if available and to the extent practicable2 and 7cc7 the number of infants identified1 for whom a plan of safe care was developed1 and for whom a referral was made for appropriate services1 as reported under section #ajf7;d77#ah72 7,,ii7 the challenges the ,state faces in developing and implementing plans of safe care in accordance with section #ajf7;b77#b77;,b77iii72 7,,iii7 the ,state's lead agency for the grant program and how that agency will coordinate with relevant ,state entities and programs1 including the child welfare agency1 the substance use disorder treatment agency1 the public health and mental health agencies1 programs funded by the ,residential ,treatment for ,pregnant and ,postpartum ,women grant program of the ,substance ,abuse and ,mental ,health ,services ,administration under section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a71 the ,state ,medicaid program1 the ,state agency administering the block grant program under title ,v of the ,social ,security ,act 7#db ,u4,s4,c4 #gja et seq471 the ,state agency administering the programs funded under part ,c of the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adca et seq471 the maternal1 infant1 and early childhood home visiting program under section #eaa of the ,social ,security ,act 7#db ,u4,s4,c4 #gaa71 the ,state judicial system1 and other agencies1 as determined by the ,secretary2 7,,iv7 how the ,state will monitor local implementation of plans of safe care1 in accordance with section #ajf7;b77#b77;,b77iii77,,ii72 7,v7 how the ,state meets the requirements of section #aibg of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#bg72 7,,vi7 how the ,state plans to utilize funding authorized under part ,e of title ,,iv of the ,social ,security ,act 7#db ,u4,s4,c4 #fgj et seq47 to assist in carrying out any plan of safe care1 including such funding authorized under section #dga7;e7 of such ,act 7as in effect on ,october #a1 #bjah7 for mental health and substance abuse prevention and treatment services and in-home parent skill-based programs and funding authorized under such section #dgb7;j7 7as in effect on ,october #a1 #bjah7 for children with a parent in a licensed residential family-based treatment facility for substance abuse2 and 7,,vii7 an assessment of the treatment and other services and programs available in the ,state1 to effectively carry out any plan of safe care developed1 including identification of needed treatment1 and other services and programs to ensure the wellbeing of young children and their families affected by substance use disorder1 such as programs carried out under part ,c of the ,individuals with ,disabilities ,education ,act and comprehensive early childhood development services and programs such as ,head ,start programs2 7ii7 a description of how the ,state plans to use funds for activities described in subparagraph 7,d7 for the purposes of ensuring ,state compliance with requirements under clauses 7ii7 and 7iii7 of section #ajf7;b77#b77;,b72 and 7iii7 an assurance that the ,state will-- 7,i7 comply with this ,act and parts ,b and ,e of title ,,iv of the ,social ,security ,act 7#db ,u4,s4,c4 #fba et seq41 #fgj et seq472 and 7,,ii7 comply with requirements to refer a child identified as substance-exposed to early intervention services as required pursuant to a grant under part ,c of the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adca et seq474 7,d7 ,uses of funds ,funds awarded to a ,state under this paragraph may be used for the following activities1 which may be carried out by the ,state directly1 or through grants or subgrants1 contracts1 or cooperative agreements3 7i7 ,improving ,state and local systems with respect to the development and implementation of plans of safe care1 which-- 7,i7 shall include parent and caregiver engagement1 as required under section #ajf7;b77#b77;,b77iii77,i71 regarding available treatment and service options1 which may include resources available for pregnant1 perinatal1 and postnatal women2 and 7,,ii7 may include activities such as-- 7aa7 developing policies1 procedures1 or protocols for the administration of evidence-based and validated screening tools for infants who may be affected by substance use withdrawal symptoms or a fetal alcohol spectrum disorder and pregnant1 perinatal1 and postnatal women whose infants may be affected by substance use withdrawal symptoms or a fetal alcohol spectrum disorder2 7bb7 improving assessments used to determine the needs of the infant and family2 7cc7 improving ongoing case management services2 and 7dd7 improving access to treatment services1 which may be prior to the pregnant woman's delivery date4 7ii7 ,developing policies1 procedures1 or protocols in consultation and coordination with health professionals1 public and private health facilities1 and substance use disorder treatment agencies to ensure that-- 7,i7 appropriate notification to child protective services is made in a timely manner2 7,,ii7 a plan of safe care is in place1 where needed1 before the infant is discharged from the birth or health care facility2 and 7,,iii7 such health and related agency professionals are trained on how to follow such protocols and are aware of the supports that may be provided under a plan of safe care4 7iii7 ,training health professionals and health system leaders1 child welfare workers1 substance use disorder treatment agencies1 and other related professionals such as home visiting agency staff and law enforcement in relevant topics including-- 7,i7 ,state mandatory reporting laws and the referral and notification process2 7,,ii7 the co-occurrence of pregnancy and substance use disorder2 7,,iii7 the clinical guidance about treating substance use disorder in pregnant and postpartum women2 7,,iv7 appropriate screening and interventions for infants affected by substance use disorder1 withdrawal symptoms1 or a fetal alcohol spectrum disorder and the requirements under section #ajf7;b77#b77;,b77iii72 and 7,v7 appropriate strategies to address the mental health needs of the parent and child together4 7iv7 ,establishing partnerships1 agreements1 or memoranda of understanding between the lead agency and health professionals1 health facilities1 child welfare professionals1 substance use disorder and mental health disorder treatment programs1 early childhood education programs1 and maternal and child health and early intervention professionals1 including home visiting providers1 peer-to-peer recovery programs such as parent mentoring programs1 and housing agencies to facilitate the implementation of1 and compliance with section #ajf7;b77#b7 and clause 7ii7 of this subparagraph1 in areas which may include-- 7,i7 developing a comprehensive1 multi-disciplinary assessment and intervention process for infants and their families who are affected by substance use disorder1 withdrawal symptoms1 or a fetal alcohol spectrum disorder1 that includes meaningful engagement with and takes into account the unique needs of each family and addresses differences between legal1 medically supervised substance use1 and substance use disorder2 7,,ii7 ensuring that treatment approaches for serving infants1 pregnant women1 and perinatal and postnatal women whose infants may be affected by substance use1 withdrawal symptoms1 or a fetal alcohol spectrum disorder1 are designed to1 where appropriate1 keep infants with their mothers during both inpatient and outpatient treatment2 and 7,,iii7 increasing access to evidence-based medication-assisted treatment approved by the ,food and ,drug ,administration1 behavioral therapy1 and counseling services for the treatment of substance use disorders1 as appropriate4 7v7 ,developing and updating systems of technology for improved data collection and monitoring under section #ajf7;b77#b77;,b77iii71 including existing electronic medical records1 to measure the outcomes achieved through the plans of safe care1 including monitoring systems to meet the requirements of this ,act and submission of performance measures4 7,e7 ,reporting ,each ,state that receives funds under this paragraph1 for each year such funds are received1 shall submit a report to the ,secretary1 disaggregated by geographic location1 economic status1 and major racial and ethnic groups1 except that such disaggregation shall not be required if the results would reveal personally identifiable information1 on the following3 7i7 ,the number of the infants identified under section #ajf7;b77#b77;,b77ii7 who experienced removal due to parental substance use concerns who are reunified with parents1 and the length of time between such removal and reunification4 7ii7 ,the number of the infants identified under section #ajf7;b77#b77;,b77ii7 who experienced substantiated reports of child abuse or neglect and received differential response while in the care of their birth parents or within #a year after a reunification has occurred4 7iii7 ,the number of the infants identified under section #ajf7;b77#b77;,b77ii7 who experienced a return to out-of-home care within one year after reunification4 7,f7 ,secretary's report to congress ,the ,secretary shall submit an annual report to the ,committee on ,health1 ,education1 ,labor1 and ,pensions and the ,committee on ,appropriations of the ,senate and the ,committee on ,education and the ,workforce and the ,committee on ,appropriations of the ,house of ,representatives that includes the information described in subparagraph 7,e7 and recommendations or observations on the challenges1 successes1 and lessons derived from implementation of the grant program4 7,g7 ,reservation of funds ,the ,secretary shall use the amount reserved under subparagraph 7,b77i77,i7 for the purposes of-- 7i7 providing technical assistance1 including programs of in-depth technical assistance1 to additional ,states1 territories1 and ,indian tribes in accordance with the substance-exposed infant initiative developed by the ,national ,center on ,substance ,abuse and ,child ,welfare2 7ii7 issuing guidance on the requirements of this ,act with respect to infants born with and identified as being affected by substance use or withdrawal symptoms or fetal alcohol spectrum disorder1 as described in clauses 7ii7 and 7iii7 of section #ajf7;b77#b77;,b71 including by-- 7,i7 clarifying key terms2 and 7,,ii7 disseminating best practices on implementation of plans of safe care1 on such topics as differential response1 collaboration and coordination1 and identification and delivery of services1 for different populations2 7iii7 supporting ,state efforts to develop information technology systems to manage plans of safe care2 and 7iv7 preparing the ,secretary's report to ,congress described in subparagraph 7,f74 7,h7 ,authorization of appropriations ,to carry out the program under this paragraph1 there are authorized to be appropriated #fj1jjj1jjj for each of fiscal years #bjai through #bjbc4 4 7b7 ,definition ,section #c of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eaja note7 is amended-- 7#a7 in paragraph 7#g71 by striking 2 and and inserting a semicolon2 7#b7 by redesignating paragraph 7#h7 as paragraph 7#i72 and 7#c7 by inserting after paragraph 7#g7 the following3 7#h7 the term substance use disorder means the abuse of alcohol or other drugs2 and 4 #daj4 ,regulations relating to special registration for telemedicine ,section #caa7;h7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hca7;h77 is amended by striking paragraph 7#b7 and inserting the following3 7#b7 ,regulations 7,a7 ,in general ,not later than #a year after the date of enactment of the ,opioid ,crisis ,response ,act of #bjah1 in consultation with the ,secretary1 and in accordance with the procedure described in subparagraph 7,b71 the ,attorney ,general shall promulgate final regulations specifying-- 7i7 the limited circumstances in which a special registration under this subsection may be issued2 and 7ii7 the procedure for obtaining a special registration under this subsection4 7,b7 ,procedure ,in promulgating final regulations under subparagraph 7,a71 the ,attorney ,general shall-- 7i7 issue a notice of proposed rulemaking that includes a copy of the proposed regulations2 7ii7 provide a period of not less than #fj days for comments on the proposed regulations2 7iii7 finalize the proposed regulation not later than #f months after the close of the comment period2 and 7iv7 publish the final regulations not later than #cj days before the effective date of the final regulations4 4 #daa4 ,national ,health ,service ,corps behavioral and mental health professionals providing obligated service in schools and other community-based settings ,subpart ,,iii of part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bedl et seq47 is amended by adding at the end the following3 #cch,n4 ,behavioral and mental health professionals providing obligated service in schools and other community-based settings 7a7 ,schools and community-,based settings ,an entity to which a ,corps member is assigned under section #ccc may direct such ,corps member to provide service as a behavioral and mental health professional at a school or other community-based setting located in a health professional shortage area4 7b7 ,obligated service 7#a7 ,in general ,any service described in subsection 7a7 that a ,corps member provides may count towards such ,corps member's completion of any obligated service requirements under the ,scholarship ,program or the ,loan ,repayment ,program1 subject to any limitation imposed under paragraph 7#b74 7#b7 ,limitation ,the ,secretary may impose a limitation on the number of hours of service described in subsection 7a7 that a ,corps member may credit towards completing obligated service requirements1 provided that the limitation allows a member to credit service described in subsection 7a7 for not less than #ej percent of the total hours required to complete such obligated service requirements4 7c7 ,rule of construction ,the authorization under subsection 7a7 shall be notwithstanding any other provision of this subpart or subpart ,,ii4 4 #dab4 ,loan repayment for substance use disorder treatment providers 7a7 ,loan repayment for substance use treatment providers ,the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary7 shall enter into contracts under section #cch;,b of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bedl-#a7 with eligible health professionals providing substance use disorder treatment services in substance use disorder treatment facilities1 as defined by the ,secretary4 7b7 ,provision of substance use disorder treatment ,in carrying out the activities described in subsection 7a7-- 7#a7 such facilities shall be located in mental health professional shortage areas designated under section #ccb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e72 7#b7 section #cca7;a77#c77;,d7 of such ,act 7#db ,u4,s4,c4 #bed;d7a77#c77;,d77 shall be applied as if the term primary health services includes health services regarding substance use disorder treatment2 7#c7 section #cca7;a77#c77;,e77i7 of such ,act 7#db ,u4,s4,c4 #bed;d7a77#c77;,e77i77 shall be applied as if the term behavioral and mental health professionals includes masters level1 licensed substance use disorder treatment counselors2 and 7#d7 such professionals and facilities shall provide-- 7,a7 counseling by a program counselor or other certified professional who is licensed and qualified by education1 training1 or experience to assess the psychological and sociological background of patients1 to contribute to the appropriate treatment plan for the patient1 and to monitor progress2 and 7,b7 all drugs approved by the ,food and ,drug ,administration to treat substance use disorders4 7c7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #be1jjj1jjj for each of fiscal years #bjai through #bjbc4 #dac4 ,improving treatment for pregnant and postpartum women 7a7 ,report 7#a7 ,in general ,not later than #fj days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services 7referred to in this subsection as the ,secretary7 shall submit to the appropriate committees of ,congress and make available to the public on the internet website of the ,department of ,health and ,human ,services a report regarding the implementation of the recommendations in the strategy relating to prenatal opioid use1 including neonatal abstinence syndrome1 developed pursuant to section #b of the ,protecting ,our ,infants ,act of #bjae 7,public ,law #aad-ia74 ,such report shall include-- 7,a7 an update on the implementation of the recommendations in the strategy1 including information regarding the agencies involved in the implementation2 and 7,b7 information on additional funding or authority the ,secretary requires1 if any1 to implement the strategy1 which may include authorities needed to coordinate implementation of such strategy across the ,department of ,health and ,human ,services4 7#b7 ,periodic updates ,the ,secretary shall periodically update the report under paragraph 7#a74 7b7 ,residential treatment programs for pregnant and postpartum women ,section #ejh7s7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a7s77 is amended by striking #af1ijj1jjj for each of fiscal years #bjag through #bjba and inserting #bi1ica1jjj for each of fiscal years #bjai through #bjbc4 #dad4 ,early interventions for pregnant women and infants 7a7 ,development of educational materials by ,center for ,substance ,abuse ,prevention ,section #eae7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#ba7;b77 is amended-- 7#a7 in paragraph 7#ac71 by striking and at the end2 7#b7 in paragraph 7#ad71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7#ae7 in cooperation with relevant stakeholders and the ,director of the ,centers for ,disease ,control and ,prevention1 develop educational materials for clinicians to use with pregnant women for shared decisionmaking regarding pain management during pregnancy4 4 7b7 ,guidelines and recommendations by ,center for ,substance ,abuse ,treatment ,section #ejg7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb7b77 is amended-- 7#a7 in paragraph 7#ac71 by striking and at the end2 7#b7 in paragraph 7#ad71 by striking the period at the end and inserting a semicolon2 and 7#c7 by adding at the end the following3 7#ae7 in cooperation with the ,secretary1 implement and disseminate1 as appropriate1 the recommendations in the report entitled ,protecting ,our ,infants ,act3 ,final ,strategy issued by the ,department of ,health and ,human ,services in #bjag2 and 4 7c7 ,support of partnerships by ,center for ,substance ,abuse ,treatment ,section #ejg7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb7b771 as amended by subsection 7b71 is further amended by adding at the end the following3 7#af7 in cooperation with relevant stakeholders1 support public-private partnerships to assist with education about1 and support with respect to1 substance use disorder for pregnant women and health care providers who treat pregnant women and babies4 4 ,v ,prevention #eja4 ,study on prescribing limits ,not later than #b years after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services1 in consultation with the ,attorney ,general1 shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a report on the impact of ,federal and ,state laws and regulations that limit the length1 quantity1 or dosage of opioid prescriptions4 ,such report shall address-- 7#a7 the impact of such limits on-- 7,a7 the incidence and prevalence of overdose related to prescription opioids2 7,b7 the incidence and prevalence of overdose related to illicit opioids2 7,c7 the prevalence of opioid use disorders2 and 7,d7 medically appropriate use of1 and access to1 opioids1 including any impact on travel expenses and pain management outcomes for patients1 whether such limits are associated with significantly higher rates of negative health outcomes1 including suicide1 and whether the impact of such limits differs based on clinical indication for which opioids are prescribed2 7#b7 whether such limits lead to a significant increase in burden for prescribers of opioids or prescribers of treatments for opioid use disorder1 including any impact on patient access to treatment1 and whether any such burden is mitigated by any factors such as electronic prescribing2 and 7#c7 the impact of such limits on diversion or misuse of any controlled substance in schedule ,,ii1 ,,iii1 or ,,iv of section #bjb7;c7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hab7;c774 #ejb4 ,programs for health care workforce 7a7 ,program for education and training in pain care ,section #gei of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;i7 is amended-- 7#a7 in subsection 7a71 by inserting nonprofit after private2 7#b7 in subsection 7b7-- 7,a7 in the matter preceding paragraph 7#a71 by striking award may be made under subsection 7a7 only if the applicant for the award agrees that the program carried out with the award will include and inserting entity receiving an award under this section shall develop a comprehensive education and training plan that includes2 7,b7 in paragraph 7#a7-- 7i7 by inserting preventing1 after diagnosing12 and 7ii7 by inserting non-addictive medical products and non-pharmacologic treatments and after including2 7,c7 in paragraph 7#b7-- 7i7 by inserting ,federal1 ,state1 and local after applicable2 and 7ii7 by striking the degree to which and all that follows through effective pain care and inserting opioids2 7,d7 in paragraph 7#c71 by inserting and1 as appropriate1 non-pharmacotherapy before the semicolon2 7,e7 in paragraph 7#d7-- 7i7 by inserting any before cultural2 and 7ii7 by striking 2 and and inserting 22 7,f7 in paragraph 7#e71 by striking provision of pain care4 and inserting scientific basis of pain and the provision of pain care1 including through non-addictive medical products and non-pharmacologic treatments2 and2 and 7,g7 by adding at the end the following3 7#f7 the dangers of opioid abuse1 detection of early warning signs of opioid use disorders1 and safe disposal options for prescription medications1 including such options provided by law enforcement1 or other innovative deactivation mechanisms4 2 7#c7 in subsection 7d71 by inserting prevention1 after diagnosis12 and 7#d7 in subsection 7e71 by striking #bjaj through #bjab and inserting #bjai through #bjbc4 7b7 ,mental and behavioral health education and training program ,section #gef7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;e-#a7;a77 is amended-- 7#a7 in paragraph 7#a71 by inserting 1 trauma1 after focus on child and adolescent mental health2 and 7#b7 in paragraphs 7#b7 and 7#c71 by inserting trauma-informed care and before substance use disorder prevention and treatment services4 #ejc4 ,education and awareness campaigns ,section #ajb of the ,comprehensive ,addiction and ,recovery ,act of #bjaf 7,public ,law #aad-aih7 is amended-- 7#a7 by amending subsection 7a7 to read as follows3 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention and in coordination with the heads of other departments and agencies1 shall advance education and awareness regarding the risks related to misuse and abuse of opioids1 as appropriate1 which may include developing or improving existing programs1 conducting activities1 and awarding grants that advance the education and awareness of-- 7#a7 the public1 including patients and consumers2 7#b7 patients1 consumers1 and other appropriate members of the public1 regarding such risks related to unused opioids and the dispensing options under section #cji7;f7 of the ,controlled ,substances ,act1 as applicable2 7#c7 providers1 which may include-- 7,a7 providing for continuing education on appropriate prescribing practices2 7,b7 education related to applicable ,state or local prescriber limit laws1 information on the use of non-addictive or non-opioid alternatives for pain management1 and the use of overdose reversal drugs1 as appropriate2 7,c7 disseminating and improving the use of evidence-based opioid prescribing guidelines across relevant health care settings1 as appropriate1 and updating guidelines as necessary2 7,d7 implementing strategies1 such as best practices1 to encourage and facilitate the use of prescriber guidelines1 in accordance with ,state and local law2 and 7,e7 disseminating information to providers about prescribing options for controlled substances1 including such options under section #cji7;f7 of the ,controlled ,substances ,act1 as applicable2 and 7#d7 other appropriate entities4 2 and 7#b7 in subsection 7b7-- 7,a7 by striking opioid abuse each place such term appears and inserting opioid misuse and abuse2 and 7,b7 in paragraph 7#b71 by striking safe disposal of prescription medications and other and inserting non-addictive or non-opioid treatment options1 safe disposal options for prescription medications1 and other applicable4 #ejd4 ,enhanced controlled substance overdoses data collection1 analysis1 and dissemination ,part ,j of title ,,iii of the ,public ,health ,service ,act is amended by inserting after section #cib 7#db ,u4,s4,c4 #bhj;b-#a7 the following3 #cib;,a4 ,enhanced controlled substance overdoses data collection1 analysis1 and dissemination 7a7 ,in general ,the ,director of the ,centers for ,disease ,control and ,prevention1 using the authority provided to the ,director under section #cib1 may-- 7#a7 to the extent practicable1 carry out and expand any controlled substance overdose data collection1 analysis1 and dissemination activity described in subsection 7b72 7#b7 provide training and technical assistance to ,states1 localities1 and ,indian tribes for the purpose of carrying out any such activity2 and 7#c7 award grants to ,states1 localities1 and ,indian tribes for the purpose of carrying out any such activity4 7b7 ,controlled substance overdose data collection and analysis activities ,a controlled substance overdose data collection1 analysis1 and dissemination activity described in this subsection is any of the following activities3 7#a7 ,improving the timeliness of reporting aggregate data to the public1 including data on fatal and nonfatal controlled substance overdoses4 7#b7 ,enhancing the comprehensiveness of controlled substance overdose data by collecting information on such overdoses from appropriate sources such as toxicology reports1 death scene investigations1 and emergency department services4 7#c7 ,modernizing the system for coding causes of death related to controlled substance overdoses to use an electronic-based system4 7#d7 ,using data to help identify risk factors associated with controlled substance overdoses1 including the delivery of certain health care services4 7#e7 ,supporting entities involved in reporting information on controlled substance overdoses1 such as coroners and medical examiners1 to improve accurate testing and reporting of causes and contributing factors of such overdoses1 and analysis of various opioid analogues to controlled substances overdoses4 7#f7 ,working to enable and encourage the access1 exchange1 and use of data regarding controlled substances overdoses among data sources and entities4 7c7 ,controlled substance defined ,in this section1 the term controlled substance has the meaning given that term in section #ajb of the ,controlled ,substances ,act4 4 #eje4 ,preventing overdoses of controlled substances ,part ,j of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;b et seq471 as amended by section #ejd1 is further amended by inserting after section #cib;,a the following3 #cib;,b4 ,preventing overdoses of controlled substances 7a7 ,prevention activities 7#a7 ,in general ,the ,director of the ,centers for ,disease ,control and ,prevention 7referred to in this section as the ,director71 using the authority provided to the ,director under section #cib1 may-- 7,a7 to the extent practicable1 carry out and expand any prevention activity described in paragraph 7#b72 7,b7 provide training and technical assistance to ,states1 localities1 and ,indian tribes to carrying out any such activity2 and 7,c7 award grants to ,states1 localities1 and tribes for the purpose of carrying out any such activity4 7#b7 ,prevention activities ,a prevention activity described in this paragraph is an activity to improve the efficiency and use of a new or currently operating prescription drug monitoring program-- 7,a7 encouraging all authorized users 7as specified by the ,state or other entity7 to register with and use the program2 7,b7 enabling such users to access any data updates in as close to real-time as practicable2 7,c7 providing for a mechanism for the program to notify authorized users of any potential misuse or abuse of controlled substances and any detection of inappropriate prescribing practices relating to such substances2 7,d7 encouraging the analysis of prescription drug monitoring data for purposes of providing de-identified1 aggregate reports based on such analysis to ,state public health agencies1 ,state licensing boards1 and other appropriate ,state agencies1 as permitted under applicable ,federal and ,state law and the policies of the prescription drug monitoring program and not containing any protected health information1 to prevent inappropriate prescribing1 drug diversion1 or abuse and misuse of controlled substances1 and to facilitate better coordination among agencies2 7,e7 enhancing interoperability between the program and any health information technology 7including certified health information technology71 including by integrating program data into such technology2 7,f7 updating program capabilities to respond to technological innovation for purposes of appropriately addressing the occurrence and evolution of controlled substance overdoses2 and 7,g7 facilitating and encouraging data exchange between the program and the prescription drug monitoring programs of other ,states4 7b7 ,additional grants ,the ,director may award grants to ,states1 localities1 and ,indian tribes-- 7#a7 to carry out innovative projects for grantees to rapidly respond to controlled substance misuse1 abuse1 and overdoses1 including changes in patterns of controlled substance use2 and 7#b7 for any other evidence-based activity for preventing controlled substance misuse1 abuse1 and overdoses as the ,director determines appropriate4 7c7 ,research ,the ,director may conduct studies and evaluations to address substance use disorders1 including preventing substance use disorders or other related topics the ,director determines appropriate4 7d7 ,public and prescriber education ,pursuant to section #ajb of the ,comprehensive ,addiction and ,recovery ,act of #bjaf1 the ,director may advance the education and awareness of prescribers and the public regarding the risk of abuse of prescription opioids4 7e7 ,controlled substance defined ,in this section1 the term controlled substance has the meaning given that term in section #ajb of the ,controlled ,substances ,act4 7f7 ,authorization of appropriations ,for purposes of carrying out this section1 section #cib;,a of this ,act1 and section #ajb of the ,comprehensive ,addiction and ,recovery ,act of #bjaf1 there is authorized to be appropriated #dhf1jjj1jjj for each of fiscal years #bjai through #bjbd4 4 #ejf4 ,,cdc surveillance and data collection for child1 youth1 and adult trauma 7a7 ,data collection ,the ,director of the ,centers for ,disease ,control and ,prevention 7referred to in this section as the ,director7 may1 in cooperation with the ,states1 collect and report data on adverse childhood experiences through the ,behavioral ,risk ,factor ,surveillance ,system1 the ,youth ,risk ,behavior ,surveillance ,system1 and other relevant public health surveys or questionnaires4 7b7 ,timing ,the collection of data under subsection 7a7 may occur in fiscal year #bjai and every #b years thereafter4 7c7 ,data from tribal and rural areas ,the ,director shall encourage each ,state that participates in collecting and reporting data under subsection 7a7 to collect and report data from tribal and rural areas within such ,state1 in order to generate a statistically reliable representation of such areas4 7d7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated such sums as may be necessary for the period of fiscal years #bjai through #bjba4 #ejg4 ,reauthorization of ,,nasper ,section #cii,o of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g-#c7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a71 in the matter preceding subparagraph 7,a71 by striking ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration and ,director of the ,centers for ,disease ,control and ,prevention and inserting ,director of the ,centers for ,disease ,control and ,prevention and the ,assistant ,secretary for ,mental ,health and ,substance ,use ,disorders2 and 7,b7 by adding at the end the following3 7#d7 ,states and local governments 7,a7 ,in general ,in the case of a ,state that does not have a prescription drug monitoring program1 a county or other unit of local government within the ,state that has a prescription drug monitoring program shall be treated as a ,state for purposes of this section1 including for purposes of eligibility for grants under paragraph 7#a74 7,b7 ,plan for interoperability ,for purposes of meeting the interoperability requirements under subsection 7c77#c71 a county or other unit of local government shall submit a plan outlining the methods such county or unit of local government will use to ensure the capability of data sharing with other counties and units of local government within the ,state and with other ,states1 as applicable4 2 7#b7 in subsection 7c7-- 7,a7 in paragraph 7#a77;,a77iii7-- 7i7 by inserting as such standards become available1 after interoperability standards12 and 7ii7 by striking generated or identified by the ,secretary or his or her designee and inserting recognized by the ,office of the ,national ,coordinator for ,health ,information ,technology2 and 7,b7 in paragraph 7#c77;,a71 by inserting including electronic health records1 after technology systems12 7#c7 in subsection 7d77#a71 by striking not later than #a week after the date of such dispensing and inserting in as close to real time as practicable2 7#d7 in subsection 7f77#a77;,d71 by striking medicaid and inserting ,medicaid2 7#e7 in subsection 7i71 by inserting 1 in collaboration with the ,national ,coordinator for ,health ,information ,technology and the ,director of the ,national ,institute of ,standards and ,technology1 after ,the ,secretary2 and 7#f7 in subsection 7n71 by striking #bjba and inserting #bjbf4 #ejh4 ,jessie's ,law 7a7 ,best practices 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 in consultation with appropriate stakeholders1 including a patient with a history of opioid use disorder1 an expert in electronic health records1 an expert in the confidentiality of patient health information and records1 and a health care provider1 shall identify or facilitate the development of best practices regarding-- 7,a7 the circumstances under which information that a patient has provided to a health care provider regarding such patient's history of opioid use disorder should1 only at the patient's request1 be prominently displayed in the medical records 7including electronic health records7 of such patient2 7,b7 what constitutes the patient's request for the purpose described in subparagraph 7,a72 and 7,c7 the process and methods by which the information should be so displayed4 7#b7 ,dissemination ,the ,secretary shall disseminate the best practices developed under paragraph 7#a7 to health care providers and ,state agencies4 7b7 ,requirements ,in identifying or facilitating the development of best practices under subsection 7a71 as applicable1 the ,secretary1 in consultation with appropriate stakeholders1 shall consider the following3 7#a7 ,the potential for addiction relapse or overdose1 including overdose death1 when opioid medications are prescribed to a patient recovering from opioid use disorder4 7#b7 ,the benefits of displaying information about a patient's opioid use disorder history in a manner similar to other potentially lethal medical concerns1 including drug allergies and contraindications4 7#c7 ,the importance of prominently displaying information about a patient's opioid use disorder when a physician or medical professional is prescribing medication1 including methods for avoiding alert fatigue in providers4 7#d7 ,the importance of a variety of appropriate medical professionals1 including physicians1 nurses1 and pharmacists1 having access to information described in this section when prescribing or dispensing opioid medication1 consistent with ,federal and ,state laws and regulations4 7#e7 ,the importance of protecting patient privacy1 including the requirements related to consent for disclosure of substance use disorder information under all applicable laws and regulations4 7#f7 ,all applicable ,federal and ,state laws and regulations4 #eji4 ,development and dissemination of model training programs for substance use disorder patient records 7a7 ,initial programs and materials ,not later than #a year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 in consultation with appropriate experts1 shall identify the following model programs and materials 7or if no such programs or materials exist1 recognize private or public entities to develop and disseminate such programs and materials73 7#a7 ,model programs and materials for training health care providers 7including physicians1 emergency medical personnel1 psychiatrists1 psychologists1 counselors1 therapists1 nurse practitioners1 physician assistants1 behavioral health facilities and clinics1 care managers1 and hospitals1 including individuals such as general counsels or regulatory compliance staff who are responsible for establishing provider privacy policies7 concerning the permitted uses and disclosures1 consistent with the standards and regulations governing the privacy and security of substance use disorder patient records promulgated by the ,secretary under section #edc of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;dd-#b7 for the confidentiality of patient records4 7#b7 ,model programs and materials for training patients and their families regarding their rights to protect and obtain information under the standards and regulations described in paragraph 7#a74 7b7 ,requirements ,the model programs and materials described in paragraphs 7#a7 and 7#b7 of subsection 7a7 shall address circumstances under which disclosure of substance use disorder patient records is needed to-- 7#a7 facilitate communication between substance use disorder treatment providers and other health care providers to promote and provide the best possible integrated care2 7#b7 avoid inappropriate prescribing that can lead to dangerous drug interactions1 overdose1 or relapse2 and 7#c7 notify and involve families and caregivers when individuals experience an overdose4 7c7 ,periodic updates ,the ,secretary shall-- 7#a7 periodically review and update the model program and materials identified or developed under subsection 7a72 and 7#b7 disseminate such updated programs and materials to the individuals described in subsection 7a77#a74 7d7 ,input of certain entities ,in identifying1 reviewing1 or updating the model programs and materials under this section1 the ,secretary shall solicit the input of relevant stakeholders4 7e7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 such sums as may be necessary for each of fiscal years #bjai through #bjbc4 #eaj4 ,communication with families during emergencies 7a7 ,promoting ,awareness of ,authorized ,disclosures during ,emergencies ,the ,secretary of ,health and ,human ,services shall annually notify health care providers regarding permitted disclosures during emergencies1 including overdoses1 of certain health information to families and caregivers under ,federal health care privacy laws and regulations4 7b7 ,use of material ,for the purposes of carrying out subsection 7a71 the ,secretary of ,health and ,human ,services may use material produced under section #eji of this ,act or under section #aajjd of the #bast ,century ,cures ,act 7#db ,u4,s4,c4 #acbj;d-#b note74 #eaa4 ,prenatal and postnatal health ,section #cag,l of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ac7 is amended-- 7#a7 in subsection 7a7-- 7,a7 by amending paragraph 7#a7 to read as follows3 7#a7 to collect1 analyze1 and make available data on prenatal smoking1 alcohol and substance abuse and misuse1 including-- 7,a7 data on-- 7i7 the incidence1 prevalence1 and implications of such activities2 and 7ii7 the incidence and prevalence of implications and outcomes1 including neonatal abstinence syndrome and other outcomes associated with such activities2 and 7,b7 to inform such analysis1 additional information or data on family health history1 medication exposures during pregnancy1 demographic information1 such as race1 ethnicity1 geographic location1 and family history1 and other relevant information1 as appropriate2 2 7,b7 in paragraph 7#b7-- 7i7 by striking prevention of and inserting prevention and long-term outcomes associated with2 and 7ii7 by striking illegal drug use and inserting substance abuse and misuse2 7,c7 in paragraph 7#c71 by striking and cessation programs2 and and inserting 1 treatment1 and cessation programs22 7,d7 in paragraph 7#d71 by striking illegal drug use4 and inserting substance abuse and misuse2 and2 and 7,e7 by adding at the end the following3 7#e7 to issue public reports on the analysis of data described in paragraph 7#a71 including analysis of-- 7,a7 long-term outcomes of children affected by neonatal abstinence syndrome2 7,b7 health outcomes associated with prenatal smoking1 alcohol1 and substance abuse and misuse2 and 7,c7 relevant studies1 evaluations1 or information the ,secretary determines to be appropriate4 2 7#b7 in subsection 7b71 by inserting tribal entities1 after local governments12 7#c7 by redesignating subsection 7c7 as subsection 7d72 7#d7 by inserting after subsection 7b7 the following3 7c7 ,coordinating activities ,to carry out this section1 the ,secretary may-- 7#a7 provide technical and consultative assistance to entities receiving grants under subsection 7b72 7#b7 ensure a pathway for data sharing between ,states1 tribal entities1 and the ,centers for ,disease ,control and ,prevention2 7#c7 ensure data collection under this section is consistent with applicable ,state1 ,federal1 and ,tribal privacy laws2 and 7#d7 coordinate with the ,national ,coordinator for ,health ,information ,technology1 as appropriate1 to assist ,states and tribes in implementing systems that use standards recognized by such ,national ,coordinator1 as such recognized standards are available1 in order to facilitate interoperability between such systems and health information technology systems1 including certified health information technology4 2 and 7#e7 in subsection 7d71 as so redesignated1 by striking #bjja through #bjje and inserting #bjai through #bjbc4 #eab4 ,surveillance and education regarding infections associated with injection drug use and other risk factors ,section #cag,n of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ae7 is amended-- 7#a7 by amending the section heading to read as follows3 ,surveillance and education regarding infections associated with injection drug use and other risk factors2 7#b7 in subsection 7a7-- 7,a7 in the matter preceding paragraph 7#a71 by inserting activities before the colon2 7,b7 in paragraph 7#a7-- 7i7 by inserting or maintaining after implementing2 7ii7 by striking hepatitis ,c virus infection 7in this section referred to as ,,hcv infection7 and inserting infections commonly associated with injection drug use1 including viral hepatitis and human immunodeficiency virus12 and 7iii7 by striking such infection and all that follows through the period at the end and inserting such infections1 which may include the reporting of cases of such infections42 7,c7 in paragraph 7#b71 by striking ,,hcv infection and all that follows through the period at the end and inserting infections as a result of injection drug use1 receiving blood transfusions prior to ,july #aiib1 or other risk factors42 7,d7 in paragraphs 7#d7 and 7#e71 by striking ,,hcv infection each place such term appears and inserting infections described in paragraph 7#a72 and 7,e7 in paragraph 7#e71 by striking pediatricians and other primary care physicians1 and obstetricians and gynecologists and inserting substance use disorder treatment providers1 pediatricians1 other primary care providers1 and obstetrician-gynecologists2 7#c7 in subsection 7b7-- 7,a7 by striking directly and and inserting directly or2 and 7,b7 by striking hepatitis ,c1 and all that follows through the period at the end and inserting infections described in subsection 7a77#a742 7#d7 by redesignating subsection 7c7 as subsection 7d72 7#e7 by inserting after subsection 7b7 the following3 7c7 ,definition ,in this section1 the term injection drug use means-- 7#a7 intravenous administration of a substance in schedule ,i of section #bjb7;c7 of the ,controlled ,substances ,act2 7#b7 intravenous administration of a substance in schedule ,,ii1 ,,iii1 ,,iv1 or ,v of section #bjb7;c7 of the ,controlled ,substances ,act that has not been approved for intravenous use under section #eje of the ,federal ,food1 ,drug and ,cosmetic ,act or section #cea of the ,public ,health ,service ,act2 or 7#c7 intravenous administration of a substance in schedule ,,ii1 ,,iii1 ,,iv1 or ,v of section #bjb7;c7 of the ,controlled ,substances ,act that has not been prescribed to the person using the substance4 2 and 7#f7 in subsection 7d71 as so redesignated1 by striking such sums as may be necessary for each of the fiscal years #bjja through #bjje and inserting #dj1jjj1jjj for each of fiscal years #bjai through #bjbc4 #eac4 ,task force to develop best practices for trauma-informed identification1 referral1 and support 7a7 ,establishment ,there is established a task force1 to be known as the ,interagency ,task ,force on ,trauma-,informed ,care 7in this section referred to as the task force7 that shall identify1 evaluate1 and make recommendations regarding best practices with respect to children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma4 7b7 ,membership 7#a7 ,composition ,the task force shall be composed of the heads of the following ,federal departments and agencies1 or their designees3 7,a7 ,the ,centers for ,medicare ,medicaid ,services4 7,b7 ,the ,substance ,abuse and ,mental ,health ,services ,administration4 7,c7 ,the ,agency for ,healthcare ,research and ,quality4 7,d7 ,the ,centers for ,disease ,control and ,prevention4 7,e7 ,the ,indian ,health ,service4 7,f7 ,the ,department of ,veterans ,affairs4 7,g7 ,the ,national ,institutes of ,health4 7,h7 ,the ,food and ,drug ,administration4 7,i7 ,the ,health ,resources and ,services ,administration4 7,j7 ,the ,department of ,defense4 7,k7 ,the ,office of ,minority ,health4 7,l7 ,the ,administration for ,children and ,families4 7,m7 ,the ,office of the ,assistant ,secretary for ,planning and ,evaluation4 7,n7 ,the ,office for ,civil ,rights at the ,department of ,health and ,human ,services4 7,o7 ,the ,office of ,juvenile ,justice and ,delinquency ,prevention of the ,department of ,justice4 7,p7 ,the ,office of ,community ,oriented ,policing ,services of the ,department of ,justice4 7,q7 ,the ,office on ,violence ,against ,women of the ,department of ,justice4 7,r7 ,the ,national ,center for ,education ,evaluation and ,regional ,assistance of the ,department of ,education4 7,s7 ,the ,national ,center for ,special ,education ,research of the ,institute of ,education ,science4 7,t7 ,the ,office of ,elementary and ,secondary ,education of the ,department of ,education4 7,u7 ,the ,office for ,civil ,rights at the ,department of ,education4 7,v7 ,the ,office of ,special ,education and the ,rehabilitative ,services of the ,department of ,education4 7,w7 the ,bureau of ,indian ,affairs of the ,department of the ,interior4 7,x7 ,the ,veterans ,health ,administration of the ,department of ,veterans ,affairs4 7,y7 ,the ,office of ,special ,needs ,assistance ,programs of the ,department of ,housing and ,urban ,development4 7,z7 ,the ,office of ,head ,start of the ,administration for ,children and ,families4 7,,aa7 ,the ,children's ,bureau of the ,administration for ,children and ,families4 7,,bb7 ,the ,bureau of ,indian ,education of the ,department of the ,interior4 7,,cc7 ,such other ,federal agencies as the ,secretaries determine to be appropriate4 7#b7 ,date of appointments ,the heads of ,federal departments and agencies shall appoint the corresponding members of the task force not later than #f months after the date of enactment of this ,act4 7#c7 ,chairperson ,the task force shall be chaired by the ,assistant ,secretary for ,mental ,health and ,substance ,use4 7c7 ,task force duties ,the task force shall-- 7#a7 solicit input from stakeholders1 including frontline service providers1 educators1 mental health professionals1 researchers1 experts in infant1 child1 and youth trauma1 child welfare professionals1 and the public1 in order to inform the activities under paragraph 7#b72 and 7#b7 identify1 evaluate1 make recommendations1 and update such recommendations not less than annually1 to the general public1 the ,secretary of ,education1 the ,secretary of ,health and ,human ,services1 the ,secretary of ,labor1 the ,secretary of the ,interior1 the ,attorney ,general1 and other relevant cabinet ,secretaries1 and ,congress regarding-- 7,a7 a set of evidence-based1 evidence-informed1 and promising best practices with respect to-- 7i7 the identification of infants1 children and youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 and 7ii7 the expeditious referral to and implementation of trauma-informed practices and supports that prevent and mitigate the effects of trauma2 7,b7 a national strategy on how the task force and member agencies will collaborate1 prioritize options for1 and implement a coordinated approach which may include data sharing and the awarding of grants that support children and their families as appropriate1 who have experienced or are at risk of experiencing trauma2 and 7,c7 existing ,federal authorities at the ,department of ,education1 ,department of ,health and ,human ,services1 ,department of ,justice1 ,department of ,labor1 ,department of ,interior1 and other relevant agencies1 and specific ,federal grant programs to disseminate best practices on1 provide training in1 or deliver services through1 trauma-informed practices1 and disseminate such information-- 7i7 in writing to relevant program offices at such agencies to encourage grant applicants in writing to use such funds1 where appropriate1 for trauma-informed practices2 and 7ii7 to the general public through the internet website of the task force4 7d7 ,best practices ,in identifying1 evaluating1 and recommending the set of best practices under subsection 7c71 the task force shall-- 7#a7 include guidelines for providing professional development for front-line services providers1 including school personnel1 providers from child- or youth-serving organizations1 primary and behavioral health care providers1 child welfare and social services providers1 family and juvenile court judges and attorneys1 health care providers1 individuals who are mandatory reporters of child abuse or neglect1 trained nonclinical providers 7including peer mentors and clergy71 and first responders1 in-- 7,a7 understanding and identifying early signs and risk factors of trauma in children and youth1 and their families as appropriate1 including through screening processes2 7,b7 providing practices to prevent and mitigate the impact of trauma1 including by fostering safe and stable environments and relationships2 and 7,c7 developing and implementing procedures or systems that-- 7i7 are designed to quickly refer infants1 children1 youth1 and their families as appropriate1 who have experienced or are at risk of experiencing trauma to the appropriate trauma-informed screening and support1 including treatment appropriate to the age of the child1 and to ensure such infants1 children1 youth1 and family members receive such support2 7ii7 utilize and develop partnerships with local social services organizations1 such as organizations serving youth1 and clinical mental health or health care service providers with expertise in providing support services 7including trauma-informed and evidence-based treatment appropriate to the age of the child7 aimed at preventing or mitigating the effects of trauma2 7iii7 educate children and youth to-- 7,i7 understand and identify the signs1 effects1 or symptoms of trauma2 and 7,,ii7 build the resilience and coping skills to mitigate the effects of experiencing trauma2 7iv7 promote and support multi-generational practices that assist parents1 foster parents1 and kinship and other caregivers in accessing resources related to1 and developing environments conducive to1 the prevention and mitigation of trauma2 and 7v7 collect and utilize data from screenings1 referrals1 or the provision of services and supports1 conducted in the covered settings1 to evaluate and improve processes for trauma-informed support and outcomes that are culturally sensitive1 linguistically appropriate1 and specific to age ranges and sex1 as applicable2 and 7#b7 recommend best practices that are designed to avoid unwarranted custody loss or criminal penalties for parents or guardians in connection with infants1 children1 and youth who have experienced or are at risk of experiencing trauma4 7e7 ,operating plan ,not later than #a year after the date of enactment of this ,act1 the task force shall hold the first meeting4 ,not later than #b years after such date of enactment1 the task force shall submit to the ,secretary of ,education1 ,secretary of ,health and ,human ,services1 ,secretary of ,labor1 ,secretary of the ,interior1 the ,attorney ,general1 and ,congress an operating plan for carrying out the activities of the task force described in paragraphs 7#b7 and 7#c7 of subsection 7c74 ,such operating plan shall include-- 7#a7 a list of specific activities that the task force plans to carry out for purposes of carrying out duties described in subsection 7c77#b71 which may include public engagement2 7#b7 a plan for carrying out the activities under paragraphs 7#b7 and 7#c7 of subsection 7c72 7#c7 a list of members of the task force and other individuals who are not members of the task force that may be consulted to carry out such activities2 7#d7 an explanation of ,federal agency involvement and coordination needed to carry out such activities1 including any statutory or regulatory barriers to such coordination2 7#e7 a budget for carrying out such activities2 and 7#f7 other information that the task force determines appropriate4 7f7 ,final report ,not later than #c years after the date of the first meeting of the task force1 the task force shall submit to the general public1 ,secretary of ,education1 ,secretary of ,health and ,human ,services1 ,secretary of ,labor1 ,secretary of the ,interior1 the ,attorney ,general1 and other relevant cabinet ,secretaries1 and ,congress1 a final report containing all of the findings and recommendations required under this section4 7g7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated such sums as may be necessary for each of fiscal years #bjai through #bjbb4 7h7 ,sunset ,the task force shall on the date that is #fj days after the submission of the final report under subsection 7f71 but not later than ,september #cj1 #bjbb4 #ead4 ,grants to improve trauma support services and mental health care for children and youth in educational settings 7a7 ,grants1 contracts1 and cooperative agreements authorized ,the ,secretary1 in coordination with the ,director of ,substance ,abuse and ,mental ,health ,services ,administration1 is authorized to award grants to1 or enter into contracts or cooperative agreements with1 ,state educational agencies1 local educational agencies1 ,head ,start agencies 7including ,early ,head ,start agencies71 ,state or local agencies that administer public preschool programs1 ,indian tribes or their tribal educational agencies1 a school operated by the ,bureau of ,indian ,education1 a ,regional ,corporation 7as defined in section #c of the ,alaska ,native ,claims ,settlement ,act 7#dc ,u4,s4,c4 #afjb771 or a ,native ,hawaiian educational organization 7as defined in section #fbjg of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #geag771 for the purpose of increasing student access to evidence-based trauma support services and mental health care by developing innovative initiatives1 activities1 or programs to link local school systems with local trauma-informed support and mental health systems1 including those under the ,indian ,health ,service4 7b7 ,duration ,with respect to a grant1 contract1 or cooperative agreement awarded or entered into under this section1 the period during which payments under such grant1 contract or agreement are made to the recipient may not exceed #d years4 7c7 ,use of funds ,an entity that receives a grant1 contract1 or cooperative agreement under this section shall use amounts made available through such grant1 contract1 or cooperative agreement for evidence-based or promising activities1 which shall include any of the following3 7#a7 ,collaborative efforts between school-based service systems and trauma-informed support and mental health service systems to provide1 develop1 or improve prevention1 screening1 referral1 and treatment services to students1 such as by providing universal trauma screenings to identify students in need of specialized support4 7#b7 ,to implement multi-tiered positive behavioral interventions and supports1 or other trauma-informed models of support4 7#c7 ,to provide professional development to teachers1 teacher assistants1 school leaders1 specialized instructional support personnel1 and mental health professionals that-- 7,a7 fosters safe and stable learning environments that prevent and mitigate the effects of trauma1 including through social and emotional learning2 7,b7 improves school capacity to identify1 refer1 and provide services to students in need of trauma support or behavioral health services2 or 7,c7 reflects the best practices developed by the ,interagency ,task ,force on ,trauma-,informed ,care established under section #eac4 7#d7 ,engaging families and communities in efforts to increase awareness of child and youth trauma1 which may include sharing best practices with law enforcement regarding trauma-informed care and working with mental health professionals to provide interventions1 as well as longer term coordinated care within the community for children and youth who have experienced trauma and their families4 7#e7 ,to provide technical assistance to school systems and mental health agencies4 7#f7 ,to evaluate the effectiveness of the program carried out under this section in increasing student access to evidence-based trauma support services and mental health care4 7d7 ,applications ,to be eligible to receive a grant1 contract1 or cooperative agreement under this section1 an entity described in subsection 7a7 shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may reasonably require1 which shall include the following3 7#a7 ,a description of the program to be funded under the grant1 contract1 or cooperative agreement1 including how such program will increase access to evidence-based trauma support services and mental health care for students1 and1 as applicable1 the families of the students4 7#b7 ,a description of how the program will provide linguistically appropriate and culturally competent services4 7#c7 ,a description of how the program will support students and the school in improving the school climate in order to support an environment conducive to learning4 7#d7 ,an assurance that-- 7,a7 persons providing services under the grant1 contract1 or cooperative agreement are adequately trained to provide such services2 and 7,b7 teachers1 school leaders1 administrators1 specialized instructional support personnel1 representatives of local ,indian tribes as appropriate1 other school personnel1 and parents or guardians of students participating in services under this section will be engaged and involved in the design and implementation of the services4 7#e7 ,a description of how the applicant will support and integrate existing school-based services with the program in order to provide mental health services for students1 as appropriate4 7e7 ,interagency agreements 7#a7 ,designation of lead agency ,a recipient of a grant1 contract1 or cooperative agreement under this section shall designate a lead agency to direct the establishment of an interagency agreement among local educational agencies1 juvenile justice authorities1 mental health agencies1 child welfare agencies1 and other relevant entities in the ,state1 in collaboration with local entities1 such as ,indian tribes4 7#b7 ,contents ,the interagency agreement shall ensure the provision of the services described in subsection 7c71 specifying with respect to each agency1 authority1 or entity-- 7,a7 the financial responsibility for the services2 7,b7 the conditions and terms of responsibility for the services1 including quality1 accountability1 and coordination of the services2 and 7,c7 the conditions and terms of reimbursement among the agencies1 authorities1 or entities that are parties to the interagency agreement1 including procedures for dispute resolution4 7f7 ,evaluation ,the ,secretary shall reserve not to exceed #c percent of the funds made available under subsection 7l7 for each fiscal year to-- 7#a7 conduct a rigorous1 independent evaluation of the activities funded under this section2 and 7#b7 disseminate and promote the utilization of evidence-based practices regarding trauma support services and mental health care4 7g7 ,distribution of awards ,the ,secretary shall ensure that grants1 contracts1 and cooperative agreements awarded or entered into under this section are equitably distributed among the geographical regions of the ,united ,states and among tribal1 urban1 suburban1 and rural populations4 7h7 ,rule of construction ,nothing in this section shall be construed-- 7#a7 to prohibit an entity involved with a program carried out under this section from reporting a crime that is committed by a student to appropriate authorities2 or 7#b7 to prevent ,federal1 ,state1 and tribal law enforcement and judicial authorities from exercising their responsibilities with regard to the application of ,federal1 tribal1 and ,state law to crimes committed by a student4 7i7 ,supplement1 not supplant ,any services provided through programs carried out under this section shall supplement1 and not supplant1 existing mental health services1 including any special education and related services provided under the ,individuals with ,disabilities ,education ,act4 7j7 ,consultation with ,indian tribes ,in carrying out subsection 7a71 the ,secretary shall1 in a timely manner1 meaningfully consult1 engage1 and cooperate with ,indian tribes and their representatives to ensure notice of eligibility4 7k7 ,definitions ,in this section3 7#a7 ,elementary or secondary school ,the term elementary or secondary school means a public elementary and secondary school as such term is defined in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#b7 ,evidence-based ,the term evidence-based has the meaning given such term in section #haja7ba77;,a77i7 of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja7ba77;,a77i774 7#c7 ,school leader ,the term school leader has the meaning given such term in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#d7 ,secretary ,the term ,secretary means the ,secretary of ,education4 7#e7 ,specialized instructional support personnel ,the term specialized instructional support personnel has the meaning given such term in #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7l7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 such sums as may be necessary for each of fiscal years #bjai through #bjbc4 #eae4 ,national ,child ,traumatic ,stress ,initiative ,section #ehb7;j7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh-#a7;j77 is amended by striking #df1hhg1jjj for each of fiscal years #bjah through #bjbb and inserting #ec1hhg1jjj for each of fiscal years #bjai through #bjbc4