,,ii #aagth ,,congress #b;d ,session ,s4 #dhci ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #ac1 #bjbb,ms4 ,baldwin 7for herself and ,mrs4 ,shaheen7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to reauthorize and expand a grant program for ,state and ,tribal response to opioid and stimulant use and misuse1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,state ,opioid ,response ,grant ,authorization ,act of #bjbb4 #b4 ,grant program for ,state and ,tribal response to opioid and stimulant use and misuse ,section #ajjc of the #bast ,century ,cures ,act 7#db ,u4,s4,c4 #bij;ee#c note7 is amended to read as follows3 #ajjc4 ,grant program for ,state and ,tribal response to opioid and stimulant use and misuse 7a7 ,in general ,the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary7 shall carry out the grant program described in subsection 7b7 for purposes of addressing opioid use disorder and stimulant misuse and use disorders1 within ,states1 ,indian ,tribes1 and populations served by ,tribal organizations and ,urban ,indian organizations4 7b7 ,grants program 7#a7 ,in general ,subject to the availability of appropriations1 the ,secretary shall award grants to ,states1 ,indian ,tribes1 ,tribal organizations1 and ,urban ,indian organizations for the purpose of addressing opioid use disorder and stimulant use and misuse1 within such ,states1 such ,indian ,tribes1 and populations served by such ,tribal organizations and ,urban ,indian organizations1 in accordance with paragraph 7#b74 7#b7 ,minimum allocations2 preference ,in determining grant amounts for each recipient of a grant under paragraph 7#a71 the ,secretary shall-- 7,a7 ensure that each ,state receives not less than #ab1jjj1jjj2 and 7,b7 give preference to ,states1 ,indian ,tribes1 ,tribal organizations1 and ,urban ,indian organizations-- 7i7 whose populations have an incidence or prevalence of opioid use disorder that is substantially higher relative to the populations of other ,states1 ,indian ,tribes1 ,tribal organizations1 or ,urban ,indian organizations1 as applicable2 or 7ii7 whose areas are more rural relative to the populations of other ,states1 ,indian ,tribes1 ,tribal organizations1 or ,urban ,indian organizations1 as applicable4 7#c7 ,formula methodology 7,a7 ,in general ,at least #cj days before publishing a funding opportunity announcement with respect to grants under this section1 the ,secretary shall-- 7i7 develop a formula methodology1 consistent with paragraph 7#b71 to be followed in allocating grant funds awarded under this section among grantees1 which includes performance assessments for continuation awards2 and 7ii7 not later than #cj days after developing the formula methodology under clause 7i71 submit the formula methodology to-- 7,i7 the ,committee on ,health1 ,education1 ,labor1 and ,pensions and the ,committee on ,appropriations of the ,senate2 and 7,,ii7 the ,committee on ,energy and ,commerce and the ,committee on ,appropriations of the ,house of ,representatives4 7,b7 ,transition period for new formula methodology ,the ,secretary shall set a #b-year transition period for the implementation of any new formula methodology if such new formula methodology would reduce the allocation of any ,state by more than #aj percent4 7,c7 ,consideration ,the ,secretary shall ensure that the formula developed under subparagraph 7,a7 avoids a significant cliff between ,states with similar mortality rates related to opioid use disorders to prevent unusually large funding changes in ,states when compared to prior year allocations4 7,d7 ,report ,not later than #b years after the date of the enactment of the ,state ,opioid ,response ,grant ,authorization ,act of #bjbb1 the ,comptroller ,general of the ,united ,states 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 that assesses-- 7i7 how grant funding is allocated to ,states under this section and how such allocations have changed over time2 7ii7 how any changes within the specified #b-year period after the date of enactment of the ,state ,opioid ,response ,grant ,authorization ,act of #bjbb have affected the efforts of ,states to address opioid use disorder or stimulant use and misuse2 and 7iii7 the use of funding provided through the grant program under this section and other similar grant programs administered by the ,substance ,abuse and ,mental ,health ,services ,administration4 7#d7 ,use of funds ,grants awarded under this subsection shall be used for carrying out activities that supplement activities pertaining to opioid use disorder and stimulant use and misuse1 undertaken by the ,state agency responsible for administering the substance abuse prevention and treatment block grant under subpart ,,ii of part ,b of title ,,xix of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#ba et seq471 which may include public health-related activities such as the following3 7,a7 ,implementing substance use disorder and overdose prevention activities and evaluating such activities to identify effective strategies to prevent substance use disorders and overdoses4 7,b7 ,establishing or improving prescription drug monitoring programs4 7,c7 ,training for health care practitioners1 such as best practices for prescribing opioids and stimulants1 pain management1 recognizing potential cases of substance use disorders1 referral of patients to treatment programs1 preventing diversion of controlled substances1 and overdose prevention4 7,d7 ,supporting access to health care services1 including-- 7i7 services provided by federally-certified opioid or stimulant treatment programs2 7ii7 outpatient and residential substance use disorder treatment services that utilize1 or refer patients to1 medication-assisted treatment1 where clinically appropriate2 7iii7 services to treat substance use disorders provided by other appropriate health care providers and at other locations2 or 7iv7 overdose prevention programs and services1 including drugs or devices approved1 cleared1 or otherwise legally marketed under the ,federal ,food1 ,drug1 and ,cosmetic ,act for emergency treatment of known or suspected overdose4 7,e7 ,recovery support services1 including-- 7i7 community-based services that include peer supports2 7ii7 mutual aid recovery programs that support medication-assisted treatment2 7iii7 services to address housing needs1 transportation needs1 food insecurity1 and employment issues2 or 7iv7 resources or programs that support families that include an individual with a substance use disorder1 including education1 training1 outreach1 and peer support services4 7,f7 ,other public health-related activities1 as the grant recipient determines appropriate1 related to addressing substance use disorders within the ,state1 ,indian ,tribe1 ,tribal organization1 or ,urban ,indian organization1 including directing resources in accordance with local needs related to substance use disorders4 7c7 ,accountability and oversight ,a ,state receiving a grant under subsection 7b7 shall include in reporting related to substance use disorders submitted to the ,secretary pursuant to section #aidb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#eb71 a description of-- 7#a7 the purposes for which the grant funds received by the ,state under such subsection for the preceding fiscal year were expended and a description of the activities of the ,state under the grant2 7#b7 the ultimate recipients of amounts provided to the ,state2 and 7#c7 the number of individuals served through each of the activities of the ,state under the grant and the total number of individuals served through the grant4 7d7 ,limitations ,any funds made available pursuant to subsection 7i7-- 7#a7 notwithstanding any transfer authority in any appropriations ,act1 shall not be used for any purpose other than the grant program under subsection 7b72 and 7#b7 shall be subject to the same requirements as substance use disorders prevention and treatment programs under titles ,v and ,,xix of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa et seq41 #cjjw et seq474 7e7 ,indian ,tribes1 ,tribal organizations1 and ,urban ,indian organizations ,the ,secretary1 in consultation with ,indian ,tribes1 ,tribal organizations1 and ,urban ,indian organizations1 shall identify and establish appropriate mechanisms for ,indian ,tribes1 ,tribal organizations1 and ,urban ,indian organizations to demonstrate or report information as required under subsections 7b71 7c71 and 7d74 7f7 ,report to ,congress ,not later than ,september #cj1 #bjbd1 and biennially thereafter1 the ,secretary shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions and the ,committee on ,appropriations of the ,senate and the ,committee on ,energy and ,commerce and the ,committee on ,appropriations of the ,house of ,representatives a report that includes a summary of the information provided to the ,secretary in reports made pursuant to subsections 7c7 and 7e71 including-- 7#a7 the purposes for which grant funds are awarded under this section2 7#b7 the activities of the grant recipients2 and 7#c7 for each ,state1 ,indian ,tribe1 ,tribal organization1 and ,urban ,indian organization that receives a grant under this section1 the funding level provided to such recipient4 7g7 ,technical assistance ,the ,secretary1 acting1 as appropriate1 through the ,tribal ,training and ,technical ,assistance ,center of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall provide ,states1 ,indian ,tribes1 ,tribal organizations1 and ,urban ,indian organizations1 as applicable1 with-- 7#a7 technical assistance concerning grant application and submission procedures under this section2 7#b7 award management activities2 and 7#c7 enhancement of outreach and direct support to rural and underserved communities and providers in addressing substance use disorders4 7h7 ,definitions ,in this section3 7#a7 ,indian ,tribe2 ,tribal organization ,the terms ,indian ,tribe and ,tribal organization have the meanings given such terms in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#b7 ,state ,the term ,state has the meaning given such term in section #aied7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx-#fd7;b774 7#c7 ,urban indian organization ,the term ,urban ,indian organization has the meaning given such term in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc74 7i7 ,authorization of appropriations 7#a7 ,in general ,for purposes of carrying out the grant program under subsection 7b71 there is authorized to be appropriated #b1gjj1jjj1jjj for each of fiscal years #bjbc through #bjbg1 to remain available until expended4 7#b7 ,federal administrative expenses ,of the amounts made available for each fiscal year to award grants under subsection 7b71 the ,secretary shall use not more than #b percent for ,federal administrative expenses1 training1 technical assistance1 and evaluation4 7#c7 ,set aside ,of the amounts made available for each fiscal year to award grants under subsection 7b7 for a fiscal year1 the ,secretary shall-- 7,a7 award #e percent to ,indian ,tribes1 ,tribal organizations1 and ,urban ,indian organizations2 and 7,b7 award up to #ae percent to ,states with the highest age-adjusted rates of drug overdose death over the most recent #b-year period1 according to the ,director of the ,centers for ,disease ,control and ,prevention4 4