,,ii  #aag? ,,congress  #b;d ,session   
,s4 #dhci  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #ac1         
#bjbb,ms4 ,baldw9 7= h]self & ,mrs4     
,%ahe57 introduc$ ! foll[+ bill2 :i* 0  
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to reau?orize & exp& a grant
 program = ,/ate & ,tribal response to  
opioid & /imulant use & misuse1 & = o!r 
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,/ate ,opioid ,response    
,grant ,au?orization ,act ( #bjbb4  #b4 
,grant program = ,/ate & ,tribal        
response to opioid & /imulant use &     
misuse ,section #ajjc ( ! #ba/ ,c5tury  
,cures ,act 7#db ,u4,s4,c4 #bij;ee#c    
note7 is am5d$ to read z foll[s3  #ajjc4
 ,grant program = ,/ate & ,tribal       
response to opioid & /imulant use &     
misuse  7a7 ,9 g5]al ,! ,secret>y (     
,heal? & ,human ,s]vices 7ref]r$ to 9   
?is section z ! ,secret>y7 %all c>ry out
 ! grant program describ$ 9 subsection  
7b7 = purposes ( address+ opioid use    

disord] & /imulant misuse & use         
disord]s1 )9 ,/ates1 ,indian ,tribes1 & 
populations s]v$ by ,tribal             
organizations & ,urban ,indian          
organizations4  7b7 ,grants program     
7#a7 ,9 g5]al ,subject to ! availability
 ( appropriations1 ! ,secret>y %all aw>d
 grants to ,/ates1 ,indian ,tribes1     
,tribal organizations1 & ,urban ,indian 
organizations = ! purpose ( address+    
opioid use disord] & /imulant use &     
misuse1 )9 su* ,/ates1 su* ,indian      
,tribes1 & populations s]v$ by su*      
,tribal organizations & ,urban ,indian  
organizations1 9 accordance ) p>agraph  
7#b74  7#b7 ,m9imum allocations2        
pref]5ce ,9 det]m9+ grant am\nts = ea*  
recipi5t ( a grant "u p>agraph 7#a71 !  
,secret>y %all-- 7,a7 ensure t ea* ,/ate
 receives n less ?an #ab1jjj1jjj2 &     
7,b7 give pref]5ce to ,/ates1 ,indian   
,tribes1 ,tribal organizations1 & ,urban
 ,indian organizations-- 7i7 ^:         
populations h an incid5ce or preval5ce (
 opioid use disord] t is sub/antially   

high] relative to ! populations ( o!r   
,/ates1 ,indian ,tribes1 ,tribal        
organizations1 or ,urban ,indian        
organizations1 z applicable2 or  7ii7 ^:
 areas are m rural relative to !        
populations ( o!r ,/ates1 ,indian       
,tribes1 ,tribal organizations1 or      
,urban ,indian organizations1 z         
applicable4  7#c7 ,=mula me?odology     
7,a7 ,9 g5]al ,at lea/ #cj days be=e    
publi%+ a fund+ opportunity ann\ncem5t )
 respect to grants "u ?is section1 !    
,secret>y %all-- 7i7 develop a =mula    
me?odology1 consi/5t ) p>agraph 7#b71 to
 be foll[$ 9 allocat+ grant funds aw>d$ 
"u ?is section among grantees1 :i*      
includes p]=mance assessm5ts =          
cont9uation aw>ds2 &  7ii7 n lat] ?an   
#cj days aft] develop+ ! =mula          
me?odology "u clause 7i71 submit ! =mula
 me?odology to-- 7,i7 ! ,committee on   
,heal?1 ,education1 ,labor1 & ,p5sions &
 ! ,committee on ,appropriations ( !    
,s5ate2 &  7,,ii7 ! ,committee on ,en]gy
 & ,comm]ce & ! ,committee on           

,appropriations ( ! ,h\se (             
,repres5tatives4  7,b7 ,transition p]iod
 = new =mula me?odology ,! ,secret>y    
%all set a #b-ye> transition p]iod = !  
implem5tation ( any new =mula me?odology
 if su* new =mula me?odology w\ld r$uce 
! allocation ( any ,/ate by m ?an #aj   
p]c5t4  7,c7 ,consid]ation ,! ,secret>y 
%all ensure t ! =mula develop$ "u       
subp>agraph 7,a7 avoids a significant   
cliff betwe5 ,/ates ) simil> mortality  
rates relat$ to opioid use disord]s to  
prev5t unusually l>ge fund+ *anges 9    
,/ates :5 comp>$ to prior ye>           
allocations4  7,d7 ,report ,n lat] ?an  
#b ye>s aft] ! date ( ! enactm5t ( !    
,/ate ,opioid ,response ,grant          
,au?orization ,act ( #bjbb1 !           
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all submit to ! ,committee on ,heal?1  
,education1 ,labor1 & ,p5sions ( !      
,s5ate & ! ,committee on ,en]gy &       
,comm]ce ( ! ,h\se ( ,repres5tatives a  
report t assesses-- 7i7 h[ grant fund+  
is allocat$ to ,/ates "u ?is section &  

h[ su* allocations h *ang$ ov] "t2  7ii7
 h[ any *anges )9 ! specifi$ #b-ye>     
p]iod aft] ! date ( enactm5t ( ! ,/ate  
,opioid ,response ,grant ,au?orization  
,act ( #bjbb h affect$ ! ef=ts ( ,/ates 
to address opioid use disord] or        
/imulant use & misuse2 &  7iii7 ! use ( 
fund+ provid$ ?r\gh ! grant program "u  
?is section & o!r simil> grant programs 
adm9i/]$ by ! ,sub/ance ,abuse & ,m5tal 
,heal? ,s]vices ,adm9i/ration4  7#d7    
,use ( funds ,grants aw>d$ "u ?is       
subsection %all be us$ = c>ry+ out      
activities t supplem5t activities p]ta9+
 to opioid use disord] & /imulant use & 
misuse1 und]tak5 by ! ,/ate ag5cy       
responsible = adm9i/]+ ! sub/ance abuse 
prev5tion & treatm5t block grant "u     
subp>t ,,ii ( "p ,b ( title ,,xix ( !   
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjjx-#ba et seq471 :i* may   
include public heal?-relat$ activities  
su* z ! foll[+3 7,a7 ,implem5t+ sub/ance
 use disord] & ov]dose prev5tion        
activities & evaluat+ su* activities to 

id5tify effective /rategies to prev5t   
sub/ance use disord]s & ov]doses4  7,b7 
,e/abli%+ or improv+ prescription drug  
monitor+ programs4  7,c7 ,tra9+ = heal? 
c>e practition]s1 su* z be/ practices = 
prescrib+ opioids & /imulants1 pa9      
managem5t1 recogniz+ pot5tial cases (   
sub/ance use disord]s1 ref]ral ( pati5ts
 to treatm5t programs1 prev5t+ div]sion 
( controll$ sub/ances1 & ov]dose        
prev5tion4  7,d7 ,support+ access to    
heal? c>e s]vices1 includ+-- 7i7 s]vices
 provid$ by f$]ally-c]tifi$ opioid or   
/imulant treatm5t programs2  7ii7       
outpati5t & resid5tial sub/ance use     
disord] treatm5t s]vices t utilize1 or  
ref] pati5ts to1 m$ication-assi/$       
treatm5t1 :]e cl9ically appropriate2    
7iii7 s]vices to treat sub/ance use     
disord]s provid$ by o!r appropriate     
heal? c>e provid]s & at o!r locations2  
or  7iv7 ov]dose prev5tion programs &   
s]vices1 includ+ drugs or devices       
approv$1 cle>$1 or o!rwise legally      
m>ket$ "u ! ,f$]al ,food1 ,drug1 &      

,cosmetic ,act = em]g5cy treatm5t ( kn[n
 or suspect$ ov]dose4  7,e7 ,recov]y    
support s]vices1 includ+-- 7i7          
community-bas$ s]vices t include pe]    
supports2  7ii7 mutual aid recov]y      
programs t support m$ication-assi/$     
treatm5t2  7iii7 s]vices to address h\s+
 ne$s1 transportation ne$s1 food        
insecurity1 & employm5t issues2 or  7iv7
 res\rces or programs t support families
 t include an individual ) a sub/ance   
use disord]1 includ+ education1 tra9+1  
outrea*1 & pe] support s]vices4  7,f7   
,o!r public heal?-relat$ activities1 z !
 grant recipi5t det]m9es appropriate1   
relat$ to address+ sub/ance use disord]s
 )9 ! ,/ate1 ,indian ,tribe1 ,tribal    
organization1 or ,urban ,indian         
organization1 includ+ direct+ res\rces 9
 accordance ) local ne$s relat$ to      
sub/ance use disord]s4  7c7             
,acc\ntability & ov]sight ,a ,/ate      
receiv+ a grant "u subsection 7b7 %all  
include 9 report+ relat$ to sub/ance use
 disord]s submitt$ to ! ,secret>y       

pursuant to section #aidb ( ! ,public   
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjjx-#eb71 a description (-- 7#a7 !    
purposes = :i* ! grant funds receiv$ by 
! ,/ate "u su* subsection = ! prec$+    
fiscal ye> 7 exp5d$ & a description ( ! 
activities ( ! ,/ate "u ! grant2  7#b7 !
 ultimate recipi5ts ( am\nts provid$ to 
! ,/ate2 &  7#c7 ! numb] ( individuals  
s]v$ ?r\gh ea* ( ! activities ( ! ,/ate 
"u ! grant & ! total numb] ( individuals
 s]v$ ?r\gh ! grant4  7d7 ,limitations  
,any funds made available pursuant to   
subsection 7i7-- 7#a7 not)/&+ any       
transf] au?ority 9 any appropriations   
,act1 %all n be us$ = any purpose o!r   
?an ! grant program "u subsection 7b72 &
  7#b7 %all be subject to ! same        
requirem5ts z sub/ance use disord]s     
prev5tion & treatm5t programs "u titles 
,v & ,,xix ( ! ,public ,heal? ,s]vice   
,act 7#db ,u4,s4,c4 #bij;aa et seq41    
#cjjw et seq474  7e7 ,indian ,tribes1   
,tribal organizations1 & ,urban ,indian 
organizations ,! ,secret>y1 9           

consultation ) ,indian ,tribes1 ,tribal 
organizations1 & ,urban ,indian         
organizations1 %all id5tify & e/abli%   
appropriate me*anisms = ,indian ,tribes1
 ,tribal organizations1 & ,urban ,indian
 organizations to demon/rate or report  
in=mation z requir$ "u subsections 7b71 
7c71 & 7d74  7f7 ,report to ,congress ,n
 lat] ?an ,septemb] #cj1 #bjbd1 &       
bi5nially !reaft]1 ! ,secret>y %all     
submit to ! ,committee on ,heal?1       
,education1 ,labor1 & ,p5sions & !      
,committee on ,appropriations ( ! ,s5ate
 & ! ,committee on ,en]gy & ,comm]ce & !
 ,committee on ,appropriations ( ! ,h\se
 ( ,repres5tatives a report t includes a
 summ>y ( ! in=mation provid$ to !      
,secret>y 9 reports made pursuant to    
subsections 7c7 & 7e71 includ+-- 7#a7 ! 
purposes = :i* grant funds are aw>d$ "u 
?is section2  7#b7 ! activities ( !     
grant recipi5ts2 &  7#c7 = ea* ,/ate1   
,indian ,tribe1 ,tribal organization1 & 
,urban ,indian organization t receives a
 grant "u ?is section1 ! fund+ level    

provid$ to su* recipi5t4  7g7 ,te*nical 
assi/ance ,! ,secret>y1 act+1 z         
appropriate1 ?r\gh ! ,tribal ,tra9+ &   
,te*nical ,assi/ance ,c5t] ( ! ,sub/ance
 ,abuse & ,m5tal ,heal? ,s]vices        
,adm9i/ration1 %all provide ,/ates1     
,indian ,tribes1 ,tribal organizations1 
& ,urban ,indian organizations1 z       
applicable1 )-- 7#a7 te*nical assi/ance 
conc]n+ grant application & submission  
proc$ures "u ?is section2  7#b7 aw>d    
managem5t activities2 &  7#c7 enhancem5t
 ( outrea* & direct support to rural &  
und]s]v$ communities & provid]s 9       
address+ sub/ance use disord]s4  7h7    
,def9itions ,9 ?is section3 7#a7 ,indian
 ,tribe2 ,tribal organization ,! t]ms   
,indian ,tribe & ,tribal organization h 
! mean+s giv5 su* t]ms 9 section #d ( ! 
,indian ,self-,det]m9ation & ,education 
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd74  
7#b7 ,/ate ,! t]m ,/ate has ! mean+ giv5
 su* t]m 9 section #aied7;b7 ( ! ,public
 ,heal? ,s]vice ,act 7#db ,u4,s4,c4     
#cjjx-#fd7;b774  7#c7 ,urban indian     

organization ,! t]m ,urban ,indian      
organization has ! mean+ giv5 su* t]m 9 
section #d ( ! ,indian ,heal? ,c>e      
,improvem5t ,act 7#be ,u4,s4,c4 #afjc74 
7i7 ,au?orization ( appropriations  7#a7
 ,9 g5]al ,= purposes ( c>ry+ out !     
grant program "u subsection 7b71 !re is 
au?oriz$ to be appropriat$              
#b1gjj1jjj1jjj = ea* ( fiscal ye>s #bjbc
 ?r\gh #bjbg1 to rema9 available until  
exp5d$4  7#b7 ,f$]al adm9i/rative       
exp5ses ,( ! am\nts made available = ea*
 fiscal ye> to aw>d grants "u subsection
 7b71 ! ,secret>y %all use n m ?an #b   
p]c5t = ,f$]al adm9i/rative exp5ses1    
tra9+1 te*nical assi/ance1 & evaluation4
  7#c7 ,set aside ,( ! am\nts made      
available = ea* fiscal ye> to aw>d      
grants "u subsection 7b7 = a fiscal ye>1
 ! ,secret>y %all-- 7,a7 aw>d #e p]c5t  
to ,indian ,tribes1 ,tribal             
organizations1 & ,urban ,indian         
organizations2 &  7,b7 aw>d up to #ae   
p]c5t to ,/ates ) ! highe/ age-adju/$   
rates ( drug ov]dose dea? ov] ! mo/     

rec5t #b-ye> p]iod1 accord+ to !        
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion4  4