#aah? ,,congress  #a/ ,session  ,h4 ,r4 
#deca  ,,an ,,act  ,to reau?orize c]ta9 
programs t provide = opioid use disord] 
prev5tion1 recov]y1 & treatm5t1 & = o!r 
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,support = ,pati5ts &      
,communities ,reau?orization ,act4  #b4 
,table ( cont5ts ,! table ( cont5ts =   
?is ,act is z foll[s3  ,sec4 #a4 ,%ort  
title4 ,sec4 #b4 ,table ( cont5ts4      
,title ,i--,public ,heal? ,sec4 #aja4   
,pr5atal & po/natal heal?4 ,sec4 #ajb4  
,monitor+ & education reg>d+ infections 
associat$ ) illicit drug use & o!r risk 
factors4 ,sec4 #ajc4 ,prev5t+ ov]doses (
 controll$ sub/ances4 ,sec4 #ajd4       
,resid5tial treatm5t programs = pregnant
 & po/p>tum wom54 ,sec4 #aje4 ,y\?      
prev5tion & recov]y4 ,sec4 #ajf4 ,fir/  
respond] tra9+4 ,sec4 #ajg4 ,build+     
communities ( recov]y4 ,sec4 #ajh4      
,national ,pe]-,run ,tra9+ & ,te*nical  
,assi/ance ,c5t] = ,addiction ,recov]y  
,support4 ,sec4 #aji4 ,compreh5sive     
opioid recov]y c5t]s4 ,sec4 #aaj4       

,grants to address ! problems ( p]sons  
:o exp]i5ce viol5ce relat$ /ress4 ,sec4 
#aaa4 ,m5tal & behavioral heal?         
education & tra9+ grants4 ,sec4 #aab4   
,loan repaym5t program = ! sub/ance use 
disord] treatm5t work=ce4 ,sec4 #aac4   
,pilot program = public heal?           
laboratories to detect f5tanyl & o!r    
syn!tic opioids4 ,sec4 #aad4 ,monitor+ &
 report+ ( *ild1 y\?1 & adult trauma4   
,sec4 #aae4 ,task =ce to develop be/    
practices = trauma-in=m$ id5tification1 
ref]ral1 & support4 ,sec4 #aaf4         
,treatm5t1 recov]y1 & work=ce support   
grants4 ,sec4 #aag4 ,grant program =    
,/ate & ,tribal response to opioid use  
disord]s4 ,sec4 #aah4 ,ref]5ces to      
opioid ov]dose rev]sal ag5ts 9 ,,hhs    
grant programs4 ,sec4 #aai4 ,address+   
o!r concurr5t sub/ance use disord]s     
?r\gh grant program = ,/ate & ,tribal   
response to opioid use disord]s4 ,sec4  
#abj4 ,provid+ = a /udy on ! effects (  
remote monitor+ on individuals :o are   
prescrib$ opioids4 ,title               

,,ii--,controll$ ,sub/ances ,sec4 #bja4 
,deliv]y ( c]ta9 sub/ances by a ph>macy 
to an adm9i/]+ practition]4 ,sec4 #bjb4 
,review+ ! s*$ul+ ( approv$ products    
conta9+ a comb9ation ( bupr5orph9e &    
naloxone4 ,sec4 #bjc4 ,combat+ illicit  
xylaz9e4 ,sec4 #bjd4 ,te*nical          
corrections4 ,sec4 #bje4 ,requir$ tra9+ 
= prescrib]s ( controll$ sub/ances4     
,title ,,iii--,m$icaid ,sec4 #cja4      
,ext5d+ requirem5t = ,/ate ,m$icaid     
plans to provide cov]age =              
m$ication-assi/$ treatm5t4 ,sec4 #cjb4  
,exp&+ requir$ reports on ,t-,,msis     
sub/ance use disord] data to include    
m5tal heal? condition data4 ,sec4 #cjc4 
,monitor+ prescrib+ ( antipsy*otic      
m$ications4 ,sec4 #cjd4 ,lift+ ! ,,imd  
exclusion = sub/ance use disord]4 ,sec4 
#cje4 ,prohibition on t]m9ation (       
enrollm5t due to inc>c]ation4 ,sec4     
#cjf4 ,/ate option relat+ to inmates :o 
are pregnant wom5 p5d+ disposition (    
*>ges4 ,sec4 #cjg4 ,p]mitt+ access to   
m$ical assi/ance "u ! ,m$icaid program =

 fo/] y\?4 ,title ,,iv--,(fsets ,sec4   
#dja4 ,promot+ value 9 ,m$icaid manag$  
c>e4  ,i ,public ,heal?  #aja4 ,pr5atal 
& po/natal heal? ,section #cag,l7d7 ( ! 
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bdg;b-#ac7;d77 is am5d$ by   
/rik+ su* sums z may be necess>y = ea* (
 ! fiscal ye>s #bjai ?r\gh #bjbc &      
ins]t+ #d1bej1jjj = ea* ( fiscal ye>s   
#bjbd ?r\gh #bjbh4  #ajb4 ,monitor+ &   
education reg>d+ infections associat$ ) 
illicit drug use & o!r risk factors     
,section #cag,n ( ! ,public ,heal?      
,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ae7 
is am5d$--  7#a7 9 ! section head+1 by  
/rik+ ,surveillance & & ins]t+ ,monitor+
 & 2 &  7#b7 9 subsection 7d71 by /rik+ 
fiscal ye>s #bjai ?r\gh #bjbc & ins]t+  
fiscal ye>s #bjbd ?r\gh #bjbh4  #ajc4   
,prev5t+ ov]doses ( controll$ sub/ances 
7a7 ,evid5ce-bas$ prev5tion grants      
,section #cib;,a7a77#b77;,d7 ( ! ,public
 ,heal? ,s]vice ,act 7#db ,u4,s4,c4     
#bhj;b-#a7;a77#b77;,d77 is am5d$ by     
ins]t+ aft] new & em]g+ public heal?    

crises ! foll[+3 1 su* z ! f5tanyl      
crisis14  7b7 ,use ( grants by ,/ates1  
localities1 & ,indian ,tribes to conduct
 wa/ewat] surveillance ,section         
#cib;,a7a77#c77;,a7 ( ! ,public ,heal?  
,s]vice ,act 7#db ,u4,s4,c4             
#bhj;b-#a7;a77#c77;,a77 is am5d$ by     
ins]t+ 1 includ+ ?r\gh ! use ( wa/ewat] 
surveillance to id5tify tr5ds associat$ 
) controll$ sub/ance use if x is det]m9$
 by appropriate evid5ce t wa/ewat]      
surveillance is an effective way to     
survey controll$ sub/ance use )9 a      
community be=e ! semicolon4  7c7        
,au?orization ( appropriations ,section 
#cib;,a7e7 ( ! ,public ,heal? ,s]vice   
,act 7#db ,u4,s4,c4 #bhj;b-#a7;e77 is   
am5d$ by /rik+ #dif1jjj1jjj = ea* (     
fiscal ye>s #bjai ?r\gh #bjbc & ins]t+  
#eje1egi1jjj = ea* ( fiscal ye>s #bjbd  
?r\gh #bjbh4  #ajd4 ,resid5tial treatm5t
 programs = pregnant & po/p>tum wom5    
,section #ejh7s7 ( ! ,public ,heal?     
,s]vice ,act 7#db ,u4,s4,c4             
#bij;bb-#a7s77 is am5d$ by /rik+        

#bi1ica1jjj = ea* ( fiscal ye>s #bjai   
?r\gh #bjbc & ins]t+ #ch1ica1jjj = ea* (
 fiscal ye>s #bjbd ?r\gh #bjbh4  #aje4  
,y\? prev5tion & recov]y ,section       
#gajb7;c77#i7 ( ! ,,support = ,pati5ts &
 ,communities ,act 7#db ,u4,s4,c4       
#bij;bb-#g;a7c77#i77 is am5d$ by /rik+  
fiscal ye>s #bjai ?r\gh #bjbc & ins]t+  
fiscal ye>s #bjbd ?r\gh #bjbh4  #ajf4   
,fir/ respond] tra9+ ,section #edf7;h7 (
 ! ,public ,heal? ,s]vice ,act 7#db     
,u4,s4,c4 #bij;ee-#a7;h77 is am5d+ by   
/rik+ #cf1jjj1jjj = ea* ( fiscal ye>s   
#bjai ?r\gh #bjbc & ins]t+ #ef1jjj1jjj =
 ea* ( fiscal ye>s #bjbd ?r\gh #bjbh4   
#ajg4 ,build+ communities ( recov]y     
,section #edg7;f7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4             
#bij;ee-#b7;f77 is am5d$ by /rik+       
#e1jjj1jjj = ea* ( fiscal ye>s #bjai    
?r\gh #bjbc & ins]t+ #af1jjj1jjj = ea* (
 fiscal ye>s #bjbd ?r\gh #bjbh4  #ajh4  
,national ,pe]-,run ,tra9+ & ,te*nical  
,assi/ance ,c5t] = ,addiction ,recov]y  
,support ,section #edg;,a7e7 ( ! ,public

 ,heal? ,s]vice ,act 7#db ,u4,s4,c4     
#bij;ee-#b;a7e77 is am5d$ by /rik+      
#a1jjj1jjj = ea* ( fiscal ye>s #bjai    
?r\gh #bjbc & ins]t+ #b1jjj1jjj = ea* ( 
fiscal ye>s #bjbd ?r\gh #bjbh4  #aji4   
,compreh5sive opioid recov]y c5t]s  7a7 
,reau?orization ,section #eeb7;j7 ( !   
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bij;ee-#g7;j77 is am5d$ by   
/rik+ #bjai ?r\gh #bjbc & ins]t+ #bjbd  
?r\gh #bjbh4  7b7 ,docum5tation =       
evid5ce ( capacity ,to c>ry out requir$ 
activities ,section #eeb7;d7 ( ! ,public
 ,heal? ,s]vice ,act 7#db ,u4,s4,c4     
#bij;ee-#g7;d77 is am5d$ by add+ at !   
end ! foll[+3  7#c7 ,docum5tation  7,a7 
,9 g5]al ,evid5ce requir$ to be provid$ 
"u p>agraph 7#a7 may be provid$ ?r\gh a 
lett] ( int5t f p>tn] ag5cies or o!r    
relevant docum5tation 7z def9$ by !     
,secret>y74  7,b7 ,p>tn] ag5cy def9$ ,9 
?is p>agraph1 ! t]m p>tn] ag5cy means a 
non-gov]nm5tal organization or o!r      
public or private entity--  7i7 ! prim>y
 purpose ( :i* is ! deliv]y ( m5tal     

heal? or sub/ance use disord] treatm5t  
s]vices2 &  7ii7 ) :i* ! applicant      
coord9ates to provide ! full cont9uum ( 
treatm5t s]vices 7z specifi$ 9          
subsection 7g77#a77;,b77 t ! applicant  
is unable to (f] on site4  4  7c7 ,c5t] 
activities c>ri$ out ?r\gh ?ird p>ties  
,section #eeb7;g7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4             
#bij;ee-#g7;g77 is am5d$ 9 ! matt]      
prec$+ p>agraph 7#a7 by /rik+ ,ea* ,c5t]
 %all & all t foll[s ?r\gh subsection   
7f73 & ins]t+ ! foll[+3 ,ea* ,c5t] %all1
 at a m9imum1 c>ry out ! activities     
specifi$ 9 ?is subsection directly1     
?r\gh ref]ral1 or ?r\gh contractual     
arrangem5ts4 ,if a ,c5t] elects to c>ry 
out su* activities ?r\gh contractual    
arrangem5ts1 ! ,secret>y may issue      
guidance on be/ practices to ensure t ! 
,c5t] is capable ( c>ry+ out su*        
activities1 includ+ c>ry+ out su*       
activities ?r\gh te*nology-enabl$       
collaborative le>n+ & capacity build+   
models describ$ 9 subsection 7f7 &      

coord9at+ ! full cont9uum ( treatm5t    
s]vices specifi$ 9 subp>agraph 7,b74    
,su* activities include ! foll[+34      
#aaj4 ,grants to address ! problems (   
p]sons :o exp]i5ce viol5ce relat$ /ress 
,section #ehb7;j7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4             
#bij;hh-#a7;j77 is am5d$ by /rik+       
#fc1hhg1jjj = ea* ( fiscal ye>s #bjai   
?r\gh #bjbc & ins]t+ #ic1hhg1jjj = ea* (
 fiscal ye>s #bjbd ?r\gh #bjbh4  #aaa4  
,m5tal & behavioral heal? education &   
tra9+ grants ,section #gef7;f7 ( !      
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bid;e-#a7;f77 is am5d$ by    
/rik+ fiscal ye>s #bjbc ?r\gh #bjbg &   
ins]t+ fiscal ye>s #bjbd ?r\gh #bjbh4   
#aab4 ,loan repaym5t program = !        
sub/ance use disord] treatm5t work=ce   
,section #gha7;j7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4 #bie;h7j77  
is am5d$ by /rik+ #be1jjj1jjj = ea* (   
fiscal ye>s #bjai ?r\gh #bjbc & ins]t+  
#dj1jjj1jjj = ea* ( fiscal ye>s #bjbd   
?r\gh #bjbh4  #aac4 ,pilot program =    

public heal? laboratories to detect     
f5tanyl & o!r syn!tic opioids  7a7      
,detection activities ,section #gjaa7;b7
 ( ! ,,support = ,pati5ts & ,communities
 ,act 7#db ,u4,s4,c4 #bdg;d-#aj note7 is
 am5d$-- 7#a7 9 p>agraph 7#b71 by /rik+ 
& at ! end2  7#b7 9 p>agraph 7#c71 by   
/rik+ ! p]iod at ! end & ins]t+ 2 &2 &  
7#c7 by add+ at ! end ! foll[+3  7#d7   
public1 private1 & academic entities )  
exp]tise 9 detection & te/+ activities1 
su* z wa/ewat] surveillance1 ) respect  
to syn!tic opioids1 includ+ f5tanyl &   
its analogues4  4  7b7 ,au?orization (  
appropriations ,section #gjaa7;d7 ( !   
,,support = ,pati5ts & ,communities ,act
 7#db ,u4,s4,c4 #bdg;d-#aj7;d77 is am5d$
 by /rik+ fiscal ye>s #bjai ?r\gh #bjbc 
& ins]t+ fiscal ye>s #bjbd ?r\gh #bjbh4 
#aad4 ,monitor+ & report+ ( *ild1 y\?1 &
 adult trauma ,section #gaca7;e7 ( !    
,,support = ,pati5ts & ,communities ,act
 7#db ,u4,s4,c4 #bdbt7e77 is am5d$ by   
/rik+ #b1jjj1jjj = ea* ( fiscal ye>s    
#bjai ?r\gh #bjbc & ins]t+ #i1jjj1jjj = 

ea* ( fiscal ye>s #bjbd ?r\gh #bjbh4    
#aae4 ,task =ce to develop be/ practices
 = trauma-in=m$ id5tification1 ref]ral1 
& support ,section #gacb ( ! ,,support =
 ,pati5ts & ,communities ,act 7,public  
,law #aae-bga7 is am5d$--  7#a7 9       
subsection 7g7-- 7,a7 9 p>agraph 7#a71  
by /rik+ & at ! end2  7,b7 9 p>agraph   
7#b71 by /rik+ ! p]iod at ! end & ins]t+
 2 &2 &  7,c7 by add+ at ! end ! foll[+3
  7#c7 additional reports & updates to  
exi/+ reports1 z necess>y4  2 &  7#b7 by
 am5d+ subsection 7i7 to read z foll[s3 
7i7 ,sunset ,! task =ce %all sunset on  
,septemb] #cj1 #bjbf4  4  #aaf4         
,treatm5t1 recov]y1 & work=ce support   
grants ,section #gahc ( ! ,,support =   
,pati5ts & ,communities ,act 7#db       
,u4,s4,c4 #bij;ee-#h7 is am5d$--  7#a7 9
 subsection 7b71 by ins]t+ ea* be=e = a 
p]iod2  7#b7 by am5d+ subsection 7c77#b7
 to read z foll[s3  7#b7 ,rates ,! rates
 describ$ 9 ?is p>agraph are ! foll[+3  
7,a7 ,! am\nt by :i* ! av]age rate (    
drug ov]dose dea?s 9 ! ,/ate1 adju/$ =  

age1 = ! p]iod ( #e cal5d> ye>s = :i*   
!re is available data1 includ+ if       
necess>y provisional data1 imm$iately   
prec$+ ! grant cycle 7:i* %all be !     
p]iod ( cal5d> ye>s #bjah ?r\gh #bjbb = 
! fir/ grant cycle foll[+ ! enactm5t ( !
 ,support = ,pati5ts & ,communities     
,reau?orization ,act7 is above ! av]age 
national ov]dose mortality rate1 z      
det]m9$ by ! ,director ( ! ,c5t]s =     
,disease ,control & ,prev5tion1 = ! same
 p]iod4  7,b7 ,! am\nt by :i* ! av]age  
rate ( unemploym5t = ! ,/ate1 bas$ on   
data provid$ by ! ,bureau ( ,labor      
,/ati/ics1 = ! p]iod ( #e cal5d> ye>s = 
:i* !re is available data1 includ+ if   
necess>y provisional data1 imm$iately   
prec$+ ! grant cycle 7:i* %all be !     
p]iod ( cal5d> ye>s #bjah ?r\gh #bjbb = 
! fir/ grant cycle foll[+ ! enactm5t ( !
 ,support = ,pati5ts & ,communities     
,reau?orization ,act7 is above !        
national av]age = ! same p]iod4  7,c7 ,!
 am\nt by :i* ! av]age rate ( labor =ce 
p>ticipation 9 ! ,/ate1 bas$ on data    

provid$ by ! ,bureau ( ,labor ,/ati/ics1
 = ! p]iod ( #e cal5d> ye>s = :i* !re is
 available data1 includ+ if necess>y    
provisional data1 imm$iately prec$+ !   
grant cycle 7:i* %all be ! p]iod (      
cal5d> ye>s #bjah ?r\gh #bjbb = ! fir/  
grant cycle foll[+ ! enactm5t ( !       
,support = ,pati5ts & ,communities      
,reau?orization ,act7 is bel[ ! national
 av]age = ! same p]iod4  2  7#c7 9      
subsection 7g7-- 7,a7 9 p>agraphs 7#a7 &
 7#c71 by r$esignat+ subp>agraphs 7,a7 &
 7,b7 z clauses 7i7 & 7ii71             
respectively1 & adju/+ ! m>g9s          
accord+ly2  7,b7 by r$esignat+ p>agraphs
 7#a7 ?r\gh 7#c7 z subp>agraphs 7,a7    
?r\gh 7,c71 respectively1 & adju/+ !    
m>g9s accord+ly2  7,c7 by /rik+ ,an     
entity & ins]t+ ! foll[+3  7#a7 ,9 g5]al
 ,an entity  2 &  7,d7 by add+ at ! end 
! foll[+3  7#b7 ,transportation s]vices 
,an entity receiv+ a grant "u ?is       
section may use n m ?an #e p]c5t ( !    
funds = provid+ transportation =        
individuals to p>ticipate 9 an activity 

support$ by a grant "u ?is section1 :i* 
transportation %all be to or f a place (
 "w or a place :]e ! individual is      
receiv+ vocational education or job     
tra9+ s]vices or receiv+ s]vices        
directly l9k$ to treatm5t ( or recov]y f
 a sub/ance use disord]4  7#c7 ,no o!r  
au?oriz$ uses ,an entity receiv+ a grant
 "u ?is section may n use ! funds = any 
activity o!r ?an ! activities li/$ 9    
p>agraphs 7#a7 & 7#b74  2  7#d7 9       
subsection 7i77#b71 by ins]t+ 1 :i* %all
 include ! employm5t & e>n+s outcomes z 
describ$ 9 subclauses 7,i7 & 7,,iii7 (  
section #aaf7;b77#b77;,a77i7 ( !        
,work=ce ,innovation & ,opportunity ,act
 7#bi ,u4,s4,c4 #cada7;b77#b77;,a77i77  
aft] subsection 7g72  7#e7 9 subsection 
7j7--  7,a7 9 p>agraph 7#a71 by ins]t+ =
 ea* grant cycle aft] grant p]iod2 &    
7,b7 9 p>agraph 7#b7--  7i7 9 ! matt]   
prec$+ subp>agraph 7,a7-- 7,i7 by /rik+ 
! prelim9>y report & ins]t+ ea*         
prelim9>y report2 &  7,,ii7 by ins]t+ = 
! grant cycle aft] f9al report2 &  7ii7 

9 subp>agraph 7,a71 by /rik+ 7g77#c7 &  
ins]t+ 7g77#a77;,c72 &  7#f7 9          
subsection 7k71 by /rik+ #e1jjj1jjj =   
ea* ( fiscal ye>s #bjai ?r\gh #bjbc &   
ins]t+ #ab1jjj1jjj = ea* ( fiscal ye>s  
#bjbd ?r\gh #bjbh4  #aag4 ,grant program
 = ,/ate & ,tribal response to opioid   
use disord]s ,section #ajjc7;b77#d77;,a7
 ( ! #ba/ ,c5tury ,cures ,act 7#db      
,u4,s4,c4 #bij;ee-#c;a7b77#d77;,a77 is  
am5d$ aft] :i* may include drugs or     
devices approv$1 cle>$1 or o!rwise      
legally m>ket$ "u ! ,f$]al ,food1 ,drug1
 & ,cosmetic ,act by ins]t+ or f5tanyl  
or xylaz9e te/ /rips4  #aah4 ,ref]5ces  
to opioid ov]dose rev]sal ag5ts 9 ,,hhs 
grant programs  7a7 ,9 g5]al ,!         
,secret>y ( ,heal? & ,human ,s]vices    
%all ensure t1 z appropriate1 :5ev] !   
,dep>tm5t ( ,heal? & ,human ,s]vices    
issues a regulation or guidance = any   
grant program address+ opioid misuse &  
use disord]s1 any ref]5ce to an opioid  
ov]dose rev]sal drug 7su* z a ref]5ce to
 naloxone7 is inclusive ( any opioid    

ov]dose rev]sal drug t has be5 approv$  
"u section #eje ( ! ,f$]al ,food1 ,drug1
 & ,cosmetic ,act 7#ba ,u4,s4,c4 #cee7 =
 em]g5cy treatm5t ( a kn[n or suspect$  
opioid ov]dose4  7b7 ,exi/+ ref]5ces    
7#a7 ,update ,n lat] ?an "o ye> aft] !  
date ( enactm5t ( ?is ,act1 ! ,secret>y 
( ,heal? & ,human ,s]vices %all update  
all ref]5ces describ$ 9 p>agraph 7#b7 to
 be inclusive ( any opioid ov]dose      
rev]sal drug t has be5 approv$ or       
o!rwise au?oriz$ = use by ! ,food &     
,drug ,adm9i/ration4  7#b7 ,ref]5ces ,a 
ref]5ce describ$ 9 ?is p>agraph is any  
ref]5ce to an opioid ov]dose rev]sal    
drug 7su* z naloxone7 9 any regulation  
or guidance ( ! ,dep>tm5t ( ,heal? &    
,human ,s]vices t--  7,a7 0 issu$ be=e !
 date ( enactm5t ( ?is ,act2 &  7,b7 is 
includ$ 9--  7i7 ! grant program = ,/ate
 & ,tribal response to opioid use       
disord]s "u section #ajjc ( ! #ba/      
,c5tury ,cures ,act 7#db ,u4,s4,c4      
#bij;ee-#c note7 7commonly ref]r$ to z  
,/ate ,opioid ,response ,grants &       

,tribal ,opioid ,response ,grants72 or  
7ii7 ! grant program = priority sub/ance
 use disord] prev5tion ne$s ( regional &
 national significance "u section #eaf (
 ! ,public ,heal? ,s]vice ,act 7#db     
,u4,s4,c4 #bij;bb-#bb74  #aai4 ,address+
 o!r concurr5t sub/ance use disord]s    
?r\gh grant program = ,/ate & ,tribal   
response to opioid use disord]s  7a7    
,additional use ( funds ,section        
#ajjc7;b7 ( ! #ba/ ,c5tury ,cures ,act  
7#db ,u4,s4,c4 #bij;ee-#c note7 is am5d$
 by add+ at ! end ! foll[+3  7#e7 ,o!r  
concurr5t sub/ance use disord]s ,!      
,secret>y may au?orize ! recipi5t ( a   
grant "u ?is subsection1 9 addition to  
us+ ! grant = activities describ$ 9     
p>agraph 7#d7 ) respect to opioid misuse
 & use disord]s & /imulant misuse & use 
disord]s1 to use ! grant = simil>       
activities ) respect to o!r concurr5t   
sub/ance use disord]s4  4  7b7 ,annual  
report to ,congress ,section #ajjc7;f7 (
 ! #ba/ ,c5tury ,cures ,act 7#db        
,u4,s4,c4 #bij;ee-#c note7 is am5d$--   

7#a7 9 p>agraph 7#b71 /rike & at ! end2 
7#b7 9 p>agraph 7#c71 /rike ! p]iod at !
 end & ins]t a semicolon2 &  7#c7 by    
add+ at ! end ! foll[+3  7#d7 ! am\nt ( 
funds ea* ,/ate t receiv$ a grant "u    
subsection 7b7 receiv$ = ! #ab-mon?     
grant cycle cov]$ by ! report2  7#e7 !  
am\nt ( grant funds ea* su* ,/ate sp5t =
 su* grant cycle1 disaggregat$ by ! uses
 = :i* su* funds 7 sp5t1 includ+ ea*    
all[able use "u p>agraphs 7#d7 & 7#e7 ( 
subsection 7b72  7#f7 h[ _m su* ,/ates =
 su* grant cycle did n sp5d all ( !     
grant funds be=e su* grant cycle expir$2
  7#g7 h[ _m su* ,/ates = su* grant     
cycle reque/$ no-co/ ext5sions to ext5d 
! grant cycle2 &  7#h7 *all5ges = su*   
,/ates to sp5d all ( ! funds allocat$ & 
! reason = su* *all5ges1 includ+ to :at 
ext5t report+ requirem5ts or o!r        
requirem5ts plac$ an increas$ burd5 on !
 ability ( su* ,/ates to sp5d all ( !   
funds4  4  7c7 ,o!r concurr5t sub/ance  
use disord]s def9$ ,section #ajjc7;h7 ( 
! #ba/ ,c5tury ,cures ,act 7#db         

,u4,s4,c4 #bij;ee-#c note7 is am5d$--   
7#a7 by r$esignat+ p>agraphs 7#b7 ?r\gh 
7#d7 z p>agraphs 7#c7 ?r\gh 7#e72 &     
7#b7 by ins]t+ be=e p>agraph 7#c71 z    
r$esignat$1 ! foll[+3  7#b7 ,o!r        
concurr5t sub/ance use disord]s ,! t]m  
o!r concurr5t sub/ance use disord]s     
means-- 7,a7 alcohol use disord]s       
co-occurr+ ) opioid misuse & use        
disord]s z a prim>y disord]2 or  7,b7   
alcohol use disord]s co-occurr+ )       
/imulant misuse & use disord]s z a      
prim>y disord]4  4  7d7 ,rule (         
con/ruction ,no?+ 9 ?is ,act or !       
am5dm5ts made by ?is ,act %all be       
con/ru$ to *ange ! allocation ( funds   
among grantees pursuant to ! m9imum     
allocations & =mula me?odology "u       
section #ajjc ( ! #ba/ ,c5tury ,cures   
,act 7#db ,u4,s4,c4 #bij;ee-#c note74   
#abj4 ,provid+ = a /udy on ! effects (  
remote monitor+ on individuals :o are   
prescrib$ opioids  7a7 ,9 g5]al ,n lat] 
?an #ah mon?s aft] ! date ( enactm5t (  
?is ,act1 ! ,comptroll] ,g5]al ( !      

,unit$ ,/ates %all conduct a /udy &     
submit to ! ,committee on ,en]gy &      
,comm]ce ( ! ,h\se ( ,repres5tatives & !
 ,committee on ,heal?1 ,education1      
,labor1 & ,p5sions & ! ,committee on    
,f9ance ( ! ,s5ate a report on ! use (  
remote monitor+ ) respect to individuals
 :o are prescrib$ opioids4  7b7 ,report 
,! report describ$ 9 subsection 7a7 %all
 include to ! ext5t in=mation is        
available & reliable--  7#a7 an         
assessm5t ( sci5tific evid5ce relat$ to 
! efficacy1 individual outcomes1 &      
pot5tial co/ sav+s associat$ ) remote   
monitor+ = individuals :o are prescrib$ 
opioids comp>$ to su* individuals :o are
 n s monitor$2  7#b7 an assessm5t ( !   
curr5t preval5ce ( remote monitor+ =    
individuals :o are prescrib$ opioids1   
includ+ ! use ( su* monitor+ = su*      
individuals 9 o!r c\ntries2 &  7#c7     
in=mation1 includ+ recomm5dations z     
appropriate1 to improve availability1   
access1 & cov]age = remote monitor+ =   
individuals :o are prescrib$ opioids1   

includ+ ?r\gh *anges to ,f$]al heal? c>e
 programs 7z def9$ 9 section #aabh;,b ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acbj;a-#g;b774  ,,ii ,controll$        
,sub/ances  #bja4 ,deliv]y ( c]ta9      
sub/ances by a ph>macy to an adm9i/]+   
practition] ,p>agraph 7#b7 ( section    
#cji;,a7a7 ( ! ,controll$ ,sub/ances    
,act 7#ba ,u4,s4,c4 #hbi;a7a77 is am5d$ 
to read z foll[s3  7#b7 ! controll$     
sub/ance is a drug 9 s*$ule ,,iii1 ,,iv1
 or ,v t is1 pursuant to ! approval or  
lic5sure ( su* drug "u ! ,f$]al ,food1  
,drug1 & ,cosmetic ,act or section #cea 
( ! ,public ,heal? ,s]vice ,act1 to be  
adm9i/]$ by1 or "u ! sup]vision (1 !    
prescrib+ practition]2  4  #bjb4        
,review+ ! s*$ul+ ( approv$ products    
conta9+ a comb9ation ( bupr5orph9e &    
naloxone  7a7 ,secret>y ( ,,hhs ,!      
,secret>y ( ,heal? & ,human ,s]vices    
%all1 consi/5t ) ! requirem5ts &        
proc$ures set =? 9 sections #bja & #bjb 
( ! ,controll$ ,sub/ances ,act 7#ba     
,u4,s4,c4 #haa2 #hab7--  7#a7 review !  

relevant data p]ta9+ to ! s*$ul+ (      
products conta9+ a comb9ation (         
bupr5orph9e & naloxone t h be5 approv$  
"u section #eje ( ! ,f$]al ,food1 ,drug1
 & ,cosmetic ,act 7#ba ,u4,s4,c4 #cee72 
&  7#b7 if appropriate1 reque/ t !      
,attorney ,g5]al initiate rulemak+      
proce$+s to revise ! s*$ules accord+ly )
 respect to su* products4  7b7 ,attorney
 ,g5]al ,! ,attorney ,g5]al %all review 
any reque/ made by ! ,secret>y ( ,heal? 
& ,human ,s]vices "u subsection 7a77#b7 
& det]m9e :e!r to initiate proce$+s to  
revise ! s*$ules 9 accordance ) !       
crit]ia set =? 9 sections #bja & #bjb ( 
! ,controll$ ,sub/ances ,act 7#ba       
,u4,s4,c4 #haa2 #hab74  #bjc4 ,combat+  
illicit xylaz9e  7a7 ,def9itions  7#a7  
,9 g5]al ,9 ?is section1 ! t]m xylaz9e  
has ! mean+ giv5 ! t]m 9 p>agraph 7#fj7 
( section #ajb ( ! ,controll$ ,sub/ances
 ,act1 z add$ by p>agraph 7#b74  7#b7   
,controll$ ,sub/ances ,act ,section #ajb
 ( ! ,controll$ ,sub/ances ,act 7#ba    
,u4,s4,c4 #hjb7 is am5d$-- 7,a7 by      

r$esignat+ ! second p>agraph 7#eg7      
7relat+ to s]i\s drug felony7 & p>agraph
 7#eh7 z p>agraphs 7#eh7 & 7#ei71       
respectively2  7,b7 by mov+ ! m>g9 (    
p>agraph 7#eg7 #b ems to ! left2  7,c7  
by mov+ ! m>g9s ( p>agraphs 7#eh7 &     
7#ei71 z r$esignat$1 #b ems to ! left2 &
  7,d7 by add+ at ! end ! foll[+3  7#fj7
 7,a7 ,! t]m xylaz9e means ! sub/ance   
xylaz9e z well z its salts1 isom]s1 &   
salts ( isom]s :5ev] ! exi/5ce ( su*    
salts1 isom]s1 & salts ( isom]s is      
possible4  7,b7 ,except z provid$ 9     
subp>agraph 7,e71 su* t]m does n include
 a sub/ance describ$ 9 subp>agraph 7,a7 
to ! ext5t-- 7i7 su* sub/ance is an     
animal drug t has be5 approv$ by !      
,secret>y ( ,heal? & ,human ,s]vices "u 
section #eab ( ! ,f$]al ,food1 ,drug1 & 
,cosmetic ,act & su* sub/ance's use or  
int5d$ use con=ms to ! approv$          
application1 includ+ ! manufactur+1     
importation1 hold+1 or di/ribution = su*
 use2 or  7ii7 su* sub/ance is us$ or   
int5d$ = use 9 animals o!r ?an humans z 

p]mitt$ "u section #eab7;a77#d7 ( !     
,f$]al ,food1 ,drug1 & ,cosmetic ,act4  
7,c7 ,if any p]son prescribes1 disp5ses1
 di/ributes1 manufactures1 or imports   
xylaz9e = human use1 su* p]son %all be  
consid]$ to h prescrib$1 disp5s$1       
di/ribut$1 manufactur$1 or import$      
xylaz9e n subject to an exclusion "u    
subp>agraph 7,b74  4  7b7 ,placem5t (   
xylaz9e on s*$ule ,,iii ,s*$ule ,,iii 9 
section #bjb7;c7 ( ! ,controll$         
,sub/ances ,act 7#ba ,u4,s4,c4 #hab7;c77
 is am5d$ by add+ at ! end ! foll[+3    
7f7 ,xylaz9e4  4  7c7 ,,arcos track+    
,section #cjg7;i7 ( ! ,controll$        
,sub/ances ,act 7#ba ,u4,s4,c4 #hbg7;i77
 is am5d$-- 7#a7 9 ! matt] prec$+       
p>agraph 7#a7--  7,a7 by ins]t+ or      
xylaz9e aft] gamma hydroxybutyric acid2 
7,b7 by ins]t+ or #eab aft] section     
#eje2 &  7,c7 by ins]t+ respectively1   
aft] ! ,f$]al ,food1 ,drug1 & ,cosmetic 
,act12 &  7#b7 9 p>agraph 7#f71 by      
ins]t+ or xylaz9e aft] gamma            
hydroxybutyric acid4  7d7 ,report to    

,congress on xylaz9e  7#a7 ,initial     
report ,n lat] ?an #a ye> aft] ! date ( 
enactm5t ( ?is ,act1 ! ,attorney ,g5]al1
 act+ ?r\gh ! ,adm9i/rator ( ! ,drug    
,en=cem5t ,adm9i/ration & 9 coord9ation 
) ! ,commission] ( ,food & ,drugs1 %all 
submit to ,congress a report on !       
preval5ce ( illicit use ( xylaz9e 9 !   
,unit$ ,/ates & ! impacts ( su* use1    
includ+-- 7,a7 :]e ! drug is be+ div]t$2
  7,b7 :]e ! drug is orig9at+2  7,c7    
:e!r any analogues to su* drug pres5t a 
sub/antial risk ( abuse2  7,d7 :e!r & to
 :at ext5t ! illicit supply ( xylaz9e   
d]ives f ! licit supply *a92 &  7,e7    
recomm5dations = ,congress ) respect to 
:e!r xylaz9e %\ld be transf]r$ to ano!r 
s*$ule "u section #bjb ( ! ,controll$   
,sub/ances ,act 7#ba ,u4,s4,c4 #hab74   
7#b7 ,additional report ,n lat] ?an #c  
ye>s aft] ! date ( enactm5t ( ?is ,act1 
! ,attorney ,g5]al1 act+ ?r\gh !        
,adm9i/rator ( ! ,drug ,en=cem5t        
,adm9i/ration & 9 coord9ation ) !       
,commission] ( ,food & ,drugs1 %all     

submit to ,congress a report updat+     
,congress on ! preval5ce ( xylaz9e      
traffick+1 misuse1 & prolif]ation 9 !   
,unit$ ,/ates1 includ+-- 7,a7 ! /atus & 
results ( rese>* on ! impact xylaz9e has
 on human heal?2 &  7,b7 ! effects ( !  
classification ( xylaz9e "u ! ,controll$
 ,sub/ances ,act 7#ba ,u4,s4,c4 #hja et 
seq47 on ! preval5ce ( xylaz9e          
traffick+1 misuse1 & prolif]ation 9 !   
,unit$ ,/ates4  7#c7 ,obta9+ (ficial    
data ,! ,attorney ,g5]al1 act+ ?r\gh !  
,adm9i/rator ( ! ,drug ,en=cem5t        
,adm9i/ration & 9 coord9ation ) !       
,commission] ( ,food & ,drugs1 may      
secure directly f any dep>tm5t or ag5cy 
( ! ,unit$ ,/ates docum5ts1 /ati/ical   
data1 & o!r in=mation necess>y to c>ry  
out p>agraphs 7#a7 & 7#b74 ,^u receipt (
 a reque/ f ! ,attorney ,g5]al = su*    
docum5ts1 data1 & in=mation1 ! head ( ! 
dep>tm5t or ag5cy %all1 9 accordance )  
applicable proc$ures = ! appropriate    
h&l+ ( classifi$ in=mation1 promptly    
provide reasonable access to su*        

docum5ts1 data1 & in=mation4  7#d7      
,views ( exp]ts f non-,f$]al entities ,9
 develop+ ! reports "u p>agraphs 7#a7 & 
7#b71 ! ,attorney ,g5]al1 act+ ?r\gh !  
,adm9i/rator ( ! ,drug ,en=cem5t        
,adm9i/ration & 9 coord9ation ) !       
,commission] ( ,food & ,drugs1 %all     
consult )1 & take into consid]ation !   
views (1 exp]ts f appropriate non-,f$]al
 entities1 includ+ su* exp]ts f-- 7,a7 !
 sci5tific & m$ical rese>* community2   
7,b7 ! ,/ate & local law en=cem5t       
community2 &  7,c7 community-bas$       
organizations4  #bjd4 ,te*nical         
corrections ,effective z if includ$ 9 ! 
enactm5t ( ,public ,law #aag-cbh-- 7#a7 
section #abeb7;a7 ( division ,,ff (     
,public ,law #aag-cbh is am5d$1 9 !     
matt] be+ ins]t$ into section #cjb7;e7 (
 ! ,controll$ ,sub/ances ,act1 by /rik+ 
#cjc7;g7 & ins]t+ #cjc7;h72  7#b7       
section #abfb ( division ,,ff ( ,public 
,law #aag-cbh is am5d$-- 7,a7 9         
subsection 7a7--  7i7 9 ! matt] prec$+  
p>agraph 7#a71 by /rik+ #cjc7;g7 &      

ins]t+ #cjc7;h72  7ii7 9 ! matt] be+    
/rick5 by subsection 7a77#b71 by /rik+  
7g77#a7 & ins]t+ 7h77#a72 &  7iii7 9 !  
matt] be+ ins]t$ by subsection 7a77#b71 
by /rik+ 7g7 ,practition]s & ins]t+ 7h7 
,practition]s2 &  7,b7 9 subsection     
7b7--  7i7 9 ! matt] be+ /rick5 by      
p>agraph 7#a71 by /rik+ #cjc7;g77#a7 &  
ins]t+ #cjc7;h77#a72  7ii7 9 ! matt] be+
 ins]t$ by p>agraph 7#a71 by /rik+      
#cjc7;g7 & ins]t+ #cjc7;h72  7iii7 9 !  
matt] be+ /rick5 by p>agraph 7#b77;,a71 
by /rik+ #cjc7;g77#b7 & ins]t+          
#cjc7;h77#b72  7iv7 9 ! matt] be+ /rick5
 by p>agraph 7#c71 by /rik+             
#cjc7;g77#b77;,b7 & ins]t+              
#cjc7;h77#b77;,b72  7v7 9 ! matt] be+   
/rick5 by p>agraph 7#e71 by /rik+       
#cjc7;g7 & ins]t+ #cjc7;h72 &  7vi7 9 ! 
matt] be+ /rick5 by p>agraph 7#f71 by   
/rik+ #cjc7;g7 & ins]t+ #cjc7;h72 &     
7#c7 section #abfc7;b7 ( division ,,ff (
 ,public ,law #aag-cbh is am5d$-- 7,a7  
by /rik+ #cjc7;g77#b7 & ins]t+          
#cjc7;h77#b72 &  7,b7 by /rik+ 7#ba     

,u4,s4,c4 #hbc7;g77#b77 & ins]t+ 7#ba   
,u4,s4,c4 #hbc7;h77#b774  #bje4 ,requir$
 tra9+ = prescrib]s ( controll$         
sub/ances ,section #cjc ( ! ,controll$  
,sub/ances ,act 7#ba ,u4,s4,c4 #hbc7 is 
am5d$--  7#a7 by r$esignat+ ! second    
subsection 7l7 7add$ by section #abfc ( 
division ,,ff ( ,public ,law #aag-cbh7 z
 subsection 7m72 &  7#b7 9 subsection   
7m71 z r$esignat$--  7,a7 9 p>agraph    
7#a77;,a77iv7-- 7i7 9 subclause 7,i71 by
 /rik+ or ! ,commission = ,cont9u+      
,education ,provid] ,recognition        
7,,ccepr7 & ins]t+ ! ,commission =      
,cont9u+ ,education ,provid]            
,recognition 7,,ccepr71 ! ,am]ican      
,podiatric ,m$ical ,association1 !      
,c\ncil on ,podiatric ,m$ical ,education
 7,,cpme71 or ! ,academy ( ,g5]al       
,d5ti/ry2  7ii7 by r$esignat+ subclauses
 7,,ii71 7,,iii71 & 7,,iv7 z subclauses 
7,,iii71 7,,iv71 & 7,v71 respectively2 &
  7iii7 by ins]t+ aft] subclause 7,i7 ! 
foll[+3  7,,ii7 ! ,am]ican ,academy (   
,family ,physicians or any organization 

^: cont9u+ m$ical education activity has
 be5 approv$ or accr$it$ by ! ,am]ican  
,academy ( ,family ,physicians2  2 &    
7iv7 9 subclause 7,v71 z r$esignat$1 by 
/rik+ any organization approv$ by !     
,assi/ant ,secret>y = ,m5tal ,heal? &   
,sub/ance ,use1 ! ,,accme1 or ! ,,ccepr 
& ins]t+ any organization approv$ by !  
,,accme or ! ,,ccepr2  7,b7 9 p>agraph  
7#a77;,a77v7-- 7i7 by ins]t+ podiatric  
m$ic9e1 aft] allopa?ic m$ic9e1 o/eopa?ic
 m$ic9e12 &  7ii7 by /rik+ allopa?ic or 
o/eopa?ic m$ic9e curriculum & ins]t+    
allopa?ic1 o/eopa?ic1 or podiatric      
m$ic9e curriculum2  7,c7 9 p>agraph     
7#a77;,b77i71 by /rik+ or any o!r       
organization approv$ or accr$it$ by !   
,assi/ant ,secret>y = ,m5tal ,heal? &   
,sub/ance ,use or ! ,accr$itation       
,c\ncil = ,cont9u+ ,m$ical ,education & 
ins]t+ ! ,am]ican ,podiatric ,m$ical    
,association1 ! ,c\ncil on ,podiatric   
,m$ical ,education 7,,cpme71 ! ,am]ican 
,ph>maci/s ,association1 ! ,accr$itation
 ,c\ncil = ,ph>macy ,education1 !       

,am]ican ,optometric ,association1 !    
,academy ( ,g5]al ,d5ti/ry1 ! ,am]ican  
,psy*iatric ,nurses ,association1 !     
,am]ican ,academy ( ,nurs+1 ! ,am]ican  
,academy ( ,family ,physicians1 or any  
o!r organization approv$ or accr$it$ by 
! ,am]ican ,academy ( ,family           
,physicians or ! ,accr$itation ,c\ncil =
 ,cont9u+ ,m$ical ,education2 &  7,d7 9 
p>agraph 7#a77;,b77ii71 by /rik+ f an   
accr$it$ physician assi/ant s*ool or    
accr$it$ s*ool ( advanc$ practice nurs+ 
& ins]t+ f an accr$it$ physician        
assi/ant s*ool1 an accr$it$ s*ool (     
advanc$ practice nurs+1 or an accr$it$  
s*ool ( ph>macy4  ,,iii ,m$icaid  #cja4 
,ext5d+ requirem5t = ,/ate ,m$icaid     
plans to provide cov]age =              
m$ication-assi/$ treatm5t  7a7 ,9 g5]al 
,section #aije ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;d7 is am5d$-- 
7#a7 9 subsection 7a77#bi71 by /rik+ = !
 p]iod beg9n+ ,octob] #a1 #bjbj1 & end+ 
,septemb] #cj1 #bjbe1 & ins]t+ beg9n+ on
 ,octob] #a1 #bjbj12 &  7#b7 9          

subsection 7ee77#b71 by /rik+ = ! p]iod 
specifi$ 9 su* p>agraph1 if be=e !      
beg9n+ ( su* p]iod ! ,/ate c]tifies to !
 satisfaction ( ! ,secret>y & ins]t+ if 
su* ,/ate c]tifies1 n less ?an e #e ye>s
 & to ! satisfaction ( ! ,secret>y14    
7b7 ,con=m+ am5dm5t ,section            
#ajjf7;b77#d77;,a7 ( ! ,sub/ance        
,use-,disord] ,prev5tion t ,promotes    
,opioid ,recov]y & ,treatm5t = ,pati5ts 
& ,communities ,act 7#db ,u4,s4,c4      
#acif;a note7 is am5d$ by /rik+ 1 & be=e
 ,octob] #a1 #bjbe4  #cjb4 ,exp&+       
requir$ reports on ,t-,,msis sub/ance   
use disord] data to include m5tal heal? 
condition data  7a7 ,9 g5]al ,section   
#ajae7;a7 ( ! ,,support = ,pati5ts &    
,communities ,act 7#db ,u4,s4,c4        
#acbj;d-#b note7 is am5d$--  7#a7 9 !   
head+1 by /rik+ sub/ance use disord]    
data book & ins]t+ behavioral heal? data
 book2  7#b7 9 p>agraph 7#b7--  7,a7 9 !
 matt] prec$+ subp>agraph 7,a71 by      
ins]t+ 1 includ+ z updat$ 9 accordance )
 p>agraph 7#c71 aft] p>agraph 7#a72     

7,b7 9 subp>agraph 7,a71 by ins]t+ 1    
m5tal heal? condition1 or a m5tal heal? 
condition co-occurr+ ) sub/ance use     
disord] aft] sub/ance use disord]2  7,c7
 9 subp>agraph 7,b71 by ins]t+ & m5tal  
heal? treatm5t s]vices aft] sub/ance use
 disord] treatm5t s]vices2  7,d7 9      
subp>agraph 7,c7--  7i7 by ins]t+ 1     
m5tal heal? condition1 or a m5tal heal? 
condition co-occurr+ ) a sub/ance use   
disord] diagnosis aft] sub/ance use     
disord] diagnosis2 &  7ii7 by ins]t+ or 
m5tal heal? treatm5t s]vices1           
respectively1 aft] sub/ance use disord] 
treatm5t s]vices2  7,e7 9 subp>agraph   
7,d71 by ins]t+ 1 m5tal heal? condition1
 or a m5tal heal? condition co-occurr+ )
 sub/ance use disord] aft] sub/ance use 
disord] diagnosis2  7,f7 9 subp>agraph  
7,e71 by ins]t+ or m5tal heal? treatm5t 
aft] sub/ance use disord] treatm5t2 &   
7,g7 9 subp>agraph 7,f71 by ins]t+ 1    
individuals ) a m5tal heal? condition :o
 receive m5tal heal? treatm5t s]vices1 &
 individuals ) a co-occurr+ m5tal heal? 

condition & sub/ance use disord] :o     
receive sub/ance use disord] treatm5t   
s]vices & m5tal heal? treatm5t s]vices1 
aft] sub/ance use disord] treatm5t      
s]vices2 &  7#c7 9 p>agraph 7#c71 by    
/rik+ ?r\gh #bjbd4  7b7 ,application ,! 
am5dm5ts made by subsection 7a77#a7 %all
 apply beg9n+ ) respect to ! fir/ update
 made pursuant to section #ajae7;a77#c7 
( ! ,,support = ,pati5ts & ,communities 
,act 7#db ,u4,s4,c4 #acbj;d-#b note7    
aft] ! date t is #ab mon?s aft] ! date (
 enactm5t ( ?is ,act4  #cjc4 ,monitor+  
prescrib+ ( antipsy*otic m$ications     
,section #aijb7oo77#a77;,b7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acif;a7oo77#a77;,b77 is am5d$--  7#a7 9
 ! subp>agraph head+1 by /rik+ by       
*ildr52  7#b7 by ins]t+ 1 & beg9n+ on ! 
date t is #bd mon?s aft] ! date (       
enactm5t ( ,support = ,pati5ts &        
,communities ,reau?orization ,act1      
individuals ov] ! age ( #ah1 individuals
 receiv+ home & community-bas$ s]vices  
7z def9$ 9 section #ihag7;a77#b77;,b7 ( 

,public ,law #aag-b71 & individuals     
resid+ 9 in/itutional c>e sett+s        
7includ+ nurs+ facilities1 int]m$iate   
c>e facilities = individuals )          
intellectual disabilities1 & o!r su*    
in/itutional c>e sett+s7 enroll$1 aft]  
*ildr5 enroll$2 &  7#c7 by /rik+ n m ?an
 ! age ( #ah ye>s & ins]t+ subject to ! 
program4  #cjd4 ,lift+ ! ,,imd exclusion
 = sub/ance use disord]  7a7 ,mak+      
p]man5t ,/ate ,plan ,am5dm5t ,option ,to
 ,provide ,m$ical ,assi/ance = ,c]ta9   
,individuals ,:o ,are ,pati5ts 9 ,c]ta9 
,in/itutions = ,m5tal ,diseases ,section
 #aiae7l77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acifn7l77#a77 is am5d$ 
by /rik+ ,) respect to cal5d> qu>t]s    
beg9n+ dur+ ! p]iod beg9n+ ,octob] #a1  
#bjai1 & end+ ,septemb] #cj1 #bjbc1 &   
ins]t+ ,) respect to cal5d> qu>t]s      
beg9n+ on or aft] ,octob] #a1 #bjai14   
7b7 ,ma9t5ance ( ef=t revision ,section 
#aiae7l77#c7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #acifn7l77#c77 is am5d$--
 7#a7 9 subp>agraph 7,a7---  7,a7 9 !   

matt] prec$+ clause 7i71 by /rik+ o!r   
?an "u ?is title2 &  7,b7 9 clause 7i71 
by /rik+ or1 if high]1 & all t foll[s   
?r\gh 9 accordance ) ?is subsection2 &  
7#b7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,d7 ,application (       
ma9t5ance ( ef=t requirem5ts to c]ta9   
,/ates ,9 ! case ( a ,/ate ) a ,/ate    
plan am5dm5t 9 effect on ! date ( !     
enactm5t ( ?is subp>agraph1 = ! #a-ye>  
p]iod beg9n+ on su* date1 ! provisions (
 subp>agraph 7,a7 %all be appli$ z if ! 
am5dm5ts to su* subp>agraph made by !   
,support = ,pati5ts & ,communities      
,reau?orization ,act _h nev] be5 made4  
4  7c7 ,additional requirem5ts  7#a7 ,9 
g5]al  7,a7 ,g5]al requirem5ts ,section 
#aiae7l77#d7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #acifn7l77#d77 is am5d$--
 7i7 9 subp>agraph 7,a71 by /rik+ ?r\gh 
7,d7 & ins]t+ ?r\gh 7,f72  7ii7 9       
subp>agraph 7,d71 9 ! matt] prec$+      
clause 7i71 by ins]t+ h 9 place         
evid5ce-bas$1 sub/ance use              
disord]-specific individual placem5t    

crit]ia & utilization managem5t approa* 
to ensure placem5t ( su* individual 9 an
 appropriate level ( c>e & %all aft]    
,/ate %all2 &  7iii7 by add+ at ! end ! 
foll[+ new subp>agraph3  7,e7 ,review   
process ,! ,/ate %all h 9 place a       
process to review ! compliance (        
eligible in/itutions = m5tal diseases ) 
evid5ce-bas$1 sub/ance use              
disord]-specific program /&>ds =        
eligible individuals specifi$ by !      
,/ate4  4  7,b7 ,effective date ,!      
am5dm5ts made by subp>agraph 7,a7 %all  
apply ) respect to m$ical assi/ance     
furni%$ 9 cal5d> qu>t]s beg9n+ on or    
aft] ,octob] #a1 #bjbe4  7#b7 ,"o-"t    
assessm5t ,section #aiae7l77#d7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#acifn7l77#d771 z am5d$ by p>agraph     
7#a71 is fur!r am5d$ by add+ at ! end ! 
foll[+ new subp>agraph3  7,f7 ,assessm5t
  7i7 ,9 g5]al ,! ,/ate %all1 n lat] ?an
 #ab mon?s aft] ! approval ( a ,/ate    
plan am5dm5t describ$ 9 ?is subsection  
7or1 9 ! case su* ,/ate has su* an      

am5dm5t approv$ z ( ! date ( ! enactm5t 
( ?is subp>agraph1 n lat] ?an #ab mon?s 
aft] su* date71 comm5ce an assessm5t (--
  7,i7 ! availability ( treatm5t =      
individuals enroll$ "u a ,/ate plan "u  
?is title 7or waiv] ( su* plan7 9 ea*   
level ( c>e describ$ 9 subp>agraph 7,c72
 &  7,,ii7 ! availability (             
m$ication-assi/$ treatm5t & m$ically    
sup]vis$ )drawal managem5t s]vices = su*
 individuals4  7ii7 ,requir$ completion 
,! ,/ate compete an assessm5t describ$ 9
 clause 7i7 n lat] ?an #ab mon?s aft] ! 
date ! ,/ate comm5ces su* assessm5t4  4 
7#c7 ,cl>ification ( levels ( c>e       
,section #aiae7l77#g77;,a7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#acifn7l77#g77;,a77 is am5d$ by ins]t+  
7or any successor publication7 be=e !   
p]iod4  #cje4 ,prohibition on t]m9ation 
( enrollm5t due to inc>c]ation  7a7     
,m$icaid  7#a7 ,9 g5]al ,section        
#aijb7;a77#hd77;,a7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#acif;a7a77#hf77;,a771 z am5d$ by       

section #eabb7;a77#b7 ( ! ,consolidat$  
,appropriations ,act1 #bjbc 7,public    
,law #aag-cbh71 is fur!r am5d$-- 7,a7 by
 /rik+ "u ! ,/ate plan & ins]t+ "u !    
,/ate plan 7or waiv] ( su* plan72  7,b7 
by /rik+ :o is an eligible juv5ile 7z   
def9$ 9 subsection 7nn77#b772  7,c7 by  
/rik+ because ! juv5ile & ins]t+ because
 ! individual2  7,d7 by /rik+ dur+ !    
p]iod ! juv5ile & ins]t+ dur+ ! p]iod ! 
individual2 &  7,e7 by ins]t+ su* an    
individual :o is an eligible juv5ile 7z 
def9$ 9 subsection 7nn77#b77 or a woman 
dur+ pregnancy 7& dur+ ! #fj-;day beg9n+
 on ! la/ day ( pregnancy7 & aft] or 9 !
 case (4  7#b7 ,effective date ,!       
am5dm5ts made by-- 7,a7 subp>agraph 7,a7
 ( p>agraph 7#a7 %all take effect on !  
date ( ! enactm5t ( ?is ,act2 &  7,b7   
subp>agraphs 7,b7 ?r\gh 7,e7 ( p>agraph 
7#a7 %all take effect on ,janu>y #a1    
#bjbe4  7b7 ,,*ip  7#a7 ,9 g5]al        
,section #bajb7;d77#a77;,a7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acig;bb7d77#a77;,a77 is am5d$--  7,a7  

by ins]t+ or pregnancy-relat$ aft] *ild 
heal?2  7,b7 by ins]t+ or t>get$        
l[-income pregnant woman aft] t>get$    
l[-income *ild2  7,c7 by ins]t+ or      
pregnant woman aft] because ! *ild2 &   
7,d7 by ins]t+ or pregnant woman aft]   
dur+ ! p]iod ! *ild4  7#b7 ,effective   
date ,! am5dm5ts made by p>agraph 7#a7  
%all apply beg9n+ ,janu>y #a1 #bjbe4    
7c7 ,te*nical correction ,section       
#aijb7nn77#b77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acie;a7a77nn77#b77;,a77 is am5d$ by    
/rik+ ,/ate plan & ins]t+ ,/ate plan 7or
 waiv] ( su* plan74  #cjf4 ,/ate option 
relat+ to inmates :o are pregnant wom5  
p5d+ disposition ( *>ges  7a7 ,/ate     
option  7#a7 ,m$icaid ,! subdivision    
7,a7 ( section #aije7;a7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#acif;d7a77 foll[+ p>agraph 7#ca7 ( su* 
section1 z am5d$ by section #eabb ( !   
,consolidat$ ,appropriations ,act1 #bjbc
 7,public ,law #aag-cbh71 is fur!r am5d$
 by ins]t+ or a woman dur+ pregnancy 7& 

dur+ ! #fj-;day beg9n+ on ! la/ day (   
pregnancy7 aft] 7z def9$ 9 section      
#aijb7nn77#b774  7#b7 ,,*ip ,section    
#baaj7;b77#g7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acig;jj7b77#aj771 z    
am5d$ by section #eabb ( ! ,consolidat$ 
,appropriations ,act1 #bjbc 7,public    
,law #aag-cbh71 is fur!r am5d$--  7,a7  
by ins]t+ a woman dur+ pregnancy 7& dur+
 ! #fj-;day beg9n+ on ! la/ day (       
pregnancy7 or aft] ,at ! option ( !     
,/ate12 &  7,b7 by /rik+ dur+ ! p]iod t 
! *ild & ins]t+ dur+ ! p]iod t ! woman  
or *ild4  7#c7 ,effective date ,!       
am5dm5ts made by ?is subsection %all    
take effect on ,janu>y #a1 #bjbe4  7b7  
,te*nical correction ,section           
#eabb7;a77#a7 ( ! ,consolidat$          
,appropriations ,act1 #bjbc 7,public    
,law #aag-cbh7 is am5d$ by /rik+ aft] & 
all t foll[s ?r\gh ! p]iod at ! end &   
ins]t+ aft] or 9 ! case ( an eligible   
juv5ile describ$ 9 section              
#aijb7;a77#hd77;,d7 ) respect to !      
scre5+s1 diagno/ic s]vices1 ref]rals1 & 

t>get$ case managem5t s]vices requir$ "u
 su* section44  #cjg4 ,p]mitt+ access to
 m$ical assi/ance "u ! ,m$icaid program 
= fo/] y\?  7a7 ,9 g5]al ,section       
#aije7;a7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acif;d7a77 is am5d$ by  
add+ at ! end ! foll[+ new s5t5ce3 ,9 ! 
case ( an individual :o is "u ! age (   
#ba & :o is a pati5t 9 an in/itution =  
m5tal diseases t is a qualifi$          
resid5tial treatm5t program 7z def9$ 9  
section #dgb7k77#d771 ! exclusion f !   
def9ition ( m$ical assi/ance set =? 9 ! 
subdivision 7,b7 foll[+ ! la/ numb]$    
p>agraph ( ?is subsection %all n apply )
 respect to items & s]vices furni%$ to  
su* an individual :5 receiv$ outside (  
su* program44  7b7 ,effective date ,!   
am5dm5t made by p>agraph 7#a7 %all apply
 ) respect to m$ical assi/ance furni%$ 9
 cal5d> qu>t]s beg9n+ on or aft] ,janu>y
 #a1 #bjbe4  ,,iv ,(fsets  #dja4        
,promot+ value 9 ,m$icaid manag$ c>e    
,section #aijc7m77#i77;,a7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           

#acif;b7m77#i77;,a77 is am5d$ by /rik+  
7& be=e fiscal ye> #bjbd74  ,pass$ !    
,h\se ( ,repres5tatives ,decemb] #ab1   
#bjbc4;,cl]k4