,,ii #aaith ,,congress #ast ,session ,s4 #baba ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,june #ah1 #bjbe ,mr4 ,cassidy 7for himself1 ,mr4 ,sanders1 ,ms4 ,murkowski1 ,ms4 ,baldwin1 ,mr4 ,mullin1 ,ms4 ,hassan1 ,mr4 ,tuberville1 and ,mr4 ,hickenlooper7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to reauthorize certain programs that provide for opioid use disorder prevention1 treatment1 and recovery1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,,support for ,patients and ,communities ,reauthorization ,act of #bjbe4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4 ,title ,i--,prevention ,sec4 #aja4 ,prenatal and postnatal health4 ,sec4 #ajb4 ,monitoring and education regarding infections associated with illicit drug use and other risk factors4 ,sec4 #ajc4 ,preventing overdoses of controlled substances4 ,sec4 #ajd4 ,support for individuals and families impacted by fetal alcohol spectrum disorder4 ,sec4 #aje4 ,promoting state choice in ,,pdmp systems4 ,sec4 #ajf4 ,first responder training program4 ,sec4 #ajg4 ,donald ,j4 ,cohen ,national ,child ,traumatic ,stress ,initiative4 ,sec4 #ajh4 ,protecting suicide prevention lifeline from cybersecurity incidents4 ,sec4 #aji4 ,monitoring and reporting of child1 youth1 and adult trauma4 ,sec4 #aaj4 ,bruce's law4 ,sec4 #aaa4 ,guidance on at-home drug disposal systems4 ,sec4 #aab4 ,assessment of opioid drugs and actions4 ,sec4 #aac4 ,grant program for ,state and ,tribal response to opioid use disorders4 ,title ,,ii--,treatment ,sec4 #bja4 ,residential treatment program for pregnant and postpartum women4 ,sec4 #bjb4 ,improving access to addiction medicine providers4 ,sec4 #bjc4 ,mental and behavioral health education and training grants4 ,sec4 #bjd4 ,loan repayment program for substance use disorder treatment workforce4 ,sec4 #bje4 ,development and dissemination of model training programs for substance use disorder patient records4 ,sec4 #bjf4 ,task force on best practices for trauma-informed identification1 referral1 and support4 ,sec4 #bjg4 ,grants to enhance access to substance use disorder treatment4 ,sec4 #bjh4 ,state guidance related to individuals with serious mental illness and children with serious emotional disturbance4 ,sec4 #bji4 ,reviewing the scheduling of approved products containing a combination of buprenorphine and naloxone4 ,title ,,iii--,recovery ,sec4 #cja4 ,building communities of recovery4 ,sec4 #cjb4 ,peer support technical assistance center4 ,sec4 #cjc4 ,comprehensive opioid recovery centers4 ,sec4 #cjd4 ,youth prevention and recovery4 ,sec4 #cje4 ,,career ,act4 ,sec4 #cjf4 ,addressing economic and workforce impacts of the opioid crisis4 ,title ,,iv--,miscellaneous matters ,sec4 #dja4 ,delivery of a controlled substance by a pharmacy to a prescribing practitioner4 ,sec4 #djb4 ,required training for prescribers of controlled substances4 ,i ,prevention #aja4 ,prenatal and postnatal health ,section #cag,l7d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ac7;d77 is amended by striking such sums as may be necessary for each of the fiscal years #bjai through #bjbc and inserting #d1bej1jjj for each of fiscal years #bjbf through #bjcj4 #ajb4 ,monitoring and education regarding infections associated with illicit drug use and other risk factors ,section #cag,n7d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;b-#ae7;d77 is amended by striking fiscal years #bjai through #bjbc and inserting fiscal years #bjbf through #bjcj4 #ajc4 ,preventing overdoses of controlled substances 7a7 ,in general ,section #cib;,a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;b-#a7 is amended-- 7#a7 in subsection 7a77#b7-- 7,a7 in subparagraph 7,c71 by inserting and associated risks before the period at the end2 and 7,b7 in subparagraph 7,d71 by striking opioids and inserting substances causing overdose2 and 7#b7 in subsection 7b77#b7-- 7,a7 in subparagraph 7,b71 by inserting 1 and associated risk factors1 after such overdoses2 7,b7 in subparagraph 7,c71 by striking coding and inserting monitoring and identifying2 7,c7 in subparagraph 7,e7-- 7i7 by inserting a comma after public health laboratories2 and 7ii7 by inserting and other emerging substances related after analogues2 and 7,d7 in subparagraph 7,f71 by inserting and associated risk factors after overdoses4 7b7 ,additional grants ,section #cib;,a7a77#c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;b-#a7;a77#c77 is amended-- 7#a7 in the matter preceding subparagraph 7,a71 by striking and ,indian ,tribes-- and inserting and ,indian ,tribes for the following purposes32 7#b7 by amending subparagraph 7,a7 to read as follows3 7,a7 ,to carry out innovative projects for grantees to detect1 identify1 and rapidly respond to controlled substance misuse1 abuse1 and overdoses1 and associated risk factors1 including changes in patterns of such controlled substance use4 ,such projects may include the use of innovative1 evidence-based strategies for detecting such patterns1 such as wastewater surveillance1 if proven to support actionable prevention strategies1 in a manner consistent with applicable ,federal and ,state privacy laws4 2 and 7#c7 in subparagraph 7,b71 by striking for any and inserting ,for any4 7c7 ,authorization of appropriations ,section #cib;,a7e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;b-#a7;e77 is amended by striking #dif1jjj1jjj for each of fiscal years #bjai through #bjbc and inserting #eje1egi1jjj for each of fiscal years #bjbf through #bjcj4 #ajd4 ,support for individuals and families impacted by fetal alcohol spectrum disorder 7a7 ,in general ,part ,o of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;f et seq47 is amended to read as follows3 ,o ,fetal alcohol spectrum disorder prevention and services program #cii;,h4 ,fetal alcohol spectrum disorders prevention1 intervention1 and services delivery program 7a7 ,in general ,the ,secretary shall establish or continue activities to support a comprehensive fetal alcohol spectrum disorders 7referred to in this section as ,,fasd7 education1 prevention1 identification1 intervention1 and services delivery program1 which may include-- 7#a7 an education and public awareness program to support1 conduct1 and evaluate the effectiveness of-- 7,a7 educational programs targeting health professions schools1 social and other supportive services1 educators and counselors and other service providers in all phases of childhood development1 and other relevant service providers1 concerning the prevention1 identification1 and provision of services for infants1 children1 adolescents1 and adults with ,,fasd2 7,b7 strategies to educate school-age children1 including pregnant and high-risk youth1 concerning ,,fasd2 7,c7 public and community awareness programs concerning ,,fasd2 and 7,d7 strategies to coordinate information and services across affected community agencies1 including agencies providing social services such as foster care1 adoption1 and social work1 agencies providing health services1 and agencies involved in education1 vocational training1 and civil and criminal justice2 7#b7 supporting and conducting research on ,,fasd1 as appropriate1 including to-- 7,a7 develop appropriate medical diagnostic methods for identifying ,,fasd2 and 7,b7 develop effective culturally and linguistically appropriate evidence-based or evidence-informed interventions and appropriate supports for preventing prenatal alcohol exposure1 which may co-occur with exposure to other substances2 7#c7 building ,state and ,tribal capacity for the identification1 treatment1 and support of individuals with ,,fasd and their families1 which may include-- 7,a7 utilizing and adapting existing ,federal1 ,state1 or ,tribal programs to include ,,fasd identification and ,,fasd-informed support2 7,b7 developing and expanding screening and diagnostic capacity for ,,fasd2 7,c7 developing1 implementing1 and evaluating targeted ,,fasd-informed intervention programs for ,,fasd2 7,d7 providing training with respect to ,,fasd for professionals across relevant sectors2 and 7,e7 disseminating information about ,,fasd and support services to affected individuals and their families2 and 7#d7 an applied research program concerning intervention and prevention to support and conduct service demonstration projects1 clinical studies and other research models providing advocacy1 educational and vocational training1 counseling1 medical and mental health1 and other supportive services1 as well as models that integrate and coordinate such services1 that are aimed at the unique challenges facing individuals with ,,fasd and their families4 7b7 ,grants and ,technical ,assistance 7#a7 ,in general ,the ,secretary may award grants1 cooperative agreements1 and contracts and provide technical assistance to eligible entities to carry out subsection 7a74 7#b7 ,eligible entities ,to be eligible to receive a grant1 or enter into a cooperative agreement or contract1 under this section1 an entity shall-- 7,a7 be a ,state1 ,indian ,tribe or ,tribal organization1 local government1 scientific or academic institution1 or nonprofit organization2 and 7,b7 prepare and submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including a description of the activities that the entity intends to carry out using amounts received under this section4 7#c7 ,additional application contents ,the ,secretary may require that an eligible entity include in the application submitted under paragraph 7#b77;,b7-- 7,a7 a designation of an individual to serve as a ,,fasd ,state or ,tribal coordinator of activities such eligible entity proposes to carry out through a grant1 cooperative agreement1 or contract under this section2 and 7,b7 a description of an advisory committee the entity will establish to provide guidance for the entity on developing and implementing a statewide or ,tribal strategic plan to prevent ,,fasd and provide for the identification1 treatment1 and support of individuals with ,,fasd and their families4 7c7 ,definition of ,,fasd ,informed ,for purposes of this section1 the term ,,fasd-informed1 with respect to support or an intervention program1 means that such support or intervention program uses culturally and linguistically informed evidence-based or practice-based interventions and appropriate resources to support an improved quality of life for an individual with ,,fasd and the family of such individual4 #cii;,i4 ,strengthening capacity and education for fetal alcohol spectrum disorders 7a7 ,in general ,the ,secretary shall award grants1 contracts1 or cooperative agreements1 as the ,secretary determines appropriate1 to public or nonprofit private entities with demonstrated expertise in the field of fetal alcohol spectrum disorders 7referred to in this section as ,,fasd74 ,such awards shall be for the purposes of building local1 ,tribal1 ,state1 and nationwide capacities to prevent the occurrence of ,,fasd by carrying out the programs described in subsection 7b74 7b7 ,programs ,an entity receiving an award under subsection 7a7 may use such award for the following purposes3 7#a7 ,developing and supporting public education and outreach activities to raise public awareness of the risks associated with alcohol consumption during pregnancy4 7#b7 ,acting as a clearinghouse for evidence-based resources on ,,fasd prevention1 identification1 and culturally and linguistically appropriate best practices to help inform systems of care for individuals with ,,fasd across their lifespan4 7#c7 ,increasing awareness and understanding of efficacious1 evidence-based screening tools and culturally and linguistically appropriate evidence-based intervention services and best practices1 which may include improving the capacity for ,state1 ,tribal1 and local affiliates4 7#d7 ,providing technical assistance to recipients of grants1 cooperative agreements1 or contracts under section #cii;,h1 as appropriate4 7c7 ,application ,to be eligible for a grant1 contract1 or cooperative agreement under this section1 an entity shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7d7 ,subcontracting ,a public or private nonprofit entity may carry out the following activities required under this section through contracts or cooperative agreements with other public and private nonprofit entities with demonstrated expertise in ,,fasd3 7#a7 ,resource development and dissemination4 7#b7 ,intervention services4 7#c7 ,training and technical assistance4 #cii;,j4 ,authorization of appropriations ,there are authorized to be appropriated to carry out this part #ab1ejj1jjj for each of fiscal years #bjbf through #bjcj4 4 7b7 ,report ,not later than #d years after the date of enactment of this ,act1 and every year thereafter1 the ,secretary of ,health and ,human ,services shall prepare and 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 containing-- 7#a7 a review of the activities carried out pursuant to sections #cii;,h and #cii;,i of the ,public ,health ,service ,act1 as amended by subsection 7a71 to advance public education and awareness of fetal alcohol spectrum disorders 7referred to in this section as ,,fasd72 7#b7 a description of-- 7,a7 the activities carried out pursuant to such sections #cii;,h and #cii;,i to identify1 prevent1 and treat ,,fasd2 and 7,b7 methods used to evaluate the outcomes of such activities2 and 7#c7 an assessment of activities carried out pursuant to such sections #cii;,h and #cii;,i to support individuals with ,,fasd4 #aje4 ,promoting state choice in ,,pdmp systems ,section #cii,o7h7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g-#c7;h77 is amended by adding at the end the following3 7#e7 ,promoting state choice ,nothing in this section shall be construed to authorize the ,secretary to require ,states to use a specific vendor or a specific interoperability connection other than to align with nationally recognized1 consensus-based open standards1 such as in accordance with sections #cjja and #cjjd4 4 #ajf4 ,first responder training program ,section #edf of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#a7 is amended-- 7#a7 in subsection 7a71 by striking tribes and tribal and inserting ,tribes and ,tribal2 7#b7 in subsections 7a71 7c71 and 7d7-- 7,a7 by striking approved or cleared each place it appears and inserting approved1 cleared1 or otherwise legally marketed2 and 7,b7 by striking opioid each place it appears2 7#c7 in subsection 7f7-- 7,a7 by striking approved or cleared each place it appears and inserting approved1 cleared1 or otherwise legally marketed2 7,b7 in paragraph 7#a71 by striking opioid2 7,c7 in paragraph 7#b7-- 7i7 by striking opioid and heroin and inserting opioid1 heroin1 and other drug2 and 7ii7 by striking opioid overdose and inserting overdose2 and 7,d7 in paragraph 7#c71 by striking opioid and heroin2 and 7#d7 in subsection 7h71 by striking #cf1jjj1jjj for each of fiscal years #bjai through #bjbc and inserting #eg1jjj1jjj for each of fiscal years #bjbf through #bjcj4 #ajg4 ,donald ,j4 ,cohen ,national ,child ,traumatic ,stress ,initiative 7a7 ,technical amendment ,the second part ,g of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bijkk et seq471 as added by section #add of the ,community ,renewal ,tax ,relief ,act of #bjjj 7,public ,law #ajf-eed71 is amended-- 7#a7 by redesignating such part as part ,j2 and 7#b7 by redesignating sections #eha through #ehd as sections #eif through #eif;,c1 respectively4 7b7 ,in general ,section #ehb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh-#a7 is amended-- 7#a7 in the section heading1 by striking ,,violence ,,related ,,stress and inserting ,,traumatic ,,events2 7#b7 in subsection 7a7-- 7,a7 in the matter preceding paragraph 7#a71 by striking tribes and tribal and inserting ,tribes and ,tribal2 and 7,b7 in paragraph 7#b71 by inserting and dissemination after the development2 7#c7 in subsection 7b71 by inserting and dissemination after the development2 7#d7 in subsection 7d7-- 7,a7 by striking ,the ,,nctsi and inserting the following3 7#a7 ,coordinating center ,the ,,nctsi 2 and 7,b7 by adding at the end the following3 7#b7 ,,nctsi grantees ,in carrying out subsection 7a77#b71 ,,nctsi grantees shall develop trainings and other resources1 as applicable and appropriate1 to support implementation of the evidence-based practices developed and disseminated under such subsection4 2 7#e7 in subsection 7e7-- 7,a7 by redesignating paragraphs 7#a7 and 7#b7 as subparagraphs 7,a7 and 7,b71 respectively1 and adjusting the margins accordingly2 7,b7 in subparagraph 7,a71 as so redesignated1 by inserting and implementation after the dissemination2 7,c7 by striking ,the ,,nctsi and inserting the following3 7#a7 ,coordinating center ,the ,,nctsi 2 and 7,d7 by adding at the end the following3 7#b7 ,,nctsi grantees ,,nctsi grantees shall1 as appropriate1 collaborate with other such grantees1 the ,,nctsi coordinating center1 and the ,secretary in carrying out subsections 7a77#b7 and 7d77#b74 2 7#f7 by amending subsection 7h7 to read as follows3 7h7 ,application and evaluation ,to be eligible to receive a grant1 contract1 or cooperative agreement under subsection 7a71 a public or nonprofit private entity or an ,indian ,tribe or ,tribal organization shall submit to the ,secretary an application at such time1 in such manner1 and containing such information and assurances as the ,secretary may require1 including-- 7#a7 a plan for the evaluation of the activities funded under the grant1 contract1 or agreement1 including both process and outcomes evaluation1 and the submission of an evaluation at the end of the project period2 and 7#b7 a description of how such entity1 ,indian ,tribe1 or ,tribal organization will support efforts led by the ,secretary or the ,,nctsi coordinating center1 as applicable1 to evaluate activities carried out under this section4 2 and 7#g7 by amending subsection 7j7 to read as follows3 7j7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section-- 7#a7 #ih1hhg1jjj for fiscal year #bjbf2 7#b7 #ih1hhg1jjj for fiscal year #bjbg2 7#c7 #ih1hhg1jjj for fiscal year #bjbh2 7#d7 #ajj1jjj1jjj for fiscal year #bjbi2 and 7#e7 #ajj1jjj1jjj for fiscal year #bjcj4 4 #ajh4 ,protecting suicide prevention lifeline from cybersecurity incidents 7a7 ,national suicide prevention lifeline program ,section #ebj;,e-#c7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cf;c7b77 is amended-- 7#a7 in paragraph 7#d71 by striking and at the end2 7#b7 in paragraph 7#e71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7#f7 taking such steps as may be necessary to ensure the suicide prevention hotline is protected from cybersecurity incidents and eliminates known cybersecurity vulnerabilities4 4 7b7 ,reporting ,section #ebj;,e-#c of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cf;c7 is amended-- 7#a7 by redesignating subsection 7f7 as subsection 7g72 and 7#b7 by inserting after subsection 7e7 the following3 7f7 ,cybersecurity reporting 7#a7 ,notification 7,a7 ,in general ,the program's network administrator receiving ,federal funding pursuant to subsection 7a7 shall report to the ,assistant ,secretary1 in a manner that protects personal privacy1 consistent with applicable ,federal and ,state privacy laws-- 7i7 any identified cybersecurity vulnerabilities to the program within a reasonable amount of time after identification of such a vulnerability2 and 7ii7 any identified cybersecurity incidents to the program within a reasonable amount of time after identification of such incident4 7,b7 ,local and regional crisis centers ,local and regional crisis centers participating in the program shall report to the program's network administrator identified under subparagraph 7,a71 in a manner that protects personal privacy1 consistent with applicable ,federal and ,state privacy laws-- 7i7 any identified cybersecurity vulnerabilities to the program within a reasonable amount of time after identification of such vulnerability2 and 7ii7 any identified cybersecurity incidents to the program within a reasonable amount of time after identification of such incident4 7#b7 ,notification ,if the program's network administrator receiving funding pursuant to subsection 7a7 discovers1 or is informed by a local or regional crisis center pursuant to paragraph 7#a77;,b7 of1 a cybersecurity vulnerability or incident1 within a reasonable amount of time after such discovery or receipt of information1 such entity shall report the vulnerability or incident to the ,assistant ,secretary4 7#c7 ,clarification 7,a7 ,oversight 7i7 ,local and regional crisis centers ,except as provided in clause 7ii71 local and regional crisis centers participating in the program shall oversee all technology each center employs in the provision of services as a participant in the program4 7ii7 ,network administrator ,the program's network administrator receiving ,federal funding pursuant to subsection 7a7 shall oversee the technology each crisis center employs in the provision of services as a participant in the program if such oversight responsibilities are established in the applicable network participation agreement4 7,b7 ,supplement1 not supplant ,the cybersecurity incident reporting requirements under this subsection shall supplement1 and not supplant1 cybersecurity incident reporting requirements under other provisions of applicable ,federal law that are in effect on the date of the enactment of the ,,support for ,patients and ,communities ,reauthorization ,act of #bjbe4 4 7c7 ,study ,not later than #ahj days after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall-- 7#a7 conduct and complete a study that evaluates cybersecurity risks and vulnerabilities associated with the #i-h-h ,national ,suicide ,prevention ,lifeline2 and 7#b7 submit a report on the findings of such study to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives4 #aji4 ,monitoring and reporting of child1 youth1 and adult trauma ,section #gaca7;e7 of the ,,support for ,patients and ,communities ,act 7#db ,u4,s4,c4 #bdbt7e77 is amended by striking #b1jjj1jjj for each of fiscal years #bjai through #bjbc and inserting #i1jjj1jjj for each of fiscal years #bjbf through #bjcj4 #aaj4 ,bruce's law 7a7 ,youth prevention and recovery ,section #gajb7;c7 of the ,,support for ,patients and ,communities ,act 7#db ,u4,s4,c4 #bij;bb-#g;a7c77 is amended-- 7#a7 in paragraph 7#c77;,a77i71 by inserting 1 which may include strategies to increase education and awareness of the potency and dangers of synthetic opioids 7including drugs contaminated with fentanyl7 and1 as appropriate1 other emerging drug use or misuse issues before the semicolon2 and 7#b7 in paragraph 7#d77;,a71 by inserting and strategies to increase education and awareness of the potency and dangers of synthetic opioids 7including drugs contaminated with fentanyl7 and1 as appropriate1 emerging drug use or misuse issues before the semicolon4 7b7 ,interdepartmental substance use disorders coordinating committee ,section #gjbb of the ,,support for ,patients and ,communities ,act 7#db ,u4,s4,c4 #bij;aa note7 is amended-- 7#a7 by striking subsection 7g7 and inserting the following3 7g7 ,working groups 7#a7 ,in general ,the ,committee may establish working groups for purposes of carrying out the duties described in subsection 7e74 ,any such working group shall be composed of members of the ,committee 7or the designees of such members7 and may hold such meetings as are necessary to carry out the duties delegated to the working group4 7#b7 ,additional federal interagency work group on fentanyl contamination of illegal drugs 7,a7 ,establishment ,the ,secretary1 acting through the ,committee1 shall establish a ,federal ,interagency ,work ,group on ,fentanyl ,contamination of ,illegal ,drugs 7referred to in this paragraph as the ,work ,group7 consisting of representatives from relevant ,federal departments and agencies on the ,committee4 7,b7 ,consultation ,the ,work ,group shall consult with relevant stakeholders and subject matter experts1 including-- 7i7 ,state1 ,tribal1 and local subject matter experts in reducing1 preventing1 and responding to drug overdose caused by fentanyl contamination of illicit drugs2 and 7ii7 family members of both adults and youth who have overdosed by fentanyl contaminated illicit drugs4 7,c7 ,duties ,the ,work ,group shall-- 7i7 examine ,federal efforts to reduce and prevent drug overdose by fentanyl-contaminated illicit drugs2 7ii7 identify strategies to improve ,state1 ,tribal1 and local responses to overdose by fentanyl-contaminated illicit drugs2 7iii7 coordinate with the ,secretary1 as appropriate1 in carrying out activities to raise public awareness of synthetic opioids and other emerging drug use and misuse issues2 7iv7 make recommendations to ,congress for improving ,federal programs1 including with respect to the coordination of efforts across such programs2 and 7v7 make recommendations for educating youth on the potency and dangers of drugs contaminated by fentanyl4 7,d7 ,annual report to secretary ,the ,work ,group shall annually prepare and submit to the ,secretary1 the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and the ,committee on ,energy and ,commerce and the ,committee on ,education and ,workforce of the ,house of ,representatives1 a report on the activities carried out by the ,work ,group under subparagraph 7,c71 including recommendations to reduce and prevent drug overdose by fentanyl contamination of illegal drugs1 in all populations1 and specifically among youth at risk for substance misuse4 2 and 7#b7 by striking subsection 7i7 and inserting the following3 7i7 ,sunset ,the ,committee shall terminate on ,september #cj1 #bjcj4 4 #aaa4 ,guidance on at-home drug disposal systems 7a7 ,in general ,not later than one year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services1 in consultation with the ,administrator of the ,drug ,enforcement ,administration1 shall publish guidance to facilitate the use of at-home safe disposal systems for applicable drugs4 7b7 ,contents ,the guidance under subsection 7a7 shall include-- 7#a7 recommended standards for effective at-home drug disposal systems to meet applicable requirements enforced by the ,food and ,drug ,administration2 7#b7 recommended information to include as instructions for use to disseminate with at-home drug disposal systems2 7#c7 best practices and educational tools to support the use of an at-home drug disposal system1 as appropriate2 and 7#d7 recommended use of licensed health providers for the dissemination of education1 instruction1 and at-home drug disposal systems1 as appropriate4 #aab4 ,assessment of opioid drugs and actions 7a7 ,in general ,not later than one year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary7 shall publish on the website of the ,food and ,drug ,administration 7referred to in this section as the ,,fda7 a report that outlines a plan for assessing opioid analgesic drugs that are approved under section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee7 that addresses the public health effects of such opioid analgesic drugs as part of the benefit-risk assessment and the activities of the ,,fda that relate to facilitating the development of nonaddictive medical products intended to treat pain or addiction4 ,such report shall include-- 7#a7 an update on the actions taken by the ,,fda to consider the effectiveness1 safety1 benefit-risk profile1 and use of approved opioid analgesic drugs2 7#b7 a timeline for an assessment of the potential need1 as appropriate1 for labeling changes1 revised or additional postmarketing requirements1 enforcement actions1 or withdrawals for opioid analgesic drugs2 7#c7 an overview of the steps that the ,,fda has taken to support the development and approval of nonaddictive medical products intended to treat pain or addiction1 and actions planned to further support the development and approval of such products2 and 7#d7 an overview of the consideration by the ,,fda of clinical trial methodologies for analgesic drugs1 including the enriched enrollment randomized withdrawal methodology1 and the benefits and drawbacks associated with different trial methodologies for such drugs1 incorporating any public input received under subsection 7b74 7b7 ,public input ,in carrying out subsection 7a71 the ,secretary shall provide an opportunity for public input concerning the regulation by the ,,fda of opioid analgesic drugs1 including scientific evidence that relates to conditions of use1 safety1 or benefit-risk assessment 7including consideration of the public health effects7 of such opioid analgesic drugs4 #aac4 ,grant program for ,state and ,tribal response to opioid use disorders ,the activities carried out pursuant to section #ajjc7;b77#d77;,a7 of the #bast ,century ,cures ,act 7#db ,u4,s4,c4 #bij;ee-#c;a7b77#d77;,a77 may include facilitating access to products used to prevent overdose deaths by detecting the presence of one or more substances1 such as fentanyl and xylazine test strips1 to the extent the purchase and possession of such products is consistent with ,federal and ,state law4 ,,ii ,treatment #bja4 ,residential treatment program for pregnant and postpartum women ,section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a7 is amended-- 7#a7 in subsection 7d77#aa77;,c71 by striking providing health services and inserting providing health care services2 7#b7 in subsection 7g7-- 7,a7 by inserting a plan describing after will provide2 and 7,b7 by adding at the end the following3 ,such plan may include a description of how such applicant will target outreach to women disproportionately impacted by maternal substance use disorder42 and 7#c7 in subsection 7s71 by striking #bi1ica1jjj for each of fiscal years #bjai through #bjbc and inserting #ch1ica1jjj for each of fiscal years #bjbf through #bjcj4 #bjb4 ,improving access to addiction medicine providers ,section #eig of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bijll7 is amended-- 7#a7 in subsection 7a77#a71 by inserting diagnosis1 after related to2 and 7#b7 in subsection 7b71 by inserting addiction medicine1 after psychiatry14 #bjc4 ,mental and behavioral health education and training grants ,section #gef7;f7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;e-#a7;f77 is amended by striking fiscal years #bjbc through #bjbg and inserting fiscal years #bjbf through #bjcj4 #bjd4 ,loan repayment program for substance use disorder treatment workforce ,section #gha7;j7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bie;h7j77 is amended by striking #be1jjj1jjj for each of fiscal years #bjai through #bjbc and inserting #dj1jjj1jjj for each of fiscal years #bjbf through #bjcj4 #bje4 ,development and dissemination of model training programs for substance use disorder patient records ,section #gjec of the ,,support for ,patients and ,communities ,act 7#db ,u4,s4,c4 #bij;dd-#b note7 is amended by striking subsection 7e74 #bjf4 ,task force on best practices for trauma-informed identification1 referral1 and support ,section #gacb of the ,,support for ,patients and ,communities ,act 7,public ,law #aae-bga2 #acb ,stat4 #djdf7 is amended-- 7#a7 in subsection 7b77#a7-- 7,a7 by redesignating subparagraph 7,,cc7 as subparagraph 7,,dd72 and 7,b7 by inserting after subparagraph 7,,bb7 the following3 7,,cc7 ,the ,administration for ,community ,living4 2 7#b7 in subsection 7d77#a71 in the matter preceding subparagraph 7,a71 by inserting 1 developmental disability service providers before 1 individuals who are2 and 7#c7 in subsection 7i71 by striking #bjbc and inserting #bjcj4 #bjg4 ,grants to enhance access to substance use disorder treatment ,section #cbjc of the ,,support for ,patients and ,communities ,act 7#ba ,u4,s4,c4 #hbc note7 is amended-- 7#a7 by striking subsection 7b72 and 7#b7 by striking 7a7 ,in general4--,the ,secretary and inserting the following3 ,the ,secretary4 #bjh4 ,state guidance related to individuals with serious mental illness and children with serious emotional disturbance 7a7 ,review of use of certain funding ,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 ,assistant ,secretary for ,mental ,health and ,substance ,use1 shall conduct a review of ,state use of funds made available under the ,community ,mental ,health ,services ,block ,grant program under subpart ,i of part ,b of title ,,xix of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjx et seq47 7referred to in this section as the block grant program7 for first episode psychosis activities4 ,such review shall consider the following3 7#a7 ,how ,states use funds for evidence-based treatments and services according to the standard of care for individuals with early serious mental illness and children with a serious emotional disturbance4 7#b7 ,the percentages of the ,state funding under the block grant program expended on early serious mental illness and first episode psychosis1 and the number of individuals served under such funds4 7b7 ,report and guidance 7#a7 ,report ,not later than #ahj days after the completion of the review under subsection 7a71 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 describing-- 7,a7 the findings of the review under subsection 7a72 and 7,b7 any recommendations for changes to the block grant program that would facilitate improved outcomes for individuals with serious mental illness and children with serious emotional disturbance4 7#b7 ,guidance ,not later than #a year after the date on which the report is submitted under paragraph 7#a71 the ,secretary shall update the guidance provided to ,states under the block grant program on coordinated specialty care and other evidence-based mental health care services for individuals with serious mental illness and children with a serious emotional disturbance1 based on the findings and recommendations of such report4 #bji4 ,reviewing the scheduling of approved products containing a combination of buprenorphine and naloxone 7a7 ,secretary of ,,hhs ,the ,secretary of ,health and ,human ,services shall1 consistent with the requirements and procedures set forth in sections #bja and #bjb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #haa1 #hab7-- 7#a7 review the relevant data pertaining to the scheduling of products containing a combination of buprenorphine and naloxone that have been approved under section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee72 and 7#b7 if appropriate1 request that the ,attorney ,general initiate rulemaking proceedings to revise the schedules accordingly with respect to such products4 7b7 ,attorney ,general ,the ,attorney ,general shall review any request made by the ,secretary of ,health and ,human ,services under subsection 7a77#b7 and determine whether to initiate proceedings to revise the schedules in accordance with the criteria set forth in sections #bja and #bjb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #haa1 #hab74 ,,iii ,recovery #cja4 ,building communities of recovery ,section #edg7;f7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#b7;f77 is amended by striking #e1jjj1jjj for each of fiscal years #bjai through #bjbc and inserting #ag1jjj1jjj for each of fiscal years #bjbf through #bjcj4 #cjb4 ,peer support technical assistance center ,section #edg;,a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#b;a7 is amended-- 7#a7 in subsection 7b77#d71 by striking building2 and and inserting the following3 building1 such as-- 7,a7 professional development of peer support specialists2 and 7,b7 making recovery support services available in nonclinical settings2 and 2 7#b7 by redesignating subsections 7d7 and 7e7 as subsections 7e7 and 7f71 respectively2 7#c7 by inserting after subsection 7c7 the following3 7d7 ,regional centers 7#a7 ,in general ,the ,secretary may establish one regional technical assistance center 7referred to in this subsection as the ,regional ,center71 with existing resources1 to assist the ,center in carrying out activities described in subsection 7b7 within the geographic region of such ,regional ,center in a manner that is tailored to the needs of such region4 7#b7 ,evaluation ,not later than #d years after the date of enactment of the ,,support for ,patients and ,communities ,reauthorization ,act of #bjbe1 the ,secretary shall evaluate the activities of the ,regional ,center and 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 findings of such evaluation1 including-- 7,a7 a description of the distinct roles and responsibilities of the ,regional ,center and the ,center2 7,b7 available information relating to the outcomes of the ,regional ,center under this subsection1 such as any impact on the operations and efficiency of the ,center relating to requests for technical assistance and support within the region of such ,regional ,center2 7,c7 a description of any gaps or areas of duplication relating to the activities of the ,regional ,center and the ,center within such region2 and 7,d7 recommendations relating to the modification1 expansion1 or termination of the ,regional ,center under this subsection4 7#c7 ,termination ,this subsection shall terminate on ,september #cj1 #bjcj4 2 and 7#d7 in subsection 7f71 as so redesignated1 by striking #a1jjj1jjj for each of fiscal years #bjai through #bjbc and inserting #b1jjj1jjj for each of fiscal years #bjbf through #bjcj4 #cjc4 ,comprehensive opioid recovery centers ,section #eeb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;ee-#g7 is amended-- 7#a7 in subsection 7d77#b7-- 7,a7 in the matter preceding subparagraph 7,a71 by striking and in such manner and inserting 1 in such manner1 and containing such information and assurances1 including relevant documentation12 and 7,b7 in subparagraph 7,a71 by striking is capable of coordinating with other entities to carry out and inserting has the demonstrated capability to carry out1 through referral or contractual arrangements2 7#b7 in subsection 7h7-- 7,a7 by redesignating paragraphs 7#a7 through 7#d7 as subparagraphs 7,a7 through 7,d71 respectively1 and adjusting the margins accordingly2 7,b7 by striking ,with respect to and inserting the following3 7#a7 ,in general ,with respect to 2 and 7,c7 by adding at the end the following3 7#b7 ,additional reporting for certain eligible entities ,an entity carrying out activities described in subsection 7g7 through referral or contractual arrangements shall include in the submissions required under paragraph 7#a7 information related to the status of such referrals or contractual arrangements1 including an assessment of whether such referrals or contractual arrangements are supporting the ability of such entity to carry out such activities4 2 and 7#c7 in subsection 7j71 by striking #bjai through #bjbc and inserting #bjbf through #bjcj4 #cjd4 ,youth prevention and recovery ,section #gajb7;c7 of the ,,support for ,patients and ,communities ,act 7#db ,u4,s4,c4 #bij;bb-#g;a7c77 7as amended by section #aaj7;a77 is amended-- 7#a7 in paragraph 7#b7-- 7,a7 in subparagraph 7,a7-- 7i7 in clause 7i7-- 7,i7 by inserting 1 or a consortium of local educational agencies1 after a local educational agency2 and 7,,ii7 by striking high schools and inserting secondary schools2 and 7ii7 in clause 7vi71 by striking tribe1 or tribal and inserting ,tribe1 or ,tribal2 7,b7 by amending subparagraph 7,e7 to read as follows3 7,e7 ,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 2 7,c7 by redesignating subparagraph 7,k7 as subparagraph 7,l72 and 7,d7 by inserting after subparagraph 7,j7 the following3 7,k7 ,secondary school ,the term secondary 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 2 7#b7 in paragraph 7#c77;,a71 in the matter preceding clause 7i7-- 7,a7 by striking and abuse2 and 7,b7 by inserting at increased risk for substance misuse after specific populations2 7#c7 in paragraph 7#d7-- 7,a7 in the matter preceding subparagraph 7,a71 by striking ,indian tribes and inserting ,indian ,tribes2 7,b7 in subparagraph 7,a71 by striking and abuse2 and 7,c7 in subparagraph 7,b71 by striking peer mentoring and inserting peer-to-peer support2 7#d7 in paragraph 7#e71 by striking tribal and inserting ,tribal2 7#e7 in paragraph 7#f77;,a7-- 7,a7 in clause 7iv71 by striking 2 and and inserting a semicolon2 and 7,b7 by adding at the end the following3 7vi7 a plan to sustain the activities carried out under the grant program1 after the grant program has ended2 and 2 7#f7 in paragraph 7#h71 by striking #bjbb and inserting #bjbh2 and 7#g7 by amending paragraph 7#i7 to read as follows3 7#i7 ,authorization of appropriations ,to carry out this subsection1 there are authorized to be appropriated-- 7,a7 #aj1jjj1jjj for fiscal year #bjbf2 7,b7 #ab1jjj1jjj for fiscal year #bjbg2 7,c7 #ac1jjj1jjj for fiscal year #bjbh2 7,d7 #ad1jjj1jjj for fiscal year #bjbi2 and 7,e7 #ae1jjj1jjj for fiscal year #bjcj4 4 #cje4 ,,career ,act 7a7 ,in general ,section #gahc of the ,,support for ,patients and ,communities ,act 7#db ,u4,s4,c4 #bij;ee-#h7 is amended-- 7#a7 in the section heading1 by inserting 2 ,,treatment1 ,,recovery1 ,,and ,,workforce ,,support ,,grants after ,,career ,,act2 7#b7 in subsection 7b71 by inserting each before for a period2 7#c7 in subsection 7c7-- 7,a7 in paragraph 7#a71 by striking the rates described in paragraph 7#b7 and inserting the average rates for calendar years #bjah through #bjbb described in paragraph 7#b72 and 7,b7 by amending paragraph 7#b7 to read as follows3 7#b7 ,rates ,the rates described in this paragraph are the following3 7,a7 ,the highest age-adjusted average rates of drug overdose deaths for calendar years #bjah through #bjbb based on data from the ,centers for ,disease ,control and ,prevention1 including1 if necessary1 provisional data for calendar year #bjbb4 7,b7 ,the highest average rates of unemployment for calendar years #bjah through #bjbb based on data provided by the ,bureau of ,labor ,statistics4 7,c7 ,the lowest average labor force participation rates for calendar years #bjah through #bjbb based on data provided by the ,bureau of ,labor ,statistics4 2 7#d7 in subsection 7g7-- 7,a7 in each of paragraphs 7#a7 and 7#c71 by redesignating subparagraphs 7,a7 and 7,b7 as clauses 7i7 and 7ii71 respectively1 and adjusting the margins accordingly2 7,b7 by redesignating paragraphs 7#a7 through 7#c7 as subparagraphs 7,a7 through 7,c71 respectively1 and adjusting the margins accordingly2 7,c7 in the matter preceding subparagraph 7,a7 7as so redesignated71 by striking ,an entity and inserting the following3 7#a7 ,in general ,an entity 2 and 7,d7 by adding at the end the following3 7#b7 ,transportation services ,an entity receiving a grant under this section may use not more than #e percent of the funds for providing transportation for individuals to participate in an activity supported by a grant under this section1 which transportation shall be to or from a place of work or a place where the individual is receiving vocational education or job training services or receiving services directly linked to treatment of or recovery from a substance use disorder4 7#c7 ,limitation ,the ,secretary may not require an entity to1 or give priority to an entity that plans to1 use the funds of a grant under this section for activities that are not specified in this subsection4 2 7#e7 in subsection 7i77#b71 by inserting 1 which shall include employment and earnings outcomes described in subclauses 7,i7 and 7,,iii7 of section #aaf7;b77#b77;,a77i7 of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cada7;b77#b77;,a77i77 with respect to the participation of such individuals with a substance use disorder in programs and activities funded by the grant under this section after subsection 7g72 7#f7 in subsection 7j7-- 7,a7 in paragraph 7#a71 by inserting for grants awarded prior to the date of enactment of the ,,support for ,patients and ,communities ,reauthorization ,act of #bjbe after grant period under this section2 and 7,b7 in paragraph 7#b7-- 7i7 in the matter preceding subparagraph 7,a71 by striking #b years after submitting the preliminary report required under paragraph 7#a7 and inserting ,september #cj1 #bjcj2 and 7ii7 in subparagraph 7,a71 by striking 7g77#c7 and inserting 7g77#a77;,c72 and 7#g7 in subsection 7k71 by striking #e1jjj1jjj for each of fiscal years #bjai through #bjbc and inserting #ab1jjj1jjj for each of fiscal years #bjbf through #bjcj4 7b7 ,reauthorization of the ,,career ,act2 ,recovery ,housing ,pilot ,program 7#a7 ,in general ,section #hjga of the ,,support for ,patients and ,communities ,act 7#db ,u4,s4,c4 #ecja note2 ,public ,law #aae-bga7 is amended-- 7,a7 by striking the section heading and inserting ,,career ,act2 ,recovery ,housing ,pilot ,program2 7,b7 in subsection 7a71 by striking through #bjbc and inserting through #bjcj2 7,c7 in subsection 7b7-- 7i7 in paragraph 7#a71 by striking not later than #fj days after the date of enactment of this ,act and inserting not later than #fj days after the date of enactment of the ,,support for ,patients and ,communities ,reauthorization ,act of #bjbe2 and 7ii7 in paragraph 7#b77;,b77i7-- 7,i7 in subclause 7,i7-- 7aa7 by striking for calendar years #bjac through #bjag2 and 7bb7 by inserting for calendar years #bjah through #bjbb after rates of unemployment2 7,,ii7 in subclause 7,,ii7-- 7aa7 by striking for calendar years #bjac through #bjag2 and 7bb7 by inserting for calendar years #bjah through #bjbb after participation rates2 and 7,,iii7 by striking subclause 7,,iii7 and inserting the following3 7,,iii7 ,the highest age-adjusted average rates of drug overdose deaths for calendar years #bjah through #bjbb based on data from the ,centers for ,disease ,control and ,prevention1 including1 if necessary1 provisional data for calendar year #bjbb4 2 and 7,d7 in subsection 7f71 by striking ,for the #b-year period following the date of enactment of this ,act1 the and inserting ,the4 7#b7 ,conforming amendment ,subtitle ,f of title ,,viii of the ,,support for ,patients and ,communities ,act 7,public ,law #aae-bga2 #acb ,stat4 #djie7 is amended by striking the subtitle heading and inserting the following3 ,,career ,act2 ,recovery ,housing ,pilot ,program4 7c7 ,clerical amendments ,the table of contents in section #a7;b7 of the ,,support for ,patients and ,communities ,act 7,public ,law #aae-bga2 #acb ,stat4 #chid7 is amended-- 7#a7 by striking the item relating to section #gahc and inserting the following3 ,sec4 #gahc4 ,,career ,act2 treatment1 recovery1 and workforce support grants4 2 7#b7 by striking the item relating to subtitle ,f of title ,,viii and inserting the following3 ,subtitle ,f--,,career ,act2 ,recovery ,housing ,pilot ,program 2 and 7#c7 by striking the item relating to section #hjga and inserting the following3 ,sec4 #hjga4 ,,career ,act2 ,recovery ,housing ,pilot ,program4 4 #cjf4 ,addressing economic and workforce impacts of the opioid crisis ,section #hjda7;g77#a7 of the ,,support for ,patients and ,communities ,act 7#bi ,u4,s4,c4 #cbbe;a7g77#a77 is amended by striking #bjbc and inserting #bjcj4 ,,iv ,miscellaneous matters #dja4 ,delivery of a controlled substance by a pharmacy to a prescribing practitioner ,section #cji;,a7a7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbi;a7a77 is amended by striking paragraph 7#b7 and inserting the following3 7#b7 the controlled substance is a drug in schedule ,,iii1 ,,iv1 or ,v to be administered-- 7,a7 by injection or implantation for the purpose of maintenance or detoxification treatment2 or 7,b7 subject to a risk evaluation and mitigation strategy pursuant to section #eje-a of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee-a7 that includes elements to assure safe use of the drug described in subsection 7f77#c77;,e7 of such section1 including a requirement for post-administration monitoring by a health care provider2 4 #djb4 ,required training for prescribers of controlled substances 7a7 ,in general ,section #cjc of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7 is amended-- 7#a7 by redesignating the second subsection designated as subsection 7l7 as subsection 7m72 and 7#b7 in subsection 7m77#a71 as so redesignated-- 7,a7 in subparagraph 7,a7-- 7i7 in clause 7iv7-- 7,i7 in subclause 7,i7-- 7aa7 by inserting the ,american ,academy of ,family ,physicians1 the ,american ,podiatric ,medical ,association1 the ,academy of ,general ,dentistry1 the ,american ,optometric ,association1 before or any other organization2 7bb7 by striking or the ,commission and inserting 1 the ,commission2 and 7cc7 by inserting 1 or the ,council on ,podiatric ,medical ,education before the semicolon at the end2 and 7,,ii7 in subclause 7,,iii71 by inserting or the ,american ,academy of ,family ,physicians after ,association2 and 7ii7 in clause 7v71 in the matter preceding subclause 7,i7-- 7,i7 by striking osteopathic medicine1 dental surgery and inserting osteopathic medicine1 podiatric medicine1 dental surgery2 and 7,,ii7 by striking or dental medicine curriculum and inserting or dental or podiatric medicine curriculum2 and 7,b7 in subparagraph 7,b7-- 7i7 in clause 7i7-- 7,i7 by inserting the ,american ,pharmacists ,association1 the ,accreditation ,council on ,pharmacy ,education1 the ,american ,psychiatric ,nurses ,association1 the ,american ,academy of ,nursing1 the ,american ,academy of ,family ,physicians1 before or any other organization2 and 7,,ii7 by inserting 1 the ,american ,academy of ,family ,physicians1 before or the ,accreditation ,council2 and 7ii7 in clause 7ii7-- 7,i7 by striking or accredited school and inserting 1 an accredited school2 and 7,,ii7 by inserting 1 or an accredited school of pharmacy before in the ,united ,states4 7b7 ,effective date ,the amendments made by subsection 7a7 shall take effect as if enacted on ,december #bi1 #bjbb4