Overview
Title
To provide emergency assistance to States, territories, Tribal nations, and local areas affected by substance use disorder, including the use of opioids and stimulants, and to make financial assistance available to States, territories, Tribal nations, local areas, public or private nonprofit entities, and certain health providers, to provide for the development, organization, coordination, and operation of more effective and cost efficient systems for the delivery of essential services to individuals with substance use disorder and their families.
ELI5 AI
H.R. 8323 wants to help people who struggle with drug problems by giving money to states and organizations to make better plans for helping them. It also sets rules to make sure the people who get help are getting the best care possible.
Summary AI
H. R. 8323, titled the "Comprehensive Addiction Resources Emergency Act of 2024," is a bill aimed at providing emergency assistance to combat substance use disorders, including those related to opioids and stimulants, across the United States. The bill outlines a framework for distributing financial and technical assistance to states, territories, Tribal nations, and local areas to develop more effective and cost-efficient systems to deliver essential services. It establishes various grant programs to support prevention, treatment, and recovery efforts, and promotes innovations in health care delivery, training for health professionals, and systems strengthening. Additionally, the bill mandates that grant-receiving entities comply with evidence-based standards and ensures access to FDA-approved addiction treatment medications.
Published
Keywords AI
Sources
Bill Statistics
Size
Language
Complexity
AnalysisAI
The bill H.R. 8323, titled the "Comprehensive Addiction Resources Emergency Act of 2024," aims to provide comprehensive support to combat substance use disorders. It outlines a framework for emergency assistance, funding allocation, and capacity building across states, territories, tribal nations, and local entities. The primary focus is on developing efficient systems for service delivery for individuals struggling with substance use disorders, especially in areas heavily impacted by opioid and stimulant use.
General Summary
This legislative proposal seeks to address the ongoing crisis of substance use disorders in the United States by allocating substantial federal resources. It proposes to establish a series of grant programs targeting local, state, and tribal entities, focusing on initiatives ranging from prevention to treatment, and recovery support. Additionally, it seeks to enhance training and innovation in health systems and mandates specific standards for service delivery. It also makes provisions for funding research initiatives through agencies like the National Institutes of Health and the Centers for Disease Control and Prevention to improve substance use treatment and data collection efforts.
Summary of Significant Issues
A notable issue with the bill is the broad allocation of funds without detailed parameters for evaluation and accountability. The significant sums of appropriations authorized over a decade lack built-in mechanisms for regular assessment or adjustments based on changing needs. This might lead to inefficiencies and unproductive allocation of resources.
The inclusion of clauses related to labor organization policies appears politically sensitive, potentially favoring entities that comply with specific labor standards, which may sideline otherwise capable service providers. Additionally, the administrative complexities associated with certifications regarding diversion controls and misbranding may introduce compliance burdens that could be challenging for organizations to manage effectively.
Another concern is the complexity of bureaucratic structures proposed, such as the planning councils. These could impose excessive administrative layers, hindering timely and effective service implementation. Furthermore, the focus on neutrality towards organized labor could introduce political biases in fund distribution.
Impact on the Public
If implemented effectively, the bill could significantly strengthen the nation's response to substance use disorders by ensuring more resources are available for prevention and treatment, thereby alleviating the crisis. It could improve access to necessary medical treatments and support systems in both urban and rural areas.
However, the administrative complexity and potential bureaucratic inefficiencies might lead to delays or uneven implementation, potentially limiting immediate impacts. The large sums of appropriations without clear mandates for evaluation could result in resource misallocation, with funds potentially not reaching the communities most in need.
Impact on Specific Stakeholders
For local governments and nonprofit organizations, the ability to access federal funds could mean expanded capacity to provide substance use treatment services. However, smaller communities and organizations might face challenges due to the administrative requirements and complex application processes, potentially putting them at a disadvantage compared to larger or more established entities.
Tribal governments could benefit significantly from targeted funding, provided that the allocation formulas consider their specific needs and contexts. Conversely, entities required to comply with labor-related provisions might find the requirements burdensome, potentially affecting their eligibility for receiving grants.
The bill emphasizes increased research funding, which could lead to advancements in developing treatment methodologies and understanding substance use disorders more deeply. However, without clear spending oversight, these resources could be underutilized, missing opportunities to advance the field significantly.
In summary, while the bill proposes extensive measures to address substance use disorders, its success largely hinges on transparent management, robust evaluation mechanisms, and effective implementation that adapts to the evolving landscape of public health needs.
Financial Assessment
The bill, H.R. 8323, proposes substantial financial allocations aimed at addressing and managing substance use disorders, particularly those concerning opioids and stimulants. Here's a breakdown of its financial provisions and their interplay with identified issues:
Financial Summary and Appropriations
The bill authorizes a vast financial commitment across various sections, primarily earmarked for grants and program support:
Section 3406 authorizes $3.3 billion annually from fiscal year 2024 to 2033 to support local substance use emergency relief grant programs.
Section 3415 similarly allocates $4.6 billion annually for those same years to support state and tribal substance use disorder prevention and intervention programs.
Section 3425 facilitates another $1 billion annually over the same period for a broader grant program targeting public and nonprofit entities to bolster prevention, treatment, and recovery efforts.
Section 3436 addresses the Naloxone distribution program with a significant appropriation of $1 billion annually, ensuring widespread availability of opioid overdose reversal drugs.
Additional major funding includes $500 million annually from 2024 to 2033 under Section 3431 for special projects and national significance, and Section 3438 allocates equal amounts for improving data collection and surveillance activities via the Centers for Disease Control and Prevention.
Further, Section 3437 dedicates $1 billion annually to the National Institutes of Health for addiction and pain research.
Key Issues Related to Financial Allocations
Potential Administrative Inefficiency: There are broad authorizations for administrative expenses, with up to 15% allowed for the first year (as noted in Section 3) which could dilute the effectiveness of the allocated funds. This raises concerns about transparency and overall efficiency, as noted in the issues.
Lack of Evaluation Metrics: Key sections, like Sections 3431 and 3432, prescribe generous funding without clear-cut evaluation metrics, risking potential inefficiency and lack of accountability. The absence of defined success metrics or performance evaluation frameworks could lead to misuse or ineffective use of substantial funds.
Financial Planning and Adaptability: The bill provides no apparent mechanism for reassessment or realignment of allocated amounts over its ten-year duration. This rigidity, as highlighted in the issues, may lead to misaligned resource allocation unresponsive to evolving needs, particularly if the dynamics of substance use disorder and its related challenges change over time.
Capacity Concerns: Section 3436 expects states and tribes to manage significant distributions of Naloxone effectively. However, differing local capacity levels might lead to uneven implementation, straining local systems unable to handle such logistical demands, a concern mentioned among the issues.
Medicaid Waivers and Service Consistency: Allowances for waivers of Medicaid participation (highlighted in Sections 3401 and 3412) might create disparities in how services are delivered across regions, potentially limiting the scope and uniformity of services available to affected individuals.
Overall, while H.R. 8323 earmarks considerable investments towards combating substance use disorders, the identified issues suggest that the bill's success will significantly depend on effective governance, transparent fund utilization, mechanisms for accountability, and adaptation to shifting societal needs over time.
Issues
The broad language in Section 3 regarding the allocation of administrative expenses up to 15% in the first year might be excessive, potentially leading to inefficiencies in administrative operations and reduced funds available for service provision. This relates to broader concerns about transparency and oversight of fund usage.
The provision in Sections 3401 and 3412, which allows for waivers that might bypass Medicaid participation, potentially limits the reach of the program and could lead to inconsistencies in service provision across different areas.
Sections 3431 and 3432 authorize significant spending without clear metrics for evaluation, which raises concerns about the efficient and effective use of funds, accountability, and potential for wasteful spending.
Sections 3 and 3435 outline broad criteria for grant eligibility and standardized care, but do not specify sufficient enforcement mechanisms or consequences for non-compliance, risking inconsistent application and oversight.
Section 3402 and similar sections discuss the complexity of planning council structures which may impose bureaucratic burdens, potentially hindering the effectiveness and timely implementation of services.
The neutrality towards organized labor clauses in several sections (e.g., 3403, 3412) could be seen as politically charged, appearing to prioritize certain policies and potentially excluding capable service providers.
Sections 3422 and 3425 mention large expenditure authorizations for ten consecutive years without re-assessment provisions or justification for set amounts, which could lead to concerns about financial planning and adaptability to changing needs.
Section 3406 and 3415 mention recurring large budget authorizations over a decade without a mechanism for adaptability, potentially leading to funding allocations that aren't responsive to future unforeseen needs.
In Section 3436, the Naloxone distribution program assumes all states and tribes have adequate capacity to manage large distributions, which may not reflect reality and could strain local resources.
The requirement for certifications regarding diversion controls and misbranding in Sections 313 and 424 adds administrative complexity, possibly leading to compliance burdens and legal challenges if not properly managed.
Sections
Sections are presented as they are annotated in the original legislative text. Any missing headers, numbers, or non-consecutive order is due to the original text.
1. Short title; table of contents Read Opens in new tab
Summary AI
The section outlines the "Comprehensive Addiction Resources Emergency Act of 2024," which aims to address substance use issues through various grant programs and initiatives. It includes details like the program's purpose, establishment of grants, and the funding of entities involved in substance use prevention and treatment, as well as changes to existing health laws.
2. Purpose Read Opens in new tab
Summary AI
The purpose of this Act is to provide emergency help to areas heavily affected by substance use disorders, such as opioid and stimulant use. It aims to fund the development and operation of more effective systems to deliver essential services to individuals with these disorders and their families, including partnerships with public or private nonprofit entities and certain health providers.
3. Amendment to the Public Health Service Act Read Opens in new tab
Summary AI
The section of the bill amends the Public Health Service Act to establish various grant programs and initiatives aimed at addressing substance use disorders across the United States. These initiatives include creating local emergency relief grant programs, funding state and tribal prevention and intervention efforts, and enhancing support systems such as treatment provider capacity, workforce training, and harm reduction services. Additionally, funding is allocated to federal organizations like the National Institutes of Health and the Centers for Disease Control and Prevention to support research, data collection, and innovative treatment models.
Money References
- “(2) CONSIDERATION REGARDING DESIGNATION OF COUNCIL.—In making a determination of whether to establish or designate a council under paragraph (1), the chief elected official shall give priority to the designation of an existing entity that has demonstrated experience in the provision of health and support services to individuals with substance use disorder within the eligible local area, that has a structure that recognizes the Federal trust responsibility when spending Federal health care dollars, and that has demonstrated a commitment to respecting the obligation of government agencies using Federal dollars to consult with Indian tribes and confer with urban Indian organizations. “(3) DESIGNATION OF EXISTING ENTITY.—If an existing entity is designated to serve as the council under this section, the membership of the entity shall comply with the requirements of subsection (a)(1) before it performs any of the duties set forth in subsection (e). “(4) JOINT COUNCIL.—The Secretary shall establish a process to permit an eligible local area that is not contiguous with any other eligible local area to form a joint planning council with such other eligible local area or areas, as long as such areas are located in geographical proximity to each other, as determined by the Secretary,
- The Secretary may make planning grants available to eligible local areas, in an amount not to exceed $75,000, for any area that is projected to be eligible for funding under section 3401 in the following fiscal year.
- “There is authorized to be appropriated to carry out this subtitle— “(1) $3,300,000,000 for fiscal year 2024; “(2) $3,300,000,000 for fiscal year 2025; “(3) $3,300,000,000 for fiscal year 2026; “(4) $3,300,000,000 for fiscal year 2027; “(5) $3,300,000,000 for fiscal year 2028; “(6) $3,300,000,000 for fiscal year 2029; “(7) $3,300,000,000 for fiscal year 2030; “(8) $3,300,000,000 for fiscal year 2031; “(9) $3,300,000,000 for fiscal year 2032; and “(10) $3,300,000,000 for fiscal year 2033.
- , the amount of a grant under section 3411 for— “(i) each of the 50 States, the District of Columbia, and Puerto Rico for a fiscal year shall be the greater of— “(I) $2,000,000; or “(II) an amount determined under the subparagraph (C); and “(ii) each territory other than Puerto Rico for a fiscal year shall be the greater of— “(I) $500,000; or “(II) an amount determined under the subparagraph (C). “(C) DETERMINATION.— “(i) FORMULA.—For purposes of subparagraph (B), the amount referred to in this subparagraph for a State (including a territory) for a fiscal year is— “(I) an amount equal to the amount made available under section 3415 for the fiscal year involved for grants pursuant to subparagraph (B); and “(II) the percentage constituted by the sum of— “(aa) the product of 0.85 and the ratio of the State distribution factor for the State or territory to the sum of the respective distribution factors for all States; and “(bb) the product of 0.15 and the ratio of the non-local distribution factor for the State or territory (as determined under clause (iv)) to the sum of the respective non-local distribution factors for all States or territories. “(ii) STATE DISTRIBUTION FACTOR.—For purposes of clause (i)(II)(aa), the term ‘State distribution factor’ means an amount equal to— “(I) the estimated number of drug overdose deaths in the State, as determined under clause (iii); or “(II) the number of non-fatal drug overdoses in the State, as determined under clause (iv), as determined by the Secretary based on which distribution factor (subclause (I) or (II)) will result in the State receiving the greatest amount of funds. “
- “There is authorized to be appropriated to carry out this subtitle— “(1) $4,600,000,000 for fiscal year 2024; “(2) $4,600,000,000 for fiscal year 2025; “(3) $4,600,000,000 for fiscal year 2026; “(4) $4,600,000,000 for fiscal year 2027; “(5) $4,600,000,000 for fiscal year 2028; “(6) $4,600,000,000 for fiscal year 2029; “(7) $4,600,000,000 for fiscal year 2030; “(8) $4,600,000,000 for fiscal year 2031; “(9) $4,600,000,000 for fiscal year 2032; and “(10) $4,600,000,000 for fiscal year 2033.
- “(b) Amount.—A grant under this section may be made in an amount not to exceed $150,000.
- “There is authorized to be appropriated to carry out this subtitle— “(1) $1,000,000,000 for fiscal year 2024; “(2) $1,000,000,000 for fiscal year 2025; “(3) $1,000,000,000 for fiscal year 2026; “(4) $1,000,000,000 for fiscal year 2027; “(5) $1,000,000,000 for fiscal year 2028; “(6) $1,000,000,000 for fiscal year 2029; “(7) $1,000,000,000 for fiscal year 2030; “(8) $1,000,000,000 for fiscal year 2031; “(9) $1,000,000,000 for fiscal year 2032; and “(10) $1,000,000,000 for fiscal year 2033.
- “(e) Authorization of appropriations.—There is authorized to be appropriated to carry out this section— “(1) $500,000,000 for fiscal year 2024; “(2) $500,000,000 for fiscal year 2025; “(3) $500,000,000 for fiscal year 2026; “(4) $500,000,000 for fiscal year 2027; “(5) $500,000,000 for fiscal year 2028; “(6) $500,000,000 for fiscal year 2029; “(7) $500,000,000 for fiscal year 2030; “(8) $500,000,000 for fiscal year 2031; “(9) $500,000,000 for fiscal year 2032; and “(10) $500,000,000 for fiscal year 2033.
- “(5) train or result in the training of health professionals and other community providers to provide substance use disorder treatments for pregnant women, children, and adolescents. “(c) Native education and training centers.—The Secretary shall use 10 percent of the amount available under subsection (d) for each fiscal year to provide grants authorized under this subtitle to— “(1) tribal colleges and universities; “(2) Indian Health Service grant funded institutions; and “(3) Native partner institutions, including institutions of higher education with medical training programs that partner with one or more Indian tribes, tribal organizations, Native Hawaiian organizations, or tribal colleges and universities to train Native health professionals that will provide substance use disorder treatment services in Native communities. “(d) Authorization of appropriations.—There is authorized to be appropriated to carry out this section— “(1) $500,000,000 for fiscal year 2024; “(2) $500,000,000 for fiscal year 2025; “(3) $500,000,000 for fiscal year 2026; “(4) $500,000,000 for fiscal year 2027; “(5) $500,000,000 for fiscal year 2028; “(6) $500,000,000 for fiscal year 2029; “(7) $500,000,000 for fiscal year 2030; “(8) $500,000,000 for fiscal year 2031; “(9) $500,000,000 for fiscal year 2032; and “(10) $500,000,000 for fiscal year 2033.
- “(c) Authorization of appropriations.—There is authorized to be appropriated to carry out this section— “(1) $50,000,000 for fiscal year 2024; “(2) $50,000,000 for fiscal year 2025; “(3) $50,000,000 for fiscal year 2026; “(4) $50,000,000 for fiscal year 2027; “(5) $50,000,000 for fiscal year 2028; “(6) $50,000,000 for fiscal year 2029; “(7) $50,000,000 for fiscal year 2030; “(8) $50,000,000 for fiscal year 2031; “(9) $50,000,000 for fiscal year 2032; and “(10) $50,000,000 for fiscal year 2033.
- is authorized to be appropriated to carry out this subsection— “(A) $40,000,000 for fiscal year 2024; “(B) $40,000,000 for fiscal year 2025; “(C) $40,000,000 for fiscal year 2026; “(D) $40,000,000 for fiscal year 2027; “(E) $40,000,000 for fiscal year 2028; “(F) $40,000,000 for fiscal year 2029; “(G) $40,000,000 for fiscal year 2030; “(H) $40,000,000 for fiscal year 2031; “(I) $40,000,000 for fiscal year 2032; and “(J) $40,000,000 for fiscal year 2033. “(b) Research on the impact of substance use disorder in the workplace and on direct service providers.
- (3) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this subsection— “(A) $10,000,000 for fiscal year 2024; “(B) $10,000,000 for fiscal year 2025; “(C) $10,000,000 for fiscal year 2026; “(D) $10,000,000 for fiscal year 2027; “(E) $10,000,000 for fiscal year 2028; “(F) $10,000,000 for fiscal year 2029; “(G) $10,000,000 for fiscal year 2030; “(H) $10,000,000 for fiscal year 2031; “(I) $10,000,000 for fiscal year 2032; and “(J) $10,000,000 for fiscal year 2033. “SEC. 3435. Improving and expanding care. “(a) Level of care standards for substance use disorder treatment services.
- “(h) Authorization of appropriations.—There is authorized to be appropriated to carry out this suction— “(1) $1,000,000,000 for fiscal year 2024; “(2) $1,000,000,000 for fiscal year 2025; “(3) $1,000,000,000 for fiscal year 2026; “(4) $1,000,000,000 for fiscal year 2027; “(5) $1,000,000,000 for fiscal year 2028; “(6) $1,000,000,000 for fiscal year 2029; “(7) $1,000,000,000 for fiscal year 2030; “(8) $1,000,000,000 for fiscal year 2031; “(9) $1,000,000,000 for fiscal year 2032; and “(10) $1,000,000,000 for fiscal year 2033. “
- “There is authorized to be appropriated to the National Institutes of Health for the purpose of conducting research on addiction and pain, including research to develop overdose reversal drug products, non-opioid drug products and non-pharmacological treatments for addressing pain and substance use disorder, and drug products used to treat substance use disorder— “(1) $1,000,000,000 for fiscal year 2024; “(2) $1,000,000,000 for fiscal year 2025; “(3) $1,000,000,000 for fiscal year 2026; “(4) $1,000,000,000 for fiscal year 2027; “(5) $1,000,000,000 for fiscal year 2028; “(6) $1,000,000,000 for fiscal year 2029; “(7) $1,000,000,000 for fiscal year 2030; “(8) $1,000,000,000 for fiscal year 2031; “(9) $1,000,000,000 for fiscal year 2032; and “(10) $1,000,000,000 for fiscal year 2033.
- “(e) Authorization of appropriations.—There is authorized to be appropriated to carry out this section— “(1) $500,000,000 for fiscal year 2024; “(2) $500,000,000 for fiscal year 2025; “(3) $500,000,000 for fiscal year 2026; “(4) $500,000,000 for fiscal year 2027; “(5) $500,000,000 for fiscal year 2028; “(6) $500,000,000 for fiscal year 2029; “(7) $500,000,000 for fiscal year 2030; “(8) $500,000,000 for fiscal year 2031; “(9) $500,000,000 for fiscal year 2032; and “(10) $500,000,000 for fiscal year 2033.
3401. Establishment of program of grants Read Opens in new tab
Summary AI
The section establishes a program for grants to help local communities address substance use issues. Eligibility for these grants depends on specific criteria related to the area's drug overdose rates, and the funds must be managed by local or state officials according to established guidelines.
3402. Planning council Read Opens in new tab
Summary AI
The section establishes a "Planning Council" for allocating grant funds to support evidence-based substance use disorder treatment and services in eligible local areas. It outlines the council's composition, duties, conflict of interest rules, and procedures for grievance and public meetings to ensure transparency and community involvement in the decision-making process.
Money References
- — (1) IN GENERAL.—In providing for a council for purposes of subsection (a), the chief elected official of the eligible local area may establish the council directly or designate an existing entity to serve as the council, subject to paragraph (2). (2) CONSIDERATION REGARDING DESIGNATION OF COUNCIL.—In making a determination of whether to establish or designate a council under paragraph (1), the chief elected official shall give priority to the designation of an existing entity that has demonstrated experience in the provision of health and support services to individuals with substance use disorder within the eligible local area, that has a structure that recognizes the Federal trust responsibility when spending Federal health care dollars, and that has demonstrated a commitment to respecting the obligation of government agencies using Federal dollars to consult with Indian tribes and confer with urban Indian organizations. (3) DESIGNATION OF EXISTING ENTITY.—If an existing entity is designated to serve as the council under this section, the membership of the entity shall comply with the requirements of subsection (a)(1) before it performs any of the duties set forth in subsection (e). (4) JOINT COUNCIL.—The Secretary shall establish a process to permit an eligible local area that is not contiguous with any other eligible local area to form a joint planning council with such other eligible local area or areas, as long as such areas are located in geographical proximity to each other, as determined by the Secretary, and submit a joint application under section 3404.
3403. Amount of grant, use of amounts, and funding agreement Read Opens in new tab
Summary AI
The section outlines the rules for awarding grants to areas in need of support for managing substance use disorders. It specifies how grant amounts are determined, the eligible uses for the funds, criteria for receiving supplemental grants, conditions for tribal governments, and important terms and conditions that must be met by grant recipients.
3404. Application Read Opens in new tab
Summary AI
To be eligible for grant funding under this section, local areas must submit a detailed application demonstrating how they will use the funds to meet specific goals related to substance use disorder treatment, ensure compliance with evidence-based standards, and outline their plans for harm reduction and coordination with local health departments. Additionally, the application must include a plan for sliding-scale charges for services based on income, with specific provisions ensuring no charges for low-income individuals and caps on charges for others, while maintaining a policy of no charges for eligible American Indian and Alaska Native individuals.
3405. Technical assistance Read Opens in new tab
Summary AI
The Secretary is required to offer technical help to newly eligible local areas for setting up planning councils and meeting certain requirements so they can get grants. Additionally, planning grants of up to $75,000 may be provided to areas expected to qualify for future funding, and this amount will be deducted from their first-year grant award.
Money References
- The Secretary may make planning grants available to eligible local areas, in an amount not to exceed $75,000, for any area that is projected to be eligible for funding under section 3401 in the following fiscal year.
3406. Authorization of appropriations Read Opens in new tab
Summary AI
There is a section of the bill that approves a budget of $3.3 billion each year from 2024 to 2033 to support activities outlined in this part of the legislation.
Money References
- There is authorized to be appropriated to carry out this subtitle— (1) $3,300,000,000 for fiscal year 2024; (2) $3,300,000,000 for fiscal year 2025; (3) $3,300,000,000 for fiscal year 2026; (4) $3,300,000,000 for fiscal year 2027; (5) $3,300,000,000 for fiscal year 2028; (6) $3,300,000,000 for fiscal year 2029; (7) $3,300,000,000 for fiscal year 2030; (8) $3,300,000,000 for fiscal year 2031; (9) $3,300,000,000 for fiscal year 2032; and (10) $3,300,000,000 for fiscal year 2033. ---
3411. Establishment of program of grants Read Opens in new tab
Summary AI
The Secretary is responsible for giving grants to States, territories, and Tribal governments to help them deal with substance use problems in their areas.
3412. Amount of grant, use of amounts, and funding agreement Read Opens in new tab
Summary AI
This section outlines the process and requirements for distributing federal grant money to states, territories, and tribal governments to combat substance use disorders. It includes details on how the funds should be used for services like prevention, treatment, and recovery support, as well as the criteria for receiving additional funding and meeting certain standards and agreements.
Money References
- — (A) EXPEDITED DISTRIBUTION.—Not later than 90 days after an appropriation becomes available, the Secretary shall disburse 50 percent of the amount made available under section 3415 for carrying out this subtitle for such fiscal year through grants to States under section 3411, in accordance with subparagraphs (B) and (C). (B) MINIMUM ALLOTMENT.—Subject to the amount made available under section 3415, the amount of a grant under section 3411 for— (i) each of the 50 States, the District of Columbia, and Puerto Rico for a fiscal year shall be the greater of— (I) $2,000,000; or (II) an amount determined under the subparagraph (C); and (ii) each territory other than Puerto Rico for a fiscal year shall be the greater of— (I) $500,000; or (II) an amount determined under the subparagraph (C). (C) DETERMINATION.— (i) FORMULA.—For purposes of subparagraph (B), the amount referred to in this subparagraph for a State (including a territory) for a fiscal year is— (I) an amount equal to the amount made available under section 3415 for the fiscal year involved for grants pursuant to subparagraph (B); and (II) the percentage constituted by the sum of— (aa) the product of 0.85 and the ratio of the State distribution factor for the State or territory to the sum of the respective distribution factors for all States; and (bb) the product of 0.15 and the ratio of the non-local distribution factor for the State or territory (as determined under clause (iv)) to the sum of the respective non-local distribution factors for all States or territories. (ii) STATE DISTRIBUTION FACTOR.—For purposes of clause (i)(II)(aa), the term “State distribution factor” means an amount equal to— (I) the estimated number of drug overdose deaths in the State, as determined under clause (iii); or (II) the number of non-fatal drug overdoses in the State, as determined under clause (iv), as determined by the Secretary based on which distribution factor (subclause (I) or (II)) will result in the State receiving the greatest amount of funds. (iii) NUMBER OF DRUG OVERDOSES.—For purposes of clause (ii), the number of drug overdose deaths determined under this clause for a State for a fiscal year is the number of drug overdose deaths during the most recent 3-year period for which such data are available.
3413. Application Read Opens in new tab
Summary AI
Section 3413 specifies the requirements for a State to apply for a grant under section 3411, including having an approved State plan and demonstrating effective use of past funds. It also details the conditions under which service charges can be imposed based on income levels, ensuring no charges for the poorest individuals and limiting charges for others, with special considerations for American Indian and Alaska Native individuals.
3414. Technical assistance Read Opens in new tab
Summary AI
The Secretary is responsible for offering technical help, either directly or through grants and contracts, to support the administration and coordination of activities outlined in section 3412. This includes aiding in the creation of State applications for extra grants mentioned in section 3412(a)(2).
3415. Authorization of appropriations Read Opens in new tab
Summary AI
The section authorizes a total of $4.6 billion to be appropriated each year from 2024 to 2033 to support activities under the specified subtitle.
Money References
- There is authorized to be appropriated to carry out this subtitle— (1) $4,600,000,000 for fiscal year 2024; (2) $4,600,000,000 for fiscal year 2025; (3) $4,600,000,000 for fiscal year 2026; (4) $4,600,000,000 for fiscal year 2027; (5) $4,600,000,000 for fiscal year 2028; (6) $4,600,000,000 for fiscal year 2029; (7) $4,600,000,000 for fiscal year 2030; (8) $4,600,000,000 for fiscal year 2031; (9) $4,600,000,000 for fiscal year 2032; and (10) $4,600,000,000 for fiscal year 2033. ---
3421. Establishment of grant program Read Opens in new tab
Summary AI
The section establishes a grant program in which the Secretary can award funds to eligible organizations, such as public and nonprofit entities, Medicaid providers, and Indian entities, to support services related to substance use disorder treatment. Priority is given to entities with supportive labor policies, and the program emphasizes serving underserved populations, maintaining confidentiality, and ensuring accessibility, especially for low-income and rural individuals.
3422. Use of amounts Read Opens in new tab
Summary AI
Entities receiving grants under section 3421 must use the funds to provide various services aimed at combating substance use disorder, including prevention, medical treatment, recovery support, harm reduction, and administrative functions, with special mention of early intervention and emergency situations. They are allowed to allocate up to 10% of the funds for administrative tasks, but these services must not conflict with existing emergency medical systems.
3423. Technical assistance Read Opens in new tab
Summary AI
The Secretary has the authority to offer technical assistance to public or nonprofit organizations, Indian entities, and other Medicaid providers. This help can be given directly or through grants or contracts and focuses on guiding these entities through the process of applying for grants and supporting the planning and management of programs related to these grants.
3424. Planning and development grants Read Opens in new tab
Summary AI
The Secretary is authorized to give planning grants to certain public or nonprofit organizations, including Indian entities and other eligible Medicaid providers, to help them expand their ability to offer substance use disorder treatment services in underprivileged and underserved areas. Each grant provided under this section can be up to $150,000.
Money References
- (b) Amount.—A grant under this section may be made in an amount not to exceed $150,000.
3425. Authorization of appropriations Read Opens in new tab
Summary AI
The section authorizes the appropriation of $1 billion for each fiscal year from 2024 to 2033 to fund the actions outlined in the subtitle.
Money References
- There is authorized to be appropriated to carry out this subtitle— (1) $1,000,000,000 for fiscal year 2024; (2) $1,000,000,000 for fiscal year 2025; (3) $1,000,000,000 for fiscal year 2026; (4) $1,000,000,000 for fiscal year 2027; (5) $1,000,000,000 for fiscal year 2028; (6) $1,000,000,000 for fiscal year 2029; (7) $1,000,000,000 for fiscal year 2030; (8) $1,000,000,000 for fiscal year 2031; (9) $1,000,000,000 for fiscal year 2032; and (10) $1,000,000,000 for fiscal year 2033. ---
3431. Special projects of national significance Read Opens in new tab
Summary AI
The Secretary is authorized to provide grants for special projects focused on creating new ways to deliver substance use disorder treatment and harm reduction services, including funding for Indian tribes to develop culturally informed care models. This program receives $500 million annually from 2024 to 2033, with a portion allocated specifically for Indian tribes.
Money References
- (e) Authorization of appropriations.—There is authorized to be appropriated to carry out this section— (1) $500,000,000 for fiscal year 2024; (2) $500,000,000 for fiscal year 2025; (3) $500,000,000 for fiscal year 2026; (4) $500,000,000 for fiscal year 2027; (5) $500,000,000 for fiscal year 2028; (6) $500,000,000 for fiscal year 2029; (7) $500,000,000 for fiscal year 2030; (8) $500,000,000 for fiscal year 2031; (9) $500,000,000 for fiscal year 2032; and (10) $500,000,000 for fiscal year 2033. ---
3432. Education and training centers Read Opens in new tab
Summary AI
The section outlines a program where the Secretary can offer grants or contracts to support public or nonprofit organizations and schools in training health professionals to address substance use disorders and related health issues. It emphasizes training for underserved and minority communities, particularly in rural areas, and has a specific provision for Native education and training centers, with funding set at $500 million per year from 2024 to 2033.
Money References
- (a) In general.—The Secretary may make grants and enter into contracts to assist public or nonprofit entities, public or nonprofit schools, and academic health centers in meeting the cost of projects— (1) to train health professionals, including practitioners in programs under this title and other community providers, including physician addiction specialists, psychologists, counselors, case managers, social workers, peer recovery coaches, harm reduction workers, public health workers, and community health workers, and paraprofessionals, such as peer support specialists and recovery coaches, in the diagnosis, treatment, and prevention of substance use disorders and drug use-related health issues, including measures for the prevention and treatment of co-occurring infectious diseases, mental health disorders, and other conditions, and including (as applicable to the type of health professional involved), care for women, pregnant women, and children; (2) to train the faculty of schools of medicine, nursing, public health, osteopathic medicine, dentistry, allied health, social work, and mental health practice to teach health professions students to screen for and provide for the needs of individuals with substance use disorders or at risk of substance use; and (3) to develop and disseminate curricula and resource materials relating to evidence-based practices for the screening, prevention, and treatment of substance use disorders and drug use-related health issues, including information about combating stigma, prescribing best practices, overdose reversal, alternative pain therapies, and all drugs approved by the Food and Drug Administration for the treatment of substance use disorders, including for the purposes authorized under the amendments made by section 3203 of the SUPPORT for Patients and Communities Act. (b) Preference in making grants.—In making grants under subsection (a), the Secretary shall give preference to qualified projects that will— (1) train, or result in the training of, health professionals and other community providers described in subsection (a)(1), to provide substance use disorder treatments for underserved groups, including minority individuals and Indians with substance use disorder and other individuals who are at a high risk of substance use; (2) train, or result in the training of, minority health professionals and minority allied health professionals, to provide substance use disorder treatment for individuals with such disease; (3) train or result in the training of individuals who will provide substance use disorder treatment in rural or other areas that are underserved by current treatment structures; (4) train or result in the training of health professionals and allied health professionals, including counselors, case managers, social workers, peer recovery coaches, and harm reduction workers, public health workers, and community health workers, to provide treatment for infectious diseases and mental health disorders co-occurring with substance use disorder; and (5) train or result in the training of health professionals and other community providers to provide substance use disorder treatments for pregnant women, children, and adolescents. (c) Native education and training centers.—The Secretary shall use 10 percent of the amount available under subsection (d) for each fiscal year to provide grants authorized under this subtitle to— (1) tribal colleges and universities; (2) Indian Health Service grant funded institutions; and (3) Native partner institutions, including institutions of higher education with medical training programs that partner with one or more Indian tribes, tribal organizations, Native Hawaiian organizations, or tribal colleges and universities to train Native health professionals that will provide substance use disorder treatment services in Native communities. (d) Authorization of appropriations.—There is authorized to be appropriated to carry out this section— (1) $500,000,000 for fiscal year 2024; (2) $500,000,000 for fiscal year 2025; (3) $500,000,000 for fiscal year 2026; (4) $500,000,000 for fiscal year 2027; (5) $500,000,000 for fiscal year 2028; (6) $500,000,000 for fiscal year 2029; (7) $500,000,000 for fiscal year 2030; (8) $500,000,000 for fiscal year 2031; (9) $500,000,000 for fiscal year 2032; and (10) $500,000,000 for fiscal year 2033. ---
3433. Substance use disorder treatment provider capacity under the Medicaid program Read Opens in new tab
Summary AI
The section establishes funding for projects aimed at increasing substance use disorder treatment provider capacity under Medicaid, with a focus on supporting labor-friendly policies and prioritizing grants that respect employees' labor rights, except for Indian tribes. Ten percent of the funds are designated for Indian tribes and urban Indian organizations, with a total of $50 million allocated each year from 2024 to 2033.
Money References
- (c) Authorization of appropriations.—There is authorized to be appropriated to carry out this section— (1) $50,000,000 for fiscal year 2024; (2) $50,000,000 for fiscal year 2025; (3) $50,000,000 for fiscal year 2026; (4) $50,000,000 for fiscal year 2027; (5) $50,000,000 for fiscal year 2028; (6) $50,000,000 for fiscal year 2029; (7) $50,000,000 for fiscal year 2030; (8) $50,000,000 for fiscal year 2031; (9) $50,000,000 for fiscal year 2032; and (10) $50,000,000 for fiscal year 2033. ---
3434. Programs to support employees Read Opens in new tab
Summary AI
The section outlines a grant program managed by the Secretary through the Director of the National Institute for Occupational Safety and Health. The program aims to fund non-profit organizations to help workers with substance use disorders maintain or gain employment, by providing services like prevention, intervention, recovery support, and harm reduction. It also mandates research on how substance use affects workers and health providers in different occupations.
Money References
- Such report shall include, at a minimum, a description of— (A) the activities funded by the grant; (B) the number of individuals with and without substance use disorder served through activities funded by the grant, including the services provided to those individuals and the industries in which those individuals were employed at the time they received services supported by the grant; (C) for workers experiencing substance use disorder or recovering from substance use disorder served by activities funded by the grant, the number of individuals who maintained employment, the number of individuals who gained employment, and the number of individuals who failed to maintain employment over the course of the reporting period; and (D) any other information required by the Secretary. (5) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this subsection— (A) $40,000,000 for fiscal year 2024; (B) $40,000,000 for fiscal year 2025; (C) $40,000,000 for fiscal year 2026; (D) $40,000,000 for fiscal year 2027; (E) $40,000,000 for fiscal year 2028; (F) $40,000,000 for fiscal year 2029; (G) $40,000,000 for fiscal year 2030; (H) $40,000,000 for fiscal year 2031; (I) $40,000,000 for fiscal year 2032; and (J) $40,000,000 for fiscal year 2033. (b) Research on the impact of substance use disorder in the workplace and on direct service providers.
- (1) RISKS OF SUBSTANCE USE DISORDER.—The Secretary, in consultation with the Director of the National Institute for Occupational Safety and Health, shall conduct (directly or through grants or contracts) research, experiments, and demonstrations, and publish studies relating to— (A) the risks faced by employees in various occupations of developing substance use disorder and of drug overdose deaths and non-fatal drug overdoses, and the formulation of prevention activities tailored to the risks identified in these occupations, including occupational injury and illness prevention; (B) the prevalence of substance use disorder among employees in various occupations; (C) efforts that employers may undertake to assist employees who are undergoing substance use disorder treatment services in maintaining employment while ensuring workplaces are safe and healthful; (D) risks of occupational exposure to opioids and other illicit substances and the formulation of prevention activities tailored to the risks identified; and (E) other subjects related to substance use disorder in the workplace as the Secretary determines. (2) DIRECT SERVICE PROVIDERS.—The Secretary shall conduct (directly or through grants or contracts) research, experiments, and demonstrations, and publish studies relating to the occupational health and safety, recruitment, and retention of behavioral health providers who, as part of their job responsibilities, provide direct services to individuals who are at risk of experiencing substance use disorder or who are experiencing or recovering from substance use disorder, including— (A) identifying factors that the Secretary believes may endanger the health or safety of such workers, including factors that affect the risks such workers face of developing substance use disorder; (B) motivational and behavioral factors relating to the field of behavioral health providers; (C) strategies to support the recruitment and retention of behavioral health providers; and (D) other subjects related to behavioral health providers engaged in direct provision of substance use disorder prevention and treatment services as the Secretary determines appropriate. (3) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this subsection— (A) $10,000,000 for fiscal year 2024; (B) $10,000,000 for fiscal year 2025; (C) $10,000,000 for fiscal year 2026; (D) $10,000,000 for fiscal year 2027; (E) $10,000,000 for fiscal year 2028; (F) $10,000,000 for fiscal year 2029; (G) $10,000,000 for fiscal year 2030; (H) $10,000,000 for fiscal year 2031; (I) $10,000,000 for fiscal year 2032; and (J) $10,000,000 for fiscal year 2033. ---
3435. Improving and expanding care Read Opens in new tab
Summary AI
The section outlines the creation of model standards for substance use disorder treatment services and recovery residences with a focus on improving care quality, ensuring access to medication, and streamlining regulation by designating primary state agencies. It mandates annual assessments of state compliance, the establishment of toll-free complaint numbers, and the public listing of certified treatment providers.
3436. Naloxone distribution program Read Opens in new tab
Summary AI
The Naloxone Distribution Program establishes a government-led initiative to purchase and deliver opioid overdose reversal drugs, like naloxone, to states and Indian tribes. This program involves negotiating contracts with drug manufacturers for discounted prices, prioritizing areas of high need, and ensuring states meet specific requirements to promote broad distribution and access to these life-saving medications, with funding authorized at $1 billion annually from 2024 to 2033.
Money References
- (h) Authorization of appropriations.—There is authorized to be appropriated to carry out this suction— (1) $1,000,000,000 for fiscal year 2024; (2) $1,000,000,000 for fiscal year 2025; (3) $1,000,000,000 for fiscal year 2026; (4) $1,000,000,000 for fiscal year 2027; (5) $1,000,000,000 for fiscal year 2028; (6) $1,000,000,000 for fiscal year 2029; (7) $1,000,000,000 for fiscal year 2030; (8) $1,000,000,000 for fiscal year 2031; (9) $1,000,000,000 for fiscal year 2032; and (10) $1,000,000,000 for fiscal year 2033. ---
3437. Additional funding for the National Institutes of Health Read Opens in new tab
Summary AI
The section authorizes a total of $10 billion in funding over ten fiscal years, from 2024 to 2033, for the National Institutes of Health to conduct research focused on addiction, pain, and developing treatments such as overdose reversal drugs, non-opioid pain medications, and non-drug therapies for substance use disorders. Each year, $1 billion is allocated for these purposes.
Money References
- There is authorized to be appropriated to the National Institutes of Health for the purpose of conducting research on addiction and pain, including research to develop overdose reversal drug products, non-opioid drug products and non-pharmacological treatments for addressing pain and substance use disorder, and drug products used to treat substance use disorder— (1) $1,000,000,000 for fiscal year 2024; (2) $1,000,000,000 for fiscal year 2025; (3) $1,000,000,000 for fiscal year 2026; (4) $1,000,000,000 for fiscal year 2027; (5) $1,000,000,000 for fiscal year 2028; (6) $1,000,000,000 for fiscal year 2029; (7) $1,000,000,000 for fiscal year 2030; (8) $1,000,000,000 for fiscal year 2031; (9) $1,000,000,000 for fiscal year 2032; and (10) $1,000,000,000 for fiscal year 2033. ---
3438. Additional funding for the Centers for Disease Control and Prevention Read Opens in new tab
Summary AI
The section provides additional funding to the Centers for Disease Control and Prevention to enhance data collection and prevention efforts for infectious diseases, drug overdose surveillance, childhood trauma, and worker health risks. It allocates a minimum of 1.5% of these funds to assist Indian tribes and tribal epidemiology centers, with a total of $500 million per year authorized from fiscal years 2024 through 2033.
Money References
- (e) Authorization of appropriations.—There is authorized to be appropriated to carry out this section— (1) $500,000,000 for fiscal year 2024; (2) $500,000,000 for fiscal year 2025; (3) $500,000,000 for fiscal year 2026; (4) $500,000,000 for fiscal year 2027; (5) $500,000,000 for fiscal year 2028; (6) $500,000,000 for fiscal year 2029; (7) $500,000,000 for fiscal year 2030; (8) $500,000,000 for fiscal year 2031; (9) $500,000,000 for fiscal year 2032; and (10) $500,000,000 for fiscal year 2033. ---
3439. Definitions Read Opens in new tab
Summary AI
In this section, several terms are defined for the purpose of a particular title. It explains that a "planning council" refers to a substance use planning group, a "recovery residence" is a living space promoting support for those in substance use recovery, "state" means any U.S. state or territory, and "substance use disorder treatment" covers a broad range of services and interventions aimed at helping individuals with substance use disorders. Also, it clarifies that "substance use disorder treatment providers" exclude certain types of providers, and it outlines that "substance use disorder treatment services" includes various supportive services authorized under this title.
4. Amendments to the Controlled Substances Act Read Opens in new tab
Summary AI
The amendments to the Controlled Substances Act require certain dispensers, distributors, and manufacturers of Schedule II controlled substances to submit yearly certifications to the Attorney General, ensuring effective measures against unlawful diversion and compliance with laws on suspicious orders. Additionally, manufacturers must certify that their substances are not misbranded, and failures or false certifications can result in civil and criminal penalties, with collected fines contributing to the Comprehensive Addiction Resources Fund.
Money References
- , a covered officer who violates subsection (b) shall be subject to a civil penalty of not more than $25,000.
313. Certifications relating to diversion controls and misbranding Read Opens in new tab
Summary AI
The section outlines the requirements for certain dispensers, distributors, and manufacturers of schedule II controlled substances to submit annual certifications to the Attorney General, confirming their adherence to regulations that prevent improper distribution and misbranding of these substances. It also details the protocol if a manufacturer fails to provide these certifications or submits false information regarding misbranding, in which case the Secretary must notify the Attorney General.
424. Certifications by covered officers Read Opens in new tab
Summary AI
In this section, certain officers of companies involved in the manufacturing and distribution of controlled substances are required to submit specific certifications, and failing to do so or providing false information can lead to civil or criminal penalties. The penalties collected are directed to the Comprehensive Addiction Resources Fund to support public health initiatives.
Money References
- — (1) CIVIL PENALTIES.—Except as provided in paragraph (2), a covered officer who violates subsection (b) shall be subject to a civil penalty of not more than $25,000.
5. General limitation on use of funds Read Opens in new tab
Summary AI
Amounts provided by this Act can only be used for public health purposes, and they cannot be used to fund incarceration or involuntary treatment for drug use, or activities and equipment inconsistent with the Act's public health goals.
6. Federal drug demand reduction activities Read Opens in new tab
Summary AI
The section outlines changes to drug policy legislation, requiring the Director of National Drug Control Policy to publish an annual online list of drug control grants and relevant information. It also adds a requirement for evaluating federally funded programs to reduce drug demand, checking their effectiveness, interaction with state and local programs, and identifying any inefficiencies or overlaps.