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
The bill is like giving special money and help to places to fight against bad drugs that make people sick. It wants to use the money smartly to help people and teach doctors how to stop bad drugs from hurting people.
Summary AI
S. 4286, the "Comprehensive Addiction Resources Emergency Act of 2024," aims to provide emergency assistance to areas affected by substance use disorders, including the use of opioids and stimulants. The bill introduces grant programs for states, territories, tribal governments, and localities to develop better systems for delivering essential services to individuals with substance use disorder and their families. It also emphasizes improving education and training for health professionals, increasing access to treatment and prevention services, supporting innovation, and enhancing data collection. Additionally, the bill requires certifications to ensure the safe distribution of controlled substances and mandates effective management of public health-related funds.
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Bill Statistics
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Language
Complexity
AnalysisAI
General Summary
The proposed Comprehensive Addiction Resources Emergency Act of 2024 (S. 4286) aims to provide emergency assistance to various entities affected by substance use disorders, including States, territories, Tribal nations, and local areas. The bill outlines financial support and strategies to develop more effective and cost-efficient systems for delivering essential services to individuals dealing with substance use disorders (SUDs) and their families. The Act will amend the Public Health Service Act, establish local and state grant programs, allocate substantial funding, and set specific guidelines for managing and distributing funds. It also addresses aspects like innovation, training, and improvements in health systems regarding the treatment and prevention of SUDs, particularly focusing on opioid and stimulant abuse.
Summary of Significant Issues
Financial Appropriations and Ambiguity
The bill assigns substantial and fixed financial allocations—$3.3 billion annually for certain programs and $4.6 billion annually for others—without detailed breakdowns or justifications, which raises concerns about transparency and the potential for wasteful spending. The recurrence of the same funding amount for consecutive years, as seen in Sections 3406 and 3415, calls into question whether these allocations are informed by projected needs or dynamic changes in conditions.
Complexity and Comprehensibility
The language used in the bill is notably complex, which could hinder understanding and compliance, especially for stakeholders without legal expertise. Complex sections, such as those regarding grant distributions and certifications for diversion controls, might seem daunting to state and local officials or smaller entities trying to engage effectively with the bill's requirements.
Broad Eligibility Criteria and Selection Processes
The bill's broad eligibility criteria for various grants may lead to favoritism and a lack of transparency. In Sections 3405 and 3423, the absence of clear guidelines for technical assistance and grantee selection could foster inefficiencies. Additionally, waiver provisions allow entities to bypass third-party reimbursement processes, potentially reducing accountability and encouraging unsustainable reliance on grant funding.
Impact on the Public
Positive Outcomes
The primary objective is to provide critical assistance to locations with acute and persistent substance use disorder issues. By offering financial support and structured programs, the Act may enhance the development and coordination of effective services, thereby leading to improved outcomes for individuals suffering from substance use disorders. Public health could benefit broadly from the increased accessibility and affordability of treatment options and related services.
Negative Consequences
The potential for mismanagement of funds due to insufficient transparency and clarity in grant allocation processes may result in certain communities not receiving adequate support. The administrative burden that comes with compliance to complex legislative language might strain resources in less wealthy or knowledgeable districts, hindering their ability to fully benefit from the Act.
Impact on Specific Stakeholders
States and Local Governments
States and local governments stand to benefit significantly if they meet the eligibility requirements and can efficiently allocate and manage grant funds. However, the mandatory establishment of councils and administrative overhead could prove burdensome for jurisdictions with limited resources or understanding of the intricate requirements.
Tribal Nations
With specific appropriations and provisions allowing flexibility, Tribal nations could gain improved resources and support services tailored to their unique needs. However, provisions that lack detail on implementation required to consult with Indian tribes or confer with urban Indian organizations could lead to potential gaps in service provision.
Nonprofit and Community-based Organizations
These entities are integral in service delivery and may benefit from grant programs aiming to expand resources and support. The alignment of the Act with their missions could enable them to serve their communities better. However, the favoring of entities with existing labor organization agreements may sideline smaller or newer organizations that do not have such structures in place.
Conclusion
This legislation proposes a comprehensive and potentially impactful approach to addressing substance use disorders on a national scale but requires meticulous oversight to ensure the effectiveness and equitable distribution of significant financial resources. While it promises substantial benefits in enhancing treatment accessibility and coordination, the ambiguities and complexities in its language and provisions call for careful examination and possible clarifications to optimize its execution and societal benefit.
Financial Assessment
The bill, S. 4286, known as the "Comprehensive Addiction Resources Emergency Act of 2024," outlines numerous financial allocations aimed at addressing substance use disorders across various jurisdictions in the United States. The bill calls for significant and fixed financial appropriations, with specific figures delineated for different programs and initiatives.
Financial Allocations
The bill authorizes substantial funding across several sections:
Subtitle A: There is an allocation of $3.3 billion annually from fiscal years 2024 to 2033. These funds are intended to support local substance use emergency relief grant programs.
Subtitle B: This section also includes appropriations of $4.6 billion annually from fiscal years 2024 to 2033. The funds are designated for state and tribal substance use disorder prevention and intervention programs.
Subtitle C: Another significant portion of funding, $1 billion annually from fiscal years 2024 to 2033, is earmarked for other grant programs.
Each of these appropriations aims to address substance use disorders through various methods, including prevention, intervention, treatment, and recovery support services.
Issues with Financial Transparency and Accountability
The authorization of significant and fixed financial appropriations lacks detailed breakdowns, justifications, or specified objectives, which could lead to concerns about transparency, potential wasteful spending, and accountability. The vast sums, such as $3.3 billion and $4.6 billion allocated annually for specific sections, are not accompanied by detailed explanations of how this money will be exactly utilized, leading to potential ambiguities in implementation.
Complexity and Administrative Burden
The financial language throughout the bill may be overly complex, making it challenging for stakeholders without a legal background to understand. This complexity, particularly seen in the breakdown of grant distributions and the criteria for these distributions—such as the "State distribution factor" and "non-local distribution factor"—could hinder effective comprehension and stakeholder compliance.
Discretion and Decision-Making
The bill grants the Secretary broad discretion, especially in sections like the Naloxone distribution program (Section 3436). Without adequate transparency or criteria, decisions on allocating opioid overdose reversal drugs could become arbitrary and lack accountability. This is critical given the substantial funding, such as the $1 billion annually noted for this particular program.
Sustainability and Use of Waivers
The waiver provisions within the bill allow entities to operate without accepting third-party reimbursements. This could potentially reduce accountability and encourage reliance solely on grant funding, which might undermine the long-term sustainability of funded programs.
Potential for Favoritism
The bill includes provisions that may favor certain organizations with specific labor organization policies. This focus, highlighted in sections like 3402(i) and 3412(c)(2)(D), could bias the funding distribution towards entities with such policies, which may not be accessible or desired by all eligible entities, thereby potentially disadvantaging others.
In summary, the bill's significant financial allocations are not accompanied by detailed guidelines, which raises concerns about effective fund management and oversight. This, coupled with the complexity of the distribution criteria and broad discretion granted to administrative bodies, points to potential issues in equity and accountability.
Issues
The authorization of significant and fixed financial appropriations ($3.3 billion annually for Subtitle A and $4.6 billion annually for Subtitle B) lacks detailed breakdowns, justifications, or specified objectives, which could lead to concerns about transparency, potential wasteful spending, and accountability in Sections 3406 and 3415.
The language throughout the bill, especially in Sections 3 and 3433, is overly complex and may be difficult for readers without a legal background to understand, potentially impacting stakeholder compliance and understanding.
The bill requires certifications relating to diversion controls and misbranding, which may add administrative complexity and potential legal challenges for covered persons, as mentioned in Section 313.
The criteria for determining grant amounts and distributions in Sections 3403 and 3412, like 'State distribution factor' and 'non-local distribution factor,' are not clearly defined, leading to potential ambiguity and inconsistencies.
The broad range of eligible entities and the lack of specificity in guidelines for technical assistance and grantee selection in Sections 3405 and 3423 could lead to favoritism, lack of transparency, or inefficiencies in fund distribution.
The Section 3436 establishing the Naloxone distribution program allows the Secretary broad discretion in decision-making without sufficient transparency, which could result in arbitrary decisions or lack of accountability in the distribution of opioid overdose reversal drugs.
The waiver provisions allowing entities not to accept third-party reimbursements, found in Sections 3403(c)(1)(B) and 3412(b)(2)(C), might reduce accountability and encourage reliance on grant funding, potentially undermining sustainability.
The requirement for Sections to ensure a continuum of substance use services starting FY2026 (as seen in Section 3412) may limit funding access for states struggling to comply, possibly disadvantaging underserved regions.
The Section 3431 dealing with 'Special projects of national significance' lacks clear criteria or guidelines for grant selection, risking transparency and fairness concerns in fund allocation.
The emphasis on labor organization policies in various sections, like 3402(i) and 3412(c)(2)(D), might favor certain organizations over others, potentially disadvantaging entities that lack such policies.
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 amendment aims to create a grant program for local governments to tackle substance use issues. It outlines eligibility, grant administration, and fund allocation procedures to improve substance use disorder treatment services in communities.
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).
- “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.
- “(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.
- “(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 procedures and criteria for granting and using federal funds to help local areas and tribal governments address substance use disorders. It specifies how grant amounts are determined, emphasizes prioritizing areas with greater needs, and requires recipients to use the funds for various services like prevention, treatment, and recovery while adhering to specific conditions and ensuring community involvement.
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
The section describes how grants for substance use disorder treatment and services are allocated to states, territories, and tribal governments, including eligibility, funding amounts, use of funds, and conditions for receiving funding. It outlines specific services covered, criteria state applications must meet, and preferences given for grant distribution based on compliance with model standards and efforts in prevention, treatment, and management of substance use disorders.
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
The section outlines how entities should use grant money to provide a variety of services related to substance use disorder. These services include prevention and education, medical and mental health treatments, support during recovery, early interventions, harm reduction strategies, and a limited portion for administrative tasks.
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 outlines a program to boost the availability of substance use treatment providers under Medicaid by funding projects across states and territories, with a focus on supporting grantees that respect labor organizing rights. Additionally, 10% of the funds are reserved to support Indian tribes and urban Indian organizations, with a total of $50 million allocated annually 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 text outlines a program for distributing opioid overdose reversal drugs, such as naloxone, to states and Indian tribes to help combat opioid overdoses. The program includes purchasing, delivering, and negotiating contracts for these drugs, and specifies distribution requirements for states and eligible entities, while authorizing $1 billion in funding 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.