S. 2121

119 S2121 IS: SUPPORT for Patients and Communities Reauthorization Act of 2025
 U.S. Senate
 2025-06-18
 text/xml
 EN
 Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
 II
 119th CONGRESS  1st Session
 S. 2121
 IN THE SENATE OF THE UNITED STATES
 June 18, 2025
  Mr. Cassidy  (for himself,  Mr. Sanders ,  Ms. Murkowski ,  Ms. Baldwin ,  Mr. Mullin ,  Ms. Hassan ,  Mr. Tuberville , and  Mr. Hickenlooper ) introduced the following bill; which was read twice and referred to the  Committee on Health, Education, Labor, and Pensions
 A BILL
To reauthorize certain programs that provide for opioid use disorder prevention, treatment, and recovery, and for other purposes.
1.
Short title; table of contents
(a)
Short title
This Act may be cited as the   SUPPORT for Patients and Communities Reauthorization Act of 2025  .
(b)
Table of contents
The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
Title I—Prevention
Sec. 101. Prenatal and postnatal health.
Sec. 102. Monitoring and education regarding infections associated with illicit drug use and other risk factors.
Sec. 103. Preventing overdoses of controlled substances.
Sec. 104. Support for individuals and families impacted by fetal alcohol spectrum disorder.
Sec. 105. Promoting state choice in PDMP systems.
Sec. 106. First responder training program.
Sec. 107. Donald J. Cohen National Child Traumatic Stress Initiative.
Sec. 108. Protecting suicide prevention lifeline from cybersecurity incidents.
Sec. 109. Monitoring and reporting of child, youth, and adult trauma.
Sec. 110. Bruce’s law.
Sec. 111. Guidance on at-home drug disposal systems.
Sec. 112. Assessment of opioid drugs and actions.
Sec. 113. Grant program for State and Tribal response to opioid use disorders.
Title II—Treatment
Sec. 201. Residential treatment program for pregnant and postpartum women.
Sec. 202. Improving access to addiction medicine providers.
Sec. 203. Mental and behavioral health education and training grants.
Sec. 204. Loan repayment program for substance use disorder treatment workforce.
Sec. 205. Development and dissemination of model training programs for substance use disorder patient records.
Sec. 206. Task force on best practices for trauma-informed identification, referral, and support.
Sec. 207. Grants to enhance access to substance use disorder treatment.
Sec. 208. State guidance related to individuals with serious mental illness and children with serious emotional disturbance.
Sec. 209. Reviewing the scheduling of approved products containing a combination of buprenorphine and naloxone.
Title III—Recovery
Sec. 301. Building communities of recovery.
Sec. 302. Peer support technical assistance center.
Sec. 303. Comprehensive opioid recovery centers.
Sec. 304. Youth prevention and recovery.
Sec. 305. CAREER Act.
Sec. 306. Addressing economic and workforce impacts of the opioid crisis.
Title IV—Miscellaneous matters
Sec. 401. Delivery of a controlled substance by a pharmacy to a prescribing practitioner.
Sec. 402. Required training for prescribers of controlled substances.
I
Prevention
101.
Prenatal and postnatal health
Section 317L(d) of the Public Health Service Act ( 42 U.S.C. 247b–13(d) ) is amended by striking  such sums as may be necessary for each of the fiscal years 2019 through 2023  and inserting  $4,250,000 for each of fiscal years 2026 through 2030 .
102.
Monitoring and education regarding infections associated with illicit drug use and other risk factors
Section 317N(d) of the Public Health Service Act ( 42 U.S.C. 247b–15(d) ) is amended by striking  fiscal years 2019 through 2023  and inserting  fiscal years 2026 through 2030 .
103.
Preventing overdoses of controlled substances
(a)
In general
Section 392A of the Public Health Service Act ( 42 U.S.C. 280b–1 ) is amended—
(1)
in subsection (a)(2)—
(A)
in subparagraph (C), by inserting  and associated risks  before the period at the end; and
(B)
in subparagraph (D), by striking  opioids  and inserting  substances causing overdose ; and
(2)
in subsection (b)(2)—
(A)
in subparagraph (B), by inserting  , and associated risk factors,  after  such overdoses ;
(B)
in subparagraph (C), by striking  coding  and inserting  monitoring and identifying ;
(C)
in subparagraph (E)—
(i)
by inserting a comma after  public health laboratories ; and
(ii)
by inserting  and other emerging substances related  after  analogues ; and
(D)
in subparagraph (F), by inserting  and associated risk factors  after  overdoses .
(b)
Additional grants
Section 392A(a)(3) of the Public Health Service Act ( 42 U.S.C. 280b–1(a)(3) ) is amended—
(1)
in the matter preceding subparagraph (A), by striking  and Indian Tribes—  and inserting  and Indian Tribes for the following purposes: ;
(2)
by amending subparagraph (A) to read as follows:
(A)
To carry out innovative projects for grantees to detect, identify, and rapidly respond to controlled substance misuse, abuse, and overdoses, and associated risk factors, including changes in patterns of such controlled substance use. Such projects may include the use of innovative, evidence-based strategies for detecting such patterns, such as wastewater surveillance, if proven to support actionable prevention strategies, in a manner consistent with applicable Federal and State privacy laws.
 ; and
(3)
in subparagraph (B), by striking  for any  and inserting  For any .
(c)
Authorization of appropriations
Section 392A(e) of the Public Health Service Act ( 42 U.S.C. 280b–1(e) ) is amended by striking  $496,000,000 for each of fiscal years 2019 through 2023  and inserting  $505,579,000 for each of fiscal years 2026 through 2030 .
104.
Support for individuals and families impacted by fetal alcohol spectrum disorder
(a)
In general
Part O of title III of the Public Health Service Act ( 42 U.S.C. 280f et seq. ) is amended to read as follows:
O
Fetal alcohol spectrum disorder prevention and services program
399H.
Fetal alcohol spectrum disorders prevention, intervention, and services delivery program
(a)
In general
The Secretary shall establish or continue activities to support a comprehensive fetal alcohol spectrum disorders (referred to in this section as  FASD ) education, prevention, identification, intervention, and services delivery program, which may include—
(1)
an education and public awareness program to support, conduct, and evaluate the effectiveness of—
(A)
educational programs targeting health professions schools, social and other supportive services, educators and counselors and other service providers in all phases of childhood development, and other relevant service providers, concerning the prevention, identification, and provision of services for infants, children, adolescents, and adults with FASD;
(B)
strategies to educate school-age children, including pregnant and high-risk youth, concerning FASD;
(C)
public and community awareness programs concerning FASD; and
(D)
strategies to coordinate information and services across affected community agencies, including agencies providing social services such as foster care, adoption, and social work, agencies providing health services, and agencies involved in education, vocational training, and civil and criminal justice;
(2)
supporting and conducting research on FASD, as appropriate, including to—
(A)
develop appropriate medical diagnostic methods for identifying FASD; and
(B)
develop effective culturally and linguistically appropriate evidence-based or evidence-informed interventions and appropriate supports for preventing prenatal alcohol exposure, which may co-occur with exposure to other substances;
(3)
building State and Tribal capacity for the identification, treatment, and support of individuals with FASD and their families, which may include—
(A)
utilizing and adapting existing Federal, State, or Tribal programs to include FASD identification and FASD-informed support;
(B)
developing and expanding screening and diagnostic capacity for FASD;
(C)
developing, implementing, and evaluating targeted FASD-informed intervention programs for FASD;
(D)
providing training with respect to FASD for professionals across relevant sectors; and
(E)
disseminating information about FASD and support services to affected individuals and their families; and
(4)
an applied research program concerning intervention and prevention to support and conduct service demonstration projects, clinical studies and other research models providing advocacy, educational and vocational training, counseling, medical and mental health, and other supportive services, as well as models that integrate and coordinate such services, that are aimed at the unique challenges facing individuals with FASD and their families.
(b)
Grants and Technical Assistance
(1)
In general
The Secretary may award grants, cooperative agreements, and contracts and provide technical assistance to eligible entities to carry out subsection (a).
(2)
Eligible entities
To be eligible to receive a grant, or enter into a cooperative agreement or contract, under this section, an entity shall—
(A)
be a State, Indian Tribe or Tribal organization, local government, scientific or academic institution, or nonprofit organization; and
(B)
prepare and submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including a description of the activities that the entity intends to carry out using amounts received under this section.
(3)
Additional application contents
The Secretary may require that an eligible entity include in the application submitted under paragraph (2)(B)—
(A)
a designation of an individual to serve as a FASD State or Tribal coordinator of activities such eligible entity proposes to carry out through a grant, cooperative agreement, or contract under this section; and
(B)
a description of an advisory committee the entity will establish to provide guidance for the entity on developing and implementing a statewide or Tribal strategic plan to prevent FASD and provide for the identification, treatment, and support of individuals with FASD and their families.
(c)
Definition of FASD Informed
For purposes of this section, the term  FASD-informed , with respect to support or an intervention program, means that such support or intervention program uses culturally and linguistically informed evidence-based or practice-based interventions and appropriate resources to support an improved quality of life for an individual with FASD and the family of such individual.
399I.
Strengthening capacity and education for fetal alcohol spectrum disorders
(a)
In general
The Secretary shall award grants, contracts, or cooperative agreements, as the Secretary determines appropriate, to public or nonprofit private entities with demonstrated expertise in the field of fetal alcohol spectrum disorders (referred to in this section as  FASD ). Such awards shall be for the purposes of building local, Tribal, State, and nationwide capacities to prevent the occurrence of FASD by carrying out the programs described in subsection (b).
(b)
Programs
An entity receiving an award under subsection (a) may use such award for the following purposes:
(1)
Developing and supporting public education and outreach activities to raise public awareness of the risks associated with alcohol consumption during pregnancy.
(2)
Acting as a clearinghouse for evidence-based resources on FASD prevention, identification, and culturally and linguistically appropriate best practices to help inform systems of care for individuals with FASD across their lifespan.
(3)
Increasing awareness and understanding of efficacious, evidence-based screening tools and culturally and linguistically appropriate evidence-based intervention services and best practices, which may include improving the capacity for State, Tribal, and local affiliates.
(4)
Providing technical assistance to recipients of grants, cooperative agreements, or contracts under section 399H, as appropriate.
(c)
Application
To be eligible for a grant, contract, or cooperative agreement under this section, an entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.
(d)
Subcontracting
A public or private nonprofit entity may carry out the following activities required under this section through contracts or cooperative agreements with other public and private nonprofit entities with demonstrated expertise in FASD:
(1)
Resource development and dissemination.
(2)
Intervention services.
(3)
Training and technical assistance.
399J.
Authorization of appropriations
There are authorized to be appropriated to carry out this part $12,500,000 for each of fiscal years 2026 through 2030.
  .
(b)
Report
Not later than 4 years after the date of enactment of this Act, and every year thereafter, the Secretary of Health and Human Services shall prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report containing—
(1)
a review of the activities carried out pursuant to sections 399H and 399I of the Public Health Service Act, as amended by subsection (a), to advance public education and awareness of fetal alcohol spectrum disorders (referred to in this section as  FASD );
(2)
a description of—
(A)
the activities carried out pursuant to such sections 399H and 399I to identify, prevent, and treat FASD; and
(B)
methods used to evaluate the outcomes of such activities; and
(3)
an assessment of activities carried out pursuant to such sections 399H and 399I to support individuals with FASD.
105.
Promoting state choice in PDMP systems
Section 399O(h) of the Public Health Service Act ( 42 U.S.C. 280g–3(h) ) is amended by adding at the end the following:
(5)
Promoting state choice
Nothing in this section shall be construed to authorize the Secretary to require States to use a specific vendor or a specific interoperability connection other than to align with nationally recognized, consensus-based open standards, such as in accordance with sections 3001 and 3004.
 .
106.
First responder training program
Section 546 of the Public Health Service Act ( 42 U.S.C. 290ee–1 ) is amended—
(1)
in subsection (a), by striking  tribes and tribal  and inserting  Tribes and Tribal ;
(2)
in subsections (a), (c), and (d)—
(A)
by striking  approved or cleared  each place it appears and inserting  approved, cleared, or otherwise legally marketed ; and
(B)
by striking  opioid  each place it appears;
(3)
in subsection (f)—
(A)
by striking  approved or cleared  each place it appears and inserting  approved, cleared, or otherwise legally marketed ;
(B)
in paragraph (1), by striking  opioid ;
(C)
in paragraph (2)—
(i)
by striking  opioid and heroin  and inserting  opioid, heroin, and other drug ; and
(ii)
by striking  opioid overdose  and inserting  overdose ; and
(D)
in paragraph (3), by striking  opioid and heroin ; and
(4)
in subsection (h), by striking  $36,000,000 for each of fiscal years 2019 through 2023  and inserting  $57,000,000 for each of fiscal years 2026 through 2030 .
107.
Donald J. Cohen National Child Traumatic Stress Initiative
(a)
Technical amendment
The second part G of title V of the Public Health Service Act ( 42 U.S.C. 290kk et seq. ), as added by section 144 of the Community Renewal Tax Relief Act of 2000 ( Public Law 106–554 ), is amended—
(1)
by redesignating such part as part J; and
(2)
by redesignating sections 581 through 584 as sections 596 through 596C, respectively.
(b)
In general
Section 582 of the Public Health Service Act ( 42 U.S.C. 290hh–1 ) is amended—
(1)
in the section heading, by striking
VIOLENCE RELATED STRESS   and inserting
TRAUMATIC EVENTS  ;
(2)
in subsection (a)—
(A)
in the matter preceding paragraph (1), by striking  tribes and tribal  and inserting  Tribes and Tribal ; and
(B)
in paragraph (2), by inserting  and dissemination  after  the development ;
(3)
in subsection (b), by inserting  and dissemination  after  the development ;
(4)
in subsection (d)—
(A)
by striking  The NCTSI  and inserting the following:
(1)
Coordinating center
The NCTSI
 ; and
(B)
by adding at the end the following:
(2)
NCTSI grantees
In carrying out subsection (a)(2), NCTSI grantees shall develop trainings and other resources, as applicable and appropriate, to support implementation of the evidence-based practices developed and disseminated under such subsection.
 ;
(5)
in subsection (e)—
(A)
by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and adjusting the margins accordingly;
(B)
in subparagraph (A), as so redesignated, by inserting  and implementation  after  the dissemination ;
(C)
by striking  The NCTSI  and inserting the following:
(1)
Coordinating center
The NCTSI
 ; and
(D)
by adding at the end the following:
(2)
NCTSI grantees
NCTSI grantees shall, as appropriate, collaborate with other such grantees, the NCTSI coordinating center, and the Secretary in carrying out subsections (a)(2) and (d)(2).
 ;
(6)
by amending subsection (h) to read as follows:
(h)
Application and evaluation
To be eligible to receive a grant, contract, or cooperative agreement under subsection (a), a public or nonprofit private entity or an Indian Tribe or Tribal organization shall submit to the Secretary an application at such time, in such manner, and containing such information and assurances as the Secretary may require, including—
(1)
a plan for the evaluation of the activities funded under the grant, contract, or agreement, including both process and outcomes evaluation, and the submission of an evaluation at the end of the project period; and
(2)
a description of how such entity, Indian Tribe, or Tribal organization will support efforts led by the Secretary or the NCTSI coordinating center, as applicable, to evaluate activities carried out under this section.
 ; and
(7)
by amending subsection (j) to read as follows:
(j)
Authorization of appropriations
There is authorized to be appropriated to carry out this section—
(1)
$98,887,000 for fiscal year 2026;
(2)
$98,887,000 for fiscal year 2027;
(3)
$98,887,000 for fiscal year 2028;
(4)
$100,000,000 for fiscal year 2029; and
(5)
$100,000,000 for fiscal year 2030.
 .
108.
Protecting suicide prevention lifeline from cybersecurity incidents
(a)
National suicide prevention lifeline program
Section 520E–3(b) of the Public Health Service Act (42 U.S.C. 290bb–36c(b)) is amended—
(1)
in paragraph (4), by striking  and  at the end;
(2)
in paragraph (5), by striking the period at the end and inserting  ; and ; and
(3)
by adding at the end the following:
(6)
taking such steps as may be necessary to ensure the suicide prevention hotline is protected from cybersecurity incidents and eliminates known cybersecurity vulnerabilities.
 .
(b)
Reporting
Section 520E–3 of the Public Health Service Act ( 42 U.S.C. 290bb–36c ) is amended—
(1)
by redesignating subsection (f) as subsection (g); and
(2)
by inserting after subsection (e) the following:
(f)
Cybersecurity reporting
(1)
Notification
(A)
In general
The program’s network administrator receiving Federal funding pursuant to subsection (a) shall report to the Assistant Secretary, in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws—
(i)
any identified cybersecurity vulnerabilities to the program within a reasonable amount of time after identification of such a vulnerability; and
(ii)
any identified cybersecurity incidents to the program within a reasonable amount of time after identification of such incident.
(B)
Local and regional crisis centers
Local and regional crisis centers participating in the program shall report to the program’s network administrator identified under subparagraph (A), in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws—
(i)
any identified cybersecurity vulnerabilities to the program within a reasonable amount of time after identification of such vulnerability; and
(ii)
any identified cybersecurity incidents to the program within a reasonable amount of time after identification of such incident.
(2)
Notification
If the program’s network administrator receiving funding pursuant to subsection (a) discovers, or is informed by a local or regional crisis center pursuant to paragraph (1)(B) of, a cybersecurity vulnerability or incident, within a reasonable amount of time after such discovery or receipt of information, such entity shall report the vulnerability or incident to the Assistant Secretary.
(3)
Clarification
(A)
Oversight
(i)
Local and regional crisis centers
Except as provided in clause (ii), local and regional crisis centers participating in the program shall oversee all technology each center employs in the provision of services as a participant in the program.
(ii)
Network administrator
The program’s network administrator receiving Federal funding pursuant to subsection (a) shall oversee the technology each crisis center employs in the provision of services as a participant in the program if such oversight responsibilities are established in the applicable network participation agreement.
(B)
Supplement, not supplant
The cybersecurity incident reporting requirements under this subsection shall supplement, and not supplant, cybersecurity incident reporting requirements under other provisions of applicable Federal law that are in effect on the date of the enactment of the  SUPPORT for Patients and Communities Reauthorization Act of 2025 .
 .
(c)
Study
Not later than 180 days after the date of the enactment of this Act, the Comptroller General of the United States shall—
(1)
conduct and complete a study that evaluates cybersecurity risks and vulnerabilities associated with the 9–8–8 National Suicide Prevention Lifeline; and
(2)
submit a report on the findings of such study to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives.
109.
Monitoring and reporting of child, youth, and adult trauma
Section 7131(e) of the SUPPORT for Patients and Communities Act ( 42 U.S.C. 242t(e) ) is amended by striking  $2,000,000 for each of fiscal years 2019 through 2023  and inserting  $9,000,000 for each of fiscal years 2026 through 2030 .
110.
Bruce’s law
(a)
Youth prevention and recovery
Section 7102(c) of the SUPPORT for Patients and Communities Act (42 U.S.C. 290bb–7a(c)) is amended—
(1)
in paragraph (3)(A)(i), by inserting  , which may include strategies to increase education and awareness of the potency and dangers of synthetic opioids (including drugs contaminated with fentanyl) and, as appropriate, other emerging drug use or misuse issues  before the semicolon; and
(2)
in paragraph (4)(A), by inserting  and strategies to increase education and awareness of the potency and dangers of synthetic opioids (including drugs contaminated with fentanyl) and, as appropriate, emerging drug use or misuse issues  before the semicolon.
(b)
Interdepartmental substance use disorders coordinating committee
Section 7022 of the SUPPORT for Patients and Communities Act ( 42 U.S.C. 290aa  note) is amended—
(1)
by striking subsection (g) and inserting the following:
(g)
Working groups
(1)
In general
The Committee may establish working groups for purposes of carrying out the duties described in subsection (e). Any such working group shall be composed of members of the Committee (or the designees of such members) and may hold such meetings as are necessary to carry out the duties delegated to the working group.
(2)
Additional federal interagency work group on fentanyl contamination of illegal drugs
(A)
Establishment
The Secretary, acting through the Committee, shall establish a Federal Interagency Work Group on Fentanyl Contamination of Illegal Drugs (referred to in this paragraph as the  Work Group ) consisting of representatives from relevant Federal departments and agencies on the Committee.
(B)
Consultation
The Work Group shall consult with relevant stakeholders and subject matter experts, including—
(i)
State, Tribal, and local subject matter experts in reducing, preventing, and responding to drug overdose caused by fentanyl contamination of illicit drugs; and
(ii)
family members of both adults and youth who have overdosed by fentanyl contaminated illicit drugs.
(C)
Duties
The Work Group shall—
(i)
examine Federal efforts to reduce and prevent drug overdose by fentanyl-contaminated illicit drugs;
(ii)
identify strategies to improve State, Tribal, and local responses to overdose by fentanyl-contaminated illicit drugs;
(iii)
coordinate with the Secretary, as appropriate, in carrying out activities to raise public awareness of synthetic opioids and other emerging drug use and misuse issues;
(iv)
make recommendations to Congress for improving Federal programs, including with respect to the coordination of efforts across such programs; and
(v)
make recommendations for educating youth on the potency and dangers of drugs contaminated by fentanyl.
(D)
Annual report to secretary
The Work Group shall annually prepare and submit to the Secretary, the Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Energy and Commerce and the Committee on Education and Workforce of the House of Representatives, a report on the activities carried out by the Work Group under subparagraph (C), including recommendations to reduce and prevent drug overdose by fentanyl contamination of illegal drugs, in all populations, and specifically among youth at risk for substance misuse.
 ; and
(2)
by striking subsection (i) and inserting the following:
(i)
Sunset
The Committee shall terminate on September 30, 2030.
 .
111.
Guidance on at-home drug disposal systems
(a)
In general
Not later than one year after the date of enactment of this Act, the Secretary of Health and Human Services, in consultation with the Administrator of the Drug Enforcement Administration, shall publish guidance to facilitate the use of at-home safe disposal systems for applicable drugs.
(b)
Contents
The guidance under subsection (a) shall include—
(1)
recommended standards for effective at-home drug disposal systems to meet applicable requirements enforced by the Food and Drug Administration;
(2)
recommended information to include as instructions for use to disseminate with at-home drug disposal systems;
(3)
best practices and educational tools to support the use of an at-home drug disposal system, as appropriate; and
(4)
recommended use of licensed health providers for the dissemination of education, instruction, and at-home drug disposal systems, as appropriate.
112.
Assessment of opioid drugs and actions
(a)
In general
Not later than one year after the date of enactment of this Act, the Secretary of Health and Human Services (referred to in this section as the  Secretary ) shall publish on the website of the Food and Drug Administration (referred to in this section as the  FDA ) a report that outlines a plan for assessing opioid analgesic drugs that are approved under section 505 of the Federal Food, Drug, and Cosmetic Act ( 21 U.S.C. 355 ) that addresses the public health effects of such opioid analgesic drugs as part of the benefit-risk assessment and the activities of the FDA that relate to facilitating the development of nonaddictive medical products intended to treat pain or addiction. Such report shall include—
(1)
an update on the actions taken by the FDA to consider the effectiveness, safety, benefit-risk profile, and use of approved opioid analgesic drugs;
(2)
a timeline for an assessment of the potential need, as appropriate, for labeling changes, revised or additional postmarketing requirements, enforcement actions, or withdrawals for opioid analgesic drugs;
(3)
an overview of the steps that the FDA has taken to support the development and approval of nonaddictive medical products intended to treat pain or addiction, and actions planned to further support the development and approval of such products; and
(4)
an overview of the consideration by the FDA of clinical trial methodologies for analgesic drugs, including the enriched enrollment randomized withdrawal methodology, and the benefits and drawbacks associated with different trial methodologies for such drugs, incorporating any public input received under subsection (b).
(b)
Public input
In carrying out subsection (a), the Secretary shall provide an opportunity for public input concerning the regulation by the FDA of opioid analgesic drugs, including scientific evidence that relates to conditions of use, safety, or benefit-risk assessment (including consideration of the public health effects) of such opioid analgesic drugs.
113.
Grant program for State and Tribal response to opioid use disorders
The activities carried out pursuant to section 1003(b)(4)(A) of the 21st Century Cures Act (42 U.S.C. 290ee–3a(b)(4)(A)) may include facilitating access to products used to prevent overdose deaths by detecting the presence of one or more substances, such as fentanyl and xylazine test strips, to the extent the purchase and possession of such products is consistent with Federal and State law.
II
Treatment
201.
Residential treatment program for pregnant and postpartum women
Section 508 of the Public Health Service Act ( 42 U.S.C. 290bb–1 ) is amended—
(1)
in subsection (d)(11)(C), by striking  providing health services  and inserting  providing health care services ;
(2)
in subsection (g)—
(A)
by inserting  a plan describing  after  will provide ; and
(B)
by adding at the end the following:  Such plan may include a description of how such applicant will target outreach to women disproportionately impacted by maternal substance use disorder. ; and
(3)
in subsection (s), by striking  $29,931,000 for each of fiscal years 2019 through 2023  and inserting  $38,931,000 for each of fiscal years 2026 through 2030 .
202.
Improving access to addiction medicine providers
Section 597 of the Public Health Service Act ( 42 U.S.C. 290ll ) is amended—
(1)
in subsection (a)(1), by inserting  diagnosis,  after  related to ; and
(2)
in subsection (b), by inserting  addiction medicine,  after  psychiatry, .
203.
Mental and behavioral health education and training grants
Section 756(f) of the Public Health Service Act ( 42 U.S.C. 294e–1(f) ) is amended by striking  fiscal years 2023 through 2027  and inserting  fiscal years 2026 through 2030 .
204.
Loan repayment program for substance use disorder treatment workforce
Section 781(j) of the Public Health Service Act ( 42 U.S.C. 295h(j) ) is amended by striking  $25,000,000 for each of fiscal years 2019 through 2023  and inserting  $40,000,000 for each of fiscal years 2026 through 2030 .
205.
Development and dissemination of model training programs for substance use disorder patient records
Section 7053 of the SUPPORT for Patients and Communities Act ( 42 U.S.C. 290dd–2  note) is amended by striking subsection (e).
206.
Task force on best practices for trauma-informed identification, referral, and support
Section 7132 of the SUPPORT for Patients and Communities Act ( Public Law 115–271 ; 132 Stat. 4046) is amended—
(1)
in subsection (b)(1)—
(A)
by redesignating subparagraph (CC) as subparagraph (DD); and
(B)
by inserting after subparagraph (BB) the following:
(CC)
The Administration for Community Living.
 ;
(2)
in subsection (d)(1), in the matter preceding subparagraph (A), by inserting  , developmental disability service providers  before  , individuals who are ; and
(3)
in subsection (i), by striking  2023  and inserting  2030 .
207.
Grants to enhance access to substance use disorder treatment
Section 3203 of the SUPPORT for Patients and Communities Act ( 21 U.S.C. 823  note) is amended—
(1)
by striking subsection (b); and
(2)
by striking
(a)  In general .—The Secretary  and inserting the following:  The Secretary .
208.
State guidance related to individuals with serious mental illness and children with serious emotional disturbance
(a)
Review of use of certain funding
Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services (referred to in this section as the  Secretary ), acting through the Assistant Secretary for Mental Health and Substance Use, shall conduct a review of State use of funds made available under the Community Mental Health Services Block Grant program under subpart I of part B of title XIX of the Public Health Service Act ( 42 U.S.C. 300x et seq. ) (referred to in this section as the  block grant program ) for first episode psychosis activities. Such review shall consider the following:
(1)
How States use funds for evidence-based treatments and services according to the standard of care for individuals with early serious mental illness and children with a serious emotional disturbance.
(2)
The percentages of the State funding under the block grant program expended on early serious mental illness and first episode psychosis, and the number of individuals served under such funds.
(b)
Report and guidance
(1)
Report
Not later than 180 days after the completion of the review under subsection (a), the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate and the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives a report describing—
(A)
the findings of the review under subsection (a); and
(B)
any recommendations for changes to the block grant program that would facilitate improved outcomes for individuals with serious mental illness and children with serious emotional disturbance.
(2)
Guidance
Not later than 1 year after the date on which the report is submitted under paragraph (1), the Secretary shall update the guidance provided to States under the block grant program on coordinated specialty care and other evidence-based mental health care services for individuals with serious mental illness and children with a serious emotional disturbance, based on the findings and recommendations of such report.
209.
Reviewing the scheduling of approved products containing a combination of buprenorphine and naloxone
(a)
Secretary of HHS
The Secretary of Health and Human Services shall, consistent with the requirements and procedures set forth in sections 201 and 202 of the Controlled Substances Act ( 21 U.S.C. 811 , 812)—
(1)
review the relevant data pertaining to the scheduling of products containing a combination of buprenorphine and naloxone that have been approved under section 505 of the Federal Food, Drug, and Cosmetic Act ( 21 U.S.C. 355 ); and
(2)
if appropriate, request that the Attorney General initiate rulemaking proceedings to revise the schedules accordingly with respect to such products.
(b)
Attorney General
The Attorney General shall review any request made by the Secretary of Health and Human Services under subsection (a)(2) and determine whether to initiate proceedings to revise the schedules in accordance with the criteria set forth in sections 201 and 202 of the Controlled Substances Act ( 21 U.S.C. 811 , 812).
III
Recovery
301.
Building communities of recovery
Section 547(f) of the Public Health Service Act ( 42 U.S.C. 290ee–2(f) ) is amended by striking  $5,000,000 for each of fiscal years 2019 through 2023  and inserting  $17,000,000 for each of fiscal years 2026 through 2030 .
302.
Peer support technical assistance center
Section 547A of the Public Health Service Act ( 42 U.S.C. 290ee–2a ) is amended—
(1)
in subsection (b)(4), by striking  building; and  and inserting the following:
building, such as—
(A)
professional development of peer support specialists; and
(B)
making recovery support services available in nonclinical settings; and
 ;
(2)
by redesignating subsections (d) and (e) as subsections (e) and (f), respectively;
(3)
by inserting after subsection (c) the following:
(d)
Regional centers
(1)
In general
The Secretary may establish one regional technical assistance center (referred to in this subsection as the  Regional Center ), with existing resources, to assist the Center in carrying out activities described in subsection (b) within the geographic region of such Regional Center in a manner that is tailored to the needs of such region.
(2)
Evaluation
Not later than 4 years after the date of enactment of the  SUPPORT for Patients and Communities Reauthorization Act of 2025 , the Secretary shall evaluate the activities of the Regional Center and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report on the findings of such evaluation, including—
(A)
a description of the distinct roles and responsibilities of the Regional Center and the Center;
(B)
available information relating to the outcomes of the Regional Center under this subsection, such as any impact on the operations and efficiency of the Center relating to requests for technical assistance and support within the region of such Regional Center;
(C)
a description of any gaps or areas of duplication relating to the activities of the Regional Center and the Center within such region; and
(D)
recommendations relating to the modification, expansion, or termination of the Regional Center under this subsection.
(3)
Termination
This subsection shall terminate on September 30, 2030.
 ; and
(4)
in subsection (f), as so redesignated, by striking  $1,000,000 for each of fiscal years 2019 through 2023  and inserting  $2,000,000 for each of fiscal years 2026 through 2030 .
303.
Comprehensive opioid recovery centers
Section 552 of the Public Health Service Act ( 42 U.S.C. 290ee–7 ) is amended—
(1)
in subsection (d)(2)—
(A)
in the matter preceding subparagraph (A), by striking  and in such manner  and inserting  , in such manner, and containing such information and assurances, including relevant documentation, ; and
(B)
in subparagraph (A), by striking  is capable of coordinating with other entities to carry out  and inserting  has the demonstrated capability to carry out, through referral or contractual arrangements ;
(2)
in subsection (h)—
(A)
by redesignating paragraphs (1) through (4) as subparagraphs (A) through (D), respectively, and adjusting the margins accordingly;
(B)
by striking  With respect to  and inserting the following:
(1)
In general
With respect to
 ; and
(C)
by adding at the end the following:
(2)
Additional reporting for certain eligible entities
An entity carrying out activities described in subsection (g) through referral or contractual arrangements shall include in the submissions required under paragraph (1) information related to the status of such referrals or contractual arrangements, including an assessment of whether such referrals or contractual arrangements are supporting the ability of such entity to carry out such activities.
 ; and
(3)
in subsection (j), by striking  2019 through 2023  and inserting  2026 through 2030 .
304.
Youth prevention and recovery
Section 7102(c) of the SUPPORT for Patients and Communities Act (42 U.S.C. 290bb–7a(c)) (as amended by section 110(a)) is amended—
(1)
in paragraph (2)—
(A)
in subparagraph (A)—
(i)
in clause (i)—
(I)
by inserting  , or a consortium of local educational agencies,  after  a local educational agency ; and
(II)
by striking  high schools  and inserting  secondary schools ; and
(ii)
in clause (vi), by striking  tribe, or tribal  and inserting  Tribe, or Tribal ;
(B)
by amending subparagraph (E) to read as follows:
(E)
Indian Tribe; Tribal organization
The terms  Indian Tribe  and  Tribal organization  have the meanings given such terms in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 5304 ).
 ;
(C)
by redesignating subparagraph (K) as subparagraph (L); and
(D)
by inserting after subparagraph (J) the following:
(K)
Secondary school
The term  secondary school  has the meaning given such term in section 8101 of the Elementary and Secondary Education Act of 1965 ( 20 U.S.C. 7801 ).
 ;
(2)
in paragraph (3)(A), in the matter preceding clause (i)—
(A)
by striking  and abuse ; and
(B)
by inserting  at increased risk for substance misuse  after  specific populations ;
(3)
in paragraph (4)—
(A)
in the matter preceding subparagraph (A), by striking  Indian tribes  and inserting  Indian Tribes ;
(B)
in subparagraph (A), by striking  and abuse ; and
(C)
in subparagraph (B), by striking  peer mentoring  and inserting  peer-to-peer support ;
(4)
in paragraph (5), by striking  tribal  and inserting  Tribal ;
(5)
in paragraph (6)(A)—
(A)
in clause (iv), by striking  ; and  and inserting a semicolon; and
(B)
by adding at the end the following:
(vi)
a plan to sustain the activities carried out under the grant program, after the grant program has ended; and
 ;
(6)
in paragraph (8), by striking  2022  and inserting  2028 ; and
(7)
by amending paragraph (9) to read as follows:
(9)
Authorization of appropriations
To carry out this subsection, there are authorized to be appropriated—
(A)
$10,000,000 for fiscal year 2026;
(B)
$12,000,000 for fiscal year 2027;
(C)
$13,000,000 for fiscal year 2028;
(D)
$14,000,000 for fiscal year 2029; and
(E)
$15,000,000 for fiscal year 2030.
 .
305.
CAREER Act
(a)
In general
Section 7183 of the SUPPORT for Patients and Communities Act ( 42 U.S.C. 290ee–8 ) is amended—
(1)
in the section heading, by inserting
; TREATMENT, RECOVERY, AND WORKFORCE SUPPORT GRANTS   after
CAREER ACT  ;
(2)
in subsection (b), by inserting  each  before  for a period ;
(3)
in subsection (c)—
(A)
in paragraph (1), by striking  the rates described in paragraph (2)  and inserting  the average rates for calendar years 2018 through 2022 described in paragraph (2) ; and
(B)
by amending paragraph (2) to read as follows:
(2)
Rates
The rates described in this paragraph are the following:
(A)
The highest age-adjusted average rates of drug overdose deaths for calendar years 2018 through 2022 based on data from the Centers for Disease Control and Prevention, including, if necessary, provisional data for calendar year 2022.
(B)
The highest average rates of unemployment for calendar years 2018 through 2022 based on data provided by the Bureau of Labor Statistics.
(C)
The lowest average labor force participation rates for calendar years 2018 through 2022 based on data provided by the Bureau of Labor Statistics.
 ;
(4)
in subsection (g)—
(A)
in each of paragraphs (1) and (3), by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively, and adjusting the margins accordingly;
(B)
by redesignating paragraphs (1) through (3) as subparagraphs (A) through (C), respectively, and adjusting the margins accordingly;
(C)
in the matter preceding subparagraph (A) (as so redesignated), by striking  An entity  and inserting the following:
(1)
In general
An entity
 ; and
(D)
by adding at the end the following:
(2)
Transportation services
An entity receiving a grant under this section may use not more than 5 percent of the funds for providing transportation for individuals to participate in an activity supported by a grant under this section, which transportation shall be to or from a place of work or a place where the individual is receiving vocational education or job training services or receiving services directly linked to treatment of or recovery from a substance use disorder.
(3)
Limitation
The Secretary may not require an entity to, or give priority to an entity that plans to, use the funds of a grant under this section for activities that are not specified in this subsection.
 ;
(5)
in subsection (i)(2), by inserting  , which shall include employment and earnings outcomes described in subclauses (I) and (III) of section 116(b)(2)(A)(i) of the Workforce Innovation and Opportunity Act ( 29 U.S.C. 3141(b)(2)(A)(i) ) with respect to the participation of such individuals with a substance use disorder in programs and activities funded by the grant under this section  after  subsection (g) ;
(6)
in subsection (j)—
(A)
in paragraph (1), by inserting  for grants awarded prior to the date of enactment of the  SUPPORT for Patients and Communities Reauthorization Act of 2025   after  grant period under this section ; and
(B)
in paragraph (2)—
(i)
in the matter preceding subparagraph (A), by striking  2 years after submitting the preliminary report required under paragraph (1)  and inserting  September 30, 2030 ; and
(ii)
in subparagraph (A), by striking  (g)(3)  and inserting  (g)(1)(C) ; and
(7)
in subsection (k), by striking  $5,000,000 for each of fiscal years 2019 through 2023  and inserting  $12,000,000 for each of fiscal years 2026 through 2030 .
(b)
Reauthorization of the CAREER Act; Recovery Housing Pilot Program
(1)
In general
Section 8071 of the SUPPORT for Patients and Communities Act ( 42 U.S.C. 5301  note;  Public Law 115–271 ) is amended—
(A)
by striking the section heading and inserting
CAREER Act; Recovery Housing Pilot Program  ;
(B)
in subsection (a), by striking  through 2023  and inserting  through 2030 ;
(C)
in subsection (b)—
(i)
in paragraph (1), by striking  not later than 60 days after the date of enactment of this Act  and inserting  not later than 60 days after the date of enactment of the  SUPPORT for Patients and Communities Reauthorization Act of 2025  ; and
(ii)
in paragraph (2)(B)(i)—
(I)
in subclause (I)—
(aa)
by striking  for calendar years 2013 through 2017 ; and
(bb)
by inserting  for calendar years 2018 through 2022  after  rates of unemployment ;
(II)
in subclause (II)—
(aa)
by striking  for calendar years 2013 through 2017 ; and
(bb)
by inserting  for calendar years 2018 through 2022  after  participation rates ; and
(III)
by striking subclause (III) and inserting the following:
(III)
The highest age-adjusted average rates of drug overdose deaths for calendar years 2018 through 2022 based on data from the Centers for Disease Control and Prevention, including, if necessary, provisional data for calendar year 2022.
  ; and
(D)
in subsection (f), by striking  For the 2-year period following the date of enactment of this Act, the  and inserting  The .
(2)
Conforming amendment
Subtitle F of title VIII of the SUPPORT for Patients and Communities Act ( Public Law 115–271 ; 132 Stat. 4095) is amended by striking the subtitle heading and inserting the following:
CAREER Act; Recovery Housing Pilot Program
.
(c)
Clerical amendments
The table of contents in section 1(b) of the SUPPORT for Patients and Communities Act ( Public Law 115–271 ; 132 Stat. 3894) is amended—
(1)
by striking the item relating to section 7183 and inserting the following:
Sec. 7183. CAREER Act; treatment, recovery, and workforce support grants.
  ;
(2)
by striking the item relating to subtitle F of title VIII and inserting the following:
Subtitle F—CAREER Act; Recovery Housing Pilot Program
  ; and
(3)
by striking the item relating to section 8071 and inserting the following:
Sec. 8071. CAREER Act; Recovery Housing Pilot Program.
  .
306.
Addressing economic and workforce impacts of the opioid crisis
Section 8041(g)(1) of the SUPPORT for Patients and Communities Act ( 29 U.S.C. 3225a(g)(1) ) is amended by striking  2023  and inserting  2030 .
IV
Miscellaneous matters
401.
Delivery of a controlled substance by a pharmacy to a prescribing practitioner
Section 309A(a) of the Controlled Substances Act ( 21 U.S.C. 829a(a) ) is amended by striking paragraph (2) and inserting the following:
(2)
the controlled substance is a drug in schedule III, IV, or V to be administered—
(A)
by injection or implantation for the purpose of maintenance or detoxification treatment; or
(B)
subject to a risk evaluation and mitigation strategy pursuant to section 505–1 of the Federal Food, Drug, and Cosmetic Act ( 21 U.S.C. 355–1 ) that includes elements to assure safe use of the drug described in subsection (f)(3)(E) of such section, including a requirement for post-administration monitoring by a health care provider;
 .
402.
Required training for prescribers of controlled substances
(a)
In general
Section 303 of the Controlled Substances Act ( 21 U.S.C. 823 ) is amended—
(1)
by redesignating the second subsection designated as subsection (l) as subsection (m); and
(2)
in subsection (m)(1), as so redesignated—
(A)
in subparagraph (A)—
(i)
in clause (iv)—
(I)
in subclause (I)—
(aa)
by inserting  the American Academy of Family Physicians, the American Podiatric Medical Association, the Academy of General Dentistry, the American Optometric Association,  before  or any other organization ;
(bb)
by striking  or the Commission  and inserting  , the Commission ; and
(cc)
by inserting  , or the Council on Podiatric Medical Education  before the semicolon at the end; and
(II)
in subclause (III), by inserting  or the American Academy of Family Physicians  after  Association ; and
(ii)
in clause (v), in the matter preceding subclause (I)—
(I)
by striking  osteopathic medicine, dental surgery  and inserting  osteopathic medicine, podiatric medicine, dental surgery ; and
(II)
by striking  or dental medicine curriculum  and inserting  or dental or podiatric medicine curriculum ; and
(B)
in subparagraph (B)—
(i)
in clause (i)—
(I)
by inserting  the American Pharmacists Association, the Accreditation Council on Pharmacy Education, the American Psychiatric Nurses Association, the American Academy of Nursing, the American Academy of Family Physicians,  before  or any other organization ; and
(II)
by inserting  , the American Academy of Family Physicians,  before  or the Accreditation Council ; and
(ii)
in clause (ii)—
(I)
by striking  or accredited school  and inserting  , an accredited school ; and
(II)
by inserting  , or an accredited school of pharmacy  before  in the United States .
(b)
Effective date
The amendments made by subsection (a) shall take effect as if enacted on December 29, 2022.