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Title III — Recovery

S. 5000 · 116th Congress · Dec 10, 2020 · Lineage

III Recovery

A General provisions

301. Building communities of recovery

(a)
In general— Section 547 of the Public Health Service Act (42 U.S.C. 290ee–2) is amended—
(1)
by striking subsection (c);
(2)
by redesignating subsection (d) as subsection (c);
(3)
in subsection (c) (as so redesignated)—
(A)
in paragraph (1), by striking “and” at the end;
(B)
in paragraph (2)(C)(iv), by striking the period and inserting “; and”; and
(C)
by adding at the and the following:

“(3) may be used as provided for in subsection (d).”

(4)
by inserting after subsection (c) (as so redesignated), the following:

“(d) Establishment of regional technical assistance centers

“(1) In general—Grants awarded under subsection (b) may be used to provide for the establishment of regional technical assistance centers to provide regional technical assistance for the following:

“(A) Implementation of regionally driven peer delivered substance use disorder recovery support services before, during, after, or in lieu of substance use disorder treatment.

“(B) Establishment of recovery community organizations.

“(C) Establishment of recovery community centers.

“(D) Naloxone training and dissemination.

“(E) Development of connections between recovery support services, community organizations, and community centers and the broader medical community.

“(F) Establishment of online recovery support services, with parity to physical health services.

“(G) Development of recovery wellness plans to address perceived barriers to recovery, including social determinants of health.

“(H) Establishment of culturally competent (as defined in section 102 of the Developmental Disabilities Assistance and Bill of Rights Act of 2000) treatment programs to engage with racially and ethnically diverse patients.

“(2) Eligible entities—To be eligible to receive a grant under paragraph (1), an entity shall be—

“(A) a national nonprofit entity with a network of local affiliates and partners that are geographically and organizationally diverse; or

“(B) a national nonprofit organization established by individuals in personal and family recovery, serving prevention, treatment, recovery, payor, faith-based, and criminal justice stakeholders in the implementation of local substance use disorder and recovery initiatives.

“(3) Preference—In awarding grants under subsection (b), the Secretary shall give preference to organizations that—

“(A) provide culturally competent (as defined in section 102 of the Developmental Disabilities Assistance and Bill of Rights Act of 2000) services;

“(B) allow participation by individuals receiving medication-assisted treatment that involves prescription drugs approved by the Food and Drug Administration (at least one of which is an opioid agonist); and

“(C) use peer recovery advocates.”

(5)
in subsection (f), by striking “2023” and inserting “2020, and $200,000,000 for each of fiscal years 2021 through 2026”.
(b)
Continuing care and community support To maintain recovery—
(1)
In general— The Secretary shall award grants to peer recovery support services, for the purposes of providing continuing care and ongoing community support for individuals to maintain recovery from substance use disorders.
(2)
Definition— For purposes of this subsection, the term peer recovery support services means an independent nonprofit organization that provides peer recovery support services, through credentialed peer support professionals.
(3)
Authorization of appropriations— There are authorized to be appropriated, for each of fiscal years 2021 through 2026, $50,000,000 for purposes of awarding grants under paragraph (1).

302. Medication-assisted treatment for recovery from substance use disorder

(a)
In general— Section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)) is amended—
(1)
by striking paragraph (2);
(2)
by striking “(g)(1) Except as provided in paragraph (2), practitioners who dispense narcotic drugs to individuals for maintenance treatment or detoxification treatment” and inserting “(g) Practitioners who dispense narcotic drugs (other than narcotic drugs in schedule III, IV, or V) to individuals for maintenance treatment or detoxification treatment”;
(3)
by redesignating subparagraphs (A), (B), and (C) as paragraphs (1), (2), and (3), respectively; and
(4)
in paragraph (2), as redesignated, by redesignating clauses (i) and (ii) as subparagraphs (A) and (B), respectively.
(b)
Technical and conforming edits—
(1)
Section 304 of the Controlled Substances Act (21 U.S.C. 824) is amended—
(A)
in subsection (a), by striking “303(g)(1)” each place it appears and inserting “303(g)”; and
(B)
in subsection (d)(1), by striking “303(g)(1)” and inserting “303(g)”.
(2)
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—

“(A) is a narcotic drug in schedule III, IV, or V to be administered for the purpose of maintenance or detoxification treatment; and

“(B) is to be administered by injection or implantation;”

(3)
Section 520E–4(c) of the Public Health Service Act (42 U.S.C. 290bb–36d(c)) is amended, in the matter preceding paragraph (1), by striking “information on any qualified practitioner that is certified to prescribe medication for opioid dependency under section 303(g)(2)(B) of the Controlled Substances Act” and inserting “information on any practitioner who prescribes narcotic drugs in schedule III, IV, or V of section 202 of the Controlled Substances Act for the purpose of maintenance or detoxification treatment”.
(4)
Section 544(a)(3) of the Public Health Service Act (42 U.S.C. 290dd–3) is amended by striking “any practitioner dispensing narcotic drugs pursuant to section 303(g) of the Controlled Substances Act” and inserting “any practitioner dispensing narcotic drugs for the purpose of maintenance or detoxification treatment”.
(5)
Section 1833(bb)(3)(B) of the Social Security Act (42 U.S.C. 1395l(bb)(3)(B)) is amended by striking “first receives a waiver under section 303(g) of the Controlled Substances Act on or after January 1, 2019” and inserting “first begins prescribing narcotic drugs in schedule III, IV, or V of section 202 of the Controlled Substances Act for the purpose of maintenance or detoxification treatment on or after January 1, 2019”.
(6)
Section 1834(o)(3)(C)(ii) of the Social Security Act (42 U.S.C. 1395m(o)(3)(C)(ii)) is amended by striking “first receives a waiver under section 303(g) of the Controlled Substances Act on or after January 1, 2019” and inserting “first begins prescribing narcotic drugs in schedule III, IV, or V of section 202 of the Controlled Substances Act for the purpose of maintenance or detoxification treatment on or after January 1, 2019”.
(7)
Section 1866F(c)(3) of the Social Security Act (42 U.S.C. 1395cc–6(c)(3)) is amended—
(A)
in subparagraph (A), by inserting “and” at the end;
(B)
in subparagraph (B), by striking “; and” and inserting a period; and
(C)
by striking subparagraph (C).
(8)
Section 1903(aa)(2)(C) of the Social Security Act (42 U.S.C. 1396b(aa)(2)(C)) is amended—
(A)
in clause (i), by inserting “and” at the end;
(B)
by striking clause (ii); and
(C)
by redesignating clause (iii) as clause (ii).

303. Recovery in the workplace

It is the sense of Congress that an employee who is taking opioid antagonist, opioid agonist, or partial agonist drugs as part of a medication-assisted treatment program shall not be in violation of a drug-free workplace requirement.

304. Telehealth for recovery support services

(a)
Funding for the testing of incentive payments for behavioral health providers for adoption and use of certified electronic health record technology— In addition to amounts appropriated under subsection (f) of section 1135A of the Social Security Act (42 U.S.C. 13951315a), there are authorized to be appropriated to the Center for Medicare and Medicaid Innovation such sums as may be necessary for fiscal year 2021 to design, implement, and evaluate the model under subsection (b)(2)(B)(xxv) of such section. Amounts appropriated under the preceding sentence shall remain available until expended.
(b)
Telehealth for substance use disorder treatment—
(1)
Substance use disorder services furnished through telehealth under Medicare— Section 1834(m)(7) of the Social Security Act (42 U.S.C. 1395m(m)(7)) is amended by adding at the end the following: “With respect to telehealth services described in the preceding sentence that are furnished on or after January 1, 2020, nothing shall preclude the furnishing of such services through audio or telephone only technologies in the case where a physician or practitioner has already conducted an in-person medical evaluation or a telehealth evaluation that utilizes both audio and visual capabilities with the eligible telehealth individual.”.
(2)
Controlled substances dispensed by means of the internet— Section 309(e)(2) of the Controlled Substances Act (21 U.S.C. 829(e)(2)) is amended—
(A)
in subparagraph (A)(i)—
(i)
by striking “at least 1 in-person medical evaluation” and inserting the following:

“(I) 1 in-person medical evaluation”

(ii)
by adding at the end the following:

“(II) for purposes of prescribing a controlled substance in schedule III or IV, 1 telehealth evaluation; or”

(B)
by adding at the end the following:

“(D)

“(i) The term telehealth evaluation means a medical evaluation that is conducted in accordance with applicable Federal and State laws by a practitioner (other than a pharmacist) who is at a location remote from the patient and is communicating with the patient using a telecommunications system referred to in section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site practitioner.

“(ii) Nothing in clause (i) shall be construed to imply that 1 telehealth evaluation demonstrates that a prescription has been issued for a legitimate medical purpose within the usual course of professional practice.

“(iii) A practitioner who prescribes the drugs or combination of drugs that are covered under section 303(g)(2)(C) using the authority under subparagraph (A)(i)(II) of this paragraph shall adhere to nationally recognized evidence-based guidelines for the treatment of patients with opioid use disorders and a diversion control plan, as those terms are defined in section 8.2 of title 42, Code of Federal Regulations, as in effect on the date of enactment of this subparagraph.”

B Recovery housing

311. Clarifying the role of SAMHSA in promoting the availability of high-quality recovery housing

Section 501(d) of the Public Health Service Act (42 U.S.C. 290aa) is amended—
(1)
in paragraph (24)(E), by striking “and” at the end;
(2)
in paragraph (25), by striking the period at the end and inserting “; and”; and
(3)
by adding at the end the following:

“(26) collaborate with national accrediting entities and reputable providers and analysts of recovery housing services and all relevant Federal agencies, including the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, other offices and agencies within the Department of Health and Human Services, the Office of National Drug Control Policy, the Department of Justice, the Department of Housing and Urban Development, and the Department of Agriculture, to promote the availability of high-quality recovery housing for individuals with a substance use disorder.”

312. Developing guidelines for States to promote the availability of high-quality recovery housing

(a)
In general— Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, shall develop, and publish on the Internet website of the Substance Abuse and Mental Health Services Administration, consensus-based guidelines and nationally recognized standards for States to promote the availability of high-quality recovery housing for individuals with a substance use disorder. Such guidelines shall—
(1)
be developed in consultation with national accrediting entities and reputable providers and analysts of recovery housing services and be consistent with the best practices developed under section 550 of the Public Health Service Act (42 U.S.C. 290ee–5); and
(2)
to the extent practicable, build on existing best practices and suggested guidelines developed previously by the Substance Abuse and Mental Health Services Administration.
(b)
Public comment period— Before finalizing guidelines under subsection (a), the Secretary of Health and Human Services shall provide for a public comment period.
(c)
Exclusion of guideline on treatment services— In developing the guidelines under subsection (a), the Secretary may not include any guideline or standard with respect to substance use disorder treatment services.
(d)
Substance use disorder treatment services— In this section, the term substance use disorder treatment services means items or services furnished for the treatment of a substance use disorder, including—
(1)
medications approved by the Food and Drug Administration for use in such treatment, excluding each such medication used to prevent or treat a drug overdose;
(2)
the administering of such medications;
(3)
recommendations for such treatment;
(4)
clinical assessments and referrals;
(5)
counseling with a physician, psychologist, or mental health professional (including individual and group therapy); and
(6)
toxicology testing.

313. Coordination of Federal activities to promote the availability of high-quality recovery housing

Section 550 of the Public Health Service Act (42 U.S.C. 290ee–5) is amended—
(1)
by redesignating subsections (e), (f), and (g) as subsections (h), (i), and (j), respectively; and
(2)
by inserting after subsection (d) the following:

“(e) Coordination of Federal activities To promote the availability of high-Quality recovery housing for individuals with a substance use disorder

“(1) In general—The Secretary, acting through the Assistant Secretary, and the Secretary of the Department of Housing and Urban Development, shall convene and serve as the co-chairs of an interagency working group composed of representatives of each of the Federal agencies described in paragraph (2) (referred to in this section as the “working group”) for the following purposes:

“(A) To increase collaboration, cooperation, and consultation among such Federal agencies, with respect to promoting the availability of high-quality recovery housing.

“(B) To align the efforts of such agencies and avoid duplication of such efforts by such agencies.

“(C) To develop objectives, priorities, and a long- term plan for supporting State, Tribal, and local efforts with respect to the operation of high-quality recovery housing that is consistent with the best practices developed under this section.

“(D) To coordinate inspection and enforcement among Federal and State agencies.

“(E) To coordinate data collection on the quality of recovery housing.

“(2) Federal agencies described—The Federal agencies described in this paragraph are the following:

“(A) The Department of Health and Human Services.

“(B) The Centers for Medicare & Medicaid Services.

“(C) The Substance Abuse and Mental Health Services Administration.

“(D) The Health Resources and Services Administration.

“(E) The Indian Health Service.

“(F) The Department of Housing and Urban Development.

“(G) The Department of Agriculture.

“(H) The Department of Justice.

“(I) The Office of National Drug Control Policy.

“(J) The Bureau of Indian Affairs.

“(K) Any other such agency or subagency as the chair determines necessary and appropriate.

“(3) Meetings—The working group shall meet on a quarterly basis.

“(4) Reports to Congress—Beginning not later than 1 year after the date of the enactment of this section and annually thereafter, the working group shall submit to the Committee on Health, Education, Labor, and Pensions, the Committee on Agriculture, Nutrition, and Forestry, and the Committee on Finance of the Senate and the Committee on Energy and Commerce, the Committee on Ways and Means, the Committee on Agriculture, and the Committee on Financial Services of the House of Representatives a report describing the work of the working group and any recommendations of the working group to improve Federal, State, or local policy with respect to recovery housing operations.”

314. NAS study

Section 550 of the Public Health Service Act (42 U.S.C. 290ee–5), as amended by section 313, is further amended by inserting after subsection (e) (as inserted by such section 313) the following:

“(f) NAS study and report

“(1) In general—The Secretary, acting through the Assistant Secretary, shall enter into an arrangement with the National Academy of Sciences under which the National Academy agrees to conduct a study on—

“(A) the availability in the United States of high-quality recovery housing and whether that availability meets the demand for such housing in the United States; and

“(B) State, Tribal, and local regulation and oversight of recovery housing.

“(2) Report—The arrangement under paragraph (1) shall provide for the National Academy of Sciences to submit, not later than 1 year after the date of the enactment of this subsection, a report that contains—

“(A) the results of the study under such paragraph;

“(B) the National Academy’s recommendations for Federal, State, and local policies to promote the availability of high-quality recovery housing in the United States;

“(C) recommendations for Federal, State, and local policies to improve data collection on the quality of recovery housing;

“(D) recommendations for recovery housing quality metrics;

“(E) recommendations to eliminate restrictions by recovery residences that exclude individuals who take prescribed medications for opioid use disorder; and

“(F) a summary of allegations, assertions, or formal legal actions on the State and local levels by governments and non-governmental organizations with respect to the opening and operation of recovery residences.

“(3) Consultation—In conducting the study under this subsection, the National Academy of Sciences shall consult with national accrediting entities and reputable providers and analysts of recovery housing services.”

315. Grants for States to promote the availability of high quality recovery housing

Section 550 of the Public Health Service Act (42 U.S.C. 290ee–5), as amended by sections 313 and 314 is further amended by inserting after subsection (f) (as inserted by such section 314) the following:

“(g) Grants for implementing national recovery housing best practices

“(1) In general—The Secretary shall award grants to States (and political subdivisions thereof), Tribes, and territories—

“(A) for the provision of technical assistance by national accrediting entities and reputable providers and analysts of recovery housing services to implement the guidelines, nationally recognized standards, and recommendations developed under section 312 of the CARA 2.0 Act of 2020 and this section; and

“(B) to promote the availability of high-quality recovery housing for individuals with a substance use disorder and practices to maintain housing quality long term.

“(2) State enforcement plans—Beginning not later than 90 days after the date of the enactment of this paragraph and every 2 years thereafter, as a condition on the receipt of a grant under paragraph (1), each State (or political subdivisions thereof), Tribe, or territory receiving such a grant shall submit to the Secretary, and make publicly available on a publicly accessible Internet website of the State (or political subdivisions thereof), Tribe, or territory, the plan of the State (or political subdivisions thereof), Tribe, or territory, with respect to the promotion of high-quality recovery housing for individuals with a substance use disorder located within the jurisdiction of such State (or political subdivisions thereof), Tribe, or territory, and how such plan is consistent with the best practices developed under this section and guidelines developed under section 312 of the CARA 2.0 Act of 2020.

“(3) Review of accrediting entities—The Secretary shall periodically review the accrediting entities providing technical assistance pursuant to paragraph (1)(A).”

316. Authorization of appropriations

Section 550 of the Public Health Service Act (42 U.S.C. 290ee–5), as amended by sections 313, 314, and 315, is further amended by amending subsection (j) (as redesignated by such section 313) to read as follows:

“(j) Authorization of appropriations

“(1) In general—To carry out this section, there is authorized to be appropriated—

“(A) $2,000,000 for fiscal year 2021; and

“(B) $11,000,000 for each of fiscal years 2022 through 2026.

“(2) Reservations of funds—For each of fiscal years 2021 through 2026, of the amounts appropriated under paragraph (1) for such fiscal year, the Secretary shall reserve—

“(A) not less than $1,000,000 to carry out subsection (e);

“(B) not less than $1,000,000 to carry out subsection (f); and

“(C) not less than $10,000,000 to carry out subsection (g).”

317. Reputable providers and analysts of recovery housing services definition

Section 550(i) of the Public Health Service Act (42 U.S.C. 290ee–5(i)), as redesignated by section 313, is amended by adding at the end the following:

“(4) The term reputable providers and analysts of recovery housing services means recovery housing service providers and analysts that—

“(A) use evidence-based approaches;

“(B) act in accordance with guidelines issued by the Assistant Secretary for Mental Health and Substance Use;

“(C) have not been found guilty of health care fraud by the Department of Justice; and

“(D) have not been found to have violated Federal, State, or local codes of conduct with respect to recovery housing for individuals with a substance use disorder.”

318. Technical correction

Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended—
(1)
by redesignating section 550 (relating to Sobriety Treatment and Recovery Teams) (42 U.S.C. 290ee–10), as added by section 8214 of Public Law 115–271, as section 550A; and
(2)
moving such section so it appears after section 550 (relating to National Recovery Housing Best Practices).