US Codex
Pub. L.
Notes

Title I — Prevention

119th Congress · Approved Dec 1, 2025 · 139 Stat. 669

TITLE I Prevention

SEC. 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”.

SEC. 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”.

SEC. 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”.

SEC. 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:

“PART O— FETAL ALCOHOL SPECTRUM DISORDER PREVENTION AND SERVICES PROGRAM

“SEC. 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 fetal alcohol spectrum disorder or fetal alcohol effect 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.

“SEC. 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.

“SEC. 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, 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.

SEC. 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.”

SEC. 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”.

SEC. 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.”

SEC. 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.

SEC. 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”.

SEC. 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.”

SEC. 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.

SEC. 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.

SEC. 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.