---
kind: "section"
citation: "42 U.S.C. § 290ee–3a"
title: "42"
title_heading: "The Public Health and Welfare"
number: "290ee–3a"
heading: "Grant program for State and Tribal response to opioid use disorders"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/290ee-3a"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter III–A — Substance Abuse and Mental Health Services Administration"
  - "Part D — Miscellaneous Provisions Relating to Substance Abuse and Mental Health"
---

# §290ee–3a. Grant program for State and Tribal response to opioid use disorders

- (a) **In general—** The [Secretary](/usc/42/201.md?p=c) of Health and Human [Services](/usc/42/201.md?p=a) (referred to in this section as the “[Secretary](/usc/42/201.md?p=c)”) shall carry out the grant [program](/usc/42/274l–1.md?p=4) described in [subsection (b)](#b) for purposes of addressing opioid misuse and use disorders and, as applicable and appropriate, stimulant misuse and use disorders, within [States](/usc/42/201.md?p=f), Indian Tribes, and populations served by Tribal organizations and Urban Indian organizations.
- (b) **Grants program—**
  - (1) **In general—** Subject to the availability of appropriations, the [Secretary](/usc/42/201.md?p=c) shall award grants to the single [State agency](/usc/42/300s–3.md?p=12) responsible for administering the substance use prevention, [treatment](/usc/42/11851.md?p=11), and recovery [services](/usc/42/201.md?p=a) block grant under subpart II of part B of title XIX of the Public Health Service Act ([42 U.S.C. 300x–21](/usc/42/300x–21.md) et seq.), Indian Tribes, and Tribal organizations for the purpose of addressing opioid misuse and use disorders, and as applicable and appropriate, stimulant misuse and use disorders, within such [States](/usc/42/201.md?p=f), such Indian Tribes, and populations served by such Tribal organizations, in accordance with [paragraph (2)](#b-2). Indian Tribes or Tribal organizations may also apply for an award as part of a consortia or may include in an application a partnership with an Urban Indian organization.
  - (2) **Minimum allocations—** Notwithstanding [subsection (i)(3)](#i-3), in determining grant amounts for each recipient of a grant under [paragraph (1)](#b-1), the [Secretary](/usc/42/201.md?p=c) shall ensure that each [State](/usc/42/201.md?p=f) and the District of Columbia receive not less than $4,000,000 and ensure that each Territory receives not less than $250,000.
  - (3) **Formula methodology—**
    - (A) **In general—** At least 30 days before publishing a funding opportunity announcement with respect to grants under this section, the [Secretary](/usc/42/201.md?p=c) shall—
      - (i) develop a formula methodology to be followed in allocating grant funds awarded under this section among grantees, which, where applicable and appropriate based on populations being served by the relevant entity—
        - (I) with respect to [allocations](/usc/42/2021b.md?p=2) for [States](/usc/42/201.md?p=f), gives preference to [States](/usc/42/201.md?p=f) whose populations have a prevalence of opioid misuse and use disorders or [drug](/usc/42/11851.md?p=4) overdose deaths that is substantially higher relative to the populations of other [States](/usc/42/201.md?p=f);
        - (II) with respect to [allocations](/usc/42/2021b.md?p=2) for Tribes and Tribal organizations, gives preferences to Tribes and Tribal organizations (including those applying in partnership with an Urban Indian organization) serving populations with demonstrated need with respect to opioid misuse and use disorders or [drug](/usc/42/11851.md?p=4) overdose deaths;
        - (III) includes performance assessments for continuation awards; and
        - (IV) ensures that the formula avoids a funding cliff between [States](/usc/42/201.md?p=f) with similar overdose mortality rates to prevent funding reductions when compared to prior year [allocations](/usc/42/2021b.md?p=2), as determined by the [Secretary](/usc/42/201.md?p=c); and
      - (ii) not later than 30 days after developing the formula methodology under [clause (i)](#b-3-A-i), submit the formula methodology to—
        - (I) the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate; and
        - (II) the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives.
    - (B) **Report—** Not later than two years after December 29, 2022, the [Comptroller General](/usc/42/300x–64.md?p=b-1) of the United States shall 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 that—
      - (i) assesses how grant funding is allocated to [States](/usc/42/201.md?p=f) under this section and how such [allocations](/usc/42/2021b.md?p=2) have changed over time;
      - (ii) assesses how any changes in funding under this section have affected the efforts of [States](/usc/42/201.md?p=f) to address opioid misuse and use disorders and, as applicable and appropriate, stimulant misuse and use disorders; and
      - (iii) assesses the use of funding provided through the grant [program](/usc/42/274l–1.md?p=4) under this section and other similar grant [programs](/usc/42/274l–1.md?p=4) administered by the Substance Abuse and Mental Health [Services](/usc/42/201.md?p=a) Administration.
  - (4) **Use of funds—** Grants awarded under this subsection shall be used for carrying out activities that supplement activities pertaining to opioid misuse and use disorders and, as applicable and appropriate, stimulant misuse and use disorders (including co-occurring substance misuse and use disorders), undertaken by the entities described in [paragraph (1)](#b-1), which may include public health-related activities such as the following:
    - (A) Implementing substance use disorder and overdose prevention activities, including primary prevention activities, and evaluating such activities to identify effective strategies to prevent substance use disorders and overdoses, which may include [drugs](/usc/42/11851.md?p=4) or devices approved, cleared, or otherwise legally marketed under the Federal Food, [Drug](/usc/42/11851.md?p=4), and Cosmetic Act [[21 U.S.C. 301](/usc/21/301.md) et seq.].
    - (B) Establishing or improving prescription [drug](/usc/42/11851.md?p=4) monitoring [programs](/usc/42/274l–1.md?p=4).
    - (C) Training for health care practitioners, such as best [practices](/usc/42/17061.md?p=19) for prescribing opioids, pain management, recognizing potential cases of substance use disorders, referral of patients to [treatment](/usc/42/11851.md?p=11) [programs](/usc/42/274l–1.md?p=4), preventing diversion of [controlled substances](/usc/42/11851.md?p=2), and overdose prevention.
    - (D) Supporting access to and the provision of substance use disorder-related health [care services](/usc/42/300z–1.md?p=a-7), including—
      - (i) [services](/usc/42/201.md?p=a) provided by federally certified opioid [treatment](/usc/42/11851.md?p=11) [programs](/usc/42/274l–1.md?p=4);
      - (ii) [services](/usc/42/201.md?p=a) provided in outpatient and residential substance use disorder [treatment](/usc/42/11851.md?p=11) [programs](/usc/42/274l–1.md?p=4) or facilities, including those that utilize medication-assisted [treatment](/usc/42/11851.md?p=11), as appropriate; or
      - (iii) [services](/usc/42/201.md?p=a) provided by other appropriate [health care providers](/usc/42/300aa–33.md?p=1) to treat substance use disorders, including crisis [services](/usc/42/201.md?p=a) and [services](/usc/42/201.md?p=a) provided in integrated health care settings by appropriate [health care providers](/usc/42/300aa–33.md?p=1) that treat substance use disorders.
    - (E) Recovery support [services](/usc/42/201.md?p=a), including—
      - (i) community-based [services](/usc/42/201.md?p=a) that include education, outreach, and peer supports such as peer support specialists and recovery coaches to help support recovery;
      - (ii) mutual aid recovery [programs](/usc/42/274l–1.md?p=4) that support medication-assisted [treatment](/usc/42/11851.md?p=11);
      - (iii) [services](/usc/42/201.md?p=a) to address housing needs; or
      - (iv) [services](/usc/42/201.md?p=a) related to supporting families that include an individual with a substance use disorder.
    - (F) Other public health-related activities, as such entity determines appropriate, related to addressing opioid misuse and use disorders and, as applicable and appropriate, stimulant misuse and use disorders, within such entity, including directing resources in accordance with local needs related to substance use disorders.
- (c) **Accountability and oversight—** A [State](/usc/42/201.md?p=f) receiving a grant under [subsection (b)](#b) shall submit to the [Secretary](/usc/42/201.md?p=c) a description of—
  - (1) the purposes for which the grant funds received by the [State](/usc/42/201.md?p=f) under such subsection for the preceding fiscal year were expended and a description of the activities of the [State](/usc/42/201.md?p=f) under the grant;
  - (2) the ultimate recipients of amounts provided to the [State](/usc/42/201.md?p=f);
  - (3) the number of individuals served through the grant; and
  - (4) such other information as determined appropriate by the [Secretary](/usc/42/201.md?p=c).
- (d) **Limitations—** Any funds made available pursuant to [subsection (i)](#i) shall not be used for any purpose other than the grant [program](/usc/42/274l–1.md?p=4) under [subsection (b)](#b).
- (e) **Indian Tribes and Tribal organizations—** The [Secretary](/usc/42/201.md?p=c), in consultation with Indian Tribes and Tribal organizations, shall identify and establish appropriate mechanisms for Indian Tribes and Tribal organizations to demonstrate or report the information as required under subsections [(b)](#b), [(c)](#c), and [(d)](#d).
- (f) **Report to Congress—** Not later than September 30, 2024, and biennially thereafter, the [Secretary](/usc/42/201.md?p=c) shall 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, and the Committees on Appropriations of the House of Representatives and the Senate, a report that includes a summary of the information provided to the [Secretary](/usc/42/201.md?p=c) in reports made pursuant to subsections [(c)](#c) and [(d)](#d), including—
  - (1) the purposes for which grant funds are awarded under this section;
  - (2) the activities of the grant recipients; and
  - (3) each entity that receives a grant under this section, including the funding level provided to such recipient.
- (g) **Technical assistance—** The [Secretary](/usc/42/201.md?p=c), including through the Tribal Training and Technical Assistance Center of the Substance Abuse and Mental Health [Services](/usc/42/201.md?p=a) Administration, as applicable, shall provide entities described in [subsection (b)(1)](#b-1) with technical assistance concerning grant application and submission procedures under this section, award management activities, and enhancing outreach and direct support to rural and underserved communities and [providers](/usc/42/299b–21.md?p=8) in addressing substance use disorders.
- (h) **Definitions—** In this section:
  - (1) **Indian Tribe—** The term “Indian Tribe” has the meaning given the term “Indian tribe” in [section 5304 of title 25](/usc/25/5304.md).
  - (2) **Tribal organization—** The term “Tribal organization” has the meaning given the term “tribal organization” in [section 5304 of title 25](/usc/25/5304.md).
  - (3) **State—** The term “[State](/usc/42/201.md?p=f)” has the meaning given such term in [section 300x–64(b) of this title](/usc/42/300x–64.md?p=b).
  - (4) **Urban Indian organization—** The term “Urban Indian organization” has the meaning given such term in [section 1603 of title 25](/usc/25/1603.md).
- (i) **Authorization of appropriations—**
  - (1) **In general—** For purposes of carrying out the grant [program](/usc/42/274l–1.md?p=4) under [subsection (b)](#b), there is authorized to be appropriated $1,750,000,000 for each of fiscal years 2023 through 2027.
  - (2) **Federal administrative expenses—** Of the amounts made available for each fiscal year to award grants under [subsection (b)](#b), the [Secretary](/usc/42/201.md?p=c) shall not use more than 2 percent for Federal administrative expenses, training, technical assistance, and evaluation.
  - (3) **Set aside—** Of the amounts made available for each fiscal year to award grants under [subsection (b)](#b) for a fiscal year, the [Secretary](/usc/42/201.md?p=c) shall—
    - (A) award not more than 5 percent to Indian Tribes and Tribal organizations; and
    - (B) of the amount remaining after application of [subparagraph (A)](#i-3-A), set aside up to 15 percent for awards to [States](/usc/42/201.md?p=f) with the highest age-adjusted rate of [drug](/usc/42/11851.md?p=4) overdose death based on the ordinal ranking of [States](/usc/42/201.md?p=f) according to the [Director](/usc/42/11851.md?p=5) of the Centers for Disease Control and Prevention.

## Source credit

(Pub. L. 114–255, div. A, title I, § 1003, Dec. 13, 2016, 130 Stat. 1044; Pub. L. 115–271, title VII, § 7181(a), Oct. 24, 2018, 132 Stat. 4068; Pub. L. 117–328, div. FF, title I, § 1273, Dec. 29, 2022, 136 Stat. 5688.)

## Notes

### Editorial Notes

### References in Text

The Public Health Service Act, referred to in subsec. (b)(1), is act July 1, 1944, ch. 373, 58 Stat. 682. Subpart II of part B of title XIX of the Act is classified generally to subpart II (§ 300x–21 et seq.) of part B of subchapter XVII of chapter 6A of this title. For complete classification of this Act to the Code, see Short Title note set out under section 201 of this title and Tables.

The Federal Food, Drug, and Cosmetic Act, referred to in subsec. (b)(4)(A), is act June 25, 1938, ch. 675, 52 Stat. 1040, which is classified generally to chapter 9 (§ 301 et seq.) of Title 21, Food and Drugs. For complete classification of this Act to the Code, see section 301 of Title 21 and Tables.

### Codification

Section was formerly classified as a note under section 290ee–3 of this title prior to editorial reclassification and renumbering as this section.

Section was enacted as part of the 21st Century Cures Act, and not as part of the Public Health Service Act which comprises this chapter.

### Amendments

2022—Pub. L. 117–328 amended section generally. Prior to amendment, section related to grant program for purposes of addressing opioid abuse crisis within States and Indian Tribes.

2018—Subsec. (a). Pub. L. 115–271, § 7181(a)(1), substituted “subsection (h) to carry out the grant program described in subsection (b)” for “the authorization of appropriations under subsection (b) to carry out the grant program described in subsection (c)” and inserted “and Indian Tribes” after “States”.

Subsec. (b). Pub. L. 115–271, § 7181(a)(2), (3), redesignated subsec. (c) as (b) and struck out former subsec. (b) which established the Account for the State Response to the Opioid Abuse Crisis in the Treasury.

Subsec. (b)(1). Pub. L. 115–271, § 7181(a)(5)(A), inserted “and tribal” after “State” in heading and, in text, substituted “States and Indian Tribes for the purpose of addressing the opioid abuse crisis within such States and Indian Tribes” for “States for the purpose of addressing the opioid abuse crisis within such States” and inserted “or Indian Tribes” after “preference to States” and “or other Indian Tribes, as applicable” after “to other States”.

Subsec. (b)(2). Pub. L. 115–271, § 7181(a)(5)(B)(i), struck out “to a State” after “Grants awarded” in introductory provisions.

Subsec. (b)(2)(A). Pub. L. 115–271, § 7181(a)(5)(B)(ii), substituted “Establishing or improving” for “Improving State”.

Subsec. (b)(2)(C). Pub. L. 115–271, § 7181(a)(5)(B)(iii), inserted “preventing diversion of controlled substances,” after “treatment programs,”.

Subsec. (b)(2)(E). Pub. L. 115–271, § 7181(a)(5)(B)(iv), substituted “as the State or Indian Tribe determines appropriate, related to addressing the opioid abuse crisis within the State or Indian Tribe, including directing resources in accordance with local needs related to substance use disorders” for “as the State determines appropriate, related to addressing the opioid abuse crisis within the State”.

Subsec. (c). Pub. L. 115–271, § 7181(a)(6), substituted “subsection (b)” for “subsection (c)” in introductory provisions.

Pub. L. 115–271, § 7181(a)(3), redesignated subsec. (d) as (c). Former subsec. (c) redesignated (b).

Subsec. (d). Pub. L. 115–271, § 7181(a)(7)(A), substituted “subsection (h)” for “the authorization of appropriations under subsection (b)” in introductory provisions.

Pub. L. 115–271, § 7181(a)(3), redesignated subsec. (e) as (d). Former subsec. (d) redesignated (c).

Subsec. (d)(1). Pub. L. 115–271, § 7181(a)(7)(B), substituted “subsection (b)” for “subsection (c)”.

Subsecs. (e) to (i). Pub. L. 115–271, § 7181(a)(8), added subsec. (e) to (i). Former subsecs. (e) and (f) redesignated (d) and (j), respectively.

Subsec. (j). Pub. L. 115–271, § 7181(a)(4), redesignated subsec. (f) as (j).

### Statutory Notes and Related Subsidiaries

### Substance Use Disorder and Overdose Prevention Activities

Pub. L. 119–44, title I, § 113, Dec. 1, 2025, 139 Stat. 679, provided that: “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.”