State Opioid Response Grant Authorization Act of 2021
This bill reauthorizes through FY2027 and otherwise changes the State Opioid Response Grant program. This program, which is managed by the Substance Abuse and Mental Health Services Administration, provides funding for states, territories, and Indian tribes and tribal organizations to address the opioid crisis.
Specific changes to the program include (1) expanding its scope to also address stimulant use and misuse, (2) establishing a funding methodology and minimum funding allocations, and (3) allowing the use of grant funds for recovery support services.
The bill also requires the Government Accountability Office to report on issues concerning the funding and other aspects of the program.
To amend the 21st Century Cures Act to reauthorize and expand a grant 
program for State response to the opioid use disorders crisis, and for 
                            other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``State Opioid Response Grant 
Authorization Act of 2021''.

SEC. 2. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID AND 
              STIMULANT USE AND MISUSE.

    Section 1003 of the 21st Century Cures Act (42 U.S.C. 290ee-3 note) 
is amended to read as follows:

``SEC. 1003. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO OPIOID AND 
              STIMULANT USE AND MISUSE.

    ``(a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the `Secretary') shall carry out the 
grant program described in subsection (b) for purposes of addressing 
opioid and stimulant use and misuse, within States, 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 shall award grants to States, 
        Indian Tribes, Tribal organizations, and Urban Indian 
        organizations for the purpose of addressing opioid and 
        stimulant use and misuse, within such States, such Indian 
        Tribes, and populations served by such Tribal organizations and 
        Urban Indian organizations, in accordance with paragraph (2).
            ``(2) Minimum allocations; preference.--In determining 
        grant amounts for each recipient of a grant under paragraph 
        (1), the Secretary shall--
                    ``(A) ensure that each State receives not less than 
                $4,000,000; and
                    ``(B) give preference to States, Indian Tribes, 
                Tribal organizations, and Urban Indian organizations 
                whose populations have an incidence or prevalence of 
                opioid use disorders or stimulant use or misuse that is 
                substantially higher relative to the populations of 
                other States, other Indian Tribes, Tribal 
                organizations, or Urban Indian organizations, as 
                applicable.
            ``(3) Formula methodology.--
                    ``(A) In general.--Before publishing a funding 
                opportunity announcement with respect to grants under 
                this section, the Secretary shall--
                            ``(i) develop a formula methodology to be 
                        followed in allocating grant funds awarded 
                        under this section among grantees, which 
                        includes performance assessments for 
                        continuation awards; and
                            ``(ii) not later than 30 days after 
                        developing the formula methodology under clause 
                        (i), submit the formula methodology to--
                                    ``(I) the Committee on Energy and 
                                Commerce and the Committee on 
                                Appropriations of the House of 
                                Representatives; and
                                    ``(II) the Committee on Health, 
                                Education, Labor, and Pensions and the 
                                Committee on Appropriations of the 
                                Senate.
                    ``(B) Report.--Not later than two years after the 
                date of the enactment of the State Opioid Response 
                Grant Authorization Act of 2021, the Comptroller 
                General 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 under this section and how 
                        such allocations have changed over time;
                            ``(ii) assesses how any changes in funding 
                        under this section have affected the efforts of 
                        States to address opioid or stimulant use or 
                        misuse; and
                            ``(iii) assesses the use of funding 
                        provided through the grant program under this 
                        section and other similar grant programs 
                        administered by the Substance Abuse and Mental 
                        Health Services Administration.
            ``(4) Use of funds.--Grants awarded under this subsection 
        shall be used for carrying out activities that supplement 
        activities pertaining to opioid and stimulant use and misuse, 
        undertaken by the State agency responsible for administering 
        the substance abuse prevention and treatment block grant under 
        subpart II of part B of title XIX of the Public Health Service 
        Act (42 U.S.C. 300x-21 et seq.), which may include public 
        health-related activities such as the following:
                    ``(A) Implementing prevention activities, and 
                evaluating such activities to identify effective 
                strategies to prevent substance use disorders.
                    ``(B) Establishing or improving prescription drug 
                monitoring programs.
                    ``(C) Training for health care practitioners, such 
                as best practices for prescribing opioids, pain 
                management, recognizing potential cases of substance 
                use disorders, referral of patients to treatment 
                programs, preventing diversion of controlled 
                substances, and overdose prevention.
                    ``(D) Supporting access to health care services, 
                including--
                            ``(i) services provided by federally 
                        certified opioid treatment programs;
                            ``(ii) outpatient and residential substance 
                        use disorder treatment services that utilize 
                        medication-assisted treatment, as appropriate; 
                        or
                            ``(iii) other appropriate health care 
                        providers to treat substance use disorders.
                    ``(E) Recovery support services, including--
                            ``(i) community-based services that include 
                        peer supports;
                            ``(ii) mutual aid recovery programs that 
                        support medication-assisted treatment; or
                            ``(iii) services to address housing needs 
                        and family issues.
                    ``(F) Other public health-related activities, as 
                the State, Indian Tribe, Tribal organization, or Urban 
                Indian organization determines appropriate, related to 
                addressing substance use disorders within the State, 
                Indian Tribe, Tribal organization, or Urban Indian 
                organization, including directing resources in 
                accordance with local needs related to substance use 
                disorders.
    ``(c) Accountability and Oversight.--A State receiving a grant 
under subsection (b) shall include in reporting related to substance 
use disorders submitted to the Secretary pursuant to section 1942 of 
the Public Health Service Act (42 U.S.C. 300x-52), a description of--
            ``(1) the purposes for which the grant funds received by 
        the State under such subsection for the preceding fiscal year 
        were expended and a description of the activities of the State 
        under the grant;
            ``(2) the ultimate recipients of amounts provided to the 
        State; and
            ``(3) the number of individuals served through the grant.
    ``(d) Limitations.--Any funds made available pursuant to subsection 
(i)--
            ``(1) shall not be used for any purpose other than the 
        grant program under subsection (b); and
            ``(2) shall be subject to the same requirements as 
        substance use disorders prevention and treatment programs under 
        titles V and XIX of the Public Health Service Act (42 U.S.C. 
        290aa et seq., 300w et seq.).
    ``(e) Indian Tribes, Tribal Organizations, and Urban Indian 
Organizations.--The Secretary, in consultation with Indian Tribes, 
Tribal organizations, and Urban Indian organizations, shall identify 
and establish appropriate mechanisms for Indian Tribes, Tribal 
organizations, and Urban Indian organizations to demonstrate or report 
the information as required under subsections (b), (c), and (d).
    ``(f) Report to Congress.--Not later than September 30, 2024, and 
biennially thereafter, the Secretary 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 in reports made pursuant to subsections (c) and (e), 
including--
            ``(1) the purposes for which grant funds are awarded under 
        this section;
            ``(2) the activities of the grant recipients; and
            ``(3) for each State, Indian Tribe, Tribal organization, 
        and Urban Indian organization that receives a grant under this 
        section, the funding level provided to such recipient.
    ``(g) Technical Assistance.--The Secretary, including through the 
Tribal Training and Technical Assistance Center of the Substance Abuse 
and Mental Health Services Administration, shall provide States, Indian 
Tribes, Tribal organizations, and Urban Indian organizations, as 
applicable, 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 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 4 of the 
        Indian Self-Determination and Education Assistance Act (25 
        U.S.C. 5304).
            ``(2) Tribal organization.--The term `Tribal organization' 
        has the meaning given the term `tribal organization' in such 
        section 4.
            ``(3) State.--The term `State' has the meaning given such 
        term in section 1954(b) of the Public Health Service Act (42 
        U.S.C. 300x-64(b)).
            ``(4) Urban indian organization.--The term `Urban Indian 
        organization' has the meaning given such term in section 4 of 
        the Indian Health Care Improvement Act.
    ``(i) Authorization of Appropriations.--
            ``(1) In general.--For purposes of carrying out the grant 
        program under subsection (b), there is authorized to be 
        appropriated $1,750,000,000 for each of fiscal years 2022 
        through 2027, to remain available until expended.
            ``(2) Federal administrative expenses.--Of the amounts made 
        available for each fiscal year to award grants under subsection 
        (b), the Secretary shall not use more than 20 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) for a fiscal 
        year, the Secretary shall--
                    ``(A) award 5 percent to Indian Tribes, Tribal 
                organizations, and Urban Indian organizations; and
                    ``(B) of the amount remaining after application of 
                subparagraph (A), set aside up to 15 percent for awards 
                to States with the highest age-adjusted rate of drug 
                overdose death based on the ordinal ranking of States 
                according to the Director of the Centers for Disease 
                Control and Prevention.''.

            Passed the House of Representatives October 20, 2021.

            Attest:

                                             CHERYL L. JOHNSON,

                                                                 Clerk.
State Opioid Response Grant Authorization Act of 2021
To amend the 21st Century Cures Act to reauthorize and expand a grant program for State response to the opioid use disorders crisis, and for other purposes.
State Opioid Response Grant Authorization Act of 2021
State Opioid Response Grant Authorization Act of 2021
State Opioid Response Grant Authorization Act of 2021
State Opioid Response Grant Authorization Act of 2021
Rep. Trone, David J.