Bolstering commitments to State grants for substance use disorder treatment and prevention

(a) State opioid response grants (1) In general To carry out activities under section 1003 of the 21st Century Cures Act (42 U.S.C. 290ee–3 note) relating to opioids 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.), there is authorized to be appropriated, and there is appropriated, $5,500,000,000 for each of fiscal years 2027 through 2031. (2) Flexibility in use of funds Section 1003(b) of the 21st Century Cures Act (42 U.S.C. 290ee–3a(b)) is amended by adding at the end the following: (5) Flexibility States and Indian Tribes may use amounts provided under grants under this subsection to support substance use disorder treatment care and related services regardless of whether the patient involved has a primary diagnosis of opioid use disorder, so long as the individual has a substance use disorder diagnosis. (6) Rule of construction Nothing in this subsection shall be construed to prohibit States from using grant funds under this subsection to allocate amounts to local governments to establish subgrantee awards in such localities.. (3) Substance abuse prevention and treatment block grants Section 1935(a) of the Public Health Service Act (42 U.S.C. 300x–35(a)) is amended to read as follows: (a) Appropriations To carry out this subpart, subpart III, and section 505(d), there is authorized to be appropriated, and there is appropriated, out of any monies in the Treasury not otherwise appropriated, $3,000,000,000 for each of fiscal years 2027 through 2031, and $2,500,000,000 for each of fiscal years 2032 through 2036.. (b) Requirements For the purposes of carrying out activities with amounts appropriated under this section (and the amendment made by this section), the Secretary of Health and Human Services shall ensure that the following requirements are complied with: (1) Of the amount appropriated for each fiscal year under subsection (a) (and the amendment made by such subsection), $50,000,000 shall be made available to Indian Tribes or Tribal organizations. (2) Of such remaining amounts for each such fiscal year, 15 percent shall be made available to the States with the highest mortality rate related to opioid use disorders. For purposes of allocating such funds, the Secretary shall develop a formula that avoids a significant cliff between States with similar mortality rates to prevent unusually large changes in certain States when compared to prior year allocations, including consideration of new formula methodologies to avoid such funding cliffs. (3) Of the amount made available for each fiscal year under subsection (a)(1) for State Opioid Response Grants, not more than 2 percent of such amount shall be available for Federal administrative expenses, training, technical assistance, and evaluation. (4) Of the amounts not reserved under paragraphs (1) through (3), the Secretary shall make allocations to States, territories, and the District of Columbia according to a formula using national survey results that the Secretary determines are the most objective and reliable measure of drug use and drug-related deaths. (5) The formula methodology under paragraph (4) shall be submitted to the Committee on Appropriations of the House of Representatives and the Committee on Appropriations of the Senate not less than 15 days prior to publishing a Funding Opportunity Announcement. (6) The prevention and treatment activities funded through grants under this section may include education, treatment (including the provision of medication), behavioral health services for individuals in treatment programs, referral to treatment services, recovery support, and medical screening associated with such treatment. (7) Each State, including the District of Columbia, shall receive not less than $4,000,000 under grants under this section. (8) In addition to amounts appropriated under this section (and the amendment made by this section), the following amounts shall be available under section 241 of the Public Health Service Act (42 U.S.C. 238j): (A) In addition to amounts appropriated under section 1935(a) of the Public Health Service Act (42 U.S.C. 300x–35(a)), an additional $79,200,000 to carry out the provisions referred to in such section 1935(a) (relating to technical assistance, national data, data collection and evaluation activities) and the total available under this Act for activities under section 1935(b) of such Act shall not exceed 5 percent of the amounts appropriated for subpart II of part B of title XIX of such Act. (B) $2,000,000 to evaluate substance abuse treatment programs. (9) None of the funds provided for under section 1921 of the Public Health Service Act (42 U.S.C. 300x–21) or for State Opioid Response Grants under section 1003 of the 21st Century Cures Act (42 U.S.C. 290ee–3a) shall be subject to section 241 of the Public Health Service Act (42 U.S.C. 238j).