42 U.S.C. § 290ee–3a — Grant program for State and Tribal response to opioid use disorders

(a) In general HHS must carry out the grant program described in (b) to address opioid misuse and use disorders — and, as applicable and appropriate, stimulant misuse and use disorders — within states, Indian Tribes, and populations served by Tribal and Urban Indian organizations. (b) Grants program (1) In general Subject to available appropriations, the Secretary awards grants to the single state agency that administers the substance use prevention, treatment, and recovery services block grant, to Indian Tribes, and to Tribal organizations, to address opioid (and, where applicable, stimulant) misuse and use disorders. Tribes or Tribal organizations may apply as part of a consortium or partner with an Urban Indian organization. (2) Minimum allocations Each state and the District of Columbia must receive at least $4,000,000; each Territory must receive at least $250,000. (3) Formula methodology (A) At least 30 days before publishing a funding opportunity announcement, the Secretary must develop a formula methodology that, where applicable: (I) for states, gives preference to states whose populations have substantially higher opioid misuse, use disorder, or overdose death rates than other states; (II) for Tribes and Tribal organizations, gives preference to those serving populations with demonstrated need; (III) includes performance assessments for continuation awards; and (IV) avoids a funding cliff between states with similar overdose mortality rates compared to prior-year allocations. The Secretary must submit this formula to the relevant Senate and House committees within 30 days of developing it. (B) Within two years of December 29, 2022, the Comptroller General must report to Congress assessing how grant funding is allocated among states and how allocations have changed, how funding changes have affected states' efforts, and how the funding is being used. (4) Use of funds Grants must supplement (not replace) activities addressing opioid — and, where applicable, stimulant — misuse and use disorders, including co-occurring substance misuse and use disorders, which may include: (A) implementing and evaluating substance use disorder and overdose prevention activities, including primary prevention, which may include approved drugs or devices; (B) establishing or improving prescription drug monitoring programs; (C) training health care practitioners on best practices for prescribing opioids, pain management, recognizing substance use disorders, referrals, preventing diversion, and overdose prevention; (D) supporting access to substance use disorder health care services, including federally certified opioid treatment programs, outpatient and residential treatment programs (including medication-assisted treatment), and other appropriate providers, including crisis and integrated care services; (E) recovery support services, including community-based education, outreach, and peer supports; mutual aid recovery programs supporting medication-assisted treatment; housing needs; and services supporting families with a member who has a substance use disorder; and (F) other public health-related activities the entity determines appropriate, directing resources according to local needs. (c) Accountability and oversight A grantee state must submit to the Secretary a description of: (1) the purposes for which grant funds were spent in the preceding fiscal year and its grant activities; (2) the ultimate recipients of grant amounts; (3) the number of individuals served; and (4) any other information the Secretary determines appropriate. (d) Limitations Funds made available under (i) may be used only for the (b) grant program. (e) Indian Tribes and Tribal organizations The Secretary, consulting with Indian Tribes and Tribal organizations, must identify and establish appropriate mechanisms for them to demonstrate or report the information required under (b), (c), and (d). (f) Report to Congress By September 30, 2024, and every two years after, the Secretary must report to the relevant Senate and House committees, summarizing the information from (c) and (d) reports, including: (1) the purposes for which grants were awarded; (2) grantees' activities; and (3) each grant recipient and its funding level. (g) Technical assistance The Secretary, including through SAMHSA's Tribal Training and Technical Assistance Center as applicable, must give grant applicants technical assistance on application and submission procedures, award management, and enhancing outreach to rural and underserved communities. (h) Definitions "Indian Tribe" and "Tribal organization" mean what those terms mean in 25 U.S.C. § 5304. "State" has the meaning given in section 300x–64(b). "Urban Indian organization" has the meaning given in 25 U.S.C. § 1603. (i) Authorization of appropriations (1) Congress authorized $1,750,000,000 for each of fiscal years 2023 through 2027 for the (b) grant program. (2) The Secretary may not use more than 2 percent of the amounts made available each year for federal administrative expenses, training, technical assistance, and evaluation. (3) Each year, of the amounts available for (b) grants, the Secretary must: (A) award no more than 5 percent to Indian Tribes and Tribal organizations; and (B) of what remains, set aside up to 15 percent for states with the highest age-adjusted drug overdose death rates, as ranked by the CDC.