USC Subpart II

USC Subpart II
in effect

42 U.S.C. § 300x–21 Formula grants to States

(a) In generalFor the purpose described in subsection (b), the Secretary, acting through the Center for Substance Abuse Treatment, shall make an allotment each fiscal year for each State in an amount determined in accordance with section 300x–33 of this title. The Secretary shall make a grant to the State of the allotment made for the State for the fiscal year if the State submits to the Secretary an application in accordance with section 300x–32 of this title. (b) Authorized activitiesA funding agreement for a grant under subsection (a) is that, subject to section 300x–31 of this title, the State involved will expend the grant only for the purpose of carrying out the plan developed in accordance with section 300x–32(b) of this title and for planning, carrying out, and evaluating activities to prevent, treat, and provide recovery support services for substance use disorders and for related activities authorized in section 300x–24 of this title.

42 U.S.C. § 300x–22 Certain allocations

(a) Allocation regarding primary prevention programsA funding agreement for a grant under section 300x–21 of this title is that, in expending the grant, the State involved—(1) will expend not less than 20 percent for programs for individuals who do not require treatment for substance use disorders, which programs—(A) educate and counsel the individuals on such disorders; and (B) provide for activities to reduce the risk of such disorders by the individuals; (2) will, in carrying out paragraph (1)—(A) give priority to programs for populations that are at risk of developing a pattern of such disorders; and (B) ensure that programs receiving priority under subparagraph (A) develop community-based strategies for the prevention of such disorders, including strategies to discourage the use of alcoholic beverages and tobacco products by individuals to whom it is unlawful to sell or distribute such beverages or products. (b) Allocations regarding women(1) In generalSubject to paragraph (2), a funding agreement for a grant under section 300x–21 of this title for a fiscal year is that—(A) in the case of a grant for fiscal year 1993, the State involved will expend not less than 5 percent of the grant to increase (relative to fiscal year 1992) the availability of treatment services designed for pregnant women and women with dependent children (either by establishing new programs or expanding the capacity of existing programs); (B) in the case of a grant for fiscal year 1994, the State will expend not less than 5 percent of the grant to so increase (relative to fiscal year 1993) the availability of such services for such women; and (C) in the case of a grant for any subsequent fiscal year, the State will expend for such services for such women not less than an amount equal to the amount expended by the State for fiscal year 1994. (2) Waiver(A) Upon the request of a State, the Secretary may provide to the State a waiver of all or part of the requirement established in paragraph (1) if the Secretary determines that the State is providing an adequate level of treatments services for women described in such paragraph, as indicated by a comparison of the number of such women seeking the services with the availability in the State of the services. (B) The Secretary shall approve or deny a request for a waiver under subparagraph (A) not later than 120 days after the date on which the request is made. (C) Any waiver provided by the Secretary under subparagraph (A) shall be applicable only to the fiscal year involved. (3) Childcare and prenatal careA funding agreement for a grant under section 300x–21 of this title for a State is that each entity providing treatment services with amounts reserved under paragraph (1) by the State will, directly or through arrangements with other public or nonprofit private entities, make available prenatal care to women receiving such services and, while the women are receiving the services, childcare.

42 U.S.C. § 300x–23 Intravenous substance use

(a) Capacity of treatment programs(1) Notification of reaching capacityA funding agreement for a grant under section 300x–21 of this title is that the State involved will, in the case of programs of treatment for intravenous substance use disorders, require that any such program receiving amounts from the grant, upon reaching 90 percent of its capacity to admit individuals to the program, provide to the State a notification of such fact. (2) Provision of treatmentA funding agreement for a grant under section 300x–21 of this title is that the State involved will, with respect to notifications under paragraph (1), ensure that each individual who requests and is in need of treatment for intravenous substance use disorders is admitted to a program of such treatment not later than—(A) 14 days after making the request for admission to such a program; or (B) 120 days after the date of such request, if no such program has the capacity to admit the individual on the date of such request and if interim services are made available to the individual not later than 48 hours after such request. (b) Outreach to persons who inject drugsA funding agreement for a grant under section 300x–21 of this title is that the State involved, in providing amounts from the grant to any entity for treatment services for persons who inject drugs, will require the entity to carry out activities to encourage individuals in need of such treatment to undergo treatment.

42 U.S.C. § 300x–24 Requirements regarding tuberculosis and human immunodeficiency virus

(a) Tuberculosis(1) In generalA funding agreement for a grant under section 300x–21 of this title is that the State involved will require that any entity receiving amounts from the grant for operating a program of treatment for substance use disorders—(A) will, directly or through arrangements with other public or nonprofit private entities, routinely make available tuberculosis services to each individual receiving treatment for such disorders; and (B) in the case of an individual in need of such treatment who is denied admission to the program on the basis of the lack of the capacity of the program to admit the individual, will refer the individual to another provider of tuberculosis services. (2) Tuberculosis servicesFor purposes of paragraph (1), the term “tuberculosis services”, with respect to an individual, means—(A) counseling the individual with respect to tuberculosis; (B) testing to determine whether the individual has contracted such disease and testing to determine the form of treatment for the disease that is appropriate for the individual; and (C) providing such treatment to the individual. (b) Human immunodeficiency virus(1) Requirement for certain StatesIn the case of a State described in paragraph (2), a funding agreement for a grant under section 300x–21 of this title is that—(A) with respect to individuals undergoing treatment for substance use disorders, the State will, subject to paragraph (3), carry out 1 or more projects to make available to the individuals early intervention services for HIV disease at the sites at which the individuals are undergoing such treatment; (B) for the purpose of providing such early intervention services through such projects, the State will make available from the grant the percentage that is applicable for the State under paragraph (4); and (C) the State will, subject to paragraph (5), carry out such projects only in geographic areas of the State that have the greatest need for the projects. (2) Designated StatesFor purposes of this subsection, a State described in this paragraph is any State whose rate of cases of acquired immune deficiency syndrome is 10 or more such cases per 100,000 individuals (as indicated by the number of such cases reported to and confirmed by the Director of the Centers for Disease Control and Prevention for the most recent calendar year for which such data are available). (3) Use of existing programs regarding substance use disordersWith respect to programs that provide treatment services for substance use disorders, a funding agreement for a grant under section 300x–21 of this title for a designated State is that each such program participating in a project under paragraph (1) will be a program that began operation prior to the fiscal year for which the State is applying to receive the grant. A program that so began operation may participate in a project under paragraph (1) without regard to whether the program has been providing early intervention services for HIV disease. (4) Applicable percentage regarding expenditures for services(A)(i) For purposes of paragraph (1)(B), the percentage that is applicable under this paragraph for a designated State is, subject to subparagraph (B), the percentage by which the amount of the grant under section 300x–21 of this title for the State for the fiscal year involved is an increase over the amount specified in clause (ii). (ii) The amount specified in this clause is the amount that was reserved by the designated State involved from the allotment of the State under section 300x–1a 11 See References in Text note below. of this title for fiscal year 1991 in compliance with section 300x–4(c)(6)(A)(ii) 1 of this title (as such sections were in effect for such fiscal year). (B) If the percentage determined under subparagraph (A) for a designated State for a fiscal year is less than 2 percent (including a negative percentage, in the case of a State for which there is no increase for purposes of such subparagraph), the percentage applicable under this paragraph for the State is 2 percent. If the percentage so determined is 2 percent or more, the percentage applicable under this paragraph for the State is the percentage determined under subparagraph (A), subject to not exceeding 5 percent. (5) Requirement regarding rural areas(A) A funding agreement for a grant under section 300x–21 of this title for a designated State is that, if the State will carry out 2 or more projects under paragraph (1), the State will carry out 1 such project in a rural area of the State, subject to subparagraph (B). (B) The Secretary shall waive the requirement established in subparagraph (A) if the State involved certifies to the Secretary that—(i) there is insufficient demand in the State to carry out a project under paragraph (1) in any rural area of the State; or (ii) there are no rural areas in the State. (6) Manner of providing servicesWith respect to the provision of early intervention services for HIV disease to an individual, a funding agreement for a grant under section 300x–21 of this title for a designated State is that—(A) such services will be undertaken voluntarily by, and with the informed consent of, the individual; and (B) undergoing such services will not be required as a condition of receiving treatment services for substance use disorders or any other services. (7) DefinitionsFor purposes of this subsection:(A) The term “designated State” means a State described in paragraph (2). (B) The term “early intervention services”, with respect to HIV disease, means—(i) appropriate pretest counseling; (ii) testing individuals with respect to such disease, including tests to confirm the presence of the disease, tests to diagnose the extent of the deficiency in the immune system, and tests to provide information on appropriate therapeutic measures for preventing and treating the deterioration of the immune system and for preventing and treating conditions arising from the disease; (iii) appropriate post-test counseling; and (iv) providing the therapeutic measures described in clause (ii). (C) The term “HIV disease” means infection with the etiologic agent for acquired immune deficiency syndrome. (c) Expenditure of grant for compliance with agreements(1) In generalA grant under section 300x–21 of this title may be expended for purposes of compliance with the agreements required in this section, subject to paragraph (2). (2) LimitationA funding agreement for a grant under section 300x–21 of this title for a State is that the grant will not be expended to make payment for any service provided for purposes of compliance with this section to the extent that payment has been made, or can reasonably be expected to be made, with respect to such service—(A) under any State compensation program, under any insurance policy, or under any Federal or State health benefits program (including the program established in title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.] and the program established in title XIX of such Act [42 U.S.C. 1396 et seq.]); or (B) by an entity that provides health services on a prepaid basis. (d) Applicability of certain provisionSection 300x–31 of this title applies to this section (and to each other provision of this subpart).

42 U.S.C. § 300x–25 Group homes for persons in recovery from substance use disorders

(a) State revolving funds for establishment of homesA State, using funds available under section 300x–21 of this title, may establish and maintain the ongoing operation of a revolving fund in accordance with this section to support group homes for persons in recovery from substance use disorders as follows:(1) The purpose of the fund is to make loans for the costs of establishing programs for the provision of housing in which individuals recovering from alcohol or other substance use disorders may reside in groups of not less than 6 individuals. The fund is established directly by the State or through the provision of a grant or contract to a nonprofit private entity. (2) The programs are carried out in accordance with guidelines issued under subsection (b). (3) Not less than $100,000 is available for the fund. (4) Loans made from the revolving fund do not exceed $4,000 and each such loan is repaid to the revolving fund by the residents of the housing involved not later than 2 years after the date on which the loan is made. (5) Each such loan is repaid by such residents through monthly installments, and a reasonable penalty is assessed for each failure to pay such periodic installments by the date specified in the loan agreement involved. (6) Such loans are made only to nonprofit private entities agreeing that, in the operation of the program established pursuant to the loan—(A) the use of alcohol or any illegal drug in the housing provided by the program will be prohibited; (B) any resident of the housing who violates such prohibition will be expelled from the housing; (C) the costs of the housing, including fees for rent and utilities, will be paid by the residents of the housing; and (D) the residents of the housing will, through a majority vote of the residents, otherwise establish policies governing residence in the housing, including the manner in which applications for residence in the housing are approved. (b) Issuance by Secretary of guidelinesThe Secretary shall ensure that there are in effect guidelines under this subpart for the operation of programs described in subsection (a). (c) Applicability to territoriesThe requirements established in subsection (a) shall not apply to any territory of the United States other than the Commonwealth of Puerto Rico.

42 U.S.C. § 300x–26 Sale of tobacco products to individuals under age of 21

(a) In generalA funding agreement for a grant under section 300x–21 of this title is that the State involved will—(1) annually conduct random, unannounced inspections to ensure that retailers do not sell tobacco products to individuals under the age of 21; and (2) annually submit to the Secretary a report describing—(A) the activities carried out by the State to ensure that retailers do not sell tobacco products to individuals under the age of 21; (B) the extent of success the State has achieved in ensuring that retailers do not sell tobacco products to individuals under the age of 21; and (C) the strategies to be utilized by the State to ensure that retailers do not sell tobacco products to individuals under the age of 21 during the fiscal year for which the grant is sought. (b) Noncompliance of State(1) In generalBefore making a grant under section 300x–21 of this title to a State, the Secretary shall make a determination of whether the State has maintained compliance with subsection (a). If, after notice to the State and an opportunity for a hearing, the Secretary determines that the State is not in compliance with such subsections, the Secretary shall reduce the amount of the allotment under such section for the State for the fiscal year involved by an amount up to 10 percent of the amount determined under section 300x–33 of this title for the State for the applicable fiscal year. (2) Limitation(A) In generalA State shall not have funds withheld pursuant to paragraph (1) if such State for which the Secretary has made a determination of noncompliance under such paragraph—(i) certifies to the Secretary by May 1 of the fiscal year for which the funds are appropriated, consistent with subparagraph (B), that the State will commit additional State funds, in accordance with paragraph (1), to ensure that retailers do not sell tobacco products to individuals under 21 years of age; (ii) agrees to comply with a negotiated agreement for a corrective action plan that is approved by the Secretary and carried out in accordance with guidelines issued by the Secretary; or (iii) is a territory that receives less than $1,000,000 for a fiscal year under section 300x–21 of this title. (B) Certification(i) In generalThe amount of funds to be committed by a State pursuant to subparagraph (A)(i) shall be equal to 1 percent of such State’s allocation determined under section 300x–33 of this title for each percentage point by which the State misses the retailer compliance rate goal established by the Secretary. (ii) State expendituresFor a fiscal year in which a State commits funds as described in clause (i), such State shall maintain State expenditures for tobacco prevention programs and for compliance activities at a level that is not less than the level of such expenditures maintained by the State for the preceding fiscal year, plus the additional funds for tobacco compliance activities required under clause (i). The State shall submit a report to the Secretary on all State obligations of funds for such fiscal year and all State expenditures for the preceding fiscal year for tobacco prevention and compliance activities by program activity by July 31 of such fiscal year. (iii) DiscretionThe Secretary shall exercise discretion in enforcing the timing of the State obligation of the additional funds required by the certification described in subparagraph (A)(i) as late as July 31 of such fiscal year. (C) Failure to certifyIf a State described in subparagraph (A) fails to certify to the Secretary pursuant to subparagraph (A)(i) or enter into, or comply with, a negotiated agreement under subparagraph (A)(ii), the Secretary may take action pursuant to paragraph (1). (c) Implementation of reporting requirements(1) Transition periodThe Secretary shall—(A) not withhold amounts under subsection (b) for the 3-year period immediately following December 20, 2019; and (B) use discretion in exercising its authority under subsection (b) during the 2-year period immediately following the 3-year period described in subparagraph (A), to allow for a transition period for implementation of the reporting requirements under subsection (a)(2). (2) Regulations or guidanceNot later than 180 days after December 20, 2019, the Secretary shall update regulations under part 96 of title 45, Code of Federal Regulations 11 So in original. Probably should be followed by a comma. or guidance on the retailer compliance rate goal under subsection (b), the use of funds provided under section 300x–21 of this title for purposes of meeting the requirements of this section, and reporting requirements under subsection (a)(2). (3) CoordinationThe Secretary shall ensure the Assistant Secretary for Mental Health and Substance Use coordinates, as appropriate, with the Commissioner of Food and Drugs to ensure that the technical assistance provided to States under subsection (e) is consistent with applicable regulations for retailers issued under part 1140 of title 21, Code of Federal Regulations. (d) Transitional grants(1) In generalThe Secretary shall award grants under this subsection to each State that receives funding under section 300x–21 of this title to ensure compliance of each such State with this section. (2) Use of fundsA State receiving a grant under this subsection—(A) shall use amounts received under such grant for activities to plan for or ensure compliance in the State with subsection (a); and (B) in the case of a State for which the Secretary has made a determination under subsection (b) that the State is prepared to meet, or has met, the requirements of subsection (a), may use such funds for tobacco cessation activities, strategies to prevent the use of tobacco products by individuals under the age of 21, or allowable uses under section 300x–21 of this title. (3) Supplement not supplantGrants under this subsection shall be used to supplement and not supplant other Federal, State, and local public funds provided for activities under paragraph (2). (4) Authorization of appropriationsTo carry out this subsection, there are authorized to be appropriated $18,580,790 for each of fiscal years 2020 through 2024. (5) SunsetThis subsection shall have no force or effect after September 30, 2024. (e) Technical assistanceThe Secretary shall provide technical assistance to States related to the activities required under this section.

42 U.S.C. § 300x–27 Treatment services for pregnant women

(a) In generalA funding agreement for a grant under section 300x–21 of this title is that the State involved—(1) will ensure that each pregnant woman in the State who seeks or is referred for and would benefit from such services is given preference in admissions to treatment facilities receiving funds pursuant to the grant; and (2) will, in carrying out paragraph (1), publicize the availability to such women of services from the facilities and the fact that the women receive such preference. (b) Referrals regarding StatesA funding agreement for a grant under section 300x–21 of this title is that, in carrying out subsection (a)(1)—(1) the State involved will require that, in the event that a treatment facility has insufficient capacity to provide treatment services to any woman described in such subsection who seeks the services from the facility, the facility refer the woman to the State; and (2) the State, in the case of each woman for whom a referral under paragraph (1) is made to the State—(A) will refer the woman to a treatment facility that has the capacity to provide treatment services to the woman; or (B) will, if no treatment facility has the capacity to admit the woman, make interim services available to the woman not later than 48 hours after the women 11 So in original. Probably should be “woman”. seeks the treatment services.

42 U.S.C. § 300x–28 Additional agreements

(a) Improvement of process for appropriate referrals for treatmentWith respect to individuals seeking treatment services, a funding agreement for a grant under section 300x–21 of this title is that the State involved will improve the process in the State for referring the individuals to treatment facilities that can provide to the individuals the treatment modality that is most appropriate for the individuals. (b) Professional developmentA funding agreement for a grant under section 300x–21 of this title is that the State involved will ensure that prevention, treatment, and recovery personnel operating in the State’s substance use disorder prevention, treatment, and recovery systems have an opportunity to receive training, on an ongoing basis, concerning—(1) recent trends in substance use disorders in the State; (2) improved methods and evidence-based practices for providing substance use disorder prevention and treatment services; (3) performance-based accountability; (4) data collection and reporting requirements; and (5) any other matters that would serve to further improve the delivery of substance use disorder prevention and treatment services within the State. (c) Coordination of various activities and servicesA funding agreement for a grant under section 300x–21 of this title is that the State involved will coordinate prevention and treatment activities with the provision of other appropriate services (including health, social, correctional and criminal justice, educational, vocational rehabilitation, and employment services). (d) Waiver of requirement(1) In generalUpon the request of a State, the Secretary may provide to a State a waiver of any or all of the requirements established in this section if the Secretary determines that, with respect to services for the prevention and treatment of substance use disorders, the requirement involved is unnecessary for maintaining quality in the provision of such services in the State. (2) Date certain for acting upon requestThe Secretary shall approve or deny a request for a waiver under paragraph (1) not later than 120 days after the date on which the request is made. (3) Applicability of waiverAny waiver provided by the Secretary under paragraph (1) shall be applicable only to the fiscal year involved.

42 U.S.C. § 300x–30 Maintenance of effort regarding State expenditures

(a) In generalWith respect to the principal agency of a State for carrying out authorized activities, a funding agreement for a grant under section 300x–21 of this title for the State for a fiscal year is that such agency will for such year maintain aggregate State expenditures for authorized activities at a level that is not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying for the grant. (b) Exclusion of certain fundsThe Secretary may exclude from the aggregate State expenditures under subsection (a), funds appropriated to the principle agency for authorized activities which are of a non-recurring nature and for a specific purpose. (c) Waiver(1) In generalUpon the request of a State, the Secretary may waive all or part of the requirement established in subsection (a) if the Secretary determines that extraordinary economic conditions exist in the State, or any part of the State, to justify the waiver. (2) Date certain for acting upon requestThe Secretary shall approve or deny a request for a waiver under paragraph (1) not later than 120 days after the date on which the request is made. (3) Applicability of waiverAny waiver provided by the Secretary under paragraph (1) shall be applicable only to the fiscal year involved. (d) Noncompliance by State(1) In generalIn making a grant under section 300x–21 of this title to a State for a fiscal year, the Secretary shall make a determination of whether, for the previous fiscal year, the State maintained material compliance with any agreement made under subsection (a). If the Secretary determines that a State has failed to maintain such compliance, the Secretary shall reduce the amount of the allotment under section 300x–21 of this title for the State for the fiscal year for which the grant is being made by an amount equal to the amount constituting such failure for the previous fiscal year. (2) Submission of information to SecretaryThe Secretary may make a grant under section 300x–21 of this title for a fiscal year only if the State involved submits to the Secretary information sufficient for the Secretary to make the determination required in paragraph (1). (3) AlternativeA State that has failed to comply with this section and would otherwise be subject to a reduction in the State’s allotment under section 300x–21 of this title, may, upon request by the State, in lieu of having the State’s allotment under section 300x–21 of this title reduced, agree to comply with a negotiated agreement that is approved by the Secretary and carried out in accordance with guidelines issued by the Secretary. If a State fails to enter into or comply with a negotiated agreement, the Secretary may take action under this paragraph or the terms of the negotiated agreement.

42 U.S.C. § 300x–31 Restrictions on expenditure of grant

(a) In general(1) Certain restrictionsA funding agreement for a grant under section 300x–21 of this title is that the State involved will not expend the grant—(A) to provide inpatient hospital services, except as provided in subsection (b); (B) to make cash payments to intended recipients of health services; (C) to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment; (D) to satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; (E) to provide financial assistance to any entity other than a public or nonprofit private entity; or (F) to carry out any program prohibited by section 300ee–5 of this title. (2) Limitation on administrative expensesA funding agreement for a grant under section 300x–21 of this title is that the State involved will not expend more than 5 percent of the grant to pay the costs of administering the grant. (3) Limitation regarding penal and correctional institutionsA funding agreement for a State for a grant under section 300x–21 of this title is that, in expending the grant for the purpose of providing treatment services in penal or correctional institutions of the State, the State will not expend more than an amount equal to the amount expended for such purpose by the State from the grant made under section 300x–1a 11 See References in Text note below. of this title to the State for fiscal year 1991 (as section 300x–1a 1 of this title was in effect for such fiscal year). (b) Exception regarding inpatient hospital services(1) Medical necessity as preconditionWith respect to compliance with the agreement made under subsection (a), a State may expend a grant under section 300x–21 of this title to provide inpatient hospital services as treatment for substance use disorders only if it has been determined, in accordance with guidelines issued by the Secretary, that such treatment is a medical necessity for the individual involved, and that the individual cannot be effectively treated in a community-based, nonhospital, residential program of treatment. (2) Rate of paymentIn the case of an individual for whom a grant under section 300x–21 of this title is expended to provide inpatient hospital services described in paragraph (1), a funding agreement for the grant for the State involved is that the daily rate of payment provided to the hospital for providing the services to the individual will not exceed the comparable daily rate provided for community-based, nonhospital, residential programs of treatment for substance use disorders. (c) Waiver regarding construction of facilities(1) In generalThe Secretary may provide to any State a waiver of the restriction established in subsection (a)(1)(C) for the purpose of authorizing the State to expend a grant under section 300x–21 of this title for the construction of a new facility or rehabilitation of an existing facility, but not for land acquisition. (2) Standard regarding need for waiverThe Secretary may approve a waiver under paragraph (1) only if the State demonstrates to the Secretary that adequate treatment cannot be provided through the use of existing facilities and that alternative facilities in existing suitable buildings are not available. (3) AmountIn granting a waiver under paragraph (1), the Secretary shall allow the use of a specified amount of funds to construct or rehabilitate a specified number of beds for residential treatment and a specified number of slots for outpatient treatment, based on reasonable estimates by the State of the costs of construction or rehabilitation. In considering waiver applications, the Secretary shall ensure that the State has carefully designed a program that will minimize the costs of additional beds. (4) Matching fundsThe Secretary may grant a waiver under paragraph (1) only if the State agrees, with respect to the costs to be incurred by the State in carrying out the purpose of the waiver, to make available non-Federal contributions in cash toward such costs in an amount equal to not less than $1 for each $1 of Federal funds provided under section 300x–21 of this title. (5) Date certain for acting upon requestThe Secretary shall act upon a request for a waiver under paragraph (1) not later than 120 days after the date on which the request is made.

42 U.S.C. § 300x–32 Application for grant; approval of State plan

(a) In generalFor purposes of section 300x–21 of this title, an application for a grant under such section for a fiscal year is in accordance with this section if, subject to subsection (c)—(1) the application is received by the Secretary not later than October 1 of the fiscal year for which the State is seeking funds; (2) the application contains each funding agreement that is described in this subpart or subpart III for such a grant (other than any such agreement that is not applicable to the State); (3) the agreements are made through certification from the chief executive officer of the State; (4) with respect to such agreements, the application provides assurances of compliance satisfactory to the Secretary; (5) the application contains the report required in section 300x–52(a) of this title; (6)(A) the application contains a plan in accordance with subsection (b) and the plan is approved by the Secretary; and (B) the State provides assurances satisfactory to the Secretary that the State complied with the provisions of the plan under subparagraph (A) that was approved by the Secretary for the most recent fiscal year for which the State received a grant under section 300x–21 of this title; and (7) the application (including the plan under paragraph (6)) is otherwise in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this subpart. (b) State plan(1) In generalIn order for a State to be in compliance with subsection (a)(6), the State shall submit to the Secretary a plan that, at a minimum, includes the following:(A) A description of the State’s system of care that—(i) identifies the single State agency responsible for the administration of the program, including any third party who administers substance use disorder services and is responsible for complying with the requirements of the grant; (ii) provides information on the need for substance use disorder prevention and treatment services in the State, including estimates on the number of individuals who need treatment, who are pregnant women, women with dependent children, individuals with a co-occurring mental health and substance use disorder, persons who inject drugs, and persons who are experiencing homelessness; (iii) provides aggregate information on the number of individuals in treatment within the State, including the number of such individuals who are pregnant women, women with dependent children, individuals with a co-occurring mental health and substance use disorder, persons who inject drugs, and persons who are experiencing homelessness; (iv) provides a description of the system that is available to provide services by modality, including the provision of recovery support services; (v) provides a description of the State’s comprehensive statewide prevention efforts, including the number of individuals being served in the system, target populations, and priority needs, and provides a description of the amount of funds from the prevention set-aside expended on primary prevention; (vi) provides a description of—(I) the State’s comprehensive statewide recovery support services activities, including the number of individuals being served, target populations, workforce capacity (consistent with clause (viii)), and priority needs; and (II) the amount of funds received under this subpart expended on recovery support services, disaggregated by the amount expended for type of service activity; (vii) provides a description of the financial resources available; (viii) describes the existing substance use disorders workforce, including with respect to prevention, treatment, and recovery, and workforce trained in treating co-occurring substance use and mental disorders; (ix) includes a description of how the State promotes evidence-based practices; and (x) describes how the State integrates substance use disorder services and primary health care, which in the case of those individuals with co-occurring mental health and substance use disorders may include providing both mental health and substance use disorder services in primary care settings or providing primary and specialty care services in community-based mental health and substance use disorder service settings. (B) The establishment of goals and objectives for the period of the plan, including targets and milestones that are intended to be met, and the activities that will be undertaken to achieve those targets. (C) A description of how the State will comply with each funding agreement for a grant under section 300x–21 of this title that is applicable to the State, including a description of the manner in which the State intends to expend grant funds. (2) Modifications(A) Authority of SecretaryAs a condition; 11 So in original. The semicolon probably should not appear. of making a grant under section 300x–21 of this title to a State for a fiscal year, the Secretary may require that the State modify any provision of the plan submitted by the State under subsection (a)(6) (including provisions on priorities in carrying out authorized activities). If the Secretary approves the plan and makes the grant to the State for the fiscal year, the Secretary may not during such year require the State to modify the plan. (B) State request for modificationIf the State determines that a modification to such plan is necessary, the State may request the Secretary to approve the modification. Any such modification shall be in accordance with paragraph (1) and section 300x–51 of this title. (3) Authority of Center for Substance Abuse PreventionWith respect to plans submitted by the States under subsection (a)(6), including any modification under paragraph (2), the Secretary, acting through the Director of the Center for Substance Abuse Prevention, shall review and approve or disapprove the provisions of the plans that relate to prevention activities. (c) Waivers regarding certain territoriesIn the case of any territory of the United States except Puerto Rico, the Secretary may waive such provisions of this subpart and subpart III as the Secretary determines to be appropriate, other than the provisions of section 300x–31 of this title. (d) Issuance of regulations; precondition to making grants(1) RegulationsNot later than August 25, 1992, the Secretary, acting as appropriate through the Director of the Center for Treatment Improvement or the Director of the Center for Substance Abuse Prevention, shall by regulation establish standards specifying the circumstances in which the Secretary will consider an application for a grant under section 300x–21 of this title to be in accordance with this section. (2) Issuance as precondition to making grantsThe Secretary may not make payments under any grant under section 300x–21 of this title for fiscal year 1993 on or after January 1, 1993, unless the Secretary has issued standards under paragraph (1). (e) Waiver authority for certain requirements(1) In generalUpon the request of a State, the Secretary may waive the requirements of all or part of the sections described in paragraph (2) using objective criteria established by the Secretary by regulation after consultation with the States and other interested parties including consumers and providers. (2) SectionsThe sections described in paragraph (1) are sections 300x–22(b), 300x–23, 300x–24 and 300x–28 of this title. (3) Date certain for acting upon requestThe Secretary shall approve or deny a request for a waiver under paragraph (1) and inform the State of that decision not later than 120 days after the date on which the request and all the information needed to support the request are submitted. (4) Annual reporting requirementThe Secretary shall annually report to the general public on the States that receive a waiver under this subsection.

42 U.S.C. § 300x–33 Determination of amount of allotment

(a) States(1) In generalSubject to subsection (b), the Secretary shall determine the amount of the allotment required in section 300x–21 of this title for a State for a fiscal year as follows:(A) The formula established in paragraph (1) of section 300x–7(a) of this title shall apply to this subsection to the same extent and in the same manner as the formula applies for purposes of section 300x–7(a) of this title, except that, in the application of such formula for purposes of this subsection, the modifications described in subparagraph (B) shall apply. (B) For purposes of subparagraph (A), the modifications described in this subparagraph are as follows:(i) The amount specified in paragraph (2)(A) of section 300x–7(a) of this title is deemed to be the amount appropriated under section 300x–35(a) of this title for allotments under section 300x–21 of this title for the fiscal year involved. (ii) The term “P” is deemed to have the meaning given in paragraph (2) of this subsection. Section 300x–7(a)(5)(B) of this title applies to the data used in determining such term for the States. (iii) The factor determined under paragraph (8) of section 300x–7(a) of this title is deemed to have the purpose of reflecting the differences that exist between the State involved and other States in the costs of providing authorized services. (2) Determination of term “P”For purposes of this subsection, the term “P” means the percentage that is the arithmetic mean of the percentage determined under subparagraph (A) and the percentage determined under subparagraph (B), as follows:(A) The percentage constituted by the ratio of—(i) an amount equal to the sum of the total number of individuals who reside in the State involved and are between 18 and 24 years of age (inclusive) and the number of individuals in the State who reside in urbanized areas of the State and are between such years of age; to (ii) an amount equal to the total of the respective sums determined for the States under clause (i). (B) The percentage constituted by the ratio of—(i) the total number of individuals in the State who are between 25 and 64 years of age (inclusive); to (ii) an amount equal to the sum of the respective amounts determined for the States under clause (i). (b) Minimum allotments for States(1) In generalWith respect to fiscal year 2000, and each subsequent fiscal year, the amount of the allotment of a State under section 300x–21 of this title shall not be less than the amount the State received under such section for the previous fiscal year increased by an amount equal to 30.65 percent of the percentage by which the aggregate amount allotted to all States for such fiscal year exceeds the aggregate amount allotted to all States for the previous fiscal year. (2) Limitations(A) In generalExcept as provided in subparagraph (B), a State shall not receive an allotment under section 300x–21 of this title for a fiscal year in an amount that is less than an amount equal to 0.375 percent of the amount appropriated under section 300x–35(a) of this title for such fiscal year. (B) ExceptionIn applying subparagraph (A), the Secretary shall ensure that no State receives an increase in its allotment under section 300x–21 of this title for a fiscal year (as compared to the amount allotted to the State in the prior fiscal year) that is in excess of an amount equal to 300 percent of the percentage by which the amount appropriated under section 300x–35(a) of this title for such fiscal year exceeds the amount appropriated for the prior fiscal year. (3) Decrease in or equal appropriationsIf the amount appropriated under section 300x–35(a) of this title for a fiscal year is equal to or less than the amount appropriated under such section for the prior fiscal year, the amount of the State allotment under section 300x–21 of this title shall be equal to the amount that the State received under section 300x–21 of this title in the prior fiscal year decreased by the percentage by which the amount appropriated for such fiscal year is less than the amount appropriated or 11 So in original. Probably should be “for”. such section for the prior fiscal year. (c) Territories(1) Determination under formulaSubject to paragraphs (2) and (4), the amount of an allotment under section 300x–21 of this title for a territory of the United States for a fiscal year shall be the product of—(A) an amount equal to the amounts reserved under paragraph (3) for the fiscal year; and (B) a percentage equal to the quotient of—(i) the civilian population of the territory, as indicated by the most recently available data; divided by (ii) the aggregate civilian population of the territories of the United States, as indicated by such data. (2) Minimum allotment for territoriesThe amount of an allotment under section 300x–21 of this title for a territory of the United States for a fiscal year shall be the greater of—(A) the amount determined under paragraph (1) for the territory for the fiscal year; (B) $50,000; and (C) with respect to fiscal years 1993 and 1994, an amount equal to 79.4 percent of the amount received by the territory from allotments made pursuant to this part for fiscal year 1992. (3) Reservation of amountsThe Secretary shall each fiscal year reserve for the territories of the United States 1.5 percent of the amounts appropriated under section 300x–35(a) of this title for allotments under section 300x–21 of this title for the fiscal year. (4) Availability of data on populationWith respect to data on the civilian population of the territories of the United States, if the Secretary determines for a fiscal year that recent such data for purposes of paragraph (1)(B) do not exist regarding a territory, the Secretary shall for such purposes estimate the civilian population of the territory by modifying the data on the territory to reflect the average extent of change occurring during the ensuing period in the population of all territories with respect to which recent such data do exist. (5) Applicability of certain provisionsFor purposes of subsections (a) and (b), the term “State” does not include the territories of the United States. (d) Indian Tribes and Tribal organizations(1) In generalIf the Secretary—(A) receives a request from the governing body of an Indian Tribe or Tribal organization within any State that funds under this subpart be provided directly by the Secretary to such Tribe or organization; and (B) makes a determination that the members of such Tribe or Tribal organization would be better served by means of grants made directly by the Secretary under this subpart; the Secretary shall reserve from the allotment under section 300x–21 of this title for the State for the fiscal year involved an amount that bears the same ratio to the allotment as the amount provided under this subpart to the Tribe or Tribal organization for fiscal year 1991 for activities relating to the prevention and treatment of the use of substances bore to the amount of the portion of the allotment under this subpart for the State for such fiscal year that was expended for such activities. (2) Indian Tribe or Tribal organization as granteeThe amount reserved by the Secretary on the basis of a determination under this subsection shall be granted to the Indian Tribe or Tribal organization serving the individuals for whom such a determination has been made. (3) ApplicationIn order for an Indian Tribe or Tribal organization to be eligible for a grant for a fiscal year under this paragraph,22 So in original. Probably should be “subsection,”. it shall submit to the Secretary a plan for such fiscal year that meets such criteria as the Secretary may prescribe. (4) DefinitionsThe terms “Indian Tribe” and “Tribal organization” have the meanings given the terms “Indian tribe” and “tribal organization” in subsections (b) and (c) 33 See References in Text note below. of section 5304 of title 25.

42 U.S.C. § 300x–34 Definitions

For purposes of this subpart: (1) The term “authorized activities”, subject to section 300x–31 of this title, means the activities described in section 300x–21(b) of this title. (2) The term “funding agreement”, with respect to a grant under section 300x–21 of this title to a State, means that the Secretary may make such a grant only if the State makes the agreement involved. (3) The term “prevention activities”, subject to section 300x–31 of this title, means activities to prevent substance use disorders. (4) The term “substance use disorder” means the recurrent use of alcohol or other drugs that causes clinically significant impairment. (5) The term “treatment activities” means treatment services and, subject to section 300x–31 of this title, authorized activities that are related to treatment services. (6) The term “treatment facility” means an entity that provides treatment services. (7) The term “treatment services”, subject to section 300x–31 of this title, means treatment for substance use disorders.

42 U.S.C. § 300x–35 Funding

(a) Authorization of appropriationsFor the purpose of carrying out this subpart, subpart III and section 290aa–4(d) of this title with respect to substance use disorders, and section 290bb–21(d) of this title, there are authorized to be appropriated $1,908,079,000 for each of fiscal years 2023 through 2027. (b) Allocations for technical assistance, national data base, data collection, and program evaluations(1) In general(A) For the purpose of carrying out section 300x–58(a) of this title with respect to substance use disorders, section 290bb–21(d) of this title, and the purposes specified in subparagraphs (B) and (C), the Secretary shall obligate 5 percent of the amounts appropriated under subsection (a) each fiscal year. (B) The purpose specified in this subparagraph is carrying out sections 290aa–4(d) and 300y of this title with respect to substance use disorders. (C) The purpose specified in this subparagraph is the conduct of evaluations of authorized activities to determine methods for improving the availability and quality of such activities. (2) Activities of Center for Substance Abuse PreventionOf the amounts reserved under paragraph (1) for a fiscal year, the Secretary, acting through the Director of the Center for Substance Abuse Prevention, shall obligate 20 percent for carrying out paragraph (1)(C), section 300x–58(a) of this title with respect to prevention activities, and section 290bb–21(d) of this title. (3) Core data setA State that receives a new grant, contract, or cooperative agreement from amounts available to the Secretary under paragraph (1), for the purposes of improving the data collection, analysis and reporting capabilities of the State, shall be required, as a condition of receipt of funds, to collect, analyze, and report to the Secretary for each fiscal year subsequent to receiving such funds a core data set to be determined by the Secretary in conjunction with the States.

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