§ 290bb–1.
Residential treatment programs for pregnant and postpartum women
(a)
In general
The Director of the Center for Substance Abuse Treatment (referred to in this section as the “Director”) shall provide awards of grants, including the grants under subsection (r), cooperative agreements or contracts to public and nonprofit private entities for the purpose of providing to pregnant and postpartum women treatment for substance use disorders through programs in which, during the course of receiving treatment—
(1)
the women reside in or receive outpatient treatment services from facilities provided by the programs;
(2)
the minor children of the women reside with the women in such facilities, if the women so request; and
(3)
the services described in subsection (d) are available to or on behalf of the women.
(b)
Availability of services for each participant
A funding agreement for an award under subsection (a) for an applicant is that, in the program operated pursuant to such subsection—
(1)
treatment services and each supplemental service will be available through the applicant, either directly or through agreements with other public or nonprofit private entities; and
(2)
the services will be made available to each woman admitted to the program and her children.
(c)
Individualized plan of services
A funding agreement for an award under subsection (a) for an applicant is that—
(1)
in providing authorized services for an eligible woman pursuant to such subsection, the applicant will, in consultation with the women, prepare an individualized plan for the provision of services for the woman and her children; and
(2)
treatment services under the plan will include—
(A)
individual, group, and family counseling, as appropriate, regarding substance use disorders; and
(B)
follow-up services to assist the woman in preventing a relapse into such a disorder.
(d)
Required supplemental services
In the case of an eligible woman, the services referred to in subsection (a)(3) are as follows:
(1)
Prenatal and postpartum health care.
(2)
Referrals for necessary hospital services.
(3)
For the infants and children of the woman—
(A)
pediatric health care, including treatment for any perinatal effects of a maternal substance use disorder and including screenings regarding the physical and mental development of the infants and children;
(B)
counseling and other mental health services, in the case of children; and
(C)
comprehensive social services.
(4)
Providing therapeutic, comprehensive child care for children during the periods in which the woman is engaged in therapy or in other necessary health and rehabilitative activities.
(5)
Training in parenting.
(6)
Counseling on the human immunodeficiency virus and on acquired immune deficiency syndrome.
(7)
Counseling on domestic violence and sexual abuse.
(8)
Counseling on obtaining employment, including the importance of graduating from a secondary school.
(9)
Reasonable efforts to preserve and support the family unit of the woman, including promoting the appropriate involvement of parents and others, and counseling the children of the woman.
(10)
Planning for and counseling to assist reentry into society, both before and after discharge, including referrals to any public or nonprofit private entities in the community involved that provide services appropriate for the woman and the children of the woman.
(11)
Case management services, including—
(A)
assessing the extent to which authorized services are appropriate for the woman and any child of such woman;
(B)
in the case of the services that are appropriate, ensuring that the services are provided in a coordinated manner;
(C)
assistance in establishing eligibility for assistance under Federal, State, and local programs providing health services, mental health services, housing services, employment services, educational services, or social services; and
(D)
family reunification with children in kinship or foster care arrangements, where safe and appropriate.
(e)
Minimum qualifications for receipt of award
(1)
Certification by relevant State agency
With respect to the principal agency of the State involved that administers programs relating to substance use disorders, the Director may make an award under subsection (a) to an applicant only if the agency has certified to the Director that—
(A)
the applicant has the capacity to carry out a program described in subsection (a);
(B)
the plans of the applicant for such a program are consistent with the policies of such agency regarding the treatment of substance use disorders; and
(C)
the applicant, or any entity through which the applicant will provide authorized services, meets all applicable State licensure or certification requirements regarding the provision of the services involved.
(2)
Status as medicaid provider
(A)
In general
Subject to subparagraphs (B) and (C), the Director may make an award under subsection (a) only if, in the case of any authorized service that is available pursuant to the State plan approved under title XIX of the Social Security Act [
42 U.S.C. 1396 et seq.] for the State involved—
(i)
the applicant for the award will provide the service directly, and the applicant has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or
(ii)
the applicant will enter into an agreement with a public or nonprofit private entity under which the entity will provide the service, and the entity has entered into such a participation agreement plan and is qualified to receive such payments.
(B)
Waiver of participation agreements
(C)
Nonapplication of certain requirements
(f)
Requirement of matching funds
(1)
In general
With respect to the costs of the program to be carried out by an applicant pursuant to subsection (a), a funding agreement for an award under such subsection is that the applicant will make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that—
(A)
for the first fiscal year for which the applicant receives payments under an award under such subsection, is not less than $1 for each $9 of Federal funds provided in the award;
(B)
for any second such fiscal year, is not less than $1 for each $9 of Federal funds provided in the award; and
(C)
for any subsequent such fiscal year, is not less than $1 for each $3 of Federal funds provided in the award.
(2)
Determination of amount contributed
(h)
Accessibility of program; cultural context of services
A funding agreement for an award under subsection (a) for an applicant is that—
(1)
the program operated pursuant to such subsection will be operated at a location that is accessible to low-income pregnant and postpartum women; and
(2)
authorized services will be provided in the language and the cultural context that is most appropriate.
(j)
Imposition of charges
A funding agreement for an award under subsection (a) for an applicant is that, if a charge is imposed for the provision of authorized services to or on behalf of an eligible woman, such charge—
(1)
will be made according to a schedule of charges that is made available to the public;
(2)
will be adjusted to reflect the income of the woman involved; and
(3)
will not be imposed on any such woman with an income of less than 185 percent of the official poverty line, as established by the Director of the Office of Management and Budget and revised by the Secretary in accordance with
section 9902(2) of this title.
(k)
Reports to Director
A funding agreement for an award under subsection (a) is that the applicant involved will submit to the Director a report—
(1)
describing the utilization and costs of services provided under the award;
(2)
specifying the number of women served, the number of infants served, and the type and costs of services provided; and
(3)
providing such other information as the Director determines to be appropriate.
(l)
Requirement of application
(o)
Evaluations; dissemination of findings
(q)
Definitions
For purposes of this section:
(1)
The term “authorized services” means treatment services and supplemental services.
(2)
The term “eligible woman” means a woman who has been admitted to a program operated pursuant to subsection (a).
(3)
The term “funding agreement”, with respect to an award under subsection (a), means that the Director may make the award only if the applicant makes the agreement involved.
(4)
The term “treatment services” means treatment for a substance use disorder, including the counseling and services described in subsection (c)(2).
(5)
The term “supplemental services” means the services described in subsection (d).
(r)
Pilot program for State substance abuse agencies
(1)
In general
From amounts made available under subsection (s), the Director of the Center for Substance Abuse Treatment shall carry out a pilot program under which competitive grants are made by the Director to State substance abuse agencies—
(A)
to enhance flexibility in the use of funds designed to support family-based services for pregnant and postpartum women with a primary diagnosis of a substance use disorder, including opioid use disorders;
(B)
to help State substance abuse agencies address identified gaps in services furnished to such women along the continuum of care, including services provided to women in nonresidential-based settings; and
(C)
to promote a coordinated, effective, and efficient State system managed by State substance abuse agencies by encouraging new approaches and models of service delivery.
(2)
Requirements
In carrying out the pilot program under this subsection, the Director shall—
(A)
require State substance abuse agencies to submit to the Director applications, in such form and manner and containing such information as specified by the Director, to be eligible to receive a grant under the program;
(B)
identify, based on such submitted applications, State substance abuse agencies that are eligible for such grants;
(C)
require services proposed to be furnished through such a grant to support family-based treatment and other services for pregnant and postpartum women with a primary diagnosis of a substance use disorder, including opioid use disorders;
(D)
not require that services furnished through such a grant be provided solely to women that reside in facilities;
(E)
not require that grant recipients under the program make available through use of the grant all the services described in subsection (d); and
(F)
consider not applying the requirements described in paragraphs (1) and (2) of subsection (f) to an applicant, depending on the circumstances of the applicant.
(3)
Required services
(A)
In general
The Director shall specify a minimum set of services required to be made available to eligible women through a grant awarded under the pilot program under this subsection. Such minimum set of services—
(i)
shall include the services requirements described in subsection (c) and be based on the recommendations submitted under subparagraph (B); and
(ii)
may be selected from among the services described in subsection (d) and include other services as appropriate.
(4)
Evaluation and report to Congress
(B)
Report
Not later than September 30, 2026, the Director of the Center for Behavioral Health Statistics and Quality, in coordination with the Director of the Center for Substance Abuse Treatment 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 on the evaluation under subparagraph (A). The report shall include, at a minimum—
(i)
outcomes information from the pilot program, including any resulting reductions in the use of alcohol and other drugs;
(ii)
engagement in treatment services;
(iii)
retention in the appropriate level and duration of services;
(iv)
increased access to the use of medications approved by the Food and Drug Administration for the treatment of substance use disorders in combination with counseling; and
(v)
other appropriate measures.
(5)
State substance abuse agencies defined
(s)
Authorization of appropriations
([July 1, 1944, ch. 373], title V, § 508, as added [Pub. L. 102–321, title I, § 108(a)], July 10, 1992, [106 Stat. 336]; amended [Pub. L. 106–310, div. B, title XXXIII, § 3301(a)], Oct. 17, 2000, [114 Stat. 1207]; [Pub. L. 114–198, title V, § 501], July 22, 2016, [130 Stat. 724]; [Pub. L. 114–255, div. B, title VI], §§ 6001(c)(2), 6006(b), Dec. 13, 2016, [130 Stat. 1203], 1212; [Pub. L. 115–271, title VII, § 7062(b)], Oct. 24, 2018, [132 Stat. 4020]; [Pub. L. 117–328, div. FF, title I, § 1114], Dec. 29, 2022, [136 Stat. 5647].)