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Updates and reauthorizes a broad set of federal prevention, treatment, and recovery activities for substance use and mental-health care through FY2026–2030. It increases or redirects funding for multiple programs, creates/clarifies peer-support technical assistance (including a new regional center), requires a range of studies and reports, and sets new program and reporting deadlines for HHS, FDA, DEA, and related agencies. Also changes selected Controlled Substances Act and pharmacy rules to permit certain deliveries to prescribing practitioners and revises prescriber-training language; it adds programmatic flexibilities (e.g., limited use of recovery grant funds for transportation), new evaluation and oversight requirements, and deadlines for agency guidance and reviews.
Amends Section 317L(d) of the Public Health Service Act to set funding at $4,250,000 for each of fiscal years 2026 through 2030 for the prenatal and postnatal health program.
Amends Section 317N(d) of the Public Health Service Act to change references to the program years from fiscal years 2019–2023 to fiscal years 2026–2030 for monitoring and education regarding infections associated with illicit drug use and other risk factors.
Makes textual and program changes to Section 392A of the Public Health Service Act to broaden language (e.g., replacing “opioids” with “substances causing overdose”) and to change internal wording such as changing “coding” to “monitoring and identifying.”
Amends Section 392A(a)(3) to add or clarify that grants may fund innovative projects to detect, identify, and rapidly respond to controlled substance misuse, abuse, and overdoses; such projects may include evidence-based strategies like wastewater surveillance if proven to support actionable prevention strategies and consistent with Federal and State privacy laws.
Amends Section 392A(e) to authorize $505,579,000 for each of fiscal years 2026 through 2030 (replacing the prior $496,000,000 for each fiscal year 2019–2023) for activities under Section 392A.
Who is affected and how:
People at risk of overdose and people with substance use disorders: Expanded prevention, treatment, and recovery funding and program changes aim to increase access to services, expand peer support, and improve overdose-prevention measures. Changes to controlled‑substance delivery and medication-access reviews (e.g., buprenorphine) may affect timely access to medication‑assisted treatment.
Behavioral health and treatment workforce (clinicians, peer supporters, program administrators): New technical assistance, a regional peer-support center, evaluation requirements, and revised training language will require workforce development, participation in training, and compliance with updated program rules. Funding changes may create new grant opportunities and administrative reporting duties.
Mental‑health and recovery service providers, community organizations, and clinics (including crisis lifeline operators): Grant rule changes (including limited transportation allowances), reporting, and program evaluation requirements will change how these providers plan budgets, document services, and participate in federal programs.
Pharmacies and prescribing practitioners: The pharmacy delivery rule expands permitted delivery recipients for particular Schedules (III–V) in limited cases; pharmacies and practitioners will need to adopt procedures and ensure regulatory compliance.
Federal agencies (HHS, FDA, DEA and component offices such as SAMHSA): Must carry out new duties — issuing guidance, performing reviews and studies, administering restructured grant programs, tracking new reporting metrics, and reporting to Congress within statutory timelines. This will increase agency workload and require coordination across program offices.
Researchers and evaluators: New mandated studies, program evaluations, and data-reporting requirements create opportunities and obligations for academic and contractor evaluation work.
Overall, the bill changes program authorizations and administrative rules rather than imposing broad new direct costs on states; it mainly affects federal agencies, service providers, the behavioral‑health workforce, pharmacies, and people seeking or delivering SUD and mental‑health services.
Expand sections to see detailed analysis
Strikes existing paragraph (2) of 21 U.S.C. 829a(a) and inserts a replaced paragraph (2) specifying conditions under which a pharmacy may deliver a Schedule III, IV, or V controlled substance to a practitioner for administration, including injection/implantation for maintenance or detoxification treatment, or when the drug is subject to a risk evaluation and mitigation strategy under 21 U.S.C. 355–1 that includes post-administration monitoring by a health care provider.
Redesignates the second subsection designated as subsection (l) as subsection (m), and makes targeted textual amendments in the redesignated subsection (m)(1), including inserting references to 'podiatric medicine' in enumerations and modifying related curriculum and punctuation language in subparagraphs (A) and (B).
Amends subsection (g)(1) of 29 U.S.C. 3225a by striking and inserting new text (new text not provided in this section)
Replaces prior open-ended authorization for fiscal years 2019–2023 with a specified authorization of $4,250,000 for each of fiscal years 2026–2030 in section 317L(d).
Extends the referenced authorization period by replacing 'fiscal years 2019 through 2023' with 'fiscal years 2026 through 2030' in section 317N(d).
Multiple textual amendments to section 392A: modifies terminology (e.g., 'opioids' to 'substances causing overdose'), updates subparagraph language to emphasize monitoring and detection, adds allowance for innovative detection methods (including wastewater surveillance) in grants, and replaces authorization amounts with $505,579,000 for each of fiscal years 2026–2030.
Part O of title III (FASD program) is amended and replaced; reporting requirements added for the Secretary to submit periodic reports regarding sections 399H and 399I activities.
Adds a subsection clarifying that the Secretary may not require States to use a specific vendor or interoperability connection beyond aligning with nationally recognized, consensus-based open standards in section 399O(h).
Amends section 546 to update capitalization/terminology, replace certain phrases with 'approved, cleared, or otherwise legally marketed,' broaden references from 'opioid and heroin' to 'opioid, heroin, and other drug' and change authorization amounts to $57,000,000 for each of fiscal years 2026–2030.
Redesignates Part G as Part J and renumbers sections; amends section 582 (NCTSI) to adjust terminology, add responsibilities for NCTSI grantees and coordinating center collaboration, update application requirements, and set specific annual authorization amounts for fiscal years 2026–2030.
And 21 more affected sections...
CAREER Act of 2025
Safer Response Act of 2025
SUPPORT for Patients and Communities Reauthorization Act of 2025
Safe Response Act
MATE Improvement Act
Introduced March 31, 2025 by Brett Guthrie · Last progress December 1, 2025
Passed Senate without amendment by Unanimous Consent. (consideration: CR S6712)
President of the United States
Became Public Law No: 119-44.
Became Public Law No: 119-44
Signed by President.
Presented to President.
