Notice2026-11602
HHS Request for Comment on Chronic Disease of Addiction
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
June 10, 2026
Issuing agencies
Health and Human Services Department
Abstract
Thanks to President Trump's leadership, since 2017, the country has made significant progress in addressing mental health and substance use. However, President Trump and HHS Secretary Kennedy realize that the Department and country have more work to do. To facilitate this effort, HHS invites public comment in response to this RFI on the research, development, programs, and policies that have been most successful in improving availability of and access to effective prevention, treatment, and recovery interventions for addiction, mental illness, and co-occurring substance use and mental disorders. The purpose of this RFI is to identify research, programs, and policies that have been successful and recommend novel policy ideas and gaps in research that could be addressed and implemented to further the Great American Recovery using existing funding.
Full Text
<html>
<head>
<title>Federal Register, Volume 91 Issue 111 (Wednesday, June 10, 2026)</title>
</head>
<body><pre>
[Federal Register Volume 91, Number 111 (Wednesday, June 10, 2026)]
[Notices]
[Pages 35221-35223]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-11602]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
HHS Request for Comment on Chronic Disease of Addiction
AGENCY: US Department of Health and Human Services (HHS or the
Department).
ACTION: Notice of Request for Information (RFI) regarding substance
research, policy, and strategies to improve the prevention, treatment,
recovery of chronic disease of addiction and mental illness and how to
promote the Great American Recovery Initiative.
-----------------------------------------------------------------------
SUMMARY: Thanks to President Trump's leadership, since 2017, the
country has made significant progress in addressing mental health and
substance use. However, President Trump and HHS Secretary Kennedy
realize that the Department and country have more work to do. To
facilitate this effort, HHS invites public comment in response to this
RFI on the research, development, programs, and policies that have been
most successful in improving availability of and access to effective
prevention, treatment, and recovery interventions for addiction, mental
illness, and co-occurring substance use and mental disorders. The
purpose of this RFI is to identify research, programs, and policies
that have been successful and recommend novel policy ideas and gaps in
research that could be addressed and implemented to further the Great
American Recovery using existing funding.
DATES: Comments on this notice must be received by July 5, 2026.
ADDRESSES: Interested parties may submit comments electronically to
<a href="/cdn-cgi/l/email-protection#e9bbacb9a6bbbdbaaaa5aca8bba8a7aaaca6afafa0aaacbba988819b98c781819ac78e869f"><span class="__cf_email__" data-cfemail="e9bbacb9a6bbbdbaaaa5aca8bba8a7aaaca6afafa0aaacbba988819b98c781819ac78e869f">[email protected]</span></a> with the subject line `Great
American Recovery.'
FOR FURTHER INFORMATION CONTACT: Erica Moshtahedian, Agency for
Healthcare Research and Quality (AHRQ) Chief of Staff, Department of
Health and Human Services (HHS), <a href="/cdn-cgi/l/email-protection#de9bacb7bdbff093b1adb6aabfb6bbbab7bfb09ebfb6acaff0b6b6adf0b9b1a8"><span class="__cf_email__" data-cfemail="4d083f242e2c6300223e25392c252829242c230d2c253f3c6325253e632a223b">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: HHS is dedicated to promoting the health and
well-being of the American people. To advance this goal, HHS is
implementing President Trump's Executive Order (E.O.) 14379 of January
29, 2026: Addressing Addiction Through the Great American Recovery
Initiative and E.O. 14321 of July 24, 2025: Ending Crime and Disorder
on America's Streets that will bring back safety and trust to America's
communities.
This initiative represents a critical new step to strengthen
federal guidance and grants to support the nation's recovery, with a
focus on prevention, treatment, and long-term resilience. It consists
of:
Guidance
1. Strengthening Agency Collaboration
The Centers for Medicare & Medicaid Services (CMS), the Substance
Abuse and Mental Health Services Administration (SAMHSA), and the
Administration for Children and Families (ACF) issued joint guidance to
improve coordination between state Medicaid, substance abuse, mental
health, and child welfare agencies, with a focus on youth mental
health, substance use prevention, and early intervention.\1\ SAMHSA and
CMS also recently issued guidance concerning best practices for
implementing behavioral health crisis services through Medicaid and
CHIP.\2\
---------------------------------------------------------------------------
\1\ <a href="https://www.samhsa.gov/sites/default/files/dear-colleague-letter-moud.pdf">https://www.samhsa.gov/sites/default/files/dear-colleague-letter-moud.pdf</a>.
\2\ <a href="https://www.medicaid.gov/federal-policy-guidance/downloads/sho25004.pdf">https://www.medicaid.gov/federal-policy-guidance/downloads/sho25004.pdf</a>.
---------------------------------------------------------------------------
2. Engaging Faith-Based Providers
States receiving SAMHSA and ACF block grants and large formula
grants were issued new guidance and best practices on how to include
faith-based organizations as part of their provider networks. This
includes SAMHSA's State Opioid Response (SOR) grants and the Mental
Health and Substance Use Block Grants.\3\
---------------------------------------------------------------------------
\3\ <a href="https://www.samhsa.gov/sites/default/files/dear-colleague-letter-faith-based-organizations.pdf">https://www.samhsa.gov/sites/default/files/dear-colleague-letter-faith-based-organizations.pdf</a>.
---------------------------------------------------------------------------
3. Development of Non-Opioid Options
The Food and Drug Administration (FDA) issued guidance in September
2025 to help expand non-opioid options
[[Page 35222]]
for chronic pain and to curb misuse.\4\ It addresses development of
non-opioid analgesics with specific attention to establishing
indications, trial design, appropriate patient populations, and
meaningful outcomes.
---------------------------------------------------------------------------
\4\ <a href="https://www.fda.gov/regulatory-information/search-fda-guidance-documents/development-non-opioid-analgesics-chronic-pain">https://www.fda.gov/regulatory-information/search-fda-guidance-documents/development-non-opioid-analgesics-chronic-pain</a>.
---------------------------------------------------------------------------
4. Integration of Health Records
HHS aligned certain 42 CFR part 2 requirements with existing
regulations promulgated under the Health Insurance Portability and
Accountability Act of 1996 (HIPAA) and the Health Information
Technology for Economic and Clinical Health Act (HITECH) to enhance
integration of behavioral health information with other medical records
to improve patient health outcomes. The final rule provides the public
with the ability to file complaints alleging violations of the Part 2
confidentiality provisions, requires Part 2 programs to provide
notification of breaches of Part 2 records, and implements in
regulation HHS's civil enforcement authority, including the potential
for civil money penalties for violations.\5\ SAMHSA is reissuing
funding for a Center of Excellence in Privacy of Health Information
that will support integration and use of data compliance with patient
privacy protections.
---------------------------------------------------------------------------
\5\ <a href="https://www.hhs.gov/hipaa/for-professionals/regulatory-initiatives/fact-sheet-42-cfr-part-2-final-rule/index.html">https://www.hhs.gov/hipaa/for-professionals/regulatory-initiatives/fact-sheet-42-cfr-part-2-final-rule/index.html</a>.
---------------------------------------------------------------------------
5. Implementing Medications for Opioid Use Disorder
ACF, in collaboration with SAMHSA developed a new option allowing
states to leverage federal Title IV-E prevention funding as the payer
of last resort to support access to FDA-approved medications for opioid
use disorder.\6\ This action will help address the nation's opioid
crisis, support long-term recovery, prevent foster care placements, and
support and strengthen families when children are at imminent risk of
entering foster care.
---------------------------------------------------------------------------
\6\ <a href="https://www.samhsa.gov/sites/default/files/dear-colleague-letter-moud.pdf">https://www.samhsa.gov/sites/default/files/dear-colleague-letter-moud.pdf</a>.
---------------------------------------------------------------------------
6. Ending Support for Harm Reduction
SAMSHA issued guidance to the field \7\ and terms and conditions
\8\ across its grant portfolio to end support for counterproductive
harm reduction efforts that facilitate illegal drug use and its deadly
consequences. This guidance makes clear that safe use efforts and the
provision of materials and drug paraphernalia, like syringes for
illegal drug use, are not allowed with SAMHSA funding, while supporting
life-saving interventions including medications for opioid use disorder
and opioid overdose reversal medications.
---------------------------------------------------------------------------
\7\ <a href="https://www.samhsa.gov/sites/default/files/dear-colleague-letter-executive-order-ending-crime-disorder-americas-streets-07302025.pdf">https://www.samhsa.gov/sites/default/files/dear-colleague-letter-executive-order-ending-crime-disorder-americas-streets-07302025.pdf</a>.
\8\ <a href="https://www.samhsa.gov/sites/default/files/fy25-award-standard-terms-conditions.pdf">https://www.samhsa.gov/sites/default/files/fy25-award-standard-terms-conditions.pdf</a>.
---------------------------------------------------------------------------
Resources
1. Recovery Housing
In September, SAMHSA awarded more than $45 million in new
supplemental funding to SOR recipients, with a focus on sober housing
and recovery support for young adults.\9\
---------------------------------------------------------------------------
\9\ <a href="https://www.hhs.gov/press-room/samhsa-awards-45-million-funding-support-sober-housing-services.html">https://www.hhs.gov/press-room/samhsa-awards-45-million-funding-support-sober-housing-services.html</a>.
---------------------------------------------------------------------------
2. Health Technology
As part of a $20 million Behavioral Health IT (BHIT) initiative,
the Assistant Secretary for Technology Policy/Office of the National
Coordinator for Health Information Technology and SAMHSA are awarding
$5 million to test a standardized set of behavioral health data
elements to ensure interoperability and exchange of information across
providers, states, and federal programs and help further the use of
health technology to advance chronic disease of addiction and mental
health care treatment, care coordination, and integration of behavioral
and physical health care.\10\
---------------------------------------------------------------------------
\10\ <a href="https://healthit.gov/news/astp-onc-announces-selection-of-nationwide-pilot-programs-to-improve-behavioral-health-data-exchange/">https://healthit.gov/news/astp-onc-announces-selection-of-nationwide-pilot-programs-to-improve-behavioral-health-data-exchange/</a>.
---------------------------------------------------------------------------
4. STREETS Initiative
HHS announced the $100 million Safety Through Recovery, Engagement,
and Evidence-based Treatment and Supports--or STREETS--Initiative which
will fund 8 localities to transform their homelessness services systems
to focus on accountability, independence, and move away from damaging
practices like harm reduction and housing first and to connect homeless
people to the care for addiction, serious mental illness (SMI), and
cooccurring mental and chronic disease of addiction.\11\
---------------------------------------------------------------------------
\11\ <a href="https://www.hhs.gov/press-room/secretary-kennedy-announces-100-million-investment-great-american-recovery.htm">https://www.hhs.gov/press-room/secretary-kennedy-announces-100-million-investment-great-american-recovery.htm</a>.
---------------------------------------------------------------------------
5. Rural Communities Opioid Response
The Health Resources and Services Administration's (HRSA) Rural
Communities Opioid Response Program \12\ made a significant investment
of $145 million to support more than 200 active grant recipients. These
recipients cover 2,000 rural counties in 47 states and 2 territories,
and serves approximately 2 million rural residents annually,
highlighting the widespread impact of this program. This total budget
includes 162 new awards made under competitive Notice of Funding
Opportunities in FY 2026, while the remaining approximately 50 awards
were noncompeting continuation awards. This initiative focuses on
expanding access to comprehensive prevention, treatment, and recovery
services for opioid and related chronic disease of addiction in rural
communities across the nation. These efforts are coordinated with
significant behavioral health investments being made in rural
communities under the Rural Health Transformation Program established
under Public Law 119-21, which CMS refers to as the Working Families
Tax Cut (WFTC) legislation.\13\
---------------------------------------------------------------------------
\12\ <a href="https://www.hrsa.gov/rural-health/opioid-response">https://www.hrsa.gov/rural-health/opioid-response</a>.
\13\ <a href="https://www.cms.gov/files/document/rht-program-state-provided-abstracts.pdf">https://www.cms.gov/files/document/rht-program-state-provided-abstracts.pdf</a>.
---------------------------------------------------------------------------
6. SAMHSA Is Directing Targeted CCBHC Investments to Hard-Hit
Communities
This effort includes recent funding awarded to a CCBHC in
Philadelphia that serves the Kensington neighborhood.\14\ For decades,
this neighborhood has been an epicenter of homelessness and addiction,
but the introduction of illicit fentanyl and other emerging toxic
illicit drugs such as xylazine and medetomidine have had a dramatic
negative impact in an already struggling community. In FY 2026, more
than additional CCBHC expansion grants will be awarded to communities
across the United States with a focus on those most affected by
overdose, addiction, and instability and building out recovery supports
for addition or serious mental illness. SAMHSA will focus these grants
on the 100 counties hardest hit by overdose deaths through point
preferences in the grant competition.
---------------------------------------------------------------------------
\14\ <a href="https://www.samhsa.gov/about/news-announcements/statements/2025/statement-from-samhsa-pdas-dr-art-kleinschmidt-2m-award-pilot-program-help-homeless-people-mental-illness-suds-treatmen">https://www.samhsa.gov/about/news-announcements/statements/2025/statement-from-samhsa-pdas-dr-art-kleinschmidt-2m-award-pilot-program-help-homeless-people-mental-illness-suds-treatmen</a>.
---------------------------------------------------------------------------
7. SAMHSA Will Release an Assisted Outpatient Treatment (AOT) Funding
Opportunity
This funding is to better support individuals with SMI, including
homeless individuals. This opportunity will provide $10 million in new
funding to expand civil-commitment pathways, community-based treatment,
and step-down services that prevent repeated hospitalization,
incarceration, and housing instability. This is an important
[[Page 35223]]
aspect in compliance with Executive Order 14321, Ending Crime and
Disorder on America's Streets. SAMHSA is also providing technical
assistance to Assisted Outpatient Treatment (AOT) grant recipients and
the field to support the development of and implementation of AOT
through the GAINS Center for Behavioral Health and Justice
Transformation.
8. SAMHSA Is Working To Eliminate Hepatitis C To Improve Care for
Individuals With Mental Illness & Addiction
SAMHSA awarded a total of $98 million for the Hepatitis C
Elimination Initiative Pilot (otherwise known as Hep C Free).\15\
SAMHSA anticipates the program will serve an estimated 16,000 Americans
in FY 2026. These resources will help prevent, treat, and cure
Hepatitis C in individuals with chronic disease of addiction and/or SMI
and reduce the spread of this deadly disease. This initiative dovetails
with the Make America Healthy Again goal of ending chronic diseases.
---------------------------------------------------------------------------
\15\ <a href="https://www.samhsa.gov/newsroom/press-announcements/20250924/samhsa-awards-98m-for-hepatitis-c-elimination-initiative-pilot">https://www.samhsa.gov/newsroom/press-announcements/20250924/samhsa-awards-98m-for-hepatitis-c-elimination-initiative-pilot</a>.
---------------------------------------------------------------------------
Request For Information
For this RFI, more information is desired from the public,
patients, people with lived experience of addiction and recovery,
healthcare providers, community-based organizations, faith-based
organizations, policymakers and others on improvements to the programs
and policies of the United States Government and HHS that focus on
substance use, including opioid and polysubstance use, prevention,
treatment, and recovery as well as mental health treatment prevention,
and recovery in all age groups. The questions below are of particular
interest.
We encourage commenters to include supporting facts, research, and
evidence in their comments. When doing so, commenters are encouraged to
cite all sources and data sets with links as part of the comment.
Providing such citations and documentation will assist us in analyzing
the comments.
This RFI should not be construed as a policy, solicitation for
applications, or as an obligation on the part of the government to
provide support for any ideas in response to it. HHS will use the
information submitted in response to this RFI at its discretion and
will not provide comments on any respondent's submission. However,
responses to this RFI may be reflected in future solicitation(s) or
policies. The information provided will be analyzed and may appear in
reports. Please do not submit any protected health information or
confidential material that you do not wish to be made available to the
public.
An example of comments we are looking for: In the first Trump
Administration, HHS helped coordinate take back days which took
millions of pills out of homes and helped make the opioid overdose
reversal medication naloxone more widely available. While these were
significant policy wins, HHS can better coordinate with other agencies
to achieve the President's goals by ensuring there is alignment in
goals to address addiction.
Questions
1. What are programs or interventions that have rigorous, empirical
evidence of effectiveness in improving outcomes for:
<bullet> substance use prevention, treatment, and recovery?
<bullet> mental illness prevention, treatment, and recovery?
<bullet> care for co-occurring mental and chronic disease of addiction?
If applicable, provide 2-3 programs or policies for question (1).
List each activity separately and include one of the following for
each.
i. Title
ii. Type of activity
iii. Date
iv. Link (if applicable)
v. Description (3-5 sentences)
vi. Statutory authority
2. Using existing funding, what policies or changes to federal
programs might improve outcomes in:
<bullet> substance use prevention, treatment, and recovery?
<bullet> mental illness, prevention, treatment, and recovery?
<bullet> care for co-occurring mental and chronic disease of addiction?
Provide 2-3 policy ideas for question (2). List each activity
separately and include one of the following for each.
i. Title
ii. Type of activity
iii. Description (3-5 sentences)
iv. Statutory authority
3. E.O. 14379 calls for Federal efforts to, ``increase awareness of
the disease of addiction'' and to ``foster a culture that celebrates
recovery.'' How can Federal policies and programs be improved to
mitigate the stigma against Americans seeking addiction treatment and
recovery? Provide 2-3 policy ideas for question (3). List each activity
separately and include one of the following for each.
i. Title
ii. Type of activity
iii. Description (3-5 sentences)
iv. Statutory authority
4. E.O. 14379 calls for Federal efforts to, ``help Americans
receive the treatment they need'' including ``aligning relevant Federal
programs'' and ``all necessary steps to coordinate the Federal
Government's response to the addiction crisis.'' One problem in this
area is insufficient supply of addiction and mental health counselors
(a shortfall estimated by HHS-HRSA at about 77,050 and 99,780
respectively).\16\ This means it is harder for Americans to find the
help they need in their area and covered by their insurance, especially
in rural or underserved areas. How can Federal policies and programs be
improved to address this practitioner supply issue to better ensure
that every American seeking addiction treatment can find affordable
help covered by their insurance in their area? Provide 2-3 policy ideas
for question (4). List each activity separately and include one of the
following for each.
---------------------------------------------------------------------------
\16\ <a href="https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/Behavioral-Health-Workforce-Brief-2025.pdf">https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/Behavioral-Health-Workforce-Brief-2025.pdf</a>.
i. Title
ii. Type of activity
iii. Description (3-5 sentences)
iv. Statutory authority
5. How can HHS strengthen its ability to evaluate the effectiveness
of substance use and mental health prevention, treatment, and recovery
programs and initiatives? How can the Department leverage data
modernization, advanced analytics, and emerging technologies such as
artificial intelligence to enable performance measurement on a real
time or continuing basis? Provide 2-3 policy or operational ideas for
question (5). List each activity separately and include one of the
following for each.
i. Title
ii. Type of activity
iii. Description (3-5 sentences)
iv. Statutory authority
Robert F. Kennedy, Jr.,
Secretary, United States Department of Health and Human Services.
[FR Doc. 2026-11602 Filed 6-8-26; 11:15 am]
BILLING CODE 4160-90-P
</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>Indexed from Federal Register on June 10, 2026.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.