Bipartisan Safer Communities Act (P.L. 117-159): Section-by-Section Summary

Bipartisan Safer Communities Act (P.L. 117-159): Section-by-Section Summary

-Bipartisan Safer Communities Act
November 17, 2022
(P.L. 117-159): Section-by-Section Summary
Johnathan H. Duff,
On June 25, 2022, the Bipartisan Safer Communities Act (BSCA, P.L. 117-159) was signed into
Coordinator
law. The BSCA was enacted in the aftermath of mass shootings in Uvalde, TX, and Buffalo, NY.
Analyst in Health Policy
The law includes provisions related to mental health, firearms, education, and Medicaid and

Medicare. It also includes appropriations for related programs operated by the Departments of
Justice (DOJ), Education (ED), and Health and Human Services (HHS). This report describes

each of the provisions in the BSCA, along with the appropriations provided in Division B of the
BSCA.
Division A—Mental Health and Firearms Provisions
Title I—Children and Family Mental Health Services
Title I provisions are aimed primarily at enhancing access to mental health services, particularly for youth. Section 11001
amends the Protecting Access to Medicare Act of 2014 to extend the length of the Certified Community Behavioral Health
Clinic (CCBHC) demonstration period for the 10 states currently participating in the CCBHC demonstration program and
expands the demonstration program to additional states. Section 11002 requires the HHS Secretary to provide technical
assistance and issue guidance to states on improving access to Medicaid and CHIP telehealth services. Section 11003 directs
the HHS Secretary to issue updated school-based services (SBS) guidance and to establish a Technical Assistance Center to
support the delivery of Medicaid-covered school-based services. Section 11004 requires the HHS Secretary to review state
implementation of Medicaid Early Periodic, Screening, Diagnostic, and Treatment (EPSDT) requirements; identify state
EPSDT compliance concerns; provide technical assistance to states; and issue state guidance on EPSDT Medicaid coverage.
Section 11005 adds new requirements to the Health Resources and Services Administration’s (HRSA) pediatric mental health
care access program and codifies other authorities.
Title II—Firearms
Title II provisions primarily expand firearm purchasing requirements to young adults. Section 12001 amends the Gun Control
Act of 1968 (GCA) to prohibit the transfer of firearms to persons who have potentially disqualifying records as a juvenile.
The provision expands National Instant Criminal Background Check System (NICS) background check procedures to
persons 18 to 21 years of age for disqualifying juvenile records and allows authorities up to 10 business days to make
eligibility determinations. Section 12002 requires individuals who buy and resell firearms repeatedly for profit to be licensed
federally as gun dealers. Section 12003 allows DOJ Edward Byrne Memorial Justice Assistance Grant (JAG) funds to be
used for state “crisis intervention court proceedings and related programs or initiatives.” Section 12004 amends the GCA to
more explicitly prohibit straw purchases and illegal gun trafficking and strengthens other existing gun trafficking and
criminal provisions. (Straw purchases are the unlawful purchase of a firearm by one person for another.) Section 12005
amends the GCA definition of “misdemeanor crime of domestic violence” to include dating partners, spouses, former
spouses, and cohabitants. It also further defines a “dating relationship.”
Title III—Other Matters
Title III amends existing programs to reduce the overall budgetary cost of the BSCA and includes provisions related to
federal resources for school safety. Section 13101 bars the HHS Secretary from implementing, administering, or enforcing
the final Medicare anti-kickback rebate rule prior to 2027. Section 13201 changes the amount available in the Medicare
Improvement Fund. Sections 13302-13304 require the Secretary of Homeland Security to establish a Federal Clearinghouse
on School Safety Evidence-Based Practices. Section 13402 prohibits using Elementary and Secondary Education Act funds
to provide anyone with a dangerous weapon.
Division B—Appropriations
Division B of the BSCA appropriates funding to existing grant programs and other activities by the DOJ, ED, and HHS. Most
of the programs funded in Division B of the BSCA support mental health services, crisis response, school-based mental
health, and suicide prevention—including training law enforcement, educators, and health care providers on mental health
and substance use disorders.
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Contents
Introduction ..................................................................................................................................... 1
Bipartisan Safer Communities Act Provisions ................................................................................ 3
Section 1: Joseph Woodrow Hatchett United States Courthouse and Federal
Building ........................................................................................................................... 3
Section 2: Lynn C. Woolsey Post Office Building .............................................................. 3
Section 3: Short Title; Table of Contents ............................................................................ 3
Division A—Mental Health and Firearms Provisions ..................................................................... 3
Title I—Children and Family Mental Health Services .............................................................. 3
Section 11001: Expansion of Community Mental Health Services Demonstration
Program............................................................................................................................ 3
Section 11002: Medicaid and Telehealth ............................................................................ 5
Section 11003: Supporting Access to Health Care Services in Schools ............................. 7
Section 11004: Review of State Implementation of Early and Periodic Screening,
Diagnostic, and Treatment Services ................................................................................. 9
Section 11005: Pediatric Mental Health Care Access Grants ........................................... 10
Title II—Firearms .................................................................................................................... 11
Section 12001: Juvenile Records ....................................................................................... 11
Section 12002: Defining “Engaged in the Business” ........................................................ 13
Section 12003: Use of Byrne Grants for Implementation of State Crisis
Intervention Programs.................................................................................................... 14
Section 12004: Stop Illegal Trafficking in Firearms Act .................................................. 15
Section 12005: Misdemeanor Crime of Domestic Violence ............................................. 19
Title III—Other Matters .......................................................................................................... 20
Subtitle A—Extension of Moratorium .............................................................................. 20
Section 13101: Extension of Moratorium on Implementation of Rule Relating to
Eliminating the Anti-Kickback Statute Safe Harbor Protection for Prescription
Drug Rebates ................................................................................................................. 20
Subtitle B—Medicare Improvement Fund ........................................................................ 21
Section 13201: Medicare Improvement Fund ................................................................... 21
Subtitle C—Luke and Alex School Safety Act of 2022 .................................................... 22
Section 13301: Short Title ................................................................................................ 22
Section 13302: Federal Clearinghouse on School Safety Evidence-Based
Practices ......................................................................................................................... 22
Section 13303: Notification of Clearinghouse .................................................................. 23
Section 13304: Grant Program Review ............................................................................ 24
Section 13305: Rules of Construction .............................................................................. 24
Subtitle D—Amendment on ESEA Funding .................................................................... 24
Section 13401: Amendment on ESEA Funding ................................................................ 24
Division B—Appropriations ......................................................................................................... 26
Title I ....................................................................................................................................... 26
General Provisions—This Title [Title I] ................................................................................. 29
Title II ...................................................................................................................................... 30
General Provisions—This Title [Title II] ................................................................................ 35
Sections 22001-22003 ....................................................................................................... 35
Title III .................................................................................................................................... 35
General Provisions—This Division [Division B] ................................................................... 35
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Tables
Table 1. List of BSCA Provisions and Corresponding CRS Points of Contact ............................... 1
Table 2. Department of Justice Appropriations ............................................................................. 26
Table 3. Department of Health and Human Services and Department of Education
Appropriations ............................................................................................................................ 30

Appendixes
Appendix. Abbreviations Used in This Report .............................................................................. 37

Contacts
Author Information ........................................................................................................................ 39

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Introduction
On June 25, 2022, the Bipartisan Safer Communities Act (BSCA, P.L. 117-159) was signed into
law. The law includes provisions related to mental health, firearms, education, and Medicaid and
Medicare (primarily related to mental health service delivery). It also includes appropriations for
related programs operated by the Departments of Justice (DOJ), Education (ED), and Health and
Human Services (HHS). The BSCA was enacted in the aftermath of mass shootings in Buffalo,
NY and Uvalde, TX.1 The mass shooting in Uvalde—in which a high school student with unmet
mental health needs legally purchased several firearms used in the shooting—spotlighted issues
related to safeguards on firearm purchases and access to behavioral health services.2
Broadly, the BSCA amends background check procedures for firearm purchases, promotes youth
mental health initiatives, and enhances school-based mental health efforts, among other things.
Division A of the BSCA includes provisions primarily aimed at (1) expanding firearm purchasing
requirements to young adults and (2) enhancing access to mental health services, including
school-based mental health services and other youth programming. Division B of the BSCA
appropriates funding to existing grant programs and other activities of DOJ, ED, and HHS. Most
of the programs funded in Division B of the BSCA support mental health services, crisis
response, school-based mental health, and suicide prevention, including training law enforcement,
educators, and health care providers on mental health and substance use disorders.
This report describes each of the provisions in the BSCA, providing brief, relevant background
information on each provision and describing changes made by the provision. Table 2 and Table
3 provide information on the appropriations included in Division B of the BSCA. This report
provides information on the BSCA as enacted; it does not include amendments to the law or
subsequent changes to affected programs or provisions.
Table 1 lists the CRS authors of each section of the report. Questions on BSCA provisions or the
affected federal programs in each provision should be directed to the corresponding CRS analyst.
Table 1. List of BSCA Provisions and Corresponding CRS Points of Contact
Section
Section Title
CRS Point of Contact
Number
11001
Expansion of Community Mental Health Services
Alison Mitchell
Demonstration Program
Specialist in Health Care Financing
11002
Medicaid and Telehealth
Katherine M. Kehres
Analyst in Health Care Financing
11003
Supporting Access to Health Care Services in Schools
Evelyne P. Baumrucker
Specialist in Health Care Financing

1 Niels Lesniewski, “House Clears Bipartisan Gun Violence Reduction Measure,” CQ News, June 24, 2022.
2 Bernard Condon, “Texas School Shooter Left Trail of Ominous Warning Signs,” AP News, July 19, 2022,
https://apnews.com/article/uvalde-school-shooting-warning-signs-f18a8d365aa5edf0d3754df721144cf1. While most
people with mental health conditions do not pose a significant threat of violence, some research suggests that a small
segment of individuals with serious mental illness may be slightly more prone to violence than those without a mental
health condition (though acts of violence in this population remain uncommon). See, for example, Tori DeAngelis,
“Mental Illness and Violence: Debunking Myths, Addressing Realities,” Monitor on Psychology, vol. 52, no. 3,
(April/May 2021), p. 31, and Richard Van Dorn, Jan Volavka, and Norman Johnson, “Mental Disorder and Violence:
Is There a Relationship Beyond Substance Use?,” Social Psychiatry and Psychiatric Epidemiology, vol. 47, no. 3
(2012), pp. 487-503. Of note, data suggest that people with serious mental illness are more likely to be victims of
violent crime than perpetrators. See H. Khalifeh, S. Johnson, L. M. Howard, et al., “Violent and Non-Violent Crime
Against Adults with Severe Mental Illness,” The British Journal of Psychiatry, vol. 206 (2015), pp. 275-282.
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Bipartisan Safer Communities Act (P.L. 117-159): Section-by-Section Summary

Section
Section Title
CRS Point of Contact
Number
11004
Review of State Implementation of Early And Periodic
Evelyne P. Baumrucker
Screening, Diagnostic, and Treatment Services
Specialist in Health Care Financing
11005
Pediatric Mental Health Care Access Grants
Elayne J. Heisler
Specialist in Health Services
12001
Juvenile Records
Wil iam J. Krouse
Specialist in Domestic Security and
Crime Policy
12002
Defining “Engaged in the Business”
Wil iam J. Krouse
Specialist in Domestic Security and
Crime Policy
12003
Use of Byrne Grants for Implementation of State Crisis
Nathan James
Intervention Programs
Analyst in Crime Policy
12004
Stop Il egal Trafficking in Firearms Act
Wil iam J. Krouse
Specialist in Domestic Security and
Crime Policy
12005
Misdemeanor Crime Of Domestic Violence
Wil iam J. Krouse
Specialist in Domestic Security and
Crime Policy
Emily J. Hanson
Analyst in Social Policy
13101
Extension of Moratorium on Implementation of Rule Relating
Suzanne M. Kirchhoff
to Eliminating the Anti-Kickback Statute Safe Harbor
Analyst in Health Care Financing
Protection for Prescription Drug Rebates
13201
Medicare Improvement Fund
Jim Hahn
Specialist in Health Care Financing
13302
Federal Clearinghouse on School Safety Evidence-Based
Kyrie E. Dragoo
Practices
Analyst in Education Policy
13303
Notification of Clearinghouse
Kyrie E. Dragoo
Analyst in Education Policy
13304
Grant Program Review
Kyrie E. Dragoo
Analyst in Education Policy
Rebecca R. Skinner
Specialist in Education Policy
13401
Amendment on ESEA funding
Kyrie E. Dragoo
Analyst in Education Policy
Rebecca R. Skinner
Specialist in Education Policy
21001-
General Provisions—This Title [Title I]
Nathan James
21002
Analyst in Crime Policy
22001-
General Provisions—This Title [Title II]
Jessica Tol estrup
22002
Specialist in Social Policy
Karen E. Lynch
Specialist in Social Policy
23001-
General Provisions—This Division [Division B]
Jessica Tol estrup
23005
Specialist in Social Policy
Karen E. Lynch
Specialist in Social Policy
Source: CRS.
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Bipartisan Safer Communities Act Provisions
Section 1: Joseph Woodrow Hatchett United States Courthouse and Federal
Building
Section 1 designates a U.S. courthouse and federal building in Tallahassee, FL, as the “Joseph
Woodrow Hatchett United States Courthouse and Federal Building.”
Section 2: Lynn C. Woolsey Post Office Building
Section 2 designates a postal service facility in Petaluma, CA, as the “Lynn C. Woolsey Post
Office Building.”
Section 3: Short Title; Table of Contents
Section 3 notes that the act may be cited as the “Bipartisan Safer Communities Act” and provides
a table of contents for provisions in the law.
Division A—Mental Health and Firearms Provisions
Title I—Children and Family Mental Health Services
Section 11001: Expansion of Community Mental Health Services
Demonstration Program
Background
Section 223 of the Protecting Access to Medicare Act of 2014 (PAMA, P.L. 113-93) authorized a
demonstration program to improve community-based behavioral health services through
establishing certified community behavioral health clinics (CCBHCs).3 CCBHCs are facilities
operated by nonprofit, governmental, or tribal entities that offer a comprehensive range of
behavioral health services, including risk assessment, outpatient mental health and substance use
treatment, case management, psychiatric rehabilitation services, peer and family supports, 24-
hour crisis management, and primary care medical services, among others. To be certified,
CCBHCs must provide these specified services and maintain partnerships with other health and
social service providers.
In 2015, 24 states received planning grants for the CCBHC demonstration program. In 2016,
eight states were selected to participate in the initial demonstration program.4 For the states

3 Of note, FY2020 appropriations (P.L. 116-94) authorized a CCBHC expansion grant program and provided $200
million to fund this part of the program. Grants awarded under the expansion grant program provided up to $2 million
to facilities that met the certification criteria to increase access and improve the quality of their behavioral health
services. Grantees in the CCBHC expansion grant program relied on annual discretionary grants for funding. Only
CCBHCs in the demonstration program receive the enhanced Medicaid FMAP rate. The American Rescue Plan Act of
2021 also appropriated $420 million for the CCBHC expansion grants.
4 Seven of the initial eight states continue to participate in the Certified Community Behavioral Health Clinics
Demonstration Program. Pennsylvania officially withdrew from the demonstration effective June 30, 2019. (See HHS
Office of the Assistant Secretary for Planning and Evaluation, Certified Community Behavioral Health Clinics
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chosen to participate in the CCBHC demonstration program in 2016, the end of the demonstration
period had been extended by various laws, and before the BSCA, the demonstration program was
authorized through September 30, 2023. Two states were added to the demonstration program in
2020 for a period of two years beginning when the states implemented the program.
For CCBHC services provided to Medicaid enrollees, states in the demonstration receive the
enhanced federal medical assistance percentage (E-FMAP; i.e., the federal reimbursement rate
used for the State Children’s Health Insurance Program) during the applicable demonstration
period.5 In addition, the CCBHCs in these states receive enhanced Medicaid payment rates
through a prospective payment system methodology for the services provided to Medicaid
enrollees.
The HHS Secretary is required to submit annual reports to Congress about the CCBHC
demonstration program. In addition, the HHS Secretary is required to submit recommendations to
Congress about whether the CCBHC demonstration program should be continued, expanded,
modified, or terminated. Prior to enactment of the BSCA, the recommendations to Congress were
due by December 31, 2021.
Provision
Section 11001 amends PAMA Section 2236 to extend the length of the demonstration period for
the states currently participating in the CCBHC demonstration program. The provision also
expands the CCBHC demonstration program to additional states.
For the states chosen to participate in the CCBHC demonstration program in 2016, the end of the
demonstration period was extended by two years, from September 30, 2023, to September 30,
2025. For the two states added to the CCBHC demonstration program in 2020, the length of the
demonstration period was extended by four years, from a period of two years to six years from
the date the state implemented the program.
The provision provides additional planning grants for states not already selected for the
demonstration program. These planning grants are to be used to develop proposals to participate
in the CCBHC demonstration program for a period of four years. Beginning July 1, 2024, and
every two years after, up to 10 additional states may be selected to participate in the CCBHC
demonstration program.
The provision allows states no longer participating in the CCBHC demonstration program to
receive federal Medicaid funding for the prospective payment system (PPS) payment rate
provided to CCBHCs.7
The provision clarifies that the annual reports about the CCBHC demonstration program
submitted by the HHS Secretary should continue annually through the year in which the last
demonstration ends. Additionally, the due date for the HHS Secretary’s recommendations
regarding whether the demonstration programs under this section should be continued, expanded,
modified, or terminated is extended from December 31, 2021, to December 31, 2025. The
provision adds that these recommendations should include data collected after 2019, where
feasible. The provision adds a requirement for the HHS Secretary to submit a final evaluation of

Demonstration Program: Report to Congress, 2020, December 23, 2021.)
5 For the Medicaid expansion population, the expansion population federal medical assistance percentage (FMAP) rate,
which is 90%, applies.
6 42 U.S.C. 1396a note.
7 See footnote 4.
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the CCBHC demonstration programs not later than 24 months after the demonstration program
ends.
The provision appropriates $40 million for FY2023 (to remain available until expended) for (1)
awarding the new planning grants, (2) providing technical assistance to states applying for the
planning grants, and (3) carrying out demonstration programs.
Section 11002: Medicaid and Telehealth
Background
Medicaid, authorized in Social Security Act (SSA) Title XIX, is a federal-state program that
jointly finances primary and acute medical and behavioral health services, as well as long-term
services and supports (LTSS) to low-income populations, including eligible children, pregnant
women, adults, individuals with disabilities, and people aged 65 and older.8 Participation in
Medicaid is voluntary for states; all states, the District of Columbia, and U.S. territories choose to
participate.
Medicaid is jointly financed by states and the federal government. States must follow broad
federal rules governing eligibility, benefits, and other program design criteria to receive federal
matching funds, but they have flexibility to design their own versions of Medicaid within the
federal statute’s basic framework. This flexibility results in variability across state Medicaid
programs.
The State Children’s Health Insurance Program (CHIP) is a means-tested program that provides
health coverage to targeted low-income children and pregnant women in families that have annual
incomes above Medicaid eligibility levels but have no health insurance. CHIP is jointly financed
by the federal government and the states, and the states are responsible for administering CHIP.
Federal Medicaid and CHIP statutes do not recognize telehealth as a distinct service category.
However, the Centers for Medicare & Medicaid Services (CMS) defines Medicaid and CHIP
telehealth as “the use of telecommunications and information technology to provide access to
health assessment, diagnosis, intervention, consultation, supervision and information across
distance.” CMS provides states with broad flexibility to define which (if any) telehealth services
to provide through Medicaid and CHIP (e.g., primary care, behavioral health, LTSS), allowable
modalities (e.g., live video, audio only), where services can be provided, which provider types are
authorized to provide the service (subject to federal and state law), and the populations served,
among other criteria. States that limit telehealth geographically, or to specific providers, must
ensure that Medicaid enrollees in areas without telehealth coverage have face-to-face provider
access.9 In general, states must reimburse Medicaid providers for a telehealth service at the same

8 For more information, see CRS Report R43357, Medicaid: An Overview.
9 While Social Security Act (SSA) Section 1902(a)(30)(A) requires states to “assure that payments are consistent with
efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are
available under the plan at least to the extent that such care and services are available to the general population in the
geographic area,” certain provider types (e.g., behavioral health, dental) historically have low participation rates in
Medicaid and CHIP. CMS has encouraged states to consider telehealth flexibilities as a way to increase access to care,
among other strategies. For more information, see CMS, State Medicaid & CHIP Telehealth Toolkit Policy
Considerations for States Expanding Use of Telehealth, COVID-19 Version, available at https://www.medicaid.gov/
medicaid/benefits/downloads/medicaid-chip-telehealth-toolkit.pdf.
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rate as an in-person service, unless they have CMS approval to pay a different rate or with a
unique reimbursement methodology.10
During the COVID-19 public health emergency (PHE), CMS released a series of subregulatory
guidance (e.g., frequently asked questions, fact sheets, tool kits) to facilitate increased state
reliance on telehealth as a service delivery tool in Medicaid and CHIP. These materials identify
existing state flexibilities to augment telehealth and provide guidance to help states identify and
address state-level barriers to the adoption of new telehealth delivery options. For changes
requiring CMS approval, CMS provided templates and checklists to expedite state requests for
time-limited flexibilities through legal authorities such as disaster relief state plan amendments
(SPAs) and emergency-related Sections 1115, 1915(c) Appendix K, and 1135 waivers.11
The CMS COVID-19 templates and checklists for the disaster relief SPA and waivers identify an
effective date retroactive to March 1, 2020 (or as otherwise approved by CMS); the flexibilities
generally sunset in conjunction with the end of the PHE (as declared by the HHS Secretary), but
states have the option to end them earlier. After the COVID-19 PHE, as specified, states may seek
CMS approval to continue any otherwise temporary telehealth policies adopted during the
pandemic via new SPAs and Section(s) 1115 or 1915(c) waivers.
Provision
Section 11002 requires the HHS Secretary to provide technical assistance and issue guidance to
states on improving access to Medicaid and CHIP telehealth services no later than December 25,
2023. The CMS guidance must address a number of areas, including
 the use of existing Medicaid and CHIP program flexibilities to expand access to
covered services via telehealth;
 service billing best practices to allow for the creation of consistent data sets;
 strategies to integrate telehealth services into value-based care models;12
 best practices from states that expanded access to telehealth during the COVID-
19 PHE, as specified;
 strategies to promote the delivery of accessible and culturally competent health
care via telehealth, specifically addressing the needs of (1) individuals with
disabilities, (2) medically underserved urban and rural communities, (3) racial
and ethnic minorities such as American Indians and Alaska Natives, (4)
individuals with limited English proficiency, and (5) individuals of different age
groups;
 strategies to train and provide resources in multiple languages to providers and
patients on how to use telehealth, including interpreter services;
 integration of existing video platforms that enable multiperson video calls;

10 CMS approval may be obtained through a state plan amendment (SPA) or other Medicaid authority such as a Section
1115 waiver. For more information, see CRS In Focus IF11664, Medicaid Telehealth Policies in Response to COVID-
19.
11 For more information, see CRS In Focus IF11664, Medicaid Telehealth Policies in Response to COVID-19.
12 Value-based care models or arrangements are health care payment and delivery models designed to reward health
care professionals for the quality of health care provided, rather than the quantity of services rendered. Additional
information is available at https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/functional-
areas/value-based-payment-financial-simulations/index.html.
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 best practices for the delivery of Medicaid- and/or CHIP-covered services via
telehealth in schools, including mental health and substance use disorder
services;
 evaluation strategies to measure the effects of Medicaid and CHIP telehealth
service delivery on health care quality, outcomes, and costs; and
 enrollee information-sharing best practices related to the availability of telehealth
services, including the types of services offered via telehealth, allowable
modalities, and where services can be provided, among other criteria.
Section 11003: Supporting Access to Health Care Services in Schools
Background
As mentioned above, Medicaid is a federal-state program that provides primary and acute medical
and behavioral health services, as well as long-term services and supports, to low-income
populations, including children, pregnant women, adults, individuals with disabilities, and people
aged 65 and older.13 Participation in Medicaid is voluntary for states; all states, the District of
Columbia, and U.S. territories choose to participate. Medicaid is jointly financed by states and the
federal government. States must follow federal rules to receive federal matching funds, but states
have the flexibility to design their own versions of Medicaid within the federal statute’s
framework. This flexibility results in variability across state Medicaid programs.
Federal law does not define “school-based services” (SBS) as a category of Medicaid services,
nor does it define schools as a category of Medicaid providers. Rather, SBSs are Medicaid-
coverable services provided to Medicaid-enrolled children and adolescents in school settings by
qualified Medicaid providers who are enrolled in the Medicaid program. Like services furnished
elsewhere, Medicaid-covered services provided in schools must meet applicable statutory and
regulatory requirements.
Three main types of Medicaid-covered services and activities occur in schools: (1) health and
related services listed in a student’s individualized education plan (IEP), individualized family
service plan (IFSP), or individual service plans per Section 504 of the Rehabilitation Act of 1973
as required under the Individuals with Disabilities Education Act (IDEA);14 (2) preventive,
primary, and acute care services; and (3) Medicaid administrative activities. Specifically,
Medicaid is the primary payer to ED for certain specialized health care and related services (e.g.,
transportation; interpretation; speech, physical, and occupational therapies; psychological and
other counseling services) that states are required to provide to Medicaid-enrolled students with
disabilities under the IDEA.
School health programs may provide a broad range of primary care and preventive services to the
student population at large in a school. When relevant supervision, licensure, and other
requirements are met, schools may bill Medicaid for these services. Schools may also partner
with a “sponsoring agency,” such as a community health center or hospital system, to form a
school-based health center (SBHC) to furnish primary, acute, and preventive care services to the

13 For more information, see CRS Report R43357, Medicaid: An Overview.
14 For more information on IEPs, see CRS Report R41833, The Individuals with Disabilities Education Act (IDEA),
Part B: Key Statutory and Regulatory Provisions. For more information on IFSPs, see CRS Report R43631, The
Individuals with Disabilities Education Act (IDEA), Part C: Early Intervention for Infants and Toddlers with
Disabilities.
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student body at large and bill Medicaid for the services provided to Medicaid-enrolled students.15
States may also enter agreements with public authorities that maintain administrative control of
public elementary or secondary schools in a political subdivision of the state (e.g., city, county, or
school district)16 to participate in Medicaid administrative activities such as outreach, referral, and
translation services, and to reimburse them for those activities. Unlike with Medicaid direct
services, school districts are not required to have a Medicaid provider agreement to receive
payment for Medicaid administration.17
Provision
Section 11003 directs the HHS Secretary, in consultation with the Secretary of Education, to issue
updated SBS guidance and to establish a Technical Assistance Center for states, local educational
agencies (LEAs), and school-based entities to support the delivery of Medicaid-covered SBS to
Medicaid and CHIP enrollees not later than June 25, 2023.
The updated SBS guidance must
 include updates to the May 2003 Medicaid School-Based Administrative
Claiming Guide, the 1997 Medicaid and Schools Technical Assistance Guide,
and other existing SBS guidance in effect at the time of enactment and provide
clarification on allowable Medicaid reimbursement of SBSs;
 provide strategies to reduce administrative burdens on LEAs and support
compliance with federal billing, payment, and recordkeeping requirements;
 report on approved payment methods and best practices to increase the
availability of Medicaid SBSs (including best practices for using telehealth,
providing trauma-informed culturally competent care, and coordinating with
managed care entities, among other areas); and
 provide examples of SBS Medicaid providers and best practices for the
enrollment of these providers under Medicaid.
The Technical Assistance Center is intended to support state Medicaid agencies, LEAs, and
school-based entities seeking to expand their capacity for providing Medicaid SBS; to identify
ways to reduce administrative burdens; and to support state educational agencies (SEAs), LEAs,
and school-based entities in obtaining federal reimbursement for Medicaid SBSs. The Technical
Assistance Center must also ensure coordination between HHS and ED for the provision of and
payment for Medicaid SBSs, and provide guidance regarding the use of various funding sources.
The HHS Secretary must ensure that resources are designed to support small and rural schools
seeking to expand federal reimbursement for Medicaid SBSs. Finally, the Technical Assistance
Center is required to report biennially to the HHS Secretary on the work of the center, including
identifying areas where the most assistance was requested.
The provision appropriates $8 million—not otherwise appropriated for FY2022—to carry out this
provision. Such funds will remain available until expended. In addition, the provision authorizes
to be appropriated $50 million for the HHS Secretary to award grants to states for FY2022. The

15 In SBHC arrangements, the sponsoring agency typically serves as the enrolled Medicaid provider.
16 Examples include State Education Agencies (SEAs); Education Services Agencies (ESAs); Local Education
Agencies (LEAs), including charter schools that are LEAs; and public boards of education or other public authorities
within a state that maintain administrative control of public elementary or secondary schools in a city, county,
township, school district, or other political subdivision of the state.
17 The scope of allowable school-based administrative activities is described in 2003 CMS policy guidance, the
Medicaid School-Based Administrative Claiming Guide.
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grants are to be used to implement, enhance, or expand the provision of assistance through
school-based entities under Medicaid or CHIP. Such grant funds may not be used to provide
medical assistance, child health assistance, or other health services. Of note, Division B of the
BSCA appropriates a total of $50 million for carrying out the activities specified in Section 11003
(see Table 3).
Section 11004: Review of State Implementation of Early and Periodic
Screening, Diagnostic, and Treatment Services
Background
The Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) program is a required
benefit for nearly all children (under age 21) who are enrolled in Medicaid. It covers health
screenings and services, including assessments of children’s physical and mental health
development; laboratory tests (including lead blood level assessment); appropriate
immunizations; health education; and vision, dental, and hearing services.18 The screenings and
services must be provided at regular intervals that meet “reasonable” medical or dental practice
standards.19 States are required to provide all federally allowable, medically necessary treatment
to correct problems identified through screenings, even if the specific treatment needed is not
otherwise covered under a given state’s Medicaid plan.20
Any prior authorization process or service limitations that states choose to impose on EPSDT
treatment services must be based on the medical necessity determination for each child, not on
numerical caps (e.g., limitations on the number of allowable visits per year).21 EPSDT also
includes a Medicaid administration component. Each state must (1) inform all Medicaid-eligible
children under age 21 of the availability of EPSDT (referred to as EPSDT “outreach”); (2)
arrange (directly or through referrals) for corrective treatment for conditions disclosed through
EPSDT screenings; and (3) report to CMS on demographic information and counts of enrollees
who received EPSDT screenings, who were referred to and/or received corrective treatment, and
who received dental services.22
Provision
Section 11004 requires the HHS Secretary, no later than June 25, 2024, and every five years
thereafter, to
 review state implementation of Medicaid EPSDT requirements (including with
respect to the provision of these requirements by Medicaid managed care
organizations, prepaid inpatient health plans, prepaid ambulatory health plans,
and primary care case managers; hereafter referred to as Medicaid MCOs);
 identify state EPSDT compliance concerns;

18 SSA Sections 1905(r), 1902(a)(43), and 1905(a)(4)(B). EPSDT is not a mandatory benefit for the medically needy,
although states that choose to extend EPSDT to their medically needy population must make the benefit available to all
Medicaid-eligible individuals under age 21.
19 SSA Section 1905(r).
20 See footnote 13 and footnote 15.
21 CMS, EPSDT – A Guide for States, June 2014, p. 10.
22 SSA Section 1902(a)(43).
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 provide technical assistance to states to address any such EPSDT compliance
concerns; and
 issue state guidance on EPSDT Medicaid coverage that identifies best practices
for ensuring that children have access to comprehensive health care services,
including for children without a mental health or substance use disorder
diagnosis.
The HHS Secretary is required to submit a report to the Senate Committee on Finance and the
House Committee on Energy and Commerce no later than six months after each date on which
the Secretary completes the activities described above. The report must detail the most recent
EPSDT implementation review activities, including findings, actions taken by the HHS Secretary
or by states as a result of such review, and any additional actions the HHS Secretary plans to
carry out or that states must carry out as a result of such review.
The provision also requires the Comptroller General (head of the U.S. Government
Accountability Office [GAO]) to conduct a study evaluating state oversight of Medicaid MCOs
regarding EPSDT implementation. As a part of this study, the Comptroller General must provide
recommendations to improve state EPSDT implementation compliance, state oversight of
Medicaid MCOs, and CMS oversight of state Medicaid programs. The Comptroller General is
required to submit a report to Congress no later than June 25, 2025, that includes the
recommendations listed above, as well as recommendations for legislation and administrative
action, as appropriate.
The provision appropriates $5 million for each of FY2023 and FY2024, and $1 million for each
fiscal year thereafter to the HHS Secretary to carry out this EPSDT implementation review. Such
funds shall be appropriated out of any funds in the Treasury not otherwise appropriated and
remain available until expended.
Section 11005: Pediatric Mental Health Care Access Grants
Background
In 2016, the 21st Century Cures Act (P.L. 114-255) added a new Public Health Service Act
(PHSA) Section 330M, which created the Pediatric Mental Health Care Access (PMHCA)
program within HHS’s Health Resources and Services Administration (HRSA) Maternal and
Child Health Bureau. The program provides grants or cooperative agreements to states to promote
behavioral health integration into pediatric primary care using telehealth.23 The program funds 21
statewide or regional programs that provide teleconsultation, training, and technical assistance to
pediatric primary care providers to diagnose, treat, and refer children with behavioral health
conditions. The initial program authorization of appropriations was $9 million for the period
FY2018-FY2020. The program received appropriations of $10 million for each of FY2018
through FY2021. In 2021, the American Rescue Plan Act of 2021 (ARPA, P.L. 117-2)
appropriated an additional $80 million to the HHS Secretary, to remain available until expended,
to carry out the PMHCA grant program. As a result, HRSA launched the ARPA Pediatric Mental
Health Care Access—New Area Expansion grant as an expansion of the PMHCA program.24

23 U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA),
PMHCA, https://mchb.hrsa.gov/training/projects.asp?program=34.
24 HHS, “HHS Announces $14.2 Million from American Rescue Plan to Expand Pediatric Mental Health Care Access,”
press release, May 20, 2021, https://www.hhs.gov/about/news/2021/05/20/hhs-announces-142-million-american-
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Provision
Section 11005 amends PHSA Section 330M by adding new requirements to the program,
codifying certain authorities, and making several technical edits. Specifically, the BSCA
provision requires pediatric mental health care telehealth access programs to provide consultative
support, training, and technical assistance to emergency departments, state and local educational
agencies, and K-12 schools. The provision also requires PMHCA programs receiving an award to
provide information about available community mental health services to primary care providers
and adds “developmental-behavioral pediatricians” as referable providers. The provision allows
the HHS Secretary to provide technical assistance to award recipients. It also codifies cooperative
agreements as allowable awards and makes several technical edits to the authorization.
The BSCA provision amends the authorization of appropriations for the PMHCA program to $31
million for each of FY2023-FY2027.
Of note, Division B of the BSCA appropriates a total of $80 million for the Pediatric Mental
Health Care Access grant program (see Table 3).
Title II—Firearms
Section 12001: Juvenile Records
Background
The Gun Control Act of 1968 (GCA, P.L. 90-618)25 requires all firearms importers,
manufacturers, and dealers to be federally licensed. The GCA prohibits these federal firearms
licensees (FFLs) from transferring
 a long gun (i.e., shoulder-fired rifle or shotgun) or ammunition to anyone under
18 years of age, or
 a handgun or ammunition suitable for a handgun to anyone under 21 years of
age.26
The GCA also prohibits anyone from transferring a handgun to a juvenile (anyone under 18 years
of age) and prohibits a juvenile from possessing a handgun. The GCA, however, provides
exceptions to these prohibitions that allow for the temporary handgun transfer to, and possession
by, juveniles (1) in the course of employment in ranching or farming, or for target practice or
hunting, all with the written consent of the parents or guardians and in accordance with federal
and state laws; (2) for self- or household-defense; or (3) in other specified situations.27
Additionally, the GCA sets forth nine categories of persons prohibited from shipping,
transporting, receiving, or possessing firearms or ammunition: (1) convicted felons, (2) fugitives
from justice, (3) unlawful drug users, (4) mentally incompetent individuals deemed to be a danger
to themselves or others, (5) unlawfully present aliens, (6) persons discharged from the U.S.

rescue-plan-expand-pediatric-mental-health-care-access.html; and HRSA, American Rescue Plan Act – Pediatric
Mental Health Care Access – New Area Expansion, HRSA-2-121, https://www.hrsa.gov/grants/find-funding/hrsa-22-
121.
25 18 U.S.C. §§921-934.
26 18 U.S.C. §922(b)(1).
27 18 U.S.C. §922(x).
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military under dishonorable conditions, (7) persons who have renounced their U.S. citizenship,
(8) persons subject to domestic violence protection orders, and (9) domestic violence
misdemeanants.28 Under a parallel provision, it is also unlawful for anyone under any
circumstances to sell or otherwise dispose of a firearm or ammunition to any prohibited persons,
if the transferor (seller) has reasonable cause to believe that the transferee (buyer) is a person
prohibited from receiving those items.29 Violations are punishable by up to 10 years’
imprisonment.30 Under another provision, persons under felony indictment are prohibited from
receiving, but not possessing, firearms or ammunition.31 Violations are punishable by up to five
years’ imprisonment.32
Pursuant to the Brady Handgun Violence Prevention Act, 1993 (Brady Act, P.L. 103-159), the
Federal Bureau of Investigation (FBI) activated the National Instant Criminal Background
Checks System (NICS) in November 1998.33 The FBI-operated NICS queries federal, state, tribal,
territorial, and local criminal history and other public records for information that could indicate
that an unlicensed, prospective customer (transferee) is prohibited from acquiring a firearm under
the GCA. In response to an FFL-initiated background check, the NICS is to respond to an FFL
with a NICS Transaction Number (NTN) and one of four outcomes:
 proceed with transfer or permit/license issuance, indicating a prohibiting record
was not found;
 denied, indicating a prohibiting record was found;
 delayed, indicating that the system produced information suggesting there could
be a prohibiting record, such as criminal charges without a final disposition; or
 canceled for insufficient information provided.34
In the case of a proceed response, the transferee is cleared to receive the firearm, and the
background check record is purged from NICS within 24 hours. Denied requests are kept in
perpetuity. In the case of a delayed transaction, after the passage of three business days, FFLs
may proceed with the transaction at their discretion if they have not received a final eligibility
determination from the NICS.35 Canceled background checks result in a terminated transaction.
Provision
Section 12001 of the BSCA amends the GCA to
 prohibit the transfer of firearms or ammunition to persons who have previously
incurred potentially disqualifying records as a juvenile;36

28 18 U.S.C. §§922(g)(1) through (9).
29 18 U.S.C. §§922(d)(1) through (9).
30 18 U.S.C. §924(a)(2).
31 18 U.S.C. §922(n).
32 18 U.S.C. §924(a)(1)(D).
33 P.L. 103-159, November 30, 1993, 107 Stat. 1536, 1541, Section 103.
34 18 U.S.C. §922(t).
35 In the 117th Congress, the House passed the Enhanced Background Checks Act of 2021 (H.R. 1446), a bill that
would lengthen the amount of time firearms transaction could be delayed under the GCA NICS provisions. For further
information, see CRS In Focus IF11781, Firearm Background Checks Under H.R. 8 and H.R. 1446.
36 18 U.S.C. §922(d), as amended by Section 12001 of the BSCA.
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 expand NICS background check procedures to screen persons 18 to 21 years of
age for disqualifying juvenile justice or mental health records;37 and
 allow authorities to take up to 10 business days, if necessary, to make such
determinations.38
Section 12001 will necessitate upgrades to NICS to implement these measures. Records of
potentially disqualifying juvenile justice court adjudications and mental health determinations fall
principally within the domain of state and tribal law and are held by state and tribal authorities.
Section 12001 amends the Brady Act and requires the Attorney General to upgrade NICS with the
capacity to contact immediately three possible sources of disqualifying juvenile records under 18
U.S.C. §922(d) for persons under 21 years of age in the jurisdiction where they reside. Those
sources include pertinent
 state, tribal, or territorial repositories of criminal history record and/or juvenile
justice information;
 state, tribal, or territorial custodians of mental health adjudication records; and
 local law enforcement agencies.
The requirement that NICS contact these authorities expires in 10 years, on September 30, 2032.
Prior to enactment of the BSCA, such records were not routinely queried as part of a federal
firearms background check.39
Section 12002: Defining “Engaged in the Business”
Background
As noted above, the GCA (P.L. 90-618)40 requires all persons “engaged in the business” of
importing, manufacturing, and selling firearms to be licensed as federal firearms licensees, or
FFLs.41 To deter unlawful interstate firearms commerce, or gun trafficking, the GCA generally
prohibits anyone who is not an FFL from delivering a firearm to someone in another state, or
acquiring a firearm from an out-of-state source.42 Violations are punishable by up to five years’
imprisonment.43 Interstate transfers among unlicensed persons may be facilitated through an FFL
in the state where the transferee resides. The GCA further requires FFLs to maintain records on
all commercial firearms transactions. As described above, the GCA also requires FFLs to initiate
a background check through NICS on any prospective unlicensed customer who seeks to acquire
a firearm from them through a sale, trade, or redemption of firearms exchanged for collateral.44
Intrastate, private transfers between unlicensed persons “not engaged in the business” of dealing
in firearms “to predominantly earn a profit” are not covered by the recordkeeping or the
background check provisions of the GCA. However, such transfers and other matters such as
possession, registration, and the issuance of licenses to firearms owners may be covered by state

37 18 U.S.C. §922(t), as amended by Section 12001 of the BSCA.
38 Ibid.
39 For further information, see CRS In Focus IF12154, Gun Control: Juvenile Record Checks for 18- to 21-Year-Olds.
40 18 U.S.C. §§921-934.
41 18 U.S.C. §923.
42 18 U.S.C. §§922(a)(3) and (5), respectively.
43 18 U.S.C. §924(a)(1)(D).
44 18 U.S.C. §922(t).
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laws or local ordinances. Intrastate private firearm transfers have been referred to as the gun show
loophole, leading some gun control advocates to call for comprehensive or universal background
checks.45 It has been estimated that about one-in-five firearm transfers are private transfers.46
Provision
Section 12002 amends definitions in the GCA that underlie the requirement that persons buying
and selling firearms as a business at the wholesale or retail level must be federally licensed as
FFLs. Specifically, it amends the definition of “engaged in the business,” striking the phrase
“with the principal objective of livelihood and profit” and replacing it with “to predominantly
earn a profit.”47 Section 12002 defines this latter term as well, excepting firearms transfers made
to improve or liquidate a personal firearms collection from this licensure requirement.48
These measures require persons who buy and resell firearms repetitively for profit to be licensed
federally as gun dealers. In so doing, this measure could make some, but not all, intrastate, private
firearm transfers subject to GCA recordkeeping and background check requirements, if those
transfers are made by profit-oriented, repetitive firearms buyers and sellers. Arguably, such
transfers were not covered under previous law if the firearms transfers in question were not also
made as a “principal objective” of one’s “livelihood.”49
Section 12003: Use of Byrne Grants for Implementation of State Crisis
Intervention Programs
Background
The Edward Byrne Memorial Justice Assistance Grant (JAG) program was first authorized by the
Violence Against Women and Department of Justice Reauthorization Act of 2005 (P.L. 109-162).
Through JAG, DOJ provides funding to state, local, and tribal governments for state and local
initiatives, technical assistance, training, personnel, equipment, supplies, contractual support, and
criminal justice information systems in one or more of eight program purpose areas: (1) law
enforcement programs; (2) prosecution and court programs; (3) prevention and education
programs; (4) corrections and community corrections programs; (5) drug treatment and
enforcement programs; (6) planning, evaluation, and technology improvement programs; (7)
crime victim and witness programs (other than victim compensation); and (8) mental health
programs and related law enforcement and corrections programs, including behavioral programs
and crisis intervention teams.
JAG funds are allocated to each state, the District of Columbia, and the U.S. territories using a
statutorily defined formula.50 In short, each state’s allocation is based on its population and the

45 In the 117th Congress, the House passed the Bipartisan Background Checks Act of 2021 (H.R. 8), a bill that would
make nearly all intrastate, private-party firearms transactions subject to the GCA recordkeeping and background check
requirements. This bill has not been acted on in the Senate. See CRS In Focus IF11781, Firearm Background Checks
Under H.R. 8 and H.R. 1446.
46 Matthew Miller, Lisa Hepburn, and Deborah Azrael, “Firearm Acquisition Without Background Checks,” Annals of
Internal Medicine, 2017, p. 233.
47 18 U.S.C. §921(a)(21)(C).
48 18 U.S.C. §921(a)(22).
49 For further information, see CRS In Focus IF12197, Firearms Dealers “Engaged in the Business.”
50 See 34 U.S.C. §10516.
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number of reported violent crimes (i.e., murders, rapes, robberies, and aggravated assaults) in the
state.51 Specifically, half of a state’s allocation is based on its respective share of the U.S.
population, and the other half is based on its respective share of the average number of violent
crimes reported to the FBI for the three most recent years for which data are available. After each
state’s allocation is determined, 40% of it is directly awarded to units of local government in the
state (this does not occur in the District of Columbia or the territories). Awards to units of local
government are based on the jurisdiction’s proportion of the three-year average number of violent
crimes committed in its respective state. Only local governments whose allocation is $10,000 or
more are eligible to receive a direct award from DOJ. The balance of funds not awarded directly
to units of local government is administered by the state and must be distributed to the state
police department or to units of local government that were not eligible to receive a direct award
from DOJ. The other 60% of the allocation is retained by the state, and the state can use the
funding for its own purposes.
Provision
Section 12003 amends the authorization for JAG, adding a new ninth program purpose area that
allows funds to be used for state “crisis intervention court proceedings and related programs or
initiatives,” which can include drug, mental health, and veteran treatment courts, as well as
extreme risk protection order programs. For the latter, the act established standards that include
 due process rights, including, at a minimum, the right to an in-person hearing, the
right to an unbiased adjudicator, the right to know opposing evidence, the right to
present evidence, and the right to confront adverse witnesses;
 the right to be represented by counsel;
 evidentiary standards that, at a minimum, are equal to those of a similarly
situated litigant in federal or state court, including procedures to prevent
admission of evidence that is unsworn, irrelevant, based on hearsay, unreliable,
vague, speculative, and lacking a foundation; and
 penalties for abuse of the programs.
Of note, Division B of the BSCA also appropriates a total of $750 million for states to help them
implement “crisis intervention court proceedings and related programs or initiatives” (see Table
2).
Section 12004: Stop Illegal Trafficking in Firearms Act
Background
Under the GCA, Congress authorized a decentralized system of recordkeeping that allows the
Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) to trace a firearms chain of
commerce from manufacturer or importer to dealer, and to the first retail purchaser of record.52 As
part of a firearms transaction, both the federal firearm licensee (FFL) and prospective purchaser
must truthfully fill out and sign an ATF Firearms Transaction Record (Form 4473). The FFL must
verify the purchaser’s name, date of birth, and other information by examining government-

51 For more information on the specifics of how JAG funds are allocated between state and local governments, see CRS
In Focus IF10691, The Edward Byrne Memorial Justice Assistance Grant (JAG) Program.
52 18 U.S.C. §926.
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issued identification (e.g., driver’s license). The purchaser attests on Form 4473 that he or she is
not a prohibited person and is the actual transferee/buyer. The completed and signed ATF Form
4473 serves as the authorization for the FFL to initiate a firearms eligibility check through NICS.
In the case of a system proceed response, the FFL may complete the transfer.53 In the case of a
system delayed response, the FFL may proceed with the transfer at their discretion after three
business days have elapsed if they have not received a final NICS eligibility determination.
NICS denials may indicate that a transferee is engaged in what is referred to colloquially as lying
and trying. Such attempts to acquire a firearm are sometimes subject to prosecution under one of
the two provisions described below, under which persons are also prosecuted for straw purchases.
Straw purchases are the unlawful purchase of a firearm by one person for another, and are
referred to colloquially as lying and buying for the other guy.54 Under the GCA, it remains
unlawful for
 a purchaser to make any false statement to an FFL with respect to any fact
material to the lawfulness of a prospective firearms transfer under 18 U.S.C.
§922(a)(6), punishable by up to 10 years’ imprisonment, and
 any person knowingly to make any false statement with respect to the records
that FFLs are required to maintain under 18 U.S.C. §924(a)(1)(A), punishable by
up to five years’ imprisonment.
Notably, straw purchases are not easily detected, because their illegality becomes apparent only
when the straw purchaser’s true intent is revealed by a subsequent transfer to the actual buyer
(third party). The actual recipient of the firearm may be a prohibited person, who would not pass
a background check.
Provision
Subsection 12004(a) of the BSCA amends the GCA to more explicitly prohibit straw purchases
and illegal gun trafficking. Section 12004 expands federal law enforcement investigative
authorities. More specifically, Section 12004 amends the GCA by adding a new provision (18
U.S.C. §932) prohibiting any person from knowingly purchasing, or conspiring to purchase, any
firearm for, on behalf of, or at the request or demand of any other persons, if the purchaser knows
or has reasonable cause to believe that the actual buyer
 is a person prohibited from being transferred a firearm under 18 U.S.C. §922(d);
 plans to use, carry, possess, or sell (dispose of) the firearm(s) in furtherance of a
felony, federal crime of terrorism, or drug trafficking crime; or
 plans to sell or otherwise dispose of the firearm(s) to a person who would meet
any of the conditions described above.

53 See the background information provided in “Section 12001: Juvenile Records.”
54 On ATF Form 4473, a firearm transferee attests that he or she is the “actual buyer.” On this form, ATF provides the
following guidance:
For the purposes of this form, a person is the actual transferee/buyer if he/she is purchasing the
firearm for him/herself of otherwise acquiring the firearm for him/herself.... A person is also the
actual transferee/buyer if he/she is legitimately purchasing the firearm as a bona fide gift for a third
party. A gift is not bona fide if another person offered or gave the person completing this form
money, service(s), or item(s) of value to acquire the firearm for him/her, or if the other person is
prohibited by law from receiving or possessing the firearm.
This form can be downloaded from the ATF website at https://www.atf.gov/firearms/docs/4473-part-1-firearms-
transaction-record-over-counter-atf-form-53009/download. See “Question 21.a.” on p. 4.
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Violations of this new Section 932 are punishable by up to 15 years’ imprisonment. Violations
made knowingly or having reasonable cause to believe that any firearm involved will be used to
commit a felony, federal crime of terrorism, or drug trafficking crime are punishable by up to 25
years’ imprisonment.
Subsection 12004(a) also amends the GCA with a new gun trafficking provision (18 U.S.C. §933)
prohibiting any person from shipping, transporting, causing to be shipped or transported, or
otherwise disposing of any firearm to another person, with the knowledge or reasonable cause to
believe that the transferee’s use, carrying, or possession would constitute a felony. It would also
prohibit the receipt of such firearm, if the transferee knows or has reasonable cause to believe that
receiving such firearm would constitute a felony. Attempts and conspiracies to violate these
provisions are proscribed as well. Violations are punishable by up to 15 years’ imprisonment.
In addition, subsection 12004(a) amends the GCA with a follow-on provision (18 U.S.C. §934)
making any person convicted under either of the two new prior provisions subject to civil
forfeiture and fines. Convicted persons could forfeit any property constituting, or derived from,
any proceeds obtained, directly or indirectly, from straw purchasing or gun trafficking, as well as
any property used, or intended to be used, in the commission of such crimes. Persons convicted of
such crimes could also be fined twice the gross profits or other proceeds of such offenses. In
addition, Section 12004 amends federal electronic surveillance, racketeering, and money
laundering provisions, making violations of 18 U.S.C. §§932 and 933 predicate offenses.55
In regard to such crimes, subsection 12004(a) directs the U.S. Sentencing Commission to review
sentencing guidelines to reflect Congress’s intent that straw purchasers without significant
criminal histories receive sentences sufficient to deter participation in such activities and reflect
the defendant’s role and culpability, as well as any coercion, domestic violence survivor history,
or other mitigating factors. It directs that others convicted of any offense under 18 U.S.C. §§932
or 933 who are affiliated with a criminal gang, cartel, organized crime ring, or similar enterprise
should be subject to higher penalties than an otherwise unaffiliated individual.56
In addition, subsections 12004(b) through (j) include nine other provisions that are either directly
or tangentially related to gun trafficking:
 Subsection 12004(b) amends an existing GCA provision (18 U.S.C. §922(d)) that
prohibits anyone from disposing of a firearm to a prohibited person, to include
anyone who intends to sell or otherwise dispose of a firearm or ammunition in
furtherance of a felony, a federal crime of terrorism, or a drug trafficking offense
(as such terms are defined in 18 U.S.C. §932(a)), or anyone who intends to sell or
otherwise dispose of a firearm or ammunition to any prohibited person.
 Subsection 12004(c) amends a GCA penalty provision (18 U.S.C. §924(a)),
increasing the penalty for violations of either 18 U.S.C. §§922(d) or (g) from up
to 10 to up to 15 years’ imprisonment for anyone who knowingly transfers a
firearms or ammunition to a prohibited person, or for any prohibited person who
knowingly possesses such items.57
 Subsection 12004(d) amends an existing GCA provision (18 U.S.C. §924(d)) to
make firearms and ammunition regulated under the 1934 National Firearms Act

55 18 U.S.C. §§2516(1)(n), 1961(1)(B), and 1956(c)(7)(D), respectively.
56 For further information, see CRS In Focus IF12190, Gun Control: Straw Purchase and Gun Trafficking Provisions.
57 18 U.S.C. §924(a)(8).
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(NFA; P.L. 73-474) that are involved in violations of 18 U.S.C. §§932 or 933
subject to an NFA federal seizure and forfeiture provision.58
 Subsection 12004(e) amends an existing GCA provision (18 U.S.C. §924(h)) to
make it unlawful to receive a firearm or ammunition knowing, or having
reasonable cause to believe, that those items will be used to commit a felony,
federal crime of terrorism, or drug trafficking crime. Previously, this GCA
provision spoke only to the transfer of such items and not to their receipt.
 Subsection 12004(f) amends another existing GCA provision (18 U.S.C. §924(k))
to make it unlawful to smuggle or knowingly take out of the United States a
firearm or ammunition with an intent to engage in or promote conduct that is
unlawful under the Controlled Substances Import and Export Act (P.L. 91-513, as
amended),59 or that constitutes a felony, a federal crime of terrorism, or a drug
trafficking crime. Previously, this GCA provision involved only smuggling or
knowingly bringing such items into the United States. Under either of these GCA
subsections (§924(h) or §924(k)), the potential penalty is increased from 10 to 15
years’ imprisonment.
 Subsection 12004(g) prohibits DOJ, and any law enforcement agency under its
coordination, from facilitating the transfer of an operable firearm or ammunition
to any known agent of a drug cartel, unless U.S. personnel are in a position to
monitor or control those items continuously at all times.60
 Subsection 12004(h) amends the 1993 Brady Act to direct the Attorney General
to give FFLs access to NICS for the purposes of voluntarily running firearms-
related background checks on current or prospective employees.61
 Subsection 12004(i) authorizes annual appropriations of $1 million for FY2023 -
FY2027 for ATF to continue an existing anti-straw purchasing public awareness
campaign.
 Subsection 12004(j) amends the Homeland Security Act of 2002 to authorize the
Department of Homeland Security to reimburse local law enforcement agencies
for salary and administrative costs for assisting Homeland Security Investigations
in efforts to prevent illegal trafficking under the Border Enforcement Security
Task Force (BEST) program.62

58 The applicable NFA provision is 26 U.S.C. §5845(a).
59 21 U.S.C. 951 et seq.
60 This BSCA provision in Section 12004 is similar to one that Congress has included in the DOJ annual appropriation
for every fiscal year from FY2012 through FY2022. For its most current enacted iteration, see Division B, Title II,
Section 215 of the DOJ general provisions in the Consolidated Appropriations Act, 2022 (P.L. 117-103, March 15,
2022, 136 Stat. 49, 133). This provision prohibits an investigative tactic commonly known as gun walking. As part of a
flawed investigation known as “Operation Fast and Furious,” the DOJ Office of the Inspector General found that ATF
special agents did not act in a timely manner to arrest, or at least confront, suspected straw purchasers and interdict the
firearms they had purchased in multiple transactions from federally licensed gun dealers, when the agents arguably had
a reasonable suspicion or probable cause to believe that the straw purchasers were illegally trafficking firearms to
known associates of Mexican drug trafficking organizations. See U.S. Department of Justice, Office of the Inspector
General, A Review of ATF’s Operation Fast and Furious and Related Matters, September 19, 2012, pp. 419-471.
61 P.L. 103-159; November 30, 1993, 107 Stat. 1536, 1541, Section 103.
62 6 U.S.C. §240(d)(2).
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Section 12005: Misdemeanor Crime of Domestic Violence
Background
Under the GCA, there are nine categories of persons prohibited from receiving and possessing
firearms or ammunition (see the “Section 12001: Juvenile Records” section of this report).63
Under a parallel provision, it is also unlawful, under any circumstances, for an individual to sell
or otherwise dispose of a firearm or ammunition to any prohibited persons if the transferor
(seller) has reasonable cause to believe that the transferee (buyer) is a person prohibited from
receiving those items.64 In 1994, Congress amended the GCA to prohibit individuals subject to
domestic violence protection orders (DVPOs) related to harassing, stalking, or threatening an
intimate partner, or child of such intimate partner, from receiving or possessing firearms or
ammunition.65 In 1996, Congress further amended the GCA to prohibit persons convicted of a
misdemeanor crime of domestic violence (MCDVs) from receiving or possessing a firearm.
Ineligible domestic violence misdemeanants include any current or former spouse, parent, or
guardian of the victim; a person with whom the victim shares a child in common; a person who is
cohabiting with, or has cohabited with, the victim as a spouse, parent, or guardian; or a person
similarly situated to a spouse, parent, or guardian of the victim.66 The omission of dating partners
in firearm purchase prohibitions related to DVPOs and MCDVs has been referred to as the
boyfriend loophole.
Provision
Section 12005 amends the GCA definition of “misdemeanor crime of domestic violence” to
include any “person who has a current or recent former dating relationship with the victim,” in
addition to spouses, former spouses, and cohabitants.67 Correspondingly, the BSCA also amends
the GCA to define a “dating relationship” to mean
(A) a relationship between individuals who have or have recently had a continuing serious
relationship of a romantic or intimate nature.
(B) Whether a relationship constitutes a dating relationship under subparagraph (A) shall
be determined based on consideration of—
(i) the length of the relationship;
(ii) the nature of the relationship; and
(iii) the frequency and type of interaction between the individuals involved in the
relationship.68

63 18 U.S.C. §§922(g)(1) through (9).
64 18 U.S.C. §§922(d)(1) through (9).
65 Violent Crime Control and Law Enforcement Act of 1994, P.L. 103-322, September 13, 1994, 108 Stat. 1796, 2014;
Title XI, Subtitle D, Section 110401; codified at 18 U.S.C. §§922(d)(8) and (g)(8).
66 Omnibus Consolidated Appropriations Act, 1997, P.L. 104-208, September 30, 1996, 110 Stat. 3009, 3009-371; Title
VI, Section 658; codified at 18 U.S.C. §§922(d)(9) and (g)(9).
67 18 U.S.C. §921(a)(33)(A).
68 18 U.S.C. § 921(a)(37). In terms of what constitutes a “dating relationship,” subparagraph (B) of this definition is
similar to that of “a dating partner” under 18 U.S.C. §2266(a)(10).
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Section 12005 sets several limitations on the dating partner MCDV prohibition.69 First, it is
prospective and going forward it affects only MCDVs. Misdemeanor convictions prior to
enactment are not to be considered prohibitive. Second, the dating partner prohibition is time-
limited for offenders who do not have more than one MCDV involving a dating relationship and
are not otherwise prohibited under the GCA. Firearms eligibility for those offenders is to be
restored in five years from either the judgment of conviction or the completion of the person’s
custodial or supervisory sentence, whichever date comes later. Third, the provision allows
disabilities relief (firearms eligibility restoration) to anyone who had their misdemeanor
conviction expunged, set aside, or pardoned, or otherwise had their civil rights restored, unless
the terms of such relief expressly provide otherwise. Fourth, it requires that NICS-accessible
records be updated to reflect any firearms eligibility restoration for any dating partner domestic
violence misdemeanant.70
Section 12005 precludes firearms eligibility restoration for offenders who have subsequently been
convicted under any federal, state, tribal, or local law for an offense related to
 the use or attempted use of physical force,
 the threatened use of a deadly weapon, or
 any other disqualifying offense under the GCA.
Section 12005 also includes a provision stating that it does not extend the possibility of firearms
eligibility restoration to any person who is or would be prohibited under prior law (i.e., spouses,
former spouses, and cohabitants). The intent of this provision is to reduce firearms-related
intimate partner violence (homicide and injury) by addressing the boyfriend loophole.71
Title III—Other Matters
Subtitle A—Extension of Moratorium
Section 13101: Extension of Moratorium on Implementation of Rule Relating
to Eliminating the Anti-Kickback Statute Safe Harbor Protection for
Prescription Drug Rebates
Background
The federal anti-kickback statute, with certain statutory exceptions, makes it a felony for a person
to knowingly and willfully offer, pay, solicit, or receive anything of value in return for a referral

69 18 U.S.C. §921(a)(33)(C).
70 In these respects, the BSCA amendment stands in contrast to the Lautenberg amendment, which was retrospective, is
not time-limited, and does not speak to any restoration of firearms privileges to the extent that such relief might have
been available under state, tribal, or local law. See 18 U.S.C. §§922(d)(9) and (g)(9).
71 Notably, the House-passed Violence Against Women Act (VAWA) Reauthorization Act of 2021 (H.R. 1620) would
have expanded the MCDV and domestic violence protective order (DVPO) prohibitions to include dating partners or
former dating partners and persons similarly situated to a spouse, and would have made persons convicted of a
“misdemeanor crime of stalking” a 10th category of prohibited persons under the GCA. Although the VAWA
reauthorization was enacted as part of the Consolidated Appropriations Act, 2022 (P.L. 117-103), it did not include the
House-passed MCDV, DVPO, or stalking prohibitions. For further information, see CRS In Focus IF12210, Firearms
Eligibility: Domestic Violence and Dating Partners, and CRS In Focus IF11784, Firearms Eligibility: Stalking- and
Domestic Violence-Related Provisions in H.R. 1620.
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or to induce generation of business reimbursable under a federal health care program. In addition,
the HHS Office of Inspector General (OIG) has promulgated regulations that contain several safe
harbors to prevent common business arrangements from being considered kickbacks. On
November 30, 2020, the HHS OIG published a final rule that would alter an anti-kickback
regulatory safe harbor to restrict the use of manufacturer drug rebates to Medicare Part D plans.72
Implementation of the rule was delayed until 2026 as part of the Infrastructure Investment and
Jobs Act (P.L. 117-158).
Provision
Section 13101 amends Section 90006 of Division I of the Infrastructure Investment and Jobs
Act73 by striking “January 1, 2026” and inserting “January 1, 2027.” This amendment bars the
Secretary from implementing, administering, or enforcing the final anti-kickback rebate rule prior
to 2027.74
The rebate rule was forecasted to increase Medicare Part D spending. According to the
Congressional Budget Office (CBO), the delay in implementation included in the BSCA
provision is estimated to save $20.9 billion from FY2022 to FY2027.75
Subtitle B—Medicare Improvement Fund
Section 13201: Medicare Improvement Fund
Background
The Medicare Improvements for Patient and Providers Act (P.L. 110-275) added Social Security
Act (SSA) Section 1898, which authorized the HHS Secretary to establish the Medicare
Improvement Fund (MIF). The amounts in the MIF are available to the HHS Secretary “to make
improvements under the original Medicare fee-for-service program under parts A and B …
including adjustments to payments for items and services furnished by providers of services and
suppliers under such original Medicare fee-for-service program.” Many subsequent laws have
modified the amount in the fund, but to date none of the monies have been expended. These
amendments changed the amounts in the MIF available for the HHS Secretary’s use from one
time period to another. For example, the Consolidated Appropriations Act, 2022 (P.L. 117-103),
modified Section 1898 to make $5 billion available during and after FY2021.

72 Department of Health and Human Services, “85 FR 76666 - Fraud and Abuse; Removal of Safe Harbor Protection
for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-
Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees,” 85
Federal Register 76666.
73 42 U.S.C. § 1320a–7b note.
74 Note that under the Inflation Reduction Act of 2022 (P.L. 117-169), enacted on August 16, 2022, the HHS Secretary
is prohibited from enforcing the rebate rule prior to 2032.
75 Congressional Budget Office, Estimated Budgetary Effects of S. 2938, Bipartisan Safer Communities Act, Cost
Estimate, June 22, 2022, Table 2, https://www.cbo.gov/publication/58238.
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Provision
Section 13201 changes the amount available in the fund for services furnished “during and after
fiscal year 2021, $5,000,000” to “during and after fiscal year 2022, $7,500,000,000.”
Subtitle C—Luke and Alex School Safety Act of 2022
Background
Debates over how to implement coordinated homeland security policy, in the wake of the terrorist
attacks of September 11, 2001, led to the passage of the Homeland Security Act of 2002 (P.L.
107-296), the establishment of the Department of Homeland Security (DHS), and a shift from a
homeland security legislative focus on counterterrorism activities to a broader and more complex
network of interrelated issues.76 The Cybersecurity and Infrastructure Security Agency Act of
2018 (P.L. 115-278) amended the Homeland Security Act of 2002 to include cybersecurity and
infrastructure security in a new Title XXII.77 Title XXII of the Homeland Security Act of 2002 did
not include school safety requirements.
In addition, the Federal Commission on School Safety—established by then-President Trump in
the wake of the mass shooting at Marjory Stoneman Douglas High School in Parkland, FL, in
February 2018—recommended in its final report that the federal government create a
clearinghouse for federal resources on school safety that provides information on school safety
strategies and evidence-based practices.78 The federal clearinghouse, SchoolSafety.gov, launched
on February 10, 2020.
Section 13301: Short Title
Provision
Section 13301 cites this portion of the BSCA as the “Luke and Alex School Safety Act of 2022.”
The act is named after Luke Hoyer and Alex Schachter—two students killed in the school
shooting at Marjory Stoneman Douglas High School in Parkland, FL. This section amends Title
XXII of the Homeland Security Act of 2002.
Section 13302: Federal Clearinghouse on School Safety Evidence-Based
Practices
Provision
Section 13302 of the BSCA—the Luke and Alex School Safety Act of 2022—requires the DHS
Secretary to establish within DHS a Federal Clearinghouse on School Safety Evidence-Based
Practices (hereinafter referred to as the Clearinghouse for purposes of Subtitle C of the BCSA), in
coordination with the Secretary of Education, the Attorney General, and the HHS Secretary. The
Clearinghouse is tasked with identifying and publishing online evidence-based practices and
recommendations on school safety for state and local educational agencies (SEAs and LEAs,

76 See CRS Report R45701, Selected Homeland Security Issues in the 116th Congress.
77 6 U.S.C. §651 et seq.
78 Federal Commission on School Safety, Final Report of the Federal Commission on School Safety Presented to the
President of the United States, ED, DOJ, DHS, and HHS, Washington, DC, December 18, 2018, https://www2.ed.gov/
documents/school-safety/school-safety-report.pdf.
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respectively), institutions of higher education (IHEs), state and local law enforcement agencies,
health professionals, and the general public through SchoolSafety.gov (or any successor website).
The DHS Secretary must consult with the Secretary of ED and appropriate organizations to
ensure that practices published by the Clearinghouse are aligned with evidence-based practices
that support a positive and safe learning environment for all students.
The Luke and Alex School Safety Act of 2022 also outlines additional requirements for the
evidence-based practices and recommendations published by the Clearinghouse. The act provides
a series of criteria for the Clearinghouse’s identification of evidence-based practices and
recommendations, including
 the evidence or research rationale supporting the Clearinghouse’s determination
to include a practice or recommendation;
 information on existing federal programs that may support the implementation of
each evidence-based practice or recommendation; and
 developmentally appropriate options for implementing each practice or
recommendation in a variety of educational settings with children of varying ages
and levels of physical, social, sensory, and emotional development.
In addition, the Clearinghouse should present the best practice recommendations of past
commissions and other organizations that meet the Clearinghouse’s criteria, in consultation with
any personnel detailed to the Clearinghouse by the ED Secretary, HHS Secretary, or the Attorney
General, and relevant governmental, private, and nongovernmental organizations.
The DHS Secretary may produce and publish materials to assist and train personnel from SEAs,
LEAs, and law enforcement agencies on the implementation of the Clearinghouse’s evidence-
based practices and recommendations. The DHS Secretary is required to conduct continuous
improvement activities, including
 collecting data analytics, user feedback, and evaluations;
 coordinating with the heads of other relevant federal agencies to regularly assess
and identify whether any Clearinghouse evidence-based practices and
recommendations lack implementation resources from existing federal programs;
and
 establishing an external advisory board to (1) provide feedback on the
implementation of the Clearinghouse’s evidence-based practices and
recommendations, and (2) propose additional recommendations for evidence-
based practices to be included in the Clearinghouse.
Finally, the provision requires the Clearinghouse to produce materials in accessible formats to
help students’ parents and legal guardians identify Clearinghouse evidence-based practices and
recommendations that are relevant to them.
Section 13303: Notification of Clearinghouse
Provision
Section 13303 requires the Attorney General and the Secretaries of ED, DHS, and HHS to
“provide written notification of the publication of the Federal Clearinghouse on School Safety
Evidence-based Practices” to state departments of justice, education, homeland security, and
public health, and other relevant partners and advisors. For example, the Secretary of ED must
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notify SEAs and LEAs, and the DHS Secretary must notify every state homeland security
advisor, in addition to every state’s department of homeland security and other DHS partners.
Section 13304: Grant Program Review
Provision
The Clearinghouse is tasked with identifying federal and state school safety grant programs and
resources. Section 13304 requires the Clearinghouse (or the external advisory board),79 within a
year of the BSCA’s enactment, to review existing federal grant programs and identify any that
may be used to implement the Clearinghouse’s practices and recommendations. The provision
also requires the Clearinghouse to identify, and periodically report to the appropriate committees
of Congress, evidence-based practices or recommendations for which no supporting federal grant
program exists. In addition, to the extent practicable, for each state, the clearinghouse must also
identify state agencies responsible for school safety, along with any state grant programs and
other resources that could implement the Clearinghouse’s evidence-based practices and
recommendations.
Section 13305: Rules of Construction
Provision
Section 13305 of the BSCA provides two rules of construction regarding its effect on other laws.
It states that the Luke and Alex School Safety Act of 2022 should not be construed to create,
satisfy, or waive any requirements under federal civil rights laws.80 It also states that the Luke and
Alex School Safety Act of 2022 does not change the existing prohibition on any federal exercise
of direction, supervision, or control over the curriculum, program of instruction, administration,
or personnel of any educational institution, school, or school system, over any accrediting agency
or association, or over the selection or content of library resources, textbooks, or other
instructional materials by any educational institution or school system.81
Subtitle D—Amendment on ESEA Funding
Section 13401: Amendment on ESEA Funding
Background
The Elementary and Secondary Education Act (ESEA) is the primary source of federal aid for
elementary and secondary education in the United States—particularly the Title I-A program,
which authorizes federal aid for the education of disadvantaged students.82 Besides grants and

79 Refers to the external advisory board established in BSCA §13302 under 2220D of the Homeland Security Act of
2002.
80 The civil rights laws listed in the Rules of Construction are Title II of the Americans with Disabilities Act of 1990
(42 U.S.C. §12131 et seq.); the Rehabilitation Act of 1973 (29 U.S.C. §701 et seq.); Title VI of the Civil Rights Act of
1964 (42 U.S.C. §2000d et seq.); Title IX of the Education Amendments of 1972 (20 U.S.C. §1681 et seq.); and the
Age Discrimination Act of 1975 (42 U.S.C. §6101 et seq.).
81 Section 103(b) of the Department of Education Organization Act (20 U.S.C. 3403(b)).
82 Title I-A of the ESEA is found at 20 U.S.C. §6301 et seq. For more information, see CRS Report R45977, The
Elementary and Secondary Education Act (ESEA), as Amended by the Every Student Succeeds Act (ESSA): A Primer.
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contracts to SEAs, LEAs, and schools for a variety of educational purposes, the act includes a
wide range of prohibitions and requirements that apply to entities receiving ESEA funds. For
example, Section 8526 of the ESEA prohibits using ESEA funds for certain materials, programs,
and purposes, including, but not limited to, the use of ESEA funds to “promote or encourage
sexual activity.” The ESEA also includes the Gun-Free Schools Act (GFSA),83 which requires
states to adopt certain policies as a condition of receiving federal funding under the ESEA.84
Among other provisions, the GFSA requires states receiving funds under the ESEA to have in
effect a law requiring LEAs to expel from school for a period of not less than one year any
student who is determined to have brought a firearm to school, or to have possessed a firearm at
school.85
Provision
Section 13402 of the BSCA amends Section 8526 of the ESEA, adding a new prohibition on the
use of ESEA funds. Specifically, the provision prohibits using ESEA funds to provide any person
with a dangerous weapon or to provide training in the use of a dangerous weapon.86

83 ESEA, §8561; 20 U.S.C. 7961.
84 For more information, see CRS Report R46872, Federal Support for School Safety and Security.
85 For more information on the Gun-Free Schools Act, see “Gun-Free School Zones Act of 1990 and Gun-Free Schools
Act of 1994” in CRS Report R46872, Federal Support for School Safety and Security.
86 The term dangerous weapon used in this section of the BSCA has the meaning given to the term in 18 U.S.C.
§930(g)(2), which states, “The term ‘dangerous weapon’ means a weapon, device, instrument, material, or substance,
animate or inanimate, that is used for, or is readily capable of, causing death or serious bodily injury, except that such
term does not include a pocket knife with a blade of less than 2½ inches in length.”
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Division B—Appropriations
Title I
Table 2. Department of Justice Appropriations
Dollars in Millions
BSCA Heading
Program/Activity
Amount
Program Description and Enabling Authorization
DEPARTMENT OF JUSTICE
Federal Bureau of Investigations
Salaries and Expenses
$100 available until
Description: Funding is for additional resources to aid the FBI
expended
with entering records into the National Instant Criminal
Background Check System.
Authorization: Title I of Division B of the BSCA.
State and Local Law Enforcement Activities
Office of Justice Programs
State and Local Law Enforcement Assistance
$1,400 available until expended, including:
$280 for FY2022
$280 for FY2023
$280 for FY2024
$280 for FY2025
$280 for FY2026
CRS-26

BSCA Heading
Program/Activity
Amount
Program Description and Enabling Authorization

Edward Byrne Memorial Justice
($750)
Description: The BSCA amends the authorized uses for the
Assistance Grant program
($150 for FY2022)
Edward Byrne Memorial Justice Assistance Program (JAG) to
CFDA # 16.738
include crisis intervention programs. These funds may be used for
($150 for FY2023)
state crisis intervention court proceedings and related programs
($150 for FY2024)
or initiatives including drug, mental health, veteran treatment
($150 for FY2025)
courts, and extreme risk protection order programs. The amount
($150 for FY2026)
made available each year shall be allocated according to a modified
JAG formula that is based upon the prior fiscal year’s JAG
allocation and then adjusted relative to the difference between the
given fiscal year funding from this program and the previous fiscal
year’s JAG program funding.
Authorization: Omnibus Crime Control and Safe Streets Act of
1968 §500 et seq. (34 U.S.C 10151-10158).

Bureau of Justice Assistance
($200)
Description: The Bureau of Justice Assistance (BJA) can use
CFDA # 16.839
($40 for FY2022)
funds to make grants to states, local governments, or Indian tribes
for training personnel and students in preventing violence,
($40 for FY2023)
developing anonymous reporting systems, operating threat
($40 for FY2024)
assessment teams, providing specialized training for school
($40 for FY2025)
personnel, or other measures as determined by the BJA Director.
($40 for FY2026)
Authorization: STOP School Violence Act §501 et seq. (34
U.S.C 10551-10556).

Upgrades to Criminal and Mental
($200)
Description: Funding is for grants to upgrade criminal and mental
Health Records
($40 for FY2022)
health records for the National Instant Criminal Background
CFDA # 16.554 & 16.813
Check System. These grants may alternatively assist states in
($40 for FY2023)
providing disqualifying juvenile records or funding state court and
($40 for FY2024)
criminal record systems. These grants shall help to expand instant
($40 for FY2025)
background checks for persons under 21.
($40 for FY2026)
Authorization: Omnibus Crime Control and Safe Streets Act of
1968 §302 (34 U.S.C. 10132(c)(19)).
CRS-27

BSCA Heading
Program/Activity
Amount
Program Description and Enabling Authorization

Community Violence Intervention
($250)
Description: Funding is to support community violence
and Prevention Initiative
($50 for FY2022)
intervention programs. Grants are used to plan, develop, and
CFDA # 16.045
implement localized approaches toward reducing violence.
($50 for FY2023)
Authorization: Title I of Division B of the Bipartisan Safer
($50 for FY2024)
Communities Act (P.L. 117-159).
($50 for FY2025)
($50 for FY2026)
Community Oriented Policing Services
Community Oriented Policing
Community Oriented Policing
$100 available until
Description: The Community Oriented Policing Services
Services Programs
Services Programs
expended, including:
Program (COPS) is authorized to make grants for school security

CFDA # 16.710
$20 for FY2022
for the coordination with local law enforcement, training for local
law enforcement to prevent student violence, placement of
$20 for FY2023
deterrent measures, technology to alert law enforcement, or
$20 for FY2024
other measures as determined by the COPS director.
$20 for FY2025
Authorization: STOP School Violence Act §501 et seq. (34
$20 for FY2026
U.S.C. 10551-10556).
Source: CRS analysis of BSCA Division B.
Notes: BSCA=Bipartisan Safer Communities Act; CFDA=Catalogue of Federal Domestic Assistance; FBI=Federal Bureau of Investigation; U.S.C.=United States Code.
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General Provisions—This Title [Title I]
Sections 21001 and 21002 contain general provisions related to transfer authorities and reporting
requirements similar to those typically included for DOJ programs and activities in the annual
Commerce, Justice, Science, and Related Agencies (CJS) Appropriations Act.
Section 21001 prohibits the transfer of funds provided by Title I of the BSCA under the authority
provided to DOJ in Section 205 of the FY2022 CJS Appropriations Act or any successor
provisions in a subsequently enacted appropriations act.
Section 21002 requires DOJ to submit a detailed spend plan for FY2022 and FY2023 funds made
available by Title I of Division B of the BSCA to the House and Senate Appropriations
Committee within 45 days after the date of enactment. DOJ is required to submit a spend plan to
the House and Senate Appropriations Committees for the FY2024, FY2025, and FY2026 funding
made available by Title I of Division B of the BSCA as a part of DOJ’s annual budget submission
for each respective fiscal year. The spend plans are required to provide “specific and detailed
description of the intended administration, review processes, allowable purposes, eligibility
requirements, and priority areas or weightings” for the grant programs funded by Title I of the
BSCA.87

87 BSCA §21002(b).
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Title II
Table 3. Department of Health and Human Services and Department of Education Appropriations
Dollars in Millions
BSCA Heading
Program/Activity
Amount
Program Description and Enabling Authorization
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Health Surveillance and Program Support
$800 available until September 30, 2025, including:
$312.5 available until December 31, 2022 for FY2022
$162.5 available until September 30, 2023 for FY2023
$162.5 available until September 30, 2024 for FY2024
$162.5 available until September 30, 2025 for FY2025

Community Mental Health Services
($250)a
Description: The Community Mental Health Services Block
Block Grant
Grant supports community mental health services. SAMHSA
CFDA # 93.958
distributes funds to states and the District of Columbia by a
formula specified in statute. States have flexibility in the use of
block grant funds within the framework of the state plan and
federal requirements.
Authorization: PHSA §1911 et seq. (42 U.S.C 300x et seq.).

National Child Traumatic Stress
($40)a
Description: The National Child Traumatic Stress Initiative
Initiative
(NCTSI) supports the development and promotion of
CFDA # 93.243
behavioral health services for children exposed to traumatic
events, mostly through information and trainings provided by a
network of centers.
Authorization: PHSA §582 (42 U.S.C. 290hh-1).
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BSCA Heading
Program/Activity
Amount
Program Description and Enabling Authorization

Project AWARE
($240)a,b
Description: Project AWARE consists of competitive grants
CFDA # 93.243
that (1) support training teachers and school personnel on
mental health awareness and (2) connect youth with behavioral
health issues to needed services. Project AWARE State grants
support activities that identify children and youth in need of
mental health services, increase access to mental health
treatment, and promote mental health literacy among teachers
and school personnel. The ReCAST program within Project
AWARE consists of competitive grants for communities that
have recently faced civil unrest or trauma.
Authorization: PHSA §520A (42 U.S.C. 290bb-32).

Mental Health Awareness Training
($120)a
Description: Originally part of Project AWARE, Mental Health
CFDA # 93.243
Awareness Training provides training to school staff on how to
recognize mental il ness, provide initial help, and connect
students to care. SAMHSA partners with the National Council
for Mental Wellbeing to administer these grants.
Authorization: PHSA §520J (42 U.S.C. 290bb-41).

National Suicide Prevention Lifeline
($150)a
Description: The 988 Suicide & Crisis Lifeline is a national
CFDA # 93.243
hotline providing crisis counseling and services for individuals
experiencing suicidal thoughts or other mental distress. In
conjunction with states and private entities, SAMHSA provides
funding to support Lifeline operations. On July 16, 2022, the
National Suicide Prevention Lifeline transitioned from a 10-digit
phone number to a new three-digit hotline. Funding is intended
to increase call center capacity in anticipation of higher call
volumes from the new three-digit number rol out.
Authorization: PHSA §520E-3 (42 U.S.C. 290bb-36c).
Office of the Secretary
Public Health and Social Services Emergency Fund
$190 available until September 30, 2026, including:
$82 available until December 31, 2022 for FY2022
$32 available until September 30, 2023 for FY2023
$32 available until September 30, 2024 for FY2024
$32 available until September 30, 2025 for FY2025
$12 available until September 30, 2026 for FY2026
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BSCA Heading
Program/Activity
Amount
Program Description and Enabling Authorization

Primary Care Training and
($60)c
Description: Funds are used to support mental and behavioral
Enhancement
health care training for pediatricians and other primary care
CFDA # 93.884
clinicians through grants to hospitals, medical schools, physician
assistant training programs, or other nonprofit entities. These
funds can be used to plan, develop, or operate an accredited
training program, including programs for those who plan to
teach other clinicians; to provide need-based financial assistance
to medical personnel in training; or to develop innovative
models for providing care.
Authorization: PHSA §747 (42 U.S.C. 293k).

Pediatric Mental Health Care Access
($80)c
Description: Through the PMHCA grant program, HRSA
CFDA # 93.110
awards grants to states, political subdivisions, and tribal
organizations to promote behavioral health integration into
primary care using telehealth by supporting the development or
improvement of statewide or regional telehealth networks.
Program funds may also be used to provide technical assistance
to emergency departments, state educational agencies (SEAs),
local educational agencies (LEAs), tribal education agencies, and
primary/secondary schools.
Authorization: PHSA §330M (42 U.S.C. 254c-19).

Supporting Access to Health Care
($50)c
Description: The provision appropriates $50 mil ion for the
Services in Schools
HHS Secretary to award grants to states for FY2022. The grants
are to be used to implement, enhance, or expand the provision
of assistance through school-based entities under Medicaid or
the State Children’s Health Insurance Program (CHIP). Such
grant funds may not be used to provide medical assistance, child
health assistance, or other health services.
Authorization: BSCA §11003 (U.S.C. 1396a).
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BSCA Heading
Program/Activity
Amount
Program Description and Enabling Authorization
DEPARTMENT OF EDUCATION
School Improvement Programs
$1,050 available through September 30, 2025

21st Century Community Learning
($50)
Description: Funding supports activities outside of school
Centers
available through
hours that offer learning opportunities for schoolchildren.
CFDA # 84.487
September 30, 2023
Grants are made to SEAs based on a formula; SEAs then
provide funds to local entities in competitive sub-grants.
Authorization: ESEA §4201 et seq. (20 U.S.C. 7171-7175).

Student Support and Academic
($1,000)
Description: Grants are made to SEAs based on formula. The
Enrichment Grantsd

BSCA requires SEAs to award competitive grants to high-need
CFDA # 84.424
LEAs “as determined by the state.” LEAs must use these funds
for programs and activities that coordinate with community-
based services and programs, promote parent involvement, and
foster safe, healthy, supportive, and drug-free environments that
support student academic achievement. Examples include drug
prevention activities, school-based mental health programs,
child sexual abuse awareness programs, designing plans to
reduce exclusionary discipline practices, behavioral
interventions, and mentoring and school counseling.
Authorization: ESEA §4108 (20 U.S.C. 7118).
School Safety and Citizenship Education
$1,000 available through December 31, 2026, including:
$200 available until March 31, 2023 for FY2022
$200 available until December 31, 2023 for FY2023
$200 available until December 31, 2024 for FY2024
$200 available until December 31, 2025 for FY2025
$200 available until December 31, 2026 for FY2026

School Based Mental Health Services ($500)
Description: This program provides competitive grants to
Grants
($100 for FY2022)
SEAs. Funds may be used to increase the number of mental
CFDA # 84.184H
health professionals (e.g., counselors, social workers,
($100 for FY2023)
psychologists) who provide school-based mental health services
($100 for FY2024)
to students in LEAs with a demonstrated need.
($100 for FY2025)
Authorization: ESEA §4631 (20 U.S.C. §7281).
($100 for FY2026)
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BSCA Heading
Program/Activity
Amount
Program Description and Enabling Authorization

Mental Health Services Professional
($500)
Description: Grants support partnerships that train school-
Demonstration Grants
($100 for FY2022)
based mental health service providers to serve in schools and
CFDA # 84.184X
LEAs.
($100 for FY2023)
Authorization: ESEA §4631 (20 U.S.C §7281).
($100 for FY2024)
($100 for FY2025)
($100 for FY2026)
Source: CRS analysis of BSCA Division B.
Notes: BSCA=Bipartisan Safer Communities Act; CFDA=Catalogue of Federal Domestic Assistance; ESEA=Elementary and Secondary Education Act; HHS=U.S.
Department of Health and Human Services; HRSA=Health Resources and Services Administration; LEA=Local Educational Agency; PHSA=Public Health Service Act;
PMHCA=Pediatric Mental Health Care Access; SAMHSA=Substance Abuse and Mental Health Services Administration; SEA=State Educational Agency; U.S.C.=United
States Code.
a. The BSCA provides that this amount is to be divided “in equal amounts for each of fiscal years 2022 through 2025, unless stated otherwise.”
b. “[O]f which no less than $28,000,000 shall be for activities described in section 7134 of P.L. 115-271.” Section 7134 of the SUPPORT for Patients and Communities
Act (P.L. 115-271) authorizes the HHS Secretary, in coordination with SAMHSA, to award grants to SEAs and LEAs to increase student access to evidence-based
trauma support services and mental health care. The provision authorized to be appropriated $50 mil ion for each of FY2019 through FY2023, but this authorization
never received explicit funding prior to the BSCA. For more information, see CRS Report R45423, Public Health and Other Related Provisions in P.L 115-271, the
SUPPORT for Patients and Communities Act.
c. The BSCA provides that this amount is to be divided “in equal amounts for each of fiscal years 2022 through 2026, unless stated otherwise.”
d. For more information, see CRS In Focus IF10910, Student Support and Academic Enrichment (SSAE) Grants.

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Bipartisan Safer Communities Act (P.L. 117-159): Section-by-Section Summary

General Provisions—This Title [Title II]
Sections 22001-22003
Sections 22001-22003 contain general provisions related to transfer authorities and reporting
requirements that are often included with discretionary supplemental appropriations for programs
and activities associated with the annual Departments of Labor, Health and Human Services, and
Education, and Related Agencies (LHHS) Appropriations Act.
Section 22001 prohibits the transfer of funds provided by Title II of Division B of the BSCA
under specified authorities provided to HHS and ED in the FY2022 LHHS Appropriations Act
(Sections 205 and 302 of Division H of P.L. 117-103, respectively). (Within each department,
these authorities allow up to a 1% transfer, subject to certain limitations, between appropriations
provided in the FY2022 LHHS Act.) Further, Section 22001 also prohibits the transfer of funds
pursuant to Section 241(a) of the PHSA. (Section 241(a), often referred to as the PHS Evaluation
Set-Aside or PHS Evaluation Tap, allows the Secretary of HHS to redistribute a portion of
eligible PHS agency appropriations across HHS for program evaluation purposes.88)
Section 22002 requires HHS and ED to provide detailed spend plans to the House and Senate
Appropriations Committees of the anticipated uses of funds made available by Title II of Division
B of the BSCA not later than 30 days after the date of enactment. These spend plans are to be
updated every 60 days, and the appropriations committees are to be briefed on obligations
quarterly, until all funds are expended. The spend plans are to include estimated personnel and
administrative costs, and be accompanied by a listing of each contract obligation that exceeds $5
million not previously reported.
Section 22003 requires that HHS and ED provide biweekly obligation reports to the House and
Senate Appropriations Committees of funds made available by Title II of the BSCA not later than
60 days after enactment. These reports are to include anticipated uses of the funds and be updated
biweekly until all funds are expended.
Title III
General Provisions—This Division [Division B]
Sections 23001-23003 contain general provisions related to the duration and purposes of funds
that are often included with discretionary supplemental appropriations. They provide that funds in
Division B of the BSCA are in addition to amounts otherwise appropriated for that fiscal year
(§23001); no funds are available for obligation beyond that fiscal year unless expressly provided
in Division B (§23002); and that unless otherwise provided, funds in Division B are available
under the same authorities and conditions applicable to their appropriations accounts for FY2022
(§23003).
Sections 23004 and 23005 specify requirements for the budgetary treatment of funds in the
BSCA. Section 23004 provides that each amount provided by Division B of the BSCA is

88 Annual LHHS Appropriations Acts typically amend the percentage of funds available for redistribution and require
HHS to report to the appropriations committees on planned transfers under this authority. For further information, see
the report section “Public Health Service Evaluation Tap” in CRS Report R47029, Labor, Health and Human Services,
and Education: FY2022 Appropriations.
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Bipartisan Safer Communities Act (P.L. 117-159): Section-by-Section Summary

designated as an emergency requirement pursuant to Section 4001(a)(1) and Section 4001(b) of
the FY2022 budget resolution (S.Con.Res. 14). This effectively exempts these funds from
applicable budget enforcement under the budget resolution.89 Section 23005 provides that the
budgetary effects of the provisions in Divisions A and B of the BSCA shall not be entered on
either the Statutory PAYGO scorecard or the Senate PAYGO scorecard.90 This effectively
exempts these funds from any budget enforcement that would have otherwise been applicable
pursuant to those mechanisms.91 This section also provides that the budgetary effects of Division
B shall be considered discretionary appropriations for the purposes of applicable budget
enforcement.92

89 For further information, see CRS Report R46893, S.Con.Res. 14: The Budget Resolution for FY2022.
90 For further information, see CBO, The Statutory Pay-As-You Go Act and the Role of the Congress, August 2020,
https://www.cbo.gov/system/files/2020-08/56506-S-PAYGO.pdf.
91 Ibid.
92 For further information, see the notes to Table 3 in CBO Cost Estimate for S. 2938, June 22, 2022,
https://www.cbo.gov/system/files/2022-06/S2938.pdf
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Bipartisan Safer Communities Act (P.L. 117-159): Section-by-Section Summary

Appendix. Abbreviations Used in This Report
Abbreviation
Definition
ARPA
American Rescue Plan Act of 2021
ATF
Bureau of Alcohol, Tobacco, and Firearms
BEST
Border Enforcement Security Enforcement Task Force
BSCA
Bipartisan Safer Communities Act
CBO
Congressional Budget Office
CCBHC
Certified Community Behavioral Health Clinic
CFDA
Catalogue of Federal Domestic Assistance
CHIP
The State Children’s Health Insurance Program
CMS
Centers for Medicare & Medicaid Services
COVID-19
Coronavirus Disease 2019
DHS
U.S. Department of Homeland Security
DOJ
U.S. Department of Justice
DVPOs
Domestic Violence Protection Orders
ED
U.S. Department of Education
E-FMAP
Enhanced Federal Medical Assistance Percentage
EPSDT
Early, Periodic, Screening, Diagnostic, and Treatment
ESA
Education Service Agency
ESEA
Elementary and Secondary Education Act
FBI
Federal Bureau of Investigations
FFL
Federal Firearm Licensee
GAO
Government Accountability Office
GCA
Gun Control Act of 1968
GFSA
Gun-Free Schools Act
HHS
U.S. Department of Health and Human Services
HRSA
Health Resources and Services Administration
IDEA
Individuals with Disabilities Education Act
IEP
Individual Education Plan
IFSP
Individual Family Service Plan
IHEs
Institutions of Higher Education
JAG
Edward Byrne Memorial Justice Assistance Grant program
LEA
Local Educational Agency
LHHS
Departments of Labor, Health and Human Services, and Education, and Related
Agencies
LTSS
Long Term Services and Supports
MCDVs
Misdemeanor Crimes of Domestic Violence
MCO
Managed Care Organization
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Bipartisan Safer Communities Act (P.L. 117-159): Section-by-Section Summary

Abbreviation
Definition
MIF
Medicare Improvement Fund
NCTSI
National Child Traumatic Stress Initiative
NICS
National Instant Criminal Background Checks System
NTN
National Transaction Number
OIG
Office of Inspector General
PAMA
Protecting Access to Medicare Act of 2014
PAYGO
Pay-As-You Go
PHE
Public Health Emergency
PHS
Public Health Service
PHSA
Public Health Service Act
PMHCA
Pediatric Mental Health Care Access program
PPS
Prospective Payment System
SAMHSA
Substance Abuse and Mental Health Services Administration
SBHC
School-Based Health Center
SBS
School-Based Health Services
SEA
State Educational Agency
SPA
State Plan Amendment
SSA
Social Security Act
U.S.C.
United States Code
VAWA
Violence Against Women Act
Source: CRS.

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Bipartisan Safer Communities Act (P.L. 117-159): Section-by-Section Summary

Author Information

Johnathan H. Duff, Coordinator
Emily J. Hanson
Analyst in Health Policy
Analyst in Social Policy

Alison Mitchell
Kyrie E. Dragoo
Specialist in Health Care Financing
Analyst in Education Policy

Katherine M. Kehres
Suzanne M. Kirchhoff
Analyst in Health Care Financing
Analyst in Health Care Financing

Evelyne P. Baumrucker
Jim Hahn
Specialist in Health Care Financing
Specialist in Health Care Financing

Elayne J. Heisler
Jessica Tollestrup
Specialist in Health Services
Specialist in Social Policy

William J. Krouse
Karen E. Lynch
Specialist in Domestic Security and Crime Policy
Specialist in Social Policy

Nathan James
John H. Gorman
Analyst in Crime Policy
Research Assistant

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under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other
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