The bill amends Part O of the Public Health Service Act to reauthorize and broaden the federal Fetal Alcohol Spectrum Disorders (FASD) Prevention and Services program. It replaces and consolidates prior provisions, enlarges the program’s mandate to include awareness, identification, intervention, and support across the lifespan, and establishes a grant program to create FASD Centers for Excellence that provide training, technical assistance, and a national clearinghouse for best practices.
This legislation matters because it shifts federal emphasis from narrow prevention and diagnosis projects to a broader, systems-focused approach that explicitly includes Tribal capacity, culturally and linguistically appropriate interventions, and state-level coordination. The law creates new application requirements for grant recipients, authorizes open-ended appropriations for fiscal years 2025–2029, and directs HHS to report on progress — all of which will shape how states, Tribes, health systems, and service providers organize FASD-related services and surveillance.
At a Glance
What It Does
The bill amends the Public Health Service Act to expand authorized activities from prevention and diagnosis to awareness, identification, intervention, and family support, and it creates grant authority to establish Fetal Alcohol Spectrum Disorders Centers for Excellence. It replaces older statutory sections with a new structure that defines eligible grantees, allows subcontracting of services, and defines the term 'FASD-informed.'
Who It Affects
Primary targets for grants and programmatic work include State and Tribal health agencies, local governments, academic medical centers and health professions schools, nonprofit service providers, and community-based behavioral health and disability service systems. Secondary targets include education, child welfare, and justice-sector actors who will be offered training and resources.
Why It Matters
The bill centralizes federal support for FASD through funded centers and a national resource function, which could standardize screening guidance, diagnostics, and training across jurisdictions. It also embeds a requirement for culturally and linguistically appropriate programming, raising the bar for how prevention and support services must be designed and delivered.
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What This Bill Actually Does
The Act rewrites and expands Part O of Title III of the Public Health Service Act to create a more comprehensive federal FASD program. It alters the part heading and updates section 399H to use the term 'FASD' and to broaden the program’s purposes from narrow prevention and diagnosis to a menu of activities that include awareness, prevention, identification, intervention, training, and dissemination of best practices.
The statute removes some outdated subsections and introduces a statutory definition for 'FASD-informed' interventions tied to cultural and linguistic appropriateness and evidence-based or practice-based approaches.
On the grant side, the bill establishes clear eligibility parameters: States, Indian Tribes and Tribal organizations, local governments, scientific and academic institutions, and nonprofits can receive grants, cooperative agreements, or contracts. The Secretary of HHS may require applicants to designate an individual to serve as a State or Tribal FASD coordinator and to describe an advisory committee that will guide a statewide or Tribal strategic plan.
That places an emphasis on local coordination and governance as a precondition for funding.The new Centers for Excellence (new section 399I) are designed to be hubs for clinical capacity, public awareness, training, and technical assistance. Awardees may use funds to expand screening and diagnostic capacity, compile and maintain a national directory of FASD-specific services, run outreach campaigns, and convene training for clinicians, educators, judges, and social service staff.
The statute explicitly allows Centers to subcontract prevention, screening, resource development, and intervention activities to other public and private nonprofit organizations, which creates flexibility in how services are staffed and delivered.Funding structure and oversight are minimal but significant: the bill authorizes 'such sums as may be necessary' for fiscal years 2025–2029 to carry out the part, and it requires HHS to deliver a report to the relevant Congressional committees within four years on awareness and best practices. Finally, the bill includes a technical amendment repealing section 519D of the Public Health Service Act, consolidating older authorities into the revised Part O framework.
The Five Things You Need to Know
The bill replaces sections 399I–399K with a single new section (399I) creating Fetal Alcohol Spectrum Disorders Centers for Excellence authorized to receive grants, cooperative agreements, or contracts.
Eligible grant recipients explicitly include States, Indian Tribes and Tribal organizations, local governments, scientific or academic institutions, and nonprofit organizations.
The Secretary may require grant applicants to designate a State or Tribal FASD coordinator and to describe an advisory committee to guide a statewide or Tribal strategic plan.
Centers for Excellence may subcontract discrete functions (prevention, screening, resource development, intervention) to other public or private nonprofit entities with FASD expertise.
The statute authorizes 'such sums as may be necessary' for fiscal years 2025–2029 and requires the HHS Secretary to report to Senate HELP and House Energy and Commerce Committees within four years.
Section-by-Section Breakdown
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Short title
Formally names the measure the 'Advancing FASD Research, Services and Prevention Act' or 'FASD Respect Act.' This is the statutory short title used to reference the amendments in other documents and reports.
Expand purpose, terminology, and eligible activities
The bill amends the Part O heading and reworks section 399H to replace older terms with 'FASD' and to expand authorized activities from narrow prevention and diagnosis to a broader set including awareness, identification, intervention, training, and dissemination. It inserts 'health professions schools' in place of 'medical schools' and broadens references to service providers. It also removes obsolete subsections and adds a statutory definition of 'FASD-informed,' tying program content to culturally and linguistically appropriate evidence-based or practice-based supports.
Application structure and eligibility criteria
The statute establishes who may receive grants or contracts and gives the Secretary discretion to require specific application content. Practically, applicants must be a State, Tribe, local government, academic or nonprofit entity and can be asked to name a FASD coordinator and to establish an advisory committee. That creates a project-management expectation and signals that HHS plans to fund coordinated, jurisdiction-wide strategies rather than isolated pilot projects.
Fetal Alcohol Spectrum Disorders Centers for Excellence
This new section defines the Centers’ roles: expanding diagnostic capacity, running public awareness campaigns, hosting a national clearinghouse and data-based directory of FASD services, conducting cross-jurisdictional training, and providing technical assistance to grant recipients. The section permits Centers to subcontract many activities to other nonprofit entities, which permits regional networks and partnerships rather than requiring the Center to deliver all services directly.
Authorization, reporting, and technical cleanup
The bill authorizes 'such sums as may be necessary' to carry out the part for FY2025–2029 and requires an HHS report within four years assessing outreach and best-practice identification. It also repeals section 519D of the Public Health Service Act as a technical amendment, consolidating authorities under the revised Part O framework.
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Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Individuals with FASD and their families — will gain a clearer pathway to diagnosis, more locally tailored supports, and improved access to evidence-informed services and information through a national clearinghouse and expanded local capacity.
- Tribal governments and Tribal organizations — the statute expressly includes Tribal entities as eligible grantees and requires cultural and linguistic appropriateness, creating a statutory basis for Tribal-directed programs and capacity building.
- Academic medical centers and health professions schools — stand to receive grants to expand diagnostic clinics, training programs, and to serve as or partner with Centers for Excellence, supporting research and workforce development.
- State and local public health departments — will be able to apply for funds to designate coordinators, develop statewide strategic plans, and expand surveillance and screening programs.
- Service providers across sectors (education, child welfare, behavioral health) — will receive training resources and access to evidence-based guidance, which can improve cross-system identification and supports for affected individuals.
Who Bears the Cost
- State and Tribal agencies — must prepare applications, establish advisory committees, and implement strategic plans, creating administrative and planning costs that may not be fully offset by grants.
- HHS and federal program offices — will need to administer new grant programs, oversee Centers for Excellence, and produce the required report without a specified appropriation level tied to program scale.
- Health care providers and health professions schools — will face workforce training and implementation costs to expand screening and diagnostic capacity and to incorporate FASD-informed practices.
- Nonprofit and community organizations — may need to compete for funds and meet new application requirements; smaller organizations could face capacity constraints when asked to serve as subcontractors or partners.
- Cross-sector systems (courts, child welfare, education) — may need to allocate time and resources for trainings and to adapt practices in response to new guidance, imposing indirect implementation costs.
Key Issues
The Core Tension
The central dilemma is between federal standard-setting and local flexibility: the bill seeks to raise national standards for FASD identification and supports while giving HHS and grantees latitude to design culturally appropriate, locally driven programs — but it leaves funding levels and many operational details undefined, risking uneven implementation and persistent gaps between diagnosis, capacity, and actual service availability.
The bill takes a broad, permissive funding approach by authorizing 'such sums as may be necessary' rather than specifying appropriations levels or grant formulas. That gives Congress flexibility but creates execution risk: without a defined funding baseline, States and Tribes will not know the likely scale of available support when crafting applications and strategic plans.
Similarly, the statute delegates significant discretion to the Secretary on application requirements and award decisions, which could produce variable grant guidance and uneven program rollouts across administrations.
Standardizing FASD surveillance and diagnostics is an explicit goal, but the statute leaves many technical choices to federal and external partners. Developing a usable case definition and clinical diagnostic guidance across pediatric, behavioral health, education, and Tribal systems is technically difficult and may produce inconsistency in the near term.
Data collection and the creation of a national directory raise privacy and interoperability issues: who holds and maintains provider listings, what client data (if any) are shared for surveillance, and how will Tribal data sovereignty concerns be accommodated? Finally, the bill leans heavily on training and technical assistance as the route to impact without prescribing service entitlement or creating dedicated reimbursement pathways, which may limit the ability of expanded diagnostic capacity to translate into sustained access to interventions for families.
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