SEC. 6000. Short Title.
This division may be cited as the “Helping Families in Mental Health Crisis Reform Act of 2016”.
Division B — Helping Families in Mental Health Crisis
DIVISION B Helping Families in Mental Health Crisis
TITLE VI Strengthening Leadership and Accountability
Subtitle A Leadership
SEC. 6001. Assistant Secretary for Mental Health and Substance Use.
Assistant Secretary.— Section 501(c) of the Public Health Service Act (42 U.S.C. 290aa(c)) is amended to read as follows:
“(c) Assistant Secretary and Deputy Assistant Secretary.—
“(1) Assistant secretary.—The Administration shall be headed by an official to be known as the Assistant Secretary for Mental Health and Substance Use (hereinafter in this title referred to as the ‘Assistant Secretary’) who shall be appointed by the President, by and with the advice and consent of the Senate.
“(2) Deputy assistant secretary.—The Assistant Secretary, with the approval of the Secretary, may appoint a Deputy Assistant Secretary and may employ and prescribe the functions of such officers and employees, including attorneys, as are necessary to administer the activities to be carried out through the Administration.”
Transfer of Authorities.— The Secretary of Health and Human Services shall delegate to the Assistant Secretary for Mental Health and Substance Use all duties and authorities that—
as of the day before the date of enactment of this Act, were vested in the Administrator of the Substance Abuse and Mental Health Services Administration; and
are not terminated by this Act.
Conforming Amendments.— Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.), as amended by the previous provisions of this section, is further amended—
by striking “ Administrator of the Substance Abuse and Mental Health Services Administration” each place it appears and inserting “ Assistant Secretary for Mental Health and Substance Use”; and
by striking “ Administrator” or “Administrator” each place it appears (including in any headings) and inserting “ Assistant Secretary” or “Assistant Secretary”, respectively, except where the term “Administrator” appears—
in each of subsections (e) and (f) of section 501 of such Act (42 U.S.C. 290aa), including the headings of such subsections, within the term “Associate Administrator”;
in section 507(b)(6) of such Act (42 U.S.C. 290bb(b)(6)), within the term “Administrator of the Health Resources and Services Administration”;
in section 507(b)(6) of such Act (42 U.S.C. 290bb(b)(6)), within the term “Administrator of the Centers for Medicare & Medicaid Services”;
in section 519B(c)(1)(B) of such Act (42 U.S.C. 290bb–25b(c)(1)(B)), within the term “Administrator of the National Highway Traffic Safety Administration”; or
in each of sections 519B(c)(1)(B), 520C(a), and 520D(a) of such Act (42 U.S.C. 290bb–25b(c)(1)(B), 290bb–34(a), 290bb–35(a)), within the term “Administrator of the Office of Juvenile Justice and Delinquency Prevention”.
References.— After executing subsections (a), (b), and (c), any reference in statute, regulation, or guidance to the Administrator of the Substance Abuse and Mental Health Services Administration shall be construed to be a reference to the Assistant Secretary for Mental Health and Substance Use.
SEC. 6002. Strengthening the Leadership of the Substance Abuse and Mental Health Services Administration.
Section 501 of the Public Health Service Act (42 U.S.C. 290aa), as amended by section 6001, is further amended—
in subsection (b)—
in the subsection heading, by striking “ Agencies” and inserting “ Centers”; and
in the matter preceding paragraph (1), by striking “ entities” and inserting “ Centers”;
in subsection (d)—
in paragraph (1)—
by striking “ agencies” each place the term appears and inserting “ Centers”; and
by striking “ such agency” and inserting “ such Center”;
in paragraph (2)—
by striking “ agencies” and inserting “ Centers”;
by striking “ with respect to substance abuse” and inserting “ with respect to substance use disorders”; and
by striking “ and individuals who are substance abusers” and inserting “ and individuals with substance use disorders”;
in paragraph (5), by striking “ substance abuse” and inserting “ substance use disorder”;
in paragraph (6)—
by striking “ the Centers for Disease Control” and inserting “ the Centers for Disease Control and Prevention,”;
by striking “ Administration develop” and inserting “ Administration, develop”;
by striking “ HIV or tuberculosis among substance abusers and individuals with mental illness” and inserting “ HIV, hepatitis, tuberculosis, and other communicable diseases among individuals with mental or substance use disorders,”; and
by striking “ illnesses” at the end and inserting “ diseases or disorders”;
in paragraph (7), by striking “ abuse utilizing anti-addiction medications, including methadone” and inserting “ use disorders, including services that utilize drugs or devices approved or cleared by the Food and Drug Administration for the treatment of substance use disorders”;
in paragraph (8)—
by striking “ Agency for Health Care Policy Research” and inserting “ Agency for Healthcare Research and Quality”; and
by striking “ treatment and prevention” and inserting “ prevention and treatment”;
in paragraph (9)—
by inserting “ and maintenance” after “ development”;
by striking “ Agency for Health Care Policy Research” and inserting “ Agency for Healthcare Research and Quality”; and
by striking “ treatment and prevention services” and inserting “ prevention, treatment, and recovery support services and are appropriately incorporated into programs carried out by the Administration”;
in paragraph (10), by striking “ abuse” and inserting “ use disorder”;
by striking paragraph (11) and inserting the following:
“(11) work with relevant agencies of the Department of Health and Human Services on integrating mental health promotion and substance use disorder prevention with general health promotion and disease prevention and integrating mental and substance use disorders treatment services with physical health treatment services;”
in paragraph (13)—
in the matter preceding subparagraph (A), by striking “ this title, assure that” and inserting “ this title or part B of title XIX, or grant programs otherwise funded by the Administration”;
in subparagraph (A)—
by inserting “ require that” before “ all grants”; and
by striking “ and” at the end;
by redesignating subparagraph (B) as subparagraph (C);
by inserting after subparagraph (A) the following:
“(B) ensure that the director of each Center of the Administration consistently documents the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded;”
in subparagraph (C), as so redesignated—
by inserting “ require that” before “ all grants”; and
in clause (ii), by inserting “ and” after the semicolon at the end; and
by adding at the end the following:
“(D) inform a State when any funds are awarded through such a grant to any entity within such State;”
in paragraph (16), by striking “ abuse and mental health information” and inserting “ use disorder information, including evidence-based and promising best practices for prevention, treatment, and recovery support services for individuals with mental and substance use disorders,”;
in paragraph (17)—
by striking “ substance abuse” and inserting “ substance use disorder”; and
by striking “ and” at the end;
in paragraph (18), by striking the period and inserting a semicolon; and
by adding at the end the following:
“(19) consult with State, local, and tribal governments, nongovernmental entities, and individuals with mental illness, particularly adults with a serious mental illness, children with a serious emotional disturbance, and the family members of such adults and children, with respect to improving community-based and other mental health services;
“(20) collaborate with the Secretary of Defense and the Secretary of Veterans Affairs to improve the provision of mental and substance use disorder services provided by the Department of Defense and the Department of Veterans Affairs to members of the Armed Forces, veterans, and the family members of such members and veterans, including through the provision of services using the telehealth capabilities of the Department of Defense and the Department of Veterans Affairs;
“(21) collaborate with the heads of relevant Federal agencies and departments, States, communities, and nongovernmental experts to improve mental and substance use disorders services for chronically homeless individuals, including by designing strategies to provide such services in supportive housing;
“(22) work with States and other stakeholders to develop and support activities to recruit and retain a workforce addressing mental and substance use disorders;
“(23) collaborate with the Attorney General and representatives of the criminal justice system to improve mental and substance use disorders services for individuals who have been arrested or incarcerated;
“(24) after providing an opportunity for public input, set standards for grant programs under this title for mental and substance use disorders services and prevention programs, which standards may address—
“(A) the capacity of the grantee to implement the award;
“(B) requirements for the description of the program implementation approach;
“(C) the extent to which the grant plan submitted by the grantee as part of its application must explain how the grantee will reach the population of focus and provide a statement of need, which may include information on how the grantee will increase access to services and a description of measurable objectives for improving outcomes;
“(D) the extent to which the grantee must collect and report on required performance measures; and
“(E) the extent to which the grantee is proposing to use evidence-based practices; and
“(25) advance, through existing programs, the use of performance metrics, including those based on the recommendations on performance metrics from the Assistant Secretary for Planning and Evaluation under section 6021(d) of the Helping Families in Mental Health Crisis Reform Act of 2016.”
; and
in subsection (m), by adding at the end the following:
“(4) Emergency response.—Amounts made available for carrying out this subsection shall remain available through the end of the fiscal year following the fiscal year for which such amounts are appropriated.”
SEC. 6003. Chief Medical Officer.
Section 501 of the Public Health Service Act (42 U.S.C. 290aa), as amended by sections 6001 and 6002, is further amended—
by redesignating subsections (g) through (j) and subsections (k) through (o) as subsections (h) through (k) and subsections (m) through (q), respectively;
in subsection (e)(3)(C), by striking “ subsection (k)” and inserting “ subsection (m)”;
in subsection (f)(2)(C)(iii), by striking “ subsection (k)” and inserting “ subsection (m)”; and
by inserting after subsection (f) the following:
“(g) Chief Medical Officer.—
“(1) In general.—The Assistant Secretary, with the approval of the Secretary, shall appoint a Chief Medical Officer to serve within the Administration.
“(2) Eligible candidates.—The Assistant Secretary shall select the Chief Medical Officer from among individuals who—
“(A) have a doctoral degree in medicine or osteopathic medicine;
“(B) have experience in the provision of mental or substance use disorder services;
“(C) have experience working with mental or substance use disorder programs;
“(D) have an understanding of biological, psychosocial, and pharmaceutical treatments of mental or substance use disorders; and
“(E) are licensed to practice medicine in one or more States.
“(3) Duties.—The Chief Medical Officer shall—
“(A) serve as a liaison between the Administration and providers of mental and substance use disorders prevention, treatment, and recovery services;
“(B) assist the Assistant Secretary in the evaluation, organization, integration, and coordination of programs operated by the Administration;
“(C) promote evidence-based and promising best practices, including culturally and linguistically appropriate practices, as appropriate, for the prevention and treatment of, and recovery from, mental and substance use disorders, including serious mental illness and serious emotional disturbances;
“(D) participate in regular strategic planning with the Administration;
“(E) coordinate with the Assistant Secretary for Planning and Evaluation to assess the use of performance metrics to evaluate activities within the Administration related to mental and substance use disorders; and
“(F) coordinate with the Assistant Secretary to ensure mental and substance use disorders grant programs within the Administration consistently utilize appropriate performance metrics and evaluation designs.”
SEC. 6004. Improving the Quality of Behavioral Health Programs.
Section 505 of the Public Health Service Act (42 U.S.C. 290aa–4), as amended by section 6001(c), is amended—
by striking the section designation and heading and inserting the following:
“SEC. 505. CENTER FOR BEHAVIORAL HEALTH STATISTICS AND QUALITY.”
by redesignating subsections (a) through (d) as subsections (b) through (e), respectively;
before subsection (b), as redesignated by paragraph (2), by inserting the following:
“(a) In General.—The Assistant Secretary shall maintain within the Administration a Center for Behavioral Health Statistics and Quality (in this section referred to as the ‘Center’). The Center shall be headed by a Director (in this section referred to as the ‘Director’) appointed by the Secretary from among individuals with extensive experience and academic qualifications in research and analysis in behavioral health care or related fields.”
in subsection (b), as redesignated by paragraph (2)—
by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively;
by striking “ The Secretary, acting” and all that follows through “ year on—” and inserting
“(1) coordinate the Administration’s integrated data strategy, including by collecting data each year on—”
in the subparagraph (B), as redesignated by subparagraph (A), by striking “ Assistant Secretary” and inserting “ Director”; and
by adding at the end the following new paragraphs:
“(2) provide statistical and analytical support for activities of the Administration;
“(3) recommend a core set of performance metrics to evaluate activities supported by the Administration; and
“(4) coordinate with the Assistant Secretary, the Assistant Secretary for Planning and Evaluation, and the Chief Medical Officer appointed under section 501(g), as appropriate, to improve the quality of services provided by programs of the Administration and the evaluation of activities carried out by the Administration.”
in subsection (c), as so redesignated—
by striking “ With respect to the activities” and inserting “ Mental Health.—With respect to the activities”;
by striking “ Assistant Secretary” each place it appears and inserting “ Director”; and
by striking “ subsection (a)” and inserting “ subsection (b)(1)”;
in subsection (d), as so redesignated—
by striking the subsection designation and all that follows through “ With respect to the activities” and inserting the following:
“(d) Substance Abuse.—
“(1) In general.—With respect to the activities”
in paragraph (1)—
in the matter before subparagraph (A)—
by striking “ subsection (a)” and inserting “ subsection (b)(1)”; and
by striking “ Assistant Secretary” each place it appears and inserting “ Director”; and
in subparagraph (B), by inserting “ in coordination with the Centers for Disease Control and Prevention” before the semicolon at the end; and
in paragraph (2), by striking “ Annual surveys” and inserting “ Annual surveys; public availability of data.—Annual surveys”; and
in subsection (e), as so redesignated—
by striking “ After consultation” and inserting “ Consultation.—After consultation”; and
by striking “ Assistant Secretary shall develop” and inserting “ Assistant Secretary shall use existing standards and best practices to develop”.
SEC. 6005. Strategic Plan.
Section 501 of the Public Health Service Act (42 U.S.C. 290aa), as amended by sections 6001 through 6003, is further amended by inserting after subsection (k), as redesignated by section 6003, the following:
“(l) Strategic Plan.—
“(1) In general.—Not later than September 30, 2018, and every 4 years thereafter, the Assistant Secretary shall develop and carry out a strategic plan in accordance with this subsection for the planning and operation of activities carried out by the Administration, including evidence-based programs.
“(2) Coordination.—In developing and carrying out the strategic plan under this subsection, the Assistant Secretary shall take into consideration the findings and recommendations of the Assistant Secretary for Planning and Evaluation under section 6021(d) of the Helping Families in Mental Health Crisis Reform Act of 2016 and the report of the Interdepartmental Serious Mental Illness Coordinating Committee under section 6031 of such Act.
“(3) Publication of plan.—Not later than September 30, 2018, and every 4 years thereafter, the Assistant Secretary shall—
“(A) submit the strategic plan developed under paragraph (1) to the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives and the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate; and
“(B) post such plan on the Internet website of the Administration.
“(4) Contents.—The strategic plan developed under paragraph (1) shall—
“(A) identify strategic priorities, goals, and measurable objectives for mental and substance use disorders activities and programs operated and supported by the Administration, including priorities to prevent or eliminate the burden of mental and substance use disorders;
“(B) identify ways to improve the quality of services for individuals with mental and substance use disorders, and to reduce homelessness, arrest, incarceration, violence, including self-directed violence, and unnecessary hospitalization of individuals with a mental or substance use disorder, including adults with a serious mental illness or children with a serious emotional disturbance;
“(C) ensure that programs provide, as appropriate, access to effective and evidence-based prevention, diagnosis, intervention, treatment, and recovery services, including culturally and linguistically appropriate services, as appropriate, for individuals with a mental or substance use disorder;
“(D) identify opportunities to collaborate with the Health Resources and Services Administration to develop or improve—
“(i) initiatives to encourage individuals to pursue careers (especially in rural and underserved areas and with rural and underserved populations) as psychiatrists, including child and adolescent psychiatrists, psychologists, psychiatric nurse practitioners, physician assistants, clinical social workers, certified peer support specialists, licensed professional counselors, or other licensed or certified mental health or substance use disorder professionals, including such professionals specializing in the diagnosis, evaluation, or treatment of adults with a serious mental illness or children with a serious emotional disturbance; and
“(ii) a strategy to improve the recruitment, training, and retention of a workforce for the treatment of individuals with mental or substance use disorders, or co-occurring disorders;
“(E) identify opportunities to improve collaboration with States, local governments, communities, and Indian tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act); and
“(F) specify a strategy to disseminate evidence-based and promising best practices related to prevention, diagnosis, early intervention, treatment, and recovery services related to mental illness, particularly for adults with a serious mental illness and children with a serious emotional disturbance, and for individuals with a substance use disorder.”
SEC. 6006. Biennial Report Concerning Activities and Progress.
In General.— Section 501 of the Public Health Service Act (42 U.S.C. 290aa), as so amended, is further amended by amending subsection (m), as redesignated by section 6003, to read as follows:
“(m) Biennial Report Concerning Activities and Progress.—Not later than September 30, 2020, and every 2 years thereafter, the Assistant Secretary shall prepare and submit to the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives and the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate, and post on the Internet website of the Administration, a report containing at a minimum—
“(1) a review of activities conducted or supported by the Administration, including progress toward strategic priorities, goals, and objectives identified in the strategic plan developed under subsection (l);
“(2) an assessment of programs and activities carried out by the Assistant Secretary, including the extent to which programs and activities under this title and part B of title XIX meet identified goals and performance measures developed for the respective programs and activities;
“(3) a description of the progress made in addressing gaps in mental and substance use disorders prevention, treatment, and recovery services and improving outcomes by the Administration, including with respect to serious mental illnesses, serious emotional disturbances, and co-occurring disorders;
“(4) a description of the manner in which the Administration coordinates and partners with other Federal agencies and departments related to mental and substance use disorders, including activities related to—
“(A) the implementation and dissemination of research findings into improved programs, including with respect to how advances in serious mental illness and serious emotional disturbance research have been incorporated into programs;
“(B) the recruitment, training, and retention of a mental and substance use disorders workforce;
“(C) the integration of mental disorder services, substance use disorder services, and physical health services;
“(D) homelessness; and
“(E) veterans;
“(5) a description of the manner in which the Administration promotes coordination by grantees under this title, and part B of title XIX, with State or local agencies; and
“(6) a description of the activities carried out under section 501A(e), with respect to mental and substance use disorders, including—
“(A) the number and a description of grants awarded;
“(B) the total amount of funding for grants awarded;
“(C) a description of the activities supported through such grants, including outcomes of programs supported; and
“(D) information on how the National Mental Health and Substance Use Policy Laboratory is consulting with the Assistant Secretary for Planning and Evaluation and collaborating with the Center for Substance Abuse Treatment, the Center for Substance Abuse Prevention, the Center for Behavioral Health Statistics and Quality, and the Center for Mental Health Services to carry out such activities; and
“(7) recommendations made by the Assistant Secretary for Planning and Evaluation under section 6021 of the Helping Families in Mental Health Crisis Reform Act of 2016 to improve programs within the Administration, and actions taken in response to such recommendations to improve programs within the Administration.
Conforming Amendment.— Section 508(p) of the Public Health Service Act (42 U.S.C. 290bb–1(p)) is amended by striking “ section 501(k)” and inserting “ section 501(m)”.
SEC. 6007. Authorities of Centers for Mental Health Services, Substance Abuse Prevention, and Substance Abuse Treatment.
Center for Mental Health Services.— Section 520(b) of the Public Health Service Act (42 U.S.C. 290bb–31(b)) is amended—
by redesignating paragraphs (3) through (15) as paragraphs (4) through (16), respectively;
by inserting after paragraph (2) the following:
“(3) collaborate with the Director of the National Institute of Mental Health and the Chief Medical Officer, appointed under section 501(g), to ensure that, as appropriate, programs related to the prevention and treatment of mental illness and the promotion of mental health and recovery support are carried out in a manner that reflects the best available science and evidence-based practices, including culturally and linguistically appropriate services, as appropriate;”
in paragraph (5), as so redesignated, by inserting “ , including through programs that reduce risk and promote resiliency” before the semicolon;
in paragraph (6), as so redesignated, by inserting “ in collaboration with the Director of the National Institute of Mental Health,” before “ develop”;
in paragraph (8), as so redesignated, by inserting “ , increase meaningful participation of individuals with mental illness in programs and activities of the Administration,” before “ and protect the legal”;
in paragraph (10), as so redesignated, by striking “ professional and paraprofessional personnel pursuant to section 303” and inserting “ health paraprofessional personnel and health professionals”;
in paragraph (11), as so redesignated, by inserting “ and tele-mental health” after “ rural mental health”;
in paragraph (12), as so redesignated, by striking “ establish a clearinghouse for mental health information to assure the widespread dissemination of such information” and inserting “ disseminate mental health information, including evidence-based practices,”;
in paragraph (15), as so redesignated, by striking “ and” at the end;
in paragraph (16), as so redesignated, by striking the period and inserting “ ; and”; and
by adding at the end the following:
“(17) ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded.”
Director of the Center for Substance Abuse Prevention.— Section 515 of the Public Health Service Act (42 U.S.C. 290bb–21) is amended—
in the section heading, by striking “ office” and inserting “ center”;
in subsection (a)—
by striking “ an Office” and inserting “ a Center”; and
by striking “ The Office” and inserting “ The Prevention Center”; and
in subsection (b)—
in paragraph (1), by inserting “ through the reduction of risk and the promotion of resiliency” before the semicolon;
by redesignating paragraphs (3) through (11) as paragraphs (4) through (12), respectively;
by inserting after paragraph (2) the following:
“(3) collaborate with the Director of the National Institute on Drug Abuse, the Director of the National Institute on Alcohol Abuse and Alcoholism, and States to promote the study of substance abuse prevention and the dissemination and implementation of research findings that will improve the delivery and effectiveness of substance abuse prevention activities;”
in paragraph (4), as so redesignated, by striking “ literature on the adverse effects of cocaine free base (known as crack)” and inserting “ educational information on the effects of drugs abused by individuals, including drugs that are emerging as abused drugs”;
in paragraph (6), as so redesignated—
by striking “ substance abuse counselors” and inserting “ health professionals who provide substance use and misuse prevention and treatment services”; and
by striking “ drug abuse education, prevention,” and inserting “ illicit drug use education and prevention”;
by amending paragraph (7), as so redesignated, to read as follows:
“(7) in cooperation with the Director of the Centers for Disease Control and Prevention, develop and disseminate educational materials to increase awareness for individuals at greatest risk for substance use disorders to prevent the transmission of communicable diseases, such as HIV, hepatitis, tuberculosis, and other communicable diseases;”
in paragraph (9), as so redesignated—
by striking “ to discourage” and inserting “ that reduce the risk of”; and
by inserting before the semicolon “ and promote resiliency”;
in paragraph (11), as so redesignated, by striking “ and” after the semicolon;
in paragraph (12), as so redesignated, by striking the period and inserting a semicolon; and
by adding at the end the following:
“(13) ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded; and
“(14) assist and support States in preventing illicit drug use, including emerging illicit drug use issues.”
Director of the Center for Substance Abuse Treatment.— Section 507 of the Public Health Service Act (42 U.S.C. 290bb) is amended—
in subsection (a)—
by striking “ treatment of substance abuse” and inserting “ treatment of substance use disorders”; and
by striking “ abuse treatment systems” and inserting “ use disorder treatment systems”; and
in subsection (b)—
in paragraph (1), by striking “ abuse” and inserting “ use disorder”;
in paragraph (3), by striking “ abuse” and inserting “ use disorder”;
in paragraph (4), by striking “ individuals who abuse drugs” and inserting “ individuals who illicitly use drugs”;
in paragraph (9), by striking “ carried out by the Director”;
by striking paragraph (10);
by redesignating paragraphs (11) through (14) as paragraphs (10) through (13), respectively;
in paragraph (12), as so redesignated, by striking “ ; and” and inserting a semicolon; and
by striking paragraph (13), as so redesignated, and inserting the following:
“(13) ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded; and
“(14) work with States, providers, and individuals in recovery, and their families, to promote the expansion of recovery support services and systems of care oriented toward recovery.”
SEC. 6008. Advisory Councils.
Section 502(b) of the Public Health Service Act (42 U.S.C. 290aa–1(b)) is amended—
in paragraph (2)—
in subparagraph (E), by striking “ and” after the semicolon;
by redesignating subparagraph (F) as subparagraph (J); and
by inserting after subparagraph (E), the following:
“(F) the Chief Medical Officer, appointed under section 501(g);
“(G) the Director of the National Institute of Mental Health for the advisory councils appointed under subsections (a)(1)(A) and (a)(1)(D);
“(H) the Director of the National Institute on Drug Abuse for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C);
“(I) the Director of the National Institute on Alcohol Abuse and Alcoholism for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C); and”
; and
in paragraph (3), by adding at the end the following:
“(C) Not less than half of the members of the advisory council appointed under subsection (a)(1)(D)—
“(i) shall—
“(I) have a medical degree;
“(II) have a doctoral degree in psychology; or
“(III) have an advanced degree in nursing or social work from an accredited graduate school or be a certified physician assistant; and
“(ii) shall specialize in the mental health field.
“(D) Not less than half of the members of the advisory councils appointed under subsections (a)(1)(B) and (a)(1)(C)—
“(i) shall—
“(I) have a medical degree;
“(II) have a doctoral degree; or
“(III) have an advanced degree in nursing, public health, behavioral or social sciences, or social work from an accredited graduate school or be a certified physician assistant; and
“(ii) shall have experience in the provision of substance use disorder services or the development and implementation of programs to prevent substance misuse.”
SEC. 6009. Peer Review.
Section 504(b) of the Public Health Service Act (42 U.S.C. 290aa–3(b)) is amended by adding at the end the following: “ In the case of any such peer review group that is reviewing a grant, cooperative agreement, or contract related to mental illness treatment, not less than half of the members of such peer review group shall be licensed and experienced professionals in the prevention, diagnosis, or treatment of, or recovery from, mental illness or co-occurring mental illness and substance use disorders and have a medical degree, a doctoral degree in psychology, or an advanced degree in nursing or social work from an accredited program, and the Secretary, in consultation with the Assistant Secretary, shall, to the extent possible, ensure such peer review groups include broad geographic representation, including both urban and rural representatives.”.
Subtitle B Oversight and Accountability
SEC. 6021. Improving Oversight of Mental and Substance Use Disorders Programs Through the Assistant Secretary for Planning and Evaluation.
In General.— The Secretary of Health and Human Services, acting through the Assistant Secretary for Planning and Evaluation, shall ensure efficient and effective planning and evaluation of mental and substance use disorders prevention and treatment programs and related activities.
Evaluation Strategy.— In carrying out subsection (a), the Assistant Secretary for Planning and Evaluation shall, not later than 180 days after the date of enactment of this Act, develop a strategy for conducting ongoing evaluations that identifies priority programs to be evaluated by the Assistant Secretary for Planning and Evaluation and priority programs to be evaluated by other relevant offices and agencies within the Department of Health and Human Services. The strategy shall—
include a plan for evaluating programs related to mental and substance use disorders, including co-occurring disorders, across agencies, as appropriate, including programs related to—
prevention, intervention, treatment, and recovery support services, including such services for adults with a serious mental illness or children with a serious emotional disturbance;
the reduction of homelessness and incarceration among individuals with a mental or substance use disorder; and
public health and health services; and
include a plan for assessing the use of performance metrics to evaluate activities carried out by entities receiving grants, contracts, or cooperative agreements related to mental and substance use disorders prevention and treatment services under title V or title XIX of the Public Health Service Act (42 U.S.C. 290aa et seq.; 42 U.S.C. 300w et seq.).
Consultation.— In carrying out this section, the Assistant Secretary for Planning and Evaluation shall consult, as appropriate, with the Assistant Secretary for Mental Health and Substance Use, the Chief Medical Officer of the Substance Abuse and Mental Health Services Administration appointed under section 501(g) of the Public Health Service Act (42 U.S.C. 290aa(g)), as amended by section 6003, the Behavioral Health Coordinating Council of the Department of Health and Human Services, other agencies within the Department of Health and Human Services, and other relevant Federal departments and agencies.
Recommendations.— In carrying out this section, the Assistant Secretary for Planning and Evaluation shall provide recommendations to the Secretary of Health and Human Services, the Assistant Secretary for Mental Health and Substance Use, and the Congress on improving the quality of prevention and treatment programs and activities related to mental and substance use disorders, including recommendations for the use of performance metrics. The Assistant Secretary for Mental Health and Substance Use shall include such recommendations in the biennial report required by subsection 501(m) of the Public Health Service Act, as redesignated by section 6003 of this Act.
SEC. 6022. Reporting for Protection and Advocacy Organizations.
Public Availability of Reports.— Section 105(a)(7) of the Protection and Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10805(a)(7)) is amended by striking “ is located a report” and inserting “ is located, and make publicly available, a report”.
Detailed Accounting.— Section 114(a) of the Protection and Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10824(a)) is amended—
in paragraph (3), by striking “ and” at the end;
in paragraph (4), by striking the period at the end and inserting “ ; and”; and
by adding at the end the following:
“(5) using data from the existing required annual program progress reports submitted by each system funded under this title, a detailed accounting for each such system of how funds are spent, disaggregated according to whether the funds were received from the Federal Government, the State government, a local government, or a private entity.”
SEC. 6023. Gao Study.
In General.— Not later than 18 months after the date of enactment of this Act, the Comptroller General of the United States, in consultation with the Secretary of Health and Human Services and the Assistant Secretary for Mental Health and Substance Use, shall conduct an independent evaluation, and submit a report, to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives, on programs funded by allotments made under title I of the Protection and Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10801 et seq.).
Contents.— The report and evaluation required under subsection (a) shall include—
a review of the programs described in such subsection that are carried out by State agencies and such programs that are carried out by private, nonprofit organizations; and
a review of the compliance of the programs described in subsection (a) with statutory and regulatory responsibilities, such as—
responsibilities relating to family engagement;
responsibilities relating to the grievance procedure for clients or prospective clients of the system to assure that individuals with mental illness have full access to the services of the system, for individuals who have received or are receiving mental health services, and for family members of such individuals with mental illness, or representatives of such individuals or family members, to assure that the eligible system is operating in compliance with the provisions of the Protection and Advocacy for Individuals with Mental Illness Act, as required to be established by section 105(a)(9) of such Act (42 U.S.C. 10805(a)(9));
investigation of alleged abuse and neglect of persons with mental illness;
availability of adequate medical and behavioral health treatment;
denial of rights for persons with mental illness; and
compliance with the Federal prohibition on lobbying.
Subtitle C Interdepartmental Serious Mental Illness Coordinating Committee
SEC. 6031. Interdepartmental Serious Mental Illness Coordinating Committee.
Establishment.—
In general.— Not later than 3 months after the date of enactment of this Act, the Secretary of Health and Human Services, or the designee of the Secretary, shall establish a committee to be known as the Interdepartmental Serious Mental Illness Coordinating Committee (in this section referred to as the “Committee”).
Federal advisory committee act.— Except as provided in this section, the provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Committee.
Meetings.— The Committee shall meet not fewer than 2 times each year.
Responsibilities.— Not later than 1 year after the date of enactment of this Act, and 5 years after such date of enactment, the Committee shall submit to Congress and any other relevant Federal department or agency a report including—
a summary of advances in serious mental illness and serious emotional disturbance research related to the prevention of, diagnosis of, intervention in, and treatment and recovery of serious mental illnesses, serious emotional disturbances, and advances in access to services and support for adults with a serious mental illness or children with a serious emotional disturbance;
an evaluation of the effect Federal programs related to serious mental illness have on public health, including public health outcomes such as—
rates of suicide, suicide attempts, incidence and prevalence of serious mental illnesses, serious emotional disturbances, and substance use disorders, overdose, overdose deaths, emergency hospitalizations, emergency room boarding, preventable emergency room visits, interaction with the criminal justice system, homelessness, and unemployment;
increased rates of employment and enrollment in educational and vocational programs;
quality of mental and substance use disorders treatment services; or
any other criteria as may be determined by the Secretary; and
specific recommendations for actions that agencies can take to better coordinate the administration of mental health services for adults with a serious mental illness or children with a serious emotional disturbance.
Committee Extension.— Upon the submission of the second report under subsection (c), the Secretary shall submit a recommendation to Congress on whether to extend the operation of the Committee.
Membership.—
Federal members.— The Committee shall be composed of the following Federal representatives, or the designees of such representatives—
the Secretary of Health and Human Services, who shall serve as the Chair of the Committee;
the Assistant Secretary for Mental Health and Substance Use;
the Attorney General;
the Secretary of Veterans Affairs;
the Secretary of Defense;
the Secretary of Housing and Urban Development;
the Secretary of Education;
the Secretary of Labor;
the Administrator of the Centers for Medicare & Medicaid Services; and
the Commissioner of Social Security.
Non-federal members.— The Committee shall also include not less than 14 non-Federal public members appointed by the Secretary of Health and Human Services, of which—
at least 2 members shall be an individual who has received treatment for a diagnosis of a serious mental illness;
at least 1 member shall be a parent or legal guardian of an adult with a history of a serious mental illness or a child with a history of a serious emotional disturbance;
at least 1 member shall be a representative of a leading research, advocacy, or service organization for adults with a serious mental illness;
at least 2 members shall be—
a licensed psychiatrist with experience in treating serious mental illnesses;
a licensed psychologist with experience in treating serious mental illnesses or serious emotional disturbances;
a licensed clinical social worker with experience treating serious mental illnesses or serious emotional disturbances; or
a licensed psychiatric nurse, nurse practitioner, or physician assistant with experience in treating serious mental illnesses or serious emotional disturbances;
at least 1 member shall be a licensed mental health professional with a specialty in treating children and adolescents with a serious emotional disturbance;
at least 1 member shall be a mental health professional who has research or clinical mental health experience in working with minorities;
at least 1 member shall be a mental health professional who has research or clinical mental health experience in working with medically underserved populations;
at least 1 member shall be a State certified mental health peer support specialist;
at least 1 member shall be a judge with experience in adjudicating cases related to criminal justice or serious mental illness;
at least 1 member shall be a law enforcement officer or corrections officer with extensive experience in interfacing with adults with a serious mental illness, children with a serious emotional disturbance, or individuals in a mental health crisis; and
at least 1 member shall have experience providing services for homeless individuals and working with adults with a serious mental illness, children with a serious emotional disturbance, or individuals in a mental health crisis.
Terms.— A member of the Committee appointed under subsection (e)(2) shall serve for a term of 3 years, and may be reappointed for 1 or more additional 3-year terms. Any member appointed to fill a vacancy for an unexpired term shall be appointed for the remainder of such term. A member may serve after the expiration of the member’s term until a successor has been appointed.
Working Groups.— In carrying out its functions, the Committee may establish working groups. Such working groups shall be composed of Committee members, or their designees, and may hold such meetings as are necessary.
Sunset.— The Committee shall terminate on the date that is 6 years after the date on which the Committee is established under subsection (a)(1).
TITLE VII Ensuring Mental and Substance Use Disorders Prevention, Treatment, and Recovery Programs Keep Pace with Science and Technology
SEC. 7001. Encouraging Innovation and Evidence-Based Programs.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended by inserting after section 501 (42 U.S.C. 290aa) the following:
“SEC. 501A. NATIONAL MENTAL HEALTH AND SUBSTANCE USE POLICY LABORATORY.
“(a) In General.—There shall be established within the Administration a National Mental Health and Substance Use Policy Laboratory (referred to in this section as the ‘Laboratory’).
“(b) Responsibilities.—The Laboratory shall—
“(1) continue to carry out the authorities and activities that were in effect for the Office of Policy, Planning, and Innovation as such Office existed prior to the date of enactment of the Helping Families in Mental Health Crisis Reform Act of 2016;
“(2) identify, coordinate, and facilitate the implementation of policy changes likely to have a significant effect on mental health, mental illness, recovery supports, and the prevention and treatment of substance use disorder services;
“(3) work with the Center for Behavioral Health Statistics and Quality to collect, as appropriate, information from grantees under programs operated by the Administration in order to evaluate and disseminate information on evidence-based practices, including culturally and linguistically appropriate services, as appropriate, and service delivery models;
“(4) provide leadership in identifying and coordinating policies and programs, including evidence-based programs, related to mental and substance use disorders;
“(5) periodically review programs and activities operated by the Administration relating to the diagnosis or prevention of, treatment for, and recovery from, mental and substance use disorders to—
“(A) identify any such programs or activities that are duplicative;
“(B) identify any such programs or activities that are not evidence-based, effective, or efficient; and
“(C) formulate recommendations for coordinating, eliminating, or improving programs or activities identified under subparagraph (A) or (B) and merging such programs or activities into other successful programs or activities; and
“(6) carry out other activities as deemed necessary to continue to encourage innovation and disseminate evidence-based programs and practices.
“(c) Evidence-Based Practices and Service Delivery Models.—
“(1) In general.—In carrying out subsection (b)(3), the Laboratory—
“(A) may give preference to models that improve—
“(i) the coordination between mental health and physical health providers;
“(ii) the coordination among such providers and the justice and corrections system; and
“(iii) the cost effectiveness, quality, effectiveness, and efficiency of health care services furnished to adults with a serious mental illness, children with a serious emotional disturbance, or individuals in a mental health crisis; and
“(B) may include clinical protocols and practices that address the needs of individuals with early serious mental illness.
“(2) Consultation.—In carrying out this section, the Laboratory shall consult with—
“(A) the Chief Medical Officer appointed under section 501(g);
“(B) representatives of the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, on an ongoing basis;
“(C) other appropriate Federal agencies;
“(D) clinical and analytical experts with expertise in psychiatric medical care and clinical psychological care, health care management, education, corrections health care, and mental health court systems, as appropriate; and
“(E) other individuals and agencies as determined appropriate by the Assistant Secretary.
“(d) Deadline for Beginning Implementation.—The Laboratory shall begin implementation of this section not later than January 1, 2018.
“(e) Promoting Innovation.—
“(1) In general.—The Assistant Secretary, in coordination with the Laboratory, may award grants to States, local governments, Indian tribes or tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), educational institutions, and nonprofit organizations to develop evidence-based interventions, including culturally and linguistically appropriate services, as appropriate, for—
“(A) evaluating a model that has been scientifically demonstrated to show promise, but would benefit from further applied development, for—
“(i) enhancing the prevention, diagnosis, intervention, and treatment of, and recovery from, mental illness, serious emotional disturbances, substance use disorders, and co-occurring illness or disorders; or
“(ii) integrating or coordinating physical health services and mental and substance use disorders services; and
“(B) expanding, replicating, or scaling evidence-based programs across a wider area to enhance effective screening, early diagnosis, intervention, and treatment with respect to mental illness, serious mental illness, serious emotional disturbances, and substance use disorders, primarily by—
“(i) applying such evidence-based programs to the delivery of care, including by training staff in effective evidence-based treatments; or
“(ii) integrating such evidence-based programs into models of care across specialties and jurisdictions.
“(2) Consultation.—In awarding grants under this subsection, the Assistant Secretary shall, as appropriate, consult with the Chief Medical Officer, appointed under section 501(g), the advisory councils described in section 502, the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, as appropriate.
“(3) Authorization of appropriations.—There are authorized to be appropriated—
“(A) to carry out paragraph (1)(A), $7,000,000 for the period of fiscal years 2018 through 2020; and
“(B) to carry out paragraph (1)(B), $7,000,000 for the period of fiscal years 2018 through 2020.”
SEC. 7002. Promoting Access to Information on Evidence-Based Programs and Practices.
Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.) is amended by inserting after section 543 of such Act (42 U.S.C. 290dd–2) the following:
“SEC. 543A. PROMOTING ACCESS TO INFORMATION ON EVIDENCE-BASED PROGRAMS AND PRACTICES.
“(a) In General.—The Assistant Secretary shall, as appropriate, improve access to reliable and valid information on evidence-based programs and practices, including information on the strength of evidence associated with such programs and practices, related to mental and substance use disorders for States, local communities, nonprofit entities, and other stakeholders, by posting on the Internet website of the Administration information on evidence-based programs and practices that have been reviewed by the Assistant Secretary in accordance with the requirements of this section.
“(b) Applications.—
“(1) Application period.—In carrying out subsection (a), the Assistant Secretary may establish a period for the submission of applications for evidence-based programs and practices to be posted publicly in accordance with subsection (a).
“(2) Notice.—In establishing the application period under paragraph (1), the Assistant Secretary shall provide for the public notice of such application period in the Federal Register. Such notice may solicit applications for evidence-based programs and practices to address gaps in information identified by the Assistant Secretary, the National Mental Health and Substance Use Policy Laboratory established under section 501A, or the Assistant Secretary for Planning and Evaluation, including pursuant to the evaluation and recommendations under section 6021 of the Helping Families in Mental Health Crisis Reform Act of 2016 or priorities identified in the strategic plan under section 501(l).
“(c) Requirements.—The Assistant Secretary may establish minimum requirements for the applications submitted under subsection (b), including applications related to the submission of research and evaluation.
“(d) Review and Rating.—
“(1) In general.—The Assistant Secretary shall review applications prior to public posting in accordance with subsection (a), and may prioritize the review of applications for evidence-based programs and practices that are related to topics included in the notice provided under subsection (b)(2).
“(2) System.—In carrying out paragraph (1), the Assistant Secretary may utilize a rating and review system, which may include information on the strength of evidence associated with the evidence-based programs and practices and a rating of the methodological rigor of the research supporting the applications.
“(3) Public access to metrics and rating.—The Assistant Secretary shall make the metrics used to evaluate applications under this section, and any resulting ratings of such applications, publicly available.”
SEC. 7003. Priority Mental Health Needs of Regional and National Significance.
Section 520A of the Public Health Service Act (42 U.S.C. 290bb–32) is amended—
in subsection (a)—
in paragraph (4), by inserting before the period “ , which may include technical assistance centers”; and
in the flush sentence following paragraph (4)—
by inserting “ , contracts,” before “ or cooperative agreements”; and
by striking “ Indian tribes and tribal organizations” and inserting “ Indian tribes or tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), health facilities, or programs operated by or in accordance with a contract or grant with the Indian Health Service, or”; and
by amending subsection (f) to read as follows:
“(f) Authorization of Appropriations.—There are authorized to be appropriated to carry out this section $394,550,000 for each of fiscal years 2018 through 2022.”
SEC. 7004. Priority Substance Use Disorder Treatment Needs of Regional and National Significance.
Section 509 of the Public Health Service Act (42 U.S.C. 290bb–2) is amended—
in subsection (a)—
in the matter preceding paragraph (1), by striking “ abuse” and inserting “ use disorder”;
in paragraph (3), by inserting before the period “ that permit States, local governments, communities, and Indian tribes and tribal organizations (as the terms ‘Indian tribes’ and ‘tribal organizations’ are defined in section 4 of the Indian Self-Determination and Education Assistance Act) to focus on emerging trends in substance abuse and co-occurrence of substance use disorders with mental illness or other conditions”; and
in the flush sentence following paragraph (3)—
by inserting “ , contracts,” before “ or cooperative agreements”; and
by striking “ Indian tribes and tribal organizations,” and inserting “ Indian tribes or tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), health facilities, or programs operated by or in accordance with a contract or grant with the Indian Health Service, or”;
in subsection (b)—
in paragraph (1), by striking “ abuse” and inserting “ use disorder”; and
in paragraph (2), by striking “ abuse” and inserting “ use disorder”;
in subsection (e), by striking “ abuse” and inserting “ use disorder”; and
in subsection (f), by striking “ $300,000,000” and all that follows through the period and inserting “ $333,806,000 for each of fiscal years 2018 through 2022.”.
SEC. 7005. Priority Substance Use Disorder Prevention Needs of Regional and National Significance.
Section 516 of the Public Health Service Act (42 U.S.C. 290bb–22) is amended—
in the section heading, by striking “ abuse” and inserting “ use disorder”;
in subsection (a)—
in the matter preceding paragraph (1), by striking “ abuse” and inserting “ use disorder”;
in paragraph (3), by inserting before the period “ , including such programs that focus on emerging drug abuse issues”; and
in the flush sentence following paragraph (3)—
by inserting “ , contracts,” before “ or cooperative agreements”; and
by striking “ Indian tribes and tribal organizations,” and inserting “ Indian tribes or tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), health facilities, or programs operated by or in accordance with a contract or grant with the Indian Health Service,”;
in subsection (b)—
in paragraph (1), by striking “ abuse” and inserting “ use disorder”; and
in paragraph (2)—
in subparagraph (A), by striking “ ; and” at the end and inserting “ ;”;
in subparagraph (B)—
by striking “ abuse” and inserting “ use disorder”; and
by striking the period and inserting “ ; and”; and
by adding at the end the following:
“(C) substance use disorder prevention among high-risk groups.”
in subsection (e), by striking “ abuse” and inserting “ use disorder”; and
in subsection (f), by striking “ $300,000,000” and all that follows through the period and inserting “ $211,148,000 for each of fiscal years 2018 through 2022.”.
TITLE VIII Supporting State Prevention Activities and Responses to Mental Health and Substance Use Disorder Needs
SEC. 8001. Community Mental Health Services Block Grant.
by redesignating paragraphs (1) through (3) as paragraphs (2) through (4), respectively; and
by inserting before paragraph (2) (as so redesignated) the following:
“(1) providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance as defined in accordance with section 1912(c);”
in paragraph (3), by redesignating subparagraphs (A) through (C) as clauses (i) through (iii), respectively, and realigning the margins accordingly;
by redesignating paragraphs (1) through (5) as subparagraphs (A) through (E), respectively, and realigning the margins accordingly;
in the matter preceding subparagraph (A) (as so redesignated), by striking “ With respect to” and all that follows through “ are as follows:” and inserting “ In accordance with subsection (a), a State shall submit to the Secretary a plan every two years that, at a minimum, includes each of the following:”;
by inserting before subparagraph (A) (as so redesignated) the following:
“(1) System of care.—A description of the State’s system of care that contains the following:”
by striking subparagraph (A) (as so redesignated) and inserting the following:
“(A) Comprehensive community-based health systems.—The plan shall—
“(i) identify the single State agency to be responsible for the administration of the program under the grant, including any third party who administers mental health services and is responsible for complying with the requirements of this part with respect to the grant;
“(ii) provide for an organized community-based system of care for individuals with mental illness, and describe available services and resources in a comprehensive system of care, including services for individuals with co-occurring disorders;
“(iii) include a description of the manner in which the State and local entities will coordinate services to maximize the efficiency, effectiveness, quality, and cost-effectiveness of services and programs to produce the best possible outcomes (including health services, rehabilitation services, employment services, housing services, educational services, substance use disorder services, legal services, law enforcement services, social services, child welfare services, medical and dental care services, and other support services to be provided with Federal, State, and local public and private resources) with other agencies to enable individuals receiving services to function outside of inpatient or residential institutions, to the maximum extent of their capabilities, including services to be provided by local school systems under the Individuals with Disabilities Education Act;
“(iv) include a description of how the State promotes evidence-based practices, including those evidence-based programs that address the needs of individuals with early serious mental illness regardless of the age of the individual at onset, provide comprehensive individualized treatment, or integrate mental and physical health services;
“(v) include a description of case management services;
“(vi) include a description of activities that seek to engage adults with a serious mental illness or children with a serious emotional disturbance and their caregivers where appropriate in making health care decisions, including activities that enhance communication among individuals, families, caregivers, and treatment providers; and
“(vii) as appropriate to, and reflective of, the uses the State proposes for the block grant funds, include—
“(I) a description of the activities intended to reduce hospitalizations and hospital stays using the block grant funds;
“(II) a description of the activities intended to reduce incidents of suicide using the block grant funds;
“(III) a description of how the State integrates mental health and primary care using the block grant funds, which may include providing, in the case of individuals with co-occurring mental and substance use disorders, both mental and substance use disorders services in primary care settings or arrangements to provide primary and specialty care services in community-based mental and substance use disorders settings; and
“(IV) a description of recovery and recovery support services for adults with a serious mental illness and children with a serious emotional disturbance.”
in subparagraph (B) (as so redesignated)—
by striking “ The plan contains” and inserting “ The plan shall contain”; and
by striking “ presents quantitative targets to be achieved in the implementation of the system described in paragraph (1)” and inserting “ present quantitative targets and outcome measures for programs and services provided under this subpart”;
in subparagraph (C) (as so redesignated)—
by striking “ serious emotional disturbance” in the matter preceding clause (i) (as so redesignated) and all that follows through “ substance abuse services” in clause (i) (as so redesignated) and inserting the following: “ a serious emotional disturbance (as defined pursuant to subsection (c)), the plan shall provide for a system of integrated social services, educational services, child welfare services, juvenile justice services, law enforcement services, and substance use disorder services”;
by striking “ Education Act);” and inserting “ Education Act).”; and
by striking clauses (ii) and (iii) (as so redesignated);
in subparagraph (D) (as so redesignated), by striking “ plan describes” and inserting “ plan shall describe”;
in subparagraph (E) (as so redesignated)—
in the subparagraph heading by striking “ systems” and inserting “ services”;
in the first sentence, by striking “ plan describes” and all that follows through “ and provides for” and inserting “ plan shall describe the financial resources available, the existing mental health workforce, and the workforce trained in treating individuals with co-occurring mental and substance use disorders, and shall provide for”; and
in the second sentence—
by striking “ further describes” and inserting “ shall further describe”; and
by striking “ involved.” and inserting “ involved, and the manner in which the State intends to comply with each of the funding agreements in this subpart and subpart III.”;
by striking the flush matter at the end; and
by adding at the end the following:
“(2) Goals and objectives.—The establishment of goals and objectives for the period of the plan, including targets and milestones that are intended to be met, and the activities that will be undertaken to achieve those targets.”
Early Serious Mental Illness.— Section 1920 of the Public Health Service Act (42 U.S.C. 300x–9) is amended by adding at the end the following:
“(c) Early Serious Mental Illness.—
“(1) In general.—Except as provided in paragraph (2), a State shall expend not less than 10 percent of the amount the State receives for carrying out this section for each fiscal year to support evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders, regardless of the age of the individual at onset.
“(2) State flexibility.—In lieu of expending 10 percent of the amount the State receives under this section for a fiscal year as required under paragraph (1), a State may elect to expend not less than 20 percent of such amount by the end of such succeeding fiscal year.”
Additional Provisions.— Section 1915(b) of the Public Health Service Act (42 U.S.C. 300x–4(b)) is amended—
in paragraph (3)—
by striking “ The Secretary” and inserting the following:
“(A) In general.—The Secretary”
by striking “ paragraph (1) if” and inserting “ paragraph (1) in whole or in part if”;
by striking “ State justify the waiver.” and inserting “ State in the fiscal year involved or in the previous fiscal year justify the waiver”; and
by adding at the end the following:
“(B) Date certain for action upon request.—The Secretary shall approve or deny a request for a waiver under this paragraph not later than 120 days after the date on which the request is made.
“(C) Applicability of waiver.—A waiver provided by the Secretary under this paragraph shall be applicable only to the fiscal year involved.”
; and
in paragraph (4)—
in subparagraph (A)—
by inserting after the subparagraph designation the following: “ In general.—”;
by striking “ In making a grant” and inserting the following:
“(i) Determination.—In making a grant”
; and
by inserting at the end the following:
“(ii) Alternative.—A State that has failed to comply with paragraph (1) and would otherwise be subject to a reduction in the State’s allotment under section 1911 may, upon request by the State, in lieu of having the amount of the allotment under section 1911 for the State reduced for the fiscal year of the grant, agree to comply with a negotiated agreement that is approved by the Secretary and carried out in accordance with guidelines issued by the Secretary. If a State fails to enter into or comply with a negotiated agreement, the Secretary may take action under this paragraph or the terms of the negotiated agreement.”
; and
in subparagraph (B)—
by inserting after the subparagraph designation the following: “ Submission of information to the secretary.—”; and
by striking “ subparagraph (A)” and inserting “ subparagraph (A)(i)”.
Application for Grant.— Section 1917(a) of the Public Health Service Act (42 U.S.C. 300x–6(a)) is amended—
in paragraph (1), by striking “ 1941” and inserting “ 1942(a)”; and
in paragraph (5), by striking “ 1915(b)(3)(B)” and inserting “ 1915(b)”.
in subsection (a)—
by striking “ section 505” and inserting “ section 505(c)”; and
by striking “ $450,000,000” and all that follows through the period and inserting “ $532,571,000 for each of fiscal years 2018 through 2022.”; and
in subsection (b)(2) by striking “ sections 505 and” and inserting “ sections 505(c) and”.
SEC. 8002. Substance Abuse Prevention and Treatment Block Grant.
Formula Grants.— Section 1921(b) of the Public Health Service Act (42 U.S.C. 300x–21(b)) is amended—
by inserting “ carrying out the plan developed in accordance with section 1932(b) and for” after “ for the purpose of”; and
by striking “ abuse” and inserting “ use disorders”.
Outreach to Persons Who Inject Drugs.— Section 1923(b) of the Public Health Service Act (42 U.S.C. 300x–23(b)) is amended—
in the subsection heading, by striking “ Regarding Intravenous Substance Abuse” and inserting “ to Persons Who Inject Drugs”; and
by striking “ for intravenous drug abuse” and inserting “ for persons who inject drugs”.
Requirements Regarding Tuberculosis and Human Immunodeficiency Virus.— Section 1924 of the Public Health Service Act (42 U.S.C. 300x–24) is amended—
in subsection (a)(1)—
in the matter preceding subparagraph (A), by striking “ substance abuse” and inserting “ substance use disorders”; and
in subparagraph (A), by striking “ such abuse” and inserting “ such disorders”;
in subsection (b)—
in paragraph (1)(A), by striking “ substance abuse” and inserting “ substance use disorders”;
in paragraph (2), by inserting “ and Prevention” after “ Disease Control”;
in paragraph (3)—
in the paragraph heading, by striking “ abuse” and inserting “ use disorders”; and
by striking “ substance abuse” and inserting “ substance use disorders”; and
in paragraph (6)(B), by striking “ substance abuse” and inserting “ substance use disorders”;
by striking subsection (d); and
by redesignating subsection (e) as subsection (d).
in the section heading, by striking “ recovering substance abusers” and inserting “ persons in recovery from substance use disorders”; and
in subsection (a), in the matter preceding paragraph (1), by striking “ recovering substance abusers” and inserting “ persons in recovery from substance use disorders”.
Additional Agreements.— Section 1928 of the Public Health Service Act (42 U.S.C. 300x–28) is amended—
in subsection (a), by striking “ (relative to fiscal year 1992)”;
by striking subsection (b) and inserting the following:
“(b) Professional Development.—A funding agreement for a grant under section 1921 is that the State involved will ensure that prevention, treatment, and recovery personnel operating in the State’s substance use disorder prevention, treatment, and recovery systems have an opportunity to receive training, on an ongoing basis, concerning—
“(1) recent trends in substance use disorders in the State;
“(2) improved methods and evidence-based practices for providing substance use disorder prevention and treatment services;
“(3) performance-based accountability;
“(4) data collection and reporting requirements; and
“(5) any other matters that would serve to further improve the delivery of substance use disorder prevention and treatment services within the State.”
; and
in subsection (d)(1), by striking “ substance abuse” and inserting “ substance use disorders”.
Repeal.— Section 1929 of the Public Health Service Act (42 U.S.C. 300x–29) is repealed.
Maintenance of Effort.— Section 1930 of the Public Health Service Act (42 U.S.C. 300x–30) is amended—
in subsection (c)(1), by striking “ in the State justify the waiver” and inserting “ exist in the State, or any part of the State, to justify the waiver”; and
in subsection (d), by inserting at the end the following:
“(3) Alternative.—A State that has failed to comply with this section and would otherwise be subject to a reduction in the State’s allotment under section 1921, may, upon request by the State, in lieu of having the State’s allotment under section 1921 reduced, agree to comply with a negotiated agreement that is approved by the Secretary and carried out in accordance with guidelines issued by the Secretary. If a State fails to enter into or comply with a negotiated agreement, the Secretary may take action under this paragraph or the terms of the negotiated agreement.”
Restrictions on Expenditures.— Section 1931(b)(1) of the Public Health Service Act (42 U.S.C. 300x–31(b)(1)) is amended by striking “ substance abuse” and inserting “ substance use disorders”.
in subsection (a)—
in the matter preceding paragraph (1), by striking “ subsections (c) and (d)(2)” and inserting “ subsection (c)”; and
in paragraph (5), by striking “ the information required in section 1929, the information required in section 1930(c)(2), and”;
in subsection (b)—
by striking paragraph (1) and inserting the following:
“(1) In general.—In order for a State to be in compliance with subsection (a)(6), the State shall submit to the Secretary a plan that, at a minimum, includes the following:
“(A) A description of the State’s system of care that—
“(i) identifies the single State agency responsible for the administration of the program, including any third party who administers substance use disorder services and is responsible for complying with the requirements of the grant;
“(ii) provides information on the need for substance use disorder prevention and treatment services in the State, including estimates on the number of individuals who need treatment, who are pregnant women, women with dependent children, individuals with a co-occurring mental health and substance use disorder, persons who inject drugs, and persons who are experiencing homelessness;
“(iii) provides aggregate information on the number of individuals in treatment within the State, including the number of such individuals who are pregnant women, women with dependent children, individuals with a co-occurring mental health and substance use disorder, persons who inject drugs, and persons who are experiencing homelessness;
“(iv) provides a description of the system that is available to provide services by modality, including the provision of recovery support services;
“(v) provides a description of the State’s comprehensive statewide prevention efforts, including the number of individuals being served in the system, target populations, and priority needs, and provides a description of the amount of funds from the prevention set-aside expended on primary prevention;
“(vi) provides a description of the financial resources available;
“(vii) describes the existing substance use disorders workforce and workforce trained in treating co-occurring substance use and mental disorders;
“(viii) includes a description of how the State promotes evidence-based practices; and
“(ix) describes how the State integrates substance use disorder services and primary health care, which in the case of those individuals with co-occurring mental health and substance use disorders may include providing both mental health and substance use disorder services in primary care settings or providing primary and specialty care services in community-based mental health and substance use disorder service settings.
“(B) The establishment of goals and objectives for the period of the plan, including targets and milestones that are intended to be met, and the activities that will be undertaken to achieve those targets.
“(C) A description of how the State will comply with each funding agreement for a grant under section 1921 that is applicable to the State, including a description of the manner in which the State intends to expend grant funds.”
; and
in paragraph (2)—
in the paragraph heading, by striking “ authority of secretary regarding modifications” and inserting “ modifications”;
by striking “ As a condition” and inserting the following:
“(A) Authority of secretary.—As a condition;”
; and
by adding at the end the following:
“(B) State request for modification.—If the State determines that a modification to such plan is necessary, the State may request the Secretary to approve the modification. Any such modification shall be in accordance with paragraph (1) and section 1941.”
; and
in paragraph (3), by inserting, “ , including any modification under paragraph (2)” after “ subsection (a)(6)”; and
in subsection (e)(2), by striking “ section 1922(c)” and inserting “ section 1922(b)”.
in paragraph (3), by striking “ substance abuse” and inserting “ substance use disorders”; and
in paragraph (7), by striking “ substance abuse” and inserting “ substance use disorders”.
in subsection (a)—
by striking “ section 505” and inserting “ section 505(d)”; and
by striking “ $2,000,000,000 for fiscal year 2001, and such sums as may be necessary for each of the fiscal years 2002 and 2003” and inserting “ $1,858,079,000 for each of fiscal years 2018 through 2022.”; and
in subsection (b)(1)(B) by striking “ sections 505 and” and inserting “ sections 505(d) and”.
SEC. 8003. Additional Provisions Related to the Block Grants.
Subpart III of part B of title XIX of the Public Health Service Act (42 U.S.C. 300x–51 et seq.) is amended—
in section 1943(a)(3) (42 U.S.C. 300x–53(a)(3)), by striking “ section 505” and inserting “ subsections (c) and (d) of section 505”;
in section 1953(b) (42 U.S.C. 300x–63(b)), by striking “ substance abuse” and inserting “ substance use disorder”; and
by adding at the end the following:
“SEC. 1957. PUBLIC HEALTH EMERGENCIES.
“In the case of a public health emergency (as determined under section 319), the Secretary, on a State by State basis, may, as the circumstances of the emergency reasonably require and for the period of the emergency, grant an extension, or waive application deadlines or compliance with any other requirement, of a grant authorized under section 521, 1911, or 1921 or an allotment authorized under Public Law 99–319 (42 U.S.C. 10801 et seq.).
“SEC. 1958. JOINT APPLICATIONS.
“The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall permit a joint application to be submitted for grants under subpart I and subpart II upon the request of a State. Such application may be jointly reviewed and approved by the Secretary with respect to such subparts, consistent with the purposes and authorized activities of each such grant program. A State submitting such a joint application shall otherwise meet the requirements with respect to each such subpart.”
SEC. 8004. Study of Distribution of Funds under the Substance Abuse Prevention and Treatment Block Grant and the Community Mental Health Services Block Grant.
In General.— The Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, shall through a grant or contract, or through an agreement with a third party, conduct a study on the formulas for distribution of funds under the substance abuse prevention and treatment block grant, and the community mental health services block grant, under part B of title XIX of the Public Health Service Act (42 U.S.C. 300x et seq.) and recommend changes if necessary. Such study shall include—
an analysis of whether the distributions under such block grants accurately reflect the need for the services under the grants in the States;
an examination of whether the indices used under the formulas for distribution of funds under such block grants are appropriate, and if not, alternatives recommended by the Secretary;
where recommendations are included under paragraph (2) for the use of different indices, a description of the variables and data sources that should be used to determine the indices;
an evaluation of the variables and data sources that are being used for each of the indices involved, and whether such variables and data sources accurately represent the need for services, the cost of providing services, and the ability of the States to pay for such services;
the effect that the minimum allotment requirements for each such block grant have on each State’s final allotment and the effect of such requirements, if any, on each State’s formula-based allotment;
recommendations for modifications to the minimum allotment provisions to ensure an appropriate distribution of funds; and
any other information that the Secretary determines appropriate.
Report.— Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives, a report containing the findings and recommendations of the study conducted under subsection (a) and the study conducted under section 9004(g).
TITLE IX Promoting Access to Mental Health and Substance Use Disorder Care
Subtitle A Helping Individuals and Families
SEC. 9001. Grants for Treatment and Recovery for Homeless Individuals.
Section 506 of the Public Health Service Act (42 U.S.C. 290aa–5) is amended—
in subsection (a), by striking “ substance abuse” and inserting “ substance use disorder”;
in subsection (b)—
in paragraphs (1) and (3), by striking “ substance abuse” each place the term appears and inserting “ substance use disorder”; and
in paragraph (4), by striking “ substance abuse” and inserting “ a substance use disorder”;
in subsection (c)—
in paragraph (1), by striking “ substance abuse disorder” and inserting “ substance use disorder”; and
in paragraph (2)—
in subparagraph (A), by striking “ substance abuse” and inserting “ a substance use disorder”; and
in subparagraph (B), by striking “ substance abuse” and inserting “ substance use disorder”; and
in subsection (e), by striking “ , $50,000,000 for fiscal year 2001, and such sums as may be necessary for each of the fiscal years 2002 and 2003” and inserting “ $41,304,000 for each of fiscal years 2018 through 2022”.
SEC. 9002. Grants for Jail Diversion Programs.
Section 520G of the Public Health Service Act (42 U.S.C. 290bb–38) is amended—
by striking “ substance abuse” each place such term appears and inserting “ substance use disorder”;
in subsection (a)—
by striking “ Indian tribes, and tribal organizations” and inserting “ and Indian tribes and tribal organizations (as the terms ‘Indian tribes’ and ‘tribal organizations’ are defined in section 4 of the Indian Self-Determination and Education Assistance Act)”; and
by inserting “ or a health facility or program operated by or in accordance with a contract or grant with the Indian Health Service,” after “ entities,”;
in subsection (c)(2)(A)(i), by striking “ the best known” and inserting “ evidence-based”;
by redesignating subsections (d) through (i) as subsections (e) through (j), respectively;
by inserting after subsection (c) the following:
“(d) Special Consideration Regarding Veterans.—In awarding grants under subsection (a), the Secretary shall, as appropriate, give special consideration to entities proposing to use grant funding to support jail diversion services for veterans.”
in subsection (e), as so redesignated—
in paragraph (3), by striking “ ; and” and inserting a semicolon;
in paragraph (4), by striking the period and inserting “ ; and”; and
by adding at the end the following:
“(5) develop programs to divert individuals prior to booking or arrest.”
; and
in subsection (j), as so redesignated, by striking “ $10,000,000 for fiscal year 2001, and such sums as may be necessary for fiscal years 2002 through 2003” and inserting “ $4,269,000 for each of fiscal years 2018 through 2022”.
SEC. 9003. Promoting Integration of Primary and Behavioral Health Care.
Section 520K of the Public Health Service Act (42 U.S.C. 290bb–42) is amended to read as follows:
“SEC. 520K. INTEGRATION INCENTIVE GRANTS AND COOPERATIVE AGREEMENTS.
“(a) Definitions.—In this section:
“(1) Eligible entity.—The term ‘eligible entity’ means a State, or other appropriate State agency, in collaboration with 1 or more qualified community programs as described in section 1913(b)(1) or 1 or more community health centers as described in section 330.
“(2) Integrated care.—The term ‘integrated care’ means collaborative models or practices offering mental and physical health services, which may include practices that share the same space in the same facility.
“(3) Special population.—The term ‘special population’ means—
“(A) adults with a mental illness who have co-occurring physical health conditions or chronic diseases;
“(B) adults with a serious mental illness who have co-occurring physical health conditions or chronic diseases;
“(C) children and adolescents with a serious emotional disturbance with co-occurring physical health conditions or chronic diseases; or
“(D) individuals with a substance use disorder.
“(b) Grants and Cooperative Agreements.—
“(1) In general.—The Secretary may award grants and cooperative agreements to eligible entities to support the improvement of integrated care for primary care and behavioral health care in accordance with paragraph (2).
“(2) Purposes.—A grant or cooperative agreement awarded under this section shall be designed to—
“(A) promote full integration and collaboration in clinical practices between primary and behavioral health care;
“(B) support the improvement of integrated care models for primary care and behavioral health care to improve the overall wellness and physical health status of adults with a serious mental illness or children with a serious emotional disturbance; and
“(C) promote integrated care services related to screening, diagnosis, prevention, and treatment of mental and substance use disorders, and co-occurring physical health conditions and chronic diseases.
“(c) Applications.—
“(1) In general.—An eligible entity seeking a grant or cooperative agreement under this section shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may require, including the contents described in paragraph (2).
“(2) Contents.—The contents described in this paragraph are—
“(A) a description of a plan to achieve fully collaborative agreements to provide services to special populations;
“(B) a document that summarizes the policies, if any, that serve as barriers to the provision of integrated care, and the specific steps, if applicable, that will be taken to address such barriers;
“(C) a description of partnerships or other arrangements with local health care providers to provide services to special populations;
“(D) an agreement and plan to report to the Secretary performance measures necessary to evaluate patient outcomes and facilitate evaluations across participating projects; and
“(E) a plan for sustainability beyond the grant or cooperative agreement period under subsection (e).
“(d) Grant and Cooperative Agreement Amounts.—
“(1) Target amount.—The target amount that an eligible entity may receive for a year through a grant or cooperative agreement under this section shall be $2,000,000.
“(2) Adjustment permitted.—The Secretary, taking into consideration the quality of the application and the number of eligible entities that received grants under this section prior to the date of enactment of the Helping Families in Mental Health Crisis Reform Act of 2016, may adjust the target amount that an eligible entity may receive for a year through a grant or cooperative agreement under this section.
“(3) Limitation.—An eligible entity receiving funding under this section may not allocate more than 10 percent of funds awarded under this section to administrative functions, and the remaining amounts shall be allocated to health facilities that provide integrated care.
“(e) Duration.—A grant or cooperative agreement under this section shall be for a period not to exceed 5 years.
“(f) Report on Program Outcomes.—An eligible entity receiving a grant or cooperative agreement under this section shall submit an annual report to the Secretary that includes—
“(1) the progress made to reduce barriers to integrated care as described in the entity’s application under subsection (c); and
“(2) a description of functional outcomes of special populations, including—
“(A) with respect to adults with a serious mental illness, participation in supportive housing or independent living programs, attendance in social and rehabilitative programs, participation in job training opportunities, satisfactory performance in work settings, attendance at scheduled medical and mental health appointments, and compliance with prescribed medication regimes;
“(B) with respect to individuals with co-occurring mental illness and physical health conditions and chronic diseases, attendance at scheduled medical and mental health appointments, compliance with prescribed medication regimes, and participation in learning opportunities related to improved health and lifestyle practices; and
“(C) with respect to children and adolescents with a serious emotional disturbance who have co-occurring physical health conditions and chronic diseases, attendance at scheduled medical and mental health appointments, compliance with prescribed medication regimes, and participation in learning opportunities at school and extracurricular activities.
“(g) Technical Assistance for Primary-Behavioral Health Care Integration.—
“(1) In general.—The Secretary may provide appropriate information, training, and technical assistance to eligible entities that receive a grant or cooperative agreement under this section, in order to help such entities meet the requirements of this section, including assistance with—
“(A) development and selection of integrated care models;
“(B) dissemination of evidence-based interventions in integrated care;
“(C) establishment of organizational practices to support operational and administrative success; and
“(D) other activities, as the Secretary determines appropriate.
“(2) Additional dissemination of technical information.—The information and resources provided by the Secretary under paragraph (1) shall, as appropriate, be made available to States, political subdivisions of States, Indian tribes or tribal organizations (as defined in section 4 of the Indian Self-Determination and Education Assistance Act), outpatient mental health and addiction treatment centers, community mental health centers that meet the criteria under section 1913(c), certified community behavioral health clinics described in section 223 of the Protecting Access to Medicare Act of 2014, primary care organizations such as Federally qualified health centers or rural health clinics as defined in section 1861(aa) of the Social Security Act, other community-based organizations, or other entities engaging in integrated care activities, as the Secretary determines appropriate.
“(h) Authorization of Appropriations.—To carry out this section, there are authorized to be appropriated $51,878,000 for each of fiscal years 2018 through 2022.”
SEC. 9004. Projects for Assistance in Transition from Homelessness.
Formula Grants to States.— Section 521 of the Public Health Service Act (42 U.S.C. 290cc–21) is amended by striking “ 1991 through 1994” and inserting “ 2018 through 2022”.
in subsection (a)(1)(B), by striking “ substance abuse” and inserting “ a substance use disorder”;
in subsection (b)(6), by striking “ substance abuse” and inserting “ substance use disorder”;
in subsection (c), by striking “ substance abuse” and inserting “ a substance use disorder”;
in subsection (e)—
in paragraph (1), by striking “ substance abuse” and inserting “ a substance use disorder”; and
in paragraph (2), by striking “ substance abuse” and inserting “ substance use disorder”;
by striking subsection (g) and redesignating subsections (h) and (i) as (g) and (h), accordingly; and
in subsection (g), as redesignated by paragraph (5), by striking “ substance abuse” each place such term appears and inserting “ substance use disorder”.
Description of Intended Expenditures of Grant.— Section 527 of the Public Health Service Act (42 U.S.C. 290cc–27) is amended by striking “ substance abuse” each place such term appears and inserting “ substance use disorder”.
Technical Assistance.— Section 530 of the Public Health Service Act (42 U.S.C. 290cc–30) is amended by striking “ through the National Institute of Mental Health, the National Institute of Alcohol Abuse and Alcoholism, and the National Institute on Drug Abuse” and inserting “ acting through the Assistant Secretary”.
Definitions.— Section 534(4) of the Public Health Service Act (42 U.S.C. 290cc–34(4)) is amended to read as follows:
“(4) Substance use disorder services.—The term ‘substance use disorder services’ has the meaning given the term ‘substance abuse services’ in section 330(h)(5)(C).”
Funding.— Section 535(a) of the Public Health Service Act (42 U.S.C. 290cc–35(a)) is amended by striking “ $75,000,000 for each of the fiscal years 2001 through 2003” and inserting “ $64,635,000 for each of fiscal years 2018 through 2022”.
Study Concerning Formula.—
In general.— Not later than 2 years after the date of enactment of this Act, the Assistant Secretary for Mental Health and Substance Use (referred to in this section as the “Assistant Secretary”) shall conduct a study concerning the formula used under section 524 of the Public Health Service Act (42 U.S.C. 290cc–24) for making allotments to States under section 521 of such Act (42 U.S.C. 290cc–21). Such study shall include an evaluation of quality indicators of need for purposes of revising the formula for determining the amount of each allotment for the fiscal years following the submission of the study.
Report.— In accordance with section 8004(b), the Assistant Secretary shall submit to the committees of Congress described in such section a report concerning the results of the study conducted under paragraph (1).
SEC. 9005. National Suicide Prevention Lifeline Program.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C. 290bb–31 et seq.) is amended by inserting after section 520E–2 (42 U.S.C. 290bb–36b) the following:
“SEC. 520E–3. NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.
“(a) In General.—The Secretary, acting through the Assistant Secretary, shall maintain the National Suicide Prevention Lifeline program (referred to in this section as the ‘program’), authorized under section 520A and in effect prior to the date of enactment of the Helping Families in Mental Health Crisis Reform Act of 2016.
“(b) Activities.—In maintaining the program, the activities of the Secretary shall include—
“(1) coordinating a network of crisis centers across the United States for providing suicide prevention and crisis intervention services to individuals seeking help at any time, day or night;
“(2) maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social services resources; and
“(3) consulting with the Secretary of Veterans Affairs to ensure that veterans calling the suicide prevention hotline have access to a specialized veterans’ suicide prevention hotline.
“(c) Authorization of Appropriations.—To carry out this section, there are authorized to be appropriated $7,198,000 for each of fiscal years 2018 through 2022.”
SEC. 9006. Connecting Individuals and Families with Care.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C. 290bb–31 et seq.), as amended by section 9005, is further amended by inserting after section 520E–3 the following:
“SEC. 520E–4. TREATMENT REFERRAL ROUTING SERVICE.
“(a) In General.—The Secretary, acting through the Assistant Secretary, shall maintain the National Treatment Referral Routing Service (referred to in this section as the ‘Routing Service’) to assist individuals and families in locating mental and substance use disorders treatment providers.
“(b) Activities of the Secretary.—To maintain the Routing Service, the activities of the Assistant Secretary shall include administering—
“(1) a nationwide, telephone number providing year-round access to information that is updated on a regular basis regarding local behavioral health providers and community-based organizations in a manner that is confidential, without requiring individuals to identify themselves, is in languages that include at least English and Spanish, and is at no cost to the individual using the Routing Service; and
“(2) an Internet website to provide a searchable, online treatment services locator of behavioral health treatment providers and community-based organizations, which shall include information on the name, location, contact information, and basic services provided by such providers and organizations.
“(c) Removing Practitioner Contact Information.—In the event that the Internet website described in subsection (b)(2) contains information on any qualified practitioner that is certified to prescribe medication for opioid dependency under section 303(g)(2)(B) of the Controlled Substances Act, the Assistant Secretary—
“(1) shall provide an opportunity to such practitioner to have the contact information of the practitioner removed from the website at the request of the practitioner; and
“(2) may evaluate other methods to periodically update the information displayed on such website.
“(d) Rule of Construction.—Nothing in this section shall be construed to prevent the Assistant Secretary from using any unobligated amounts otherwise made available to the Administration to maintain the Routing Service.”
SEC. 9007. Strengthening Community Crisis Response Systems.
Section 520F of the Public Health Service Act (42 U.S.C. 290bb–37) is amended to read as follows:
“SEC. 520F. STRENGTHENING COMMUNITY CRISIS RESPONSE SYSTEMS.
“(a) In General.—The Secretary shall award competitive grants to—
“(1) State and local governments and Indian tribes and tribal organizations, to enhance community-based crisis response systems; or
“(2) States to develop, maintain, or enhance a database of beds at inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder treatment facilities, for adults with a serious mental illness, children with a serious emotional disturbance, or individuals with a substance use disorder.
“(b) Applications.—
“(1) In general.—To receive a grant under subsection (a), an entity shall submit to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require.
“(2) Community-based crisis response plan.—An application for a grant under subsection (a)(1) shall include a plan for—
“(A) promoting integration and coordination between local public and private entities engaged in crisis response, including first responders, emergency health care providers, primary care providers, law enforcement, court systems, health care payers, social service providers, and behavioral health providers;
“(B) developing memoranda of understanding with public and private entities to implement crisis response services;
“(C) addressing gaps in community resources for crisis intervention and prevention; and
“(D) developing models for minimizing hospital readmissions, including through appropriate discharge planning.
“(3) Beds database plan.—An application for a grant under subsection (a)(2) shall include a plan for developing, maintaining, or enhancing a real-time, Internet-based bed database to collect, aggregate, and display information about beds in inpatient psychiatric facilities and crisis stabilization units, and residential community mental health and residential substance use disorder treatment facilities to facilitate the identification and designation of facilities for the temporary treatment of individuals in mental or substance use disorder crisis.
“(c) Database Requirements.—A bed database described in this section is a database that—
“(1) includes information on inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder facilities in the State involved, including contact information for the facility or unit;
“(2) provides real-time information about the number of beds available at each facility or unit and, for each available bed, the type of patient that may be admitted, the level of security provided, and any other information that may be necessary to allow for the proper identification of appropriate facilities for treatment of individuals in mental or substance use disorder crisis; and
“(3) enables searches of the database to identify available beds that are appropriate for the treatment of individuals in mental or substance use disorder crisis.
“(d) Evaluation.—An entity receiving a grant under subsection (a)(1) shall submit to the Secretary, at such time, in such manner, and containing such information as the Secretary may reasonably require, a report, including an evaluation of the effect of such grant on—
“(1) local crisis response services and measures for individuals receiving crisis planning and early intervention supports;
“(2) individuals reporting improved functional outcomes; and
“(3) individuals receiving regular followup care following a crisis.
“(e) Authorization of Appropriations.—There are authorized to be appropriated to carry out this section, $12,500,000 for the period of fiscal years 2018 through 2022.”
SEC. 9008. Garrett Lee Smith Memorial Act Reauthorization.
Suicide Prevention Technical Assistance Center.— Section 520C of the Public Health Service Act (42 U.S.C. 290bb–34), as amended by section 6001, is further amended—
in the section heading, by striking “ youth interagency research, training, and technical assistance centers” and inserting “ suicide prevention technical assistance center”;
in subsection (a), by striking “ acting through the Assistant Secretary for Mental Health and Substance Use” and all that follows through the period at the end of paragraph (2) and inserting “ acting through the Assistant Secretary, shall establish a research, training, and technical assistance resource center to provide appropriate information, training, and technical assistance to States, political subdivisions of States, federally recognized Indian tribes, tribal organizations, institutions of higher education, public organizations, or private nonprofit organizations regarding the prevention of suicide among all ages, particularly among groups that are at a high risk for suicide.”;
by striking subsections (b) and (c);
by redesignating subsection (d) as subsection (b);
in subsection (b), as so redesignated—
in the subsection heading, by striking “ Additional Center” and inserting “ Responsibilities of the Center”;
in the matter preceding paragraph (1), by striking “ The additional research” and all that follows through “ nonprofit organizations for” and inserting “ The center established under subsection (a) shall conduct activities for the purpose of”;
by striking “ youth suicide” each place such term appears and inserting “ suicide”;
in paragraph (1)—
by striking “ the development or continuation of” and inserting “ developing and continuing”; and
by inserting “ for all ages, particularly among groups that are at a high risk for suicide” before the semicolon at the end;
in paragraph (2), by inserting “ for all ages, particularly among groups that are at a high risk for suicide” before the semicolon at the end;
in paragraph (3), by inserting “ and tribal” after “ statewide”;
in paragraph (5), by inserting “ and prevention” after “ intervention”;
in paragraph (8), by striking “ in youth”;
in paragraph (9), by striking “ and behavioral health” and inserting “ health and substance use disorder”; and
in paragraph (10), by inserting “ conducting” before “ other”; and
by striking subsection (e) and inserting the following:
“(c) Authorization of Appropriations.—For the purpose of carrying out this section, there are authorized to be appropriated $5,988,000 for each of fiscal years 2018 through 2022.
“(d) Annual Report.—Not later than 2 years after the date of enactment of this subsection, the Secretary shall submit to Congress a report on the activities carried out by the center established under subsection (a) during the year involved, including the potential effects of such activities, and the States, organizations, and institutions that have worked with the center.”
Youth Suicide Early Intervention and Prevention Strategies.— Section 520E of the Public Health Service Act (42 U.S.C. 290bb–36) is amended—
in paragraph (1) of subsection (a) and in subsection (c), by striking “ substance abuse” each place such term appears and inserting “ substance use disorder”;
in subsection (b)—
in paragraph (2)—
by striking “ ensure that each State is awarded only 1 grant or cooperative agreement under this section” and inserting “ ensure that a State does not receive more than 1 grant or cooperative agreement under this section at any 1 time”; and
by striking “ been awarded” and inserting “ received”; and
by adding after paragraph (2) the following:
“(3) Consideration.—In awarding grants under this section, the Secretary shall take into consideration the extent of the need of the applicant, including the incidence and prevalence of suicide in the State and among the populations of focus, including rates of suicide determined by the Centers for Disease Control and Prevention for the State or population of focus.”
in subsection (g)(2), by striking “ 2 years after the date of enactment of this section,” and insert “ 2 years after the date of enactment of Helping Families in Mental Health Crisis Reform Act of 2016,”; and
by striking subsection (m) and inserting the following:
“(m) Authorization of Appropriations.—For the purpose of carrying out this section, there are authorized to be appropriated $30,000,000 for each of fiscal years 2018 through 2022.”
SEC. 9009. Adult Suicide Prevention.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C. 290bb–31 et seq.) is amended by adding at the end the following:
“SEC. 520L. ADULT SUICIDE PREVENTION.
“(a) Grants.—
“(1) In general.—The Assistant Secretary shall award grants to eligible entities described in paragraph (2) to implement suicide prevention and intervention programs, for individuals who are 25 years of age or older, that are designed to raise awareness of suicide, establish referral processes, and improve care and outcomes for such individuals who are at risk of suicide.
“(2) Eligible entities.—To be eligible to receive a grant under this section, an entity shall be a community-based primary care or behavioral health care setting, an emergency department, a State mental health agency (or State health agency with mental or behavioral health functions), public health agency, a territory of the United States, or an Indian tribe or tribal organization (as the terms ‘Indian tribe’ and ‘tribal organization’ are defined in section 4 of the Indian Self-Determination and Education Assistance Act).
“(3) Use of funds.—The grants awarded under paragraph (1) shall be used to implement programs, in accordance with such paragraph, that include one or more of the following components:
“(A) Screening for suicide risk, suicide intervention services, and services for referral for treatment for individuals at risk for suicide.
“(B) Implementing evidence-based practices to provide treatment for individuals at risk for suicide, including appropriate followup services.
“(C) Raising awareness and reducing stigma of suicide.
“(b) Evaluations and Technical Assistance.—The Assistant Secretary shall—
“(1) evaluate the activities supported by grants awarded under subsection (a), and disseminate, as appropriate, the findings from the evaluation; and
“(2) provide appropriate information, training, and technical assistance, as appropriate, to eligible entities that receive a grant under this section, in order to help such entities to meet the requirements of this section, including assistance with selection and implementation of evidence-based interventions and frameworks to prevent suicide.
“(c) Duration.—A grant under this section shall be for a period of not more than 5 years.
“(d) Authorization of Appropriations.—There are authorized to be appropriated to carry out this section $30,000,000 for the period of fiscal years 2018 through 2022.”
SEC. 9010. Mental Health Awareness Training Grants.
Section 520J of the Public Health Service Act (42 U.S.C. 290bb–41) is amended—
in the section heading, by inserting “ mental health awareness” before “ training”; and
in subsection (b)—
in the subsection heading, by striking “ Illness” and inserting “ Health”;
in paragraph (1), by inserting “ veterans, law enforcement, and other categories of individuals, as determined by the Secretary,” after “ emergency services personnel”;
in paragraph (5)—
in the matter preceding subparagraph (A), by striking “ to” and inserting “ for evidence-based programs that provide training and education in accordance with paragraph (1) on matters including”; and
by striking subparagraphs (A) through (C) and inserting the following:
“(A) recognizing the signs and symptoms of mental illness; and
“(B)
(i) resources available in the community for individuals with a mental illness and other relevant resources; or
“(ii) safely de-escalating crisis situations involving individuals with a mental illness.”
; and
in paragraph (7), by striking “ , $25,000,000” and all that follows through the period at the end and inserting “ $14,693,000 for each of fiscal years 2018 through 2022.”.
SEC. 9011. Sense of Congress on Prioritizing American Indians and Alaska Native Youth Within Suicide Prevention Programs.
Findings.— The Congress finds as follows:
Suicide is the eighth leading cause of death among American Indians and Alaska Natives across all ages.
Among American Indians and Alaska Natives who are 10 to 34 years of age, suicide is the second leading cause of death.
The suicide rate among American Indian and Alaska Native adolescents and young adults ages 15 to 34 (17.9 per 100,000) is approximately 1.3 times higher than the national average for that age group (13.3 per 100,000).
Sense of Congress.— It is the sense of Congress that the Secretary of Health and Human Services, in carrying out suicide prevention and intervention programs, should prioritize programs and activities for populations with disproportionately high rates of suicide, such as American Indians and Alaska Natives.
SEC. 9012. Evidence-Based Practices for Older Adults.
Section 520A(e) of the Public Health Service Act (42 U.S.C. 290bb–32(e)) is amended by adding at the end the following:
“(3) Geriatric mental disorders.—The Secretary shall, as appropriate, provide technical assistance to grantees regarding evidence-based practices for the prevention and treatment of geriatric mental disorders and co-occurring mental health and substance use disorders among geriatric populations, as well as disseminate information about such evidence-based practices to States and nongrantees throughout the United States.”
SEC. 9013. National Violent Death Reporting System.
The Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, is encouraged to improve, particularly through the inclusion of additional States, the National Violent Death Reporting System as authorized by title III of the Public Health Service Act (42 U.S.C. 241 et seq.). Participation in the system by the States shall be voluntary.
SEC. 9014. Assisted Outpatient Treatment.
Section 224 of the Protecting Access to Medicare Act of 2014 (42 U.S.C. 290aa note) is amended—
in subsection (e), by striking “ and 2018,” and inserting “ 2018, 2019, 2020, 2021, and 2022,”; and
in subsection (g)—
in paragraph (1), by striking “ 2018” and inserting “ 2022”; and
in paragraph (2), by striking “ is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2018” and inserting “ are authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2015 through 2017, $20,000,000 for fiscal year 2018, $19,000,000 for each of fiscal years 2019 and 2020, and $18,000,000 for each of fiscal years 2021 and 2022”.
SEC. 9015. Assertive Community Treatment Grant Program.
Part B of title V of the Public Health Service Act (42 U.S.C. 290bb et seq.), as amended by section 9009, is further amended by adding at the end the following:
“SEC. 520M. ASSERTIVE COMMUNITY TREATMENT GRANT PROGRAM.
“(a) In General.—The Assistant Secretary shall award grants to eligible entities—
“(1) to establish assertive community treatment programs for adults with a serious mental illness; or
“(2) to maintain or expand such programs.
“(b) Eligible Entities.—To be eligible to receive a grant under this section, an entity shall be a State, political subdivision of a State, Indian tribe or tribal organization (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), mental health system, health care facility, or any other entity the Assistant Secretary deems appropriate.
“(c) Special Consideration.—In selecting among applicants for a grant under this section, the Assistant Secretary may give special consideration to the potential of the applicant’s program to reduce hospitalization, homelessness, and involvement with the criminal justice system while improving the health and social outcomes of the patient.
“(d) Additional Activities.—The Assistant Secretary shall—
“(1) not later than the end of fiscal year 2021, submit a report to the appropriate congressional committees on the grant program under this section, including an evaluation of—
“(A) any cost savings and public health outcomes such as mortality, suicide, substance use disorders, hospitalization, and use of services;
“(B) rates of involvement with the criminal justice system of patients;
“(C) rates of homelessness among patients; and
“(D) patient and family satisfaction with program participation; and
“(2) provide appropriate information, training, and technical assistance to grant recipients under this section to help such recipients to establish, maintain, or expand their assertive community treatment programs.
“(e) Authorization of Appropriations.—
“(1) In general.—To carry out this section, there is authorized to be appropriated $5,000,000 for the period of fiscal years 2018 through 2022.
“(2) Use of certain funds.—Of the funds appropriated to carry out this section in any fiscal year, not more than 5 percent shall be available to the Assistant Secretary for carrying out subsection (d).”
SEC. 9016. Sober Truth on Preventing Underage Drinking Reauthorization.
Section 519B of the Public Health Service Act (42 U.S.C. 290bb–25b) is amended—
in subsection (c)(3), by striking “ fiscal year 2007” and all that follows through the period at the end and inserting “ each of the fiscal years 2018 through 2022.”;
in subsection (d)(4), by striking “ fiscal year 2007” and all that follows through the period at the end and inserting “ each of the fiscal years 2018 through 2022.”;
in subsection (e)(1)(I), by striking “ fiscal year 2007” and all that follows through the period at the end and inserting “ each of the fiscal years 2018 through 2022.”;
in subsection (f)(2), by striking “ $6,000,000 for fiscal year 2007” and all that follows through the period at the end and inserting “ $3,000,000 for each of the fiscal years 2018 through 2022”; and
by adding at the end the following new subsection:
“(g) Reducing Underage Drinking Through Screening and Brief Intervention.—
“(1) Grants to pediatric health care providers to reduce underage drinking.—The Assistant Secretary may make grants to eligible entities to increase implementation of practices for reducing the prevalence of alcohol use among individuals under the age of 21, including college students.
“(2) Purposes.—Grants under this subsection shall be made to improve—
“(A) screening children and adolescents for alcohol use;
“(B) offering brief interventions to children and adolescents to discourage such use;
“(C) educating parents about the dangers of, and methods of discouraging, such use;
“(D) diagnosing and treating alcohol use disorders; and
“(E) referring patients, when necessary, to other appropriate care.
“(3) Use of funds.—An entity receiving a grant under this subsection may use such funding for the purposes identified in paragraph (2) by—
“(A) providing training to health care providers;
“(B) disseminating best practices, including culturally and linguistically appropriate best practices, as appropriate, and developing and distributing materials; and
“(C) supporting other activities, as determined appropriate by the Assistant Secretary.
“(4) Application.—To be eligible to receive a grant under this subsection, an entity shall submit an application to the Assistant Secretary at such time, and in such manner, and accompanied by such information as the Assistant Secretary may require. Each application shall include—
“(A) a description of the entity;
“(B) a description of activities to be completed;
“(C) a description of how the services specified in paragraphs (2) and (3) will be carried out and the qualifications for providing such services; and
“(D) a timeline for the completion of such activities.
“(5) Definitions.—For the purpose of this subsection:
“(A) Brief intervention.—The term ‘brief intervention’ means, after screening a patient, providing the patient with brief advice and other brief motivational enhancement techniques designed to increase the insight of the patient regarding the patient’s alcohol use, and any realized or potential consequences of such use, to effect the desired related behavioral change.
“(B) Children and adolescents.—The term ‘children and adolescents’ means any person under 21 years of age.
“(C) Eligible entity.—The term ‘eligible entity’ means an entity consisting of pediatric health care providers and that is qualified to support or provide the activities identified in paragraph (2).
“(D) Pediatric health care provider.—The term ‘pediatric health care provider’ means a provider of primary health care to individuals under the age of 21 years.
“(E) Screening.—The term ‘screening’ means using validated patient interview techniques to identify and assess the existence and extent of alcohol use in a patient.”
SEC. 9017. Center and Program Repeals.
Part B of title V of the Public Health Service Act (42 U.S.C. 290bb et seq.) is amended by striking section 506B (42 U.S.C. 290aa–5b), the second section 514 (42 U.S.C. 290bb–9) relating to methamphetamine and amphetamine treatment initiatives, and each of sections 514A, 517, 519A, 519C, 519E, 520B, 520D, and 520H (42 U.S.C. 290bb–8, 290bb–23, 290bb–25a, 290bb–25c, 290bb–25e, 290bb–33, 290bb–35, and 290bb–39).
Subtitle B Strengthening the Health Care Workforce
SEC. 9021. Mental and Behavioral Health Education and Training Grants.
Section 756 of the Public Health Service Act (42 U.S.C. 294e–1) is amended—
in subsection (a)—
in the matter preceding paragraph (1), by striking “ of higher education”; and
by striking paragraphs (1) through (4) and inserting the following:
“(1) accredited institutions of higher education or accredited professional training programs that are establishing or expanding internships or other field placement programs in mental health in psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing (which may include master’s and doctoral level programs), social work, school social work, substance use disorder prevention and treatment, marriage and family therapy, occupational therapy, school counseling, or professional counseling, including such programs with a focus on child and adolescent mental health and transitional-age youth;
“(2) accredited doctoral, internship, and post-doctoral residency programs of health service psychology (including clinical psychology, counseling, and school psychology) for the development and implementation of interdisciplinary training of psychology graduate students for providing behavioral health services, including substance use disorder prevention and treatment services, as well as the development of faculty in health service psychology;
“(3) accredited master’s and doctoral degree programs of social work for the development and implementation of interdisciplinary training of social work graduate students for providing behavioral health services, including substance use disorder prevention and treatment services, and the development of faculty in social work; and
“(4) State-licensed mental health nonprofit and for-profit organizations to enable such organizations to pay for programs for preservice or in-service training in a behavioral health-related paraprofessional field with preference for preservice or in-service training of paraprofessional child and adolescent mental health workers.”
in subsection (b)—
by striking paragraph (5);
by redesignating paragraphs (1) through (4) as paragraphs (2) through (5), respectively;
by inserting before paragraph (2), as so redesignated, the following:
“(1) an ability to recruit and place the students described in subsection (a) in areas with a high need and high demand population;”
in paragraph (3), as so redesignated, by striking “ subsection (a)” and inserting “ paragraph (2), especially individuals with mental disorder symptoms or diagnoses, particularly children and adolescents, and transitional-age youth”;
in paragraph (4), as so redesignated, by striking “ ;” and inserting “ ; and”; and
in paragraph (5), as so redesignated, by striking “ ; and” and inserting a period;
in subsection (c), by striking “ authorized under subsection (a)(1)” and inserting “ awarded under paragraphs (2) and (3) of subsection (a)”;
by amending subsection (d) to read as follows:
“(d) Priority.—In selecting grant recipients under this section, the Secretary shall give priority to—
“(1) programs that have demonstrated the ability to train psychology, psychiatry, and social work professionals to work in integrated care settings for purposes of recipients under paragraphs (1), (2), and (3) of subsection (a); and
“(2) programs for paraprofessionals that emphasize the role of the family and the lived experience of the consumer and family-paraprofessional partnerships for purposes of recipients under subsection (a)(4).”
; and
by striking subsection (e) and inserting the following:
“(e) Report to Congress.—Not later than 4 years after the date of enactment of the Helping Families in Mental Health Crisis Reform Act of 2016, the Secretary shall include in the biennial report submitted to Congress under section 501(m) an assessment on the effectiveness of the grants under this section in—
“(1) providing graduate students support for experiential training (internship or field placement);
“(2) recruiting students interested in behavioral health practice;
“(3) recruiting students in accordance with subsection (b)(1);
“(4) developing and implementing interprofessional training and integration within primary care;
“(5) developing and implementing accredited field placements and internships; and
“(6) collecting data on the number of students trained in behavioral health care and the number of available accredited internships and field placements.
“(f) Authorization of Appropriations.—For each of fiscal years 2018 through 2022, there are authorized to be appropriated to carry out this section $50,000,000, to be allocated as follows:
“(1) For grants described in subsection (a)(1), $15,000,000.
“(2) For grants described in subsection (a)(2), $15,000,000.
“(3) For grants described in subsection (a)(3), $10,000,000.
“(4) For grants described in subsection (a)(4), $10,000,000.”
SEC. 9022. Strengthening the Mental and Substance Use Disorders Workforce.
Part D of title VII of the Public Health Service Act (42 U.S.C. 294 et seq.) is amended by adding at the end the following:
“SEC. 760. TRAINING DEMONSTRATION PROGRAM.
“(a) In General.—The Secretary shall establish a training demonstration program to award grants to eligible entities to support—
“(1) training for medical residents and fellows to practice psychiatry and addiction medicine in underserved, community-based settings that integrate primary care with mental and substance use disorders prevention and treatment services;
“(2) training for nurse practitioners, physician assistants, health service psychologists, and social workers to provide mental and substance use disorders services in underserved community-based settings that integrate primary care and mental and substance use disorders services; and
“(3) establishing, maintaining, or improving academic units or programs that—
“(A) provide training for students or faculty, including through clinical experiences and research, to improve the ability to be able to recognize, diagnose, and treat mental and substance use disorders, with a special focus on addiction; or
“(B) develop evidence-based practices or recommendations for the design of the units or programs described in subparagraph (A), including curriculum content standards.
“(b) Activities.—
“(1) Training for residents and fellows.—A recipient of a grant under subsection (a)(1)—
“(A) shall use the grant funds—
“(i)
(I) to plan, develop, and operate a training program for medical psychiatry residents and fellows in addiction medicine practicing in eligible entities described in subsection (c)(1); or
“(II) to train new psychiatric residents and fellows in addiction medicine to provide and expand access to integrated mental and substance use disorders services; and
“(ii) to provide at least 1 training track that is—
“(I) a virtual training track that includes an in-person rotation at a teaching health center or in a community-based setting, followed by a virtual rotation in which the resident or fellow continues to support the care of patients at the teaching health center or in the community-based setting through the use of health information technology and, as appropriate, telehealth services;
“(II) an in-person training track that includes a rotation, during which the resident or fellow practices at a teaching health center or in a community-based setting; or
“(III) an in-person training track that includes a rotation during which the resident practices in a community-based setting that specializes in the treatment of infants, children, adolescents, or pregnant or postpartum women; and
“(B) may use the grant funds to provide additional support for the administration of the program or to meet the costs of projects to establish, maintain, or improve faculty development, or departments, divisions, or other units necessary to implement such training.
“(2) Training for other providers.—A recipient of a grant under subsection (a)(2)—
“(A) shall use the grant funds to plan, develop, or operate a training program to provide mental and substance use disorders services in underserved, community-based settings, as appropriate, that integrate primary care and mental and substance use disorders prevention and treatment services; and
“(B) may use the grant funds to provide additional support for the administration of the program or to meet the costs of projects to establish, maintain, or improve faculty development, or departments, divisions, or other units necessary to implement such program.
“(3) Academic units or programs.—A recipient of a grant under subsection (a)(3) shall enter into a partnership with organizations such as an education accrediting organization (such as the Liaison Committee on Medical Education, the Accreditation Council for Graduate Medical Education, the Commission on Osteopathic College Accreditation, the Accreditation Commission for Education in Nursing, the Commission on Collegiate Nursing Education, the Accreditation Council for Pharmacy Education, the Council on Social Work Education, American Psychological Association Commission on Accreditation, or the Accreditation Review Commission on Education for the Physician Assistant) to carry out activities under subsection (a)(3).
“(c) Eligible Entities.—
“(1) Training for residents and fellows.—To be eligible to receive a grant under subsection (a)(1), an entity shall—
“(A) be a consortium consisting of—
“(i) at least one teaching health center; and
“(ii) the sponsoring institution (or parent institution of the sponsoring institution) of—
“(I) a psychiatry residency program that is accredited by the Accreditation Council of Graduate Medical Education (or the parent institution of such a program); or
“(II) a fellowship in addiction medicine, as determined appropriate by the Secretary; or
“(B) be an entity described in subparagraph (A)(ii) that provides opportunities for residents or fellows to train in community-based settings that integrate primary care with mental and substance use disorders prevention and treatment services.
“(2) Training for other providers.—To be eligible to receive a grant under subsection (a)(2), an entity shall be—
“(A) a teaching health center (as defined in section 749A(f));
“(B) a Federally qualified health center (as defined in section 1905(l)(2)(B) of the Social Security Act);
“(C) a community mental health center (as defined in section 1861(ff)(3)(B) of the Social Security Act);
“(D) a rural health clinic (as defined in section 1861(aa) of the Social Security Act);
“(E) a health center operated by the Indian Health Service, an Indian tribe, a tribal organization, or an urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act); or
“(F) an entity with a demonstrated record of success in providing training for nurse practitioners, physician assistants, health service psychologists, and social workers.
“(3) Academic units or programs.—To be eligible to receive a grant under subsection (a)(3), an entity shall be a school of medicine or osteopathic medicine, a nursing school, a physician assistant training program, a school of pharmacy, a school of social work, an accredited public or nonprofit private hospital, an accredited medical residency program, or a public or private nonprofit entity which the Secretary has determined is capable of carrying out such grant.
“(d) Priority.—
“(1) In general.—In awarding grants under subsection (a)(1) or (a)(2), the Secretary shall give priority to eligible entities that—
“(A) demonstrate sufficient size, scope, and capacity to undertake the requisite training of an appropriate number of psychiatric residents, fellows, nurse practitioners, physician assistants, or social workers in addiction medicine per year to meet the needs of the area served;
“(B) demonstrate experience in training providers to practice team-based care that integrates mental and substance use disorder prevention and treatment services with primary care in community-based settings;
“(C) demonstrate experience in using health information technology and, as appropriate, telehealth to support—
“(i) the delivery of mental and substance use disorders services at the eligible entities described in subsections (c)(1) and (c)(2); and
“(ii) community health centers in integrating primary care and mental and substance use disorders treatment; or
“(D) have the capacity to expand access to mental and substance use disorders services in areas with demonstrated need, as determined by the Secretary, such as tribal, rural, or other underserved communities.
“(2) Academic units or programs.—In awarding grants under subsection (a)(3), the Secretary shall give priority to eligible entities that—
“(A) have a record of training the greatest percentage of mental and substance use disorders providers who enter and remain in these fields or who enter and remain in settings with integrated primary care and mental and substance use disorder prevention and treatment services;
“(B) have a record of training individuals who are from underrepresented minority groups, including native populations, or from a rural or disadvantaged background;
“(C) provide training in the care of vulnerable populations such as infants, children, adolescents, pregnant and postpartum women, older adults, homeless individuals, victims of abuse or trauma, individuals with disabilities, and other groups as defined by the Secretary;
“(D) teach trainees the skills to provide interprofessional, integrated care through collaboration among health professionals; or
“(E) provide training in cultural competency and health literacy.
“(e) Duration.—Grants awarded under this section shall be for a minimum of 5 years.
“(f) Study and Report.—
“(1) Study.—
“(A) In general.—The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall conduct a study on the results of the demonstration program under this section.
“(B) Data submission.—Not later than 90 days after the completion of the first year of the training program and each subsequent year that the program is in effect, each recipient of a grant under subsection (a) shall submit to the Secretary such data as the Secretary may require for analysis for the report described in paragraph (2).
“(2) Report to congress.—Not later than 1 year after receipt of the data described in paragraph (1)(B), the Secretary shall submit to Congress a report that includes—
“(A) an analysis of the effect of the demonstration program under this section on the quality, quantity, and distribution of mental and substance use disorders services;
“(B) an analysis of the effect of the demonstration program on the prevalence of untreated mental and substance use disorders in the surrounding communities of health centers participating in the demonstration; and
“(C) recommendations on whether the demonstration program should be expanded.
“(g) Authorization of Appropriations.—There are authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2018 through 2022.”
SEC. 9023. Clarification on Current Eligibility for Loan Repayment Programs.
The Administrator of the Health Resources and Services Administration shall clarify the eligibility pursuant to section 338B(b)(1)(B) of the Public Health Service Act (42 U.S.C. 254l–1(b)(1)(B)) of child and adolescent psychiatrists for the National Health Service Corps Loan Repayment Program under subpart III of part D of title III of such Act (42 U.S.C. 254l et seq.).
SEC. 9024. Minority Fellowship Program.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended by adding at the end the following:
“PART K— MINORITY FELLOWSHIP PROGRAM
“SEC. 597. FELLOWSHIPS.
“(a) In General.—The Secretary shall maintain a program, to be known as the Minority Fellowship Program, under which the Secretary shall award fellowships, which may include stipends, for the purposes of—
“(1) increasing the knowledge of mental and substance use disorders practitioners on issues related to prevention, treatment, and recovery support for individuals who are from racial and ethnic minority populations and who have a mental or substance use disorder;
“(2) improving the quality of mental and substance use disorder prevention and treatment services delivered to racial and ethnic minority populations; and
“(3) increasing the number of culturally competent mental and substance use disorders professionals who teach, administer services, conduct research, and provide direct mental or substance use disorder services to racial and ethnic minority populations.
“(b) Training Covered.—The fellowships awarded under subsection (a) shall be for postbaccalaureate training (including for master’s and doctoral degrees) for mental and substance use disorder treatment professionals, including in the fields of psychiatry, nursing, social work, psychology, marriage and family therapy, mental health counseling, and substance use disorder and addiction counseling.
“(c) Authorization of Appropriations.—To carry out this section, there are authorized to be appropriated $12,669,000 for each of fiscal years 2018 through 2022.”
SEC. 9025. Liability Protections for Health Professional Volunteers at Community Health Centers.
Section 224 of the Public Health Service Act (42 U.S.C. 233) is amended by adding at the end the following:
“(q)
(1) For purposes of this section, a health professional volunteer at a deemed entity described in subsection (g)(4) shall, in providing a health professional service eligible for funding under section 330 to an individual, be deemed to be an employee of the Public Health Service for a calendar year that begins during a fiscal year for which a transfer was made under paragraph (4)(C). The preceding sentence is subject to the provisions of this subsection.
“(2) In providing a health service to an individual, a health care practitioner shall for purposes of this subsection be considered to be a health professional volunteer at an entity described in subsection (g)(4) if the following conditions are met:
“(A) The service is provided to the individual at the facilities of an entity described in subsection (g)(4), or through offsite programs or events carried out by the entity.
“(B) The entity is sponsoring the health care practitioner pursuant to paragraph (3)(B).
“(C) The health care practitioner does not receive any compensation for the service from the individual, the entity described in subsection (g)(4), or any third-party payer (including reimbursement under any insurance policy or health plan, or under any Federal or State health benefits program), except that the health care practitioner may receive repayment from the entity described in subsection (g)(4) for reasonable expenses incurred by the health care practitioner in the provision of the service to the individual, which may include travel expenses to or from the site of services.
“(D) Before the service is provided, the health care practitioner or the entity described in subsection (g)(4) posts a clear and conspicuous notice at the site where the service is provided of the extent to which the legal liability of the health care practitioner is limited pursuant to this subsection.
“(E) At the time the service is provided, the health care practitioner is licensed or certified in accordance with applicable Federal and State laws regarding the provision of the service.
“(F) At the time the service is provided, the entity described in subsection (g)(4) maintains relevant documentation certifying that the health care practitioner meets the requirements of this subsection.
“(3) Subsection (g) (other than paragraphs (3) and (5)) and subsections (h), (i), and (l) apply to a health care practitioner for purposes of this subsection to the same extent and in the same manner as such subsections apply to an officer, governing board member, employee, or contractor of an entity described in subsection (g)(4), subject to paragraph (4), and subject to the following:
“(A) The first sentence of paragraph (1) applies in lieu of the first sentence of subsection (g)(1)(A).
“(B) With respect to an entity described in subsection (g)(4), a health care practitioner is not a health professional volunteer at such entity unless the entity sponsors the health care practitioner. For purposes of this subsection, the entity shall be considered to be sponsoring the health care practitioner if—
“(i) with respect to the health care practitioner, the entity submits to the Secretary an application meeting the requirements of subsection (g)(1)(D); and
“(ii) the Secretary, pursuant to subsection (g)(1)(E), determines that the health care practitioner is deemed to be an employee of the Public Health Service.
“(C) In the case of a health care practitioner who is determined by the Secretary pursuant to subsection (g)(1)(E) to be a health professional volunteer at such entity, this subsection applies to the health care practitioner (with respect to services performed on behalf of the entity sponsoring the health care practitioner pursuant to subparagraph (B)) for any cause of action arising from an act or omission of the health care practitioner occurring on or after the date on which the Secretary makes such determination.
“(D) Subsection (g)(1)(F) applies to a health care practitioner for purposes of this subsection only to the extent that, in providing health services to an individual, each of the conditions specified in paragraph (2) is met.
“(4)
(A) Amounts in the fund established under subsection (k)(2) shall be available for transfer under subparagraph (C) for purposes of carrying out this subsection.
“(B)
(i) Not later than May 1 of each fiscal year, the Attorney General, in consultation with the Secretary, shall submit to the Congress a report providing an estimate of the amount of claims (together with related fees and expenses of witnesses) that, by reason of the acts or omissions of health professional volunteers, will be paid pursuant to this section during the calendar year that begins in the following fiscal year.
“(ii) Subsection (k)(1)(B) applies to the estimate under clause (i) regarding health professional volunteers to the same extent and in the same manner as such subsection applies to the estimate under such subsection regarding officers, governing board members, employees, and contractors of entities described in subsection (g)(4).
“(iii) The report shall include a summary of the data relied upon for the estimate in clause (i), including the number of claims filed and paid from the previous calendar year.
“(C) Not later than December 31 of each fiscal year, the Secretary shall transfer from the fund under subsection (k)(2) to the appropriate accounts in the Treasury an amount equal to the estimate made under subparagraph (B) for the calendar year beginning in such fiscal year, subject to the extent of amounts in the fund.
“(5)
(A) This subsection shall take effect on October 1, 2017, except as provided in subparagraph (B) and paragraph (6).
“(B) Effective on the date of the enactment of this subsection—
“(i) the Secretary may issue regulations for carrying out this subsection, and the Secretary may accept and consider applications submitted pursuant to paragraph (3)(B); and
“(ii) reports under paragraph (4)(B) may be submitted to Congress.
“(6) Beginning on October 1, 2022, this subsection shall cease to have any force or effect.”
SEC. 9026. Reports.
Workforce Development Report.—
In general.— Not later than 2 years after the date of enactment of this Act, the Administrator of the Health Resources and Services Administration, in consultation with the Assistant Secretary for Mental Health and Substance Use, shall conduct a study and publicly post on the appropriate Internet website of the Department of Health and Human Services a report on the adult and pediatric mental health and substance use disorder workforce in order to inform Federal, State, and local efforts related to workforce enhancement.
Contents.— The report under this subsection shall contain—
national and State-level projections of the supply and demand of the mental health and substance use disorder health workforce, disaggregated by profession;
an assessment of the mental health and substance use disorder workforce capacity, strengths, and weaknesses as of the date of the report, including the extent to which primary care providers are preventing, screening, or referring for mental and substance use disorder services;
information on trends within the mental health and substance use disorder provider workforce, including the number of individuals expected to enter the mental health workforce over the next 5 years; and
any additional information determined by the Administrator of the Health Resources and Services Administration, in consultation with the Assistant Secretary for Mental Health and Substance Use, to be relevant to the mental health and substance use disorder provider workforce.
Peer-Support Specialist Programs.—
In general.— The Comptroller General of the United States shall conduct a study on peer-support specialist programs in up to 10 States that receive funding from the Substance Abuse and Mental Health Services Administration.
Contents of study.— In conducting the study under paragraph (1), the Comptroller General of the United States shall examine and identify best practices, in the States selected pursuant to such paragraph, related to training and credential requirements for peer-support specialist programs, such as—
hours of formal work or volunteer experience related to mental and substance use disorders conducted through such programs;
types of peer-support specialist exams required for such programs in the selected States;
codes of ethics used by such programs in the selected States;
required or recommended skill sets for such programs in the selected States; and
requirements for continuing education.
Report.— Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report on the study conducted under paragraph (1).
Subtitle C Mental Health on Campus Improvement
SEC. 9031. Mental Health and Substance Use Disorder Services on Campus.
in the section heading, by striking “ and behavioral health” and inserting “ health and substance use disorder”;
in subsection (a)—
by striking “ Services,” and inserting “ Services and”;
by striking “ and behavioral health problems” and inserting “ health or substance use disorders”;
by striking “ substance abuse” and inserting “ substance use disorders”; and
by adding after, “ suicide attempts,” the following: “ prevent mental and substance use disorders, reduce stigma, and improve the identification and treatment for students at risk,”;
in subsection (b)—
in the matter preceding paragraph (1), by striking “ for—” and inserting “ for one or more of the following:”; and
by striking paragraphs (1) through (6) and inserting the following:
“(1) Educating students, families, faculty, and staff to increase awareness of mental and substance use disorders.
“(2) The operation of hotlines.
“(3) Preparing informational material.
“(4) Providing outreach services to notify students about available mental and substance use disorder services.
“(5) Administering voluntary mental and substance use disorder screenings and assessments.
“(6) Supporting the training of students, faculty, and staff to respond effectively to students with mental and substance use disorders.
“(7) Creating a network infrastructure to link institutions of higher education with health care providers who treat mental and substance use disorders.
“(8) Providing mental and substance use disorders prevention and treatment services to students, which may include recovery support services and programming and early intervention, treatment, and management, including through the use of telehealth services.
“(9) Conducting research through a counseling or health center at the institution of higher education involved regarding improving the behavioral health of students through clinical services, outreach, prevention, or academic success, in a manner that is in compliance with all applicable personal privacy laws.
“(10) Supporting student groups on campus, including athletic teams, that engage in activities to educate students, including activities to reduce stigma surrounding mental and behavioral disorders, and promote mental health.
“(11) Employing appropriately trained staff.
“(12) Developing and supporting evidence-based and emerging best practices, including a focus on culturally and linguistically appropriate best practices.”
in subsection (c)(5), by striking “ substance abuse” and inserting “ substance use disorder”;
in subsection (d)—
in the matter preceding paragraph (1), by striking “ An institution of higher education desiring a grant under this section” and inserting “ To be eligible to receive a grant under this section, an institution of higher education”;
by striking paragraph (1) and inserting—
“(1) A description of the population to be targeted by the program carried out under the grant, including veterans whenever possible and appropriate, and of identified mental and substance use disorder needs of students at the institution of higher education.”
in paragraph (2), by inserting “ , which may include, as appropriate and in accordance with subsection (b)(7), a plan to seek input from relevant stakeholders in the community, including appropriate public and private entities, in order to carry out the program under the grant” before the period at the end; and
by adding after paragraph (5) the following new paragraphs:
“(6) An outline of the objectives of the program carried out under the grant.
“(7) For an institution of higher education proposing to use the grant for an activity described in paragraph (8) or (9) of subsection (b), a description of the policies and procedures of the institution of higher education that are related to applicable laws regarding access to, and sharing of, treatment records of students at any campus-based mental health center or partner organization, including the policies and State laws governing when such records can be accessed and shared for non-treatment purposes and a description of the process used by the institution of higher education to notify students of these policies and procedures, including the extent to which written consent is required.
“(8) An assurance that grant funds will be used to supplement and not supplant any other Federal, State, or local funds available to carry out activities of the type carried out under the grant.”
in subsection (e)(1), by striking “ and behavioral health problems” and inserting “ health and substance use disorders”;
in subsection (f)(2)—
by striking “ and behavioral health” and inserting “ health and substance use disorder”; and
by striking “ suicide and substance abuse” and inserting “ suicide and substance use disorders”;
by redesignating subsection (h) as subsection (i);
by inserting after subsection (g) the following new subsection:
“(h) Technical Assistance.—The Secretary may provide technical assistance to grantees in carrying out this section.”
; and
in subsection (i), as redesignated by paragraph (8), by striking “ $5,000,000 for fiscal year 2005” and all that follows through the period at the end and inserting “ $7,000,000 for each of fiscal years 2018 through 2022.”.
SEC. 9032. Interagency Working Group on College Mental Health.
Purpose.— It is the purpose of this section to provide for the establishment of a College Campus Task Force to discuss mental and behavioral health concerns on campuses of institutions of higher education.
Establishment.— The Secretary of Health and Human Services (referred to in this section as the “Secretary”) shall establish a College Campus Task Force (referred to in this section as the “Task Force”) to discuss mental and behavioral health concerns on campuses of institutions of higher education.
Membership.— The Task Force shall be composed of a representative from each Federal agency (as appointed by the head of the agency) that has jurisdiction over, or is affected by, mental health and education policies and projects, including—
the Department of Education;
the Department of Health and Human Services;
the Department of Veterans Affairs; and
such other Federal agencies as the Assistant Secretary for Mental Health and Substance Use, in consultation with the Secretary, determines to be appropriate.
Duties.— The Task Force shall—
serve as a centralized mechanism to coordinate a national effort to—
discuss and evaluate evidence and knowledge on mental and behavioral health services available to, and the prevalence of mental illness among, the age population of students attending institutions of higher education in the United States;
determine the range of effective, feasible, and comprehensive actions to improve mental and behavioral health on campuses of institutions of higher education;
examine and better address the needs of the age population of students attending institutions of higher education dealing with mental illness;
survey Federal agencies to determine which policies are effective in encouraging, and how best to facilitate outreach without duplicating, efforts relating to mental and behavioral health promotion;
establish specific goals within and across Federal agencies for mental health promotion, including determinations of accountability for reaching those goals;
develop a strategy for allocating responsibilities and ensuring participation in mental and behavioral health promotion, particularly in the case of competing agency priorities;
coordinate plans to communicate research results relating to mental and behavioral health amongst the age population of students attending institutions of higher education to enable reporting and outreach activities to produce more useful and timely information;
provide a description of evidence-based practices, model programs, effective guidelines, and other strategies for promoting mental and behavioral health on campuses of institutions of higher education;
make recommendations to improve Federal efforts relating to mental and behavioral health promotion on campuses of institutions of higher education and to ensure Federal efforts are consistent with available standards, evidence, and other programs in existence as of the date of enactment of this Act;
monitor Federal progress in meeting specific mental and behavioral health promotion goals as they relate to settings of institutions of higher education; and
examine and disseminate best practices related to intracampus sharing of treatment records;
consult with national organizations with expertise in mental and behavioral health, especially those organizations working with the age population of students attending institutions of higher education; and
consult with and seek input from mental health professionals working on campuses of institutions of higher education as appropriate.
Meetings.—
In general.— The Task Force shall meet not fewer than three times each year.
Annual conference.— The Secretary shall sponsor an annual conference on mental and behavioral health in settings of institutions of higher education to enhance coordination, build partnerships, and share best practices in mental and behavioral health promotion, data collection, analysis, and services.
Definition.— In this section, the term “institution of higher education” has the meaning given such term in section 101 of the Higher Education Act of 1965 (20 U.S.C. 1001).
Authorization of Appropriations.— To carry out this section, there are authorized to be appropriated $1,000,000 for the period of fiscal years 2018 through 2022.
SEC. 9033. Improving Mental Health on College Campuses.
Part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.) is amended by adding at the end the following:
“SEC. 549. MENTAL AND BEHAVIORAL HEALTH OUTREACH AND EDUCATION ON COLLEGE CAMPUSES.
“(a) Purpose.—It is the purpose of this section to increase access to, and reduce the stigma associated with, mental health services to ensure that students at institutions of higher education have the support necessary to successfully complete their studies.
“(b) National Public Education Campaign.—The Secretary, acting through the Assistant Secretary and in collaboration with the Director of the Centers for Disease Control and Prevention, shall convene an interagency, public-private sector working group to plan, establish, and begin coordinating and evaluating a targeted public education campaign that is designed to focus on mental and behavioral health on the campuses of institutions of higher education. Such campaign shall be designed to—
“(1) improve the general understanding of mental health and mental disorders;
“(2) encourage help-seeking behaviors relating to the promotion of mental health, prevention of mental disorders, and treatment of such disorders;
“(3) make the connection between mental and behavioral health and academic success; and
“(4) assist the general public in identifying the early warning signs and reducing the stigma of mental illness.
“(c) Composition.—The working group convened under subsection (b) shall include—
“(1) mental health consumers, including students and family members;
“(2) representatives of institutions of higher education;
“(3) representatives of national mental and behavioral health associations and associations of institutions of higher education;
“(4) representatives of health promotion and prevention organizations at institutions of higher education;
“(5) representatives of mental health providers, including community mental health centers; and
“(6) representatives of private-sector and public-sector groups with experience in the development of effective public health education campaigns.
“(d) Plan.—The working group under subsection (b) shall develop a plan that—
“(1) targets promotional and educational efforts to the age population of students at institutions of higher education and individuals who are employed in settings of institutions of higher education, including through the use of roundtables;
“(2) develops and proposes the implementation of research-based public health messages and activities;
“(3) provides support for local efforts to reduce stigma by using the National Health Information Center as a primary point of contact for information, publications, and service program referrals; and
“(4) develops and proposes the implementation of a social marketing campaign that is targeted at the population of students attending institutions of higher education and individuals who are employed in settings of institutions of higher education.
“(e) Definition.—In this section, the term ‘institution of higher education’ has the meaning given such term in section 101 of the Higher Education Act of 1965 (20 U.S.C. 1001).
“(f) Authorization of Appropriations.—To carry out this section, there are authorized to be appropriated $1,000,000 for the period of fiscal years 2018 through 2022.”
TITLE X Strengthening Mental and Substance Use Disorder Care for Children and Adolescents
SEC. 10001. Programs for Children with a Serious Emotional Disturbance.
Comprehensive Community Mental Health Services for Children With a Serious Emotional Disturbance.— Section 561(a)(1) of the Public Health Service Act (42 U.S.C. 290ff(a)(1)) is amended by inserting “ , which may include efforts to identify and serve children at risk” before the period.
Requirements With Respect to Carrying Out Purpose of Grants.— Section 562(b) of the Public Health Service Act (42 U.S.C. 290ff–1(b)) is amended by striking “ will not provide an individual with access to the system if the individual is more than 21 years of age” and inserting “ will provide an individual with access to the system through the age of 21 years”.
Additional Provisions.— Section 564(f) of the Public Health Service Act (42 U.S.C. 290ff–3(f)) is amended by inserting “ (and provide a copy to the State involved)” after “ to the Secretary”.
in subsection (b)(1)—
in the matter preceding subparagraph (A), by striking “ receiving a grant under section 561(a)” and inserting “ , regardless of whether such public entity is receiving a grant under section 561(a)”; and
in subparagraph (B), by striking “ pursuant to” and inserting “ described in”;
in subsection (d)(1), by striking “ not more than 21 years of age” and inserting “ through the age of 21 years”; and
in subsection (f)(1), by striking “ $100,000,000 for fiscal year 2001, and such sums as may be necessary for each of the fiscal years 2002 and 2003” and inserting “ $119,026,000 for each of fiscal years 2018 through 2022”.
SEC. 10002. Increasing Access to Pediatric Mental Health Care.
Title III of the Public Health Service Act is amended by inserting after section 330L of such Act (42 U.S.C. 254c–18) the following new section:
“SEC. 330M PEDIATRIC MENTAL HEALTH CARE ACCESS GRANTS.
“(a) In General.—The Secretary, acting through the Administrator of the Health Resources and Services Administration and in coordination with other relevant Federal agencies, shall award grants to States, political subdivisions of States, and Indian tribes and tribal organizations (for purposes of this section, as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b)) to promote behavioral health integration in pediatric primary care by—
“(1) supporting the development of statewide or regional pediatric mental health care telehealth access programs; and
“(2) supporting the improvement of existing statewide or regional pediatric mental health care telehealth access programs.
“(b) Program Requirements.—
“(1) In general.—A pediatric mental health care telehealth access program referred to in subsection (a), with respect to which a grant under such subsection may be used, shall—
“(A) be a statewide or regional network of pediatric mental health teams that provide support to pediatric primary care sites as an integrated team;
“(B) support and further develop organized State or regional networks of pediatric mental health teams to provide consultative support to pediatric primary care sites;
“(C) conduct an assessment of critical behavioral consultation needs among pediatric providers and such providers’ preferred mechanisms for receiving consultation, training, and technical assistance;
“(D) develop an online database and communication mechanisms, including telehealth, to facilitate consultation support to pediatric practices;
“(E) provide rapid statewide or regional clinical telephone or telehealth consultations when requested between the pediatric mental health teams and pediatric primary care providers;
“(F) conduct training and provide technical assistance to pediatric primary care providers to support the early identification, diagnosis, treatment, and referral of children with behavioral health conditions;
“(G) provide information to pediatric providers about, and assist pediatric providers in accessing, pediatric mental health care providers, including child and adolescent psychiatrists, and licensed mental health professionals, such as psychologists, social workers, or mental health counselors and in scheduling and conducting technical assistance;
“(H) assist with referrals to specialty care and community or behavioral health resources; and
“(I) establish mechanisms for measuring and monitoring increased access to pediatric mental health care services by pediatric primary care providers and expanded capacity of pediatric primary care providers to identify, treat, and refer children with mental health problems.
“(2) Pediatric mental health teams.—In this subsection, the term ‘pediatric mental health team’ means a team consisting of at least one case coordinator, at least one child and adolescent psychiatrist, and at least one licensed clinical mental health professional, such as a psychologist, social worker, or mental health counselor. Such a team may be regionally based.
“(c) Application.—A State, political subdivision of a State, Indian tribe, or tribal organization seeking a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan for the comprehensive evaluation of activities that are carried out with funds received under such grant.
“(d) Evaluation.—A State, political subdivision of a State, Indian tribe, or tribal organization that receives a grant under this section shall prepare and submit an evaluation of activities that are carried out with funds received under such grant to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require, including a process and outcome evaluation.
“(e) Access to Broadband.—In administering grants under this section, the Secretary may coordinate with other agencies to ensure that funding opportunities are available to support access to reliable, high-speed Internet for providers.
“(f) Matching Requirement.—The Secretary may not award a grant under this section unless the State, political subdivision of a State, Indian tribe, or tribal organization involved agrees, with respect to the costs to be incurred by the State, political subdivision of a State, Indian tribe, or tribal organization in carrying out the purpose described in this section, to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 20 percent of Federal funds provided in the grant.
“(g) Authorization of Appropriations.—To carry out this section, there are authorized to be appropriated, $9,000,000 for the period of fiscal years 2018 through 2022.”
SEC. 10003. Substance Use Disorder Treatment and Early Intervention Services for Children and Adolescents.
The first section 514 of the Public Health Service Act (42 U.S.C. 290bb–7), relating to substance abuse treatment services for children and adolescents, is amended—
in the section heading, by striking “ abuse treatment” and inserting “ use disorder treatment and early intervention”;
by striking subsection (a) and inserting the following:
“(a) In General.—The Secretary shall award grants, contracts, or cooperative agreements to public and private nonprofit entities, including Indian tribes or tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), or health facilities or programs operated by or in accordance with a contract or grant with the Indian Health Service, for the purpose of—
“(1) providing early identification and services to meet the needs of children and adolescents who are at risk of substance use disorders;
“(2) providing substance use disorder treatment services for children, including children and adolescents with co-occurring mental illness and substance use disorders; and
“(3) providing assistance to pregnant women, and parenting women, with substance use disorders, in obtaining treatment services, linking mothers to community resources to support independent family lives, and staying in recovery so that children are in safe, stable home environments and receive appropriate health care services.”
in subsection (b)—
by striking paragraph (1) and inserting the following:
“(1) apply evidence-based and cost-effective methods;”
in paragraph (2)—
by striking “ treatment”; and
by inserting “ substance abuse,” after “ child welfare,”;
in paragraph (3), by striking “ substance abuse disorders” and inserting “ substance use disorders, including children and adolescents with co-occurring mental illness and substance use disorders,”;
in paragraph (5), by striking “ treatment;” and inserting “ services; and”;
in paragraph (6), by striking “ substance abuse treatment; and” and inserting “ treatment.”; and
by striking paragraph (7); and
in subsection (f), by striking “ $40,000,000” and all that follows through the period and inserting “ $29,605,000 for each of fiscal years 2018 through 2022.”.
SEC. 10004. Children’s Recovery from Trauma.
The first section 582 of the Public Health Service Act (42 U.S.C. 290hh–1; relating to grants to address the problems of persons who experience violence related stress) is amended—
in subsection (a), by striking “ developing programs” and all that follows through the period at the end and inserting the following:
“(1) the continued operation of the National Child Traumatic Stress Initiative (referred to in this section as the ‘NCTSI’), which includes a cooperative agreement with a coordinating center, that focuses on the mental, behavioral, and biological aspects of psychological trauma response, prevention of the long-term consequences of child trauma, and early intervention services and treatment to address the long-term consequences of child trauma; and
“(2) the development of knowledge with regard to evidence-based practices for identifying and treating mental, behavioral, and biological disorders of children and youth resulting from witnessing or experiencing a traumatic event.”
in subsection (b)—
by striking “ subsection (a) related” and inserting “ subsection (a)(2) (related”;
by striking “ treating disorders associated with psychological trauma” and inserting “ treating mental, behavioral, and biological disorders associated with psychological trauma)”; and
by striking “ mental health agencies and programs that have established clinical and basic research” and inserting “ universities, hospitals, mental health agencies, and other programs that have established clinical expertise and research”;
by redesignating subsections (c) through (g) as subsections (g) through (k), respectively;
by inserting after subsection (b), the following:
“(c) Child Outcome Data.—The NCTSI coordinating center described in subsection (a)(1) shall collect, analyze, report, and make publicly available, as appropriate, NCTSI-wide child treatment process and outcome data regarding the early identification and delivery of evidence-based treatment and services for children and families served by the NCTSI grantees.
“(d) Training.—The NCTSI coordinating center shall facilitate the coordination of training initiatives in evidence-based and trauma-informed treatments, interventions, and practices offered to NCTSI grantees, providers, and partners.
“(e) Dissemination and Collaboration.—The NCTSI coordinating center shall, as appropriate, collaborate with—
“(1) the Secretary, in the dissemination of evidence-based and trauma-informed interventions, treatments, products, and other resources to appropriate stakeholders; and
“(2) appropriate agencies that conduct or fund research within the Department of Health and Human Services, for purposes of sharing NCTSI expertise, evaluation data, and other activities, as appropriate.
“(f) Review.—The Secretary shall, consistent with the peer-review process, ensure that NCTSI applications are reviewed by appropriate experts in the field as part of a consensus-review process. The Secretary shall include review criteria related to expertise and experience in child trauma and evidence-based practices.”
in subsection (g) (as so redesignated), by striking “ with respect to centers of excellence are distributed equitably among the regions of the country” and inserting “ are distributed equitably among the regions of the United States”;
in subsection (i) (as so redesignated), by striking “ recipient may not exceed 5 years” and inserting “ recipient shall not be less than 4 years, but shall not exceed 5 years”; and
in subsection (j) (as so redesignated), by striking “ $50,000,000” and all that follows through “ 2006” and inserting “ $46,887,000 for each of fiscal years 2018 through 2022”.
SEC. 10005. Screening and Treatment for Maternal Depression.
Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by inserting after section 317L (42 U.S.C. 247b–13) the following:
“SEC. 317L–1. SCREENING AND TREATMENT FOR MATERNAL DEPRESSION.
“(a) Grants.—The Secretary shall make grants to States to establish, improve, or maintain programs for screening, assessment, and treatment services, including culturally and linguistically appropriate services, as appropriate, for women who are pregnant, or who have given birth within the preceding 12 months, for maternal depression.
“(b) Application.—To seek a grant under this section, a State shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require. At a minimum, any such application shall include explanations of—
“(1) how a program, or programs, will increase the percentage of women screened and treated, as appropriate, for maternal depression in 1 or more communities; and
“(2) how a program, or programs, if expanded, would increase access to screening and treatment services for maternal depression.
“(c) Priority.—In awarding grants under this section, the Secretary may give priority to States proposing to improve or enhance access to screening services for maternal depression in primary care settings.
“(d) Use of Funds.—The activities eligible for funding through a grant under subsection (a)—
“(1) shall include—
“(A) providing appropriate training to health care providers; and
“(B) providing information to health care providers, including information on maternal depression screening, treatment, and followup support services, and linkages to community-based resources; and
“(2) may include—
“(A) enabling health care providers (including obstetrician-gynecologists, pediatricians, psychiatrists, mental health care providers, and adult primary care clinicians) to provide or receive real-time psychiatric consultation (in-person or remotely) to aid in the treatment of pregnant and parenting women;
“(B) establishing linkages with and among community-based resources, including mental health resources, primary care resources, and support groups; and
“(C) utilizing telehealth services for rural areas and medically underserved areas (as defined in section 330I(a)).
“(e) Authorization of Appropriations.—To carry out this section, there are authorized to be appropriated $5,000,000 for each of fiscal years 2018 through 2022.”
SEC. 10006. Infant and Early Childhood Mental Health Promotion, Intervention, and Treatment.
Part Q of title III of the Public Health Service Act (42 U.S.C. 280h et seq.) is amended by adding at the end the following:
“SEC. 399Z–2. INFANT AND EARLY CHILDHOOD MENTAL HEALTH PROMOTION, INTERVENTION, AND TREATMENT.
“(a) Grants.—The Secretary shall—
“(1) award grants to eligible entities to develop, maintain, or enhance infant and early childhood mental health promotion, intervention, and treatment programs, including—
“(A) programs for infants and children at significant risk of developing, showing early signs of, or having been diagnosed with mental illness, including a serious emotional disturbance; and
“(B) multigenerational therapy and other services that support the caregiving relationship; and
“(2) ensure that programs funded through grants under this section are evidence-informed or evidence-based models, practices, and methods that are, as appropriate, culturally and linguistically appropriate, and can be replicated in other appropriate settings.
“(b) Eligible Children and Entities.—In this section:
“(1) Eligible child.—The term ‘eligible child’ means a child from birth to not more than 12 years of age who—
“(A) is at risk for, shows early signs of, or has been diagnosed with a mental illness, including a serious emotional disturbance; and
“(B) may benefit from infant and early childhood intervention or treatment programs or specialized preschool or elementary school programs that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development.
“(2) Eligible entity.—The term ‘eligible entity’ means a human services agency or nonprofit institution that—
“(A) employs licensed mental health professionals who have specialized training and experience in infant and early childhood mental health assessment, diagnosis, and treatment, or is accredited or approved by the appropriate State agency, as applicable, to provide for children from infancy to 12 years of age mental health promotion, intervention, or treatment services; and
“(B) provides services or programs described in subsection (a) that are evidence-based or that have been scientifically demonstrated to show promise but would benefit from further applied development.
“(c) Application.—An eligible entity seeking a grant under subsection (a) shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.
“(d) Use of Funds for Early Intervention and Treatment Programs.—An eligible entity may use amounts awarded under a grant under subsection (a)(1) to carry out the following:
“(1) Provide age-appropriate mental health promotion and early intervention services or mental illness treatment services, which may include specialized programs, for eligible children at significant risk of developing, showing early signs of, or having been diagnosed with a mental illness, including a serious emotional disturbance. Such services may include social and behavioral services as well as multigenerational therapy and other services that support the caregiving relationship.
“(2) Provide training for health care professionals with expertise in infant and early childhood mental health care with respect to appropriate and relevant integration with other disciplines such as primary care clinicians, early intervention specialists, child welfare staff, home visitors, early care and education providers, and others who work with young children and families.
“(3) Provide mental health consultation to personnel of early care and education programs (including licensed or regulated center-based and home-based child care, home visiting, preschool special education, and early intervention programs) who work with children and families.
“(4) Provide training for mental health clinicians in infant and early childhood in promising and evidence-based practices and models for infant and early childhood mental health treatment and early intervention, including with regard to practices for identifying and treating mental illness and behavioral disorders of infants and children resulting from exposure or repeated exposure to adverse childhood experiences or childhood trauma.
“(5) Provide age-appropriate assessment, diagnostic, and intervention services for eligible children, including early mental health promotion, intervention, and treatment services.
“(e) Matching Funds.—The Secretary may not award a grant under this section to an eligible entity unless the eligible entity agrees, with respect to the costs to be incurred by the eligible entity in carrying out the activities described in subsection (d), to make available non-Federal contributions (in cash or in kind) toward such costs in an amount that is not less than 10 percent of the total amount of Federal funds provided in the grant.
“(f) Authorization of Appropriations.—To carry out this section, there are authorized to be appropriated $20,000,000 for the period of fiscal years 2018 through 2022.”
TITLE XI Compassionate Communication on Hipaa
SEC. 11001. Sense of Congress.
Findings.— Congress finds the following:
According to the National Survey on Drug Use and Health, in 2015, there were approximately 9,800,000 adults in the United States with serious mental illness.
The Substance Abuse and Mental Health Services Administration defines the term “serious mental illness” as an illness affecting individuals 18 years of age or older as having, at any time in the past year, a diagnosable mental, behavioral, or emotional disorder that results in serious functional impairment and substantially interferes with or limits one or more major life activities.
In reporting on the incidence of serious mental illness, the Substance Abuse and Mental Health Services Administration includes major depression, schizophrenia, bipolar disorder, and other mental disorders that cause serious impairment.
Adults with a serious mental illness are at a higher risk for chronic physical illnesses and premature death.
According to the World Health Organization, adults with a serious mental illness have lifespans that are 10 to 25 years shorter than those without serious mental illness. The vast majority of these deaths are due to chronic physical medical conditions, such as cardiovascular, respiratory, and infectious diseases, as well as diabetes and hypertension.
According to the World Health Organization, the majority of deaths of adults with a serious mental illness that are due to physical medical conditions are preventable.
Supported decision making can facilitate care decisions in areas where serious mental illness may impact the capacity of an individual to determine a course of treatment while still allowing the individual to make decisions independently.
Help should be provided to adults with a serious mental illness to address their acute or chronic physical illnesses, make informed choices about treatment, and understand and follow through with appropriate treatment.
There is confusion in the health care community regarding permissible practices under the regulations promulgated under the Health Insurance Portability and Accountability Act of 1996 (commonly known as “HIPAA”). This confusion may hinder appropriate communication of health care information or treatment preferences with appropriate caregivers.
Sense of Congress.— It is the sense of Congress that clarification is needed regarding the privacy rule promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. 1320d–2 note) regarding existing permitted uses and disclosures of health information by health care professionals to communicate with caregivers of adults with a serious mental illness to facilitate treatment.
SEC. 11002. Confidentiality of Records.
Not later than 1 year after the date on which the Secretary of Health and Human Services (in this title referred to as the “Secretary”) first finalizes regulations updating part 2 of title 42, Code of Federal Regulations, relating to confidentiality of alcohol and drug abuse patient records, after the date of enactment of this Act, the Secretary shall convene relevant stakeholders to determine the effect of such regulations on patient care, health outcomes, and patient privacy.
SEC. 11003. Clarification on Permitted Uses and Disclosures of Protected Health Information.
In General.— The Secretary, acting through the Director of the Office for Civil Rights, shall ensure that health care providers, professionals, patients and their families, and others involved in mental or substance use disorder treatment have adequate, accessible, and easily comprehensible resources relating to appropriate uses and disclosures of protected health information under the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. 1320d–2 note).
Guidance.—
Issuance.— In carrying out subsection (a), not later than 1 year after the date of enactment of this section, the Secretary shall issue guidance clarifying the circumstances under which, consistent with regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996, a health care provider or covered entity may use or disclose protected health information.
Circumstances addressed.— The guidance issued under this section shall address circumstances including those that—
require the consent of the patient;
require providing the patient with an opportunity to object;
are based on the exercise of professional judgment regarding whether the patient would object when the opportunity to object cannot practicably be provided because of the incapacity of the patient or an emergency treatment circumstance; and
are determined, based on the exercise of professional judgment, to be in the best interest of the patient when the patient is not present or otherwise incapacitated.
Communication with family members and caregivers.— In addressing the circumstances described in paragraph (2), the guidance issued under this section shall clarify permitted uses or disclosures of protected health information for purposes of—
communicating with a family member of the patient, caregiver of the patient, or other individual, to the extent that such family member, caregiver, or individual is involved in the care of the patient;
in the case that the patient is an adult, communicating with a family member of the patient, caregiver of the patient, or other individual involved in the care of the patient;
in the case that the patient is a minor, communicating with the parent or caregiver of the patient;
involving the family members or caregivers of the patient, or others involved in the patient’s care or care plan, including facilitating treatment and medication adherence;
listening to the patient, or receiving information with respect to the patient from the family or caregiver of the patient;
communicating with family members of the patient, caregivers of the patient, law enforcement, or others when the patient presents a serious and imminent threat of harm to self or others; and
communicating to law enforcement and family members or caregivers of the patient about the admission of the patient to receive care at, or the release of a patient from, a facility for an emergency psychiatric hold or involuntary treatment.
SEC. 11004. Development and Dissemination of Model Training Programs.
Initial Programs and Materials.— Not later than 1 year after the date of the enactment of this Act, the Secretary, in consultation with appropriate experts, shall identify the following model programs and materials, or (in the case that no such programs or materials exist) recognize private or public entities to develop and disseminate each of the following:
Model programs and materials for training health care providers (including physicians, emergency medical personnel, psychiatrists, including child and adolescent psychiatrists, psychologists, counselors, therapists, nurse practitioners, physician assistants, behavioral health facilities and clinics, care managers, and hospitals, including individuals such as general counsels or regulatory compliance staff who are responsible for establishing provider privacy policies) regarding the permitted uses and disclosures, consistent with the standards governing the privacy and security of individually identifiable health information promulgated by the Secretary under part C of title XI of the Social Security Act (42 U.S.C. 1320d et seq.) and regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. 1320d–2 note) and such part C, of the protected health information of patients seeking or undergoing mental or substance use disorder treatment.
A model program and materials for training patients and their families regarding their rights to protect and obtain information under the standards and regulations specified in paragraph (1).
Periodic Updates.— The Secretary shall—
periodically review and update the model programs and materials identified or developed under subsection (a); and
disseminate the updated model programs and materials to the individuals described in subsection (a).
Coordination.— The Secretary shall carry out this section in coordination with the Director of the Office for Civil Rights within the Department of Health and Human Services, the Assistant Secretary for Mental Health and Substance Use, the Administrator of the Health Resources and Services Administration, and the heads of other relevant agencies within the Department of Health and Human Services.
Input of Certain Entities.— In identifying, reviewing, or updating the model programs and materials under subsections (a) and (b), the Secretary shall solicit the input of relevant national, State, and local associations; medical societies; licensing boards; providers of mental and substance use disorder treatment; organizations with expertise on domestic violence, sexual assault, elder abuse, and child abuse; and organizations representing patients and consumers and the families of patients and consumers.
Funding.— There are authorized to be appropriated to carry out this section—
$4,000,000 for fiscal year 2018;
$2,000,000 for each of fiscal years 2019 and 2020; and
$1,000,000 for each of fiscal years 2021 and 2022.
TITLE XII Medicaid Mental Health Coverage
SEC. 12001. Rule of Construction Related to Medicaid Coverage of Mental Health Services and Primary Care Services Furnished on the Same Day.
Nothing in title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) shall be construed as prohibiting separate payment under the State plan under such title (or under a waiver of the plan) for the provision of a mental health service or primary care service under such plan, with respect to an individual, because such service is—
a primary care service furnished to the individual by a provider at a facility on the same day a mental health service is furnished to such individual by such provider (or another provider) at the facility; or
a mental health service furnished to the individual by a provider at a facility on the same day a primary care service is furnished to such individual by such provider (or another provider) at the facility.
SEC. 12002. Study and Report Related to Medicaid Managed Care Regulation.
Study.— The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall conduct a study on coverage under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) of services provided through a medicaid managed care organization (as defined in section 1903(m) of such Act (42 U.S.C. 1396b(m)) or a prepaid inpatient health plan (as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)) with respect to individuals over the age of 21 and under the age of 65 for the treatment of a mental health disorder in institutions for mental diseases (as defined in section 1905(i) of such Act (42 U.S.C. 1396d(i))). Such study shall include information on the following:
The extent to which States, including the District of Columbia and each territory or possession of the United States, are providing capitated payments to such organizations or plans for enrollees who are receiving services in institutions for mental diseases.
The number of individuals receiving medical assistance under a State plan under such title XIX, or a waiver of such plan, who receive services in institutions for mental diseases through such organizations and plans.
The range of and average number of months, and the length of stay during such months, that such individuals are receiving such services in such institutions.
How such organizations or plans determine when to provide for the furnishing of such services through an institution for mental diseases in lieu of other benefits (including the full range of community-based services) under their contract with the State agency administering the State plan under such title XIX, or a waiver of such plan, to address psychiatric or substance use disorder treatment.
The extent to which the provision of services within such institutions has affected the capitated payments for such organizations or plans.
Report.— Not later than 3 years after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the study conducted under subsection (a).
SEC. 12003. Guidance on Opportunities for Innovation.
Not later than 1 year after the date of the enactment of this Act, the Administrator of the Centers for Medicare & Medicaid Services shall issue a State Medicaid Director letter regarding opportunities to design innovative service delivery systems, including systems for providing community-based services, for adults with a serious mental illness or children with a serious emotional disturbance who are receiving medical assistance under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.). The letter shall include opportunities for demonstration projects under section 1115 of such Act (42 U.S.C. 1315) to improve care for such adults and children.
SEC. 12004. Study and Report on Medicaid Emergency Psychiatric Demonstration Project.
Collection of Information.— The Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, shall, to the extent practical and data is available, with respect to each State that has participated in the demonstration project established under section 2707 of the Patient Protection and Affordable Care Act (42 U.S.C. 1396a note), collect from each such State information on the following:
The number of institutions for mental diseases (as defined in section 1905(i) of the Social Security Act (42 U.S.C. 1396d(i))) and beds in such institutions that received payment for the provision of services to individuals who receive medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) (or under a waiver of such plan) through the demonstration project in each such State as compared to the total number of institutions for mental diseases and beds in the State.
The extent to which there is a reduction in expenditures under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) or other spending on the full continuum of physical or mental health care for individuals who receive treatment in an institution for mental diseases under the demonstration project, including outpatient, inpatient, emergency, and ambulatory care, that is attributable to such individuals receiving treatment in institutions for mental diseases under the demonstration project.
The number of forensic psychiatric hospitals, the number of beds in such hospitals, and the number of forensic psychiatric beds in other hospitals in such State, based on the most recent data available, to the extent practical, as determined by such Administrator.
The amount of any disproportionate share hospital payments under section 1923 of the Social Security Act (42 U.S.C. 1396r–4) that institutions for mental diseases in the State received during the period beginning on July 1, 2012, and ending on June 30, 2015, and the extent to which the demonstration project reduced the amount of such payments.
The most recent data regarding all facilities or sites in the State in which any adults with a serious mental illness who are receiving medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) (or under a waiver of such plan) are treated during the period referred to in paragraph (4), to the extent practical, as determined by the Administrator, including—
the types of such facilities or sites (such as an institution for mental diseases, a hospital emergency department, or other inpatient hospital);
the average length of stay in such a facility or site by such an individual, disaggregated by facility type; and
the payment rate under the State plan (or a waivers of such plan) for services furnished to such an individual for that treatment, disaggregated by facility type, during the period in which the demonstration project is in operation.
The extent to which the utilization of hospital emergency departments during the period in which the demonstration project was is in operation differed, with respect to individuals who are receiving medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) (or under a waiver of such plan), between—
those individuals who received treatment in an institution for mental diseases under the demonstration project;
those individuals who met the eligibility requirements for the demonstration project but who did not receive treatment in an institution for mental diseases under the demonstration project; and
those adults with a serious mental illness who did not meet such eligibility requirements and did not receive treatment for such illness in an institution for mental diseases.
Report.— Not later than 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report that summarizes and analyzes the information collected under subsection (a). Such report may be submitted as part of the report required under section 2707(f) of the Patient Protection and Affordable Care Act (42 U.S.C. 1396a note) or separately.
SEC. 12005. Providing Epsdt Services to Children in Imds.
by striking “ effective January 1, 1973” and inserting “ (A) effective January 1, 1973”; and
by inserting before the semicolon at the end the following: “ , and, (B) for individuals receiving services described in subparagraph (A), early and periodic screening, diagnostic, and treatment services (as defined in subsection (r)), whether or not such screening, diagnostic, and treatment services are furnished by the provider of the services described in such subparagraph”.
Effective Date.— The amendments made by subsection (a) shall apply with respect to items and services furnished in calendar quarters beginning on or after January 1, 2019.
SEC. 12006. Electronic Visit Verification System Required for Personal Care Services and Home Health Care Services under Medicaid.
In General.— Section 1903 of the Social Security Act (42 U.S.C. 1396b) is amended by inserting after subsection (k) the following new subsection:
“(l)
(1) Subject to paragraphs (3) and (4), with respect to any amount expended for personal care services or home health care services requiring an in-home visit by a provider that are provided under a State plan under this title (or under a waiver of the plan) and furnished in a calendar quarter beginning on or after January 1, 2019 (or, in the case of home health care services, on or after January 1, 2023), unless a State requires the use of an electronic visit verification system for such services furnished in such quarter under the plan or such waiver, the Federal medical assistance percentage shall be reduced—
“(A) in the case of personal care services—
“(i) for calendar quarters in 2019 and 2020, by .25 percentage points;
“(ii) for calendar quarters in 2021, by .5 percentage points;
“(iii) for calendar quarters in 2022, by .75 percentage points; and
“(iv) for calendar quarters in 2023 and each year thereafter, by 1 percentage point; and
“(B) in the case of home health care services—
“(i) for calendar quarters in 2023 and 2024, by .25 percentage points;
“(ii) for calendar quarters in 2025, by .5 percentage points;
“(iii) for calendar quarters in 2026, by .75 percentage points; and
“(iv) for calendar quarters in 2027 and each year thereafter, by 1 percentage point.
“(2) Subject to paragraphs (3) and (4), in implementing the requirement for the use of an electronic visit verification system under paragraph (1), a State shall—
“(A) consult with agencies and entities that provide personal care services, home health care services, or both under the State plan (or under a waiver of the plan) to ensure that such system—
“(i) is minimally burdensome;
“(ii) takes into account existing best practices and electronic visit verification systems in use in the State; and
“(iii) is conducted in accordance with the requirements of HIPAA privacy and security law (as defined in section 3009 of the Public Health Service Act);
“(B) take into account a stakeholder process that includes input from beneficiaries, family caregivers, individuals who furnish personal care services or home health care services, and other stakeholders, as determined by the State in accordance with guidance from the Secretary; and
“(C) ensure that individuals who furnish personal care services, home health care services, or both under the State plan (or under a waiver of the plan) are provided the opportunity for training on the use of such system.
“(3) Paragraphs (1) and (2) shall not apply in the case of a State that, as of the date of the enactment of this subsection, requires the use of any system for the electronic verification of visits conducted as part of both personal care services and home health care services, so long as the State continues to require the use of such system with respect to the electronic verification of such visits.
“(4)
(A) In the case of a State described in subparagraph (B), the reduction under paragraph (1) shall not apply—
“(i) in the case of personal care services, for calendar quarters in 2019; and
“(ii) in the case of home health care services, for calendar quarters in 2023.
“(B) For purposes of subparagraph (A), a State described in this subparagraph is a State that demonstrates to the Secretary that the State—
“(i) has made a good faith effort to comply with the requirements of paragraphs (1) and (2) (including by taking steps to adopt the technology used for an electronic visit verification system); and
“(ii) in implementing such a system, has encountered unavoidable system delays.
“(5) In this subsection:
“(A) The term ‘electronic visit verification system’ means, with respect to personal care services or home health care services, a system under which visits conducted as part of such services are electronically verified with respect to—
“(i) the type of service performed;
“(ii) the individual receiving the service;
“(iii) the date of the service;
“(iv) the location of service delivery;
“(v) the individual providing the service; and
“(vi) the time the service begins and ends.
“(B) The term ‘home health care services’ means services described in section 1905(a)(7) provided under a State plan under this title (or under a waiver of the plan).
“(C) The term ‘personal care services’ means personal care services provided under a State plan under this title (or under a waiver of the plan), including services provided under section 1905(a)(24), 1915(c), 1915(i), 1915(j), or 1915(k) or under a wavier under section 1115.
“(6)
(A) In the case in which a State requires personal care service and home health care service providers to utilize an electronic visit verification system operated by the State or a contractor on behalf of the State, the Secretary shall pay to the State, for each quarter, an amount equal to 90 per centum of so much of the sums expended during such quarter as are attributable to the design, development, or installation of such system, and 75 per centum of so much of the sums for the operation and maintenance of such system.
“(B) Subparagraph (A) shall not apply in the case in which a State requires personal care service and home health care service providers to utilize an electronic visit verification system that is not operated by the State or a contractor on behalf of the State.”
Collection and Dissemination of Best Practices.— Not later than January 1, 2018, the Secretary of Health and Human Services shall, with respect to electronic visit verification systems (as defined in subsection (l)(5) of section 1903 of the Social Security Act (42 U.S.C. 1396b), as inserted by subsection (a)), collect and disseminate best practices to State Medicaid Directors with respect to—
training individuals who furnish personal care services, home health care services, or both under the State plan under title XIX of such Act (or under a waiver of the plan) on such systems and the operation of such systems and the prevention of fraud with respect to the provision of personal care services or home health care services (as defined in such subsection (l)(5)); and
the provision of notice and educational materials to family caregivers and beneficiaries with respect to the use of such electronic visit verification systems and other means to prevent such fraud.
Rules of Construction.—
No employer-employee relationship established.— Nothing in the amendment made by this section may be construed as establishing an employer-employee relationship between the agency or entity that provides for personal care services or home health care services and the individuals who, under a contract with such an agency or entity, furnish such services for purposes of part 552 of title 29, Code of Federal Regulations (or any successor regulations).
No particular or uniform electronic visit verification system required.— Nothing in the amendment made by this section shall be construed to require the use of a particular or uniform electronic visit verification system (as defined in subsection (l)(5) of section 1903 of the Social Security Act (42 U.S.C. 1396b), as inserted by subsection (a)) by all agencies or entities that provide personal care services or home health care under a State plan under title XIX of the Social Security Act (or under a waiver of the plan) (42 U.S.C. 1396 et seq.).
No limits on provision of care.— Nothing in the amendment made by this section may be construed to limit, with respect to personal care services or home health care services provided under a State plan under title XIX of the Social Security Act (or under a waiver of the plan) (42 U.S.C. 1396 et seq.), provider selection, constrain beneficiaries’ selection of a caregiver, or impede the manner in which care is delivered.
No prohibition on state quality measures requirements.— Nothing in the amendment made by this section shall be construed as prohibiting a State, in implementing an electronic visit verification system (as defined in subsection (l)(5) of section 1903 of the Social Security Act (42 U.S.C. 1396b), as inserted by subsection (a)), from establishing requirements related to quality measures for such system.
TITLE XIII Mental Health Parity
SEC. 13001. Enhanced Compliance with Mental Health and Substance Use Disorder Coverage Requirements.
Compliance Program Guidance Document.— Section 2726(a) of the Public Health Service Act (42 U.S.C. 300gg–26(a)) is amended by adding at the end the following:
“(6) Compliance program guidance document.—
“(A) In general.—Not later than 12 months after the date of enactment of the Helping Families in Mental Health Crisis Reform Act of 2016, the Secretary, the Secretary of Labor, and the Secretary of the Treasury, in consultation with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury, shall issue a compliance program guidance document to help improve compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, and section 9812 of the Internal Revenue Code of 1986, as applicable. In carrying out this paragraph, the Secretaries may take into consideration the 2016 publication of the Department of Health and Human Services and the Department of Labor, entitled ‘Warning Signs - Plan or Policy Non-Quantitative Treatment Limitations (NQTLs) that Require Additional Analysis to Determine Mental Health Parity Compliance’.
“(B) Examples illustrating compliance and noncompliance.—
“(i) In general.—The compliance program guidance document required under this paragraph shall provide illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, based on investigations of violations of such sections, including—
“(I) examples illustrating requirements for information disclosures and nonquantitative treatment limitations; and
“(II) descriptions of the violations uncovered during the course of such investigations.
“(ii) Nonquantitative treatment limitations.—To the extent that any example described in clause (i) involves a finding of compliance or noncompliance with regard to any requirement for nonquantitative treatment limitations, the example shall provide sufficient detail to fully explain such finding, including a full description of the criteria involved for approving medical and surgical benefits and the criteria involved for approving mental health and substance use disorder benefits.
“(iii) Access to additional information regarding compliance.—In developing and issuing the compliance program guidance document required under this paragraph, the Secretaries specified in subparagraph (A)—
“(I) shall enter into interagency agreements with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury to share findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable; and
“(II) shall seek to enter into an agreement with a State to share information on findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable.
“(C) Recommendations.—The compliance program guidance document shall include recommendations to advance compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, and encourage the development and use of internal controls to monitor adherence to applicable statutes, regulations, and program requirements. Such internal controls may include illustrative examples of nonquantitative treatment limitations on mental health and substance use disorder benefits, which may fail to comply with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, in relation to nonquantitative treatment limitations on medical and surgical benefits.
“(D) Updating the compliance program guidance document.—The Secretary, the Secretary of Labor, and the Secretary of the Treasury, in consultation with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury, shall update the compliance program guidance document every 2 years to include illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable.”
Additional Guidance.— Section 2726(a) of the Public Health Service Act (42 U.S.C. 300gg–26(a)), as amended by subsection (a), is further amended by adding at the end the following:
“(7) Additional guidance.—
“(A) In general.—Not later than 12 months after the date of enactment of the Helping Families in Mental Health Crisis Reform Act of 2016, the Secretary, the Secretary of Labor, and the Secretary of the Treasury shall issue guidance to group health plans and health insurance issuers offering group or individual health insurance coverage to assist such plans and issuers in satisfying the requirements of this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable.
“(B) Disclosure.—
“(i) Guidance for plans and issuers.—The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use for disclosing information to ensure compliance with the requirements under this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such sections, as applicable).
“(ii) Documents for participants, beneficiaries, contracting providers, or authorized representatives.—The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use to provide any participant, beneficiary, contracting provider, or authorized representative, as applicable, with documents containing information that the health plans or issuers are required to disclose to participants, beneficiaries, contracting providers, or authorized representatives to ensure compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, compliance with any regulation issued pursuant to such respective section, or compliance with any other applicable law or regulation. Such guidance shall include information that is comparative in nature with respect to—
“(I) nonquantitative treatment limitations for both medical and surgical benefits and mental health and substance use disorder benefits;
“(II) the processes, strategies, evidentiary standards, and other factors used to apply the limitations described in subclause (I); and
“(III) the application of the limitations described in subclause (I) to ensure that such limitations are applied in parity with respect to both medical and surgical benefits and mental health and substance use disorder benefits.
“(C) Nonquantitative treatment limitations.—The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods, processes, strategies, evidentiary standards, and other factors that group health plans and health insurance issuers offering group or individual health insurance coverage may use regarding the development and application of nonquantitative treatment limitations to ensure compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such respective section), including—
“(i) examples of methods of determining appropriate types of nonquantitative treatment limitations with respect to both medical and surgical benefits and mental health and substance use disorder benefits, including nonquantitative treatment limitations pertaining to—
“(I) medical management standards based on medical necessity or appropriateness, or whether a treatment is experimental or investigative;
“(II) limitations with respect to prescription drug formulary design; and
“(III) use of fail-first or step therapy protocols;
“(ii) examples of methods of determining—
“(I) network admission standards (such as credentialing); and
“(II) factors used in provider reimbursement methodologies (such as service type, geographic market, demand for services, and provider supply, practice size, training, experience, and licensure) as such factors apply to network adequacy;
“(iii) examples of sources of information that may serve as evidentiary standards for the purposes of making determinations regarding the development and application of nonquantitative treatment limitations;
“(iv) examples of specific factors, and the evidentiary standards used to evaluate such factors, used by such plans or issuers in performing a nonquantitative treatment limitation analysis;
“(v) examples of how specific evidentiary standards may be used to determine whether treatments are considered experimental or investigative;
“(vi) examples of how specific evidentiary standards may be applied to each service category or classification of benefits;
“(vii) examples of methods of reaching appropriate coverage determinations for new mental health or substance use disorder treatments, such as evidence-based early intervention programs for individuals with a serious mental illness and types of medical management techniques;
“(viii) examples of methods of reaching appropriate coverage determinations for which there is an indirect relationship between the covered mental health or substance use disorder benefit and a traditional covered medical and surgical benefit, such as residential treatment or hospitalizations involving voluntary or involuntary commitment; and
“(ix) additional illustrative examples of methods, processes, strategies, evidentiary standards, and other factors for which the Secretary determines that additional guidance is necessary to improve compliance with this section, section 712 of the Employee Retirement Income Security Act of 1974, or section 9812 of the Internal Revenue Code of 1986, as applicable.
“(D) Public comment.—Prior to issuing any final guidance under this paragraph, the Secretary shall provide a public comment period of not less than 60 days during which any member of the public may provide comments on a draft of the guidance.”
Availability of Plan Information.—
Solicitation of public feedback.— Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury shall solicit feedback from the public on how the disclosure request process for documents containing information that health plans or health insurance issuers are required under Federal or State law to disclose to participants, beneficiaries, contracting providers, or authorized representatives to ensure compliance with existing mental health parity and addiction equity requirements can be improved while continuing to ensure consumers’ rights to access all information required by Federal or State law to be disclosed.
Public availability.— Not later than 12 months after the date of the enactment of this Act, the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury shall make such feedback publicly available.
NAIC.— The Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury shall share feedback obtained pursuant to paragraph (1) directly with the National Association of Insurance Commissioners to the extent such feedback includes recommendations for the development of simplified information disclosure tools to provide consistent information for consumers. Such feedback may be taken into consideration by the National Association of Insurance Commissioners and other appropriate entities for the voluntary development and voluntary use of common templates and other sample standardized forms to improve consumer access to plan information.
Improving Compliance.—
In general.— In the case that the Secretary of Health and Human Services, the Secretary of Labor, or the Secretary of the Treasury determines that a group health plan or health insurance issuer offering group or individual health insurance coverage has violated, at least 5 times, section 2726 of the Public Health Service Act (42 U.S.C. 300gg–26), section 712 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185a), or section 9812 of the Internal Revenue Code of 1986, respectively, the appropriate Secretary shall audit plan documents for such health plan or issuer in the plan year following the Secretary’s determination in order to help improve compliance with such section.
Rule of construction.— Nothing in this subsection shall be construed to limit the authority, as in effect on the day before the date of enactment of this Act, of the Secretary of Health and Human Services, the Secretary of Labor, or the Secretary of the Treasury to audit documents of health plans or health insurance issuers.
SEC. 13002. Action Plan for Enhanced Enforcement of Mental Health and Substance Use Disorder Coverage.
Public Meeting.—
In general.— Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services shall convene a public meeting of stakeholders described in paragraph (2) to produce an action plan for improved Federal and State coordination related to the enforcement of section 2726 of the Public Health Service Act (42 U.S.C. 300gg–26), section 712 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185a), and section 9812 of the Internal Revenue Code of 1986, and any comparable provisions of State law (in this section such sections and provisions are collectively referred to as “mental health parity and addiction equity requirements”).
Stakeholders.— The stakeholders described in this paragraph shall include each of the following:
The Federal Government, including representatives from—
the Department of Health and Human Services;
the Department of the Treasury;
the Department of Labor; and
the Department of Justice.
State governments, including—
State health insurance commissioners;
appropriate State agencies, including agencies on public health or mental health; and
State attorneys general or other representatives of State entities involved in the enforcement of mental health parity and addiction equity requirements.
Representatives from key stakeholder groups, including—
the National Association of Insurance Commissioners;
health insurance issuers;
providers of mental health and substance use disorder treatment;
employers; and
patients or their advocates.
Action Plan.— Not later than 6 months after the conclusion of the public meeting under subsection (a), the Secretary of Health and Human Services shall finalize the action plan described in such subsection and make it plainly available on the Internet website of the Department of Health and Human Services.
Content.— The action plan under this section shall—
take into consideration the recommendations of the Mental Health and Substance Use Disorder Parity Task Force in its final report issued in October of 2016, and any subsequent Federal and State actions in relation to such recommendations;
reflect the input of the stakeholders participating in the public meeting under subsection (a);
identify specific strategic objectives regarding how the various Federal and State agencies charged with enforcement of mental health parity and addiction equity requirements will collaborate to improve enforcement of such requirements;
provide a timeline for implementing the action plan; and
provide specific examples of how such objectives may be met, which may include—
providing common educational information and documents, such as the Consumer Guide to Disclosure Rights, to patients about their rights under mental health parity and addiction equity requirements;
facilitating the centralized collection of, monitoring of, and response to patient complaints or inquiries relating to mental health parity and addiction equity requirements, which may be through the development and administration of—
a single, toll-free telephone number; and
a new parity website—
to help consumers find the appropriate Federal or State agency to assist with their parity complaints, appeals, and other actions; and
that takes into consideration, but is not duplicative of, the parity beta site being tested, and released for public comment, by the Department of Health and Human Services as of the date of the enactment of this Act;
Federal and State law enforcement agencies entering into memoranda of understanding to better coordinate enforcement responsibilities and information sharing—
including whether such agencies should make the results of enforcement actions related to mental health parity and addiction equity requirements publicly available; and
which may include State Policy Academies on Parity Implementation for State Officials and other forums to bring together national experts to provide technical assistance to teams of State officials on strategies to advance compliance with mental health parity and addiction equity requirements in both the commercial market, and in the Medicaid program under title XIX of the Social Security Act and the State Children’s Health Insurance Program under title XXI of such Act; and
recommendations to the Congress regarding the need for additional legal authority to improve enforcement of mental health parity and addiction equity requirements, including the need for additional legal authority to ensure that nonquantitative treatment limitations are applied, and the extent and frequency of the applications of such limitations, both to medical and surgical benefits and to mental health and substance use disorder benefits in a comparable manner.
SEC. 13003. Report on Investigations Regarding Parity in Mental Health and Substance Use Disorder Benefits.
In General.— Not later than 1 year after the date of enactment of this Act, and annually thereafter for the subsequent 5 years, the Assistant Secretary of Labor of the Employee Benefits Security Administration, in collaboration with the Administrator of the Centers for Medicare & Medicaid Services and the Secretary of the Treasury, shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report summarizing the results of all closed Federal investigations completed during the preceding 12-month period with findings of any serious violation regarding compliance with mental health and substance use disorder coverage requirements under section 2726 of the Public Health Service Act (42 U.S.C. 300gg–26), section 712 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185a), and section 9812 of the Internal Revenue Code of 1986.
Contents.— Subject to subsection (c), a report under subsection (a) shall, with respect to investigations described in such subsection, include each of the following:
The number of closed Federal investigations conducted during the covered reporting period.
Each benefit classification examined by any such investigation conducted during the covered reporting period.
Each subject matter, including compliance with requirements for quantitative and nonquantitative treatment limitations, of any such investigation conducted during the covered reporting period.
A summary of the basis of the final decision rendered for each closed investigation conducted during the covered reporting period that resulted in a finding of a serious violation.
Limitation.— Any individually identifiable information shall be excluded from reports under subsection (a) consistent with protections under the health privacy and security rules promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. 1320d–2 note).
SEC. 13004. Gao Study on Parity in Mental Health and Substance Use Disorder Benefits.
Not later than 3 years after the date of enactment of this Act, the Comptroller General of the United States, in consultation with the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury, shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report detailing the extent to which group health plans or health insurance issuers offering group or individual health insurance coverage that provides both medical and surgical benefits and mental health or substance use disorder benefits, medicaid managed care organizations with a contract under section 1903(m) of the Social Security Act (42 U.S.C. 1396b(m)), and health plans provided under the State Children’s Health Insurance Program under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) comply with section 2726 of the Public Health Service Act (42 U.S.C. 300gg–26), section 712 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185a), and section 9812 of the Internal Revenue Code of 1986, including—
how nonquantitative treatment limitations, including medical necessity criteria, of such plans or issuers comply with such sections;
how the responsible Federal departments and agencies ensure that such plans or issuers comply with such sections, including an assessment of how the Secretary of Health and Human Services has used its authority to conduct audits of such plans to ensure compliance;
a review of how the various Federal and State agencies responsible for enforcing mental health parity requirements have improved enforcement of such requirements in accordance with the objectives and timeline described in the action plan under section 13002; and
recommendations for how additional enforcement, education, and coordination activities by responsible Federal and State departments and agencies could better ensure compliance with such sections, including recommendations regarding the need for additional legal authority.
SEC. 13005. Information and Awareness on Eating Disorders.
Information.— The Secretary of Health and Human Services, acting through the Director of the Office on Women’s Health, may—
update information, related fact sheets, and resource lists related to eating disorders that are available on the public Internet website of the National Women’s Health Information Center sponsored by the Office on Women’s Health, to include—
updated findings and current research related to eating disorders, as appropriate; and
information about eating disorders, including information related to males and females;
incorporate, as appropriate, and in coordination with the Secretary of Education, information from publicly available resources into appropriate obesity prevention programs developed by the Office on Women’s Health; and
make publicly available (through a public Internet website or other method) information, related fact sheets, and resource lists, as updated under paragraph (1), and the information incorporated into appropriate obesity prevention programs under paragraph (2).
Awareness.— The Secretary of Health and Human Services may advance public awareness on—
the types of eating disorders;
the seriousness of eating disorders, including prevalence, comorbidities, and physical and mental health consequences;
methods to identify, intervene, refer for treatment, and prevent behaviors that may lead to the development of eating disorders;
discrimination and bullying based on body size;
the effects of media on self-esteem and body image; and
the signs and symptoms of eating disorders.
SEC. 13006. Education and Training on Eating Disorders.
The Secretary of Health and Human Services may facilitate the identification of model programs and materials for educating and training health professionals in effective strategies to—
identify individuals with eating disorders;
provide early intervention services for individuals with eating disorders;
refer patients with eating disorders for appropriate treatment;
prevent the development of eating disorders; and
provide appropriate treatment services for individuals with eating disorders.
SEC. 13007. Clarification of Existing Parity Rules.
If a group health plan or a health insurance issuer offering group or individual health insurance coverage provides coverage for eating disorder benefits, including residential treatment, such group health plan or health insurance issuer shall provide such benefits consistent with the requirements of section 2726 of the Public Health Service Act (42 U.S.C. 300gg–26), section 712 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185a), and section 9812 of the Internal Revenue Code of 1986.
TITLE XIV Mental Health and Safe Communities
Subtitle A Mental Health and Safe Communities
SEC. 14001. Law Enforcement Grants for Crisis Intervention Teams, Mental Health Purposes.
Edward Byrne Memorial Justice Assistance Grant Program.— Section 501(a)(1) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3751(a)(1)) is amended by adding at the end the following:
“(H) Mental health programs and related law enforcement and corrections programs, including behavioral programs and crisis intervention teams.”
Community Oriented Policing Services Program.— Section 1701(b) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3796dd(b)) is amended—
in paragraph (17), by striking “ and” at the end;
by redesignating paragraph (18) as paragraph (22);
by inserting after paragraph (17) the following:
“(18) to provide specialized training to law enforcement officers to—
“(A) recognize individuals who have a mental illness; and
“(B) properly interact with individuals who have a mental illness, including strategies for verbal de-escalation of crises;
“(19) to establish collaborative programs that enhance the ability of law enforcement agencies to address the mental health, behavioral, and substance abuse problems of individuals encountered by law enforcement officers in the line of duty;
“(20) to provide specialized training to corrections officers to recognize individuals who have a mental illness;
“(21) to enhance the ability of corrections officers to address the mental health of individuals under the care and custody of jails and prisons, including specialized training and strategies for verbal de-escalation of crises; and”
; and
in paragraph (22), as redesignated, by striking “ through (17)” and inserting “ through (21)”.
Modifications to the Staffing for Adequate Fire and Emergency Response Grants.— Section 34(a)(1)(B) of the Federal Fire Prevention and Control Act of 1974 (15 U.S.C. 2229a(a)(1)(B)) is amended by inserting before the period at the end the following: “ and to provide specialized training to paramedics, emergency medical services workers, and other first responders to recognize individuals who have mental illness and how to properly intervene with individuals with mental illness, including strategies for verbal de-escalation of crises”.
SEC. 14002. Assisted Outpatient Treatment Programs.
In General.— Section 2201 of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3796ii) is amended in paragraph (2)(B), by inserting before the semicolon the following: “ , or court-ordered assisted outpatient treatment when the court has determined such treatment to be necessary”.
Definitions.— Section 2202 of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3796ii—1) is amended—
in paragraph (1), by striking “ and” at the end;
in paragraph (2), by striking the period at the end and inserting a semicolon; and
by adding at the end the following:
“(3) the term ‘court-ordered assisted outpatient treatment’ means a program through which a court may order a treatment plan for an eligible patient that—
“(A) requires such patient to obtain outpatient mental health treatment while the patient is not currently residing in a correctional facility or inpatient treatment facility; and
“(B) is designed to improve access and adherence by such patient to intensive behavioral health services in order to—
“(i) avert relapse, repeated hospitalizations, arrest, incarceration, suicide, property destruction, and violent behavior; and
“(ii) provide such patient with the opportunity to live in a less restrictive alternative to incarceration or involuntary hospitalization; and
“(4) the term ‘eligible patient’ means an adult, mentally ill person who, as determined by a court—
“(A) has a history of violence, incarceration, or medically unnecessary hospitalizations;
“(B) without supervision and treatment, may be a danger to self or others in the community;
“(C) is substantially unlikely to voluntarily participate in treatment;
“(D) may be unable, for reasons other than indigence, to provide for any of his or her basic needs, such as food, clothing, shelter, health, or safety;
“(E) has a history of mental illness or a condition that is likely to substantially deteriorate if the person is not provided with timely treatment; or
“(F) due to mental illness, lacks capacity to fully understand or lacks judgment to make informed decisions regarding his or her need for treatment, care, or supervision.”
SEC. 14003. Federal Drug and Mental Health Courts.
Definitions.— In this section—
the term “eligible offender” means a person who—
previously or currently has been diagnosed by a qualified mental health professional as having a mental illness, mental retardation, or co-occurring mental illness and substance abuse disorders; or
manifests obvious signs of mental illness, mental retardation, or co-occurring mental illness and substance abuse disorders during arrest or confinement or before any court;
comes into contact with the criminal justice system or is arrested or charged with an offense that is not—
a crime of violence, as defined under applicable State law or in section 3156 of title 18, United States Code; or
a serious drug offense, as defined in section 924(e)(2)(A) of title 18, United States Code; and
is determined by a judge to be eligible; and
the term “mental illness” means a diagnosable mental, behavioral, or emotional disorder—
of sufficient duration to meet diagnostic criteria within the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association; and
that has resulted in functional impairment that substantially interferes with or limits 1 or more major life activities.
Establishment of Program.— Not later than 1 year after the date of enactment of this Act, the Attorney General shall establish a pilot program to determine the effectiveness of diverting eligible offenders from Federal prosecution, Federal probation, or a Bureau of Prisons facility, and placing such eligible offenders in drug or mental health courts.
Program Specifications.— The pilot program established under subsection (b) shall involve—
continuing judicial supervision, including periodic review, of program participants who have a substance abuse problem or mental illness; and
the integrated administration of services and sanctions, which shall include—
mandatory periodic testing, as appropriate, for the use of controlled substances or other addictive substances during any period of supervised release or probation for each program participant;
substance abuse treatment for each program participant who requires such services;
diversion, probation, or other supervised release with the possibility of prosecution, confinement, or incarceration based on noncompliance with program requirements or failure to show satisfactory progress toward completing program requirements;
programmatic offender management, including case management, and aftercare services, such as relapse prevention, health care, education, vocational training, job placement, housing placement, and child care or other family support services for each program participant who requires such services;
outpatient or inpatient mental health treatment, as ordered by the court, that carries with it the possibility of dismissal of charges or reduced sentencing upon successful completion of such treatment;
centralized case management, including—
the consolidation of all cases, including violations of probations, of the program participant; and
coordination of all mental health treatment plans and social services, including life skills and vocational training, housing and job placement, education, health care, and relapse prevention for each program participant who requires such services; and
continuing supervision of treatment plan compliance by the program participant for a term not to exceed the maximum allowable sentence or probation period for the charged or relevant offense and, to the extent practicable, continuity of psychiatric care at the end of the supervised period.
Implementation; Duration.— The pilot program established under subsection (b) shall be conducted—
in not less than 1 United States judicial district, designated by the Attorney General in consultation with the Director of the Administrative Office of the United States Courts, as appropriate for the pilot program; and
during fiscal year 2017 through fiscal year 2021.
Criteria for Designation.— Before making a designation under subsection (d)(1), the Attorney General shall—
obtain the approval, in writing, of the United States Attorney for the United States judicial district being designated;
obtain the approval, in writing, of the chief judge for the United States judicial district being designated; and
determine that the United States judicial district being designated has adequate behavioral health systems for treatment, including substance abuse and mental health treatment.
Assistance From Other Federal Entities.— The Administrative Office of the United States Courts and the United States Probation Offices shall provide such assistance and carry out such functions as the Attorney General may request in monitoring, supervising, providing services to, and evaluating eligible offenders placed in a drug or mental health court under this section.
Reports.— The Attorney General, in consultation with the Director of the Administrative Office of the United States Courts, shall monitor the drug and mental health courts under this section, and shall submit a report to Congress on the outcomes of the program at the end of the period described in subsection (d)(2).
SEC. 14004. Mental Health in the Judicial System.
Part V of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3796ii et seq.) is amended by inserting at the end the following:
“SEC. 2209. MENTAL HEALTH RESPONSES IN THE JUDICIAL SYSTEM.
“(a) Pretrial Screening and Supervision.—
“(1) In general.—The Attorney General may award grants to States, units of local government, territories, Indian Tribes, nonprofit agencies, or any combination thereof, to develop, implement, or expand pretrial services programs to improve the identification and outcomes of individuals with mental illness.
“(2) Allowable uses.—Grants awarded under this subsection may be may be used for—
“(A) behavioral health needs and risk screening of defendants, including verification of interview information, mental health evaluation, and criminal history screening;
“(B) assessment of risk of pretrial misconduct through objective, statistically validated means, and presentation to the court of recommendations based on such assessment, including services that will reduce the risk of pre-trial misconduct;
“(C) followup review of defendants unable to meet the conditions of pretrial release;
“(D) evaluation of process and results of pre-trial service programs;
“(E) supervision of defendants who are on pretrial release, including reminders to defendants of scheduled court dates;
“(F) reporting on process and results of pretrial services programs to relevant public and private mental health stakeholders; and
“(G) data collection and analysis necessary to make available information required for assessment of risk.
“(b) Behavioral Health Assessments and Intervention.—
“(1) In general.—The Attorney General may award grants to States, units of local government, territories, Indian Tribes, nonprofit agencies, or any combination thereof, to develop, implement, or expand a behavioral health screening and assessment program framework for State or local criminal justice systems.
“(2) Allowable uses.—Grants awarded under this subsection may be used for—
“(A) promotion of the use of validated assessment tools to gauge the criminogenic risk, substance abuse needs, and mental health needs of individuals;
“(B) initiatives to match the risk factors and needs of individuals to programs and practices associated with research-based, positive outcomes;
“(C) implementing methods for identifying and treating individuals who are most likely to benefit from coordinated supervision and treatment strategies, and identifying individuals who can do well with fewer interventions; and
“(D) collaborative decision-making among the heads of criminal justice agencies, mental health systems, judicial systems, substance abuse systems, and other relevant systems or agencies for determining how treatment and intensive supervision services should be allocated in order to maximize benefits, and developing and utilizing capacity accordingly.
“(c) Use of Grant Funds.—A State, unit of local government, territory, Indian Tribe, or nonprofit agency that receives a grant under this section shall, in accordance with subsection (b)(2), use grant funds for the expenses of a treatment program, including—
“(1) salaries, personnel costs, equipment costs, and other costs directly related to the operation of the program, including costs relating to enforcement;
“(2) payments for treatment providers that are approved by the State or Indian Tribe and licensed, if necessary, to provide needed treatment to program participants, including aftercare supervision, vocational training, education, and job placement; and
“(3) payments to public and nonprofit private entities that are approved by the State or Indian Tribe and licensed, if necessary, to provide alcohol and drug addiction treatment to offenders participating in the program.
“(d) Supplement of Non-Federal Funds.—
“(1) In general.—Grants awarded under this section shall be used to supplement, and not supplant, non-Federal funds that would otherwise be available for programs described in this section.
“(2) Federal share.—The Federal share of a grant made under this section may not exceed 50 percent of the total costs of the program described in an application under subsection (e).
“(e) Applications.—To request a grant under this section, a State, unit of local government, territory, Indian Tribe, or nonprofit agency shall submit an application to the Attorney General in such form and containing such information as the Attorney General may reasonably require.
“(f) Geographic Distribution.—The Attorney General shall ensure that, to the extent practicable, the distribution of grants under this section is equitable and includes—
“(1) each State; and
“(2) a unit of local government, territory, Indian Tribe, or nonprofit agency—
“(A) in each State; and
“(B) in rural, suburban, Tribal, and urban jurisdictions.
“(g) Reports and Evaluations.—For each fiscal year, each grantee under this section during that fiscal year shall submit to the Attorney General a report on the effectiveness of activities carried out using such grant. Each report shall include an evaluation in such form and containing such information as the Attorney General may reasonably require. The Attorney General shall specify the dates on which such reports shall be submitted.
“(h) Accountability.—Grants awarded under this section shall be subject to the following accountability provisions:
“(1) Audit requirement.—
“(A) Definition.—In this paragraph, the term ‘unresolved audit finding’ means a finding in the final audit report of the Inspector General of the Department of Justice under subparagraph (C) that the audited grantee has used grant funds for an unauthorized expenditure or otherwise unallowable cost that is not closed or resolved within 1 year after the date on which final audit report is issued.
“(B) Audits.—Beginning in the first fiscal year beginning after the date of enactment of this section, and in each fiscal year thereafter, the Inspector General of the Department of Justice shall conduct audits of grantees under this section to prevent waste, fraud, and abuse of funds by grantees. The Inspector General shall determine the appropriate number of grantees to be audited each year.
“(C) Final audit report.—The Inspector General of the Department of Justice shall submit to the Attorney General a final report on each audit conducted under subparagraph (B).
“(D) Mandatory exclusion.—Grantees under this section about which there is an unresolved audit finding shall not be eligible to receive a grant under this section during the 2 fiscal years beginning after the end of the 1-year period described in subparagraph (A).
“(E) Priority.—In making grants under this section, the Attorney General shall give priority to applicants that did not have an unresolved audit finding during the 3 fiscal years before submitting an application for a grant under this section.
“(F) Reimbursement.—If an entity receives a grant under this section during the 2-fiscal-year period during which the entity is prohibited from receiving grants under subparagraph (D), the Attorney General shall—
“(i) deposit an amount equal to the amount of the grant that was improperly awarded to the grantee into the General Fund of the Treasury; and
“(ii) seek to recoup the costs of the repayment under clause (i) from the grantee that was erroneously awarded grant funds.
“(2) Nonprofit agency requirements.—
“(A) Definition.—For purposes of this paragraph and the grant program under this section, the term ‘nonprofit agency’ means an organization that is described in section 501(c)(3) of the Internal Revenue Code of 1986 (26 U.S.C. 501(c)(3)) and is exempt from taxation under section 501(a) of the Internal Revenue Code of 1986 (26 U.S.C. 501(a)).
“(B) Prohibition.—The Attorney General may not award a grant under this section to a nonprofit agency that holds money in an offshore account for the purpose of avoiding paying the tax described in section 511(a) of the Internal Revenue Code of 1986 (26 U.S.C. 511(a)).
“(C) Disclosure.—Each nonprofit agency that is awarded a grant under this section and uses the procedures prescribed in regulations to create a rebuttable presumption of reasonableness for the compensation of its officers, directors, trustees, and key employees, shall disclose to the Attorney General, in the application for the grant, the process for determining such compensation, including the independent persons involved in reviewing and approving such compensation, the comparability data used, and contemporaneous substantiation of the deliberation and decision. Upon request, the Attorney General shall make the information disclosed under this subparagraph available for public inspection.
“(3) Conference expenditures.—
“(A) Limitation.—Not more than $20,000 of the amounts made available to the Department of Justice to carry out this section may be used by the Attorney General, or by any individual or entity awarded a grant under this section to host, or make any expenditures relating to, a conference unless the Deputy Attorney General provides prior written authorization that the funds may be expended to host the conference or make such expenditure.
“(B) Written approval.—Written approval under subparagraph (A) shall include a written estimate of all costs associated with the conference, including the cost of all food, beverages, audio-visual equipment, honoraria for speakers, and entertainment.
“(C) Report.—The Deputy Attorney General shall submit an annual report to the Committee on the Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives on all conference expenditures approved under this paragraph.
“(4) Annual certification.—Beginning in the first fiscal year beginning after the date of enactment of this subsection, the Attorney General shall submit to the Committee on the Judiciary and the Committee on Appropriations of the Senate and the Committee on the Judiciary and the Committee on Appropriations of the House of Representatives an annual certification—
“(A) indicating whether—
“(i) all final audit reports issued by the Office of the Inspector General under paragraph (1) have been completed and reviewed by the appropriate Assistant Attorney General or Director;
“(ii) all mandatory exclusions required under paragraph (1)(D) have been issued; and
“(iii) any reimbursements required under paragraph (1)(F) have been made; and
“(B) that includes a list of any grantees excluded under paragraph (1)(D) from the previous year.
“(i) Preventing Duplicative Grants.—
“(1) In general.—Before the Attorney General awards a grant to an applicant under this section, the Attorney General shall compare the possible grant with any other grants awarded to the applicant under this Act to determine whether the grants are for the same purpose.
“(2) Report.—If the Attorney General awards multiple grants to the same applicant for the same purpose, the Attorney General shall submit to the Committee on the Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives a report that includes—
“(A) a list of all duplicate grants awarded, including the total dollar amount of any such grants awarded; and
“(B) the reason the Attorney General awarded the duplicate grants.”
SEC. 14005. Forensic Assertive Community Treatment Initiatives.
Section 2991 of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa) is amended by—
redesignating subsection (j) as subsection (o); and
inserting after subsection (i) the following:
“(j) Forensic Assertive Community Treatment (FACT) Initiative Program.—
“(1) In general.—The Attorney General may make grants to States, units of local government, territories, Indian Tribes, nonprofit agencies, or any combination thereof, to develop, implement, or expand Assertive Community Treatment initiatives to develop forensic assertive community treatment (referred to in this subsection as ‘FACT’) programs that provide high intensity services in the community for individuals with mental illness with involvement in the criminal justice system to prevent future incarcerations.
“(2) Allowable uses.—Grant funds awarded under this subsection may be used for—
“(A) multidisciplinary team initiatives for individuals with mental illnesses with criminal justice involvement that address criminal justice involvement as part of treatment protocols;
“(B) FACT programs that involve mental health professionals, criminal justice agencies, chemical dependency specialists, nurses, psychiatrists, vocational specialists, forensic peer specialists, forensic specialists, and dedicated administrative support staff who work together to provide recovery oriented, 24/7 wraparound services;
“(C) services such as integrated evidence-based practices for the treatment of co-occurring mental health and substance-related disorders, assertive outreach and engagement, community-based service provision at participants’ residence or in the community, psychiatric rehabilitation, recovery oriented services, services to address criminogenic risk factors, and community tenure;
“(D) payments for treatment providers that are approved by the State or Indian Tribe and licensed, if necessary, to provide needed treatment to eligible offenders participating in the program, including behavioral health services and aftercare supervision; and
“(E) training for all FACT teams to promote high-fidelity practice principles and technical assistance to support effective and continuing integration with criminal justice agency partners.
“(3) Supplement and not supplant.—Grants made under this subsection shall be used to supplement, and not supplant, non-Federal funds that would otherwise be available for programs described in this subsection.
“(4) Applications.—To request a grant under this subsection, a State, unit of local government, territory, Indian Tribe, or nonprofit agency shall submit an application to the Attorney General in such form and containing such information as the Attorney General may reasonably require.”
SEC. 14006. Assistance for Individuals Transitioning Out of Systems.
Section 2976(f) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797w(f)) is amended—
in paragraph (5), by striking “ and” at the end;
in paragraph (6), by striking the period at the end and inserting a semicolon; and
by adding at the end the following:
“(7) provide mental health treatment and transitional services for those with mental illnesses or with co-occurring disorders, including housing placement or assistance; and”
SEC. 14007. Co-Occurring Substance Abuse and Mental Health Challenges in Drug Courts.
Part EE of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797u et seq.) is amended—
in section 2951(a)(1) (42 U.S.C. 3797u(a)(1)), by inserting “ , including co-occurring substance abuse and mental health problems,” after “ problems”; and
in section 2959(a) (42 U.S.C. 3797u–8(a)), by inserting “ , including training for drug court personnel and officials on identifying and addressing co-occurring substance abuse and mental health problems” after “ part”.
SEC. 14008. Mental Health Training for Federal Uniformed Services.
In General.— Not later than 180 days after the date of enactment of this Act, the Secretary of Defense, the Secretary of Homeland Security, the Secretary of Health and Human Services, and the Secretary of Commerce shall provide the following to each of the uniformed services (as that term is defined in section 101 of title 10, United States Code) under their direction:
Training programs.— Programs that offer specialized and comprehensive training in procedures to identify and respond appropriately to incidents in which the unique needs of individuals with mental illnesses are involved.
Improved technology.— Computerized information systems or technological improvements to provide timely information to Federal law enforcement personnel, other branches of the uniformed services, and criminal justice system personnel to improve the Federal response to mentally ill individuals.
Cooperative programs.— The establishment and expansion of cooperative efforts to promote public safety through the use of effective intervention with respect to mentally ill individuals encountered by members of the uniformed services.
SEC. 14009. Advancing Mental Health as Part of Offender Reentry.
Reentry Demonstration Projects.— Section 2976(f) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797w(f)), as amended by section 14006, is amended—
in paragraph (3)(C), by inserting “ mental health services,” before “ drug treatment”; and
by adding at the end the following:
“(8) target offenders with histories of homelessness, substance abuse, or mental illness, including a prerelease assessment of the housing status of the offender and behavioral health needs of the offender with clear coordination with mental health, substance abuse, and homelessness services systems to achieve stable and permanent housing outcomes with appropriate support service.”
Mentoring Grants.— Section 211(b)(2) of the Second Chance Act of 2007 (42 U.S.C. 17531(b)(2)) is amended by inserting “ , including mental health care” after “ community”.
SEC. 14010. School Mental Health Crisis Intervention Teams.
Section 2701(b) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797a(b)) is amended—
by redesignating paragraphs (4) and (5) as paragraphs (5) and (6), respectively; and
by inserting after paragraph (3) the following:
“(4) The development and operation of crisis intervention teams that may include coordination with law enforcement agencies and specialized training for school officials in responding to mental health crises.”
SEC. 14011. Active-Shooter Training for Law Enforcement.
The Attorney General, as part of the Preventing Violence Against Law Enforcement and Ensuring Officer Resilience and Survivability Initiative (VALOR) of the Department of Justice, may provide safety training and technical assistance to local law enforcement agencies, including active-shooter response training.
SEC. 14012. Co-Occurring Substance Abuse and Mental Health Challenges in Residential Substance Abuse Treatment Programs.
Section 1901(a) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3796ff(a)) is amended—
in paragraph (1), by striking “ and” at the end;
in paragraph (2), by striking the period at the end and inserting “ ; and”; and
by adding at the end the following:
“(3) developing and implementing specialized residential substance abuse treatment programs that identify and provide appropriate treatment to inmates with co-occurring mental health and substance abuse disorders or challenges.”
SEC. 14013. Mental Health and Drug Treatment Alternatives to Incarceration Programs.
Title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3711 et seq.) is amended by striking part CC and inserting the following:
“PART CC— MENTAL HEALTH AND DRUG TREATMENT ALTERNATIVES TO INCARCERATION PROGRAMS
“SEC. 2901. MENTAL HEALTH AND DRUG TREATMENT ALTERNATIVES TO INCARCERATION PROGRAMS.
“(a) Definitions.—In this section—
“(1) the term ‘eligible entity’ means a State, unit of local government, Indian tribe, or nonprofit organization; and
“(2) the term ‘eligible participant’ means an individual who—
“(A) comes into contact with the criminal justice system or is arrested or charged with an offense that is not—
“(i) a crime of violence, as defined under applicable State law or in section 3156 of title 18, United States Code; or
“(ii) a serious drug offense, as defined in section 924(e)(2)(A) of title 18, United States Code;
“(B) has a history of, or a current—
“(i) substance use disorder;
“(ii) mental illness; or
“(iii) co-occurring mental illness and substance use disorder; and
“(C) has been approved for participation in a program funded under this section by the relevant law enforcement agency, prosecuting attorney, defense attorney, probation official, corrections official, judge, representative of a mental health agency, or representative of a substance abuse agency, as required by law.
“(b) Program Authorized.—The Attorney General may make grants to eligible entities to develop, implement, or expand a treatment alternative to incarceration program for eligible participants, including—
“(1) pre-booking treatment alternative to incarceration programs, including—
“(A) law enforcement training on substance use disorders, mental illness, and co-occurring mental illness and substance use disorders;
“(B) receiving centers as alternatives to incarceration of eligible participants;
“(C) specialized response units for calls related to substance use disorders, mental illness, or co-occurring mental illness and substance use disorders; and
“(D) other arrest and pre-booking treatment alternatives to incarceration models; or
“(2) post-booking treatment alternative to incarceration programs, including—
“(A) specialized clinical case management;
“(B) pre-trial services related to substances use disorders, mental illness, and co-occurring mental illness and substance use disorders;
“(C) prosecutor and defender based programs;
“(D) specialized probation;
“(E) treatment and rehabilitation programs; and
“(F) problem-solving courts, including mental health courts, drug courts, co-occurring mental health and substance abuse courts, DWI courts, and veterans treatment courts.
“(c) Application.—
“(1) In general.—An eligible entity desiring a grant under this section shall submit an application to the Attorney General—
“(A) that meets the criteria under paragraph (2); and
“(B) at such time, in such manner, and accompanied by such information as the Attorney General may require.
“(2) Criteria.—An eligible entity, in submitting an application under paragraph (1), shall—
“(A) provide extensive evidence of collaboration with State and local government agencies overseeing health, community corrections, courts, prosecution, substance abuse, mental health, victims services, and employment services, and with local law enforcement agencies;
“(B) demonstrate consultation with the Single State Authority for Substance Abuse of the State (as that term is defined in section 201(e) of the Second Chance Act of 2007);
“(C) demonstrate that evidence-based treatment practices will be utilized; and
“(D) demonstrate that evidence-based screening and assessment tools will be used to place participants in the treatment alternative to incarceration program.
“(d) Requirements.—Each eligible entity awarded a grant for a treatment alternative to incarceration program under this section shall—
“(1) determine the terms and conditions of participation in the program by eligible participants, taking into consideration the collateral consequences of an arrest, prosecution or criminal conviction;
“(2) ensure that each substance abuse and mental health treatment component is licensed and qualified by the relevant jurisdiction;
“(3) for programs described in subsection (b)(2), organize an enforcement unit comprised of appropriately trained law enforcement professionals under the supervision of the State, Tribal, or local criminal justice agency involved, the duties of which shall include—
“(A) the verification of addresses and other contact information of each eligible participant who participates or desires to participate in the program; and
“(B) if necessary, the location, apprehension, arrest, and return to custody of an eligible participant in the program who has absconded from the facility of a treatment provider or has otherwise significantly violated the terms and conditions of the program, consistent with Federal and State confidentiality requirements;
“(4) notify the relevant criminal justice entity if any eligible participant in the program absconds from the facility of the treatment provider or otherwise violates the terms and conditions of the program, consistent with Federal and State confidentiality requirements;
“(5) submit periodic reports on the progress of treatment or other measured outcomes from participation in the program of each eligible participant in the program to the relevant State, Tribal, or local criminal justice agency, including mental health courts, drug courts, co-occurring mental health and substance abuse courts, DWI courts, and veterans treatment courts;
“(6) describe the evidence-based methodology and outcome measurements that will be used to evaluate the program, and specifically explain how such measurements will provide valid measures of the impact of the program; and
“(7) describe how the program could be broadly replicated if demonstrated to be effective.
“(e) Use of Funds.—An eligible entity shall use a grant received under this section for expenses of a treatment alternative to incarceration program, including—
“(1) salaries, personnel costs, equipment costs, and other costs directly related to the operation of the program, including the enforcement unit;
“(2) payments for treatment providers that are approved by the relevant State or Tribal jurisdiction and licensed, if necessary, to provide needed treatment to eligible offenders participating in the program, including aftercare supervision, vocational training, education, and job placement; and
“(3) payments to public and nonprofit private entities that are approved by the State or Tribal jurisdiction and licensed, if necessary, to provide alcohol and drug addiction treatment to eligible offenders participating in the program.
“(f) Supplement Not Supplant.—An eligible entity shall use Federal funds received under this section only to supplement the funds that would, in the absence of those Federal funds, be made available from other Federal and non-Federal sources for the activities described in this section, and not to supplant those funds. The Federal share of a grant made under this section may not exceed 50 percent of the total costs of the program described in an application under subsection (d).
“(g) Geographic Distribution.—The Attorney General shall ensure that, to the extent practicable, the geographical distribution of grants under this section is equitable and includes a grant to an eligible entity in—
“(1) each State;
“(2) rural, suburban, and urban areas; and
“(3) Tribal jurisdictions.
“(h) Reports and Evaluations.—Each fiscal year, each recipient of a grant under this section during that fiscal year shall submit to the Attorney General a report on the outcomes of activities carried out using that grant in such form, containing such information, and on such dates as the Attorney General shall specify.
“(i) Accountability.—All grants awarded by the Attorney General under this section shall be subject to the following accountability provisions:
“(1) Audit requirement.—
“(A) Definition.—In this paragraph, the term ‘unresolved audit finding’ means a finding in the final audit report of the Inspector General of the Department of Justice that the audited grantee has utilized grant funds for an unauthorized expenditure or otherwise unallowable cost that is not closed or resolved within 12 months from the date on which the final audit report is issued.
“(B) Audits.—Beginning in the first fiscal year beginning after the date of enactment of this subsection, and in each fiscal year thereafter, the Inspector General of the Department of Justice shall conduct audits of recipients of grants under this section to prevent waste, fraud, and abuse of funds by grantees. The Inspector General shall determine the appropriate number of grantees to be audited each year.
“(C) Mandatory exclusion.—A recipient of grant funds under this section that is found to have an unresolved audit finding shall not be eligible to receive grant funds under this section during the first 2 fiscal years beginning after the end of the 12-month period described in subparagraph (A).
“(D) Priority.—In awarding grants under this section, the Attorney General shall give priority to eligible applicants that did not have an unresolved audit finding during the 3 fiscal years before submitting an application for a grant under this section.
“(E) Reimbursement.—If an entity is awarded grant funds under this section during the 2-fiscal-year period during which the entity is barred from receiving grants under subparagraph (C), the Attorney General shall—
“(i) deposit an amount equal to the amount of the grant funds that were improperly awarded to the grantee into the General Fund of the Treasury; and
“(ii) seek to recoup the costs of the repayment to the fund from the grant recipient that was erroneously awarded grant funds.
“(2) Nonprofit organization requirements.—
“(A) Definition.—For purposes of this paragraph and the grant programs under this part, the term ‘nonprofit organization’ means an organization that is described in section 501(c)(3) of the Internal Revenue Code of 1986 and is exempt from taxation under section 501(a) of such Code.
“(B) Prohibition.—The Attorney General may not award a grant under this part to a nonprofit organization that holds money in offshore accounts for the purpose of avoiding paying the tax described in section 511(a) of the Internal Revenue Code of 1986.
“(C) Disclosure.—Each nonprofit organization that is awarded a grant under this section and uses the procedures prescribed in regulations to create a rebuttable presumption of reasonableness for the compensation of its officers, directors, trustees, and key employees, shall disclose to the Attorney General, in the application for the grant, the process for determining such compensation, including the independent persons involved in reviewing and approving such compensation, the comparability data used, and contemporaneous substantiation of the deliberation and decision. Upon request, the Attorney General shall make the information disclosed under this subparagraph available for public inspection.
“(3) Conference expenditures.—
“(A) Limitation.—No amounts made available to the Department of Justice under this section may be used by the Attorney General, or by any individual or entity awarded discretionary funds through a cooperative agreement under this section, to host or support any expenditure for conferences that uses more than $20,000 in funds made available by the Department of Justice, unless the head of the relevant agency or department, provides prior written authorization that the funds may be expended to host the conference.
“(B) Written approval.—Written approval under subparagraph (A) shall include a written estimate of all costs associated with the conference, including the cost of all food, beverages, audio-visual equipment, honoraria for speakers, and entertainment.
“(C) Report.—The Deputy Attorney General shall submit an annual report to the Committee on the Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives on all conference expenditures approved under this paragraph.
“(4) Annual certification.—Beginning in the first fiscal year beginning after the date of enactment of this subsection, the Attorney General shall submit, to the Committee on the Judiciary and the Committee on Appropriations of the Senate and the Committee on the Judiciary and the Committee on Appropriations of the House of Representatives, an annual certification—
“(A) indicating whether—
“(i) all audits issued by the Office of the Inspector General under paragraph (1) have been completed and reviewed by the appropriate Assistant Attorney General or Director;
“(ii) all mandatory exclusions required under paragraph (1)(C) have been issued; and
“(iii) all reimbursements required under paragraph (1)(E) have been made; and
“(B) that includes a list of any grant recipients excluded under paragraph (1) from the previous year.
“(5) Preventing duplicative grants.—
“(A) In general.—Before the Attorney General awards a grant to an applicant under this section, the Attorney General shall compare potential grant awards with other grants awarded under this Act to determine if duplicate grant awards are awarded for the same purpose.
“(B) Report.—If the Attorney General awards duplicate grants to the same applicant for the same purpose the Attorney General shall submit to the Committee on the Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives a report that includes—
“(i) a list of all duplicate grants awarded, including the total dollar amount of any duplicate grants awarded; and
“(ii) the reason the Attorney General awarded the duplicate grants.”
SEC. 14014. National Criminal Justice and Mental Health Training and Technical Assistance.
Part HH of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa et seq.) is amended by adding at the end the following:
“SEC. 2992. NATIONAL CRIMINAL JUSTICE AND MENTAL HEALTH TRAINING AND TECHNICAL ASSISTANCE.
“(a) Authority.—The Attorney General may make grants to eligible organizations to provide for the establishment of a National Criminal Justice and Mental Health Training and Technical Assistance Center.
“(b) Eligible Organization.—For purposes of subsection (a), the term ‘eligible organization’ means a national nonprofit organization that provides technical assistance and training to, and has special expertise and broad, national-level experience in, mental health, crisis intervention, criminal justice systems, law enforcement, translating evidence into practice, training, and research, and education and support of people with mental illness and the families of such individuals.
“(c) Use of Funds.—Any organization that receives a grant under subsection (a) shall collaborate with other grant recipients to establish and operate a National Criminal Justice and Mental Health Training and Technical Assistance Center to—
“(1) provide law enforcement officer training regarding mental health and working with individuals with mental illnesses, with an emphasis on de-escalation of encounters between law enforcement officers and those with mental disorders or in crisis, which shall include support the development of in-person and technical information exchanges between systems and the individuals working in those systems in support of the concepts identified in the training;
“(2) provide education, training, and technical assistance for States, Indian tribes, territories, units of local government, service providers, nonprofit organizations, probation or parole officers, prosecutors, defense attorneys, emergency response providers, and corrections institutions to advance practice and knowledge relating to mental health crisis and approaches to mental health and criminal justice across systems;
“(3) provide training and best practices to mental health providers and criminal justice agencies relating to diversion initiatives, jail and prison strategies, reentry of individuals with mental illnesses into the community, and dispatch protocols and triage capabilities, including the establishment of learning sites;
“(4) develop suicide prevention and crisis intervention training and technical assistance for criminal justice agencies;
“(5) develop a receiving center system and pilot strategy that provides, for a jurisdiction, a single point of entry into the mental health and substance abuse system for assessments and appropriate placement of individuals experiencing a crisis;
“(6) collect data and best practices in mental health and criminal health and criminal justice initiatives and policies from grantees under this part, other recipients of grants under this section, Federal, State, and local agencies involved in the provision of mental health services, and nongovernmental organizations involved in the provision of mental health services;
“(7) develop and disseminate to mental health providers and criminal justice agencies evaluation tools, mechanisms, and measures to better assess and document performance measures and outcomes relating to the provision of mental health services;
“(8) disseminate information to States, units of local government, criminal justice agencies, law enforcement agencies, and other relevant entities about best practices, policy standards, and research findings relating to the provision of mental health services; and
“(9) provide education and support to individuals with mental illness involved with, or at risk of involvement with, the criminal justice system, including the families of such individuals.
“(d) Accountability.—Grants awarded under this section shall be subject to the following accountability provisions:
“(1) Audit requirement.—
“(A) Definition.—In this paragraph, the term ‘unresolved audit finding’ means a finding in the final audit report of the Inspector General of the Department of Justice under subparagraph (C) that the audited grantee has used grant funds for an unauthorized expenditure or otherwise unallowable cost that is not closed or resolved within 1 year after the date on which the final audit report is issued.
“(B) Audits.—Beginning in the first fiscal year beginning after the date of enactment of this section, and in each fiscal year thereafter, the Inspector General of the Department of Justice shall conduct audits of grantees under this section to prevent waste, fraud, and abuse of funds by grantees. The Inspector General shall determine the appropriate number of grantees to be audited each year.
“(C) Final audit report.—The Inspector General of the Department of Justice shall submit to the Attorney General a final report on each audit conducted under subparagraph (B).
“(D) Mandatory exclusion.—Grantees under this section about which there is an unresolved audit finding shall not be eligible to receive a grant under this section during the 2 fiscal years beginning after the end of the 1-year period described in subparagraph (A).
“(E) Priority.—In making grants under this section, the Attorney General shall give priority to applicants that did not have an unresolved audit finding during the 3 fiscal years before submitting an application for a grant under this section.
“(F) Reimbursement.—If an entity receives a grant under this section during the 2-fiscal-year period during which the entity is prohibited from receiving grants under subparagraph (D), the Attorney General shall—
“(i) deposit an amount equal to the amount of the grant that was improperly awarded to the grantee into the General Fund of the Treasury; and
“(ii) seek to recoup the costs of the repayment under clause (i) from the grantee that was erroneously awarded grant funds.
“(2) Nonprofit agency requirements.—
“(A) Definition.—For purposes of this paragraph and the grant program under this section, the term ‘nonprofit agency’ means an organization that is described in section 501(c)(3) of the Internal Revenue Code of 1986 (26 U.S.C. 501(c)(3)) and is exempt from taxation under section 501(a) of the Internal Revenue Code of 1986 (26 U.S.C. 501(a)).
“(B) Prohibition.—The Attorney General may not award a grant under this section to a nonprofit agency that holds money in an offshore account for the purpose of avoiding paying the tax described in section 511(a) of the Internal Revenue Code of 1986 (26 U.S.C. 511(a)).
“(C) Disclosure.—Each nonprofit agency that is awarded a grant under this section and uses the procedures prescribed in regulations to create a rebuttable presumption of reasonableness for the compensation of its officers, directors, trustees, and key employees, shall disclose to the Attorney General, in the application for the grant, the process for determining such compensation, including the independent persons involved in reviewing and approving such compensation, the comparability data used, and contemporaneous substantiation of the deliberation and decision. Upon request, the Attorney General shall make the information disclosed under this subparagraph available for public inspection.
“(3) Conference expenditures.—
“(A) Limitation.—No amounts made available to the Department of Justice under this section may be used by the Attorney General, or by any individual or entity awarded discretionary funds through a cooperative agreement under this section, to host or support any expenditure for conferences that uses more than $20,000 in funds made available by the Department of Justice, unless the head of the relevant agency or department, provides prior written authorization that the funds may be expended to host the conference.
“(B) Written approval.—Written approval under subparagraph (A) shall include a written estimate of all costs associated with the conference, including the cost of all food, beverages, audio-visual equipment, honoraria for speakers, and entertainment.
“(C) Report.—The Deputy Attorney General shall submit an annual report to the Committee on the Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives on all conference expenditures approved under this paragraph.
“(4) Annual certification.—Beginning in the first fiscal year beginning after the date of enactment of this subsection, the Attorney General shall submit to the Committee on the Judiciary and the Committee on Appropriations of the Senate and the Committee on the Judiciary and the Committee on Appropriations of the House of Representatives an annual certification—
“(A) indicating whether—
“(i) all final audit reports issued by the Office of the Inspector General under paragraph (1) have been completed and reviewed by the appropriate Assistant Attorney General or Director;
“(ii) all mandatory exclusions required under paragraph (1)(D) have been issued; and
“(iii) any reimbursements required under paragraph (1)(F) have been made; and
“(B) that includes a list of any grantees excluded under paragraph (1)(D) from the previous year.
“(5) Preventing duplicative grants.—
“(A) In general.—Before the Attorney General awards a grant to an applicant under this section, the Attorney General shall compare potential grant awards with other grants awarded under this Act to determine if duplicate grant awards are awarded for the same purpose.
“(B) Report.—If the Attorney General awards duplicate grants to the same applicant for the same purpose the Attorney General shall submit to the Committee on the Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives a report that includes—
“(i) a list of all duplicate grants awarded, including the total dollar amount of any duplicate grants awarded; and
“(ii) the reason the Attorney General awarded the duplicate grants.”
SEC. 14015. Improving Department of Justice Data Collection on Mental Illness Involved in Crime.
In General.— Notwithstanding any other provision of law, on or after the date that is 90 days after the date on which the Attorney General promulgates regulations under subsection (b), any data prepared by, or submitted to, the Attorney General or the Director of the Federal Bureau of Investigation with respect to the incidences of homicides, law enforcement officers killed, seriously injured, and assaulted, or individuals killed or seriously injured by law enforcement officers shall include data with respect to the involvement of mental illness in such incidences, if any.
Regulations.— Not later than 90 days after the date of the enactment of this Act, the Attorney General shall promulgate or revise regulations as necessary to carry out subsection (a).
SEC. 14016. Reports on the Number of Mentally Ill Offenders in Prison.
Report on the Cost of Treating the Mentally Ill in the Criminal Justice System.— Not later than 12 months after the date of enactment of this Act, the Comptroller General of the United States shall submit to Congress a report detailing the cost of imprisonment for individuals who have serious mental illness by the Federal Government or a State or unit of local government, which shall include—
the number and type of crimes committed by individuals with serious mental illness each year; and
detail strategies or ideas for preventing crimes by those individuals with serious mental illness from occurring.
Definition.— For purposes of this section, the Attorney General, in consultation with the Assistant Secretary of Mental Health and Substance Use Disorders, shall define “serious mental illness” based on the “Health Care Reform for Americans with Severe Mental Illnesses: Report” of the National Advisory Mental Health Council, American Journal of Psychiatry 1993; 150:1447–1465.
SEC. 14017. Codification of Due Process for Determinations by Secretary of Veterans Affairs of Mental Capacity of Beneficiaries.
In General.— Chapter 55 of title 38, United States Code, is amended by inserting after section 5501 the following new section:
“§ 5501A. Beneficiaries’ rights in mental competence determinations
“The Secretary may not make an adverse determination concerning the mental capacity of a beneficiary to manage monetary benefits paid to or for the beneficiary by the Secretary under this title unless such beneficiary has been provided all of the following, subject to the procedures and timelines prescribed by the Secretary for determinations of incompetency:
“(1) Notice of the proposed adverse determination and the supporting evidence.
“(2) An opportunity to request a hearing.
“(3) An opportunity to present evidence, including an opinion from a medical professional or other person, on the capacity of the beneficiary to manage monetary benefits paid to or for the beneficiary by the Secretary under this title.
“(4) An opportunity to be represented at no expense to the Government (including by counsel) at any such hearing and to bring a medical professional or other person to provide relevant testimony at any such hearing.”
Clerical Amendment.— The table of sections at the beginning of such chapter 55 is amended by inserting after the item relating to section 5501 the following new item:
“5501A. Beneficiaries’ rights in mental competence determinations”.
Effective Date.— Section 5501A of title 38, United States Code, as added by subsection (a), shall apply to determinations made by the Secretary of Veterans Affairs on or after the date of the enactment of this Act.
SEC. 14018. Reauthorization of Appropriations.
Subsection (o) of section 2991 of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa), as redesignated by section 14006, is amended—
in paragraph (1)(C), by striking “ 2009 through 2014” and inserting “ 2017 through 2021”; and
by adding at the end the following:
“(3) Limitation.—Not more than 20 percent of the funds authorized to be appropriated under this section may be used for purposes described in subsection (i) (relating to veterans).”
Subtitle B Comprehensive Justice and Mental Health
SEC. 14021. Sequential Intercept Model.
Section 2991 of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa), as amended by section 14005, is amended by inserting after subsection (j), the following:
“(k) Sequential Intercept Grants.—
“(1) Definition.—In this subsection, the term ‘eligible entity’ means a State, unit of local government, Indian tribe, or tribal organization.
“(2) Authorization.—The Attorney General may make grants under this subsection to an eligible entity for sequential intercept mapping and implementation in accordance with paragraph (3).
“(3) Sequential intercept mapping; implementation.—An eligible entity that receives a grant under this subsection may use funds for—
“(A) sequential intercept mapping, which—
“(i) shall consist of—
“(I) convening mental health and criminal justice stakeholders to—
“(aa) develop a shared understanding of the flow of justice-involved individuals with mental illnesses through the criminal justice system; and
“(bb) identify opportunities for improved collaborative responses to the risks and needs of individuals described in item (aa); and
“(II) developing strategies to address gaps in services and bring innovative and effective programs to scale along multiple intercepts, including—
“(aa) emergency and crisis services;
“(bb) specialized police-based responses;
“(cc) court hearings and disposition alternatives;
“(dd) reentry from jails and prisons; and
“(ee) community supervision, treatment and support services; and
“(ii) may serve as a starting point for the development of strategic plans to achieve positive public health and safety outcomes; and
“(B) implementation, which shall—
“(i) be derived from the strategic plans described in subparagraph (A)(ii); and
“(ii) consist of—
“(I) hiring and training personnel;
“(II) identifying the eligible entity’s target population;
“(III) providing services and supports to reduce unnecessary penetration into the criminal justice system;
“(IV) reducing recidivism;
“(V) evaluating the impact of the eligible entity’s approach; and
“(VI) planning for the sustainability of effective interventions.”
SEC. 14022. Prison and Jails.
Section 2991 of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa) is amended by inserting after subsection (k), as added by section 14021, the following:
“(l) Correctional Facilities.—
“(1) Definitions.—
“(A) Correctional facility.—The term ‘correctional facility’ means a jail, prison, or other detention facility used to house people who have been arrested, detained, held, or convicted by a criminal justice agency or a court.
“(B) Eligible inmate.—The term ‘eligible inmate’ means an individual who—
“(i) is being held, detained, or incarcerated in a correctional facility; and
“(ii) manifests obvious signs of a mental illness or has been diagnosed by a qualified mental health professional as having a mental illness.
“(2) Correctional facility grants.—The Attorney General may award grants to applicants to enhance the capabilities of a correctional facility—
“(A) to identify and screen for eligible inmates;
“(B) to plan and provide—
“(i) initial and periodic assessments of the clinical, medical, and social needs of inmates; and
“(ii) appropriate treatment and services that address the mental health and substance abuse needs of inmates;
“(C) to develop, implement, and enhance—
“(i) post-release transition plans for eligible inmates that, in a comprehensive manner, coordinate health, housing, medical, employment, and other appropriate services and public benefits;
“(ii) the availability of mental health care services and substance abuse treatment services; and
“(iii) alternatives to solitary confinement and segregated housing and mental health screening and treatment for inmates placed in solitary confinement or segregated housing; and
“(D) to train each employee of the correctional facility to identify and appropriately respond to incidents involving inmates with mental health or co-occurring mental health and substance abuse disorders.”
SEC. 14023. Allowable Uses.
Section 2991(b)(5)(I) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa(b)(5)(I)) is amended by adding at the end the following:
“(v) Teams addressing frequent users of crisis services.—Multidisciplinary teams that—
“(I) coordinate, implement, and administer community-based crisis responses and long-term plans for frequent users of crisis services;
“(II) provide training on how to respond appropriately to the unique issues involving frequent users of crisis services for public service personnel, including criminal justice, mental health, substance abuse, emergency room, healthcare, law enforcement, corrections, and housing personnel;
“(III) develop or support alternatives to hospital and jail admissions for frequent users of crisis services that provide treatment, stabilization, and other appropriate supports in the least restrictive, yet appropriate, environment; and
“(IV) develop protocols and systems among law enforcement, mental health, substance abuse, housing, corrections, and emergency medical service operations to provide coordinated assistance to frequent users of crisis services.”
SEC. 14024. Law Enforcement Training.
Section 2991(h) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa(h)) is amended—
in paragraph (1), by adding at the end the following:
“(F) Academy training.—To provide support for academy curricula, law enforcement officer orientation programs, continuing education training, and other programs that teach law enforcement personnel how to identify and respond to incidents involving persons with mental health disorders or co-occurring mental health and substance abuse disorders.”
; and
by adding at the end the following:
“(4) Priority consideration.—The Attorney General, in awarding grants under this subsection, shall give priority to programs that law enforcement personnel and members of the mental health and substance abuse professions develop and administer cooperatively.”
SEC. 14025. Federal Law Enforcement Training.
Not later than 1 year after the date of enactment of this Act, the Attorney General shall provide direction and guidance for the following:
Training programs.— Programs that offer specialized and comprehensive training, in procedures to identify and appropriately respond to incidents in which the unique needs of individuals who have a mental illness are involved, to first responders and tactical units of—
Federal law enforcement agencies; and
other Federal criminal justice agencies such as the Bureau of Prisons, the Administrative Office of the United States Courts, and other agencies that the Attorney General determines appropriate.
Improved technology.— The establishment of, or improvement of existing, computerized information systems to provide timely information to employees of Federal law enforcement agencies, and Federal criminal justice agencies to improve the response of such employees to situations involving individuals who have a mental illness.
SEC. 14026. Gao Report.
No later than 1 year after the date of enactment of this Act, the Comptroller General of the United States, in coordination with the Attorney General, shall submit to Congress a report on—
the practices that Federal first responders, tactical units, and corrections officers are trained to use in responding to individuals with mental illness;
procedures to identify and appropriately respond to incidents in which the unique needs of individuals who have a mental illness are involved, to Federal first responders and tactical units;
the application of evidence-based practices in criminal justice settings to better address individuals with mental illnesses; and
recommendations on how the Department of Justice can expand and improve information sharing and dissemination of best practices.
SEC. 14027. Evidence Based Practices.
Section 2991(c) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa(c)) is amended—
in paragraph (3), by striking “ or” at the end;
by redesignating paragraph (4) as paragraph (6); and
by inserting after paragraph (3), the following:
“(4) propose interventions that have been shown by empirical evidence to reduce recidivism;
“(5) when appropriate, use validated assessment tools to target preliminarily qualified offenders with a moderate or high risk of recidivism and a need for treatment and services; or”
SEC. 14028. Transparency, Program Accountability, and Enhancement of Local Authority.
In General.— Section 2991(a) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa(a)) is amended—
in paragraph (7)—
in the heading, by striking “ Mental illness” and inserting “ Mental illness; mental health disorder”; and
by striking “ term ‘mental illness’ means” and inserting “ terms ‘mental illness’ and ‘mental health disorder’ mean”; and
by striking paragraph (9) and inserting the following:
“(9) Preliminarily qualified offender.—
“(A) In general.—The term ‘preliminarily qualified offender’ means an adult or juvenile accused of an offense who—
“(i)
(I) previously or currently has been diagnosed by a qualified mental health professional as having a mental illness or co-occurring mental illness and substance abuse disorders;
“(II) manifests obvious signs of mental illness or co-occurring mental illness and substance abuse disorders during arrest or confinement or before any court; or
“(III) in the case of a veterans treatment court provided under subsection (i), has been diagnosed with, or manifests obvious signs of, mental illness or a substance abuse disorder or co-occurring mental illness and substance abuse disorder;
“(ii) has been unanimously approved for participation in a program funded under this section by, when appropriate—
“(I) the relevant—
“(aa) prosecuting attorney;
“(bb) defense attorney;
“(cc) probation or corrections official; and
“(dd) judge; and
“(II) a representative from the relevant mental health agency described in subsection (b)(5)(B)(i);
“(iii) has been determined, by each person described in clause (ii) who is involved in approving the adult or juvenile for participation in a program funded under this section, to not pose a risk of violence to any person in the program, or the public, if selected to participate in the program; and
“(iv) has not been charged with or convicted of—
“(I) any sex offense (as defined in section 111 of the Sex Offender Registration and Notification Act (42 U.S.C. 16911)) or any offense relating to the sexual exploitation of children; or
“(II) murder or assault with intent to commit murder.
“(B) Determination.—In determining whether to designate a defendant as a preliminarily qualified offender, the relevant prosecuting attorney, defense attorney, probation or corrections official, judge, and mental health or substance abuse agency representative shall take into account—
“(i) whether the participation of the defendant in the program would pose a substantial risk of violence to the community;
“(ii) the criminal history of the defendant and the nature and severity of the offense for which the defendant is charged;
“(iii) the views of any relevant victims to the offense;
“(iv) the extent to which the defendant would benefit from participation in the program;
“(v) the extent to which the community would realize cost savings because of the defendant’s participation in the program; and
“(vi) whether the defendant satisfies the eligibility criteria for program participation unanimously established by the relevant prosecuting attorney, defense attorney, probation or corrections official, judge and mental health or substance abuse agency representative.”
Technical and Conforming Amendment.— Section 2927(2) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797s–6(2)) is amended by striking “ has the meaning given that term in section 2991(a).” and inserting
“(A) does not have as an element the use, attempted use, or threatened use of physical force against the person or property of another; or
“(B) is not a felony that by its nature involves a substantial risk that physical force against the person or property of another may be used in the course of committing the offense.”
SEC. 14029. Grant Accountability.
Section 2991 of title I of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa) is amended by inserting after subsection (l), as added by section 14022, the following:
“(m) Accountability.—All grants awarded by the Attorney General under this section shall be subject to the following accountability provisions:
“(1) Audit requirement.—
“(A) Definition.—In this paragraph, the term ‘unresolved audit finding’ means a finding in the final audit report of the Inspector General of the Department of Justice that the audited grantee has utilized grant funds for an unauthorized expenditure or otherwise unallowable cost that is not closed or resolved within 12 months from the date when the final audit report is issued.
“(B) Audits.—Beginning in the first fiscal year beginning after the date of enactment of this subsection, and in each fiscal year thereafter, the Inspector General of the Department of Justice shall conduct audits of recipients of grants under this section to prevent waste, fraud, and abuse of funds by grantees. The Inspector General shall determine the appropriate number of grantees to be audited each year.
“(C) Mandatory exclusion.—A recipient of grant funds under this section that is found to have an unresolved audit finding shall not be eligible to receive grant funds under this section during the first 2 fiscal years beginning after the end of the 12-month period described in subparagraph (A).
“(D) Priority.—In awarding grants under this section, the Attorney General shall give priority to eligible applicants that did not have an unresolved audit finding during the 3 fiscal years before submitting an application for a grant under this section.
“(E) Reimbursement.—If an entity is awarded grant funds under this section during the 2-fiscal-year period during which the entity is barred from receiving grants under subparagraph (C), the Attorney General shall—
“(i) deposit an amount equal to the amount of the grant funds that were improperly awarded to the grantee into the General Fund of the Treasury; and
“(ii) seek to recoup the costs of the repayment to the fund from the grant recipient that was erroneously awarded grant funds.
“(2) Nonprofit organization requirements.—
“(A) Definition.—For purposes of this paragraph and the grant programs under this part, the term ‘nonprofit organization’ means an organization that is described in section 501(c)(3) of the Internal Revenue Code of 1986 and is exempt from taxation under section 501(a) of such Code.
“(B) Prohibition.—The Attorney General may not award a grant under this part to a nonprofit organization that holds money in offshore accounts for the purpose of avoiding paying the tax described in section 511(a) of the Internal Revenue Code of 1986.
“(C) Disclosure.—Each nonprofit organization that is awarded a grant under this section and uses the procedures prescribed in regulations to create a rebuttable presumption of reasonableness for the compensation of its officers, directors, trustees, and key employees, shall disclose to the Attorney General, in the application for the grant, the process for determining such compensation, including the independent persons involved in reviewing and approving such compensation, the comparability data used, and contemporaneous substantiation of the deliberation and decision. Upon request, the Attorney General shall make the information disclosed under this subparagraph available for public inspection.
“(3) Conference expenditures.—
“(A) Limitation.—No amounts made available to the Department of Justice under this section may be used by the Attorney General, or by any individual or entity awarded discretionary funds through a cooperative agreement under this section, to host or support any expenditure for conferences that uses more than $20,000 in funds made available by the Department of Justice, unless the head of the relevant agency or department, provides prior written authorization that the funds may be expended to host the conference.
“(B) Written approval.—Written approval under subparagraph (A) shall include a written estimate of all costs associated with the conference, including the cost of all food, beverages, audio-visual equipment, honoraria for speakers, and entertainment.
“(C) Report.—The Deputy Attorney General shall submit an annual report to the Committee on the Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives on all conference expenditures approved under this paragraph.
“(4) Annual certification.—Beginning in the first fiscal year beginning after the date of enactment of this subsection, the Attorney General shall submit, to the Committee on the Judiciary and the Committee on Appropriations of the Senate and the Committee on the Judiciary and the Committee on Appropriations of the House of Representatives, an annual certification—
“(A) indicating whether—
“(i) all audits issued by the Office of the Inspector General under paragraph (1) have been completed and reviewed by the appropriate Assistant Attorney General or Director;
“(ii) all mandatory exclusions required under paragraph (1)(C) have been issued; and
“(iii) all reimbursements required under paragraph (1)(E) have been made; and
“(B) that includes a list of any grant recipients excluded under paragraph (1) from the previous year.
“(n) Preventing Duplicative Grants.—
“(1) In general.—Before the Attorney General awards a grant to an applicant under this section, the Attorney General shall compare potential grant awards with other grants awarded under this Act to determine if duplicate grant awards are awarded for the same purpose.
“(2) Report.—If the Attorney General awards duplicate grants to the same applicant for the same purpose the Attorney General shall submit to the Committee on the Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives a report that includes—
“(A) a list of all duplicate grants awarded, including the total dollar amount of any duplicate grants awarded; and
“(B) the reason the Attorney General awarded the duplicate grants.”