I 

114TH CONGRESS 

2D SESSION H. R. 4435 

To improve access to mental health and substance use disorder prevention, 

treatment, crisis, and recovery services. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 2, 2016 

Mr. GENE GREEN of Texas (for himself, Ms. DEGETTE, Mr. KENNEDY, Ms. 

MATSUI, Mr. TONKO, and Mr. LOEBSACK) introduced the following bill; 

which was referred to the Committee on Energy and Commerce, and in 

addition to the Committees on the Judiciary, Ways and Means, Education and the Workforce, and Natural Resources, for a period to be subsequently determined by the Speaker, in each case for consideration of 

such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To improve access to mental health and substance use 

disorder prevention, treatment, crisis, and recovery services. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Comprehensive Behavioral Health Reform and Recovery 

6 Act of 2016’’. 

7 (b) TABLE OF CONTENTS.—The table of contents for 

8 this Act is as follows: 


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Sec. 1. Short title; table of contents. 

TITLE I—STRENGTHENING AND INVESTING IN SAMHSA 

PROGRAMS 

Sec. 101. Assistant Secretary for Mental Health and Substance Use Disorders. 

Sec. 102. Office of Chief Medical Officer. 

Sec. 103. Independent audit of SAMHSA. 

Sec. 104. Center for Behavioral Health Statistics and Quality. 

Sec. 105. Innovation grants. 

Sec. 106. Demonstration grants. 

Sec. 107. Early intervention and treatment in childhood. 

Sec. 108. Block grants. 

Sec. 109. Children’s recovery from trauma. 

Sec. 110. Garrett Lee Smith Memorial Act reauthorization. 

Sec. 111. National Suicide Prevention Lifeline Program. 

Sec. 112. Adult suicide prevention. 

Sec. 113. Peer review and advisory councils. 

Sec. 114. Adult trauma. 

Sec. 115. Reducing the stigma of serious mental illness. 

Sec. 116. Report on mental health and substance abuse treatment in the 

States. 

Sec. 117. Mental health first aid training grants. 

Sec. 118. Acute care bed registry grant for States. 

Sec. 119. Older adult mental health grants. 

TITLE II—INTERAGENCY SERIOUS MENTAL ILLNESS 

COORDINATING COMMITTEE 

Sec. 201. Interagency Serious Mental Illness Coordinating Committee. 

TITLE III—COMMUNICATIONS BETWEEN INDIVIDUALS, FAMILIES, 

AND PROVIDERS 

Sec. 301. Clarification of circumstances under which disclosure of protected 

health information of mental illness patients is permitted. 

Sec. 302. Development and dissemination of model training programs. 

Sec. 303. Modernizing privacy protections. 

Sec. 304. Improving communication with individuals, families, and providers. 

TITLE IV—IMPROVING MEDICAID AND MEDICARE MENTAL 

HEALTH SERVICES 

Subtitle A—Medicaid Provisions 

Sec. 401. Enhanced Medicaid coverage relating to certain mental health services. 

Sec. 402. Extension and expansion of demonstration programs to improve community mental health services. 

Sec. 403. Terms for extension and expansion of Medicaid emergency psychiatric 

demonstration project. 

Sec. 404. Community-based mental health services Medicaid option for children 

in or at risk of psychiatric residential treatment. 

Sec. 405. Expansion of CMMI authority to support major mental illness 

projects in Medicaid. 

Sec. 406. Medicaid data and reporting. 

Sec. 407. At-risk youth Medicaid protection. 


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Subtitle B—Medicare Provisions 

Sec. 411. Elimination of 190-day lifetime limit on coverage of inpatient psychiatric hospital services under Medicare. 

Sec. 412. Modifications to Medicare discharge planning requirements. 

Subtitle C—Provisions Related to Medicaid and Medicare 

Sec. 421. Reports on Medicaid and Medicare part D formulary and appeals 

practices with respect to coverage of mental health drugs. 

TITLE V—STRENGTHENING THE BEHAVIORAL HEALTH 

WORKFORCE AND IMPROVING ACCESS TO CARE 

Sec. 501. Nationwide workforce strategy. 

Sec. 502. Report on best practices for peer-support specialist programs, training, and certification. 

Sec. 503. Advisory Council on Graduate Medical Education. 

Sec. 504. Telepsychiatry and primary care provider training grant program. 

Sec. 505. Liability protections for health care professional volunteers at community health centers and federally qualified community behavioral health clinics. 

Sec. 506. Minority Fellowship Program. 

Sec. 507. National Health Service Corps. 

Sec. 508. SAMHSA grant program for development and implementation of curricula for continuing education on serious mental illness. 

Sec. 509. Peer professional workforce development grant program. 

Sec. 510. Demonstration grant program to recruit, train, and professionally 

support psychiatric physicians in Indian health programs. 

Sec. 511. Education and training on eating disorders for health professionals. 

Sec. 512. Primary and behavioral health care integration grant programs. 

Sec. 513. Health professions competencies to address racial, ethnic, sexual, and 

gender minority behavioral health disparities. 

Sec. 514. Behavioral health crisis systems. 

Sec. 515. Mental health in schools. 

Sec. 516. Examining mental health care for children. 

Sec. 517. Reporting compliance study. 

Sec. 518. Strengthening connections to community care demonstration grant 

program. 

Sec. 519. Assertive community treatment grant program for individuals with 

serious mental illness. 

Sec. 520. Improving mental and behavioral health on college campuses. 

Sec. 521. Inclusion of occupational therapists in National Health Service Corps 

program. 

TITLE VI—IMPROVING MENTAL HEALTH RESEARCH AND 

COORDINATION 

Sec. 601. Increase in funding for certain research. 

TITLE VII—BEHAVIORAL HEALTH INFORMATION TECHNOLOGY 

Sec. 701. Extension of health information technology assistance for behavioral 

and mental health and substance abuse. 

Sec. 702. Extension of eligibility for Medicare and Medicaid health information 

technology implementation assistance. 


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TITLE VIII—MAKING PARITY WORK 

Sec. 801. Strengthening parity in mental health and substance use disorder 

benefits. 

Sec. 802. Report on investigations regarding parity in mental health and substance use disorder benefits. 

Sec. 803. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders. 

Sec. 804. Report to Congress on Federal assistance to State insurance regulators regarding mental health parity enforcement. 

TITLE IX—SUBSTANCE ABUSE 

Subtitle A—Prevention 

Sec. 901. Practitioner education. 

Sec. 902. Co-prescribing opioid overdose reversal drugs grant program. 

Sec. 903. Opioid overdose reversal co-prescribing guidelines. 

Sec. 904. Surveillance capacity building. 

Subtitle B—Crisis 

Sec. 921. Grants to support syringe exchange programs. 

Sec. 922. Grant program to reduce drug overdose deaths. 

Subtitle C—Treatment 

Sec. 931. Expansion of patient limits under waiver. 

Sec. 932. Definitions. 

Sec. 933. Evaluation by assistant Secretary for planning and evaluation. 

Sec. 934. Reauthorization of residential treatment programs for pregnant and 

postpartum women. 

Sec. 935. Pilot program grants for State substance abuse agencies. 

Sec. 936. Evidence-based opioid and heroin treatment and interventions demonstration. 

Sec. 937. Adolescent treatment and recovery services demonstration grant program. 

Sec. 938. Study on treatment infrastructure. 

Sec. 939. Substance use disorder professional loan repayment program. 

Subtitle D—Recovery 

Sec. 951. National youth recovery initiative. 

Sec. 952. Grants to enhance and expand recovery support services. 


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1 TITLE I—STRENGTHENING AND 

2 INVESTING IN SAMHSA PRO3 GRAMS 

4 SEC. 101. ASSISTANT SECRETARY FOR MENTAL HEALTH 

5 AND SUBSTANCE USE DISORDERS. 

6 (a) IN GENERAL.—Section 501 of the Public Health 

7 Service Act (42 U.S.C. 290aa) is amended— 

8 (1) in subsection (c)(1), by adding at the end 

9 the following: ‘‘The Administrator shall be selected 

10 from individuals who have appropriate education and 

11 experience. The Administrator shall also be the As12 sistant Secretary for Mental Health and Substance 

13 Abuse.’’; 

14 (2) in subsection (d)— 

15 (A) by striking ‘‘The Secretary’’ and all 

16 that follows through ‘‘(1) supervise the func17 tions’’ and inserting the following: 

18 ‘‘(1) SECRETARY’S AUTHORITIES.—The Sec19 retary, acting through the Administrator, shall— 

20 ‘‘(A) supervise the functions’’; 

21 (B) by moving the indentation of each of 

22 paragraphs (2) through (18) 2 ems to the right 

23 and redesignating such paragraphs as subpara24 graphs (B) through (R), respectively; and 

25 (3) by adding at the end the following: 


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1 ‘‘(2) ASSISTANT SECRETARY’S AUTHORITIES.— 

2 The Assistant Secretary for Mental Health and Sub3 stance Abuse shall— 

4 ‘‘(A) serve as the effective and visible advo5 cate for individuals with, or at risk for, mental 

6 illness and substance use disorders within the 

7 Department of Health and Human Services and 

8 with other departments, agencies, and instru9 mentalities of the Federal Government; 

10 ‘‘(B) assist the Secretary in all matters 

11 pertaining to issues that impact the prevention, 

12 treatment, and recovery of individuals with 

13 mental illness or substance use disorders; 

14 ‘‘(C) coordinate Federal programs and ac15 tivities related to promoting mental health and 

16 preventing substance abuse; 

17 ‘‘(D) coordinate activities with Federal en18 tities to implement and build awareness of pro19 grams providing benefits affecting individuals 

20 with mental illness or substance use disorders; 

21 ‘‘(E) promote and coordinate research, 

22 treatment, and services across departments, 

23 agencies, organizations, and individuals with re24 spect to prevention, treatment, and recovery 

25 support research and programs for individuals 


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1 with, or at risk for, substance use disorders or 

2 mental illness; 

3 ‘‘(F) coordinate functions within the De4 partment of Health and Human Services— 

5 ‘‘(i) to improve the treatment of, and 

6 related services to, individuals with sub7 stance use disorders or mental illness; 

8 ‘‘(ii) to improve substance misuse and 

9 abuse prevention and mental health pro10 motion services; 

11 ‘‘(iii) to ensure access to effective, evi12 dence-based treatment for individuals with 

13 mental illnesses and individuals with a sub14 stance use disorder; 

15 ‘‘(iv) to ensure that grant programs of 

16 the Department adhere to scientific stand17 ards for individuals with mental illness or 

18 substance use disorders; and 

19 ‘‘(v) to support the development and 

20 implementation of initiatives to encourage 

21 individuals to pursue careers (especially in 

22 underserved areas and populations) as psy23 chiatrists, psychologists, psychiatric nurse 

24 practitioners, clinical social workers, physi25 cian assistants, peer support specialists, 


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1 and other licensed or certified mental 

2 health and substance abuse professionals; 

3 ‘‘(G) within the Department of Health and 

4 Human Services, coordinate all programs and 

5 activities relating to— 

6 ‘‘(i) the prevention of, and treatment 

7 and recovery for, mental health or sub8 stance use disorders; or 

9 ‘‘(ii) the reduction of homelessness 

10 among individuals with mental illness or 

11 substance use disorders; 

12 ‘‘(H) across the Federal Government, in 

13 conjunction with the Interagency Serious Men14 tal Illness Coordinating Committee under sec15 tion 501A— 

16 ‘‘(i) review all programs and activities 

17 relating to the prevention of, or treatment 

18 or rehabilitation for, mental illness or sub19 stance use disorders; 

20 ‘‘(ii) identify any such programs and 

21 activities that are duplicative; 

22 ‘‘(iii) identify any such programs and 

23 activities that are not evidence-based, ef24 fective, or efficient; and 


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1 ‘‘(iv) formulate recommendations for 

2 expanding, coordinating, eliminating, and 

3 improving programs and activities identi4 fied pursuant to subparagraph (B) or (C) 

5 and merging such programs and activities 

6 into other, successful programs and activi7 ties; and 

8 ‘‘(I) identify evidence-based best practices 

9 across the Federal Government for treatment 

10 and services for those with mental health and 

11 substance use disorders by reviewing practices 

12 for efficiency, effectiveness, quality, coordina13 tion, and cost effectiveness.’’. 

14 (b) PRIORITIZATION OF INTEGRATION OF SERVICES, 

15 EARLY DIAGNOSIS, INTERVENTION, AND WORKFORCE

16 DEVELOPMENT.—In carrying out the duties described in 

17 section 501(d)(2) of the Public Health Service Act, as 

18 added by subsection (a), the Assistant Secretary shall 

19 prioritize— 

20 (1) the integration of mental health, substance 

21 use, and physical health services for the purpose of 

22 diagnosing, preventing, treating, or providing reha23 bilitation for mental illness or substance use dis24 orders, including any such services provided through 

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1 tion) or other entities other than the Department of 

2 Health and Human Services; 

3 (2) crisis intervention for, early diagnosis and 

4 intervention services for the prevention of, and treat5 ment and rehabilitation for, serious mental illness, 

6 serious emotional disturbance, or substance use dis7 orders; and 

8 (3) workforce development for— 

9 (A) appropriate treatment of serious men10 tal illness, serious emotional disturbance, or 

11 substance use disorders; and 

12 (B) research activities that advance sci13 entific and clinical understandings of these dis14 orders, including the development and imple15 mentation of a continuing nationwide strategy 

16 to increase the psychiatric workforce with psy17 chiatrists, child and adolescent psychiatrists, 

18 psychologists, psychiatric nurse practitioners, 

19 clinical social workers, peer support specialists, 

20 and other licensed or certified mental health or 

21 substance abuse professionals. 

22 (c) REQUIREMENTS AND RESTRICTIONS ON AUTHOR23 ITY TO AWARD GRANTS.—In awarding any grant or fi24 nancial assistance, the Administrator of the Substance 

25 Abuse and Mental Health Services Administration, and 


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1 any agency or official within such Administration, shall 

2 comply with the following: 

3 (1) Any program to be funded shall be dem4 onstrated— 

5 (A) in the case of an ongoing program, to 

6 be effective; and 

7 (B) in the case of a new program, to have 

8 the prospect of being effective. 

9 (2) The programs and activities to be funded 

10 shall, as appropriate, use evidence-based best prac11 tices or emerging evidence-based practices that are 

12 translational and can be expanded or replicated to 

13 other States, local communities, agencies, tribes, or 

14 through the Medicaid program under title XIX of 

15 the Social Security Act. 

16 (3) An application for the grant or financial as17 sistance shall include, as applicable, a scientific jus18 tification based on previously demonstrated models, 

19 the number of individuals to be served, the popu20 lation to be targeted, what objective outcomes meas21 ures will be used, and details on how the program 

22 or activity to be funded can be replicated and by 

23 whom. 

24 (4) Applicants shall be evaluated and selected 

25 through a blind, peer-review process by individuals 


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1 with expertise appropriate to the grant or other fi2 nancial assistance, such as health care providers 

3 with professional experience in mental health or sub4 stance abuse research or treatment. 

5 (5) The Secretary shall adopt a policy that en6 sures that any member of a peer review group does 

7 not have a conflict of interest with respect to any 

8 program or grant to be reviewed. 

9 (6) Award recipients may be periodically re10 viewed and audited at the discretion of the Inspector 

11 General of the Department of Health and Human 

12 Services or the Comptroller General of the United 

13 States to ensure that— 

14 (A) the best scientific method for both 

15 services and data collection is being followed; 

16 and 

17 (B) Federal funds are being used as re18 quired by the conditions of the award. 

19 (7) Award recipients that fail an audit or fail 

20 to provide information pursuant to an audit shall 

21 have their awards terminated or shall be placed on 

22 a corrective action plan to address the issues raised 

23 in the audit findings. 

24 (d) DEFINITION.—In this Act, except as inconsistent 

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1 retary’’ means the Assistant Secretary for Mental Health 

2 and Substance Use Disorders. 

3 SEC. 102. OFFICE OF CHIEF MEDICAL OFFICER. 

4 (a) IN GENERAL.—Section 501 of the Public Health 

5 Service Act (42 U.S.C. 290aa) is amended— 

6 (1) by redesignating subsections (g) through (o) 

7 as subsections (h) through (p), respectively; and 

8 (2) by inserting after subsection (f) the fol9 lowing: 

10 ‘‘(g) CHIEF MEDICAL OFFICE.—The Administrator 

11 shall establish within the Administration a Chief Medical 

12 Office, to be headed by a Chief Medical Officer, who shall 

13 be a psychiatrist. The Chief Medical Office shall be staffed 

14 by mental health and substance abuse providers.’’. 

15 (b) CONFORMING CHANGES.—Title V of the Public 

16 Health Service Act (42 U.S.C. 290aa et seq.) is amend17 ed— 

18 (1) in subsections (e)(3)(C) and (f)(2)(C)(iii) of 

19 section 501, by striking ‘‘subsection (k)’’ and insert20 ing ‘‘subsection (l)’’; and 

21 (2) in section 508(p), by striking ‘‘501(k)’’ and 

22 inserting ‘‘501(l)’’. 

23 SEC. 103. INDEPENDENT AUDIT OF SAMHSA. 

24 (a) IN GENERAL.—The Secretary shall enter into an 

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1 pendent entity to conduct a full assessment and review of 

2 the Substance Abuse and Mental Health Services Admin3 istration (in this section referred to as ‘‘SAMHSA’’). 

4 (b) REPORT.—The contract or cooperative agreement 

5 under subsection (a) shall require that, not later than 18 

6 months after the date of enactment of this Act, the exter7 nal, independent entity will submit to the Committee on 

8 Energy and Commerce of the House of Representatives 

9 and the Committee on Health, Education, Labor, and 

10 Pensions of the Senate a report on the findings and con11 clusion of the assessment and review. 

12 (c) TOPICS.—The assessment and review conducted 

13 pursuant to subsection (a), and the report submitted pur14 suant to subsection (b), shall address each of the fol15 lowing: 

16 (1) Whether the mission of SAMHSA is appro17 priate. 

18 (2) Whether the program authority of 

19 SAMHSA is appropriate. 

20 (3) Whether SAMHSA has adequate staffing, 

21 including technical expertise, to fulfill its mission. 

22 (4) Whether SAMHSA is funded appropriately. 

23 (5) The efficacy of the programs funded by 

24 SAMHSA. 


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1 (6) Whether funding is being spent in a way 

2 that effectively supports and promotes the authori3 ties vested by section 501(d) of the Public Health 

4 Service Act, as amended by section 101 of this Act. 

5 (7) Whether SAMHSA’s focus on recovery is 

6 appropriate. 

7 (8) Additional steps SAMHSA can take to ful8 fill its charge of leading public health efforts to ad9 vance the behavioral health of the Nation and reduce 

10 the impact of substance abuse and mental illness on 

11 the Nation’s communities. 

12 (9) Whether standards for SAMHSA’s grant 

13 programs are effective. 

14 (10) Whether standards for SAMHSA’s ap15 pointment of peer-review panels to evaluate grant 

16 applications is appropriate. 

17 (11) How SAMHSA serves individuals with 

18 mental illness, serious mental illness, serious emo19 tional disturbance, or substance use disorders, and 

20 individuals with co-occurring conditions. 

21 SEC. 104. CENTER FOR BEHAVIORAL HEALTH STATISTICS 

22 AND QUALITY. 

23 Title V of the Public Health Service Act (42 U.S.C. 

24 290aa et seq.) is amended— 


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1 (1) in section 501(b) (42 U.S.C. 290aa(b)), by 

2 adding at the end the following: 

3 ‘‘(4) The Center for Behavioral Health Statis4 tics and Quality.’’; 

5 (2) in section 502(a)(1) (42 U.S.C. 290aa– 

6 1(a)(1))— 

7 (A) in subparagraph (C), by striking 

8 ‘‘and’’ at the end; 

9 (B) in subparagraph (D), by striking the 

10 period at the end and inserting ‘‘and’’; and 

11 (C) by inserting after subparagraph (D) 

12 the following: 

13 ‘‘(E) the Center for Behavioral Health 

14 Statistics and Quality.’’; and 

15 (3) in part B (42 U.S.C. 290bb et seq.) by add16 ing at the end the following new subpart: 

17 ‘‘Subpart 4—Center for Behavioral Health Statistics 

18 and Quality 

19 ‘‘SEC. 520L. CENTER FOR BEHAVIORAL HEALTH STATISTICS 

20 AND QUALITY. 

21 ‘‘(a) ESTABLISHMENT.—There is established in the 

22 Administration a Center for Behavioral Health Statistics 

23 and Quality (in this section referred to as the ‘Center’). 

24 The Center shall be headed by a Director (in this section 

25 referred to as the ‘Director’) appointed by the Secretary 


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1 from among individuals with extensive experience and aca2 demic qualifications in research and analysis in behavioral 

3 health care or related fields. 

4 ‘‘(b) DUTIES.—The Director of the Center shall— 

5 ‘‘(1) coordinate the Administration’s integrated 

6 data strategy by coordinating— 

7 ‘‘(A) surveillance and data collection (in8 cluding that authorized by section 505); 

9 ‘‘(B) evaluation; 

10 ‘‘(C) statistical and analytic support; 

11 ‘‘(D) service systems research; and 

12 ‘‘(E) performance and quality information 

13 systems; 

14 ‘‘(2) maintain operation of the National Reg15 istry of Evidence-Based Programs and Practices to 

16 provide for the evaluation and dissemination to the 

17 Administration of the evidence-based practices and 

18 services delivery models of grantees and other inter19 ested parties; 

20 ‘‘(3) recommend a core set of measurement 

21 standards for grant programs administered by the 

22 Administration; and 

23 ‘‘(4) lead evaluation efforts for the grant pro24 grams, contracts, and collaborative agreements of 

25 the Administration. 


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1 ‘‘(c) BIANNUAL REPORT TO CONGRESS.—Not later 

2 than 2 years after the date of enactment of this section, 

3 and every 2 years thereafter, the Director of the Center 

4 shall submit to Congress a report on the quality of services 

5 furnished through grant programs of the Administration, 

6 including applicable measures of outcomes for individuals 

7 and public outcomes such as— 

8 ‘‘(1) the number of patients screened positive 

9 for unhealthy alcohol use who receive brief coun10 seling as appropriate; the number of patients 

11 screened positive for tobacco use and receiving 

12 smoking cessation interventions; the number of pa13 tients with a new diagnosis of major depressive epi14 sode who are assessed for suicide risk; the number 

15 of patients screened positive for clinical depression 

16 with a documented follow-up plan; and the number 

17 of patients with a documented pain assessment that 

18 have a follow-up treatment plan when pain is 

19 present; and satisfaction with care; 

20 ‘‘(2) the incidence and prevalence of substance 

21 use and mental disorders; the number of suicide at22 tempts and suicide completions; overdoses seen in 

23 emergency rooms resulting from alcohol and drug 

24 use; emergency room boarding; overdose deaths; 

25 emergency psychiatric hospitalizations; new criminal 


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1 justice involvement while in treatment; stable hous2 ing; and rates of involvement in employment, edu3 cation, and training; and 

4 ‘‘(3) such other measures for outcomes of serv5 ices as the Director may determine. 

6 ‘‘(d) STAFFING COMPOSITION.—The staff of the Cen7 ter may include individuals with advanced degrees and 

8 field expertise as well as clinical and research experience 

9 in mental and substance use disorders such as— 

10 ‘‘(1) professionals with clinical and research ex11 pertise in the prevention and treatment of, and re12 covery from, substance use and mental disorders; 

13 ‘‘(2) professionals with training and expertise in 

14 statistics or research and survey design and meth15 odologies; and 

16 ‘‘(3) other related fields in the social and behav17 ioral sciences, as specified by relevant position de18 scriptions. 

19 ‘‘(e) GRANTS AND CONTRACTS.—In carrying out the 

20 duties established in subsection (b), the Director may 

21 make grants to and enter into contracts and cooperative 

22 agreements with public and nonprofit private entities. 

23 ‘‘(f) DEFINITION.—In this section, the term ‘emer24 gency room boarding’ means the practice of admitting pa25 tients to an emergency department and holding such paVerDate Sep 11 2014 02:27 Feb 05, 2016 Jkt 059200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\H4435.IH H4435

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1 tients in the department until inpatient psychiatric beds 

2 become available.’’. 

3 SEC. 105. INNOVATION GRANTS. 

4 (a) IN GENERAL.—The Assistant Secretary, acting 

5 through the Substance Abuse and Mental Health Services 

6 Administration, shall award grants to State and local gov7 ernments, tribes and tribal organizations, educational in8 stitutions, and nonprofit organizations for expanding a 

9 model that has been scientifically demonstrated to show 

10 promise, but would benefit from further applied research, 

11 for— 

12 (1) enhancing the screening, diagnosis, and 

13 treatment of mental illness and serious mental ill14 ness; or 

15 (2) integrating or coordinating physical, mental 

16 health, and substance use services. 

17 (b) DURATION.—A grant under this section shall be 

18 for a period of not less than 3 years and not more than 

19 5 years. 

20 (c) LIMITATIONS.—Of the amounts made available 

21 for carrying out this section for a fiscal year, not less than 

22 one-third shall be awarded for screening, diagnosis, treat23 ment, or services, as described in subsection (a), for indi24 viduals (or subpopulations of individuals) who are below 


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1 the age of 18 when activities funded through the grant 

2 award are initiated. 

3 (d) GUIDELINES.—As a condition on receipt of an 

4 award under this section, an applicant shall agree to ad5 here to any requirements or guidelines issued by the Sec6 retary on research designs and data collection. 

7 (e) TERMINATION.—The Secretary may terminate 

8 any award under this section upon a determination that— 

9 (1) the recipient is not providing information 

10 requested by the Secretary in connection with the 

11 award; or 

12 (2) there is a clear failure in the effectiveness 

13 of the recipient’s programs or activities funded 

14 through the award. 

15 (f) REPORTING.—As a condition on receipt of an 

16 award under this section, an applicant shall agree— 

17 (1) to report to the Secretary the results of pro18 grams and activities funded through the award; and 

19 (2) to include in such reporting any relevant 

20 data requested by the Secretary. 

21 (g) AUTHORIZATION OF APPROPRIATIONS.—For the 

22 purpose of providing grants under this section, there is 

23 authorized to be appropriated $40,000,000 for each of fis24 cal years 2017 through 2021. 


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1 SEC. 106. DEMONSTRATION GRANTS. 

2 (a) GRANTS.—The Secretary of Health and Human 

3 Services (in this section referred to as the ‘‘Secretary’’), 

4 acting through the Substance Abuse and Mental Health 

5 Services Administration, shall award grants to States, 

6 counties, local governments, tribes and tribal organiza7 tions, educational institutions, and private nonprofit orga8 nizations for the expansion, replication, or scaling of evi9 dence-based programs across a wider area to enhance ef10 fective screening, early diagnosis, intervention, and treat11 ment with respect to mental illness, serious mental illness, 

12 and serious emotional disturbance, primarily by— 

13 (1) applied delivery of care, including training 

14 staff in effective evidence-based treatment; and 

15 (2) integrating models of care across specialties 

16 and jurisdictions. 

17 (b) DURATION.—A grant under this section shall be 

18 for a period of not less than 3 years and not more than 

19 5 years. 

20 (c) LIMITATIONS.—Of the amounts made available 

21 for carrying out this section for a fiscal year— 

22 (1) not less than half shall be awarded for 

23 screening, diagnosis, intervention, and treatment, as 

24 described in subsection (a), for individuals (or sub25 populations of individuals) who are below the age of 


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1 26 when activities funded through the grant award 

2 are initiated; 

3 (2) no amounts shall be made available for any 

4 program or project that is not evidence-based; 

5 (3) no amounts shall be made available for pri6 mary prevention; and 

7 (4) no amounts shall be made available solely 

8 for the purpose of expanding facilities or increasing 

9 staff at an existing program, although funds may be 

10 so used by an existing program if such an expansion 

11 or increase is needed to support the implementation 

12 of a new program under this section. 

13 (d) TERMINATION.—The Secretary may terminate 

14 any award under this section upon a determination that— 

15 (1) the recipient is not providing information 

16 requested by the Secretary in connection with the 

17 award; or 

18 (2) there is a clear failure in the effectiveness 

19 of the recipient’s programs or activities funded 

20 through the award. 

21 (e) REPORTING.—As a condition on receipt of an 

22 award under this section, an applicant shall agree— 

23 (1) to report to the Secretary the results of pro24 grams and activities funded through the award; and 


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1 (2) to include in such reporting any relevant 

2 data requested by the Secretary. 

3 (f) AUTHORIZATION OF APPROPRIATIONS.—For the 

4 purpose of providing grants under this section, there is 

5 authorized to be appropriated $80,000,000 for each of fis6 cal years 2017 through 2021. 

7 SEC. 107. EARLY INTERVENTION AND TREATMENT IN 

8 CHILDHOOD. 

9 (a) GRANTS.—The Secretary of Health and Human 

10 Services (in this Act referred to as the ‘‘Secretary’’), act11 ing through the Substance Abuse and Mental Health Serv12 ices Administration, shall— 

13 (1) award grants to eligible entities to initiate 

14 and undertake, for eligible children, early childhood 

15 intervention and treatment programs, and special16 ized preschool and elementary school programs, with 

17 the goal of preventing chronic and serious mental ill18 ness and serious emotional disturbance; 

19 (2) award grants to not more than 3 eligible en20 tities for studying the longitudinal outcomes of pro21 grams funded under paragraph (1) on eligible chil22 dren who were treated 5 or more years prior to the 

23 enactment of this Act; and 

24 (3) ensure that programs and activities funded 

25 through grants under this subsection are based on 


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1 a sound scientific model that shows evidence and 

2 promise and can be replicated in other settings. 

3 (b) ELIGIBLE ENTITIES AND CHILDREN.—In this 

4 section: 

5 (1) ELIGIBLE ENTITY.—The term ‘‘eligible enti6 ty’’ means a nonprofit institution that— 

7 (A) is accredited by State mental health, 

8 education, or human services agencies, as appli9 cable, for the treatment or education of children 

10 from 0 to 12 years of age; and 

11 (B) provides services that include early 

12 childhood intervention and specialized preschool 

13 and elementary school programs focused on 

14 children whose primary need is a social or emo15 tional disability (in addition to any learning dis16 ability). 

17 (2) ELIGIBLE CHILD.—The term ‘‘eligible 

18 child’’ means a child who is at least 0 years old and 

19 not more than 12 years old— 

20 (A) whose primary need is a social and 

21 emotional disability (in addition to any learning 

22 disability); 

23 (B) who is at risk of developing serious 

24 mental illness and/or may show early signs of 

25 mental illness; and 


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1 (C) who could benefit from early childhood 

2 intervention and specialized preschool or ele3 mentary school programs with the goal of pre4 venting or treating chronic and serious mental 

5 illness. 

6 (c) APPLICATION.—An eligible entity seeking a grant 

7 under subsection (a) shall submit to the Secretary an ap8 plication at such time, in such manner, and containing 

9 such information as the Secretary may require. 

10 (d) USE OF FUNDS FOR EARLY CHILDHOOD INTER11 VENTION AND TREATMENT PROGRAMS.—An eligible enti12 ty shall use amounts awarded under a grant under sub13 section (a)(1) to carry out the following activities: 

14 (1) Deliver (or facilitate) for eligible children 

15 treatment and education, early childhood interven16 tion, and specialized preschool and elementary school 

17 programs, including the provision of medically based 

18 child care and early education services. 

19 (2) Treat and educate eligible children, includ20 ing startup, curricula development, operating and 

21 capital needs, staff and equipment, assessment and 

22 intervention services, administration and medication 

23 requirements, enrollment costs, collaboration with 

24 primary care providers and psychiatrists, other re25 lated services to meet emergency needs of children, 


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1 and communication with families and medical pro2 fessionals concerning the children. 

3 (3) Develop and implement other strategies to 

4 address identified treatment and educational needs 

5 of eligible children that have reliable and valid eval6 uation modalities built into assess outcomes based 

7 on sound scientific metrics. 

8 (e) USE OF FUNDS FOR LONGITUDINAL STUDY.—In 

9 conducting a study on longitudinal outcomes through a 

10 grant under subsection (a)(2), an eligible entity shall in11 clude an analysis of— 

12 (1) the individuals treated and educated; 

13 (2) the success of such treatment and education 

14 in— 

15 (A) avoiding the onset of serious emotional 

16 disturbance and serious mental illness; or 

17 (B) the preparation of such children for 

18 the care and management of serious emotional 

19 disturbance and serious mental illness; 

20 (3) any evidence-based best practices generally 

21 applicable as a result of such treatment and edu22 cational techniques used with such children; and 

23 (4) the ability of programs to be replicated as 

24 a best practice model of intervention. 


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1 (f) REQUIREMENTS.—In carrying out this section, 

2 the Secretary shall ensure that each entity receiving a 

3 grant under subsection (a) maintains a written agreement 

4 with the Secretary, and provides regular written reports, 

5 as required by the Secretary, regarding the quality, effi6 ciency, and effectiveness of intervention and treatment for 

7 eligible children preventing or treating the development 

8 and onset of serious mental illness or serious emotional 

9 disturbance. 

10 (g) AMOUNT OF AWARDS.— 

11 (1) AMOUNTS FOR EARLY CHILDHOOD INTER12 VENTION AND TREATMENT PROGRAMS.—The 

13 amount of an award to an eligible entity under sub14 section (a)(1) shall be not more than $600,000 per 

15 fiscal year. 

16 (2) AMOUNTS FOR LONGITUDINAL STUDY.— 

17 The total amount of an award to an eligible entity 

18 under subsection (a)(2) (for one or more fiscal 

19 years) shall be not less than $1,000,000 and not 

20 greater than $2,000,000. 

21 (h) PROJECT TERMS.—The period of a grant— 

22 (1) for awards under subsection (a)(1), shall be 

23 not less than 3 fiscal years and not more than 5 fis24 cal years; and 


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1 (2) for awards under subsection (a)(2), shall be 

2 not more than 5 fiscal years. 

3 (i) MATCHING FUNDS.—The Secretary may not 

4 award a grant under this section to an eligible entity un5 less the eligible entity agrees, with respect to the costs to 

6 be incurred by the eligible entity in carrying out the activi7 ties described in subparagraph (D), to make available non8 Federal contributions (in cash or in kind) toward such 

9 costs in an amount equal to not less than 10 percent of 

10 Federal funds provided in the grant. 

11 (j) AUTHORIZATION OF APPROPRIATIONS.—To carry 

12 out this section, there is authorized to be appropriated 

13 $5,000,000 for each of fiscal years 2017 through 2021. 

14 SEC. 108. BLOCK GRANTS. 

15 (a) BEST PRACTICES IN CLINICAL CARE MODELS.— 

16 Section 1920 of the Public Health Service Act (42 U.S.C. 

17 300x–9) is amended by adding at the end the following: 

18 ‘‘(c) BEST PRACTICES IN CLINICAL CARE MOD19 ELS.—The Substance Abuse and Mental Health Services 

20 Administration, acting in collaboration with the Director 

21 of the National Institute of Mental Health, shall require 

22 States to obligate at least 5 percent of the amounts appro23 priated for a fiscal year under subsection (a) to support 

24 evidence-based programs that address the needs of individ25 uals with early serious mental illness or serious emotional 


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1 disturbance, including psychotic disorders, regardless of 

2 the age of individual onset. Such models shall translate 

3 evidence-based interventions and best available science 

4 into systems of care, such as through models such as— 

5 ‘‘(1) the Recovery After an Initial Schizo6 phrenia Episode research project of the National In7 stitute of Mental Health; and 

8 ‘‘(2) the North American Prodrome Longitu9 dinal Study.’’. 

10 (b) ADDITIONAL PROGRAM REQUIREMENTS.— 

11 (1) INTEGRATED SERVICES.—Subsection (b)(1) 

12 of section 1912 of the Public Health Service Act (42 

13 U.S.C. 300x–1(b)(1)) is amended— 

14 (A) by striking ‘‘The plan provides’’ and 

15 inserting: 

16 ‘‘(A) The plan provides’’; 

17 (B) in subparagraph (A), as inserted by 

18 paragraph (1), in the second sentence, by strik19 ing ‘‘health and mental health services’’ and in20 serting ‘‘integrated physical and mental health 

21 services’’; 

22 (C) in such subparagraph (A), by striking 

23 ‘‘The plan shall include’’ through the period at 

24 the end and inserting ‘‘The plan shall integrate 

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1 ciency, effectiveness, quality, coordination, and 

2 cost effectiveness of those services and pro3 grams to produce the best possible outcomes for 

4 those with serious mental illness or serious 

5 emotional disturbance.’’; and 

6 (D) by adding at the end the following new 

7 subparagraph: 

8 ‘‘(B) The plan shall include a separate de9 scription of case management services and pro10 vide for activities leading to improved outcomes, 

11 such as reduction of rates of suicides, suicide 

12 attempts, substance abuse, overdose deaths, 

13 emergency hospitalizations, incarceration, 

14 crimes, arrest, victimization, homelessness, job15 lessness, medication nonadherence, and edu16 cation and vocational programs drop outs. The 

17 plan must also include a detailed list of services 

18 available for individuals with serious mental ill19 ness or serious emotional disturbance in each 

20 county or county equivalent. 

21 ‘‘(C) The plan shall include a separate de22 scription of active programs that seek to engage 

23 individuals with serious mental illness in 

24 proactively making their own health care deci25 sions and enhancing communication among 


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1 themselves, their families, and their treatment 

2 providers by allowing for early intervention by 

3 reducing legal proceedings related to involun4 tary treatment. Such programs may include 

5 services that help develop psychiatric advanced 

6 directives.’’. 

7 (2) DATA COLLECTION SYSTEM.—Subsection 

8 (b)(2) of section 1912 of the Public Health Service 

9 Act (42 U.S.C. 300x–1(b)(2)) is amended— 

10 (A) by striking ‘‘The plan contains an esti11 mate of’’ and inserting the following: ‘‘The plan 

12 contains— 

13 ‘‘(A) an estimate of’’; 

14 (B) in subparagraph (A), as inserted by 

15 paragraph (1), by inserting ‘‘, such as reduc16 tions in homelessness, emergency hospitaliza17 tion, incarceration, and unemployment’’ after 

18 ‘‘targets’’; 

19 (C) in such subparagraph, by striking the 

20 period at the end and inserting ‘‘; and’’; and 

21 (D) by adding at the end the following new 

22 subparagraph: 

23 ‘‘(B) an agreement by the State to report 

24 to the Secretary such data as may be required 

25 by the Secretary concerning— 


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1 ‘‘(i) comprehensive community mental 

2 health services in the State; and 

3 ‘‘(ii) public health outcomes for per4 sons with serious mental illness or serious 

5 emotional disturbance in the State, such as 

6 rates of suicides, suicide attempts, sub7 stance abuse, overdose deaths, emergency 

8 hospitalizations, incarceration, crimes, ar9 rest, victimization, homelessness, jobless10 ness, medication nonadherence, and edu11 cation and vocational programs drop 

12 outs.’’. 

13 (3) IMPLEMENTATION OF PLAN.—Subsection 

14 (d)(1) of section 1912 of the Public Health Service 

15 Act (42 U.S.C. 300x–1(d)(1)) is amended— 

16 (A) by striking ‘‘Except as provided’’ and 

17 inserting: 

18 ‘‘(A) Except as provided’’; and 

19 (B) by adding at the end the following new 

20 subparagraph: 

21 ‘‘(B) For individuals receiving treatment 

22 through funds awarded under a grant under 

23 section 1911, a State shall include in the State 

24 plan for the first year beginning after the date 

25 of the enactment of this subparagraph and each 


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1 subsequent year, a de-individualized report, con2 taining information that is de-identified, on the 

3 services provided to those individuals, includ4 ing— 

5 ‘‘(i) outcomes and the overall cost of 

6 such treatment provided; and 

7 ‘‘(ii) county or county equivalent level 

8 data on such population, such as overall 

9 costs and raw number data on rates of in10 voluntary commitment orders, suicides, 

11 suicide attempts, substance abuse, over12 dose deaths, emergency hospitalizations, 

13 incarceration, crimes, arrest, victimization, 

14 homelessness, joblessness, medication non15 adherence, and education and vocational 

16 programs drop outs.’’. 

17 (c) INCENTIVES FOR STATE-BASED OUTCOME MEAS18 URES.—Section 1920 of the Public Health Service Act (42 

19 U.S.C. 300x–9) is amended by adding at the end the fol20 lowing: 

21 ‘‘(c) INCENTIVES FOR STATE-BASED OUTCOME

22 MEASURES.— 

23 ‘‘(1) IN GENERAL.—In addition to the amounts 

24 made available under subsection (a) for each fiscal 

25 year, the Secretary shall provide to each State that 


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1 meets the conditions under paragraph (2) by the end 

2 of the first quarter of the subsequent fiscal year, an 

3 equally divided share of the funding under para4 graph (3). 

5 ‘‘(2) CONDITIONS.—The Secretary shall define 

6 the conditions under which a State is eligible to re7 ceive the additional amount under paragraph (1). 

8 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

9 For purposes of this subsection, there is authorized 

10 to be appropriated $25,000,000 for each of fiscal 

11 years 2017 through 2021. Any amounts made avail12 able under paragraph (1) shall be in addition to the 

13 State’s block grant allocation.’’. 

14 (d) EVIDENCE-BASED SERVICES DELIVERY MOD15 ELS.—Section 1912 of the Public Health Service Act (42 

16 U.S.C. 300x–1) is amended by adding at the end the fol17 lowing new subsection: 

18 ‘‘(e) EXPANSION OF MODELS.— 

19 ‘‘(1) IN GENERAL.—Taking into account the re20 sults of evaluations of block grant programs, the 

21 Secretary may, as part of the program of block 

22 grants under this subpart, provide for expanded use 

23 across the Nation of evidence-based service delivery 

24 models by providers funded under such block grants, 

25 so long as— 


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1 ‘‘(A) the Secretary determines that such 

2 expansion will— 

3 ‘‘(i) result in more effective use of 

4 funds under such block grants without re5 ducing the quality of care; or 

6 ‘‘(ii) improve the quality of patient 

7 care without significantly increasing spend8 ing; 

9 ‘‘(B) the Secretary determines that such 

10 expansion would improve the quality of patient 

11 care; and 

12 ‘‘(C) the Secretary determines that the 

13 change will— 

14 ‘‘(i) significantly reduce severity and 

15 duration of symptoms of mental illness; 

16 ‘‘(ii) reduce rates of suicide, suicide 

17 attempts, substance abuse, overdose, emer18 gency hospitalizations, emergency room 

19 boarding, incarceration, crime, arrest, vic20 timization, homelessness, or joblessness; or 

21 ‘‘(iii) significantly improve the quality 

22 of patient care and mental health crisis 

23 outcomes without significantly increasing 

24 spending. 


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1 ‘‘(2) DEFINITION.—In this subsection, the term 

2 ‘emergency room boarding’ means the practice of ad3 mitting patients to an emergency department and 

4 holding them in the department until inpatient psy5 chiatric beds become available.’’. 

6 (e) PERIOD FOR EXPENDITURE OF GRANT FUNDS.— 

7 Section 1913 of the Public Health Service Act (42 U.S.C. 

8 300x–2), as amended, is further amended by adding at 

9 the end the following: 

10 ‘‘(d) PERIOD FOR EXPENDITURE OF GRANT

11 FUNDS.—In implementing a plan submitted under section 

12 1912(a), a State receiving grant funds under section 1911 

13 may make such funds available to providers of services de14 scribed in subsection (b) for the provision of services with15 out fiscal year limitation, so long as any carryover is spent 

16 within 3 years of the year in which the funding was pro17 vided.’’. 

18 (f) ACTIVE OUTREACH AND ENGAGEMENT.—Section 

19 1915 of the Public Health Service Act (42 U.S.C. 300x– 

20 4) is amended by adding at the end of the following: 

21 ‘‘(c) ACTIVE OUTREACH AND ENGAGEMENT TO PER22 SONS WITH SERIOUS MENTAL ILLNESS.— 

23 ‘‘(1) IN GENERAL.—A funding agreement for a 

24 grant under section 1911 is that the State involved 

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1 dividuals with serious mental illness in comprehen2 sive services in order to avert relapse, repeated hos3 pitalizations, arrest, incarceration, suicide, and to 

4 provide the individuals with the opportunity to live 

5 in the least restrictive setting, through a comprehen6 sive program of evidence-based and culturally rel7 evant assertive outreach and engagement services fo8 cusing on individuals who are homeless, have co-oc9 curring disorders, are at risk for incarceration or re10 incarceration, or have a history of treatment failure, 

11 including repeated hospitalizations or emergency 

12 room usage. 

13 ‘‘(2) EVIDENCE-BASED ASSERTIVE OUTREACH

14 AND ENGAGEMENT SERVICES.— 

15 ‘‘(A) SAMHSA.—The Administrator of 

16 the Substance Abuse and Mental Health Serv17 ices Administration, in cooperation with the Di18 rector of the National Institute of Mental 

19 Health, shall develop— 

20 ‘‘(i) a list of evidence-based culturally 

21 and linguistically relevant assertive out22 reach and engagement services; and 

23 ‘‘(ii) criteria to be used to assess the 

24 scope and effectiveness of the approaches 

25 taken by such services, such as the ability 


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1 to provide same-day appointments for 

2 emergent situations. 

3 ‘‘(B) TYPES OF ASSERTIVE OUTREACH

4 AND ENGAGEMENT SERVICES.—For purposes of 

5 paragraph (1), appropriate programs of evi6 dence-based assertive outreach and engagement 

7 services may include peer support programs; 

8 the Wellness Recovery Action Plan, Assertive 

9 Community Treatment, and Forensic Assertive 

10 Community Treatment of the Substance Abuse 

11 and Mental Health Services Administration; ap12 propriate supportive housing programs incor13 porating a Housing First model; and intensive, 

14 evidence-based approaches to early intervention 

15 in psychosis, such as the Recovery After an Ini16 tial Schizophrenia Episode model of the Na17 tional Institute of Mental Health and the Spe18 cialized Treatment Early in Psychosis pro19 gram.’’. 

20 SEC. 109. CHILDREN’S RECOVERY FROM TRAUMA. 

21 Section 582 of the Public Health Service Act (42 

22 U.S.C. 290hh–1) is amended— 

23 (1) in subsection (a), by striking ‘‘developing 

24 programs’’ and all that follows through the period at 


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1 the end and inserting ‘‘developing and maintaining 

2 programs that provide for— 

3 ‘‘(1) the continued operation of the National 

4 Child Traumatic Stress Initiative (referred to in this 

5 section as the ‘NCTSI’), which includes a coordi6 nating center, that focuses on the mental, behav7 ioral, and biological aspects of psychological trauma 

8 response, prevention of the long-term consequences 

9 of child trauma, and early intervention services and 

10 treatment to address the long-term consequences of 

11 child trauma; and 

12 ‘‘(2) the development of knowledge with regard 

13 to evidence-based practices for identifying and treat14 ing mental, behavioral, and biological disorders of 

15 children and youth resulting from witnessing or ex16 periencing a traumatic event.’’; 

17 (2) in subsection (b)— 

18 (A) by striking ‘‘subsection (a) related’’ 

19 and inserting ‘‘subsection (a)(2) (related’’; 

20 (B) by striking ‘‘treating disorders associ21 ated with psychological trauma’’ and inserting 

22 ‘‘treating mental, behavioral, and biological dis23 orders associated with psychological trauma)’’; 

24 and 


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1 (C) by striking ‘‘mental health agencies 

2 and programs that have established clinical and 

3 basic research’’ and inserting ‘‘universities, hos4 pitals, mental health agencies, and other pro5 grams that have established clinical expertise 

6 and research’’; 

7 (3) by redesignating subsections (c) through (g) 

8 as subsections (g) through (k), respectively; 

9 (4) by inserting after subsection (b), the fol10 lowing: 

11 ‘‘(c) CHILD OUTCOME DATA.—The NCTSI coordi12 nating center shall collect, analyze, and report NCTSI13 wide child treatment process and outcome data regarding 

14 the early identification and delivery of evidence-based 

15 treatment and services for children and families served by 

16 the NCTSI grantees. 

17 ‘‘(d) TRAINING.—The NCTSI coordinating center 

18 shall facilitate the coordination of training initiatives in 

19 evidence-based and trauma-informed treatments, interven20 tions, and practices offered to NCTSI grantees, providers, 

21 and partners. 

22 ‘‘(e) DISSEMINATION AND COLLABORATION.—The 

23 NCTSI coordinating center shall, as appropriate, collabo24 rate with— 


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1 ‘‘(1) the Secretary, in the dissemination of evi2 dence-based and trauma-informed interventions, 

3 treatments, products, and other resources to appro4 priate stakeholders; and 

5 ‘‘(2) appropriate agencies that conduct or fund 

6 research within the Department of Health and 

7 Human Services, for purposes of sharing NCTSI ex8 pertise, evaluation data, and other activities, as ap9 propriate. 

10 ‘‘(f) REVIEW.—The Secretary shall, consistent with 

11 the peer review process, ensure that NCTSI applications 

12 are reviewed by appropriate experts in the field as part 

13 of a consensus review process. The Secretary shall include 

14 review criteria related to expertise and experience in child 

15 trauma and evidence-based practices.’’; 

16 (5) in subsection (g) (as so redesignated), by 

17 striking ‘‘with respect to centers of excellence are 

18 distributed equitably among the regions of the coun19 try’’ and inserting ‘‘are distributed equitably among 

20 the regions of the United States’’; 

21 (6) in subsection (i) (as so redesignated), by 

22 striking ‘‘recipient may not exceed 5 years’’ and in23 serting ‘‘recipient shall not be less than 4 years, but 

24 shall not exceed 5 years’’; and 


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1 (7) in subsection (j) (as so redesignated), by 

2 striking ‘‘$50,000,000’’ and all that follows through 

3 ‘‘2006’’ and inserting ‘‘$47,000,000 for each of fis4 cal years 2017 through 2021’’. 

5 SEC. 110. GARRETT LEE SMITH MEMORIAL ACT REAUTHOR6 IZATION. 

7 (a) INTERAGENCY RESEARCH, TRAINING, AND TECH8 NICAL ASSISTANCE CENTERS.—Section 520C of the Pub9 lic Health Service Act (42 U.S.C. 290bb–34) is amend10 ed— 

11 (1) in subsection (d)— 

12 (A) in paragraph (1), by striking ‘‘youth 

13 suicide early intervention and prevention strate14 gies’’ and inserting ‘‘suicide early intervention 

15 and prevention strategies for all ages, particu16 larly for youth’’; 

17 (B) in paragraph (2), by striking ‘‘youth 

18 suicide early intervention and prevention strate19 gies’’ and inserting ‘‘suicide early intervention 

20 and prevention strategies for all ages, particu21 larly for youth’’; 

22 (C) in paragraph (3)— 

23 (i) by striking ‘‘youth’’; and 


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1 (ii) by inserting before the semicolon 

2 the following: ‘‘for all ages, particularly for 

3 youth’’; 

4 (D) in paragraph (4), by striking ‘‘youth 

5 suicide’’ and inserting ‘‘suicide for all ages, par6 ticularly among youth’’; 

7 (E) in paragraph (5), by striking ‘‘youth 

8 suicide early intervention techniques and tech9 nology’’ and inserting ‘‘suicide early interven10 tion techniques and technology for all ages, par11 ticularly for youth’’; 

12 (F) in paragraph (7)— 

13 (i) by striking ‘‘youth’’; and 

14 (ii) by inserting ‘‘for all ages, particu15 larly for youth,’’ after ‘‘strategies’’; and 

16 (G) in paragraph (8)— 

17 (i) by striking ‘‘youth suicide’’ each 

18 place that such appears and inserting ‘‘sui19 cide’’; and 

20 (ii) by striking ‘‘in youth’’ and insert21 ing ‘‘among all ages, particularly among 

22 youth’’; and 

23 (2) by amending subsection (e) to read as fol24 lows: 


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1 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 

2 purpose of carrying out this section, there is authorized 

3 to be appropriated $5,988,000 for each of fiscal years 

4 2017 through 2021.’’. 

5 (b) YOUTH SUICIDE EARLY INTERVENTION AND

6 PREVENTION STRATEGIES.—Section 520E of the Public 

7 Health Service Act (42 U.S.C. 290bb–36) is amended— 

8 (1) in subsection (b), by striking paragraph (2) 

9 and inserting the following: 

10 ‘‘(2) LIMITATION.—In carrying out this section, 

11 the Secretary shall ensure that a State does not re12 ceive more than one grant or cooperative agreement 

13 under this section at any one time. For purposes of 

14 the preceding sentences, a State shall be considered 

15 to have received a grant or cooperative agreement if 

16 the eligible entity involved is the State or an entity 

17 designated by the State under paragraph (1)(B). 

18 Nothing in this paragraph shall be construed to 

19 apply to entities described in paragraph (1)(C).’’; 

20 and 

21 (2) by striking subsection (m) and inserting the 

22 following: 

23 ‘‘(m) AUTHORIZATION OF APPROPRIATIONS.—For 

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1 ized to be appropriated $35,427,000 for each of fiscal 

2 years 2017 through 2021.’’. 

3 (c) MENTAL AND BEHAVIORAL HEALTH SERVICES

4 ON CAMPUS.—Section 520E–2(h) of the Public Health 

5 Service Act (42 U.S.C. 290bb–36b(h)) is amended by 

6 striking ‘‘$5,000,000 for fiscal year 2005’’ and all that 

7 follows through the period and inserting ‘‘$6,488,000 for 

8 each of fiscal years 2017 through 2021.’’. 

9 SEC. 111. NATIONAL SUICIDE PREVENTION LIFELINE PRO10 GRAM. 

11 Subpart 3 of part B of title V of the Public Health 

12 Service Act is amended by inserting after section 520E– 

13 2 of such Act (42 U.S.C. 290bb–36b), as amended, the 

14 following: 

15 ‘‘SEC. 520E–3. NATIONAL SUICIDE PREVENTION LIFELINE 

16 PROGRAM. 

17 ‘‘(a) IN GENERAL.—The Secretary shall maintain the 

18 National Suicide Prevention Lifeline program, including 

19 by— 

20 ‘‘(1) coordinating a network of crisis centers 

21 across the United States for providing suicide pre22 vention and crisis intervention services to individuals 

23 seeking help at any time, day or night; 


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1 ‘‘(2) maintaining a suicide prevention hotline to 

2 link callers to local emergency, mental health, and 

3 social services resources; and 

4 ‘‘(3) consulting with the Secretary of Veterans 

5 Affairs to ensure that veterans calling the suicide 

6 prevention hotline have access to a specialized vet7 erans’ suicide prevention hotline. 

8 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—To 

9 carry out this section, there are authorized to be appro10 priated $8,000,000 for each of fiscal years 2017 through 

11 2021.’’. 

12 SEC. 112. ADULT SUICIDE PREVENTION. 

13 (a) GRANTS.— 

14 (1) AUTHORITY.—The Administrator of the 

15 Substance Abuse and Mental Health Services Ad16 ministration (referred to in this section as the ‘‘Ad17 ministrator’’) may award grants to eligible entities 

18 in order to implement suicide prevention efforts 

19 amongst adults 25 and older. 

20 (2) PURPOSE.—The grant program under this 

21 section shall be designed to raise suicide awareness, 

22 establish referral processes, and improve clinical care 

23 practice standards for treating suicide ideation, 

24 plans, and attempts among adults. 


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1 (3) RECIPIENTS.—To be eligible to receive a 

2 grant under this section, an entity shall be a com3 munity-based primary care or behavioral health care 

4 setting, an emergency department, a State mental 

5 health agency, an Indian tribe, a tribal organization, 

6 or any other entity the Administrator deems appro7 priate. 

8 (4) NATURE OF ACTIVITIES.—The grants 

9 awarded under paragraph (1) shall be used to imple10 ment programs that— 

11 (A) screen for suicide risk in adults and 

12 provide intervention and referral to treatment; 

13 (B) implement evidence-based practices to 

14 treat individuals who are at suicide risk, includ15 ing appropriate follow-up services; and 

16 (C) raise awareness, reduce stigma, and 

17 foster open dialog about suicide prevention. 

18 (b) ADDITIONAL ACTIVITIES.—The Administrator 

19 shall— 

20 (1) evaluate the activities supported by grants 

21 awarded under subsection (a) in order to further the 

22 Nation’s understanding of effective interventions to 

23 prevent suicide in adults; 

24 (2) disseminate the findings from the evaluation 

25 as the Administrator considers appropriate; and 


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1 (3) provide appropriate information, training, 

2 and technical assistance to eligible entities that re3 ceive a grant under this section, in order to help 

4 such entities to meet the requirements of this sec5 tion, including assistance with— 

6 (A) selection and implementation of evi7 dence-based interventions and frameworks to 

8 prevent suicide, such as the Zero Suicide frame9 work; and 

10 (B) other activities as the Administrator 

11 determines appropriate. 

12 (c) DURATION.—A grant under this section shall be 

13 for a period of not more than 5 years. 

14 (d) AUTHORIZATION OF APPROPRIATIONS.— 

15 (1) IN GENERAL.—There is authorized to be 

16 appropriated to carry out this section $15,000,000 

17 for each of fiscal years 2017 through 2021. 

18 (2) USE OF CERTAIN FUNDS.—Of the funds ap19 propriated to carry out this section in any fiscal 

20 year, the lesser of 5 percent of such funds or 

21 $500,000 shall be available to the Administrator for 

22 purposes of carrying out subsection (b). 

23 SEC. 113. PEER REVIEW AND ADVISORY COUNCILS. 

24 (a) IN GENERAL.—Section 501 of the Public Health 

25 Service Act (42 U.S.C. 290aa) is amended— 


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1 (1) in subsection (i), as redesignated by section 

2 102, by inserting at the end the following: ‘‘For any 

3 such peer-review group reviewing a proposal or grant 

4 related to the treatment of mental illness, no fewer 

5 than half of the members of the group shall be expe6 rienced mental health providers.’’; and 

7 (2) in subsection (m), as redesignated by sec8 tion 102— 

9 (A) in paragraph (2), by striking ‘‘and’’ at 

10 the end; and 

11 (B) in paragraph (3), by striking the pe12 riod at the end and inserting ‘‘; and’’. 

13 (b) ADVISORY COUNCILS.—Paragraph (3) of section 

14 502(b) of the Public Health Service Act (42 U.S.C. 

15 290aa–1(b)) is amended by adding at the end the fol16 lowing: 

17 ‘‘(C) No fewer than one-third of the mem18 bers of an advisory council for the Center for 

19 Mental Health Services shall be mental health 

20 care providers with— 

21 ‘‘(i) experience in mental health re22 search or treatment; and 

23 ‘‘(ii) expertise in the fields on which 

24 they are advising. 


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1 ‘‘(D) The Secretary shall adopt a policy 

2 that ensures members of advisory councils do 

3 not have conflicts of interest with any program 

4 or grant about which the members are to ad5 vise.’’. 

6 (c) PEER REVIEW.—Section 504 of the Public Health 

7 Service Act (42 U.S.C. 290aa–3) is amended— 

8 (1) by adding at the end of subsection (b) the 

9 following: ‘‘At least half of the members of any peer10 review group established under subsection (a) that 

11 pertains to the treatment of mental illness shall be 

12 licensed and experienced mental health profes13 sionals.’’; and 

14 (2) by adding at the end the following: 

15 ‘‘(e) SCIENTIFIC CONTROLS AND STANDARDS.—Peer 

16 review under this section shall ensure that any research 

17 concerning an intervention is based on scientific evidence 

18 indicating whether the intervention reduces symptoms, im19 proves medical or behavioral outcomes, or improves social 

20 functioning.’’. 

21 SEC. 114. ADULT TRAUMA. 

22 (a) GRANTS.— 

23 (1) AUTHORITY.—The Administrator of the 

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1 ministrator’’) may award grants to eligible entities 

2 in order to implement trauma-informed care in pri3 mary care and public health settings. 

4 (2) PURPOSE.—The grant program under this 

5 section shall be designed to facilitate and evaluate 

6 the impact of appropriate trauma screening and re7 sponses in primary care settings in order to further 

8 advance the Nation’s understanding of the need for 

9 addressing trauma in nonbehavioral health settings. 

10 (3) RECIPIENTS.—To be eligible to receive a 

11 grant under this section, an entity shall be a com12 munity-based, primary care setting, an academic re13 search setting in conjunction with primary care set14 tings, or any other entity the Administrator deems 

15 appropriate. 

16 (4) NATURE OF ACTIVITIES.—The grants 

17 awarded under paragraph (1) shall be used to imple18 ment programs that— 

19 (A) screen for trauma in adults, provide 

20 intervention and referral to treatment, and pro21 vide follow-up services, as appropriate; and 

22 (B) engage and involve trauma survivors, 

23 people receiving services, and family members 

24 receiving services in program design. 


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1 (5) PRACTITIONERS.—As a condition on receipt 

2 of a grant under paragraph (1), an entity shall 

3 agree that practitioners used to carry out any pro4 gram through the grant will be trained in interven5 tions that, as described in ‘‘SAMHSA’s Concept of 

6 Trauma and Guidance for a Trauma-Informed Ap7 proach’’, are— 

8 (A) based on the best available empirical 

9 evidence and science; 

10 (B) culturally appropriate; and 

11 (C) reflecting principles of a trauma-in12 formed approach. 

13 (b) ADDITIONAL ACTIVITIES.—The Director shall— 

14 (1) evaluate the activities supported by grants 

15 awarded under subsection (a) in order to further the 

16 Nation’s understanding of the need for, and com17 plexity of, addressing trauma in nonbehavioral 

18 health settings; 

19 (2) disseminate the findings from the evaluation 

20 as the Administrator considers appropriate; 

21 (3) provide appropriate information, training, 

22 and technical assistance to eligible entities that re23 ceive a grant under this section, in order to help 

24 such entities to meet the requirements of this sec25 tion, including assistance with— 


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1 (A) selection and implementation of cul2 turally appropriate, evidence-based interven3 tions that reflect the principles of trauma-in4 formed approach; 

5 (B) incorporating principles of peer sup6 port and trauma-informed care in hiring, super7 vision, and staff evaluation; 

8 (C) establishment of organizational prac9 tices and policies to support trauma-informed 

10 approaches to care; and 

11 (D) other activities as the Administrator 

12 determines appropriate. 

13 (c) DURATION.—A grant under this section shall be 

14 for a period of not more than 5 years. 

15 (d) AUTHORIZATION OF APPROPRIATIONS.— 

16 (1) IN GENERAL.—There is authorized to be 

17 appropriated to carry out this section $3,000,000 for 

18 each of fiscal years 2017 through 2021. 

19 (2) USE OF CERTAIN FUNDS.—Of the funds ap20 propriated to carry out this section in any fiscal 

21 year, the lesser of 5 percent of such funds or 

22 $500,000 shall be available to the Director for pur23 poses of carrying out subsection (b). 


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1 SEC. 115. REDUCING THE STIGMA OF SERIOUS MENTAL ILL2 NESS. 

3 (a) IN GENERAL.—The Secretary of Health and 

4 Human Services and the Secretary of Education shall or5 ganize a national awareness campaign involving public 

6 health organizations, advocacy groups for persons with se7 rious mental illness or serious emotional disturbance, and 

8 social media companies to assist secondary school students 

9 and postsecondary students in— 

10 (1) reducing the stigma associated with serious 

11 mental illness and serious emotional disturbance; 

12 (2) understanding how to assist an individual 

13 who is demonstrating signs of a serious mental ill14 ness or serious emotional disturbance; and 

15 (3) understanding the importance of seeking 

16 treatment from a physician, clinical psychologist, 

17 psychiatric nurse practitioner, or licensed mental 

18 health professional when a student believes the stu19 dent may be suffering from a serious mental illness, 

20 serious emotional disturbance, or behavioral health 

21 disorder. 

22 (b) DATA COLLECTION.—The Secretary of Health 

23 and Human Services shall evaluate the program under 

24 subsection (a) on public health to determine whether the 

25 program has made an impact on public health, such as 

26 reducing mortality rates of persons with serious mental 


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1 illness or serious emotional disturbance, the prevalence of 

2 serious mental illness and serious emotional disturbance, 

3 physician and clinical psychological visits, and emergency 

4 room visits for psychiatric services. 

5 (c) SECONDARY SCHOOL DEFINED.—For purposes of 

6 this section, the term ‘‘secondary school’’ has the meaning 

7 given the term in section 9101 of the Elementary and Sec8 ondary Education Act of 1965 (20 U.S.C. 7801). 

9 (d) AUTHORIZATION OF APPROPRIATIONS.—To carry 

10 out this section, there is authorized to be appropriated 

11 $1,000,000 for each of fiscal years 2017 through 2021. 

12 SEC. 116. REPORT ON MENTAL HEALTH AND SUBSTANCE 

13 ABUSE TREATMENT IN THE STATES. 

14 (a) IN GENERAL.—Not later than 18 months after 

15 the date of enactment of this Act, and not less than every 

16 2 years thereafter, the Secretary of Health and Human 

17 Services shall submit to the Congress and make available 

18 to the public a report on mental health and substance use 

19 treatment in the States, including the following: 

20 (1) A detailed report on how Federal mental 

21 health and substance use treatment funds are used 

22 in each State including: 

23 (A) The numbers of individuals with men24 tal illness, serious mental illness, serious emo25 tional disturbance, substance use disorders, or 


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1 co-occurring disorders who are served with Fed2 eral funds. 

3 (B) The types of programs made available 

4 to individuals with mental illness, serious men5 tal illness, substance use disorders, or co-occur6 ring disorders. 

7 (2) A summary of best practice models in the 

8 States highlighting programs that are cost effective, 

9 provide evidence-based care, increase access to care, 

10 integrate physical, psychiatric, psychological, and be11 havioral medicine, and improve outcomes for individ12 uals with mental illness or substance use disorders. 

13 (3) A statistical report of outcome measures in 

14 each State, for individuals with mental illness, seri15 ous mental illness, substance use disorders, and co16 occurring disorders, such as— 

17 (A) rates of suicide, suicide attempts, sub18 stance abuse, overdose, overdose deaths, health 

19 outcomes, emergency psychiatric hospitaliza20 tions, and emergency room boarding; and 

21 (B) arrests, incarcerations, victimization, 

22 homelessness, joblessness, employment, and en23 rollment in educational or vocational programs. 

24 (b) DEFINITION.—In this subsection, the term 

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1 ting patients to an emergency department and holding 

2 them in the department until inpatient psychiatric beds 

3 become available. 

4 SEC. 117. MENTAL HEALTH FIRST AID TRAINING GRANTS. 

5 Section 520J of the Public Health Service Act (42 

6 U.S.C. 290bb–41) is amended to read as follows: 

7 ‘‘SEC. 520J. MENTAL HEALTH FIRST AID TRAINING GRANTS. 

8 ‘‘(a) GRANTS.—The Secretary, acting through the 

9 Administrator, shall award grants to States, political sub10 divisions of States, Indian tribes, tribal organizations, and 

11 nonprofit private entities to initiate and sustain mental 

12 health first aid training programs. 

13 ‘‘(b) PROGRAM REQUIREMENTS.— 

14 ‘‘(1) IN GENERAL.—To be eligible for funding 

15 under subsection (a), a mental health first aid train16 ing program shall— 

17 ‘‘(A) be designed to train individuals in the 

18 categories listed in paragraph (2) to accomplish 

19 the objectives described in paragraph (3); 

20 ‘‘(B) ensure that training is conducted by 

21 trainers that are properly licensed and 

22 credentialed by nonprofit entities as designated 

23 by the Secretary; and 

24 ‘‘(C) include— 

25 ‘‘(i) at a minimum— 


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1 ‘‘(I) a core live training course 

2 for individuals in the categories listed 

3 in paragraph (2) on the skills, re4 sources, and knowledge to assist indi5 viduals in crisis to connect with ap6 propriate local mental health care 

7 services; 

8 ‘‘(II) training on mental health 

9 resources, including the location of 

10 community mental health centers de11 scribed in section 1913(c), in the 

12 State and local community; and 

13 ‘‘(III) training on action plans 

14 and protocols for referral to such re15 sources; and 

16 ‘‘(ii) where feasible, continuing edu17 cation and updated training for individuals 

18 in the categories listed in paragraph (2). 

19 ‘‘(2) CATEGORIES OF INDIVIDUALS TO BE

20 TRAINED.—The categories of individuals listed in 

21 this paragraph are the following: 

22 ‘‘(A) Emergency services personnel and 

23 other first responders. 

24 ‘‘(B) Police officers and other law enforce25 ment personnel. 


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1 ‘‘(C) Teachers and school administrators. 

2 ‘‘(D) Human resources professionals. 

3 ‘‘(E) Faith community leaders. 

4 ‘‘(F) Nurses and other primary care per5 sonnel. 

6 ‘‘(G) Students enrolled in an elementary 

7 school, a secondary school, or an institution of 

8 higher education. 

9 ‘‘(H) The parents of students described in 

10 subparagraph (G). 

11 ‘‘(I) Veterans. 

12 ‘‘(J) Other individuals, audiences or train13 ing populations as determined appropriate by 

14 the Secretary. 

15 ‘‘(3) OBJECTIVES OF TRAINING.—To be eligible 

16 for funding under subsection (a), a mental health 

17 first aid training program shall be designed to train 

18 individuals in the categories listed in paragraph (2) 

19 to accomplish each of the following objectives (as ap20 propriate for the individuals to be trained, taking 

21 into consideration their age): 

22 ‘‘(A) Safe de-escalation of crisis situations. 

23 ‘‘(B) Recognition of the signs and symp24 toms of mental illness, including such common 

25 psychiatric conditions as schizophrenia, bipolar 


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1 disorder, major clinical depression, and anxiety 

2 disorders. 

3 ‘‘(C) Timely referral to mental health serv4 ices in the early stages of developing mental 

5 disorders in order to— 

6 ‘‘(i) avoid more costly subsequent be7 havioral health care; and 

8 ‘‘(ii) enhance the effectiveness of men9 tal health services. 

10 ‘‘(c) DISTRIBUTION OF AWARDS.—In awarding 

11 grants under this section, the Secretary shall— 

12 ‘‘(1) ensure that grants are equitably distrib13 uted among the geographical regions of the United 

14 States; and 

15 ‘‘(2) pay particular attention to the mental 

16 health training needs of populations and target audi17 ences residing in rural areas. 

18 ‘‘(d) APPLICATION.—A State, political subdivision of 

19 a State, Indian tribe, tribal organization, or nonprofit pri20 vate entity that desires a grant under this section shall 

21 submit an application to the Secretary at such time, in 

22 such manner, and containing such information as the Sec23 retary may require, including a plan for the rigorous eval24 uation of activities that are carried out with funds received 

25 under such grant. 


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1 ‘‘(e) EVALUATION.—A State, political subdivision of 

2 a State, Indian tribe, tribal organization, or nonprofit pri3 vate entity that receives a grant under this section shall 

4 prepare and submit an evaluation to the Secretary at such 

5 time, in such manner, and containing such information as 

6 the Secretary may reasonably require, including an evalua7 tion of activities carried out with funds received under 

8 such grant and a process and outcome evaluation. 

9 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

10 carry out this section, there are authorized to be appro11 priated $20,000,000 for each of fiscal years 2017 through 

12 2021.’’. 

13 SEC. 118. ACUTE CARE BED REGISTRY GRANT FOR STATES. 

14 (a) IN GENERAL.—The Secretary of Health and 

15 Human Services, acting through the Administrator of the 

16 Substance Abuse and Mental Health Services Administra17 tion, shall award grants to State mental health agencies 

18 to develop and administer, or maintain an existing, real19 time Internet-based bed registry described in subsection 

20 (b), to collect, aggregate, and display information about 

21 available beds in public and private inpatient psychiatric 

22 facilities and public and private residential crisis stabiliza23 tion units, and residential community mental health and 

24 residential substance abuse treatment facilities to facili25 tate the identification and designation of facilities for the 


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1 temporary treatment of individuals in psychiatric or sub2 stance abuse crisis. 

3 (b) REGISTRY REQUIREMENTS.—A bed registry de4 scribed in this subsection is a registry that— 

5 (1) includes descriptive information for every 

6 public and private inpatient psychiatric facility, 

7 every public and private residential crisis stabiliza8 tion unit, and residential community mental health 

9 and residential substance abuse facility in the State 

10 involved, including contact information for the facil11 ity or unit; 

12 (2) provides real-time information about the 

13 number of beds available at each facility or unit and, 

14 for each available bed, the type of patient that may 

15 be admitted, the level of security provided, and any 

16 other information that may be necessary to allow for 

17 the proper identification of appropriate facilities for 

18 treatment of individuals in psychiatric or substance 

19 abuse crisis; and 

20 (3) allows employees and designees of commu21 nity mental health and substance abuse service pro22 viders, employees of inpatient psychiatric facilities, 

23 public and private residential crisis stabilization 

24 units, or residential substance abuse treatment fa25 cilities, and health care providers working in an 


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1 emergency room of a hospital or clinic or other facil2 ity rendering emergency medical care to perform 

3 searches of the registry to identify available beds 

4 that are appropriate for the treatment of individuals 

5 in psychiatric crisis or substance abuse crisis. 

6 (c) AUTHORIZATION OF APPROPRIATIONS.—To carry 

7 out this section, there are authorized to be appropriated 

8 $15,000,000 for each of fiscal years 2017 through 2021. 

9 SEC. 119. OLDER ADULT MENTAL HEALTH GRANTS. 

10 (a) IN GENERAL.—The Secretary of Health and 

11 Human Services, acting through the Director of the Cen12 ter for Mental Health Services, shall award grants, con13 tracts, or cooperative agreements to public and private 

14 nonprofit entities for projects that address the mental 

15 health needs of older adults, including programs to— 

16 (1) support the establishment and maintenance 

17 of interdisciplinary geriatric mental health specialist 

18 outreach teams in community settings where older 

19 adults reside or receive social services, in order to 

20 provide screening, referrals, and evidence-based 

21 intervention and treatment services, including serv22 ices provided by licensed mental health professionals; 

23 (2) develop and implement older adult suicide 

24 early intervention and prevention strategies in 1 or 

25 more settings that serve seniors, and collect and 


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1 analyze data on older adult suicide early intervention 

2 and prevention services for purposes of monitoring, 

3 research, and policy development; and 

4 (3) otherwise improve the mental health of 

5 older adults, as determined by the Secretary. 

6 (b) CONSIDERATIONS IN AWARDING GRANTS.—In 

7 awarding grants under this section, the Secretary, to the 

8 extent feasible, shall ensure that— 

9 (1) projects are funded in a variety of geo10 graphic areas, including urban and rural areas; 

11 (2) a variety of populations, including racial 

12 and ethnic minorities and low-income populations, 

13 are served by projects funded under this section; and 

14 (3) older adult suicide intervention and preven15 tion programs are targeted towards areas with high 

16 older adult suicide rates. 

17 (c) APPLICATION.—To be eligible to receive a grant 

18 under this section, a public or private nonprofit entity 

19 shall— 

20 (1) submit an application to the Secretary (in 

21 such form, containing such information, and at such 

22 time as the Secretary may specify); 

23 (2) agree to report to the Secretary standard24 ized clinical and behavioral data or other perform25 ance data necessary to evaluate patient or program 


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1 outcomes and to facilitate evaluations across partici2 pating projects; and 

3 (3) demonstrate how such applicant will col4 laborate with other State and local public and pri5 vate nonprofit organizations. 

6 (d) DURATION.—A project may receive funding under 

7 a grant under this section for a period of up to 3 years, 

8 and such funding may be extended for a period of 2 addi9 tional years, at the discretion of the Secretary. 

10 (e) SUPPLEMENT, NOT SUPPLANT.—Funds made 

11 available under this section shall be used to supplement, 

12 and not supplant, other Federal, State, or local funds 

13 available to an entity to carry out activities described in 

14 this section. 

15 (f) REPORT.—Grantees under this section shall, be16 ginning with the end of the second year of the grant, sub17 mit yearly reports to the Secretary on the activities of the 

18 grantee in support of the grant and the latest performance 

19 data. Such reports shall contain recommendations as how 

20 to replicate the project funded through the grant. 

21 (g) DEFINITIONS.—In this section, the term ‘‘older 

22 adult’’ has the meaning given the term ‘‘older individual’’ 

23 in section 102 of the Older Americans Act of 1965 (42 

24 U.S.C. 3002). 


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1 (h) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated to carry out this section, 

3 $5,000,000 for each of fiscal years 2017 through 2021. 

4 TITLE II—INTERAGENCY SERI5 OUS MENTAL ILLNESS CO6 ORDINATING COMMITTEE 

7 SEC. 201. INTERAGENCY SERIOUS MENTAL ILLNESS CO8 ORDINATING COMMITTEE. 

9 Title V of the Public Health Service Act, as amended 

10 by section 101, is further amended by inserting after sec11 tion 501 of such Act the following: 

12 ‘‘SEC. 501A. INTERAGENCY SERIOUS MENTAL ILLNESS CO13 ORDINATING COMMITTEE. 

14 ‘‘(a) ESTABLISHMENT.—The Assistant Secretary for 

15 Mental Health and Substance Use Disorders (in this sec16 tion referred to as the ‘Assistant Secretary’) shall estab17 lish a committee, to be known as the Interagency Serious 

18 Mental Illness Coordinating Committee (in this section re19 ferred to as the ‘Committee’), to assist the Assistant Sec20 retary in carrying out the Assistant Secretary’s duties. 

21 ‘‘(b) RESPONSIBILITIES.—The Committee, in coordi22 nation with the Assistant Secretary, shall— 

23 ‘‘(1) develop and annually update a summary of 

24 advances in serious mental illness research related to 

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1 nosis or rule out, intervention, and access to services 

2 and supports for individuals with serious mental ill3 ness; 

4 ‘‘(2) monitor Federal activities with respect to 

5 serious mental illness; 

6 ‘‘(3) make recommendations to the Assistant 

7 Secretary regarding any appropriate changes to such 

8 activities, including recommendations with respect to 

9 the strategic plan developed under paragraph (5); 

10 ‘‘(4) make recommendations to the Assistant 

11 Secretary regarding public participation in decisions 

12 relating to serious mental illness; 

13 ‘‘(5) develop and update every 5 years a stra14 tegic plan for the conduct and support of programs 

15 and services to assist individuals with serious mental 

16 illness, including— 

17 ‘‘(A) a summary of the advances in serious 

18 mental illness research developed under para19 graph (1); 

20 ‘‘(B) a list of the Federal programs and 

21 activities identified under paragraph (2); 

22 ‘‘(C) an analysis of the efficiency, effective23 ness, quality, coordination, and cost-effective24 ness of Federal programs and activities relating 

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1 bilitation of serious mental illness, including an 

2 accounting of the costs of such programs and 

3 activities with administrative costs 

4 disaggregated from the costs of services and 

5 care; and 

6 ‘‘(D) a plan with recommendations— 

7 ‘‘(i) for the coordination and improve8 ment of Federal programs and activities 

9 related to serious mental illness, including 

10 budgetary requirements; 

11 ‘‘(ii) for improving outcomes for indi12 viduals with a serious mental illness in13 cluding appropriate benchmarks to meas14 ure progress on achieving improvements; 

15 ‘‘(iii) for the mental health workforce; 

16 ‘‘(iv) to disseminate relevant informa17 tion developed by the coordinating com18 mittee to the public, health care providers, 

19 social service providers, public health offi20 cials, courts, law enforcement, and other 

21 relevant groups; 

22 ‘‘(v) to identify research needs, includ23 ing longitudinal studies of pediatric popu24 lations; and 


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1 ‘‘(vi) for vulnerable and underserved 

2 populations, including pediatric popu3 lations, geriatric populations, and racial, 

4 ethnic, sexual, and gender minorities; and 

5 ‘‘(6) submit to the Congress such strategic plan 

6 and any updates to such plan. 

7 ‘‘(c) MEMBERSHIP.— 

8 ‘‘(1) IN GENERAL.—The Committee shall be 

9 composed of— 

10 ‘‘(A) the Assistant Secretary for Mental 

11 Health and Substance Use Disorders (or the 

12 Assistant Secretary’s designee), who shall serve 

13 as the Chair of the Committee; 

14 ‘‘(B) the Director of the National Institute 

15 of Mental Health (or the Director’s designee); 

16 ‘‘(C) the Attorney General of the United 

17 States (or the Attorney General’s designee); 

18 ‘‘(D) the Director of the Centers for Dis19 ease Control and Prevention (or the Director’s 

20 designee); 

21 ‘‘(E) the Director of the National Insti22 tutes of Health (or the Director’s designee); 

23 ‘‘(F) the Director of the Indian Health 

24 Service; 


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1 ‘‘(G) a member of the United States Inter2 agency Council on Homelessness; 

3 ‘‘(H) the Administrator of the Centers for 

4 Medicare & Medicaid Service (or the Adminis5 trator’s designee); 

6 ‘‘(I) the Secretary of Defense (or the Sec7 retary’s designee); 

8 ‘‘(J) the Secretary of Education (or the 

9 Secretary’s designee); 

10 ‘‘(K) the Secretary of Labor (or the Sec11 retary’s designee); 

12 ‘‘(L) the Secretary of Veterans Affairs (or 

13 the Secretary’s designee); 

14 ‘‘(M) the Commissioner of the Social Secu15 rity Administration (or the Commissioner’s des16 ignee); and 

17 ‘‘(N) the additional members appointed 

18 under paragraph (2). 

19 ‘‘(2) ADDITIONAL MEMBERS.—Not fewer than 

20 members of the Committee, or 1 20 ⁄3 of the total 

21 membership of the Committee, whichever is greater, 

22 shall be composed of non-Federal public members to 

23 be appointed by the Assistant Secretary, of which— 

24 ‘‘(A) at least five such members shall be 

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1 rious mental illness who has benefited from 

2 medical treatment under the care of a licensed 

3 mental health professional; 

4 ‘‘(B) at least three such members shall be 

5 a parent or legal guardian of an individual with 

6 a history of serious mental illness, including at 

7 least one of whom is the parent or legal guard8 ian of a child who has either attempted suicide 

9 or is incarcerated for a crime committed while 

10 experiencing a serious mental illness or serious 

11 emotional disturbance; 

12 ‘‘(C) at least one such member shall be a 

13 representative of a leading research, advocacy, 

14 and service organization for individuals with se15 rious mental illness; 

16 ‘‘(D) at least one such member shall be— 

17 ‘‘(i) a licensed psychiatrist with expe18 rience treating serious mental illness; or 

19 ‘‘(ii) a licensed clinical psychologist 

20 with experience treating serious mental ill21 ness; 

22 ‘‘(E) at least one member shall be a li23 censed mental health counselor or 

24 psychotherapist; 


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1 ‘‘(F) at least one member shall be a li2 censed clinical social worker; 

3 ‘‘(G) at least one member shall be a li4 censed psychiatric nurse or nurse practitioner; 

5 ‘‘(H) at least one member shall be a men6 tal health professional with a significant focus 

7 in his or her practice working with children and 

8 adolescents; 

9 ‘‘(I) at least one member shall be a mental 

10 health professional who spends a significant 

11 concentration of his or her professional time or 

12 leadership practicing community mental health; 

13 ‘‘(J) at least one member shall be a mental 

14 health professional with substantial experience 

15 working with mentally ill individuals who have 

16 a history of violence or suicide; 

17 ‘‘(K) at least one such member shall be a 

18 State certified mental health peer specialist; 

19 ‘‘(L) at least one member shall be a judge 

20 with experience adjudicating cases related to 

21 criminal justice and serious mental illness; 

22 ‘‘(M) at least one member shall be a law 

23 enforcement officer with extensive experience in 

24 interfacing with psychiatric and psychological 


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1 disorders or individuals in mental health crisis; 

2 and 

3 ‘‘(N) at least one member shall be a cor4 rections officer with extensive experience in 

5 interfacing with psychiatric and psychological 

6 disorders or individuals in mental health crisis. 

7 ‘‘(d) REPORTS TO CONGRESS.—Not later than 2 

8 years after the date of enactment of this Act, and every 

9 3 years thereafter, the Committee shall submit a report 

10 to the Congress— 

11 ‘‘(1) evaluating the impact of projects address12 ing priority mental health needs of regional and na13 tional significance under sections 501, 509, 516, and 

14 520A including measurement of public health out15 comes such as— 

16 ‘‘(A) reduced rates of suicide, suicide at17 tempts, substance abuse, overdose, overdose 

18 deaths, emergency hospitalizations, emergency 

19 room boarding, incarceration, crime, arrest, vic20 timization, homelessness, and joblessness; 

21 ‘‘(B) increased rates of employment and 

22 enrollment in educational and vocational pro23 grams; and 

24 ‘‘(C) such other criteria as may be deter25 mined by the Assistant Secretary; 


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1 ‘‘(2) formulating recommendations for the co2 ordination and improvement of Federal programs 

3 and activities that affect individuals with serious 

4 mental illness; 

5 ‘‘(3) identifying any such programs and activi6 ties that are duplicative; and 

7 ‘‘(4) summarizing all recommendations made, 

8 activities carried out, and results achieved pursuant 

9 to the workforce development strategy under section 

10 501. 

11 ‘‘(e) ADMINISTRATIVE SUPPORT; TERMS OF SERV12 ICE; OTHER PROVISIONS.—The following provisions shall 

13 apply with respect to the Committee: 

14 ‘‘(1) The Assistant Secretary shall provide such 

15 administrative support to the Committee as may be 

16 necessary for the Committee to carry out its respon17 sibilities. 

18 ‘‘(2) Members of the Committee appointed 

19 under subsection (c)(2) shall serve for a term of 4 

20 years, and may be reappointed for one or more addi21 tional 4-year terms. Any member appointed to fill a 

22 vacancy for an unexpired term shall be appointed for 

23 the remainder of such term. A member may serve 

24 after the expiration of the member’s term until a 

25 successor has taken office. 


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1 ‘‘(3) The Committee shall meet at the call of 

2 the chair or upon the request of the Assistant Sec3 retary. The Committee shall meet not fewer than 2 

4 times each year. 

5 ‘‘(4) All meetings of the Committee shall be 

6 public and shall include appropriate time periods for 

7 questions and presentations by the public. 

8 ‘‘(f) SUBCOMMITTEES; ESTABLISHMENT AND MEM9 BERSHIP.—In carrying out its functions, the Committee 

10 may establish subcommittees and convene workshops and 

11 conferences. Such subcommittees shall be composed of 

12 Committee members and may hold such meetings as are 

13 necessary to enable the subcommittees to carry out their 

14 duties. 

15 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

16 is authorized to be appropriated $1,000,000 to carry out 

17 the staffing functions under subsection (e)(1) for each of 

18 fiscal years 2017 through 2021.’’. 


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1 TITLE III—COMMUNICATIONS 

2 BETWEEN INDIVIDUALS, FAM3 ILIES, AND PROVIDERS 

4 SEC. 301. CLARIFICATION OF CIRCUMSTANCES UNDER 

5 WHICH DISCLOSURE OF PROTECTED HEALTH 

6 INFORMATION OF MENTAL ILLNESS PA7 TIENTS IS PERMITTED. 

8 The HITECH Act (title XIII of division A of Public 

9 Law 111–5) is amended by adding at the end of subtitle 

10 D of such Act (42 U.S.C. 17921 et seq.) the following: 

11 ‘‘PART 3—IMPROVED PRIVACY AND SECURITY 

12 PROVISIONS FOR MENTAL ILLNESS PATIENTS 

13 ‘‘SEC. 13431. CLARIFICATION OF CIRCUMSTANCES UNDER 

14 WHICH DISCLOSURE OF PROTECTED HEALTH 

15 INFORMATION IS PERMITTED. 

16 ‘‘(a) IN GENERAL.—Not later than one year after the 

17 date of enactment of this section, the Secretary shall pro18 mulgate final regulations clarifying the circumstances 

19 under which, consistent with the standards governing the 

20 privacy and security of individually identifiable health in21 formation promulgated by the Secretary under sections 

22 262(a) and 264 of the Health Insurance Portability and 

23 Accountability Act of 1996, health care providers and cov24 ered entities may disclose the protected health information 


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1 of patients with a mental illness, including for purposes 

2 of— 

3 ‘‘(1) communicating with a patient’s family, 

4 caregivers, friends, or others involved in the pa5 tient’s care, including communication about treat6 ments, side effects, risk factors, and the availability 

7 of community resources; 

8 ‘‘(2) communicating with family or caregivers 

9 when the patient is an adult; 

10 ‘‘(3) communicating with the parent or care11 giver of a patient who is a minor; 

12 ‘‘(4) considering the patient’s capacity to agree 

13 or object to the sharing of their information; 

14 ‘‘(5) communicating and sharing information 

15 with a patient’s family or caregivers when— 

16 ‘‘(A) the patient consents; or 

17 ‘‘(B) the patient does not consent, but the 

18 patient lacks the capacity to agree or object and 

19 the communication or sharing of information is 

20 in the patient’s best interest; 

21 ‘‘(6) involving a patient’s family members, 

22 friends, or caregivers, or others involved in the pa23 tient’s care in the patient’s care plan, including 

24 treatment and medication adherence, in dealing with 


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1 patient failures to adhere to medication or other 

2 therapy; 

3 ‘‘(7) listening to or receiving information from 

4 family members or caregivers about their loved ones 

5 receiving mental illness treatment; 

6 ‘‘(8) communicating with family members, care7 givers, law enforcement, or others when the patient 

8 presents a serious and imminent threat of harm to 

9 self or others; and 

10 ‘‘(9) communicating to law enforcement and 

11 family members or caregivers about the admission of 

12 a patient to receive care at a facility or the release 

13 of a patient who was admitted to a facility for an 

14 emergency psychiatric hold or involuntary treatment. 

15 ‘‘(b) COORDINATION.—The Secretary shall carry out 

16 this section in coordination with the Director of the Office 

17 for Civil Rights within the Department of Health and 

18 Human Services. 

19 ‘‘(c) CONSISTENCY WITH GUIDANCE.—The Secretary 

20 shall ensure that the regulations under this section are 

21 consistent with the guidance entitled ‘HIPAA Privacy 

22 Rule and Sharing Information Related to Mental Health’, 

23 issued by the Department of Health and Human Services 

24 on February 20, 2014.’’. 


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1 SEC. 302. DEVELOPMENT AND DISSEMINATION OF MODEL 

2 TRAINING PROGRAMS. 

3 (a) INITIAL PROGRAMS AND MATERIALS.—Not later 

4 than one year after promulgating final regulations under 

5 section 13431 of the HITECH Act, as added by section 

6 301, the Secretary of Health and Human Services (in this 

7 section referred to as the ‘‘Secretary’’) shall develop and 

8 disseminate— 

9 (1) a model program and materials for training 

10 health care providers (including physicians, emer11 gency medical personnel, psychologists, counselors, 

12 therapists, behavioral health facilities and clinics, 

13 care managers, and hospitals) regarding the cir14 cumstances under which, consistent with the stand15 ards governing the privacy and security of individ16 ually identifiable health information promulgated by 

17 the Secretary under sections 262(a) and 264 of the 

18 Health Insurance Portability and Accountability Act 

19 of 1996, the protected health information of patients 

20 with a mental illness may be disclosed with and 

21 without patient consent; 

22 (2) a model program and materials for training 

23 lawyers and others in the legal profession on such 

24 circumstances; and 

25 (3) a model program and materials for training 

26 patients and their families regarding their rights to 


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1 protect and obtain information under the standards 

2 specified in paragraph (1). 

3 (b) PERIODIC UPDATES.—The Secretary shall— 

4 (1) periodically review and update the model 

5 programs and materials developed under subsection 

6 (a); and 

7 (2) disseminate the updated model programs 

8 and materials. 

9 (c) CONTENTS.—The programs and materials devel10 oped under subsection (a) shall address the guidance enti11 tled ‘‘HIPAA Privacy Rule and Sharing Information Re12 lated to Mental Health’’, issued by the Department of 

13 Health and Human Services on February 20, 2014. 

14 (d) COORDINATION.—The Secretary shall carry out 

15 this section in coordination with the Director of the Office 

16 for Civil Rights within the Department of Health and 

17 Human Services, the Administrator of the Substance 

18 Abuse and Mental Health Services Administration, the 

19 Administrator of the Health Resources and Services Ad20 ministration, and the heads of other relevant agencies 

21 within the Department of Health and Human Services. 

22 (e) INPUT OF CERTAIN ENTITIES.—In developing the 

23 model programs and materials required by subsections (a) 

24 and (b), the Secretary shall solicit the input of relevant 


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1 national, State, and local associations, medical societies, 

2 and licensing boards. 

3 (f) FUNDING.—There is authorized to be appro4 priated to carry out this section $5,000,000 for fiscal year 

5 2017 and $25,000,000 for the period of fiscal years 2018 

6 through 2023. 

7 SEC. 303. MODERNIZING PRIVACY PROTECTIONS. 

8 Not later than two years after the date of the enact9 ment of this Act, the Secretary of Health and Human 

10 Services shall issue a final rule modernizing the privacy 

11 protections under section 543 of the Public Health Service 

12 Act (42 U.S.C. 290dd–2). 

13 SEC. 304. IMPROVING COMMUNICATION WITH INDIVID14 UALS, FAMILIES, AND PROVIDERS. 

15 (a) GRANTS.— 

16 (1) AUTHORITY.—The Secretary of Health and 

17 Human Services, acting through the Administrator 

18 of the Substance Abuse and Mental Health Services 

19 Administration, shall award grants to eligible enti20 ties for the implementation of pilot programs de21 signed to enhance care and promote recovery by sup22 porting communication between individuals in treat23 ment, their families, providers, and other individuals 

24 involved in their care. 


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1 (2) RECIPIENTS.—To be eligible to receive a 

2 grant under this section, an entity shall be a State, 

3 county, city, tribe, tribal organization, institutions of 

4 higher education, public organization, or private 

5 nonprofit organizations. 

6 (3) NATURE OF ACTIVITIES.—The grants 

7 awarded under paragraph (1) shall be used to imple8 ment evidence-based or innovative programs, such as 

9 Adapted or Open Dialogue, that enhance care and 

10 promote recovery by supporting communities be11 tween individuals and those involved in their treat12 ment, care, and support. 

13 (b) ADDITIONAL ACTIVITIES.—The Secretary shall— 

14 (1) evaluate the activities supported by grants 

15 awarded under subsection (a) in order to further the 

16 Nation’s understanding of effective communication 

17 strategies between individuals with mental illness 

18 and their families and health care providers; 

19 (2) disseminate the findings from the evaluation 

20 as the Secretary considers appropriate; 

21 (3) make recommendations for scaling up suc22 cessful models across the country, including in pub23 licly funded programs; and 

24 (4) other activities as the Secretary determines 

25 appropriate. 


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1 (c) DURATION.—A grant under this section shall be 

2 for a period of not more than 5 years. 

3 (d) AUTHORIZATION OF APPROPRIATIONS.— 

4 (1) IN GENERAL.—There is authorized to be 

5 appropriated to carry out this section $2,000,000 for 

6 each of fiscal years 2017 through 2021. 

7 (2) USE OF CERTAIN FUNDS.—Of the funds ap8 propriated to carry out this section in any fiscal 

9 year, no more than 5 percent shall be available to 

10 the Secretary for the purposes of carrying out sub11 section (b). 

12 TITLE IV—IMPROVING MED13 ICAID AND MEDICARE MEN14 TAL HEALTH SERVICES 

15 Subtitle A—Medicaid Provisions 

16 SEC. 401. ENHANCED MEDICAID COVERAGE RELATING TO 

17 CERTAIN MENTAL HEALTH SERVICES. 

18 (a) MEDICAID COVERAGE OF MENTAL HEALTH

19 SERVICES AND PRIMARY CARE SERVICES FURNISHED ON

20 THE SAME DAY.—Section 1902 of the Social Security Act 

21 (42 U.S.C. 1396a) is amended— 

22 (1) in subsection (a), by inserting after para23 graph (77) the following new paragraph: 

24 ‘‘(78) in the case of a State that does not have 

25 in effect (as of the date of the enactment of this 


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1 paragraph) under its State plan a payment method2 ology that allows for full reimbursement of all same3 day qualifying services through a single payment, 

4 not prohibit payment under the plan for a mental 

5 health service or primary care service furnished to 

6 an individual at a community mental health center 

7 meeting the criteria specified in section 1913(c) of 

8 the Public Health Service Act or a federally qualified 

9 health center (as defined in section 1861(aa)(3)) for 

10 which payment would otherwise be payable under 

11 the plan, with respect to such individual, if such 

12 service were not a same-day qualifying service (as 

13 defined in subsection (ll));’’; and 

14 (2) by adding at the end the following new sub15 section: 

16 ‘‘(ll) SAME-DAY QUALIFYING SERVICES DEFINED.— 

17 For purposes of subsection (a)(78), the term ‘same-day 

18 qualifying service’ means— 

19 ‘‘(1) a primary care service furnished to an in20 dividual by a provider at a facility on the same day 

21 a mental health service is furnished to such indi22 vidual by such provider (or another provider) at the 

23 facility; and 

24 ‘‘(2) a mental health service furnished to an in25 dividual by a provider at a facility on the same day 


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1 a primary care service is furnished to such individual 

2 by such provider (or another provider) at the facil3 ity.’’. 

4 (b) PROVIDING FULL-RANGE OF EPSDT SERVICES

5 TO CHILDREN IN IMDS.—Section 1905(h) of the Social 

6 Security Act (42 U.S.C. 1396d(h)) is amended by adding 

7 at the end the following new paragraph: 

8 ‘‘(3) Such term includes the full-range of early and 

9 periodic screening, diagnostic, and treatment services (as 

10 defined in subsection (r)).’’. 

11 (c) OPTIONAL LIMITED COVERAGE OF INPATIENT

12 SERVICES FURNISHED IN INSTITUTIONS FOR MENTAL

13 DISEASES.—Section 1903(m)(2) of the Social Security 

14 Act (42 U.S.C. 1396b(m)(2)) is amended by adding at the 

15 end the following new subparagraph: 

16 ‘‘(I)(i) Notwithstanding the limitation specified in the 

17 subdivision (B) following paragraph (29) of section 

18 1905(a), beginning on the date of the enactment of this 

19 subparagraph, a State may provide, as part of the monthly 

20 capitated payment made by the State under this title to 

21 a medicaid managed care organization or a prepaid inpa22 tient health plan (as defined in section 438.2 of title 42, 

23 Code of Federal Regulations (or any successor regula24 tion)), for payment for limited inpatient psychiatric hos25 pital services provided by such organization or health plan, 


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1 at the option of the individual receiving such services, in 

2 lieu of services covered under the State plan during the 

3 month for which the payment is made. 

4 ‘‘(ii) In this subparagraph, the term ‘limited inpatient 

5 psychiatric hospital services’ means the services described 

6 in subparagraphs (A) and (B) of section 1905(h)(1)— 

7 ‘‘(I) that are furnished to individuals over 21 

8 years of age and under 65 years of age in an institu9 tion for mental diseases (as defined in section 

10 1905(i)) that is an inpatient hospital facility or a 

11 sub-acute care facility providing crisis residential 

12 services (as defined by the Secretary); and 

13 ‘‘(II) for which the length of stay in such an in14 stitution is for a short-term stay of not more than 

15 15 days during the month for which the capitated 

16 payment referred to in clause (i) is made.’’. 

17 (d) EFFECTIVE DATE.— 

18 (1) IN GENERAL.—Subject to paragraph (2), 

19 the amendments made by subsections (a) and (b) 

20 shall apply to items and services furnished after the 

21 date of the enactment of this section. 

22 (2) EXCEPTION FOR STATE LEGISLATION.—In 

23 the case of a State plan under title XIX of the So24 cial Security Act, which the Secretary of Health and 

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1 tion in order for the respective plan to meet any re2 quirement imposed by amendments made by sub3 sections (a) and (b), the respective plan shall not be 

4 regarded as failing to comply with the requirements 

5 of such title solely on the basis of its failure to meet 

6 such an additional requirement before the first day 

7 of the first calendar quarter beginning after the 

8 close of the first regular session of the State legisla9 ture that begins after the date of enactment of this 

10 Act. For purposes of the previous sentence, in the 

11 case of a State that has a 2-year legislative session, 

12 each year of the session shall be considered to be a 

13 separate regular session of the State legislature. 

14 SEC. 402. EXTENSION AND EXPANSION OF DEMONSTRA15 TION PROGRAMS TO IMPROVE COMMUNITY 

16 MENTAL HEALTH SERVICES. 

17 Paragraph (3) of section 223(d) of the Protecting Ac18 cess to Medicare Act of 2014 (Public Law 113–93; 128 

19 Stat. 1077) is amended to read as follows: 

20 ‘‘(3) NUMBER AND LENGTH OF DEMONSTRA21 TION PROGRAMS.— 

22 ‘‘(A) IN GENERAL.—Except as provided in 

23 subparagraphs (B) and (C), not more than 8 

24 States shall be selected for 2-year demonstra25 tion programs under this subsection. 


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1 ‘‘(B) THREE-YEAR EXTENSION.—A State 

2 selected to participate in the demonstration 

3 project under this subsection shall, upon the re4 quest of the State, be permitted to continue to 

5 participate in the demonstration project for an 

6 additional 3-year period, if the Secretary makes 

7 the determination specified in subparagraph 

8 (D) with respect to the State. The Secretary 

9 shall provide each such State with notice of that 

10 determination. 

11 ‘‘(C) EXPANSION TO ADDITIONAL

12 STATES.— 

13 ‘‘(i) IN GENERAL.—The Secretary 

14 may expand the number of eligible States 

15 participating in the demonstration project, 

16 if, with respect to any such State, the Sec17 retary makes the determination specified in 

18 subparagraph (D). The period of the par19 ticipation of any such eligible State in the 

20 demonstration project shall end on Decem21 ber 31, 2022, regardless of the date on 

22 which the State begins participating in the 

23 demonstration project. 

24 ‘‘(ii) NOTIFICATION.—The Secretary 

25 shall provide each State that applies to be 


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1 added to the demonstration project under 

2 this subsection with notice of the deter3 mination under subparagraph (D) and the 

4 standards used to make such determina5 tion. 

6 ‘‘(D) DETERMINATION.—The determina7 tion specified in this subparagraph is that the 

8 Secretary determines that, in the case of a re9 quest under subparagraph (B) or an expansion 

10 of the demonstration project under subpara11 graph (C)— 

12 ‘‘(i) the continued participation of a 

13 State in the demonstration project under 

14 this subsection or an expansion of the 

15 project to any additional State (as applica16 ble) will measurably improve access to, and 

17 participation in, services described in sub18 section (a)(2)(D) by individuals eligible for 

19 medical assistance under the State Med20 icaid program; and 

21 ‘‘(ii) any such State is in full compli22 ance with the reporting requirements 

23 under paragraph (7) and any quality re24 porting requirements established by the 

25 Secretary.’’. 


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1 SEC. 403. TERMS FOR EXTENSION AND EXPANSION OF MED2 ICAID EMERGENCY PSYCHIATRIC DEM3 ONSTRATION PROJECT. 

4 Section 2707(f)(4) of the Patient Protection and Af5 fordable Care Act (42 U.S.C. 1396a note; Public Law 

6 111–148), as amended by section 2(c) of the Improving 

7 Access to Emergency Psychiatric Care Act (Public Law 

8 114–97), is amended by striking subparagraph (C). 

9 SEC. 404. COMMUNITY-BASED MENTAL HEALTH SERVICES 

10 MEDICAID OPTION FOR CHILDREN IN OR AT 

11 RISK OF PSYCHIATRIC RESIDENTIAL TREAT12 MENT. 

13 Section 1915(c) of the Social Security Act (42 U.S.C. 

14 1396n(c)) is amended— 

15 (1) in paragraph (1)— 

16 (A) in the first sentence, by striking ‘‘or a 

17 nursing facility or intermediate care facility for 

18 the mentally retarded’’ and inserting ‘‘, nursing 

19 facility, intermediate care facility for the men20 tally retarded, or psychiatric residential treat21 ment facility’’; and 

22 (B) in the second sentence, by striking ‘‘or 

23 intermediate care facility for the mentally re24 tarded’’ and inserting ‘‘intermediate care facil25 ity for the mentally retarded, or psychiatric res26 idential treatment facility’’; 


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1 (2) in paragraph (2)— 

2 (A) in subparagraph (B)— 

3 (i) in clause (i), by striking ‘‘or serv4 ices in an intermediate care facility for the 

5 mentally retarded’’ and inserting ‘‘services 

6 in an intermediate care facility for the 

7 mentally retarded, or services in a psy8 chiatric residential treatment facility’’; and 

9 (ii) in the matter following clause (iii), 

10 by striking ‘‘or services in an intermediate 

11 care facility for the mentally retarded’’ and 

12 inserting ‘‘services in an intermediate care 

13 facility for the mentally retarded, or serv14 ices in a psychiatric residential treatment 

15 facility’’; and 

16 (B) in subparagraph (C)— 

17 (i) by striking ‘‘or intermediate care 

18 facility for the mentally retarded’’ and in19 serting ‘‘intermediate care facility for the 

20 mentally retarded, or psychiatric residen21 tial treatment facility’’; and 

22 (ii) by striking ‘‘or services in an in23 termediate care facility for the mentally re24 tarded’’ and inserting ‘‘services in an inter25 mediate care facility for the mentally reVerDate Sep 11 2014 02:27 Feb 05, 2016 Jkt 059200 PO 00000 Frm 00092 Fmt 6652 Sfmt 6201 E:\BILLS\H4435.IH H4435

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1 tarded, or services in a psychiatric residen2 tial treatment facility’’; 

3 (3) in paragraph (7)(A), by striking ‘‘or inter4 mediate care facilities for the mentally retarded’’ 

5 and inserting ‘‘intermediate care facilities for the 

6 mentally retarded, or psychiatric residential treat7 ment facilities’’; and 

8 (4) by adding at the end the following new 

9 paragraph: 

10 ‘‘(11) For purposes of this subsection, the term ‘psy11 chiatric residential treatment facility’ has the meaning 

12 given such term in section 483.352 of title 42, Code of 

13 Federal Regulations (or any successor regulation).’’. 

14 SEC. 405. EXPANSION OF CMMI AUTHORITY TO SUPPORT 

15 MAJOR MENTAL ILLNESS PROJECTS IN MED16 ICAID. 

17 Section 1115A(b)(2)(B) of the Social Security Act 

18 (42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the 

19 end the following new clause: 

20 ‘‘(xxv) Focusing primarily on title 

21 XIX, preventing major mental illness and 

22 substance use disorders and reducing the 

23 impact of long-term mental illness and 

24 substance use disorders among children, 

25 adolescents, pregnant women, and adults 


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1 through multi-level treatment including but 

2 not limited to outreach, clinical assessment 

3 and mental health services, and supported 

4 education and employment.’’. 

5 SEC. 406. MEDICAID DATA AND REPORTING. 

6 (a) GUIDANCE ON REPORTING MEDICAID MENTAL

7 HEALTH SCREENING AND TREATMENT FOR YOUTH.— 

8 The Secretary of Health and Human Services shall de9 velop guidance for the annual reporting by States of men10 tal health screening provided to children eligible for med11 ical assistance for early and periodic screening, diagnostic, 

12 and treatment services under title XIX of the Social Secu13 rity Act. Such guidance shall be provided in the form of 

14 a modification of the CMS 416 Annual EPSDT Participa15 tion Report in a manner so that the report includes infor16 mation on the number of children under 12 years of age, 

17 and the number of individuals who are at least 12 years 

18 of age but not older than 21 years of age, who receive 

19 mental health screening services, the number of such chil20 dren and individuals who are referred for mental health 

21 treatment, and the number of such children and individ22 uals who are receive treatment for mental health condi23 tions under such title. 

24 (b) MACPAC.—Section 1900(b)(6) of the Social Se25 curity Act (42 U.S.C. 1396(b)(6)) is amended— 


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1 (1) by striking ‘‘MACPAC shall consult’’ and 

2 inserting the following: 

3 ‘‘(A) IN GENERAL.—MACPAC shall con4 sult’’; and 

5 (2) by adding at the end the following new sub6 paragraph: 

7 ‘‘(B) REVIEW AND REPORTS REGARDING

8 BEHAVIORAL HEALTH PROVIDER REIMBURSE9 MENT.— 

10 ‘‘(i) IN GENERAL.—MACPAC shall 

11 survey selected State Medicaid programs’ 

12 behavioral health provider reimbursement 

13 rates and beneficiary utilization of behav14 ioral health services and shall submit an 

15 annual report to Congress regarding such 

16 review. 

17 ‘‘(ii) REQUIRED REPORT INFORMA18 TION.—Each such report regarding behav19 ioral health services shall include selected 

20 data relating to— 

21 ‘‘(I) beneficiary behavioral health 

22 service encounters; and 

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1 ment rates and the sources for such 

2 rates. 

3 ‘‘(iii) DATA.—Notwithstanding any 

4 other provision of law, the Secretary regu5 larly shall provide MACPAC with— 

6 ‘‘(I) the most recent State re7 ports and most recent independent 

8 certified audits submitted under sec9 tion 1923(j); 

10 ‘‘(II) cost reports submitted 

11 under title XVIII; and 

12 ‘‘(III) such other data as 

13 MACPAC may request, 

14 for purposes of conducting the reviews and 

15 preparing and submitting the annual re16 ports required under this subparagraph.’’. 

17 SEC. 407. AT-RISK YOUTH MEDICAID PROTECTION. 

18 (a) IN GENERAL.—Section 1902 of the Social Secu19 rity Act (42 U.S.C. 1396a), as amended by section 401, 

20 is further amended— 

21 (1) in subsection (a)— 

22 (A) by striking ‘‘and’’ at the end of para23 graph (80); 

24 (B) by striking the period at the end of 

25 paragraph (81) and inserting ‘‘; and’’; and 


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1 (C) by inserting after paragraph (81) the 

2 following new paragraph: 

3 ‘‘(82) provide that— 

4 ‘‘(A) the State shall not terminate (but 

5 may suspend) eligibility for medical assistance 

6 under a State plan for an individual who is an 

7 eligible juvenile (as defined in subsection 

8 (mm)(2)) because the juvenile is an inmate of 

9 a public institution (as defined in subsection 

10 (mm)(3)); 

11 ‘‘(B) the State shall automatically restore 

12 eligibility for such medical assistance to such an 

13 individual upon the individual’s release from 

14 any such public institution, unless (and until 

15 such date as) there is a determination that the 

16 individual no longer meets the eligibility re17 quirements for such medical assistance; and 

18 ‘‘(C) the State shall process any applica19 tion for medical assistance submitted by, or on 

20 behalf of, a juvenile who is an inmate of a pub21 lic institution notwithstanding that the juvenile 

22 is such an inmate.’’; and 

23 (2) by adding at the end the following new sub24 section: 


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1 ‘‘(mm) JUVENILE; ELIGIBLE JUVENILE; PUBLIC IN2 STITUTION.—For purposes of subsection (a)(82) and this 

3 subsection: 

4 ‘‘(1) JUVENILE.—The term ‘juvenile’ means an 

5 individual who is— 

6 ‘‘(A) under 19 years of age (or such higher 

7 age as the State has elected under section 

8 475(8)(B)(iii)); or 

9 ‘‘(B) is described in subsection 

10 (a)(10)(A)(i)(IX). 

11 ‘‘(2) ELIGIBLE JUVENILE.—The term ‘eligible 

12 juvenile’ means a juvenile who is an inmate of a 

13 public institution and was eligible for medical assist14 ance under the State plan immediately before be15 coming an inmate of such a public institution or who 

16 becomes eligible for such medical assistance while an 

17 inmate of a public institution. 

18 ‘‘(3) INMATE OF A PUBLIC INSTITUTION.—The 

19 term ‘inmate of a public institution’ has the meaning 

20 given such term for purposes of applying the sub21 division (A) following paragraph (29) of section 

22 1905(a), taking into account the exception in such 

23 subdivision for a patient of a medical institution.’’. 

24 (b) NO CHANGE IN EXCLUSION FROM MEDICAL AS25 SISTANCE FOR INMATES OF PUBLIC INSTITUTIONS.— 


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1 Nothing in this section shall be construed as changing the 

2 exclusion from medical assistance under the subdivision 

3 (A) following paragraph (29) of section 1905(a) of the So4 cial Security Act (42 U.S.C. 1396d(a)), including any ap5 plicable restrictions on a State submitting claims for Fed6 eral financial participation under title XIX of such Act 

7 for such assistance. 

8 (c) EFFECTIVE DATE.— 

9 (1) IN GENERAL.—Except as provided in para10 graph (2), the amendments made by subsection (a) 

11 shall apply to eligibility of juveniles who become in12 mates of public institutions on or after the date that 

13 is 1 year after the date of the enactment of this Act. 

14 (2) RULE FOR CHANGES REQUIRING STATE

15 LEGISLATION.—In the case of a State plan for med16 ical assistance under title XIX of the Social Security 

17 Act which the Secretary of Health and Human Serv18 ices determines requires State legislation (other than 

19 legislation appropriating funds) in order for the plan 

20 to meet the additional requirements imposed by the 

21 amendments made by subsection (a), the State plan 

22 shall not be regarded as failing to comply with the 

23 requirements of such title solely on the basis of its 

24 failure to meet these additional requirements before 

25 the first day of the first calendar quarter beginning 


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1 after the close of the first regular session of the 

2 State legislature that begins after the date of the en3 actment of this Act. For purposes of the previous 

4 sentence, in the case of a State that has a 2-year 

5 legislative session, each year of such session shall be 

6 deemed to be a separate regular session of the State 

7 legislature. 

8 Subtitle B—Medicare Provisions 

9 SEC. 411. ELIMINATION OF 190-DAY LIFETIME LIMIT ON 

10 COVERAGE OF INPATIENT PSYCHIATRIC HOS11 PITAL SERVICES UNDER MEDICARE. 

12 Section 1812 of the Social Security Act (42 U.S.C. 

13 1395d) is amended— 

14 (1) in subsection (b)— 

15 (A) in paragraph (1), by adding ‘‘or’’ at 

16 the end; 

17 (B) in paragraph (2), by striking ‘‘; or’’ at 

18 the end and inserting a period; and 

19 (C) by striking paragraph (3); and 

20 (2) in subsection (c), by striking ‘‘or in deter21 mining the 190-day limit under subsection (b)(3)’’. 

22 SEC. 412. MODIFICATIONS TO MEDICARE DISCHARGE PLAN23 NING REQUIREMENTS. 

24 Section 1861(ee) of the Social Security Act (42 

25 U.S.C. 1395x(ee)) is amended— 


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1 (1) in paragraph (1), by inserting ‘‘and, in the 

2 case of a psychiatric hospital or a psychiatric unit 

3 (as described in the matter following clause (v) of 

4 section 1886(d)(1)(B)), if it also meets the guide5 lines and standards established by the Secretary 

6 under paragraph (4)’’ before the period at the end; 

7 and 

8 (2) by adding at the end the following new 

9 paragraph: 

10 ‘‘(4) The Secretary shall develop guidelines and 

11 standards, in addition to those developed under paragraph 

12 (2), for the discharge planning process of a psychiatric 

13 hospital or a psychiatric unit (as described in the matter 

14 following clause (v) of section 1886(d)(1)(B)) in order to 

15 ensure a timely and smooth transition to the most appro16 priate type of and setting for posthospital or rehabilitative 

17 care, taking into account variations in posthospital care 

18 access, including mental health professional shortage 

19 areas designated by the Health Resources and Services 

20 Administration. The Secretary shall issue final regulations 

21 implementing such guidelines and standards not later than 

22 24 months after the date of the enactment of this para23 graph. The guidelines and standards shall include the fol24 lowing: 


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1 ‘‘(A) The hospital or unit must identify the 

2 types of services needed upon discharge for the pa3 tients being treated by the hospital or unit. 

4 ‘‘(B) The hospital or unit must— 

5 ‘‘(i) identify organizations that offer com6 munity services to the community that is served 

7 by the hospital or unit and the types of services 

8 provided by the organizations; and 

9 ‘‘(ii) make demonstrated efforts to estab10 lish connections, relationships, and partnerships 

11 with such organizations. 

12 ‘‘(C) The hospital or unit must arrange (with 

13 the participation of the patient and of any other in14 dividuals selected by the patient for such purpose) 

15 for the development and implementation of a dis16 charge plan for the patient as part of the patient’s 

17 overall treatment plan from admission to discharge. 

18 Such discharge plan shall meet the requirements de19 scribed in subparagraphs (G) and (H) of paragraph 

20 (2). 

21 ‘‘(D) The hospital or unit shall coordinate with 

22 the patient (or assist the patient with) the referral 

23 for posthospital or rehabilitative care and as part of 

24 that referral the hospital or unit shall include trans25 mitting to the receiving organization, in a timely 


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1 manner, appropriate information about the care fur2 nished to the patient by the hospital or unit and rec3 ommendations for posthospital or rehabilitative care 

4 to be furnished to the patient by the organization.’’. 

5 Subtitle C—Provisions Related to 

6 Medicaid and Medicare 

7 SEC. 421. REPORTS ON MEDICAID AND MEDICARE PART D 

8 FORMULARY AND APPEALS PRACTICES WITH 

9 RESPECT TO COVERAGE OF MENTAL HEALTH 

10 DRUGS. 

11 (a) MEDICAID.— 

12 (1) IN GENERAL.—Not later than one year 

13 after the date of the enactment of this Act, the 

14 Comptroller General of the United States shall sub15 mit to Congress a report that, with respect to men16 tal health drugs, describes the practices of the State 

17 with respect to the following (for both such drugs 

18 furnished on a fee-for-service basis and through 

19 Medicaid managed care organizations): 

20 (A) The establishment of formularies and 

21 preferred drugs lists. 

22 (B) The appeal of any coverage determina23 tion. 

24 (2) MENTAL HEALTH DRUG DEFINED.—In this 

25 section, the term ‘‘mental health drug’’ means a covVerDate Sep 11 2014 02:27 Feb 05, 2016 Jkt 059200 PO 00000 Frm 00103 Fmt 6652 Sfmt 6201 E:\BILLS\H4435.IH H4435

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1 ered outpatient drug (as defined in section 1927(k) 

2 of the Social Security Act (42 U.S.C. 1396r–8(k))) 

3 that— 

4 (A) is approved or licensed under section 

5 505 of the Federal Food, Drug, and Cosmetic 

6 Act (21 U.S.C. 355) or section 351 of the Pub7 lic Health Service Act (42 U.S.C. 262) to be 

8 used for the treatment of a mental health dis9 order, including major depression, bipolar 

10 (manic-depressive) disorder, panic disorder, ob11 sessive-compulsive disorder, schizophrenia, and 

12 schizoaffective disorder; and 

13 (B) is covered under the State plan under 

14 title XIX of the Social Security Act (42 U.S.C. 

15 1396 et seq.) (or under a waiver of such plan). 

16 (b) MEDICARE.— 

17 (1) STUDY.— 

18 (A) IN GENERAL.—The Inspector General 

19 of the Department of Health and Human Serv20 ices shall conduct a study that examines, with 

21 respect to the Medicare program established 

22 under title XVIII of the Social Security Act (42 

23 U.S.C. 1395 et seq.), the extent to which Medi24 care part D appeals-related processes are transVerDate Sep 11 2014 02:27 Feb 05, 2016 Jkt 059200 PO 00000 Frm 00104 Fmt 6652 Sfmt 6201 E:\BILLS\H4435.IH H4435

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1 parent, fair, effective, and in compliance with 

2 existing statutory and regulatory requirements. 

3 (B) INCLUDED ELEMENTS OF STUDY.— 

4 The study required under paragraph (1) shall 

5 include— 

6 (i) an identification, with respect to a 

7 two-year period beginning not earlier than 

8 January 1, 2010, of— 

9 (I) the number of grievances, re10 considerations, and independent re11 views and appeals pursuant to Medi12 care part D appeals-related processes 

13 that were lodged, requested, or other14 wise filed during such period by part 

15 D eligible individuals who were en16 rolled in prescription drug plans of17 fered by PDP sponsors under part D 

18 of title XVIII of the Social Security 

19 Act (42 U.S.C. 1395 et seq.); and 

20 (II) with respect to such griev21 ances, reconsiderations, and inde22 pendent reviews and appeals that were 

23 so lodged, requested, or otherwise 

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1 ances, reconsiderations, and inde2 pendent reviews and appeals that were 

3 decided in favor of such individuals; 

4 and 

5 (ii) an examination of the extent to 

6 which Medicare part D appeals-related 

7 processes, with respect to grievances, re8 considerations, and independent reviews 

9 and appeals that relate to benefits for psy10 chiatric medications under such part, are 

11 transparent, fair, effective, and in compli12 ance with existing statutory and regulatory 

13 requirements. 

14 (2) REPORT.—Not later than one year after the 

15 date of the enactment of this Act, such Inspector 

16 General shall submit to Congress a report on the re17 sults of the study described in subsection (a), includ18 ing the recommendations of such Inspector General, 

19 if any, for improvements that can be made to Medi20 care part D appeals-related processes. 

21 (3) DEFINITIONS.—For purposes of this sec22 tion: 

23 (A) MEDICARE PART D APPEALS-RELATED

24 PROCESSES.—The term ‘‘Medicare part D ap25 peals-related processes’’ means— 


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1 (i) grievance procedures provided by 

2 PDP sponsors pursuant to subsection (f) 

3 of section 1860D–4 of the Social Security 

4 Act (42 U.S.C. 1395w–104); 

5 (ii) reconsiderations provided by PDP 

6 sponsors pursuant to subsection (g) of 

7 such section; and 

8 (iii) independent reviews and appeals 

9 to which part D eligible individuals are en10 titled under subsection (h) of such section. 

11 (B) PART D TERMS.—The terms ‘‘part D 

12 eligible individual’’, ‘‘prescription drug plan’’, 

13 and ‘‘PDP sponsor’’ have the meanings given 

14 such terms by section 1840D–41 of the Social 

15 Security Act (42 U.S.C. 1395w–151). 

16 (c) ACCESS TO TREATMENTS FOR RESISTANT DE17 PRESSION IN THE MEDICARE AND MEDICAID PRO18 GRAMS.—Not later than one year after the date of the en19 actment of this Act, the Comptroller General of the United 

20 States shall submit to Congress a report that reviews— 

21 (1) access of available treatments for resistant 

22 depression under the Medicare program under title 

23 XVIII of the Social Security Act and the Medicaid 

24 program under title XIX of such Act; and 


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1 (2) the length of time to adopt, and processes 

2 for the adoption of, newly available treatment for re3 sistant depression for individuals entitled to benefits 

4 under part A of such title XVIII or enrolled under 

5 part B of such title and for individuals enrolled 

6 under a State plan under such title XIX. 

7 TITLE V—STRENGTHENING THE 

8 BEHAVIORAL HEALTH WORK9 FORCE AND IMPROVING AC10 CESS TO CARE 

11 SEC. 501. NATIONWIDE WORKFORCE STRATEGY. 

12 (a) IN GENERAL.—Not later than one year after the 

13 date of enactment of this Act, the Substance Abuse Men14 tal Health and Services Administration shall, submit to 

15 the Congress a report containing a nationwide strategy to 

16 increase the culturally aware behavioral health workforce 

17 and recruit professionals for the treatment of individuals 

18 with mental illness and substance use disorders. 

19 (b) DESIGN.—The nationwide strategy shall be de20 signed— 

21 (1) to encourage and incentivize students en22 rolled in accredited medical or osteopathic medical 

23 school to enter the specialty of psychiatry; 

24 (2) to promote greater research-oriented psy25 chiatrist residency training on evidence-based service 


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1 delivery models for individuals with serious mental 

2 illness or substance use disorders; 

3 (3) to promote appropriate Federal administra4 tive and fiscal mechanisms that support— 

5 (A) evidence-based collaborative care mod6 els; and 

7 (B) the necessary trained and culturally 

8 aware preventionists, health care practitioners, 

9 paraprofessionals, and peers; 

10 (4) to increase access to child and adolescent 

11 psychiatric services in order to promote early inter12 vention for prevention and mitigation of mental ill13 ness; and 

14 (5) to identify populations and locations that 

15 are most underserved by mental health and sub16 stance use professionals and the most in need of 

17 psychiatrists (including child and adolescent psychia18 trists), psychologists, psychiatric nurse practitioners, 

19 physician assistants, clinical social workers, mental 

20 health counselors, substance abuse counselors, peer21 support specialists, recovery coaches, and other men22 tal health and substance use disorder professionals. 


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1 SEC. 502. REPORT ON BEST PRACTICES FOR PEER-SUP2 PORT SPECIALIST PROGRAMS, TRAINING, 

3 AND CERTIFICATION. 

4 (a) IN GENERAL.—Not later than 2 years after the 

5 date of enactment of this Act, the Secretary shall submit 

6 to the Congress and make publicly available a report on 

7 best practices and professional standards in States for— 

8 (1) establishing and operating health care pro9 grams using peer-support specialists; and 

10 (2) training and certifying peer-support special11 ists. 

12 (b) PEER-SUPPORT SPECIALIST DEFINED.—In this 

13 subsection, the term ‘‘peer-support specialist’’ means an 

14 individual who— 

15 (1) uses his or her lived experience of recovery 

16 from mental illness or substance abuse, plus skills 

17 learned in formal training, to facilitate support 

18 groups, and to work on a one-on-one basis, with in19 dividuals with a serious mental illness or a substance 

20 use disorder; 

21 (2) has benefited or is benefiting from mental 

22 health or substance use treatment services or sup23 ports; 

24 (3) provides non-medical services; and 


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1 (4) performs services only within his or her 

2 area of training, expertise, competence, or scope of 

3 practice. 

4 (c) CONTENTS.—The report under this section shall 

5 include information on best practices and standards with 

6 regard to the following: 

7 (1) Hours of formal work or volunteer experi8 ence related to mental health and substance use 

9 issues. 

10 (2) Types of peer support specialists used by 

11 different health care programs. 

12 (3) Types of peer specialist exams required. 

13 (4) Code of ethics. 

14 (5) Additional training required prior to certifi15 cation, including in areas such as— 

16 (A) ethics; 

17 (B) scope of practice; 

18 (C) crisis intervention; 

19 (D) State confidentiality laws; 

20 (E) Federal privacy protections, including 

21 under the Health Insurance Portability and Ac22 countability Act of 1996; and 

23 (F) other areas as determined by the Sec24 retary. 


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1 (6) Requirements to explain what, where, when, 

2 and how to accurately complete all required docu3 mentation activities. 

4 (7) Required or recommended skill sets, such as 

5 knowledge of— 

6 (A) risk indicators, including individual 

7 stressors, triggers, and indicators of escalating 

8 symptoms; 

9 (B) basic de-escalation techniques; 

10 (C) basic suicide prevention concepts and 

11 techniques; 

12 (D) indicators that the consumer may be 

13 experiencing abuse or neglect; 

14 (E) stages of change or recovery; 

15 (F) the typical process that should be fol16 lowed to access or participate in community 

17 mental health and related services; and 

18 (G) circumstances when it is appropriate 

19 to request assistance from other professionals 

20 to help meet the consumer’s recovery goals. 

21 (8) Requirements for continuing education. 

22 SEC. 503. ADVISORY COUNCIL ON GRADUATE MEDICAL 

23 EDUCATION. 

24 Section 762(b) of the Public Health Service Act (42 

25 U.S.C. 294o(b)) is amended— 


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1 (1) by redesignating paragraphs (4) through 

2 (6) as paragraphs (5) through (7), respectively; and 

3 (2) by inserting after paragraph (3) the fol4 lowing: 

5 ‘‘(4) the Assistant Secretary for Mental Health 

6 and Substance Use Disorders;’’. 

7 SEC. 504. TELEPSYCHIATRY AND PRIMARY CARE PROVIDER 

8 TRAINING GRANT PROGRAM. 

9 (a) IN GENERAL.—The Secretary of Health and 

10 Human Services shall establish a grant program (in this 

11 subsection referred to as the ‘‘grant program’’) under 

12 which the Secretary shall award to 10 eligible States (as 

13 described in subsection (e)) grants for carrying out all of 

14 the purposes described in subsections (b), (c), and (d). 

15 (b) TRAINING PROGRAM FOR CERTAIN PRIMARY

16 CARE PROVIDERS.—For purposes of subsection (a), the 

17 purpose described in this paragraph, with respect to a 

18 grant awarded to a State under the grant program, is for 

19 the State to establish a training program to train primary 

20 care providers in— 

21 (1) valid and reliable behavioral-health screen22 ing tools for violence and suicide risk, early signs of 

23 serious mental illness, and untreated substance 

24 abuse, including any standardized behavioral-health 


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1 screening tools that are determined appropriate by 

2 the Secretary; 

3 (2) implementing the use of behavioral-health 

4 screening tools in their practices; 

5 (3) establishment of recommended intervention 

6 and treatment protocols for individuals in mental 

7 health crisis, especially for individuals whose illness 

8 makes them less receptive to mental health services; 

9 and 

10 (4) implementing the evidence-based collabo11 rative care model of integrated medical-behavioral 

12 health care in their practices. 

13 (c) PAYMENTS FOR MENTAL HEALTH SERVICES

14 PROVIDED BY CERTAIN PRIMARY CARE PROVIDERS.— 

15 (1) IN GENERAL.—For purposes of subsection 

16 (a), the purpose described in this paragraph, with 

17 respect to a grant awarded to a State under the 

18 grant program, is for the State to provide, in ac19 cordance with this paragraph, in the case of a pri20 mary care physician who participates in the training 

21 program of the State establish pursuant to sub22 section (b), payments to the primary care providers 

23 for services furnished by the primary care providers. 

24 (2) CONSIDERATIONS.—The Secretary, in de25 termining the structure, quality, and form of payVerDate Sep 11 2014 02:27 Feb 05, 2016 Jkt 059200 PO 00000 Frm 00114 Fmt 6652 Sfmt 6201 E:\BILLS\H4435.IH H4435

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1 ment under paragraph (1) shall seek to find innova2 tive payment systems which may take into account— 

3 (A) the nature and quality of services ren4 dered; 

5 (B) the patients’ health outcome; 

6 (C) the geographical location where serv7 ices were provided; 

8 (D) the acuteness of the patient’s medical 

9 condition; 

10 (E) the duration of services provided; 

11 (F) the feasibility of replicating the pay12 ment model in other locations nationwide; and 

13 (G) proper triage and enduring linkage to 

14 appropriate treatment provider for subspecialty 

15 care in child or forensic issues; family crisis 

16 intervention; drug or alcohol rehabilitation; 

17 management of suicidal or violent behavior risk, 

18 and treatment for serious mental illness. 

19 (d) TELEHEALTH SERVICES FOR MENTAL HEALTH

20 DISORDERS.— 

21 (1) IN GENERAL.—For purposes of subsection 

22 (a), the purpose described in this paragraph, with 

23 respect to a grant awarded to a State under the 

24 grant program, is for the State to provide, in the 

25 case of an individual furnished items and services by 


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1 a primary care physician during an office visit, for 

2 payment for a consultation provided by a psychia3 trist or psychologist to such primary care provider 

4 with respect to such individual through the use of 

5 qualified telehealth technology for the identification, 

6 diagnosis, mitigation, or treatment of a mental 

7 health disorder if such consultation occurs not later 

8 than the first business day that follows such visit. 

9 (2) QUALIFIED TELEHEALTH TECHNOLOGY.— 

10 For purposes of paragraph (1), the term ‘‘qualified 

11 telehealth technology’’, with respect to the provision 

12 of items and services to a patient by a health care 

13 provider, includes the use of interactive audio, audio14 only telephone conversation, video, or other tele15 communications technology by a health care provider 

16 to deliver health care services within the scope of the 

17 provider’s practice including the use of electronic 

18 media for consultation relating to the health care di19 agnosis or treatment of the patient. 

20 (e) ELIGIBLE STATE.— 

21 (1) IN GENERAL.—For purposes of this sub22 section, an eligible State is a State that has sub23 mitted to the Secretary an application under para24 graph (2) and has been selected under paragraph 

25 (4). 


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1 (2) APPLICATION.—A State seeking to partici2 pate in the grant program under this subsection 

3 shall submit to the Secretary, at such time and in 

4 such format as the Secretary requires, an applica5 tion that includes such information, provisions, and 

6 assurances as the Secretary may require. 

7 (3) MATCHING REQUIREMENT.—The Secretary 

8 may not make a grant under the grant program un9 less the State involved agrees, with respect to the 

10 costs to be incurred by the State in carrying out the 

11 purposes described in this subsection, to make avail12 able non-Federal contributions (in cash or in kind) 

13 toward such costs in an amount equal to not less 

14 than 20 percent of Federal funds provided in the 

15 grant. 

16 (4) SELECTION.—A State shall be determined 

17 eligible for the grant program by the Secretary on 

18 a competitive basis among States with applications 

19 meeting the requirements of paragraphs (2) and (3). 

20 In selecting State applications for the grant pro21 gram, the Secretary shall seek to achieve an appro22 priate national balance in the geographic distribu23 tion of grants awarded under the grant program. 

24 (f) TARGET POPULATION.—In seeking a grant under 

25 this subsection, a State shall demonstrate how the grant 


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1 will improve care for individuals with co-occurring behav2 ioral health and physical health conditions, vulnerable pop3 ulations, socially isolated populations, rural populations, 

4 and other populations who have limited access to qualified 

5 mental health providers. 

6 (g) LENGTH OF GRANT PROGRAM.—The grant pro7 gram under this subsection shall be conducted for a period 

8 of 3 consecutive years. 

9 (h) PUBLIC AVAILABILITY OF FINDINGS AND CON10 CLUSIONS.—Subject to Federal privacy protections with 

11 respect to individually identifiable information, the Sec12 retary shall make the findings and conclusions resulting 

13 from the grant program under this subsection available 

14 to the public. 

15 (i) AUTHORIZATION OF APPROPRIATIONS.—Out of 

16 any funds in the Treasury not otherwise appropriated, 

17 there is authorized to be appropriated to carry out this 

18 subsection, $3,000,000 for each of the fiscal years 2017 

19 through 2021. 

20 (j) REPORTS.— 

21 (1) REPORTS.—For each fiscal year that grants 

22 are awarded under this subsection, the Secretary 

23 shall conduct a study on the results of the grants 

24 and submit to the Congress a report on such results 

25 that includes the following: 


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1 (A) An evaluation of the grant program 

2 outcomes, including a summary of activities 

3 carried out with the grant and the results 

4 achieved through those activities. 

5 (B) Recommendations on how to improve 

6 access to mental health services at grantee loca7 tions. 

8 (C) An assessment of access to mental 

9 health services under the program. 

10 (D) An assessment of the impact of the 

11 demonstration project on the costs of the full 

12 range of mental health services (including inpa13 tient, emergency and ambulatory care). 

14 (E) Recommendations on congressional ac15 tion to improve the grant. 

16 (F) Recommendations to improve training 

17 of primary care providers. 

18 (2) REPORT.—Not later than December 31, 

19 2018, the Secretary shall submit to Congress and 

20 make available to the public a report on the findings 

21 of the evaluation under subparagraph (A) and also 

22 a policy outline on how Congress can expand the 

23 grant program to the national level. 


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1 SEC. 505. LIABILITY PROTECTIONS FOR HEALTH CARE 

2 PROFESSIONAL VOLUNTEERS AT COMMU3 NITY HEALTH CENTERS AND FEDERALLY 

4 QUALIFIED COMMUNITY BEHAVIORAL 

5 HEALTH CLINICS. 

6 Section 224 of the Public Health Service Act (42 

7 U.S.C. 233) is amended by adding at the end the fol8 lowing: 

9 ‘‘(q)(1) In this subsection, the term ‘federally quali10 fied community behavioral health clinic’ means— 

11 ‘‘(A) a federally qualified community behavioral 

12 health clinic with a certification in effect under sec13 tion 223 of the Protecting Access to Medicare Act 

14 of 2014; or 

15 ‘‘(B) a community mental health center meeting 

16 the criteria specified in section 1913(c) of this Act. 

17 ‘‘(2) For purposes of this section, a health care pro18 fessional volunteer at an entity described in subsection 

19 (g)(4) or a federally qualified community behavioral health 

20 clinic shall, in providing health care services eligible for 

21 funding under section 330 or subpart I of part B of title 

22 XIX to an individual, be deemed to be an employee of the 

23 Public Health Service for a calendar year that begins dur24 ing a fiscal year for which a transfer was made under 

25 paragraph (5)(C). The preceding sentence is subject to the 

26 provisions of this subsection. 


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1 ‘‘(3) In providing a health care service to an indi2 vidual, a health care professional shall for purposes of this 

3 subsection be considered to be a health professional volun4 teer at an entity described in subsection (g)(4) or at a 

5 federally qualified community behavioral health clinic if 

6 the following conditions are met: 

7 ‘‘(A) The service is provided to the individual at 

8 the facilities of an entity described in subsection 

9 (g)(4), at a federally qualified community behavioral 

10 health clinic, or through offsite programs or events 

11 carried out by the center. 

12 ‘‘(B) The center or entity is sponsoring the 

13 health care professional volunteer pursuant to para14 graph (4)(B). 

15 ‘‘(C) The health care professional does not re16 ceive any compensation for the service from the indi17 vidual or from any third-party payer (including re18 imbursement under any insurance policy or health 

19 plan, or under any Federal or State health benefits 

20 program), except that the health care professional 

21 may receive repayment from the entity described in 

22 subsection (g)(4) or the center for reasonable ex23 penses incurred by the health care professional in 

24 the provision of the service to the individual. 


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1 ‘‘(D) Before the service is provided, the health 

2 care professional or the center or entity described in 

3 subsection (g)(4) posts a clear and conspicuous no4 tice at the site where the service is provided of the 

5 extent to which the legal liability of the health care 

6 professional is limited pursuant to this subsection. 

7 ‘‘(E) At the time the service is provided, the 

8 health care professional is licensed or certified in ac9 cordance with applicable law regarding the provision 

10 of the service. 

11 ‘‘(4) Subsection (g) (other than paragraphs (3) and 

12 (5)) and subsections (h), (i), and (l) apply to a health care 

13 professional for purposes of this subsection to the same 

14 extent and in the same manner as such subsections apply 

15 to an officer, governing board member, employee, or con16 tractor of an entity described in subsection (g)(4), subject 

17 to paragraph (5) and subject to the following: 

18 ‘‘(A) The first sentence of paragraph (2) ap19 plies in lieu of the first sentence of subsection 

20 (g)(1)(A). 

21 ‘‘(B) With respect to an entity described in sub22 section (g)(4) or a federally qualified community be23 havioral health clinic, a health care professional is 

24 not a health professional volunteer at such center 

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1 sional. For purposes of this subsection, the center 

2 shall be considered to be sponsoring the health care 

3 professional if— 

4 ‘‘(i) with respect to the health care profes5 sional, the center submits to the Secretary an 

6 application meeting the requirements of sub7 section (g)(1)(D); and 

8 ‘‘(ii) the Secretary, pursuant to subsection 

9 (g)(1)(E), determines that the health care pro10 fessional is deemed to be an employee of the 

11 Public Health Service. 

12 ‘‘(C) In the case of a health care professional 

13 who is determined by the Secretary pursuant to sub14 section (g)(1)(E) to be a health professional volun15 teer at such center, this subsection applies to the 

16 health care professional (with respect to services de17 scribed in paragraph (2)) for any cause of action 

18 arising from an act or omission of the health care 

19 professional occurring on or after the date on which 

20 the Secretary makes such determination. 

21 ‘‘(D) Subsection (g)(1)(F) applies to a health 

22 professional volunteer for purposes of this subsection 

23 only to the extent that, in providing health services 

24 to an individual, each of the conditions specified in 

25 paragraph (3) is met. 


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1 ‘‘(5)(A) Amounts in the fund established under sub2 section (k)(2) shall be available for transfer under sub3 paragraph (C) for purposes of carrying out this subsection 

4 for health professional volunteers at entities described in 

5 subsection (g)(4). 

6 ‘‘(B) Not later than May 1 of each fiscal year, the 

7 Attorney General, in consultation with the Secretary, shall 

8 submit to the Congress a report providing an estimate of 

9 the amount of claims (together with related fees and ex10 penses of witnesses) that, by reason of the acts or omis11 sions of health care professional volunteers, will be paid 

12 pursuant to this subsection during the calendar year that 

13 begins in the following fiscal year. Subsection (k)(1)(B) 

14 applies to the estimate under the preceding sentence re15 garding health care professional volunteers to the same 

16 extent and in the same manner as such subsection applies 

17 to the estimate under such subsection regarding officers, 

18 governing board members, employees, and contractors of 

19 entities described in subsection (g)(4). 

20 ‘‘(C) Not later than December 31 of each fiscal year, 

21 the Secretary shall transfer from the fund under sub22 section (k)(2) to the appropriate accounts in the Treasury 

23 an amount equal to the estimate made under subpara24 graph (B) for the calendar year beginning in such fiscal 

25 year, subject to the extent of amounts in the fund. 


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1 ‘‘(6)(A) This subsection takes effect on October 1, 

2 2017, except as provided in subparagraph (B). 

3 ‘‘(B) Effective on the date of the enactment of this 

4 subsection— 

5 ‘‘(i) the Secretary may issue regulations for car6 rying out this subsection, and the Secretary may ac7 cept and consider applications submitted pursuant to 

8 paragraph (4)(B); and 

9 ‘‘(ii) reports under paragraph (5)(B) may be 

10 submitted to the Congress.’’. 

11 SEC. 506. MINORITY FELLOWSHIP PROGRAM. 

12 Title V of the Public Health Service Act (42 U.S.C. 

13 290aa et seq.), as amended, is further amended by adding 

14 at the end the following: 

15 ‘‘PART K—MINORITY FELLOWSHIP PROGRAM 

16 ‘‘SEC. 597. FELLOWSHIPS. 

17 ‘‘(a) IN GENERAL.—The Secretary shall maintain a 

18 program, to be known as the Minority Fellowship Pro19 gram, under which the Secretary awards fellowships, 

20 which may include stipends, for the purposes of— 

21 ‘‘(1) increasing behavioral health practitioners’ 

22 knowledge of issues related to prevention, treatment, 

23 and recovery support for mental and substance use 

24 disorders among racial and ethnic minority popu25 lations; 


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1 ‘‘(2) improving the quality of mental and sub2 stance use disorder prevention and treatment deliv3 ered to ethnic minorities; and 

4 ‘‘(3) increasing the number of culturally com5 petent behavioral health professionals who teach, ad6 minister, conduct services research, and provide di7 rect mental health or substance use services to un8 derserved minority populations. 

9 ‘‘(b) TRAINING COVERED.—The fellowships under 

10 subsection (a) shall be for postbaccalaureate training (in11 cluding for master’s and doctoral degrees) for mental 

12 health professionals, including in the fields of psychiatry, 

13 nursing, social work, psychology, marriage and family 

14 therapy, professional counseling, and substance use and 

15 addiction counseling. 

16 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—To 

17 carry out this section, there are authorized to be appro18 priated $11,000,000 for fiscal year 2017, $14,000,000 for 

19 fiscal year 2018, $16,000,000 for fiscal year 2019, 

20 $18,000,000 for fiscal year 2020, and $20,000,000 for fis21 cal year 2021.’’. 

22 SEC. 507. NATIONAL HEALTH SERVICE CORPS. 

23 (a) DEFINITIONS.— 

24 (1) PRIMARY HEALTH SERVICES.—Section 

25 331(a)(3)(D) of the Public Health Service Act (42 


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1 U.S.C. 254d(a)(3)) is amended by inserting ‘‘(in2 cluding pediatric mental health subspecialty serv3 ices)’’ after ‘‘pediatrics’’. 

4 (2) BEHAVIORAL AND MENTAL HEALTH PRO5 FESSIONALS.—Clause (i) of section 331(a)(3)(E) of 

6 the Public Health Service Act (42 U.S.C. 

7 254d(a)(3)(E)) is amended by inserting ‘‘(and pedi8 atric subspecialists thereof)’’ before the period at the 

9 end. 

10 (b) ELIGIBILITY TO PARTICIPATE IN LOAN REPAY11 MENT PROGRAM.—Section 338B(b)(1)(B) of the Public 

12 Health Service Act (42 U.S.C. 254l–1(b)(1)(B)) is amend13 ed by inserting ‘‘, including any physician child and ado14 lescent psychiatry residency or fellowship training pro15 gram’’ after ‘‘be enrolled in an approved graduate training 

16 program in medicine, osteopathic medicine, dentistry, be17 havioral and mental health, or other health profession’’. 

18 SEC. 508. SAMHSA GRANT PROGRAM FOR DEVELOPMENT 

19 AND IMPLEMENTATION OF CURRICULA FOR 

20 CONTINUING EDUCATION ON SERIOUS MEN21 TAL ILLNESS. 

22 Title V of the Public Health Service Act is amended 

23 by inserting after section 520I (42 U.S.C. 290bb–40) the 

24 following: 


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1 ‘‘SEC. 520I–1. CURRICULA FOR CONTINUING EDUCATION ON 

2 SERIOUS MENTAL ILLNESS. 

3 ‘‘(a) GRANTS.—The Secretary may award grants to 

4 eligible entities for the development and implementation 

5 of curricula for providing continuing education and train6 ing to health care professionals on identifying, referring, 

7 and treating individuals with serious mental illness or seri8 ous emotional disturbance. 

9 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to seek a 

10 grant under this section, an entity shall be a public or 

11 nonprofit entity that— 

12 ‘‘(1) provides continuing education or training 

13 to health care professionals; or 

14 ‘‘(2) applies for the grant in partnership with 

15 another entity that provides such education and 

16 training. 

17 ‘‘(c) PREFERENCE.—In awarding grants under this 

18 section, the Secretary shall give preference to eligible enti19 ties proposing to develop and implement curricula for pro20 viding continuing education and training to— 

21 ‘‘(1) health care professionals in primary care 

22 specialties; or 

23 ‘‘(2) health care professionals who are required, 

24 as a condition of State licensure, to participate in 

25 continuing education or training specific to mental 

26 health. 


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1 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—To 

2 carry out this section, there are authorized to be appro3 priated $1,000,000 for each of fiscal years 2017 through 

4 2021.’’. 

5 SEC. 509. PEER PROFESSIONAL WORKFORCE DEVELOP6 MENT GRANT PROGRAM. 

7 (a) IN GENERAL.—For the purposes described in 

8 subsection (b), the Secretary of Health and Human Serv9 ices shall award grants to develop and sustain behavioral 

10 health paraprofessional training and education programs, 

11 including through tuition support. 

12 (b) PURPOSES.—The purposes of grants under this 

13 section are— 

14 (1) to increase the number of behavioral health 

15 paraprofessionals, including trained peers, recovery 

16 coaches, mental health and addiction specialists, pre17 vention specialists, and pre-masters-level addiction 

18 counselors; and 

19 (2) to help communities develop the infrastruc20 ture to train and certify peers as behavioral health 

21 paraprofessionals. 

22 (c) ELIGIBLE ENTITIES.—To be eligible to receive a 

23 grant under this section, an entity shall be a community 

24 college or other entity the Secretary deems appropriate. 


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1 (d) GEOGRAPHIC DISTRIBUTION.—In awarding 

2 grants under this section, the Secretary shall seek to 

3 achieve an appropriate national balance in the geographic 

4 distribution of such awards. 

5 (e) SPECIAL CONSIDERATION.—In awarding grants 

6 under this section, the Secretary may give special consid7 eration to proposed and existing programs targeting peer 

8 professionals serving youth ages 16 to 25. 

9 (f) AUTHORIZATION OF APPROPRIATIONS.—To carry 

10 out this section, there is authorized to be appropriated to 

11 carry out this section $5,000,000 for each of fiscal years 

12 2017 through 2021. 

13 SEC. 510. DEMONSTRATION GRANT PROGRAM TO RECRUIT, 

14 TRAIN, AND PROFESSIONALLY SUPPORT PSY15 CHIATRIC PHYSICIANS IN INDIAN HEALTH 

16 PROGRAMS. 

17 (a) ESTABLISHMENT.—The Secretary of Health and 

18 Human Services (in this section referred to as the ‘‘Sec19 retary’’), in consultation with the Director of the Indian 

20 Health Service and demonstration programs established 

21 under section 123 of the Indian Health Care Improvement 

22 Act (25 U.S.C. 1616p), shall award one 5-year grant to 

23 one eligible entity to carry out a demonstration program 

24 (in this Act referred to as the ‘‘Program’’) under which 


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1 the eligible entity shall carry out the activities described 

2 in subsection (b). 

3 (b) ACTIVITIES TO BE CARRIED OUT BY RECIPIENT

4 OF GRANT UNDER PROGRAM.—Under the Program, the 

5 grant recipient shall— 

6 (1) create a nationally replicable workforce 

7 model that identifies and incorporates best practices 

8 for recruiting, training, deploying, and professionally 

9 supporting Native American and non-Native Amer10 ican psychiatric physicians to be fully integrated into 

11 medical, mental, and behavioral health systems in 

12 Indian health programs; 

13 (2) recruit to participate in the Program Native 

14 American and non-Native American psychiatric phy15 sicians who demonstrate interest in providing spe16 cialty health care services (as defined in section 

17 313(a)(3) of the Indian Health Care Improvement 

18 Act (25 U.S.C. 1638g(a)(3))) and primary care serv19 ices to American Indians and Alaska Natives; 

20 (3) provide such psychiatric physicians partici21 pating in the Program with not more than 1 year of 

22 supplemental clinical and cultural competency train23 ing to enable such physicians to provide such spe24 cialty health care services and primary care services 

25 in Indian health programs; 


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1 (4) with respect to such psychiatric physicians 

2 who are participating in the Program and trained 

3 under paragraph (3), deploy such physicians to prac4 tice specialty care or primary care in Indian health 

5 programs for a period of not less than 2 years and 

6 professionally support such physicians for such pe7 riod with respect to practicing such care in such pro8 grams; and 

9 (5) not later than 1 year after the last day of 

10 the 5-year period for which the grant is awarded 

11 under subsection (a), submit to the Secretary and to 

12 the appropriate committees of Congress a report 

13 that shall include— 

14 (A) the workforce model created under 

15 paragraph (1); 

16 (B) strategies for disseminating the work17 force model to other entities with the capability 

18 of adopting it; and 

19 (C) recommendations for the Secretary and 

20 Congress with respect to supporting an effective 

21 and stable psychiatric and mental health work22 force that serves American Indians and Alaska 

23 Natives. 

24 (c) ELIGIBLE ENTITIES.— 


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1 (1) REQUIREMENTS.—To be eligible to receive 

2 the grant under this section, an entity shall— 

3 (A) submit to the Secretary an application 

4 at such time, in such manner, and containing 

5 such information as the Secretary may require; 

6 (B) be a department of psychiatry within 

7 a medical school in the United States that is 

8 accredited by the Liaison Committee on Medical 

9 Education or a public or private nonprofit enti10 ty affiliated with a medical school in the United 

11 States that is accredited by the Liaison Com12 mittee on Medical Education; and 

13 (C) have in existence, as of the time of 

14 submission of the application under subpara15 graph (A), a relationship with Indian health 

16 programs in at least two States with a dem17 onstrated need for psychiatric physicians and 

18 provide assurances that the grant will be used 

19 to serve rural and non-rural American Indian 

20 and Alaska Native populations in at least two 

21 States. 

22 (2) PRIORITY IN SELECTING GRANT RECIPI23 ENT.—In awarding the grant under this section, the 

24 Secretary shall give priority to an eligible entity that 

25 satisfies each of the following: 


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1 (A) Demonstrates sufficient infrastructure 

2 in size, scope, and capacity to undertake the 

3 supplemental clinical and cultural competency 

4 training of a minimum of 5 psychiatric physi5 cians, and to provide ongoing professional sup6 port to psychiatric physicians during the de7 ployment period to an Indian health program. 

8 (B) Demonstrates a record in successfully 

9 recruiting, training, and deploying physicians 

10 who are American Indians and Alaska Natives. 

11 (C) Demonstrates the ability to establish a 

12 program advisory board, which may be pri13 marily composed of representatives of federally 

14 recognized tribes, Alaska Natives, and Indian 

15 health programs to be served by the Program. 

16 (d) ELIGIBILITY OF PSYCHIATRIC PHYSICIANS TO

17 PARTICIPATE IN THE PROGRAM.— 

18 (1) IN GENERAL.—To be eligible to participate 

19 in the Program, as described in subsection (b), a 

20 psychiatric physician shall— 

21 (A) be licensed or eligible for licensure to 

22 practice in the State to which the physician is 

23 to be deployed under subsection (b)(4); and 

24 (B) demonstrate a commitment beyond the 

25 one year of training described in subsection 


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1 (b)(3) and two years of deployment described in 

2 subsection (b)(4) to a career as a specialty care 

3 physician or primary care physician providing 

4 mental health services in Indian health pro5 grams. 

6 (2) PREFERENCE.—In selecting physicians to 

7 participate under the Program, as described in sub8 section (b)(2), the grant recipient shall give pref9 erence to physicians who are American Indians and 

10 Alaska Natives. 

11 (e) LOAN FORGIVENESS.—Under the Program, any 

12 psychiatric physician accepted to participate in the Pro13 gram shall, notwithstanding the provisions of subsection 

14 (b) of section 108 of the Indian Health Care Improvement 

15 Act (25 U.S.C. 1616a) and upon acceptance into the Pro16 gram, be deemed eligible and enrolled to participate in the 

17 Indian Health Service Loan Repayment Program under 

18 such section 108. Under such Loan Repayment Program, 

19 the Secretary shall pay on behalf of the physician for each 

20 year of deployment under the Program under this section 

21 up to $35,000 for loans described in subsection (g)(1) of 

22 such section 108. 

23 (f) DEFERRAL OF CERTAIN SERVICE.—The starting 

24 date of required service of individuals in the National 

25 Health Service Corps Service Program under title II of 


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1 the Public Health Service Act (42 U.S.C. 202 et seq.) who 

2 are psychiatric physicians participating under the Pro3 gram under this section shall be deferred until the date 

4 that is 30 days after the date of completion of the partici5 pation of such a physician in the Program under this sec6 tion. 

7 (g) DEFINITIONS.—For purposes of this section: 

8 (1) AMERICAN INDIANS AND ALASKA NA9 TIVES.—The term ‘‘American Indians and Alaska 

10 Natives’’ has the meaning given the term ‘‘Indian’’ 

11 in section 447.50(b)(1) of title 42, Code of Federal 

12 Regulations, as in existence as of the date of the en13 actment of this Act. 

14 (2) INDIAN HEALTH PROGRAM.—The term ‘‘In15 dian health program’’ has the meaning given such 

16 term in section 104(12) of the Indian Health Care 

17 Improvement Act (25 U.S.C. 1603(12)). 

18 (3) PROFESSIONALLY SUPPORT.—The term 

19 ‘‘professionally support’’ means, with respect to psy20 chiatric physicians participating in the Program and 

21 deployed to practice specialty care or primary care 

22 in Indian health programs, the provision of com23 pensation to such physicians for the provision of 

24 such care during such deployment and may include 

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1 tices, field training, and other activities deemed ap2 propriate by the recipient of the grant under this 

3 section. 

4 (4) PSYCHIATRIC PHYSICIAN.—The term ‘‘psy5 chiatric physician’’ means a medical doctor or doctor 

6 of osteopathy in good standing who has successfully 

7 completed four-year psychiatric residency training or 

8 who is enrolled in four-year psychiatric residency 

9 training in a residency program accredited by the 

10 Accreditation Council for Graduate Medical Edu11 cation. 

12 (h) AUTHORIZATION OF APPROPRIATIONS.—There is 

13 authorized to be appropriated to carry out this section 

14 $1,000,000 for each of the fiscal years 2017 through 

15 2021. 

16 SEC. 511. EDUCATION AND TRAINING ON EATING DIS17 ORDERS FOR HEALTH PROFESSIONALS. 

18 (a) IN GENERAL.—The Secretary of Health and 

19 Human Services, acting through the Administrator of the 

20 Substance Abuse and Mental Health Services Administra21 tion, shall award grants to eligible entities to integrate 

22 training into existing curricula for primary care physi23 cians, other licensed or certified health and mental health 

24 professionals, and public health professionals that may in25 clude— 


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1 (1) early intervention and identification of eat2 ing disorders; 

3 (2) types of treatment (including family-based 

4 treatment, inpatient, residential, partial hospitaliza5 tion programming, intensive outpatient and out6 patient); 

7 (3) how to properly refer patients to treatment; 

8 (4) steps to aid in the prevention of the devel9 opment of eating disordered behaviors; and 

10 (5) how to treat individuals with eating dis11 orders. 

12 (b) APPLICATION.—An entity that desires a grant 

13 under this section shall submit to the Secretary an appli14 cation at such time, in such manner, and containing such 

15 information as the Secretary may require, including a plan 

16 for the use of funds that may be awarded and an evalua17 tion of the training that will be provided. 

18 (c) USE OF FUNDS.—An entity that receives a grant 

19 under this section shall use the funds made available 

20 through such grant to— 

21 (1) use a training program containing evidence22 based findings, promising emerging best practices, 

23 or recommendations that pertain to the identifica24 tion, early intervention, prevention of the develop25 ment of eating disordered behaviors, and treatment 


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1 of eating disorders to conduct educational training 

2 and conferences, including Internet-based courses 

3 and teleconferences, on— 

4 (A) how to help prevent the development of 

5 eating disordered behaviors, identify, intervene 

6 early, and appropriately and adequately treat 

7 eating disordered patients; 

8 (B) how to identify individuals with eating 

9 disorders, and those who are at risk for suf10 fering from eating disorders and, therefore, at 

11 risk for related severe medical and mental 

12 health conditions; 

13 (C) how to conduct a comprehensive as14 sessment of individual and familial health risk 

15 factors; and 

16 (D) how to conduct a comprehensive as17 sessment of a treatment plan; and 

18 (2) evaluate and report to the Secretary on the 

19 effectiveness of the training provided by such entity 

20 in increasing knowledge and changing attitudes and 

21 behaviors of trainees. 

22 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

23 authorized to be appropriated to carry out this section 

24 $1,000,000 for each of the fiscal years 2017 through 

25 2021. 


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1 SEC. 512. PRIMARY AND BEHAVIORAL HEALTH CARE INTE2 GRATION GRANT PROGRAMS. 

3 Section 520K of the Public Health Service Act (42 

4 U.S.C. 290bb–42) is amended to read as follows: 

5 ‘‘SEC. 520K. INTEGRATION INCENTIVE GRANTS. 

6 ‘‘(a) IN GENERAL.—The Secretary shall establish a 

7 primary and behavioral health care integration grant pro8 gram. The Secretary may award grants and cooperative 

9 agreements to eligible entities to expend funds for im10 provements in integrated settings with integrated prac11 tices. 

12 ‘‘(b) DEFINITIONS.—In this section: 

13 ‘‘(1) INTEGRATED CARE.—The term ‘integrated 

14 care’ means full collaboration in merged or trans15 formed practices offering behavioral and physical 

16 health services within the same shared practice 

17 space in the same facility, where the entity— 

18 ‘‘(A) provides services in a shared space 

19 that ensures services will be available and ac20 cessible promptly and in a manner which pre21 serves human dignity and assures continuity of 

22 care; 

23 ‘‘(B) ensures communication among the in24 tegrated care team that is consistent and team25 based; 


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1 ‘‘(C) ensures shared decisionmaking be2 tween behavioral health and primary care pro3 viders; 

4 ‘‘(D) provides evidence-based services in a 

5 mode of service delivery appropriate for the tar6 get population; 

7 ‘‘(E) employs staff who are multidisci8 plinary and culturally and linguistically com9 petent; 

10 ‘‘(F) provides integrated services related to 

11 screening, diagnosis, and treatment of mental 

12 illness and substance use disorder and co-occur13 ring primary care conditions and chronic dis14 eases; and 

15 ‘‘(G) provides targeted case management, 

16 including services to assist individuals gaining 

17 access to needed medical, social, educational, 

18 and other services and applying for income se19 curity, housing, employment, and other benefits 

20 to which they may be entitled. 

21 ‘‘(2) INTEGRATED CARE TEAM.—The term ‘in22 tegrated care team’ means a team that includes— 

23 ‘‘(A) allopathic or osteopathic medical doc24 tors, such as a primary care physician and a 

25 psychiatrist; 


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1 ‘‘(B) licensed clinical behavioral health 

2 professionals, such as psychologists or social 

3 workers; 

4 ‘‘(C) a case manager; and 

5 ‘‘(D) other members, such as psychiatric 

6 advanced practice nurses, physician assistants, 

7 peer-support specialists or other allied health 

8 professionals, such as mental health counselors. 

9 ‘‘(3) SPECIAL POPULATION.—The term ‘special 

10 population’ means— 

11 ‘‘(A) adults with mental illnesses who have 

12 co-occurring primary care conditions with 

13 chronic diseases; 

14 ‘‘(B) adults with serious mental illnesses 

15 who have co-occurring primary care conditions 

16 with chronic diseases; 

17 ‘‘(C) children and adolescents with serious 

18 emotional disturbances with co-occurring pri19 mary care conditions and chronic diseases; 

20 ‘‘(D) older adults with mental illness who 

21 have co-occurring primary care conditions with 

22 chronic conditions; 

23 ‘‘(E) individuals with substance use dis24 order; or 


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1 ‘‘(F) individuals from populations for 

2 which there is a significant disparity in the 

3 quality, outcomes, cost, or use of mental health 

4 or substance use disorder services or a signifi5 cant disparity in access to such services, as 

6 compared to the general population, such as ra7 cial and ethnic minorities and rural populations. 

8 ‘‘(c) PURPOSE.—The grant program under this sec9 tion shall be designed to lead to full collaboration between 

10 primary and behavioral health in an integrated practice 

11 model to ensure that— 

12 ‘‘(1) the overall wellness and physical health 

13 status of individuals with serious mental illness or 

14 serious emotional disturbance and co-occurring sub15 stance use disorders is supported through integra16 tion of primary care into community mental health 

17 centers meeting the criteria specified in section 

18 1913(c) of the Social Security Act or certified com19 munity behavioral health clinics described in section 

20 223 of the Protecting Access to Medicare Act of 

21 2014; or 

22 ‘‘(2) the mental health status of individuals 

23 with significant co-occurring psychiatric and physical 

24 conditions will be supported through integration of 

25 behavioral health into primary care settings. 


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1 ‘‘(d) ELIGIBLE ENTITIES.—To be eligible to receive 

2 a grant or cooperative agreement under this section, an 

3 entity shall be a State department of health, State mental 

4 health or addiction agency, State Medicaid agency, or li5 censed health care provider or institution. The Adminis6 trator may give preference to States that have existing in7 tegrated care models, such as those authorized by section 

8 1945 of the Social Security Act. 

9 ‘‘(e) APPLICATION.—An eligible entity desiring a 

10 grant or cooperative agreement under this section shall 

11 submit an application to the Administrator at such time, 

12 in such manner, and accompanied by such information as 

13 the Administrator may require, including a description of 

14 a plan to achieve fully collaborative agreements to provide 

15 services to special populations and— 

16 ‘‘(1) a document that summarizes the State17 specific policies that inhibit the provision of inte18 grated care, and the specific steps that will be taken 

19 to address such barriers, such as through licensing 

20 and billing procedures; and 

21 ‘‘(2) a plan to develop and share a de-identified 

22 patient registry to track treatment implementation 

23 and clinical outcomes to inform clinical interven24 tions, patient education, and engagement with 

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1 pliance with applicable national and State health in2 formation privacy laws. 

3 ‘‘(f) GRANT AMOUNTS.—The maximum annual grant 

4 amount under this section shall be $2,000,000, of which 

5 not more than 10 percent may be allocated to State ad6 ministrative functions, and the remaining amounts shall 

7 be allocated to health facilities that provide integrated 

8 care. 

9 ‘‘(g) DURATION.—A grant under this section shall be 

10 for a period of 5 years. 

11 ‘‘(h) REPORT ON PROGRAM OUTCOMES.—An entity 

12 receiving a grant or cooperative agreement under this sec13 tion shall submit an annual report to the Administrator 

14 that includes— 

15 ‘‘(1) the progress to reduce barriers to inte16 grated care, including regulatory and billing bar17 riers, as described in the entity’s application under 

18 subsection (d); and 

19 ‘‘(2) a description of functional outcomes of 

20 special populations, such as— 

21 ‘‘(A) with respect to individuals with seri22 ous mental illness, participation in supportive 

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1 tunities, attendance at scheduled medical and 

2 mental health appointments, and compliance 

3 with treatment plans; 

4 ‘‘(B) with respect to individuals with co-oc5 curring mental illness and primary care condi6 tions and chronic diseases, attendance at sched7 uled medical and mental health appointments, 

8 compliance with treatment plans, and participa9 tion in learning opportunities related to im10 proved health and lifestyle practice; and 

11 ‘‘(C) with respect to children and adoles12 cents with serious emotional disorders who have 

13 co-occurring primary care conditions and chron14 ic diseases, attendance at scheduled medical 

15 and mental health appointments, compliance 

16 with treatment plans, and participation in 

17 learning opportunities at school and extra18 curricular activities. 

19 ‘‘(i) TECHNICAL ASSISTANCE CENTER FOR PRIMARY20 BEHAVIORAL HEALTH CARE INTEGRATION.— 

21 ‘‘(1) IN GENERAL.—The Secretary shall estab22 lish a program through which such Secretary shall 

23 provide appropriate information, training, and tech24 nical assistance to eligible entities that receive a 

25 grant or cooperative agreement under this section, in 


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1 order to help such entities to meet the requirements 

2 of this section, including assistance with— 

3 ‘‘(A) development and selection of inte4 grated care models; 

5 ‘‘(B) dissemination of evidence-based inter6 ventions in integrated care; 

7 ‘‘(C) establishment of organizational prac8 tices to support operational and administrative 

9 success; and 

10 ‘‘(D) other activities, as the Secretary de11 termines appropriate. 

12 ‘‘(2) ADDITIONAL DISSEMINATION OF TECH13 NICAL INFORMATION.—The information and re14 sources provided by the technical assistance program 

15 established under paragraph (1) shall be made avail16 able to States, political subdivisions of a State, In17 dian tribes or tribal organizations (as defined in sec18 tion 4 of the Indian Self-Determination and Edu19 cation Assistance Act), outpatient mental health and 

20 addiction treatment centers, community mental 

21 health centers that meet the criteria under section 

22 1913(c), certified community behavioral health clin23 ics described in section 223 of the Protecting Access 

24 to Medicare Act of 2014, primary care organizations 

25 such as Federally qualified health centers or rural 


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1 health centers, other community-based organiza2 tions, or other entities engaging in integrated care 

3 activities, as the Secretary determines appropriate. 

4 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—To 

5 carry out this section, there are authorized to be appro6 priated $50,000,000 for each of fiscal years 2017 through 

7 2021, of which $2,000,000 shall be available to the tech8 nical assistance program under subsection (i).’’. 

9 SEC. 513. HEALTH PROFESSIONS COMPETENCIES TO AD10 DRESS RACIAL, ETHNIC, SEXUAL, AND GEN11 DER MINORITY BEHAVIORAL HEALTH DIS12 PARITIES. 

13 (a) IN GENERAL.—The Secretary of Health and 

14 Human Services shall award grants to national organiza15 tions for the purpose of developing, and disseminating to 

16 health professional educational programs, curricula or 

17 core competencies addressing behavioral health disparities 

18 among racial, ethnic, sexual, and gender minority groups. 

19 (b) USE OF FUNDS.—Organizations receiving funds 

20 under subsection (a) shall use the funds to develop and 

21 disseminate curricula or core competencies, as described 

22 in such subsection, for use in the training of students in 

23 the professions of social work, psychology, psychiatry, 

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1 seling, or other mental health and substance use disorder 

2 providers that the Secretary deems appropriate. 

3 (c) ALLOWABLE ACTIVITIES.—Organizations receiv4 ing funds under subsection (a) may use the funds to en5 gage in the following activities related to the development 

6 and dissemination of curricula or core competencies: 

7 (1) Formation of committees or working groups 

8 comprised of experts from accredited health profes9 sions schools to identify core competencies relating 

10 to mental health disparities among racial and ethnic 

11 minority groups. 

12 (2) Planning of workshops in national fora to 

13 allow for public input into the educational needs as14 sociated with mental health disparities among racial 

15 and ethnic minority groups. 

16 (3) Dissemination and promotion of the use of 

17 curricula or core competencies in undergraduate and 

18 graduate health professions training programs na19 tionwide. 

20 (d) DEFINITIONS.—In this section, the term ‘‘racial 

21 and ethnic minority group’’ has the meaning given to such 

22 term in section 1707(g) of the Public Health Service Act 

23 (42 U.S.C. 300u–6(g)). 


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1 (e) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to carry out this section 

3 $1,000,000 for each of fiscal years 2017 through 2021. 

4 SEC. 514. BEHAVIORAL HEALTH CRISIS SYSTEMS. 

5 (a) DEFINITIONS.—For purposes of this section, the 

6 following definitions shall apply: 

7 (1) ELIGIBLE ENTITY.—The term ‘‘eligible enti8 ty’’ means a State, political subdivision of a State, 

9 or nonprofit private entity. 

10 (2) SECRETARY.—The term ‘‘Secretary’’ means 

11 the Secretary of Health and Human Services. 

12 (3) STATE.—The term ‘‘State’’ means each 

13 State of the United States, the District of Columbia, 

14 each commonwealth, territory or possession of the 

15 United States, and each federally recognized Indian 

16 tribe. 

17 (b) ESTABLISHMENT OF GRANT PROGRAM.— 

18 (1) ESTABLISHMENT.—The Secretary shall es19 tablish a program to award grants to eligible entities 

20 to establish and implement a system for preventing 

21 and de-escalating behavioral health crises. 

22 (2) USE OF FUNDS.— 

23 (A) IN GENERAL.—Grants under this sec24 tion may be used to carry out programs that— 


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1 (i) expand early intervention and 

2 treatment services to improve access to be3 havioral health crisis assistance and ad4 dress unmet behavioral health care needs; 

5 (ii) expand the continuum of services 

6 to address crisis prevention, crisis interven7 tion, and crisis stabilization; and 

8 (iii) reduce unnecessary hospitaliza9 tions by appropriately utilizing community10 based services and improving access to 

11 timely behavioral health crisis assistance. 

12 (B) AUTHORIZED ACTIVITIES.—The pro13 grams described in subparagraph (A) may in14 clude activities such as: 

15 (i) Mobile support or crisis support 

16 centers that provide field-based behavioral 

17 health assistance to individuals with men18 tal health or substance use disorders and 

19 links such individuals in crisis to appro20 priate services. 

21 (ii) School and community-based early 

22 intervention and prevention programs that 

23 provide mobile response, screening and as24 sessment, training and education, and 

25 peer-based and family services. 


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1 (iii) Mental health crisis intervention 

2 and response training for law enforcement 

3 officers to increase officers’ understanding 

4 and recognition of mental illnesses as well 

5 as increase their awareness of health care 

6 services available to individuals in crisis. 

7 (3) APPLICATION.—To be considered for a 

8 grant under this section, an eligible entity shall sub9 mit an application to the Secretary at such time, in 

10 such manner, and containing such information as 

11 the Secretary may require. At minimum, such appli12 cation shall include a description of— 

13 (A) the activities to be funded with the 

14 grant; 

15 (B) community needs; 

16 (C) the population to be served; and 

17 (D) the interaction between the activities 

18 described in subparagraph (A) and public sys19 tems of health and mental health care, law en20 forcement, social services, and related assist21 ance programs. 

22 (4) SELECTING AMONG APPLICANTS.— 

23 (A) IN GENERAL.—Grants shall be award24 ed to eligible entities on a competitive basis. 


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1 (B) SELECTION CRITERIA.—The Secretary 

2 shall evaluate applicants based on such criteria 

3 as the Secretary determines to be appropriate, 

4 including the ability of an applicant to carry 

5 out the activities described in paragraph (2). 

6 (5) REPORTS.— 

7 (A) ANNUAL REPORTS.— 

8 (i) ELIGIBLE ENTITIES.—As a condi9 tion of receiving a grant under this section, 

10 an eligible entity shall agree to submit a 

11 report to the Secretary, on an annual 

12 basis, describing the activities carried out 

13 with the grant and assessing the effective14 ness of such activities. 

15 (ii) SECRETARY.—The Secretary 

16 shall, on an annual basis, and using the re17 ports received under clause (i), report to 

18 Congress on the overall impact and effec19 tiveness of the grant program under this 

20 section. 

21 (B) FINAL REPORT.—Not later than Janu22 ary 15, 2021, the Secretary shall submit to 

23 Congress a final report that includes rec24 ommendations with respect to the feasibility 

25 and advisability of extending or expanding the 


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1 grant program. The report shall also provide an 

2 assessment of which systems and system ele3 ments proved most effective. 

4 (6) COLLECTION OF DATA.—The Secretary 

5 shall collect data on the grant program to determine 

6 its effectiveness in reducing the social impact of 

7 mental health crises and the feasibility and advis8 ability of extending the grant program. 

9 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

10 authorized to be appropriated to carry out this section 

11 $10,000,000 for each of fiscal years 2017 through 2021. 

12 SEC. 515. MENTAL HEALTH IN SCHOOLS. 

13 (a) TECHNICAL AMENDMENTS.—The second part G 

14 (relating to services provided through religious organiza15 tions) of title V of the Public Health Service Act (42 

16 U.S.C. 290kk et seq.) is amended— 

17 (1) by redesignating such part as part J; and 

18 (2) by redesignating sections 581 through 584 

19 as sections 596 through 596C, respectively. 

20 (b) SCHOOL-BASED MENTAL HEALTH AND CHIL21 DREN AND VIOLENCE.—Section 581 of the Public Health 

22 Service Act (42 U.S.C. 290hh) is amended to read as fol23 lows: 


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1 ‘‘SEC. 581. SCHOOL-BASED MENTAL HEALTH AND CHIL2 DREN AND VIOLENCE. 

3 ‘‘(a) IN GENERAL.—The Secretary, in collaboration 

4 with the Secretary of Education and in consultation with 

5 the Attorney General, shall, directly or through grants, 

6 contracts, or cooperative agreements awarded to public en7 tities and local education agencies, assist local commu8 nities and schools in applying a public health approach 

9 to mental health services both in schools and in the com10 munity. Such approach should provide comprehensive age 

11 appropriate services and supports, be linguistically and 

12 culturally appropriate, be trauma-informed, and incor13 porate age appropriate strategies of positive behavioral 

14 interventions and supports. A comprehensive school men15 tal health program funded under this section shall assist 

16 children in dealing with trauma and violence. 

17 ‘‘(b) ACTIVITIES.—Under the program under sub18 section (a), the Secretary may— 

19 ‘‘(1) provide financial support to enable local 

20 communities to implement a comprehensive cul21 turally and linguistically appropriate, trauma-in22 formed, and age-appropriate, school mental health 

23 program that incorporates positive behavioral inter24 ventions, client treatment, and supports to foster the 

25 health and development of children; 


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1 ‘‘(2) provide technical assistance to local com2 munities with respect to the development of pro3 grams described in paragraph (1); 

4 ‘‘(3) provide assistance to local communities in 

5 the development of policies to address child and ado6 lescent trauma and mental health issues and violence 

7 when and if it occurs; 

8 ‘‘(4) facilitate community partnerships among 

9 families, students, law enforcement agencies, edu10 cation systems, mental health and substance use dis11 order service systems, family-based mental health 

12 service systems, welfare agencies, health care service 

13 systems (including physicians), faith-based pro14 grams, trauma networks, and other community15 based systems; and 

16 ‘‘(5) establish mechanisms for children and ado17 lescents to report incidents of violence or plans by 

18 other children, adolescents, or adults to commit vio19 lence. 

20 ‘‘(c) REQUIREMENTS.— 

21 ‘‘(1) IN GENERAL.—To be eligible for a grant, 

22 contract, or cooperative agreement under subsection 

23 (a), an entity shall— 

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1 gram or agency that is involved in mental 

2 health; and 

3 ‘‘(B) submit an application, that is en4 dorsed by all members of the partnership, that 

5 contains the assurances described in paragraph 

6 (2). 

7 ‘‘(2) REQUIRED ASSURANCES.—An application 

8 under paragraph (1) shall contain assurances as fol9 lows: 

10 ‘‘(A) That the applicant will ensure that, 

11 in carrying out activities under this section, the 

12 local educational agency involved will enter into 

13 a memorandum of understanding— 

14 ‘‘(i) with, at least one, public or pri15 vate mental health entity, health care enti16 ty, law enforcement or juvenile justice enti17 ty, child welfare agency, family-based men18 tal health entity, family or family organiza19 tion, trauma network, or other community20 based entity; and 

21 ‘‘(ii) that clearly states— 

22 ‘‘(I) the responsibilities of each 

23 partner with respect to the activities 

24 to be carried out; 


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1 ‘‘(II) how each such partner will 

2 be accountable for carrying out such 

3 responsibilities; and 

4 ‘‘(III) the amount of non-Federal 

5 funding or in-kind contributions that 

6 each such partner will contribute in 

7 order to sustain the program. 

8 ‘‘(B) That the comprehensive school-based 

9 mental health program carried out under this 

10 section supports the flexible use of funds to ad11 dress— 

12 ‘‘(i) the promotion of the social, emo13 tional, and behavioral health of all students 

14 in an environment that is conducive to 

15 learning; 

16 ‘‘(ii) the reduction in the likelihood of 

17 at risk students developing social, emo18 tional, behavioral health problems, or sub19 stance use disorders; 

20 ‘‘(iii) the early identification of social, 

21 emotional, behavioral problems, or sub22 stance use disorders and the provision of 

23 early intervention services; 

24 ‘‘(iv) the treatment or referral for 

25 treatment of students with existing social, 


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1 emotional, behavioral health problems, or 

2 substance use disorders; and 

3 ‘‘(v) the development and implementa4 tion of programs to assist children in deal5 ing with trauma and violence. 

6 ‘‘(C) That the comprehensive school-based 

7 mental health program carried out under this 

8 section will provide for in-service training of all 

9 school personnel, including ancillary staff and 

10 volunteers, in— 

11 ‘‘(i) the techniques and supports need12 ed to identify early children with trauma 

13 histories and children with, or at risk of, 

14 mental illness; 

15 ‘‘(ii) the use of referral mechanisms 

16 that effectively link such children to appro17 priate treatment and intervention services 

18 in the school and in the community and to 

19 follow-up when services are not available; 

20 ‘‘(iii) strategies that promote a school21 wide positive environment; 

22 ‘‘(iv) strategies for promoting the so23 cial, emotional, mental, and behavioral 

24 health of all students; and 


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1 ‘‘(v) strategies to increase the knowl2 edge and skills of school and community 

3 leaders about the impact of trauma and vi4 olence and on the application of a public 

5 health approach to comprehensive school6 based mental health programs. 

7 ‘‘(D) That the comprehensive school-based 

8 mental health program carried out under this 

9 section will include comprehensive training for 

10 parents, siblings, and other family members of 

11 children with mental health disorders, and for 

12 concerned members of the community in— 

13 ‘‘(i) the techniques and supports need14 ed to identify early children with trauma 

15 histories, and children with, or at risk of, 

16 mental illness; 

17 ‘‘(ii) the use of referral mechanisms 

18 that effectively link such children to appro19 priate treatment and intervention services 

20 in the school and in the community and 

21 follow-up when such services are not avail22 able; and 

23 ‘‘(iii) strategies that promote a school24 wide positive environment. 


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1 ‘‘(E) That the comprehensive school-based 

2 mental health program carried out under this 

3 section will demonstrate the measures to be 

4 taken to sustain the program after funding 

5 under this section terminates. 

6 ‘‘(F) That the local education agency part7 nership involved is supported by the State edu8 cational and mental health system to ensure 

9 that the sustainability of the programs is estab10 lished after funding under this section termi11 nates. 

12 ‘‘(G) That the comprehensive school-based 

13 mental health program carried out under this 

14 section will be based on trauma-informed and 

15 evidence-based practices. 

16 ‘‘(H) That the comprehensive school-based 

17 mental health program carried out under this 

18 section will be coordinated with early inter19 vening activities carried out under the Individ20 uals with Disabilities Education Act. 

21 ‘‘(I) That the comprehensive school-based 

22 mental health program carried out under this 

23 section will be trauma-informed and culturally 

24 and linguistically appropriate. 


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1 ‘‘(J) That the comprehensive school-based 

2 mental health program carried out under this 

3 section will include a broad needs assessment of 

4 youth who drop out of school due to policies of 

5 ‘zero tolerance’ with respect to drugs, alcohol, 

6 or weapons and an inability to obtain appro7 priate services. 

8 ‘‘(K) That the mental health services pro9 vided through the comprehensive school-based 

10 mental health program carried out under this 

11 section will be provided by qualified mental and 

12 behavioral health professionals who are certified 

13 or licensed by the State involved and practicing 

14 within their area of expertise. 

15 ‘‘(3) COORDINATOR.—Any entity that is a 

16 member of a partnership described in paragraph 

17 (1)(A) may serve as the coordinator of funding and 

18 activities under the grant if all members of the part19 nership agree. 

20 ‘‘(4) COMPLIANCE WITH HIPAA.—A grantee 

21 under this section shall be deemed to be a covered 

22 entity for purposes of compliance with the regula23 tions promulgated under section 264(c) of the 

24 Health Insurance Portability and Accountability Act 


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1 of 1996 with respect to any patient records devel2 oped through activities under the grant. 

3 ‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary 

4 shall ensure that grants, contracts, or cooperative agree5 ments under subsection (a) will be distributed equitably 

6 among the regions of the country and among urban and 

7 rural areas. 

8 ‘‘(e) DURATION OF AWARDS.—With respect to a 

9 grant, contract, or cooperative agreement under sub10 section (a), the period during which payments under such 

11 an award will be made to the recipient shall be 5 years. 

12 An entity may receive only one award under this section, 

13 except that an entity that is providing services and sup14 ports on a regional basis may receive additional funding 

15 after the expiration of the preceding grant period. 

16 ‘‘(f) EVALUATION AND MEASURES OF OUTCOMES.— 

17 ‘‘(1) DEVELOPMENT OF PROCESS.—The Ad18 ministrator shall develop a fiscally appropriate proc19 ess for evaluating activities carried out under this 

20 section. Such process shall include— 

21 ‘‘(A) the development of guidelines for the 

22 submission of program data by grant, contract, 

23 or cooperative agreement recipients; 

24 ‘‘(B) the development of measures of out25 comes (in accordance with paragraph (2)) to be 


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1 applied by such recipients in evaluating pro2 grams carried out under this section; and 

3 ‘‘(C) the submission of annual reports by 

4 such recipients concerning the effectiveness of 

5 programs carried out under this section. 

6 ‘‘(2) MEASURES OF OUTCOMES.— 

7 ‘‘(A) IN GENERAL.—The Administrator 

8 shall develop measures of outcomes to be ap9 plied by recipients of assistance under this sec10 tion, and the Administrator, in evaluating the 

11 effectiveness of programs carried out under this 

12 section. Such measures shall include student 

13 and family measures as provided for in sub14 paragraph (B) and local educational measures 

15 as provided for under subparagraph (C). 

16 ‘‘(B) STUDENT AND FAMILY MEASURES OF

17 OUTCOMES.—The measures of outcomes devel18 oped under paragraph (1)(B) relating to stu19 dents and families shall, with respect to activi20 ties carried out under a program under this 

21 section, at a minimum include provisions to 

22 evaluate whether the program is effective in— 

23 ‘‘(i) increasing social and emotional 

24 competency; 


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1 ‘‘(ii) increasing academic competency 

2 (as defined by the Secretary); 

3 ‘‘(iii) reducing disruptive and aggres4 sive behaviors; 

5 ‘‘(iv) improving child functioning; 

6 ‘‘(v) reducing substance use disorders; 

7 ‘‘(vi) reducing suspensions, truancy, 

8 expulsions and violence; 

9 ‘‘(vii) increasing graduation rates (as 

10 defined in section 1111(b)(2)(C)(vi) of the 

11 Elementary and Secondary Education Act 

12 of 1965); and 

13 ‘‘(viii) improving access to care for 

14 mental health disorders. 

15 ‘‘(C) LOCAL EDUCATIONAL OUTCOMES.— 

16 The outcome measures developed under para17 graph (1)(B) relating to local educational sys18 tems shall, with respect to activities carried out 

19 under a program under this section, at a min20 imum include provisions to evaluate— 

21 ‘‘(i) the effectiveness of comprehensive 

22 school mental health programs established 

23 under this section; 

24 ‘‘(ii) the effectiveness of formal part25 nership linkages among child and family 


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1 serving institutions, community support 

2 systems, and the educational system; 

3 ‘‘(iii) the progress made in sustaining 

4 the program once funding under the grant 

5 has expired; 

6 ‘‘(iv) the effectiveness of training and 

7 professional development programs for all 

8 school personnel that incorporate indica9 tors that measure cultural and linguistic 

10 competencies under the program in a man11 ner that incorporates appropriate cultural 

12 and linguistic training; 

13 ‘‘(v) the improvement in perception of 

14 a safe and supportive learning environment 

15 among school staff, students, and parents; 

16 ‘‘(vi) the improvement in case-finding 

17 of students in need of more intensive serv18 ices and referral of identified students to 

19 early intervention and clinical services; 

20 ‘‘(vii) the improvement in the imme21 diate availability of clinical assessment and 

22 treatment services within the context of 

23 the local community to students posing a 

24 danger to themselves or others; 


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1 ‘‘(viii) the increased successful matric2 ulation to postsecondary school; and 

3 ‘‘(ix) reduced referrals to juvenile jus4 tice. 

5 ‘‘(3) SUBMISSION OF ANNUAL DATA.—An entity 

6 that receives a grant, contract, or cooperative agree7 ment under this section shall annually submit to the 

8 Administrator a report that includes data to evalu9 ate the success of the program carried out by the en10 tity based on whether such program is achieving the 

11 purposes of the program. Such reports shall utilize 

12 the measures of outcomes under paragraph (2) in a 

13 reasonable manner to demonstrate the progress of 

14 the program in achieving such purposes. 

15 ‘‘(4) EVALUATION BY ADMINISTRATOR.—Based 

16 on the data submitted under paragraph (3), the Ad17 ministrator shall annually submit to Congress a re18 port concerning the results and effectiveness of the 

19 programs carried out with assistance received under 

20 this section. 

21 ‘‘(5) LIMITATION.—A grantee shall use not to 

22 exceed 10 percent of amounts received under a grant 

23 under this section to carry out evaluation activities 

24 under this subsection. 


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1 ‘‘(g) INFORMATION AND EDUCATION.—The Sec2 retary shall establish comprehensive information and edu3 cation programs to disseminate the findings of the knowl4 edge development and application under this section to the 

5 general public and to health care professionals. 

6 ‘‘(h) AMOUNT OF GRANTS AND AUTHORIZATION OF

7 APPROPRIATIONS.— 

8 ‘‘(1) AMOUNT OF GRANTS.—A grant under this 

9 section shall be in an amount that is not more than 

10 $1,000,000 for each of fiscal years 2017 through 

11 2021. The Secretary shall determine the amount of 

12 each such grant based on the population of children 

13 up to age 21 of the area to be served under the 

14 grant. 

15 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

16 There is authorized to be appropriated to carry out 

17 this section, $20,000,000 for each of fiscal years 

18 2017 through 2021.’’. 

19 (c) CONFORMING AMENDMENT.—Part G of title V of 

20 the Public Health Service Act (42 U.S.C. 290hh et seq.), 

21 as amended by this section, is further amended by striking 

22 the part heading and inserting the following: 


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1 ‘‘PART G—SCHOOL-BASED MENTAL HEALTH’’. 

2 SEC. 516. EXAMINING MENTAL HEALTH CARE FOR CHIL3 DREN. 

4 (a) IN GENERAL.—Not later than one year after the 

5 date of enactment of this Act, the Comptroller General 

6 of the United States shall conduct an independent evalua7 tion, and submit to the Committee on Health, Education, 

8 Labor, and Pensions of the Senate and the Committee on 

9 Energy and Commerce of the House of Representatives, 

10 a report concerning the utilization of mental health serv11 ices for children, including the usage of psychotropic medi12 cations. 

13 (b) CONTENT.—The report submitted under sub14 section (a) shall review and assess— 

15 (1) the ways in which children access mental 

16 health care, including information on whether chil17 dren are screened and treated by primary care or 

18 specialty physicians or other health care providers, 

19 what types of referrals for additional care are rec20 ommended, and any barriers to accessing this care; 

21 (2) the extent to which children prescribed psy22 chotropic medications in the United States face bar23 riers to more comprehensive or other mental health 

24 services, interventions, and treatments; 

25 (3) the extent to which children are prescribed 

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1 cluding the frequency of concurrent medication 

2 usage; and 

3 (4) the tools, assessments, and medications that 

4 are available and used to diagnose and treat children 

5 with mental health disorders. 

6 SEC. 517. REPORTING COMPLIANCE STUDY. 

7 (a) IN GENERAL.—The Secretary of Health and 

8 Human Services shall enter into an arrangement with the 

9 Institute of Medicine of the National Academies (or, if the 

10 Institute declines, another appropriate entity) under 

11 which, not later than 2 years after the date of enactment 

12 of this Act, the Institute will submit to the appropriate 

13 committees of Congress a report that evaluates the com14 bined paperwork burden of— 

15 (1) community mental health centers meeting 

16 the criteria specified in section 1913(c) of the Public 

17 Health Service Act (42 U.S.C. 300x–2), including 

18 such centers meeting such criteria as in effect on the 

19 day before the date of enactment of this Act; and 

20 (2) federally qualified community mental health 

21 clinics certified pursuant to section 223 of the Pro22 tecting Access to Medicare Act of 2014 (Public Law 

23 113–93), as amended by section 505. 

24 (b) SCOPE.—In preparing the report under sub25 section (a), the Institute of Medicine (or, if applicable, 


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1 other appropriate entity) shall examine licensing, certifi2 cation, service definitions, claims payment, billing codes, 

3 and financial auditing requirements used by the Office of 

4 Management and Budget, the Centers for Medicare & 

5 Medicaid Services, the Health Resources and Services Ad6 ministration, the Substance Abuse and Mental Health 

7 Services Administration, the Office of the Inspector Gen8 eral of the Department of Health and Human Services, 

9 State Medicaid agencies, State departments of health, 

10 State departments of education, and State and local juve11 nile justice, social service agencies, and private insurers 

12 to— 

13 (1) establish an estimate of the combined na14 tionwide cost of complying with such requirements, 

15 in terms of both administrative funding and staff 

16 time; 

17 (2) establish an estimate of the per capita cost 

18 to each center or clinic described in subparagraph 

19 (A) or (B) of paragraph (1) to comply with such re20 quirements, in terms of both administrative funding 

21 and staff time; and 

22 (3) make administrative and statutory rec23 ommendations to Congress (which recommendations 

24 may include a uniform methodology) to reduce the 

25 paperwork burden experienced by centers and clinics 


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1 described in subparagraph (A) or (B) of paragraph 

2 (1). 

3 SEC. 518. STRENGTHENING CONNECTIONS TO COMMUNITY 

4 CARE DEMONSTRATION GRANT PROGRAM. 

5 (a) IN GENERAL.—The Secretary of Health and 

6 Human Services, acting through the Substance Abuse and 

7 Mental Health Services Administration, shall establish a 

8 demonstration grant program to award grants to eligible 

9 entities to help to connect incarcerated and recently re10 leased individuals with mental illness or substance use dis11 orders with community-based treatment providers and 

12 coverage opportunities upon release from a corrections fa13 cility. 

14 (b) DESIGN.—The demonstration grant program 

15 under this section shall be designed to ensure that incar16 cerated and recently released individuals with mental ill17 ness or substance use disorders have the information and 

18 help they need to connect to community-based care and 

19 coverage upon release from a corrections facility. 

20 (c) RECIPIENTS.—To be eligible to receive a grant 

21 under this section, an entity shall be a State Medicaid 

22 agency, State mental health agency, State substance abuse 

23 agency, county, city, nonprofit community-based organiza24 tion, or any other entity the Secretary deems appropriate. 


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1 (d) APPLICATION REQUIREMENT.—To seek an award 

2 under this section, an applicant shall provide a plan detail3 ing the applicant’s strategy for carrying out the program 

4 to be funded through the award. 

5 (e) SPECIAL CONSIDERATIONS.—In awarding grants 

6 under this section, the Secretary may consider— 

7 (1) the number of individuals or correctional fa8 cilities proposed to be served; and 

9 (2) the potential for replicability of the model 

10 proposed. 

11 (f) REPORTS.— 

12 (1) ANNUAL REPORTS.—As a condition of re13 ceiving a grant under this section, an eligible entity 

14 shall agree to submit a report to the Secretary, on 

15 an annual basis, describing the activities carried out 

16 with the grant and assessing the effectiveness of 

17 such activities. Such information shall include— 

18 (A) the number of individuals served with 

19 mental illness, serious mental illness, substance 

20 use disorders, or co-occurring mental health 

21 and substance use disorders; 

22 (B) the number of connections completed 

23 between individuals and community-based pro24 viders; 


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1 (C) the number of connections completed 

2 between individuals and community-based cov3 erage; and 

4 (D) any other information required by the 

5 Secretary. 

6 (2) SECRETARY.—The Secretary shall, on an 

7 annual basis, and using the reports received under 

8 paragraph (1), report to Congress on the overall im9 pact and effectiveness of the grant program under 

10 this section. 

11 (3) FINAL REPORT.—Not later than January 

12 15, 2020, the Secretary shall submit to Congress a 

13 final report that includes recommendations with re14 spect to the feasibility and advisability of extending 

15 or expanding the grant program under this section. 

16 The report shall also provide an assessment of which 

17 programs and program elements proved most effec18 tive. 

19 (g) AUTHORIZATION OF APPROPRIATIONS.—To carry 

20 out this section, there is authorized to be appropriated to 

21 carry out this section $5,000,000 for each of fiscal years 

22 2017 through 2021. 


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1 SEC. 519. ASSERTIVE COMMUNITY TREATMENT GRANT 

2 PROGRAM FOR INDIVIDUALS WITH SERIOUS 

3 MENTAL ILLNESS. 

4 (a) IN GENERAL.—The Secretary of Health and 

5 Human Services, acting through the Substance Abuse and 

6 Mental Health Services Administration, shall award 

7 grants to eligible entities— 

8 (1) to establish assertive community treatment 

9 programs for individuals with serious mental illness; 

10 or 

11 (2) to maintain or expand such programs. 

12 (b) ELIGIBLE ENTITIES.—To be eligible to receive a 

13 grant under this section, an entity shall be a State, county, 

14 city, tribes, tribal organizations, mental health system, 

15 health care facility, or any other entity the Secretary 

16 deems appropriate. 

17 (c) SPECIAL CONSIDERATION.—In selecting among 

18 applicants for a grant under this section, the Secretary 

19 may give special consideration to the potential of the appli20 cant’s program to reduce hospitalization, homelessness, in21 carceration, and interaction with the criminal justice sys22 tem while improving the health and social outcomes of the 

23 patient. 

24 (d) ADDITIONAL ACTIVITIES.—The Secretary shall— 

25 (1) at the conclusion of each fiscal year, submit 

26 a report to the appropriate congressional committees 


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1 on the grant program under this section, including 

2 an evaluation of— 

3 (A) cost savings and public health out4 comes such as mortality, suicide, substance 

5 abuse, hospitalization, and use of services; 

6 (B) rates of incarceration of patients; 

7 (C) rates of homelessness among patients; 

8 and 

9 (D) patient and family satisfaction with 

10 program participation; and 

11 (2) provide appropriate information, training, 

12 and technical assistance to grant recipients under 

13 this section to help such recipients to establish, 

14 maintain, or expand their assertive community treat15 ment programs. 

16 (e) AUTHORIZATION OF APPROPRIATIONS.— 

17 (1) IN GENERAL.—To carry out this section, 

18 there is authorized to be appropriated $20,000,000 

19 for each of fiscal years 2017 through 2021. 

20 (2) USE OF CERTAIN FUNDS.—Of the funds ap21 propriated to carry out this section in any fiscal 

22 year, no more than 5 percent shall be available to 

23 the Secretary for carrying out subsection (d). 


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1 SEC. 520. IMPROVING MENTAL AND BEHAVIORAL HEALTH 

2 ON COLLEGE CAMPUSES. 

3 Title V of the Public Health Service Act (42 U.S.C. 

4 290aa et seq.) is amended by inserting after section 

5 520E–3, as added by section 111 of this Act, the fol6 lowing: 

7 ‘‘SEC. 520E–4. GRANTS TO IMPROVE MENTAL AND BEHAV8 IORAL HEALTH ON COLLEGE CAMPUSES. 

9 ‘‘(a) PURPOSE.—It is the purpose of this section, 

10 with respect to college and university settings, to— 

11 ‘‘(1) increase access to mental and behavioral 

12 health services; 

13 ‘‘(2) foster and improve the prevention of men14 tal and behavioral health disorders, and the pro15 motion of mental health wellness; 

16 ‘‘(3) improve the identification and treatment 

17 for students at risk; 

18 ‘‘(4) improve collaboration and the development 

19 of appropriate levels of mental and behavioral health 

20 care; 

21 ‘‘(5) reduce the stigma for students with mental 

22 health disorders and enhance their access to mental 

23 health services; and 

24 ‘‘(6) improve the efficacy of outreach efforts. 

25 ‘‘(b) GRANTS.—The Secretary, acting through the 

26 Administrator and in consultation with the Secretary of 


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1 Education, shall award competitive grants to eligible enti2 ties to improve mental and behavioral health services and 

3 outreach on college and university campuses. 

4 ‘‘(c) ELIGIBILITY.—To be eligible to receive a grant 

5 under subsection (b), an entity shall— 

6 ‘‘(1) be an institution of higher education (as 

7 defined in section 101 of the Higher Education Act 

8 of 1965 (20 U.S.C. 1001)); and 

9 ‘‘(2) submit to the Secretary an application at 

10 such time, in such manner, and containing such in11 formation as the Secretary may require, including 

12 the information required under subsection (d). 

13 ‘‘(d) APPLICATION.—An application for a grant 

14 under this section shall include— 

15 ‘‘(1) a description of the population to be tar16 geted by the program carried out under the grant, 

17 the particular mental and behavioral health needs of 

18 the students involved; 

19 ‘‘(2) a description of the Federal, State, local, 

20 private, and institutional resources available for 

21 meeting the needs of such students at the time the 

22 application is submitted; 

23 ‘‘(3) an outline of the objectives of the program 

24 carried out under the grant; 


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1 ‘‘(4) a description of activities, services, and 

2 training to be provided under the program, including 

3 planned outreach strategies to reach students not 

4 currently seeking services; 

5 ‘‘(5) a plan to seek input from community men6 tal health providers, when available, community 

7 groups, and other public and private entities in car8 rying out the program; 

9 ‘‘(6) a plan, when applicable, to meet the spe10 cific mental and behavioral health needs of veterans 

11 attending institutions of higher education; 

12 ‘‘(7) a description of the methods to be used to 

13 evaluate the outcomes and effectiveness of the pro14 gram; and 

15 ‘‘(8) an assurance that grant funds will be used 

16 to supplement, and not supplant, any other Federal, 

17 State, or local funds available to carry out activities 

18 of the type carried out under the grant. 

19 ‘‘(e) SPECIAL CONSIDERATIONS.—In awarding 

20 grants under this section, the Secretary shall give special 

21 consideration to applications that describe programs to be 

22 carried out under the grant that— 

23 ‘‘(1) demonstrate the greatest need for new or 

24 additional mental and behavioral health services, in 

25 part by providing information on current ratios of 


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1 students to mental and behavioral health profes2 sionals; 

3 ‘‘(2) propose effective approaches for initiating 

4 or expanding campus services and supports using 

5 evidence-based practices; 

6 ‘‘(3) target traditionally underserved popu7 lations and populations most at risk; 

8 ‘‘(4) where possible, demonstrate an awareness 

9 of, and a willingness to, coordinate with a commu10 nity mental health center or other mental health re11 source in the community, to support screening and 

12 referral of students requiring intensive services; 

13 ‘‘(5) identify how the college or university will 

14 address psychiatric emergencies, including how in15 formation will be communicated with families or 

16 other appropriate parties; 

17 ‘‘(6) propose innovative practices that will im18 prove efficiencies in clinical care, broaden collabora19 tions with primary care, or improve prevention pro20 grams; and 

21 ‘‘(7) demonstrate the greatest potential for rep22 lication and dissemination. 

23 ‘‘(f) USE OF FUNDS.—Amounts received under a 

24 grant under this section may be used to— 


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1 ‘‘(1) provide mental and behavioral health serv2 ices to students, including prevention, promotion of 

3 mental health, voluntary screening, early interven4 tion, voluntary assessment, voluntary treatment, 

5 management, and education services relating to the 

6 mental and behavioral health of students; 

7 ‘‘(2) conduct research through a counseling or 

8 health center at the institution of higher education 

9 involved regarding improving the mental and behav10 ioral health of college and university students 

11 through clinical services, outreach, prevention, or 

12 academic success; 

13 ‘‘(3) provide outreach services to notify stu14 dents about the existence of mental and behavioral 

15 health services; 

16 ‘‘(4) educate students, families, faculty, staff, 

17 and communities to increase awareness of mental 

18 health issues; 

19 ‘‘(5) support student groups on campus that 

20 engage in activities to educate students, including 

21 activities to reduce stigma surrounding mental and 

22 behavioral disorders, and promote mental health 

23 wellness; 

24 ‘‘(6) employ appropriately trained staff; 


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1 ‘‘(7) provide training to students, faculty, and 

2 staff to respond effectively to students with mental 

3 and behavioral health issues; 

4 ‘‘(8) expand mental health training through in5 ternship, post-doctorate, and residency programs; 

6 ‘‘(9) develop and support evidence-based and 

7 emerging best practices, including a focus on cul8 turally and linguistically appropriate best practices; 

9 and 

10 ‘‘(10) evaluate and disseminate best practices to 

11 other colleges and universities. 

12 ‘‘(g) DURATION OF GRANTS.—A grant under this 

13 section shall be awarded for a period not to exceed 3 years. 

14 ‘‘(h) EVALUATION AND REPORTING.— 

15 ‘‘(1) EVALUATION.—Not later than 18 months 

16 after the date on which a grant is received under 

17 this section, the eligible entity involved shall submit 

18 to the Secretary the results of an evaluation to be 

19 conducted by the entity (or by another party under 

20 contract with the entity) concerning the effectiveness 

21 of the activities carried out under the grant and 

22 plans for the sustainability of such efforts. 

23 ‘‘(2) REPORT.—Not later than 2 years after the 

24 date of enactment of this section, the Secretary shall 


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1 submit to the appropriate committees of Congress a 

2 report concerning the results of— 

3 ‘‘(A) the evaluations conducted under 

4 paragraph (1); and 

5 ‘‘(B) an evaluation conducted by the Sec6 retary to analyze the effectiveness and efficacy 

7 of the activities conducted with grants under 

8 this section. 

9 ‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may 

10 provide technical assistance to grantees in carrying out 

11 this section. 

12 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated $15,000,000 for each 

14 of fiscal years 2017 through 2021.’’. 

15 SEC. 521. INCLUSION OF OCCUPATIONAL THERAPISTS IN 

16 NATIONAL HEALTH SERVICE CORPS PRO17 GRAM. 

18 (a) INCLUSION OF OCCUPATIONAL THERAPISTS.— 

19 Section 331(a)(3)(E)(i) of the Public Health Service Act 

20 (42 U.S.C. 254d(a)(3)(E)(i)) is amended by inserting 

21 ‘‘subject to section 521(b)(2) of the Comprehensive Be22 havioral Health Reform and Recovery Act of 2016, occu23 pational therapists,’’ after ‘‘psychiatric nurse specialists,’’. 

24 (b) EFFECTIVE DATE; CONTINGENT IMPLEMENTA25 TION.— 


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1 (1) EFFECTIVE DATE.—Subject to paragraph 

2 (2), the amendment made by subsection (a) shall 

3 apply beginning on October 1, 2016. 

4 (2) CONTINGENT IMPLEMENTATION.—The 

5 amendment made by subsection (a) shall apply with 

6 respect to obligations entered into for a fiscal year 

7 after fiscal year 2016 only if the total amount made 

8 available for the purpose of carrying out subparts II 

9 and III of part D of title III of the Public Health 

10 Service Act (42 U.S.C. 254d et seq.) for such fiscal 

11 year is greater than the total amount made available 

12 for such purpose for fiscal year 2016. 

13 TITLE VI—IMPROVING MENTAL 

14 HEALTH RESEARCH AND CO15 ORDINATION 

16 SEC. 601. INCREASE IN FUNDING FOR CERTAIN RESEARCH. 

17 Section 402A(a) of the Public Health Service Act (42 

18 U.S.C. 282a(a)) is amended by adding at the end the fol19 lowing: 

20 ‘‘(3) FUNDING FOR THE BRAIN INITIATIVE AT

21 THE NATIONAL INSTITUTE OF MENTAL HEALTH.— 

22 ‘‘(A) FUNDING.—In addition to amounts 

23 made available pursuant to paragraphs (1) and 

24 (2), there are authorized to be appropriated to 

25 the National Institute of Mental Health for the 


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1 purpose described in subparagraph (B)(ii) 

2 $40,000,000 for each of fiscal years 2017 

3 through 2021. 

4 ‘‘(B) PURPOSES.—Amounts appropriated 

5 pursuant to subparagraph (A) shall be used ex6 clusively for the purpose of conducting or sup7 porting— 

8 ‘‘(i) research on the determinants of 

9 self- and other directed-violence in mental 

10 illness, including studies directed at the 

11 causes of such violence and at intervention 

12 to reduce the risk of self harm, suicide, 

13 and interpersonal violence; or 

14 ‘‘(ii) brain research through the Brain 

15 Research through Advancing Innovative 

16 Neurotechnologies Initiative.’’. 

17 TITLE VII—BEHAVIORAL 

18 HEALTH INFORMATION TECH19 NOLOGY 

20 SEC. 701. EXTENSION OF HEALTH INFORMATION TECH21 NOLOGY ASSISTANCE FOR BEHAVIORAL AND 

22 MENTAL HEALTH AND SUBSTANCE ABUSE. 

23 Section 3000(3) of the Public Health Service Act (42 

24 U.S.C. 300jj(3)) is amended by inserting before ‘‘and any 

25 other category’’ the following: ‘‘behavioral and mental 


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1 health professionals (as defined in section 

2 331(a)(3)(E)(i)), a substance abuse professional, a psy3 chiatric hospital (as defined in section 1861(f) of the So4 cial Security Act), a community mental health center 

5 meeting the criteria specified in section 1913(c), a residen6 tial or outpatient mental health or substance use treat7 ment facility,’’. 

8 SEC. 702. EXTENSION OF ELIGIBILITY FOR MEDICARE AND 

9 MEDICAID HEALTH INFORMATION TECH10 NOLOGY IMPLEMENTATION ASSISTANCE. 

11 (a) PAYMENT INCENTIVES FOR ELIGIBLE PROFES12 SIONALS UNDER MEDICARE.—Section 1848 of the Social 

13 Security Act (42 U.S.C. 1395w–4) is amended— 

14 (1) in subsection (a)(7)— 

15 (A) in subparagraph (E), by adding at the 

16 end the following new clause: 

17 ‘‘(iv) ADDITIONAL ELIGIBLE PROFES18 SIONAL.—The term ‘additional eligible pro19 fessional’ means a clinical psychologist pro20 viding qualified psychologist services (as 

21 defined in section 1861(ii)).’’; and 

22 (B) by adding at the end the following new 

23 subparagraph: 

24 ‘‘(F) APPLICATION TO ADDITIONAL ELIGI25 BLE PROFESSIONALS.—The Secretary shall 


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1 apply the provisions of this paragraph with re2 spect to an additional eligible professional in 

3 the same manner as such provisions apply to an 

4 eligible professional, except in applying sub5 paragraph (A)— 

6 ‘‘(i) in clause (i), the reference to 

7 2015 shall be deemed a reference to 2020; 

8 ‘‘(ii) in clause (ii), the references to 

9 2015, 2016, and 2017 shall be deemed ref10 erences to 2020, 2021, and 2022, respec11 tively; and 

12 ‘‘(iii) in clause (iii), the reference to 

13 2018 shall be deemed a reference to 

14 2023.’’; and 

15 (2) in subsection (o)— 

16 (A) in paragraph (5), by adding at the end 

17 the following new subparagraph: 

18 ‘‘(D) ADDITIONAL ELIGIBLE PROFES19 SIONAL.—The term ‘additional eligible profes20 sional’ means a clinical psychologist providing 

21 qualified psychologist services (as defined in 

22 section 1861(ii)).’’; and 

23 (B) by adding at the end the following new 

24 paragraph: 


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1 ‘‘(6) APPLICATION TO ADDITIONAL ELIGIBLE

2 PROFESSIONALS.—The Secretary shall apply the 

3 provisions of this subsection with respect to an addi4 tional eligible professional in the same manner as 

5 such provisions apply to an eligible professional, ex6 cept in applying— 

7 ‘‘(A) paragraph (1)(A)(ii), the reference to 

8 2016 shall be deemed a reference to 2021; 

9 ‘‘(B) paragraph (1)(B)(ii), the references 

10 to 2011 and 2012 shall be deemed references to 

11 2016 and 2017, respectively; 

12 ‘‘(C) paragraph (1)(B)(iii), the references 

13 to 2013 shall be deemed references to 2018; 

14 ‘‘(D) paragraph (1)(B)(v), the references 

15 to 2014 shall be deemed references to 2019; 

16 and 

17 ‘‘(E) paragraph (1)(E), the reference to 

18 2011 shall be deemed a reference to 2016.’’. 

19 (b) ELIGIBLE HOSPITALS.—Section 1886 of the So20 cial Security Act (42 U.S.C. 1395ww) is amended— 

21 (1) in subsection (b)(3)(B)(ix), by adding at the 

22 end the following new subclause: 

23 ‘‘(V) The Secretary shall apply 

24 the provisions of this subsection with 

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1 pital (as defined in subsection 

2 (n)(6)(C)) in the same manner as 

3 such provisions apply to an eligible 

4 hospital, except in applying— 

5 ‘‘(aa) subclause (I), the ref6 erences to 2015, 2016, and 2017 

7 shall be deemed references to 

8 2020, 2021, and 2022, respec9 tively; and 

10 ‘‘(bb) subclause (III), the 

11 reference to 2015 shall be 

12 deemed a reference to 2020.’’; 

13 and 

14 (2) in subsection (n)— 

15 (A) in paragraph (6), by adding at the end 

16 the following new subparagraph: 

17 ‘‘(C) ADDITIONAL ELIGIBLE HOSPITAL.— 

18 The term ‘additional eligible hospital’ means an 

19 inpatient hospital that is a psychiatric hospital 

20 (as defined in section 1861(f)).’’; and 

21 (B) by adding at the end the following new 

22 paragraph: 

23 ‘‘(7) APPLICATION TO ADDITIONAL ELIGIBLE

24 HOSPITALS.—The Secretary shall apply the provi25 sions of this subsection with respect to an additional 


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1 eligible hospital in the same manner as such provi2 sions apply to an eligible hospital, except in apply3 ing— 

4 ‘‘(A) paragraph (2)(E)(ii), the references 

5 to 2013 and 2015 shall be deemed references to 

6 2018 and 2020, respectively; and 

7 ‘‘(B) paragraph (2)(G)(i), the reference to 

8 2011 shall be deemed a reference to 2016.’’. 

9 (c) MEDICAID PROVIDERS.—Section 1903(t) of the 

10 Social Security Act (42 U.S.C. 1396b(t)) is amended— 

11 (1) in paragraph (2)(B)— 

12 (A) in clause (i), by striking ‘‘, or’’ at the 

13 end and inserting a semicolon; 

14 (B) in clause (ii), by striking the period at 

15 the end and inserting a semicolon; and 

16 (C) by inserting after clause (ii) the fol17 lowing new clauses: 

18 ‘‘(iii) a public hospital that is principally a 

19 psychiatric hospital (as defined in section 

20 1861(f)); 

21 ‘‘(iv) a private hospital that is principally 

22 a psychiatric hospital (as defined in section 

23 1861(f)) and that has at least 10 percent of its 

24 patient volume (as estimated in accordance with 

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1 tributable to individuals receiving medical as2 sistance under this title; 

3 ‘‘(v) a community mental health center 

4 meeting the criteria specified in section 1913(c) 

5 of the Public Health Service Act; or 

6 ‘‘(vi) a residential or outpatient mental 

7 health or substance use treatment facility 

8 that— 

9 ‘‘(I) is accredited by the Joint Com10 mission on Accreditation of Healthcare Or11 ganizations, the Commission on Accredita12 tion of Rehabilitation Facilities, the Coun13 cil on Accreditation, or any other national 

14 accrediting agency recognized by the Sec15 retary; and 

16 ‘‘(II) has at least 10 percent of its pa17 tient volume (as estimated in accordance 

18 with a methodology established by the Sec19 retary) attributable to individuals receiving 

20 medical assistance under this title.’’; and 

21 (2) in paragraph (3)(B)— 

22 (A) in clause (iv), by striking ‘‘; and’’ at 

23 the end and inserting a semicolon; 

24 (B) in clause (v), by striking the period at 

25 the end and inserting ‘‘; and’’; and 


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1 (C) by adding at the end the following new 

2 clause: 

3 ‘‘(vi) clinical psychologist providing quali4 fied psychologist services (as defined in section 

5 1861(ii)), if such clinical psychologist is prac6 ticing in an outpatient clinic that— 

7 ‘‘(I) is led by a clinical psychologist; 

8 and 

9 ‘‘(II) is not otherwise receiving pay10 ment under paragraph (1) as a Medicaid 

11 provider described in paragraph (2)(B).’’. 

12 (d) MEDICARE ADVANTAGE ORGANIZATIONS.—Sec13 tion 1853 of the Social Security Act (42 U.S.C. 1395w– 

14 23) is amended— 

15 (1) in subsection (l)— 

16 (A) in paragraph (1)— 

17 (i) by inserting ‘‘or additional eligible 

18 professionals (as described in paragraph 

19 (9))’’ after ‘‘paragraph (2)’’; and 

20 (ii) by inserting ‘‘and additional eligi21 ble professionals’’ before ‘‘under such sec22 tions’’; 

23 (B) in paragraph (3)(B)— 

24 (i) in clause (i) in the matter pre25 ceding subclause (I), by inserting ‘‘or an 


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1 additional eligible professional described in 

2 paragraph (9)’’ after ‘‘paragraph (2)’’; and 

3 (ii) in clause (ii)— 

4 (I) in the matter preceding sub5 clause (I), by inserting ‘‘or an addi6 tional eligible professional described in 

7 paragraph (9)’’ after ‘‘paragraph 

8 (2)’’; and 

9 (II) in subclause (I), by inserting 

10 ‘‘or an additional eligible professional, 

11 respectively,’’ after ‘‘eligible profes12 sional’’; 

13 (C) in paragraph (3)(C), by inserting ‘‘and 

14 additional eligible professionals’’ after ‘‘all eligi15 ble professionals’’; 

16 (D) in paragraph (4)(D), by adding at the 

17 end the following new sentence: ‘‘In the case 

18 that a qualifying MA organization attests that 

19 not all additional eligible professionals of the 

20 organization are meaningful EHR users with 

21 respect to an applicable year, the Secretary 

22 shall apply the payment adjustment under this 

23 paragraph based on the proportion of all such 

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1 tion that are not meaningful EHR users for 

2 such year.’’; 

3 (E) in paragraph (6)(A), by inserting 

4 ‘‘and, as applicable, each additional eligible pro5 fessional described in paragraph (9)’’ after 

6 ‘‘paragraph (2)’’; 

7 (F) in paragraph (6)(B), by inserting 

8 ‘‘and, as applicable, each additional eligible hos9 pital described in paragraph (9)’’ after ‘‘sub10 section (m)(1)’’; 

11 (G) in paragraph (7)(A), by inserting 

12 ‘‘and, as applicable, additional eligible profes13 sionals’’ after ‘‘eligible professionals’’; 

14 (H) in paragraph (7)(B), by inserting 

15 ‘‘and, as applicable, additional eligible profes16 sionals’’ after ‘‘eligible professionals’’; 

17 (I) in paragraph (8)(B), by inserting ‘‘and 

18 additional eligible professionals described in 

19 paragraph (9)’’ after ‘‘paragraph (2)’’; and 

20 (J) by adding at the end the following new 

21 paragraph: 

22 ‘‘(9) ADDITIONAL ELIGIBLE PROFESSIONAL DE23 SCRIBED.—With respect to a qualifying MA organi24 zation, an additional eligible professional described 

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1 sional (as defined for purposes of section 1848(o)) 

2 who— 

3 ‘‘(A)(i) is employed by the organization; or 

4 ‘‘(ii)(I) is employed by, or is a partner of, 

5 an entity that through contract with the organi6 zation furnishes at least 80 percent of the enti7 ty’s Medicare patient care services to enrollees 

8 of such organization; and 

9 ‘‘(II) furnishes at least 80 percent of the 

10 professional services of the additional eligible 

11 professional covered under this title to enrollees 

12 of the organization; and 

13 ‘‘(B) furnishes, on average, at least 20 

14 hours per week of patient care services.’’; and 

15 (2) in subsection (m)— 

16 (A) in paragraph (1)— 

17 (i) by inserting ‘‘or additional eligible 

18 hospitals (as described in paragraph (7))’’ 

19 after ‘‘paragraph (2)’’; and 

20 (ii) by inserting ‘‘and additional eligi21 ble hospitals’’ before ‘‘under such sec22 tions’’; 

23 (B) in paragraph (3)(A)(i), by inserting 

24 ‘‘or additional eligible hospital’’ after ‘‘eligible 

25 hospital’’; 


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1 (C) in paragraph (3)(A)(ii), by inserting 

2 ‘‘or an additional eligible hospital’’ after ‘‘eligi3 ble hospital’’ in each place it occurs; 

4 (D) in paragraph (3)(B)— 

5 (i) in clause (i), by inserting ‘‘or an 

6 additional eligible hospital described in 

7 paragraph (7)’’ after ‘‘paragraph (2)’’; and 

8 (ii) in clause (ii)— 

9 (I) in the matter preceding sub10 clause (I), by inserting ‘‘or an addi11 tional eligible hospital described in 

12 paragraph (7)’’ after ‘‘paragraph 

13 (2)’’; and 

14 (II) in subclause (I), by inserting 

15 ‘‘or an additional eligible hospital, re16 spectively,’’ after ‘‘eligible hospital’’; 

17 (E) in paragraph (4)(A), by inserting ‘‘or 

18 one or more additional eligible hospitals (as de19 fined in section 1886(n)), as appropriate,’’ after 

20 ‘‘section 1886(n)(6)(A))’’; 

21 (F) in paragraph (4)(D), by adding at the 

22 end the following new sentence: ‘‘In the case 

23 that a qualifying MA organization attests that 

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1 spect to an applicable period, the Secretary 

2 shall apply the payment adjustment under this 

3 paragraph based on the methodology specified 

4 by the Secretary, taking into account the pro5 portion of such additional eligible hospitals, or 

6 discharges from such hospitals, that are not 

7 meaningful EHR users for such period.’’; 

8 (G) in paragraph (5)(A), by inserting 

9 ‘‘and, as applicable, each additional eligible hos10 pital described in paragraph (7)’’ after ‘‘para11 graph (2)’’; 

12 (H) in paragraph (5)(B), by inserting 

13 ‘‘and additional eligible hospitals, as applica14 ble,’’ after ‘‘eligible hospitals’’; 

15 (I) in paragraph (6)(B), by inserting ‘‘and 

16 additional eligible hospitals described in para17 graph (7)’’ after ‘‘paragraph (2)’’; and 

18 (J) by adding at the end the following new 

19 paragraph: 

20 ‘‘(7) ADDITIONAL ELIGIBLE HOSPITAL DE21 SCRIBED.—With respect to a qualifying MA organi22 zation, an additional eligible hospital described in 

23 this paragraph is an additional eligible hospital (as 

24 defined in section 1886(n)(6)(C)) that is under com25 mon corporate governance with such organization 


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1 and serves individuals enrolled under an MA plan of2 fered by such organization.’’. 

3 TITLE VIII—MAKING PARITY 

4 WORK 

5 SEC. 801. STRENGTHENING PARITY IN MENTAL HEALTH 

6 AND SUBSTANCE USE DISORDER BENEFITS. 

7 (a) PUBLIC HEALTH SERVICE ACT.—Section 

8 2726(a) of the Public Health Service Act (42 U.S.C. 

9 300gg–26(a)) is amended by adding at the end the fol10 lowing new paragraphs: 

11 ‘‘(6) DISCLOSURE AND ENFORCEMENT RE12 QUIREMENTS.— 

13 ‘‘(A) DISCLOSURE REQUIREMENTS.— 

14 ‘‘(i) REGULATIONS.—Not later than 

15 December 31, 2016, the Secretary, in co16 operation with the Secretaries of Labor 

17 and the Treasury, as appropriate, shall 

18 issue additional regulations for carrying 

19 out this section, including an explanation 

20 of documents that must be disclosed by 

21 plans and issuers, the process governing 

22 such disclosures by plans and issuers, and 

23 analyses that must be conducted by plans 

24 and issuers by a group health plan or 

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1 surance coverage in the group or individual 

2 market in order for such plan or issuer to 

3 demonstrate compliance with the provisions 

4 of this section. 

5 ‘‘(ii) DISCLOSURE REQUIREMENTS.— 

6 Documents required to be disclosed by a 

7 group health plan or health insurance 

8 issuer offering health insurance coverage in 

9 the group or individual market under 

10 clause (i) shall include an annual report 

11 that details the specific analyses performed 

12 to ensure compliance of such plan or cov13 erage with the law and regulations. At a 

14 minimum, with respect to the application 

15 of non-quantitative treatment limitations 

16 (in this paragraph referred to as NQTLs) 

17 to benefits under the plan or coverage, 

18 such report shall— 

19 ‘‘(I) identify the specific factors 

20 the plan or coverage used in per21 forming its NQTL analysis; 

22 ‘‘(II) identify and define the spe23 cific evidentiary standards relied on to 

24 evaluate the factors; 


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1 ‘‘(III) describe how the evi2 dentiary standards are applied to each 

3 service category for mental health, 

4 substance use disorders, medical bene5 fits, and surgical benefits; 

6 ‘‘(IV) disclose the results of the 

7 analyses of the specific evidentiary 

8 standards in each service category; 

9 and 

10 ‘‘(V) disclose the specific findings 

11 of the plan or coverage in each service 

12 category and the conclusions reached 

13 with respect to whether the processes, 

14 strategies, evidentiary standards, or 

15 other factors used in applying the 

16 NQTL to mental health or substance 

17 use disorder benefits are comparable 

18 to, and applied no more stringently 

19 than, the processes, strategies, evi20 dentiary standards, or other factors 

21 used in applying the limitation with 

22 respect to medical and surgical bene23 fits in the same classification. 

24 ‘‘(iii) GUIDANCE.—The Secretary, in 

25 cooperation with the Secretaries of Labor 


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1 and the Treasury, as appropriate, shall 

2 issue guidance to group health plans and 

3 health insurance issuers offering health in4 surance coverage in the group or individual 

5 markets on how to satisfy the requirements 

6 of this section with respect to making in7 formation available to current and poten8 tial participants and beneficiaries. Such in9 formation shall include certificate of cov10 erage documents and instruments under 

11 which the plan or coverage involved is ad12 ministered and operated that specify, in13 clude, or refer to procedures, formulas, and 

14 methodologies applied to determine a par15 ticipant or beneficiary’s benefit under the 

16 plan or coverage, regardless of whether 

17 such information is contained in a docu18 ment designated as the ‘plan document’. 

19 Such guidance shall include a disclosure of 

20 how the plan or coverage involved has pro21 vided that processes, strategies, evidentiary 

22 standards, and other factors used in apply23 ing the NQTL to mental health or sub24 stance use disorder benefits are com25 parable to, and applied no more stringently 


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1 than, the processes, strategies, evidentiary 

2 standards, or other factors used in apply3 ing the limitation with respect to medical 

4 and surgical benefits in the same classi5 fication. 

6 ‘‘(iv) DEFINITIONS.—In this para7 graph and paragraph (7), the terms ‘non8 quantitative treatment limitations’, ‘com9 parable to’, and ‘applied no more strin10 gently than’ have the meanings given such 

11 terms in sections 146 and 147 of title 45, 

12 Code of Federal Regulations (or any suc13 cessor regulation). 

14 ‘‘(B) ENFORCEMENT.— 

15 ‘‘(i) PROCESS FOR COMPLAINTS.—The 

16 Secretary, in cooperation with the Secre17 taries of Labor and the Treasury, as ap18 propriate, shall, with respect to group 

19 health plans and health insurance issuers 

20 offering health insurance coverage in the 

21 group or individual market, issue guidance 

22 to clarify the process and timeline for cur23 rent and potential participants and bene24 ficiaries (and authorized representatives 

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1 pants and beneficiaries) with respect to 

2 such plans and coverage to file formal 

3 complaints of such plans or issuers being 

4 in violation of this section, including guid5 ance, by plan type, on the relevant State, 

6 regional, and national offices with which 

7 such complaints should be filed. 

8 ‘‘(ii) AUTHORITY FOR PUBLIC EN9 FORCEMENT.—The Secretary, in consulta10 tion with the Secretaries of Labor and the 

11 Treasury, shall make available to the pub12 lic on the Consumer Parity Portal website 

13 established under paragraph (7) de-identi14 fied information on audits and investiga15 tions of group health plans and health in16 surance issuers conducted under this sec17 tion. 

18 ‘‘(iii) AUDITS.— 

19 ‘‘(I) RANDOMIZED AUDITS.—The 

20 Secretary in cooperation with the Sec21 retaries of Labor and the Treasury, is 

22 authorized to conduct randomized au23 dits of group health plans and health 

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1 vidual market to determine compli2 ance with this section. Such audits 

3 shall be conducted on no fewer than 

4 twelve plans and issuers per plan 

5 year. Information from such audits 

6 shall be made plainly available on the 

7 Consumer Parity Portal website es8 tablished under paragraph (7). 

9 ‘‘(II) ADDITIONAL AUDITS.—In 

10 the case of a group health plan or 

11 health insurance issuer offering health 

12 insurance coverage in the group or in13 dividual market with respect to which 

14 any claim has been filed during a plan 

15 year, the Secretary may audit the 

16 books and records of such plan or 

17 issuer to determine compliance with 

18 this section. Information detailing the 

19 results of the audit shall be made 

20 available on the Consumer Parity Por21 tal website established under para22 graph (7). 

23 ‘‘(iv) DENIAL RATES.—The Secretary 

24 shall collect information on the rates of 

25 and reasons for denial by group health 


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1 plans and health insurance issuers offering 

2 health insurance coverage in the group or 

3 individual market of claims for outpatient 

4 and inpatient mental health and substance 

5 use disorder services compared to the rates 

6 of and reasons for denial of claims for 

7 medical and surgical services. For the first 

8 plan year beginning at least two years 

9 after the date of the enactment of this 

10 paragraph and each subsequent plan year, 

11 the Secretary shall submit to the Com12 mittee on Energy and Commerce of the 

13 House of Representatives and the Com14 mittee on Health, Education, Labor, and 

15 Pensions of the Senate, and make plainly 

16 available on the Consumer Parity Portal 

17 website under paragraph (7), the informa18 tion collected under the previous sentence 

19 with respect to the previous plan year. 

20 ‘‘(7) CONSUMER PARITY PORTAL WEBSITE.— 

21 The Secretary, in consultation with the Secretaries 

22 of Labor and the Treasury, shall establish a one23 stop Internet website portal for— 

24 ‘‘(A) submitting complaints and violations 

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1 ployee Retirement Income Security Act of 1974, 

2 and section 9812 of the Internal Revenue Code 

3 of 1986; and 

4 ‘‘(B) for each of such Secretaries to submit 

5 information in order to provide such informa6 tion to health care consumers pursuant to para7 graph (6), section 712(a)(6) of the Employee 

8 Retirement Income Security Act of 1974, and 

9 section 9812(a)(6) of the Internal Revenue 

10 Code of 1986. 

11 Such portal shall have the ability to take basic infor12 mation related to the complaint, including name, 

13 contact information, and brief narrative, and trans14 mit such information in a timely fashion to the ap15 propriate State or Federal enforcement agency. Once 

16 the consumer information is submitted, such portal 

17 shall provide the consumer with contact information 

18 for the appropriate enforcement agency to follow-up 

19 on the complaint.’’. 

20 (b) EMPLOYEE RETIREMENT INCOME SECURITY ACT

21 OF 1974.—Section 712(a) of the Employee Retirement In22 come Security Act of 1974 (29 U.S.C. 1185a(a)) is 

23 amended by adding at the end the following new para24 graph: 


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1 ‘‘(6) DISCLOSURE AND ENFORCEMENT RE2 QUIREMENTS.— 

3 ‘‘(A) DISCLOSURE REQUIREMENTS.— 

4 ‘‘(i) REGULATIONS.—Not later than 

5 December 31, 2016, the Secretary, in co6 operation with the Secretaries of Health 

7 and Human Services and the Treasury, as 

8 appropriate, shall issue additional regula9 tions for carrying out this section, includ10 ing an explanation of documents that must 

11 be disclosed by plans and issuers, the proc12 ess governing such disclosures by plans 

13 and issuers, and analyses that must be 

14 conducted by plans and issuers by a group 

15 health plan (or health insurance coverage 

16 offered in connection with such a plan) in 

17 order for such plan or issuer to dem18 onstrate compliance with the provisions of 

19 this section. 

20 ‘‘(ii) DISCLOSURE REQUIREMENTS.— 

21 Documents required to be disclosed by a 

22 group health plan (or health insurance cov23 erage offered in connection with such a 

24 plan) under clause (i) shall include an an25 nual report that details the specific analVerDate Sep 11 2014 02:27 Feb 05, 2016 Jkt 059200 PO 00000 Frm 00207 Fmt 6652 Sfmt 6201 E:\BILLS\H4435.IH H4435

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1 yses performed to ensure compliance of 

2 such plan or coverage with the law or regu3 lations. At a minimum, with respect to the 

4 application of non-quantitative treatment 

5 limitations (in this paragraph referred to 

6 as NQTLs) to benefits under the plan or 

7 coverage, such report shall— 

8 ‘‘(I) identify the specific factors 

9 the plan or coverage used in per10 forming its NQTL analysis; 

11 ‘‘(II) identify and define the spe12 cific evidentiary standards relied on to 

13 evaluate the factors; 

14 ‘‘(III) describe how the evi15 dentiary standards are applied to each 

16 service category for mental health, 

17 substance use disorders, medical bene18 fits, and surgical benefits; 

19 ‘‘(IV) disclose the results of the 

20 analyses of the specific evidentiary 

21 standards in each service category; 

22 and 

23 ‘‘(V) disclose the specific findings 

24 of the plan or coverage in each service 

25 category and the conclusions reached 


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1 with respect to whether the processes, 

2 strategies, evidentiary standards, or 

3 other factors used in applying the 

4 NQTL to mental health or substance 

5 use disorder benefits are comparable 

6 to, and applied no more stringently 

7 than, the processes, strategies, evi8 dentiary standards, or other factors 

9 used in applying the limitation with 

10 respect to medical and surgical bene11 fits in the same classification. 

12 ‘‘(iii) GUIDANCE.—The Secretary, in 

13 cooperation with the Secretaries of Health 

14 and Human Services and the Treasury, as 

15 appropriate, shall issue guidance to group 

16 health plans (and health insurance cov17 erage offered in connection with such a 

18 plan) on how to satisfy the requirements of 

19 this section with respect to making infor20 mation available to current and potential 

21 participants and beneficiaries. Such infor22 mation shall include certificate of coverage 

23 documents and instruments under which 

24 the plan or coverage involved is adminis25 tered and operated that specify, include, or 


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1 refer to procedures, formulas, and meth2 odologies applied to determine a partici3 pant or beneficiary’s benefit under the plan 

4 or coverage, regardless of whether such in5 formation is contained in a document des6 ignated as the ‘plan document’. Such guid7 ance shall include a disclosure of how the 

8 plan or coverage involved has provided that 

9 processes, strategies, evidentiary stand10 ards, and other factors used in applying 

11 the NQTL to mental health or substance 

12 use disorder benefits are comparable to, 

13 and applied no more stringently than, the 

14 processes, strategies, evidentiary stand15 ards, or other factors used in applying the 

16 limitation with respect to medical and sur17 gical benefits in the same classification. 

18 ‘‘(iv) DEFINITIONS.—In this para19 graph, the terms ‘non-quantitative treat20 ment limitations’, ‘comparable to’, and ‘ap21 plied no more stringently than’ have the 

22 meanings given such terms in sections 146 

23 and 147 of title 45, Code of Federal Regu24 lations (or any successor regulation). 

25 ‘‘(B) ENFORCEMENT.— 


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1 ‘‘(i) PROCESS FOR COMPLAINTS.—The 

2 Secretary, in cooperation with the Secre3 taries of Health and Human Services and 

4 the Treasury, as appropriate, shall, with 

5 respect to group health plans (and health 

6 insurance coverage offered in connection 

7 with such a plan), issue guidance to clarify 

8 the process and timeline for current and 

9 potential participants and beneficiaries 

10 (and authorized representatives and health 

11 care providers of such participants and 

12 beneficiaries) with respect to such plans 

13 (and coverage) to file formal complaints of 

14 such plans (or coverage) being in violation 

15 of this section, including guidance, by plan 

16 type, on the relevant State, regional, and 

17 national offices with which such complaints 

18 should be filed. 

19 ‘‘(ii) AUTHORITY FOR PUBLIC EN20 FORCEMENT.—The Secretary, in consulta21 tion with the Secretaries of Labor and the 

22 Treasury, shall make available to the pub23 lic on the Consumer Parity Portal website 

24 established under section 2726(a)(7) of the 

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1 formation on audits and investigations of 

2 group health plans (and health insurance 

3 coverage offered in connection with such a 

4 plan) conducted under this section. 

5 ‘‘(iii) AUDITS.— 

6 ‘‘(I) RANDOMIZED AUDITS.—The 

7 Secretary in cooperation with the Sec8 retaries of Health and Human Serv9 ices and the Treasury, is authorized 

10 to conduct randomized audits of 

11 group health plans (and health insur12 ance coverage offered in connection 

13 with such a plan) to determine com14 pliance with this section. Such audits 

15 shall be conducted on no fewer than 

16 twelve plans and coverage per plan 

17 year. Information from such audits 

18 shall be made plainly available on the 

19 Consumer Parity Portal website es20 tablished under section 2726(a)(7) of 

21 the Public Health Service Act. 

22 ‘‘(II) ADDITIONAL AUDITS.—In 

23 the case of a group health plan (or 

24 health insurance coverage offered in 

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1 spect to which any claim has been 

2 filed during a plan year, the Secretary 

3 may audit the books and records of 

4 such plan (or coverage) to determine 

5 compliance with this section. Informa6 tion detailing the results of the audit 

7 shall be made available on the Con8 sumer Parity Portal website estab9 lished under section 2726(a)(7) of the 

10 Public Health Service Act. 

11 ‘‘(iv) DENIAL RATES.—The Secretary 

12 shall collect information on the rates of 

13 and reasons for denial by group health 

14 plans (and health insurance coverage of15 fered in connection with such a plan) of 

16 claims for outpatient and inpatient mental 

17 health and substance use disorder services 

18 compared to the rates of and reasons for 

19 denial of claims for medical and surgical 

20 services. For the first plan year beginning 

21 at least two years after the date of the en22 actment of this paragraph and each subse23 quent plan year, the Secretary shall submit 

24 to the Committee on Energy and Com25 merce of the House of Representatives and 


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1 the Committee on Health, Education, 

2 Labor, and Pensions of the Senate, and 

3 make plainly available on the Consumer 

4 Parity Portal website under section 

5 2726(a)(7) of the Public Health Service 

6 Act, the information collected under the 

7 previous sentence with respect to the pre8 vious plan year.’’. 

9 (c) INTERNAL REVENUE CODE OF 1986.—Section 

10 9812(a) of the Internal Revenue Code of 1986 is amended 

11 by adding at the end the following new paragraph: 

12 ‘‘(6) DISCLOSURE AND ENFORCEMENT RE13 QUIREMENTS.— 

14 ‘‘(A) DISCLOSURE REQUIREMENTS.— 

15 ‘‘(i) REGULATIONS.—Not later than 

16 December 31, 2016, the Secretary, in co17 operation with the Secretaries of Health 

18 and Human Services and Labor, as appro19 priate, shall issue additional regulations for 

20 carrying out this section, including an ex21 planation of documents that must be dis22 closed by plans and issuers, the process 

23 governing such disclosures by plans and 

24 issuers, and analyses that must be con25 ducted by plans and issuers by a group 


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1 health plan in order for such plan to dem2 onstrate compliance with the provisions of 

3 this section. 

4 ‘‘(ii) DISCLOSURE REQUIREMENTS.— 

5 Documents required to be disclosed by a 

6 group health plan under clause (i) shall in7 clude an annual report that details the spe8 cific analyses performed to ensure compli9 ance of such plan with the law and regula10 tions. At a minimum, with respect to the 

11 application of non-quantitative treatment 

12 limitations (in this paragraph referred to 

13 as NQTLs) to benefits under the plan or 

14 coverage, such report shall— 

15 ‘‘(I) identify the specific factors 

16 the plan or coverage used in per17 forming its NQTL analysis; 

18 ‘‘(II) identify and define the spe19 cific evidentiary standards relied on to 

20 evaluate the factors; 

21 ‘‘(III) describe how the evi22 dentiary standards are applied to each 

23 service category for mental health, 

24 substance use disorders, medical bene25 fits, and surgical benefits; 


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1 ‘‘(IV) disclose the results of the 

2 analyses of the specific evidentiary 

3 standards in each service category; 

4 and 

5 ‘‘(V) disclose the specific findings 

6 of the plan in each service category 

7 and the conclusions reached with re8 spect to whether the processes, strate9 gies, evidentiary standards, or other 

10 factors used in applying the NQTL to 

11 mental health or substance use dis12 order benefits are comparable to, and 

13 applied no more stringently than, the 

14 processes, strategies, evidentiary 

15 standards, or other factors used in ap16 plying the limitation with respect to 

17 medical and surgical benefits in the 

18 same classification. 

19 ‘‘(iii) GUIDANCE.—The Secretary, in 

20 cooperation with the Secretaries of Health 

21 and Human Services and Labor, as appro22 priate, shall issue guidance to group health 

23 plans on how to satisfy the requirements of 

24 this section with respect to making infor25 mation available to current and potential 


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1 participants and beneficiaries. Such infor2 mation shall include certificate of coverage 

3 documents and instruments under which 

4 the plan involved is administered and oper5 ated that specify, include, or refer to pro6 cedures, formulas, and methodologies ap7 plied to determine a participant or bene8 ficiary’s benefit under the plan, regardless 

9 of whether such information is contained 

10 in a document designated as the ‘plan doc11 ument’. Such guidance shall include a dis12 closure of how the plan involved has pro13 vided that processes, strategies, evidentiary 

14 standards, and other factors used in apply15 ing the NQTL to mental health or sub16 stance use disorder benefits are com17 parable to, and applied no more stringently 

18 than, the processes, strategies, evidentiary 

19 standards, or other factors used in apply20 ing the limitation with respect to medical 

21 and surgical benefits in the same classi22 fication. 

23 ‘‘(iv) DEFINITIONS.—In this para24 graph, the terms ‘non-quantitative treat25 ment limitations’, ‘comparable to’, and ‘apVerDate Sep 11 2014 02:27 Feb 05, 2016 Jkt 059200 PO 00000 Frm 00217 Fmt 6652 Sfmt 6201 E:\BILLS\H4435.IH H4435

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1 plied no more stringently than’ have the 

2 meanings given such terms in sections 146 

3 and 147 of title 45, Code of Federal Regu4 lations (or any successor regulation). 

5 ‘‘(B) ENFORCEMENT.— 

6 ‘‘(i) PROCESS FOR COMPLAINTS.—The 

7 Secretary, in cooperation with the Secre8 taries of Health and Human Services and 

9 Labor, as appropriate, shall, with respect 

10 to group health plans, issue guidance to 

11 clarify the process and timeline for current 

12 and potential participants and beneficiaries 

13 (and authorized representatives and health 

14 care providers of such participants and 

15 beneficiaries) with respect to such plans 

16 (and coverage) to file formal complaints of 

17 such plans being in violation of this sec18 tion, including guidance, by plan type, on 

19 the relevant State, regional, and national 

20 offices with which such complaints should 

21 be filed. 

22 ‘‘(ii) AUTHORITY FOR PUBLIC EN23 FORCEMENT.—The Secretary, in consulta24 tion with the Secretaries of Labor and the 

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1 lic on the Consumer Parity Portal website 

2 established under section 2726(a)(7) of the 

3 Public Health Service Act de-identified in4 formation on audits and investigations of 

5 group health plans conducted under this 

6 section. 

7 ‘‘(iii) AUDITS.— 

8 ‘‘(I) RANDOMIZED AUDITS.—The 

9 Secretary in cooperation with the Sec10 retaries of Health and Human Serv11 ices and Labor, is authorized to con12 duct randomized audits of group 

13 health plans to determine compliance 

14 with this section. Such audits shall be 

15 conducted on no fewer than twelve 

16 plans per plan year. Information from 

17 such audits shall be made plainly 

18 available on the Consumer Parity Por19 tal website established under section 

20 2726(a)(7) of the Public Health Serv21 ice Act. 

22 ‘‘(II) ADDITIONAL AUDITS.—In 

23 the case of a group health plan with 

24 respect to which any claim has been 

25 filed during a plan year, the Secretary 


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1 may audit the books and records of 

2 such plan to determine compliance 

3 with this section. Information detail4 ing the results of the audit shall be 

5 made available on the Consumer Par6 ity Portal website established under 

7 section 2726(a)(7) of the Public 

8 Health Service Act. 

9 ‘‘(iv) DENIAL RATES.—The Secretary 

10 shall collect information on the rates of 

11 and reasons for denial by group health 

12 plans of claims for outpatient and inpa13 tient mental health and substance use dis14 order services compared to the rates of and 

15 reasons for denial of claims for medical 

16 and surgical services. For the first plan 

17 year beginning at least two years after the 

18 date of the enactment of this paragraph 

19 and each subsequent plan year, the Sec20 retary shall submit to the Committee on 

21 Energy and Commerce of the House of 

22 Representatives and the Committee on 

23 Health, Education, Labor, and Pensions of 

24 the Senate, and make plainly available on 

25 the Consumer Parity Portal website under 


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1 section 2726(a)(7) of the Public Health 

2 Service Act, the information collected 

3 under the previous sentence with respect to 

4 the previous plan year.’’. 

5 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

6 authorized to be appropriated $2,000,000 for each of fis7 cal years 2017 through 2021 to carry out this section, in8 cluding the amendments made by this section. 

9 SEC. 802. REPORT ON INVESTIGATIONS REGARDING PAR10 ITY IN MENTAL HEALTH AND SUBSTANCE 

11 USE DISORDER BENEFITS. 

12 (a) IN GENERAL.—Not later than one year after the 

13 date of the enactment of this Act, and annually thereafter, 

14 the Administrator of the Centers for Medicare & Medicaid 

15 Services, in collaboration with the Assistant Secretary of 

16 Labor of the Employee Benefits Security Administration 

17 and the Secretary of the Treasury shall submit to the Con18 gress a report— 

19 (1) identifying Federal investigations conducted 

20 or completed during the preceding 12-month period 

21 regarding compliance with parity in mental health, 

22 substance use disorder benefits, including benefits 

23 provided to persons with mental illness, including se24 rious mental illness, and substance use disorders 

25 under the Paul Wellstone and Pete Domenici Mental 


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1 Health Parity and Addiction Equity Act of 2008 

2 (subtitle B of title V of division C of Public Law 

3 110–343); and 

4 (2) summarizing the results of such investiga5 tions. 

6 (b) CONTENTS.—Subject to paragraph (3), each re7 port under paragraph (1) shall include the following infor8 mation: 

9 (1) The number of investigations opened and 

10 closed during the covered reporting period. 

11 (2) The benefit classification or classifications 

12 examined by each investigation. 

13 (3) The subject matter or subject matters of 

14 each investigation, including quantitative and non15 quantitative treatment limitations. 

16 (4) A summary of the basis of the final decision 

17 rendered for each investigation. 

18 (c) LIMITATION.—Individually identifiable informa19 tion shall be excluded from reports under paragraph (1) 

20 consistent with Federal privacy protections. 


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1 SEC. 803. GAO STUDY ON PREVENTING DISCRIMINATORY 

2 COVERAGE LIMITATIONS FOR INDIVIDUALS 

3 WITH SERIOUS MENTAL ILLNESS AND SUB4 STANCE USE DISORDERS. 

5 Not later than one year after the date of the enact6 ment of this Act, the Comptroller General of the United 

7 States shall submit to Congress a report describing the 

8 evidence regarding the extent to which private health in9 surance plans have nonquantitative treatment limits for 

10 mental health, substance use disorder, and other health 

11 services. The report shall also assess the Departments of 

12 Health and Human Services, Labor, and the Treasury’s 

13 oversight of private health insurance plans and Medicaid 

14 managed care plans under section 1903 of the Social Se15 curity Act (42 U.S.C. 1396b), compliance with the Paul 

16 Wellstone and Pete Domenici Mental Health Parity and 

17 Addiction Equity Act of 2008 (subtitle B of title V of divi18 sion C of Public Law 110–343) (as amended by Public 

19 Law 111–148) (in this section referred to as the ‘‘law’’), 

20 including— 

21 (1) how the responsible Federal departments 

22 and agencies ensure that plans comply with the law, 

23 including how the plans apply nonquantitative treat24 ment limitations and medical necessity criteria to be25 havioral health services compared to medical or sur26 gical services; and 


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1 (2) how proper enforcement, education, and co2 ordination activities within responsible Federal de3 partments and agencies can be used to ensure full 

4 compliance with the law, including educational ac5 tivities directed to State insurance commissioners. 

6 SEC. 804. REPORT TO CONGRESS ON FEDERAL ASSISTANCE 

7 TO STATE INSURANCE REGULATORS RE8 GARDING MENTAL HEALTH PARITY EN9 FORCEMENT. 

10 Not later than one year after the date of enactment 

11 of this Act, the Secretary of Health and Human Services 

12 shall submit to Congress a report detailing— 

13 (1) the ways in which State governments and 

14 State insurance regulators are either empowered or 

15 required to enforce the Paul Wellstone and Pete 

16 Domenici Mental Health Parity and Addiction Eq17 uity Act of 2008 (subtitle B of title V of division C 

18 of Public Law 110–343); 

19 (2) their capability to carry out these enforce20 ment powers or requirements; and 

21 (3) any technical assistance to State govern22 ment and State insurance regulators that has been 

23 communicated by the Department of Health and 

24 Human Services. 


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1 TITLE IX—SUBSTANCE ABUSE 

2 Subtitle A—Prevention 

3 SEC. 901. PRACTITIONER EDUCATION. 

4 (a) EDUCATION REQUIREMENTS.— 

5 (1) REGISTRATION CONSIDERATION.—Section 

6 303(f) of the Controlled Substances Act (21 U.S.C. 

7 823(f)) is amended by inserting after paragraph (5) 

8 the following: 

9 ‘‘(6) The applicant’s compliance with the train10 ing requirements described in subsection (g)(3) dur11 ing any previous period in which the applicant has 

12 been subject to such training requirements.’’. 

13 (2) TRAINING REQUIREMENTS.—Section 303(g) 

14 of the Controlled Substances Act (21 U.S.C. 823(g)) 

15 is amended by adding at the end the following: 

16 ‘‘(3)(A) To be registered to prescribe or otherwise 

17 dispense opioids for the treatment of pain, or pain man18 agement, a practitioner described in paragraph (1) shall 

19 comply with the 12-hour training requirement of subpara20 graph (B) at least once during each 3-year period. 

21 ‘‘(B) The training requirement of this subparagraph 

22 is that the practitioner has completed not less than 12 

23 hours of training (through classroom situations, seminars 

24 at professional society meetings, electronic communica25 tions, or otherwise) with respect to— 


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1 ‘‘(i) the treatment and management of opioid2 dependent patients; 

3 ‘‘(ii) pain management treatment guidelines; 

4 and 

5 ‘‘(iii) early detection of opioid addiction, includ6 ing through such methods as Screening, Brief Inter7 vention, and Referral to Treatment (SBIRT), 

8 that is provided by the American Society of Addiction 

9 Medicine, the American Academy of Addiction Psychiatry, 

10 the American Medical Association, the American Osteo11 pathic Association, the American Psychiatric Association, 

12 the American Academy of Pain Management, the Amer13 ican Pain Society, the American Academy of Pain Medi14 cine, the American Board of Pain Medicine, the American 

15 Society of Interventional Pain Physicians, or any other or16 ganization that the Secretary determines is appropriate 

17 for purposes of this subparagraph.’’. 

18 (b) FUNDING.—The Drug Enforcement Administra19 tion shall fund the enforcement of the requirements speci20 fied in section 303(g)(3) of the Controlled Substances Act 

21 (as added by subsection (a)) through the use of a portion 

22 of the licensing fees paid by controlled substance pre23 scribers under the Controlled Substances Act (21 U.S.C. 

24 801 et seq.). 


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1 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated to carry out this section 

3 $1,000,000 for each of fiscal years 2017 through 2021. 

4 SEC. 902. CO-PRESCRIBING OPIOID OVERDOSE REVERSAL 

5 DRUGS GRANT PROGRAM. 

6 (a) ESTABLISHMENT.— 

7 (1) IN GENERAL.—Not later than six months 

8 after the date of the enactment of this Act, the Sec9 retary of Health and Human Services shall estab10 lish, in accordance with this section, a four-year co11 prescribing opioid overdose reversal drugs grant pro12 gram (in this title referred to as the ‘‘grant pro13 gram’’) under which the Secretary shall provide not 

14 more than a total of 12 grants to eligible entities to 

15 carry out the activities described in subsection (c). 

16 (2) ELIGIBLE ENTITY.—For purposes of this 

17 section, the term ‘‘eligible entity’’ means a federally 

18 qualified health center (as defined in section 

19 1861(aa) of the Social Security Act (42 U.S.C. 

20 1395x(aa))), an opioid treatment program under 

21 part 8 of title 42, Code of Federal Regulations, or 

22 section 303(g) of the Controlled Substances Act (21 

23 U.S.C. 823(g)), a program approved by a State sub24 stance abuse agency, or any other entity that the 

25 Secretary deems appropriate. 


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1 (3) CO-PRESCRIBING.—For purposes of this 

2 title, the term ‘‘co-prescribing’’ means, with respect 

3 to an opioid overdose reversal drug, the practice of 

4 prescribing such drug in conjunction with an opioid 

5 prescription for patients at an elevated risk of over6 dose, or in conjunction with an opioid agonist ap7 proved under section 505 of the Federal Food, 

8 Drug, and Cosmetic Act (21 U.S.C. 355) for the 

9 treatment of opioid abuse disorders, or in other cir10 cumstances in which a provider identifies a patient 

11 at an elevated risk for an intentional or uninten12 tional drug overdose from heroin or prescription 

13 opioid therapies. For purposes of the previous sen14 tence, a patient may be at an elevated risk of over15 dose if the patient meets the criteria under the exist16 ing co-prescribing guidelines that the Secretary 

17 deems appropriate, such as the criteria provided in 

18 the Opioid Overdose Toolkit published by the Sub19 stance Abuse and Mental Health Services Adminis20 tration. 

21 (b) APPLICATION.—To be eligible to receive a grant 

22 under this section, an eligible entity shall submit to the 

23 Secretary of Health and Human Services, in such form 

24 and manner as specified by the Secretary, an application 

25 that describes— 


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1 (1) the extent to which the area to which the 

2 entity will furnish services through use of the grant 

3 is experiencing significant morbidity and mortality 

4 caused by opioid abuse; 

5 (2) the criteria that will be used to identify eli6 gible patients to participate in such program; and 

7 (3) how such program will work to try to iden8 tify State, local, or private funding to continue the 

9 program after expiration of the grant. 

10 (c) USE OF FUNDS.—An eligible entity receiving a 

11 grant under this section may use the grant for any of the 

12 following activities: 

13 (1) To establish a program for co-prescribing 

14 opioid overdose reversal drugs, such as naloxone. 

15 (2) To train and provide resources for health 

16 care providers and pharmacists on the co-prescribing 

17 of opioid overdose reversal drugs. 

18 (3) To establish mechanisms and processes, 

19 consistent with applicable Federal and State privacy 

20 rules, for tracking patients participating in the pro21 gram described in paragraph (1) and the health out22 comes of such patients. 

23 (4) To purchase opioid overdose reversal drugs 

24 for distribution under the program described in 

25 paragraph (1). 


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1 (5) To offset the co-pays and other cost sharing 

2 associated with opioid overdose reversal drugs to en3 sure that cost is not a limiting factor for eligible pa4 tients. 

5 (6) To conduct community outreach, in con6 junction with community-based organizations, de7 signed to raise awareness of co-prescribing practices, 

8 and the availability of opioid overdose reversal 

9 drugs. 

10 (7) To establish protocols to connect patients 

11 who have experienced a drug overdose with appro12 priate treatment, including medication assisted 

13 treatment and appropriate counseling and behavioral 

14 therapies. 

15 (d) EVALUATIONS BY RECIPIENTS.—As a condition 

16 of receipt of a grant under this section, an eligible entity 

17 shall, for each year for which the grant is received, submit 

18 to the Secretary of Health and Human Services informa19 tion on appropriate outcome measures specified by the 

20 Secretary to assess the outcomes of the program funded 

21 by the grant, including— 

22 (1) the number of prescribers trained; 

23 (2) the number of prescribers who have co-pre24 scribed an opioid overdose reversal drugs to at least 

25 one patient; 


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1 (3) the total number of prescriptions written for 

2 opioid overdose reversal drugs; 

3 (4) the percentage of patients at elevated risk 

4 who received a prescription for an opioid overdose 

5 reversal drug; 

6 (5) the number of patients reporting use of an 

7 opioid overdose reversal drug; and 

8 (6) any other outcome measures that the Sec9 retary deems appropriate. 

10 (e) REPORTS BY SECRETARY.—For each year of the 

11 grant program under this section, the Secretary of Health 

12 and Human Services shall submit to the appropriate com13 mittees of the House of Representatives and of the Senate 

14 a report aggregating the information received from the 

15 grant recipients for such year under subsection (d) and 

16 evaluating the outcomes achieved by the programs funded 

17 by grants made under this section. 

18 (f) AUTHORIZATION OF APPROPRIATIONS.—There is 

19 authorized to be appropriated to carry out this section and 

20 section 903 $4,000,000 for each of fiscal years 2017 

21 through 2021. 

22 SEC. 903. OPIOID OVERDOSE REVERSAL CO-PRESCRIBING 

23 GUIDELINES. 

24 (a) IN GENERAL.—The Secretary of Health and 

25 Human Services shall establish a grant program under 


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1 which the Secretary shall award grants to eligible State 

2 entities to develop opioid overdose reversal co-prescribing 

3 guidelines. 

4 (b) ELIGIBLE STATE ENTITIES.—For purposes of 

5 subsection (a), eligible State entities are State depart6 ments of health in conjunction with State medical boards; 

7 city, county, and local health departments; and community 

8 stakeholder groups involved in reducing opioid overdose 

9 deaths. 

10 (c) ADMINISTRATIVE PROVISIONS.— 

11 (1) GRANT AMOUNTS.—A grant made under 

12 this section may not be for more than $200,000 per 

13 grant. 

14 (2) PRIORITIZATION.—In awarding grants 

15 under this section, the Secretary shall give priority 

16 to eligible State entities which propose to base their 

17 guidelines on existing guidelines on co-prescribing to 

18 speed enactment, including guidelines of— 

19 (A) the Department of Veterans Affairs; 

20 (B) nationwide medical societies, such as 

21 the American Society of Addiction Medicine or 

22 American Medical Association; and 

23 (C) the Centers for Disease Control and 

24 Prevention. 


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1 SEC. 904. SURVEILLANCE CAPACITY BUILDING. 

2 (a) PROGRAM AUTHORIZED.—The Secretary of 

3 Health and Human Services, acting through the Director 

4 of the Centers for Disease Control and Prevention, shall 

5 award cooperative agreements or grants to eligible entities 

6 to improve fatal and nonfatal drug overdose surveillance 

7 and reporting capabilities, including— 

8 (1) providing training to improve identification 

9 of drug overdose as the cause of death by coroners 

10 and medical examiners; 

11 (2) establishing, in cooperation with the Na12 tional Poison Data System, coroners, and medical 

13 examiners, a comprehensive national program for 

14 surveillance of, and reporting to an electronic data15 base on, drug overdose deaths in the United States; 

16 and 

17 (3) establishing, in cooperation with the Na18 tional Poison Data System, a comprehensive na19 tional program for surveillance of, and reporting to 

20 an electronic database on, fatal and nonfatal drug 

21 overdose occurrences, including epidemiological and 

22 toxicologic analysis and trends. 

23 (b) ELIGIBLE ENTITY.—To be eligible to receive a 

24 grant or cooperative agreement under this section, an enti25 ty shall be— 

26 (1) a State, local, or tribal government; or 


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1 (2) the National Poison Data System working 

2 in conjunction with a State, local, or tribal govern3 ment. 

4 (c) APPLICATION.— 

5 (1) IN GENERAL.—An eligible entity desiring a 

6 grant or cooperative agreement under this section 

7 shall submit to the Secretary an application at such 

8 time, in such manner, and containing such informa9 tion as the Secretary may require. 

10 (2) CONTENTS.—An application described in 

11 paragraph (1) shall include— 

12 (A) a description of the activities to be 

13 funded through the grant or cooperative agree14 ment; and 

15 (B) evidence that the eligible entity has the 

16 capacity to carry out such activities. 

17 (d) REPORT.—As a condition of receipt of a grant 

18 or cooperative agreement under this section, an eligible en19 tity shall agree to prepare and submit, not later than 90 

20 days after the end of the grant or cooperative agreement 

21 period, a report to the Secretary describing the results of 

22 the activities supported through the grant or cooperative 

23 agreement. 

24 (e) NATIONAL POISON DATA SYSTEM.—In this sec25 tion, the term ‘‘National Poison Data System’’ means the 


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1 system operated by the American Association of Poison 

2 Control Centers, in partnership with the Centers for Dis3 ease Control and Prevention, for real-time local, State, 

4 and national electronic reporting, and the corresponding 

5 database network. 

6 (f) AUTHORIZATION OF APPROPRIATIONS.—There is 

7 authorized to be appropriated to carry out this section 

8 $5,000,000 for each of the fiscal years 2017 through 

9 2021. 

10 Subtitle B—Crisis 

11 SEC. 921. GRANTS TO SUPPORT SYRINGE EXCHANGE PRO12 GRAMS. 

13 (a) IN GENERAL.—The Secretary of Health and 

14 Human Services may award grants to State, local, and 

15 tribal governments and community organizations to sup16 port syringe exchange programs. 

17 (b) USE OF FUNDS.—Grants under subsection (a) 

18 may be used to support carrying out syringe exchange pro19 grams, including through— 

20 (1) providing outreach, counseling, health edu21 cation, case management, syringe disposal, and 

22 other services as determined appropriate by the Sec23 retary of Health and Human Services; and 

24 (2) providing technical assistance, including 

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1 ment and implementation of syringe exchange pro2 grams. 

3 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

4 authorized to be appropriated $15,000,000 for each of fis5 cal years 2017 through 2021 to carry out this section, of 

6 which— 

7 (1) at least 15 percent shall be for syringe ex8 change programs that have been in operation for 

9 less than 3 years; and 

10 (2) 5 percent shall be for technical assistance 

11 under subsection (b)(2). 

12 SEC. 922. GRANT PROGRAM TO REDUCE DRUG OVERDOSE 

13 DEATHS. 

14 (a) PROGRAM AUTHORIZED.—The Secretary of 

15 Health and Human Services, acting through the Adminis16 trator of the Substance Abuse and Mental Health Services 

17 Administration, shall award grants or enter into coopera18 tive agreements with eligible entities to enable the eligible 

19 entities to reduce deaths occurring from overdoses of 

20 drugs. 

21 (b) ELIGIBLE ENTITIES.—To be eligible to receive a 

22 grant or cooperative agreement under this section, an enti23 ty shall be a partnership between any of the following: a 

24 State, local, or tribal government, a correctional institu25 tion, a law enforcement agency, a community agency, a 


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1 professional organization in the field of poison control and 

2 surveillance, or a private nonprofit organization. 

3 (c) APPLICATION.— 

4 (1) IN GENERAL.—An eligible entity desiring a 

5 grant or cooperative agreement under this section 

6 shall submit to the Secretary of Health and Human 

7 Services an application at such time, in such man8 ner, and containing such information as the Sec9 retary may require. 

10 (2) CONTENTS.—An application under para11 graph (1) shall include— 

12 (A) a description of the activities to be 

13 funded through the grant or cooperative agree14 ment; and 

15 (B) evidence that the eligible entity has the 

16 capacity to carry out such activities. 

17 (d) PRIORITY.—In entering into grants and coopera18 tive agreements under subsection (a), the Secretary of 

19 Health and Human Services shall give priority to eligible 

20 entities that— 

21 (1) include a public health agency or commu22 nity-based organization; and 

23 (2) have expertise in preventing deaths occur24 ring from overdoses of drugs in populations at high 

25 risk of such deaths. 


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1 (e) ELIGIBLE ACTIVITIES.—As a condition of receipt 

2 of a grant or cooperative agreement under this section, 

3 an eligible entity shall agree to use the grant or coopera4 tive agreement to do each of the following: 

5 (1) Purchase and distribute the drug naloxone 

6 or a similarly effective medication. 

7 (2) Carry out one or more of the following ac8 tivities: 

9 (A) Educating prescribers and pharmacists 

10 about overdose prevention and naloxone pre11 scription, or prescriptions of a similarly effec12 tive medication. 

13 (B) Training first responders, other indi14 viduals in a position to respond to an overdose, 

15 and law enforcement and corrections officials on 

16 the effective response to individuals who have 

17 overdosed on drugs. Training pursuant to this 

18 subparagraph may include any activity that is 

19 educational, instructional, or consultative in na20 ture, and may include volunteer training, 

21 awareness building exercises, outreach to indi22 viduals who are at risk of a drug overdose, and 

23 distribution of educational materials. 

24 (C) Implementing and enhancing programs 

25 to provide overdose prevention, recognition, 


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1 treatment, and response to individuals in need 

2 of such services. 

3 (D) Educating the public and providing 

4 outreach to the public about overdose preven5 tion and naloxone prescriptions, or prescriptions 

6 of other similarly effective medications. 

7 (f) COORDINATING CENTER.— 

8 (1) ESTABLISHMENT.—The Secretary of Health 

9 and Human Services shall establish and provide for 

10 the operation of a coordinating center responsible 

11 for— 

12 (A) collecting, compiling, and dissemi13 nating data on the programs and activities 

14 under this section, including tracking and eval15 uating the distribution and use of naloxone and 

16 other similarly effective medication; 

17 (B) evaluating such data and, based on 

18 such evaluation, developing best practices for 

19 preventing deaths occurring from drug 

20 overdoses; 

21 (C) making such best practices specific to 

22 the type of community involved; 

23 (D) coordinating and harmonizing data 

24 collection measures; 


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1 (E) evaluating the effects of the program 

2 on overdose rates; and 

3 (F) education and outreach to the public 

4 about overdose prevention and prescription of 

5 naloxone and other similarly effective medica6 tion. 

7 (2) REPORTS TO CENTER.—As a condition on 

8 receipt of a grant or cooperative agreement under 

9 this section, an eligible entity shall agree to prepare 

10 and submit, not later than 90 days after the end of 

11 the award period, a report to such coordinating cen12 ter and the Secretary of Health and Human Services 

13 describing the results of the activities supported 

14 through the grant or cooperative agreement. 

15 (g) DURATION.—The period of a grant or cooperative 

16 agreement under this section shall be 4 years. 

17 (h) DEFINITION.—In this part, the term ‘‘drug’’— 

18 (1) means a drug, as defined in section 201 of 

19 the Federal Food, Drug, and Cosmetic Act (21 

20 U.S.C. 321); and 

21 (2) includes controlled substances, as defined in 

22 section 102 of the Controlled Substances Act (21 

23 U.S.C. 802). 

24 (i) AUTHORIZATION OF APPROPRIATIONS.—There is 

25 authorized to be appropriated $20,000,000 to carry out 


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1 this section for each of the fiscal years 2017 through 

2 2021. 

3 Subtitle C—Treatment 

4 SEC. 931. EXPANSION OF PATIENT LIMITS UNDER WAIVER. 

5 Section 303(g)(2)(B) of the Controlled Substances 

6 Act (21 U.S.C. 823(g)(2)(B)) is amended— 

7 (1) in clause (i), by striking ‘‘physician’’ and in8 serting ‘‘practitioner’’; 

9 (2) in clause (iii)— 

10 (A) by striking ‘‘30’’ and inserting ‘‘100’’; 

11 and 

12 (B) by striking ‘‘, unless, not sooner’’ and 

13 all that follows through the end and inserting a 

14 period; and 

15 (3) by inserting at the end the following new 

16 clause: 

17 ‘‘(iv) Not earlier than 1 year after the date 

18 on which a qualifying practitioner obtained an 

19 initial waiver pursuant to clause (iii), the quali20 fying practitioner may submit a second notifica21 tion to the Secretary of the need and intent of 

22 the qualifying practitioner to treat an unlimited 

23 number of patients, if the qualifying practi24 tioner— 


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1 ‘‘(I)(aa) satisfies the requirements of 

2 item (aa), (bb), (cc), or (dd) of subpara3 graph (G)(ii)(I); and 

4 ‘‘(bb) agrees to fully participate in the 

5 Prescription Drug Monitoring Program of 

6 the State in which the qualifying practi7 tioner is licensed, pursuant to applicable 

8 State guidelines; or 

9 ‘‘(II)(aa) satisfies the requirements of 

10 item (ee), (ff), or (gg) of subparagraph 

11 (G)(ii)(I); 

12 ‘‘(bb) agrees to fully participate in the 

13 Prescription Drug Monitoring Program of 

14 the State in which the qualifying practi15 tioner is licensed, pursuant to applicable 

16 State guidelines; 

17 ‘‘(cc) practices in a qualified practice 

18 setting; and 

19 ‘‘(dd) has completed not less than 24 

20 hours of training (through classroom situa21 tions, seminars at professional society 

22 meetings, electronic communications, or 

23 otherwise) with respect to the treatment 

24 and management of opiate-dependent pa25 tients for substance use disorders provided 


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1 by the American Society of Addiction Med2 icine, the American Academy of Addiction 

3 Psychiatry, the American Medical Associa4 tion, the American Osteopathic Associa5 tion, the American Psychiatric Association, 

6 or any other organization that the Sec7 retary determines is appropriate for pur8 poses of this subclause.’’. 

9 SEC. 932. DEFINITIONS. 

10 Section 303(g)(2)(G) of the Controlled Substances 

11 Act (21 U.S.C. 823(g)(2)(G)) is amended— 

12 (1) by striking clause (ii) and inserting the fol13 lowing: 

14 ‘‘(ii) The term ‘qualifying practitioner’ 

15 means the following: 

16 ‘‘(I) A physician who is licensed under 

17 State law and who meets 1 or more of the 

18 following conditions: 

19 ‘‘(aa) The physician holds a 

20 board certification in addiction psychi21 atry from the American Board of 

22 Medical Specialties. 

23 ‘‘(bb) The physician holds an ad24 diction certification from the Amer25 ican Society of Addiction Medicine. 


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1 ‘‘(cc) The physician holds a 

2 board certification in addiction medi3 cine from the American Osteopathic 

4 Association. 

5 ‘‘(dd) The physician holds a 

6 board certification from the American 

7 Board of Addiction Medicine. 

8 ‘‘(ee) The physician has com9 pleted not less than 8 hours of train10 ing (through classroom situations, 

11 seminar at professional society meet12 ings, electronic communications, or 

13 otherwise) with respect to the treat14 ment and management of opiate-de15 pendent patients for substance use 

16 disorders provided by the American 

17 Society of Addiction Medicine, the 

18 American Academy of Addiction Psy19 chiatry, the American Medical Asso20 ciation, the American Osteopathic As21 sociation, the American Psychiatric 

22 Association, or any other organization 

23 that the Secretary determines is ap24 propriate for purposes of this sub25 clause. 


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1 ‘‘(ff) The physician has partici2 pated as an investigator in 1 or more 

3 clinical trials leading to the approval 

4 of a narcotic drug in schedule III, IV, 

5 or V for maintenance or detoxification 

6 treatment, as demonstrated by a 

7 statement submitted to the Secretary 

8 by this sponsor of such approved 

9 drug. 

10 ‘‘(gg) The physician has such 

11 other training or experience as the 

12 Secretary determines will demonstrate 

13 the ability of the physician to treat 

14 and manage opiate-dependent pa15 tients. 

16 ‘‘(II) A nurse practitioner or physi17 cian assistant who is licensed under State 

18 law and meets all of the following condi19 tions: 

20 ‘‘(aa) The nurse practitioner or 

21 physician assistant is licensed under 

22 State law to prescribe schedule III, 

23 IV, or V medications for pain. 


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1 ‘‘(bb) The nurse practitioner or 

2 physician assistant satisfies 1 or more 

3 of the following: 

4 ‘‘(AA) Has completed not 

5 fewer than 24 hours of training 

6 (through classroom situations, 

7 seminar at professional society 

8 meetings, electronic communica9 tions, or otherwise) with respect 

10 to the treatment and manage11 ment of opiate-dependent pa12 tients for substance use disorders 

13 provided by the American Society 

14 of Addiction Medicine, the Amer15 ican Academy of Addiction Psy16 chiatry, the American Medical 

17 Association, the American Osteo18 pathic Association, the American 

19 Psychiatric Association, or any 

20 other organization that the Sec21 retary determines is appropriate 

22 for purposes of this subclause. 

23 ‘‘(BB) Has such other train24 ing or experience as the Sec25 retary determines will demVerDate Sep 11 2014 02:27 Feb 05, 2016 Jkt 059200 PO 00000 Frm 00246 Fmt 6652 Sfmt 6201 E:\BILLS\H4435.IH H4435

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1 onstrate the ability of the nurse 

2 practitioner or physician assist3 ant to treat and manage opiate4 dependent patients. 

5 ‘‘(cc) The nurse practitioner or 

6 physician assistant practices within 

7 the scope of their State license, in8 cluding compliance with any super9 vision or collaboration requirements 

10 under State law. 

11 ‘‘(dd) The nurse practitioner or 

12 physician assistant practice in a quali13 fied practice setting.’’; and 

14 (2) by adding at the end the following: 

15 ‘‘(iii) The term ‘qualified practice setting’ 

16 means 1 or more of the following treatment set17 tings: 

18 ‘‘(I) A National Committee for Qual19 ity Assurance-recognized Patient-Centered 

20 Medical Home or Patient-Centered Spe21 cialty Practice. 

22 ‘‘(II) A Centers for Medicaid & Medi23 care Services-recognized Accountable Care 

24 Organization. 


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1 ‘‘(III) A clinical facility administered 

2 by the Department of Veterans Affairs, 

3 Department of Defense, or Indian Health 

4 Service. 

5 ‘‘(IV) A Behavioral Health Home ac6 credited by the Joint Commission. 

7 ‘‘(V) A Federally-qualified health cen8 ter (as defined in section 1905(l)(2)(B) of 

9 the Social Security Act (42 U.S.C. 

10 1396d(l)(2)(B))) or a Federally-qualified 

11 health center look-alike. 

12 ‘‘(VI) A Substance Abuse and Mental 

13 Health Services-certified Opioid Treatment 

14 Program. 

15 ‘‘(VII) A clinical program of a State 

16 or Federal jail, prison, or other facility 

17 where individuals are incarcerated. 

18 ‘‘(VIII) A clinic that demonstrates 

19 compliance with the Model Policy on 

20 DATA 2000 and Treatment of Opioid Ad21 diction in the Medical Office issued by the 

22 Federation of State Medical Boards. 

23 ‘‘(IX) A treatment setting that is part 

24 of an Accreditation Council for Graduate 

25 Medical Education, American Association 


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1 of Colleges of Osteopathic Medicine, or 

2 American Osteopathic Association-accred3 ited residency or fellowship training pro4 gram. 

5 ‘‘(X) Any other practice setting ap6 proved by a State regulatory board, State 

7 substance abuse agency, or State Medicaid 

8 Plan to provide addiction treatment serv9 ices. 

10 ‘‘(XI) Any other practice setting ap11 proved by the Secretary.’’. 

12 SEC. 933. EVALUATION BY ASSISTANT SECRETARY FOR 

13 PLANNING AND EVALUATION. 

14 Two years after the date on which the first notifica15 tion under clause (iv) of section 303(g)(2)(B) of the Con16 trolled Substances Act (21 U.S.C. 823(g)(2)(B)), as added 

17 by section 931, is received by the Secretary of Health and 

18 Human Services, the Assistant Secretary for Planning and 

19 Evaluation shall initiate an evaluation of the effectiveness 

20 of the amendments made by sections 301 and 302, which 

21 shall include an evaluation of— 

22 (1) any changes in the availability and use of 

23 medication-assisted treatment for opioid addiction; 

24 (2) the quality of medication-assisted treatment 

25 programs; 


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1 (3) the integration of medication-assisted treat2 ment with routine healthcare services; 

3 (4) diversion of opioid addiction treatment 

4 medication; 

5 (5) changes in State or local policies and legis6 lation relating to opioid addiction treatment; 

7 (6) the use of nurse practitioners and physician 

8 assistants who prescribe opioid addiction medication; 

9 (7) the use of Prescription Drug Monitoring 

10 Programs by waived practitioners to maximize safety 

11 of patient care and prevent diversion of opioid addic12 tion medication; 

13 (8) the findings of the Drug Enforcement Ad14 ministration inspections of waived practitioners, in15 cluding the frequency with which the Drug Enforce16 ment Administration finds no documentation of ac17 cess to behavioral health services; and 

18 (9) the effectiveness of cross-agency collabora19 tion between the Department of Health and Human 

20 Services and the Drug Enforcement Administration 

21 for expanding effective opioid addiction treatment. 


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1 SEC. 934. REAUTHORIZATION OF RESIDENTIAL TREAT2 MENT PROGRAMS FOR PREGNANT AND 

3 POSTPARTUM WOMEN. 

4 Section 508 of the Public Health Service Act (42 

5 U.S.C. 290bb–1) is amended— 

6 (1) in subsection (p), by inserting ‘‘(other than 

7 subsection (r))’’ after ‘‘section’’; and 

8 (2) in subsection (r), by striking ‘‘such sums’’ 

9 and all that follows through ‘‘2003’’ and inserting 

10 ‘‘$40,000,000 for each of fiscal years 2017 through 

11 2021’’. 

12 SEC. 935. PILOT PROGRAM GRANTS FOR STATE SUBSTANCE 

13 ABUSE AGENCIES. 

14 (a) IN GENERAL.—Section 508 of the Public Health 

15 Service Act (42 U.S.C. 290bb–1) is amended— 

16 (1) by redesignating subsection (r), as amended 

17 by section 934, as subsection (s); and 

18 (2) by inserting after subsection (q) the fol19 lowing new subsection: 

20 ‘‘(r) PILOT PROGRAM FOR STATE SUBSTANCE

21 ABUSE AGENCIES.— 

22 ‘‘(1) IN GENERAL.—From amounts made avail23 able under subsection (s), the Director of the Center 

24 for Substance Abuse Treatment shall carry out a 

25 pilot program under which competitive grants are 


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1 made by the Director to State substance abuse agen2 cies to— 

3 ‘‘(A) enhance flexibility in the use of funds 

4 designed to support family-based services for 

5 pregnant and postpartum women with a pri6 mary diagnosis of a substance use disorder, in7 cluding opioid use disorders; 

8 ‘‘(B) help State substance abuse agencies 

9 address identified gaps in services furnished to 

10 such women along the continuum of care, in11 cluding services provided to women in non-resi12 dential based settings; and 

13 ‘‘(C) promote a coordinated, effective, and 

14 efficient State system managed by State sub15 stance abuse agencies by encouraging new ap16 proaches and models of service delivery. 

17 ‘‘(2) REQUIREMENTS.—In carrying out the 

18 pilot program under this subsection, the Director 

19 shall— 

20 ‘‘(A) require State substance abuse agen21 cies to submit to the Director applications, in 

22 such form and manner and containing such in23 formation as specified by the Director, to be eli24 gible to receive a grant under the program; 


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1 ‘‘(B) identify, based on such submitted ap2 plications, State substance abuse agencies that 

3 are eligible for such grants; 

4 ‘‘(C) require services proposed to be fur5 nished through such a grant to support family 

6 based treatment and other services for pregnant 

7 and postpartum women with a primary diag8 nosis of a substance use disorder, including 

9 opioid use disorders; 

10 ‘‘(D) not require that services furnished 

11 through such a grant be provided solely to 

12 women that reside in facilities; 

13 ‘‘(E) not require that grant recipients 

14 under the program make available through use 

15 of the grant all services described in subsection 

16 (d); and 

17 ‘‘(F) consider not applying requirements 

18 described in paragraphs (1) and (2) of sub19 section (f) to applicants, depending on the cir20 cumstances of the applicant. 

21 ‘‘(3) REQUIRED SERVICES.— 

22 ‘‘(A) IN GENERAL.—The Director shall 

23 specify a minimum set of services required to be 

24 made available to eligible women through a 


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1 grant awarded under the pilot program under 

2 this subsection. Such minimum set— 

3 ‘‘(i) shall include requirements de4 scribed in subsection (c) and be based on 

5 the recommendations submitted under sub6 paragraph (B); and 

7 ‘‘(ii) may be selected from among the 

8 services described in subsection (d) and in9 clude other services as appropriate. 

10 ‘‘(B) STAKEHOLDER INPUT.—The Director 

11 shall convene and solicit recommendations from 

12 stakeholders, including State substance abuse 

13 agencies, health care providers, persons in re14 covery from substance abuse, and other appro15 priate individuals, for the minimum set of serv16 ices described in subparagraph (A). 

17 ‘‘(4) DURATION.—The pilot program under this 

18 subsection shall not exceed 5 years. 

19 ‘‘(5) EVALUATION AND REPORT TO CON20 GRESS.—The Director of the Center for Behavioral 

21 Health Statistics and Quality shall fund an evalua22 tion of the pilot program at the conclusion of the 

23 first grant cycle funded by the pilot program. The 

24 Director of the Center for Behavioral Health Statis25 tics and Quality, in coordination with the Director of 


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1 the Center for Substance Abuse Treatment shall 

2 submit to the relevant Committees of jurisdiction of 

3 the House of Representatives and the Senate a re4 port on such evaluation. The report shall include at 

5 a minimum outcomes information from the pilot pro6 gram, including any resulting reductions in the use 

7 of alcohol and other drugs; engagement in treatment 

8 services; retention in the appropriate level and dura9 tion of services; increased access to the use of medi10 cations approved by the Food and Drug Administra11 tion for the treatment of substance use disorders in 

12 combination with counseling; and other appropriate 

13 measures. 

14 ‘‘(6) STATE SUBSTANCE ABUSE AGENCIES DE15 FINED.—For purposes of this subsection, the term 

16 ‘State substance abuse agency’ means, with respect 

17 to a State, the agency in such State that manages 

18 the Substance Abuse Prevention and Treatment 

19 Block Grant under part B of title XIX.’’. 

20 (b) FUNDING.—Subsection (s) of section 508 of the 

21 Public Health Service Act (42 U.S.C. 290bb–1), as 

22 amended by section 934 and redesignated by subsection 

23 (a), is further amended by adding at the end the following 

24 new sentence: ‘‘Of the amounts made available for a year 

25 pursuant to the previous sentence to carry out this section, 


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1 not more than 25 percent of such amounts shall be made 

2 available for such year to carry out subsection (r), other 

3 than paragraph (5) of such subsection.’’. 

4 SEC. 936. EVIDENCE-BASED OPIOID AND HEROIN TREAT5 MENT AND INTERVENTIONS DEMONSTRA6 TION. 

7 Subpart 1 of part B of title V of the Public Health 

8 Service Act (42 U.S.C. 290bb et seq.) is amended— 

9 (1) by redesignating section 514 (42 U.S.C. 

10 290bb–9), as added by section 3632 of the Meth11 amphetamine Anti-Proliferation Act of 2000 (Public 

12 Law 106–310; 114 Stat. 1236), as section 514B; 

13 and 

14 (2) by adding at the end the following: 

15 ‘‘SEC. 514C. EVIDENCE-BASED OPIOID AND HEROIN TREAT16 MENT AND INTERVENTIONS DEMONSTRA17 TION. 

18 ‘‘(a) GRANTS.— 

19 ‘‘(1) AUTHORITY TO MAKE GRANTS.—The Di20 rector of the Center for Substance Abuse Treatment 

21 (referred to in this section as the ‘Director’) shall 

22 award grants to State substance abuse agencies, 

23 units of local government, nonprofit organizations, 

24 and Indian tribes or tribal organizations (as defined 

25 in section 4 of the Indian Health Care Improvement 


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1 Act (25 U.S.C. 1603)) that have a high rate, or 

2 have had a rapid increase, in the use of heroin or 

3 other opioids, in order to permit such entities to ex4 pand activities, including an expansion in the avail5 ability of medication assisted treatment, evidence6 based counseling, or behavioral therapies with re7 spect to the treatment of addiction in the specific 

8 geographical areas of such entities where there is a 

9 rate or rapid increase in the use of heroin or other 

10 opioids. 

11 ‘‘(2) RECIPIENTS.—The entities receiving 

12 grants under paragraph (1) shall be selected by the 

13 Director. 

14 ‘‘(3) NATURE OF ACTIVITIES.—The grant funds 

15 awarded under paragraph (1) shall be used for ac16 tivities that are based on reliable scientific evidence 

17 of efficacy in the treatment of problems related to 

18 heroin or other opioids. 

19 ‘‘(b) GEOGRAPHIC DISTRIBUTION.—The Director 

20 shall ensure that grants awarded under subsection (a) are 

21 distributed equitably among the various regions of the Na22 tion and among rural, urban, and suburban areas that are 

23 affected by the use of heroin or other opioids. 

24 ‘‘(c) ADDITIONAL ACTIVITIES.—The Director shall— 


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1 ‘‘(1) evaluate the activities supported by grants 

2 awarded under subsection (a); 

3 ‘‘(2) disseminate widely such significant infor4 mation derived from the evaluation as the Director 

5 considers appropriate; 

6 ‘‘(3) provide States, Indian tribes and tribal or7 ganizations, and providers with technical assistance 

8 in connection with the provision of treatment of 

9 problems related to heroin and other opioids; and 

10 ‘‘(4) fund only those applications that specifi11 cally support recovery services as a critical compo12 nent of the grant program. 

13 ‘‘(d) DEFINITION.—The term ‘medication assisted 

14 treatment’ means the use, for problems relating to heroin 

15 and other opioids, of medications approved by the Food 

16 and Drug Administration in combination with counseling 

17 and behavioral therapies. 

18 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

19 ‘‘(1) IN GENERAL.—There is authorized to be 

20 appropriated to carry out this section $300,000,000 

21 for each of fiscal years 2017 through 2021. 

22 ‘‘(2) USE OF CERTAIN FUNDS.—Of the funds 

23 appropriated to carry out this section in any fiscal 

24 year, not more than 5 percent of such funds shall 


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1 be available to the Director for purposes of carrying 

2 out subsection (c).’’. 

3 SEC. 937. ADOLESCENT TREATMENT AND RECOVERY SERV4 ICES DEMONSTRATION GRANT PROGRAM. 

5 Subpart 1 of part B of title V of the Public Health 

6 Service Act (42 U.S.C. 290bb et seq.), as amended by sec7 tion 936, is further amended by adding at the end the 

8 following: 

9 ‘‘SEC. 514D. GRANTS TO IMPROVE ACCESS TO TREATMENT 

10 AND RECOVERY FOR ADOLESCENTS. 

11 ‘‘(a) IN GENERAL.—The Secretary, acting through 

12 the Director of the Center for Substance Abuse Treat13 ment, shall award grants, contracts, or cooperative agree14 ments to eligible State substance abuse agencies and other 

15 entities determined appropriate by the Director for the 

16 purpose of increasing the capacity of substance use dis17 order treatment and recovery services for adolescents. 

18 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant, 

19 contract, or cooperative agreement under subsection (a) 

20 an entity shall— 

21 ‘‘(1) prepare and submit to the Director an ap22 plication at such time, in such manner, and contain 

23 such information as the Director may require, in24 cluding a plan for the evaluation of any activities 


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1 carried out with the funds provided under this sec2 tion; 

3 ‘‘(2) ensure that all entities receiving support 

4 under the grant, contract, or cooperative agreement 

5 comply with all applicable State licensure or certifi6 cation requirements regarding the provision of the 

7 services involved; and 

8 ‘‘(3) provide the Director with periodic evalua9 tions of the progress of the activities funded under 

10 this section and an evaluation at the completion of 

11 such activities, as the Director determines to be ap12 propriate. 

13 ‘‘(c) PRIORITY.—In awarding grants, contracts, and 

14 cooperative agreements under subsection (a), the Director 

15 shall give priority to applicants who propose to fill a dem16 onstrated geographic need for adolescent specific residen17 tial treatment services. 

18 ‘‘(d) USE OF FUNDS.—Amounts awarded under 

19 grants, contracts, or cooperative agreements under this 

20 section may be used to enable health care providers or fa21 cilities that provide treatment and recovery assistance for 

22 adolescents with a substance use disorder to provide the 

23 following services: 

24 ‘‘(1) Individualized patient centered care that is 

25 specific to circumstances of the individual patient. 


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1 ‘‘(2) Clinically appropriate, trauma-informed, 

2 gender-specific and age appropriate treatment serv3 ices that are based on reliable scientific evidence of 

4 efficacy in the treatment of problems related to sub5 stance use disorders. 

6 ‘‘(3) Clinically appropriate care to address 

7 treatment for substance use and any co-occurring 

8 physical and mental health disorders at the same lo9 cation, and through access to primary care services. 

10 ‘‘(4) Coordination of treatment services with re11 covery and other social support, including edu12 cational, vocational training, assistance with the ju13 venile justice system, child welfare, and mental 

14 health agencies. 

15 ‘‘(5) Aftercare and long-term recovery support, 

16 including peer support services. 

17 ‘‘(e) DURATION OF ASSISTANCE.—Grants, contracts, 

18 and cooperative agreements awarded under subsection (a) 

19 shall be for a period not to exceed 5 years. 

20 ‘‘(f) ADDITIONAL ACTIVITIES.—The Director shall— 

21 ‘‘(1) collect and evaluate the activities carried 

22 out with amount received under subsection (a); 

23 ‘‘(2) disseminate widely such significant infor24 mation derived from the evaluation as the Secretary 

25 considers appropriate; and 


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1 ‘‘(3) provide States, Indian tribes and tribal or2 ganizations, and providers with technical assistance 

3 in connection with the provision of treatment and re4 covery services funded through this section to ado5 lescents related to the abuse of heroin and other 

6 opioids. 

7 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.— 

8 ‘‘(1) IN GENERAL.—There is authorized to be 

9 appropriated to carry out this section, $25,000,000 

10 for each of fiscal years 2017 through 2021. 

11 ‘‘(2) USE OF CERTAIN FUNDS.—Of the funds 

12 appropriated to carry out this section in any fiscal 

13 year, not more than 5 percent of such funds shall 

14 be available to the Director for purposes of carrying 

15 out subsection (f).’’. 

16 SEC. 938. STUDY ON TREATMENT INFRASTRUCTURE. 

17 Not later than 24 months after the date of enactment 

18 of this Act, the Comptroller General of the United States 

19 shall initiate an evaluation, and submit to Congress a re20 port, of the inpatient and outpatient treatment capacity, 

21 availability, and needs of the United States, which shall 

22 include, to the extent data is available— 

23 (1) the capacity of acute residential or inpatient 

24 detoxification programs; 


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1 (2) the capacity of inpatient clinical stabiliza2 tion programs, transitional residential support serv3 ices, and residential rehabilitation programs; 

4 (3) the capacity of demographic specific resi5 dential or inpatient treatment programs, such as 

6 those designed for pregnant women or adolescents; 

7 (4) geographical differences of the availability 

8 of residential and outpatient treatment and recovery 

9 options for substance use disorders across the con10 tinuum of care; 

11 (5) the availability of residential and outpatient 

12 treatment programs that offer treatment options 

13 based on reliable scientific evidence of efficacy for 

14 the treatment of substance use disorders, including 

15 the use of Food and Drug Administration-approved 

16 medicines and evidence-based nonpharmacological 

17 therapies; 

18 (6) the number of patients in residential and 

19 specialty outpatient treatment services for substance 

20 use disorders; and 

21 (7) an assessment of the need for residential 

22 and outpatient treatment for substance use disorders 

23 across the continuum of care. 


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1 SEC. 939. SUBSTANCE USE DISORDER PROFESSIONAL LOAN 

2 REPAYMENT PROGRAM. 

3 Subpart 3 of part E of title VII of the Public Health 

4 Service Act (42 U.S.C. 295f et seq.) is amended by adding 

5 at the end the following: 

6 ‘‘SEC. 779. SUBSTANCE USE DISORDER PROFESSIONAL 

7 LOAN REPAYMENT PROGRAM. 

8 ‘‘(a) ESTABLISHMENT.—The Secretary shall estab9 lish and carry out a substance use disorder health profes10 sional loan repayment program under which qualified 

11 health professionals agree to be employed full time for a 

12 specified period (which shall be not less than 2 years) in 

13 providing substance use disorder prevention and treatment 

14 services. 

15 ‘‘(b) PROGRAM ADMINISTRATION.—Through the pro16 gram established under this section, the Secretary shall 

17 enter into contracts with qualified health professionals 

18 under which— 

19 ‘‘(1) a qualified health professional agrees to 

20 provide substance use disorder prevention and treat21 ment services with respect to an area or population 

22 that (as determined by the Secretary)— 

23 ‘‘(A) has a shortage of such services (as 

24 defined by the Secretary); and 


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1 ‘‘(B) has a sufficient population of individ2 uals with a substance use disorder to support 

3 the provision of such services; and 

4 ‘‘(2) the Secretary agrees to make payments on 

5 the principal and interest of undergraduate, or grad6 uate education loans of the qualified health profes7 sional— 

8 ‘‘(A) of not more than $35,000 for each 

9 year of service described in paragraph (1); and 

10 ‘‘(B) for not more than 3 years. 

11 ‘‘(c) QUALIFIED HEALTH PROFESSIONAL DE12 FINED.—In this section, the term ‘qualified health profes13 sional’ means an individual who is (or will be upon the 

14 completion of the individual’s graduate education) a psy15 chiatrist, psychologist, nurse practitioner, physician assist16 ant, clinical social worker, substance abuse counselor, or 

17 other substance use disorder health professional. 

18 ‘‘(d) PRIORITY.—In entering into agreements under 

19 this section, the Secretary shall give priority to applicants 

20 who— 

21 ‘‘(1) have familiarity with evidence-based meth22 ods and culturally and linguistically competent 

23 health care services; and 

24 ‘‘(2) demonstrate financial need. 


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1 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

2 is authorized to be appropriated $20,000,000 for each of 

3 fiscal years 2017 through 2021 to carry out this section.’’. 

4 Subtitle D—Recovery 

5 SEC. 951. NATIONAL YOUTH RECOVERY INITIATIVE. 

6 (a) DEFINITIONS.—In this section: 

7 (1) ELIGIBLE ENTITY.—The term ‘‘eligible enti8 ty’’ means— 

9 (A) a high school that has been accredited 

10 as a recovery high school by the Association of 

11 Recovery Schools; 

12 (B) an accredited high school that is seek13 ing to establish or expand recovery support 

14 services; 

15 (C) an institution of higher education; 

16 (D) a recovery program at a nonprofit col17 legiate institution; or 

18 (E) a nonprofit organization. 

19 (2) INSTITUTION OF HIGHER EDUCATION.—The 

20 term ‘‘institution of higher education’’ has the 

21 meaning given the term in section 101 of the Higher 

22 Education Act of 1965 (20 U.S.C. 1001). 

23 (3) RECOVERY PROGRAM.—The term ‘‘recovery 

24 program’’— 


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1 (A) means a program to help individuals 

2 who are recovering from substance use dis3 orders to initiate, stabilize, and maintain 

4 healthy and productive lives in the community; 

5 and 

6 (B) includes peer-to-peer support and com7 munal activities to build recovery skills and 

8 supportive social networks. 

9 (b) GRANTS AUTHORIZED.—The Secretary of Health 

10 and Human Services, acting through the Substance Abuse 

11 and Mental Health Services Administration, in consulta12 tion with the Secretary of Education, may award grants 

13 to eligible entities to enable the entities to— 

14 (1) provide substance use recovery support serv15 ices to young people in high school and enrolled in 

16 institutions of higher education; 

17 (2) help build communities of support for young 

18 people in recovery through a spectrum of activities 

19 such as counseling and healthy and wellness-oriented 

20 social activities; and 

21 (3) encourage initiatives designed to help young 

22 people achieve and sustain recovery from substance 

23 use disorders. 


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1 (c) USE OF FUNDS.—Grants awarded under sub2 section (b) may be used for activities to develop, support, 

3 and maintain youth recovery support services, including— 

4 (1) the development and maintenance of a dedi5 cated physical space for recovery programs; 

6 (2) dedicated staff for the provision of recovery 

7 programs; 

8 (3) healthy and wellness-oriented social activi9 ties and community engagement; 

10 (4) establishment of recovery high schools; 

11 (5) coordination of recovery programs with— 

12 (A) substance use disorder treatment pro13 grams and systems; 

14 (B) providers of mental health services; 

15 (C) primary care providers; 

16 (D) the criminal justice system, including 

17 the juvenile justice system; 

18 (E) employers; 

19 (F) housing services; 

20 (G) child welfare services; 

21 (H) institutions of secondary higher edu22 cation and institutions of higher education; and 

23 (I) other programs or services related to 

24 the welfare of an individual in recovery from a 

25 substance use disorder; 


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1 (6) the development of peer-to-peer support 

2 programs or services; and 

3 (7) additional activities that help youths and 

4 young adults to achieve recovery from substance use 

5 disorders. 

6 (d) TECHNICAL SUPPORT.—The Secretary of Health 

7 and Human Services shall provide technical support to re8 cipients of grants under this section. 

9 (e) AUTHORIZATION OF APPROPRIATIONS.—There is 

10 authorized to be appropriated to carry out this section 

11 $30,000,000 for each of fiscal years 2017 through 2021. 

12 SEC. 952. GRANTS TO ENHANCE AND EXPAND RECOVERY 

13 SUPPORT SERVICES. 

14 Subpart 1 of part B of title V of the Public Health 

15 Service Act (42 U.S.C. 290bb et seq.), as amended by sec16 tions 306 and 307, is further amended by adding at the 

17 end the following: 

18 ‘‘SEC. 514E. GRANTS TO ENHANCE AND EXPAND RECOVERY 

19 SUPPORT SERVICES. 

20 ‘‘(a) IN GENERAL.—The Secretary, acting through 

21 the Administrator of the Substance Abuse and Mental 

22 Health Services Administration, shall award grants to 

23 State substance abuse agencies and nonprofit organiza24 tions to develop, expand, and enhance recovery support 

25 services for individuals with substance use disorders. 


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1 ‘‘(b) ELIGIBLE ENTITIES.—In the case of an appli2 cant that is not a State substance abuse agency, to be 

3 eligible to receive a grant under this section, the entity 

4 shall— 

5 ‘‘(1) prepare and submit to the Secretary an 

6 application at such time, in such manner, and con7 tain such information as the Secretary may require, 

8 including a plan for the evaluation of any activities 

9 carried out with the funds provided under this sec10 tion; 

11 ‘‘(2) demonstrate the inclusion of individuals in 

12 recovery from a substance use disorder in leadership 

13 levels or governing bodies of the entity; 

14 ‘‘(3) have as a primary mission the provision of 

15 long-term recovery support for substance use dis16 orders; and 

17 ‘‘(4) be accredited by the Council on the Ac18 creditation of Peer Recovery Support Services or 

19 meet any applicable State certification requirements 

20 regarding the provision of the recovery services in21 volved. 

22 ‘‘(c) USE OF FUNDS.—Amounts awarded under a 

23 grant under this section shall be used to provide for the 

24 following activities: 


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1 ‘‘(1) Educating and mentoring that assists indi2 viduals and families with substance use disorders in 

3 navigating systems of care. 

4 ‘‘(2) Peer recovery support services which in5 clude peer coaching and mentoring. 

6 ‘‘(3) Recovery-focused community education 

7 and outreach programs, including training on the 

8 use of all forms of opioid overdose antagonists used 

9 to counter the effects of an overdose. 

10 ‘‘(4) Training, mentoring, and education to de11 velop and enhance peer mentoring and coaching. 

12 ‘‘(5) Programs aimed at identifying and reduc13 ing stigma and discriminatory practices that serve as 

14 barriers to substance use disorder recovery and 

15 treatment of these disorders. 

16 ‘‘(6) Developing partnerships between networks 

17 that support recovery and other community organi18 zations and services, including— 

19 ‘‘(A) public and private substance use dis20 order treatment programs and systems; 

21 ‘‘(B) health care providers; 

22 ‘‘(C) recovery-focused addiction and recov23 ery professionals; 

24 ‘‘(D) faith-based organizations; 


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1 ‘‘(E) organizations focused on criminal jus2 tice reform; 

3 ‘‘(F) schools; and 

4 ‘‘(G) social service agencies in the commu5 nity, including educational, juvenile justice, 

6 child welfare, housing, and mental health agen7 cies. 

8 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

9 is authorized to be appropriated to carry out this section, 

10 $100,000,000 for each of fiscal years 2017 through 

11 2021.’’. 

Æ 


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