I

104TH CONGRESS

1ST SESSION H. R. 2207

To provide for substance abuse and mental health performance partnerships,

and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

AUGUST 4, 1995

Mr. DINGELL (for himself and Mr. WAXMAN) (both by request) introduced the

following bill; which was referred to the Committee on Commerce

A BILL

To provide for substance abuse and mental health

performance partnerships, and for other purposes.

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 AND REFERENCES IN ACT.

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

5 ‘‘Substance Abuse and Mental Health Performance Part6 nership Act of 1995’’.

7 (b) REFERENCES IN ACT.—The amendments in this

8 Act apply to the Public Health Service Act unless other9 wise specifically stated.
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1 TITLE I—MENTAL HEALTH

2 SEC. 101. REPLACEMENT OF STATE PLAN PROGRAM WITH

3 PERFORMANCE PARTNERSHIPS.

4 (a) ELIMINATION OF STATE PLAN PROGRAM RE5 QUIREMENTS.—Subpart I of part B of title XIX is amend6 ed by striking sections 1911 (concerning formula grants

7 to States), 1912 (concerning State plans for community

8 mental health services), and 1913 (concerning services for

9 children and community programs).

10 (b) PERFORMANCE PARTNERSHIP FRAMEWORK.—

11 Subpart I of part B of title XIX is further amended by

12 inserting after the subpart heading the following new sec13 tions:

14 ‘‘SEC. 1911. PERFORMANCE PARTNERSHIP GOALS AND OB15 JECTIVES.

16 ‘‘(a) GOALS.—The goals of this subpart are for the

17 States and the Federal Government, working together in

18 a partnership, to improve the quality of life of adults with

19 serious mental illness and children with a serious emo20 tional disturbance, and to improve the overall mental

21 health of the Nation, by—

22 ‘‘(1) promoting access to comprehensive com23 munity mental health services for adults with serious

24 mental illness and children with a serious emotional

25 disturbance; and
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1 ‘‘(2) increasing development of systems of inte2 grated comprehensive community based services for

3 adults with serious mental illness and children with

4 a serious emotional disturbance.

5 ‘‘(b) PERFORMANCE PARTNERSHIP OBJECTIVES.—

6 ‘‘(1) The Secretary, in consultation with the

7 States, local governments, Indian tribes, and other

8 interested parties designated by the Secretary (in9 cluding consumers and relatives of consumers), shall

10 specify by the end of September 1996 (and from

11 time to time revise, as needed)—

12 ‘‘(A) a list of performance partnership ob13 jectives to carry out the goals of this subpart,

14 and

15 ‘‘(B) a core set of not more than five of

16 those objectives that address mental health

17 problems of national significance.

18 ‘‘(2) Each performance partnership objective

19 shall include—

20 ‘‘(A) a performance indicator;

21 ‘‘(B) the specific population being ad22 dressed;

23 ‘‘(C) a quantifiable performance target;

24 and
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1 ‘‘(D) a date by which the target level is to

2 be achieved.

3 ‘‘(3) In specifying the performance partnership

4 objectives, the Secretary shall be guided by the fol5 lowing principles—

6 ‘‘(A) objectives should be closely related to

7 the goals of this subpart, and be viewed as im8 portant by and understandable to State policy9 makers and the general public;

10 ‘‘(B) actions taken under the partnership

11 agreement should be expected to have an im12 pact on the objective;

13 ‘‘(C) measurable progress in achieving the

14 objective should be expected over the period of

15 the grant;

16 ‘‘(D) objectives should be result-oriented,

17 including a mix of outcome, process and capac18 ity measures, and, if an objective measures

19 process or capacity, it should be demonstrably

20 linked to the achievement of a health outcome;

21 and

22 ‘‘(E) data to track the objective should, to

23 the extent practicable, be comparable for all

24 grant recipients, meet reasonable statistical

25 standards for quality, and be available in a
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1 timely fashion, at appropriate periodicity, and

2 at reasonable cost.

3 ‘‘SEC. 1913. STATE PERFORMANCE PARTNERSHIP PRO4 POSAL.

5 ‘‘(a) IN GENERAL.—In order to be eligible to receive

6 a grant under this subpart, a State shall propose to the

7 Secretary a performance partnership in accordance with

8 the provisions of this section.

9 ‘‘(b) ELEMENTS RELATED TO PERFORMANCE OB10 JECTIVES.—The State proposal under this section shall

11 contain—

12 ‘‘(1) a list on one or more objectives (derived

13 from the performance partnership objectives speci14 fied under section 1911(b)) toward which the State

15 will work and a performance target for each objec16 tive which the State will seek to achieve by the end

17 of the partnership period;

18 ‘‘(2) a rationale for the State’s selection of its

19 objectives, including its performance targets, and

20 timeframes;

21 ‘‘(3) a statement of the State’s strategies for

22 achieving the objectives over the course of the grant

23 period;

24 ‘‘(4) a statement of the estimate amount to be

25 expended to carry out each strategy; and
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1 ‘‘(5) an assurance that the State will report an2 nually on all core performance objectives specified

3 under section 1911(b)(1)(B) (regardless of whether

4 it is working toward those objectives) and the spe5 cific objectives toward which the State will work

6 under the performance partnership.

7 A State may select an objective that is not a specified per8 formance partnership objective under section 1911 if it

9 demonstrates to the Secretary that the objective relates

10 to a significant mental health problem in the State that

11 would not otherwise be addressed appropriately (and that

12 a suitable performance indicator exists to measure

13 progress toward the objective).

14 ‘‘SEC. 1913. FEDERAL-STATE PERFORMANCE PARTNERSHIP.

15 ‘‘(a) NEGOTIATIONS CONCERNING STATE PRO16 POSAL.—

17 ‘‘(1) A State submitting a proposed perform18 ance partnership and the Secretary shall make all

19 reasonable efforts to agree on a performance part20 nership pursuant to which the State shall expend the

21 grant provided under this subpart.

22 ‘‘(2) In the negotiations concerning the State’s

23 proposal, the Secretary shall consider the extent to

24 which the State’s proposed objectives, performance

25 targets, timeframes, and strategies are likely to ad-
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1 dress appropriately the most significant mental

2 health problems (as measured by applicable indica3 tors) within the State, including the mental health

4 problems of vulnerable populations (such as home5 less individuals and children with a serious emo6 tional disturbance).

7 ‘‘(b) PARTNERSHIP PERIOD.—The Secretary, in con8 sultation with the State, shall set the duration of the part9 nership with the State under this subpart. Initial and sub10 sequent partnership periods shall be not less than three

11 nor more than five years, except that the Secretary may

12 agree to a partnership period of less than three years

13 where a State demonstrates to the Secretary’s satisfaction

14 that such shorter period is appropriate.

15 ‘‘(c) ASSESSMENT AND ADJUSTMENT.—

16 ‘‘(1) THE SECRETARY SHALL ASSESS ANNU17 ALLY.—

18 ‘‘(A) the progress achieved nationally to19 ward each of the objectives in the core set of

20 performance partnership objectives; and

21 ‘‘(B) in consultation with each State, the

22 State’s progress toward each objective agreed

23 upon in the performance partnership under this

24 subpart.
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1 The Secretary shall make assessments publicly avail2 able.

3 ‘‘(2) The Secretary and a State may at any

4 time in the course of a performance partnership re5 negotiate, and revise by mutual agreement, the ele6 ments of the partnership in light of new information

7 or changed circumstances (including information or

8 changes identified during assessments under para9 graph (1)).

10 ‘‘(d) GRANTS TO STATES; USE OF FUNDS.—

11 ‘‘(1) A grant shall be made to each State which

12 has reached agreement with the Secretary on a per13 formance partnership under this subpart, and is car14 rying out activities in accordance with the terms of

15 such partnership, in an amount equal to its allot16 ment under section 1918, for each fiscal year for

17 which the partnership is in effect.

18 ‘‘(2) Funds paid to a State from a grant de19 scribed in paragraph (1) may be used only for the

20 purpose of carrying out the partnership developed

21 under this section (including related data collection,

22 evaluation, planning, administration, and edu23 cational activities), except that a State may transfer

24 up to 10 percent of its grant to its allotment under

25 subpart II.’’.
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1 (c) ADDITIONAL GENERAL PROVISIONS CONCERNING

2 PARTNERSHIPS.—

3 (1) Subsection (a) of section 1917 is relocated

4 and redesignated as subsection (c) of section 1912,

5 as added by subsection (b) of this section, and is

6 amended—

7 (A) in the matter preceding paragraph (2),

8 to read as follows:

9 ‘‘(c) ADDITIONAL ELEMENTS.—A State proposal is

10 in accordance with this subsection if—’’;

11 (B) by striking ‘‘application’’ throughout

12 and substituting ‘‘proposal’’;

13 (C) in paragraph (3), by inserting ‘‘pro14 posed performance partnership and’’ before

15 ‘‘agreements’’;

16 (D) in paragraph (7), by striking ‘‘includ17 ing the plan under section 1912(a))’’; and

18 (E) by striking paragraph (5) and redesig19 nating paragraphs (2) through (4), (6), and (7)

20 as paragraphs (1) through (5).

21 (2) Section 1917(b) is—

22 (A) amended by striking ‘‘section 1911’’

23 and inserting ‘‘this subpart’’, and
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1 (B) relocated and redesignated as sub2 section (e) of section 1913, as added by sub3 section (b) of this section.

4 (3) The heading of section 1917 is repealed.

5 (d) CONFORMING AMENDMENTS.—

6 (1) The heading to subpart I of part B of title

7 XIX is amended by striking ‘‘Block’’ and inserting

8 ‘‘Performance Partnership’’.

9 (2) Sections 1914(a), 1915, 1916, 1918, and

10 1919(2) are each amended by striking ‘‘section

11 1911’’ each place it occurs and inserting ‘‘this sub12 part’’.

13 (3) Section 1914(b)(1) is amended by striking

14 ‘‘plans’’ each place it occurs and inserting ‘‘perform15 ance partnerships’’.

16 (4) Sections 1915(a) and 1941 are each amend17 ed by striking ‘‘plan’’ each place is occurs and in18 serting ‘‘performance partnership’’.

19 (5) The heading to section 1915(a) is amended

20 by striking ‘‘PLAN’’ and inserting ‘‘PERFORMANCE

21 PARTNERSHIPS’’.

22 (6) The heading to section 1941 is amended by

23 striking ‘‘PLANS’’ and inserting ‘‘PARTNER24 SHIPS’’.
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1 (7) Section 1944(b)(3) is amended by striking

2 ‘‘1912(d) or’’.

3 (8) Section 1945(d)(2)(A) is amended by strik4 ing ‘‘the condition established in section 1912(d)

5 and’’.

6 (9) Subpart III of part B of title XIX is

7 amended throughout by striking ‘‘section 1911’’ and

8 inserting ‘‘subpart I’’.

9 (10) Section 520(b) is amended—

10 (A) by striking paragraph (5), and

11 (B) by renumbering paragraphs (6)

12 through (14) as (5) through (13).

13 SEC. 102. REVIEW BY PLANNING COUNCIL OF STATE’S RE14 PORT.

15 Section 1915(a)(1) is amended by inserting ‘‘(and the

16 State’s report under section 1942(a) concerning the pre17 ceding fiscal year)’’ after ‘‘to the grant’’.

18 SEC. 103. STATE OPPORTUNITY TO CORRECT OR MITIGATE

19 FAILURE TO MAINTAIN EFFORT.

20 Section 1915(b)(3)(A) is amended by striking the

21 second sentence and adding the following: ‘‘If the Sec22 retary determines that a State has failed to maintain such

23 compliance, the Secretary may permit the State, within

24 one year (or less) after notification, to correct or mitigate

25 the noncompliance. If the State does not carry out a cor-
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1 rection or mitigation as specified by the Secretary (or if

2 the Secretary decided it was not appropriate to provide

3 that opportunity), the Secretary shall reduce the amount

4 of the grant under this subpart for the State for the cur5 rent fiscal year by an amount equal to the amount con6 stituting such failure. That reduction shall be applied first

7 to the amounts for administrative expenses under section

8 1916(b).’’.

9 SEC. 104. FUNDING FOR ORGANIZATIONS THAT ARE FOR–

10 PROFIT.

11 Section 1916(a) is amended—

12 (1) by adding ‘‘or’’ at the end of paragraph (3),

13 (2) by striking ‘‘; or’’ at the end of paragraph

14 (4) and adding a period, and

15 (3) by striking paragraph (5).

16 SEC. 105. MINIMUM AMOUNT FOR ALLOTMENTS.

17 (a) IN GENERAL.—Section 1918(b) is amended to

18 read as follows:

19 ‘‘(b) MINIMUM ALLOTMENTS.—For each fiscal year,

20 the amount of the allotment of a State shall be at least

21 equal to the amount the State received for fiscal year 1995

22 under this subpart and former part C of title V (but this

23 minimum shall be proportionately reduced to the extent

24 that the appropriation under this subpart for a fiscal year
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1 is less than the sum of the appropriations under this sub2 part and former part C of title V for fiscal year 1995).’’.

3 (b) CONFORMING AMENDMENT.—Section

4 1918(c)(2)(C) is amended to read as follows:

5 ‘‘(C) the amount determined under sub6 section (b).’’.

7 SEC. 106. APPROPRIATION AUTHORIZATIONS.

8 Section 1920(a) is amended by striking

9 ‘‘$450,000,000’’ and all that follows and inserting

10 ‘‘$305,000,000 for fiscal year 1996, and such sums as

11 may be necessary for each of the four succeeding fiscal

12 years.’’.

13 SEC. 107. DATA COLLECTION, TECHNICAL ASSISTANCE,

14 EVALUATIONS, INCENTIVE GRANTS, AND

15 FUNDING FOR INDIAN TRIBES.

16 (a) RESERVED FUNDS.—Section 1920(b) is amended

17 to read as follows:

18 ‘‘(b) RESERVED FUNDS.—

19 ‘‘(1) DATA COLLECTION, TECHNICAL ASSIST20 ANCE, AND PROGRAM EVALUATIONS.—The Secretary

21 shall reserve 5 percent of the amounts appropriated

22 for a fiscal year under subsection (a)—

23 ‘‘(A) to carry out sections 505 (providing

24 for data collection) and 1948(a) (providing for
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1 technical assistance to States) with respect to

2 mental health, and

3 ‘‘(B) to conduct evaluations concerning

4 programs supported under this subpart.

5 The Secretary may carry out activities funded pur6 suant to this paragraph directly, or through grants,

7 contracts, or cooperative agreements.

8 ‘‘(2) INCENTIVE GRANTS.—The Secretary may

9 reserve up to 10 percent of the amounts appro10 priated for a fiscal year under subsection (a) to

11 make payments to States that the Secretary has de12 termined demonstrate high or improved performance

13 towards achieving their targets. In making payments

14 under the preceding sentence the Secretary shall

15 take into account the comparable difficulty of a

16 State’s objectives and performance targets.

17 ‘‘(3) FUNDING FOR INDIAN TRIBES.—The Sec18 retary shall reserve 3 percent of the amounts appro19 priated for a fiscal year under subsection (a) to

20 make payments to Indian tribes and tribal organiza21 tions to carry out the goals of this subpart.’’.

22 (b) DATA COLLECTION AUTHORITY.—Section 505(a)

23 is amended—

24 (1) by striking ‘‘and’’ at the end of paragraph

25 (1),
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1 (2) by striking the period at the end of para2 graph (2) and inserting ‘‘; and’’, and

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

4 ‘‘(3) other factors as needed to carry out part

5 B of title XIX.

6 The Secretary may conduct activities under the preceding

7 sentence directly, or through grants, contracts, or coopera8 tive agreements.’’.

9 (c) CONFORMING AMENDMENT.—Section 1948(a) is

10 amended by striking ‘‘through contract, or through

11 grants’’ and inserting ‘‘or through grants, contracts, or

12 cooperative agreements’’.

13 SEC. 108. REPEAL OF GRANT PROGRAM FOR TRANSITION

14 FROM HOMELESSNESS.

15 Part C of title V is repealed.

16 SEC. 109. MENTAL HEALTH SERVICES AND TRAINING DEM17 ONSTRATION PROJECTS.

18 (a) GENERAL DEMONSTRATION AUTHORITY.—Sec19 tion 520A is amended to read as follows:

20 ‘‘MENTAL HEALTH SERVICES AND TRAINING

21 DEMONSTRATION PROJECTS

22 ‘‘SEC. 520A. (a) IN GENERAL.—The Secretary may

23 make grants to, and enter into contracts and cooperative

24 agreements with, States, local governments, Indian tribes,

25 and other public and private entities for mental health pre26 vention, treatment, and training demonstration projects
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1 (and may establish financial matching, maintenance of ef2 fort, or non-supplementation requirements for any or all

3 projects). A specific project may receive funding under

4 this section for no more than three years.

5 ‘‘(b) FOCUS OF PROJECTS.—Projects will be chosen

6 based on practical service needs and current policy ques7 tions as determined by the Secretary in consultation with

8 the States, local governments, Indian tribes, consumers,

9 and relatives of consumers. Projects shall be designed for

10 the development of timely, relevant, and replicable results

11 of immediate use to service providers and officials who de12 velop policy.

13 ‘‘(c) EVALUATION.—The Secretary shall evaluate

14 each project carried out under subsection (a) and shall dis15 seminate to appropriate public and private entities infor16 mation on effective projects.’’.

17 (b) REPEAL OF AUTHORITIES FOR DEMONSTRATION

18 PROJECTS FOR INDIVIDUALS WITH POSITIVE HIV TEST

19 RESULTS.—Section 520B is repealed.

20 (c) CONFORMING AMENDMENTS.—

21 (1) Section 520(b)(6) (as renumbered by sec22 tion 101(d)(8) of this Act) is amended by striking

23 ‘‘sections 520A’’ and all that follows and inserting

24 ‘‘section 520A’’.
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1 (2) Section 612 of the Stewart B. McKinney

2 Homeless Assistance Act is repealed.

3 SEC. 110. PROTECTION AND ADVOCACY FOR MENTALLY ILL

4 INDIVIDUALS.

5 (a) APPROPRIATION AUTHORIZATIONS.—Section 117

6 of the Protection and Advocacy for Mentally Ill Individuals

7 Act of 1986 is amended—

8 (1) by striking ‘‘and’’ after ‘‘1992,’’, and

9 (2) by inserting before the period the following: ‘‘,

10 $22,000,000 for fiscal year 1996, and such sums as may

11 be necessary for each of the four succeeding fiscal years’’.

12 (b) ADJUSTMENT TO HOLD-HARMLESS.—

13 (1) Section 112(a)(2) of the Protection and Ad14 vocacy for Mentally Ill Individuals Act of 1986 is

15 amended to read as follows:

16 ‘‘(2)(A) The minimum amount of the allotment of an

17 eligible system shall be the product (rounded to the near18 est 100 dollars) of the appropriate base amount specified

19 in subparagraph (B) and the factor specified in subpara20 graph (C).

21 ‘‘(B) For purposes of subparagraph (A), the appro22 priate base amount is—

23 ‘‘(i) for American Samoa, Guam, the Marshall

24 Islands, the Federated States of Micronesia, the

25 Commonwealth of the Northern Mariana Islands,
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1 the Republic of Palau, and the Virgin Islands,

2 $139,300, and

3 ‘‘(ii) for any other State, $260,000.

4 ‘‘(C) For purposes of subparagraph (A), the factor

5 is the ratio of the appropriation under section 117 for the

6 fiscal year for which the allotment is made to that appro7 priation for fiscal year 1995.’’.

8 (2)(A) Section 112(a) of that Act is amended

9 by striking paragraph (3).

10 (B) Section 112(a)(1)(B) of that Act is amend11 ed by striking ‘‘Trust Territory of the Pacific Is12 lands’’ and inserting ‘‘Marshall Islands, the Fed13 erated States of Micronesia, the Republic of Palau’’.

14 SEC. 111. COMPREHENSIVE COMMUNITY SERVICES FOR

15 CHILDREN WITH A SERIOUS EMOTIONAL DIS16 TURBANCE.

17 (a) APPROPRIATION AUTHORIZATIONS.—Section

18 565(f)(1) is amended—

19 (1) by striking ‘‘and’’ after ‘‘1993,’’, and

20 (2) by inserting before the period the following:

21 ‘‘, $60,000,000 for fiscal year 1996, and such sums

22 as may be necessary for each of the four succeeding

23 fiscal years’’.

24 (b) FLEXIBILITY FOR INDIAN TRIBES AND TERRI25 TORIES.—Section 562(c) is amended by adding at the end
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1 the following: ‘‘The Secretary may waive one or more of

2 the requirements of the preceding sentence (for a public

3 entity that is an Indian tribe or tribal organization, or

4 American Samoa, Guam, the Marshall Islands, the Fed5 erated States of Micronesia, the Commonwealth of the

6 Northern Mariana Islands, the Republic of Palau, or the

7 Virgin Islands) if the Secretary finds, after peer review,

8 that the system of care is family-centered and uses the

9 least restrictive environment that is clinically appro10 priate.’’.

11 SEC. 112. NONDISCHARGEABILITY IN BANKRUPTCY OF PAY12 BACK FOR MENTAL HEALTH CLINICAL

13 TRAINEESHIPS.

14 (a) GENERAL RULE.—Section 303(d) is amended by

15 adding at the end the following:

16 ‘‘(6) Any obligation of an individual under paragraph

17 (3) may be released by a discharge in bankruptcy under

18 title 11, United States Code, only if the discharge is grant19 ed after the expiration of the seven-year period beginning

20 on the first date that payment under that paragraph is

21 required, and only if the Bankruptcy Court finds that the

22 nondischarge of the obligation would be unconscionable.’’.

23 (b) CONFORMING AMENDMENTS TO BANKRUPTCY

24 CODE.—
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1 (1) Section 523(a) of title 11, United States

2 Code, is amended—

3 (A) by striking ‘‘or’’ at the end of para4 graph (11),

5 (B) by adding ‘‘or’’ at the end of para6 graph (12), and

7 (C) by adding at the end the following:

8 ‘‘(13) that under provisions of the Public

9 Health Service Act is not to be discharged.’’.

10 (2) Section 1328(a)(2) of title 11, United

11 States Code, is amended by striking ‘‘or (8)’’ and in12 serting ‘‘, (8), or (13)’’.

13 TITLE II—SUBSTANCE ABUSE

14 SEC. 201. REPLACEMENT OF STATE PLAN PROGRAM WITH

15 PERFORMANCE PARTNERSHIPS.

16 (a) ELIMINATION OF STATE PLAN PROGRAM RE17 QUIREMENTS.—Subpart II of part B of title XIX is

18 amended—

19 (1) by striking section 1921 (concerning for20 mula grants to States),

21 (2) by redesignating section 1922 as section

22 1923A, and

23 (3) by striking section 1923 (concerning intra24 venous substance abuse programs).
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1 (b) PERFORMANCE PARTNERSHIP FRAMEWORK.—

2 Subpart II of part B of title XIX is further amended by

3 inserting after the subpart heading the following new sec4 tions:

5 ‘‘SEC. 1921. PERFORMANCE PARTNERSHIP GOALS AND OB6 JECTIVES.

7 ‘‘(a) GOALS.—The goals of this subpart are for the

8 States and the Federal Government, working together in

9 a partnership—

10 ‘‘(1) to reduce the incidence and prevalence of

11 substance abuse and dependence;

12 ‘‘(2) to improve access to and availability of ap13 propriate prevention and treatment programs for

14 targeted populations;

15 ‘‘(3) to enhance the effectiveness of substance

16 abuse prevention and treatment programs; and

17 ‘‘(4) to reduce the community and personal

18 health risks for substance abuse.

19 ‘‘(b) PERFORMANCE PARTNERSHIP OBJECTIVES.—

20 ‘‘(1) The Secretary, in consultation with the

21 States, local governments, Indian tribes, and other

22 interested parties designated by the Secretary (in23 cluding consumers and relatives of consumers), shall

24 specify by the end of September 1996 (and from

25 time to time revise, as needed)—
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1 ‘‘(A) a list of performance partnership ob2 jectives to carry out the goals of this subpart,

3 and

4 ‘‘(B) a core set of not more than five of

5 those objectives that address substance abuse

6 problems of national significance.

7 ‘‘(2) Each performance partnership objective

8 shall include—

9 ‘‘(A) a performance indicator;

10 ‘‘(B) the specific population being ad11 dressed;

12 ‘‘(C) a quantifiable performance target;

13 and

14 ‘‘(D) a date by which the target level is to

15 be achieved.

16 ‘‘(3) In specifying the performance partnership

17 objectives, the Secretary shall consider the goals,

18 priorities, and objectives of the National Drug Con19 trol Strategy and be guided by the following prin20 ciples—

21 ‘‘(A) objectives should be closely related to

22 the goals of this subpart, and be viewed as im23 portant by and understandable to State policy24 makers and the general public;
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1 ‘‘(B) actions taken under the partnership

2 agreement should be expected to have an im3 pact on the objective;

4 ‘‘(C) measurable progress in achieving the

5 objective should be expected over the period of

6 the grant;

7 ‘‘(D) objectives should be results-oriented,

8 including a mix of outcome, process and capac9 ity measurers, and, if an objective measures

10 process or capacity, it should be demonstrably

11 linked to the achievement of a health outcome;

12 and

13 ‘‘(E) data to track the objective should, to

14 the extent practicable, be comparable for all

15 grant recipients, meet reasonable statistical

16 standards for quality, and be available in a

17 timely fashion, at appropriate periodicity, and

18 at reasonable cost.

19 ‘‘SEC. 1922. STATE PERFORMANCE PARTNERSHIP PRO20 POSAL.

21 ‘‘(a) IN GENERAL.—In order to be eligible to receive

22 a grant under this subpart, a State shall propose to the

23 Secretary a performance partnership in accordance with

24 the provisions of this section.
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1 ‘‘(b) ELEMENTS RELATED TO PERFORMANCE OB2 JECTIVES.—The State proposal under this section shall

3 contain—

4 ‘‘(1) a list of one or more objectives (derived

5 from the performance partnership objectives speci6 fied under section 1921(b)) toward which the State

7 will work and a performance target for each objec8 tive which the State will seek to achieve by the end

9 of the partnership period;

10 ‘‘(2) a rationale for the State’s selection of its

11 objectives, including its performance targets, and

12 timeframes;

13 ‘‘(3) a statement of the State’s strategies for

14 achieving the objectives over the course of the grant

15 period;

16 ‘‘(4) a statement of the estimated amount to be

17 expended to carry out each strategy; and

18 ‘‘(5) an assurance that the State will report an19 nually on all core performance objectives specified

20 under section 1921(b)(1)(B) (regardless of whether

21 it is working toward those objectives) and the spe22 cific objectives toward which the State will work

23 under the performance partnership.

24 A State may select an objective that is not a specified per25 formance partnership objective under section 1921 if it
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1 demonstrates to the Secretary that the objective relates

2 to a significant health problem related to substance abuse

3 in the State that would not otherwise be addressed appro4 priately (and that a suitable performance indicator exists

5 to measure progress toward the objective).

6 ‘‘SEC. 1923. FEDERAL-STATE PERFORMANCE PARTNERSHIP.

7 ‘‘(a) NEGOTIATIONS CONCERNING STATE PRO8 POSAL.—

9 ‘‘(1) A State submitting a proposed perform10 ance partnership and the Secretary shall make all

11 reasonable efforts to agree on a performance part12 nership pursuant to which the State shall expend the

13 grant provided under this subpart.

14 ‘‘(2) In the negotiations concerning the State’s

15 proposal, the Secretary shall consider the extent to

16 which the State’s proposed objectives, performance

17 targets, timeframes, and strategies are likely to ad18 dress appropriately the most significant health prob19 lems associated with substance abuse (as measured

20 by applicable indicators) within the State, including

21 the health problems associated with substance abuse

22 of vulnerable populations (such as pregnant women

23 and women with children).

24 ‘‘(b) PARTNERSHIP PERIOD.—The Secretary, in con25 sultation with the State, shall set the duration of the part-
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1 nership with the State under this subpart. Initial and sub2 sequent partnership periods shall be not less than three

3 nor more than five years, except that the Secretary may

4 agree to a partnership period of less than three years

5 where a State demonstrates to the Secretary’s satisfaction

6 that such shorter period is appropriate.

7 ‘‘(c) ASSESSMENT AND ADJUSTMENT.—

8 ‘‘(1) THE SECRETARY SHALL ASSESS ANNU9 ALLY—

10 ‘‘(A) the progress achieved nationally to11 ward each of the objectives in the core set of

12 performance partnership objectives; and

13 ‘‘(B) in consultation with each State, the

14 State’s progress toward each objective agreed

15 upon in the performance partnership under this

16 subpart.

17 The Secretary shall make assessments publicly avail18 able.

19 ‘‘(2) REVISION OF PERFORMANCE PARTNER20 SHIPS.—The Secretary and a State may at any time

21 in the course of a performance partnership renego22 tiate, and revise by mutual agreement, the elements

23 of the partnership in light of new information or

24 changed circumstances (including information or
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1 changes identified during assessments under para2 graph (1)).

3 ‘‘(d) GRANTS TO STATES; USE OF FUNDS.—

4 ‘‘(1) A grant shall be made to each State which

5 has reached agreement with the Secretary on a per6 formance partnership under this subpart, and is car7 rying out activities in accordance with the terms of

8 such partnership, in an amount equal to its allot9 ment under section 1933, for each fiscal year in

10 which the partnership is in effect.

11 ‘‘(2) Funds paid to a State from a grant de12 scribed in paragraph (1) may be used only for the

13 purpose of carrying out the partnership developed

14 under this section (including related data collection,

15 evaluation, planning, administration, and edu16 cational activities), except that a State may transfer

17 up to 10 percent of its grant to its allotment under

18 subpart I.’’.

19 (c) ADDITIONAL GENERAL PROVISIONS CONCERNING

20 PARTNERSHIPS.—

21 (1) Section 1932 is amended by striking ‘‘sec22 tion 1921’’ each place it occurs and inserting ‘‘this

23 subpart’’.

24 (2) Subsection (a) of section 1932 is relocated

25 and redesignated as subsection (c) of section 1922,
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1 as added by subsection (b) of this section, and is

2 amended—

3 (A) in the matter preceding paragraph (2),

4 to read as follows:

5 ‘‘(c) ADDITIONAL ELEMENTS.—A State proposal is

6 in accordance with this subsection if—’’;

7 (B) by striking ‘‘application’’ throughout

8 and substituting ‘‘proposal’’;

9 (C) in paragraph (3), by inserting ‘‘pro10 posed performance partnership and’’ before

11 ‘‘agreements’’;

12 (D) in paragraph (7), by striking ‘‘includ13 ing the plan under paragraph (6))’’; and

14 (E) by striking paragraphs (5) and (6) and

15 redesignating paragraphs (2) through (4) and

16 (7) as paragraphs (1) through (4).

17 (3) Section 1932(c) is relocated and redesig18 nated as subsection (e) of section 1923, as added by

19 subsection (b) of this section.

20 (4) The remainder of section 1932 is repealed.

21 (d) CONFORMING AMENDMENTS.—

22 (1) The heading to subpart II of part B of title

23 XIX is amended by striking ‘‘Block’’ and inserting

24 ‘‘Performance Partnership’’.
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1 (2) Sections 1924, 1926, 1928, 1930, 1931,

2 1933, and 1934(2) are each amended by striking

3 ‘‘section 1921’’ each place it occurs and inserting

4 ‘‘this subpart’’.

5 (3) Subpart III of part B of title XIX is

6 amended throughout by striking ‘‘section 1921’’ and

7 inserting ‘‘subpart II’’.

8 SEC. 202. REPEALS, REDESIGNATIONS, AND CONFORMING

9 AMENDMENTS.

10 (a) SUBSTANCE ABUSE AND TUBERCULOSIS.—Sec11 tion 1924 is amended—

12 (1) in the heading, by striking ‘‘TUBER13 CULOSIS AND’’;

14 (2) by striking subsection (a);

15 (3) in subsection (c)—

16 (A) in the heading, by striking ‘‘AGREE17 MENTS’’ and inserting ‘‘PARTNERSHIPS’’, and

18 (B) in paragraph (1), by striking ‘‘Agree19 ments’’ and inserting ‘‘Partnerships’’; and

20 (4) by redesignating subsections (b) through (e)

21 as subsections (a) through (d).

22 (b) GROUP HOMES FOR RECOVERING SUBSTANCE

23 ABUSERS.—

24 (1) Section 1925 is repealed.

25 (2) Section 507(b) is amended—
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1 (A) in paragraph (11), by striking ‘‘includ2 ing the effect of living in housing provided by

3 programs established under section 1925,’’,

4 (B) in paragraph (12), by striking ‘‘para5 graph (11)’’ and inserting ‘‘paragraph (9)’’,

6 (C) by striking paragraphs (1) and (5),

7 and

8 (D) by renumbering paragraphs (2), (3),

9 (4), (6), (7), (8), (9), (10), (11) and (12) as

10 (1), (2), (3), (4), (5), (6), (7), (8), (9), and

11 (10), respectively.

12 (c) CERTAIN ALLOCATIONS.—Section 1923A (as re13 designated by section 201(a)) is further redesignated and

14 relocated as section 1925, and is amended—

15 (1) in the matter in subsection (b) preceding

16 paragraph (1), by striking ‘‘section 1921’’ and in17 serting ‘‘this subpart’’,

18 (2) by striking subsections (a) (concerning allo19 cations regarding alcohol and other drugs) and (c)

20 (concerning allocations regarding women);

21 (3) in the heading, by striking ‘‘CERTAIN AL22 LOCATIONS’’ and inserting ALLOCATION RE23 GARDING PRIMARY PREVENTION PROGRAMS’’;

24 and
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1 (4) by striking the subsection designation ‘‘(b)’’

2 and the heading that follows.

3 (d) TREATMENT SERVICES FOR PREGNANT

4 WOMEN.—

5 (1) Section 1927 is repealed.

6 (2) CONFORMING AMENDMENT.—Section

7 1934(6) is repealed.

8 (e) ADDITIONAL AGREEMENTS.—Section 1928 is

9 amended—

10 (1) by striking subsections (a) (concerning

11 treatment referral process), (b) (concerning continu12 ing education), and (d) (concerning waivers);

13 (2) in the heading, by striking ‘‘ADDITIONAL

14 AGREEMENTS’’ and inserting ‘‘COORDINATION

15 OF VARIOUS ACTIVITIES AND SERVICES’’; and

16 (3) by striking the subsection designation ‘‘(c)’’

17 and the heading that follows.

18 (f) STATEWIDE ASSESSMENT OF NEEDS.—Section

19 1929 is repealed.

20 SEC. 203. HIGHER THRESHOLD FOR REQUIREMENT CON21 CERNING HUMAN IMMUNODEFICIENCY

22 VIRUS.

23 Section 1924(b)(2) is amended by striking ‘‘10’’

24 and inserting ‘‘15’’.
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1 SEC. 204. STATE OPPORTUNITY TO CORRECT OR MITIGATE

2 FAILURE TO MAINTAIN EFFORT.

3 Section 1930(c)(1) is amended by striking the second

4 sentence and adding the following: ‘‘If the Secretary deter5 mines that a State has failed to maintain such compliance,

6 the Secretary may permit the State, within one year (or

7 less) after notification, to correct or mitigate the non8 compliance. If the State does not carry out a correction

9 or mitigation as specified by the Secretary (or if the Sec10 retary decided it was not appropriate to provide that op11 portunity), the Secretary shall reduce the amount of the

12 grant under this subpart for the State for the current fis13 cal year by an amount equal to the amount constituting

14 such failure. That reduction shall be applied first to the

15 amounts for administrative expenses under section

16 1931(a)(2).’’.

17 SEC. 205. FUNDING FOR ORGANIZATIONS THAT ARE FOR18 PROFIT.

19 Section 1931(a)(1) is amended—

20 (1) by adding ‘‘or’’ at the end of subparagraph

21 (D); and

22 (2) by striking subparagraph (E).

23 SEC. 206. APPROPRIATION AUTHORIZATIONS.

24 Section 1935(a) is amended by striking

25 ‘‘$1,500,000,000’’ and all that follows and inserting

26 ‘‘$1,294,000,000 for fiscal year 1996, and such sums as
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1 may be necessary for each of the four succeeding fiscal

2 years.’’.

3 SEC. 207. DATA COLLECTION, TECHNICAL ASSISTANCE,

4 EVALUATIONS, INCENTIVE GRANTS, AND

5 FUNDING FOR INDIAN TRIBES.

6 Section 1935(b) is amended to read as follows:

7 ‘‘(b) RESERVED FUNDS.—

8 ‘‘(1) DATA COLLECTION, TECHNICAL ASSIST9 ANCE, AND PROGRAM EVALUATIONS.—

10 ‘‘(A) The Secretary shall reserve 5 percent

11 of the amounts appropriated for a fiscal year

12 under subsection (a)—

13 ‘‘(i) to carry out sections 505 (provid14 ing for data collection) and 1948(a) (pro15 viding for technical assistance to States)

16 with respect to substance abuse;

17 ‘‘(ii) to carry out section 515(d) (pro18 viding for a substance abuse prevention

19 data base); and

20 ‘‘(iii) to conduct evaluations concern21 ing programs supported under this sub22 part.

23 The Secretary may carry out activities funded

24 pursuant to this paragraph directly, or through

25 grants, contracts, or cooperative agreements.
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1 ‘‘(B) Of the amounts reserved under sub2 paragraph (A) for a fiscal year, 20 percent shall

3 be used for activities related to prevention.

4 ‘‘(2) INCENTIVE GRANTS.—The Secretary may

5 reserve up to 10 percent of the amounts appro6 priated for a fiscal year under subsection (a) to

7 make payments to States that the Secretary has de8 termined demonstrate high or improved performance

9 toward achieving their targets. In making payments

10 under the preceding sentence the Secretary shall

11 take into account the comparable difficulty of a

12 State’s objectives and performance targets.

13 ‘‘(3) FUNDING FOR INDIAN TRIBES.—The Sec14 retary shall reserve 3 percent of the amounts appro15 priated for a fiscal year under subsection (a) to

16 make payments to Indian tribes and tribal organiza17 tions to carry out the goals of this subpart.’’.

18 SEC. 208. SUBSTANCE ABUSE PREVENTION, TREATMENT,

19 AND TRAINING DEMONSTRATION PROJECTS.

20 (a) GENERAL DEMONSTRATION AUTHORITY.—Sec21 tion 506 is amended to read as follows:

22 ‘‘SUBSTANCE ABUSE PREVENTION, TREATMENT, AND

23 TRAINING DEMONSTRATION PROJECTS

24 ‘‘SEC. 506. (a) IN GENERAL.—The Secretary may

25 make grants to, and enter into contracts and cooperative

26 agreements with, States, local governments, Indian tribes,
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1 and other public and private entities for substance abuse

2 prevention, treatment, and training demonstration

3 projects (and may establish financial matching, mainte4 nance of effort, or non-supplantation requirements for any

5 or all projects). A specific project may receive funding

6 under this section for no more than three years.

7 ‘‘(b) FOCUS OF PROJECTS.—Projects will be chosen

8 based on practical service needs and currant policy ques9 tions as determined by the Secretary in consultation with

10 the States, local governments, Indian tribes, consumers,

11 and relatives of consumers. Projects shall be designed for

12 the development of timely, relevant, and replicable results

13 of immediate use to service providers and officials who de14 velop policy. Projects should consider the goals, priorities,

15 and objectives of the National Drug Control Strategy.

16 ‘‘(c) EVALUATION.—The Secretary shall evaluate

17 each project carried out under subsection (a) and shall dis18 seminate to appropriate public and private entities infor19 mation on effective projects.’’.

20 (b) REPEAL OF REDUNDANT AUTHORITIES.—

21 (1) Sections 508, 509, 510, 511, 512,

22 515(b)(5), 516, 517, 518, part F of title V, and sub23 part I of part C of title XIX are repealed.
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1 (2) Section 515(b) is further amended by re2 numbering paragraphs (6) through (10) as (5)

3 through (9).

4 (3) Part C of title XIX is further amended—

5 (A) by striking the heading to subpart

6 II, and

7 (B) by striking ‘‘CERTAIN PROGRAMS

8 REGARDING SUBSTANCE ABUSE’’ in the

9 heading to the part and inserting ‘‘TREAT10 MENT OF NARCOTICS DEPENDENCE’’.

11 SEC. 209. STATE SUBSTANCE ABUSE PREVENTION AND

12 TREATMENT PLANNING COUNCIL.

13 Subpart II of part B of title XIX is further amended

14 by inserting after section 1926 the following:

15 ‘‘SEC. 1927. STATE SUBSTANCE ABUSE PREVENTION AND

16 TREATMENT PLANNING COUNCIL.

17 ‘‘(a) IN GENERAL.—A funding agreement for a grant

18 under this subpart is that the State involved will establish

19 and maintain a State substance abuse prevention and

20 treatment planning council in accordance with the condi21 tions described in this section.

22 ‘‘(b) DUTIES.—A condition under subsection (a) for

23 a council is that the duties of the council are—

24 ‘‘(1) to review performance partnerships and re25 lated reports provided to the council by the State in-
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1 volved and to submit to the State any recommenda2 tions of the council for modifications,

3 ‘‘(2) to serve as an advocate for individuals suf4 fering from substance abuse, and

5 ‘‘(3) to monitor, review, and evaluate, not less

6 than once each year, the allocation and adequacy of

7 substance abuse prevention and treatment services

8 within the State.

9 ‘‘(c) MEMBERSHIP.—

10 ‘‘(1) IN GENERAL.—A condition under sub11 section (a) for a council is that the council be com12 posed of residents of the State, including representa13 tives of—

14 ‘‘(A) the principal State agencies with re15 spect to—

16 ‘‘(i) substance abuse prevention and

17 treatment, education, vocational rehabilita18 tion, criminal justice, housing, and social

19 services, and

20 ‘‘(ii) the development of the plan sub21 mitted pursuant to title XIX of the Social

22 Security Act,

23 ‘‘(B) public and private entities concerned

24 with the need, planning, operation, funding, and
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1 use of substance abuse prevention and treat2 ment services and related support services,

3 ‘‘(C) individuals who are receiving (or have

4 received) substance abuse prevention or treat5 ment services, and

6 ‘‘(D) the families of such individuals.

7 ‘‘(2) LIMITATION ON STATE EMPLOYEES AND

8 PROVIDERS.—A condition under subsection (a) for a

9 council is that not less than 50 percent of the mem10 bers of the council are individuals who are not State

11 employees or providers of substance abuse preven12 tion or treatment services.

13 ‘‘(d) REVIEW OF STATE PERFORMANCE PARTNER14 SHIP BY PLANNING COUNCIL.—The Secretary may make

15 a grant under this subpart only if—

16 ‘‘(1) the performance partnership submitted

17 under this subpart with respect to the grant (and

18 the State’s report under section 1942(a) concerning

19 the preceding fiscal year) has been reviewed by the

20 council, and

21 ‘‘(2) the State submits to the Secretary any

22 recommendations received by the State from the

23 council for modifications to the performance partner24 ship (without regard to whether the State has made

25 the recommended modifications).’’.
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1 SEC. 210. REPEAL OF OBSOLETE PROVISIONS CONCERNING

2 SUBSTANCE ABUSE ALLOCATIONS.

3 (a) IN GENERAL—Section 1933 is amended—

4 (1) by striking subsection (b);

5 (2) in subsection (c)(2)—

6 (A) by adding ‘‘and’’ at the end of sub7 paragraph (A);

8 (B) by striking ‘‘; and’’ at the end of sub9 paragraph (B) and adding a period; and

10 (C) by striking subparagraph (C); and

11 (3) by redesignating subsections (c) and (d) as

12 (b) and (c), respectively.

13 (b) CONFORMING AMENDMENT.—Section 1992(c) (as

14 redesignated by section 201(c)(2) of this Act) is amended

15 by striking ‘‘section 1933(c)(2)(B)’’ and inserting ‘‘section

16 1933(b)(2)(B)’’.

17 SEC. 211. REPEAL OF OBSOLETE ADDICT REFERRAL PROVI18 SIONS.

19 (a) REPEAL OF OBSOLETE PUBLIC HEALTH SERV20 ICE ACT AUTHORITIES.—Part E of title III is repealed.

21 (b) REPEAL OF OBSOLETE NARA AUTHORITIES.—

22 Titles III and IV of the Narcotic Addict Rehabilitation

23 Act of 1966 are repealed.

24 (c) REPEAL OF OBSOLETE TITLE 28 AUTHORI25 TIES.—
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1 (1) Chapter 175 of title 28, United States

2 Code, is repealed.

3 (2) The table of contents to part VI of title 28,

4 United States Code, is amended by striking the ma5 terial related to chapter 175.

6 TITLE III—GENERAL

7 SEC. 301. REPORTING BY STATES ON PERFORMANCE.

8 Section 1942(a) is amended—

9 (1) by striking ‘‘and’’ at the end of paragraph

10 (1),

11 (2) by striking the period at the end of para12 graph (2) and inserting ‘‘; and’’, and

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

14 ‘‘(3) the performance of the State in relation to

15 the objectives specified or agreed upon under section

16 1911(b)(1)(B) and 1913, or section 1921(b)(1)(B)

17 and 1923, as applicable.’’.

18 SEC. 302. ELIMINATION OF STATE PEER REVIEW REQUIRE19 MENT.

20 Section 1943(a) is amended—

21 (1) by striking paragraph (1), and

22 (2) by renumbering paragraphs (2) and (3) as

23 (1) and (2), respectively.
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1 SEC. 303. ON SITE PERFORMANCE REVIEWS.

2 Section 1945(g)(1) is amended by striking ‘‘in fiscal

3 year 1994’’ and all that follows and inserting ‘‘, not more

4 frequently than every three nor less frequently than every

5 five years, conduct an on-site performance review of a

6 State’s activities supported under this part.’’.

7 SEC. 304. ADDITIONAL YEAR FOR OBLIGATION BY STATE.

8 Section 1952(a) is amended by striking everything

9 after ‘‘available for obligation’’ and inserting ‘‘and expend10 iture until the end of the fiscal year following the fiscal

11 year for which the amounts were paid.’’.

12 SEC. 305. DEFINITIONS.

13 Section 1954(b) is amended by striking paragraph

14 (4) and inserting the following:

15 ‘‘(4) The term ‘performance indicator’ means a

16 quantifiable characteristic used as a measurement.

17 ‘‘(5) The term ‘performance target’ means a

18 numerical value sought to be achieved within a spec19 ified period of time.’’.

20 SEC. 306. APPROPRIATION AUTHORIZATIONS FOR DEM21 ONSTRATION PROGRAMS.

22 Part A of title V is amended by adding after section

23 506 the following:
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1 ‘‘APPROPRIATION AUTHORIZATIONS FOR DEMONSTRATION

2 PROJECTS

3 ‘‘SEC. 506A. For the purpose of carrying out sections

4 506 and 520A there are authorized to be appropriated

5 $506,000,000 for fiscal year 1996, $483,000,000 for fis6 cal year 1997, $300,000,000 for fiscal year 1998, and

7 such sums as may be necessary for each of the two suc8 ceeding fiscal years.’’.

9 SEC. 307. HEADINGS.

10 (a) HEADING TO TITLE XIX.—The heading to title

11 XIX is amended by striking ‘‘BLOCK’’ and inserting

12 ‘‘PERFORMANCE PARTNERSHIP’’.

13 (b) HEADING TO PART B OF TITLE XIX.—The head14 ing to part B of title XIX is amended by striking

15 ‘‘BLOCK’’ and inserting ‘‘PERFORMANCE PARTNERSHIP’’.

16 SEC. 308. REGULATIONS.

17 Section 1949 is amended to read as follows:

18 ‘‘SEC. 1949. REGULATIONS.

19 ‘‘The Secretary shall prescribe regulations as needed

20 to carry out this part.’’.

21 SEC. 309. EFFECTIVE DATES AND TRANSITIONAL PROVI22 SIONS.

23 (a) APPROPRIATION AUTHORIZATIONS AND DEM24 ONSTRATIONS.—
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1 (1) The amendments made by sections 105,

2 106, 108, 109, 110, 111, 206, 208, and 306 of this

3 Act apply to periods beginning after fiscal year

4 1995.

5 (2) A project that receives support for fiscal

6 year 1996, 1997, or 1998 under section 506 or

7 520A of the Public Health Service Act (as amended

8 by section 109(a) or 208(a) of this Act, respec9 tively), and that previously received support under

10 title V of the Public Health Service Act for fiscal

11 year 1995, shall be subject to the requirements to

12 which that project was subject for fiscal year 1995

13 unless the Secretary of Health and Human Services

14 determines otherwise.

15 (b) STATE OPPORTUNITY TO CORRECT OR MITIGATE

16 FAILURE TO MAINTAIN EFFORT.—The amendments

17 made by sections 103 and 204 apply to failures occurring

18 after fiscal year 1994.

19 (c) REPEAL OF PENALTY PROVISION FOR FAILURE

20 TO IMPLEMENT COMPLETELY, AND OF OBSOLETE PROVI21 SIONS.—The repeal of section 1912(d) of the Public

22 Health Service Act by section 101(a) of this Act, and the

23 amendments enacted by sections 210 and 211 of this Act,

24 are effective upon enactment.
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1 (d) EFFECTIVE DATE FOR NONDISCHARGEABILITY

2 IN BANKRUPTCY.—The amendment made by section

3 112(a) applies to bankruptcy proceedings in which a dis4 charge has not been granted before 31 days after the date

5 of enactment of this Act.

6 (e) FUNDING FOR INDIAN TRIBES.—Sections

7 1920(b)(3) and 1935(b)(3) of the Public Health Service

8 Act (as amended and enacted by sections 107(a) and 207,

9 respectively, of this Act) apply to fiscal years after fiscal

10 year 1996.

11 (f) PERFORMANCE PARTNERSHIP AND RELATED

12 PROVISIONS.—

13 (1) The amendments made by the preceding

14 sections of this Act (other than the amendments list15 ed in the preceding subsections of this section) apply

16 to activities related to grants for periods after fiscal

17 year 1996, except that the amendments apply with

18 respect to a State (for either of the grant programs

19 affected by those amendments), if earlier, on the ef20 fective date of a performance partnership under such

21 program.

22 (2) The Secretary of Health and Human Serv23 ices may select a list of prototype performance part24 nership objectives and a core set of those objectives

25 on which all States should report (as provided in
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1 section 1911 or 1921 of the Public Health Service

2 Act, as amended by sections 101(a) and 201(a), re3 spectively, of this Act, but without consultation with

4 other parties). The amendments made by the preced5 ing sections of this Act (other than the amendments

6 listed in the preceding subsections of this section),

7 in conjunction with the first sentence of this para8 graph, apply (until the time applicable under para9 graph (1) of this subsection with respect to a State

10 (for either of the grant programs affected by those

11 amendments) at such time as the Secretary of

12 Health and Human Services and the State may

13 agree.

14 (3) In the case of the initial partnership pro15 posal by a State under paragraph (2) of this sub16 section, or under subpart I or II of part B of title

17 XIX of the Public Health Service Act—

18 (A) if the Secretary of Health and Human

19 Services and a State reach agreement on or be20 fore March 31 of a fiscal year, the performance

21 partnership shall take effect, at State option, as

22 of the beginning of such fiscal year or of the

23 succeeding fiscal year; and

24 (B) if such agreement is reached after

25 March 31 of a fiscal year, the performance
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1 partnership shall take effect as of the beginning

2 of the succeeding fiscal year.

3 (4) The requirements of part C of title V of the

4 Public Health Service Act (as in effect on the day

5 before the date of enactment of this Act) shall con6 tinue to apply (until the time applicable under para7 graph (1) or (2) of this subsection), with respect to

8 a State, to that portion of a grant to the State for

9 a fiscal year under subpart I of part B of title XIX

10 of that Act that bears the same relationship to the

11 entire grant as the amount granted to the State for

12 fiscal year 1995 under part C of title V of that Act

13 bore to the amount granted to the State for fiscal

14 year 1995 under part C of title V and subpart I of

15 part B of title XIX of that Act.

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