106TH CONGRESS

1ST SESSION S. 976

AN ACT

To amend title V of the Public Health Service Act to focus

the authority of the Substance Abuse and Mental Health

Services Administration on community-based services for

children and adolescents, to enhance flexibility and accountability, to establish programs for youth treatment,

and to respond to crises, especially those related to children and violence.

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 ‘‘Youth Drug and Mental Health Services Act’’.
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1 (b) TABLE OF CONTENTS.—The table of contents for

2 this Act is as follows:

Sec. 1. Short title; table of contents.

TITLE I—PROVISIONS RELATING TO SERVICES FOR CHILDREN

AND ADOLESCENTS

Sec. 101. Children and violence.

Sec. 102. Emergency response.

Sec. 103. High risk youth reauthorization.

Sec. 104. Substance abuse treatment services for children and adolescents.

Sec. 105. Comprehensive community services for children with serious emotional disturbance.

Sec. 106. Services for children of substance abusers.

Sec. 107. Services for youth offenders.

Sec. 108. Grants for strengthening families through community partnerships.

Sec. 109. General provisions.

TITLE II—PROVISIONS RELATING TO MENTAL HEALTH

Sec. 201. Priority mental health needs of regional and national significance.

Sec. 202. Grants for the benefit of homeless individuals.

Sec. 203. Projects for assistance in transition from homelessness.

Sec. 204. Community mental health services performance partnership block

grant.

Sec. 205. Determination of allotment.

Sec. 206. Protection and Advocacy for Mentally Ill Individuals Act of 1986.

Sec. 207. Requirement relating to the rights of residents of certain facilities.

TITLE III—PROVISIONS RELATING TO SUBSTANCE ABUSE

Sec. 301. Priority substance abuse treatment needs of regional and national

significance.

Sec. 302. Priority substance abuse prevention needs of regional and national

significance.

Sec. 303. Substance abuse prevention and treatment performance partnership

block grant.

Sec. 304. Determination of allotments.

Sec. 305. Nondiscrimination and institutional safeguards for religious providers.

Sec. 306. Alcohol and drug prevention or treatment services for Indians and

Native Alaskans.

TITLE IV—PROVISIONS RELATING TO FLEXIBILITY AND

ACCOUNTABILITY

Sec. 401. General authorities and peer review.

Sec. 402. Advisory councils.

Sec. 403. General provisions for the performance partnership block grants.

Sec. 404. Data infrastructure projects.

Sec. 405. Repeal of obsolete addict referral provisions.

Sec. 406. Individuals with co-occurring disorders.

Sec. 407. Services for individuals with co-occurring disorders.
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1 TITLE I—PROVISIONS RELATING

2 TO SERVICES FOR CHILDREN

3 AND ADOLESCENTS

4 SEC. 101. CHILDREN AND VIOLENCE.

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

6 290aa et seq.) is amended by adding at the end the fol7 lowing:

8 ‘‘PART G—PROJECTS FOR CHILDREN AND VIOLENCE

9 ‘‘SEC. 581. CHILDREN AND VIOLENCE.

10 ‘‘(a) IN GENERAL.—The Secretary, in consultation

11 with the Secretary of Education and the Attorney General,

12 shall carry out directly or through grants, contracts or co13 operative agreements with public entities a program to as14 sist local communities in developing ways to assist children

15 in dealing with violence.

16 ‘‘(b) ACTIVITIES.—Under the program under sub17 section (a), the Secretary may—

18 ‘‘(1) provide financial support to enable local

19 communities to implement programs to foster the

20 health and development of children;

21 ‘‘(2) provide technical assistance to local com22 munities with respect to the development of pro23 grams described in paragraph (1);
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1 ‘‘(3) provide assistance to local communities in

2 the development of policies to address violence when

3 and if it occurs; and

4 ‘‘(4) assist in the creation of community part5 nerships among law enforcement, education systems

6 and mental health and substance abuse service sys7 tems.

8 ‘‘(c) REQUIREMENTS.—An application for a grant,

9 contract or cooperative agreement under subsection (a)

10 shall demonstrate that—

11 ‘‘(1) the applicant will use amounts received to

12 create a partnership described in subsection (b)(4)

13 to address issues of violence in schools;

14 ‘‘(2) the activities carried out by the applicant

15 will provide a comprehensive method for addressing

16 violence, that will include—

17 ‘‘(A) security;

18 ‘‘(B) educational reform;

19 ‘‘(C) the review and updating of school

20 policies;

21 ‘‘(D) alcohol and drug abuse prevention

22 and early intervention services;

23 ‘‘(E) mental health prevention and treat24 ment services; and
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1 ‘‘(F) early childhood development and psy2 chosocial services; and

3 ‘‘(3) the applicant will use amounts received

4 only for the services described in subparagraphs (D),

5 (E), and (F) of paragraph (2).

6 ‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary

7 shall ensure that grants, contracts or cooperative agree8 ments under subsection (a) will be distributed equitably

9 among the regions of the country and among urban and

10 rural areas.

11 ‘‘(e) DURATION OF AWARDS.—With respect to a

12 grant, contract or cooperative agreement under subsection

13 (a), the period during which payments under such an

14 award will be made to the recipient may not exceed 5

15 years.

16 ‘‘(f) EVALUATION.—The Secretary shall conduct an

17 evaluation of each project carried out under this section

18 and shall disseminate the results of such evaluations to

19 appropriate public and private entities.

20 ‘‘(g) INFORMATION AND EDUCATION.—The Sec21 retary shall establish comprehensive information and edu22 cation programs to disseminate the findings of the knowl23 edge development and application under this section to the

24 general public and to health care professionals.
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1 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There

2 is authorized to be appropriated to carry out this section,

3 $100,000,000 for fiscal year 2000, and such sums as may

4 be necessary for each of fiscal years 2001 and 2002.

5 ‘‘SEC. 582. GRANTS TO ADDRESS THE PROBLEMS OF PER6 SONS WHO EXPERIENCE VIOLENCE RELATED

7 STRESS.

8 ‘‘(a) IN GENERAL.—The Secretary shall award

9 grants, contracts or cooperative agreements to public and

10 nonprofit private entities, as well as to Indian tribes and

11 tribal organizations, for the purpose of establishing a na12 tional and regional centers of excellence on psychological

13 trauma response and for developing knowledge with re14 gard to evidence-based practices for treating psychiatric

15 disorders resulting from witnessing or experiencing such

16 stress.

17 ‘‘(b) PRIORITIES.—In awarding grants, contracts or

18 cooperative agreements under subsection (a) related to the

19 development of knowledge on evidence-based practices for

20 treating disorders associated with psychological trauma,

21 the Secretary shall give priority to programs that work

22 with children, adolescents, adults, and families who are

23 survivors and witnesses of domestic, school and commu24 nity violence and terrorism.
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1 ‘‘(c) GEOGRAPHICAL DISTRIBUTION.—The Secretary

2 shall ensure that grants, contracts or cooperative agree3 ments under subsection (a) with respect to centers of ex4 cellence are distributed equitably among the regions of the

5 country and among urban and rural areas.

6 ‘‘(d) EVALUATION.—The Secretary, as part of the

7 application process, shall require that each applicant for

8 a grant, contract or cooperative agreement under sub9 section (a) submit a plan for the rigorous evaluation of

10 the activities funded under the grant, contract or agree11 ment, including both process and outcomes evaluation,

12 and the submission of an evaluation at the end of the

13 project period.

14 ‘‘(e) DURATION OF AWARDS.—With respect to a

15 grant, contract or cooperative agreement under subsection

16 (a), the period during which payments under such an

17 award will be made to the recipient may not exceed 5

18 years. Such grants, contracts or agreements may be re19 newed.

20 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There

21 is authorized to be appropriated to carry out this section,

22 $50,000,000 for fiscal year 2000, and such sums as may

23 be necessary for each of fiscal years 2001 and 2002.’’.
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1 SEC. 102. EMERGENCY RESPONSE.

2 Section 501 of the Public Health Service Act (42

3 U.S.C. 290aa) is amended—

4 (1) by redesignating subsection (m) as sub5 section (o);

6 (2) by inserting after subsection (l) the fol7 lowing:

8 ‘‘(m) EMERGENCY RESPONSE.—

9 ‘‘(1) IN GENERAL.—Notwithstanding section

10 504 and except as provided in paragraph (2), the

11 Secretary may use not to exceed 3 percent of all

12 amounts appropriated under this title for a fiscal

13 year to make noncompetitive grants, contracts or co14 operative agreements to public entities to enable

15 such entities to address emergency substance abuse

16 or mental health needs in local communities.

17 ‘‘(2) EXCEPTIONS.—Amounts appropriated

18 under part C shall not be subject to paragraph (1).

19 ‘‘(3) EMERGENCIES.—The Secretary shall es20 tablish criteria for determining that a substance

21 abuse or mental health emergency exists and publish

22 such criteria in the Federal Register prior to pro23 viding funds under this subsection.

24 ‘‘(n) LIMITATION ON THE USE OF CERTAIN INFOR25 MATION.—No information, if an establishment or person

26 supplying the information or described in it is identifiable,
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1 obtained in the course of activities undertaken or sup2 ported under this title may be used for any purpose other

3 than the purpose for which it was supplied unless such

4 establishment or person has consented (as determined

5 under regulations of the Secretary) to its use for such

6 other purpose. Such information may not be published or

7 released in other form if the person who supplied the infor8 mation or who is described in it is identifiable unless such

9 person has consented (as determined under regulations of

10 the Secretary) to its publication or release in other form.’’;

11 and

12 (3) in subsection (o) (as so redesignated), by

13 striking ‘‘1993’’ and all that follows through the pe14 riod and inserting ‘‘2000, and such sums as may be

15 necessary for each of the fiscal years 2001 and

16 2002.’’.

17 SEC. 103. HIGH RISK YOUTH REAUTHORIZATION.

18 Section 517(h) of the Public Health Service Act (42

19 U.S.C. 290bb–23(h)) is amended by striking

20 ‘‘$70,000,000’’ and all that follows through ‘‘1994’’ and

21 inserting ‘‘such sums as may be necessary for each of the

22 fiscal years 2000 through 2002’’.
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1 SEC. 104. SUBSTANCE ABUSE TREATMENT SERVICES FOR

2 CHILDREN AND ADOLESCENTS.

3 Subpart 1 of part B of title V of the Public Health

4 Service Act (42 U.S.C. 290bb et seq.) is amended by add5 ing at the end the following:

6 ‘‘SEC. 514. SUBSTANCE ABUSE TREATMENT SERVICES FOR

7 CHILDREN AND ADOLESCENTS.

8 ‘‘(a) IN GENERAL.—The Secretary shall award

9 grants, contracts, or cooperative agreements to public and

10 private nonprofit entities, including Native Alaskan enti11 ties and Indian tribes and tribal organizations, for the

12 purpose of providing substance abuse treatment services

13 for children and adolescents.

14 ‘‘(b) PRIORITY.—In awarding grants, contracts, or

15 cooperative agreements under subsection (a), the Sec16 retary shall give priority to applicants who propose to—

17 ‘‘(1) apply evidenced-based and cost effective

18 methods for the treatment of substance abuse

19 among children and adolescents;

20 ‘‘(2) coordinate the provision of treatment serv21 ices with other social service agencies in the commu22 nity, including educational, juvenile justice, child

23 welfare, and mental health agencies;

24 ‘‘(3) provide a continuum of integrated treat25 ment services, including case management, for chil-
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1 dren and adolescents with substance abuse disorders

2 and their families;

3 ‘‘(4) provide treatment that is gender-specific

4 and culturally appropriate;

5 ‘‘(5) involve and work with families of children

6 and adolescents receiving treatment;

7 ‘‘(6) provide aftercare services for children and

8 adolescents and their families after completion of

9 substance abuse treatment; and

10 ‘‘(7) address the relationship between substance

11 abuse and violence.

12 ‘‘(c) DURATION OF GRANTS.—The Secretary shall

13 award grants, contracts, or cooperative agreements under

14 subsection (a) for periods not to exceed 5 fiscal years.

15 ‘‘(d) APPLICATION.—An entity desiring a grant, con16 tract, or cooperative agreement under subsection (a) shall

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

18 such manner, and accompanied by such information as the

19 Secretary may reasonably require.

20 ‘‘(e) EVALUATION.—An entity that receives a grant,

21 contract, or cooperative agreement under subsection (a)

22 shall submit, in the application for such grant, contract,

23 or cooperative agreement, a plan for the evaluation of any

24 project undertaken with funds provided under this section.

25 Such entity shall provide the Secretary with periodic eval-
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1 uations of the progress of such project and such evaluation

2 at the completion of such project as the Secretary deter3 mines to be appropriate.

4 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There

5 are authorized to be appropriated to carry out this section,

6 $40,000,000 for fiscal year 2000, and such sums as may

7 be necessary for fiscal years 2001 and 2002.

8 ‘‘SEC. 514A. EARLY INTERVENTION SERVICES FOR CHIL9 DREN AND ADOLESCENTS.

10 ‘‘(a) IN GENERAL.—The Secretary shall award

11 grants, contracts, or cooperative agreements to public and

12 private nonprofit entities, including local educational agen13 cies (as defined in section 14101 of the Elementary and

14 Secondary Education Act of 1965 (20 U.S.C. 8801)), for

15 the purpose of providing early intervention substance

16 abuse services for children and adolescents.

17 ‘‘(b) PRIORITY.—In awarding grants, contracts, or

18 cooperative agreements under subsection (a), the Sec19 retary shall give priority to applicants who demonstrate

20 an ability to—

21 ‘‘(1) screen for and assess substance use and

22 abuse by children and adolescents;

23 ‘‘(2) make appropriate referrals for children

24 and adolescents who are in need of treatment for

25 substance abuse;
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1 ‘‘(3) provide early intervention services, includ2 ing counseling and ancillary services, that are de3 signed to meet the developmental needs of children

4 and adolescents who are at risk for substance abuse;

5 and

6 ‘‘(4) develop networks with the educational, ju7 venile justice, social services, and other agencies and

8 organizations in the State or local community in9 volved that will work to identify children and adoles10 cents who are in need of substance abuse treatment

11 services.

12 ‘‘(c) CONDITION.—In awarding grants, contracts, or

13 cooperative agreements under subsection (a), the Sec14 retary shall ensure that such grants, contracts, or coopera15 tive agreements are allocated, subject to the availability

16 of qualified applicants, among the principal geographic re17 gions of the United States, to Indian tribes and tribal or18 ganizations, and to urban and rural areas.

19 ‘‘(d) DURATION OF GRANTS.—The Secretary shall

20 award grants, contracts, or cooperative agreements under

21 subsection (a) for periods not to exceed 5 fiscal years.

22 ‘‘(e) APPLICATION.—An entity desiring a grant, con23 tract, or cooperative agreement under subsection (a) shall

24 submit an application to the Secretary at such time, in
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1 such manner, and accompanied by such information as the

2 Secretary may reasonably require.

3 ‘‘(f) EVALUATION.—An entity that receives a grant,

4 contract, or cooperative agreement under subsection (a)

5 shall submit, in the application for such grant, contract,

6 or cooperative agreement, a plan for the evaluation of any

7 project undertaken with funds provided under this section.

8 Such entity shall provide the Secretary with periodic eval9 uations of the progress of such project and such evaluation

10 at the completion of such project as the Secretary deter11 mines to be appropriate.

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

13 are authorized to be appropriated to carry out this section,

14 $20,000,000 for fiscal year 2000, and such sums as may

15 be necessary for fiscal years 2001 and 2002.

16 ‘‘SEC. 514B. YOUTH INTERAGENCY RESEARCH, TRAINING,

17 AND TECHNICAL ASSISTANCE CENTERS.

18 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting

19 through the Administrator of the Substance Abuse and

20 Mental Health Services Administration, and in consulta21 tion with the Administrator of the Office of Juvenile Jus22 tice and Delinquency Prevention, the Director of the Bu23 reau of Justice Assistance and the Director of the Na24 tional Institutes of Health, shall award grants or contracts

25 to public or nonprofit private entities to establish not more
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1 than 4 research, training, and technical assistance centers

2 to carry out the activities described in subsection (c).

3 ‘‘(b) APPLICATION.—A public or private nonprofit

4 entity desiring a grant or contract under subsection (a)

5 shall prepare and submit an application to the Secretary

6 at such time, in such manner, and containing such infor7 mation as the Secretary may require.

8 ‘‘(c) AUTHORIZED ACTIVITIES.—A center established

9 under a grant or contract under subsection (a) shall—

10 ‘‘(1) provide training with respect to state-of11 the-art mental health and justice-related services

12 and successful mental health and substance abuse13 justice collaborations that focus on children and ado14 lescents, to public policymakers, law enforcement ad15 ministrators, public defenders, police, probation offi16 cers, judges, parole officials, jail administrators and

17 mental health and substance abuse providers and

18 administrators;

19 ‘‘(2) engage in research and evaluations con20 cerning State and local justice and mental health

21 systems, including system redesign initiatives, and

22 disseminate information concerning the results of

23 such evaluations;

24 ‘‘(3) provide direct technical assistance, includ25 ing assistance provided through toll-free telephone
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1 numbers, concerning issues such as how to accom2 modate individuals who are being processed through

3 the courts under the Americans with Disabilities Act

4 of 1990 (42 U.S.C. 12101 et seq.), what types of

5 mental health or substance abuse service approaches

6 are effective within the judicial system, and how

7 community-based mental health or substance abuse

8 services can be more effective, including relevant re9 gional, ethnic, and gender-related considerations;

10 and

11 ‘‘(4) provide information, training, and tech12 nical assistance to State and local governmental offi13 cials to enhance the capacity of such officials to pro14 vide appropriate services relating to mental health or

15 substance abuse.

16 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the

17 purpose of carrying out this section, there is authorized

18 to be appropriated $4,000,000 for fiscal year 2000, and

19 such sums as may be necessary for fiscal years 2001 and

20 2002.

21 ‘‘SEC. 514C. PREVENTION OF METHAMPHETAMINE AND IN22 HALANT ABUSE AND ADDICTION.

23 ‘‘(a) GRANTS.—The Director of the Center for Sub24 stance Abuse Prevention (referred to in this section as the

25 ‘Director’) may make grants to and enter into contracts
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1 and cooperative agreements with public and nonprofit pri2 vate entities to enable such entities—

3 ‘‘(1) to carry out school-based programs con4 cerning the dangers of methamphetamine or inhal5 ant abuse and addiction, using methods that are ef6 fective and evidence-based, including initiatives that

7 give students the responsibility to create their own

8 anti-drug abuse education programs for their

9 schools; and

10 ‘‘(2) to carry out community-based meth11 amphetamine or inhalant abuse and addiction pre12 vention programs that are effective and evidence13 based.

14 ‘‘(b) USE OF FUNDS.—Amounts made available

15 under a grant, contract or cooperative agreement under

16 subsection (a) shall be used for planning, establishing, or

17 administering methamphetamine or inhalant prevention

18 programs in accordance with subsection (c).

19 ‘‘(c) PREVENTION PROGRAMS AND ACTIVITIES.—

20 ‘‘(1) IN GENERAL.—Amounts provided under

21 this section may be used—

22 ‘‘(A) to carry out school-based programs

23 that are focused on those districts with high or

24 increasing rates of methamphetamine or inhal25 ant abuse and addiction and targeted at popu-
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1 lations which are most at risk to start meth2 amphetamine or inhalant abuse;

3 ‘‘(B) to carry out community-based preven4 tion programs that are focused on those popu5 lations within the community that are most at6 risk for methamphetamine or inhalant abuse

7 and addiction;

8 ‘‘(C) to assist local government entities to

9 conduct appropriate methamphetamine or inhal10 ant prevention activities;

11 ‘‘(D) to train and educate State and local

12 law enforcement officials, prevention and edu13 cation officials, members of community anti14 drug coalitions and parents on the signs of

15 methamphetamine or inhalant abuse and addic16 tion and the options for treatment and preven17 tion;

18 ‘‘(E) for planning, administration, and

19 educational activities related to the prevention

20 of methamphetamine or inhalant abuse and ad21 diction;

22 ‘‘(F) for the monitoring and evaluation of

23 methamphetamine or inhalant prevention activi24 ties, and reporting and disseminating resulting

25 information to the public; and
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1 ‘‘(G) for targeted pilot programs with eval2 uation components to encourage innovation and

3 experimentation with new methodologies.

4 ‘‘(2) PRIORITY.—The Director shall give pri5 ority in making grants under this section to rural

6 and urban areas that are experiencing a high rate

7 or rapid increases in methamphetamine or inhalant

8 abuse and addiction.

9 ‘‘(d) ANALYSES AND EVALUATION.—

10 ‘‘(1) IN GENERAL.—Up to $500,000 of the

11 amount available in each fiscal year to carry out this

12 section shall be made available to the Director, act13 ing in consultation with other Federal agencies, to

14 support and conduct periodic analyses and evalua15 tions of effective prevention programs for meth16 amphetamine or inhalant abuse and addiction and

17 the development of appropriate strategies for dis18 seminating information about and implementing

19 these programs.

20 ‘‘(2) ANNUAL REPORTS.—The Director shall

21 submit to the Committee on Health, Education,

22 Labor, and Pensions and the Committee on Appro23 priations of the Senate and the Committee on Com24 merce and Committee on Appropriations of the

25 House of Representatives, an annual report with the
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1 results of the analyses and evaluation under para2 graph (1).

3 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There

4 is authorized to be appropriated to carry out subsection

5 (a), $10,000,000 for fiscal year 2000, and such sums as

6 may be necessary for each of fiscal years 2001 and

7 2002.’’.

8 SEC. 105. COMPREHENSIVE COMMUNITY SERVICES FOR

9 CHILDREN WITH SERIOUS EMOTIONAL DIS10 TURBANCE.

11 (a) MATCHING FUNDS.—Section 561(c)(1)(D) of the

12 Public Health Service Act (42 U.S.C. 290ff(c)(1)(D)) is

13 amended by striking ‘‘fifth’’ and inserting ‘‘fifth and

14 sixth’’.

15 (b) FLEXIBILITY FOR INDIAN TRIBES AND TERRI16 TORIES.—Section 562 of the Public Health Service Act

17 (42 U.S.C. 290ff–1) is amended by adding at the end the

18 following:

19 ‘‘(g) WAIVERS.—The Secretary may waive 1 or more

20 of the requirements of subsection (c) for a public entity

21 that is an Indian Tribe or tribal organization, or American

22 Samoa, Guam, the Marshall Islands, the Federated States

23 of Micronesia, the Commonwealth of the Northern Mar24 iana Islands, the Republic of Palau, or the United States

25 Virgin Islands if the Secretary determines, after peer re-
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1 view, that the system of care is family-centered and uses

2 the least restrictive environment that is clinically appro3 priate.’’.

4 (c) DURATION OF GRANTS.—Section 565(a) of the

5 Public Health Service Act (42 U.S.C. 290ff–4(a)) is

6 amended by striking ‘‘5 fiscal’’ and inserting ‘‘6 fiscal’’.

7 (d) AUTHORIZATION OF APPROPRIATIONS.—Section

8 565(f)(1) of the Public Health Service Act (42 U.S.C.

9 290ff–4(f)(1)) is amended by striking ‘‘1993’’ and all that

10 follows and inserting ‘‘2000, and such sums as may be

11 necessary for each of the fiscal years 2001 and 2002.’’.

12 (e) CURRENT GRANTEES.—

13 (1) IN GENERAL.—Entities with active grants

14 under section 561 of the Public Health Service Act

15 (42 U.S.C. 290ff) on the date of enactment of this

16 Act shall be eligible to receive a 6th year of funding

17 under the grant in an amount not to exceed the

18 amount that such grantee received in the 5th year

19 of funding under such grant. Such 6th year may be

20 funded without requiring peer and Advisory Council

21 review as required under section 504 of such Act (42

22 U.S.C. 290aa–3).

23 (2) LIMITATION.—Paragraph (1) shall apply

24 with respect to a grantee only if the grantee agrees
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1 to comply with the provisions of section 561 as

2 amended by subsection (a).

3 SEC. 106. SERVICES FOR CHILDREN OF SUBSTANCE ABUS4 ERS.

5 (a) ADMINISTRATION AND ACTIVITIES.—

6 (1) ADMINISTRATION.—Section 399D(a) of the

7 Public Health Service Act (42 U.S.C. 280d(a)(1)) is

8 amended—

9 (A) in paragraph (1), by striking ‘‘Admin10 istrator’’ and all that follows through ‘‘Adminis11 tration’’ and insert ‘‘Administrator of the Sub12 stance Abuse and Mental Health Services Ad13 ministration’’; and

14 (B) in paragraph (2), by striking ‘‘Admin15 istrator of the Substance Abuse and Mental

16 Health Services Administration’’ and inserting

17 ‘‘Administrator of the Health Resources and

18 Services Administration’’.

19 (2) ACTIVITIES.—Section 399D(a)(1) of the

20 Public Health Service Act (42 U.S.C. 280d(a)(1)) is

21 amended—

22 (A) in subparagraph (B), by striking

23 ‘‘and’’ at the end;

24 (B) in subparagraph (C), by striking the

25 period and inserting the following: ‘‘through
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1 youth service agencies, family social services,

2 child care providers, Head Start, schools and

3 after-school programs, early childhood develop4 ment programs, community-based family re5 source and support centers, the criminal justice

6 system, health, substance abuse and mental

7 health providers through screenings conducted

8 during regular childhood examinations and

9 other examinations, self and family member re10 ferrals, substance abuse treatment services, and

11 other providers of services to children and fami12 lies; and’’; and

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

14 ‘‘(D) to provide education and training to

15 health, substance abuse and mental health pro16 fessionals, and other providers of services to

17 children and families through youth service

18 agencies, family social services, child care, Head

19 Start, schools and after-school programs, early

20 childhood development programs, community21 based family resource and support centers, the

22 criminal justice system, and other providers of

23 services to children and families.’’.
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1 (3) IDENTIFICATION OF CERTAIN CHILDREN.—

2 Section 399D(a)(3)(A) of the Public Health Service

3 Act (42 U.S.C. 280d(a)(3)(A)) is amended—

4 (A) in clause (i), by striking ‘‘(i) the enti5 ty’’ and inserting ‘‘(i)(I) the entity’’;

6 (B) in clause (ii)—

7 (i) by striking ‘‘(ii) the entity’’ and in8 serting ‘‘(II) the entity’’; and

9 (ii) by striking the period and insert10 ing ‘‘; and’’; and

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

12 ‘‘(ii) the entity will identify children

13 who may be eligible for medical assistance

14 under a State program under title XIX or

15 XXI of the Social Security Act.’’.

16 (b) SERVICES FOR CHILDREN.—Section 399D(b) of

17 the Public Health Service Act (42 U.S.C. 280d(b)) is

18 amended—

19 (1) in paragraph (1), by inserting ‘‘alcohol and

20 drug,’’ after ‘‘psychological,’’;

21 (2) by striking paragraph (5) and inserting the

22 following:

23 ‘‘(5) Developmentally and age-appropriate drug

24 and alcohol early intervention, treatment and pre25 vention services.’’; and
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1 (3) by inserting after paragraph (8), the fol2 lowing:

3 ‘‘Services shall be provided under paragraphs (2) through

4 (8) by a public health nurse, social worker, or similar pro5 fessional, or by a trained worker from the community who

6 is supervised by a professional, or by an entity, where the

7 professional or entity provides assurances that the profes8 sional or entity is licensed or certified by the State if re9 quired and is complying with applicable licensure or cer10 tification requirements.’’.

11 (c) SERVICES FOR AFFECTED FAMILIES.—Section

12 399D(c) of the Public Health Service Act (42 U.S.C.

13 280d(c)) is amended—

14 (1) in paragraph (1)—

15 (A) in the matter preceding subparagraph

16 (A), by inserting before the colon the following:

17 ‘‘, or by an entity, where the professional or en18 tity provides assurances that the professional or

19 entity is licensed or certified by the State if re20 quired and is complying with applicable licen21 sure or certification requirements’’; and

22 (B) by adding at the end the following:

23 ‘‘(D) Aggressive outreach to family mem24 bers with substance abuse problems.
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1 ‘‘(E) Inclusion of consumer in the develop2 ment, implementation, and monitoring of Fam3 ily Services Plan.’’;

4 (2) in paragraph (2)—

5 (A) by striking subparagraph (A) and in6 serting the following:

7 ‘‘(A) Alcohol and drug treatment services,

8 including screening and assessment, diagnosis,

9 detoxification, individual, group and family

10 counseling, relapse prevention,

11 pharmacotherapy treatment, after-care services,

12 and case management.’’;

13 (B) in subparagraph (C), by striking ‘‘, in14 cluding educational and career planning’’ and

15 inserting ‘‘and counseling on the human im16 munodeficiency virus and acquired immune de17 ficiency syndrome’’;

18 (C) in subparagraph (D), by striking ‘‘con19 flict and’’; and

20 (D) in subparagraph (E), by striking ‘‘Re21 medial’’ and inserting ‘‘Career planning and’’;

22 and

23 (3) in paragraph (3)(D), by inserting ‘‘which

24 include child abuse and neglect prevention tech25 niques’’ before the period.
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1 (d) ELIGIBLE ENTITIES.—Section 399D(d) of the

2 Public Health Service Act (42 U.S.C. 280d(d)) is

3 amended—

4 (1) by striking the matter preceding paragraph

5 (1) and inserting:

6 ‘‘(d) ELIGIBLE ENTITIES.—The Secretary shall dis7 tribute the grants through the following types of entities:’’;

8 (2) in paragraph (1), by striking ‘‘drug treat9 ment’’ and inserting ‘‘drug early intervention, pre10 vention or treatment; and

11 (3) in paragraph (2)—

12 (A) in subparagraph (A), by striking ‘‘;

13 and’’ and inserting ‘‘; or’’; and

14 (B) in subparagraph (B), by inserting ‘‘or

15 pediatric health or mental health providers and

16 family mental health providers’’ before the pe17 riod.

18 (e) SUBMISSION OF INFORMATION.—Section

19 399D(h) of the Public Health Service Act (42 U.S.C.

20 280d(h)) is amended—

21 (1) in paragraph (2)—

22 (A) by inserting ‘‘including maternal and

23 child health’’ before ‘‘mental’’;

24 (B) by striking ‘‘treatment programs’’; and
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1 (C) by striking ‘‘and the State agency re2 sponsible for administering public maternal and

3 child health services’’ and inserting ‘‘, the State

4 agency responsible for administering alcohol

5 and drug programs, the State lead agency, and

6 the State Interagency Coordinating Council

7 under part H of the Individuals with Disabil8 ities Education Act; and’’; and

9 (2) by striking paragraph (3) and redesignating

10 paragraph (4) as paragraph (3).

11 (f) REPORTS TO THE SECRETARY.—Section

12 399D(i)(6) of the Public Health Service Act (42 U.S.C.

13 280d(i)(6)) is amended—

14 (1) in subparagraph (B), by adding ‘‘and’’ at

15 the end; and

16 (2) by striking subparagraphs (C), (D), and (E)

17 and inserting the following:

18 ‘‘(C) the number of case workers or other

19 professionals trained to identify and address

20 substance abuse issues.’’.

21 (g) EVALUATIONS.—Section 399D(l) of the Public

22 Health Service Act (42 U.S.C. 280d(l)) is amended—

23 (1) in paragraph (3), by adding ‘‘and’’ at the

24 end;
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1 (2) in paragraph (4), by striking the semicolon

2 and inserting the following: ‘‘, including increased

3 participation in work or employment-related activi4 ties and decreased participation in welfare pro5 grams.’’; and

6 (3) by striking paragraphs (5) and (6).

7 (h) REPORT TO CONGRESS.—Section 399D(m) of the

8 Public Health Service Act (42 U.S.C. 280d(m)) is

9 amended—

10 (1) in paragraph (2), by adding ‘‘and’’ at the

11 end;

12 (2) in paragraph (3)—

13 (A) in subparagraph (A), by adding ‘‘and’’

14 at the end;

15 (B) in subparagraph (B), by striking the

16 semicolon and inserting a period; and

17 (C) by striking subparagraphs (C), (D),

18 and (E); and

19 (3) by striking paragraphs (4) and (5).

20 (i) DATA COLLECTION.—Section 399D(n) of the

21 Public Health Service Act (42 U.S.C. 280d(n)) is amend22 ed by adding at the end the following: ‘‘The periodic report

23 shall include a quantitative estimate of the prevalence of

24 alcohol and drug problems in families involved in the child

25 welfare system, the barriers to treatment and prevention
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1 services facing these families, and policy recommendations

2 for removing the identified barriers, including training for

3 child welfare workers.’’.

4 (j) DEFINITION.—Section 399D(o)(2)(B) of the Pub5 lic Health Service Act (42 U.S.C. 280d(o)(2)(B)) is

6 amended by striking ‘‘dangerous’’.

7 (k) AUTHORIZATION OF APPROPRIATIONS.—Section

8 399D(p) of the Public Health Service Act (42 U.S.C.

9 280d(p)) is amended to read as follows:

10 ‘‘(p) AUTHORIZATION OF APPROPRIATIONS.—For the

11 purpose of carrying out this section, there are authorized

12 to be appropriated $50,000,000 for fiscal year 2000, and

13 such sums as may be necessary for each of fiscal years

14 2001 and 2002.’’.

15 (l) GRANTS FOR TRAINING AND CONFORMING

16 AMENDMENTS.—Section 399D of the Public Health Serv17 ice Act (42 U.S.C. 280d) is amended—

18 (1) by striking subsection (f);

19 (2) by striking subsection (k);

20 (3) by redesignating subsections (d), (e), (g),

21 (h), (i), (j), (l), (m), (n), (o), and (p) as subsections

22 (e) through (o), respectively;

23 (4) by inserting after subsection (c), the fol24 lowing:
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1 ‘‘(d) TRAINING FOR PROVIDERS OF SERVICES TO

2 CHILDREN AND FAMILIES.—The Secretary may make a

3 grant under subsection (a) for the training of health, sub4 stance abuse and mental health professionals and other

5 providers of services to children and families through

6 youth service agencies, family social services, child care

7 providers, Head Start, schools and after-school programs,

8 early childhood development programs, community-based

9 family resource centers, the criminal justice system, and

10 other providers of services to children and families. Such

11 training shall be to assist professionals in recognizing the

12 drug and alcohol problems of their clients and to enhance

13 their skills in identifying and understanding the nature of

14 substance abuse, and obtaining substance abuse early

15 intervention, prevention and treatment resources.’’;

16 (5) in subsection (k)(2) (as so redesignated), by

17 striking ‘‘(h)’’ and inserting ‘‘(i)’’; and

18 (6) in paragraphs (3)(E) and (5) of subsection

19 (m) (as so redesignated), by striking ‘‘(d)’’ and in20 serting ‘‘(e)’’.

21 (m) TRANSFER AND REDESIGNATION.—Section

22 399D of the Public Health Service Act (42 U.S.C. 280d),

23 as amended by this section—

24 (1) is transferred to title V;

25 (2) is redesignated as section 519; and
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1 (3) is inserted after section 518.

2 (n) CONFORMING AMENDMENT.—Title III of the

3 Public Health Service Act (42 U.S.C. 241 et seq.) is

4 amended by striking the heading of part L.

5 SEC. 107. SERVICES FOR YOUTH OFFENDERS.

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

7 Service Act (42 U.S.C. 290bb–31 et seq.) is amended by

8 adding at the end the following:

9 ‘‘SEC. 520C. SERVICES FOR YOUTH OFFENDERS.

10 ‘‘(a) IN GENERAL.—The Secretary, acting through

11 the Director of the Center for Mental Health Services, and

12 in consultation with the Director of the Center for Sub13 stance Abuse Treatment, the Administrator of the Office

14 of Juvenile Justice and Delinquency Prevention, and the

15 Director of the Special Education Programs, shall award

16 grants on a competitive basis to State or local juvenile jus17 tice agencies to enable such agencies to provide aftercare

18 services for youth offenders who have been discharged

19 from facilities in the juvenile or criminal justice system

20 and have serious emotional disturbances or are at risk of

21 developing such disturbances.

22 ‘‘(b) USE OF FUNDS.—A State or local juvenile jus23 tice agency receiving a grant under subsection (a) shall

24 use the amounts provided under the grant—
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1 ‘‘(1) to develop a plan describing the manner in

2 which the agency will provide services for each youth

3 offender who has a serious emotional disturbance

4 and has been detained or incarcerated in facilities

5 within the juvenile or criminal justice system;

6 ‘‘(2) to provide a network of core or aftercare

7 services or access to such services for each youth of8 fender, including diagnostic and evaluation services,

9 substance abuse treatment services, outpatient men10 tal health care services, medication management

11 services, intensive home-based therapy, intensive day

12 treatment services, respite care, and therapeutic fos13 ter care;

14 ‘‘(3) to establish a program that coordinates

15 with other State and local agencies providing rec16 reational, social, educational, vocational, or oper17 ational services for youth, to enable the agency re18 ceiving a grant under this section to provide commu19 nity-based system of care services for each youth of20 fender that addresses the special needs of the youth

21 and helps the youth access all of the aforementioned

22 services; and

23 ‘‘(4) using not more than 20 percent of funds

24 received, to provide planning and transition services
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1 as described in paragraph (3) for youth offenders

2 while such youth are incarcerated or detained.

3 ‘‘(c) APPLICATION.—A State or local juvenile justice

4 agency that desires a grant under subsection (a) shall sub5 mit an application to the Secretary at such time, in such

6 manner, and accompanied by such information as the Sec7 retary may reasonably require.

8 ‘‘(d) REPORT.—Not later than 3 years after the date

9 of enactment of this section and annually thereafter, the

10 Secretary shall prepare and submit, to the Committee on

11 Health, Education, Labor, and Pensions of the Senate and

12 the Committee on Commerce of the House of Representa13 tives, a report that describes the services provided pursu14 ant to this section.

15 ‘‘(e) DEFINITIONS.—In this section:

16 ‘‘(1) SERIOUS EMOTIONAL DISTURBANCE.—The

17 term ‘serious emotional disturbance’ with respect to

18 a youth offender means an offender who currently,

19 or at any time within the 1-year period ending on

20 the day on which services are sought under this sec21 tion, has a diagnosable mental, behavioral, or emo22 tional disorder that functionally impairs the offend23 er’s life by substantially limiting the offender’s role

24 in family, school, or community activities, and inter25 fering with the offender’s ability to achieve or main-
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1 tain 1 or more developmentally-appropriate social,

2 behavior, cognitive, communicative, or adaptive

3 skills.

4 ‘‘(2) COMMUNITY-BASED SYSTEM OF CARE.—

5 The term ‘community-based system of care’ means

6 the provision of services for the youth offender by

7 various State or local agencies that in an inter8 agency fashion or operating as a network addresses

9 the recreational, social, educational, vocational, men10 tal health, substance abuse, and operational needs of

11 the youth offender.

12 ‘‘(3) YOUTH OFFENDER.—The term ‘youth of13 fender’ means an individual who is 21 years of age

14 or younger who has been discharged from a State or

15 local juvenile or criminal justice system, except that

16 if the individual is between the ages of 18 and 21

17 years, such individual has had contact with the State

18 or local juvenile or criminal justice system prior to

19 attaining 18 years of age and is under the jurisdic20 tion of such a system at the time services are

21 sought.

22 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There

23 is authorized to be appropriated to carry out this section

24 $40,000,000 for fiscal year 2000, and such sums as may

25 be necessary for each of fiscal years 2001 and 2002.’’.
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1 SEC. 108. GRANTS FOR STRENGTHENING FAMILIES

2 THROUGH COMMUNITY PARTNERSHIPS.

3 Subpart 2 of part B of Title V of the Public Health

4 Service Act (42 U.S.C. 290bb-21 et seq) is amended by

5 adding at the end the following:

6 ‘‘SEC. 519A. GRANTS FOR STRENGTHENING FAMILIES.

7 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting

8 through the Director of the Prevention Center, may make

9 grants to public and nonprofit private entities to develop

10 and implement model substance abuse prevention pro11 grams to provide early intervention and substance abuse

12 prevention services for individuals of high-risk families

13 and the communities in which such individuals reside.

14 ‘‘(b) PRIORITY.—In awarding grants under sub15 section (a), the Secretary shall give priority to applicants

16 that—

17 ‘‘(1) have proven experience in preventing sub18 stance abuse by individuals of high-risk families and

19 reducing substance abuse in communities of such in20 dividuals;

21 ‘‘(2) have demonstrated the capacity to imple22 ment community-based partnership initiatives that

23 are sensitive to the diverse backgrounds of individ24 uals of high-risk families and the communities of

25 such individuals;
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1 ‘‘(3) have experience in providing technical as2 sistance to support substance abuse prevention pro3 grams that are community-based;

4 ‘‘(4) have demonstrated the capacity to imple5 ment research-based substance abuse prevention

6 strategies; and

7 ‘‘(5) have implemented programs that involve

8 families, residents, community agencies, and institu9 tions in the implementation and design of such pro10 grams.

11 ‘‘(c) DURATION OF GRANTS.—The Secretary shall

12 award grants under subsection (a) for a period not to ex13 ceed 5 years.

14 ‘‘(d) USE OF FUNDS.—An applicant that is awarded

15 a grant under subsection (a) shall—

16 ‘‘(1) in the first fiscal year that such funds are

17 received under the grant, use such funds to develop

18 a model substance abuse prevention program; and

19 ‘‘(2) in the fiscal year following the first fiscal

20 year that such funds are received, use such funds to

21 implement the program developed under paragraph

22 (1) to provide early intervention and substance

23 abuse prevention services to—

24 ‘‘(A) strengthen the environment of chil25 dren of high risk families by targeting interven-
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1 tions at the families of such children and the

2 communities in which such children reside;

3 ‘‘(B) strengthen protective factors, such

4 as—

5 ‘‘(i) positive adult role models;

6 ‘‘(ii) messages that oppose substance

7 abuse;

8 ‘‘(iii) community actions designed to

9 reduce accessibility to and use of illegal

10 substances; and

11 ‘‘(iv) willingness of individuals of fam12 ilies in which substance abuse occurs to

13 seek treatment for substance abuse;

14 ‘‘(C) reduce family and community risks,

15 such as family violence, alcohol or drug abuse,

16 crime, and other behaviors that may effect

17 healthy child development and increase the like18 lihood of substance abuse; and

19 ‘‘(D) build collaborative and formal part20 nerships between community agencies, institu21 tions, and businesses to ensure that comprehen22 sive high quality services are provided, such as

23 early childhood education, health care, family

24 support programs, parent education programs,

25 and home visits for infants.
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1 ‘‘(e) APPLICATION.—To be eligible to receive a grant

2 under subsection (a), an applicant shall prepare and sub3 mit to the Secretary an application that—

4 ‘‘(1) describes a model substance abuse preven5 tion program that such applicant will establish;

6 ‘‘(2) describes the manner in which the services

7 described in subsection (d)(2) will be provided; and

8 ‘‘(3) describe in as much detail as possible the

9 results that the entity expects to achieve in imple10 menting such a program.

11 ‘‘(f) MATCHING FUNDING.—The Secretary may not

12 make a grant to a entity under subsection (a) unless that

13 entity agrees that, with respect to the costs to be incurred

14 by the entity in carrying out the program for which the

15 grant was awarded, the entity will make available non16 Federal contributions in an amount that is not less than

17 40 percent of the amount provided under the grant.

18 ‘‘(g) REPORT TO SECRETARY.—An applicant that is

19 awarded a grant under subsection (a) shall prepare and

20 submit to the Secretary a report in such form and con21 taining such information as the Secretary may require, in22 cluding an assessment of the efficacy of the model sub23 stance abuse prevention program implemented by the ap24 plicant and the short, intermediate, and long term results

25 of such program.
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1 ‘‘(h) EVALUATIONS.—The Secretary shall conduct

2 evaluations, based in part on the reports submitted under

3 subsection (g), to determine the effectiveness of the pro4 grams funded under subsection (a) in reducing substance

5 use in high-risk families and in making communities in

6 which such families reside in stronger. The Secretary shall

7 submit such evaluations to the appropriate committees of

8 Congress.

9 ‘‘(i) HIGH-RISK FAMILIES.—In this section, the term

10 ‘high-risk family’ means a family in which the individuals

11 of such family are at a significant risk of using or abusing

12 alcohol or any illegal substance.

13 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There

14 is authorized to be appropriated to carry out this section,

15 $3,000,000 for fiscal year 2000, and such sums as may

16 be necessary for each of the fiscal years 2001 and 2002.’’.

17 SEC. 109. GENERAL PROVISIONS.

18 (a) DUTIES OF THE CENTER FOR SUBSTANCE ABUSE

19 TREATMENT.—Section 507(b) of the Public Health Serv20 ice Act (42 U.S.C. 290bb(b)) is amended—

21 (1) by redesignating paragraphs (2) through

22 (12) as paragraphs (4) through (14), respectively;

23 (2) by inserting after paragraph (1), the fol24 lowing:
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1 ‘‘(2) ensure that emphasis is placed on children

2 and adolescents in the development of treatment

3 programs;

4 ‘‘(3) collaborate with the Attorney General to

5 develop programs to provide substance abuse treat6 ment services to individuals who have had contact

7 with the Justice system, especially adolescents;’’;

8 and

9 (3) in paragraph 14 (as so redesignated), by

10 striking ‘‘paragraph (11)’’ and inserting ‘‘paragraph

11 (13)’’.

12 (b) OFFICE FOR SUBSTANCE ABUSE PREVENTION.—

13 Section 515(b) of the Public Health Service Act (42

14 U.S.C. 290bb-21(b)) is amended—

15 (1) by redesignating paragraphs (9) and (10)

16 as (10) and (11);

17 (2) by inserting after paragraph (8), the fol18 lowing:

19 ‘‘(9) collaborate with the Attorney General of

20 the Department of Justice to develop programs to

21 prevent drug abuse among high risk youth;’’; and

22 (3) in paragraph (10) (as so redesignated), by

23 striking ‘‘public concerning’’ and inserting ‘‘public,

24 especially adolescent audiences, concerning’’.
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1 (c) DUTIES OF THE CENTER FOR MENTAL HEALTH

2 SERVICES.—Section 520(b) of the Public Health Service

3 Act (42 U.S.C. 290bb–3(b)) is amended—

4 (1) by redesignating paragraphs (3) through

5 (14) as paragraphs (4) through (15), respectively;

6 and

7 (2) by inserting after paragraph (2), the fol8 lowing:

9 ‘‘(3) collaborate with the Department of Edu10 cation and the Department of Justice to develop

11 programs to assist local communities in addressing

12 violence among children and adolescents;’’.

13 TITLE II—PROVISIONS

14 RELATING TO MENTAL HEALTH

15 SEC. 201. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL

16 AND NATIONAL SIGNIFICANCE.

17 (a) IN GENERAL.—Section 520A of the Public

18 Health Service Act (42 U.S.C. 290bb–32) is amended to

19 read as follows:

20 ‘‘SEC. 520A. PRIORITY MENTAL HEALTH NEEDS OF RE21 GIONAL AND NATIONAL SIGNIFICANCE.

22 ‘‘(a) PROJECTS.—The Secretary shall address pri23 ority mental health needs of regional and national signifi24 cance (as determined under subsection (b)) through the

25 provision of or through assistance for—
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1 ‘‘(1) knowledge development and application

2 projects for prevention, treatment, and rehabilita3 tion, and the conduct or support of evaluations of

4 such projects;

5 ‘‘(2) training and technical assistance pro6 grams;

7 ‘‘(3) targeted capacity response programs; and

8 ‘‘(4) systems change grants including statewide

9 family network grants and client-oriented and con10 sumer run self-help activities.

11 The Secretary may carry out the activities described in

12 this subsection directly or through grants, contracts, or

13 cooperative agreements with States, political subdivisions

14 of States, Indian tribes and tribal organizations, other

15 public or private nonprofit entities.

16 ‘‘(b) PRIORITY MENTAL HEALTH NEEDS.—

17 ‘‘(1) DETERMINATION OF NEEDS.—Priority

18 mental health needs of regional and national signifi19 cance shall be determined by the Secretary in con20 sultation with States and other interested groups.

21 The Secretary shall meet with the States and inter22 ested groups on an annual basis to discuss program

23 priorities.

24 ‘‘(2) SPECIAL CONSIDERATION.—In developing

25 program priorities described in paragraph (1), the
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1 Secretary, in conjunction with the Director of the

2 Center for Mental Health Services, the Director of

3 the Center for Substance Abuse Treatment, and the

4 Administrator of the Health Resources and Services

5 Administration, shall give special consideration to

6 promoting the integration of mental health services

7 into primary health care systems.

8 ‘‘(c) REQUIREMENTS.—

9 ‘‘(1) IN GENERAL.—Recipients of grants, con10 tracts, and cooperative agreements under this sec11 tion shall comply with information and application

12 requirements determined appropriate by the Sec13 retary.

14 ‘‘(2) DURATION OF AWARD.—With respect to a

15 grant, contract, or cooperative agreement awarded

16 under this section, the period during which pay17 ments under such award are made to the recipient

18 may not exceed 5 years.

19 ‘‘(3) MATCHING FUNDS.—The Secretary may,

20 for projects carried out under subsection (a), require

21 that entities that apply for grants, contracts, or co22 operative agreements under this section provide non23 Federal matching funds, as determined appropriate

24 by the Secretary, to ensure the institutional commit25 ment of the entity to the projects funded under the
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1 grant, contract, or cooperative agreement. Such non2 Federal matching funds may be provided directly or

3 through donations from public or private entities

4 and may be in cash or in kind, fairly evaluated, in5 cluding plant, equipment, or services.

6 ‘‘(4) MAINTENANCE OF EFFORT.—With respect

7 to activities for which a grant, contract or coopera8 tive agreement is awarded under this section, the

9 Secretary may require that recipients for specific

10 projects under subsection (a) agree to maintain ex11 penditures of non-Federal amounts for such activi12 ties at a level that is not less than the level of such

13 expenditures maintained by the entity for the fiscal

14 year preceding the fiscal year for which the entity

15 receives such a grant, contract, or cooperative agree16 ment.

17 ‘‘(d) EVALUATION.—The Secretary shall evaluate

18 each project carried out under subsection (a)(1) and shall

19 disseminate the findings with respect to each such evalua20 tion to appropriate public and private entities.

21 ‘‘(e) INFORMATION AND EDUCATION.—The Secretary

22 shall establish information and education programs to dis23 seminate and apply the findings of the knowledge develop24 ment and application, training, and technical assistance

25 programs, and targeted capacity response programs,
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1 under this section to the general public, to health care pro2 fessionals, and to interested groups. The Secretary shall

3 make every effort to provide linkages between the findings

4 of supported projects and State agencies responsible for

5 carrying out mental health services.

6 ‘‘(f) AUTHORIZATION OF APPROPRIATION.—

7 ‘‘(1) IN GENERAL.—There are authorized to be

8 appropriated to carry out this section, $300,000,000

9 for fiscal year 2000, and such sums as may be nec10 essary for each of the fiscal years 2001 and 2002.

11 ‘‘(2) DATA INFRASTRUCTURE.—If amounts are

12 not appropriated for a fiscal year to carry out sec13 tion 1971 with respect to mental health, then the

14 Secretary shall make available, from the amounts

15 appropriated for such fiscal year under paragraph

16 (1), an amount equal to the sum of $6,000,000 and

17 10 percent of all amounts appropriated for such fis18 cal year under such paragraph in excess of

19 $100,000,000, to carry out such section 1971.’’.

20 (b) CONFORMING AMENDMENTS.—

21 (1) Section 303 of the Public Health Service

22 Act (42 U.S.C. 242a) is repealed.

23 (2) Section 520B of the Public Health Service

24 Act (42 U.S.C. 290bb–33) is repealed.
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1 (3) Section 612 of the Stewart B. McKinney

2 Homeless Assistance Act (42 U.S.C. 290aa–3 note)

3 is repealed.

4 SEC. 202. GRANTS FOR THE BENEFIT OF HOMELESS INDI5 VIDUALS.

6 Section 506 of the Public Health Service Act (42

7 U.S.C. 290aa–5) is amended to read as follows:

8 ‘‘SEC. 506. GRANTS FOR THE BENEFIT OF HOMELESS INDI9 VIDUALS.

10 ‘‘(a) IN GENERAL.—The Secretary shall award

11 grants, contracts and cooperative agreements to commu12 nity-based public and private nonprofit entities for the

13 purposes of providing mental health and substance abuse

14 services for homeless individuals. In carrying out this sec15 tion, the Secretary shall consult with the Interagency

16 Council on the Homeless, established under section 201

17 of the Stewart B. McKinney Homeless Assistance Act (42

18 U.S.C. 11311).

19 ‘‘(b) PREFERENCES.—In awarding grants, contracts,

20 and cooperative agreements under subsection (a), the Sec21 retary shall give a preference to—

22 ‘‘(1) entities that provide integrated primary

23 health, substance abuse, and mental health services

24 to homeless individuals;
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1 ‘‘(2) entities that demonstrate effectiveness in

2 serving runaway, homeless, and street youth;

3 ‘‘(3) entities that have experience in providing

4 substance abuse and mental health services to home5 less individuals;

6 ‘‘(4) entities that demonstrate experience in

7 providing housing for individuals in treatment for or

8 in recovery from mental illness or substance abuse;

9 and

10 ‘‘(5) entities that demonstrate effectiveness in

11 serving homeless veterans.

12 ‘‘(c) SERVICES FOR CERTAIN INDIVIDUALS.—In

13 awarding grants, contracts, and cooperative agreements

14 under subsection (a), the Secretary shall not—

15 ‘‘(1) prohibit the provision of services under

16 such subsection to homeless individuals who are suf17 fering from a substance abuse disorder and are not

18 suffering from a mental health disorder; and

19 ‘‘(2) make payments under subsection (a) to

20 any entity that has a policy of—

21 ‘‘(A) excluding individuals from mental

22 health services due to the existence or suspicion

23 of substance abuse; or
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1 ‘‘(B) has a policy of excluding individuals

2 from substance abuse services due to the exist3 ence or suspicion of mental illness.

4 ‘‘(d) TERM OF THE AWARDS.—No entity may receive

5 a grant, contract, or cooperative agreement under sub6 section (a) for more than 5 years.

7 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There

8 is authorized to be appropriated to carry out this section,

9 $50,000,000 for fiscal year 2000, and such sums as may

10 be necessary for each of the fiscal years 2001 and 2002.’’.

11 SEC. 203. PROJECTS FOR ASSISTANCE IN TRANSITION

12 FROM HOMELESSNESS.

13 (a) WAIVERS FOR TERRITORIES.—Section 522 of the

14 Public Health Service Act (42 U.S.C. 290cc–22) is amend15 ed by adding at the end the following:

16 ‘‘(i) WAIVER FOR TERRITORIES.—With respect to the

17 United States Virgin Islands, Guam, American Samoa,

18 Palau, the Marshall Islands, and the Commonwealth of

19 the Northern Mariana Islands, the Secretary may waive

20 the provisions of this part that the Secretary determines

21 to be appropriate.’’.

22 (b) AUTHORIZATION OF APPROPRIATION.—Section

23 535(a) of the Public Health Service Act (42 U.S.C.

24 290cc–35(a)) is amended by striking ‘‘1991 through

25 1994’’ and inserting ‘‘2000 through 2002’’.
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1 SEC. 204. COMMUNITY MENTAL HEALTH SERVICES PER2 FORMANCE PARTNERSHIP BLOCK GRANT.

3 (a) CRITERIA FOR PLAN.—Section 1912(b) of the

4 Public Health Service Act (42 U.S.C. 300x–2(b)) is

5 amended by striking paragraphs (1) through (12) and in6 serting the following:

7 ‘‘(1) COMPREHENSIVE COMMUNITY-BASED MEN8 TAL HEALTH SYSTEMS.—The plan provides for an

9 organized community-based system of care for indi10 viduals with mental illness and describes available

11 services and resources in a comprehensive system of

12 care, including services for dually diagnosed individ13 uals. The description of the system of care shall in14 clude health and mental health services, rehabilita15 tion services, employment services, housing services,

16 educational services, substance abuse services, med17 ical and dental care, and other support services to

18 be provided to individuals with Federal, State and

19 local public and private resources to enable such in20 dividuals to function outside of inpatient or residen21 tial institutions to the maximum extent of their ca22 pabilities, including services to be provided by local

23 school systems under the Individuals with Disabil24 ities Education Act. The plan shall include a sepa25 rate description of case management services and
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1 provide for activities leading to reduction of hos2 pitalization.

3 ‘‘(2) MENTAL HEALTH SYSTEM DATA AND EPI4 DEMIOLOGY.—The plan contains an estimate of the

5 incidence and prevalence in the State of serious

6 mental illness among adults and serious emotional

7 disturbance among children and presents quan8 titative targets to be achieved in the implementation

9 of the system described in paragraph (1).

10 ‘‘(3) CHILDREN’S SERVICES.—In the case of

11 children with serious emotional disturbance, the

12 plan—

13 ‘‘(A) subject to subparagraph (B), provides

14 for a system of integrated social services, edu15 cational services, juvenile services, and sub16 stance abuse services that, together with health

17 and mental health services, will be provided in

18 order for such children to receive care appro19 priate for their multiple needs (such system to

20 include services provided under the Individuals

21 with Disabilities Education Act);

22 ‘‘(B) provides that the grant under section

23 1911 for the fiscal year involved will not be ex24 pended to provide any service under such sys-
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1 tem other than comprehensive community men2 tal health services; and

3 ‘‘(C) provides for the establishment of a

4 defined geographic area for the provision of the

5 services of such system.

6 ‘‘(4) TARGETED SERVICES TO RURAL AND

7 HOMELESS POPULATIONS.—The plan describes the

8 State’s outreach to and services for individuals who

9 are homeless and how community-based services will

10 be provided to individuals residing in rural areas.

11 ‘‘(5) MANAGEMENT SYSTEMS.—The plan de12 scribes the financial resources, staffing and training

13 for mental health providers that is necessary to im14 plement the plan, and provides for the training of

15 providers of emergency health services regarding

16 mental health. The plan further describes the man17 ner in which the State intends to expend the grant

18 under section 1911 for the fiscal year involved.

19 Except as provided for in paragraph (3), the State plan

20 shall contain the information required under this sub21 section with respect to both adults with serious mental ill22 ness and children with serious emotional disturbance.’’.

23 (b) REVIEW OF PLANNING COUNCIL OF STATE’S RE24 PORT.—Section 1915(a) of the Public Health Service Act

25 (42 U.S.C. 300x–4(a)) is amended—
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1 (1) in paragraph (1), by inserting ‘‘and the re2 port of the State under section 1942(a) concerning

3 the preceding fiscal year’’ after ‘‘to the grant’’; and

4 (2) in paragraph (2), by inserting before the pe5 riod ‘‘and any comments concerning the annual re6 port’’.

7 (c) MAINTENANCE OF EFFORT.—Section 1915(b) of

8 the Public Health Service Act (42 U.S.C. 300x–4(b)) is

9 amended—

10 (1) by redesignating paragraphs (2) and (3) as

11 paragraphs (3) and (4), respectively; and

12 (2) by inserting after paragraph (1), the fol13 lowing:

14 ‘‘(2) EXCLUSION OF CERTAIN FUNDS.—The

15 Secretary may exclude from the aggregate State ex16 penditures under subsection (a), funds appropriated

17 to the principle agency for authorized activities

18 which are of a non-recurring nature and for a spe19 cific purpose.’’.

20 (d) APPLICATION FOR GRANTS.—Section 1917(a)(1)

21 of the Public Health Service Act (42 U.S.C. 300x–6(a)(1))

22 is amended to read as follows:

23 ‘‘(1) the plan is received by the Secretary not

24 later than September 1 of the fiscal year prior to the

25 fiscal year for which a State is seeking funds, and
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1 the report from the previous fiscal year as required

2 under section 1941 is received by December 1 of the

3 fiscal year of the grant;’’.

4 (e) WAIVERS FOR TERRITORIES.—Section 1917(b) of

5 the Public Health Service Act (42 U.S.C. 300x–6(b)) is

6 amended by striking ‘‘whose allotment under section 1911

7 for the fiscal year is the amount specified in section

8 1918(c)(2)(B)’’ and inserting in its place ‘‘except Puerto

9 Rico’’.

10 (f) AUTHORIZATION OF APPROPRIATION.—Section

11 1920 of the Public Health Service Act (42 U.S.C. 300x–

12 9) is amended—

13 (1) in subsection (a), by striking

14 ‘‘$450,000,000’’ and all that follows through the end

15 and inserting ‘‘$450,000,000 for fiscal year 2000,

16 and such sums as may be necessary for each of the

17 fiscal years 2001 and 2002.’’; and

18 (2) in subsection (b)(2), by striking ‘‘section

19 505’’ and inserting ‘‘sections 505 and 1971’’.

20 SEC. 205. DETERMINATION OF ALLOTMENT.

21 Section 1918(b) of the Public Health Service Act (42

22 U.S.C. 300x–7(b)) is amended to read as follows:

23 ‘‘(b) MINIMUM ALLOTMENTS FOR STATES.—With re24 spect to fiscal year 2000, and subsequent fiscal years, the

25 amount of the allotment of a State under section 1911
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1 shall not be less than the amount the State received under

2 such section for fiscal year 1998.’’.

3 SEC. 206. PROTECTION AND ADVOCACY FOR MENTALLY ILL

4 INDIVIDUALS ACT OF 1986.

5 (a) SHORT TITLE.—The first section of the Protec6 tion and Advocacy for Mentally Ill Individuals Act of 1986

7 (Public Law 99–319) is amended to read as follows:

8 ‘‘SECTION 1. SHORT TITLE.

9 ‘‘This Act may be cited as the ‘Protection and Advo10 cacy for Individuals with Mental Illness Act’.’’.

11 (b) DEFINITIONS.—Section 102 of the Protection

12 and Advocacy for Individuals with Mental Illness Act (as

13 amended by subsection (a)) (42 U.S.C. 10802) is

14 amended—

15 (1) in paragraph (4)—

16 (A) in the matter preceding subparagraph

17 (A), by inserting ‘‘, except as provided in sec18 tion 104(d),’’ after ‘‘means’’;

19 (B) in subparagraph (B)—

20 (i) by striking ‘‘(i)’’ who’’ and insert21 ing ‘‘(i)(I) who’’;

22 (ii) by redesignating clauses (ii) and

23 (iii) as subclauses (II) and (III);
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1 (iii) in subclause (III) (as so redesig2 nated), by striking the period and inserting

3 ‘‘; or’’; and

4 (iv) by adding at the end the fol5 lowing:

6 ‘‘(ii) who satisfies the requirements of sub7 paragraph (A) and lives in a community set8 ting, including their own home.’’; and

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

10 ‘‘(8) The term ‘American Indian consortium’

11 means a consortium established under part C of the

12 Developmental Disabilities Assistance and Bill of

13 Rights Act (42 U.S.C. 6042 et seq.).’’.

14 (c) USE OF ALLOTMENTS.—Section 104 of the Pro15 tection and Advocacy for Individuals with Mental Illness

16 Act (as amended by subsection (a)) (42 U.S.C. 10804)

17 is amended by adding at the end the following:

18 ‘‘(d) The definition of ‘individual with a mental ill19 ness’ contained in section 102(4)(B)(iii) shall apply, and

20 thus an eligible system may use its allotment under this

21 title to provide representation to such individuals, only if

22 the total allotment under this title for any fiscal year is

23 $30,000,000 or more, and in such case, an eligible system

24 must give priority to representing persons with mental ill-
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1 ness as defined in subparagraphs (A) and (B)(i) of section

2 102(4).’’.

3 (d) MINIMUM AMOUNT.—Paragraph (2) of section

4 112(a) of the Protection and Advocacy for Individuals

5 with Mental Illness Act (as amended by subsection (a))

6 (42 U.S.C. 10822(a)(2)) is amended to read as follows:

7 ‘‘(2)(A) The minimum amount of the allotment

8 of an eligible system shall be the product (rounded

9 to the nearest $100) of the appropriate base amount

10 determined under subparagraph (B) and the factor

11 specified in subparagraph (C).

12 ‘‘(B) For purposes of subparagraph (A), the

13 appropriate base amount—

14 ‘‘(i) for American Samoa, Guam, the Mar15 shall Islands, the Federated States of Micro16 nesia, the Commonwealth of the Northern Mar17 iana Islands, the Republic of Palau, and the

18 Virgin Islands, is $139,300; and

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

20 ‘‘(C) The factor specified in this subparagraph

21 is the ratio of the amount appropriated under sec22 tion 117 for the fiscal year for which the allotment

23 is being made to the amount appropriated under

24 such section for fiscal year 1995.
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1 ‘‘(D) If the total amount appropriated for a fis2 cal year is at least $25,000,000, the Secretary shall

3 make an allotment in accordance with subparagraph

4 (A) to the eligible system serving the American In5 dian consortium.’’.

6 (e) TECHNICAL AMENDMENTS.—Section 112(a) of

7 the Protection and Advocacy for Individuals with Mental

8 Illness Act (as amended by subsection (a)) (42 U.S.C.

9 10822(a)) is amended—

10 (1) in paragraph (1)(B), by striking ‘‘Trust

11 Territory of the Pacific Islands’’ and inserting

12 ‘‘Marshall Islands, the Federated States of Micro13 nesia, the Republic of Palau’’; and

14 (2) by striking paragraph (3).

15 (f) REAUTHORIZATION.—Section 117 of the Protec16 tion and Advocacy for Individuals with Mental Illness Act

17 (as amended by subsection (a)) (42 U.S.C. 10827) is

18 amended by striking ‘‘1995’’ and inserting ‘‘2002’’.

19 SEC. 207. REQUIREMENT RELATING TO THE RIGHTS OF

20 RESIDENTS OF CERTAIN FACILITIES.

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

22 290aa et seq.) is amended by adding at the end the fol23 lowing:
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1 ‘‘PART H—REQUIREMENT RELATING TO THE

2 RIGHTS OF RESIDENTS OF CERTAIN FACILITIES

3 ‘‘SEC. 591. REQUIREMENT RELATING TO THE RIGHTS OF

4 RESIDENTS OF CERTAIN FACILITIES.

5 ‘‘(a) IN GENERAL.—A public or private general hos6 pital, nursing facility, intermediate care facility, residen7 tial treatment center, or other health care facility, that

8 receives support in any form from any program supported

9 in whole or in part with funds appropriated to any Federal

10 department or agency shall protect and promote the rights

11 of each resident of the facility, including the right to be

12 free from physical or mental abuse, corporal punishment,

13 and any restraints or involuntary seclusions imposed for

14 purposes of discipline or convenience.

15 ‘‘(b) REQUIREMENTS.—Restraints and seclusion may

16 only be imposed on a resident of a facility described in

17 subsection (a) if—

18 ‘‘(1) the restraints or seclusion are imposed to

19 ensure the physical safety of the resident, a staff

20 member, or others; and

21 ‘‘(2) the restraints or seclusion are imposed

22 only upon the written order of a physician, or other

23 licensed independent practitioner permitted by the

24 State and the facility to order such restraint or se25 clusion, that specifies the duration and cir26 cumstances under which the restraints are to be
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1 used (except in emergency circumstances specified

2 by the Secretary until such an order could reason3 ably be obtained).

4 ‘‘(c) DEFINITIONS.—In this section:

5 ‘‘(1) RESTRAINTS.—The term ‘restraints’

6 means—

7 ‘‘(A) any physical restraint that is a me8 chanical or personal restriction that immobilizes

9 or reduces the ability of an individual to move

10 his or her arms, legs, or head freely, not includ11 ing devices, such as orthopedically prescribed

12 devices, surgical dressings or bandages, protec13 tive helmets, or any other methods that involves

14 the physical holding of a resident for the pur15 pose of conducting routine physical examina16 tions or tests or to protect the resident from

17 falling out of bed or to permit the resident to

18 participate in activities without the risk of

19 physical harm to the resident; and

20 ‘‘(B) a drug or medication that is used as

21 a restraint to control behavior or restrict the

22 resident’s freedom of movement that is not a

23 standard treatment for the resident’s medical or

24 psychiatric condition.
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1 ‘‘(2) SECLUSION.—The term ‘seclusion’ means

2 any separation of the resident from the general pop3 ulation of the facility that prevents the resident from

4 returning to such population if he or she desires.

5 ‘‘SEC. 592. REPORTING REQUIREMENT.

6 ‘‘(a) IN GENERAL.— Each facility to which the Pro7 tection and Advocacy for Mentally Ill Individuals Act of

8 1986 applies shall notify the appropriate agency, as deter9 mined by the Secretary, of each death that occurs at each

10 such facility while a patient is restrained or in seclusion,

11 of each death occurring within 24 hours after the patient

12 has been removed from restraints and seclusion, or where

13 it is reasonable to assume that a patient’s death is a result

14 of such seclusion or restraint. A notification under this

15 section shall include the name of the resident and shall

16 be provided not later than 7 days after the date of the

17 death of the individual involved.

18 ‘‘(b) FACILITY.—In this section, the term ‘facility’

19 has the meaning given the term ‘facilities’ in section

20 102(3) of the Protection and Advocacy for Mentally Ill

21 Individuals Act of 1986 (42 U.S.C. 10802(3)).’’.

22 ‘‘SEC. 593. REGULATIONS AND ENFORCEMENT.

23 ‘‘(a) TRAINING.—Not later than 1 year after the date

24 of enactment of this part, the Secretary, after consultation

25 with appropriate State and local protection and advocacy
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1 organizations, physicians, facilities, and other health care

2 professionals and patients, shall promulgate regulations

3 that require facilities to which the Protection and Advo4 cacy for Mentally Ill Individuals Act of 1986 (42 U.S.C.

5 10801 et seq.) applies, to meet the requirements of sub6 section (b).

7 ‘‘(b) REQUIREMENTS.—The regulations promulgated

8 under subsection (a) shall require that—

9 ‘‘(1) facilities described in subsection (a) ensure

10 that there is an adequate number of qualified profes11 sional and supportive staff to evaluate patients, for12 mulate written individualized, comprehensive treat13 ment plans, and to provide active treatment meas14 ures;

15 ‘‘(2) appropriate training be provided for the

16 staff of such facilities in the use of restraints and

17 any alternatives to the use of restraints; and

18 ‘‘(3) such facilities provide complete and accu19 rate notification of deaths, as required under section

20 592(a).

21 ‘‘(c) ENFORCEMENT.—A facility to which this part

22 applies that fails to comply with any requirement of this

23 part, including a failure to provide appropriate training,

24 shall not be eligible for participation in any program sup-
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1 ported in whole or in part by funds appropriated to any

2 Federal department or agency.’’.

3 TITLE III—PROVISIONS RELAT4 ING TO SUBSTANCE ABUSE

5 SEC. 301. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS

6 OF REGIONAL AND NATIONAL SIGNIFICANCE.

7 (a) RESIDENTIAL TREATMENT PROGRAMS FOR

8 PREGNANT AND POSTPARTUM WOMEN.—Section 508(r)

9 of the Public Health Service Act (42 U.S.C. 290bb-1(r))

10 is amended to read as follows:

11 ‘‘(r) AUTHORIZATION OF APPROPRIATIONS.—For the

12 purpose of carrying out this section, there are authorized

13 to be appropriated such sums as may be necessary to fiscal

14 years 2000 through 2002.’’.

15 (b) PRIORITY SUBSTANCE ABUSE TREATMENT.—

16 Section 509 of the Public Health Service Act (42 U.S.C.

17 290bb–1) is amended to read as follows:

18 ‘‘SEC. 509. PRIORITY SUBSTANCE ABUSE TREATMENT

19 NEEDS OF REGIONAL AND NATIONAL SIG20 NIFICANCE.

21 ‘‘(a) PROJECTS.—The Secretary shall address pri22 ority substance abuse treatment needs of regional and na23 tional significance (as determined under subsection (b))

24 through the provision of or through assistance for—
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1 ‘‘(1) knowledge development and application

2 projects for treatment and rehabilitation and the

3 conduct or support of evaluations of such projects;

4 ‘‘(2) training and technical assistance; and

5 ‘‘(3) targeted capacity response programs.

6 The Secretary may carry out the activities described in

7 this section directly or through grants, contracts, or coop8 erative agreements with States, political subdivisions of

9 States, Indian tribes and tribal organizations, other public

10 or nonprofit private entities.

11 ‘‘(b) PRIORITY SUBSTANCE ABUSE TREATMENT

12 NEEDS.—

13 ‘‘(1) IN GENERAL.—Priority substance abuse

14 treatment needs of regional and national significance

15 shall be determined by the Secretary after consulta16 tion with States and other interested groups. The

17 Secretary shall meet with the States and interested

18 groups on an annual basis to discuss program prior19 ities.

20 ‘‘(2) SPECIAL CONSIDERATION.—In developing

21 program priorities under paragraph (1), the Sec22 retary, in conjunction with the Director of the Cen23 ter for Substance Abuse Treatment, the Director of

24 the Center for Mental Health Services, and the Ad25 ministrator of the Health Resources and Services
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1 Administration, shall give special consideration to

2 promoting the integration of substance abuse treat3 ment services into primary health care systems.

4 ‘‘(c) REQUIREMENTS.—

5 ‘‘(1) IN GENERAL.—Recipients of grants, con6 tracts, or cooperative agreements under this section

7 shall comply with information and application re8 quirements determined appropriate by the Secretary.

9 ‘‘(2) DURATION OF AWARD.—With respect to a

10 grant, contract, or cooperative agreement awarded

11 under this section, the period during which pay12 ments under such award are made to the recipient

13 may not exceed 5 years.

14 ‘‘(3) MATCHING FUNDS.—The Secretary may,

15 for projects carried out under subsection (a), require

16 that entities that apply for grants, contracts, or co17 operative agreements under that project provide

18 non-Federal matching funds, as determined appro19 priate by the Secretary, to ensure the institutional

20 commitment of the entity to the projects funded

21 under the grant, contract, or cooperative agreement.

22 Such non-Federal matching funds may be provided

23 directly or through donations from public or private

24 entities and may be in cash or in kind, fairly evalu25 ated, including plant, equipment, or services.
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1 ‘‘(4) MAINTENANCE OF EFFORT.—With respect

2 to activities for which a grant, contract, or coopera3 tive agreement is awarded under this section, the

4 Secretary may require that recipients for specific

5 projects under subsection (a) agree to maintain ex6 penditures of non-Federal amounts for such activi7 ties at a level that is not less than the level of such

8 expenditures maintained by the entity for the fiscal

9 year preceding the fiscal year for which the entity

10 receives such a grant, contract, or cooperative agree11 ment.

12 ‘‘(d) EVALUATION.—The Secretary shall evaluate

13 each project carried out under subsection (a)(1) and shall

14 disseminate the findings with respect to each such evalua15 tion to appropriate public and private entities.

16 ‘‘(e) INFORMATION AND EDUCATION.—The Secretary

17 shall establish comprehensive information and education

18 programs to disseminate and apply the findings of the

19 knowledge development and application, training and tech20 nical assistance programs, and targeted capacity response

21 programs under this section to the general public, to

22 health professionals and other interested groups. The Sec23 retary shall make every effort to provide linkages between

24 the findings of supported projects and State agencies re-
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1 sponsible for carrying out substance abuse prevention and

2 treatment programs.

3 ‘‘(f) AUTHORIZATION OF APPROPRIATION.—There

4 are authorized to be appropriated to carry out this section,

5 $300,000,000 for fiscal year 2000 and such sums as may

6 be necessary for each of the fiscal years 2001 and 2002.’’.

7 (c) CONFORMING AMENDMENTS.—The following sec8 tions of the Public Health Service Act are repealed:

9 (1) Section 510 (42 U.S.C. 290bb–3).

10 (2) Section 511 (42 U.S.C. 290bb–4).

11 (3) Section 512 (42 U.S.C. 290bb–5).

12 (4) Section 571 (42 U.S.C. 290gg).

13 SEC. 302. PRIORITY SUBSTANCE ABUSE PREVENTION

14 NEEDS OF REGIONAL AND NATIONAL SIG15 NIFICANCE.

16 (a) IN GENERAL.—Section 516 of the Public Health

17 Service Act (42 U.S.C. 290bb–1) is amended to read as

18 follows:

19 ‘‘SEC. 516. PRIORITY SUBSTANCE ABUSE PREVENTION

20 NEEDS OF REGIONAL AND NATIONAL SIG21 NIFICANCE.

22 ‘‘(a) PROJECTS.—The Secretary shall address pri23 ority substance abuse prevention needs of regional and na24 tional significance (as determined under subsection (b))

25 through the provision of or through assistance for—
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1 ‘‘(1) knowledge development and application

2 projects for prevention and the conduct or support

3 of evaluations of such projects;

4 ‘‘(2) training and technical assistance; and

5 ‘‘(3) targeted capacity response programs.

6 The Secretary may carry out the activities described in

7 this section directly or through grants, contracts, or coop8 erative agreements with States, political subdivisions of

9 States, Indian tribes and tribal organizations, or other

10 public or nonprofit private entities.

11 ‘‘(b) PRIORITY SUBSTANCE ABUSE PREVENTION

12 NEEDS.—

13 ‘‘(1) IN GENERAL.—Priority substance abuse

14 prevention needs of regional and national signifi15 cance shall be determined by the Secretary in con16 sultation with the States and other interested

17 groups. The Secretary shall meet with the States

18 and interested groups on an annual basis to discuss

19 program priorities.

20 ‘‘(2) SPECIAL CONSIDERATION.—In developing

21 program priorities under paragraph (1), the Sec22 retary shall give special consideration to—

23 ‘‘(A) applying the most promising strate24 gies and research-based primary prevention ap25 proaches; and
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1 ‘‘(B) promoting the integration of sub2 stance abuse prevention information and activi3 ties into primary health care systems.

4 ‘‘(c) REQUIREMENTS.—

5 ‘‘(1) IN GENERAL.—Recipients of grants, con6 tracts, and cooperative agreements under this sec7 tion shall comply with information and application

8 requirements determined appropriate by the Sec9 retary.

10 ‘‘(2) DURATION OF AWARD.—With respect to a

11 grant, contract, or cooperative agreement awarded

12 under this section, the period during which pay13 ments under such award are made to the recipient

14 may not exceed 5 years.

15 ‘‘(3) MATCHING FUNDS.—The Secretary may,

16 for projects carried out under subsection (a), require

17 that entities that apply for grants, contracts, or co18 operative agreements under that project provide

19 non-Federal matching funds, as determined appro20 priate by the Secretary, to ensure the institutional

21 commitment of the entity to the projects funded

22 under the grant, contract, or cooperative agreement.

23 Such non-Federal matching funds may be provided

24 directly or through donations from public or private
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1 entities and may be in cash or in kind, fairly evalu2 ated, including plant, equipment, or services.

3 ‘‘(4) MAINTENANCE OF EFFORT.—With respect

4 to activities for which a grant, contract, or coopera5 tive agreement is awarded under this section, the

6 Secretary may require that recipients for specific

7 projects under subsection (a) agree to maintain ex8 penditures of non-Federal amounts for such activi9 ties at a level that is not less than the level of such

10 expenditures maintained by the entity for the fiscal

11 year preceding the fiscal year for which the entity

12 receives such a grant, contract, or cooperative agree13 ment.

14 ‘‘(d) EVALUATION.—The Secretary shall evaluate

15 each project carried out under subsection (a)(1) and shall

16 disseminate the findings with respect to each such evalua17 tion to appropriate public and private entities.

18 ‘‘(e) INFORMATION AND EDUCATION.—The Secretary

19 shall establish comprehensive information and education

20 programs to disseminate the findings of the knowledge de21 velopment and application, training and technical assist22 ance programs, and targeted capacity response programs

23 under this section to the general public and to health pro24 fessionals. The Secretary shall make every effort to pro25 vide linkages between the findings of supported projects
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1 and State agencies responsible for carrying out substance

2 abuse prevention and treatment programs.

3 ‘‘(f) AUTHORIZATION OF APPROPRIATION.—There

4 are authorized to be appropriated to carry out this section,

5 $300,000,000 for fiscal year 2000, and such sums as may

6 be necessary for each of the fiscal years 2001 and 2002.’’.

7 (b) CONFORMING AMENDMENTS.—Section 518 of the

8 Public Health Service Act (42 U.S.C. 290bb–24) is re9 pealed.

10 SEC. 303. SUBSTANCE ABUSE PREVENTION AND TREAT11 MENT PERFORMANCE PARTNERSHIP BLOCK

12 GRANT.

13 (a) ALLOCATION REGARDING ALCOHOL AND OTHER

14 DRUGS.—Section 1922 of the Public Health Service Act

15 (42 U.S.C. 300x–22) is amended by—

16 (1) striking subsection (a); and

17 (2) redesignating subsections (b) and (c) as

18 subsections (a) and (b).

19 (b) GROUP HOMES FOR RECOVERING SUBSTANCE

20 ABUSERS.—Section 1925(a) of the Public Health Service

21 Act (42 U.S.C. 300x–25(a)) is amended by striking ‘‘For

22 fiscal year 1993’’ and all that follows through the colon

23 and inserting the following: ‘‘A State, using funds avail24 able under section 1921, may establish and maintain the

25 ongoing operation of a revolving fund in accordance with
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1 this section to support group homes for recovering sub2 stance abusers as follows:’’.

3 (c) MAINTENANCE OF EFFORT.—Section 1930 of the

4 Public Health Service Act (42 U.S.C. 300x–30) is

5 amended—

6 (1) by redesignating subsections (b) and (c) as

7 subsections (c) and (d) respectively; and

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

10 ‘‘(b) EXCLUSION OF CERTAIN FUNDS.—The Sec11 retary may exclude from the aggregate State expenditures

12 under subsection (a), funds appropriated to the principle

13 agency for authorized activities which are of a non-recur14 ring nature and for a specific purpose.’’.

15 (d) APPLICATIONS FOR GRANTS.—Section

16 1932(a)(1) of the Public Health Service Act (42 U.S.C.

17 300x–32(a)(1)) is amended to read as follows:

18 ‘‘(1) the application is received by the Secretary

19 not later than October 1 of the fiscal year for which

20 the State is seeking funds;’’.

21 (e) WAIVER FOR TERRITORIES.—Section 1932(c) of

22 the Public Health Service Act (42 U.S.C. 300x–32(c)) is

23 amended by striking ‘‘whose allotment under section 1921

24 for the fiscal year is the amount specified in section

25 1933(c)(2)(B)’’ and inserting ‘‘except Puerto Rico’’.
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1 (f) WAIVER AUTHORITY FOR CERTAIN REQUIRE2 MENTS.—

3 (1) IN GENERAL.—Section 1932 of the Public

4 Health Service Act (42 U.S.C. 300x–32) is amended

5 by adding at the end the following:

6 ‘‘(e) WAIVER AUTHORITY FOR CERTAIN REQUIRE7 MENTS.—

8 ‘‘(1) IN GENERAL.—Upon the request of a

9 State, the Secretary may waive the requirements of

10 all or part of the sections described in paragraph (2)

11 using objective criteria established by the Secretary

12 by regulation after consultation with the States and

13 other interested parties including consumers and

14 providers.

15 ‘‘(2) SECTIONS.—The sections described in

16 paragraph (1) are sections 1922(c), 1923, 1924 and

17 1928.

18 ‘‘(3) DATE CERTAIN FOR ACTING UPON RE19 QUEST.—The Secretary shall approve or deny a re20 quest for a waiver under paragraph (1) and inform

21 the State of that decision not later than 120 days

22 after the date on which the request and all the infor23 mation needed to support the request are submitted.

24 ‘‘(4) ANNUAL REPORTING REQUIREMENT.—The

25 Secretary shall annually report to the general public
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1 on the States that receive a waiver under this sub2 section.’’.

3 (2) CONFORMING AMENDMENTS.—Effective

4 upon the publication of the regulations developed in

5 accordance with section 1932(e)(1) of the Public

6 Health Service Act (42 U.S.C. 300x–32(d))—

7 (A) section 1922(c) of the Public Health

8 Service Act (42 U.S.C. 300x–22(c)) is amended

9 by—

10 (i) striking paragraph (2); and

11 (ii) redesignating paragraph (3) as

12 paragraph (2); and

13 (B) section 1928(d) of the Public Health

14 Service Act (42 U.S.C. 300x–28(d)) is repealed.

15 (g) AUTHORIZATION OF APPROPRIATION.—Section

16 1935 of the Public Health Service Act (42 U.S.C. 300x–

17 35) is amended—

18 (1) in subsection (a), by striking

19 ‘‘$1,500,000,000’’ and all that follows through the

20 end and inserting ‘‘$2,000,000,000 for fiscal year

21 2000, and such sums as may be necessary for each

22 of the fiscal years 2001 and 2002.’’;

23 (2) in subsection (b)(1), by striking ‘‘section

24 505’’ and inserting ‘‘sections 505 and 1971’’;
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1 (3) in subsection (b)(2), by striking ‘‘1949(a)’’

2 and inserting ‘‘1948(a)’’; and

3 (4) in subsection (b), by adding at the end the

4 following:

5 ‘‘(3) CORE DATA SET.—A State that receives a

6 new grant, contract, or cooperative agreement from

7 amounts available to the Secretary under paragraph

8 (1), for the purposes of improving the data collec9 tion, analysis and reporting capabilities of the State,

10 shall be required, as a condition of receipt of funds,

11 to collect, analyze, and report to the Secretary for

12 each fiscal year subsequent to receiving such funds

13 a core data set to be determined by the Secretary in

14 conjunction with the States.’’.

15 SEC. 304. DETERMINATION OF ALLOTMENTS.

16 Section 1933(b) of the Public Health Service Act (42

17 U.S.C. 300x–33(b)) is amended to read as follows:

18 ‘‘(b) MINIMUM ALLOTMENTS FOR STATES.—

19 ‘‘(1) IN GENERAL.—With respect to fiscal year

20 2000, and each subsequent fiscal year, the amount

21 of the allotment of a State under section 1921 shall

22 not be less than the amount the State received

23 under such section for the previous fiscal year in24 creased by an amount equal to 30.65 percent of the

25 percentage by which the aggregate amount allotted
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1 to all States for such fiscal year exceeds the aggre2 gate amount allotted to all States for the previous

3 fiscal year.

4 ‘‘(2) LIMITATIONS.—

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

6 subparagraph (B), a State shall not receive an

7 allotment under section 1921 for a fiscal year

8 in an amount that is less than an amount equal

9 to 0.375 percent of the amount appropriated

10 under section 1935(a) for such fiscal year.

11 ‘‘(B) EXCEPTION.—In applying subpara12 graph (A), the Secretary shall ensure that no

13 State receives an increase in its allotment under

14 section 1921 for a fiscal year (as compared to

15 the amount allotted to the State in the prior

16 fiscal year) that is in excess of an amount equal

17 to 300 percent of the percentage by which the

18 amount appropriated under section 1935(a) for

19 such fiscal year exceeds the amount appro20 priated for the prior fiscal year.

21 ‘‘(3) DECREASE IN OR EQUAL APPROPRIA22 TIONS.—If the amount appropriated under section

23 1935(a) for a fiscal year is equal to or less than the

24 amount appropriated under such section for the

25 prior fiscal year, the amount of the State allotment
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1 under section 1921 shall be equal to the amount

2 that the State received under section 1921 in the

3 prior fiscal year decreased by the percentage by

4 which the amount appropriated for such fiscal year

5 is less than the amount appropriated or such section

6 for the prior fiscal year.’’.

7 SEC. 305. NONDISCRIMINATION AND INSTITUTIONAL SAFE8 GUARDS FOR RELIGIOUS PROVIDERS.

9 Subpart III of part B of title XIX of the Public

10 Health Service Act (42 U.S.C. 300x–51 et seq.) is amend11 ed by adding at the end the following:

12 ‘‘SEC. 1955. SERVICES PROVIDED BY NONGOVERNMENTAL

13 ORGANIZATIONS.

14 ‘‘(a) PURPOSES.—The purposes of this section are—

15 ‘‘(1) to prohibit discrimination against non16 governmental organizations and certain individuals

17 on the basis of religion in the distribution of govern18 ment funds to provide substance abuse services

19 under this title and title V, and the receipt of serv20 ices under such titles; and

21 ‘‘(2) to allow the organizations to accept the

22 funds to provide the services to the individuals with23 out impairing the religious character of the organi24 zations or the religious freedom of the individuals.
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1 ‘‘(b) RELIGIOUS ORGANIZATIONS INCLUDED AS NON2 GOVERNMENTAL PROVIDERS.—

3 ‘‘(1) IN GENERAL.—A State may administer

4 and provide substance abuse services under any pro5 gram under this title or title V through grants, con6 tracts, or cooperative agreements to provide assist7 ance to beneficiaries under such titles with non8 governmental organizations.

9 ‘‘(2) REQUIREMENT.—A State that elects to

10 utilize nongovernmental organizations as provided

11 for under paragraph (1) shall consider, on the same

12 basis as other nongovernmental organizations, reli13 gious organizations to provide services under sub14 stance abuse programs under this title or title V, so

15 long as the programs under such titles are imple16 mented in a manner consistent with the Establish17 ment Clause of the first amendment to the Constitu18 tion. Neither the Federal Government nor a State or

19 local government receiving funds under such pro20 grams shall discriminate against an organization

21 that provides services under, or applies to provide

22 services under, such programs, on the basis that the

23 organization has a religious character.

24 ‘‘(c) RELIGIOUS CHARACTER AND INDEPENDENCE.—
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1 ‘‘(1) IN GENERAL.—A religious organization

2 that provides services under any substance abuse

3 program under this title or title V shall retain its

4 independence from Federal, State, and local govern5 ments, including such organization’s control over the

6 definition, development, practice, and expression of

7 its religious beliefs.

8 ‘‘(2) ADDITIONAL SAFEGUARDS.—Neither the

9 Federal Government nor a State or local government

10 shall require a religious organization—

11 ‘‘(A) to alter its form of internal govern12 ance; or

13 ‘‘(B) to remove religious art, icons, scrip14 ture, or other symbols;

15 in order to be eligible to provide services under any

16 substance abuse program under this title or title V.

17 ‘‘(d) EMPLOYMENT PRACTICES.—

18 ‘‘(1) SUBSTANCE ABUSE.—A religious or19 ganization that provides services under any sub20 stance abuse program under this title or title V may

21 require that its employees providing services under

22 such program adhere to rules forbidding the use of

23 drugs or alcohol.

24 ‘‘(2) TITLE VII EXEMPTION.—The exemption of

25 a religious organization provided under section 702
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1 or 703(e)(2) of the Civil Rights Act of 1964 (42

2 U.S.C. 2000e–1, 2000e–2(e)(2)) regarding employ3 ment practices shall not be affected by the religious

4 organization’s provision of services under, or receipt

5 of funds from, any substance abuse program under

6 this title or title V.

7 ‘‘(e) RIGHTS OF BENEFICIARIES OF ASSISTANCE.—

8 ‘‘(1) IN GENERAL.—If an individual described

9 in paragraph (3) has an objection to the religious

10 character of the organization from which the indi11 vidual receives, or would receive, services funded

12 under any substance abuse program under this title

13 or title V, the appropriate Federal, State, or local

14 governmental entity shall provide to such individual

15 (if otherwise eligible for such services) within a rea16 sonable period of time after the date of such objec17 tion, services that—

18 ‘‘(A) are from an alternative provider that

19 is accessible to the individual; and

20 ‘‘(B) have a value that is not less than the

21 value of the services that the individual would

22 have received from such organization.

23 ‘‘(2) NOTICE.—The appropriate Federal, State,

24 or local governmental entity shall ensure that notice
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1 is provided to individuals described in paragraph (3)

2 of the rights of such individuals under this section.

3 ‘‘(3) INDIVIDUAL DESCRIBED.—An individual

4 described in this paragraph is an individual who re5 ceives or applies for services under any substance

6 abuse program under this title or title V.

7 ‘‘(f) NONDISCRIMINATION AGAINST BENE8 FICIARIES.—A religious organization providing services

9 through a grant, contract, or cooperative agreement under

10 any substance abuse program under this title or title V

11 shall not discriminate, in carrying out such program,

12 against an individual described in subsection (e)(3) on the

13 basis of religion, a religious belief, a refusal to hold a reli14 gious belief, or a refusal to actively participate in a reli15 gious practice.

16 ‘‘(g) FISCAL ACCOUNTABILITY.—

17 ‘‘(1) IN GENERAL.—Except as provided in para18 graph (2), any religious organization providing serv19 ices under any substance abuse program under this

20 title or title V shall be subject to the same regula21 tions as other nongovernmental organizations to ac22 count in accord with generally accepted accounting

23 principles for the use of such funds provided under

24 such program.
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1 ‘‘(2) LIMITED AUDIT.—Such organization shall

2 segregate government funds provided under such

3 substance abuse program into a separate account.

4 Only the government funds shall be subject to audit

5 by the government.

6 ‘‘(h) COMPLIANCE.—Any party that seeks to enforce

7 such party’s rights under this section may assert a civil

8 action for injunctive relief exclusively in an appropriate

9 Federal or State court against the entity, agency or offi10 cial that allegedly commits such violation.

11 ‘‘(i) LIMITATIONS ON USE OF FUNDS FOR CERTAIN

12 PURPOSES.—No funds provided through a grant or con13 tract to a religious organization to provide services under

14 any substance abuse program under this title or title V

15 shall be expended for sectarian worship, instruction, or

16 proselytization.

17 ‘‘(j) EFFECT ON STATE AND LOCAL FUNDS.—If a

18 State or local government contributes State or local funds

19 to carry out any substance abuse program under this title

20 or title V, the State or local government may segregate

21 the State or local funds from the Federal funds provided

22 to carry out the program or may commingle the State or

23 local funds with the Federal funds. If the State or local

24 government commingles the State or local funds, the pro25 visions of this section shall apply to the commingled funds
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1 in the same manner, and to the same extent, as the provi2 sions apply to the Federal funds.

3 ‘‘(k) TREATMENT OF INTERMEDIATE CONTRAC4 TORS.—If a nongovernmental organization (referred to in

5 this subsection as an ‘intermediate organization’), acting

6 under a contract or other agreement with the Federal Gov7 ernment or a State or local government, is given the au8 thority under the contract or agreement to select non9 governmental organizations to provide services under any

10 substance abuse program under this title or title V, the

11 intermediate organization shall have the same duties

12 under this section as the government but shall retain all

13 other rights of a nongovernmental organization under this

14 section.’’.

15 SEC. 306. ALCOHOL AND DRUG PREVENTION OR TREAT16 MENT SERVICES FOR INDIANS AND NATIVE

17 ALASKANS.

18 Part D of title V of the Public Health Service Act

19 (42 U.S.C. 290dd et seq.) is amended by adding at the

20 end the following:

21 ‘‘SEC. 544. ALCOHOL AND DRUG PREVENTION OR TREAT22 MENT SERVICES FOR INDIANS AND NATIVE

23 ALASKANS.

24 ‘‘(a) IN GENERAL.—The Secretary shall award

25 grants, contracts, or cooperative agreements to public and
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1 private nonprofit entities, including Native Alaskan enti2 ties and Indian tribes and tribal organizations, for the

3 purpose of providing alcohol and drug prevention or treat4 ment services for Indians and Native Alaskans.

5 ‘‘(b) PRIORITY.—In awarding grants, contracts, or

6 cooperative agreements under subsection (a), the Sec7 retary shall give priority to applicants that—

8 ‘‘(1) propose to provide alcohol and drug pre9 vention or treatment services on reservations;

10 ‘‘(2) propose to employ culturally-appropriate

11 approaches, as determined by the Secretary, in pro12 viding such services; and

13 ‘‘(3) have provided prevention or treatment

14 services to Native Alaskan entities and Indian tribes

15 and tribal organizations for at least 1 year prior to

16 applying for a grant under this section.

17 ‘‘(c) DURATION.—The Secretary shall award grants,

18 contracts, or cooperative agreements under subsection (a)

19 for a period not to exceed 5 years.

20 ‘‘(d) APPLICATION.—An entity desiring a grant, con21 tract, or cooperative agreement under subsection (a) shall

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

23 such manner, and accompanied by such information as the

24 Secretary may reasonably require.
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1 ‘‘(e) EVALUATION.—An entity that receives a grant,

2 contract, or cooperative agreement under subsection (a)

3 shall submit, in the application for such grant, a plan for

4 the evaluation of any project undertaken with funds pro5 vided under this section. Such entity shall provide the Sec6 retary with periodic evaluations of the progress of such

7 project and such evaluation at the completion of such

8 project as the Secretary determines to be appropriate. The

9 final evaluation submitted by such entity shall include a

10 recommendation as to whether such project shall continue.

11 ‘‘(f) REPORT.—Not later than 3 years after the date

12 of enactment of this section and annually thereafter, the

13 Secretary shall prepare and submit, to the Committee on

14 Health, Education, Labor, and Pensions of the Senate, a

15 report describing the services provided pursuant to this

16 section.

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

18 are authorized to be appropriated to carry out this section,

19 $15,000,000 for fiscal year 2000, and such sums as may

20 be necessary for fiscal years 2001 and 2002.

21 ‘‘SEC. 545. ESTABLISHMENT OF COMMISSION.

22 ‘‘(a) IN GENERAL.—There is established a commis23 sion to be known as the Commission on Indian and Native

24 Alaskan Health Care that shall examine the health con25 cerns of Indians and Native Alaskans who reside on res-
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1 ervations and tribal lands (hereafter in this section re2 ferred to as the ‘Commission’).

3 ‘‘(b) MEMBERSHIP.—

4 ‘‘(1) IN GENERAL.—The Commission estab5 lished under subsection (a) shall consist of—

6 ‘‘(A) the Secretary;

7 ‘‘(B) 15 members who are experts in the

8 health care field and issues that the Commis9 sion is established to examine; and

10 ‘‘(C) the Director of the Indian Health

11 Service and the Commissioner of Indian Affairs,

12 who shall be nonvoting members.

13 ‘‘(2) APPOINTING AUTHORITY.—Of the 15

14 members of the Commission described in paragraph

15 (1)(B)—

16 ‘‘(A) 2 shall be appointed by the Speaker

17 of the House of Representatives;

18 ‘‘(B) 2 shall be appointed by the Minority

19 Leader of the House of Representatives;

20 ‘‘(C) 2 shall be appointed by the Majority

21 Leader of the Senate;

22 ‘‘(D) 2 shall be appointed by the Minority

23 Leader of the Senate; and

24 ‘‘(E) 7 shall be appointed by the Secretary.
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1 ‘‘(3) LIMITATION.—Not fewer than 10 of the

2 members appointed to the Commission shall be Indi3 ans or Native Alaskans.

4 ‘‘(4) CHAIRPERSON.—The Secretary shall serve

5 as the Chairperson of the Commission.

6 ‘‘(5) EXPERTS.—The Commission may seek the

7 expertise of any expert in the health care field to

8 carry out its duties.

9 ‘‘(c) PERIOD OF APPOINTMENT.—Members shall be

10 appointed for the life of the Commission. Any vacancy in

11 the Commission shall not affect its powers, but shall be

12 filed in the same manner as the original appointment.

13 ‘‘(d) DUTIES OF THE COMMISSION.—The Commis14 sion shall—

15 ‘‘(1) study the health concerns of Indians and

16 Native Alaskans; and

17 ‘‘(2) prepare the reports described in subsection

18 (i).

19 ‘‘(e) POWERS OF THE COMMISSION.—

20 ‘‘(1) HEARINGS.—The Commission may hold

21 such hearings, including hearings on reservations, sit

22 and act at such times and places, take such testi23 mony, and receive such information as the Commis24 sion considers advisable to carry out the purpose for

25 which the Commission was established.
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1 ‘‘(2) INFORMATION FROM FEDERAL AGEN2 CIES.—The Commission may secure directly from

3 any Federal department or agency such information

4 as the Commission considers necessary to carry out

5 the purpose for which the Commission was estab6 lished. Upon request of the Chairperson of the Com7 mission, the head of such department or agency

8 shall furnish such information to the Commission.

9 ‘‘(f) COMPENSATION OF MEMBERS.—

10 ‘‘(1) IN GENERAL.—Except as provided in sub11 paragraph (B), each member of the Commission

12 may be compensated at a rate not to exceed the

13 daily equivalent of the annual rate of basic pay pre14 scribed for level IV of the Executive Schedule under

15 section 5315 of title 5, United States Code, for each

16 day (including travel time), during which that mem17 ber is engaged in the actual performance of the du18 ties of the Commission.

19 ‘‘(2) LIMITATION.—Members of the Commis20 sion who are officers or employees of the United

21 States shall receive no additional pay on account of

22 their service on the Commission.

23 ‘‘(g) TRAVEL EXPENSES OF MEMBERS.—The mem24 bers of the Commission shall be allowed travel expenses,

25 including per diem in lieu of subsistence, at rates author-
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1 ized for employees of agencies under section 5703 of title

2 5, United States Code, while away from their homes or

3 regular places of business in the performance of services

4 for the Commission.

5 ‘‘(h) COMMISSION PERSONNEL MATTERS.—

6 ‘‘(1) IN GENERAL.—The Secretary, in accord7 ance with rules established by the Commission, may

8 select and appoint a staff director and other per9 sonnel necessary to enable the Commission to carry

10 out its duties.

11 ‘‘(2) COMPENSATION OF PERSONNEL.—The

12 Secretary, in accordance with rules established by

13 the Commission, may set the amount of compensa14 tion to be paid to the staff director and any other

15 personnel that serve the Commission.

16 ‘‘(3) DETAIL OF GOVERNMENT EMPLOYEES.—

17 Any Federal Government employee may be detailed

18 to the Commission without reimbursement, and the

19 detail shall be without interruption or loss of civil

20 service status or privilege.

21 ‘‘(4) CONSULTANT SERVICES.—The Chair22 person of the Commission is authorized to procure

23 the temporary and intermittent services of experts

24 and consultants in accordance with section 3109 of

25 title 5, United States Code, at rates not to exceed
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1 the daily equivalent of the annual rate of basic pay

2 prescribed for level IV of the Executive Schedule

3 under section 5315 of such title.

4 ‘‘(i) REPORT.—

5 ‘‘(1) IN GENERAL.—Not later than 3 years

6 after the date of enactment of the Youth Drug and

7 Mental Health Services Act, the Secretary shall pre8 pare and submit, to the Committee on Health, Edu9 cation, Labor, and Pensions of the Senate, a report

10 that shall—

11 ‘‘(A) detail the health problems faced by

12 Indians and Native Alaskans who reside on res13 ervations;

14 ‘‘(B) examine and explain the causes of

15 such problems;

16 ‘‘(C) describe the health care services

17 available to Indians and Native Alaskans who

18 reside on reservations and the adequacy of such

19 services;

20 ‘‘(D) identify the reasons for the provision

21 of inadequate health care services for Indians

22 and Native Alaskans who reside on reserva23 tions, including the availability of resources;
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1 ‘‘(E) develop measures for tracking the

2 health status of Indians and Native Americans

3 who reside on reservations; and

4 ‘‘(F) make recommendations for improve5 ments in the health care services provided for

6 Indians and Native Alaskans who reside on res7 ervations, including recommendations for legis8 lative change.

9 ‘‘(2) EXCEPTION.—In addition to the report re10 quired under paragraph (1), not later than 2 years

11 after the date of enactment of the Youth Drug and

12 Mental Health Services Act, the Secretary shall pre13 pare and submit, to the Committee on Health, Edu14 cation, Labor, and Pensions of the Senate, a report

15 that describes any alcohol and drug abuse among In16 dians and Native Alaskans who reside on reserva17 tions.

18 ‘‘(j) PERMANENT COMMISSION.—Section 14 of the

19 Federal Advisory Committee Act (5 U.S.C. App.) shall not

20 apply to the Commission.

21 ‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There

22 is authorized to be appropriated to carry out this section

23 $5,000,000 for fiscal year 2000, and such sums as may

24 be necessary for fiscal years 2001 and 2002.’’.
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1 TITLE IV—PROVISIONS RELAT2 ING TO FLEXIBILITY AND AC3 COUNTABILITY

4 SEC. 401. GENERAL AUTHORITIES AND PEER REVIEW.

5 (a) GENERAL AUTHORITIES.—Paragraph (1) of sec6 tion 501(e) of the Public Health Service Act (42 U.S.C.

7 290aa(e)) is amended to read as follows:

8 ‘‘(1) IN GENERAL.—There may be in the Ad9 ministration an Associate Administrator for Alcohol

10 Prevention and Treatment Policy to whom the Ad11 ministrator may delegate the functions of promoting,

12 monitoring, and evaluating service programs for the

13 prevention and treatment of alcoholism and alcohol

14 abuse within the Center for Substance Abuse Pre15 vention, the Center for Substance Abuse Treatment

16 and the Center for Mental Health Services, and co17 ordinating such programs among the Centers, and

18 among the Centers and other public and private en19 tities. The Associate Administrator also may ensure

20 that alcohol prevention, education, and policy strate21 gies are integrated into all programs of the Centers

22 that address substance abuse prevention, education,

23 and policy, and that the Center for Substance Abuse

24 Prevention addresses the Healthy People 2010 goals

25 and the National Dietary Guidelines of the Depart-
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1 ment of Health and Human Services and the De2 partment of Agriculture related to alcohol consump3 tion.’’.

4 (b) PEER REVIEW.—Section 504 of the Public

5 Health Service (42 U.S.C. 290aa–3) is amended as fol6 lows:

7 ‘‘SEC. 504. PEER REVIEW.

8 ‘‘(a) IN GENERAL.—The Secretary, after consulta9 tion with the Administrator, shall require appropriate peer

10 review of grants, cooperative agreements, and contracts to

11 be administered through the agency which exceed the sim12 ple acquisition threshold as defined in section 4(11) of the

13 Office of Federal Procurement Policy Act.

14 ‘‘(b) MEMBERS.—The members of any peer review

15 group established under subsection (a) shall be individuals

16 who by virtue of their training or experience are eminently

17 qualified to perform the review functions of the group. Not

more than 1 18 ⁄4 of the members of any such peer review

19 group shall be officers or employees of the United States.

20 ‘‘(c) ADVISORY COUNCIL REVIEW.—If the direct cost

21 of a grant or cooperative agreement (described in sub22 section (a)) exceeds the simple acquisition threshold as de23 fined by section 4(11) of the Office of Federal Procure24 ment Policy Act, the Secretary may make such a grant
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1 or cooperative agreement only if such grant or cooperative

2 agreement is recommended—

3 ‘‘(1) after peer review required under sub4 section (a); and

5 ‘‘(2) by the appropriate advisory council.

6 ‘‘(d) CONDITIONS.—The Secretary may establish lim7 ited exceptions to the limitations contained in this section

8 regarding participation of Federal employees and advisory

9 council approval. The circumstances under which the Sec10 retary may make such an exception shall be made public.’’.

11 SEC. 402. ADVISORY COUNCILS.

12 Section 502(e) of the Public Health Service Act (42

13 U.S.C. 290aa–1(e)) is amended in the first sentence by

14 striking ‘‘3 times’’ and inserting ‘‘2 times’’.

15 SEC. 403. GENERAL PROVISIONS FOR THE PERFORMANCE

16 PARTNERSHIP BLOCK GRANTS.

17 (a) PLANS FOR PERFORMANCE PARTNERSHIPS.—

18 Section 1949 of the Public Health Service Act (42 U.S.C.

19 300x–59) is amended as follows:

20 ‘‘SEC. 1949. PLANS FOR PERFORMANCE PARTNERSHIPS.

21 ‘‘(a) DEVELOPMENT.—The Secretary in conjunction

22 with States and other interested groups shall develop sepa23 rate plans for the programs authorized under subparts I

24 and II for creating more flexibility for States and account-
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1 ability based on outcome and other performance measures.

2 The plans shall each include—

3 ‘‘(1) a description of the flexibility that would

4 be given to the States under the plan;

5 ‘‘(2) the common set of performance measures

6 that would be used for accountability, including

7 measures that would be used for the program under

8 subpart II for pregnant addicts, HIV transmission,

9 tuberculosis, and those with a co-occurring sub10 stance abuse and mental disorders, and for pro11 grams under subpart I for children with serious

12 emotional disturbance and adults with serious men13 tal illness and for individuals with co-occurring men14 tal health and substance abuse disorders;

15 ‘‘(3) the definitions for the data elements to be

16 used under the plan;

17 ‘‘(4) the obstacles to implementation of the plan

18 and the manner in which such obstacles would be re19 solved;

20 ‘‘(5) the resources needed to implement the per21 formance partnerships under the plan; and

22 ‘‘(6) an implementation strategy complete with

23 recommendations for any necessary legislation.

24 ‘‘(b) SUBMISSION.—Not later than 2 years after the

25 date of enactment of this Act, the plans developed under
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1 subsection (a) shall be submitted to the Committee on

2 Health, Education, Labor, and Pensions of the Senate and

3 the Committee on Commerce of the House of Representa4 tives.

5 ‘‘(c) INFORMATION.—As the elements of the plans de6 scribed in subsection (a) are developed, States are encour7 aged to provide information to the Secretary on a vol8 untary basis.

9 ‘‘(d) PARTICIPANTS.—The Secretary shall include

10 among those interested groups that participate in the de11 velopment of the plan consumers of mental health or sub12 stance abuse services, providers, representatives of polit13 ical divisions of States, and representatives of racial and

14 ethnic groups including Native Americans.’’.

15 (b) AVAILABILITY TO STATES OF GRANT PRO16 GRAMS.—Section 1952 of the Public Health Service Act

17 (42 U.S.C. 300x–62) is amended as follows:

18 ‘‘SEC. 1952. AVAILABILITY TO STATES OF GRANT PAY19 MENTS.

20 ‘‘Any amounts paid to a State for a fiscal year under

21 section 1911 or 1921 shall be available for obligation and

22 expenditure until the end of the fiscal year following the

23 fiscal year for which the amounts were paid.’’.
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1 SEC. 404. DATA INFRASTRUCTURE PROJECTS.

2 Part C of title XIX of the Public Health Service Act

3 (42 U.S.C. 300y et seq.) is amended—

4 (1) by striking the headings for part C and sub5 part I and inserting the following:

6 ‘‘PART C—CERTAIN PROGRAMS REGARDING

7 MENTAL HEALTH AND SUBSTANCE ABUSE

8 ‘‘Subpart I—Data Infrastructure Development’’;

9 (2) by striking section 1971 (42 U.S.C. 300y)

10 and inserting the following:

11 ‘‘SEC. 1971. DATA INFRASTRUCTURE DEVELOPMENT.

12 ‘‘(a) IN GENERAL.—The Secretary may make grants

13 to, and enter into contracts or cooperative agreements

14 with States for the purpose of developing and operating

15 mental health or substance abuse data collection, analysis,

16 and reporting systems with regard to performance meas17 ures including capacity, process, and outcomes measures.

18 ‘‘(b) PROJECTS.—The Secretary shall establish cri19 teria to ensure that services will be available under this

20 section to States that have a fundamental basis for the

21 collection, analysis, and reporting of mental health and

22 substance abuse performance measures and States that do

23 not have such basis. The Secretary will establish criteria

24 for determining whether a State has a fundamental basis

25 for the collection, analysis, and reporting of data.
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1 ‘‘(c) CONDITION OF RECEIPT OF FUNDS.—As a con2 dition of the receipt of an award under this section a State

3 shall agree to collect, analyze, and report to the Secretary

4 within 2 years of the date of the award on a core set of

5 performance measures to be determined by the Secretary

6 in conjunction with the States.

7 ‘‘(d) DURATION OF SUPPORT.—The period during

8 which payments may be made for a project under sub9 section (a) may be not less than 3 years nor more than

10 5 years.

11 ‘‘(e) AUTHORIZATION OF APPROPRIATION.—

12 ‘‘(1) IN GENERAL.—For the purpose of car13 rying out this section, there are authorized to be ap14 propriated such sums as may be necessary for each

15 of the fiscal years 2000, 2001 and 2002.

16 ‘‘(2) ALLOCATION.—Of the amounts appro17 priated under paragraph (1) for a fiscal year, 50

18 percent shall be expended to support data infrastruc19 ture development for mental health and 50 percent

20 shall be expended to support data infrastructure de21 velopment for substance abuse.’’.
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1 SEC. 405. REPEAL OF OBSOLETE ADDICT REFERRAL PROVI2 SIONS.

3 (a) REPEAL OF OBSOLETE PUBLIC HEALTH SERV4 ICE ACT AUTHORITIES.—Part E of title III (42 U.S.C.

5 257 et seq.) is repealed.

6 (b) REPEAL OF OBSOLETE NARA AUTHORITIES.—

7 Titles III and IV of the Narcotic Addict Rehabilitation

8 Act of 1966 (Public Law 89–793) are repealed.

9 (c) REPEAL OF OBSOLETE TITLE 28 AUTHORI10 TIES.—

11 (1) IN GENERAL.—Chapter 175 of title 28,

12 United States Code, is repealed.

13 (2) TABLE OF CONTENTS.—The table of con14 tents to part VI of title 28, United States Code, is

15 amended by striking the items relating to chapter

16 175.

17 SEC. 406. INDIVIDUALS WITH CO-OCCURRING DISORDERS.

18 The Public Health Service Act is amended by insert19 ing after section 503 (42 U.S.C. 290aa–2) the following:

20 ‘‘SEC. 503A. REPORT ON INDIVIDUALS WITH CO-OCCURRING

21 MENTAL ILLNESS AND SUBSTANCE ABUSE

22 DISORDERS.

23 ‘‘(a) IN GENERAL.—Not later than 2 years after the

24 date of enactment of this section, the Secretary shall, after

25 consultation with organizations representing States, men26 tal health and substance abuse treatment providers, pre-
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1 vention specialists, individuals receiving treatment serv2 ices, and family members of such individuals, prepare and

3 submit to the Committee on Health, Education, Labor,

4 and Pensions of the Senate and the Committee on Com5 merce of the House of Representatives, a report on pre6 vention and treatment services for individuals who have

7 co-occurring mental illness and substance abuse disorders.

8 ‘‘(b) REPORT CONTENT.—The report under sub9 section (a) shall be based on data collected from existing

10 Federal and State surveys regarding the treatment of co11 occurring mental illness and substance abuse disorders

12 and shall include—

13 ‘‘(1) a summary of the manner in which indi14 viduals with co-occurring disorders are receiving

15 treatment, including the most up-to-date information

16 available regarding the number of children and

17 adults with co-occurring mental illness and sub18 stance abuse disorders and the manner in which

19 funds provided under sections 1911 and 1921 are

20 being utilized, including the number of such children

21 and adults served with such funds;

22 ‘‘(2) a summary of improvements necessary to

23 ensure that individuals with co-occurring mental ill24 ness and substance abuse disorders receive the serv25 ices they need;
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1 ‘‘(3) a summary of practices for preventing sub2 stance abuse among individuals who have a mental

3 illness and are at risk of having or acquiring a sub4 stance abuse disorder; and

5 ‘‘(4) a summary of evidenced-based practices

6 for treating individuals with co-occurring mental ill7 ness and substance abuse disorders and rec8 ommendations for implementing such practices.

9 ‘‘(c) FUNDS FOR REPORT.—The Secretary may obli10 gate funds to carry out this section with such appropria11 tions as are available.’’.

12 SEC. 407. SERVICES FOR INDIVIDUALS WITH CO-OCCUR13 RING DISORDERS.

14 Subpart III of part B of title XIX of the Public

15 Health Service Act (42 U.S.C. 300x–51 et seq.) (as

16 amended by section 305) is further amended by adding

17 at the end the following:

18 ‘‘SEC. 1956. SERVICES FOR INDIVIDUALS WITH CO-OCCUR19 RING DISORDERS.

20 ‘‘States may use funds available for treatment under

21 sections 1911 and 1921 to treat persons with co-occurring

22 substance abuse and mental disorders as long as funds

23 available under such sections are used for the purposes
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1 for which they were authorized by law and can be tracked

2 for accounting purposes.’’.

Passed the Senate November 3, 1999.

Attest:

Secretary.
106TH CONGRESS

1ST SESSION S. 976

AN ACT

To amend title V of the Public Health Service Act

to focus the authority of the Substance Abuseand Mental Health Services Administration oncommunity-based services for children and adolescents, to enhance flexibility and accountability,to establish programs for youth treatment, andto respond to crises, especially those related tochildren and violence.