IC 

114TH CONGRESS 

2D SESSION S. 1893 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 5, 2016 

Referred to the Committee on Energy and Commerce 

AN ACT 

To reauthorize and improve programs related to mental 

health and substance use disorders. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the Mental Health Aware3 ness and Improvement Act of 2015. 

4 SEC. 2. GARRETT LEE SMITH MEMORIAL ACT REAUTHOR5 IZATION. 

6 (a) SUICIDE PREVENTION TECHNICAL ASSISTANCE

7 CENTER.—Section 520C of the Public Health Service Act 

8 (42 U.S.C. 290bb–34) is amended— 

9 (1) in the section heading, by striking the sec10 tion heading and inserting ‘‘SUICIDE PREVENTION

11 TECHNICAL ASSISTANCE CENTER.’’; 

12 (2) in subsection (a), by striking ‘‘and in con13 sultation with’’ and all that follows through the pe14 riod at the end of paragraph (2) and inserting ‘‘shall 

15 establish a research, training, and technical assist16 ance resource center to provide appropriate informa17 tion, training, and technical assistance to States, po18 litical subdivisions of States, federally recognized In19 dian tribes, tribal organizations, institutions of high20 er education, public organizations, or private non21 profit organizations regarding the prevention of sui22 cide among all ages, particularly among groups that 

23 are at high risk for suicide.’’; 

24 (3) by striking subsections (b) and (c); 

25 (4) by redesignating subsection (d) as sub26 section (b); 


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1 (5) in subsection (b), as so redesignated— 

2 (A) by striking the subsection heading and 

3 inserting ‘‘RESPONSIBILITIES OF THE CEN4 TER.’’; 

5 (B) in the matter preceding paragraph (1), 

6 by striking ‘‘The additional research’’ and all 

7 that follows through ‘‘nonprofit organizations 

8 for’’ and inserting ‘‘The center established 

9 under subsection (a) shall conduct activities for 

10 the purpose of’’; 

11 (C) by striking ‘‘youth suicide’’ each place 

12 such term appears and inserting ‘‘suicide’’; 

13 (D) in paragraph (1)— 

14 (i) by striking ‘‘the development or 

15 continuation of’’ and inserting ‘‘developing 

16 and continuing’’; and 

17 (ii) by inserting ‘‘for all ages, particu18 larly among groups that are at high risk 

19 for suicide’’ before the semicolon at the 

20 end; 

21 (E) in paragraph (2), by inserting ‘‘for all 

22 ages, particularly among groups that are at 

23 high risk for suicide’’ before the semicolon at 

24 the end; 


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1 (F) in paragraph (3), by inserting ‘‘and 

2 tribal’’ after ‘‘statewide’’; 

3 (G) in paragraph (5), by inserting ‘‘and 

4 prevention’’ after ‘‘intervention’’; 

5 (H) in paragraph (8), by striking ‘‘in 

6 youth’’; 

7 (I) in paragraph (9), by striking ‘‘and be8 havioral health’’ and inserting ‘‘health and sub9 stance use disorder’’; and 

10 (J) in paragraph (10), by inserting ‘‘con11 ducting’’ before ‘‘other’’; and 

12 (6) by striking subsection (e) and inserting the 

13 following: 

14 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the 

15 purpose of carrying out this section, there are authorized 

16 to be appropriated $6,000,000 for each of fiscal years 

17 2016 through 2020. 

18 ‘‘(d) ANNUAL REPORT.—Not later than 2 years after 

19 the date of enactment of this subsection, the Secretary 

20 shall submit to Congress a report on the activities carried 

21 out by the center established under subsection (a) during 

22 the year involved, including the potential impacts of such 

23 activities, and the States, organizations, and institutions 

24 that have worked with the center.’’. 


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1 (b) YOUTH SUICIDE EARLY INTERVENTION AND

2 PREVENTION STRATEGIES.—Section 520E of the Public 

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

4 (1) in paragraph (1) of subsection (a) and in 

5 subsection (c), by striking ‘‘substance abuse’’ each 

6 place such term appears and inserting ‘‘substance 

7 use disorder’’; 

8 (2) in subsection (b)(2)— 

9 (A) by striking ‘‘each State is awarded 

10 only 1 grant or cooperative agreement under 

11 this section’’ and inserting ‘‘a State does not 

12 receive more than 1 grant or cooperative agree13 ment under this section at any 1 time’’; and 

14 (B) by striking ‘‘been awarded’’ and insert15 ing ‘‘received’’; and 

16 (3) in subsection (g)(2), by striking ‘‘2 years after 

17 the date of enactment of this section,’’ and insert ‘‘2 years 

18 after the date of enactment of the Mental Health Aware19 ness and Improvement Act of 2015,’’. 

20 (4) by striking subsection (m) and inserting the 

21 following: 

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

23 the purpose of carrying out this section, there are author24 ized to be appropriated $30,000,000 for each of fiscal 

25 years 2016 through 2020.’’. 


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1 (c) MENTAL HEALTH AND SUBSTANCE USE DIS2 ORDER SERVICES.—Section 520E–2 of the Public Health 

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

4 (1) in the section heading, by striking ‘‘AND

5 BEHAVIORAL HEALTH’’ and inserting ‘‘HEALTH

6 AND SUBSTANCE USE DISORDER’’; 

7 (2) in subsection (a)— 

8 (A) by striking ‘‘Services,’’ and inserting 

9 ‘‘Services and’’; 

10 (B) by striking ‘‘and behavioral health 

11 problems’’ and inserting ‘‘health or substance 

12 use disorders’’; and 

13 (C) by striking ‘‘substance abuse’’ and in14 serting ‘‘substance use disorders’’; 

15 (3) in subsection (b)— 

16 (A) in the matter preceding paragraph (1), 

17 by striking ‘‘for—’’ and inserting ‘‘for one or 

18 more of the following:’’; and 

19 (B) by striking paragraphs (1) through (6) 

20 and inserting the following: 

21 ‘‘(1) Educating students, families, faculty, and 

22 staff to increase awareness of mental health and 

23 substance use disorders. 

24 ‘‘(2) The operation of hotlines. 

25 ‘‘(3) Preparing informational material. 


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1 ‘‘(4) Providing outreach services to notify stu2 dents about available mental health and substance 

3 use disorder services. 

4 ‘‘(5) Administering voluntary mental health and 

5 substance use disorder screenings and assessments. 

6 ‘‘(6) Supporting the training of students, fac7 ulty, and staff to respond effectively to students with 

8 mental health and substance use disorders. 

9 ‘‘(7) Creating a network infrastructure to link 

10 colleges and universities with health care providers 

11 who treat mental health and substance use dis12 orders.’’; 

13 (4) in subsection (c)(5), by striking ‘‘substance 

14 abuse’’ and inserting ‘‘substance use disorder’’; 

15 (5) in subsection (d)— 

16 (A) in the matter preceding paragraph (1), 

17 by striking ‘‘An institution of higher education 

18 desiring a grant under this section’’ and insert19 ing ‘‘To be eligible to receive a grant under this 

20 section, an institution of higher education’’; 

21 (B) in paragraph (1)— 

22 (i) by striking ‘‘and behavioral 

23 health’’ and inserting ‘‘health and sub24 stance use disorder’’; and 


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1 (ii) by inserting ‘‘, including veterans 

2 whenever possible and appropriate,’’ after 

3 ‘‘students’’; and 

4 (C) in paragraph (2), by inserting ‘‘, which 

5 may include, as appropriate and in accordance 

6 with subsection (b)(7), a plan to seek input 

7 from relevant stakeholders in the community, 

8 including appropriate public and private enti9 ties, in order to carry out the program under 

10 the grant’’ before the period at the end; 

11 (6) in subsection (e)(1), by striking ‘‘and behav12 ioral health problems’’ and inserting ‘‘health and 

13 substance use disorders’’; 

14 (7) in subsection (f)(2)— 

15 (A) by striking ‘‘and behavioral health’’ 

16 and inserting ‘‘health and substance use dis17 order’’; and 

18 (B) by striking ‘‘suicide and substance 

19 abuse’’ and inserting ‘‘suicide and substance 

20 use disorders’’; and 

21 (8) in subsection (h), by striking ‘‘$5,000,000 

22 for fiscal year 2005’’ and all that follows through 

23 the period at the end and inserting ‘‘$6,500,000 for 

24 each of fiscal years 2016 through 2020.’’. 


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1 SEC. 3. MENTAL HEALTH AWARENESS TRAINING GRANTS. 

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

3 U.S.C. 290bb–41) is amended— 

4 (1) in the section heading, by inserting ‘‘MEN5 TAL HEALTH AWARENESS’’ before ‘‘TRAINING’’; 

6 and 

7 (2) in subsection (b)— 

8 (A) in the subsection heading, by striking 

9 ‘‘ILLNESS’’ and inserting ‘‘HEALTH’’; 

10 (B) in paragraph (1), by inserting ‘‘and 

11 other categories of individuals, as determined 

12 by the Secretary,’’ after ‘‘emergency services 

13 personnel’’; 

14 (C) in paragraph (5)— 

15 (i) in the matter preceding subpara16 graph (A), by striking ‘‘to’’ and inserting 

17 ‘‘for evidence-based programs for the pur18 pose of’’; and 

19 (ii) by striking subparagraphs (A) 

20 through (C) and inserting the following: 

21 ‘‘(A) recognizing the signs and symptoms 

22 of mental illness; and 

23 ‘‘(B)(i) providing education to personnel 

24 regarding resources available in the community 

25 for individuals with a mental illness and other 

26 relevant resources; or 


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1 ‘‘(ii) the safe de-escalation of crisis situa2 tions involving individuals with a mental ill3 ness.’’; and 

4 (D) in paragraph (7), by striking ‘‘, 

5 $25,000,000’’ and all that follows through the 

6 period at the end and inserting ‘‘$15,000,000 

7 for each of fiscal years 2016 through 2020.’’. 

8 SEC. 4. CHILDREN’S RECOVERY FROM TRAUMA. 

9 Section 582 of the Public Health Service Act (42 

10 U.S.C. 290hh–1) is amended— 

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

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

13 the end and inserting ‘‘developing and maintaining 

14 programs that provide for— 

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

16 Child Traumatic Stress Initiative (referred to in this 

17 section as the ‘NCTSI’), which includes a coopera18 tive agreement with a coordinating center, that fo19 cuses on the mental, behavioral, and biological as20 pects of psychological trauma response, prevention 

21 of the long-term consequences of child trauma, and 

22 early intervention services and treatment to address 

23 the long-term consequences of child trauma; and 

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

25 to evidence-based practices for identifying and treatVerDate Sep 11 2014 00:36 Jan 06, 2016 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1893.RFH S1893

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1 ing mental, behavioral, and biological disorders of 

2 children and youth resulting from witnessing or ex3 periencing a traumatic event.’’; 

4 (2) in subsection (b)— 

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

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

7 (B) by striking ‘‘treating disorders associ8 ated with psychological trauma’’ and inserting 

9 ‘‘treating mental, behavioral, and biological dis10 orders associated with psychological trauma)’’; 

11 and 

12 (C) by striking ‘‘mental health agencies 

13 and programs that have established clinical and 

14 basic research’’ and inserting ‘‘universities, hos15 pitals, mental health agencies, and other pro16 grams that have established clinical expertise 

17 and research’’; 

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

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

20 (4) by inserting after subsection (b), the fol21 lowing: 

22 ‘‘(c) CHILD OUTCOME DATA.—The NCTSI coordi23 nating center shall collect, analyze, and report NCTSI24 wide child treatment process and outcome data regarding 

25 the early identification and delivery of evidence-based 


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1 treatment and services for children and families served by 

2 the NCTSI grantees. 

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

4 shall facilitate the coordination of training initiatives in 

5 evidence-based and trauma-informed treatments, interven6 tions, and practices offered to NCTSI grantees, providers, 

7 and partners. 

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

9 NCTSI coordinating center shall, as appropriate, collabo10 rate with— 

11 ‘‘(1) the Secretary, in the dissemination of evi12 dence-based and trauma-informed interventions, 

13 treatments, products, and other resources to appro14 priate stakeholders; and 

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

16 research within the Department of Health and 

17 Human Services, for purposes of sharing NCTSI ex18 pertise, evaluation data, and other activities, as ap19 propriate. 

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

21 the peer review process, ensure that NCTSI applications 

22 are reviewed by appropriate experts in the field as part 

23 of a consensus review process. The Secretary shall include 

24 review criteria related to expertise and experience in child 

25 trauma and evidence-based practices.’’; 


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

2 striking ‘‘with respect to centers of excellence are 

3 distributed equitably among the regions of the coun4 try’’ and inserting ‘‘are distributed equitably among 

5 the regions of the United States’’; 

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

7 striking ‘‘recipient may not exceed 5 years’’ and in8 serting ‘‘recipient shall not be less than 4 years, but 

9 shall not exceed 5 years’’; and 

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

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

12 ‘‘2006’’ and inserting ‘‘$46,000,000 for each of fis13 cal years 2016 through 2020’’. 

14 SEC. 5. ASSESSING BARRIERS TO BEHAVIORAL HEALTH IN15 TEGRATION. 

16 (a) IN GENERAL.—Not later than 2 years after the 

17 date of enactment of this Act, the Comptroller General 

18 of the United States shall submit a report to the Com19 mittee on Health, Education, Labor, and Pensions of the 

20 Senate and the Committee on Energy and Commerce of 

21 the House of Representatives concerning Federal require22 ments that impact access to treatment of mental health 

23 and substance use disorders related to integration with 

24 primary care, administrative and regulatory issues, quality 

25 measurement and accountability, and data sharing. 


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1 (b) CONTENTS.—The report submitted under sub2 section (a) shall include the following: 

3 (1) An evaluation of the administrative or regu4 latory burden on behavioral health care providers. 

5 (2) The identification of outcome and quality 

6 measures relevant to integrated health care, evalua7 tion of the data collection burden on behavioral 

8 health care providers, and any alternative methods 

9 for evaluation. 

10 (3) An analysis of the degree to which elec11 tronic data standards, including interoperability and 

12 meaningful use includes behavioral health measures, 

13 and an analysis of strategies to address barriers to 

14 health information exchange posed by part 2 of title 

15 42, Code of Federal Regulations. 

16 (4) An analysis of the degree to which Federal 

17 rules and regulations for behavioral and physical 

18 health care are aligned, including recommendations 

19 to address any identified barriers. 

20 (5) An analysis of the challenges to behavioral 

21 health and primary care integration faced by pro22 viders in rural areas. 


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1 SEC. 6. INCREASING EDUCATION AND AWARENESS OF 

2 TREATMENTS FOR OPIOID USE DISORDERS. 

3 (a) IN GENERAL.—In order to improve the quality 

4 of care delivery and treatment outcomes among patients 

5 with opioid use disorders, the Secretary of Health and 

6 Human Services (referred to in this section as the ‘‘Sec7 retary’’), acting through the Administrator for the Sub8 stance Abuse and Mental Health Services Administration, 

9 may advance, through existing programs as appropriate, 

10 the education and awareness of providers, patients, and 

11 other appropriate stakeholders regarding all products ap12 proved by the Food and Drug Administration to treat 

13 opioid use disorders. 

14 (b) ACTIVITIES.—The activities described in sub15 section (a) may include— 

16 (1) disseminating evidence-based practices for 

17 the treatment of opioid use disorders; 

18 (2) facilitating continuing education programs 

19 for health professionals involved in treating opioid 

20 use disorders; 

21 (3) increasing awareness among relevant stake22 holders of the treatment of opioid use disorders; 

23 (4) assessing current barriers to the treatment 

24 of opioid use disorders for patients and providers 

25 and development and implementation of strategies to 

26 mitigate such barriers; and 


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1 (5) continuing innovative approaches to the 

2 treatment of opioid use disorders in various treat3 ment settings, such as prisons, community mental 

4 health centers, primary care, and hospitals. 

5 (c) REPORT.—Not later than 1 year after the date 

6 of enactment of this Act, if the Secretary carries out the 

7 activities under this section, the Secretary shall submit to 

8 the Committee on Health, Education, Labor, and Pen9 sions of the Senate and the Committee on Energy and 

10 Commerce of the House of Representatives a report that 

11 examines— 

12 (1) the activities the Substance Abuse and Men13 tal Health Services Administration conducts under 

14 this section, including any potential impacts on 

15 health care costs associated with such activities; 

16 (2) the role of adherence in the treatment of 

17 opioid use disorders and methods to reduce opioid 

18 use disorders; and 

19 (3) recommendations on priorities and strate20 gies to address co-occurring substance use disorders 

21 and mental illnesses. 

22 SEC. 7. EXAMINING MENTAL HEALTH CARE FOR CHILDREN. 

23 (a) IN GENERAL.—Not later than 1 year after the 

24 date of enactment of this Act, the Comptroller General 

25 of the United States shall conduct an independent evaluaVerDate Sep 11 2014 00:36 Jan 06, 2016 Jkt 059200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\S1893.RFH S1893

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1 tion, and submit to the Committee on Health, Education, 

2 Labor, and Pensions of the Senate and the Committee on 

3 Energy and Commerce of the House of Representatives, 

4 a report concerning the utilization of mental health serv5 ices for children, including the usage of psychotropic medi6 cations. 

7 (b) CONTENT.—The report submitted under sub8 section (a) shall review and assess— 

9 (1) the ways in which children access mental 

10 health care, including information on whether chil11 dren are treated by primary care or specialty pro12 viders, what types of referrals for additional care are 

13 recommended, and any barriers to accessing this 

14 care; 

15 (2) the extent to which children are prescribed 

16 psychotropic medications in the United States in17 cluding the frequency of concurrent medication 

18 usage; and 

19 (3) the tools, assessments, and medications that 

20 are available and used to diagnose and treat children 

21 with mental health disorders. 

22 SEC. 8. EVIDENCE BASED PRACTICES FOR OLDER ADULTS. 

23 Section 520A(e) of the Public Health Service Act (42 

24 U.S.C. 290bb–32(e)) is amended by adding at the end the 

25 following: 


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1 ‘‘(3) GERIATRIC MENTAL HEALTH DIS2 ORDERS.—The Secretary shall, as appropriate, pro3 vide technical assistance to grantees regarding evi4 dence-based practices for the prevention and treat5 ment of geriatric mental health disorders and co-oc6 curring mental health and substance use disorders 

7 among geriatric populations, as well as disseminate 

8 information about such evidence-based practices to 

9 States and nongrantees throughout the United 

10 States.’’. 

11 SEC. 9. NATIONAL VIOLENT DEATH REPORTING SYSTEM. 

12 The Secretary of Health and Human Services, acting 

13 through the Director of the Centers for Disease Control 

14 and Prevention, is encouraged to improve, particularly 

15 through the inclusion of additional States, the National 

16 Violent Death Reporting System as authorized by title III 

17 of the Public Health Service Act (42 U.S.C. 241 et seq.). 

18 Participation in the system by the States shall be vol19 untary. 

20 SEC. 10. GAO STUDY ON VIRGINIA TECH RECOMMENDA21 TIONS. 

22 (a) IN GENERAL.—Not later than 1 year after the 

23 date of enactment of this Act, the Comptroller General 

24 of the United States shall conduct an independent evalua25 tion, and submit to the appropriate committees of ConVerDate Sep 11 2014 00:36 Jan 06, 2016 Jkt 059200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\S1893.RFH S1893

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1 gress a report concerning the status of implementation of 

2 recommendations made in the report to the President, On 

3 Issues Raised by the Virginia Tech Tragedy, by the Secre4 taries of Health and Human Services and Education and 

5 the Attorney General of the United States, submitted to 

6 the President on June 13, 2007. 

7 (b) CONTENT.—The report submitted to the commit8 tees of Congress under subsection (a) shall review and as9 sess— 

10 (1) the extent to which the recommendations in 

11 the report that include participation by the Depart12 ment of Health and Human Services were imple13 mented; 

14 (2) whether there are any barriers to implemen15 tation of such recommendations; and 

16 (3) identification of any additional actions the 

17 Federal government can take to support States and 

18 local communities and ensure that the Federal gov19 ernment and Federal law are not obstacles to ad20 dressing at the community level— 

21 (A) school violence; and 

22 (B) mental illness. 

23 SEC. 11. PERFORMANCE METRICS. 

24 (a) EVALUATION OF CURRENT PROGRAMS.— 


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1 (1) IN GENERAL.—Not later than 180 days 

2 after the date of enactment of this Act, the Assist3 ant Secretary for Planning and Evaluation of the 

4 Department of Health and Human Services shall 

5 conduct an evaluation of the impact of activities re6 lated to the prevention and treatment of mental ill7 ness and substance use disorders conducted by the 

8 Substance Abuse and Mental Health Services Ad9 ministration. 

10 (2) ASSESSMENT OF PERFORMANCE

11 METRICS.—The evaluation conducted under para12 graph (1) shall include an assessment of the use of 

13 performance metrics to evaluate activities carried 

14 out by entities receiving grants, contracts, or cooper15 ative agreements related to mental illness or sub16 stance use disorders under title V or title XIX of the 

17 Public Health Service Act (42 U.S.C. 290aa et seq.; 

18 42 U.S.C. 300w et seq.). 

19 (3) RECOMMENDATIONS.—The evaluation con20 ducted under paragraph (1) shall include rec21 ommendations for the use of performance metrics to 

22 improve the quality of programs related to the pre23 vention and treatment of mental illness and sub24 stance use disorders. 


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1 (b) USE OF PERFORMANCE METRICS.—Not later 

2 than 1 year after the date of enactment of this Act, the 

3 Secretary of Health and Human Services, acting through 

4 the Administrator of the Substance Abuse and Mental 

5 Health Services Administration, shall advance, through 

6 existing programs, the use of performance metrics, taking 

7 into consideration the recommendations under subsection 

8 (a)(3), to improve programs related to the prevention and 

9 treatment of mental illness and substance use disorders. 

Passed the Senate December 18, 2015. 

Attest: JULIE E. ADAMS, 

Secretary. 


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