II 

114TH CONGRESS 

1ST SESSION S. 1893 

To reauthorize and improve programs related to mental health and substance 

use disorders. 

IN THE SENATE OF THE UNITED STATES 

JULY 29, 2015 

Mr. ALEXANDER (for himself, Mrs. MURRAY, Mr. ENZI, Mr. FRANKEN, Mr. 

ISAKSON, Mr. BENNET, Mr. KIRK, Ms. BALDWIN, Mr. ROBERTS, Mr. 

MURPHY, Ms. AYOTTE, Mr. BLUMENTHAL, Mr. WICKER, Mr. CASEY, Mr. 

UDALL, Mr. DURBIN, Ms. MIKULSKI, Ms. HEITKAMP, and Mr. CASSIDY) 

introduced the following bill; which was read twice and referred to the 

Committee on Health, Education, Labor, and Pensions 

A BILL 

To reauthorize and improve programs related to mental 

health and substance use disorders. 

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— 


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1 (1) in the section heading, by striking the sec2 tion heading and inserting ‘‘SUICIDE PREVENTION

3 TECHNICAL ASSISTANCE CENTER.’’; 

4 (2) in subsection (a), by striking ‘‘and in con5 sultation with’’ and all that follows through the pe6 riod at the end of paragraph (2) and inserting ‘‘shall 

7 establish a research, training, and technical assist8 ance resource center to provide appropriate informa9 tion, training, and technical assistance to States, po10 litical subdivisions of States, federally recognized In11 dian tribes, tribal organizations, institutions of high12 er education, public organizations, or private non13 profit organizations regarding the prevention of sui14 cide among all ages, particularly among groups that 

15 are at high risk for suicide.’’; 

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

17 (4) by redesignating subsection (d) as sub18 section (b); 

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

20 (A) by striking the subsection heading and 

21 inserting ‘‘RESPONSIBILITIES OF THE CEN22 TER.’’; 

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

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

25 that follows through ‘‘nonprofit organizations 


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1 for’’ and inserting ‘‘The center established 

2 under subsection (a) shall conduct activities for 

3 the purpose of’’; 

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

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

6 (D) in paragraph (1)— 

7 (i) by striking ‘‘the development or 

8 continuation of’’ and inserting ‘‘developing 

9 and continuing’’; and 

10 (ii) by inserting ‘‘for all ages, particu11 larly among groups that are at high risk 

12 for suicide’’ before the semicolon at the 

13 end; 

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

15 ages, particularly among groups that are at 

16 high risk for suicide’’ before the semicolon at 

17 the end; 

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

19 tribal’’ after ‘‘statewide’’; 

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

21 prevention’’ after ‘‘intervention’’; 

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

23 youth’’; 


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1 (I) in paragraph (9), by striking ‘‘and be2 havioral health’’ and inserting ‘‘health and sub3 stance use disorder’’; and 

4 (J) in paragraph (10), by inserting ‘‘con5 ducting’’ before ‘‘other’’; and 

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

7 following: 

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

9 purpose of carrying out this section, there are authorized 

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

11 2016 through 2020.’’. 

12 (b) YOUTH SUICIDE EARLY INTERVENTION AND

13 PREVENTION STRATEGIES.—Section 520E of the Public 

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

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

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

17 place such term appears and inserting ‘‘substance 

18 use disorder’’; 

19 (2) in subsection (b)(2)— 

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

21 only 1 grant or cooperative agreement under 

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

23 receive more than 1 grant or cooperative agree24 ment under this section at any 1 time’’; and 


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1 (B) by striking ‘‘been awarded’’ and insert2 ing ‘‘received’’; and 

3 (3) by striking subsection (m) and inserting the 

4 following: 

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

6 the purpose of carrying out this section, there are author7 ized to be appropriated $23,500,000 for each of fiscal 

8 years 2016 through 2020.’’. 

9 (c) MENTAL HEALTH AND SUBSTANCE USE DIS10 ORDER SERVICES.—Section 520E–2 of the Public Health 

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

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

13 BEHAVIORAL HEALTH’’ and inserting ‘‘HEALTH

14 AND SUBSTANCE USE DISORDER’’; 

15 (2) in subsection (a)— 

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

17 ‘‘Services and’’; 

18 (B) by striking ‘‘and behavioral health 

19 problems’’ and inserting ‘‘health or substance 

20 use disorders’’; and 

21 (C) by striking ‘‘substance abuse’’ and in22 serting ‘‘substance use disorders’’; 

23 (3) in subsection (b)— 


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

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

3 more of the following:’’; and 

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

5 and inserting the following: 

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

7 staff to increase awareness of mental health and 

8 substance use disorders. 

9 ‘‘(2) The operation of hotlines. 

10 ‘‘(3) Preparing informational material. 

11 ‘‘(4) Providing outreach services to notify stu12 dents about available mental health and substance 

13 use disorder services. 

14 ‘‘(5) Administering voluntary mental health and 

15 substance use disorder screenings and assessments. 

16 ‘‘(6) Supporting the training of students, fac17 ulty, and staff to respond effectively to students with 

18 mental health and substance use disorders. 

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

20 colleges and universities with health care providers 

21 who treat mental health and substance use dis22 orders.’’; 

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

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

25 (5) in subsection (d)— 


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

2 by striking ‘‘An institution of higher education 

3 desiring a grant under this section’’ and insert4 ing ‘‘To be eligible to receive a grant under this 

5 section, an institution of higher education’’; 

6 (B) in paragraph (1)— 

7 (i) by striking ‘‘and behavioral 

8 health’’ and inserting ‘‘health and sub9 stance use disorder’’; and 

10 (ii) by inserting ‘‘, including veterans 

11 whenever possible and appropriate,’’ after 

12 ‘‘students’’; and 

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

14 may include, as appropriate and in accordance 

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

16 from relevant stakeholders in the community, 

17 including appropriate public and private enti18 ties, in order to carry out the program under 

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

20 (6) in subsection (e)(1), by striking ‘‘and behav21 ioral health problems’’ and inserting ‘‘health and 

22 substance use disorders’’; 

23 (7) in subsection (f)(2)— 


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

2 and inserting ‘‘health and substance use dis3 order’’; and 

4 (B) by striking ‘‘suicide and substance 

5 abuse’’ and inserting ‘‘suicide and substance 

6 use disorders’’; and 

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

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

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

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

11 SEC. 3. MENTAL HEALTH AWARENESS TRAINING GRANTS. 

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

13 U.S.C. 290bb–41) is amended— 

14 (1) in the section heading, by inserting ‘‘MEN15 TAL HEALTH AWARENESS’’ before ‘‘TRAINING’’; 

16 and 

17 (2) in subsection (b)— 

18 (A) in the subsection heading, by striking 

19 ‘‘ILLNESS’’ and inserting ‘‘HEALTH’’; 

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

21 other categories of individuals, as determined 

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

23 personnel’’; 

24 (C) in paragraph (5)— 


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1 (i) in the matter preceding subpara2 graph (A), by striking ‘‘to’’ and inserting 

3 ‘‘for evidence-based programs for the pur4 pose of’’; and 

5 (ii) by striking subparagraphs (A) 

6 through (C) and inserting the following: 

7 ‘‘(A) recognizing the signs and symptoms 

8 of mental illness; and 

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

10 regarding resources available in the community 

11 for individuals with a mental illness and other 

12 relevant resources; or 

13 ‘‘(ii) the safe de-escalation of crisis situa14 tions involving individuals with a mental ill15 ness.’’; and 

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

17 $25,000,000’’ and all that follows through the 

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

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

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

21 Section 582 of the Public Health Service Act (42 

22 U.S.C. 290hh–1) is amended— 

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

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


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1 the end and inserting ‘‘developing and maintaining 

2 programs that provide for— 

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

4 Child Traumatic Stress Initiative (referred to in this 

5 section as the ‘NCTSI’), which includes a coopera6 tive agreement with a coordinating center, that fo7 cuses on the mental, behavioral, and biological as8 pects of psychological trauma response, prevention 

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

10 early intervention services and treatment to address 

11 the long-term consequences of child trauma; and 

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

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

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

17 (2) in subsection (b)— 

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

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

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

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

24 and 


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1 (C) by striking ‘‘mental health agencies 

2 and programs that have established clinical and 

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

6 and research’’; 

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

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

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

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

14 the early identification and delivery of evidence-based 

15 treatment and services for children and families served by 

16 the NCTSI grantees. 

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

18 shall facilitate the coordination of training initiatives in 

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

21 and partners. 

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

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


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

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

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

6 research within the Department of Health and 

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

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

11 the peer review process, ensure that NCTSI applications 

12 are reviewed by appropriate experts in the field as part 

13 of a consensus review process. The Secretary shall include 

14 review criteria related to expertise and experience in child 

15 trauma and evidence-based practices.’’; 

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

17 striking ‘‘with respect to centers of excellence are 

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

20 the regions of the United States’’; 

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

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

24 shall not exceed 5 years’’; and 


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

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

3 ‘‘2006’’ and inserting ‘‘$46,000,000 for each of fis4 cal years 2016 through 2020’’. 

5 SEC. 5. ASSESSING BARRIERS TO BEHAVIORAL HEALTH IN6 TEGRATION. 

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

8 date of enactment of this Act, the Comptroller General 

9 of the United States shall submit a report to the Com10 mittee on Health, Education, Labor, and Pensions of the 

11 Senate and the Committee on Energy and Commerce of 

12 the House of Representatives concerning Federal require13 ments that impact access to treatment of mental health 

14 and substance use disorders related to integration with 

15 primary care, administrative and regulatory issues, quality 

16 measurement and accountability, and data sharing. 

17 (b) CONTENTS.—The report submitted under sub18 section (a) shall include the following: 

19 (1) An evaluation of the administrative or regu20 latory burden on behavioral health care providers. 

21 (2) The identification of outcome and quality 

22 measures relevant to integrated health care, evalua23 tion of the data collection burden on behavioral 

24 health care providers, and any alternative methods 

25 for evaluation. 


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1 (3) An analysis of the degree to which elec2 tronic data standards, including interoperability and 

3 meaningful use includes behavioral health measures, 

4 and an analysis of strategies to address barriers to 

5 health information exchange posed by part 2 of title 

6 42, Code of Federal Regulations. 

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

8 rules and regulations for behavioral and physical 

9 health care are aligned, including recommendations 

10 to address any identified barriers. 

11 SEC. 6. INCREASING EDUCATION AND AWARENESS OF 

12 TREATMENTS FOR OPIOID USE DISORDERS. 

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

14 of care delivery and treatment outcomes among patients 

15 with opioid use disorders, the Secretary of Health and 

16 Human Services (referred to in this section as the ‘‘Sec17 retary’’), acting through the Administrator for the Sub18 stance Abuse and Mental Health Services Administration, 

19 may advance, through existing programs as appropriate, 

20 the education and awareness of providers, patients, and 

21 other appropriate stakeholders regarding all products ap22 proved by the Food and Drug Administration to treat 

23 opioid use disorders. 

24 (b) ACTIVITIES.—The activities described in sub25 section (a) may include— 


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1 (1) disseminating evidence-based practices for 

2 the treatment of opioid use disorders; 

3 (2) facilitating continuing education programs 

4 for health professionals involved in treating opioid 

5 use disorders; 

6 (3) increasing awareness among relevant stake7 holders of the treatment of opioid use disorders; 

8 (4) assessing current barriers to the treatment 

9 of opioid use disorders for patients and providers 

10 and development and implementation of strategies to 

11 mitigate such barriers; and 

12 (5) continuing innovative approaches to the 

13 treatment of opioid use disorders in various treat14 ment settings, such as prisons, community mental 

15 health centers, primary care, and hospitals. 

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

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

18 activities under this section, the Secretary shall submit to 

19 the Committee on Health, Education, Labor, and Pen20 sions of the Senate and the Committee on Energy and 

21 Commerce of the House of Representatives a report that 

22 examines— 

23 (1) the activities the Substance Abuse and Men24 tal Health Services Administration conducts under 


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1 this section, including any potential impacts on 

2 health care costs associated with such activities; 

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

4 opioid use disorders and methods to reduce opioid 

5 use disorders; and 

6 (3) recommendations on priorities and strate7 gies to address co-occurring substance use disorders 

8 and mental illnesses. 

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

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

11 date of enactment of this Act, the Comptroller General 

12 of the United States shall conduct an independent evalua13 tion, and submit to the Committee on Health, Education, 

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

15 Energy and Commerce of the House of Representatives, 

16 a report concerning the utilization of mental health serv17 ices for children, including the usage of psychotropic medi18 cations. 

19 (b) CONTENT.—The report submitted under sub20 section (a) shall review and assess— 

21 (1) the ways in which children access mental 

22 health care, including information on whether chil23 dren are treated by primary care or specialty pro24 viders, what types of referrals for additional care are 


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1 recommended, and any barriers to accessing this 

2 care; 

3 (2) the extent to which children are prescribed 

4 psychotropic medications in the United States in5 cluding the frequency of concurrent medication 

6 usage; and 

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

8 are available and used to diagnose and treat children 

9 with mental health disorders. 

10 SEC. 8. EVIDENCE-BASED PRACTICES FOR OLDER ADULTS. 

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

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

13 following: 

14 ‘‘(3) GERIATRIC MENTAL HEALTH DIS15 ORDERS.—The Secretary shall, as appropriate, pro16 vide technical assistance to grantees regarding evi17 dence-based practices for the prevention and treat18 ment of geriatric mental health disorders and co-oc19 curring mental health and substance use disorders 

20 among geriatric populations, as well as disseminate 

21 information about such evidence-based practices to 

22 States and nongrantees throughout the United 

23 States.’’. 


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1 SEC. 9. NATIONAL VIOLENT DEATH REPORTING SYSTEM. 

2 The Secretary of Health and Human Services, acting 

3 through the Director of the Centers for Disease Control 

4 and Prevention, is encouraged to improve, particularly 

5 through the inclusion of additional States, the National 

6 Violent Death Reporting System as authorized by title III 

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

8 Participation in the system by the States shall be vol9 untary. 

10 SEC. 10. GAO STUDY ON VIRGINIA TECH RECOMMENDA11 TIONS. 

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

13 date of enactment of this Act, the Comptroller General 

14 of the United States shall conduct an independent evalua15 tion, and submit to the appropriate committees of Con16 gress a report concerning the status of implementation of 

17 recommendations made in the report to the President, On 

18 Issues Raised by the Virginia Tech Tragedy, by the Secre19 taries of Health and Human Services and Education and 

20 the Attorney General of the United States, submitted to 

21 the President on June 13, 2007. 

22 (b) CONTENT.—The report submitted to the commit23 tees of Congress under subsection (a) shall review and as24 sess— 

25 (1) the extent to which the recommendations in 

26 the report that include participation by the DepartVerDate Sep 11 2014 04:27 Jul 31, 2015 Jkt 049200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\S1893.IS S1893

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1 ment of Health and Human Services were imple2 mented; 

3 (2) whether there are any barriers to implemen4 tation of such recommendations; and 

5 (3) identification of any additional actions the 

6 Federal Government can take to support States and 

7 local communities and ensure that the Federal Gov8 ernment and Federal law are not obstacles to ad9 dressing at the community level— 

10 (A) school violence; and 

11 (B) mental illness. 

Æ 


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