II 

Calendar No. 247 

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, Mr. CASSIDY, Ms. 

COLLINS, Ms. MURKOWSKI, Mr. DONNELLY, and Mr. BLUNT) introduced 

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

on Health, Education, Labor, and Pensions 

OCTOBER 1, 2015 

Reported by Mr. ALEXANDER, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

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. 


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1 SEC. 2. GARRETT LEE SMITH MEMORIAL ACT REAUTHOR2 IZATION. 

3 (a) SUICIDE PREVENTION TECHNICAL ASSISTANCE

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

5 (42 U.S.C. 290bb–34) is amended— 

6 (1) in the section heading, by striking the sec7 tion heading and inserting ‘‘SUICIDE PREVENTION

8 TECHNICAL ASSISTANCE CENTER.’’; 

9 (2) in subsection (a), by striking ‘‘and in con10 sultation with’’ and all that follows through the pe11 riod at the end of paragraph (2) and inserting ‘‘shall 

12 establish a research, training, and technical assist13 ance resource center to provide appropriate informa14 tion, training, and technical assistance to States, po15 litical subdivisions of States, federally recognized In16 dian tribes, tribal organizations, institutions of high17 er education, public organizations, or private non18 profit organizations regarding the prevention of sui19 cide among all ages, particularly among groups that 

20 are at high risk for suicide.’’; 

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

22 (4) by redesignating subsection (d) as sub23 section (b); 

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


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1 (A) by striking the subsection heading and 

2 inserting ‘‘RESPONSIBILITIES OF THE CEN3 TER.’’; 

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

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

6 that follows through ‘‘nonprofit organizations 

7 for’’ and inserting ‘‘The center established 

8 under subsection (a) shall conduct activities for 

9 the purpose of’’; 

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

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

12 (D) in paragraph (1)— 

13 (i) by striking ‘‘the development or 

14 continuation of’’ and inserting ‘‘developing 

15 and continuing’’; and 

16 (ii) by inserting ‘‘for all ages, particu17 larly among groups that are at high risk 

18 for suicide’’ before the semicolon at the 

19 end; 

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

21 ages, particularly among groups that are at 

22 high risk for suicide’’ before the semicolon at 

23 the end; 

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

25 tribal’’ after ‘‘statewide’’; 


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

2 prevention’’ after ‘‘intervention’’; 

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

4 youth’’; 

5 (I) in paragraph (9), by striking ‘‘and be6 havioral health’’ and inserting ‘‘health and sub7 stance use disorder’’; and 

8 (J) in paragraph (10), by inserting ‘‘con9 ducting’’ before ‘‘other’’; and 

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

11 following: 

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

13 purpose of carrying out this section, there are authorized 

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

15 2016 through 2020.’’. 

16 (b) YOUTH SUICIDE EARLY INTERVENTION AND

17 PREVENTION STRATEGIES.—Section 520E of the Public 

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

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

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

21 place such term appears and inserting ‘‘substance 

22 use disorder’’; 

23 (2) in subsection (b)(2)— 

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

25 only 1 grant or cooperative agreement under 


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

2 receive more than 1 grant or cooperative agree3 ment under this section at any 1 time’’; and 

4 (B) by striking ‘‘been awarded’’ and insert5 ing ‘‘received’’; and 

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

7 following: 

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

9 the purpose of carrying out this section, there are author10 ized to be appropriated $23,500,000 for each of fiscal 

11 years 2016 through 2020.’’. 

12 (c) MENTAL HEALTH AND SUBSTANCE USE DIS13 ORDER SERVICES.—Section 520E–2 of the Public Health 

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

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

16 BEHAVIORAL HEALTH’’ and inserting ‘‘HEALTH

17 AND SUBSTANCE USE DISORDER’’; 

18 (2) in subsection (a)— 

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

20 ‘‘Services and’’; 

21 (B) by striking ‘‘and behavioral health 

22 problems’’ and inserting ‘‘health or substance 

23 use disorders’’; and 

24 (C) by striking ‘‘substance abuse’’ and in25 serting ‘‘substance use disorders’’; 


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1 (3) in subsection (b)— 

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

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

4 more of the following:’’; and 

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

6 and inserting the following: 

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

8 staff to increase awareness of mental health and 

9 substance use disorders. 

10 ‘‘(2) The operation of hotlines. 

11 ‘‘(3) Preparing informational material. 

12 ‘‘(4) Providing outreach services to notify stu13 dents about available mental health and substance 

14 use disorder services. 

15 ‘‘(5) Administering voluntary mental health and 

16 substance use disorder screenings and assessments. 

17 ‘‘(6) Supporting the training of students, fac18 ulty, and staff to respond effectively to students with 

19 mental health and substance use disorders. 

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

21 colleges and universities with health care providers 

22 who treat mental health and substance use dis23 orders.’’; 

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

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


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1 (5) in subsection (d)— 

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

3 by striking ‘‘An institution of higher education 

4 desiring a grant under this section’’ and insert5 ing ‘‘To be eligible to receive a grant under this 

6 section, an institution of higher education’’; 

7 (B) in paragraph (1)— 

8 (i) by striking ‘‘and behavioral 

9 health’’ and inserting ‘‘health and sub10 stance use disorder’’; and 

11 (ii) by inserting ‘‘, including veterans 

12 whenever possible and appropriate,’’ after 

13 ‘‘students’’; and 

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

15 may include, as appropriate and in accordance 

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

17 from relevant stakeholders in the community, 

18 including appropriate public and private enti19 ties, in order to carry out the program under 

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

21 (6) in subsection (e)(1), by striking ‘‘and behav22 ioral health problems’’ and inserting ‘‘health and 

23 substance use disorders’’; 

24 (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 00:08 Oct 02, 2015 Jkt 049200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6401 E:\BILLS\S1893.RS 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. 

12 SECTION 1. SHORT TITLE. 

13 This Act may be cited as the Mental Health Awareness 

14 and Improvement Act of 2015. 

15 SEC. 2. GARRETT LEE SMITH MEMORIAL ACT REAUTHOR16 IZATION. 

17 (a) SUICIDE PREVENTION TECHNICAL ASSISTANCE

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

19 (42 U.S.C. 290bb–34) is amended— 

20 (1) in the section heading, by striking the section 

21 heading and inserting ‘‘SUICIDE PREVENTION

22 TECHNICAL ASSISTANCE CENTER.’’; 

23 (2) in subsection (a), by striking ‘‘and in con24 sultation with’’ and all that follows through the pe25 riod at the end of paragraph (2) and inserting ‘‘shall 


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1 establish a research, training, and technical assist2 ance resource center to provide appropriate informa3 tion, training, and technical assistance to States, po4 litical subdivisions of States, federally recognized In5 dian tribes, tribal organizations, institutions of high6 er education, public organizations, or private non7 profit organizations regarding the prevention of sui8 cide among all ages, particularly among groups that 

9 are at high risk for suicide.’’; 

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

11 (4) by redesignating subsection (d) as subsection 

12 (b); 

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

14 (A) by striking the subsection heading and 

15 inserting ‘‘RESPONSIBILITIES OF THE CENTER.’’; 

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

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

18 that follows through ‘‘nonprofit organizations 

19 for’’ and inserting ‘‘The center established under 

20 subsection (a) shall conduct activities for the 

21 purpose of’’; 

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

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

24 (D) in paragraph (1)— 


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1 (i) by striking ‘‘the development or 

2 continuation of’’ and inserting ‘‘developing 

3 and continuing’’; and 

4 (ii) by inserting ‘‘for all ages, particu5 larly among groups that are at high risk for 

6 suicide’’ before the semicolon at the end; 

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

8 ages, particularly among groups that are at high 

9 risk for suicide’’ before the semicolon at the end; 

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

11 tribal’’ after ‘‘statewide’’; 

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

13 prevention’’ after ‘‘intervention’’; 

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

15 youth’’; 

16 (I) in paragraph (9), by striking ‘‘and be17 havioral health’’ and inserting ‘‘health and sub18 stance use disorder’’; and 

19 (J) in paragraph (10), by inserting ‘‘con20 ducting’’ before ‘‘other’’; and 

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

22 following: 

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

24 purpose of carrying out this section, there are authorized 


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1 to be appropriated $6,000,000 for each of fiscal years 2016 

2 through 2020.’’. 

3 (b) YOUTH SUICIDE EARLY INTERVENTION AND PRE4 VENTION STRATEGIES.—Section 520E of the Public Health 

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

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

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

8 place such term appears and inserting ‘‘substance use 

9 disorder’’; 

10 (2) in subsection (b)(2)— 

11 (A) by striking ‘‘each State is awarded only 

12 1 grant or cooperative agreement under this sec13 tion’’ and inserting ‘‘a State does not receive 

14 more than 1 grant or cooperative agreement 

15 under this section at any 1 time’’; and 

16 (B) by striking ‘‘been awarded’’ and insert17 ing ‘‘received’’; and 

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

19 following: 

20 ‘‘(m) AUTHORIZATION OF APPROPRIATIONS.—For the 

21 purpose of carrying out this section, there are authorized 

22 to be appropriated $23,500,000 for each of fiscal years 2016 

23 through 2020.’’. 


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1 (c) MENTAL HEALTH AND SUBSTANCE USE DISORDER

2 SERVICES.—Section 520E–2 of the Public Health Service 

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

4 (1) in the section heading, by striking ‘‘AND BE5 HAVIORAL HEALTH’’ and inserting ‘‘HEALTH AND

6 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 use 

12 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 sub23 stance 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 use 

3 disorder services. 

4 ‘‘(5) Administering voluntary mental health and 

5 substance use disorder screenings and assessments. 

6 ‘‘(6) Supporting the training of students, faculty, 

7 and staff to respond effectively to students with men8 tal 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 health’’ 

23 and inserting ‘‘health and substance use 

24 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 from 

7 relevant stakeholders in the community, includ8 ing appropriate public and private entities, in 

9 order to carry out the program under the grant’’ 

10 before the period at the end; 

11 (6) in subsection (e)(1), by striking ‘‘and behav12 ioral health problems’’ and inserting ‘‘health and sub13 stance use disorders’’; 

14 (7) in subsection (f)(2)— 

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

16 inserting ‘‘health and substance use disorder’’; 

17 and 

18 (B) by striking ‘‘suicide and substance 

19 abuse’’ and inserting ‘‘suicide and substance use 

20 disorders’’; and 

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

22 fiscal year 2005’’ and all that follows through the pe23 riod at the end and inserting ‘‘$6,500,000 for each of 

24 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 by 

12 the Secretary,’’ after ‘‘emergency services per13 sonnel’’; 

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 of 

22 mental illness; and 

23 ‘‘(B)(i) providing education to personnel re24 garding resources available in the community for 

25 individuals with a mental illness and other rel26 evant 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 pe6 riod at the end and inserting ‘‘$15,000,000 for 

7 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 cooperative 

18 agreement with a coordinating center, that focuses on 

19 the mental, behavioral, and biological aspects of psy20 chological trauma response, prevention of the long21 term consequences of child trauma, and early inter22 vention services and treatment to address the long23 term consequences of child trauma; and 

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

25 evidence-based practices for identifying and treating 


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1 mental, behavioral, and biological disorders of chil2 dren and youth resulting from witnessing or experi3 encing a traumatic event.’’; 

4 (2) in subsection (b)— 

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

6 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 and 

13 programs that have established clinical and basic 

14 research’’ and inserting ‘‘universities, hospitals, 

15 mental health agencies, and other programs that 

16 have established clinical expertise and research’’; 

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

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

19 (4) by inserting after subsection (b), the fol20 lowing: 

21 ‘‘(c) CHILD OUTCOME DATA.—The NCTSI coordi22 nating center shall collect, analyze, and report NCTSI-wide 

23 child treatment process and outcome data regarding the 

24 early identification and delivery of evidence-based treatVerDate Sep 11 2014 00:08 Oct 02, 2015 Jkt 049200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6203 E:\BILLS\S1893.RS S1893

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1 ment and services for children and families served by the 

2 NCTSI grantees. 

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

4 facilitate the coordination of training initiatives in evi5 dence-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 the 

21 peer review process, ensure that NCTSI applications are re22 viewed by appropriate experts in the field as part of a con23 sensus review process. The Secretary shall include review 

24 criteria related to expertise and experience in child trauma 

25 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 dis3 tributed equitably among the regions of the country’’ 

4 and inserting ‘‘are distributed equitably among the 

5 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 fiscal 

13 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 of 

18 the United States shall submit a report to the Committee 

19 on Health, Education, Labor, and Pensions of the Senate 

20 and the Committee on Energy and Commerce of the House 

21 of Representatives concerning Federal requirements that 

22 impact access to treatment of mental health and substance 

23 use disorders related to integration with primary care, ad24 ministrative and regulatory issues, quality measurement 

25 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 health 

8 care providers, and any alternative methods for eval9 uation. 

10 (3) An analysis of the degree to which electronic 

11 data standards, including interoperability and mean12 ingful use includes behavioral health measures, and 

13 an analysis of strategies to address barriers to health 

14 information exchange posed by part 2 of title 42, 

15 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 to 

19 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 of 

4 care delivery and treatment outcomes among patients with 

5 opioid use disorders, the Secretary of Health and Human 

6 Services (referred to in this section as the ‘‘Secretary’’), act7 ing through the Administrator for the Substance Abuse and 

8 Mental Health Services Administration, may advance, 

9 through existing programs as appropriate, the education 

10 and awareness of providers, patients, and other appropriate 

11 stakeholders regarding all products approved by the Food 

12 and Drug Administration to treat opioid use disorders. 

13 (b) ACTIVITIES.—The activities described in subsection 

14 (a) may include— 

15 (1) disseminating evidence-based practices for 

16 the treatment of opioid use disorders; 

17 (2) facilitating continuing education programs 

18 for health professionals involved in treating opioid 

19 use disorders; 

20 (3) increasing awareness among relevant stake21 holders of the treatment of opioid use disorders; 

22 (4) assessing current barriers to the treatment of 

23 opioid use disorders for patients and providers and 

24 development and implementation of strategies to miti25 gate such barriers; and 


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1 (5) continuing innovative approaches to the 

2 treatment of opioid use disorders in various treatment 

3 settings, such as prisons, community mental health 

4 centers, primary care, and hospitals. 

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

6 enactment of this Act, if the Secretary carries out the activi7 ties under this section, the Secretary shall submit to the 

8 Committee on Health, Education, Labor, and Pensions of 

9 the Senate and the Committee on Energy and Commerce 

10 of the House of Representatives a report that examines— 

11 (1) the activities the Substance Abuse and Men12 tal Health Services Administration conducts under 

13 this section, including any potential impacts on 

14 health care costs associated with such activities; 

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

16 opioid use disorders and methods to reduce opioid use 

17 disorders; and 

18 (3) recommendations on priorities and strategies 

19 to address co-occurring substance use disorders and 

20 mental illnesses. 

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

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

23 of enactment of this Act, the Comptroller General of the 

24 United States shall conduct an independent evaluation, and 

25 submit to the Committee on Health, Education, Labor, and 


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1 Pensions of the Senate and the Committee on Energy and 

2 Commerce of the House of Representatives, a report con3 cerning the utilization of mental health services for chil4 dren, including the usage of psychotropic medications. 

5 (b) CONTENT.—The report submitted under subsection 

6 (a) shall review and assess— 

7 (1) the ways in which children access mental 

8 health care, including information on whether chil9 dren are treated by primary care or specialty pro10 viders, what types of referrals for additional care are 

11 recommended, and any barriers to accessing this care; 

12 (2) the extent to which children are prescribed 

13 psychotropic medications in the United States includ14 ing the frequency of concurrent medication usage; and 

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

16 are available and used to diagnose and treat children 

17 with mental health disorders. 

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

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

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

21 following: 

22 ‘‘(3) GERIATRIC MENTAL HEALTH DISORDERS.— 

23 The Secretary shall, as appropriate, provide technical 

24 assistance to grantees regarding evidence-based prac25 tices for the prevention and treatment of geriatric 


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1 mental health disorders and co-occurring mental 

2 health and substance use disorders among geriatric 

3 populations, as well as disseminate information about 

4 such evidence-based practices to States and non5 grantees throughout the United States.’’. 

6 SEC. 9. NATIONAL VIOLENT DEATH REPORTING SYSTEM. 

7 The Secretary of Health and Human Services, acting 

8 through the Director of the Centers for Disease Control and 

9 Prevention, is encouraged to improve, particularly through 

10 the inclusion of additional States, the National Violent 

11 Death Reporting System as authorized by title III of the 

12 Public Health Service Act (42 U.S.C. 241 et seq.). Partici13 pation in the system by the States shall be voluntary. 

14 SEC. 10. GAO STUDY ON VIRGINIA TECH RECOMMENDA15 TIONS. 

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

17 of enactment of this Act, the Comptroller General of the 

18 United States shall conduct an independent evaluation, and 

19 submit to the appropriate committees of Congress a report 

20 concerning the status of implementation of recommenda21 tions made in the report to the President, On Issues Raised 

22 by the Virginia Tech Tragedy, by the Secretaries of Health 

23 and Human Services and Education and the Attorney Gen24 eral of the United States, submitted to the President on 

25 June 13, 2007. 


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1 (b) CONTENT.—The report submitted to the committees 

2 of Congress under subsection (a) shall review and assess— 

3 (1) the extent to which the recommendations in 

4 the report that include participation by the Depart5 ment of Health and Human Services were imple6 mented; 

7 (2) whether there are any barriers to implemen8 tation of such recommendations; and 

9 (3) identification of any additional actions the 

10 Federal government can take to support States and 

11 local communities and ensure that the Federal gov12 ernment and Federal law are not obstacles to address13 ing at the community level— 

14 (A) school violence; and 

15 (B) mental illness. 


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Calendar No. 247 

114TH CONGRESS 

1ST SESSION S. 1893 

A BILL 

To reauthorize and improve programs related to 

mental health and substance use disorders. 

OCTOBER 1, 2015 

Reported with an amendment 


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