```

[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 1893 Reported in Senate (RS)]

<DOC>

                                                       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.

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the Mental Health Awareness and 
Improvement Act of 2015.</DELETED>

<DELETED>SEC. 2. GARRETT LEE SMITH MEMORIAL ACT 
              REAUTHORIZATION.</DELETED>

<DELETED>    (a) Suicide Prevention Technical Assistance Center.--
Section 520C of the Public Health Service Act (42 U.S.C. 290bb-34) is 
amended--</DELETED>
        <DELETED>    (1) in the section heading, by striking the 
        section heading and inserting ``suicide prevention technical 
        assistance center.'';</DELETED>
        <DELETED>    (2) in subsection (a), by striking ``and in 
        consultation with'' and all that follows through the period at 
        the end of paragraph (2) and inserting ``shall establish a 
        research, training, and technical assistance resource center to 
        provide appropriate information, training, and technical 
        assistance to States, political subdivisions of States, 
        federally recognized Indian tribes, tribal organizations, 
        institutions of higher education, public organizations, or 
        private nonprofit organizations regarding the prevention of 
        suicide among all ages, particularly among groups that are at 
        high risk for suicide.'';</DELETED>
        <DELETED>    (3) by striking subsections (b) and (c);</DELETED>
        <DELETED>    (4) by redesignating subsection (d) as subsection 
        (b);</DELETED>
        <DELETED>    (5) in subsection (b), as so redesignated--
        </DELETED>
                <DELETED>    (A) by striking the subsection heading and 
                inserting ``Responsibilities of the 
                Center.'';</DELETED>
                <DELETED>    (B) in the matter preceding paragraph (1), 
                by striking ``The additional research'' and all that 
                follows through ``nonprofit organizations for'' and 
                inserting ``The center established under subsection (a) 
                shall conduct activities for the purpose 
                of'';</DELETED>
                <DELETED>    (C) by striking ``youth suicide'' each 
                place such term appears and inserting 
                ``suicide'';</DELETED>
                <DELETED>    (D) in paragraph (1)--</DELETED>
                        <DELETED>    (i) by striking ``the development 
                        or continuation of'' and inserting ``developing 
                        and continuing''; and</DELETED>
                        <DELETED>    (ii) by inserting ``for all ages, 
                        particularly among groups that are at high risk 
                        for suicide'' before the semicolon at the 
                        end;</DELETED>
                <DELETED>    (E) in paragraph (2), by inserting ``for 
                all ages, particularly among groups that are at high 
                risk for suicide'' before the semicolon at the 
                end;</DELETED>
                <DELETED>    (F) in paragraph (3), by inserting ``and 
                tribal'' after ``statewide'';</DELETED>
                <DELETED>    (G) in paragraph (5), by inserting ``and 
                prevention'' after ``intervention'';</DELETED>
                <DELETED>    (H) in paragraph (8), by striking ``in 
                youth'';</DELETED>
                <DELETED>    (I) in paragraph (9), by striking ``and 
                behavioral health'' and inserting ``health and 
                substance use disorder''; and</DELETED>
                <DELETED>    (J) in paragraph (10), by inserting 
                ``conducting'' before ``other''; and</DELETED>
        <DELETED>    (6) by striking subsection (e) and inserting the 
        following:</DELETED>
<DELETED>    ``(c) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be appropriated 
$6,000,000 for each of fiscal years 2016 through 2020.''.</DELETED>
<DELETED>    (b) Youth Suicide Early Intervention and Prevention 
Strategies.--Section 520E of the Public Health Service Act (42 U.S.C. 
290bb-36) is amended--</DELETED>
        <DELETED>    (1) in paragraph (1) of subsection (a) and in 
        subsection (c), by striking ``substance abuse'' each place such 
        term appears and inserting ``substance use 
        disorder'';</DELETED>
        <DELETED>    (2) in subsection (b)(2)--</DELETED>
                <DELETED>    (A) by striking ``each State is awarded 
                only 1 grant or cooperative agreement under this 
                section'' and inserting ``a State does not receive more 
                than 1 grant or cooperative agreement under this 
                section at any 1 time''; and</DELETED>
                <DELETED>    (B) by striking ``been awarded'' and 
                inserting ``received''; and</DELETED>
        <DELETED>    (3) by striking subsection (m) and inserting the 
        following:</DELETED>
<DELETED>    ``(m) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be appropriated 
$23,500,000 for each of fiscal years 2016 through 2020.''.</DELETED>
<DELETED>    (c) Mental Health and Substance Use Disorder Services.--
Section 520E-2 of the Public Health Service Act (42 U.S.C. 290bb-36b) 
is amended--</DELETED>
        <DELETED>    (1) in the section heading, by striking ``and 
        behavioral health'' and inserting ``health and substance use 
        disorder'';</DELETED>
        <DELETED>    (2) in subsection (a)--</DELETED>
                <DELETED>    (A) by striking ``Services,'' and 
                inserting ``Services and'';</DELETED>
                <DELETED>    (B) by striking ``and behavioral health 
                problems'' and inserting ``health or substance use 
                disorders''; and</DELETED>
                <DELETED>    (C) by striking ``substance abuse'' and 
                inserting ``substance use disorders'';</DELETED>
        <DELETED>    (3) in subsection (b)--</DELETED>
                <DELETED>    (A) in the matter preceding paragraph (1), 
                by striking ``for--'' and inserting ``for one or more 
                of the following:''; and</DELETED>
                <DELETED>    (B) by striking paragraphs (1) through (6) 
                and inserting the following:</DELETED>
        <DELETED>    ``(1) Educating students, families, faculty, and 
        staff to increase awareness of mental health and substance use 
        disorders.</DELETED>
        <DELETED>    ``(2) The operation of hotlines.</DELETED>
        <DELETED>    ``(3) Preparing informational material.</DELETED>
        <DELETED>    ``(4) Providing outreach services to notify 
        students about available mental health and substance use 
        disorder services.</DELETED>
        <DELETED>    ``(5) Administering voluntary mental health and 
        substance use disorder screenings and assessments.</DELETED>
        <DELETED>    ``(6) Supporting the training of students, 
        faculty, and staff to respond effectively to students with 
        mental health and substance use disorders.</DELETED>
        <DELETED>    ``(7) Creating a network infrastructure to link 
        colleges and universities with health care providers who treat 
        mental health and substance use disorders.'';</DELETED>
        <DELETED>    (4) in subsection (c)(5), by striking ``substance 
        abuse'' and inserting ``substance use disorder'';</DELETED>
        <DELETED>    (5) in subsection (d)--</DELETED>
                <DELETED>    (A) in the matter preceding paragraph (1), 
                by striking ``An institution of higher education 
                desiring a grant under this section'' and inserting 
                ``To be eligible to receive a grant under this section, 
                an institution of higher education'';</DELETED>
                <DELETED>    (B) in paragraph (1)--</DELETED>
                        <DELETED>    (i) by striking ``and behavioral 
                        health'' and inserting ``health and substance 
                        use disorder''; and</DELETED>
                        <DELETED>    (ii) by inserting ``, including 
                        veterans whenever possible and appropriate,'' 
                        after ``students''; and</DELETED>
                <DELETED>    (C) in paragraph (2), by inserting ``, 
                which may include, as appropriate and in accordance 
                with subsection (b)(7), a plan to seek input from 
                relevant stakeholders in the community, including 
                appropriate public and private entities, in order to 
                carry out the program under the grant'' before the 
                period at the end;</DELETED>
        <DELETED>    (6) in subsection (e)(1), by striking ``and 
        behavioral health problems'' and inserting ``health and 
        substance use disorders'';</DELETED>
        <DELETED>    (7) in subsection (f)(2)--</DELETED>
                <DELETED>    (A) by striking ``and behavioral health'' 
                and inserting ``health and substance use disorder''; 
                and</DELETED>
                <DELETED>    (B) by striking ``suicide and substance 
                abuse'' and inserting ``suicide and substance use 
                disorders''; and</DELETED>
        <DELETED>    (8) in subsection (h), by striking ``$5,000,000 
        for fiscal year 2005'' and all that follows through the period 
        at the end and inserting ``$6,500,000 for each of fiscal years 
        2016 through 2020.''.</DELETED>

<DELETED>SEC. 3. MENTAL HEALTH AWARENESS TRAINING GRANTS.</DELETED>

<DELETED>    Section 520J of the Public Health Service Act (42 U.S.C. 
290bb-41) is amended--</DELETED>
        <DELETED>    (1) in the section heading, by inserting ``mental 
        health awareness'' before ``training''; and</DELETED>
        <DELETED>    (2) in subsection (b)--</DELETED>
                <DELETED>    (A) in the subsection heading, by striking 
                ``Illness'' and inserting ``Health'';</DELETED>
                <DELETED>    (B) in paragraph (1), by inserting ``and 
                other categories of individuals, as determined by the 
                Secretary,'' after ``emergency services 
                personnel'';</DELETED>
                <DELETED>    (C) in paragraph (5)--</DELETED>
                        <DELETED>    (i) in the matter preceding 
                        subparagraph (A), by striking ``to'' and 
                        inserting ``for evidence-based programs for the 
                        purpose of''; and</DELETED>
                        <DELETED>    (ii) by striking subparagraphs (A) 
                        through (C) and inserting the 
                        following:</DELETED>
                <DELETED>    ``(A) recognizing the signs and symptoms 
                of mental illness; and</DELETED>
                <DELETED>    ``(B)(i) providing education to personnel 
                regarding resources available in the community for 
                individuals with a mental illness and other relevant 
                resources; or</DELETED>
                <DELETED>    ``(ii) the safe de-escalation of crisis 
                situations involving individuals with a mental 
                illness.''; and</DELETED>
                <DELETED>    (D) in paragraph (7), by striking ``, 
                $25,000,000'' and all that follows through the period 
                at the end and inserting ``$15,000,000 for each of 
                fiscal years 2016 through 2020.''.</DELETED>

<DELETED>SEC. 4. CHILDREN'S RECOVERY FROM TRAUMA.</DELETED>

<DELETED>    Section 582 of the Public Health Service Act (42 U.S.C. 
290hh-1) is amended--</DELETED>
        <DELETED>    (1) in subsection (a), by striking ``developing 
        programs'' and all that follows through the period at the end 
        and inserting ``developing and maintaining programs that 
        provide for--</DELETED>
        <DELETED>    ``(1) the continued operation of the National 
        Child Traumatic Stress Initiative (referred to in this section 
        as the `NCTSI'), which includes a cooperative agreement with a 
        coordinating center, that focuses on the mental, behavioral, 
        and biological aspects of psychological trauma response, 
        prevention of the long-term consequences of child trauma, and 
        early intervention services and treatment to address the long-
        term consequences of child trauma; and</DELETED>
        <DELETED>    ``(2) the development of knowledge with regard to 
        evidence-based practices for identifying and treating mental, 
        behavioral, and biological disorders of children and youth 
        resulting from witnessing or experiencing a traumatic 
        event.'';</DELETED>
        <DELETED>    (2) in subsection (b)--</DELETED>
                <DELETED>    (A) by striking ``subsection (a) related'' 
                and inserting ``subsection (a)(2) (related'';</DELETED>
                <DELETED>    (B) by striking ``treating disorders 
                associated with psychological trauma'' and inserting 
                ``treating mental, behavioral, and biological disorders 
                associated with psychological trauma)''; and</DELETED>
                <DELETED>    (C) by striking ``mental health agencies 
                and programs that have established clinical and basic 
                research'' and inserting ``universities, hospitals, 
                mental health agencies, and other programs that have 
                established clinical expertise and 
                research'';</DELETED>
        <DELETED>    (3) by redesignating subsections (c) through (g) 
        as subsections (g) through (k), respectively;</DELETED>
        <DELETED>    (4) by inserting after subsection (b), the 
        following:</DELETED>
<DELETED>    ``(c) Child Outcome Data.--The NCTSI coordinating center 
shall collect, analyze, and report NCTSI-wide child treatment process 
and outcome data regarding the early identification and delivery of 
evidence-based treatment and services for children and families served 
by the NCTSI grantees.</DELETED>
<DELETED>    ``(d) Training.--The NCTSI coordinating center shall 
facilitate the coordination of training initiatives in evidence-based 
and trauma-informed treatments, interventions, and practices offered to 
NCTSI grantees, providers, and partners.</DELETED>
<DELETED>    ``(e) Dissemination and Collaboration.--The NCTSI 
coordinating center shall, as appropriate, collaborate with--</DELETED>
        <DELETED>    ``(1) the Secretary, in the dissemination of 
        evidence-based and trauma-informed interventions, treatments, 
        products, and other resources to appropriate stakeholders; 
        and</DELETED>
        <DELETED>    ``(2) appropriate agencies that conduct or fund 
        research within the Department of Health and Human Services, 
        for purposes of sharing NCTSI expertise, evaluation data, and 
        other activities, as appropriate.</DELETED>
<DELETED>    ``(f) Review.--The Secretary shall, consistent with the 
peer review process, ensure that NCTSI applications are reviewed by 
appropriate experts in the field as part of a consensus review process. 
The Secretary shall include review criteria related to expertise and 
experience in child trauma and evidence-based practices.'';</DELETED>
        <DELETED>    (5) in subsection (g) (as so redesignated), by 
        striking ``with respect to centers of excellence are 
        distributed equitably among the regions of the country'' and 
        inserting ``are distributed equitably among the regions of the 
        United States'';</DELETED>
        <DELETED>    (6) in subsection (i) (as so redesignated), by 
        striking ``recipient may not exceed 5 years'' and inserting 
        ``recipient shall not be less than 4 years, but shall not 
        exceed 5 years''; and</DELETED>
        <DELETED>    (7) in subsection (j) (as so redesignated), by 
        striking ``$50,000,000'' and all that follows through ``2006'' 
        and inserting ``$46,000,000 for each of fiscal years 2016 
        through 2020''.</DELETED>

<DELETED>SEC. 5. ASSESSING BARRIERS TO BEHAVIORAL HEALTH 
              INTEGRATION.</DELETED>

<DELETED>    (a) In General.--Not later than 2 years after the date of 
enactment of this Act, the Comptroller General of the United States 
shall submit a report to the Committee on Health, Education, Labor, and 
Pensions of the Senate and the Committee on Energy and Commerce of the 
House of Representatives concerning Federal requirements that impact 
access to treatment of mental health and substance use disorders 
related to integration with primary care, administrative and regulatory 
issues, quality measurement and accountability, and data 
sharing.</DELETED>
<DELETED>    (b) Contents.--The report submitted under subsection (a) 
shall include the following:</DELETED>
        <DELETED>    (1) An evaluation of the administrative or 
        regulatory burden on behavioral health care 
        providers.</DELETED>
        <DELETED>    (2) The identification of outcome and quality 
        measures relevant to integrated health care, evaluation of the 
        data collection burden on behavioral health care providers, and 
        any alternative methods for evaluation.</DELETED>
        <DELETED>    (3) An analysis of the degree to which electronic 
        data standards, including interoperability and meaningful use 
        includes behavioral health measures, and an analysis of 
        strategies to address barriers to health information exchange 
        posed by part 2 of title 42, Code of Federal 
        Regulations.</DELETED>
        <DELETED>    (4) An analysis of the degree to which Federal 
        rules and regulations for behavioral and physical health care 
        are aligned, including recommendations to address any 
        identified barriers.</DELETED>

<DELETED>SEC. 6. INCREASING EDUCATION AND AWARENESS OF TREATMENTS FOR 
              OPIOID USE DISORDERS.</DELETED>

<DELETED>    (a) In General.--In order to improve the quality of care 
delivery and treatment outcomes among patients with opioid use 
disorders, the Secretary of Health and Human Services (referred to in 
this section as the ``Secretary''), acting through the Administrator 
for the Substance Abuse and Mental Health Services Administration, may 
advance, through existing programs as appropriate, the education and 
awareness of providers, patients, and other appropriate stakeholders 
regarding all products approved by the Food and Drug Administration to 
treat opioid use disorders.</DELETED>
<DELETED>    (b) Activities.--The activities described in subsection 
(a) may include--</DELETED>
        <DELETED>    (1) disseminating evidence-based practices for the 
        treatment of opioid use disorders;</DELETED>
        <DELETED>    (2) facilitating continuing education programs for 
        health professionals involved in treating opioid use 
        disorders;</DELETED>
        <DELETED>    (3) increasing awareness among relevant 
        stakeholders of the treatment of opioid use 
        disorders;</DELETED>
        <DELETED>    (4) assessing current barriers to the treatment of 
        opioid use disorders for patients and providers and development 
        and implementation of strategies to mitigate such barriers; 
        and</DELETED>
        <DELETED>    (5) continuing innovative approaches to the 
        treatment of opioid use disorders in various treatment 
        settings, such as prisons, community mental health centers, 
        primary care, and hospitals.</DELETED>
<DELETED>    (c) Report.--Not later than 1 year after the date of 
enactment of this Act, if the Secretary carries out the activities 
under this section, the Secretary shall submit to the Committee on 
Health, Education, Labor, and Pensions of the Senate and the Committee 
on Energy and Commerce of the House of Representatives a report that 
examines--</DELETED>
        <DELETED>    (1) the activities the Substance Abuse and Mental 
        Health Services Administration conducts under this section, 
        including any potential impacts on health care costs associated 
        with such activities;</DELETED>
        <DELETED>    (2) the role of adherence in the treatment of 
        opioid use disorders and methods to reduce opioid use 
        disorders; and</DELETED>
        <DELETED>    (3) recommendations on priorities and strategies 
        to address co-occurring substance use disorders and mental 
        illnesses.</DELETED>

<DELETED>SEC. 7. EXAMINING MENTAL HEALTH CARE FOR CHILDREN.</DELETED>

<DELETED>    (a) In General.--Not later than 1 year after the date of 
enactment of this Act, the Comptroller General of the United States 
shall conduct an independent evaluation, and submit to the Committee on 
Health, Education, Labor, and Pensions of the Senate and the Committee 
on Energy and Commerce of the House of Representatives, a report 
concerning the utilization of mental health services for children, 
including the usage of psychotropic medications.</DELETED>
<DELETED>    (b) Content.--The report submitted under subsection (a) 
shall review and assess--</DELETED>
        <DELETED>    (1) the ways in which children access mental 
        health care, including information on whether children are 
        treated by primary care or specialty providers, what types of 
        referrals for additional care are recommended, and any barriers 
        to accessing this care;</DELETED>
        <DELETED>    (2) the extent to which children are prescribed 
        psychotropic medications in the United States including the 
        frequency of concurrent medication usage; and</DELETED>
        <DELETED>    (3) the tools, assessments, and medications that 
        are available and used to diagnose and treat children with 
        mental health disorders.</DELETED>

<DELETED>SEC. 8. EVIDENCE-BASED PRACTICES FOR OLDER ADULTS.</DELETED>

<DELETED>    Section 520A(e) of the Public Health Service Act (42 
U.S.C. 290bb-32(e)) is amended by adding at the end the 
following:</DELETED>
        <DELETED>    ``(3) Geriatric mental health disorders.--The 
        Secretary shall, as appropriate, provide technical assistance 
        to grantees regarding evidence-based practices for the 
        prevention and treatment of geriatric mental health disorders 
        and co-occurring mental health and substance use disorders 
        among geriatric populations, as well as disseminate information 
        about such evidence-based practices to States and nongrantees 
        throughout the United States.''.</DELETED>

<DELETED>SEC. 9. NATIONAL VIOLENT DEATH REPORTING SYSTEM.</DELETED>

<DELETED>    The Secretary of Health and Human Services, acting through 
the Director of the Centers for Disease Control and Prevention, is 
encouraged to improve, particularly through the inclusion of additional 
States, the National Violent Death Reporting System as authorized by 
title III of the Public Health Service Act (42 U.S.C. 241 et seq.). 
Participation in the system by the States shall be voluntary.</DELETED>

<DELETED>SEC. 10. GAO STUDY ON VIRGINIA TECH RECOMMENDATIONS.</DELETED>

<DELETED>    (a) In General.--Not later than 1 year after the date of 
enactment of this Act, the Comptroller General of the United States 
shall conduct an independent evaluation, and submit to the appropriate 
committees of Congress a report concerning the status of implementation 
of recommendations made in the report to the President, On Issues 
Raised by the Virginia Tech Tragedy, by the Secretaries of Health and 
Human Services and Education and the Attorney General of the United 
States, submitted to the President on June 13, 2007.</DELETED>
<DELETED>    (b) Content.--The report submitted to the committees of 
Congress under subsection (a) shall review and assess--</DELETED>
        <DELETED>    (1) the extent to which the recommendations in the 
        report that include participation by the Department of Health 
        and Human Services were implemented;</DELETED>
        <DELETED>    (2) whether there are any barriers to 
        implementation of such recommendations; and</DELETED>
        <DELETED>    (3) identification of any additional actions the 
        Federal Government can take to support States and local 
        communities and ensure that the Federal Government and Federal 
        law are not obstacles to addressing at the community level--
        </DELETED>
                <DELETED>    (A) school violence; and</DELETED>
                <DELETED>    (B) mental illness.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the Mental Health Awareness and 
Improvement Act of 2015.

SEC. 2. GARRETT LEE SMITH MEMORIAL ACT REAUTHORIZATION.

    (a) Suicide Prevention Technical Assistance Center.--Section 520C 
of the Public Health Service Act (42 U.S.C. 290bb-34) is amended--
            (1) in the section heading, by striking the section heading 
        and inserting ``suicide prevention technical assistance 
        center.'';
            (2) in subsection (a), by striking ``and in consultation 
        with'' and all that follows through the period at the end of 
        paragraph (2) and inserting ``shall establish a research, 
        training, and technical assistance resource center to provide 
        appropriate information, training, and technical assistance to 
        States, political subdivisions of States, federally recognized 
        Indian tribes, tribal organizations, institutions of higher 
        education, public organizations, or private nonprofit 
        organizations regarding the prevention of suicide among all 
        ages, particularly among groups that are at high risk for 
        suicide.'';
            (3) by striking subsections (b) and (c);
            (4) by redesignating subsection (d) as subsection (b);
            (5) in subsection (b), as so redesignated--
                    (A) by striking the subsection heading and 
                inserting ``Responsibilities of the Center.'';
                    (B) in the matter preceding paragraph (1), by 
                striking ``The additional research'' and all that 
                follows through ``nonprofit organizations for'' and 
                inserting ``The center established under subsection (a) 
                shall conduct activities for the purpose of'';
                    (C) by striking ``youth suicide'' each place such 
                term appears and inserting ``suicide'';
                    (D) in paragraph (1)--
                            (i) by striking ``the development or 
                        continuation of'' and inserting ``developing 
                        and continuing''; and
                            (ii) by inserting ``for all ages, 
                        particularly among groups that are at high risk 
                        for suicide'' before the semicolon at the end;
                    (E) in paragraph (2), by inserting ``for all ages, 
                particularly among groups that are at high risk for 
                suicide'' before the semicolon at the end;
                    (F) in paragraph (3), by inserting ``and tribal'' 
                after ``statewide'';
                    (G) in paragraph (5), by inserting ``and 
                prevention'' after ``intervention'';
                    (H) in paragraph (8), by striking ``in youth'';
                    (I) in paragraph (9), by striking ``and behavioral 
                health'' and inserting ``health and substance use 
                disorder''; and
                    (J) in paragraph (10), by inserting ``conducting'' 
                before ``other''; and
            (6) by striking subsection (e) and inserting the following:
    ``(c) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $6,000,000 
for each of fiscal years 2016 through 2020.''.
    (b) Youth Suicide Early Intervention and Prevention Strategies.--
Section 520E of the Public Health Service Act (42 U.S.C. 290bb-36) is 
amended--
            (1) in paragraph (1) of subsection (a) and in subsection 
        (c), by striking ``substance abuse'' each place such term 
        appears and inserting ``substance use disorder'';
            (2) in subsection (b)(2)--
                    (A) by striking ``each State is awarded only 1 
                grant or cooperative agreement under this section'' and 
                inserting ``a State does not receive more than 1 grant 
                or cooperative agreement under this section at any 1 
                time''; and
                    (B) by striking ``been awarded'' and inserting 
                ``received''; and
            (3) by striking subsection (m) and inserting the following:
    ``(m) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $23,500,000 
for each of fiscal years 2016 through 2020.''.
    (c) Mental Health and Substance Use Disorder Services.--Section 
520E-2 of the Public Health Service Act (42 U.S.C. 290bb-36b) is 
amended--
            (1) in the section heading, by striking ``and behavioral 
        health'' and inserting ``health and substance use disorder'';
            (2) in subsection (a)--
                    (A) by striking ``Services,'' and inserting 
                ``Services and'';
                    (B) by striking ``and behavioral health problems'' 
                and inserting ``health or substance use disorders''; 
                and
                    (C) by striking ``substance abuse'' and inserting 
                ``substance use disorders'';
            (3) in subsection (b)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``for--'' and inserting ``for one or more of 
                the following:''; and
                    (B) by striking paragraphs (1) through (6) and 
                inserting the following:
            ``(1) Educating students, families, faculty, and staff to 
        increase awareness of mental health and substance use 
        disorders.
            ``(2) The operation of hotlines.
            ``(3) Preparing informational material.
            ``(4) Providing outreach services to notify students about 
        available mental health and substance use disorder services.
            ``(5) Administering voluntary mental health and substance 
        use disorder screenings and assessments.
            ``(6) Supporting the training of students, faculty, and 
        staff to respond effectively to students with mental health and 
        substance use disorders.
            ``(7) Creating a network infrastructure to link colleges 
        and universities with health care providers who treat mental 
        health and substance use disorders.'';
            (4) in subsection (c)(5), by striking ``substance abuse'' 
        and inserting ``substance use disorder'';
            (5) in subsection (d)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``An institution of higher education desiring 
                a grant under this section'' and inserting ``To be 
                eligible to receive a grant under this section, an 
                institution of higher education'';
                    (B) in paragraph (1)--
                            (i) by striking ``and behavioral health'' 
                        and inserting ``health and substance use 
                        disorder''; and
                            (ii) by inserting ``, including veterans 
                        whenever possible and appropriate,'' after 
                        ``students''; and
                    (C) in paragraph (2), by inserting ``, which may 
                include, as appropriate and in accordance with 
                subsection (b)(7), a plan to seek input from relevant 
                stakeholders in the community, including appropriate 
                public and private entities, in order to carry out the 
                program under the grant'' before the period at the end;
            (6) in subsection (e)(1), by striking ``and behavioral 
        health problems'' and inserting ``health and substance use 
        disorders'';
            (7) in subsection (f)(2)--
                    (A) by striking ``and behavioral health'' and 
                inserting ``health and substance use disorder''; and
                    (B) by striking ``suicide and substance abuse'' and 
                inserting ``suicide and substance use disorders''; and
            (8) in subsection (h), by striking ``$5,000,000 for fiscal 
        year 2005'' and all that follows through the period at the end 
        and inserting ``$6,500,000 for each of fiscal years 2016 
        through 2020.''.

SEC. 3. MENTAL HEALTH AWARENESS TRAINING GRANTS.

    Section 520J of the Public Health Service Act (42 U.S.C. 290bb-41) 
is amended--
            (1) in the section heading, by inserting ``mental health 
        awareness'' before ``training''; and
            (2) in subsection (b)--
                    (A) in the subsection heading, by striking 
                ``Illness'' and inserting ``Health'';
                    (B) in paragraph (1), by inserting ``and other 
                categories of individuals, as determined by the 
                Secretary,'' after ``emergency services personnel'';
                    (C) in paragraph (5)--
                            (i) in the matter preceding subparagraph 
                        (A), by striking ``to'' and inserting ``for 
                        evidence-based programs for the purpose of''; 
                        and
                            (ii) by striking subparagraphs (A) through 
                        (C) and inserting the following:
                    ``(A) recognizing the signs and symptoms of mental 
                illness; and
                    ``(B)(i) providing education to personnel regarding 
                resources available in the community for individuals 
                with a mental illness and other relevant resources; or
                    ``(ii) the safe de-escalation of crisis situations 
                involving individuals with a mental illness.''; and
                    (D) in paragraph (7), by striking ``, $25,000,000'' 
                and all that follows through the period at the end and 
                inserting ``$15,000,000 for each of fiscal years 2016 
                through 2020.''.

SEC. 4. CHILDREN'S RECOVERY FROM TRAUMA.

    Section 582 of the Public Health Service Act (42 U.S.C. 290hh-1) is 
amended--
            (1) in subsection (a), by striking ``developing programs'' 
        and all that follows through the period at the end and 
        inserting ``developing and maintaining programs that provide 
        for--
            ``(1) the continued operation of the National Child 
        Traumatic Stress Initiative (referred to in this section as the 
        `NCTSI'), which includes a cooperative agreement with a 
        coordinating center, that focuses on the mental, behavioral, 
        and biological aspects of psychological trauma response, 
        prevention of the long-term consequences of child trauma, and 
        early intervention services and treatment to address the long-
        term consequences of child trauma; and
            ``(2) the development of knowledge with regard to evidence-
        based practices for identifying and treating mental, 
        behavioral, and biological disorders of children and youth 
        resulting from witnessing or experiencing a traumatic event.'';
            (2) in subsection (b)--
                    (A) by striking ``subsection (a) related'' and 
                inserting ``subsection (a)(2) (related'';
                    (B) by striking ``treating disorders associated 
                with psychological trauma'' and inserting ``treating 
                mental, behavioral, and biological disorders associated 
                with psychological trauma)''; and
                    (C) by striking ``mental health agencies and 
                programs that have established clinical and basic 
                research'' and inserting ``universities, hospitals, 
                mental health agencies, and other programs that have 
                established clinical expertise and research'';
            (3) by redesignating subsections (c) through (g) as 
        subsections (g) through (k), respectively;
            (4) by inserting after subsection (b), the following:
    ``(c) Child Outcome Data.--The NCTSI coordinating center shall 
collect, analyze, and report NCTSI-wide child treatment process and 
outcome data regarding the early identification and delivery of 
evidence-based treatment and services for children and families served 
by the NCTSI grantees.
    ``(d) Training.--The NCTSI coordinating center shall facilitate the 
coordination of training initiatives in evidence-based and trauma-
informed treatments, interventions, and practices offered to NCTSI 
grantees, providers, and partners.
    ``(e) Dissemination and Collaboration.--The NCTSI coordinating 
center shall, as appropriate, collaborate with--
            ``(1) the Secretary, in the dissemination of evidence-based 
        and trauma-informed interventions, treatments, products, and 
        other resources to appropriate stakeholders; and
            ``(2) appropriate agencies that conduct or fund research 
        within the Department of Health and Human Services, for 
        purposes of sharing NCTSI expertise, evaluation data, and other 
        activities, as appropriate.
    ``(f) Review.--The Secretary shall, consistent with the peer review 
process, ensure that NCTSI applications are reviewed by appropriate 
experts in the field as part of a consensus review process. The 
Secretary shall include review criteria related to expertise and 
experience in child trauma and evidence-based practices.'';
            (5) in subsection (g) (as so redesignated), by striking 
        ``with respect to centers of excellence are distributed 
        equitably among the regions of the country'' and inserting 
        ``are distributed equitably among the regions of the United 
        States'';
            (6) in subsection (i) (as so redesignated), by striking 
        ``recipient may not exceed 5 years'' and inserting ``recipient 
        shall not be less than 4 years, but shall not exceed 5 years''; 
        and
            (7) in subsection (j) (as so redesignated), by striking 
        ``$50,000,000'' and all that follows through ``2006'' and 
        inserting ``$46,000,000 for each of fiscal years 2016 through 
        2020''.

SEC. 5. ASSESSING BARRIERS TO BEHAVIORAL HEALTH INTEGRATION.

    (a) In General.--Not later than 2 years after the date of enactment 
of this Act, the Comptroller General of the United States shall submit 
a report to the Committee on Health, Education, Labor, and Pensions of 
the Senate and the Committee on Energy and Commerce of the House of 
Representatives concerning Federal requirements that impact access to 
treatment of mental health and substance use disorders related to 
integration with primary care, administrative and regulatory issues, 
quality measurement and accountability, and data sharing.
    (b) Contents.--The report submitted under subsection (a) shall 
include the following:
            (1) An evaluation of the administrative or regulatory 
        burden on behavioral health care providers.
            (2) The identification of outcome and quality measures 
        relevant to integrated health care, evaluation of the data 
        collection burden on behavioral health care providers, and any 
        alternative methods for evaluation.
            (3) An analysis of the degree to which electronic data 
        standards, including interoperability and meaningful use 
        includes behavioral health measures, and an analysis of 
        strategies to address barriers to health information exchange 
        posed by part 2 of title 42, Code of Federal Regulations.
            (4) An analysis of the degree to which Federal rules and 
        regulations for behavioral and physical health care are 
        aligned, including recommendations to address any identified 
        barriers.
            (5) An analysis of the challenges to behavioral health and 
        primary care integration faced by providers in rural areas.

SEC. 6. INCREASING EDUCATION AND AWARENESS OF TREATMENTS FOR OPIOID USE 
              DISORDERS.

    (a) In General.--In order to improve the quality of care delivery 
and treatment outcomes among patients with opioid use disorders, the 
Secretary of Health and Human Services (referred to in this section as 
the ``Secretary''), acting through the Administrator for the Substance 
Abuse and Mental Health Services Administration, may advance, through 
existing programs as appropriate, the education and awareness of 
providers, patients, and other appropriate stakeholders regarding all 
products approved by the Food and Drug Administration to treat opioid 
use disorders.
    (b) Activities.--The activities described in subsection (a) may 
include--
            (1) disseminating evidence-based practices for the 
        treatment of opioid use disorders;
            (2) facilitating continuing education programs for health 
        professionals involved in treating opioid use disorders;
            (3) increasing awareness among relevant stakeholders of the 
        treatment of opioid use disorders;
            (4) assessing current barriers to the treatment of opioid 
        use disorders for patients and providers and development and 
        implementation of strategies to mitigate such barriers; and
            (5) continuing innovative approaches to the treatment of 
        opioid use disorders in various treatment settings, such as 
        prisons, community mental health centers, primary care, and 
        hospitals.
    (c) Report.--Not later than 1 year after the date of enactment of 
this Act, if the Secretary carries out the activities under this 
section, the Secretary shall submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives a report that 
examines--
            (1) the activities the Substance Abuse and Mental Health 
        Services Administration conducts under this section, including 
        any potential impacts on health care costs associated with such 
        activities;
            (2) the role of adherence in the treatment of opioid use 
        disorders and methods to reduce opioid use disorders; and
            (3) recommendations on priorities and strategies to address 
        co-occurring substance use disorders and mental illnesses.

SEC. 7. EXAMINING MENTAL HEALTH CARE FOR CHILDREN.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Comptroller General of the United States shall conduct 
an independent evaluation, and submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives, a report 
concerning the utilization of mental health services for children, 
including the usage of psychotropic medications.
    (b) Content.--The report submitted under subsection (a) shall 
review and assess--
            (1) the ways in which children access mental health care, 
        including information on whether children are treated by 
        primary care or specialty providers, what types of referrals 
        for additional care are recommended, and any barriers to 
        accessing this care;
            (2) the extent to which children are prescribed 
        psychotropic medications in the United States including the 
        frequency of concurrent medication usage; and
            (3) the tools, assessments, and medications that are 
        available and used to diagnose and treat children with mental 
        health disorders.

SEC. 8. EVIDENCE BASED PRACTICES FOR OLDER ADULTS.

    Section 520A(e) of the Public Health Service Act (42 U.S.C. 290bb-
32(e)) is amended by adding at the end the following:
            ``(3) Geriatric mental health disorders.--The Secretary 
        shall, as appropriate, provide technical assistance to grantees 
        regarding evidence-based practices for the prevention and 
        treatment of geriatric mental health disorders and co-occurring 
        mental health and substance use disorders among geriatric 
        populations, as well as disseminate information about such 
        evidence-based practices to States and nongrantees throughout 
        the United States.''.

SEC. 9. NATIONAL VIOLENT DEATH REPORTING SYSTEM.

    The Secretary of Health and Human Services, acting through the 
Director of the Centers for Disease Control and Prevention, is 
encouraged to improve, particularly through the inclusion of additional 
States, the National Violent Death Reporting System as authorized by 
title III of the Public Health Service Act (42 U.S.C. 241 et seq.). 
Participation in the system by the States shall be voluntary.

SEC. 10. GAO STUDY ON VIRGINIA TECH RECOMMENDATIONS.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Comptroller General of the United States shall conduct 
an independent evaluation, and submit to the appropriate committees of 
Congress a report concerning the status of implementation of 
recommendations made in the report to the President, On Issues Raised 
by the Virginia Tech Tragedy, by the Secretaries of Health and Human 
Services and Education and the Attorney General of the United States, 
submitted to the President on June 13, 2007.
    (b) Content.--The report submitted to the committees of Congress 
under subsection (a) shall review and assess--
            (1) the extent to which the recommendations in the report 
        that include participation by the Department of Health and 
        Human Services were implemented;
            (2) whether there are any barriers to implementation of 
        such recommendations; and
            (3) identification of any additional actions the Federal 
        government can take to support States and local communities and 
        ensure that the Federal government and Federal law are not 
        obstacles to addressing at the community level--
                    (A) school violence; and
                    (B) mental illness.
                                                       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
```