I 

114TH CONGRESS 

2D SESSION H. R. 5327 

To reauthorize and improve programs related to mental health and substance 

use disorders. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 25, 2016 

Ms. KUSTER (for herself and Mr. MOONEY of West Virginia) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To reauthorize and improve programs related to mental 

health and substance use disorders. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Mental Health Aware5 ness and Improvement Act of 2016’’. 

6 SEC. 2. GARRETT LEE SMITH MEMORIAL ACT REAUTHOR7 IZATION. 

8 (a) SUICIDE PREVENTION TECHNICAL ASSISTANCE

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

10 (42 U.S.C. 290bb–34) is amended— 


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

3 TECHNICAL ASSISTANCE CENTER.’’; 

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

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

15 are at high risk for suicide.’’; 

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

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

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

20 (A) by striking the subsection heading and 

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

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

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

25 that follows through ‘‘nonprofit organizations 


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1 for’’ and inserting ‘‘The center established 

2 under subsection (a) shall conduct activities for 

3 the purpose of’’; 

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

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

6 (D) in paragraph (1)— 

7 (i) by striking ‘‘the development or 

8 continuation of’’ and inserting ‘‘developing 

9 and continuing’’; and 

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

12 for suicide’’ before the semicolon at the 

13 end; 

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

15 ages, particularly among groups that are at 

16 high risk for suicide’’ before the semicolon at 

17 the end; 

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

19 tribal’’ after ‘‘statewide’’; 

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

21 prevention’’ after ‘‘intervention’’; 

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

23 youth’’; 


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

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

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

7 following: 

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

9 purpose of carrying out this section, there are authorized 

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

11 2016 through 2020. 

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

13 the date of enactment of this subsection, the Secretary 

14 shall submit to Congress a report on the activities carried 

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

16 the year involved, including the potential impacts of such 

17 activities, and the States, organizations, and institutions 

18 that have worked with the center.’’. 

19 (b) YOUTH SUICIDE EARLY INTERVENTION AND

20 PREVENTION STRATEGIES.—Section 520E of the Public 

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

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

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

24 place such term appears and inserting ‘‘substance 

25 use disorder’’; 


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1 (2) in subsection (b)(2)— 

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

3 only 1 grant or cooperative agreement under 

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

5 receive more than 1 grant or cooperative agree6 ment under this section at any 1 time’’; and 

7 (B) by striking ‘‘been awarded’’ and insert8 ing ‘‘received’’; 

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

10 after the date of enactment of this section,’’ and in11 sert ‘‘2 years after the date of enactment of the 

12 Mental Health Awareness and Improvement Act of 

13 2015,’’; and 

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

15 following: 

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

17 the purpose of carrying out this section, there are author18 ized to be appropriated $30,000,000 for each of fiscal 

19 years 2016 through 2020.’’. 

20 (c) MENTAL HEALTH AND SUBSTANCE USE DIS21 ORDER SERVICES.—Section 520E–2 of the Public Health 

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

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

24 BEHAVIORAL HEALTH’’ and inserting ‘‘HEALTH

25 AND SUBSTANCE USE DISORDER’’; 


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1 (2) in subsection (a)— 

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

3 ‘‘Services and’’; 

4 (B) by striking ‘‘and behavioral health 

5 problems’’ and inserting ‘‘health or substance 

6 use disorders’’; and 

7 (C) by striking ‘‘substance abuse’’ and in8 serting ‘‘substance use disorders’’; 

9 (3) in subsection (b)— 

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

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

12 more of the following:’’; and 

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

14 and inserting the following: 

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

16 staff to increase awareness of mental health and 

17 substance use disorders. 

18 ‘‘(2) The operation of hotlines. 

19 ‘‘(3) Preparing informational material. 

20 ‘‘(4) Providing outreach services to notify stu21 dents about available mental health and substance 

22 use disorder services. 

23 ‘‘(5) Administering voluntary mental health and 

24 substance use disorder screenings and assessments. 


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1 ‘‘(6) Supporting the training of students, fac2 ulty, and staff to respond effectively to students with 

3 mental health and substance use disorders. 

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

5 colleges and universities with health care providers 

6 who treat mental health and substance use dis7 orders.’’; 

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

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

10 (5) in subsection (d)— 

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

12 by striking ‘‘An institution of higher education 

13 desiring a grant under this section’’ and insert14 ing ‘‘To be eligible to receive a grant under this 

15 section, an institution of higher education’’; 

16 (B) in paragraph (1)— 

17 (i) by striking ‘‘and behavioral 

18 health’’ and inserting ‘‘health and sub19 stance use disorder’’; and 

20 (ii) by inserting ‘‘, including veterans 

21 whenever possible and appropriate,’’ after 

22 ‘‘students’’; and 

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

24 may include, as appropriate and in accordance 

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


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1 from relevant stakeholders in the community, 

2 including appropriate public and private enti3 ties, in order to carry out the program under 

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

5 (6) in subsection (e)(1), by striking ‘‘and behav6 ioral health problems’’ and inserting ‘‘health and 

7 substance use disorders’’; 

8 (7) in subsection (f)(2)— 

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

10 and inserting ‘‘health and substance use dis11 order’’; and 

12 (B) by striking ‘‘suicide and substance 

13 abuse’’ and inserting ‘‘suicide and substance 

14 use disorders’’; and 

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

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

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

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

19 SEC. 3. MENTAL HEALTH AWARENESS TRAINING GRANTS. 

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

21 U.S.C. 290bb–41) is amended— 

22 (1) in the section heading, by inserting ‘‘MEN23 TAL HEALTH AWARENESS’’ before ‘‘TRAINING’’; 

24 and 

25 (2) in subsection (b)— 


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1 (A) in the subsection heading, by striking 

2 ‘‘ILLNESS’’ and inserting ‘‘HEALTH’’; 

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

4 other categories of individuals, as determined 

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

6 personnel’’; 

7 (C) in paragraph (5)— 

8 (i) in the matter preceding subpara9 graph (A), by striking ‘‘to’’ and inserting 

10 ‘‘for evidence-based programs for the pur11 pose of’’; and 

12 (ii) by striking subparagraphs (A) 

13 through (C) and inserting the following: 

14 ‘‘(A) recognizing the signs and symptoms 

15 of mental illness; and 

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

17 regarding resources available in the community 

18 for individuals with a mental illness and other 

19 relevant resources; or 

20 ‘‘(ii) the safe de-escalation of crisis situa21 tions involving individuals with a mental ill22 ness.’’; and 

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

24 $25,000,000’’ and all that follows through the 


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

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

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

4 Section 582 of the Public Health Service Act (42 

5 U.S.C. 290hh–1) is amended— 

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

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

8 the end and inserting ‘‘developing and maintaining 

9 programs that provide for— 

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

11 Child Traumatic Stress Initiative (referred to in this 

12 section as the ‘NCTSI’), which includes a coopera13 tive agreement with a coordinating center, that fo14 cuses on the mental, behavioral, and biological as15 pects of psychological trauma response, prevention 

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

17 early intervention services and treatment to address 

18 the long-term consequences of child trauma; and 

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

20 to evidence-based practices for identifying and treat21 ing mental, behavioral, and biological disorders of 

22 children and youth resulting from witnessing or ex23 periencing a traumatic event.’’; 

24 (2) in subsection (b)— 


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

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

3 (B) by striking ‘‘treating disorders associ4 ated with psychological trauma’’ and inserting 

5 ‘‘treating mental, behavioral, and biological dis6 orders associated with psychological trauma)’’; 

7 and 

8 (C) by striking ‘‘mental health agencies 

9 and programs that have established clinical and 

10 basic research’’ and inserting ‘‘universities, hos11 pitals, mental health agencies, and other pro12 grams that have established clinical expertise 

13 and research’’; 

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

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

16 (4) by inserting after subsection (b), the fol17 lowing: 

18 ‘‘(c) CHILD OUTCOME DATA.—The NCTSI coordi19 nating center shall collect, analyze, and report NCTSI20 wide child treatment process and outcome data regarding 

21 the early identification and delivery of evidence-based 

22 treatment and services for children and families served by 

23 the NCTSI grantees. 

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

25 shall facilitate the coordination of training initiatives in 


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1 evidence-based and trauma-informed treatments, interven2 tions, and practices offered to NCTSI grantees, providers, 

3 and partners. 

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

5 NCTSI coordinating center shall, as appropriate, collabo6 rate with— 

7 ‘‘(1) the Secretary, in the dissemination of evi8 dence-based and trauma-informed interventions, 

9 treatments, products, and other resources to appro10 priate stakeholders; and 

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

12 research within the Department of Health and 

13 Human Services, for purposes of sharing NCTSI ex14 pertise, evaluation data, and other activities, as ap15 propriate. 

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

17 the peer review process, ensure that NCTSI applications 

18 are reviewed by appropriate experts in the field as part 

19 of a consensus review process. The Secretary shall include 

20 review criteria related to expertise and experience in child 

21 trauma and evidence-based practices.’’; 

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

23 striking ‘‘with respect to centers of excellence are 

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1 try’’ and inserting ‘‘are distributed equitably among 

2 the regions of the United States’’; 

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

4 striking ‘‘recipient may not exceed 5 years’’ and in5 serting ‘‘recipient shall not be less than 4 years, but 

6 shall not exceed 5 years’’; and 

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

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

9 ‘‘2006’’ and inserting ‘‘$46,000,000 for each of fis10 cal years 2016 through 2020’’. 

11 SEC. 5. ASSESSING BARRIERS TO BEHAVIORAL HEALTH IN12 TEGRATION. 

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

14 date of enactment of this Act, the Comptroller General 

15 of the United States shall submit a report to the Com16 mittee on Health, Education, Labor, and Pensions of the 

17 Senate and the Committee on Energy and Commerce of 

18 the House of Representatives concerning Federal require19 ments that impact access to treatment of mental health 

20 and substance use disorders related to integration with 

21 primary care, administrative and regulatory issues, quality 

22 measurement and accountability, and data sharing. 

23 (b) CONTENTS.—The report submitted under sub24 section (a) shall include the following: 


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1 (1) An evaluation of the administrative or regu2 latory burden on behavioral health care providers. 

3 (2) The identification of outcome and quality 

4 measures relevant to integrated health care, evalua5 tion of the data collection burden on behavioral 

6 health care providers, and any alternative methods 

7 for evaluation. 

8 (3) An analysis of the degree to which elec9 tronic data standards, including interoperability and 

10 meaningful use includes behavioral health measures, 

11 and an analysis of strategies to address barriers to 

12 health information exchange posed by part 2 of title 

13 42, Code of Federal Regulations. 

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

15 rules and regulations for behavioral and physical 

16 health care are aligned, including recommendations 

17 to address any identified barriers. 

18 (5) An analysis of the challenges to behavioral 

19 health and primary care integration faced by pro20 viders in rural areas. 

21 SEC. 6. INCREASING EDUCATION AND AWARENESS OF 

22 TREATMENTS FOR OPIOID USE DISORDERS. 

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

24 of care delivery and treatment outcomes among patients 

25 with opioid use disorders, the Secretary of Health and 


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1 Human Services (referred to in this section as the ‘‘Sec2 retary’’), acting through the Administrator for the Sub3 stance Abuse and Mental Health Services Administration, 

4 may advance, through existing programs as appropriate, 

5 the education and awareness of providers, patients, and 

6 other appropriate stakeholders regarding all products ap7 proved by the Food and Drug Administration to treat 

8 opioid use disorders. 

9 (b) ACTIVITIES.—The activities described in sub10 section (a) may include— 

11 (1) disseminating evidence-based practices for 

12 the treatment of opioid use disorders; 

13 (2) facilitating continuing education programs 

14 for health professionals involved in treating opioid 

15 use disorders; 

16 (3) increasing awareness among relevant stake17 holders of the treatment of opioid use disorders; 

18 (4) assessing current barriers to the treatment 

19 of opioid use disorders for patients and providers 

20 and development and implementation of strategies to 

21 mitigate such barriers; and 

22 (5) continuing innovative approaches to the 

23 treatment of opioid use disorders in various treat24 ment settings, such as prisons, community mental 

25 health centers, primary care, and hospitals. 


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

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

3 activities under this section, the Secretary shall submit to 

4 the Committee on Health, Education, Labor, and Pen5 sions of the Senate and the Committee on Energy and 

6 Commerce of the House of Representatives a report that 

7 examines— 

8 (1) the activities the Substance Abuse and Men9 tal Health Services Administration conducts under 

10 this section, including any potential impacts on 

11 health care costs associated with such activities; 

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

13 opioid use disorders and methods to reduce opioid 

14 use disorders; and 

15 (3) recommendations on priorities and strate16 gies to address co-occurring substance use disorders 

17 and mental illnesses. 

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

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

20 date of enactment of this Act, the Comptroller General 

21 of the United States shall conduct an independent evalua22 tion, and submit to the Committee on Health, Education, 

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

24 Energy and Commerce of the House of Representatives, 

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1 ices for children, including the usage of psychotropic medi2 cations. 

3 (b) CONTENT.—The report submitted under sub4 section (a) shall review and assess— 

5 (1) the ways in which children access mental 

6 health care, including information on whether chil7 dren are treated by primary care or specialty pro8 viders, what types of referrals for additional care are 

9 recommended, and any barriers to accessing this 

10 care; 

11 (2) the extent to which children are prescribed 

12 psychotropic medications in the United States in13 cluding the frequency of concurrent medication 

14 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 DIS23 ORDERS.—The Secretary shall, as appropriate, pro24 vide technical assistance to grantees regarding evi25 dence-based practices for the prevention and treatVerDate Sep 11 2014 22:14 May 27, 2016 Jkt 059200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\H5327.IH H5327

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1 ment of geriatric mental health disorders and co-oc2 curring mental health and substance use disorders 

3 among geriatric populations, as well as disseminate 

4 information about such evidence-based practices to 

5 States and nongrantees throughout the United 

6 States.’’. 

7 SEC. 9. NATIONAL VIOLENT DEATH REPORTING SYSTEM. 

8 The Secretary of Health and Human Services, acting 

9 through the Director of the Centers for Disease Control 

10 and Prevention, is encouraged to improve, particularly 

11 through the inclusion of additional States, the National 

12 Violent Death Reporting System as authorized by title III 

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

14 Participation in the system by the States shall be vol15 untary. 

16 SEC. 10. GAO STUDY ON VIRGINIA TECH RECOMMENDA17 TIONS. 

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

19 date of enactment of this Act, the Comptroller General 

20 of the United States shall conduct an independent evalua21 tion, and submit to the appropriate committees of Con22 gress a report, concerning the status of implementation 

23 of recommendations made in the report to the President, 

24 On Issues Raised by the Virginia Tech Tragedy, by the 

25 Secretaries of Health and Human Services and Education 


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1 and the Attorney General of the United States, submitted 

2 to the President on June 13, 2007. 

3 (b) CONTENT.—The report submitted to the commit4 tees of Congress under subsection (a) shall review and as5 sess— 

6 (1) the extent to which the recommendations in 

7 the report that include participation by the Depart8 ment of Health and Human Services were imple9 mented; 

10 (2) whether there are any barriers to implemen11 tation of such recommendations; and 

12 (3) identification of any additional actions the 

13 Federal Government can take to support States and 

14 local communities and ensure that the Federal Gov15 ernment and Federal law are not obstacles to ad16 dressing at the community level— 

17 (A) school violence; and 

18 (B) mental illness. 

19 SEC. 11. PERFORMANCE METRICS. 

20 (a) EVALUATION OF CURRENT PROGRAMS.— 

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

22 after the date of enactment of this Act, the Assist23 ant Secretary for Planning and Evaluation of the 

24 Department of Health and Human Services shall 

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1 lated to the prevention and treatment of mental ill2 ness and substance use disorders conducted by the 

3 Substance Abuse and Mental Health Services Ad4 ministration. 

5 (2) ASSESSMENT OF PERFORMANCE

6 METRICS.—The evaluation conducted under para7 graph (1) shall include an assessment of the use of 

8 performance metrics to evaluate activities carried 

9 out by entities receiving grants, contracts, or cooper10 ative agreements related to mental illness or sub11 stance use disorders under title V or title XIX of the 

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

13 42 U.S.C. 300w et seq.). 

14 (3) RECOMMENDATIONS.—The evaluation con15 ducted under paragraph (1) shall include rec16 ommendations for the use of performance metrics to 

17 improve the quality of programs related to the pre18 vention and treatment of mental illness and sub19 stance use disorders. 

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

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

22 Secretary of Health and Human Services, acting through 

23 the Administrator of the Substance Abuse and Mental 

24 Health Services Administration, shall advance, through 

25 existing programs, the use of performance metrics, taking 


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1 into consideration the recommendations under subsection 

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

3 treatment of mental illness and substance use disorders. 

Æ 


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