I 

111TH CONGRESS 

2D SESSION H. R. 5466 

To amend titles V and XIX of the Public Health Service Act to revise 

and extend substance use disorder and mental health programs, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 28, 2010 

Mr. KENNEDY (for himself and Mr. GENE GREEN of Texas) introduced the 

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

A BILL 

To amend titles V and XIX of the Public Health Service 

Act to revise and extend substance use disorder and 

mental health programs, and for other purposes. 

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘SAMHSA Modernization Act of 2010’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of 

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Amendments to title V of the Public Health Service Act. 

Sec. 3. Amendments to title XIX of the Public Health Service Act. 

Sec. 4. Repeal. 


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Sec. 5. Amendments to the Protection and Advocacy for Individuals with Mental Illness Act. 

Sec. 6. Study of the distribution of funds under the Substance Abuse Prevention and treatment block grant and the community Mental 

Health Services block grant. 

Sec. 7. Task force on behavioral and mental health in medical education. 

Sec. 8. Council on Integration of Health Care Education. 

1 SEC. 2. AMENDMENTS TO TITLE V OF THE PUBLIC HEALTH 

2 SERVICE ACT. 

3 (a) IN GENERAL.—Title V of the Public Health Serv4 ice Act (42 U.S.C. 290aa et seq.), except for the second 

5 part G (41 U.S.C. 290kk et seq.), is amended to read as 

6 follows: 

7 ‘‘TITLE V—SUBSTANCE ABUSE 

8 AND MENTAL HEALTH SERV9 ICES ADMINISTRATION 

10 ‘‘PART A—ORGANIZATION AND GENERAL 

11 AUTHORITIES 

12 ‘‘SEC. 501. SUBSTANCE ABUSE AND MENTAL HEALTH SERV13 ICES ADMINISTRATION. 

14 ‘‘(a) ESTABLISHMENT.—The Substance Abuse and 

15 Mental Health Services Administration (hereafter referred 

16 to in this title as the ‘Administration’) is an agency of 

17 the Service. 

18 ‘‘(b) AGENCIES.—The following entities are agencies 

19 of the Administration: 

20 ‘‘(1) The Center for Substance Abuse Treat21 ment. 


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1 ‘‘(2) The Center for Substance Abuse Preven2 tion. 

3 ‘‘(3) The Center for Mental Health Services. 

4 ‘‘(c) ADMINISTRATOR AND DEPUTY ADMINIS5 TRATOR.— 

6 ‘‘(1) ADMINISTRATOR.—The Administration 

7 shall be headed by an Administrator (hereinafter in 

8 this title referred to as the ‘Administrator’) who 

9 shall be appointed by the President, by and with the 

10 advice and consent of the Senate. 

11 ‘‘(2) DEPUTY ADMINISTRATOR.—The Adminis12 trator, with the approval of the Secretary, may ap13 point a Deputy Administrator and may employ and 

14 prescribe the functions of such officers and employ15 ees, including attorneys, as are necessary to admin16 ister the activities to be carried out through the Ad17 ministration. 

18 ‘‘(d) AUTHORITIES.—The Secretary, acting through 

19 the Administrator, shall— 

20 ‘‘(1) supervise the functions of the centers of 

21 the Administration in order to assure that the pro22 grams carried out through each such center receive 

23 appropriate and equitable support and that there is 

24 cooperation among the centers in the implementa25 tion of such programs; 


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1 ‘‘(2) establish and implement, through the re2 spective centers, a comprehensive program to im3 prove the provision of treatment and related services 

4 to individuals with respect to substance use dis5 orders and mental illness and to improve substance 

6 use disorder prevention services, promote mental 

7 health and protect the legal rights of individuals 

8 with mental illness or substance use disorders; 

9 ‘‘(3) carry out the administrative and financial 

10 management, policy development and planning, eval11 uation, knowledge dissemination, and public infor12 mation functions that are required for the implemen13 tation of this title; 

14 ‘‘(4) assure that the Administration conduct 

15 and coordinate demonstration projects, evaluations, 

16 and service system assessments and other activities 

17 necessary to improve the availability and quality of 

18 prevention, treatment, and related services that re19 flect the needs and preferences of individuals with 

20 mental illness or substance use disorders and their 

21 families; 

22 ‘‘(5) support activities that will improve the 

23 provision of treatment, prevention and related serv24 ices, including the development of national mental 


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1 health and substance use disorder goals and model 

2 programs; 

3 ‘‘(6) in cooperation with the National Institutes 

4 of Health, the Centers for Disease Control and Pre5 vention, and the Health Resources and Services Ad6 ministration develop educational materials and inter7 vention strategies to reduce the risks of HIV, hepa8 titis C, sexually transmitted diseases, tuberculosis, 

9 and other communicable diseases among individuals 

10 with mental illness or substance use disorders and to 

11 develop appropriate mental health and substance use 

12 disorder services for individuals with such illnesses; 

13 ‘‘(7) coordinate Federal policy with respect to 

14 the provision of treatment services for substance use 

15 disorders utilizing anti-addiction medications, includ16 ing the certification of opioid treatment programs 

17 and monitoring compliance with requirements estab18 lished in regulations, including the authority to mon19 itor and inspect programs to ensure quality service 

20 and to suspend and revoke such certifications; 

21 ‘‘(8) conduct programs, and assure the coordi22 nation of such programs with activities of the Na23 tional Institutes of Health and the Agency for 

24 Healthcare Research and Quality, as appropriate, to 

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1 pact of prevention and treatment services and sys2 tems of care in order to identify the manner in 

3 which such services can most effectively be provided; 

4 ‘‘(9) collaborate with the Director of the Na5 tional Institutes of Health in the development of a 

6 system by which the relevant research findings of 

7 the National Institute on Drug Abuse, the National 

8 Institute on Alcohol Abuse and Alcoholism, the Na9 tional Institute of Mental Health, and, as appro10 priate, the Agency for Healthcare Research and 

11 Quality are disseminated to service providers in a 

12 manner designed to improve the delivery and effec13 tiveness of treatment and prevention services; 

14 ‘‘(10) encourage public and private entities that 

15 provide health insurance to provide benefits for sub16 stance use disorder and mental health services; 

17 ‘‘(11) promote the integration of substance use 

18 disorder and mental health services into the main19 stream of the health care delivery system of the 

20 United States; 

21 ‘‘(12) monitor compliance by hospitals and 

22 other facilities with the requirements of sections 562 

23 and 563; 

24 ‘‘(13) with respect to grant programs author25 ized under this title and part B of title XIX— 


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1 ‘‘(A) require that all grants that are 

2 awarded for the provision of services are subject 

3 to performance and outcome evaluations using 

4 the performance measures developed in accord5 ance with section 504(b); 

6 ‘‘(B) require that all grants that are 

7 awarded to entities other than States are 

8 awarded only after the State in which the entity 

9 intends to provide services— 

10 ‘‘(i) is notified of the pendency of the 

11 grant application; and 

12 ‘‘(ii) is afforded an opportunity to 

13 comment on the merits of the application; 

14 and 

15 ‘‘(C) inform the State when funds are 

16 awarded to entities within the State; 

17 ‘‘(14) assure that services provided with 

18 amounts appropriated under this title are culturally 

19 and linguistically appropriate; 

20 ‘‘(15) improve coordination among prevention 

21 programs, treatment facilities and nonhealth care 

22 systems such as employers, labor unions, and 

23 schools, and encourage the adoption of employee as24 sistance programs and student assistance programs; 


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1 ‘‘(16) maintain a clearinghouse for substance 

2 use disorder and mental health information to as3 sure the widespread dissemination of such informa4 tion to States, political subdivisions, educational 

5 agencies and institutions, treatment providers, and 

6 the general public; 

7 ‘‘(17) in collaboration with the National Insti8 tute on Aging, and in consultation with the National 

9 Institute on Drug Abuse, the National Institute on 

10 Alcohol Abuse and Alcoholism and the National In11 stitute of Mental Health, as appropriate, promote 

12 and evaluate mental health and substance use dis13 order services for older Americans in need of such 

14 services; 

15 ‘‘(18) promote the coordination of service pro16 grams conducted by other departments, agencies, or17 ganizations and individuals that are or may be re18 lated to the problems of individuals suffering from 

19 mental illness or substance use disorders, including 

20 liaisons with the Social Security Administration, 

21 Centers for Medicare & Medicaid Services, and other 

22 programs of the Department, as well as liaisons with 

23 the Department of Education, Department of Jus24 tice, and other Federal Departments and offices, as 

25 appropriate; 


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1 ‘‘(19) collaborate with the Secretary of Defense 

2 and the Secretary of Veterans Affairs to improve the 

3 provision of mental health and substance use dis4 order services provided by the Department of De5 fense and the Department of Veterans Affairs to 

6 veterans and their families (including members of 

7 the national guard and military reserve components 

8 who have served in active duty and their families), 

9 including through the provision of services using the 

10 telehealth capabilities of the Department of Veterans 

11 Affairs; 

12 ‘‘(20) in coordination with the Assistant Sec13 retary for Preparedness and Response of the De14 partment of Health and Human Services, the Ad15 ministrator of the Federal Emergency Management 

16 Agency, and the Director of the Centers for Disease 

17 Control and Prevention, work with States to estab18 lish mental health and substance use disorder emer19 gency response plans and assist in incorporating 

20 such plans into State emergency response plans in 

21 preparation for possible emergencies or major disas22 ters; 

23 ‘‘(21) in coordination with the Secretary of 

24 Education and the Secretary of Homeland Security, 

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1 tal health and substance use disorder emergency re2 sponse plans and incorporate such plans into overall 

3 institutional emergency response plans; 

4 ‘‘(22) work with the Health Resources and 

5 Services Administration and the Centers for Disease 

6 Control and Prevention on integrating mental health 

7 and substance use disorder promotion with general 

8 health promotion and disease prevention; 

9 ‘‘(23) collaborate with Federal departments and 

10 programs that are part of the President’s Inter11 agency Council on Homelessness, particularly the 

12 Department of Housing and Urban Development, 

13 the Department of Labor, and the Department of 

14 Veterans Affairs, and with other agencies within the 

15 Department of Health and Human Services, particu16 larly the Health Resources and Services Administra17 tion, the Administration on Children and Families, 

18 and the Centers for Medicare & Medicaid Services, 

19 to design national strategies for providing services in 

20 supportive housing that will assist in ending chronic 

21 homelessness and to implement programs that ad22 dress chronic homelessness; 

23 ‘‘(24) work with States and other stakeholders 

24 to develop and support activities to recruit and re25 tain a mental health and substance use disorders 


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1 workforce that is qualified to provide mental health 

2 or substance use disorder prevention and treatment 

3 services in the public sector, which may include fel4 lowships, internships, and encouraging efforts to 

5 identify essential skills and abilities for non-degreed 

6 and bachelor degreed direct care staff, community 

7 leaders, and individuals in recovery and their fami8 lies; and 

9 ‘‘(25) ensure that parents receiving services 

10 from a program authorized under this title or under 

11 part B of title XIX, receive referral for evaluation 

12 for early intervention under part C of the Individ13 uals with Disabilities Education Improvement Act. 

14 ‘‘(e) ASSOCIATE ADMINISTRATOR FOR ALCOHOL

15 PREVENTION AND TREATMENT POLICY.— 

16 ‘‘(1) IN GENERAL.—There may be in the Ad17 ministration an Associate Administrator for Alcohol 

18 Prevention and Treatment Policy to whom the Ad19 ministrator may delegate the function of promoting 

20 and coordinating activities related to the prevention 

21 and reduction of underage drinking, as well as pro22 moting, monitoring, and evaluating service programs 

23 for the prevention and treatment of alcoholism and 

24 alcohol abuse within the Center for Substance Abuse 

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1 ment and the Center for Mental Health Services, 

2 and coordinating such programs among the Centers, 

3 and among the Centers and other public and private 

4 entities. The Associate Administrator also may en5 sure that alcohol prevention, education, and policy 

6 strategies are integrated into all programs of the 

7 Centers that address substance use disorder preven8 tion, education, and policy, and that the Center for 

9 Substance Abuse Prevention addresses the Healthy 

10 People 2010 goals and the National Dietary Guide11 lines of the Department of Health and Human Serv12 ices and the Department of Agriculture related to al13 cohol consumption. 

14 ‘‘(2) PLAN.—The Administrator, acting 

15 through the Associate Administrator for Alcohol 

16 Prevention and Treatment Policy, shall develop, and 

17 periodically review and as appropriate revise, a plan 

18 for programs and policies to treat and prevent alco19 holism and alcohol abuse. The plan shall be devel20 oped (and reviewed and revised) in collaboration 

21 with the Directors of the Centers of the Administra22 tion and in consultation with members of other Fed23 eral agencies and public and private entities. 

24 ‘‘(3) REPORT.— 


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1 ‘‘(A) IN GENERAL.—Not less than once 

2 during each 2-year period, the Administrator, 

3 acting through the Associate Administrator for 

4 Alcohol Prevention and Treatment Policy, shall 

5 prepare a report describing the alcoholism and 

6 alcohol abuse prevention and treatment pro7 grams undertaken by the Administration and 

8 its agencies particularly those focusing on un9 derage drinking, and the report shall include a 

10 detailed statement of the expenditures made for 

11 the activities reported on and the personnel 

12 used in connection with such activities. 

13 ‘‘(B) REVISIONS.—Each report under sub14 paragraph (A) shall include a description of any 

15 revisions in the plan under paragraph (2) made 

16 during the preceding 2 years. 

17 ‘‘(f) ASSOCIATE ADMINISTRATOR FOR WOMEN’S

18 SERVICES.— 

19 ‘‘(1) APPOINTMENT.—The Administrator, with 

20 the approval of the Secretary, shall appoint an Asso21 ciate Administrator for Women’s Services. 

22 ‘‘(2) DUTIES.—The Associate Administrator 

23 appointed under paragraph (1) shall— 

24 ‘‘(A) establish a committee to be known as 

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1 ices (hereafter in this subparagraph referred to 

2 as the ‘Coordinating Committee’), which shall 

3 be composed of the Directors of the agencies of 

4 the Administration (or the designees of the Di5 rectors); 

6 ‘‘(B) acting through the Coordinating 

7 Committee, with respect to women’s substance 

8 use disorders and mental health services— 

9 ‘‘(i) identify the need for such serv10 ices, and make an estimate each fiscal year 

11 of the funds needed to adequately support 

12 the services; 

13 ‘‘(ii) identify needs regarding the co14 ordination of services; 

15 ‘‘(iii) encourage the agencies of the 

16 Administration to support such services; 

17 ‘‘(iv) assure that the unique needs of 

18 minority women, including Native Amer19 ican, Alaskan Native, Hispanic, African20 American and Asian women, are recog21 nized and addressed within the activities of 

22 the Administration; 

23 ‘‘(v) recognize the distinct condition of 

24 maternal addiction and the specific needs 

25 that pregnant and parenting women and 


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1 their children present to treatment ap2 proaches and interventions; and 

3 ‘‘(vi) explore the relationship between 

4 sexual violence, trauma, and maternal ad5 diction in order to effectively respond to 

6 the distinct pathways to addiction for preg7 nant and parenting women; 

8 ‘‘(C) establish an advisory committee to be 

9 known as the Advisory Committee for Women’s 

10 Services, which shall be composed of not more 

11 than 10 individuals, a majority of whom shall 

12 be women, who are not officers or employees of 

13 the Federal Government, to be appointed by the 

14 Administrator from among physicians, practi15 tioners, treatment providers, prevention special16 ists, and other health professionals, whose clin17 ical practice, specialization, or professional ex18 pertise includes a significant focus on women’s 

19 substance use disorders and mental health con20 ditions, that shall— 

21 ‘‘(i) advise the Associate Adminis22 trator on appropriate activities to be un23 dertaken by the agencies of the Adminis24 tration with respect to women’s substance 

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1 cluding services which require a multidisci2 plinary approach; 

3 ‘‘(ii) collect and review data, including 

4 information provided by the Secretary, and 

5 report biannually to the Administrator re6 garding the extent to which women are 

7 represented among senior personnel, and 

8 make recommendations regarding improve9 ment in the participation of women in the 

10 workforce of the Administration; and 

11 ‘‘(iii) prepare a description of activi12 ties of the Committee, including findings 

13 made by the Committee regarding— 

14 ‘‘(I) the extent of expenditures 

15 made for substance use disorder and 

16 mental health services for women and 

17 pregnant and parenting women by the 

18 Administration; and 

19 ‘‘(II) the estimated level of fund20 ing needed for substance use disorder 

21 and mental health services to meet the 

22 needs of women and pregnant and 

23 parenting women; 

24 ‘‘(D) improve the collection of data on 

25 women’s health by— 


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1 ‘‘(i) reviewing the current data at the 

2 Administration to determine its uniformity 

3 and applicability; 

4 ‘‘(ii) developing standards for all pro5 grams funded by the Administration so 

6 that data are, to the extent practicable, 

7 collected and reported using common re8 porting formats, linkages and definitions; 

9 and 

10 ‘‘(iii) reporting to the Administrator a 

11 plan for incorporating the standards devel12 oped under clause (ii) in all Administration 

13 programs and a plan to assure that the 

14 data so collected are accessible to health 

15 professionals, providers, researchers, and 

16 members of the public; and 

17 ‘‘(E) shall establish, maintain, and operate 

18 a program to provide information on women’s 

19 substance use disorder and mental health serv20 ices. 

21 ‘‘(3) DEFINITION.—For purposes of this sub22 section, the term ‘women’s substance use disorder 

23 and mental health conditions’, with respect to 

24 women of all age, ethnic, and racial groups, means 


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1 all aspects of substance use disorders and mental ill2 ness— 

3 ‘‘(A) unique to or that directly affects 

4 women; or 

5 ‘‘(B) with respect to which there have been 

6 insufficient services involving women or insuffi7 cient data. 

8 ‘‘(g) ASSOCIATE ADMINISTRATOR FOR OLDER ADULT

9 SERVICES.— 

10 ‘‘(1) APPOINTMENT.—The Administrator, with 

11 the consent of the Secretary, shall appoint an indi12 vidual to serve as the Associate Administrator of 

13 Older Adult Services. 

14 ‘‘(2) DUTIES.—The Associate Administrator 

15 appointed under paragraph (1) shall act as the lead 

16 staff for the coordination, promotion, and moni17 toring of— 

18 ‘‘(A) services research on the prevention 

19 and identification of mental health and sub20 stance use disorders in the older adult popu21 lation, including the risk of suicide; 

22 ‘‘(B) innovative projects for the delivery of 

23 community-based mental health and substance 

24 use disorder services for older adults, including 


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1 senior suicide prevention and the integration of 

2 mental health services in primary care settings; 

3 ‘‘(C) support for the development and dis4 semination of evidence-based practice models, 

5 including models to address mental health and 

6 substance-related disorders in older adults, in7 cluding the risk of suicide; 

8 ‘‘(D) the development of model training 

9 programs for mental health and substance use 

10 disorder professionals and caregivers serving 

11 older adults; and 

12 ‘‘(E) other activities, as designated by the 

13 Administrator, to improve the mental health 

14 and substance use disorders of older adults. 

15 ‘‘(h) SERVICES OF EXPERTS.— 

16 ‘‘(1) IN GENERAL.—The Administrator may ob17 tain (in accordance with section 3109 of title 5, 

18 United States Code, but without regard to the limi19 tation in such section on the number of days or the 

20 period of service) the services of not more than 20 

21 experts or consultants who have professional quali22 fications. Such experts and consultants shall be ob23 tained for the Administration and for each of its 

24 centers. 

25 ‘‘(2) COMPENSATION AND EXPENSES.— 


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1 ‘‘(A) IN GENERAL.—Experts and consult2 ants whose services are obtained under para3 graph (1) shall be paid or reimbursed for their 

4 expenses associated with traveling to and from 

5 their assignment location in accordance with 

6 sections 5724, 5724a(a), 5724a(c), and 5726(c) 

7 of title 5, United States Code. 

8 ‘‘(B) LIMITATIONS.—Expenses specified in 

9 subparagraph (A) may not be allowed in con10 nection with the assignment of an expert or 

11 consultant whose services are obtained under 

12 paragraph (1), unless and until the expert or 

13 consultant agrees in writing to complete the en14 tire period of assignment or one year, whichever 

15 is shorter, unless separated or reassigned for 

16 reasons beyond the control of the expert or con17 sultant that are acceptable to the Secretary. If 

18 the expert or consultant violates the agreement, 

19 the money spent by the United States for the 

20 expenses specified in subparagraph (A) is recov21 erable from the expert or consultant as a debt 

22 of the United States. The Secretary may waive 

23 in whole or in part a right of recovery under 

24 this subparagraph. 


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1 ‘‘(i) PEER REVIEW GROUPS.—The Administrator 

2 shall, without regard to the provisions of title 5, United 

3 States Code, governing appointments in the competitive 

4 service, and without regard to the provisions of chapter 

5 51 and subchapter III of chapter 53 of such title, relating 

6 to classification and General Schedule pay rates, establish 

7 such peer review groups and program advisory committees 

8 as are needed to carry out the requirements of this title 

9 and appoint and pay members of such groups, except that 

10 officers and employees of the United States shall not re11 ceive additional compensation for services as members of 

12 such groups. The Federal Advisory Committee Act shall 

13 not apply to the duration of a peer review group appointed 

14 under this subsection. 

15 ‘‘(j) VOLUNTARY SERVICES.—The Administrator 

16 may accept voluntary and uncompensated services. 

17 ‘‘(k) ADMINISTRATION.—The Administrator shall en18 sure that programs and activities assigned under this title 

19 to the Administration are fully administered by the respec20 tive Centers to which such programs and activities are as21 signed. 

22 ‘‘(l) REPORT CONCERNING ACTIVITIES AND

23 PROGRESS.—Not later than 2 years after the date of en24 actment of the SAMHSA Modernization Act of 2010, and 

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1 pare and submit to the Committee on Energy and Com2 merce and the Committee on Appropriations of the House 

3 of Representatives, and to the Committee on Health, Edu4 cation, Labor, and Pensions and the Committee on Appro5 priations of the Senate, the report containing, at a min6 imum— 

7 ‘‘(1) the development and assessment of popu8 lation-based indicators of mental health and sub9 stance use disorders for the United States and the 

10 progress made in addressing gaps in services and 

11 improving outcomes by the Administration and by 

12 other public health agencies; 

13 ‘‘(2) a description of the activities carried out 

14 by the Administration to improve the availability 

15 and quality of the mental health and substance use 

16 disorder prevention and treatment services; 

17 ‘‘(3) an assessment of the success of programs 

18 funded under this title and part B of title XIX in 

19 meeting the goals of the program using the meas20 ures of performance developed in accordance with 

21 section 504(b); and 

22 ‘‘(4) a description of the manner in which the 

23 Administration engages in partnerships with other 

24 Federal agencies and promotes coordination by 


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1 grantees under this title and part B of title XIX 

2 with other State or local agencies. 

3 ‘‘(m) APPLICATIONS FOR GRANTS AND CON4 TRACTS.— 

5 ‘‘(1) IN GENERAL.—With respect to awards of 

6 grants, cooperative agreements, and contracts under 

7 this title or other statutory authority of the Admin8 istration, the Administrator, or the Director of the 

9 Center involved, as the case may be, may not make 

10 such an award unless— 

11 ‘‘(A) an application for the award is sub12 mitted to the official involved; 

13 ‘‘(B) with respect to carrying out the pur14 pose for which the award is to be provided, the 

15 application provides assurances of compliance 

16 with the requirements of the grant, cooperative 

17 agreement, or contract satisfactory to such offi18 cial; and 

19 ‘‘(C) the application is otherwise in such 

20 form, is made in such manner, and contains 

21 such agreements, assurances, and information 

22 as the official determines to be necessary to 

23 carry out the purpose for which the award is to 

24 be provided. 


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1 ‘‘(2) CONSIDERATION OF RELIGION IN EMPLOY2 MENT DECISIONS.—With respect to any activity to 

3 be funded (in whole or in part) through an award 

4 of a grant, cooperative agreement, or contract under 

5 this title or any other statutory authority of the Ad6 ministration, the Administrator, or the Director of 

7 the Center involved, as the case may be, may not 

8 make such an award unless the applicant agrees to 

9 refrain from considering religion or any profession of 

10 faith when making any employment decision regard11 ing an individual who is or will be assigned to carry 

12 out any portion of the activity. This paragraph ap13 plies notwithstanding any other provision of Federal 

14 law, including any exemption otherwise applicable to 

15 a religious corporation, association, educational in16 stitution, or society. 

17 ‘‘(n) EMERGENCY RESPONSE.— 

18 ‘‘(1) IN GENERAL.—Notwithstanding section 

19 504 and except as provided in paragraph (2), the 

20 Secretary may use not to exceed 2.5 percent of all 

21 amounts appropriated under this title for a fiscal 

22 year to make noncompetitive grants, contracts or co23 operative agreements to public entities to enable 

24 such entities to address emergency substance use 


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1 disorder or mental health needs in local commu2 nities. 

3 ‘‘(2) EXCEPTIONS.—Amounts appropriated 

4 under part C shall not be subject to paragraph (1). 

5 ‘‘(3) EMERGENCIES.—The Secretary shall es6 tablish criteria for determining that a substance use 

7 disorder or mental health emergency exists and pub8 lish such criteria in the Federal Register prior to 

9 providing funds under this subsection. 

10 ‘‘(o) LIMITATION ON THE USE OF CERTAIN INFOR11 MATION.—No information, if an establishment or person 

12 supplying the information or described in it is identifiable, 

13 obtained in the course of activities undertaken or sup14 ported under section 504 may be used for any purpose 

15 other than the purpose for which it was supplied unless 

16 such establishment or person has consented (as deter17 mined under regulations of the Secretary) to its use for 

18 such other purpose. Such information may not be pub19 lished or released in other form if the person who supplied 

20 the information or who is described in it is identifiable 

21 unless such person has consented (as determined under 

22 regulations of the Secretary) to its publication or release 

23 in other form. 

24 ‘‘(p) JOINT FUNDING OF PROJECTS.— 

25 ‘‘(1) IN GENERAL.— 


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1 ‘‘(A) AUTHORITY.—The Administrator is 

2 authorized to enter into arrangements with 

3 other Federal agencies to jointly carry out 

4 projects of common interest, to transfer to such 

5 agencies funds appropriated under any applica6 ble program under this title, and to receive and 

7 use funds from such, for projects of common in8 terest. 

9 ‘‘(B) USE.—Funds transferred or received 

10 pursuant to subparagraph (A) shall be used 

11 only for purposes for which such funds were ap12 propriated and shall be made available by con13 tract or grant only to recipients eligible to re14 ceive such funds under such laws. 

15 ‘‘(C) APPLICATION OF PROCEDURES.—If 

16 the Administrator enters into an arrangement 

17 under this subsection for the administration of 

18 a project, the Federal agency administering the 

19 project shall use such agency’s procedures to 

20 award contracts or grants and to administer 

21 such awards, unless the parties to the arrange22 ment specify the use of procedures of another 

23 agency that is a party to the arrangement. 

24 ‘‘(D) CRITERIA.—If the Administrator has 

25 entered into an arrangement authorized under 


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1 this paragraph and the Secretary and the heads 

2 of the other Federal agencies participating in 

3 the arrangement determine that joint funding is 

4 necessary to address a special need consistent 

5 with the purposes and authorized activities of 

6 each program that provides funding under the 

7 joint project, the Administrator and the heads 

8 of the other participating agencies may develop 

9 a single set of criteria for the jointly funded 

10 project and require each applicant for such 

11 project to submit a single application for review 

12 by the participating agencies. 

13 ‘‘(2) JOINT APPLICATIONS.—The Administrator 

14 may develop the criteria for, and require the submis15 sion of, joint applications under 2 or more applicable 

16 programs under which funds are awarded on a com17 petitive basis, and may jointly review and approve 

18 such applications separately from other applications 

19 under such programs, where the Secretary deter20 mines that such joint awards are necessary to ad21 dress a special need consistent with the purposes 

22 and authorized activities of each such program. Any 

23 applicant for such a joint award shall meet the eligi24 bility requirements of each such program. 


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1 ‘‘(3) LIMITATIONS ON JOINT FUNDING.—The 

2 Secretary may not construe the provisions of this 

3 subsection to take precedence over a limitation on 

4 joint funding contained in an applicable law. 

5 ‘‘(4) CONGRESSIONAL NOTICE.— 

6 ‘‘(A) IN GENERAL.—The Administrator 

7 shall provide notice to the Committee on En8 ergy and Commerce of the House of Represent9 atives and Committee on Health, Education, 

10 Labor, and Pensions of the Senate and the 

11 Subcommittee on Labor, Health and Human 

12 Services and Education of the Committee on 

13 Appropriations of the House of Representatives 

14 and the Subcommittee on Labor, Health and 

15 Human Services and Education of the Com16 mittee on Appropriations of the Senate of each 

17 joint funding agreement made with other Fed18 eral agencies under this subsection not later 

19 than 60 days after the making of such agree20 ments. 

21 ‘‘(B) REQUIREMENTS.—A notice under 

22 subparagraph (A) shall include— 

23 ‘‘(i) a description of the purpose and 

24 objectives of the joint funding arrange25 ment; 


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1 ‘‘(ii) the amounts and sources, by pro2 gram, of the funds dedicated to such ar3 rangement; and 

4 ‘‘(iii) the criteria developed to govern 

5 the award of contracts and grants. 

6 ‘‘(q) PUBLICATIONS.—The Secretary, without regard 

7 to section 501 of title 44, United States Code, shall 

8 promptly publish, make available in accessible formats, 

9 and disseminate widely, the results of research, dem10 onstration projects, and evaluations conducted or sup11 ported under this title. 

12 ‘‘(r) INTERNATIONAL.—For the purpose of advancing 

13 the status of the health sciences in the United States (and 

14 thereby the health of the American people), the Adminis15 trator may provide training and technical assistance to 

16 foreign countries or international organizations, and par17 ticipate with foreign countries or international organiza18 tions in cooperative endeavors in health care technology, 

19 health services research, and statistical activities related 

20 to substance use disorders and mental health, including 

21 participating and otherwise cooperating in any inter22 national meetings, conferences, or other activities con23 cerning with substance use disorders or mental health. 

24 ‘‘(s) DEFINITION.—In this title, the terms ‘emer25 gency’ and ‘major disaster’ have the meanings given such 


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1 terms in section 102 of the Robert T. Stafford Disaster 

2 Relief and Emergency Assistance Act. 

3 ‘‘(t) AUTHORIZATION OF APPROPRIATIONS.—For the 

4 purpose of providing grants, cooperative agreements, and 

5 contracts under this section, there are authorized to be 

6 appropriated $50,000,000 for fiscal year 2011, and such 

7 sums as may be necessary for each of the fiscal years 2012 

8 through 2015. 

9 ‘‘SEC. 502. ADVISORY COUNCILS. 

10 ‘‘(a) APPOINTMENT.— 

11 ‘‘(1) IN GENERAL.—The Secretary shall appoint 

12 an advisory council for— 

13 ‘‘(A) the Substance Abuse and Mental 

14 Health Services Administration; 

15 ‘‘(B) the Center for Substance Abuse 

16 Treatment; 

17 ‘‘(C) the Center for Substance Abuse Pre18 vention; and 

19 ‘‘(D) the Center for Mental Health Serv20 ices. 

21 Each such advisory council shall advise, consult 

22 with, and make recommendations to the Secretary 

23 and the Administrator or Director of the Adminis24 tration or Center for which the advisory council is 

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1 ties carried out by and through the Administration 

2 or Center and the policies respecting such activities. 

3 ‘‘(2) FUNCTION AND ACTIVITIES.—An advisory 

4 council— 

5 ‘‘(A) may on the basis of the materials 

6 provided by the organization respecting activi7 ties conducted at the organization, make rec8 ommendations to the Administrator or Director 

9 of the Administration or Center for which it 

10 was established respecting such activities; 

11 ‘‘(B) may collect, by correspondence or by 

12 personal investigation, information as to studies 

13 and services that are being carried on in the 

14 United States or any other country as to the 

15 diseases, disorders, or other aspects of human 

16 health with respect to which the organization 

17 was established and with the approval of the 

18 Administrator or Director, whichever is appro19 priate, make such information available through 

20 appropriate publications for the benefit of pub21 lic and private health entities and health profes22 sions personnel and for the information of the 

23 general public; and 

24 ‘‘(C) may appoint subcommittees and con25 vene workshops and conferences. 


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1 ‘‘(b) MEMBERSHIP.— 

2 ‘‘(1) IN GENERAL.—Each advisory council shall 

3 consist of nonvoting ex officio members and not 

4 more than 12 members to be appointed by the Sec5 retary under paragraph (3). 

6 ‘‘(2) EX OFFICIO MEMBERS.—The ex officio 

7 members of an advisory council shall consist of— 

8 ‘‘(A) the Secretary; 

9 ‘‘(B) the Administrator; 

10 ‘‘(C) the Director of the Center for which 

11 the council is established; 

12 ‘‘(D) the Under Secretary for Health of 

13 the Department of Veterans Affairs; 

14 ‘‘(E) the Assistant Secretary for Defense 

15 for Health Affairs (or the designates of such of16 ficers); and 

17 ‘‘(F) such additional officers or employees 

18 of the United States as the Secretary deter19 mines necessary for the advisory council to ef20 fectively carry out its functions. 

21 ‘‘(3) APPOINTED MEMBERS.—Individuals shall 

22 be appointed to an advisory council under paragraph 

23 (1) as follows: 

24 ‘‘(A) Nine of the members shall be ap25 pointed by the Secretary from among the leadVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00032 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 ing representatives of the health disciplines (in2 cluding public health and behavioral and social 

3 sciences and, as practicable, age-appropriate 

4 health experts) relevant to the activities of the 

5 Administration or Center for which the advisory 

6 council is established. 

7 ‘‘(B) Three of the members shall be ap8 pointed by the Secretary from the general pub9 lic (including an older adult or a member of 

10 their family), and shall include consumers and 

11 leaders in fields of public policy, public rela12 tions, law, health policy economics, or manage13 ment. 

14 ‘‘(C) The Secretary shall appoint a mem15 ber of the Women’s Advisory Council estab16 lished under section 501(f)(2)(C) to each of the 

17 advisory councils as a liaison between such 

18 councils and the Women’s Advisory Council. 

19 ‘‘(4) COMPENSATION.—Members of an advisory 

20 council who are officers or employees of the United 

21 States shall not receive any compensation for service 

22 on the advisory council. The remaining members of 

23 an advisory council shall receive, for each day (in24 cluding travel time) they are engaged in the per25 formance of the functions of the advisory council, 


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1 compensation at rates not to exceed the daily equiva2 lent to the annual rate in effect for Executive Level 

3 II. 

4 ‘‘(c) TERMS OF OFFICE.— 

5 ‘‘(1) IN GENERAL.—The term of office of a 

6 member of an advisory council appointed under sub7 section (b) shall be 4 years, except that any member 

8 appointed to fill a vacancy for an unexpired term 

9 shall serve for the remainder of such term. The Sec10 retary shall make appointments to an advisory coun11 cil in such a manner as to ensure that the terms of 

12 the members not all expire in the same year. A 

13 member of an advisory council may serve after the 

14 expiration of such member’s term until a successor 

15 has been appointed and taken office. 

16 ‘‘(2) REAPPOINTMENTS.—A member who has 

17 been appointed to an advisory council for a term of 

18 4 years may not be reappointed to an advisory coun19 cil during the 2-year period beginning on the date on 

20 which such 4-year term expired. 

21 ‘‘(3) TIME FOR APPOINTMENT.—If a vacancy 

22 occurs in an advisory council among the members 

23 under subsection (b), the Secretary shall make an 

24 appointment to fill such vacancy within 90 days 

25 from the date the vacancy occurs. 


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1 ‘‘(d) CHAIR.—The Secretary shall select a member 

2 of an advisory council to serve as the chair of the council. 

3 The Secretary may so select an individual from among the 

4 appointed members, or may select the Administrator or 

5 the Director of the Center involved. The term of office 

6 of the chair shall be 2 years unless the Secretary appoints 

7 the Administrator to serve as the chair. 

8 ‘‘(e) MEETINGS.—An advisory council shall meet at 

9 the call of the chairperson or upon the request of the Ad10 ministrator or Director of the Administration or Center 

11 for which the advisory council is established, but in no 

12 event less than 2 times during each fiscal year. The loca13 tion of the meetings of each advisory council shall be sub14 ject to the approval of the Administrator or Director of 

15 Administration or Center for which the council was estab16 lished. 

17 ‘‘(f) EXECUTIVE SECRETARY AND STAFF.—The Ad18 ministrator or Director of the Administration or Center 

19 for which the advisory council is established shall des20 ignate a member of the staff of the Administration or Cen21 ter for which the advisory council is established to serve 

22 as the Executive Secretary of the advisory council. The 

23 Administrator or Director shall make available to the advi24 sory council such staff, information, and other assistance 

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1 trator or Director shall provide orientation and training 

2 for new members of the advisory council to provide for 

3 their effective participation in the functions of the advisory 

4 council. 

5 ‘‘SEC. 503. PEER REVIEW. 

6 ‘‘(a) IN GENERAL.—The Secretary, after consulta7 tion with the Administrator, shall require appropriate peer 

8 review of grants, cooperative agreements, and contracts to 

9 be administered through the agency which exceed the sim10 ple acquisition threshold as defined in section 4(11) of the 

11 Office of Federal Procurement Policy Act. 

12 ‘‘(b) MEMBERS.—The members of any peer review 

13 group established under subsection (a) shall be individuals 

14 who by virtue of their training or experience are eminently 

15 qualified to perform the review functions of the group. Not 

16 more than one-fourth of the members of any such peer 

17 review group shall be officers or employees of the United 

18 States. 

19 ‘‘(c) CONDITIONS.—The Secretary may establish lim20 ited exceptions to the limitations contained in this section 

21 regarding participation of Federal employees. The cir22 cumstances under which the Secretary may make such an 

23 exception shall be made public. 

24 ‘‘SEC. 504. DATA COLLECTION. 

25 ‘‘(a) DATA.— 


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1 ‘‘(1) IN GENERAL.—The Secretary, acting 

2 through the Administrator, shall, at a minimum, col3 lect data each year— 

4 ‘‘(A) with respect to mental health, con5 cerning— 

6 ‘‘(i) the national incidence and preva7 lence of the various forms of mental illness 

8 and, in particular, the national incidence 

9 and prevalence of adults with serious men10 tal illness and children with serious emo11 tional disturbance (as such terms are de12 fined for purposes of section 1912); 

13 ‘‘(ii) the number and variety of public 

14 and nonprofit private treatment programs; 

15 ‘‘(iii) the number and demographic 

16 characteristics of individuals receiving 

17 treatment through such programs; 

18 ‘‘(iv) the type of care received by such 

19 individuals; 

20 ‘‘(v) the relationship between mental 

21 illness and physical diseases; and 

22 ‘‘(vi) such other issues as may be ap23 propriate; and 

24 ‘‘(B) with respect to substance use, con25 cerning— 


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1 ‘‘(i) the national incidence and preva2 lence of the various forms of substance 

3 use; 

4 ‘‘(ii) the incidence and prevalence of 

5 such various forms of substance use in 

6 major metropolitan areas selected by the 

7 Secretary; 

8 ‘‘(iii) the number of individuals admit9 ted to the emergency rooms of hospitals as 

10 a result of the abuse of alcohol or other 

11 drugs; 

12 ‘‘(iv) the number of deaths occurring 

13 as a result of substance use disorders, as 

14 indicated in reports by coroners; 

15 ‘‘(v) the number and variety of public 

16 and private nonprofit treatment programs, 

17 including their capacity and type of patient 

18 services available; 

19 ‘‘(vi) the number of individuals seek20 ing treatment through such programs, the 

21 number and demographic characteristics of 

22 individuals receiving such treatment, the 

23 percentage of individuals who complete 

24 such programs, and, with respect to indi25 viduals receiving such treatment, the 


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1 length of time between an individual’s re2 quest for treatment and the commence3 ment of treatment; 

4 ‘‘(vii) the number of such individuals 

5 who return for treatment after the comple6 tion of a prior treatment in such programs 

7 and the method of treatment utilized dur8 ing the prior treatment; 

9 ‘‘(viii) the number of individuals re10 ceiving public assistance for such treat11 ment programs; 

12 ‘‘(ix) the costs and effectiveness of the 

13 different types of treatment modalities for 

14 drug and alcohol abuse and the aggregate 

15 relative costs of each such treatment mo16 dality provided within a State in each fis17 cal year; 

18 ‘‘(x) to the extent information is avail19 able, the number of individuals receiving 

20 treatment for alcohol or drug abuse who 

21 have private insurance coverage for the 

22 costs of such treatment; 

23 ‘‘(xi) the extent of alcohol and drug 

24 abuse among high school students and 

25 among the general population; and 


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1 ‘‘(xii) the number of alcohol and drug 

2 abuse counselors and other substance use 

3 disorder treatment personnel employed in 

4 public and private treatment facilities. 

5 ‘‘(2) ANNUAL SURVEYS.—The Secretary shall 

6 carry out annual surveys with respect to the collec7 tion of data under this subsection. Summaries and 

8 analyses of such data shall be made available to the 

9 public. 

10 ‘‘(b) NATIONAL OUTCOME MEASURES.— 

11 ‘‘(1) IN GENERAL.—The Secretary, in consulta12 tion with States and other stakeholders, shall estab13 lish national outcome measures (including client and 

14 community measures) for substance abuse and men15 tal health programs to be used by recipients of as16 sistance through programs authorized under this 

17 title and part B of title XIX, as appropriate. 

18 ‘‘(2) EVALUATION.—The Secretary shall be re19 sponsible for evaluating the effect of the implemen20 tation of the outcome measures developed under 

21 paragraph (1) and whether such outcome measures 

22 continue to be important for measuring program 

23 success and for recommending additional measures 

24 or modification to current measures. 


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1 ‘‘(3) MODIFICATIONS.—Any modifications made 

2 as a result of an evaluation under paragraph (2) 

3 shall be made only after the Secretary has consulted 

4 with States and other stakeholders and after such 

5 modification are published in the Federal Register. 

6 ‘‘(4) DEEMED PUBLICATION.—National out7 come measures agreed to by the States and other 

8 stakeholders prior to the date of enactment of the 

9 SAMHSA Modernization Act of 2010 are deemed to 

10 have been published in the Federal Register for the 

11 purposes of paragraph (3). 

12 ‘‘(c) STATE INFRASTRUCTURE GRANTS.— 

13 ‘‘(1) IN GENERAL.—The Secretary may award 

14 grants to, and enter into contracts or cooperative 

15 agreements with, States for the purpose of devel16 oping and operating mental health or substance use 

17 disorder data collection, analysis, and reporting sys18 tems in accordance with the outcome measures de19 veloped under subsection (b). 

20 ‘‘(2) MATCHING REQUIREMENT.— 

21 ‘‘(A) IN GENERAL.—With respect to the 

22 costs of the program to be carried out under a 

23 grant under paragraph (1) by a State, the Sec24 retary may make an award under such para25 graph only if the applicant agrees to make 


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1 available (directly or through donations from 

2 public or private entities) non-Federal contribu3 tions toward such costs in an amount that is 

4 not less than 50 percent of such costs. 

5 ‘‘(B) DETERMINATION OF AMOUNT CON6 TRIBUTED.—Non-Federal contributions under 

7 subparagraph (A) may be in cash or in kind, 

8 fairly evaluated, including plant, equipment, or 

9 services. Amounts provided by the Federal Gov10 ernment, or services assisted or subsidized to 

11 any significant extent by the Federal Govern12 ment, may not be included in determining the 

13 amount of such contributions. 

14 ‘‘(3) DURATION OF SUPPORT.—The period dur15 ing which payments may be made for a program 

16 under paragraph (1) may be not less than 3 years 

17 nor more than 5 years. 

18 ‘‘(d) UNIFORM CRITERIA.—After consultation with 

19 the States and with appropriate national organizations, 

20 the Administrator shall develop uniform criteria for the 

21 collection of data, using the best available technology, pur22 suant to this section. 

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

24 purpose of carrying out this section, there are authorized 


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1 to be appropriated such sums as may be necessary for 

2 each of fiscal years 2011 through 2015. 

3 ‘‘SEC. 505. SUPPORTIVE SERVICES FOR HOMELESS INDIVID4 UALS. 

5 ‘‘(a) GRANTS FOR TREATMENT AND RECOVERY FOR

6 HOMELESS INDIVIDUALS.— 

7 ‘‘(1) IN GENERAL.—The Secretary shall award 

8 grants, contracts and cooperative agreements to 

9 community-based public and private nonprofit enti10 ties for the purposes of providing mental health and 

11 substance use disorder services for homeless individ12 uals. In carrying out this section, the Secretary shall 

13 consult with the Interagency Council on the Home14 less, established under section 201 of the Stewart B. 

15 McKinney Homeless Assistance Act (42 U.S.C. 

16 11311). 

17 ‘‘(2) PREFERENCES.—In awarding grants, con18 tracts, and cooperative agreements under paragraph 

19 (1), the Secretary shall give a preference to— 

20 ‘‘(A) entities that provide integrated pri21 mary health, substance use disorder, and men22 tal health services to homeless individuals; 

23 ‘‘(B) entities that demonstrate effective24 ness in serving runaway, homeless, and street 

25 youth; 


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1 ‘‘(C) entities that have experience in pro2 viding substance use disorder and mental health 

3 services to homeless individuals; 

4 ‘‘(D) entities that demonstrate experience 

5 in providing housing for individuals in treat6 ment for or in recovery from mental illness or 

7 substance use disorders; and 

8 ‘‘(E) entities that demonstrate effective9 ness in serving homeless veterans. 

10 ‘‘(3) SERVICES FOR CERTAIN INDIVIDUALS.—In 

11 awarding grants, contracts, and cooperative agree12 ments under paragraph (1), the Secretary shall 

13 not— 

14 ‘‘(A) prohibit the provision of services 

15 under such subsection to homeless individuals 

16 who are suffering from a substance use disorder 

17 and are not suffering from a mental health dis18 order; and 

19 ‘‘(B) make payments under such para20 graph to any entity that has a policy of— 

21 ‘‘(i) excluding individuals from mental 

22 health services due to the existence or sus23 picion of substance use disorder; or 

24 ‘‘(ii) has a policy of excluding individ25 uals from substance use disorder services 


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1 due to the existence or suspicion of mental 

2 illness. 

3 ‘‘(b) GRANTS FOR SERVICES TO END LONG-TERM

4 HOMELESSNESS.— 

5 ‘‘(1) IN GENERAL.— 

6 ‘‘(A) GRANTS.—The Secretary shall make 

7 grants to entities described in subparagraph 

8 (B) for the purpose of carrying out projects to 

9 provide the services described in paragraph (4) 

10 to chronically homeless individuals in perma11 nent supportive housing. 

12 ‘‘(B) ELIGIBLE ENTITIES.—For purposes 

13 of subparagraph (A), an entity described in this 

14 subparagraph is— 

15 ‘‘(i) a State or political subdivision of 

16 a State, an American Indian and Alaska 

17 Native tribe, tribal organization, a health 

18 facility or program operated by or pursu19 ant to a contract or grant with the Indian 

20 Health Service, or a public or nonprofit 

21 private entity, including a community22 based provider of homelessness services, 

23 health care, housing, or other services im24 portant to individuals experiencing chronic 

25 homelessness; or 


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1 ‘‘(ii) a consortium composed of enti2 ties described in clause (i), which consor3 tium includes a public or nonprofit private 

4 entity that serves as the lead applicant and 

5 has responsibility for fiscal management, 

6 program management, and coordinating 

7 the activities of the consortium. 

8 ‘‘(2) PRIORITIES.—In making grants under 

9 paragraph (1), the Secretary shall give priority to 

10 applicants demonstrating that the applicants— 

11 ‘‘(A) target the services described in para12 graph (4) to individuals or families who— 

13 ‘‘(i) have been homeless for longer pe14 riods of time or have experienced more epi15 sodes of homelessness than are required to 

16 meet the definition of chronic homelessness 

17 under this section; 

18 ‘‘(ii) have high rates of utilization of 

19 emergency public systems of care; or 

20 ‘‘(iii) have a history of interactions 

21 with law enforcement and the criminal jus22 tice system; 

23 ‘‘(B) have greater funding commitments 

24 from State or local government agencies respon25 sible for overseeing mental health treatment, 


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1 substance use disorder treatment, medical care, 

2 and employment (including commitments to 

3 provide Federal funds in accordance with para4 graph (5)(B)(ii)(II)); 

5 ‘‘(C) will provide for an increase in the 

6 number of units of permanent supportive hous7 ing that would serve chronically homeless indi8 viduals in the community as a result of an 

9 award of a grant under paragraph (1); and 

10 ‘‘(D) have demonstrated experience pro11 viding services to address the mental health and 

12 substance use disorder problems of chronically 

13 homeless individuals living in permanent sup14 portive housing settings. 

15 ‘‘(3) GEOGRAPHIC DISTRIBUTION.—The Sec16 retary shall ensure that consideration is given to ge17 ographic distribution (such as urban and rural 

18 areas) in the awarding of grants under paragraph 

19 (1). 

20 ‘‘(4) SERVICES.—The services referred to in 

21 paragraph (1) are the following: 

22 ‘‘(A) Services provided by the grantee or 

23 by qualified subcontractors that promote recov24 ery, resiliency, and self-sufficiency and address 


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1 barriers to housing stability, including the fol2 lowing: 

3 ‘‘(i) Mental health services, including 

4 treatment services and recovery support 

5 services and services that promote resil6 iency. 

7 ‘‘(ii) Substance use disorder treatment 

8 and recovery support services, including 

9 counseling, treatment planning, recovery 

10 coaching, and relapse prevention. 

11 ‘‘(iii) Integrated, coordinated treat12 ment and recovery support services for co13 occurring disorders. 

14 ‘‘(iv) Health education, including re15 ferrals for medical and dental care. 

16 ‘‘(v) Services designed to help individ17 uals make progress toward self-sufficiency 

18 and recovery, including benefits advocacy, 

19 money management, life-skills training, 

20 self-help programs, and engagement and 

21 motivational interventions. 

22 ‘‘(vi) Parental skills and family sup23 port. 

24 ‘‘(vii) Case management. 


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1 ‘‘(viii) Other supportive services that 

2 promote an end to chronic homelessness. 

3 ‘‘(ix) Coordination or partnership with 

4 other agencies, programs, or mainstream 

5 benefits to maximize the availability of 

6 services and resources to meet the needs of 

7 chronically homeless persons living in sup8 portive housing using cost-effective ap9 proaches that avoid duplication. 

10 ‘‘(x) Data collection and measuring 

11 performance outcomes as specified in para12 graph (11). 

13 ‘‘(B) Services, as described in subpara14 graph (A), that are delivered to individuals and 

15 families who are chronically homeless and who 

16 are scheduled to become residents of permanent 

17 supportive housing within 90 days pending the 

18 location or development of an appropriate unit 

19 of housing. 

20 ‘‘(C) For individuals and families who are 

21 otherwise eligible, and who have voluntarily cho22 sen to seek other housing opportunities after a 

23 period of tenancy in supportive housing, serv24 ices, as described in subparagraph (A), that are 

25 delivered, for a period of 90 days after exiting 


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1 permanent supportive housing or until the indi2 viduals have transitioned to comprehensive serv3 ices adequate to meet their current needs, pro4 vided that the purpose of the services is to sup5 port the individuals in their choice to transition 

6 into housing that is responsive to their indi7 vidual needs and preferences. 

8 ‘‘(5) MATCHING FUNDS.— 

9 ‘‘(A) IN GENERAL.—A condition for the re10 ceipt of a grant under paragraph (1) is that, 

11 with respect to the cost of the project to be car12 ried out by an applicant pursuant to such sub13 section, the applicant agrees as follows: 

14 ‘‘(i) In the case of the initial grant 

15 pursuant to paragraph (10)(A)(i), the ap16 plicant will, in accordance with subpara17 graphs (B) and (C), make available con18 tributions toward such costs in an amount 

19 that is not less than $1 for each $3 of 

20 Federal funds provided in the grant. 

21 ‘‘(ii) In the case of a renewal grant 

22 pursuant to paragraph (10)(A)(ii), the ap23 plicant will, in accordance with subpara24 graphs (B) and (C), make available con25 tributions toward such costs in an amount 


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1 that is not less than $1 for each $1 of 

2 Federal funds provided in the grant. 

3 ‘‘(B) SOURCE OF CONTRIBUTION.—For 

4 purposes of subparagraph (A), contributions 

5 made by an applicant are in accordance with 

6 this paragraph if made as follows: 

7 ‘‘(i) The contribution is made from 

8 funds of the applicant or from donations 

9 from public or private entities. 

10 ‘‘(ii) Of the contribution— 

11 ‘‘(I) not less than 80 percent is 

12 from non-Federal funds; and 

13 ‘‘(II) not more than 20 percent is 

14 from Federal funds provided under 

15 programs that— 

16 ‘‘(aa) are not expressly di17 rected at services for homeless 

18 individuals, but whose purposes 

19 are broad enough to include the 

20 provision of a service or services 

21 described in paragraph (4) as au22 thorized expenditures under such 

23 program; and 

24 ‘‘(bb) do not prohibit Fed25 eral funds under the program 


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1 from being used to provide a con2 tribution that is required as a 

3 condition for obtaining Federal 

4 funds. 

5 ‘‘(C) DETERMINATION OF AMOUNT CON6 TRIBUTED.—Contributions required in subpara7 graph (A) may be in cash or in kind, fairly 

8 evaluated, including plant, equipment, or serv9 ices. Amounts provided by the Federal Govern10 ment, or services assisted or subsidized to any 

11 significant extent by the Federal Government, 

12 may not be included in determining the amount 

13 of non-Federal contributions required in sub14 paragraph (B)(ii)(I). 

15 ‘‘(6) ADMINISTRATIVE EXPENSES.—A condition 

16 for the receipt of a grant under paragraph (1) is 

17 that the applicant involved agree that not more than 

18 10 percent of the grant will be expended for admin19 istrative expenses with respect to the grant. Ex20 penses for data collection and measuring perform21 ance outcomes as specified in paragraph (11) shall 

22 not be considered as administrative expenses subject 

23 to the limitation in this paragraph. 

24 ‘‘(7) CERTAIN USES OF FUNDS.—Notwith25 standing other provisions of this section, not more 


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1 than 20 percent of the individuals served by a grant2 ee under paragraph (1) may be homeless individuals 

3 who are not chronically homeless. 

4 ‘‘(8) APPLICATION FOR GRANT.—A grant may 

5 be made under paragraph (1) only if an application 

6 for the grant is submitted to the Secretary and the 

7 application is in such form, is made in such manner, 

8 and contains such agreements, assurances, and in9 formation as the Secretary determines to be nec10 essary to carry out this subsection. 

11 ‘‘(9) CERTAIN REQUIREMENTS.—A condition 

12 for the receipt of a grant under paragraph (1) is 

13 that the applicant involved demonstrate the fol14 lowing: 

15 ‘‘(A) The applicant and all direct providers 

16 of services have the experience, infrastructure, 

17 and expertise needed to ensure the quality and 

18 effectiveness of services, which may be dem19 onstrated by any of the following: 

20 ‘‘(i) Compliance with all local, city, 

21 county, or State requirements for licensing, 

22 accreditation, or certification (if any) 

23 which are applicable to the proposed 

24 project. 


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1 ‘‘(ii) A minimum of 2 years experience 

2 providing comparable services that do not 

3 require licensing, accreditation, or certifi4 cation. 

5 ‘‘(iii) Certification as a Medicaid serv6 ice provider, including health care for the 

7 homeless programs and community health 

8 centers. 

9 ‘‘(iv) An executed agreement with a 

10 relevant State or local government agency 

11 that will provide oversight over the mental 

12 health, substance use disorder, or other 

13 services that will be delivered by the 

14 project. 

15 ‘‘(B) There is a mechanism for deter16 mining whether residents are chronically home17 less. Such a mechanism may rely on local data 

18 systems or records of shelter admission. If there 

19 are no sources of data regarding the duration 

20 or number of homeless episodes, or if such data 

21 are unreliable for the purposes of this para22 graph, an applicant must demonstrate that the 

23 project will implement appropriate procedures, 

24 taking into consideration the capacity of local 

25 homeless service providers to document episodes 


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1 of homelessness and the challenges of engaging 

2 persons who have been chronically homeless, to 

3 verify that an individual or family meets the 

4 definition for being chronically homeless under 

5 this subsection. 

6 ‘‘(C) The applicant participates in a local, 

7 regional, or statewide homeless management in8 formation system. 

9 ‘‘(10) DURATION OF INITIAL AND RENEWAL

10 GRANTS; ADDITIONAL PROVISIONS REGARDING RE11 NEWAL GRANTS.— 

12 ‘‘(A) IN GENERAL.—Subject to subpara13 graphs (B) and (C), the period during which 

14 payments are made to a grantee under para15 graph (1) shall be in accordance with the fol16 lowing: 

17 ‘‘(i) In the case of the initial grant, 

18 the period of payments shall be not less 

19 than 3 years and not more than 5 years. 

20 ‘‘(ii) In the case of a subsequent grant 

21 (referred to in this subsection as a ‘re22 newal grant’), the period of payments shall 

23 be not more than 5 years. 

24 ‘‘(B) ANNUAL APPROVAL; AVAILABILITY

25 OF APPROPRIATIONS; NUMBER OF GRANTS.— 


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1 The provision of payments under an initial or 

2 renewal grant is subject to annual approval by 

3 the Secretary of the payments and to the avail4 ability of appropriations for the fiscal year in5 volved to make the payments. This paragraph 

6 may not be construed as establishing a limita7 tion on the number of grants under paragraph 

8 (1) that may be made to an entity. 

9 ‘‘(C) ADDITIONAL PROVISIONS REGARDING

10 RENEWAL GRANTS.— 

11 ‘‘(i) COMPLIANCE WITH MINIMUM

12 STANDARDS.—A renewal grant may be 

13 made by the Secretary only if the Sec14 retary determines that the applicant in15 volved has, in the project carried out with 

16 the grant, maintained compliance with 

17 minimum standards for quality and suc18 cessful outcomes for housing retention, as 

19 determined by the Secretary. 

20 ‘‘(ii) AMOUNT.—The maximum 

21 amount of a renewal grant under this 

22 paragraph shall not exceed an amount 

23 equal to 75 percent of the amount of the 

24 grant awarded in the final year of the ini25 tial grant period. 


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1 ‘‘(11) STRATEGIC PERFORMANCE OUTCOMES

2 AND REPORTS.— 

3 ‘‘(A) IN GENERAL.—The Secretary shall, 

4 as a condition of the receipt of grants under 

5 paragraph (1), require grantees to provide data 

6 regarding the performance outcomes of the 

7 projects carried out under the grants. Con8 sistent with the requirements and procedures 

9 established by the Secretary, each grantee shall 

10 measure and report specific performance out11 comes related to the long-term goals of increas12 ing stability within the community for people 

13 who have been chronically homeless, and de14 creasing the recurrence of periods of homeless15 ness. 

16 ‘‘(B) PERFORMANCE OUTCOMES.—The 

17 performance outcomes described under subpara18 graph (A) shall include, with respect to individ19 uals who have been chronically homeless— 

20 ‘‘(i) improvements in housing sta21 bility; 

22 ‘‘(ii) improvements in employment 

23 and education; 

24 ‘‘(iii) reductions in problems related to 

25 substance use disorders; 


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1 ‘‘(iv) reductions in problems related to 

2 mental health disorders; and 

3 ‘‘(v) other areas as the Secretary de4 termines appropriate. 

5 ‘‘(C) COORDINATION AND CONSISTENCY

6 WITH OTHER HOMELESS ASSISTANCE PRO7 GRAMS.— 

8 ‘‘(i) PROCEDURES.—In establishing 

9 strategic performance outcomes and re10 porting requirements under subparagraph 

11 (A), the Secretary shall develop and imple12 ment procedures that minimize the costs 

13 and burdens to grantees and program par14 ticipants, and that are practical, stream15 lined, and designed for consistency with 

16 the requirements of the homeless assist17 ance programs administered by the Sec18 retary of Housing and Urban Develop19 ment. 

20 ‘‘(ii) APPLICANT COORDINATION.— 

21 Applicants under this subsection shall co22 ordinate with community stakeholders, in23 cluding participants in the local homeless 

24 management information system, con25 cerning the development of systems to 


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1 measure performance outcomes and with 

2 the Secretary for assistance with data col3 lection and measurements activities. 

4 ‘‘(D) REPORT.—A grantee shall submit an 

5 annual report to the Secretary that— 

6 ‘‘(i) identifies the grantee’s progress 

7 toward achieving its strategic performance 

8 outcomes; and 

9 ‘‘(ii) describes other activities con10 ducted by the grantee to increase the par11 ticipation, housing stability, and other im12 provements in outcomes for individuals 

13 who have been chronically homeless. 

14 ‘‘(12) TRAINING AND TECHNICAL ASSIST15 ANCE.—The Secretary, directly or through awards of 

16 grants or contracts to public or nonprofit private en17 tities, shall provide training and technical assistance 

18 regarding the planning, development, and provision 

19 of services in projects under paragraph (1). 

20 ‘‘(c) DEFINITIONS.—For purposes of this section: 

21 ‘‘(1) CHRONICALLY HOMELESS.— 

22 ‘‘(A) IN GENERAL.—The term ‘chronically 

23 homeless’, used with respect to an individual or 

24 family, means an individual or family who— 


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1 ‘‘(i) is homeless and lives or resides in 

2 a place not meant for human habitation, a 

3 safe haven, or in an emergency shelter; 

4 ‘‘(ii) has been homeless and living or 

5 residing in a place not meant for human 

6 habitation, a safe haven, or in an emer7 gency shelter continuously for at least 1 

8 year or on at least 4 separate occasions in 

9 the last 3 years; and 

10 ‘‘(iii) has an adult head of household 

11 (or a minor head of household if no adult 

12 is present in the household) with a 

13 diagnosable substance use disorder, serious 

14 mental illness, developmental disability (as 

15 defined in section 102 of the Develop16 mental Disabilities Assistance and Bill of 

17 Rights Act of 2000 (42 U.S.C. 15002)), 

18 post traumatic stress disorder, cognitive 

19 impairments resulting from a brain injury, 

20 or chronic physical illness or disability, in21 cluding the co-occurrence of 2 or more of 

22 those conditions. 

23 ‘‘(B) RULE OF CONSTRUCTION.—A person 

24 who currently lives or resides in an institutional 

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1 order or mental health treatment facility, hos2 pital or other similar facility, and has resided 

3 there for fewer than 90 days shall be considered 

4 chronically homeless if such person met all of 

5 the requirements described in subparagraph (A) 

6 prior to entering that facility. 

7 ‘‘(2) HOMELESS.—The term ‘homeless’ means 

8 sleeping in a place not meant for human habitation 

9 or in an emergency homeless shelter. 

10 ‘‘(3) HOMELESS INDIVIDUAL.—The term 

11 ‘homeless individual’ has the meaning given such 

12 term in section 330(h)(5)(A). 

13 ‘‘(4) PERMANENT SUPPORTIVE HOUSING.— 

14 ‘‘(A) IN GENERAL.—The term ‘permanent 

15 supportive housing’ means permanent, afford16 able housing with flexible support services that 

17 are available and designed to help the tenants 

18 stay housed and build the necessary skills to 

19 live as independently as possible. Such term 

20 does not include housing that is time-limited. 

21 Supportive housing offers residents assistance 

22 in reaching their full potential, which may in23 clude opportunities to secure other housing that 

24 meets their needs and preferences, based on in25 dividual choice instead of the requirements of 


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1 time-limited transitional programs. Under this 

2 section, permanent affordable housing includes 

3 permanent housing funded or assisted through 

4 title IV of the McKinney-Vento Homeless As5 sistance Act and section (8) of the United 

6 States Housing Act of 1937. 

7 ‘‘(B) AFFORDABLE.—For purposes of sub8 paragraph (A), the term ‘affordable’ means 

9 within the financial means of individuals who 

10 are extremely low income, as defined by the 

11 Secretary of Housing and Urban Development. 

12 ‘‘(5) SUBSTANCE USE DISORDER SERVICES.— 

13 The term ‘substance use disorder services’ has the 

14 meaning given the term ‘substance abuse services’ in 

15 section 330(h)(5)(C). 

16 ‘‘(d) TERM OF THE AWARDS.—No entity may receive 

17 a grant, contract, or cooperative agreement under this sec18 tion for more than 5 years. 

19 ‘‘(e) REPORT.—Not later than 2 years after the date 

20 of enactment of the SAMHSA Modernization Act of 2010, 

21 and once every 2 years thereafter, the Secretary shall sub22 mit to the appropriate committees of Congress a report 

23 concerning the programs and services provided under this 

24 section. Such report shall include— 


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1 ‘‘(1) a summary of the information received by 

2 the Secretary under paragraph (11) of subsection 

3 (b); 

4 ‘‘(2) a description of how the services provided 

5 under each such program are coordinated with State 

6 and local social service programs and homelessness 

7 assistance programs and Department of Veterans 

8 Affairs services programs; and 

9 ‘‘(3) an evaluation of the manner in which 

10 funds are used under such programs and the effec11 tiveness of such programs in ending chronic home12 lessness and improving outcomes for individuals with 

13 mental illness and substance use disorder problems. 

14 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.— 

15 ‘‘(1) IN GENERAL.—There is authorized to be 

16 appropriated to carry out this section, $100,000,000 

17 for fiscal year 2011, and such sums as may be nec18 essary for each of the fiscal years 2012 through 

19 2015. 

20 ‘‘(2) CONTINUING GRANTS.—Of the total 

21 amount appropriated to carry out this section, 

22 amounts shall first be allocated for continuing 

23 grants awarded under section 505(a) (as such sec24 tion existed on the day before the date of enactment 

25 of the SAMHSA Modernization Act of 2010. 


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1 ‘‘(3) REMAINING FUNDS.—Upon complying 

2 with paragraph (2), any remaining funds shall be al3 located equally between subsections (a) and (b). 

4 ‘‘SEC. 506. AMERICAN INDIANS AND ALASKA NATIVES. 

5 ‘‘(a) TECHNICAL ASSISTANCE.—The Secretary shall 

6 provide technical assistance to American Indian and Alas7 ka Native tribes and tribal organizations in submitting ap8 plications for any program of grants under this title. 

9 ‘‘(b) SAMHSA TRIBAL TECHNICAL ADVISORY

10 GROUP.— 

11 ‘‘(1) IN GENERAL.—The Secretary shall estab12 lish and maintain a Tribal Technical Advisory Group 

13 (referred to in this section as the ‘Group’) that shall 

14 be composed of— 

15 ‘‘(A) Indian representation, as selected by 

16 the tribes, from each of the 12 administrative 

17 units (Area Offices) of the Indian Health Serv18 ice; 

19 ‘‘(B) a representative of the Indian Health 

20 Service; 

21 ‘‘(C) representatives of National Indian 

22 Organizations with general interests in Indian 

23 health care; 

24 ‘‘(D) a representative of the Administra25 tion; and 


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1 ‘‘(E) a representative of a national organi2 zation representing States’ interests in mental 

3 health and substance use disorders. 

4 ‘‘(2) PURPOSE.—The purpose of the Group is 

5 to enhance the tribal government to Federal Govern6 ment relationship by providing recommendations and 

7 advice to tribes, States, and the Administration 

8 through— 

9 ‘‘(A) identifying the barriers and issues in 

10 providing mental health and substance use dis11 order treatments and services between the Ad12 ministration, States and tribal health programs, 

13 including those programs administered by the 

14 Indian Health Service; 

15 ‘‘(B) providing expertise on policies, guide16 lines, and programmatic issues affecting the de17 livery of mental health and substance use dis18 order care for American Indians and Alaska 

19 Natives; 

20 ‘‘(C) facilitating any interaction relating to 

21 intergovernmental and intragovernmental re22 sponsibilities; and 

23 ‘‘(D) providing any other advice or assist24 ance to the Administration to improve the menVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00065 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 tal health and substance use disorder status lev2 els of American Indians and Alaska Natives. 

3 ‘‘(3) SUPPORT NO SUPPLANT.—The Group shall 

4 support and not supplant the tribal consultation 

5 process between the Administration and tribes. 

6 ‘‘(4) REPORT.—Not later than 1 year after the 

7 date of the enactment of the SAMHSA Moderniza8 tion Act of 2010, and annually thereafter, the Group 

9 shall prepare and submit, to the Secretary, the Com10 mittee on Indian Affairs and the Committee on 

11 Health, Education, Labor, and Pensions of the Sen12 ate, and the Committee on Natural Resources and 

13 the Committee on Energy and Commerce of the 

14 House of Representatives, a report describing the 

15 activities, findings, and recommendations pursuant 

16 to this section. 

17 ‘‘(c) DUTIES.—The Secretary shall appoint an indi18 vidual within the Administration to— 

19 ‘‘(1) act as a point of contact for tribes and 

20 tribal organizations; 

21 ‘‘(2) coordinate and provide technical assistance 

22 to tribes and tribal organizations; 

23 ‘‘(3) act as a knowledgeable source on American 

24 Indian and Alaska Native mental health and sub25 stance use disorders issues; 


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1 ‘‘(4) advise grant review panels about the effec2 tiveness of traditional intervention and treatment 

3 methods used by American Indians and Alaska Na4 tives; 

5 ‘‘(5) coordinates activities between the Adminis6 tration and the Group; and 

7 ‘‘(6) coordinate activities between the Adminis8 tration and Indian Health Service. 

9 ‘‘(d) SPECIAL MENTAL HEALTH AND SUBSTANCE

10 USE DISORDERS PROGRAMS FOR AMERICAN INDIANS AND

11 ALASKA NATIVES.— 

12 ‘‘(1) IN GENERAL.—The Secretary shall award 

13 grants, in addition to discretionary grants under this 

14 title, to provide services for mental health and sub15 stance use disorders in accordance with paragraph 

16 (2). 

17 ‘‘(2) SERVICE THROUGH INDIAN HEALTH FA18 CILITIES.—For purposes of paragraph (1), services 

19 under such subsection shall be considered to be pro20 vided in accordance with this subsection if such serv21 ices are provided through an American Indian and 

22 Alaska Native program operated by an Indian tribe, 

23 tribal organization, Indian Health Service, or a 

24 health facility or program operated by or pursuant 


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1 to a contract or grant with the Indian Health Serv2 ice. 

3 ‘‘(3) DATA COLLECTION.—The Secretary shall 

4 periodically collect and report on information con5 cerning the numbers of people served through grants 

6 pursuant to this subsection and the effectiveness of 

7 such grants. 

8 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

9 There are authorized to be appropriated to carry out 

10 this subsection, $40,000,000 for fiscal year 2011, 

11 and such sums as may be necessary for fiscal years 

12 2012 through and 2015. 

13 ‘‘SEC. 507. EARLY DETECTION AND INTERVENTION FOR 

14 MENTAL ILLNESS AND SUBSTANCE ABUSE 

15 DISORDERS. 

16 ‘‘(a) IN GENERAL.—The Administrator may award 

17 grants, contracts, or cooperative agreements to eligible en18 tities for mental illness and substance abuse screening, 

19 brief intervention, referral, and recovery services for indi20 viduals in primary health care settings. 

21 ‘‘(b) ELIGIBLE ENTITY.—In this section, the term 

22 ‘eligible entity’ means a public or private nonprofit entity 

23 that— 

24 ‘‘(1) provides primary health services; 


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1 ‘‘(2) seeks to integrate mental illness and sub2 stance abuse services into its service system; 

3 ‘‘(3) has developed a working relationship with 

4 providers of mental health and substance abuse serv5 ices; and 

6 ‘‘(4) demonstrates a need for the inclusion of 

7 mental illness and substance abuse services in its 

8 service system. 

9 ‘‘(c) PRIORITY.—In awarding grants, contracts, and 

10 cooperative agreements under this section, the Secretary 

11 shall give priority to eligible entities that— 

12 ‘‘(1) provide services in rural or frontier areas 

13 of the Nation; 

14 ‘‘(2) provide services to American Indian or 

15 Alaska Native populations; or 

16 ‘‘(3) provide services on university and college 

17 campuses. 

18 ‘‘(d) USE OF FUNDS.—The Secretary may award a 

19 grant to an eligible entity under this section only if the 

20 entity agrees to use the grant— 

21 ‘‘(1) to provide screening, brief interventions, 

22 referral, and recovery services for mental health and 

23 substance abuse; 

24 ‘‘(2) to coordinate these services with primary 

25 health care services in the same program; 


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1 ‘‘(3) to develop a network of facilities to which 

2 patients can be referred if needed; 

3 ‘‘(4) to purchase needed screening and other 

4 tools that are— 

5 ‘‘(A) necessary for providing the services; 

6 and 

7 ‘‘(B) supported by research; and 

8 ‘‘(5) to maintain communication with appro9 priate State mental health and substance abuse 

10 agencies. 

11 ‘‘(d) DURATION.—The period of a grant, contract, or 

12 cooperative agreement awarded under this section may not 

13 exceed 5 years. 

14 ‘‘(e) EVALUATION.—The Secretary may not award a 

15 grant, contract, or cooperative agreement to an eligible en16 tity under this section unless the entity agrees— 

17 ‘‘(1) to prepare and submit to the Secretary at 

18 the end of the grant, contract, or cooperative agree19 ment period an evaluation of all activities funded 

20 through the grant, contract, or cooperative agree21 ment; and 

22 ‘‘(2) to use such performance measures as may 

23 be stipulated by the Secretary for purposes of such 

24 evaluation. 


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1 ‘‘(f) STUDY.—Not later than 4 years after the first 

2 appropriation of funds to carry out this section, the Sec3 retary— 

4 ‘‘(1) shall conduct a study on the benefits of in5 tegrating mental illness and substance abuse care 

6 within primary health care, focusing on the perform7 ance measures stipulated by the Secretary for pur8 poses of evaluations under subsection (e); and 

9 ‘‘(2) shall submit the results of such study to 

10 the Committee on Health, Education, Labor, and 

11 Pensions of the Senate and the Committee on En12 ergy and Commerce of the House of Representa13 tives. 

14 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.— 

15 ‘‘(1) IN GENERAL.—To carry out this section, 

16 there are authorized to be appropriated $60,000,000 

17 for fiscal year 2011 and such sums as may be nec18 essary for fiscal years 2012 through 2015. 

19 ‘‘(2) PROGRAM MANAGEMENT.—Of the funds 

20 appropriated to carry out this section for a fiscal 

21 year, the Secretary may use not more than 5 percent 

22 to manage the program under this section. 


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1 ‘‘SEC. 508. REPORT ON COORDINATION BETWEEN THE SUB2 STANCE ABUSE AND MENTAL HEALTH SERV3 ICES ADMINISTRATION AND THE FEDERAL 

4 EMERGENCY MANAGEMENT AGENCY. 

5 ‘‘Not later than 1 year after the date of enactment 

6 of the SAMHSA Modernization Act of 2010, the Adminis7 trator, in coordination with the Administrator of the Fed8 eral Emergency Management Agency, shall submit to the 

9 appropriate committees of Congress a report that contains 

10 the following: 

11 ‘‘(1) A description of the manner in which the 

12 Federal Emergency Management Agency and the 

13 Administration have coordinated to provide mental 

14 health and substance use disorder outreach, coun15 seling, and treatment following Presidentially de16 clared disasters. 

17 ‘‘(2) An analysis of the manner in which the 

18 services provided (as described in paragraph (1)) 

19 have been coordinated with existing State and local 

20 mental health and substance use disorder programs, 

21 including the manner in which such services assisted 

22 the emergency response and post-disaster recovery 

23 and how such services are delivered during the tran24 sition from an emergency response situation to a 

25 post-disaster and recovery situation. 


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1 ‘‘(3) An analysis of the methods by which the 

2 Federal Emergency Management Agency and the 

3 Administration coordinated with other appropriate 

4 Federal agencies to leverage use of supplemental 

5 funds appropriated by Congress to meet the mental 

6 health and substance use disorder needs of the af7 fected individuals following Presidentially declared 

8 disasters. 

9 ‘‘(4) Recommendations of the actions that may 

10 be taken by the Federal Emergency Management 

11 Agency and the Administration to facilitate the im12 proved provision of mental health and substance use 

13 disorder outreach, counseling, and treatment fol14 lowing Presidentially declared disasters, including an 

15 analysis of ways in which the Crisis Counseling Pro16 gram may be used to meet community-identified 

17 mental health and substance use disorder needs. 

18 ‘‘PART B—CENTERS AND PROGRAMS 

19 ‘‘Subpart 1—Center for Substance Abuse Treatment 

20 ‘‘SEC. 510. CENTER FOR SUBSTANCE ABUSE TREATMENT. 

21 ‘‘(a) IN GENERAL.—There is established in the Ad22 ministration a Center for Substance Abuse Treatment 

23 (hereafter in this section referred to as the ‘Center’). The 

24 Center shall be headed by a Director (hereafter in this 

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1 retary from among individuals with extensive experience 

2 or academic qualifications in the treatment of substance 

3 use disorders or in the evaluation of substance use dis4 order treatment systems. 

5 ‘‘(b) DUTIES.—The Director of the Center shall— 

6 ‘‘(1) administer the substance use disorder 

7 treatment block grant program authorized in section 

8 1921; 

9 ‘‘(2) ensure that emphasis is placed on children 

10 and adolescents in the development of treatment 

11 programs; 

12 ‘‘(3) collaborate with the Attorney General to 

13 develop programs to provide substance use disorder 

14 treatment services to individuals who have had con15 tact with the Justice system, especially adolescents; 

16 ‘‘(4) collaborate with the Director of the Center 

17 for Substance Abuse Prevention in order to provide 

18 outreach services to identify individuals in need of 

19 treatment services, with emphasis on the provision of 

20 such services to pregnant and postpartum women 

21 and their infants and to individuals who use drugs 

22 intravenously; 

23 ‘‘(5) collaborate with the Director of the Na24 tional Institute on Drug Abuse, with the Director of 

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1 holism, and with the States to promote the study, 

2 dissemination, and implementation of research find3 ings that will improve the delivery and effectiveness 

4 of treatment services; 

5 ‘‘(6) collaborate with the Administrator of the 

6 Health Resources and Services Administration and 

7 the Administrator of the Centers for Medicare & 

8 Medicaid Services to promote the increased integra9 tion into the mainstream of the health care system 

10 of the United States of programs for providing 

11 treatment services; 

12 ‘‘(7) evaluate plans submitted by the States 

13 pursuant to section 1931(a)(6) in order to determine 

14 whether the plans adequately provide for the avail15 ability, allocation, and effectiveness of treatment 

16 services; 

17 ‘‘(8) sponsor regional workshops on improving 

18 the quality and availability of treatment services; 

19 ‘‘(9) provide technical assistance to public and 

20 nonprofit private entities that provide treatment 

21 services, including technical assistance with respect 

22 to the process of submitting to the Director applica23 tions for any program of grants or contracts carried 

24 out by the Director; 


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1 ‘‘(10) carry out activities to educate individuals 

2 on the need for establishing treatment facilities with3 in their communities; 

4 ‘‘(11) encourage public and private entities that 

5 provide health insurance to provide benefits for out6 patient treatment services and other nonhospital7 based treatment services; 

8 ‘‘(12) evaluate treatment programs to deter9 mine the quality and appropriateness of various 

10 forms of treatment, which shall be carried out 

11 through grants, contracts, or cooperative agreements 

12 provided to public or nonprofit private entities; 

13 ‘‘(13) in carrying out paragraph (12), assess 

14 the quality, appropriateness, and costs of various 

15 treatment forms from specific patient groups and 

16 ensure that the national outcome measures devel17 oped under section 504(b) are used with respect to 

18 all appropriate grants administered by the Center; 

19 and 

20 ‘‘(14) work with States, providers, and individ21 uals in recovery and their families to promote the 

22 expansion of recovery support services and recovery 

23 oriented systems of care. 

24 ‘‘(c) GRANTS AND CONTRACTS.—In carrying out the 

25 duties established in subsection (b), the Director may 


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1 make grants to and enter into contracts and cooperative 

2 agreements with public and nonprofit private entities. 

3 ‘‘SEC. 511. RESIDENTIAL TREATMENT PROGRAMS FOR 

4 PREGNANT AND PARENTING WOMEN. 

5 ‘‘(a) IN GENERAL.—The Director of the Center for 

6 Substance Abuse Treatment shall provide awards of 

7 grants, cooperative agreement, or contracts to public and 

8 nonprofit private entities for the purpose of providing to 

9 pregnant and parenting women treatment for substance 

10 use disorders through programs in which, during the 

11 course of receiving treatment— 

12 ‘‘(1) the women reside in or receive outpatient 

13 treatment services from facilities provided by the 

14 programs; 

15 ‘‘(2) the minor children of the women reside 

16 with the women in such facilities, if the women so 

17 request; and 

18 ‘‘(3) the services described in subsection (d) are 

19 available to or on behalf of the women. 

20 ‘‘(b) AVAILABILITY OF SERVICES FOR EACH PARTIC21 IPANT.—A funding agreement for an award under sub22 section (a) for an applicant is that, in the program oper23 ated pursuant to such subsection— 

24 ‘‘(1) treatment services and each supplemental 

25 service will be available through the applicant, either 


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1 directly or through agreements with other public or 

2 nonprofit private entities; and 

3 ‘‘(2) services will be made available to each 

4 woman and child admitted to the program. 

5 ‘‘(c) INDIVIDUALIZED PLAN OF SERVICES.—A fund6 ing agreement for an award under subsection (a) for an 

7 applicant is that— 

8 ‘‘(1) in providing authorized services for an eli9 gible woman pursuant to such subsection, the appli10 cant will, in consultation with the women, prepare 

11 an individualized plan for the provision of services 

12 for the woman and her child; and 

13 ‘‘(2) treatment services under the plan will in14 clude— 

15 ‘‘(A) individual, group, and family coun16 seling, as appropriate, regarding substance use 

17 disorders; and 

18 ‘‘(B) follow-up services to assist the 

19 woman in preventing a relapse into such abuse. 

20 ‘‘(d) REQUIRED SUPPLEMENTAL SERVICES.—In the 

21 case of an eligible woman, the services referred to in sub22 section (a)(3) are as follows: 

23 ‘‘(1) Prenatal and postpartum health care. 

24 ‘‘(2) Referrals for necessary hospital services. 


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1 ‘‘(3) For the infants and children of the 

2 woman— 

3 ‘‘(A) pediatric health care, including treat4 ment for any perinatal effects of maternal sub5 stance use disorders and including screenings 

6 regarding the physical and mental development 

7 of the infants and children; 

8 ‘‘(B) counseling and other mental health 

9 services, in the case of children; and 

10 ‘‘(C) comprehensive social services. 

11 ‘‘(4) Providing therapeutic, comprehensive child 

12 care for children during the periods in which the 

13 woman is engaged in therapy or in other necessary 

14 health and rehabilitative activities. 

15 ‘‘(5) Training in parenting. 

16 ‘‘(6) Counseling on the human immuno17 deficiency virus and on acquired immune deficiency 

18 syndrome. 

19 ‘‘(7) Counseling on domestic violence and sexual 

20 abuse. 

21 ‘‘(8) Counseling on obtaining employment, in22 cluding the importance of graduating from a sec23 ondary school. 

24 ‘‘(9) Reasonable efforts to preserve and support 

25 the family unit of the woman, including promoting 


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1 the appropriate involvement of parents and others, 

2 and counseling the children of the woman. 

3 ‘‘(10) Planning for and counseling to assist re4 entry into society, both before and after discharge, 

5 including referrals to any public or nonprofit private 

6 entities in the community involved that provide serv7 ices appropriate for the woman and the children of 

8 the woman. 

9 ‘‘(11) Case management services, including— 

10 ‘‘(A) assessing the extent to which author11 ized services are appropriate for the woman and 

12 her children; 

13 ‘‘(B) in the case of the services that are 

14 appropriate, ensuring that the services are pro15 vided in a coordinated manner; 

16 ‘‘(C) assistance in establishing eligibility 

17 for assistance under Federal, State, and local 

18 programs providing health services, mental 

19 health services, housing services, employment 

20 services, educational services, or social services; 

21 and 

22 ‘‘(D) family reunification with children in 

23 kinship or foster care arrangements, where safe 

24 and appropriate. 


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1 ‘‘(e) MINIMUM QUALIFICATIONS FOR RECEIPT OF

2 AWARD.— 

3 ‘‘(1) CERTIFICATION BY RELEVANT STATE

4 AGENCY.—With respect to the principal agency of 

5 the State involved that administers programs relat6 ing to substance use disorders, the Director may 

7 make an award under subsection (a) to an applicant 

8 only if the agency has certified to the Director 

9 that— 

10 ‘‘(A) the applicant has the capacity to 

11 carry out a program described in subsection (a); 

12 ‘‘(B) the plans of the applicant for such a 

13 program are consistent with the policies of such 

14 agency regarding the treatment of substance 

15 use disorders; and 

16 ‘‘(C) the applicant, or any entity through 

17 which the applicant will provide authorized 

18 services, meets all applicable State licensure or 

19 certification requirements regarding the provi20 sion of the services involved. 

21 ‘‘(2) STATUS AS MEDICAID PROVIDER.— 

22 ‘‘(A) IN GENERAL.—Subject to subpara23 graphs (B) and (C), the Director may make an 

24 award under subsection (a) only if, in the case 

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1 suant to the State plan approved under title 

2 XIX of the Social Security Act for the State in3 volved— 

4 ‘‘(i) the applicant for the award will 

5 provide the service directly, and the appli6 cant has entered into a participation agree7 ment under the State plan and is qualified 

8 to receive payments under such plan; or 

9 ‘‘(ii) the applicant will enter into an 

10 agreement with a public or nonprofit pri11 vate entity under which the entity will pro12 vide the service, and the entity has entered 

13 into such a participation agreement plan 

14 and is qualified to receive such payments. 

15 ‘‘(B) WAIVER OF PARTICIPATION AGREE16 MENTS.— 

17 ‘‘(i) IN GENERAL.—In the case of an 

18 entity making an agreement pursuant to 

19 subparagraph (A)(ii) regarding the provi20 sion of services, the requirement estab21 lished in such subparagraph regarding a 

22 participation agreement shall be waived by 

23 the Director if the entity does not, in pro24 viding health care services, impose a 

25 charge or accept reimbursement available 


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1 from any third-party payor, including re2 imbursement under any insurance policy or 

3 under any Federal or State health benefits 

4 plan. 

5 ‘‘(ii) DONATIONS.—A determination 

6 by the Director of whether an entity re7 ferred to in clause (i) meets the criteria for 

8 a waiver under such clause shall be made 

9 without regard to whether the entity ac10 cepts voluntary donations regarding the 

11 provision of services to the public. 

12 ‘‘(C) NONAPPLICATION OF CERTAIN RE13 QUIREMENTS.—With respect to any authorized 

14 service that is available pursuant to the State 

15 plan described in subparagraph (A), the re16 quirements established in such subparagraph 

17 shall not apply to the provision of any such 

18 service by an institution for mental diseases to 

19 an individual who has attained 21 years of age 

20 and who has not attained 65 years of age. For 

21 purposes of the preceding sentence, the term 

22 ‘institution for mental diseases’ has the mean23 ing given such term in section 1905(i) of the 

24 Social Security Act. 

25 ‘‘(f) REQUIREMENT OF MATCHING FUNDS.— 


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1 ‘‘(1) IN GENERAL.—With respect to the costs of 

2 the program to be carried out by an applicant pursu3 ant to subsection (a), a funding agreement for an 

4 award under such subsection is that the applicant 

5 will make available (directly or through donations 

6 from public or private entities) non-Federal con7 tributions toward such costs in an amount that— 

8 ‘‘(A) for the first fiscal year for which the 

9 applicant receives payments under an award 

10 under such subsection, is not less than $1 for 

11 each $9 of Federal funds provided in the 

12 award; 

13 ‘‘(B) for any second such fiscal year, is not 

14 less than $1 for each $9 of Federal funds pro15 vided in the award; and 

16 ‘‘(C) for any subsequent such fiscal year, is 

17 not less than $1 for each $3 of Federal funds 

18 provided in the award. 

19 ‘‘(2) DETERMINATION OF AMOUNT CONTRIB20 UTED.—Non-Federal contributions required in para21 graph (1) may be in cash or in kind, fairly evalu22 ated, including plant, equipment, or services. 

23 Amounts provided by the Federal Government, or 

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1 cluded in determining the amount of such non-Fed2 eral contributions. 

3 ‘‘(g) OUTREACH.—A funding agreement for an award 

4 under subsection (a) for an applicant is that the applicant 

5 will provide outreach services in the community involved 

6 to identify women who are engaging in substance use dis7 orders and to encourage the women to undergo treatment 

8 for such abuse. 

9 ‘‘(h) ACCESSIBILITY OF PROGRAM; CULTURAL CON10 TEXT OF SERVICES.—A funding agreement for an award 

11 under subsection (a) for an applicant is that— 

12 ‘‘(1) the program operated pursuant to such 

13 subsection will be operated at a location that is ac14 cessible to low-income pregnant and parenting 

15 women; and 

16 ‘‘(2) authorized services will be provided in the 

17 language and the cultural context that is most ap18 propriate. 

19 ‘‘(i) CONTINUING EDUCATION.—A funding agree20 ment for an award under subsection (a) is that the appli21 cant involved will provide for continuing education in 

22 treatment services for the individuals who will provide 

23 treatment in the program to be operated by the applicant 

24 pursuant to such subsection. 


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1 ‘‘(j) IMPOSITION OF CHARGES.—A funding agree2 ment for an award under subsection (a) for an applicant 

3 is that, if a charge is imposed for the provision of author4 ized services to on behalf of an eligible woman, such 

5 charge— 

6 ‘‘(1) will be made according to a schedule of 

7 charges that is made available to the public; 

8 ‘‘(2) will be adjusted to reflect the income of 

9 the woman involved; and 

10 ‘‘(3) will not be imposed on any such woman 

11 with an income of less than 185 percent of the offi12 cial poverty line, as established by the Director of 

13 the Office of Management and Budget and revised 

14 by the Secretary in accordance with section 673(2) 

15 of the Omnibus Budget Reconciliation Act of 1981. 

16 ‘‘(k) REPORTS TO DIRECTOR.—A funding agreement 

17 for an award under subsection (a) is that the applicant 

18 involved will submit to the Director a report— 

19 ‘‘(1) describing the utilization and costs of serv20 ices provided under the award; 

21 ‘‘(2) specifying the number of women served, 

22 the number of infants served, and the type and costs 

23 of services provided; and 

24 ‘‘(3) providing such other information as the 

25 Director determines to be appropriate. 


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1 ‘‘(l) REQUIREMENT OF APPLICATION.—The Director 

2 may make an award under subsection (a) only if an appli3 cation for the award is submitted to the Director con4 taining such agreements, and the application is in such 

5 form, is made in such manner, and contains such other 

6 agreements and such assurances and information as the 

7 Director determines to be necessary to carry out this sec8 tion. 

9 ‘‘(m) ALLOCATION OF AWARDS.—In making awards 

10 under subsection (a), the Director shall give priority to 

11 any entity that agrees to use the award for a program 

12 serving an area that is a rural area, an area designated 

13 under section 332 by the Administrator of the Health Re14 sources and Services Administration as a health profes15 sional shortage area with a shortage of professionals, or 

16 an area determined by the Director to have a shortage 

17 of family-based substance use disorder treatment options. 

18 ‘‘(n) DURATION OF AWARD.—The period during 

19 which payments are made to an entity from an award 

20 under subsection (a) may not exceed 5 years. The provi21 sion of such payments shall be subject to annual approval 

22 by the Director of the payments and subject to the avail23 ability of appropriations for the fiscal year involved to 

24 make the payments. This subsection may not be construed 


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1 to establish a limitation on the number of awards under 

2 such subsection that may be made to an entity. 

3 ‘‘(o) EVALUATIONS; DISSEMINATION OF FINDINGS.— 

4 The Director shall, directly or through contract, provide 

5 for the conduct of evaluations of programs carried out 

6 pursuant to subsection (a). The Director shall disseminate 

7 to the States the findings made as a result of the evalua8 tions. 

9 ‘‘(p) DEFINITIONS.—For purposes of this section: 

10 ‘‘(1) The term ‘authorized services’ means 

11 treatment services and supplemental services. 

12 ‘‘(2) The term ‘eligible woman’ means a woman 

13 who has been admitted to a program operated pur14 suant to subsection (a). 

15 ‘‘(3) The term ‘funding agreement’, with re16 spect to an award under subsection (a), means that 

17 the Director may make the award only if the appli18 cant makes the agreement involved. 

19 ‘‘(4) The term ‘treatment services’ means treat20 ment for substance use disorders, including the 

21 counseling and services described in subsection 

22 (c)(2). 

23 ‘‘(5) The term ‘supplemental services’ means 

24 the services described in subsection (d). 


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1 ‘‘(q) AUTHORIZATION OF APPROPRIATIONS.—For the 

2 purpose of carrying out this section, there are authorized 

3 to be appropriated $50,000,000 for each of fiscal years 

4 2011 through 2015. 

5 ‘‘SEC. 512. PRIORITY SUBSTANCE USE DISORDER TREAT6 MENT NEEDS OF REGIONAL AND NATIONAL 

7 SIGNIFICANCE. 

8 ‘‘(a) PROJECTS.—The Secretary shall address pri9 ority substance use disorder treatment needs of regional 

10 and national significance (as determined under subsection 

11 (b)) through the provision of or through assistance for— 

12 ‘‘(1) knowledge development and application 

13 projects for treatment and rehabilitation and the 

14 conduct or support of evaluations of such projects; 

15 ‘‘(2) training and technical assistance; and 

16 ‘‘(3) targeted capacity response programs that 

17 permit States, local jurisdictions, communities, and 

18 American Indian and Alaska Native tribes to focus 

19 on emerging trends in substance use and co-occur20 rence of substance use disorders with mental illness 

21 or other disorders. 

22 The Secretary may carry out the activities described in 

23 this section directly or through grants, contracts, or coop24 erative agreements with States, political subdivisions of 

25 States, territories, American Indian and Alaska Native 


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1 tribes, tribal organizations, or a health facility or program 

2 operated by or pursuant to a contract or grant with the 

3 Indian Health Service, and other public or nonprofit pri4 vate entities. 

5 ‘‘(b) PRIORITY SUBSTANCE USE DISORDER TREAT6 MENT NEEDS.— 

7 ‘‘(1) IN GENERAL.—Priority substance use dis8 order treatment needs of regional and national sig9 nificance shall be determined by the Secretary after 

10 consultation with States and other interested groups. 

11 The Secretary shall meet with the States and inter12 ested groups on an annual basis to discuss program 

13 priorities. 

14 ‘‘(2) SPECIAL CONSIDERATION.—In developing 

15 program priorities under paragraph (1), the Sec16 retary shall give special consideration to promoting 

17 the integration of substance use disorder treatment 

18 services into primary health care systems and to 

19 provide treatment for older adults with substance 

20 use disorders. 

21 ‘‘(c) REQUIREMENTS.— 

22 ‘‘(1) IN GENERAL.—Recipients of grants, con23 tracts, or cooperative agreements under this section 

24 shall comply with information and application re25 quirements determined appropriate by the Secretary. 


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1 ‘‘(2) DURATION OF AWARD.—With respect to a 

2 grant, contract, or cooperative agreement awarded 

3 under this section, the period during which pay4 ments under such award are made to the recipient 

5 may not exceed 5 years. 

6 ‘‘(3) MATCHING FUNDS.—The Secretary may, 

7 for projects carried out under subsection (a), require 

8 that entities that apply for grants, contracts, or co9 operative agreements under that project provide 

10 non-Federal matching funds, as determined appro11 priate by the Secretary, to ensure the institutional 

12 commitment of the entity to the projects funded 

13 under the grant, contract, or cooperative agreement. 

14 Such non-Federal matching funds may be provided 

15 directly or through donations from public or private 

16 entities and may be in cash or in kind, fairly evalu17 ated, including plant, equipment, or services. 

18 ‘‘(4) MAINTENANCE OF EFFORT.—With respect 

19 to activities for which a grant, contract, or coopera20 tive agreement is awarded under this section, the 

21 Secretary may require that recipients for specific 

22 projects under subsection (a) agree to maintain ex23 penditures of non-Federal amounts for such activi24 ties at a level that is not less than the level of such 

25 expenditures maintained by the entity for the fiscal 


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1 year preceding the fiscal year for which the entity 

2 receives such a grant, contract, or cooperative agree3 ment. 

4 ‘‘(d) EVALUATION.—The Secretary shall evaluate 

5 each project carried out under subsection (a)(1) and shall 

6 disseminate the findings with respect to each such evalua7 tion to appropriate public and private entities. 

8 ‘‘(e) INFORMATION AND EDUCATION.—The Secretary 

9 shall establish comprehensive information and education 

10 programs to disseminate and apply the findings of the 

11 knowledge development and application, training and tech12 nical assistance programs, and targeted capacity response 

13 programs under this section to the general public, to 

14 health professionals and other interested groups. The Sec15 retary shall make every effort to provide linkages between 

16 the findings of supported projects and State agencies re17 sponsible for carrying out substance use disorder preven18 tion and treatment programs. 

19 ‘‘(f) AUTHORIZATION OF APPROPRIATION.—There 

20 are authorized to be appropriated to carry out this section, 

21 $500,000,000 for fiscal year 2011, and such sums as may 

22 be necessary for each of the fiscal years 2012 through 

23 2015. 


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1 ‘‘SEC. 513. SERVICES TO ASSIST LOCAL COMMUNITIES IN 

2 ADDRESSING EMERGING DRUGS. 

3 ‘‘(a) GRANTS.— 

4 ‘‘(1) IN GENERAL.—The Secretary shall award 

5 grants to eligible entities to assist local communities 

6 in addressing emerging drug issues. 

7 ‘‘(2) DEFINITION.—In this section, the term 

8 ‘emerging drug issue’ means, with respect to an 

9 area— 

10 ‘‘(A) a drug treatment problem that has 

11 occurred because of— 

12 ‘‘(i) a sudden increase in the demand 

13 for drug treatment in the area; or 

14 ‘‘(ii) the necessity of drug treatment 

15 protocols that the area is not equipped to 

16 provide; and 

17 ‘‘(B) the lack of resources within the area 

18 to address the problem. 

19 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

20 under this section, an entity shall— 

21 ‘‘(1) be a public or nonprofit private entity, in22 cluding American Indian and Alaska Native tribes, 

23 tribal organizations, or a health facility or program 

24 operated by or pursuant to a contract or grant with 

25 the Indian Health Service; 


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1 ‘‘(2) submit to the Secretary an application at 

2 such time, in such manner, and containing such in3 formation as the Secretary may require, including— 

4 ‘‘(A) information that demonstrates an 

5 emerging drug issue in the area to be served 

6 under the grant and the lack of available re7 sources to address such issue; 

8 ‘‘(B) a description of the area to be served 

9 under the grant and the target population, if 

10 relevant, and the need of such population for 

11 services; 

12 ‘‘(C) data on the prevalence of the emerg13 ing drug involved using whatever data may be 

14 available from the appropriate State or local 

15 agencies, including admissions data, waiting 

16 lists, data from law enforcement, and other 

17 data to establish that there is an emerging drug 

18 problem; 

19 ‘‘(D) a summary of the need involved that 

20 is based not only on prevalence but the fact 

21 that the emerging drug requires skills that the 

22 area does not have; 

23 ‘‘(E) a statement on the attempts by the 

24 local areas to find funding from other sources 

25 including the State; 


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1 ‘‘(F) information to demonstrate that the 

2 identified need is consistent with the State pri3 orities (as evidenced by a letter from the gov4 ernor of the State); 

5 ‘‘(G) a list of goals and objectives with re6 spect to activities under the grant; 

7 ‘‘(H) an assurance that the entity will use 

8 evidence-based practices, when available, in pro9 viding services under the grant; and 

10 ‘‘(I) an assurance that treatment activities 

11 will be coordinated with prevention efforts. 

12 ‘‘(c) USE OF FUNDS.—An entity shall use amounts 

13 received under a grant to— 

14 ‘‘(1) carry out outreach and other strategies to 

15 increase participation in, and access to, drug treat16 ment services; 

17 ‘‘(2) provide outpatient or residential drug 

18 treatment services, including screening, assessment, 

19 and care management services; 

20 ‘‘(3) provide for the involvement of friends and 

21 families in drug treatment; and 

22 ‘‘(4) provide recovery support services that help 

23 prevent relapse and promote sustained recovery, in24 cluding assistance with employment, housing, and 

25 establishing community connections. 


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1 ‘‘(d) COORDINATION OF SERVICES.—An entity that 

2 receives a grant under this section shall ensure that— 

3 ‘‘(1) services provided under the grant are co4 ordinated with other community, social, and health 

5 agency service provider programs, including pro6 grams conducted by mental health departments, so7 cial services departments, health departments, edu8 cation agencies, juvenile and adult justice systems, 

9 and child welfare agencies; and 

10 ‘‘(2) drug treatment service systems are 

11 partnered with prevention systems. 

12 ‘‘(e) PRIORITY.—In awarding grants under this sec13 tion, the Secretary shall give priority to entities that use 

14 a portion of grant funds to serve rural areas. 

15 ‘‘(f) DATA COLLECTION.—A grantee shall collect 

16 data on the national outcome measures established under 

17 section 504(b) and any other data needed to demonstrate 

18 the success of the grantee in achieving the goals and objec19 tives described in its application under subsection 

20 (b)(2)(F). 

21 ‘‘(g) EVALUATION.—A grantee shall conduct and 

22 evaluation of the activities carried out under the grant and 

23 provide the results of such evaluation to the Secretary. 

24 ‘‘(h) GRANT PERIOD.—The period of a grant under 

25 this section shall be 3 years. 


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1 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated to carry out this section, 

3 such sums as may be necessary for each of fiscal years 

4 2011 through 2015. 

5 ‘‘SEC. 514. ACTION BY THE CENTER FOR SUBSTANCE ABUSE 

6 TREATMENT AND STATES CONCERNING MILI7 TARY FACILITIES. 

8 ‘‘(a) CENTER FOR SUBSTANCE ABUSE TREAT9 MENT.—The Director of the Center for Substance Abuse 

10 Treatment shall— 

11 ‘‘(1) coordinate with the agencies represented 

12 on the Commission on Alternative Utilization of 

13 Military Facilities the utilization of military facilities 

14 or parts thereof, as identified by such Commission, 

15 established under the National Defense Authoriza16 tion Act of 1989, that could be utilized or renovated 

17 to house nonviolent persons for drug treatment pur18 poses; 

19 ‘‘(2) notify State agencies responsible for the 

20 oversight of drug abuse treatment entities and pro21 grams of the availability of space at the installations 

22 identified in paragraph (1); and 

23 ‘‘(3) assist State agencies responsible for the 

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1 lations described in paragraph (1) into residential 

2 treatment centers. 

3 ‘‘(b) STATES.—With regard to military facilities or 

4 parts thereof, as identified by the Commission on Alter5 native Utilization of Military Facilities established under 

6 section 3042 of the Comprehensive Alcohol Abuse, Drug 

7 Abuse, and Mental Health Amendments Act of 1988, that 

8 could be utilized or renovated to house nonviolent persons 

9 for drug treatment purposes, State agencies responsible 

10 for the oversight of drug abuse treatment entities and pro11 grams shall— 

12 ‘‘(1) establish eligibility criteria for the treat13 ment of individuals at such facilities; 

14 ‘‘(2) select treatment providers to provide drug 

15 abuse treatment at such facilities; 

16 ‘‘(3) provide assistance to treatment providers 

17 selected under paragraph (2) to assist such pro18 viders in securing financing to fund the cost of the 

19 programs at such facilities; and 

20 ‘‘(4) establish, regulate, and coordinate with the 

21 military official in charge of the facility, work pro22 grams for individuals receiving treatment at such fa23 cilities. 

24 ‘‘(c) RESERVATION OF SPACE.—Prior to notifying 

25 States of the availability of space at military facilities 


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1 under subsection (a)(2), the Director may reserve space 

2 at such facilities to conduct research or demonstration 

3 projects. 

4 ‘‘SEC. 515. SUBSTANCE USE DISORDER TREATMENT AND 

5 EARLY INTERVENTION SERVICES FOR CHIL6 DREN AND ADOLESCENTS. 

7 ‘‘(a) IN GENERAL.—The Secretary shall award 

8 grants, contracts, or cooperative agreements to public and 

9 private nonprofit entities, including American Indian and 

10 Alaska Native tribes, tribal organizations, or a health fa11 cility or program operated by or pursuant to a contract 

12 or grant with the Indian Health Service, for the purpose 

13 of— 

14 ‘‘(1) providing early identification and services 

15 to meet the needs of children and adolescents who 

16 are at risk of substance use disorders; and 

17 ‘‘(2) providing substance use disorder treatment 

18 services for children, including children and adoles19 cents with co-occurring mental illness and substance 

20 use disorders. 

21 ‘‘(b) PRIORITY.—In awarding grants, contracts, or 

22 cooperative agreements under subsection (a), the Sec23 retary shall give priority to applicants who propose to— 

24 ‘‘(1) apply evidence-based and cost effective 

25 methods; 


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1 ‘‘(2) coordinate the provision of services with 

2 other social service agencies in the community, in3 cluding educational, juvenile justice, child welfare, 

4 substance abuse, and mental health agencies; 

5 ‘‘(3) provide a continuum of integrated treat6 ment services, including case management, for chil7 dren and adolescents with substance use disorders, 

8 including children and adolescents with co-occurring 

9 mental illness and substance use disorders and their 

10 families; 

11 ‘‘(4) provide services that are gender-specific 

12 and culturally appropriate; 

13 ‘‘(5) involve and work with families of children 

14 and adolescents receiving services; and 

15 ‘‘(6) provide aftercare services for children and 

16 adolescents and their families after completion of 

17 treatment. 

18 ‘‘(c) DURATION OF GRANTS.—The Secretary shall 

19 award grants, contracts, or cooperative agreements under 

20 subsection (a) for 5 fiscal years. 

21 ‘‘(d) APPLICATION.—An entity desiring a grant, con22 tract, or cooperative agreement under subsection (a) shall 

23 submit an application to the Secretary at such time, in 

24 such manner, and accompanied by such information as the 

25 Secretary may reasonably require. 


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1 ‘‘(e) EVALUATION.—An entity that receives a grant, 

2 contract, or cooperative agreement under subsection (a) 

3 shall submit, in the application for such grant, contract, 

4 or cooperative agreement, a plan for the evaluation of any 

5 project undertaken with funds provided under this section. 

6 Such entity shall provide the Secretary with periodic eval7 uations of the progress of such project and such evaluation 

8 at the completion of such project as the Secretary deter9 mines to be appropriate. 

10 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

11 are authorized to be appropriated to carry out this section, 

12 $60,000,000 for fiscal year 2011, and such sums as may 

13 be necessary for fiscal years 2012 through 2015. 

14 ‘‘Subpart 2—Center for Substance Abuse Prevention 

15 ‘‘SEC. 520. CENTER FOR SUBSTANCE ABUSE PREVENTION. 

16 ‘‘(a) IN GENERAL.—There is established in the Ad17 ministration a Center for Substance Abuse Prevention 

18 (hereafter referred to in this part as the ‘Prevention Cen19 ter’). The Center shall be headed by a Director appointed 

20 by the Secretary from individuals with extensive experi21 ence or academic qualifications in the prevention of drug 

22 or alcohol abuse. 

23 ‘‘(b) DUTIES.—The Director of the Prevention Cen24 ter shall— 


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1 ‘‘(1) sponsor regional workshops on the preven2 tion of drug and alcohol abuse through the reduction 

3 of risk and the promotion of resiliency; 

4 ‘‘(2) coordinate the findings of research spon5 sored by agencies of the Service on the prevention 

6 of drug and alcohol abuse; 

7 ‘‘(3) develop effective drug and alcohol abuse 

8 prevention literature (including literature on the ad9 verse effects of emerging drugs); 

10 ‘‘(4) in cooperation with the Secretary of Edu11 cation, assure the widespread dissemination of pre12 vention materials among States, political subdivi13 sions, and school systems; 

14 ‘‘(5) support clinical training programs for sub15 stance use disorder prevention practitioners and 

16 other health professionals involved in drug abuse 

17 education, prevention; 

18 ‘‘(6) in cooperation with the Director of the 

19 Centers for Disease Control and Prevention, develop 

20 educational materials designed to increase awareness 

21 of those at greatest risk for substance use disorders 

22 thereby preventing new infections and reducing the 

23 probability of the transmission of HIV, Hepatitis C, 

24 sexually transmitted diseases, tuberculosis, and other 

25 communicable diseases; 


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1 ‘‘(7) conduct training, technical assistance, data 

2 collection, and evaluation activities of programs sup3 ported under the Drug Free Schools and Commu4 nities Act of 1986; 

5 ‘‘(8) support the development of model, innova6 tive, community-based programs that reduce the risk 

7 of substance use and promote resiliency among 

8 young people; 

9 ‘‘(9) collaborate with the Attorney General of 

10 the Department of Justice to develop programs to 

11 prevent drug abuse among high risk youth; 

12 ‘‘(10) prepare for distribution documentary 

13 films and public service announcements for television 

14 and radio to educate the public, especially adolescent 

15 audiences, concerning the dangers to health result16 ing from the consumption of alcohol and drugs and, 

17 to the extent feasible, use appropriate private orga18 nizations and business concerns in the preparation 

19 of such announcements; and 

20 ‘‘(11) develop and support innovative dem21 onstration programs designed to identify and deter 

22 the improper use or abuse of anabolic steroids by 

23 students, especially students in secondary schools. 

24 ‘‘(c) GRANTS, CONTRACTS, COOPERATIVE AGREE25 MENTS.—The Director may make grants and enter into 


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1 contracts and cooperative agreements in carrying out sub2 section (b). 

3 ‘‘SEC. 521. PRIORITY SUBSTANCE USE DISORDER PREVEN4 TION NEEDS OF REGIONAL AND NATIONAL 

5 SIGNIFICANCE. 

6 ‘‘(a) PROJECTS.—The Secretary shall address pri7 ority substance use disorder prevention needs of regional 

8 and national significance (as determined under subsection 

9 (b)) through the provision of or through assistance for— 

10 ‘‘(1) knowledge development and application 

11 projects for prevention and the conduct or support 

12 of evaluations of such projects; 

13 ‘‘(2) training and technical assistance; and 

14 ‘‘(3) targeted capacity response programs, in15 cluding a focus on emerging drugs. 

16 The Secretary may carry out the activities described in 

17 this section directly or through grants, contracts, or coop18 erative agreements with States, territories, political sub19 divisions of States, American Indian and Alaska Native 

20 tribes, tribal organizations and a health facility or pro21 gram operated by or pursuant to a contract or grant with 

22 the Indian Health Service, or other public or nonprofit pri23 vate entities. 

24 ‘‘(b) PRIORITY SUBSTANCE USE DISORDER PREVEN25 TION NEEDS.— 


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1 ‘‘(1) IN GENERAL.—Priority substance use dis2 order prevention needs of regional and national sig3 nificance shall be determined by the Secretary in 

4 consultation with the States and other interested 

5 groups. The Secretary shall meet with the States 

6 and interested groups on an annual basis to discuss 

7 program priorities. 

8 ‘‘(2) SPECIAL PRIORITY AND CONSIDER9 ATION.— 

10 ‘‘(A) PRIORITY.—In developing priority 

11 needs under paragraph (1), the Secretary shall 

12 ensure that specific priority is given to high risk 

13 youth, including youth who— 

14 ‘‘(i) are failing in, or who have 

15 dropped out of, school; 

16 ‘‘(ii) associate with peers who engage 

17 in substance use; 

18 ‘‘(iii) live in communities where drugs 

19 and alcohol are readily available; 

20 ‘‘(iv) are raised in a family with a his21 tory of problem behaviors including drug 

22 and alcohol abuse; 

23 ‘‘(v) are identified as children of a 

24 substance abuser; 


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1 ‘‘(vi) are victims of physical, sexual, 

2 or psychological abuse; 

3 ‘‘(vii) have committed a violent or de4 linquent act; 

5 ‘‘(viii) have experienced mental health 

6 problems; 

7 ‘‘(ix) have attempted suicide; or 

8 ‘‘(x) have experienced long-term phys9 ical pain due to injury. 

10 ‘‘(B) CONSIDERATIONS.—In developing 

11 program priorities under paragraph (1), the 

12 Secretary shall give special consideration to— 

13 ‘‘(i) applying the most promising 

14 strategies and research-based primary pre15 vention approaches; 

16 ‘‘(ii) promoting the integration of sub17 stance use disorder prevention information 

18 and activities into primary health care sys19 tems; and 

20 ‘‘(iii) supporting education projects 

21 that focus on, or include, specific informa22 tion about the oral health risks and condi23 tions associated with drug use. 

24 ‘‘(c) REQUIREMENTS.— 


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1 ‘‘(1) IN GENERAL.—Recipients of grants, con2 tracts, and cooperative agreements under this sec3 tion shall comply with information and application 

4 requirements determined appropriate by the Sec5 retary. 

6 ‘‘(2) DURATION OF AWARD.—With respect to a 

7 grant, contract, or cooperative agreement awarded 

8 under this section, the period during which pay9 ments under such award are made to the recipient 

10 may not exceed 5 years. 

11 ‘‘(3) MATCHING FUNDS.—The Secretary may, 

12 for projects carried out under subsection (a), require 

13 that entities that apply for grants, contracts, or co14 operative agreements under that project provide 

15 non-Federal matching funds, as determined appro16 priate by the Secretary, to ensure the institutional 

17 commitment of the entity to the projects funded 

18 under the grant, contract, or cooperative agreement. 

19 Such non-Federal matching funds may be provided 

20 directly or through donations from public or private 

21 entities and may be in cash or in kind, fairly evalu22 ated, including plant, equipment, or services. 

23 ‘‘(4) MAINTENANCE OF EFFORT.—With respect 

24 to activities for which a grant, contract, or coopera25 tive agreement is awarded under this section, the 


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1 Secretary may require that recipients for specific 

2 projects under subsection (a) agree to maintain ex3 penditures of non-Federal amounts for such activi4 ties at a level that is not less than the level of such 

5 expenditures maintained by the entity for the fiscal 

6 year preceding the fiscal year for which the entity 

7 receives such a grant, contract, or cooperative agree8 ment. 

9 ‘‘(d) EVALUATION.—The Secretary shall evaluate 

10 each project carried out under subsection (a)(1) and shall 

11 disseminate the findings with respect to each such evalua12 tion to appropriate public and private entities. 

13 ‘‘(e) INFORMATION AND EDUCATION.—The Secretary 

14 shall establish comprehensive information and education 

15 programs to disseminate the findings of the knowledge de16 velopment and application, training and technical assist17 ance programs, and targeted capacity response programs 

18 under this section to the general public and to health pro19 fessionals. The Secretary shall make every effort to pro20 vide linkages between the findings of supported projects 

21 and State agencies responsible for carrying out substance 

22 use disorder prevention and treatment programs. 

23 ‘‘(f) AUTHORIZATION OF APPROPRIATION.—There 

24 are authorized to be appropriated to carry out this section, 

25 $300,000,000 for fiscal year 2011, and such sums as may 


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1 be necessary for each of the fiscal years 2012 through 

2 2015. 

3 ‘‘SEC. 522. PROGRAMS TO REDUCE UNDERAGE DRINKING. 

4 ‘‘(a) DEFINITIONS.—For purposes of this section: 

5 ‘‘(1) The term ‘alcohol beverage industry’ 

6 means the brewers, vintners, distillers, importers, 

7 distributors, and retail or online outlets that sell or 

8 serve beer, wine, and distilled spirits. 

9 ‘‘(2) The term ‘school-based prevention’ means 

10 programs, which are institutionalized, and run by 

11 staff members or school-designated persons or orga12 nizations in any grade of school, kindergarten 

13 through 12th grade. 

14 ‘‘(3) The term ‘youth’ means persons under the 

15 age of 21. 

16 ‘‘(4) The term ‘IOM report’ means the report 

17 released in September 2003 by the National Re18 search Council, Institute of Medicine, and entitled 

19 ‘Reducing Underage Drinking: A Collective Respon20 sibility’. 

21 ‘‘(b) SENSE OF CONGRESS.—It is the sense of the 

22 Congress that: 

23 ‘‘(1) A multi-faceted effort is needed to more 

24 successfully address the problem of underage drink25 ing in the United States. A coordinated approach to 


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1 prevention, intervention, treatment, enforcement, 

2 and research is key to making progress. This Act 

3 recognizes the need for a focused national effort, 

4 and addresses particulars of the Federal portion of 

5 that effort, as well as Federal support for State ac6 tivities. 

7 ‘‘(2) The Secretary of Health and Human Serv8 ices shall continue to conduct research and collect 

9 data on the short and long-range impact of alcohol 

10 use and abuse upon adolescent brain development 

11 and other organ systems. 

12 ‘‘(3) States and communities, including colleges 

13 and universities, are encouraged to adopt com14 prehensive prevention approaches, including— 

15 ‘‘(A) evidence-based screening, programs 

16 and curricula; 

17 ‘‘(B) brief intervention strategies; 

18 ‘‘(C) consistent policy enforcement; and 

19 ‘‘(D) environmental changes that limit un20 derage access to alcohol. 

21 ‘‘(4) Public health groups, consumer groups, 

22 and the alcohol beverage industry should continue 

23 and expand evidence-based efforts to prevent and re24 duce underage drinking. 


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1 ‘‘(5) The entertainment industries have a pow2 erful impact on youth, and they should use rating 

3 systems and marketing codes to reduce the likeli4 hood that underage audiences will be exposed to 

5 movies, recordings, or television programs with un6 suitable alcohol content. 

7 ‘‘(6) The National Collegiate Athletic Associa8 tion, its member colleges and universities, and ath9 letic conferences should affirm a commitment to a 

10 policy of discouraging alcohol use among underage 

11 students and other young fans. 

12 ‘‘(7) Alcohol is a unique product and should be 

13 regulated differently than other products by the 

14 States and Federal Government. States have pri15 mary authority to regulate alcohol distribution and 

16 sale, and the Federal Government should support 

17 and supplement these State efforts. States also have 

18 a responsibility to fight youth access to alcohol and 

19 reduce underage drinking. Continued State regula20 tion and licensing of the manufacture, importation, 

21 sale, distribution, transportation and storage of alco22 holic beverages are clearly in the public interest and 

23 are critical to promoting responsible consumption, 

24 preventing illegal access to alcohol by persons under 

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1 cial sources, maintaining industry integrity and an 

2 orderly marketplace, and furthering effective State 

3 tax collection. 

4 ‘‘(c) INTERAGENCY COORDINATING COMMITTEE; AN5 NUAL REPORT ON STATE UNDERAGE DRINKING PREVEN6 TION AND ENFORCEMENT ACTIVITIES.— 

7 ‘‘(1) INTERAGENCY COORDINATING COMMITTEE

8 ON THE PREVENTION OF UNDERAGE DRINKING.— 

9 ‘‘(A) IN GENERAL.—The Secretary, in col10 laboration with the Federal officials specified in 

11 subparagraph (B), shall formally establish and 

12 enhance the efforts of the interagency coordi13 nating committee, that began operating in 

14 2004, focusing on underage drinking (referred 

15 to in this subsection as the ‘Committee’). 

16 ‘‘(B) OTHER AGENCIES.—The officials re17 ferred to in paragraph (1) are the Secretary of 

18 Education, the Attorney General, the Secretary 

19 of Transportation, the Secretary of the Treas20 ury, the Secretary of Defense, the Surgeon 

21 General, the Director of the Centers for Disease 

22 Control and Prevention, the Director of the Na23 tional Institute on Alcohol Abuse and Alco24 holism, the Administrator of the Substance 

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1 tion, the Director of the National Institute on 

2 Drug Abuse, the Assistant Secretary for Chil3 dren and Families, the Director of the Office of 

4 National Drug Control Policy, the Adminis5 trator of the National Highway Traffic Safety 

6 Administration, the Administrator of the Office 

7 of Juvenile Justice and Delinquency Prevention, 

8 the Chairman of the Federal Trade Commis9 sion, and such other Federal officials as the 

10 Secretary of Health and Human Services deter11 mines to be appropriate. 

12 ‘‘(C) CHAIR.—The Secretary of Health 

13 and Human Services shall serve as the chair of 

14 the Committee. 

15 ‘‘(D) DUTIES.—The Committee shall guide 

16 policy and program development across the 

17 Federal Government with respect to underage 

18 drinking, provided, however, that nothing in 

19 this section shall be construed as transferring 

20 regulatory or program authority from an Agen21 cy to the Coordinating Committee. 

22 ‘‘(E) CONSULTATIONS.—The Committee 

23 shall actively seek the input of and shall consult 

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1 est groups, foundations, and alcohol beverage 

2 industry trade associations and companies. 

3 ‘‘(F) ANNUAL REPORT.— 

4 ‘‘(i) IN GENERAL.—The Secretary, on 

5 behalf of the Committee, shall annually 

6 submit to the Congress a report that sum7 marizes— 

8 ‘‘(I) all programs and policies of 

9 Federal agencies designed to prevent 

10 and reduce underage drinking; 

11 ‘‘(II) the extent of progress in 

12 preventing and reducing underage 

13 drinking nationally; 

14 ‘‘(III) data that the Secretary 

15 shall collect with respect to the infor16 mation specified in clause (ii); and 

17 ‘‘(IV) such other information re18 garding underage drinking as the Sec19 retary determines to be appropriate. 

20 ‘‘(ii) CERTAIN INFORMATION.—The 

21 report under clause (i) shall include infor22 mation on the following: 

23 ‘‘(I) Patterns and consequences 

24 of underage drinking as reported in 

25 research and surveys such as, but not 


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1 limited to Monitoring the Future, 

2 Youth Risk Behavior Surveillance 

3 System, the National Survey on Drug 

4 Use and Health, and the Fatality 

5 Analysis Reporting System. 

6 ‘‘(II) Measures of the availability 

7 of alcohol from commercial and non8 commercial sources to underage popu9 lations. 

10 ‘‘(III) Measures of the exposure 

11 of underage populations to messages 

12 regarding alcohol in advertising and 

13 the entertainment media as reported 

14 by the Federal Trade Commission. 

15 ‘‘(IV) Surveillance data, includ16 ing information on the onset and 

17 prevalence of underage drinking, con18 sumption patterns and the means of 

19 underage access. The Secretary shall 

20 develop a plan to improve the collec21 tion, measurement and consistency of 

22 reporting Federal underage alcohol 

23 data. 


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1 ‘‘(V) Any additional findings re2 sulting from research conducted or 

3 supported under subsection (f). 

4 ‘‘(VI) Evidence-based best prac5 tices to prevent and reduce underage 

6 drinking and provide treatment serv7 ices to those youth who need them. 

8 ‘‘(2) ANNUAL REPORT ON STATE UNDERAGE

9 DRINKING PREVENTION AND ENFORCEMENT ACTIVI10 TIES.— 

11 ‘‘(A) IN GENERAL.—The Secretary shall, 

12 with input and collaboration from other appro13 priate Federal agencies, States, Indian tribes, 

14 territories, and public health, consumer, and al15 cohol beverage industry groups, annually issue 

16 a report on each State’s performance in enact17 ing, enforcing, and creating laws, regulations, 

18 and programs to prevent or reduce underage 

19 drinking. 

20 ‘‘(B) STATE PERFORMANCE MEASURES.— 

21 ‘‘(i) IN GENERAL.—The Secretary 

22 shall develop, in consultation with the 

23 Committee, a set of measures to be used in 

24 preparing the report on best practices. 


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1 ‘‘(ii) CATEGORIES.—In developing 

2 these measures, the Secretary shall con3 sider categories including, but not limited 

4 to: 

5 ‘‘(I) Whether or not the State 

6 has comprehensive anti-underage 

7 drinking laws such as for the illegal 

8 sale, purchase, attempt to purchase, 

9 consumption, or possession of alcohol; 

10 illegal use of fraudulent ID; illegal 

11 furnishing or obtaining of alcohol for 

12 an individual under 21 years; the de13 gree of strictness of the penalties for 

14 such offenses; and the prevalence of 

15 the enforcement of each of these in16 fractions. 

17 ‘‘(II) Whether or not the State 

18 has comprehensive liability statutes 

19 pertaining to underage access to alco20 hol such as dram shop, social host, 

21 and house party laws, and the preva22 lence of enforcement of each of these 

23 laws. 

24 ‘‘(III) Whether or not the State 

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1 sive enforcement efforts to prevent 

2 underage access to alcohol at retail 

3 outlets, such as random compliance 

4 checks and shoulder tap programs, 

5 and the number of compliance checks 

6 within alcohol retail outlets measured 

7 against the number of total alcohol re8 tail outlets in each State, and the re9 sult of such checks. 

10 ‘‘(IV) Whether or not the State 

11 encourages training on the proper 

12 selling and serving of alcohol for all 

13 sellers and servers of alcohol as a con14 dition of employment. 

15 ‘‘(V) Whether or not the State 

16 has policies and regulations with re17 gard to direct sales to consumers and 

18 home delivery of alcoholic beverages. 

19 ‘‘(VI) Whether or not the State 

20 has programs or laws to deter adults 

21 from purchasing alcohol for minors; 

22 and the number of adults targeted by 

23 these programs. 

24 ‘‘(VII) Whether or not the State 

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1 ents, and caregivers to deter underage 

2 drinking; and the number of individ3 uals served by these programs. 

4 ‘‘(VIII) Whether or not the State 

5 has enacted graduated drivers licenses 

6 and the extent of those provisions. 

7 ‘‘(IX) The amount that the State 

8 invests, per youth capita, on the pre9 vention of underage drinking, further 

10 broken down by the amount spent 

11 on— 

12 ‘‘(aa) compliance check pro13 grams in retail outlets, including 

14 providing technology to prevent 

15 and detect the use of false identi16 fication by minors to make alco17 hol purchases; 

18 ‘‘(bb) checkpoints and satu19 ration patrols that include the 

20 goal of reducing and deterring 

21 underage drinking; 

22 ‘‘(cc) community-based, 

23 school-based, and higher-edu24 cation-based programs to prevent 

25 underage drinking; 


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1 ‘‘(dd) underage drinking 

2 prevention programs that target 

3 youth within the juvenile justice 

4 and child welfare systems; and 

5 ‘‘(ee) other State efforts or 

6 programs as deemed appropriate. 

7 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

8 There are authorized to be appropriated to carry out 

9 this subsection $1,000,000 for fiscal year 2011, and 

10 $1,000,000 for each of the fiscal years 2012 through 

11 2015. 

12 ‘‘(d) NATIONAL MEDIA CAMPAIGN TO PREVENT UN13 DERAGE DRINKING.— 

14 ‘‘(1) SCOPE OF THE CAMPAIGN.—The Secretary 

15 shall continue to fund and oversee the production, 

16 broadcasting, and evaluation of the national adult17 oriented media public service campaign if the Sec18 retary determines that such campaign is effective in 

19 achieving the media campaign’s measurable objec20 tives. 

21 ‘‘(2) REPORT.—The Secretary shall provide a 

22 report to the Congress annually detailing the pro23 duction, broadcasting, and evaluation of the cam24 paign referred to in paragraph (1), and to detail in 

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1 ducing underage drinking, the need for and likely ef2 fectiveness of an expanded adult-oriented media 

3 campaign, and the feasibility and the likely effective4 ness of a national youth-focused media campaign to 

5 combat underage drinking. 

6 ‘‘(3) CONSULTATION REQUIREMENT.—In car7 rying out the media campaign, the Secretary shall 

8 direct the entity carrying out the national adult-ori9 ented media public service campaign to consult with 

10 interested parties including both the alcohol bev11 erage industry and public health and consumer 

12 groups. The progress of this consultative process is 

13 to be covered in the report under paragraph (2). 

14 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

15 There are authorized to be appropriated to carry out 

16 this subsection, $1,000,000 for fiscal year 2011 and 

17 $1,000,000 for each of the fiscal years 2012 through 

18 2015. 

19 ‘‘(e) INTERVENTIONS.— 

20 ‘‘(1) COMMUNITY-BASED COALITION ENHANCE21 MENT GRANTS TO PREVENT UNDERAGE DRINK22 ING.— 

23 ‘‘(A) AUTHORIZATION OF PROGRAM.—The 

24 Administrator of the Substance Abuse and 

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1 sultation with the Director of the Office of Na2 tional Drug Control Policy, shall award, if the 

3 Administrator determines that the Department 

4 of Health and Human Services is not currently 

5 conducting activities that duplicate activities of 

6 the type described in this subsection, ‘enhance7 ment grants’ to eligible entities to design, test, 

8 evaluate and disseminate effective strategies to 

9 maximize the effectiveness of community-wide 

10 approaches to preventing and reducing under11 age drinking. This subsection is subject to the 

12 availability of appropriations. 

13 ‘‘(B) PURPOSES.—The purposes of this 

14 paragraph are to— 

15 ‘‘(i) prevent and reduce alcohol use 

16 among youth in communities throughout 

17 the United States; 

18 ‘‘(ii) strengthen collaboration among 

19 communities, the Federal Government, and 

20 State, local, and tribal governments; 

21 ‘‘(iii) enhance intergovernmental co22 operation and coordination on the issue of 

23 alcohol use among youth; 

24 ‘‘(iv) serve as a catalyst for increased 

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1 tion among all sectors and organizations of 

2 a community that first demonstrates a 

3 long-term commitment to reducing alcohol 

4 use among youth; 

5 ‘‘(v) disseminate to communities time6 ly information regarding state-of-the-art 

7 practices and initiatives that have proven 

8 to be effective in preventing and reducing 

9 alcohol use among youth; and 

10 ‘‘(vi) enhance, not supplant, effective 

11 local community initiatives for preventing 

12 and reducing alcohol use among youth. 

13 ‘‘(C) APPLICATION.—An eligible entity de14 siring an enhancement grant under this para15 graph shall submit an application to the Admin16 istrator at such time, and in such manner, and 

17 accompanied by such information as the Admin18 istrator may require. Each application shall in19 clude— 

20 ‘‘(i) a complete description of the enti21 ty’s current underage alcohol use preven22 tion initiatives and how the grant will ap23 propriately enhance the focus on underage 

24 drinking issues; or 


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1 ‘‘(ii) a complete description of the en2 tity’s current initiatives, and how it will 

3 use this grant to enhance those initiatives 

4 by adding a focus on underage drinking 

5 prevention. 

6 ‘‘(D) USES OF FUNDS.—Each eligible enti7 ty that receives a grant under this paragraph 

8 shall use the grant funds to carry out the ac9 tivities described in such entity’s application 

10 submitted pursuant to subparagraph (C). 

11 Grants under this paragraph shall not exceed 

12 $50,000 per year and may not exceed four 

13 years. 

14 ‘‘(E) SUPPLEMENT NOT SUPPLANT.— 

15 Grant funds provided under this paragraph 

16 shall be used to supplement, not supplant, Fed17 eral and non-Federal funds available for car18 rying out the activities described in this para19 graph. 

20 ‘‘(F) EVALUATION.—Grants under this 

21 paragraph shall be subject to the same evalua22 tion requirements and procedures as the evalua23 tion requirements and procedures imposed on 

24 recipients of drug free community grants. 


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1 ‘‘(G) DEFINITIONS.—For purposes of this 

2 paragraph, the term ‘eligible entity’ means an 

3 organization that is currently receiving or has 

4 received grant funds under the Drug-Free Com5 munities Act of 1997 (21 U.S.C. 1521 et seq.). 

6 ‘‘(H) ADMINISTRATIVE EXPENSES.—Not 

7 more than 6 percent of a grant under this para8 graph may be expended for administrative ex9 penses. 

10 ‘‘(I) AUTHORIZATION OF APPROPRIA11 TIONS.—There are authorized to be appro12 priated to carry out this paragraph $5,000,000 

13 for fiscal year 2011, and $5,000,000 for each 

14 of the fiscal years 2012 through 2015. 

15 ‘‘(2) GRANTS DIRECTED AT PREVENTING AND

16 REDUCING ALCOHOL ABUSE AT INSTITUTIONS OF

17 HIGHER EDUCATION.— 

18 ‘‘(A) AUTHORIZATION OF PROGRAM.—The 

19 Secretary shall award grants to eligible entities 

20 to enable the entities to prevent and reduce the 

21 rate of underage alcohol consumption including 

22 binge drinking among students at institutions 

23 of higher education. 

24 ‘‘(B) APPLICATIONS.—An eligible entity 

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1 graph shall submit an application to the Sec2 retary at such time, in such manner, and ac3 companied by such information as the Secretary 

4 may require. Each application shall include— 

5 ‘‘(i) a description of how the eligible 

6 entity will work to enhance an existing, or 

7 where none exists to build a, statewide coa8 lition; 

9 ‘‘(ii) a description of how the eligible 

10 entity will target underage students in the 

11 State; 

12 ‘‘(iii) a description of how the eligible 

13 entity intends to ensure that the statewide 

14 coalition is actually implementing the pur15 pose of this section and moving toward in16 dicators described in subparagraph (D); 

17 ‘‘(iv) a list of the members of the 

18 statewide coalition or interested parties in19 volved in the work of the eligible entity; 

20 ‘‘(v) a description of how the eligible 

21 entity intends to work with State agencies 

22 on substance use disorder prevention and 

23 education; 

24 ‘‘(vi) the anticipated impact of funds 

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1 venting and reducing the rates of underage 

2 alcohol use; 

3 ‘‘(vii) outreach strategies, including 

4 ways in which the eligible entity proposes 

5 to— 

6 ‘‘(I) reach out to students and 

7 community stakeholders; 

8 ‘‘(II) promote the purpose of this 

9 paragraph; 

10 ‘‘(III) address the range of needs 

11 of the students and the surrounding 

12 communities; and 

13 ‘‘(IV) address community norms 

14 for underage students regarding alco15 hol use; and 

16 ‘‘(viii) such additional information as 

17 required by the Secretary. 

18 ‘‘(C) USES OF FUNDS.—Each eligible enti19 ty that receives a grant under this paragraph 

20 shall use the grant funds to carry out the ac21 tivities described in such entity’s application 

22 submitted pursuant to subparagraph (B). 

23 ‘‘(D) ACCOUNTABILITY.—On the date on 

24 which the Secretary first publishes a notice in 

25 the Federal Register soliciting applications for 


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1 grants under this paragraph, the Secretary 

2 shall include in the notice achievement indica3 tors for the program authorized under this 

4 paragraph. The achievement indicators shall be 

5 designed— 

6 ‘‘(i) to measure the impact that the 

7 statewide coalitions assisted under this 

8 paragraph are having on the institutions of 

9 higher education and the surrounding com10 munities, including changes in the number 

11 of incidents of any kind in which students 

12 have abused alcohol or consumed alcohol 

13 while under the age of 21 (including viola14 tions, physical assaults, sexual assaults, re15 ports of intimidation, disruptions of school 

16 functions, disruptions of student studies, 

17 mental health referrals, illnesses, or 

18 deaths); 

19 ‘‘(ii) to measure the quality and acces20 sibility of the programs or information of21 fered by the eligible entity; and 

22 ‘‘(iii) to provide such other measures 

23 of program impact as the Secretary deter24 mines appropriate. 


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1 ‘‘(E) SUPPLEMENT NOT SUPPLANT.— 

2 Grant funds provided under this paragraph 

3 shall be used to supplement, and not supplant, 

4 Federal and non-Federal funds available for 

5 carrying out the activities described in this 

6 paragraph. 

7 ‘‘(F) DEFINITIONS.—For purposes of this 

8 paragraph: 

9 ‘‘(i) ELIGIBLE ENTITY.—The term ‘el10 igible entity’ means a State, institution of 

11 higher education, or nonprofit entity. 

12 ‘‘(ii) INSTITUTION OF HIGHER EDU13 CATION.—The term ‘institution of higher 

14 education’ has the meaning given the term 

15 in section 101(a) of the Higher Education 

16 Act of 1965. 

17 ‘‘(iii) SECRETARY.—The term ‘Sec18 retary’ means the Secretary of Education. 

19 ‘‘(iv) STATE.—The term ‘State’ 

20 means each of the 50 States, the District 

21 of Columbia, and the Commonwealth of 

22 Puerto Rico. 

23 ‘‘(v) STATEWIDE COALITION.—The 

24 term ‘statewide coalition’ means a coalition 

25 that— 


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1 ‘‘(I) includes, but is not limited 

2 to— 

3 ‘‘(aa) institutions of higher 

4 education within a State; and 

5 ‘‘(bb) a nonprofit group, a 

6 community underage drinking 

7 prevention coalition, or another 

8 substance use disorder prevention 

9 group within a State; and 

10 ‘‘(II) works toward lowering the 

11 alcohol abuse rate by targeting under12 age students at institutions of higher 

13 education throughout the State and in 

14 the surrounding communities. 

15 ‘‘(vi) SURROUNDING COMMUNITY.— 

16 The term ‘surrounding community’ means 

17 the community— 

18 ‘‘(I) that surrounds an institution 

19 of higher education participating in a 

20 statewide coalition; 

21 ‘‘(II) where the students from 

22 the institution of higher education 

23 take part in the community; and 


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1 ‘‘(III) where students from the 

2 institution of higher education live in 

3 off-campus housing. 

4 ‘‘(G) ADMINISTRATIVE EXPENSES.—Not 

5 more than 5 percent of a grant under this para6 graph may be expended for administrative ex7 penses. 

8 ‘‘(H) AUTHORIZATION OF APPROPRIA9 TIONS.—There are authorized to be appro10 priated to carry out this paragraph $6,000,000 

11 for fiscal year 2011, and $6,000,000 for each 

12 of the fiscal years 2012 through 2015. 

13 ‘‘(f) ADDITIONAL RESEARCH.— 

14 ‘‘(1) ADDITIONAL RESEARCH ON UNDERAGE

15 DRINKING.— 

16 ‘‘(A) IN GENERAL.—The Secretary shall, 

17 subject to the availability of appropriations, col18 lect data, and conduct or support research that 

19 is not duplicative of research currently being 

20 conducted or supported by the Department of 

21 Health and Human Services, on underage 

22 drinking, with respect to the following: 

23 ‘‘(i) Comprehensive community-based 

24 programs or strategies and statewide sys25 tems to prevent and reduce underage 


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1 drinking, across the underage years from 

2 early childhood to age 21, including pro3 grams funded and implemented by govern4 ment entities, public health interest groups 

5 and foundations, and alcohol beverage 

6 companies and trade associations. 

7 ‘‘(ii) Annually obtain and report more 

8 precise information than is currently col9 lected on the scope of the underage drink10 ing problem and patterns of underage alco11 hol consumption, including improved 

12 knowledge about the problem and progress 

13 in preventing, reducing and treating under14 age drinking; as well as information on the 

15 rate of exposure of youth to advertising 

16 and other media messages encouraging and 

17 discouraging alcohol consumption. 

18 ‘‘(iii) Compiling information on the in19 volvement of alcohol in unnatural deaths of 

20 persons ages 12 to 20 in the United 

21 States, including suicides, homicides, and 

22 unintentional injuries such as falls, 

23 drownings, burns, poisonings, and motor 

24 vehicle crash deaths. 


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1 ‘‘(B) CERTAIN MATTERS.—The Secretary 

2 shall carry out activities toward the following 

3 objectives with respect to underage drinking: 

4 ‘‘(i) Obtaining new epidemiological 

5 data within the national or targeted sur6 veys that identify alcohol use and attitudes 

7 about alcohol use during pre- and early 

8 adolescence, including harm caused to self 

9 or others as a result of adolescent alcohol 

10 use such as violence, date rape, risky sex11 ual behavior, and prenatal alcohol expo12 sure. 

13 ‘‘(ii) Developing or identifying suc14 cessful clinical treatments for youth with 

15 alcohol problems. 

16 ‘‘(C) PEER REVIEW.—Research under sub17 paragraph (A) shall meet current Federal 

18 standards for scientific peer review. 

19 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

20 There are authorized to be appropriated to carry out 

21 this subsection $6,000,000 for fiscal year 2011, and 

22 $6,000,000 for each of the fiscal years 2012 through 

23 2015. 


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1 ‘‘SEC. 523. SERVICES FOR INDIVIDUALS WITH FETAL ALCO2 HOL SYNDROME. 

3 ‘‘(a) IN GENERAL.—The Secretary shall make 

4 awards of grants, cooperative agreements, or contracts to 

5 public and nonprofit private entities, including American 

6 Indian and Alaska Native tribes, tribal organizations, and 

7 a health facility or program operated by or pursuant to 

8 a contract or grant with the Indian Health Service, to pro9 vide services to individuals diagnosed with fetal alcohol 

10 syndrome or alcohol-related birth defects. 

11 ‘‘(b) USE OF FUNDS.—An award under subsection 

12 (a) may, subject to subsection (d), be used to— 

13 ‘‘(1) screen and test individuals to determine 

14 the type and level of services needed; 

15 ‘‘(2) develop a comprehensive plan for providing 

16 services to the individual; 

17 ‘‘(3) provide mental health counseling; 

18 ‘‘(4) provide substance use disorder prevention 

19 services and treatment, if needed; 

20 ‘‘(5) coordinate services with other social pro21 grams including social services, justice system, edu22 cational services, health services, mental health and 

23 substance use disorder services, financial assistance 

24 programs, vocational services and housing assistance 

25 programs; 

26 ‘‘(6) provide vocational services; 


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1 ‘‘(7) provide health counseling; 

2 ‘‘(8) provide housing assistance; 

3 ‘‘(9) parenting skills training; 

4 ‘‘(10) overall case management; 

5 ‘‘(11) supportive services for families of individ6 uals with Fetal Alcohol Syndrome; 

7 ‘‘(12) provide respite care for caretakers of in8 dividuals with Fetal Alcohol Syndrome and other 

9 prenatal alcohol-related disorders; 

10 ‘‘(13) recruit and train mentors for individuals 

11 with Fetal Alcohol Syndrome and other prenatal al12 cohol-related disorders; 

13 ‘‘(14) provide educational and supportive serv14 ices to families of individuals with Fetal Alcohol 

15 Spectrum Disorders; and 

16 ‘‘(15) provide other services and programs, to 

17 the extent authorized by the Secretary after consid18 eration of recommendations made by the National 

19 Task Force on Fetal Alcohol Syndrome. 

20 ‘‘(c) REQUIREMENTS.—To be eligible to receive an 

21 award under subsection (a), an applicant shall— 

22 ‘‘(1) demonstrate that the program will be part 

23 of a coordinated, comprehensive system of care for 

24 such individuals; 


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1 ‘‘(2) demonstrate an established communication 

2 with other social programs in the community includ3 ing social services, justice system, financial assist4 ance programs, health services, educational services, 

5 mental health and substance use disorder services, 

6 vocational services and housing assistance services; 

7 ‘‘(3) show a history of working with individuals 

8 with fetal alcohol syndrome or alcohol-related birth 

9 defects; 

10 ‘‘(4) provide assurance that the services will be 

11 provided in a culturally and linguistically appro12 priate manner; and 

13 ‘‘(5) provide assurance that at the end of the 

14 5-year award period, other mechanisms will be iden15 tified to meet the needs of the individuals and fami16 lies served under such award. 

17 ‘‘(d) RELATIONSHIP TO PAYMENTS UNDER OTHER

18 PROGRAMS.—An award may be made under subsection (a) 

19 only if the applicant involved agrees that the award will 

20 not be expended to pay the expenses of providing any serv21 ice under this section to an individual to the extent that 

22 payment has been made, or can reasonably be expected 

23 to be made, with respect to such expenses— 


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1 ‘‘(1) under any State compensation program, 

2 under an insurance policy, or under any Federal or 

3 State health benefits program; or 

4 ‘‘(2) by an entity that provides health services 

5 on a prepaid basis. 

6 ‘‘(e) DURATION OF AWARDS.—With respect to an 

7 award under subsection (a), the period during which pay8 ments under such award are made to the recipient may 

9 not exceed 5 years. 

10 ‘‘(f) EVALUATION.—The Secretary shall evaluate 

11 each project carried out under subsection (a) and shall dis12 seminate the findings with respect to each such evaluation 

13 to appropriate public and private entities. 

14 ‘‘(g) FUNDING.— 

15 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.— 

16 For the purpose of carrying out this section, there 

17 are authorized to be appropriated $25,000,000 for 

18 fiscal year 2011, and such sums as may be nec19 essary for each of the fiscal years 2012 through 

20 2015. 

21 ‘‘(2) ALLOCATION.—Of the amounts appro22 priated under paragraph (1) for a fiscal year, not 

23 less than $300,000 shall, for purposes relating to 

24 fetal alcohol syndrome and alcohol-related birth de25 fects, be made available for collaborative, coordiVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00137 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 nated interagency efforts with the National Institute 

2 on Alcohol Abuse and Alcoholism, the National In3 stitute on Child Health and Human Development, 

4 the Health Resources and Services Administration, 

5 the Agency for Healthcare Research and Quality, 

6 the Centers for Disease Control and Prevention, the 

7 Department of Education, and the Department of 

8 Justice. 

9 ‘‘SEC. 524. CENTERS OF EXCELLENCE ON SERVICES FOR IN10 DIVIDUALS WITH FETAL ALCOHOL SYN11 DROME AND ALCOHOL-RELATED BIRTH DE12 FECTS AND TREATMENT FOR INDIVIDUALS 

13 WITH SUCH CONDITIONS AND THEIR FAMI14 LIES. 

15 ‘‘(a) IN GENERAL.—The Secretary shall make 

16 awards of grants, cooperative agreements, or contracts to 

17 public or nonprofit private entities for the purposes of es18 tablishing not more than four centers of excellence to 

19 study techniques for the prevention of fetal alcohol syn20 drome and alcohol-related birth defects and adaptations 

21 of innovative clinical interventions and service delivery im22 provements for the provision of comprehensive services to 

23 individuals with fetal alcohol syndrome or alcohol-related 

24 birth defects and their families and for providing training 

25 on such conditions. 


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1 ‘‘(b) USE OF FUNDS.—An award under subsection 

2 (a) may be used to— 

3 ‘‘(1) study adaptations of innovative clinical 

4 interventions and service delivery improvements 

5 strategies for children and adults with fetal alcohol 

6 syndrome or alcohol-related birth defects and their 

7 families; 

8 ‘‘(2) identify communities which have an exem9 plary comprehensive system of care for such individ10 uals so that they can provide technical assistance to 

11 other communities attempting to set up such a sys12 tem of care; 

13 ‘‘(3) provide technical assistance to commu14 nities who do not have a comprehensive system of 

15 care for such individuals and their families; 

16 ‘‘(4) train community leaders, mental health 

17 and substance use disorder professionals, families, 

18 law enforcement personnel, judges, health profes19 sionals, persons working in financial assistance pro20 grams, social service personnel, child welfare profes21 sionals, and other service providers on the implica22 tions of fetal alcohol syndrome and alcohol-related 

23 birth defects, the early identification of and referral 

24 for such conditions; 


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1 ‘‘(5) develop innovative techniques for pre2 venting alcohol use by women in child bearing years; 

3 or 

4 ‘‘(6) perform other functions, to the extent au5 thorized by the Secretary after consideration of rec6 ommendations made by the National Task Force on 

7 Fetal Alcohol Syndrome. 

8 ‘‘(c) REPORT.— 

9 ‘‘(1) IN GENERAL.—A recipient of an award 

10 under subsection (a) shall at the end of the period 

11 of funding report to the Secretary on any innovative 

12 techniques that have been discovered for preventing 

13 alcohol abuse, alcohol use among women of child 

14 bearing years, and alcohol use among pregnant 

15 women and women considering pregnancy. 

16 ‘‘(2) DISSEMINATION OF FINDINGS.—The Sec17 retary shall upon receiving a report under paragraph 

18 (1) disseminate the findings to appropriate public 

19 and private entities. 

20 ‘‘(d) DURATION OF AWARDS.—With respect to an 

21 award under subsection (a), the period during which pay22 ments under such award are made to the recipient may 

23 not exceed 5 years. 

24 ‘‘(e) EVALUATION.—The Secretary shall evaluate 

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1 seminate the findings with respect to each such evaluation 

2 to appropriate public and private entities. 

3 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the 

4 purpose of carrying out this section, there are authorized 

5 to be appropriated $9,200,000 for fiscal year 2011, and 

6 such sums as may be necessary for each of the fiscal years 

7 2012 through 2015. 

8 ‘‘Subpart 3—Center for Mental Health Services 

9 ‘‘SEC. 525. CENTER FOR MENTAL HEALTH SERVICES. 

10 ‘‘(a) ESTABLISHMENT.—There is established in the 

11 Administration a Center for Mental Health Services (here12 after in this section referred to as the ‘Center’). The Cen13 ter shall be headed by a Director (hereafter in this section 

14 referred to as the ‘Director’) appointed by the Secretary 

15 from among individuals with extensive experience or aca16 demic qualifications in the provision of mental health serv17 ices or in the evaluation of mental health service systems. 

18 ‘‘(b) DUTIES.—The Director of the Center shall— 

19 ‘‘(1) design national goals and establish na20 tional priorities for— 

21 ‘‘(A) the prevention of mental illness; and 

22 ‘‘(B) the promotion of mental health; 

23 ‘‘(2) encourage and assist local entities and 

24 State agencies to achieve the goals and priorities de25 scribed in paragraph (1); 


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1 ‘‘(3) collaborate with the Department of Edu2 cation and the Department of Justice to develop 

3 programs to assist local communities in addressing 

4 violence among children and adolescents; 

5 ‘‘(4) develop and coordinate Federal prevention 

6 policies and programs and to assure increased focus 

7 on the prevention of mental illness and the pro8 motion of mental health through programs that re9 duce risk and promote resiliency; 

10 ‘‘(5) develop improved methods of treating indi11 viduals with mental health problems and improved 

12 methods of assisting the families of such individuals; 

13 ‘‘(6) administer the mental health services block 

14 grant program authorized in section 1911; 

15 ‘‘(7) promote policies and programs at Federal, 

16 State, and local levels and in the private sector that 

17 foster independence, increase meaningful participa18 tion of, and protect the legal rights of persons with 

19 mental illness, including carrying out the provisions 

20 of the Protection and Advocacy of Individuals with 

21 Mental Illness Act; 

22 ‘‘(8) carry out the programs under part C; 

23 ‘‘(9) carry out responsibilities for the Human 

24 Resource Development program, and programs of 


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1 clinical training for paraprofessional personnel and 

2 health professionals; 

3 ‘‘(10) conduct services-related assessments, in4 cluding evaluations of the organization and financing 

5 of care, self-help and consumer-run programs, men6 tal health economics, mental health service systems, 

7 rural mental health, tele-mental health, and improve 

8 the capacity of State to conduct evaluations of pub9 licly funded mental health programs; 

10 ‘‘(11) provide technical assistance to public and 

11 private entities that are providers of mental health 

12 services; 

13 ‘‘(12) conduct surveys with respect to mental 

14 health, such as the National Reporting Program; 

15 and 

16 ‘‘(13) assist States in improving their mental 

17 health data collection. 

18 ‘‘(c) GRANTS AND CONTRACTS.—In carrying out the 

19 duties established in subsection (b), the Director may 

20 makes grants to and enter into contracts and cooperative 

21 agreements with public and nonprofit private entities. 

22 ‘‘SEC. 526. PRIORITY MENTAL HEALTH NEEDS OF RE23 GIONAL AND NATIONAL SIGNIFICANCE. 

24 ‘‘(a) PROJECTS.—The Secretary shall address pri25 ority mental health needs of regional and national signifiVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00143 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 cance (as determined under subsection (b)) through the 

2 provision of or through assistance for— 

3 ‘‘(1) knowledge development and application 

4 projects for prevention, treatment, and rehabilita5 tion, and the conduct or support of evaluations of 

6 such projects; 

7 ‘‘(2) training and technical assistance pro8 grams; 

9 ‘‘(3) targeted capacity response programs; and 

10 ‘‘(4) systems change grants including statewide 

11 family network grants and client-oriented and con12 sumer run self-help activities which may include 

13 technical assistance centers. 

14 The Secretary may carry out the activities described in 

15 this subsection directly or through grants, contracts, or 

16 cooperative agreements with States, territories, political 

17 subdivisions of States, Indian tribes and tribal organiza18 tions, other public or private nonprofit entities. 

19 ‘‘(b) PRIORITY MENTAL HEALTH NEEDS.— 

20 ‘‘(1) DETERMINATION OF NEEDS.—Priority 

21 mental health needs of regional and national signifi22 cance shall be determined by the Secretary in con23 sultation with States and other interested groups. 

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1 ested groups on an annual basis to discuss program 

2 priorities. 

3 ‘‘(2) SPECIAL CONSIDERATION.—In developing 

4 program priorities described in paragraph (1), the 

5 Secretary shall give special consideration to pro6 moting the integration of mental health services into 

7 primary health care systems. 

8 ‘‘(c) REQUIREMENTS.— 

9 ‘‘(1) IN GENERAL.—Recipients of grants, con10 tracts, and cooperative agreements under this sec11 tion shall comply with information and application 

12 requirements determined appropriate by the Sec13 retary. 

14 ‘‘(2) DURATION OF AWARD.—With respect to a 

15 grant, contract, or cooperative agreement awarded 

16 under this section, the period during which pay17 ments under such award are made to the recipient 

18 may not exceed 5 years. 

19 ‘‘(3) MATCHING FUNDS.—The Secretary may, 

20 for projects carried out under subsection (a), require 

21 that entities that apply for grants, contracts, or co22 operative agreements under this section provide non23 Federal matching funds, as determined appropriate 

24 by the Secretary, to ensure the institutional commit25 ment of the entity to the projects funded under the 


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1 grant, contract, or cooperative agreement. Such non2 Federal matching funds may be provided directly or 

3 through donations from public or private entities 

4 and may be in cash or in kind, fairly evaluated, in5 cluding plant, equipment, or services. The require6 ments of this paragraph shall apply to Statewide 

7 consumer family networks. 

8 ‘‘(4) MAINTENANCE OF EFFORT.—With respect 

9 to activities for which a grant, contract or coopera10 tive agreement is awarded under this section, the 

11 Secretary may require that recipients for specific 

12 projects under subsection (a) agree to maintain ex13 penditures of non-Federal amounts for such activi14 ties at a level that is not less than the level of such 

15 expenditures maintained by the entity for the fiscal 

16 year preceding the fiscal year for which the entity 

17 receives such a grant, contract, or cooperative agree18 ment. 

19 ‘‘(d) EVALUATION.—The Secretary shall evaluate 

20 each project carried out under subsection (a)(1) and shall 

21 disseminate the findings with respect to each such evalua22 tion to appropriate public and private entities. 

23 ‘‘(e) INFORMATION AND EDUCATION.— 

24 ‘‘(1) IN GENERAL.—The Secretary shall estab25 lish information and education programs to dissemiVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00146 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 nate and apply the findings of the knowledge devel2 opment and application, training, and technical as3 sistance programs, and targeted capacity response 

4 programs, under this section to the general public, 

5 to health care professionals, and to interested 

6 groups. The Secretary shall make every effort to 

7 provide linkages between the findings of supported 

8 projects and State agencies responsible for carrying 

9 out mental health services. 

10 ‘‘(2) RURAL AND UNDERSERVED AREAS.—In 

11 disseminating information on evidence-based prac12 tices in the provision of children’s mental health 

13 services under this subsection, the Secretary shall 

14 ensure that such information is distributed to rural 

15 and medically underserved areas. 

16 ‘‘(f) AUTHORIZATION OF APPROPRIATION.— 

17 ‘‘(1) IN GENERAL.—There are authorized to be 

18 appropriated to carry out this section, $300,000,000 

19 for fiscal year 2011, and such sums as may be nec20 essary for each of the fiscal years 2012 through 

21 2015. 

22 ‘‘(2) DATA INFRASTRUCTURE.—If amounts are 

23 not appropriated for a fiscal year to carry out sec24 tion 1971 with respect to mental health, then the 

25 Secretary shall make available, from the amounts 


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1 appropriated for such fiscal year under paragraph 

2 (1), an amount equal to the sum of $6,000,000 and 

3 10 percent of all amounts appropriated for such fis4 cal year under such paragraph in excess of 

5 $100,000,000, to carry out such section 1971. 

6 ‘‘SEC. 527. SUICIDE PREVENTION TECHNICAL ASSISTANCE 

7 CENTER. 

8 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting 

9 through the Administrator of the Substance Abuse and 

10 Mental Health Services Administration, shall establish a 

11 research, training, and technical assistance resource cen12 ter to provide appropriate information, training, and tech13 nical assistance to States, political subdivisions of States, 

14 federally recognized Indian tribes, tribal organizations, in15 stitutions of higher education, public organizations, or pri16 vate nonprofit organizations concerning the prevention of 

17 suicide among all ages, particularly among groups that are 

18 at high risk for suicide. 

19 ‘‘(b) RESPONSIBILITIES OF THE CENTER.—The cen20 ter established under subsection (a) shall— 

21 ‘‘(1) assist in the development or continuation 

22 of statewide and tribal suicide early intervention and 

23 prevention strategies for all ages, particularly among 

24 groups that are at high risk for suicide; 


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1 ‘‘(2) ensure the surveillance of suicide early 

2 intervention and prevention strategies for all ages, 

3 particularly among groups that are at high risk for 

4 suicide; 

5 ‘‘(3) study the costs and effectiveness of state6 wide and tribal suicide early intervention and pre7 vention strategies in order to provide information 

8 concerning relevant issues of importance to State, 

9 tribal, and national policymakers; 

10 ‘‘(4) further identify and understand causes 

11 and associated risk factors for suicide for all ages, 

12 particularly among groups that are at high risk for 

13 suicide; 

14 ‘‘(5) analyze the efficacy of new and existing 

15 suicide early intervention and prevention techniques 

16 and technology for all ages, particularly among 

17 groups that are at high risk for suicide; 

18 ‘‘(6) ensure the surveillance of suicidal behav19 iors and nonfatal suicidal attempts; 

20 ‘‘(7) study the effectiveness of State-sponsored 

21 statewide and tribal suicide early intervention and 

22 prevention strategies for all ages particularly among 

23 groups that are at high risk for suicide on the over24 all wellness and health promotion strategies related 

25 to suicide attempts; 


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1 ‘‘(8) promote the sharing of data regarding sui2 cide with Federal agencies involved with suicide 

3 early intervention and prevention, and State-spon4 sored statewide and tribal suicide early intervention 

5 and prevention strategies for the purpose of identi6 fying previously unknown mental health causes and 

7 associated risk factors for suicide among all ages 

8 particularly among groups that are at high risk for 

9 suicide; 

10 ‘‘(9) evaluate and disseminate outcomes and 

11 best practices of mental health and substance use 

12 disorder services at institutions of higher education; 

13 and 

14 ‘‘(10) conduct other activities determined ap15 propriate by the Secretary. 

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

17 purpose of carrying out this section, there are authorized 

18 to be appropriated $5,000,000 for fiscal year 2011, and 

19 such sums as may be necessary for each of fiscal years 

20 2012 through 2015. 

21 ‘‘SEC. 528. YOUTH SUICIDE EARLY INTERVENTION AND 

22 PREVENTION STRATEGIES. 

23 ‘‘(a) IN GENERAL.—The Secretary, acting through 

24 the Administrator of the Substance Abuse and Mental 


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1 Health Services Administration, shall award grants or co2 operative agreements to eligible entities to— 

3 ‘‘(1) develop and implement State-sponsored 

4 statewide or tribal youth suicide early intervention 

5 and prevention strategies in schools, educational in6 stitutions, juvenile justice systems, substance use 

7 disorder programs, mental health programs, foster 

8 care systems, and other child and youth support or9 ganizations; 

10 ‘‘(2) support public organizations and private 

11 nonprofit organizations actively involved in State12 sponsored statewide or tribal youth suicide early 

13 intervention and prevention strategies and in the de14 velopment and continuation of State-sponsored 

15 statewide youth suicide early intervention and pre16 vention strategies; 

17 ‘‘(3) provide grants to institutions of higher 

18 education to coordinate the implementation of State19 sponsored statewide or tribal youth suicide early 

20 intervention and prevention strategies; 

21 ‘‘(4) collect and analyze data on State-spon22 sored statewide or tribal youth suicide early inter23 vention and prevention services that can be used to 

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1 search, technical assistance, and policy development; 

2 and 

3 ‘‘(5) assist eligible entities, through State-spon4 sored statewide or tribal youth suicide early inter5 vention and prevention strategies, in achieving tar6 gets for youth suicide reductions under title V of the 

7 Social Security Act. 

8 ‘‘(b) ELIGIBLE ENTITY.— 

9 ‘‘(1) DEFINITION.—In this section, the term 

10 ‘eligible entity’ means— 

11 ‘‘(A) a State; 

12 ‘‘(B) a public organization or private non13 profit organization designated by a State to de14 velop or direct the State-sponsored statewide 

15 youth suicide early intervention and prevention 

16 strategy; or 

17 ‘‘(C) a federally recognized Indian tribe or 

18 tribal organization (as defined in the Indian 

19 Self-Determination and Education Assistance 

20 Act) or an urban Indian organization (as de21 fined in the Indian Health Care Improvement 

22 Act) that is actively involved in the development 

23 and continuation of a tribal youth suicide early 

24 intervention and prevention strategy. 


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1 ‘‘(2) LIMITATION.—In carrying out this section, 

2 the Secretary shall ensure that a State does not re3 ceive more than one grant or cooperative agreement 

4 under this section at any one time. For purposes of 

5 the preceding sentence, a State shall be considered 

6 to have received a grant or cooperative agreement if 

7 the eligible entity involved is the State or an entity 

8 designated by the State under paragraph (1)(B). 

9 Nothing in this paragraph shall be constructed to 

10 apply to entities described in paragraph (1)(C). 

11 ‘‘(c) PREFERENCE.—In providing assistance under a 

12 grant or cooperative agreement under this section, an eli13 gible entity shall give preference to public organizations, 

14 private nonprofit organizations, political subdivisions, in15 stitutions of higher education, and tribal organizations ac16 tively involved with the State-sponsored statewide or tribal 

17 youth suicide early intervention and prevention strategy 

18 that— 

19 ‘‘(1) provide early intervention and assessment 

20 services, including screening programs, to youth who 

21 are at risk for mental or emotional disorders that 

22 may lead to a suicide attempt, and that are inte23 grated with school systems, educational institutions, 

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1 grams, mental health programs, foster care systems, 

2 and other child and youth support organizations; 

3 ‘‘(2) demonstrate collaboration among early 

4 intervention and prevention services or certify that 

5 entities will engage in future collaboration; 

6 ‘‘(3) employ or include in their applications a 

7 commitment to evaluate youth suicide early interven8 tion and prevention practices and strategies adapted 

9 to the local community; 

10 ‘‘(4) provide timely referrals for appropriate 

11 community-based mental health care and treatment 

12 of youth who are at risk for suicide in child-serving 

13 settings and agencies; 

14 ‘‘(5) provide immediate support and informa15 tion resources to families of youth who are at risk 

16 for suicide; 

17 ‘‘(6) offer access to services and care to youth 

18 with diverse linguistic and cultural backgrounds; 

19 ‘‘(7) offer appropriate postsuicide intervention 

20 services, care, and information to families, friends, 

21 schools, educational institutions, juvenile justice sys22 tems, substance use disorder programs, mental 

23 health programs, foster care systems, and other 

24 child and youth support organizations of youth who 

25 recently completed suicide; 


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1 ‘‘(8) offer continuous and up-to-date informa2 tion and awareness campaigns that target parents, 

3 family members, child care professionals, community 

4 care providers, and the general public and highlight 

5 the risk factors associated with youth suicide and 

6 the life-saving help and care available from early 

7 intervention and prevention services; 

8 ‘‘(9) ensure that information and awareness 

9 campaigns on youth suicide risk factors, and early 

10 intervention and prevention services, use effective 

11 communication mechanisms that are targeted to and 

12 reach youth, families, schools, educational institu13 tions, and youth organizations; 

14 ‘‘(10) provide a timely response system to en15 sure that child-serving professionals and providers 

16 are properly trained in youth suicide early interven17 tion and prevention strategies and that child-serving 

18 professionals and providers involved in early inter19 vention and prevention services are properly trained 

20 in effectively identifying youth who are at risk for 

21 suicide; 

22 ‘‘(11) provide continuous training activities for 

23 child care professionals and community care pro24 viders on the latest youth suicide early intervention 

25 and prevention services practices and strategies; 


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1 ‘‘(12) conduct annual self-evaluations of out2 comes and activities, including consulting with inter3 ested families and advocacy organizations; 

4 ‘‘(13) provide services in areas or regions with 

5 rates of youth suicide that exceed the national aver6 age as determined by the Centers for Disease Con7 trol and Prevention; and 

8 ‘‘(14) obtain informed written consent from a 

9 parent or legal guardian of an at-risk child before 

10 involving the child in a youth suicide early interven11 tion and prevention program. 

12 ‘‘(d) REQUIREMENT FOR DIRECT SERVICES.—Not 

13 less than 85 percent of grant funds received under this 

14 section shall be used to provide direct services, of which 

15 not less than 5 percent shall be used for activities author16 ized under subsection (a)(3). 

17 ‘‘(e) CONSULTATION AND POLICY DEVELOPMENT.— 

18 ‘‘(1) IN GENERAL.—In carrying out this sec19 tion, the Secretary shall collaborate with relevant 

20 Federal agencies and suicide working groups respon21 sible for early intervention and prevention services 

22 relating to youth suicide. 

23 ‘‘(2) CONSULTATION.—In carrying out this sec24 tion, the Secretary shall consult with— 


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1 ‘‘(A) State and local agencies, including 

2 agencies responsible for early intervention and 

3 prevention services under title XIX of the So4 cial Security Act, the State Children’s Health 

5 Insurance Program under title XXI of the So6 cial Security Act, and programs funded by 

7 grants under title V of the Social Security Act; 

8 ‘‘(B) local and national organizations that 

9 serve youth at risk for suicide and their fami10 lies; 

11 ‘‘(C) relevant national medical and other 

12 health and education specialty organizations; 

13 ‘‘(D) youth who are at risk for suicide, 

14 who have survived suicide attempts, or who are 

15 currently receiving care from early intervention 

16 services; 

17 ‘‘(E) families and friends of youth who are 

18 at risk for suicide, who have survived suicide at19 tempts, who are currently receiving care from 

20 early intervention and prevention services, or 

21 who have completed suicide; 

22 ‘‘(F) qualified professionals who possess 

23 the specialized knowledge, skills, experience, 

24 and relevant attributes needed to serve youth at 

25 risk for suicide and their families; and 


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1 ‘‘(G) third-party payers, managed care or2 ganizations, and related commercial industries. 

3 ‘‘(3) POLICY DEVELOPMENT.—In carrying out 

4 this section, the Secretary shall— 

5 ‘‘(A) coordinate and collaborate on policy 

6 development at the Federal level with the rel7 evant Department of Health and Human Serv8 ices agencies and suicide working groups; and 

9 ‘‘(B) consult on policy development at the 

10 Federal level with the private sector, including 

11 consumer, medical, suicide prevention advocacy 

12 groups, and other health and education profes13 sional-based organizations, with respect to 

14 State-sponsored statewide or tribal youth sui15 cide early intervention and prevention strate16 gies. 

17 ‘‘(f) RULE OF CONSTRUCTION; RELIGIOUS AND

18 MORAL ACCOMMODATION.—Nothing in this section shall 

19 be construed to require suicide assessment, early interven20 tion, or treatment services for youth whose parents or 

21 legal guardians object based on the parents’ or legal 

22 guardians’ religious beliefs or moral objections. 

23 ‘‘(g) EVALUATIONS AND REPORT.— 

24 ‘‘(1) EVALUATIONS BY ELIGIBLE ENTITIES.— 

25 Not later than 18 months after receiving a grant or 


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1 cooperative agreement under this section, an eligible 

2 entity shall submit to the Secretary the results of an 

3 evaluation to be conducted by the entity concerning 

4 the effectiveness of the activities carried out under 

5 the grant or agreement. 

6 ‘‘(2) REPORT.—Not later than 2 years after the 

7 date of enactment of this section, the Secretary shall 

8 submit to the appropriate committees of Congress a 

9 report concerning the results of— 

10 ‘‘(A) the evaluations conducted under 

11 paragraph (1); and 

12 ‘‘(B) an evaluation conducted by the Sec13 retary to analyze the effectiveness and efficacy 

14 of the activities conducted with grants, collabo15 rations, and consultations under this section. 

16 ‘‘(h) RULE OF CONSTRUCTION; STUDENT MEDICA17 TION.—Nothing in this section shall be construed to allow 

18 school personnel to require that a student obtain any 

19 medication as a condition of attending school or receiving 

20 services. 

21 ‘‘(i) PROHIBITION.—Funds appropriated to carry out 

22 this section, section 527, or section 529 shall not be used 

23 to pay for or refer for abortion. 

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1 ten, informed consent from the child’s parent or legal 

2 guardian for assessment services, school-sponsored pro3 grams, and treatment involving medication related to 

4 youth suicide conducted in elementary and secondary 

5 schools. The requirement of the preceding sentence does 

6 not apply in the following cases: 

7 ‘‘(1) In an emergency, where it is necessary to 

8 protect the immediate health and safety of the stu9 dent or other students. 

10 ‘‘(2) Other instances, as defined by the State, 

11 where parental consent cannot reasonably be ob12 tained. 

13 ‘‘(k) RELATION TO EDUCATION PROVISIONS.—Noth14 ing in this section shall be construed to supersede section 

15 444 of the General Education Provisions Act, including 

16 the requirement of prior parental consent for the disclo17 sure of any education records. Nothing in this section shall 

18 be construed to modify or affect parental notification re19 quirements for programs authorized under the Elementary 

20 and Secondary Education Act of 1965 (as amended by the 

21 No Child Left Behind Act of 2001; Public Law 107–110). 

22 ‘‘(l) DEFINITIONS.—In this section: 

23 ‘‘(1) EARLY INTERVENTION.—The term ‘early 

24 intervention’ means a strategy or approach that is 


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1 intended to prevent an outcome or to alter the 

2 course of an existing condition. 

3 ‘‘(2) EDUCATIONAL INSTITUTION; INSTITUTION

4 OF HIGHER EDUCATION; SCHOOL.—The term— 

5 ‘‘(A) ‘educational institution’ means a 

6 school or institution of higher education; 

7 ‘‘(B) ‘institution of higher education’ has 

8 the meaning given such term in section 101 of 

9 the Higher Education Act of 1965; and 

10 ‘‘(C) ‘school’ means an elementary or sec11 ondary school (as such terms are defined in sec12 tion 9101 of the Elementary and Secondary 

13 Education Act of 1965). 

14 ‘‘(3) PREVENTION.—The term ‘prevention’ 

15 means a strategy or approach that reduces the likeli16 hood or risk of onset, or delays the onset, of adverse 

17 health problems that have been known to lead to sui18 cide. 

19 ‘‘(4) YOUTH.—The term ‘youth’ means individ20 uals who are between 10 and 24 years of age. 

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

22 the purpose of carrying out this section, there are author23 ized to be appropriated $34,000,000 for fiscal year 2011, 

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1 cal year 2013, $46,000,000 for fiscal year 2014, and 

2 $50,000,000 for fiscal year 2015. 

3 ‘‘SEC. 529. MENTAL HEALTH AND SUBSTANCE USE DIS4 ORDERS SERVICES ON CAMPUS. 

5 ‘‘(a) IN GENERAL.—The Secretary, acting through 

6 the Director of the Center for Mental Health Services, in 

7 consultation with the Secretary of Education, may award 

8 grants on a competitive basis to institutions of higher edu9 cation to enhance services for students with mental health 

10 or substance use disorders that can lead to school failure, 

11 such as depression, substance use disorders, and suicide 

12 attempts, so that students will successfully complete their 

13 studies. 

14 ‘‘(b) USE OF FUNDS.—The Secretary may not make 

15 a grant to an institution of higher education under this 

16 section unless the institution agrees to use the grant only 

17 for— 

18 ‘‘(1) educational seminars; 

19 ‘‘(2) the operation of hot lines; 

20 ‘‘(3) preparation of informational material; 

21 ‘‘(4) preparation of educational materials for 

22 families of students to increase awareness of poten23 tial mental health and substance use disorders issues 

24 of students enrolled at the institution of higher edu25 cation; 


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1 ‘‘(5) training programs for students and cam2 pus personnel to respond effectively to students with 

3 mental health and substance use disorders that can 

4 lead to school failure, such as depression, substance 

5 use disorders, and suicide attempts, and for staff on 

6 voluntary screening for such behavioral health prob7 lems; 

8 ‘‘(6) the creation of a networking infrastructure 

9 to link colleges and universities that do not have 

10 mental health services with health care providers 

11 who can treat mental health and substance use dis12 orders; or 

13 ‘‘(7) the administration of voluntary mental 

14 health screenings and assessments, not including the 

15 provision of direct services. 

16 ‘‘(c) ELIGIBLE GRANT RECIPIENTS.—Any institution 

17 of higher education receiving a grant under this section 

18 may carry out activities under the grant through— 

19 ‘‘(1) college counseling centers; 

20 ‘‘(2) college and university psychological service 

21 centers; 

22 ‘‘(3) mental health centers; 

23 ‘‘(4) psychology training clinics; or 


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1 ‘‘(5) institution of higher education supported, 

2 evidence-based, mental health and substance use dis3 order programs. 

4 ‘‘(d) APPLICATION.—An institution of higher edu5 cation desiring a grant under this section shall prepare 

6 and submit an application to the Secretary at such time 

7 and in such manner as the Secretary may require. At a 

8 minimum, the application shall include the following: 

9 ‘‘(1) A description of identified mental health 

10 and substance use disorder needs of students at the 

11 institution of higher education. 

12 ‘‘(2) A description of Federal, State, local, pri13 vate, and institutional resources currently available 

14 to address the needs described in paragraph (1) at 

15 the institution of higher education. 

16 ‘‘(3) A description of the outreach strategies of 

17 the institution of higher education for promoting ac18 cess to services, including a proposed plan for reach19 ing those students most in need of mental health 

20 services. 

21 ‘‘(4) A plan to evaluate program outcomes, in22 cluding a description of the proposed use of funds, 

23 the program objectives, and how the objectives will 

24 be met. 


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1 ‘‘(5) An assurance that the institution will sub2 mit a report to the Secretary each fiscal year on the 

3 activities carried out with the grant and the results 

4 achieved through those activities. 

5 ‘‘(e) REQUIREMENT OF MATCHING FUNDS.— 

6 ‘‘(1) IN GENERAL.—The Secretary may make a 

7 grant under this section to an institution of higher 

8 education only if the institution agrees to make 

9 available (directly or through donations from public 

10 or private entities) non-Federal contributions in an 

11 amount that is not less than $1 for each $1 of Fed12 eral funds provided in the grant, toward the costs of 

13 activities carried out with the grant (as described in 

14 subsection (b)) and other activities by the institution 

15 to reduce student mental health and substance use 

16 disorders. 

17 ‘‘(2) DETERMINATION OF AMOUNT CONTRIB18 UTED.—Non-Federal contributions required under 

19 paragraph (1) may be in cash or in kind. Amounts 

20 provided by the Federal Government, or services as21 sisted or subsidized to any significant extent by the 

22 Federal Government, may not be included in deter23 mining the amount of such non-Federal contribu24 tions. 


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1 ‘‘(3) WAIVER.—The Secretary may waive the 

2 requirement established in paragraph (1) with re3 spect to an institution of higher education if the Sec4 retary determines that extraordinary need at the in5 stitution justifies the waiver. 

6 ‘‘(f) REPORTS.—For each fiscal year that grants are 

7 awarded under this section, the Secretary shall conduct 

8 a study on the results of the grants and submit to the 

9 Congress a report on such results that includes the fol10 lowing: 

11 ‘‘(1) An evaluation of the grant program out12 comes, including a summary of activities carried out 

13 with the grant and the results achieved through 

14 those activities. 

15 ‘‘(2) Recommendations on how to improve ac16 cess to mental health and substance use disorder 

17 services at institutions of higher education, including 

18 efforts to reduce the incidence of suicide and sub19 stance use disorders. 

20 ‘‘(g) DEFINITION.—In this section, the term ‘institu21 tion of higher education’ has the meaning given such term 

22 in section 101 of the Higher Education Act of 1965. 

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

24 purpose of carrying out this section, there are authorized 

25 to be appropriated $5,400,000 for fiscal year 2011, 


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1 $5,800,000 for fiscal year 2012, $6,200,000 for fiscal year 

2 2013, $6,600,000 for fiscal year 2014, and $7,000,000 

3 for fiscal year 2015. 

4 ‘‘SEC. 530. GRANTS FOR JAIL DIVERSION PROGRAMS. 

5 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary shall 

6 make up to 125 grants to States, political subdivisions of 

7 States, American Indian and Alaska Native tribes and 

8 tribal organizations, acting directly or through agreements 

9 with other public or nonprofit entities, or a health facility 

10 or program operated by or pursuant to a contract or grant 

11 with the Indian Health Service, to develop and implement 

12 programs to divert individuals with a mental illness from 

13 the criminal justice system to community-based services. 

14 ‘‘(b) ADMINISTRATION.— 

15 ‘‘(1) CONSULTATION.—The Secretary shall con16 sult with the Attorney General and any other appro17 priate officials in carrying out this section. 

18 ‘‘(2) REGULATORY AUTHORITY.—The Secretary 

19 shall issue regulations and guidelines necessary to 

20 carry out this section, including methodologies and 

21 outcome measures for evaluating programs carried 

22 out by States, political subdivisions of States, Indian 

23 tribes, and tribal organizations receiving grants 

24 under subsection (a). 

25 ‘‘(c) APPLICATIONS.— 


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1 ‘‘(1) IN GENERAL.—To receive a grant under 

2 subsection (a), the chief executive of a State, chief 

3 executive of a subdivision of a State, Indian tribe or 

4 tribal organization shall prepare and submit an ap5 plication to the Secretary at such time, in such man6 ner, and containing such information as the Sec7 retary shall reasonably require. 

8 ‘‘(2) CONTENT.—Such application shall— 

9 ‘‘(A) contain an assurance that— 

10 ‘‘(i) community-based mental health 

11 services will be available for the individuals 

12 who are diverted from the criminal justice 

13 system, and that such services are based 

14 on evidence-based practices, reflect current 

15 research findings, include case manage16 ment, assertive community treatment, 

17 medication management and access, inte18 grated mental health and co-occurring sub19 stance use disorder treatment, and psy20 chiatric rehabilitation, and will be coordi21 nated with social services, including life 

22 skills training, housing placement, voca23 tional training, education job placement, 

24 and health care; 


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1 ‘‘(ii) there has been relevant inter2 agency collaboration between the appro3 priate criminal justice, mental health, and 

4 substance use disorder systems; and 

5 ‘‘(iii) the Federal support provided 

6 will be used to supplement, and not sup7 plant, State, local, Indian tribe, or tribal 

8 organization sources of funding that would 

9 otherwise be available; 

10 ‘‘(B) demonstrate that the diversion pro11 gram will be integrated with an existing system 

12 of care for those with mental illness; 

13 ‘‘(C) explain the applicant’s inability to 

14 fund the program adequately without Federal 

15 assistance; 

16 ‘‘(D) specify plans for obtaining necessary 

17 support and continuing the proposed program 

18 following the conclusion of Federal support; and 

19 ‘‘(E) describe methodology and outcome 

20 measures that will be used in evaluating the 

21 program. 

22 ‘‘(d) USE OF FUNDS.—A State, political subdivision 

23 of a State, Indian tribe, or tribal organization that receives 

24 a grant under subsection (a) may use funds received under 

25 such grant to— 


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1 ‘‘(1) integrate the diversion program into the 

2 existing system of care; 

3 ‘‘(2) create or expand community-based mental 

4 health and co-occurring mental illness and substance 

5 use disorder services to accommodate the diversion 

6 program; 

7 ‘‘(3) train professionals involved in the system 

8 of care, and law enforcement officers, attorneys, and 

9 judges; and 

10 ‘‘(4) provide community outreach and crisis 

11 intervention. 

12 ‘‘(e) FEDERAL SHARE.— 

13 ‘‘(1) IN GENERAL.—The Secretary shall pay to 

14 a State, political subdivision of a State, Indian tribe, 

15 or tribal organization receiving a grant under sub16 section (a) the Federal share of the cost of activities 

17 described in the application. 

18 ‘‘(2) FEDERAL SHARE.—The Federal share of a 

19 grant made under this section shall not exceed 75 

20 percent of the total cost of the program carried out 

21 by the State, political subdivision of a State, Indian 

22 tribe, or tribal organization. Such share shall be 

23 used for new expenses of the program carried out by 

24 such State, political subdivision of a State, Indian 

25 tribe, or tribal organization. 


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1 ‘‘(3) NON-FEDERAL SHARE.—The non-Federal 

2 share of payments made under this section may be 

3 made in cash or in kind fairly evaluated, including 

4 planned equipment or services. The Secretary may 

5 waive the requirement of matching contributions. 

6 ‘‘(f) GEOGRAPHIC DISTRIBUTION.—The Secretary 

7 shall ensure that such grants awarded under subsection 

8 (a) are equitably distributed among the geographical re9 gions of the United States and between urban and rural 

10 populations. 

11 ‘‘(g) TRAINING AND TECHNICAL ASSISTANCE.— 

12 Training and technical assistance may be provided by the 

13 Secretary to assist a State, political subdivision of a State, 

14 Indian tribe, or tribal organization receiving a grant under 

15 subsection (a) in establishing and operating a diversion 

16 program. 

17 ‘‘(h) EVALUATIONS.—The programs described in 

18 subsection (a) shall be evaluated not less than one time 

19 in every 12-month period using the methodology and out20 come measures identified in the grant application. 

21 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There 

22 are authorized to be appropriated to carry out this section 

23 $10,000,000 for fiscal year 2011, and such sums as may 

24 be necessary for fiscal years 2012 through 2015. 


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1 ‘‘SEC. 531. GRANTS FOR THE INTEGRATED TREATMENT OF 

2 SERIOUS MENTAL ILLNESS AND CO-OCCUR3 RING SUBSTANCE USE DISORDERS. 

4 ‘‘(a) IN GENERAL.—The Secretary shall award 

5 grants, contracts, or cooperative agreements to States, po6 litical subdivisions of States, Indian tribes, tribal organiza7 tions, and private nonprofit organizations for the develop8 ment or expansion of programs to provide integrated 

9 treatment services for individuals with a serious mental 

10 illness and a co-occurring substance use disorders. 

11 ‘‘(b) PRIORITY.—In awarding grants, contracts, and 

12 cooperative agreements under subsection (a), the Sec13 retary shall give priority to applicants that emphasize the 

14 provision of services for individuals with a serious mental 

15 illness and a co-occurring substance use disorders who— 

16 ‘‘(1) have a history of interactions with law en17 forcement or the criminal justice system; 

18 ‘‘(2) have recently been released from incarcer19 ation; 

20 ‘‘(3) have a history of unsuccessful treatment in 

21 either an inpatient or outpatient setting; 

22 ‘‘(4) have never followed through with out23 patient services despite repeated referrals; or 

24 ‘‘(5) are homeless. 

25 ‘‘(c) USE OF FUNDS.—A State, political subdivision 

26 of a State, American Indian or Alaska Native tribe, tribal 


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1 organization, or a health facility operated by or pursuant 

2 to a contract or grant with the Indian Health Service, or 

3 private nonprofit organization that receives a grant, con4 tract, or cooperative agreement under subsection (a) shall 

5 use funds received under such grant— 

6 ‘‘(1) to provide fully integrated services rather 

7 than serial or parallel services; 

8 ‘‘(2) to employ staff that are cross-trained in 

9 the diagnosis and treatment of both serious mental 

10 illness and substance use disorders; 

11 ‘‘(3) to provide integrated mental health and 

12 substance use disorder services at the same location; 

13 ‘‘(4) to provide services that are linguistically 

14 appropriate and culturally competent; 

15 ‘‘(5) to provide at least 10 programs for inte16 grated treatment of both mental illness and sub17 stance use disorders at sites that previously provided 

18 only mental health services or only substance use 

19 disorder services; and 

20 ‘‘(6) to provide services in coordination with 

21 other existing public and private community pro22 grams. 

23 ‘‘(d) CONDITION.—The Secretary shall ensure that a 

24 State, political subdivision of a State, Indian tribe, tribal 

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1 ceives a grant, contract, or cooperative agreement under 

2 subsection (a) maintains the level of effort necessary to 

3 sustain existing mental health and substance use disorder 

4 programs for other populations served by mental health 

5 systems in the community. 

6 ‘‘(e) DISTRIBUTION OF AWARDS.—The Secretary 

7 shall ensure that grants, contracts, or cooperative agree8 ments awarded under subsection (a) are equitably distrib9 uted among the geographical regions of the United States 

10 and between urban and rural populations. 

11 ‘‘(f) DURATION.—The Secretary shall award grants, 

12 contract, or cooperative agreements under this subsection 

13 for a period of not more than 5 years. 

14 ‘‘(g) APPLICATION.—A State, political subdivision of 

15 a State, Indian tribe, tribal organization, or private non16 profit organization that desires a grant, contract, or coop17 erative agreement under this subsection shall prepare and 

18 submit an application to the Secretary at such time, in 

19 such manner, and containing such information as the Sec20 retary may require. Such application shall include a plan 

21 for the rigorous evaluation of activities funded with an 

22 award under such subsection, including a process and out23 comes evaluation. 

24 ‘‘(h) EVALUATION.—A State, political subdivision of 

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1 profit organization that receives a grant, contract, or coop2 erative agreement under this subsection shall prepare and 

3 submit a plan for the rigorous evaluation of the program 

4 funded under such grant, contract, or agreement, includ5 ing both process and outcomes evaluation, and the submis6 sion of an evaluation at the end of the project period. 

7 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There 

8 are authorized to be appropriated to carry out this section, 

9 $14,000,000 for fiscal year 2011, and such sums as may 

10 be necessary for each of fiscal years 2012 through 2015. 

11 ‘‘SEC. 532. GRANTS RELATING TO THE INTEGRATION AND 

12 CO-LOCATING OF SERVICES. 

13 ‘‘(a) GRANTS FOR INTEGRATION OF MENTAL

14 HEALTH AND SUBSTANCE USE DISORDER SERVICES IN

15 PRIMARY CARE AND MENTAL HEALTH SETTINGS.— 

16 ‘‘(1) IN GENERAL.—The Secretary, acting 

17 through the Director of the Center for Mental 

18 Health Services, shall award grants to public and 

19 private nonprofit entities to integrate mental health 

20 and substance use disorder early intervention, pre21 vention, treatment, referral, and recovery services 

22 into primary care settings, for projects that address 

23 mental health and substance use disorder needs, in24 cluding programs that— 


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1 ‘‘(A) integrate mental health services for 

2 older adults into primary care settings, in order 

3 to provide screening, referrals, and evidence4 based intervention and treatment services by in5 dividuals with appropriate training and experi6 ence in the treatment of older adults, including 

7 licensed mental health professionals; and 

8 ‘‘(B) provide mental health and substance 

9 use disorders early intervention, prevention, 

10 treatment, referral, and recovery services, for 

11 children and adults, that are in coordination 

12 with community mental health service programs 

13 and other appropriately trained providers of 

14 care. 

15 ‘‘(2) APPLICATION.—To be eligible to receive a 

16 grant or cooperative agreement under this sub17 section an entity shall prepare and submit to the 

18 Secretary an application at such time, in such man19 ner, and containing such information the Secretary 

20 may require, including— 

21 ‘‘(A) an assessment of the mental health 

22 and substance use disorders care needs of pa23 tients served by the primary care provider and 

24 how such needs will be addressed; 


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1 ‘‘(B) assurances that the primary care set2 ting will have appropriately qualified mental 

3 health and substance use disorders professional 

4 staff, including licensed mental health profes5 sionals, to ensure prompt treatment or triage 

6 for referral services or providers; 

7 ‘‘(C) assurances that the primary care set8 ting will encourage formal coordination with 

9 community mental health service programs and 

10 other appropriate providers to ensure continuity 

11 of care; 

12 ‘‘(D) assurances that the primary care set13 ting has experience in providing services to a 

14 variety of populations, including racial and eth15 nic minorities and low-income populations; 

16 ‘‘(E) assurances that the primary care set17 tings uses evidence-based intervention and 

18 treatment protocols (to the extent such proto19 cols are available) for mental health and sub20 stance use disorders; 

21 ‘‘(F) assurances to report to the Secretary 

22 standardized clinical and behavioral data and 

23 other performance data necessary to evaluate 

24 patient outcomes and to facilitate evaluations 

25 across participating projects; and 


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1 ‘‘(G) a plan for sustainability beyond the 

2 Federal grant period. 

3 ‘‘(3) USE OF FUNDS.—Amounts awarded under 

4 this subsection may be used to— 

5 ‘‘(A) provide mental health promotion and 

6 substance use disorder prevention services; 

7 ‘‘(B) screen individuals for mental illness 

8 or substance use; 

9 ‘‘(C) diagnose and determine an appro10 priate intervention; 

11 ‘‘(D) provide brief intervention for individ12 uals at risk of mental illness or substance use; 

13 ‘‘(E) treat or refer for treatment of a men14 tal illness or substance use disorder; 

15 ‘‘(F) provide recovery support services or 

16 referring individuals for services; 

17 ‘‘(G) provide caregiver support and edu18 cational and transportation services to improve 

19 access and retention; or 

20 ‘‘(H) facilitate networking between pri21 mary care professionals and mental health and 

22 substance use disorders professionals for— 

23 ‘‘(i) case management development; 

24 and 

25 ‘‘(ii) professional mentoring. 


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1 ‘‘(4) DURATION.—A project may receive fund2 ing pursuant to a grant under this subsection for a 

3 period of up to 3 years, with an extension period of 

4 2 additional years at the discretion of the Secretary. 

5 ‘‘(5) SUPPLEMENT, NOT SUPPLANT.—Funds 

6 made available under this subsection shall supple7 ment, and not supplant, other Federal, State, or 

8 local funds available to an entity to carry out activi9 ties described in this subsection. 

10 ‘‘(6) MATCHING REQUIREMENTS.—With respect 

11 to the costs of the activities to be carried out by an 

12 entity under a grant or cooperative agreement under 

13 this subsection, beginning with the third year of the 

14 grant program, an entity shall provide assurances 

15 that the entity will make available (directly or 

16 through donations from public or private entities, in17 cluding in-kind donations) non-Federal contributions 

18 towards such costs in an amount that is not less 

19 than $1 for each $4 of Federal funds provided under 

20 the grant or cooperative agreement. 

21 ‘‘(7) REPORT.—Grantees under this subsection 

22 shall, beginning with the end of the second year of 

23 the grant, submit yearly reports to the Secretary on 

24 the activities of the grantee in support of the grant 

25 and the latest performance data. Such reports shall 


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1 contain recommendations as how to replicate the 

2 project. 

3 ‘‘(b) GRANTS FOR CO-LOCATING PRIMARY AND SPE4 CIALTY CARE IN COMMUNITY-BASED MENTAL HEALTH

5 SETTINGS.— 

6 ‘‘(1) DEFINITIONS.—In this subsection: 

7 ‘‘(A) ELIGIBLE ENTITY.—The term ‘eligi8 ble entity’ means a qualified community mental 

9 health program defined under section 

10 1913(b)(1). 

11 ‘‘(B) SPECIAL POPULATIONS.—The term 

12 ‘special populations’ refers to the following 3 

13 groups: 

14 ‘‘(i) Children and adolescents with 

15 mental and emotional disturbances who 

16 have co-occurring primary care conditions 

17 and chronic diseases. 

18 ‘‘(ii) Adults with mental illnesses who 

19 have co-occurring primary care conditions 

20 and chronic diseases. 

21 ‘‘(iii) Older adults with mental ill22 nesses who have co-occurring primary care 

23 conditions and chronic diseases. 

24 ‘‘(2) PROGRAM AUTHORIZED.—The Secretary, 

25 acting through the Administrator of the Substance 


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1 Abuse and Mental Health Services Administration 

2 and in coordination with the Director of the Health 

3 Resources and Services Administration, shall award 

4 grants to eligible entities to establish demonstration 

5 projects for the provision of coordinated and inte6 grated services to special populations through the 

7 co-location of primary and specialty care services in 

8 community-based mental health and substance use 

9 disorder settings. 

10 ‘‘(3) APPLICATION.—To be eligible to receive a 

11 grant under this subsection, an eligible entity shall 

12 submit an application to the Administrator at such 

13 time, in such manner, and accompanied by such in14 formation as the Administrator may require. Each 

15 such application shall include— 

16 ‘‘(A) an assessment of the primary care 

17 needs of the patients served by the eligible enti18 ty and a description of how the eligible entity 

19 will address such needs; and 

20 ‘‘(B) a description of partnerships, cooper21 ative agreements, or other arrangements with 

22 local primary care providers, including commu23 nity health centers, to provide services to spe24 cial populations. 

25 ‘‘(4) USE OF FUNDS.— 


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1 ‘‘(A) IN GENERAL.—For the benefit of spe2 cial populations, an eligible entity shall use 

3 funds awarded under this subsection for— 

4 ‘‘(i) the provision, by qualified pri5 mary care professionals on a reasonable 

6 cost basis, of— 

7 ‘‘(I) primary care services on site 

8 at the eligible entity; 

9 ‘‘(II) diagnostic and laboratory 

10 services; or 

11 ‘‘(III) adult and pediatric eye, 

12 ear, and dental screenings; 

13 ‘‘(ii) reasonable costs associated with 

14 medically necessary referrals to qualified 

15 specialty care professionals; 

16 ‘‘(iii) information technology required 

17 to accommodate the clinical needs of pri18 mary and specialty care professionals; or 

19 ‘‘(iv) equipment needed to provide pri20 mary care services on site at the eligible 

21 entity. 

22 ‘‘(B) LIMITATION.—Not to exceed 15 per23 cent of grant funds may be used for activities 

24 described in clauses (iii) and (iv) of subpara25 graph (A). 


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1 ‘‘(5) GEOGRAPHIC DISTRIBUTION.—The Sec2 retary shall ensure that grants awarded under this 

3 subsection are equitably distributed among the geo4 graphical regions of the United States and between 

5 urban and rural populations. 

6 ‘‘(6) EVALUATION.—Not later than 3 months 

7 after a grant or cooperative agreement awarded 

8 under this subsection expires, an eligible entity shall 

9 submit to the Secretary the results of an evaluation 

10 to be conducted by the entity concerning the effec11 tiveness of the activities carried out under the grant 

12 or agreement. 

13 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated to carry out this section, 

15 $70,000,0000 for fiscal year 2011 and such sums as may 

16 be necessary for each of fiscal years 2012 through 2015. 

17 ‘‘SEC. 533. TRAINING GRANTS. 

18 ‘‘(a) IN GENERAL.—The Secretary shall award 

19 grants in accordance with the provisions of this section. 

20 ‘‘(b) MENTAL ILLNESS AWARENESS TRAINING

21 GRANTS.— 

22 ‘‘(1) IN GENERAL.—The Secretary shall award 

23 grants to States, political subdivisions of States, 

24 American Indian and Alaska Native tribes, tribal or25 ganizations, a health facility or program operated by 


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1 or pursuant to a contract or grant with the Indian 

2 Health Service, and nonprofit private entities to 

3 train teachers and other relevant school personnel to 

4 recognize symptoms of childhood and adolescent 

5 mental disorders, to refer family members to the ap6 propriate mental health services if necessary, to 

7 train emergency services personnel to identify and 

8 appropriately respond to persons with a mental ill9 ness, and to provide education to such teachers and 

10 personnel regarding resources that are available in 

11 the community for individuals with a mental illness. 

12 ‘‘(2) EMERGENCY SERVICES PERSONNEL.—In 

13 this subsection, the term ‘emergency services per14 sonnel’ includes paramedics, firefighters, law en15 forcement, and emergency medical technicians. 

16 ‘‘(3) DISTRIBUTION OF AWARDS.—The Sec17 retary shall ensure that such grants awarded under 

18 this subsection are equitably distributed among the 

19 geographical regions of the United States and be20 tween urban and rural populations. 

21 ‘‘(4) APPLICATION.—A State, political subdivi22 sion of a State, Indian tribe, tribal organization, or 

23 nonprofit private entity that desires a grant under 

24 this subsection shall submit an application to the 

25 Secretary at such time, in such manner, and conVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00184 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 taining such information as the Secretary may re2 quire, including a plan for the rigorous evaluation of 

3 activities that are carried out with funds received 

4 under a grant under this subsection. 

5 ‘‘(5) USE OF FUNDS.—A State, political sub6 division of a State, Indian tribe, tribal organization, 

7 or nonprofit private entity receiving a grant under 

8 this subsection shall use funds from such grant to— 

9 ‘‘(A) train teachers and other relevant 

10 school personnel to recognize symptoms of 

11 childhood and adolescent mental disorders and 

12 appropriately respond; 

13 ‘‘(B) train emergency services personnel to 

14 identify and appropriately respond to persons 

15 with a mental illness; and 

16 ‘‘(C) provide education to such teachers 

17 and personnel regarding resources that are 

18 available in the community for individuals with 

19 a mental illness. 

20 ‘‘(6) EVALUATION.—A State, political subdivi21 sion of a State, Indian tribe, tribal organization, or 

22 nonprofit private entity that receives a grant under 

23 this subsection shall prepare and submit an evalua24 tion to the Secretary at such time, in such manner, 

25 and containing such information as the Secretary 


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1 may reasonably require, including an evaluation of 

2 activities carried out with funds received under the 

3 grant under this subsection and a process and out4 come evaluation. 

5 ‘‘(7) AUTHORIZATION OF APPROPRIATIONS.— 

6 There is authorized to be appropriated to carry out 

7 this subsection, $25,000,000 for fiscal year 2011 

8 and such sums as may be necessary for each of fis9 cal years 2012 through 2015. 

10 ‘‘SEC. 534. OLDER ADULT MENTAL HEALTH GRANTS. 

11 ‘‘(a) IN GENERAL.—The Secretary, acting through 

12 the Director of the Center for Mental Health Services, 

13 shall award grants, contracts, and cooperative agreements 

14 to public and private nonprofit entities for projects that 

15 address the mental health needs of older adults, including 

16 programs to— 

17 ‘‘(1) support the establishment and mainte18 nance of interdisciplinary geriatric mental health 

19 specialist outreach teams in community settings 

20 where older adults reside or receive social services, 

21 in order to provide screening, referrals, and evi22 dence-based intervention and treatment services, in23 cluding services provided by licensed mental health 

24 professionals; 


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1 ‘‘(2) develop and implement older adult suicide 

2 early intervention and prevention strategies in 1 or 

3 more settings that serve seniors, and collect and 

4 analyze data on older adult suicide early intervention 

5 and prevention services for purposes of monitoring, 

6 research, and policy development; and 

7 ‘‘(3) other programs as designated by the Sec8 retary, that would improve the mental health of 

9 older Americans. 

10 ‘‘(b) CONSIDERATIONS IN AWARDING GRANTS.—In 

11 awarding grants under this section, the Secretary, to the 

12 extent feasible, shall ensure that— 

13 ‘‘(1) projects are funded in a variety of geo14 graphic areas, including urban and rural areas; 

15 ‘‘(2) a variety of populations, including racial 

16 and ethnic minorities and low-income populations, 

17 are served by projects funded under this section; and 

18 ‘‘(3) older adult suicide intervention and pre19 vention programs are targeted towards areas with 

20 high older adult suicide rates. 

21 ‘‘(c) APPLICATION.—To be eligible to receive a grant 

22 under this section, a public or private nonprofit entity 

23 shall— 


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1 ‘‘(1) submit an application to the Secretary (in 

2 such form, containing such information, and at such 

3 time as the Secretary may specify); 

4 ‘‘(2) agree to report to the Secretary standard5 ized clinical and behavioral data or other perform6 ance data necessary to evaluate patient or program 

7 outcomes and to facilitate evaluations across partici8 pating projects; 

9 ‘‘(3) demonstrate how such applicant will col10 laborate with other State and local public and pri11 vate nonprofit organizations; and 

12 ‘‘(4) submit a plan for the sustainability of the 

13 program beyond the Federal grant period. 

14 ‘‘(d) DURATION.—A project may receive funding 

15 under a grant under this section for a period of up to 

16 3 years, with an extension period of 2 additional years, 

17 at the discretion of the Secretary. 

18 ‘‘(e) SUPPLEMENT, NOT SUPPLANT.—Funds made 

19 available under this section shall be used to supplement, 

20 and not supplant, other Federal, State, or local funds 

21 available to an entity to carry out activities described in 

22 this section. 

23 ‘‘(f) MATCHING REQUIREMENT.—With respect to the 

24 costs of the activities to be carried out by an entity under 

25 a grant under this section, beginning with the third year 


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1 of the grant program, an entity shall provide assurances 

2 that the entity will make available (directly or through a 

3 donation from public or private entities, including in-kind 

4 donations) non-Federal contributions towards such costs 

5 in an amount that is not less than $1 for each $4 of Fed6 eral funds provided under the grant. 

7 ‘‘(g) REPORT.—Grantees under this section shall, be8 ginning with the end of the second year of the grant, sub9 mit yearly reports to the Secretary on the activities of the 

10 grantee in support of the grant and the latest performance 

11 data. Such reports shall contain recommendations as how 

12 to replicate the project. 

13 ‘‘(h) DEFINITIONS.—In this section, the term ‘older 

14 adult’ has the meaning given the term ‘older individual’ 

15 in section 101 of the Older Americans Act of 1965. 

16 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 

17 authorized to be appropriated to carry out this section, 

18 such sums as may be necessary for each of fiscal years 

19 2011 through 2015. 

20 ‘‘SEC. 535. GRANTS FOR TELE-MENTAL HEALTH IN RURAL 

21 AND MEDICALLY UNDERSERVED AREAS. 

22 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting 

23 through the Administrator of the Substance Abuse and 

24 Mental Health Services Administration and in coordina25 tion with the Administrator of the Health Resources and 


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1 Services Administration and the National Coordinator for 

2 Health Information Technology, shall award grants to eli3 gible entities to provide tele-mental health in rural and 

4 medically underserved areas. The Secretary shall ensure 

5 that such grant are coordinated with, and are not duplica6 tive of, activities funded by the Federal Communications 

7 Commission. 

8 ‘‘(b) ELIGIBLE ENTITY.—To be eligible for assist9 ance under the program under subsection (a), an entity 

10 shall be a qualified community program as determined by 

11 the Secretary. 

12 ‘‘(c) APPLICATION.— 

13 ‘‘(1) IN GENERAL.—Each eligible entity desir14 ing a grant under this section shall submit an appli15 cation to the Secretary at such time, in such man16 ner, and containing such information as the Sec17 retary may reasonably require. 

18 ‘‘(2) ASSURANCES.—The application shall in19 clude assurances that the applicant will meet the re20 quirements of this subsection and that the applicant 

21 possesses sufficient infrastructure to manage the ac22 tivities to be funded through the grant and to evalu23 ate and report on the outcomes resulting from such 

24 activities. 


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1 ‘‘(d) USE OF FUNDS.—An eligible entity shall use 

2 funds received under a grant under this section for— 

3 ‘‘(1) the provision of tele-mental health services, 

4 including the provision of services to children and 

5 older adults; or 

6 ‘‘(2) technological improvements for the provi7 sion of tele-mental health services in accordance with 

8 any guidelines, as available, on health information 

9 technology that are developed by the Secretary. 

10 ‘‘(e) GEOGRAPHIC DISTRIBUTION.—The Secretary 

11 shall ensure that grants awarded under this section are 

12 equitably distributed among the geographical regions of 

13 the United States and between urban and rural popu14 lations. 

15 ‘‘(f) EVALUATION.—Not later than 3 months after 

16 the end of a project that is funded by a grant awarded 

17 under this section, the eligible entity involved shall submit 

18 to the Secretary the results of an evaluation to be con19 ducted by the entity concerning the effectiveness of the 

20 activities carried out under the grant. 

21 ‘‘(g) REPORT.—Not later than 5 years after the date 

22 of enactment of this section, the Secretary shall prepare 

23 and submit to the appropriate committees of Congress a 

24 report that shall evaluate the activities funded under this 

25 section. 


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1 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to carry out this section 

3 $20,000,000 for fiscal year 2011, and such sums as may 

4 be necessary for each of fiscal years 2012 through 2015. 

5 ‘‘SEC. 536. IMPROVING HEALTH INFORMATION TECH6 NOLOGY FOR MENTAL HEALTH PROVIDERS. 

7 ‘‘The Secretary, in consultation with the Secretary of 

8 Veterans Affairs, shall collaborate with the Administrator 

9 and the National Coordinator for Health Information 

10 Technology to develop and implement a plan for ensuring 

11 that the National Health Information Infrastructure ad12 dresses the needs of mental health and substance abuse 

13 treatment providers. 

14 ‘‘PART C—PROJECTS FOR ASSISTANCE IN 

15 TRANSITION FROM HOMELESSNESS 

16 ‘‘SEC. 541. FORMULA GRANTS TO STATES. 

17 ‘‘For the purpose of carrying out section 542, the 

18 Secretary, acting through the Director of the Center for 

19 Mental Health Services, shall for each fiscal year make 

20 an allotment for each State in an amount determined in 

21 accordance with section 544. The Secretary shall make 

22 payments, as grants, each such fiscal year to each State 

23 from the allotment for the State if the Secretary approves 

24 for the fiscal year involved an application submitted by 

25 the State pursuant to section 549. 


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1 ‘‘SEC. 542. PURPOSE OF GRANTS. 

2 ‘‘(a) IN GENERAL.—The Secretary may not make 

3 payments under section 541 unless the State involved 

4 agrees that the payments will be expended solely for mak5 ing grants to political subdivisions of the State, and to 

6 nonprofit private entities (including community-based vet7 erans organizations and other community organizations), 

8 for the purpose of providing the services specified in sub9 section (b) to individuals who— 

10 ‘‘(1)(A) are suffering from serious mental ill11 ness; or 

12 ‘‘(B) are suffering from serious mental illness 

13 and from substance use disorders; and 

14 ‘‘(2) are homeless or at imminent risk of be15 coming homeless. 

16 ‘‘(b) SPECIFICATION OF SERVICES.—The services re17 ferred to in subsection (a) are— 

18 ‘‘(1) outreach services; 

19 ‘‘(2) screening and diagnostic treatment serv20 ices; 

21 ‘‘(3) habilitation and rehabilitation services; 

22 ‘‘(4) community mental health services; 

23 ‘‘(5) alcohol or drug treatment services; 

24 ‘‘(6) staff training, including the training of in25 dividuals who work in shelters, mental health clinics, 


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1 substance use disorder programs, and other sites 

2 where homeless individuals require services; 

3 ‘‘(7) case management services, including— 

4 ‘‘(A) preparing a plan for the provision of 

5 community mental health services to the eligible 

6 homeless individual involved, and reviewing 

7 such plan not less than once every 3 months; 

8 ‘‘(B) providing assistance in obtaining and 

9 coordinating social and maintenance services for 

10 the eligible homeless individuals, including serv11 ices relating to daily living activities, personal 

12 financial planning, transportation services, and 

13 habilitation and rehabilitation services, 

14 prevocational and vocational services, and hous15 ing services; 

16 ‘‘(C) providing assistance to the eligible 

17 homeless individual in obtaining income support 

18 services, including housing assistance, food 

19 stamps, and supplemental security income bene20 fits; 

21 ‘‘(D) referring the eligible homeless indi22 vidual for such other services as may be appro23 priate; and 

24 ‘‘(E) providing representative payee serv25 ices in accordance with section 1631(a)(2) of 


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1 the Social Security Act if the eligible homeless 

2 individual is receiving aid under title XVI of 

3 such act and if the applicant is designated by 

4 the Secretary to provide such services; 

5 ‘‘(8) supportive and supervisory services in resi6 dential settings; 

7 ‘‘(9) referrals for primary health services, job 

8 training, educational services, and relevant housing 

9 services; 

10 ‘‘(10) subject to subsection (h)(1)— 

11 ‘‘(A) minor renovation, expansion, and re12 pair of housing; 

13 ‘‘(B) planning of housing; 

14 ‘‘(C) technical assistance in applying for 

15 housing assistance; 

16 ‘‘(D) improving the coordination of hous17 ing services; 

18 ‘‘(E) security deposits; 

19 ‘‘(F) the costs associated with matching el20 igible homeless individuals with appropriate 

21 housing situations; and 

22 ‘‘(G) 1-time rental payments to prevent 

23 eviction; and 

24 ‘‘(11) other appropriate services, as determined 

25 by the Secretary. 


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1 ‘‘(c) COORDINATION.—The Secretary may not make 

2 payments under section 541 unless the State involved 

3 agrees to make grants pursuant to subsection (a) only to 

4 entities that have the capacity to provide, directly or 

5 through arrangements, the services specified in section 

6 542(b), including coordinating the provision of services in 

7 order to meet the needs of eligible homeless individuals 

8 who are both mentally ill and suffering from substance 

9 use disorder. 

10 ‘‘(d) SPECIAL CONSIDERATION REGARDING VET11 ERANS.—The Secretary may not make payments under 

12 section 541 unless the State involved agrees that, in mak13 ing grants to entities pursuant to subsection (a), the State 

14 will give special consideration to entities with a dem15 onstrated effectiveness in serving homeless veterans. 

16 ‘‘(e) SPECIAL RULES.—The Secretary may not make 

17 payments under section 541 unless the State involved 

18 agrees that grants pursuant to subsection (a) will not be 

19 made to any entity that— 

20 ‘‘(1) has a policy of excluding individuals from 

21 mental health services due to the existence or sus22 picion of substance use disorders; or 

23 ‘‘(2) has a policy of excluding individuals from 

24 substance use disorder services due to the existence 

25 or suspicion of mental illness. 


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1 ‘‘(f) ADMINISTRATIVE EXPENSES.—The Secretary 

2 may not make payments under section 541 unless the 

3 State involved agrees that not more than 4 percent of the 

4 payments will be expended for administrative expenses re5 garding the payments. 

6 ‘‘(g) MAINTENANCE OF EFFORT.—The Secretary 

7 may not make payments under section 541 unless the 

8 State involved agrees that the State will maintain State 

9 expenditures for services specified in subsection (b) at a 

10 level that is not less than the average level of such expend11 itures maintained by the State for the 2-year period pre12 ceding the fiscal year for which the State is applying to 

13 receive such payments. 

14 ‘‘(h) RESTRICTIONS ON USE OF FUNDS.—The Sec15 retary may not make payments under section 541 unless 

16 the State involved agrees that— 

17 ‘‘(1) not more than 20 percent of the payments 

18 will be expended for housing services under sub19 section (b)(10); and 

20 ‘‘(2) the payments will not be expended— 

21 ‘‘(A) to support emergency shelters or con22 struction of housing facilities; 

23 ‘‘(B) for inpatient psychiatric treatment 

24 costs or inpatient substance use disorder treat25 ment costs; or 


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1 ‘‘(C) to make cash payments to intended 

2 recipients of mental health or substance use 

3 disorder services. 

4 ‘‘(i) WAIVER FOR TERRITORIES.—With respect to the 

5 United States Virgin Islands, Guam, American Samoa, 

6 Palau, the Marshall Islands, and the Commonwealth of 

7 the Northern Mariana Islands, the Secretary may waive 

8 the provisions of this part that the Secretary determines 

9 to be appropriate. 

10 ‘‘SEC. 543. REQUIREMENT OF MATCHING FUNDS. 

11 ‘‘(a) IN GENERAL.—The Secretary may not make 

12 payments under section 541 unless, with respect to the 

13 costs of providing services pursuant to section 542, the 

14 State involved agrees to make available, directly or 

15 through donations from public or private entities, non16 Federal contributions toward such costs in an amount that 

17 is not less than $1 for each $3 of Federal funds provided 

18 in such payments. 

19 ‘‘(b) DETERMINATION OF AMOUNT.—Non-Federal 

20 contributions required in subsection (a) may be in cash 

21 or in kind, fairly evaluated, including plant, equipment, 

22 or services. Amounts provided by the Federal Government, 

23 or services assisted or subsidized to any significant extent 

24 by the Federal Government, shall not be included in deter25 mining the amount of such non-Federal contributions. 


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1 ‘‘(c) LIMITATION REGARDING GRANTS BY STATES.— 

2 The Secretary may not make payments under section 541 

3 unless the State involved agrees that the State will not 

4 require the entities to which grants are provided pursuant 

5 to section 542(a) to provide non-Federal contributions in 

6 excess of the non-Federal contributions described in sub7 section (a). 

8 ‘‘SEC. 544. DETERMINATION OF AMOUNT OF ALLOTMENT. 

9 ‘‘(a) DETERMINATION UNDER FORMULA.—Subject 

10 to subsection (b), the allotment required in section 541 

11 for a State for a fiscal year is the product of— 

12 ‘‘(1) an amount equal to the amount appro13 priated for allotments under section 555 for the fis14 cal year; and 

15 ‘‘(2) a percentage equal to the quotient of— 

16 ‘‘(A) an amount equal to the population 

17 living in urbanized areas of the State involved, 

18 as indicated by the most recent data collected 

19 by the Bureau of the Census; and 

20 ‘‘(B) an amount equal to the population 

21 living in urbanized areas of the United States, 

22 as indicated by the sum of the respective 

23 amounts determined for the States under sub24 paragraph (A). 

25 ‘‘(b) MINIMUM ALLOTMENT.— 


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1 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

2 the allotment for a State under section 541 for a fis3 cal year shall, at a minimum, be the greater of— 

4 ‘‘(A) the amount the State received under 

5 section 541 in fiscal year 2007; and 

6 ‘‘(B) $600,000 for each of the several 

7 States, the District of Columbia, and the Com8 monwealth of Puerto Rico, and $100,000 for 

9 each of Guam, the Virgin Islands, American 

10 Samoa, and the Commonwealth of the Northern 

11 Mariana Islands. 

12 ‘‘(2) CONDITION.—If the funds appropriated in 

13 any fiscal year under section 555 are insufficient to 

14 ensure that States receive a minimum allotment in 

15 accordance with paragraph (1), then— 

16 ‘‘(A) no State shall receive less than the 

17 amount they received in fiscal year 2007; and 

18 ‘‘(B) any funds remaining after amounts 

19 are provided under subparagraph (A) shall be 

20 used to meet the requirement of paragraph 

21 (1)(B), to the maximum extent possible. 

22 ‘‘(c) STUDY CONCERNING FORMULA.—Not later than 

23 1 year after the date of enactment of the SAMHSA Mod24 ernization Act of 2010, the Administrator shall conduct 

25 a study concerning the formula used for allotments under 


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1 subsection (a). Such study shall include an evaluation of 

2 quality indicators of need for purposes of revising such 

3 formula for determinations of the amount of subsequent 

4 allotments. The Administrator shall submit to the appro5 priate committees of Congress, a report concerning the re6 sults of such study. 

7 ‘‘SEC. 545. CONVERSION TO CATEGORICAL PROGRAM IN 

8 EVENT OF FAILURE OF STATE REGARDING 

9 EXPENDITURE OF GRANTS. 

10 ‘‘(a) IN GENERAL.—Subject to subsection (c), the 

11 Secretary shall, from the amounts specified in subsection 

12 (b), make grants to public and nonprofit private entities 

13 for the purpose of providing to eligible homeless individ14 uals the services specified in section 542(b). 

15 ‘‘(b) SPECIFICATION OF FUNDS.—The amounts re16 ferred to in subsection (a) are any amounts made available 

17 in appropriations Acts for allotments under section 541 

18 that are not paid to a State as a result of— 

19 ‘‘(1) the failure of the State to submit an appli20 cation under section 549; 

21 ‘‘(2) the failure of the State, in the determina22 tion of the Secretary, to prepare the application in 

23 accordance with such section or to submit the appli24 cation within a reasonable period of time; or 


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1 ‘‘(3) the State informing the Secretary that the 

2 State does not intend to expend the full amount of 

3 the allotment made to the State. 

4 ‘‘(c) REQUIREMENT OF PROVISION OF SERVICES IN

5 STATE INVOLVED.—With respect to grants under sub6 section (a), amounts made available under subsection (b) 

7 as a result of the State involved shall be available only 

8 for grants to provide services in such State. 

9 ‘‘SEC. 546. PROVISION OF CERTAIN INFORMATION FROM 

10 STATE. 

11 ‘‘The Secretary may not make payments under sec12 tion 541 to a State unless, as part of the application re13 quired in section 549, the State submits to the Secretary 

14 a statement— 

15 ‘‘(1) identifying existing programs providing 

16 services and housing to eligible homeless individuals 

17 and identify gaps in the delivery systems of such 

18 programs; 

19 ‘‘(2) containing a plan for providing services 

20 and housing to eligible homeless individuals, which 

21 plan— 

22 ‘‘(A) describes the coordinated and com23 prehensive means of providing services and 

24 housing to homeless individuals; and 


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1 ‘‘(B) includes documentation that suitable 

2 housing for eligible homeless individuals will ac3 company the provision of services to such indi4 viduals; 

5 ‘‘(3) describes the source of the non-Federal 

6 contributions described in section 543; 

7 ‘‘(4) contains assurances that the non-Federal 

8 contributions described in section 543 will be avail9 able at the beginning of the grant period; 

10 ‘‘(5) describe any voucher system that may be 

11 used to carry out this part; and 

12 ‘‘(6) contain such other information or assur13 ances as the Secretary may reasonably require. 

14 ‘‘SEC. 547. DESCRIPTION OF INTENDED EXPENDITURES OF 

15 GRANT. 

16 ‘‘(a) IN GENERAL.—The Secretary may not make 

17 payments under section 541 unless— 

18 ‘‘(1) as part of the application required in sec19 tion 549, the State involved submits to the Secretary 

20 a description of the intended use for the fiscal year 

21 of the amounts for which the State is applying pur22 suant to such section; 

23 ‘‘(2) such description identifies the geographic 

24 areas within the State in which the greatest num25 bers of homeless individuals with a need for mental 


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1 health, substance use disorder, and housing services 

2 are located; 

3 ‘‘(3) such description provides information re4 lating to the programs and activities to be supported 

5 and services to be provided, including information 

6 relating to coordinating such programs and activities 

7 with any similar programs and activities of public 

8 and private entities; and 

9 ‘‘(4) the State agrees that such description will 

10 be revised throughout the year as may be necessary 

11 to reflect substantial changes in the programs and 

12 activities assisted by the State pursuant to section 

13 542. 

14 ‘‘(b) OPPORTUNITY FOR PUBLIC COMMENT.—The 

15 Secretary may not make payments under section 541 un16 less the State involved agrees that, in developing and car17 rying out the description required in subsection (a), the 

18 State will provide public notice with respect to the descrip19 tion (including any revisions) and such opportunities as 

20 may be necessary to provide interested persons, such as 

21 family members, consumers, and mental health, substance 

22 use disorder, and housing agencies, an opportunity to 

23 present comments and recommendations with respect to 

24 the description. 


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1 ‘‘(c) RELATIONSHIP TO STATE COMPREHENSIVE

2 MENTAL HEALTH SERVICES PLAN.— 

3 ‘‘(1) IN GENERAL.—The Secretary may not 

4 make payments under section 541 unless the serv5 ices to be provided pursuant to the description re6 quired in subsection (a) are consistent with the 

7 State comprehensive mental health services plan re8 quired in subpart I of part B of title XIX. 

9 ‘‘(2) SPECIAL RULE.—The Secretary may not 

10 make payments under section 541 unless the serv11 ices to be provided pursuant to the description re12 quired in subsection (a) have been considered in the 

13 preparation of, have been included in, and are con14 sistent with, the State comprehensive mental health 

15 services plan referred to in paragraph (1). 

16 ‘‘SEC. 548. REQUIREMENT OF REPORTS BY STATES. 

17 ‘‘(a) IN GENERAL.—The Secretary may not make 

18 payments under section 541 unless the State involved 

19 agrees that, by not later than January 31 of each fiscal 

20 year, the State will prepare and submit to the Secretary 

21 a report in such form and containing such information as 

22 the Secretary determines (after consultation with the Ad23 ministrator of the Substance Abuse and Mental Health 

24 Services Administration) to be necessary for— 


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1 ‘‘(1) securing a record and a description of the 

2 purposes for which amounts received under section 

3 541 were expended during the preceding fiscal year 

4 and of the recipients of such amounts; and 

5 ‘‘(2) determining whether such amounts were 

6 expended in accordance with the provisions of this 

7 part. 

8 ‘‘(b) AVAILABILITY TO PUBLIC OF REPORTS.—The 

9 Secretary may not make payments under section 541 un10 less the State involved agrees to make copies of the reports 

11 described in subsection (a) available for public inspection. 

12 ‘‘(c) EVALUATIONS BY COMPTROLLER GENERAL.— 

13 The Administrator of the Substance Abuse and Mental 

14 Health Services Administration shall evaluate at least 

15 once every 3 years the expenditures of grants under this 

16 part by eligible entities in order to ensure that expendi17 tures are consistent with the provisions of this part, and 

18 shall include in such evaluation recommendations regard19 ing changes needed in program design or operations. 

20 ‘‘SEC. 549. REQUIREMENT OF APPLICATION. 

21 ‘‘The Secretary may not make payments under sec22 tion 541 unless the State involved— 

23 ‘‘(1) submits to the Secretary an application for 

24 the payments containing agreements and informa25 tion in accordance with this part; 


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1 ‘‘(2) the agreements are made through certifi2 cation from the chief executive officer of the State; 

3 and 

4 ‘‘(3) the application otherwise is in such form, 

5 is made in such manner, and contains such agree6 ments, assurances, and information as the Secretary 

7 determines to be necessary to carry out this part. 

8 ‘‘SEC. 550. TECHNICAL ASSISTANCE. 

9 ‘‘The Secretary, through the Administrator, shall 

10 provide technical assistance to eligible entities in devel11 oping planning and operating programs in accordance 

12 with the provisions of this part. 

13 ‘‘SEC. 551. FAILURE TO COMPLY WITH AGREEMENTS. 

14 ‘‘(a) REPAYMENT OF PAYMENTS.— 

15 ‘‘(1) The Secretary may, subject to subsection 

16 (c), require a State to repay any payments received 

17 by the State under section 541 that the Secretary 

18 determines were not expended by the State in ac19 cordance with the agreements required to be con20 tained in the application submitted by the State pur21 suant to section 549. 

22 ‘‘(2) If a State fails to make a repayment re23 quired in paragraph (1), the Secretary may offset 

24 the amount of the repayment against the amount of 


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1 any payment due to be paid to the State under sec2 tion 541. 

3 ‘‘(b) WITHHOLDING OF PAYMENTS.— 

4 ‘‘(1) The Secretary may, subject to subsection 

5 (c), withhold payments due under section 541 if the 

6 Secretary determines that the State involved is not 

7 expending amounts received under such section in 

8 accordance with the agreements required to be con9 tained in the application submitted by the State pur10 suant to section 549. 

11 ‘‘(2) The Secretary shall cease withholding pay12 ments from a State under paragraph (1) if the Sec13 retary determines that there are reasonable assur14 ances that the State will expend amounts received 

15 under section 541 in accordance with the agree16 ments referred to in such paragraph. 

17 ‘‘(3) The Secretary may not withhold funds 

18 under paragraph (1) from a State for a minor fail19 ure to comply with the agreements referred to in 

20 such paragraph. 

21 ‘‘(c) OPPORTUNITY FOR HEARING.—Before requiring 

22 repayment of payments under subsection (a)(1), or with23 holding payments under subsection (b)(1), the Secretary 

24 shall provide to the State an opportunity for a hearing. 


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1 ‘‘(d) RULE OF CONSTRUCTION.—Notwithstanding 

2 any other provision of this part, a State receiving pay3 ments under section 541 may not, with respect to any 

4 agreements required to be contained in the application 

5 submitted under section 549, be considered to be in viola6 tion of any such agreements by reason of the fact that 

7 the State, in the regular course of providing services under 

8 section 542(b) to eligible homeless individuals, incidentally 

9 provides services to homeless individuals who are not eligi10 ble homeless individuals. 

11 ‘‘SEC. 552. PROHIBITION AGAINST CERTAIN FALSE STATE12 MENTS. 

13 ‘‘(a) IN GENERAL.— 

14 ‘‘(1) A person may not knowingly make or 

15 cause to be made any false statement or representa16 tion of a material fact in connection with the fur17 nishing of items or services for which amounts may 

18 be paid by a State from payments received by the 

19 State under section 541. 

20 ‘‘(2) A person with knowledge of the occurrence 

21 of any event affecting the right of the person to re22 ceive any amounts from payments made to the State 

23 under section 541 may not conceal or fail to disclose 

24 any such event with the intent of securing such an 

25 amount that the person is not authorized to receive 


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1 or securing such an amount in an amount greater 

2 than the amount the person is authorized to receive. 

3 ‘‘(b) CRIMINAL PENALTY FOR VIOLATION OF PROHI4 BITION.—Any person who violates a prohibition estab5 lished in subsection (a) may for each violation be fined 

6 in accordance with title 18, United States Code, or impris7 oned for not more than 5 years, or both. 

8 ‘‘SEC. 553. NONDISCRIMINATION. 

9 ‘‘(a) IN GENERAL.— 

10 ‘‘(1) RULE OF CONSTRUCTION REGARDING CER11 TAIN CIVIL RIGHTS LAWS.—For the purpose of ap12 plying the prohibitions against discrimination on the 

13 basis of age under the Age Discrimination Act of 

14 1975, on the basis of handicap under section 504 of 

15 the Rehabilitation Act of 1973, on the basis of sex 

16 under title IX of the Education Amendments of 

17 1972, or on the basis of race, color, or national ori18 gin under title VI of the Civil Rights Act of 1964, 

19 programs and activities funded in whole or in part 

20 with funds made available under section 541 shall be 

21 considered to be programs and activities receiving 

22 Federal financial assistance. 

23 ‘‘(2) PROHIBITION.—No person shall on the 

24 ground of sex or religion be excluded from participa25 tion in, be denied the benefits of, or be subjected to 


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1 discrimination under, any program or activity fund2 ed in whole or in part with funds made available 

3 under section 541. 

4 ‘‘(b) ENFORCEMENT.— 

5 ‘‘(1) REFERRALS TO ATTORNEY GENERAL

6 AFTER NOTICE.—Whenever the Secretary finds that 

7 a State, or an entity that has received a payment 

8 pursuant to section 541, has failed to comply with 

9 a provision of law referred to in subsection (a)(1), 

10 with subsection (a)(2), or with an applicable regula11 tion (including one prescribed to carry out sub12 section (a)(2)), the Secretary shall notify the chief 

13 executive officer of the State and shall request the 

14 chief executive officer to secure compliance. If within 

15 a reasonable period of time, not to exceed 60 days, 

16 the chief executive officer fails or refuses to secure 

17 compliance, the Secretary may— 

18 ‘‘(A) refer the matter to the Attorney Gen19 eral with a recommendation that an appropriate 

20 civil action be instituted; 

21 ‘‘(B) exercise the powers and functions 

22 provided by the Age Discrimination Act of 

23 1975, section 504 of the Rehabilitation Act of 

24 1973, title IX of the Education Amendments of 


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1 1972, or title VI of the Civil Rights Act of 

2 1964, as may be applicable; or 

3 ‘‘(C) take such other actions as may be au4 thorized by law. 

5 ‘‘(2) AUTHORITY OF ATTORNEY GENERAL.— 

6 When a matter is referred to the Attorney General 

7 pursuant to paragraph (1)(A), or whenever the At8 torney General has reason to believe that a State or 

9 an entity is engaged in a pattern or practice in viola10 tion of a provision of law referred to in subsection 

11 (a)(1) or in violation of subsection (a)(2), the Attor12 ney General may bring a civil action in any appro13 priate district court of the United States for such re14 lief as may be appropriate, including injunctive re15 lief. 

16 ‘‘SEC. 554. DEFINITIONS. 

17 ‘‘For purposes of this part: 

18 ‘‘(1) ELIGIBLE HOMELESS INDIVIDUAL.—The 

19 term ‘eligible homeless individual’ means an indi20 vidual described in section 542(a). 

21 ‘‘(2) HOMELESS INDIVIDUAL.—The term 

22 ‘homeless individual’ has the meaning given such 

23 term in section 330(h)(5)(A). 

24 ‘‘(3) STATE.—The term ‘State’ means each of 

25 the several States, the District of Columbia, the 


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1 Commonwealth of Puerto Rico, the Virgin Islands, 

2 Guam, American Samoa, and the Commonwealth of 

3 the Northern Mariana Islands. 

4 ‘‘(4) SUBSTANCE USE DISORDER SERVICES.— 

5 The term ‘substance use disorder services’ has the 

6 meaning given the term ‘substance abuse services’ in 

7 section 330(h)(5)(C). 

8 ‘‘SEC. 555. FUNDING. 

9 ‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 

10 purpose of carrying out this part, there is authorized to 

11 be appropriated $75,000,000 for each of the fiscal years 

12 2011 through 2015. 

13 ‘‘(b) ALLOCATION FOR TECHNICAL ASSISTANCE.— 

14 For purposes of carrying out section 550, the Adminis15 trator shall obligate 2 percent of the amounts appro16 priated under subsection (a) for a fiscal year. 

17 ‘‘PART D—MISCELLANEOUS PROVISIONS RELAT18 ING TO SUBSTANCE USE DISORDERS AND 

19 MENTAL ILLNESS 

20 ‘‘SEC. 561. SUBSTANCE USE DISORDERS AMONG GOVERN21 MENT AND OTHER EMPLOYEES. 

22 ‘‘(a) PROGRAMS AND SERVICES.— 

23 ‘‘(1) DEVELOPMENT.—The Secretary, acting 

24 through the Administrator of the Substance Abuse 

25 and Mental Health Services Administration, shall be 


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1 responsible for fostering substance use disorder pre2 vention and treatment programs and services in 

3 State and local governments and in private industry. 

4 ‘‘(2) MODEL PROGRAMS.— 

5 ‘‘(A) IN GENERAL.—Consistent with the 

6 responsibilities described in paragraph (1), the 

7 Secretary, acting through the Administrator of 

8 the Substance Abuse and Mental Health Serv9 ices Administration, shall develop a variety of 

10 model programs suitable for replication on a 

11 cost-effective basis in different types of business 

12 concerns and State and local governmental enti13 ties. 

14 ‘‘(B) DISSEMINATION OF INFORMATION.— 

15 The Secretary, acting through the Adminis16 trator of the Substance Abuse and Mental 

17 Health Services Administration, shall dissemi18 nate information and materials relative to such 

19 model programs to the State agencies respon20 sible for the administration of substance use 

21 disorder prevention, treatment, and rehabilita22 tion activities and shall, to the extent feasible 

23 provide technical assistance to such agencies as 

24 requested. 

25 ‘‘(b) DEPRIVATION OF EMPLOYMENT.— 


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1 ‘‘(1) PROHIBITION.—No person may be denied 

2 or deprived of Federal civilian employment or a Fed3 eral professional or other license or right solely on 

4 the grounds of prior substance use disorders. 

5 ‘‘(2) APPLICATION.—This subsection shall not 

6 apply to employment in— 

7 ‘‘(A) the Central Intelligence Agency; 

8 ‘‘(B) the Federal Bureau of Investigation; 

9 ‘‘(C) the National Security Agency; 

10 ‘‘(D) any other department or agency of 

11 the Federal Government designated for pur12 poses of national security by the President; or 

13 ‘‘(E) in any position in any department or 

14 agency of the Federal Government, not referred 

15 to in subparagraphs (A) through (D), which po16 sition is determined pursuant to regulations 

17 prescribed by the head of such agency or de18 partment to be a sensitive position. 

19 ‘‘(3) REHABILITATION ACT.—The inapplica20 bility of the prohibition described in paragraph (1) 

21 to the employment described in paragraph (2) shall 

22 not be construed to reflect on the applicability of the 

23 Rehabilitation Act of 1973 or other anti-discrimina24 tion laws to such employment. 


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1 ‘‘(c) CONSTRUCTION.—This section shall not be con2 strued to prohibit the dismissal from employment of a 

3 Federal civilian employee who cannot properly function in 

4 his employment. 

5 ‘‘SEC. 562. ADMISSION OF SUBSTANCE ABUSERS TO PRI6 VATE AND PUBLIC HOSPITALS AND OUT7 PATIENT FACILITIES. 

8 ‘‘(a) NONDISCRIMINATION.—Substance abusers who 

9 are suffering from medical conditions shall not be dis10 criminated against in admission or treatment, solely be11 cause of their substance use disorder, by any private or 

12 public general hospital, or outpatient facility (as defined 

13 in section 1624(4)) which receives support in any form 

14 from any program supported in whole or in part by funds 

15 appropriated to any Federal department or agency. 

16 ‘‘(b) REGULATIONS.— 

17 ‘‘(1) IN GENERAL.—The Secretary shall issue 

18 regulations for the enforcement of the policy of sub19 section (a) with respect to the admission and treat20 ment of substance abusers in hospitals and out21 patient facilities which receive support of any kind 

22 from any program administered by the Secretary. 

23 Such regulations shall include procedures for deter24 mining (after opportunity for a hearing if requested) 

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1 tion of failure to comply with such subsection, and 

2 opportunity for a violator to comply with such sub3 section. If the Secretary determines that a hospital 

4 or outpatient facility subject to such regulations has 

5 violated subsection (a) and such violation continues 

6 after an opportunity has been afforded for compli7 ance, the Secretary may suspend or revoke, after op8 portunity for a hearing, all or part of any support 

9 of any kind received by such hospital from any pro10 gram administered by the Secretary. The Secretary 

11 may consult with the officials responsible for the ad12 ministration of any other Federal program from 

13 which such hospital or outpatient facility receives 

14 support of any kind, with respect to the suspension 

15 or revocation of such other Federal support for such 

16 hospital or outpatient facility. 

17 ‘‘(2) DEPARTMENT OF VETERANS AFFAIRS.— 

18 The Secretary of Veterans Affairs, acting through 

19 the Under Secretary for Health, shall, to the max20 imum feasible extent consistent with their respon21 sibilities under title 38, United States Code, pre22 scribe regulations making applicable the regulations 

23 prescribed by the Secretary under paragraph (1) to 

24 the provision of hospital care, nursing home care, 

25 domiciliary care, and medical services under such 


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1 title 38 to veterans suffering from substance use dis2 orders. In prescribing and implementing regulations 

3 pursuant to this paragraph, the Secretary shall, 

4 from time to time, consult with the Secretary of 

5 Health and Human Services in order to achieve the 

6 maximum possible coordination of the regulations, 

7 and the implementation thereof, which they each 

8 prescribe. 

9 ‘‘SEC. 563. CONFIDENTIALITY OF RECORDS. 

10 ‘‘(a) REQUIREMENT.—Records of the identity, diag11 nosis, prognosis, or treatment of any patient which are 

12 maintained in connection with the performance of any pro13 gram or activity relating to substance use disorder edu14 cation, prevention, training, treatment, rehabilitation, or 

15 research, which is conducted, regulated, or directly or indi16 rectly assisted by any department or agency of the United 

17 States shall, except as provided in subsection (e), be con18 fidential and be disclosed only for the purposes and under 

19 the circumstances expressly authorized under subsection 

20 (b). 

21 ‘‘(b) PERMITTED DISCLOSURE.— 

22 ‘‘(1) CONSENT.—The content of any record re23 ferred to in subsection (a) may be disclosed in ac24 cordance with the prior written consent of the pa25 tient with respect to whom such record is mainVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00218 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 tained, but only to such extent, under such cir2 cumstances, and for such purposes as may be al3 lowed under regulations prescribed pursuant to sub4 section (g). 

5 ‘‘(2) METHOD FOR DISCLOSURE.—Whether or 

6 not the patient, with respect to whom any given 

7 record referred to in subsection (a) is maintained, 

8 gives written consent, the content of such record 

9 may be disclosed as follows: 

10 ‘‘(A) To medical personnel to the extent 

11 necessary to meet a bona fide medical emer12 gency. 

13 ‘‘(B) To qualified personnel for the pur14 pose of conducting scientific research, manage15 ment audits, financial audits, or program eval16 uation, but such personnel may not identify, di17 rectly or indirectly, any individual patient in 

18 any report of such research, audit, or evalua19 tion, or otherwise disclose patient identities in 

20 any manner. 

21 ‘‘(C) If authorized by an appropriate order 

22 of a court of competent jurisdiction granted 

23 after application showing good cause therefore, 

24 including the need to avert a substantial risk of 

25 death or serious bodily harm. In assessing good 


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1 cause the court shall weigh the public interest 

2 and the need for disclosure against the injury 

3 to the patient, to the physician-patient relation4 ship, and to the treatment services. Upon the 

5 granting of such order, the court, in deter6 mining the extent to which any disclosure of all 

7 or any part of any record is necessary, shall im8 pose appropriate safeguards against unauthor9 ized disclosure. 

10 ‘‘(c) USE OF RECORDS IN CRIMINAL PRO11 CEEDINGS.—Except as authorized by a court order grant12 ed under subsection (b)(2)(C), no record referred to in 

13 subsection (a) may be used to initiate or substantiate any 

14 criminal charges against a patient or to conduct any inves15 tigation of a patient. 

16 ‘‘(d) APPLICATION.—The prohibitions of this section 

17 continue to apply to records concerning any individual who 

18 has been a patient, irrespective of whether or when such 

19 individual ceases to be a patient. 

20 ‘‘(e) NONAPPLICABILITY.—The prohibitions of this 

21 section do not apply to any interchange of records— 

22 ‘‘(1) within the Uniformed Services or within 

23 those components of the Department of Veterans Af24 fairs furnishing health care to veterans; or 


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1 ‘‘(2) between such components and the Uni2 formed Services. 

3 The prohibitions of this section do not apply to the report4 ing under State law of incidents of suspected child abuse 

5 and neglect to the appropriate State or local authorities. 

6 ‘‘(f) PENALTIES.—Any person who violates any provi7 sion of this section or any regulation issued pursuant to 

8 this section shall be fined in accordance with title 18, 

9 United States Code. 

10 ‘‘(g) REGULATIONS.—Except as provided in sub11 section (h), the Secretary shall prescribe regulations to 

12 carry out the purposes of this section. Such regulations 

13 may contain such definitions, and may provide for such 

14 safeguards and procedures, including procedures and cri15 teria for the issuance and scope of orders under subsection 

16 (b)(2)(C), as in the judgment of the Secretary are nec17 essary or proper to effectuate the purposes of this section, 

18 to prevent circumvention or evasion thereof, or to facilitate 

19 compliance therewith. 

20 ‘‘(h) APPLICATION TO DEPARTMENT OF VETERANS

21 AFFAIRS.—The Secretary of Veterans Affairs, acting 

22 through the Chief Medical Director, shall, to the maximum 

23 feasible extent consistent with their responsibilities under 

24 title 38, United States Code, prescribe regulations making 

25 applicable the regulations prescribed by the Secretary of 


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1 Health and Human Services under subsection (g) of this 

2 section to records maintained in connection with the provi3 sion of hospital care, nursing home care, domiciliary care, 

4 and medical services under such title 38 to veterans suf5 fering from substance use disorders. In prescribing and 

6 implementing regulations pursuant to this subsection, the 

7 Secretary of Veterans Affairs shall, from time to time, 

8 consult with the Secretary of Health and Human Services 

9 in order to achieve the maximum possible coordination of 

10 the regulations, and the implementation thereof, which 

11 they each prescribe. 

12 ‘‘PART E—CHILDREN WITH SERIOUS EMOTIONAL 

13 DISTURBANCES 

14 ‘‘SEC. 571. COMPREHENSIVE COMMUNITY MENTAL HEALTH 

15 SERVICES FOR CHILDREN WITH SERIOUS 

16 EMOTIONAL DISTURBANCES. 

17 ‘‘(a) GRANTS TO CERTAIN PUBLIC ENTITIES.— 

18 ‘‘(1) IN GENERAL.—The Secretary, acting 

19 through the Director of the Center for Mental 

20 Health Services, shall make grants to public entities 

21 for the purpose of providing comprehensive commu22 nity mental health services to children with a serious 

23 emotional disturbance, which may include efforts to 

24 identify and serve children at risk. 


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1 ‘‘(2) DEFINITION OF PUBLIC ENTITY.—For 

2 purposes of this part, the term ‘public entity’ means 

3 any State, any political subdivision of a State, and 

4 any Indian tribe or tribal organization (as defined in 

5 section 4(b) and section 4(c) of the Indian Self-De6 termination and Education Assistance Act). 

7 ‘‘(b) CONSIDERATIONS IN MAKING GRANTS.— 

8 ‘‘(1) REQUIREMENT OF STATUS AS GRANTEE

9 UNDER PART B OF TITLE XIX.—The Secretary may 

10 make a grant under subsection (a) to a public entity 

11 only if— 

12 ‘‘(A) in the case of a public entity that is 

13 a State, the State is such a grantee under sec14 tion 1911; 

15 ‘‘(B) in the case of a public entity that is 

16 a political subdivision of a State, the State in 

17 which the political subdivision is located is such 

18 a grantee; and 

19 ‘‘(C) in the case of a public entity that is 

20 an Indian tribe or tribal organization, the State 

21 in which the tribe or tribal organization is lo22 cated is such a grantee. 

23 ‘‘(2) REQUIREMENT OF STATUS AS MEDICAID

24 PROVIDER.— 


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1 ‘‘(A) Subject to subparagraph (B), the 

2 Secretary may make a grant under subsection 

3 (a) only if, in the case of any service under such 

4 subsection that is covered in the State plan ap5 proved under title XIX of the Social Security 

6 Act for the State involved— 

7 ‘‘(i) the public entity involved will pro8 vide the service directly, and the entity has 

9 entered into a participation agreement 

10 under the State plan and is qualified to re11 ceive payments under such plan; or 

12 ‘‘(ii) the public entity will enter into 

13 an agreement with an organization under 

14 which the organization will provide the 

15 service, and the organization has entered 

16 into such a participation agreement and is 

17 qualified to receive such payments. 

18 ‘‘(B)(i) In the case of an organization 

19 making an agreement under subparagraph 

20 (A)(ii) regarding the provision of services under 

21 subsection (a), the requirement established in 

22 such subparagraph regarding a participation 

23 agreement shall be waived by the Secretary if 

24 the organization does not, in providing health 

25 or mental health services, impose a charge or 


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1 accept reimbursement available from any third2 party payor, including reimbursement under 

3 any insurance policy or under any Federal or 

4 State health benefits program. 

5 ‘‘(ii) A determination by the Secretary of 

6 whether an organization referred to in clause (i) 

7 meets the criteria for a waiver under such 

8 clause shall be made without regard to whether 

9 the organization accepts voluntary donations re10 garding the provision of services to the public. 

11 ‘‘(3) CERTAIN CONSIDERATIONS.—In making 

12 grants under subsection (a), the Secretary shall— 

13 ‘‘(A) equitably allocate such assistance 

14 among the principal geographic regions of the 

15 United States; 

16 ‘‘(B) consider the extent to which the pub17 lic entity involved has a need for the grant; and 

18 ‘‘(C) in the case of any public entity that 

19 is a political subdivision of a State or that is an 

20 Indian tribe or tribal organization— 

21 ‘‘(i) shall consider any comments re22 garding the application of the entity for 

23 such a grant that are received by the Sec24 retary from the State in which the entity 

25 is located; and 


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1 ‘‘(ii) shall give special consideration to 

2 the entity if the State agrees to provide a 

3 portion of the non-Federal contributions 

4 required in subsection (c) regarding such a 

5 grant. 

6 ‘‘(c) MATCHING FUNDS.— 

7 ‘‘(1) IN GENERAL.—A funding agreement for a 

8 grant under subsection (a) is that the public entity 

9 involved will, with respect to the costs to be incurred 

10 by the entity in carrying out the purpose described 

11 in such subsection, make available (directly or 

12 through donations from public or private entities) 

13 non-Federal contributions toward such costs in an 

14 amount that— 

15 ‘‘(A) for the first fiscal year for which the 

16 entity receives payments from a grant under 

17 such subsection, is not less than $1 for each $3 

18 of Federal funds provided in the grant; 

19 ‘‘(B) for any second or third such fiscal 

20 year, is not less than $1 for each $3 of Federal 

21 funds provided in the grant; 

22 ‘‘(C) for any fourth such fiscal year, is not 

23 less than $1 for each $1 of Federal funds pro24 vided in the grant; and 


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1 ‘‘(D) for any fifth and sixth such fiscal 

2 year, is not less than $2 for each $1 of Federal 

3 funds provided in the grant. 

4 ‘‘(2) DETERMINATION OF AMOUNT CONTRIB5 UTED.— 

6 ‘‘(A) Non-Federal contributions required in 

7 paragraph (1) may be in cash or in kind, fairly 

8 evaluated, including plant, equipment, or serv9 ices. Amounts provided by the Federal Govern10 ment, or services assisted or subsidized to any 

11 significant extent by the Federal Government, 

12 may not be included in determining the amount 

13 of such non-Federal contributions. 

14 ‘‘(B) In making a determination of the 

15 amount of non-Federal contributions for pur16 poses of subparagraph (A), the Secretary may 

17 include only non-Federal contributions in excess 

18 of the average amount of non-Federal contribu19 tions made by the public entity involved toward 

20 the purpose described in subsection (a) for the 

21 2-year period preceding the first fiscal year for 

22 which the entity receives a grant under such 

23 section. 

24 ‘‘(3) WAIVER REGARDING NATIVE AMERICAN

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1 ZATIONS.—In the case of a grantee that is a Native 

2 Americans or Alaskan Native tribe or tribal organi3 zation, the Secretary may waive, in whole or in part, 

4 the requirements of this subsection. 

5 ‘‘SEC. 572. REQUIREMENTS WITH RESPECT TO CARRYING 

6 OUT PURPOSE OF GRANTS. 

7 ‘‘(a) SYSTEMS OF COMPREHENSIVE CARE.— 

8 ‘‘(1) IN GENERAL.—A funding agreement for a 

9 grant under section 571(a) is that, with respect to 

10 children with a serious emotional disturbance, the 

11 public entity involved will carry out the purpose de12 scribed in such section only through establishing and 

13 operating 1 or more systems of care for making each 

14 of the mental health services specified in subsection 

15 (c) available to each child provided access to the sys16 tem. In providing for such a system, the public enti17 ty may make grants to, and enter into contracts 

18 with, public and nonprofit private entities. 

19 ‘‘(2) STRUCTURE OF SYSTEM.—A funding 

20 agreement for a grant under section 571(a) is that 

21 a system of care under paragraph (1) will— 

22 ‘‘(A) be established in a community se23 lected by the public entity involved; 

24 ‘‘(B) consist of such public agencies and 

25 nonprofit private entities in the community as 


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1 are necessary to ensure that each of the serv2 ices specified in subsection (c) is available to 

3 each child provided access to the system; 

4 ‘‘(C) be established pursuant to agree5 ments that the public entity enters into with the 

6 agencies and entities described in subparagraph 

7 (B); 

8 ‘‘(D) coordinate the provision of the serv9 ices of the system; and 

10 ‘‘(E) establish an office whose functions 

11 are to serve as the location through which chil12 dren are provided access to the system, to co13 ordinate the provision of services of the system, 

14 and to provide information to the public regard15 ing the system. 

16 ‘‘(3) COLLABORATION OF LOCAL PUBLIC ENTI17 TIES.—A funding agreement for a grant under sec18 tion 571(a) is that, for purposes of the establish19 ment and operation of a system of care under para20 graph (1), the public entity involved will seek col21 laboration among all public agencies that provide 

22 human services in the community in which the sys23 tem is established, including but not limited to those 

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1 ices, child welfare services, or juvenile justice serv2 ices. 

3 ‘‘(b) LIMITATION ON AGE OF CHILDREN PROVIDED

4 ACCESS TO SYSTEM.—A funding agreement for a grant 

5 under section 571(a) is that a system of care under sub6 section (a) will provide an individual with access to the 

7 system through the age of 21 years. 

8 ‘‘(c) REQUIRED MENTAL HEALTH SERVICES OF SYS9 TEM.—A funding agreement for a grant under section 

10 571(a) is that mental health services provided by a system 

11 of care under subsection (a) will include, with respect to 

12 a serious emotional disturbance in a child— 

13 ‘‘(1) diagnostic and evaluation services; 

14 ‘‘(2) outpatient services provided in a clinic, of15 fice, school or other appropriate location, including 

16 individual, group and family counseling services, pro17 fessional consultation, and review and management 

18 of medications; 

19 ‘‘(3) emergency services, available 24-hours a 

20 day, 7 days a week; 

21 ‘‘(4) intensive home-based services for children 

22 and their families when the child is at imminent risk 

23 of out-of-home placement; 

24 ‘‘(5) intensive day-treatment services; 

25 ‘‘(6) respite care; 


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1 ‘‘(7) therapeutic foster care services, and serv2 ices in therapeutic foster family homes or individual 

3 therapeutic residential homes, and groups homes 

4 caring for not more than 10 children; and 

5 ‘‘(8) assisting the child in making the transition 

6 from the services received as a child to the services 

7 to be received as an adult. 

8 ‘‘(d) REQUIRED ARRANGEMENTS REGARDING OTHER

9 APPROPRIATE SERVICES.— 

10 ‘‘(1) IN GENERAL.—A funding agreement for a 

11 grant under section 571(a) is that— 

12 ‘‘(A) a system of care under subsection (a) 

13 will enter into a memorandum of understanding 

14 with each of the providers specified in para15 graph (2) in order to facilitate the availability 

16 of the services of the provider involved to each 

17 child provided access to the system; and 

18 ‘‘(B) the grant under such section 571(a), 

19 and the non-Federal contributions made with 

20 respect to the grant, will not be expended to 

21 pay the costs of providing such non-mental 

22 health services to any individual. 

23 ‘‘(2) SPECIFICATION OF NON-MENTAL HEALTH

24 SERVICES.—The providers referred to in paragraph 

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1 tal health services, providers of educational services, 

2 providers of vocational counseling and vocational re3 habilitation services, and providers of protection and 

4 advocacy services with respect to mental health. 

5 ‘‘(3) FACILITATION OF SERVICES OF CERTAIN

6 PROGRAMS.—A funding agreement for a grant under 

7 section 571(a) is that a system of care under sub8 section (a) will, for purposes of paragraph (1), enter 

9 into a memorandum of understanding regarding fa10 cilitation of— 

11 ‘‘(A) services available pursuant to title 

12 XIX of the Social Security Act, including serv13 ices regarding early periodic screening, diag14 nosis, and treatment; 

15 ‘‘(B) services available under parts B and 

16 C of the Individuals with Disabilities Education 

17 Act; and 

18 ‘‘(C) services available under other appro19 priate programs, as identified by the Secretary. 

20 ‘‘(e) GENERAL PROVISIONS REGARDING SERVICES

21 OF SYSTEM.— 

22 ‘‘(1) CASE MANAGEMENT SERVICES.—A fund23 ing agreement for a grant under section 571(a) is 

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1 vide for the case management of each child provided 

2 access to the system in order to ensure that— 

3 ‘‘(A) the services provided through the sys4 tem to the child are coordinated and that the 

5 need of each such child for the services is peri6 odically reassessed; 

7 ‘‘(B) information is provided to the family 

8 of the child on the extent of progress being 

9 made toward the objectives established for the 

10 child under the plan of services implemented for 

11 the child pursuant to section 573; and 

12 ‘‘(C) the system provides assistance with 

13 respect to— 

14 ‘‘(i) establishing the eligibility of the 

15 child, and the family of the child, for fi16 nancial assistance and services under Fed17 eral, State, or local programs providing for 

18 health services, mental health services, 

19 educational services, social services, or 

20 other services; and 

21 ‘‘(ii) seeking to ensure that the child 

22 receives appropriate services available 

23 under such programs. 

24 ‘‘(2) OTHER PROVISIONS.—A funding agree25 ment for a grant under section 571(a) is that a sysVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00233 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 tem of care under subsection (a), in providing the 

2 services of the system, will— 

3 ‘‘(A) provide the services of the system in 

4 the cultural context that is most appropriate for 

5 the child and family involved; 

6 ‘‘(B) ensure that individuals providing 

7 such services to the child can effectively com8 municate with the child and family in the most 

9 direct manner; 

10 ‘‘(C) provide the services without discrimi11 nating against the child or the family of the 

12 child on the basis of race, religion, national ori13 gin, sex, disability, or age; 

14 ‘‘(D) seek to ensure that each child pro15 vided access to the system of care remains in 

16 the least restrictive, most normative environ17 ment that is clinically appropriate; and 

18 ‘‘(E) provide outreach services to inform 

19 individuals, as appropriate, of the services avail20 able from the system, including identifying chil21 dren with a serious emotional disturbance who 

22 are in the early stages of such disturbance. 

23 ‘‘(3) RULE OF CONSTRUCTION.—An agreement 

24 made under paragraph (2) may not be construed— 


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1 ‘‘(A) with respect to subparagraph (C) of 

2 such paragraph— 

3 ‘‘(i) to prohibit a system of care under 

4 subsection (a) from requiring that, in 

5 housing provided by the grantee for pur6 poses of residential treatment services au7 thorized under subsection (c), males and 

8 females be segregated to the extent appro9 priate in the treatment of the children in10 volved; or 

11 ‘‘(ii) to prohibit the system of care 

12 from complying with the agreement made 

13 under subsection (b); or 

14 ‘‘(B) with respect to subparagraph (D) of 

15 such paragraph, to authorize the system of care 

16 to expend the grant under section 571(a) (or 

17 the non-Federal contributions made with re18 spect to the grant) to provide legal services or 

19 any service with respect to which expenditures 

20 regarding the grant are prohibited under sub21 section (d)(1)(B). 

22 ‘‘(f) RESTRICTIONS ON USE OF GRANT.—A funding 

23 agreement for a grant under section 571(a) is that the 

24 grant, and the non-Federal contributions made with re25 spect to the grant, will not be expended— 


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1 ‘‘(1) to purchase or improve real property (in2 cluding the construction or renovation of facilities); 

3 ‘‘(2) to provide for room and board in residen4 tial programs serving 10 or fewer children; 

5 ‘‘(3) to provide for room and board or other 

6 services or expenditures associated with care of chil7 dren in residential treatment centers serving more 

8 than 10 children or in inpatient hospital settings, ex9 cept intensive home-based services and other services 

10 provided on an ambulatory or outpatient basis; or 

11 ‘‘(4) to provide for the training of any indi12 vidual, except training authorized in section 

13 574(a)(2) and training provided through any appro14 priate course in continuing education whose duration 

15 does not exceed 2 days. 

16 ‘‘(g) WAIVERS.—The Secretary may waive one or 

17 more of the requirements of subsection (c) for a public 

18 entity that is an Indian Tribe or tribal organization, or 

19 American Samoa, Guam, the Marshall Islands, the Fed20 erated States of Micronesia, the Commonwealth of the 

21 Northern Mariana Islands, the Republic of Palau, or the 

22 United States Virgin Islands if the Secretary determines, 

23 after peer review, that the system of care is family-cen24 tered and uses the least restrictive environment that is 

25 clinically appropriate. 


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1 ‘‘SEC. 573. INDIVIDUALIZED PLAN FOR SERVICES. 

2 ‘‘(a) IN GENERAL.—A funding agreement for a grant 

3 under section 571(a) is that a system of care under section 

4 572(a) will develop and carry out an individualized plan 

5 of services for each child provided access to the system, 

6 and that the plan will be developed and carried out with 

7 the participation of the family of the child and, unless 

8 clinically inappropriate, with the participation of the child. 

9 ‘‘(b) MULTIDISCIPLINARY TEAM.—A funding agree10 ment for a grant under section 571(a) is that the plan 

11 required in subsection (a) will be developed, and reviewed 

12 and as appropriate revised not less than once each year, 

13 by a multidisciplinary team of appropriately qualified indi14 viduals who provide services through the system, including 

15 as appropriate mental health services, other health serv16 ices, educational services, social services, and vocational 

17 counseling and rehabilitation; 

18 ‘‘(c) COORDINATION WITH SERVICES UNDER INDI19 VIDUALS WITH DISABILITIES EDUCATION ACT.—A fund20 ing agreement for a grant under section 571(a) is that, 

21 with respect to a plan under subsection (a) for a child, 

22 the multidisciplinary team required in subsection (b) 

23 will— 

24 ‘‘(1) in developing, carrying out, reviewing, and 

25 revising the plan consider any individualized edu26 cation program in effect for the child pursuant to 


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1 part B of the Individuals with Disabilities Education 

2 Act; 

3 ‘‘(2) ensure that the plan is consistent with 

4 such individualized education program and provides 

5 for coordinating services under the plan with serv6 ices under such program; and 

7 ‘‘(3) ensure that the memorandum of under8 standing entered into under section 572(d)(3)(B) re9 garding such Act includes provisions regarding com10 pliance with this subsection. 

11 ‘‘(d) CONTENTS OF PLAN.—A funding agreement for 

12 a grant under section 571(a) is that the plan required in 

13 subsection (a) for a child will— 

14 ‘‘(1) identify and state the needs of the child 

15 for the services available pursuant to section 572 

16 through the system; 

17 ‘‘(2) provide for each of such services that is 

18 appropriate to the circumstances of the child, includ19 ing, except in the case of children who are less than 

20 14 years of age, the provision of appropriate voca21 tional counseling and rehabilitation, and transition 

22 services (as defined in section 602 of the Individuals 

23 with Disabilities Education Act); 


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1 ‘‘(3) establish objectives to be achieved regard2 ing the needs of the child and the methodology for 

3 achieving the objectives; and 

4 ‘‘(4) designate an individual to be responsible 

5 for providing the case management required in sec6 tion 572(e)(1) or certify that case management serv7 ices will be provided to the child as part of the indi8 vidualized education program of the child under the 

9 Individuals with Disabilities Education Act. 

10 ‘‘SEC. 574. ADDITIONAL PROVISIONS. 

11 ‘‘(a) OPTIONAL SERVICES.—In addition to services 

12 described in subsection (c) of section 572, a system of care 

13 under subsection (a) of such section may, in expending 

14 a grant under section 571(a), provide for— 

15 ‘‘(1) preliminary assessments to determine 

16 whether a child should be provided access to the sys17 tem; 

18 ‘‘(2) training in— 

19 ‘‘(A) the administration of the system; 

20 ‘‘(B) the provision of intensive home-based 

21 services under paragraph (4) of section 572(c), 

22 intensive day treatment under paragraph (5) of 

23 such section, and foster care or group homes 

24 under paragraph (7) of such section; and 


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1 ‘‘(C) the development of individualized 

2 plans for purposes of section 573; 

3 ‘‘(3) recreational activities for children provided 

4 access to the system; and 

5 ‘‘(4) such other services as may be appropriate 

6 in providing for the comprehensive needs with re7 spect to mental health of children with a serious 

8 emotional disturbance. 

9 ‘‘(b) COMPREHENSIVE PLAN.—The Secretary may 

10 make a grant under section 571(a) only if, with respect 

11 to the jurisdiction of the public entity involved, the entity 

12 has submitted to the Secretary, and has had approved by 

13 the Secretary, a plan for the development of a jurisdiction14 wide system of care for community-based services for chil15 dren with a serious emotional disturbance that specifies 

16 the progress the public entity has made in developing the 

17 jurisdiction-wide system, the extent of cooperation across 

18 agencies serving children in the establishment of the sys19 tem, the Federal and non-Federal resources currently 

20 committed to the establishment of the system, and the cur21 rent gaps in community services and the manner in which 

22 the grant under section 571(a) will be expended to address 

23 such gaps and establish local systems of care. 

24 ‘‘(c) LIMITATION ON IMPOSITION OF FEES FOR

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1 tion 571(a) is that, if a charge is imposed for the provision 

2 of services under the grant, such charge— 

3 ‘‘(1) will be made according to a schedule of 

4 charges that is made available to the public; 

5 ‘‘(2) will be adjusted to reflect the income of 

6 the family of the child involved; and 

7 ‘‘(3) will not be imposed on any child whose 

8 family has income and resources of equal to or less 

9 than 100 percent of the official poverty line, as es10 tablished by the Director of the Office of Manage11 ment and Budget and revised by the Secretary in ac12 cordance with section 673(2) of the Omnibus Budget 

13 Reconciliation Act of 1981. 

14 ‘‘(d) RELATIONSHIP TO ITEMS AND SERVICES

15 UNDER OTHER PROGRAMS.—A funding agreement for a 

16 grant under section 571(a) is that the grant, and the non17 Federal contributions made with respect to the grant, will 

18 not be expended to make payment for any item or service 

19 to the extent that payment has been made, or can reason20 ably be expected to be made, with respect to such item 

21 or service— 

22 ‘‘(1) under any State compensation program, 

23 under an insurance policy, or under any Federal or 

24 State health benefits program; or 


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1 ‘‘(2) by an entity that provides health services 

2 on a prepaid basis. 

3 ‘‘(e) LIMITATION ON ADMINISTRATIVE EXPENSES.— 

4 A funding agreement for a grant under section 571(a) is 

5 that not more than 2 percent of the grant will be expended 

6 for administrative expenses incurred with respect to the 

7 grant by the public entity involved. 

8 ‘‘(f) REPORTS TO SECRETARY.—A funding agree9 ment for a grant under section 571(a) is that the public 

10 entity involved will annually submit to the Secretary (and 

11 provide a copy to the State involved) a report on the activi12 ties of the entity under the grant that includes a descrip13 tion of the number of children provided access to systems 

14 of care operated pursuant to the grant, the demographic 

15 characteristics of the children, the types and costs of serv16 ices provided pursuant to the grant, the availability and 

17 use of third-party reimbursements, estimates of the unmet 

18 need for such services in the jurisdiction of the entity, and 

19 the manner in which the grant has been expended toward 

20 the establishment of a jurisdiction-wide system of care for 

21 children with a serious emotional disturbance, and such 

22 other information as the Secretary may require with re23 spect to the grant. 


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1 ‘‘(g) DESCRIPTION OF INTENDED USES OF

2 GRANT.—The Secretary may make a grant under section 

3 571(a) only if— 

4 ‘‘(1) the public entity involved submits to the 

5 Secretary a description of the purposes for which the 

6 entity intends to expend the grant; 

7 ‘‘(2) the description identifies the populations, 

8 areas, and localities in the jurisdiction of the entity 

9 with a need for services under this section; and 

10 ‘‘(3) the description provides information relat11 ing to the services and activities to be provided, in12 cluding a description of the manner in which the 

13 services and activities will be coordinated with any 

14 similar services or activities of public or nonprofit 

15 entities. 

16 ‘‘(h) REQUIREMENT OF APPLICATION.—The Sec17 retary may make a grant under section 571(a) only if an 

18 application for the grant is submitted to the Secretary, 

19 the application contains the description of intended uses 

20 required in subsection (g), and the application is in such 

21 form, is made in such manner, and contains such agree22 ments, assurances, and information as the Secretary de23 termines to be necessary to carry out this section. 


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1 ‘‘SEC. 575. GENERAL PROVISIONS. 

2 ‘‘(a) DURATION OF SUPPORT.—The period during 

3 which payments are made to a public entity from a grant 

4 under section 571(a) may not exceed 6 fiscal years. 

5 ‘‘(b) TECHNICAL ASSISTANCE.— 

6 ‘‘(1) IN GENERAL.—The Secretary shall, upon 

7 the request of a public entity— 

8 ‘‘(A) provide technical assistance to the en9 tity regarding the process of submitting to the 

10 Secretary applications for grants under section 

11 571(a) and 576; and 

12 ‘‘(B) provide to the entity training and 

13 technical assistance with respect to the plan14 ning, development, and operation of systems of 

15 care pursuant to section 572. 

16 ‘‘(2) AUTHORITY FOR GRANTS AND CON17 TRACTS.—The Secretary may provide technical as18 sistance under subsection (a) directly or through 

19 grants to, or contracts with, public and nonprofit 

20 private entities. 

21 ‘‘(c) EVALUATIONS AND REPORTS BY SECRETARY.— 

22 ‘‘(1) IN GENERAL.—The Secretary shall, di23 rectly or through contracts with public or private en24 tities, provide for annual evaluations of programs 

25 carried out pursuant to section 571(a). The evalua26 tions shall assess the effectiveness of the systems of 


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1 care operated pursuant to such section, including 

2 longitudinal studies of outcomes of services provided 

3 by such systems, other studies regarding such out4 comes, the effect of activities under this part on the 

5 utilization of hospital and other institutional set6 tings, the barriers to and achievements resulting 

7 from interagency collaboration in providing commu8 nity-based services to children with a serious emo9 tional disturbance, and assessments by parents of 

10 the effectiveness of the systems of care. 

11 ‘‘(2) REPORT TO CONGRESS.—The Secretary 

12 shall, not later than 1 year after the date on which 

13 amounts are first appropriated under subsection (c), 

14 and annually thereafter, submit to the Congress a 

15 report summarizing evaluations carried out pursuant 

16 to paragraph (1) during the preceding fiscal year 

17 and making such recommendations for administra18 tive and legislative initiatives with respect to this 

19 section as the Secretary determines to be appro20 priate. 

21 ‘‘(d) DEFINITIONS.—For purposes of this part: 

22 ‘‘(1) The term ‘child’ means an individual 

23 through the age of 21 years. 


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1 ‘‘(2) The term ‘family’, with respect to a child 

2 provided access to a system of care under section 

3 572(a), means— 

4 ‘‘(A) the legal guardian of the child; and 

5 ‘‘(B) as appropriate regarding mental 

6 health services for the child, the parents of the 

7 child (biological or adoptive, as the case may 

8 be) and any foster parents of the child. 

9 ‘‘(3) The term ‘funding agreement’, with re10 spect to a grant under section 571(a) to a public en11 tity, means that the Secretary may make such a 

12 grant only if the public entity makes the agreement 

13 involved. 

14 ‘‘(4) The term ‘serious emotional disturbance’ 

15 includes, with respect to a child, any child who has 

16 a serious emotional disorder, a serious behavioral 

17 disorder, or a serious mental disorder. 

18 ‘‘(e) RULE OF CONSTRUCTION.—Nothing in this part 

19 shall be construed as limiting the rights of a child with 

20 a serious emotional disturbance under the Individuals with 

21 Disabilities Education Act. 

22 ‘‘SEC. 576. STATE INTEGRATED SYSTEMS OF CARE GRANTS 

23 FOR KEEPING FAMILIES TOGETHER. 

24 ‘‘(a) IN GENERAL.—The Secretary, acting through 

25 the Director of the Center for Mental Health Services, 


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1 shall award grants or cooperative agreements to States for 

2 the purpose of facilitating and promoting the implementa3 tion in local communities of an integrated system of care 

4 for children with mental illness, especially for those with 

5 serious emotional disturbance. 

6 ‘‘(b) APPLICATIONS.—To be eligible for a grant 

7 under subsection (a), a State shall submit to the Secretary 

8 an applications that shall include, at a minimum, the fol9 lowing: 

10 ‘‘(1) An assurance that the State will establish 

11 a board to be made up of, at least, the directors of 

12 the State departments or agencies responsible for 

13 mental health, substance use disorder, child welfare, 

14 education, medicaid, juvenile justice, and consumers 

15 and families of consumers to carry out the purpose 

16 of the grant. 

17 ‘‘(2) A description of the specific population 

18 that the State wishes to focus on under the grant. 

19 ‘‘(3) An assurance that the plan required under 

20 subsection (e) will be submitted within 18 months of 

21 the receipt of the grant. 

22 ‘‘(4) Otherwise be in such form, made in such 

23 manner, and contain such agreements, assurances, 

24 and information as the Secretary determines to be 

25 necessary. 


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1 ‘‘(c) DURATION OF GRANTS.—The period during 

2 which payments are made under a grant under this section 

3 may not exceed 5 years. 

4 ‘‘(d) PRIORITY.—In awarding grants under this sec5 tion, the Secretary shall give priority to States that elect 

6 to use grant funds to focus on children who are, or are 

7 at risk of being placed, in the child welfare or juvenile 

8 justice systems as a direct result of parents relinquishing 

9 their rights in order to get the mental health services their 

10 child needs. 

11 ‘‘(e) PLAN.—To be eligible to receive a grant under 

12 this section, a State shall agree to submit to the Secretary 

13 for approval, a plan, within 18 months of the receipt of 

14 the grant, that at a minimum includes the following: 

15 ‘‘(1) A description of the population that the 

16 State will focus on, including indications on the 

17 number of individuals in the population and the se18 verity of their mental illness. 

19 ‘‘(2) A description of how these individuals are 

20 being served or not served by the State system. 

21 ‘‘(3) A description of the finances that are cur22 rently being used throughout the State to serve this 

23 population, including funds from the mental health 

24 agency. 


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1 ‘‘(4) A description of the types of services such 

2 population is receiving, including if applicable, serv3 ices provided under section 571. 

4 ‘‘(5) A description of the coordination that ex5 ists among the various agencies serving children, in6 cluding child welfare, education, health, and juvenile 

7 justice agencies. 

8 ‘‘(6) A description of the barriers that exist in 

9 the provision of services, including State policies and 

10 procedures. 

11 ‘‘(7) A description of how the State intends to 

12 overcome these barriers, including changing the bar13 riers within State policies and procedures. 

14 ‘‘(8) A description of how the State will finance 

15 the implementation of systems of care for children. 

16 ‘‘(9) A description of how the State intends to 

17 promote a comprehensive system of care that in18 cludes a shift in reliance on residential and institu19 tional services to increased home and community20 based services. 

21 ‘‘(10) A description of the number of children 

22 in the child welfare or juvenile justice system as a 

23 direct result of parents relinquishing their rights in 

24 order to get the mental health services that their 

25 child needed. 


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1 ‘‘(11) A description of how the State intends to 

2 track outcomes through data collection for individ3 uals that receive services in the system of care, in4 cluding improved school attendance and achieve5 ment, reduced substance use, reduced contact with 

6 law enforcement, detention and arrest rates, reduc7 tions in out-of-home placement, and mental health 

8 improvements sustained. 

9 ‘‘(f) USE OF FUNDS.—Amounts received under a 

10 grant under this section may be used for any activity nec11 essary for the development of the plan submitted under 

12 subsection (e) and any costs associated with the implemen13 tation of the approved plan. 

14 ‘‘(g) TRAINING AND TECHNICAL ASSISTANCE.—The 

15 Secretary shall, upon the request of the State, provide 

16 training and technical assistance to the State in the devel17 opment and implementation of the plan submitted under 

18 subsection (e). 

19 ‘‘(h) REPORTS.—Beginning with the second year in 

20 which a State receives a grant under this section, and each 

21 grant year thereafter, the State shall submit a report to 

22 the Secretary detailing the State’s progress in imple23 menting the plan submitted under subsection (e). 


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1 ‘‘SEC. 577. AUTHORIZATION OF APPROPRIATIONS. 

2 ‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 

3 purpose of carrying out this part, there are authorized to 

4 be appropriated $150,000,000 for fiscal year 2011, and 

5 such sums as may be necessary for each of the fiscal years 

6 2012 through 2015. 

7 ‘‘(b) GRANTS UNDER SECTION 576.—Not to exceed 

8 $10,000,000 of the amount appropriated under subsection 

9 (a) for each fiscal year may be used for grants under sec10 tion 576. 

11 ‘‘PART F—WORKFORCE DEVELOPMENT 

12 ‘‘SEC. 581. WORKFORCE DEVELOPMENT GRANTS, CON13 TRACTS, AND COOPERATIVE AGREEMENTS 

14 FOR MENTAL HEALTH AND SUBSTANCE USE 

15 DISORDERS. 

16 ‘‘(a) PURPOSE.—It is the purpose of this section to 

17 promote workforce development by identifying and imple18 menting innovative and effective strategies to recruit and 

19 retain qualified mental health promotion and treatment 

20 and substance use disorder prevention and treatment staff 

21 and by disseminating those strategies to States and public 

22 and non-profit private providers of mental health and sub23 stance use disorder services. 

24 ‘‘(b) GRANTS AND CONTRACTS.—The Secretary shall 

25 award grants, contracts, or cooperative agreements to eli26 gible entities to identify and implement effective, innovaVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00251 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 tive strategies to recruit and retain a workforce qualified 

2 to provide mental health and substance use disorder pre3 vention and treatment services in the public sector. 

4 ‘‘(c) ELIGIBILITY.—To be eligible to receive a grant, 

5 contract, or cooperative agreement under this section, an 

6 entity shall— 

7 ‘‘(1) be a State, American Indian or Alaska Na8 tive tribe, tribal organization, a health facility or 

9 program operated by or pursuant to a contract or 

10 grant with the Indian Health Service, or non-profit 

11 entity; 

12 ‘‘(2) submit to the Secretary an application at 

13 such time, in such manner, and containing such in14 formation as the Secretary may require; 

15 ‘‘(3) agree to collect and provide to the Sec16 retary such data as required by the Secretary to ob17 jectively demonstrate the effect of the strategy im18 plemented through such grant, contract, or coopera19 tive agreement; and 

20 ‘‘(4) agree to participate in conferences con21 ducted by the Secretary expressly for the purposes 

22 of developing recommendations on best practices for 

23 recruiting and retaining a qualified workforce. 

24 ‘‘(d) USE OF FUNDS.— 


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1 ‘‘(1) IN GENERAL.—An entity shall use 

2 amounts received under this section to identify and 

3 implement innovative strategies to— 

4 ‘‘(A) identify and recruit individuals into 

5 the mental health and substance use disorder 

6 public service workforce, including paraprofes7 sionals and individuals in recovery and their 

8 families; 

9 ‘‘(B) assist individuals in obtaining basic 

10 or specialized competencies for providing mental 

11 health promotion and treatment services and 

12 substance use disorder prevention, treatment, 

13 and recovery services; and 

14 ‘‘(C) retain qualified mental health and 

15 substance use disorder treatment staff, includ16 ing staff who provide services that promote 

17 mental health, prevent substance use, or treat 

18 mental illness and substance use disorders. 

19 ‘‘(2) LIMITATION.—Eligible entities that receive 

20 funds under this section may not use such funds to 

21 pay for loan repayment or forgiveness programs, or 

22 for a degree at an institution of higher education or 

23 at any other institution. 


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1 ‘‘(e) PRIORITIES.—In awarding grants, contracts, or 

2 cooperative agreements under this section the Secretary 

3 shall ensure that priority is given to— 

4 ‘‘(1) entities in rural areas and mental health 

5 and substance use disorder manpower shortage 

6 areas; and 

7 ‘‘(2) entities that agree to focus on the inclu8 sion of racial and ethnic minorities in the workforce. 

9 ‘‘(f) GEOGRAPHIC DISTRIBUTION.—The Secretary 

10 shall ensure that to the extent practicable, an equitable 

11 distribution of grants, contracts, and cooperative agree12 ments among the geographical regions of the United 

13 States and between urban and rural populations. 

14 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 

15 provide technical assistance to eligible entities and conduct 

16 conferences to promote the sharing of ideas for the devel17 opment of best practices in the recruitment and retention 

18 of a qualified mental health and substance use disorder 

19 prevention and treatment workforce. 

20 ‘‘(h) EVALUATION.—Not later than 3 years after the 

21 receipt of a grant, contract, or cooperative agreement 

22 under this section, an entity shall— 

23 ‘‘(1) conduct an evaluation of the activities car24 ried out with funds received under the grant, con25 tract, or cooperative agreement; 


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1 ‘‘(2) submit to the Secretary a report con2 cerning the results of the evaluation under para3 graph (1); and 

4 ‘‘(3) participate in any further evaluation of the 

5 program by the Secretary. 

6 ‘‘(i) DISSEMINATION.—The Secretary shall dissemi7 nate to States and public and non-profit private providers 

8 of mental health and substance use disorder services the 

9 proven effective strategies developed under this section. 

10 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 

11 is authorized to be appropriated to carry out this section, 

12 $25,000,000 for fiscal year 2011, and such sums as may 

13 be necessary for each of fiscal years 2012 through 2015. 

14 ‘‘SEC. 582. DATA COLLECTION AND REPORT ON WORK15 FORCE ISSUES. 

16 ‘‘Not later than 5 years after the date of enactment 

17 of the SAMHSA Modernization Act of 2010, the Adminis18 trator shall submit to the appropriate committees of Con19 gress a report based on the data collected pursuant to sec20 tions 1912(b) and 1931(b). Such report shall contain— 

21 ‘‘(1) an assessment of the mental health and 

22 substance use disorder workforce capacity, strengths, 

23 and weaknesses as of the date of the report; 


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1 ‘‘(2) recommendations for legislation to assist 

2 Congress in reauthorizing this title in fiscal year 

3 2014; 

4 ‘‘(3) specific recommendations for States, com5 munities, and public and non-profit private providers 

6 of mental health and substance use disorder services; 

7 ‘‘(4) data and best practices identified under 

8 section 581; and 

9 ‘‘(5) recommendations for national outcomes 

10 measures of workforce. 

11 ‘‘PART G—SCHOOL–BASED MENTAL HEALTH 

12 ‘‘SEC. 585. SCHOOL-BASED MENTAL HEALTH AND CHIL13 DREN AND VIOLENCE. 

14 ‘‘(a) IN GENERAL.—The Secretary, in collaboration 

15 with the Secretary of Education and in consultation with 

16 the Attorney General, shall, directly or through grants, 

17 contracts or cooperative agreements awarded to public en18 tities and local education agencies, assist local commu19 nities and schools in applying a public health approach 

20 to mental health services both in schools and in the com21 munity. Such approach should provide comprehensive age 

22 appropriate services and supports and incorporate age ap23 propriate strategies of positive behavioral interventions 

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1 gram funded under this section shall assist children in 

2 dealing with violence. 

3 ‘‘(b) ACTIVITIES.—Under the program under sub4 section (a), the Secretary may— 

5 ‘‘(1) provide financial support to enable local 

6 communities to implement a comprehensive school 

7 mental health program that incorporates positive be8 havioral interventions and supports to foster the 

9 health and development of children; 

10 ‘‘(2) provide technical assistance to local com11 munities with respect to the development of pro12 grams described in paragraph (1); 

13 ‘‘(3) provide assistance to local communities in 

14 the development of policies to address child and ado15 lescent mental health issues and violence when and 

16 if it occurs; 

17 ‘‘(4) facilitate community partnerships among 

18 families, students, law enforcement agencies, edu19 cation systems, mental health and substance use dis20 order service systems, family-based mental health 

21 service systems, welfare agencies, healthcare service 

22 systems, and other community-based systems; and 

23 ‘‘(5) establish mechanisms for children and ado24 lescents to report incidents of violence or plans by 

25 other children or adolescents to commit violence. 


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1 ‘‘(c) REQUIREMENTS.— 

2 ‘‘(1) IN GENERAL.—To be eligible for a grant, 

3 contract, or cooperative agreement under subsection 

4 (a) an entity shall— 

5 ‘‘(A) be a partnership between a local edu6 cation agency and at least one community pro7 gram or agency that is involved in mental 

8 health; and 

9 ‘‘(B) submit an application, that is en10 dorsed by all members of the partnership, that 

11 makes the assurances described in paragraph 

12 (2). 

13 ‘‘(2) REQUIRED ASSURANCES.—An application 

14 under paragraph (1) shall assure the following: 

15 ‘‘(A) That the applicant will ensure that, 

16 in carrying out activities under this section, the 

17 local educational agency involved will enter into 

18 a memorandum of understanding— 

19 ‘‘(i) with, at a minimum, public or 

20 private mental health entities, healthcare 

21 entities, law enforcement or juvenile justice 

22 entities, child welfare agencies, family23 based mental health entities, families and 

24 family organizations, and other commu25 nity-based entities; and 


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1 ‘‘(ii) that clearly states— 

2 ‘‘(I) the responsibilities of each 

3 partner with respect to the activities 

4 to be carried out; 

5 ‘‘(II) how each partner will be ac6 countable for carrying out such re7 sponsibilities; and 

8 ‘‘(III) the amount of non-Federal 

9 funding or in-kind contributions that 

10 each such partner will contribute in 

11 order to sustain the program. 

12 ‘‘(B) That the comprehensive school-based 

13 mental health program carried out under this 

14 section support the flexible use of funds to ad15 dress— 

16 ‘‘(i) the promotion of the social, emo17 tional, and mental health of all students in 

18 an environment that is conducive to learn19 ing; 

20 ‘‘(ii) the reduction in the likelihood of 

21 at risk students developing social or emo22 tional problems or mental health and sub23 stance use disorders; 

24 ‘‘(iii) the early identification of social 

25 or emotional problems or mental health 


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1 and substance use disorders and the provi2 sion of early intervention services; 

3 ‘‘(iv) the treatment or referral for 

4 treatment of students with existing social 

5 or emotional problems or mental health 

6 and substance use disorders; and 

7 ‘‘(v) the development and implementa8 tion of programs to assist children in deal9 ing with violence. 

10 ‘‘(C) That the comprehensive mental 

11 health program carried out under this section 

12 will provide for in-service training of all school 

13 personnel, including ancillary staff and volun14 teers, in— 

15 ‘‘(i) the techniques and support need16 ed to identify early children with, or at risk 

17 of, mental illness; 

18 ‘‘(ii) the use of referral mechanisms 

19 that effectively link such children to treat20 ment intervention services; 

21 ‘‘(iii) strategies that promote a 

22 schoolwide positive environment, and in23 cludes an on-going training and coaching 

24 component; 


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1 ‘‘(iv) strategies for promoting the so2 cial, emotional, and mental health of all 

3 students; and 

4 ‘‘(v) strategies to increase the knowl5 edge and skills of school and community 

6 leaders on the application of a public 

7 health approach to comprehensive school8 based mental health programs. 

9 ‘‘(D) That the comprehensive school-based 

10 mental health programs carried out under this 

11 section will demonstrate the measures to be 

12 taken to sustain the program after funding 

13 under this section terminates. 

14 ‘‘(E) That the local education agency part15 nership involved is supported by the State edu16 cational and mental health system to ensure 

17 that the sustainability of the programs is estab18 lished after funding under this section termi19 nates. 

20 ‘‘(F) That the comprehensive school-based 

21 mental health program carried out under this 

22 section is based on scientifically valid research, 

23 when available, or evidence-based practices. 

24 ‘‘(G) That the comprehensive school-based 

25 mental health program carried out under this 


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1 section is coordinated with early intervening ac2 tivities carried out under the Individuals with 

3 Disabilities Education Act. 

4 ‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary 

5 shall ensure that grants, contracts or cooperative agree6 ments under subsection (a) will be distributed equitably 

7 among the regions of the country and among urban and 

8 rural areas. 

9 ‘‘(e) DURATION OF AWARDS.—With respect to a 

10 grant, contract or cooperative agreement under subsection 

11 (a), the period during which payments under such an 

12 award will be made to the recipient shall be 5 years. An 

13 entity may only receive one award under this section, ex14 cept that an entity that is providing services and supports 

15 on a regional basis may receive additional funding after 

16 the expiration of the preceding grant period. 

17 ‘‘(f) EVALUATION AND MEASURES OF OUTCOMES.— 

18 ‘‘(1) DEVELOPMENT OF PROCESS.—The Ad19 ministrator shall develop a process for evaluating ac20 tivities carried out under this section. Such process 

21 shall include— 

22 ‘‘(A) the development of guidelines for the 

23 submission of program data by such recipients; 

24 ‘‘(B) the development of measures of out25 comes (in accordance with paragraph (2)) to be 


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1 applied by such recipients in evaluating pro2 grams carried out under this section; and 

3 ‘‘(C) the submission of annual reports by 

4 such recipients concerning the effectiveness of 

5 programs carried out under this section. 

6 ‘‘(2) MEASURES OF OUTCOMES.— 

7 ‘‘(A) IN GENERAL.—The Administrator 

8 shall develop measures of outcomes to be ap9 plied by recipients of assistance under this sec10 tion, and the Administrator, in evaluating the 

11 effectiveness of programs carried out under this 

12 section. Such measures shall include student 

13 and family measures as provided for in sub14 paragraph (B) and local educational measures 

15 as provided for under subparagraph (C). 

16 ‘‘(B) STUDENT AND FAMILY MEASURES OF

17 OUTCOMES.—The measures of outcomes devel18 oped under paragraph (1)(B) relating to stu19 dents and families shall, with respect to activi20 ties carried out under a program under this 

21 section, at a minimum include provisions to 

22 evaluate— 

23 ‘‘(i) whether the program resulted in 

24 an increase in social and emotional com25 petency; 


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1 ‘‘(ii) whether the program resulted in 

2 an increase in student academic achieve3 ment; 

4 ‘‘(iii) whether the program resulted in 

5 a reduction in disruptive and aggressive 

6 behaviors; 

7 ‘‘(iv) whether the program resulted in 

8 improved family functioning; 

9 ‘‘(v) whether the program resulted in 

10 a reduction in substance use disorders; 

11 ‘‘(vi) whether the program resulted in 

12 a reduction in suspensions, truancy, expul13 sions and violence; and 

14 ‘‘(vii) whether the program resulted in 

15 improved access to care for mental health 

16 disorders. 

17 ‘‘(C) LOCAL EDUCATIONAL OUTCOMES.— 

18 The outcome measures developed under para19 graph (1)(B) relating to local educational sys20 tems shall, with respect to activities carried out 

21 under a program under this section, at a min22 imum include provisions to evaluate— 

23 ‘‘(i) the effectiveness of comprehensive 

24 school mental health programs established 

25 under this section; 


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1 ‘‘(ii) the effectiveness of formal part2 nership linkages among child and family 

3 serving institutions, community support 

4 systems, and the educational system; 

5 ‘‘(iii) the progress made in sustaining 

6 the program once funding under the grant 

7 has expired; and 

8 ‘‘(iv) the effectiveness of training and 

9 professional development programs for all 

10 school personnel. 

11 ‘‘(3) SUBMISSION OF ANNUAL DATA.—An entity 

12 that receives a grant, contract, or cooperative agree13 ment under this section shall annually submit to the 

14 Administrator a report that include data to evaluate 

15 the success of the program carried out by the entity 

16 based on whether such program is achieving the pur17 poses of the program. Such reports shall utilize the 

18 measures of outcomes under paragraph (2) in a rea19 sonable manner to demonstrate the progress of the 

20 program in achieving such purposes. 

21 ‘‘(4) EVALUATION BY ADMINISTRATOR.—Based 

22 on the data submitted under paragraph (3), the Ad23 ministrator shall annually submit to Congress a re24 port concerning the results and effectiveness of the 


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1 programs carried out with assistance received under 

2 this section. 

3 ‘‘(g) INFORMATION AND EDUCATION.—The Sec4 retary shall establish comprehensive information and edu5 cation programs to disseminate the findings of the knowl6 edge development and application under this section to the 

7 general public and to health care professionals. 

8 ‘‘(h) AMOUNT OF GRANTS AND AUTHORIZATION OF

9 APPROPRIATIONS.— 

10 ‘‘(1) AMOUNT OF GRANTS.—A grant under this 

11 section shall be in an amount that is not more than 

12 $1,000,000 for each of grant years 2011 through 

13 2015. The Secretary shall determine the amount of 

14 each such grant based on criteria determined by the 

15 Secretary. 

16 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

17 There is authorized to be appropriated to carry out 

18 this section, $200,000,000 for each of fiscal years 

19 2011 through 2015. 

20 ‘‘SEC. 586. GRANTS TO ADDRESS THE PROBLEMS OF PER21 SONS WHO EXPERIENCE VIOLENCE RELATED 

22 STRESS. 

23 ‘‘(a) IN GENERAL.—The Secretary shall award 

24 grants, contracts or cooperative agreements to public and 

25 nonprofit private entities, as well as to Indian tribes and 


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1 tribal organizations, for the purpose of developing and 

2 maintaining programs that provide for the continued oper3 ation of the National Child Traumatic Stress Initiative, 

4 that focus on the behavioral and biological aspects of psy5 chological trauma response and for developing knowledge 

6 with regard to evidence-based practices for treating trau7 ma-related disorders of children and youth resulting from 

8 witnessing or experiencing a traumatic event. 

9 ‘‘(b) PRIORITIES.—In awarding grants, contracts or 

10 cooperative agreements under subsection (a) related to the 

11 development of knowledge and provision of services based 

12 on evidence-based practices for treating disorders associ13 ated with psychological trauma, the Secretary shall give 

14 priority to mental health agencies and programs that have 

15 established clinical and basic research experience in the 

16 field of trauma-related mental disorders, and that con17 tribute to the establishment of a national trauma infra18 structure. 

19 ‘‘(c) GEOGRAPHICAL DISTRIBUTION.—The Secretary 

20 shall ensure that grants, contracts or cooperative agree21 ments under subsection (a) with respect to centers of ex22 cellence are distributed equitably among the regions of the 

23 country and among urban and rural areas. 

24 ‘‘(d) EVALUATION.—The Secretary, as part of the 

25 application process, shall require that each applicant for 


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1 a grant, contract or cooperative agreement under sub2 section (a) submit a plan for the rigorous evaluation of 

3 the activities funded under the grant, contract or agree4 ment, including both process and outcomes evaluation, 

5 and the submission of an evaluation at the end of the 

6 project period. 

7 ‘‘(e) DURATION OF AWARDS.—With respect to a 

8 grant, contract or cooperative agreement under subsection 

9 (a), the period during which payments under such an 

10 award will be made to the recipient for 5 years. Such 

11 grants, contracts or agreements may be renewed, except 

12 that expertise and experience in the field of trauma-related 

13 disorders shall be the priority criterion for new and con14 tinuing grant, contract, or cooperative agreement awards. 

15 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

16 is authorized to be appropriated to carry out this section, 

17 $50,000,000 for fiscal year 2011, and such sums as may 

18 be necessary for each of fiscal years 2012 through 2015. 


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1 ‘‘PART H—REQUIREMENT RELATING TO THE 

2 RIGHTS OF RESIDENTS OF CERTAIN FACILITIES 

3 ‘‘Subpart I—Medical Facilities 

4 ‘‘SEC. 591. REQUIREMENT RELATING TO THE RIGHTS OF 

5 RESIDENTS OF CERTAIN MEDICAL FACILI6 TIES. 

7 ‘‘(a) IN GENERAL.—A public or private general hos8 pital, nursing facility, intermediate care facility, or other 

9 health care facility, that receives support in any form from 

10 any program supported in whole or in part with funds ap11 propriated to any Federal department or agency shall pro12 tect and promote the rights of each resident of the facility, 

13 including the right to be free from physical or mental 

14 abuse, corporal punishment, and any restraints or involun15 tary seclusions imposed for purposes of discipline or con16 venience. 

17 ‘‘(b) REQUIREMENTS.—Restraints and seclusion may 

18 only be imposed on a resident of a facility described in 

19 subsection (a) if— 

20 ‘‘(1) the restraints or seclusion are imposed to 

21 ensure the physical safety of the resident, a staff 

22 member, or others; and 

23 ‘‘(2) the restraints or seclusion are imposed 

24 only upon the written order of a physician, or other 

25 licensed practitioner permitted by the State and the 

26 facility to order such restraint or seclusion, that 


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1 specifies the duration and circumstances under 

2 which the restraints are to be used (except in emer3 gency circumstances specified by the Secretary until 

4 such an order could reasonably be obtained). 

5 ‘‘(c) CURRENT LAW.—This part shall not be con6 strued to affect or impede any Federal or State law or 

7 regulations that provide greater protections than this part 

8 regarding seclusion and restraint. 

9 ‘‘(d) DEFINITIONS.—In this section: 

10 ‘‘(1) RESTRAINTS.—The term ‘restraints’ 

11 means— 

12 ‘‘(A) any physical restraint that is a me13 chanical or personal restriction that immobilizes 

14 or reduces the ability of an individual to move 

15 his or her arms, legs, or head freely, not includ16 ing devices, such as orthopedically prescribed 

17 devices, surgical dressings or bandages, protec18 tive helmets, or any other methods that involves 

19 the physical holding of a resident for the pur20 pose of conducting routine physical examina21 tions or tests or to protect the resident from 

22 falling out of bed or to permit the resident to 

23 participate in activities without the risk of 

24 physical harm to the resident (such term does 

25 not include a physical escort); and 


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1 ‘‘(B) a drug or medication that is used as 

2 a restraint to control behavior or restrict the 

3 resident’s freedom of movement that is not a 

4 standard treatment for the resident’s medical or 

5 psychiatric condition. 

6 ‘‘(2) SECLUSION.—The term ‘seclusion’ means 

7 a behavior control technique involving locked isola8 tion. Such term does not include a time out. 

9 ‘‘(3) PHYSICAL ESCORT.—The term ‘physical 

10 escort’ means the temporary touching or holding of 

11 the hand, wrist, arm, shoulder or back for the pur12 pose of inducing a resident who is acting out to walk 

13 to a safe location. 

14 ‘‘(4) TIME OUT.—The term ‘time out’ means a 

15 behavior management technique that is part of an 

16 approved treatment program and may involve the 

17 separation of the resident from the group, in a non18 locked setting, for the purpose of calming. Time out 

19 is not seclusion. 

20 ‘‘SEC. 592. REPORTING REQUIREMENT. 

21 ‘‘(a) IN GENERAL.—Each facility to which the Pro22 tection and Advocacy for Mentally Ill Individuals Act of 

23 1986 applies shall notify the appropriate agency, as deter24 mined by the Secretary, of each death that occurs at each 

25 such facility while a patient is restrained or in seclusion, 


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1 of each death occurring within 24 hours after the patient 

2 has been removed from restraints and seclusion, or where 

3 it is reasonable to assume that a patient’s death is a result 

4 of such seclusion or restraint. A notification under this 

5 section shall include the name of the resident and shall 

6 be provided not later than 7 days after the date of the 

7 death of the individual involved. 

8 ‘‘(b) FACILITY.—In this section, the term ‘facility’ 

9 has the meaning given the term ‘facilities’ in section 

10 102(3) of the Protection and Advocacy for Mentally Ill 

11 Individuals Act of 1986 (42 U.S.C. 10802(3)). 

12 ‘‘SEC. 593. REGULATIONS AND ENFORCEMENT. 

13 ‘‘(a) TRAINING.—Not later than 1 year after the date 

14 of the enactment of this part, the Secretary, after con15 sultation with appropriate State and local protection and 

16 advocacy organizations, physicians, facilities, and other 

17 health care professionals and patients, shall promulgate 

18 regulations that require facilities to which the Protection 

19 and Advocacy for Mentally Ill Individuals Act of 1986 (42 

20 U.S.C. 10801 et seq.) applies, to meet the requirements 

21 of subsection (b). 

22 ‘‘(b) REQUIREMENTS.—The regulations promulgated 

23 under subsection (a) shall require that— 

24 ‘‘(1) facilities described in subsection (a) ensure 

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1 sional and supportive staff to evaluate patients, for2 mulate written individualized, comprehensive treat3 ment plans, and to provide active treatment meas4 ures; 

5 ‘‘(2) appropriate training be provided for the 

6 staff of such facilities in the use of restraints and 

7 any alternatives to the use of restraints; and 

8 ‘‘(3) such facilities provide complete and accu9 rate notification of deaths, as required under section 

10 592(a). 

11 ‘‘(c) ENFORCEMENT.—A facility to which this part 

12 applies that fails to comply with any requirement of this 

13 part, including a failure to provide appropriate training, 

14 shall not be eligible for participation in any program sup15 ported in whole or in part by funds appropriated to any 

16 Federal department or agency. 

17 ‘‘Subpart II—Non-Medical and Community-Based 

18 Facilities 

19 ‘‘SEC. 595. REQUIREMENT RELATING TO THE RIGHTS OF IN20 DIVIDUALS OF CERTAIN NON-MEDICAL, COM21 MUNITY-BASED FACILITIES FOR CHILDREN 

22 AND YOUTH. 

23 ‘‘(a) PROTECTION OF RIGHTS.— 

24 ‘‘(1) IN GENERAL.— 


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1 ‘‘(A) COMMUNITY-BASED FACILITIES.—A 

2 public or private non-medical, community-based 

3 facility for children and youth (as defined in 

4 regulations to be promulgated by the Secretary) 

5 that receives support in any form from any pro6 gram supported in whole or in part with funds 

7 appropriated under this Act shall protect and 

8 promote the rights of each resident of the facil9 ity, including the right to be free from physical 

10 or mental abuse, corporal punishment, and any 

11 restraints or involuntary seclusions imposed for 

12 purposes of discipline or convenience. 

13 ‘‘(B) SCHOOLS.—A public, private, resi14 dential or non-residential school (as defined in 

15 regulations to be promulgated by the Secretary 

16 in consultation with the Secretary of Edu17 cation) that receives support in any form from 

18 any program supported in whole or in part with 

19 funds appropriated to any Federal department 

20 or agency shall protect and promote the rights 

21 of each individual of the facility, including the 

22 right to be free from physical or mental abuse, 

23 corporal punishment (as defined by State law), 

24 and any restraints or involuntary seclusions im25 posed for purposes of discipline or convenience. 


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1 ‘‘(2) NONAPPLICABILITY.—Notwithstanding 

2 this part, a facility that provides inpatient psy3 chiatric treatment services for individuals under the 

4 age of 21, as authorized and defined in subsections 

5 (a)(16) and (h) of section 1905 of the Social Secu6 rity Act, shall comply with the requirements of part 

7 H. 

8 ‘‘(3) APPLICABILITY OF MEDICAID PROVI9 SIONS.—A non-medical, community-based facility for 

10 children and youth funded under the Medicaid pro11 gram under title XIX of the Social Security Act 

12 shall continue to meet all existing requirements for 

13 participation in such program that are not affected 

14 by this part. 

15 ‘‘(b) REQUIREMENTS.— 

16 ‘‘(1) IN GENERAL.—Physical restraints and se17 clusion may only be imposed on an individual by a 

18 facility described in subsection (a)(1) if— 

19 ‘‘(A) the restraints or seclusion are im20 posed only in emergency circumstances and only 

21 to ensure the immediate physical safety of the 

22 individual, a staff member, students, or others 

23 and less restrictive interventions have been de24 termined to be ineffective; and 


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1 ‘‘(B) the restraints or seclusion are im2 posed only by an individual trained and cer3 tified, by a State-recognized body (as defined in 

4 regulation promulgated by the Secretary, and in 

5 the case of facilities described in subsection 

6 (a)(1)(B) promulgated by the Secretary in con7 sultation with the Secretary of Education) and 

8 pursuant to a process determined appropriate 

9 by the State and approved by the Secretary, 

10 and in the case of facilities described in sub11 section (a)(1)(B) approved by the Secretary in 

12 consultation with the Secretary of Education, in 

13 the prevention and use of physical restraint and 

14 seclusion, including the needs and behaviors of 

15 the population served, relationship building, al16 ternatives to restraint and seclusion, de-esca17 lation methods, avoiding power struggles, 

18 thresholds for restraints and seclusion, the 

19 physiological and psychological impact of re20 straint and seclusion, monitoring physical signs 

21 of distress and obtaining medical assistance, 

22 legal issues, position asphyxia, escape and eva23 sion techniques, time limits, the process for ob24 taining approval for continued restraints, proce25 dures to address problematic restraints, docuVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00276 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 mentation, processing with children, and follow2 up with staff, and investigation of injuries and 

3 complaints. 

4 ‘‘(2) INTERIM PROCEDURES RELATING TO

5 TRAINING AND CERTIFICATION.— 

6 ‘‘(A) IN GENERAL.—Until such time as the 

7 State develops a process to assure the proper 

8 training and certification of facility personnel in 

9 the skills and competencies referred to in para10 graph (1)(B), the facility involved shall develop 

11 and implement an interim procedure that meets 

12 the requirements of subparagraph (B). 

13 ‘‘(B) REQUIREMENTS.—A procedure devel14 oped under subparagraph (A) shall— 

15 ‘‘(i) ensure that a supervisory or sen16 ior staff person with training in restraint 

17 and seclusion who is competent to conduct 

18 a face-to-face assessment (as defined in 

19 regulations promulgated by the Secretary, 

20 and in the case of facilities described in 

21 subsection (a)(1)(B) promulgated by the 

22 Secretary in consultation with the Sec23 retary of Education), will assess the men24 tal and physical well-being of the child or 

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1 sure that the restraint or seclusion is being 

2 done in a safe manner; 

3 ‘‘(ii) ensure that the assessment re4 quired under clause (i) take place as soon 

5 as practicable, but in no case later than 1 

6 hour after the initiation of the restraint or 

7 seclusion; and 

8 ‘‘(iii) ensure that the supervisory or 

9 senior staff person continues to monitor 

10 the situation for the duration of the re11 straint and seclusion. 

12 ‘‘(3) LIMITATIONS.— 

13 ‘‘(A) IN GENERAL.—The use of a drug or 

14 medication that is used as a restraint to control 

15 behavior or restrict the individual’s freedom of 

16 movement that is not a standard treatment for 

17 the individual’s medical or psychiatric condition 

18 in a facility described in subsection (a)(1) is 

19 prohibited. 

20 ‘‘(B) PROHIBITION.—The use of mechan21 ical restraints in a facility described in sub22 section (a)(1) is prohibited. 

23 ‘‘(C) LIMITATION.—A facility for children 

24 and youth described in subsection (a)(1) may 

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1 tinuously face-to-face monitoring the individual 

2 and when strong licensing or accreditation and 

3 internal controls are in place. 

4 ‘‘(c) RULE OF CONSTRUCTION.— 

5 ‘‘(1) IN GENERAL.—Nothing in this section 

6 shall be construed as prohibiting the use of re7 straints for medical immobilization, adaptive sup8 port, or medical protection. 

9 ‘‘(2) CURRENT LAW.—This part shall not be 

10 construed to affect or impede any Federal or State 

11 law or regulations that provide greater protections 

12 than this part regarding seclusion and restraint. 

13 ‘‘(d) DEFINITIONS.—In this section: 

14 ‘‘(1) MECHANICAL RESTRAINT.—The term ‘me15 chanical restraint’ means the use of devices as a 

16 means of restricting an individual’s freedom of 

17 movement. 

18 ‘‘(2) PHYSICAL ESCORT.—The term ‘physical 

19 escort’ means the temporary touching or holding of 

20 the hand, wrist, arm, shoulder or back for the pur21 pose of inducing an individual who is acting out to 

22 walk to a safe location. 

23 ‘‘(3) PHYSICAL RESTRAINT.—The term ‘phys24 ical restraint’ means a personal restriction that im25 mobilizes or reduces the ability of an individual to 


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1 move his or her arms, legs, or head freely. Such 

2 term does not include a physical escort. 

3 ‘‘(4) SECLUSION.—The term ‘seclusion’ means 

4 a behavior control technique involving locked isola5 tion. Such term does not include a time out. 

6 ‘‘(5) TIME OUT.—The term ‘time out’ means a 

7 behavior management technique that is part of an 

8 approved treatment program or individual service 

9 plan and may involve the separation of the indi10 vidual from the group, in a non-locked setting, for 

11 the purpose of calming. Time out is not seclusion. 

12 ‘‘SEC. 596. REPORTING REQUIREMENT. 

13 ‘‘Each facility (described in section 595(a)(1)) shall 

14 notify the appropriate State licensing or regulatory agen15 cy, as determined by the Secretary, and in the case of fa16 cilities described in section 595(a)(1)(B) determined by 

17 the Secretary in consultation with the Secretary of Edu18 cation— 

19 ‘‘(1) of each death that occurs at each such fa20 cility. A notification under this section shall include 

21 the name of the resident and shall be provided not 

22 later than 24 hours after the time of the individuals 

23 death; and 

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1 retary, in consultation with the Secretary of Edu2 cation in the case of facilities described in section 

3 595(a)(1)(B), and the States. 

4 ‘‘SEC. 597. REGULATIONS AND ENFORCEMENT. 

5 ‘‘(a) TRAINING.—Not later than 6 months after the 

6 date of the enactment of the SAMHSA Modernization Act 

7 of 2010, the Secretary, after consultation with the Sec8 retary of Education in the case of facilities described in 

9 section 595(a)(1)(B), appropriate State, local, public and 

10 private protection and advocacy organizations, health care 

11 professionals, social workers, facilities described in section 

12 595(a)(1), and individuals receiving services from such fa13 cilities, shall promulgate regulations that— 

14 ‘‘(1) require States that license non-medical, 

15 community-based residential facilities for children 

16 and youth to develop licensing rules and monitoring 

17 requirements concerning behavior management prac18 tice that will ensure compliance with Federal regula19 tions and to meet the requirements of subsection 

20 (b); 

21 ‘‘(2) require States that monitor compliance of 

22 facilities described in section 595(a)(1)(B) with Fed23 eral and State laws and standards to develop rules 

24 and monitoring requirements concerning behavior 

25 management practice that will ensure compliance 


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1 with Federal regulations and meet the requirements 

2 of subsection (b); 

3 ‘‘(3) require States to develop and implement 

4 such licensing rules and monitoring requirements 

5 within 1 year after the promulgation of the regula6 tions referred to in the matter preceding paragraph 

7 (1); and 

8 ‘‘(4) support the development of national guide9 lines and standards on the quality, quantity, orienta10 tion and training, required under this part, as well 

11 as the certification or licensure of those staff respon12 sible for the implementation of behavioral interven13 tion concepts and techniques. 

14 ‘‘(b) REQUIREMENTS.—The regulations promulgated 

15 under subsection (a) shall require— 

16 ‘‘(1) that facilities described in subsection (a) 

17 ensure that there is an adequate number of qualified 

18 professional and supportive staff to evaluate individ19 uals, formulate written individualized, comprehensive 

20 treatment plans, and to provide active treatment 

21 measures; 

22 ‘‘(2) the provision of appropriate training and 

23 certification of the staff of such facilities in the pre24 vention and use of physical restraint and seclusion, 

25 including the needs and behaviors of the population 


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1 served, relationship building, alternatives to re2 straint, de-escalation methods, avoiding power strug3 gles, thresholds for restraints, the physiological im4 pact of restraint and seclusion, monitoring physical 

5 signs of distress and obtaining medical assistance, 

6 legal issues, position asphyxia, escape and evasion 

7 techniques, time limits for the use of restraint and 

8 seclusion, the process for obtaining approval for con9 tinued restraints and seclusion, procedures to ad10 dress problematic restraints, documentation, proc11 essing with children, and follow-up with staff, and 

12 investigation of injuries and complaints; and 

13 ‘‘(3) that such facilities provide complete and 

14 accurate notification of deaths, as required under 

15 section 596. 

16 ‘‘(c) ENFORCEMENT.—A State to which this part ap17 plies that fails to comply with any requirement of this 

18 part, including a failure to provide appropriate training 

19 and certification, shall not be eligible for participation in 

20 any program supported in whole or in part by funds ap21 propriated to any Federal department or agency.’’. 

22 (b) TECHNICAL AMENDMENTS.—Part G of title V of 

23 the Public Health Service Act (42 U.S.C. 290kk et seq.), 

24 as added by section 144 of the Community Renewal Tax 

25 Relief Act of 2000 (as enacted into law by section 1(a)(7) 


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1 of Public Law 106–554; 114 Stat. 2763A–619), is amend2 ed— 

3 (1) by redesignating such part as part I; 

4 (2) by transferring such part so as to appear 

5 after part H (as so designated by the amendment 

6 made by subsection (a)); and 

7 (3) by redesignating sections 581 through 584 

8 as sections 599 through 599C, respectively. 

9 SEC. 3. AMENDMENTS TO TITLE XIX OF THE PUBLIC 

10 HEALTH SERVICE ACT. 

11 (a) IN GENERAL.—Part B of title XIX of the Public 

12 Health Service Act (42 U.S.C. 300x–1 et seq.), except for 

13 section 1955 (42 U.S.C. 300x–65), is amended to read 

14 as follows: 

15 ‘‘PART B—BLOCK GRANTS REGARDING MENTAL 

16 HEALTH AND SUBSTANCE USE DISORDERS 

17 ‘‘Subpart I—Block Grants for Community Mental 

18 Health Services 

19 ‘‘SEC. 1911. FORMULA GRANTS TO STATES. 

20 ‘‘(a) IN GENERAL.—For the purpose described in 

21 subsection (b), the Secretary, acting through the Director 

22 of the Center for Mental Health Services, shall make an 

23 allotment each fiscal year for each State in an amount 

24 determined in accordance with section 1918. The Sec25 retary shall make a grant to the State of the allotment 


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1 made for the State for the fiscal year if the State submits 

2 to the Secretary an application in accordance with section 

3 1917. 

4 ‘‘(b) PURPOSE OF GRANTS.—A funding agreement 

5 for a grant under subsection (a) is that, subject to section 

6 1916, the State involved will expend the grant only for 

7 the purpose of— 

8 ‘‘(1) providing community mental health serv9 ices for adults with serious mental illness and chil10 dren with serious emotional disturbances as defined 

11 in accordance with section 1912(c); 

12 ‘‘(2) carrying out the plan submitted under sec13 tion 1912(a) by the State for the fiscal year in14 volved; 

15 ‘‘(3) evaluating programs and services carried 

16 out under this subpart; and 

17 ‘‘(4) planning, administration, and educational 

18 activities related to providing services under the 

19 plan. 

20 ‘‘SEC. 1912. STATE PLAN FOR COMPREHENSIVE COMMU21 NITY MENTAL HEALTH SERVICES FOR CER22 TAIN INDIVIDUALS. 

23 ‘‘(a) IN GENERAL.—The Secretary may make a grant 

24 under section 1911 only if— 


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1 ‘‘(1) the State involved submits to the Secretary 

2 a plan for providing comprehensive community men3 tal health services to adults with a serious mental ill4 ness and to children with a serious emotional dis5 turbance; 

6 ‘‘(2) the plan meets the criteria specified in 

7 subsection (b); and 

8 ‘‘(3) the plan is approved by the Secretary. 

9 ‘‘(b) CRITERIA FOR PLAN.— 

10 ‘‘(1) IN GENERAL.—In accordance with sub11 section (a), a State shall, at least once every 3 years, 

12 submit to the Secretary a plan that, at a minimum, 

13 includes the following: 

14 ‘‘(A) SYSTEM OF CARE.—A description of 

15 the State’s system of care that contains the fol16 lowing: 

17 ‘‘(i) COMPREHENSIVE COMMUNITY18 BASED MENTAL HEALTH SYSTEMS.—The 

19 plan shall— 

20 ‘‘(I) identify the single State 

21 agency to be responsible for the ad22 ministration of the program under the 

23 grant, including any third party who 

24 administers mental health services 

25 and is responsible for complying with 


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1 the requirements of this part with re2 spect to the grant; 

3 ‘‘(II) provide for an organized 

4 community-based system of care for 

5 individuals with mental illness and de6 scribe available services and resources 

7 in a comprehensive system of care, in8 cluding services for individuals with 

9 co-occurring disorders; 

10 ‘‘(III) include a description of the 

11 manner in which the State and local 

12 entities will coordinate services (in13 cluding health services, rehabilitation 

14 services, employment services, housing 

15 services, educational services, sub16 stance use disorder services, juvenile 

17 justice services, law enforcement serv18 ices, social services, child welfare serv19 ices, medical and dental care services, 

20 and other support services to be pro21 vided with Federal, State, and local 

22 public and private resources) with 

23 other agencies to enable individuals 

24 receiving services to function outside 

25 of inpatient or residential institutions, 


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1 to the maximum extent of their capa2 bilities, including services to be pro3 vided by local school systems under 

4 the Individuals with Disabilities Edu5 cation Act; 

6 ‘‘(IV) include a description of 

7 how the State promotes evidence8 based practices; 

9 ‘‘(V) include a description of case 

10 management services; 

11 ‘‘(VI) provide for activities lead12 ing to a reduction of hospitalization; 

13 ‘‘(VII) include a description of 

14 how the State integrates mental 

15 health and substance use disorder 

16 services and primary health care, 

17 which may include providing mental 

18 health and substance use disorder 

19 services in primary care settings or 

20 providing primary and specialty care 

21 services in community-based mental 

22 health and substance use disorder 

23 service settings; and 

24 ‘‘(VIII) include a description of 

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1 sition of children with serious emo2 tional disturbances from the children’s 

3 service system to the adult service sys4 tem. 

5 ‘‘(ii) MENTAL HEALTH SYSTEM DATA

6 AND EPIDEMIOLOGY.—Utilizing the defini7 tions for adults with a serious mental ill8 ness and children with a serious emotional 

9 disturbance established in accordance with 

10 subsection (c), the plan shall— 

11 ‘‘(I) provide estimates on the in12 cidence and prevalence of individuals 

13 who are adults with a serious mental 

14 illness and children with a serious 

15 emotional disturbance in the State, by 

16 age, sex, race, and ethnicity; 

17 ‘‘(II) provide information on the 

18 number of adults with a serious men19 tal illness and children with a serious 

20 emotional disturbance in community21 based treatment within the State by 

22 age, sex, race, and ethnicity; 

23 ‘‘(III) provide estimates on the 

24 number of adults with a serious men25 tal illness and children with a serious 


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1 emotional disturbance who are home2 less or have a co-occurring mental 

3 health and substance use disorder; 

4 and 

5 ‘‘(IV) provide the latest national 

6 outcome measurement data in accord7 ance with section 504(b). 

8 ‘‘(iii) CHILDREN’S SERVICES.—In the 

9 case of children with a serious emotional 

10 disturbance (as defined pursuant to sub11 section (c)), the plan shall provide for a 

12 system of integrated social services, edu13 cational services, child welfare services, ju14 venile justice services, law enforcement 

15 services, and substance use disorder serv16 ices that, together with health and mental 

17 health services, will be provided in order 

18 for such children to receive care that is ap19 propriate for their multiple needs (such 

20 system to include services provided under 

21 the Individuals with Disabilities Education 

22 Act). 

23 ‘‘(iv) TARGETED SERVICES TO RURAL, 

24 HOMELESS, AND OLDER ADULT POPU25 LATIONS.—The plan shall describe the 


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1 State’s outreach to and services for indi2 viduals who are homeless and older adults 

3 with mental illness, and the manner in 

4 which community-based services will be 

5 provided to individuals residing in rural 

6 areas. 

7 ‘‘(v) MANAGEMENT SERVICES.—The 

8 plan shall describe— 

9 ‘‘(I) the resources available in the 

10 State to pay for the services including 

11 funding under Medicaid, other Fed12 eral programs such as grants to the 

13 State, local jurisdictions of the State, 

14 or non-profit private entities awarded 

15 grants under title V and how the 

16 State is maximizing these resources, 

17 and the manner in which the State in18 tends to expend the grant under sec19 tion 1911 for the fiscal year involved; 

20 ‘‘(II) the manner in which the 

21 State intends to comply with each of 

22 the funding agreements in this sub23 part and subpart III; and 

24 ‘‘(III) the existing mental health 

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1 force, including data on the number of 

2 individuals who serve in the system of 

3 care designated by profession, the 

4 need for additional professionals and 

5 paraprofessionals, the efforts of the 

6 State to recruit and retain a qualified 

7 mental health and substance use dis8 orders workforce, and a copy of the 

9 standards the State uses in certifying 

10 or licensing community-based mental 

11 health services facilities and mental 

12 health providers. 

13 ‘‘(B) SYSTEM ANALYSIS.—An analysis of 

14 the mental health system of care within the 

15 State that identifies the strengths and weak16 nesses of that system of care, and an assess17 ment of the adequacy of that system of care to 

18 respond to the need for services. 

19 ‘‘(C) GOAL AND OBJECTIVES.—A set of 

20 quantifiable goals and objectives for the period 

21 of the plan, including goals and objectives re22 lated to the national outcomes measures estab23 lished in accordance with section 504, including 

24 targets and milestones that are intended to be 


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1 met and the activities that will be undertaken 

2 to achieve those targets. 

3 ‘‘(D) OTHER INFORMATION.—Any other 

4 information determined appropriate by the Sec5 retary. 

6 ‘‘(2) AUTHORITY REGARDING MODIFICA7 TIONS.—As a condition of awarding a grant to a 

8 State under section 1911 for a fiscal year, the Sec9 retary may require that the State modify any provi10 sion of the plan submitted by the State under this 

11 section (including provisions on priorities in carrying 

12 out authorized activities). If the Secretary approves 

13 such plan and awards a grant to the State for the 

14 fiscal year, the Secretary may not during such year 

15 require the State to modify the plan. 

16 ‘‘(3) STATE REQUEST FOR MODIFICATIONS.—If 

17 the State determines that modifications to the State 

18 plan under this section are necessary, the State may 

19 request the approval of the Secretary for such modi20 fications through the annual report of the State 

21 under section 1942. 

22 ‘‘(4) MENTAL HEALTH EMERGENCY RE23 SPONSE.— 

24 ‘‘(A) REQUIREMENTS.—The State plan 

25 under this section shall include the State’s plan 


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1 for addressing the mental health and substance 

2 use disorder needs of individuals in the State in 

3 the event of an emergency or major disaster. 

4 ‘‘(B) DEMONSTRATION.—The State shall 

5 demonstrate how the mental health and sub6 stance use disorder plan under subparagraph 

7 (A) for providing for the mental health needs of 

8 individuals in the event of an emergency or 

9 major disaster is incorporated into the State’s 

10 All-Hazards Public Health Emergency Pre11 paredness and Response Plan required under 

12 section 319C–1. If the mental health emergency 

13 response plan under subparagraph (A) is not so 

14 incorporated, the State shall describe how such 

15 plan will be incorporated into the State Emer16 gency Response Plan during the period that the 

17 State plan under this section is in effect. 

18 ‘‘(C) DEFINITIONS.—In this paragraph, 

19 the terms ‘emergency’ and ‘major disaster’ have 

20 the meanings given such terms in section 102 

21 of the Robert T. Stafford Disaster Relief and 

22 Emergency Assistance Act. 

23 ‘‘(c) DEFINITIONS REGARDING MENTAL ILLNESS

24 AND EMOTIONAL DISTURBANCE; METHODS FOR ESTI25 MATE OF INCIDENCE AND PREVALENCE.— 


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1 ‘‘(1) ESTABLISHMENT BY SECRETARY OF DEFI2 NITIONS; DISSEMINATION.—For purposes of this 

3 subpart, the Secretary shall establish definitions for 

4 the terms ‘adults with a serious mental illness’ and 

5 ‘children with a serious emotional disturbance’. The 

6 Secretary shall disseminate the definitions to the 

7 States. 

8 ‘‘(2) STANDARDIZED METHODS.—The Secretary 

9 shall establish standardized methods for making the 

10 estimates required in subsection (b)(1) with respect 

11 to a State. A funding agreement for a grant under 

12 section 1911 for the State is that the State will uti13 lize such methods in making the estimates. 

14 ‘‘SEC. 1913. CERTAIN AGREEMENTS. 

15 ‘‘(a) ALLOCATION FOR SYSTEMS OF INTEGRATED

16 SERVICES FOR CHILDREN.— 

17 ‘‘(1) IN GENERAL.—With respect to children 

18 with a serious emotional disturbance, a funding 

19 agreement for a grant under section 1911 is that the 

20 State involved will expend not less than an amount 

21 equal to the amount expended by the State for fiscal 

22 year 2006. 

23 ‘‘(2) WAIVER.— 

24 ‘‘(A) Upon the request of a State, the Sec25 retary may provide to the State a waiver of all 


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1 or part of the requirement established in para2 graph (1) if the Secretary determines that the 

3 State is providing an adequate level of com4 prehensive community mental health services 

5 for children with a serious emotional disturb6 ance, as indicated by a comparison of the num7 ber of such children for which such services are 

8 sought with the availability in the State of the 

9 services. 

10 ‘‘(B) The Secretary shall approve or deny 

11 a request for a waiver under subparagraph (A) 

12 not later than 120 days after the date on which 

13 the request is made. 

14 ‘‘(C) Any waiver provided by the Secretary 

15 under subparagraph (A) shall be applicable only 

16 to the fiscal year involved. 

17 ‘‘(b) PROVIDERS OF SERVICES.—A funding agree18 ment for a grant under section 1911 for a State is that, 

19 with respect to the plan submitted under section 1912(a) 

20 for the fiscal year involved— 

21 ‘‘(1) services under the plan will be provided 

22 only through appropriate, qualified community pro23 grams (which may include community mental health 

24 centers, child mental-health programs, psychosocial 

25 rehabilitation programs, mental health peer-support 


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1 programs, and mental-health primary consumer-di2 rected programs); and 

3 ‘‘(2) services under the plan will be provided 

4 through community mental health centers only if the 

5 centers meet the criteria specified in subsection (c). 

6 ‘‘(c) CRITERIA FOR MENTAL HEALTH CENTERS.— 

7 The criteria referred to in subsection (b)(2) regarding 

8 community mental health centers are as follows: 

9 ‘‘(1) With respect to mental health services, the 

10 centers provide services as follows: 

11 ‘‘(A) Services principally to individuals re12 siding in a defined geographic area (hereafter 

13 in this subsection referred to as a ‘service 

14 area’). 

15 ‘‘(B) Outpatient services, including special16 ized outpatient services for children, older 

17 Americans, individuals with a serious mental ill18 ness, and residents of the service areas of the 

19 centers who have been discharged from inpa20 tient treatment at a mental health facility. 

21 ‘‘(C) 24-hour-a-day emergency care serv22 ices. 

23 ‘‘(D) Day treatment or other partial hos24 pitalization services, or psychosocial rehabilita25 tion services. 


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1 ‘‘(E) Screening for patients being consid2 ered for admission to State mental health facili3 ties to determine the appropriateness of such 

4 admission. 

5 ‘‘(2) The mental health services of the centers 

6 are provided, within the limits of the capacities of 

7 the centers, to any individual residing or employed 

8 in the service area of the center regardless of ability 

9 to pay for such services. 

10 ‘‘(3) The mental health services of the centers 

11 are available and accessible promptly, as appropriate 

12 and in a manner which preserves human dignity and 

13 assures continuity and high quality care. 

14 ‘‘SEC. 1914. STATE MENTAL HEALTH PLANNING COUNCIL. 

15 ‘‘(a) IN GENERAL.—A funding agreement for a grant 

16 under section 1911 is that the State involved will establish 

17 and maintain a State mental health planning council in 

18 accordance with the conditions described in this section. 

19 ‘‘(b) DUTIES.—A condition under subsection (a) for 

20 a Council is that the duties of the Council are— 

21 ‘‘(1) to review plans provided to the Council 

22 pursuant to section 1915(a) by the State involved 

23 and to submit to the State any recommendations of 

24 the Council for modifications to the plans; 


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1 ‘‘(2) to serve as an advocate for adults with a 

2 serious mental illness, children with a severe emo3 tional disturbance, and other individuals with mental 

4 illnesses or emotional problems; and 

5 ‘‘(3) to monitor, review, and evaluate, not less 

6 than once each year, the allocation and adequacy of 

7 mental health services within the State. 

8 ‘‘(c) MEMBERSHIP.— 

9 ‘‘(1) IN GENERAL.—A condition under sub10 section (a) for a Council is that the Council be com11 posed of residents of the State, including representa12 tives of— 

13 ‘‘(A) the principal State agencies with re14 spect to— 

15 ‘‘(i) mental health, education, voca16 tional rehabilitation, criminal justice, hous17 ing, and social services; and 

18 ‘‘(ii) the development of the plan sub19 mitted pursuant to title XIX of the Social 

20 Security Act; 

21 ‘‘(B) public and private entities concerned 

22 with the need, planning, operation, funding, and 

23 use of mental health services and related sup24 port services; 


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1 ‘‘(C) adults with serious mental illnesses 

2 who are receiving (or have received) mental 

3 health services; and 

4 ‘‘(D) the families of such adults or families 

5 of children with emotional disturbance. 

6 ‘‘(2) CERTAIN REQUIREMENTS.—A condition 

7 under subsection (a) for a Council is that— 

8 ‘‘(A) with respect to the membership of the 

9 Council, the ratio of parents of children with a 

10 serious emotional disturbance to other members 

11 of the Council is sufficient to provide adequate 

12 representation of such children in the delibera13 tions of the Council; and 

14 ‘‘(B) not less than 50 percent of the mem15 bers of the Council are individuals who are not 

16 State employees or providers of mental health 

17 services. 

18 ‘‘(d) DEFINITION.—For purposes of this section, the 

19 term ‘Council’ means a State mental health planning 

20 council. 

21 ‘‘SEC. 1915. ADDITIONAL PROVISIONS. 

22 ‘‘(a) REVIEW OF STATE PLAN BY MENTAL HEALTH

23 PLANNING COUNCIL.—The Secretary may make a grant 

24 under section 1911 to a State only if— 


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1 ‘‘(1) the plan submitted under section 1912(a) 

2 with respect to the grant and the report of the State 

3 under section 1942(a) concerning the preceding fis4 cal year has been reviewed by the State mental 

5 health planning council under section 1914; and 

6 ‘‘(2) the State submits to the Secretary any 

7 recommendations received by the State from such 

8 council for modifications to the plan (without regard 

9 to whether the State has made the recommended 

10 modifications) and any comments concerning the an11 nual report. 

12 ‘‘(b) MAINTENANCE OF EFFORT REGARDING STATE

13 EXPENDITURES FOR MENTAL HEALTH.— 

14 ‘‘(1) REQUIREMENT.— 

15 ‘‘(A) IN GENERAL.—A funding agreement 

16 for a grant under section 1911 is that the State 

17 involved will maintain State expenditures for 

18 community mental health services at a level 

19 that is not less than the average level of such 

20 expenditures maintained by the State for the 2- 

21 year period preceding the fiscal year for which 

22 the State is applying for the grant. 

23 ‘‘(B) CONDITION.—A State shall be 

24 deemed to be in compliance with subparagraph 

25 (A) for a fiscal year if State expenditures of the 


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1 type described in subparagraph (A) for such fis2 cal year are at least 97 percent of the average 

3 of such State expenditures for the preceding 2- 

4 year period. 

5 ‘‘(2) FUTURE FISCAL YEARS.—Determinations 

6 of whether a State has complied with paragraph (1) 

7 for each fiscal year shall be based on the State fund8 ing level for the preceding 2-year period as required 

9 under paragraph (1)(A) without regard to reduction 

10 in the actual amount of State expenditures as per11 mitted under paragraph (1)(B) or under a waiver 

12 under paragraph (4). 

13 ‘‘(3) EXCLUSION OF CERTAIN FUNDS.—The 

14 Secretary may exclude from the aggregate State ex15 penditures under paragraph (1), funds appropriated 

16 for authorized activities which are of a non-recurring 

17 nature and for a specific purpose. 

18 ‘‘(4) WAIVER.— 

19 ‘‘(A) IN GENERAL.—The Secretary may, 

20 upon the request of a State, waive the require21 ments established in paragraph (1), in whole or 

22 in part, if— 

23 ‘‘(i) the Secretary determines that ex24 traordinary economic conditions in the 


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1 State in the year involved or in the pre2 vious year justify the waiver; or 

3 ‘‘(ii) the State or any part of the 

4 State has experienced a natural disaster 

5 that has received a Presidential Disaster 

6 Declaration under section 102 of the Rob7 ert T. Stafford Disaster Relief and Emer8 gency Assistance Act. 

9 ‘‘(B) DATE CERTAIN FOR ACTING UPON

10 REQUEST.—The Secretary shall approve or 

11 deny a request for a waiver under subparagraph 

12 (A) not later than 120 days after the date on 

13 which the request is made. 

14 ‘‘(C) APPLICABILITY OF WAIVER.—A waiv15 er provided by the Secretary under subpara16 graph (A) shall be applicable only to the fiscal 

17 year involved. 

18 ‘‘(5) NONCOMPLIANCE BY STATE.— 

19 ‘‘(A) IN GENERAL.—In making a grant 

20 under section 1911 to a State for a fiscal year, 

21 the Secretary shall make a determination of 

22 whether, for the previous fiscal year, the State 

23 complied with the agreement made under para24 graph (1). If the Secretary determines that a 

25 State has failed to maintain such compliance, 


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1 the Secretary shall reduce the amount of the al2 lotment under section 1911 for the State in the 

3 year in which the determination is made by an 

4 amount equal to the amount constituting such 

5 failure for the previous fiscal year. 

6 ‘‘(B) ALTERNATIVE PENALTY.—A State 

7 that has failed to comply with this section and 

8 that would otherwise be subject to a reduction 

9 in the State’s allotment under section 1911, 

10 may, with the approval of the Secretary, in lieu 

11 of having the State’s allotment under section 

12 1911 reduced, agree to comply with the results 

13 of a negotiated agreement that is approved by 

14 the Secretary and carried out in accordance 

15 with guidelines issued by the Secretary. 

16 ‘‘(C) SUBMISSION OF INFORMATION TO

17 THE SECRETARY.—The Secretary may make a 

18 grant under section 1911 for a fiscal year only 

19 if the State involved submits to the Secretary 

20 information sufficient to enable the Secretary to 

21 make the determination required in subpara22 graph (A). 


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1 ‘‘SEC. 1916. RESTRICTIONS ON USE OF PAYMENTS. 

2 ‘‘(a) IN GENERAL.—A funding agreement for a grant 

3 under section 1911 is that the State involved will not ex4 pend the grant— 

5 ‘‘(1) to provide inpatient services; 

6 ‘‘(2) to make cash payments to intended recipi7 ents of health services; 

8 ‘‘(3) to purchase or improve land, purchase, 

9 construct, or permanently improve (other than minor 

10 remodeling) any building or other facility, or pur11 chase major medical equipment; 

12 ‘‘(4) to satisfy any requirement for the expendi13 ture of non-Federal funds as a condition for the re14 ceipt of Federal funds; or 

15 ‘‘(5) to provide financial assistance to any enti16 ty other than a public or nonprofit private entity. 

17 ‘‘(b) LIMITATION ON ADMINISTRATIVE EXPENSES.— 

18 A funding agreement for a grant under section 1911 is 

19 that the State involved will not expend more than 5 per20 cent of the grant for administrative expenses with respect 

21 to the grant. 

22 ‘‘SEC. 1917. APPLICATION FOR GRANT. 

23 ‘‘(a) IN GENERAL.—For purposes of section 1911, an 

24 application for a grant under such section for a fiscal year 

25 is in accordance with this section if, subject to subsection 

26 (b)— 


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1 ‘‘(1) the plan is received by the Secretary not 

2 later than September 1 of the fiscal year prior to the 

3 fiscal year for which a State is seeking funds, and 

4 the report from the previous fiscal year as required 

5 under section 1942(a) is received by December 1 of 

6 the fiscal year of the grant; 

7 ‘‘(2) the application contains each funding 

8 agreement that is described in this subpart or sub9 part III for such a grant (other than any such 

10 agreement that is not applicable to the State); 

11 ‘‘(3) the agreements are made through certifi12 cation from the chief executive officer of the State; 

13 ‘‘(4) with respect to such agreements, the appli14 cation provides assurances of compliance satisfactory 

15 to the Secretary; 

16 ‘‘(5) the application contains the plan required 

17 in section 1912(a), the information required in sec18 tion 1915(b), and the report required in section 

19 1942(a); 

20 ‘‘(6) the application contains recommendations 

21 in compliance with section 1915(a), or if no such 

22 recommendations are received by the State, the ap23 plication otherwise demonstrates compliance with 

24 such section; and 


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1 ‘‘(7) the application (including the plan under 

2 section 1912(a)) is otherwise in such form, is made 

3 in such manner, and contains such agreements, as4 surances, and information as the Secretary deter5 mines to be necessary to carry out this subpart. 

6 ‘‘(b) WAIVERS REGARDING CERTAIN TERRI7 TORIES.—In the case of any territory of the United States 

8 except Puerto Rico, the Secretary may waive such provi9 sions of this subpart and subpart III as the Secretary de10 termines to be appropriate, other than the provisions of 

11 section 1916. 

12 ‘‘SEC. 1918. DETERMINATION OF AMOUNT OF ALLOTMENT. 

13 ‘‘(a) STATES.— 

14 ‘‘(1) DETERMINATION UNDER FORMULA.—Sub15 ject to subsection (b), the Secretary shall determine 

16 the amount of the allotment required in section 

17 1911 for a State for a fiscal year in accordance with 

18 the following formula: 

‘‘x 

A (——) u 

19 ‘‘(2) DETERMINATION OF TERM ‘A’.—For pur20 poses of paragraph (1), the term ‘A’ means the dif21 ference between— 

22 ‘‘(A) the amount appropriated under sec23 tion 1920(a) for allotments under section 1911 

24 for the fiscal year involved; and 


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1 ‘‘(B) an amount equal to 1.5 percent of 

2 the amount referred to in subparagraph (A). 

3 ‘‘(3) DETERMINATION OF TERM ‘U’.—For pur4 poses of paragraph (1), the term ‘U’ means the sum 

5 of the respective terms ‘X’ determined for the States 

6 under paragraph (4). 

7 ‘‘(4) DETERMINATION OF TERM ‘X’.—For pur8 poses of paragraph (1), the term ‘X’ means the 

9 product of— 

10 ‘‘(A) an amount equal to the product of— 

11 ‘‘(i) the term ‘P’, as determined for 

12 the State involved under paragraph (5); 

13 and 

14 ‘‘(ii) the factor determined under 

15 paragraph (8) for the State; and 

16 ‘‘(B) the greater of— 

17 ‘‘(i) 0.4; and 

18 ‘‘(ii) an amount equal to an amount 

19 determined for the State in accordance 

20 with the following formula: 

‘‘R% 1 = .35 (——) P% 

21 ‘‘(5) DETERMINATION OF TERM ‘P’.— 

22 ‘‘(A) For purposes of paragraph (4), the 

23 term ‘P’ means the sum of— 


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1 ‘‘(i) an amount equal to the product 

2 of 0.107 and the number of individuals in 

3 the State who are between 18 and 24 years 

4 of age (inclusive); 

5 ‘‘(ii) an amount equal to the product 

6 of 0.166 and the number of individuals in 

7 the State who are between 25 and 44 years 

8 of age (inclusive); 

9 ‘‘(iii) an amount equal to the product 

10 of 0.099 and the number of individuals in 

11 the State who are between 45 and 64 years 

12 of age (inclusive); and 

13 ‘‘(iv) an amount equal to the product 

14 of 0.082 and the number of individuals in 

15 the State who are 65 years of age or older. 

16 ‘‘(B) With respect to data on population 

17 that is necessary for purposes of making a de18 termination under subparagraph (A), the Sec19 retary shall use the most recent data that is 

20 available from the Secretary of Commerce pur21 suant to the decennial census and pursuant to 

22 reasonable estimates by such Secretary of 

23 changes occurring in the data in the ensuing 

24 period. 

25 ‘‘(6) DETERMINATION OF TERM ‘R%’.— 


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1 ‘‘(A) For purposes of paragraph (4), the 

2 term ‘R%’, except as provided in subparagraph 

3 (D), means the percentage constituted by the 

4 ratio of the amount determined under subpara5 graph (B) for the State involved to the amount 

6 determined under subparagraph (C). 

7 ‘‘(B) The amount determined under this 

8 subparagraph for the State involved is the 

9 quotient of— 

10 ‘‘(i) the most recent 3-year arithmetic 

11 mean of the total taxable resources of the 

12 State, as determined by the Secretary of 

13 the Treasury; divided by 

14 ‘‘(ii) the factor determined under 

15 paragraph (8) for the State. 

16 ‘‘(C) The amount determined under this 

17 subparagraph is the sum of the respective 

18 amounts determined for the States under sub19 paragraph (B) (including the District of Colum20 bia). 

21 ‘‘(D)(i) In the case of the District of Co22 lumbia, for purposes of paragraph (4), the term 

23 ‘R%’ means the percentage constituted by the 

24 ratio of the amount determined under clause 


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1 (ii) for such District to the amount determined 

2 under clause (iii). 

3 ‘‘(ii) The amount determined under this 

4 clause for the District of Columbia is the 

5 quotient of— 

6 ‘‘(I) the most recent 3-year arithmetic 

7 mean of total personal income in such Dis8 trict, as determined by the Secretary of 

9 Commerce; divided by 

10 ‘‘(II) the factor determined under 

11 paragraph (8) for the District. 

12 ‘‘(iii) The amount determined under this 

13 clause is the sum of the respective amounts de14 termined for the States (including the District 

15 of Columbia) by making, for each State, the 

16 same determination as is described in clause (ii) 

17 for the District of Columbia. 

18 ‘‘(7) DETERMINATION OF TERM ‘P%’.—For 

19 purposes of paragraph (4), the term ‘P%’ means the 

20 percentage constituted by the ratio of the term ‘P’ 

21 determined under paragraph (5) for the State in22 volved to the sum of the respective terms ‘P’ deter23 mined for the States. 

24 ‘‘(8) DETERMINATION OF CERTAIN FACTOR.— 


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1 ‘‘(A) The factor determined under this 

2 paragraph for the State involved is a factor 

3 whose purpose is to adjust the amount deter4 mined under clause (i) of paragraph (4)(A), 

5 and the amounts determined under each of sub6 paragraphs (B)(i) and (D)(ii)(I) of paragraph 

7 (6), to reflect the differences that exist between 

8 the State and other States in the costs of pro9 viding comprehensive community mental health 

10 services to adults with a serious mental illness 

11 and to children with a serious emotional dis12 turbance. 

13 ‘‘(B) Subject to subparagraph (C), the fac14 tor determined under this paragraph and in ef15 fect for the fiscal year involved shall be deter16 mined according to the methodology described 

17 in the report entitled ‘Adjusting the Alcohol, 

18 Drug Abuse and Mental Health Services Block 

19 Grant Allocations for Poverty Populations and 

20 Cost of Service’, dated March 30, 1990, and 

21 prepared by Health Economics Research, a cor22 poration, pursuant to a contract with the Na23 tional Institute on Drug Abuse. 

24 ‘‘(C) The factor determined under this 

25 paragraph for the State involved may not for 


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1 any fiscal year be greater than 1.1 or less than 

2 0.9. 

3 ‘‘(D)(i) Not later than October 1, 1992, 

4 the Secretary, after consultation with the 

5 Comptroller General, shall in accordance with 

6 this section make a determination for each 

7 State of the factor that is to be in effect for the 

8 State under this paragraph. The factor so de9 termined shall remain in effect through fiscal 

10 year 1994, and shall be recalculated every third 

11 fiscal year thereafter. 

12 ‘‘(ii) After consultation with the Comp13 troller General, the Secretary shall, through 

14 publication in the Federal Register, periodically 

15 make such refinements in the methodology re16 ferred to in subparagraph (B) as are consistent 

17 with the purpose described in subparagraph 

18 (A). 

19 ‘‘(b) MINIMUM ALLOTMENTS FOR STATES.—With re20 spect to fiscal year 2000, and subsequent fiscal years, the 

21 amount of the allotment of a State under section 1911 

22 shall not be less than the amount the State received under 

23 such section for fiscal year 1998. 

24 ‘‘(c) TERRITORIES.— 


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1 ‘‘(1) DETERMINATION UNDER FORMULA.—Sub2 ject to paragraphs (2) and (4), the amount of an al3 lotment under section 1911 for a territory of the 

4 United States for a fiscal year shall be the product 

5 of— 

6 ‘‘(A) an amount equal to the amounts re7 served under paragraph (3) for the fiscal year; 

8 and 

9 ‘‘(B) a percentage equal to the quotient 

10 of— 

11 ‘‘(i) the civilian population of the ter12 ritory, as indicated by the most recently 

13 available data; divided by 

14 ‘‘(ii) the aggregate civilian population 

15 of the territories of the United States, as 

16 indicated by such data. 

17 ‘‘(2) MINIMUM ALLOTMENT FOR TERRI18 TORIES.—The amount of an allotment under section 

19 1911 for a territory of the United States for a fiscal 

20 year shall be the greater of— 

21 ‘‘(A) the amount determined under para22 graph (1) for the territory for the fiscal year; 

23 ‘‘(B) $50,000; and 

24 ‘‘(C) with respect to fiscal years 1993 and 

25 1994, an amount equal to 20.6 percent of the 


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1 amount received by the territory from allot2 ments made pursuant to this part for fiscal 

3 year 1992. 

4 ‘‘(3) RESERVATION OF AMOUNTS.—The Sec5 retary shall each fiscal year reserve for the terri6 tories of the United States 1.5 percent of the 

7 amounts appropriated under section 1920(a) for al8 lotments under section 1911 for the fiscal year. 

9 ‘‘(4) AVAILABILITY OF DATA ON POPU10 LATION.—With respect to data on the civilian popu11 lation of the territories of the United States, if the 

12 Secretary determines for a fiscal year that recent 

13 such data for purposes of paragraph (1)(B) do not 

14 exist regarding a territory, the Secretary shall for 

15 such purposes estimate the civilian population of the 

16 territory by modifying the data on the territory to 

17 reflect the average extent of change occurring during 

18 the ensuing period in the population of all territories 

19 with respect to which recent such data do exist. 

20 ‘‘(5) APPLICABILITY OF CERTAIN PROVI21 SIONS.—For purposes of subsection (a), the term 

22 ‘State’ does not include the territories of the United 

23 States. 

24 ‘‘SEC. 1919. DEFINITIONS. 

25 ‘‘For purposes of this subpart: 


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1 ‘‘(1) The terms ‘adults with a serious mental 

2 illness’ and ‘children with a serious emotional dis3 turbance’ have the meanings given such terms under 

4 section 1912(c)(1). 

5 ‘‘(2) The term ‘funding agreement’, with re6 spect to a grant under section 1911 to a State, 

7 means that the Secretary may make such a grant 

8 only if the State makes the agreement involved. 

9 ‘‘SEC. 1920. FUNDING. 

10 ‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 

11 purpose of carrying out this subpart, and subpart III and 

12 section 504 with respect to mental health, there are au13 thorized to be appropriated $450,000,000 for fiscal year 

14 2011, and such sums as may be necessary for each of the 

15 fiscal years 2012 through 2015. 

16 ‘‘(b) ALLOCATIONS FOR TECHNICAL ASSISTANCE, 

17 DATA COLLECTION, AND PROGRAM EVALUATION.— 

18 ‘‘(1) IN GENERAL.—For the purpose of car19 rying out section 1948(a) and 1945(g) with respect 

20 to mental health and the purposes specified in para21 graphs (2) and (3), the Secretary shall obligate 5 

22 percent of the amounts appropriated under sub23 section (a) for a fiscal year. 


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1 ‘‘(2) DATA COLLECTION.—The purpose speci2 fied in this paragraph is carrying out section 504 

3 with respect to mental health. 

4 ‘‘(3) PROGRAM EVALUATION.—The purpose 

5 specified in this paragraph is the conduct of evalua6 tions of prevention and treatment programs and 

7 services with respect to mental health to determine 

8 methods for improving the availability and quality of 

9 such programs and services. 

10 ‘‘Subpart II—Block Grants for Prevention and 

11 Treatment of Substance Use Disorders 

12 ‘‘SEC. 1921. FORMULA GRANTS TO STATES. 

13 ‘‘(a) IN GENERAL.—For the purpose described in 

14 subsection (b), the Secretary, acting through the Center 

15 for Substance Abuse Treatment, shall make an allotment 

16 each fiscal year for each State in an amount determined 

17 in accordance with section 1932. The Secretary shall make 

18 a grant to the State of the allotment made for the State 

19 for the fiscal year if the State submits to the Secretary 

20 an application in accordance with section 1931. 

21 ‘‘(b) AUTHORIZED ACTIVITIES.—A funding agree22 ment for a grant under subsection (a) is that, subject to 

23 section 1930, the State involved will expend the grant only 

24 for the purpose of carrying out the plan developed in ac25 cordance with section 1931(b) and for planning, carrying 


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1 out, and evaluating activities to prevent and treat sub2 stance use disorders and for related activities authorized 

3 in section 1924. 

4 ‘‘SEC. 1922. CERTAIN ALLOCATIONS. 

5 ‘‘(a) ALLOCATION REGARDING PRIMARY PREVEN6 TION PROGRAMS.—A funding agreement for a grant under 

7 section 1921 is that, in expending the grant, the State 

8 involved will expend not less than 20 percent for programs 

9 to prevent the abuse of alcohol and drugs that are— 

10 ‘‘(1) designed to reach an entire population or 

11 large audience, including activities intended to ad12 dress environmental issues related to the use of alco13 hol and drugs; 

14 ‘‘(2) designed to target subgroups that may be 

15 at risk of using substances; and 

16 ‘‘(3) designed to identify and intervene with in17 dividuals who are experiencing early signs of sub18 stance use or abuse. 

19 ‘‘(b) ALLOCATIONS REGARDING WOMEN.— 

20 ‘‘(1) IN GENERAL.—Subject to paragraph (2), a 

21 funding agreement for a grant under section 1921 

22 for a fiscal year is that the State will expend not less 

23 than it expended in fiscal year 2006 on treatment 

24 services for pregnant women and women with de25 pendent children. 


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1 ‘‘(2) WAIVER.— 

2 ‘‘(A) Upon the request of a State, the Sec3 retary may provide to the State a waiver of all 

4 or part of the requirement established in para5 graph (1) if the Secretary determines that the 

6 State is providing an adequate level of treat7 ments services for women described in such 

8 paragraph, as indicated by a comparison of the 

9 number of such women seeking the services 

10 with the availability in the State of the services. 

11 ‘‘(B) The Secretary shall approve or deny 

12 a request for a waiver under subparagraph (A) 

13 not later than 120 days after the date on which 

14 the request is made. 

15 ‘‘(C) Any waiver provided by the Secretary 

16 under subparagraph (A) shall be applicable only 

17 to the fiscal year involved. 

18 ‘‘(3) CHILDCARE AND PRENATAL CARE.—A 

19 funding agreement for a grant under section 1921 

20 for a State is that each entity providing treatment 

21 services with amounts reserved under paragraph (1) 

22 by the State will, directly or through arrangements 

23 with other public or nonprofit private entities, make 

24 available prenatal care to women receiving such servVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00319 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 ices and, while the women are receiving the services, 

2 childcare. 

3 ‘‘SEC. 1923. INTRAVENOUS SUBSTANCE ABUSE. 

4 ‘‘A funding agreement for a grant under section 1921 

5 is that the State involved, in providing amounts from the 

6 grant to any entity for treatment services, will require the 

7 entity to carry out activities to encourage individuals in 

8 need of such treatment who are intravenous drug users 

9 to undergo treatment. 

10 ‘‘SEC. 1924. REQUIREMENTS REGARDING TUBERCULOSIS 

11 AND OTHER COMMUNICABLE DISEASES, AND 

12 THE HUMAN IMMUNODEFICIENCY VIRUS. 

13 ‘‘(a) TUBERCULOSIS AND OTHER COMMUNICABLE

14 DISEASES.— 

15 ‘‘(1) IN GENERAL.—A funding agreement for a 

16 grant under section 1921 is that the State involved 

17 will require that any entity receiving amounts from 

18 the grant for operating a program of treatment for 

19 substance use disorders— 

20 ‘‘(A) will, directly or through arrangements 

21 with other public or nonprofit private entities, 

22 routinely make available services for tuber23 culosis and other communicable diseases to each 

24 individual receiving treatment for such abuse; 

25 and 


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1 ‘‘(B) in the case of an individual in need 

2 of such treatment who is denied admission to 

3 the program on the basis of the lack of the ca4 pacity of the program to admit the individual, 

5 will refer the individual to another provider of 

6 tuberculosis and other communicable diseases 

7 services. 

8 ‘‘(2) SERVICES.—For purposes of paragraph 

9 (1), the term ‘tuberculosis and other communicable 

10 diseases services’, with respect to an individual, 

11 means— 

12 ‘‘(A) counseling the individual with respect 

13 to tuberculosis and other communicable dis14 eases; 

15 ‘‘(B) testing to determine whether the indi16 vidual has contracted and of such diseases and 

17 testing to determine the form of treatment for 

18 the disease that is appropriate for the indi19 vidual; and 

20 ‘‘(C) providing such treatment to the indi21 vidual. 

22 ‘‘(b) HUMAN IMMUNODEFICIENCY VIRUS.— 

23 ‘‘(1) REQUIREMENT FOR CERTAIN STATES.— 


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1 ‘‘(A) IN GENERAL.—In the case of a State 

2 described in paragraph (2), a funding agree3 ment for a grant under section 1921 is that— 

4 ‘‘(i) with respect to individuals under5 going treatment for substance use dis6 orders, the State will, subject to subsection 

7 (c), carry out 1 or more projects to make 

8 available to the individuals early interven9 tion services for HIV disease at the sites at 

10 which the individuals are undergoing such 

11 treatment; 

12 ‘‘(ii) for the purpose of providing such 

13 early intervention services through such 

14 projects, the State will make available 5 

15 percent of the amount of the grant; and 

16 ‘‘(iii) the State will, subject to sub17 section (d), carry out such projects only in 

18 geographic areas of the State that have the 

19 greatest need for the projects. 

20 ‘‘(B) OTHER STATES.—In the case of a 

21 State that is not a designated State as de22 scribed in paragraph (2), the State may expend 

23 not to exceed 5 percent of the amount of the 

24 grant for the provision of HIV early interven25 tion services on the condition that the State 


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1 provides such services in accordance with this 

2 subsection. 

3 ‘‘(2) DESIGNATED STATES.—For purposes of 

4 this subsection, a State described in this paragraph 

5 is any State whose rate of cases of acquired immune 

6 deficiency syndrome is 10 or more such cases per 

7 100,000 individuals (as indicated by the number of 

8 such cases reported to and confirmed by the Direc9 tor of the Centers for Disease Control and Preven10 tion for the most recent calendar year for which 

11 such data are available). 

12 ‘‘(3) USE OF EXISTING PROGRAMS REGARDING

13 SUBSTANCE USE DISORDERS.—With respect to pro14 grams that provide treatment services for substance 

15 use disorders, a funding agreement for a grant 

16 under section 1921 for a designated State is that 

17 each such program participating in a project under 

18 paragraph (1) will be a program that began oper19 ation prior to the fiscal year for which the State is 

20 applying to receive the grant. A program that so 

21 began operation may participate in a project under 

22 paragraph (1) without regard to whether the pro23 gram has been providing early intervention services 

24 for HIV disease. 


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1 ‘‘(4) REQUIREMENT REGARDING RURAL

2 AREAS.— 

3 ‘‘(1) IN GENERAL.—A funding agreement 

4 for a grant under section 1921 for a designated 

5 State is that, if the State will carry out 2 or 

6 more projects under subsection (a), the State 

7 will carry out 1 such project in a rural area of 

8 the State, subject to subparagraph (B). 

9 ‘‘(2) WAIVER.—The Secretary shall waive 

10 the requirement established in subparagraph 

11 (A) if the State involved certifies to the Sec12 retary that— 

13 ‘‘(A) there is insufficient demand in 

14 the State to carry out a project under sub15 section (a) in any rural area of the State; 

16 or 

17 ‘‘(B) there are no rural areas in the 

18 State. 

19 ‘‘(5) MANNER OF PROVIDING SERVICES.—With 

20 respect to the provision of early intervention services 

21 for HIV disease to an individual, a funding agree22 ment for a grant under section 1921 for a des23 ignated State is that— 


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1 ‘‘(1) such services will be undertaken vol2 untarily by, and with the informed consent of, 

3 the individual; and 

4 ‘‘(2) undergoing such services will not be 

5 required as a condition of receiving treatment 

6 services for substance use disorders or any 

7 other services. 

8 ‘‘(c) EXPENDITURE OF GRANT FOR COMPLIANCE

9 WITH AGREEMENTS.— 

10 ‘‘(1) IN GENERAL.—A grant under section 1921 

11 may be expended for purposes of compliance with 

12 the agreements required in this section, subject to 

13 paragraph (2). 

14 ‘‘(2) LIMITATION.—A funding agreement for a 

15 grant under section 1921 for a State is that the 

16 grant will not be expended to make payment for any 

17 service provided for purposes of compliance with this 

18 section to the extent that payment has been made, 

19 or can reasonably be expected to be made, with re20 spect to such service— 

21 ‘‘(A) under any State compensation pro22 gram, under any insurance policy, or under any 

23 Federal or State health benefits program (in24 cluding the program established in title XVIII 


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1 of the Social Security Act and the program es2 tablished in title XIX of such Act); or 

3 ‘‘(B) by an entity that provides health 

4 services on a prepaid basis. 

5 ‘‘(d) APPLICABILITY OF CERTAIN PROVISION.—Sec6 tion 1930 applies to this section (and to each other provi7 sion of this subpart). 

8 ‘‘(e) DEFINITIONS.—For purposes of this section: 

9 ‘‘(1) EARLY INTERVENTION SERVICES.—The 

10 term ‘early intervention services’, with respect to 

11 HIV disease, means— 

12 ‘‘(A) appropriate pretest counseling; 

13 ‘‘(B) testing individuals with respect to 

14 such disease, including tests to confirm the 

15 presence of the disease, tests to diagnose the 

16 extent of the deficiency in the immune system, 

17 and tests to provide information on appropriate 

18 therapeutic measures for preventing and treat19 ing the deterioration of the immune system and 

20 for preventing and treating conditions arising 

21 from the disease; 

22 ‘‘(C) appropriate post-test counseling; and 

23 ‘‘(D) providing the therapeutic measures 

24 described in subparagraph (B). 


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1 ‘‘(2) HIV DISEASE.—The term ‘HIV disease’ 

2 means infection with the etiologic agent for acquired 

3 immune deficiency syndrome. 

4 ‘‘SEC. 1925. GROUP HOMES FOR RECOVERING SUBSTANCE 

5 ABUSERS. 

6 ‘‘(a) STATE REVOLVING FUNDS FOR ESTABLISH7 MENT OF HOMES.—A State, using funds available under 

8 section 1921, may establish and maintain the ongoing op9 eration of a revolving fund in accordance with this section 

10 to support group homes for recovering substance abusers 

11 as follows: 

12 ‘‘(1) The purpose of the fund is to make loans 

13 for the costs of establishing programs for the provi14 sion of housing in which individuals recovering from 

15 alcohol or drug abuse may reside in groups of not 

16 less than 6 individuals. The fund is established di17 rectly by the State or through the provision of a 

18 grant or contract to a nonprofit private entity. 

19 ‘‘(2) The programs are carried out in accord20 ance with guidelines issued under subsection (b). 

21 ‘‘(3) Not less than $100,000 is available for the 

22 fund. 

23 ‘‘(4) Loans made from the revolving fund do 

24 not exceed $4,000 and each such loan is repaid to 

25 the revolving fund by the residents of the housing 


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1 involved not later than 2 years after the date on 

2 which the loan is made. 

3 ‘‘(5) Each such loan is repaid by such residents 

4 through monthly installments, and a reasonable pen5 alty is assessed for each failure to pay such periodic 

6 installments by the date specified in the loan agree7 ment involved. 

8 ‘‘(6) Such loans are made only to nonprofit pri9 vate entities agreeing that, in the operation of the 

10 program established pursuant to the loan— 

11 ‘‘(A) the use of alcohol or any illegal drug 

12 in the housing provided by the program will be 

13 prohibited; 

14 ‘‘(B) any resident of the housing who vio15 lates such prohibition will be expelled from the 

16 housing; 

17 ‘‘(C) the costs of the housing, including 

18 fees for rent and utilities, will be paid by the 

19 residents of the housing; and 

20 ‘‘(D) the residents of the housing will, 

21 through a majority vote of the residents, other22 wise establish policies governing residence in 

23 the housing, including the manner in which ap24 plications for residence in the housing are ap25 proved. 


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1 ‘‘(b) ISSUANCE BY SECRETARY OF GUIDELINES.— 

2 The Secretary shall ensure that there are in effect guide3 lines under this subpart for the operation of programs de4 scribed in subsection (a). 

5 ‘‘(c) APPLICABILITY TO TERRITORIES.—The require6 ments established in subsection (a) shall not apply to any 

7 territory of the United States other than the Common8 wealth of Puerto Rico. 

9 ‘‘SEC. 1926. STATE LAW REGARDING SALE OF TOBACCO 

10 PRODUCTS TO INDIVIDUALS UNDER AGE OF 

11 18. 

12 ‘‘(a) RELEVANT LAW.—The Secretary may make a 

13 grant under section 1921 only if the State involved has 

14 in effect a law providing that it is unlawful for any manu15 facturer, retailer, or distributor of tobacco products to sell 

16 or distribute any such product to any individual under the 

17 age of 18. 

18 ‘‘(b) ENFORCEMENT.— 

19 ‘‘(1) IN GENERAL.—A funding agreement for a 

20 grant under section 1921 is that the State involved 

21 will enforce the law described in subsection (a) in a 

22 manner that can reasonably be expected to reduce 

23 the extent to which tobacco products are available to 

24 individuals under the age of 18. 


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1 ‘‘(2) ACTIVITIES AND REPORTS REGARDING EN2 FORCEMENT.—A funding agreement for a grant 

3 under section 1921 is that the State involved will— 

4 ‘‘(A) annually conduct random, unan5 nounced inspections to ensure compliance with 

6 the law described in subsection (a); and 

7 ‘‘(B) annually submit to the Secretary a 

8 report describing— 

9 ‘‘(i) the activities carried out by the 

10 State to enforce such law during the fiscal 

11 year preceding the fiscal year for which the 

12 State is seeking the grant; 

13 ‘‘(ii) the extent of success the State 

14 has achieved in reducing the availability of 

15 tobacco products to individuals under the 

16 age of 18; and 

17 ‘‘(iii) the strategies to be utilized by 

18 the State for enforcing such law during the 

19 fiscal year for which the grant is sought. 

20 ‘‘(c) NONCOMPLIANCE OF STATE.— 

21 ‘‘(1) IN GENERAL.—Before making a grant 

22 under section 1921 to a State, the Secretary shall 

23 make a determination of whether the State has 

24 maintained compliance with subsection (b). If, after 

25 notice to the State and an opportunity for a hearing, 


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1 the Secretary determines that the State is not in 

2 compliance with such subsection, the Secretary 

3 shall— 

4 ‘‘(A) reduce the amount of the allotment 

5 under such section for the State for the fiscal 

6 year involved by an amount equal to 40 percent 

7 of the amount determined under section 1933 

8 for the State for the fiscal year; or 

9 ‘‘(B) require the State to certify to the 

10 Secretary by May 1 of the fiscal year for which 

11 the State is seeking grant funds, that the State 

12 will— 

13 ‘‘(i) maintain State expenditures in 

14 such fiscal year for tobacco prevention pro15 grams and for compliance activities, in16 cluding enforcement, at a level that is not 

17 less than the level of expenditures main18 tained by the State for such activities for 

19 the previous fiscal year; and 

20 ‘‘(ii) increase State expenditures to 

21 ensure compliance with the State law re22 quired under subsection (a) by an amount 

23 equal to the product of— 


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1 ‘‘(I) 1 percent of such State’s al2 location under section 1921 for the 

3 fiscal year; and 

4 ‘‘(II) the number of percentage 

5 points by which the State has failed to 

6 achieve the retailer compliance rate 

7 goal established by the Secretary for 

8 such State under this section. 

9 ‘‘(2) EXPENDITURE REPORT.—A State to which 

10 paragraph (1)(B) applies shall, not later than July 

11 31 of the fiscal year for which such paragraph is 

12 being applied, submit to the Secretary a report con13 cerning— 

14 ‘‘(A) all expenditures of the State for to15 bacco prevention and compliance activities, in16 cluding enforcement, during the fiscal year im17 mediately preceding such fiscal year; and 

18 ‘‘(B) all obligations for such activities (list19 ed by program) for the fiscal year for which 

20 such paragraph is being applied. 

21 ‘‘(3) DISCRETION OF SECRETARY.—The Sec22 retary shall have discretion relating to the timing of 

23 the State’s obligation of the additional funds as re24 quired under the State certification described in 

25 paragraph (1)(B)(ii). 


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1 ‘‘(d) TERRITORIES.—A funding agreement for a 

2 grant under section 1921 is that a territory involved will 

3 submit to the Secretary for approval, a comprehensive to4 bacco prevention and control plan to reduce the avail5 ability of tobacco products to minors within the territory. 

6 ‘‘(e) DEFINITION.—For purposes of this section: 

7 ‘‘(1) STATE.—The term ‘State’ includes the 

8 States, the District of Columbia, and the Common9 wealth of Puerto Rico. 

10 ‘‘(2) TERRITORY.—The term ‘territory’ means 

11 American Samoa, the Republic of Palau, the Fed12 erated States of Micronesia, the Marshall Islands, 

13 the Commonwealth of the Northern Mariana Is14 lands, the United States Virgin Islands, and Guam. 

15 ‘‘SEC. 1927. TREATMENT SERVICES FOR PREGNANT WOMEN. 

16 ‘‘(a) IN GENERAL.—A funding agreement for a grant 

17 under section 1921 is that the State involved— 

18 ‘‘(1) will ensure that each pregnant woman in 

19 the State who seeks or is referred for and would 

20 benefit from such services is given preference in ad21 missions to treatment facilities receiving funds pur22 suant to the grant; and 

23 ‘‘(2) will, in carrying out paragraph (1), pub24 licize the availability to such women of services from 


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1 the facilities and the fact that the women receive 

2 such preference. 

3 ‘‘(b) REFERRALS REGARDING STATES.—A funding 

4 agreement for a grant under section 1921 is that, in car5 rying out subsection (a)(1)— 

6 ‘‘(1) the State involved will require that, in the 

7 event that a treatment facility has insufficient ca8 pacity to provide treatment services to any woman 

9 described in such subsection who seeks the services 

10 from the facility, the facility refer the woman to the 

11 State; and 

12 ‘‘(2) the State, in the case of each woman for 

13 whom a referral under paragraph (1) is made to the 

14 State— 

15 ‘‘(A) will refer the woman to a treatment 

16 facility that has the capacity to provide treat17 ment services to the woman; or 

18 ‘‘(B) will, if no treatment facility has the 

19 capacity to admit the woman, make interim 

20 services available to the woman not later than 

21 48 hours after the women seeks the treatment 

22 services. 

23 ‘‘SEC. 1928. ADDITIONAL AGREEMENTS. 

24 ‘‘(a) IMPROVEMENT OF PROCESS FOR APPROPRIATE

25 REFERRALS FOR TREATMENT.—With respect to individVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00334 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 uals seeking treatment services, a funding agreement for 

2 a grant under section 1921 is that the State involved will 

3 improve the process in the State for referring the individ4 uals to treatment facilities that can provide to the individ5 uals the treatment modality that is most appropriate for 

6 the individuals. 

7 ‘‘(b) PROFESSIONAL DEVELOPMENT.—A funding 

8 agreement for a grant under section 1921 is that the State 

9 involved will ensure that prevention and treatment profes10 sionals operating in the State’s substance use disorder 

11 prevention and treatment system have an opportunity to 

12 receive training, on an ongoing basis, concerning— 

13 ‘‘(1) recent trends in drug abuse in the State; 

14 ‘‘(2) improved methods and evidence-based 

15 practices for providing substance use disorder pre16 vention and treatment services; 

17 ‘‘(3) performance-based accountability; 

18 ‘‘(4) data collection and reporting requirements; 

19 ‘‘(5) any other matters that would serve to fur20 ther improve the delivery of substance use disorder 

21 prevention and treatment services with the State; 

22 and 

23 ‘‘(6) innovative practices developed under sec24 tion 581. 


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1 ‘‘(c) COORDINATION OF VARIOUS ACTIVITIES AND

2 SERVICES.—A funding agreement for a grant under sec3 tion 1921 is that the State involved will coordinate preven4 tion and treatment activities with the provision of other 

5 appropriate services (including health, social, correctional 

6 and criminal justice, educational, vocational rehabilitation, 

7 housing, and employment services). 

8 ‘‘(d) WAIVER OF REQUIREMENT.— 

9 ‘‘(1) IN GENERAL.—Upon the request of a 

10 State, the Secretary may provide to a State a waiver 

11 of any or all of the requirements established in this 

12 section if the Secretary determines that, with respect 

13 to services for the prevention and treatment of sub14 stance use disorders, the requirement involved is un15 necessary for maintaining quality in the provision of 

16 such services in the State. 

17 ‘‘(2) DATE CERTAIN FOR ACTING UPON RE18 QUEST.—The Secretary shall approve or deny a re19 quest for a waiver under paragraph (1) not later 

20 than 120 days after the date on which the request 

21 is made. 

22 ‘‘(3) APPLICABILITY OF WAIVER.—Any waiver 

23 provided by the Secretary under paragraph (1) shall 

24 be applicable only to the fiscal year involved. 


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1 ‘‘SEC. 1929. MAINTENANCE OF EFFORT REGARDING STATE 

2 EXPENDITURES. 

3 ‘‘(a) REQUIREMENT.— 

4 ‘‘(1) IN GENERAL.—With respect to the prin5 cipal agency of a State for carrying out authorized 

6 activities, a funding agreement for a grant under 

7 section 1921 for the State for a fiscal year is that 

8 such agency will for such year maintain aggregate 

9 State expenditures for authorized activities at a level 

10 that is not less than the average level of such ex11 penditures maintained by the State for the 2-year 

12 period preceding the fiscal year for which the State 

13 is applying for the grant. 

14 ‘‘(2) MATERIAL COMPLIANCE.—A State shall be 

15 deemed to be in compliance with paragraph (1) for 

16 a fiscal year if State expenditures of the type de17 scribed in such paragraph for such fiscal year are at 

18 least 97 percent of such State expenditures for the 

19 preceding 2-year period. 

20 ‘‘(3) FUTURE OBLIGATIONS.—In applying para21 graph (1) to a State, the Secretary shall determine 

22 such State’s compliance with such paragraph based 

23 on the amount of State expenditures that con24 stituted actual compliance, not material compliance 

25 (as provided for in paragraph (2)), or that would 


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1 have been required if the State had not been granted 

2 a waiver under subsection (c). 

3 ‘‘(b) EXCLUSION OF CERTAIN FUNDS.—The Sec4 retary may exclude from the aggregate State expenditures 

5 under subsection (a), funds appropriated to the principle 

6 agency for authorized activities which are of a non-recur7 ring nature and for a specific purpose. 

8 ‘‘(c) WAIVER.— 

9 ‘‘(1) IN GENERAL.—Upon the request of a 

10 State, the Secretary may waive all or part of the re11 quirement established in subsection (a)(1)— 

12 ‘‘(A) if the Secretary determines that ex13 traordinary economic conditions in the State in 

14 the fiscal year involved or in the previous fiscal 

15 year justify the waiver; and 

16 ‘‘(B) if the State or any part of the State 

17 has experienced an emergency or a natural dis18 aster that has received a Presidential Disaster 

19 Declaration under section 102 of the Robert T. 

20 Stafford Disaster Relief and Emergency Assist21 ance Act. 

22 ‘‘(2) DATE CERTAIN FOR ACTING UPON RE23 QUEST.—The Secretary shall approve or deny a re24 quest for a waiver under paragraph (1) not later 


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1 than 120 days after the date on which the request 

2 is made. 

3 ‘‘(3) APPLICABILITY OF WAIVER.—Any waiver 

4 provided by the Secretary under paragraph (1) shall 

5 be applicable only to the fiscal year involved. 

6 ‘‘(d) NONCOMPLIANCE BY STATE.— 

7 ‘‘(1) IN GENERAL.—In making a grant under 

8 section 1921 to a State for a fiscal year, the Sec9 retary shall make a determination of whether, for 

10 the previous fiscal year, the State complied with any 

11 agreement made under subsection (a). If the Sec12 retary determines that a State has failed to main13 tain such compliance, the Secretary shall reduce the 

14 amount of the allotment under section 1921 for the 

15 State for the year in which a final determination is 

16 made, by an amount equal to the amount consti17 tuting such failure. 

18 ‘‘(2) ALTERNATIVE PENALTY.—A State that 

19 has failed to comply with this section and that would 

20 otherwise be subject to a reduction in the State’s al21 lotment under section 1921, may, with the approval 

22 of the Secretary, in lieu of having the State’s allot23 ment under section 1921 reduced, agree to comply 

24 with a negotiated agreement that is approved by the 


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1 Secretary and carried out in accordance with guide2 lines issued by the Secretary. 

3 ‘‘(3) SUBMISSION OF INFORMATION TO SEC4 RETARY.—The Secretary may make a grant under 

5 section 1921 for a fiscal year only if the State in6 volved submits to the Secretary information suffi7 cient for the Secretary to make the determination 

8 required in paragraph (1). 

9 ‘‘SEC. 1930. RESTRICTIONS ON EXPENDITURE OF GRANT. 

10 ‘‘(a) IN GENERAL.— 

11 ‘‘(1) CERTAIN RESTRICTIONS.—A funding 

12 agreement for a grant under section 1921 is that the 

13 State involved will not expend the grant— 

14 ‘‘(A) to provide inpatient hospital services, 

15 except as provided in subsection (b); 

16 ‘‘(B) to make cash payments to intended 

17 recipients of health services; 

18 ‘‘(C) to purchase or improve land, pur19 chase, construct, or permanently improve (other 

20 than minor remodeling) any building or other 

21 facility, or purchase major medical equipment; 

22 ‘‘(D) to satisfy any requirement for the ex23 penditure of non-Federal funds as a condition 

24 for the receipt of Federal funds; 


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1 ‘‘(E) to provide financial assistance to any 

2 entity other than a public or nonprofit private 

3 entity; or 

4 ‘‘(F) to carry out any program prohibited 

5 by section 256(b) of the Health Omnibus Pro6 grams Extension of 1988 (42 U.S.C. 300ee–5). 

7 ‘‘(2) LIMITATION ON ADMINISTRATIVE EX8 PENSES.—A funding agreement for a grant under 

9 section 1921 is that the State involved will not ex10 pend more than 5 percent of the grant to pay the 

11 costs of administering the grant. 

12 ‘‘(3) LIMITATION REGARDING PENAL AND COR13 RECTIONAL INSTITUTIONS.—A funding agreement 

14 for a State for a grant under section 1921 is that, 

15 in expending the grant for the purpose of providing 

16 treatment services in penal or correctional institu17 tions of the State, the State will not expend more 

18 than an amount equal to the amount expended for 

19 such purpose by the State from the grant made 

20 under section 1912A to the State for fiscal year 

21 1991 (as section 1912A was in effect for such fiscal 

22 year). 

23 ‘‘(b) EXCEPTION REGARDING INPATIENT HOSPITAL

24 SERVICES.— 


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1 ‘‘(1) MEDICAL NECESSITY AS PRECONDITION.— 

2 With respect to compliance with the agreement made 

3 under subsection (a), a State may expend a grant 

4 under section 1921 to provide inpatient hospital 

5 services as treatment for substance use disorders 

6 only if it has been determined, in accordance with 

7 guidelines issued by the Secretary, that such treat8 ment is a medical necessity for the individual in9 volved, and that the individual cannot be effectively 

10 treated in a community-based, nonhospital, residen11 tial program of treatment. 

12 ‘‘(2) RATE OF PAYMENT.—In the case of an in13 dividual for whom a grant under section 1921 is ex14 pended to provide inpatient hospital services de15 scribed in paragraph (1), a funding agreement for 

16 the grant for the State involved is that the daily rate 

17 of payment provided to the hospital for providing the 

18 services to the individual will not exceed the com19 parable daily rate provided for community-based, 

20 nonhospital, residential programs of treatment for 

21 substance use disorders. 

22 ‘‘(c) WAIVER REGARDING CONSTRUCTION OF FACILI23 TIES.— 

24 ‘‘(1) IN GENERAL.—The Secretary may provide 

25 to any State a waiver of the restriction established 


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1 in subsection (a)(1)(C) for the purpose of author2 izing the State to expend a grant under section 1921 

3 for the construction of a new facility or rehabilita4 tion of an existing facility, but not for land acquisi5 tion. 

6 ‘‘(2) STANDARD REGARDING NEED FOR WAIV7 ER.—The Secretary may approve a waiver under 

8 paragraph (1) only if the State demonstrates to the 

9 Secretary that adequate treatment cannot be pro10 vided through the use of existing facilities and that 

11 alternative facilities in existing suitable buildings are 

12 not available. 

13 ‘‘(3) AMOUNT.—In granting a waiver under 

14 paragraph (1), the Secretary shall allow the use of 

15 a specified amount of funds to construct or rehabili16 tate a specified number of beds for residential treat17 ment and a specified number of slots for outpatient 

18 treatment, based on reasonable estimates by the 

19 State of the costs of construction or rehabilitation. 

20 In considering waiver applications, the Secretary 

21 shall ensure that the State has carefully designed a 

22 program that will minimize the costs of additional 

23 beds. 

24 ‘‘(4) MATCHING FUNDS.—The Secretary may 

25 grant a waiver under paragraph (1) only if the State 


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1 agrees, with respect to the costs to be incurred by 

2 the State in carrying out the purpose of the waiver, 

3 to make available non-Federal contributions in cash 

4 toward such costs in an amount equal to not less 

5 than $1 for each $1 of Federal funds provided under 

6 section 1921. 

7 ‘‘(5) DATE CERTAIN FOR ACTING UPON RE8 QUEST.—The Secretary shall act upon a request for 

9 a waiver under paragraph (1) not later than 120 

10 days after the date on which the request is made. 

11 ‘‘SEC. 1931. APPLICATION FOR GRANT; APPROVAL OF 

12 STATE PLAN. 

13 ‘‘(a) IN GENERAL.—For purposes of section 1921, an 

14 application for a grant under such section for a fiscal year 

15 is in accordance with this section if, subject to subsection 

16 (c)— 

17 ‘‘(1) the application is received by the Secretary 

18 not later than October 1 of the fiscal year for which 

19 the State is seeking funds; 

20 ‘‘(2) the application contains each funding 

21 agreement that is described in this subpart or sub22 part III for such a grant (other than any such 

23 agreement that is not applicable to the State); 

24 ‘‘(3) the agreements are made through certifi25 cation from the chief executive officer of the State; 


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1 ‘‘(4) with respect to such agreements, the appli2 cation provides assurances of compliance satisfactory 

3 to the Secretary; 

4 ‘‘(5) the application contains the information 

5 required in section 1929 and the report required in 

6 section 1942; 

7 ‘‘(6)(A) the application contains a plan in ac8 cordance with subsection (b) and the plan is ap9 proved by the Secretary; and 

10 ‘‘(B) the State provides assurances satisfactory 

11 to the Secretary that the State complied with the 

12 provisions of the plan under subparagraph (A) that 

13 was approved by the Secretary for the most recent 

14 fiscal year for which the State received a grant 

15 under section 1921; and 

16 ‘‘(7) the application (including the plan under 

17 paragraph (6)) is otherwise in such form, is made in 

18 such manner, and contains such agreements, assur19 ances, and information as the Secretary determines 

20 to be necessary to carry out this subpart. 

21 ‘‘(b) STATE PLANS.— 

22 ‘‘(1) IN GENERAL.—In order for a State to be 

23 in compliance with subsection (a)(6), the State shall 

24 submit to the Secretary, every 3 years, a plan that, 

25 at a minimum, includes the following: 


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1 ‘‘(A) A description of the State’s system of 

2 care that— 

3 ‘‘(i) identifies the single State agency 

4 responsible for the administration of the 

5 program, including any third party who 

6 administers substance use disorder services 

7 and is responsible for complying with the 

8 requirements of the grant; 

9 ‘‘(ii) provides information on the need 

10 for substance use disorder prevention and 

11 treatment services in the State by age, sex, 

12 race, and ethnicity including estimates on 

13 the number of individuals who need treat14 ment, who are women, who are pregnant, 

15 who are women with children, who are in16 dividuals with a co-occurring mental health 

17 and substance use disorder, who are intra18 venous drug users and who are homeless 

19 individuals; 

20 ‘‘(iii) provides a description of con21 sequences and consumption patterns by lo22 cation, age, sex, race, and ethnicity; 

23 ‘‘(iv) provides information on the cur24 rent number of individuals in treatment 

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1 nicity including the number of such indi2 viduals who are women, who are pregnant, 

3 who have children, individuals with a co-oc4 curring mental health and substance use 

5 disorder, intravenous drug users and who 

6 are homeless individuals; 

7 ‘‘(v) provides a description of the sys8 tem that is available to provide services by 

9 modality, including the provision of recov10 ery support services; 

11 ‘‘(vi) provides an assessment on the 

12 adequacy of the system to respond to the 

13 need; 

14 ‘‘(vii) provides the latest performance 

15 outcome data, including outcome data de16 termined in accordance with section 

17 504(b); 

18 ‘‘(viii) provides a description of the 

19 State’s comprehensive statewide prevention 

20 effort, including the number of individuals 

21 being served in the system, and provides a 

22 description of the amount of funds from 

23 the prevention set-aside expended on pri24 mary prevention; 


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1 ‘‘(ix) identifies target populations and 

2 priority needs for prevention services; 

3 ‘‘(x) provides a description of the re4 sources available in the State to pay for 

5 the services, including funding under Med6 icaid, title XXVI, and other Federal pro7 grams such as grants to the State, local 

8 jurisdiction of the State or nonprofit pri9 vate entities awarded under title V and 

10 how the State is maximizing these re11 sources; 

12 ‘‘(xi) provides a description of the 

13 manner in which the State and local enti14 ties coordinate prevention and treatment 

15 services with other agencies, including 

16 health, mental health, juvenile justice, law 

17 enforcement, education, social services, and 

18 child welfare; 

19 ‘‘(xii) describes the existing mental 

20 health and substance use disorders work21 force, including data on the number of in22 dividuals who serve in the system of care 

23 designated by profession, the need for ad24 ditional professionals and paraprofes25 sionals, the efforts of the State to recruit 


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1 and retain a qualified mental health and 

2 substance use disorders workforce, and a 

3 copy of the standards the State uses in 

4 certifying or licensing facilities and coun5 selors for prevention and treatment facili6 ties; 

7 ‘‘(xiii) includes a description of how 

8 the State promotes evidenced-based prac9 tices; and 

10 ‘‘(xiv) a description of how the State 

11 integrates mental health and substance use 

12 disorder services and primary health care, 

13 which may include providing mental health 

14 and substance use disorder services in pri15 mary care settings or providing primary 

16 and specialty care services in community17 based mental health and substance use dis18 order service settings. 

19 ‘‘(B) An analysis of the system that identi20 fies the strengths and weaknesses of the system 

21 of care, and an assessment of the adequacy of 

22 the system to respond to the need for services. 

23 ‘‘(C) The establishment of goals and objec24 tives, including goals and objectives for the out25 come measures established under section 


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1 504(b), for the period of the plan including tar2 gets and milestones that are intended to be met 

3 and the activities that will be undertaken to 

4 achieve those targets. 

5 ‘‘(D) A description of how the State will 

6 comply with each funding agreement for a 

7 grant under section 1921 that is applicable to 

8 the State, including a description of the manner 

9 in which the State intends to expend the grant. 

10 ‘‘(E) Data on the percentage of grant 

11 funds expended for primary prevention services. 

12 ‘‘(2) AUTHORITY OF THE SECRETARY REGARD13 ING MODIFICATIONS.—As a condition of awarding a 

14 grant under section 1921 to a State for a fiscal 

15 year, the Secretary may require that the State mod16 ify any provision of the plan submitted by the State 

17 under subsection (a)(6) (including provisions on pri18 orities in carrying out authorized activities) only 

19 after significant dialogue and negotiations between 

20 the State and the Secretary concerning the identified 

21 modifications. If the Secretary approves the plan 

22 and awards the grant to the State for the fiscal 

23 year, the Secretary may not during such year re24 quire the State to modify the plan. 


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1 ‘‘(3) STATE REQUEST FOR MODIFICATION.—If 

2 the State determines that modifications to the plan 

3 are necessary, the State may request the Secretary 

4 to approve such modifications through its annual re5 port required under section 1942. 

6 ‘‘(4) SUBSTANCE USE DISORDER EMERGENCY

7 RESPONSE.— 

8 ‘‘(A) REQUIREMENTS.—The State plan 

9 under this section shall includes the State’s 

10 plan for addressing the mental health and sub11 stance use disorder needs of individuals in the 

12 State in the event of an emergency or major 

13 disaster. 

14 ‘‘(B) DEMONSTRATION.—The State shall 

15 demonstrate how the mental health and sub16 stance use disorder plan under subparagraph 

17 (A) for providing for the substance use disorder 

18 health needs of individuals in the event of an 

19 emergency or major disaster is incorporated 

20 into the State’s All-Hazards Public Health 

21 Emergency Preparedness and Response Plan 

22 required under section 319C–1. If the sub23 stance use disorder emergency response plan 

24 under subparagraph (A) is not so incorporated, 

25 the State shall describe how such plan will be 


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1 incorporated into the State Emergency Re2 sponse Plan during the period that the State 

3 plan under this section is in effect. 

4 ‘‘(C) DEFINITIONS.—In this paragraph, 

5 the terms ‘emergency’ and ‘major disaster’ have 

6 the meanings given such terms in section 102 

7 of the Robert T. Stafford Disaster Relief and 

8 Emergency Assistance Act. 

9 ‘‘(c) WAIVERS REGARDING CERTAIN TERRI10 TORIES.—In the case of any territory of the United States 

11 except Puerto Rico, the Secretary may waive such provi12 sions of this subpart and subpart III as the Secretary de13 termines to be appropriate, other than the provisions of 

14 section 1930. 

15 ‘‘(d) ISSUANCE OF REGULATIONS.—The Secretary 

16 shall establish standards specifying the circumstances in 

17 which the Secretary will consider an application for a 

18 grant under section 1921 to be in accordance with this 

19 section. 

20 ‘‘SEC. 1932. DETERMINATION OF AMOUNT OF ALLOTMENT. 

21 ‘‘(a) STATES.— 

22 ‘‘(1) IN GENERAL.—Subject to subsection (b), 

23 the Secretary shall determine the amount of the al24 lotment required in section 1921 for a State for a 

25 fiscal year as follows: 


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1 ‘‘(A) The formula established in paragraph 

2 (1) of section 1918(a) shall apply to this sub3 section to the same extent and in the same 

4 manner as the formula applies for purposes of 

5 section 1918(a), except that, in the application 

6 of such formula for purposes of this subsection, 

7 the modifications described in subparagraph 

8 (B) shall apply. 

9 ‘‘(B) For purposes of subparagraph (A), 

10 the modifications described in this subpara11 graph are as follows: 

12 ‘‘(i) The amount specified in para13 graph (2)(A) of section 1918(a) is deemed 

14 to be the amount appropriated under sec15 tion 1935(a) for allotments under section 

16 1921 for the fiscal year involved. 

17 ‘‘(ii) The term ‘P’ is deemed to have 

18 the meaning given in paragraph (2) of this 

19 subsection. Section 1918(a)(5)(B) applies 

20 to the data used in determining such term 

21 for the States. 

22 ‘‘(iii) The factor determined under 

23 paragraph (8) of section 1918(a) is 

24 deemed to have the purpose of reflecting 

25 the differences that exist between the State 


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1 involved and other States in the costs of 

2 providing authorized services. 

3 ‘‘(2) DETERMINATION OF TERM ‘P’.—For pur4 poses of this subsection, the term ‘P’ means the per5 centage that is the arithmetic mean of the percent6 age determined under subparagraph (A) and the 

7 percentage determined under subparagraph (B), as 

8 follows: 

9 ‘‘(A) The percentage constituted by the 

10 ratio of— 

11 ‘‘(i) an amount equal to the sum of 

12 the total number of individuals who reside 

13 in the State involved and are between 18 

14 and 24 years of age (inclusive) and the 

15 number of individuals in the State who re16 side in urbanized areas of the State and 

17 are between such years of age; to 

18 ‘‘(ii) an amount equal to the total of 

19 the respective sums determined for the 

20 States under clause (i). 

21 ‘‘(B) The percentage constituted by the 

22 ratio of— 

23 ‘‘(i) the total number of individuals in 

24 the State who are between 25 and 64 years 

25 of age (inclusive); to 


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1 ‘‘(ii) an amount equal to the sum of 

2 the respective amounts determined for the 

3 States under clause (i). 

4 ‘‘(b) MINIMUM ALLOTMENTS FOR STATES.— 

5 ‘‘(1) IN GENERAL.—With respect to fiscal year 

6 2000, and each subsequent fiscal year, the amount 

7 of the allotment of a State under section 1921 shall 

8 not be less than the amount the State received 

9 under such section for the previous fiscal year in10 creased by an amount equal to 30.65 percent of the 

11 percentage by which the aggregate amount allotted 

12 to all States for such fiscal year exceeds the aggre13 gate amount allotted to all States for the previous 

14 fiscal year. 

15 ‘‘(2) LIMITATIONS.— 

16 ‘‘(A) IN GENERAL.—Except as provided in 

17 subparagraph (B), a State shall not receive an 

18 allotment under section 1921 for a fiscal year 

19 in an amount that is less than an amount equal 

20 to 0.375 percent of the amount appropriated 

21 under section 1935(a) for such fiscal year. 

22 ‘‘(B) EXCEPTION.—In applying subpara23 graph (A), the Secretary shall ensure that no 

24 State receives an increase in its allotment under 

25 section 1921 for a fiscal year (as compared to 


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1 the amount allotted to the State in the prior 

2 fiscal year) that is in excess of an amount equal 

3 to 300 percent of the percentage by which the 

4 amount appropriated under section 1935(a) for 

5 such fiscal year exceeds the amount appro6 priated for the prior fiscal year. 

7 ‘‘(3) DECREASE IN OR EQUAL APPROPRIA8 TIONS.—If the amount appropriated under section 

9 1935(a) for a fiscal year is equal to or less than the 

10 amount appropriated under such section for the 

11 prior fiscal year, the amount of the State allotment 

12 under section 1921 shall be equal to the amount 

13 that the State received under section 1921 in the 

14 prior fiscal year decreased by the percentage by 

15 which the amount appropriated for such fiscal year 

16 is less than the amount appropriated or such section 

17 for the prior fiscal year. 

18 ‘‘(c) TERRITORIES.— 

19 ‘‘(1) DETERMINATION UNDER FORMULA.—Sub20 ject to paragraphs (2) and (4), the amount of an al21 lotment under section 1921 for a territory of the 

22 United States for a fiscal year shall be the product 

23 of— 


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1 ‘‘(A) an amount equal to the amounts re2 served under paragraph (3) for the fiscal year; 

3 and 

4 ‘‘(B) a percentage equal to the quotient 

5 of— 

6 ‘‘(i) the civilian population of the ter7 ritory, as indicated by the most recently 

8 available data; divided by 

9 ‘‘(ii) the aggregate civilian population 

10 of the territories of the United States, as 

11 indicated by such data. 

12 ‘‘(2) MINIMUM ALLOTMENT FOR TERRI13 TORIES.—The amount of an allotment under section 

14 1921 for a territory of the United States for a fiscal 

15 year shall be the greater of— 

16 ‘‘(A) the amount determined under para17 graph (1) for the territory for the fiscal year; 

18 ‘‘(B) $50,000; and 

19 ‘‘(C) with respect to fiscal years 1993 and 

20 1994, an amount equal to 79.4 percent of the 

21 amount received by the territory from allot22 ments made pursuant to this part for fiscal 

23 year 1992. 

24 ‘‘(3) RESERVATION OF AMOUNTS.—The Sec25 retary shall each fiscal year reserve for the terriVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00357 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 tories of the United States 1.5 percent of the 

2 amounts appropriated under section 1935(a) for al3 lotments under section 1921 for the fiscal year. 

4 ‘‘(4) AVAILABILITY OF DATA ON POPU5 LATION.—With respect to data on the civilian popu6 lation of the territories of the United States, if the 

7 Secretary determines for a fiscal year that recent 

8 such data for purposes of paragraph (1)(B) do not 

9 exist regarding a territory, the Secretary shall for 

10 such purposes estimate the civilian population of the 

11 territory by modifying the data on the territory to 

12 reflect the average extent of change occurring during 

13 the ensuing period in the population of all territories 

14 with respect to which recent such data do exist. 

15 ‘‘(5) APPLICABILITY OF CERTAIN PROVI16 SIONS.—For purposes of subsections (a) and (b), the 

17 term ‘State’ does not include the territories of the 

18 United States. 

19 ‘‘(d) INDIAN TRIBES AND TRIBAL ORGANIZA20 TIONS.— 

21 ‘‘(1) IN GENERAL.—If the Secretary— 

22 ‘‘(A) receives a request from the governing 

23 body of an Indian tribe or tribal organization 

24 within any State that funds under this subpart 


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1 be provided directly by the Secretary to such 

2 tribe or organization; and 

3 ‘‘(B) makes a determination that the mem4 bers of such tribe or tribal organization would 

5 be better served by means of grants made di6 rectly by the Secretary under this; 

7 the Secretary shall reserve from the allotment under 

8 section 1921 for the State for the fiscal year in9 volved an amount that bears the same ratio to the 

10 allotment as the amount provided under this subpart 

11 to the tribe or tribal organization for fiscal year 

12 1991 for activities relating to the prevention and 

13 treatment of the abuse of alcohol and other drugs 

14 bore to the amount of the portion of the allotment 

15 under this subpart for the State for such fiscal year 

16 that was expended for such activities. 

17 ‘‘(2) TRIBE OR TRIBAL ORGANIZATION AS

18 GRANTEE.—The amount reserved by the Secretary 

19 on the basis of a determination under this para20 graph shall be granted to the Indian tribe or tribal 

21 organization serving the individuals for whom such 

22 a determination has been made. 

23 ‘‘(3) APPLICATION.—In order for an Indian 

24 tribe or tribal organization to be eligible for a grant 

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1 mit to the Secretary a plan for such fiscal year that 

2 meets such criteria as the Secretary may prescribe. 

3 ‘‘(4) DEFINITION.—The terms ‘Indian tribe’ 

4 and ‘tribal organization’ have the same meaning 

5 given such terms in subsections (b) and (c) of sec6 tion 4 of the Indian Self-Determination and Edu7 cation Assistance Act. 

8 ‘‘SEC. 1933. DEFINITIONS. 

9 ‘‘For purposes of this subpart: 

10 ‘‘(1) The term ‘authorized activities’, subject to 

11 section 1931, means the activities described in sec12 tion 1921(b). 

13 ‘‘(2) The term ‘funding agreement’, with re14 spect to a grant under section 1921 to a State, 

15 means that the Secretary may make such a grant 

16 only if the State makes the agreement involved. 

17 ‘‘(3) The term ‘prevention activities’, subject to 

18 section 1931, means activities to prevent substance 

19 use disorders. 

20 ‘‘(4) The term ‘substance use disorder’ means 

21 the abuse of alcohol or other drugs. 

22 ‘‘(5) The term ‘treatment activities’ means 

23 treatment services and, subject to section 1931, au24 thorized activities that are related to treatment serv25 ices. 


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1 ‘‘(6) The term ‘treatment facility’ means an en2 tity that provides treatment services. 

3 ‘‘(7) The term ‘treatment services’, subject to 

4 section 1931, means treatment for substance use 

5 disorder. 

6 ‘‘SEC. 1934. FUNDING. 

7 ‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 

8 purpose of carrying out this subpart, subpart III and sec9 tion 504 with respect to substance use disorders and sec10 tion 1945(g) with respect to investigations, there are au11 thorized to be appropriated $2,000,000,000 for fiscal year 

12 2011, and such sums as may be necessary for each of the 

13 fiscal years 2012 through 2015. 

14 ‘‘(b) ALLOCATIONS FOR TECHNICAL ASSISTANCE, 

15 NATIONAL DATA BASE, DATA COLLECTION, AND PRO16 GRAM EVALUATIONS.— 

17 ‘‘(1) IN GENERAL.— 

18 ‘‘(A) For the purpose of carrying out sec19 tion 1948(a) with respect to substance use dis20 orders, section 1945(g), and the purposes speci21 fied in subparagraphs (B) and (C), the Sec22 retary shall obligate 5 percent of the amounts 

23 appropriated under subsection (a) each fiscal 

24 year. 


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1 ‘‘(B) The purpose specified in this sub2 paragraph is the collection of data in this para3 graph is carrying out section 504 with respect 

4 to substance use disorders. 

5 ‘‘(C) The purpose specified in this sub6 paragraph is the conduct of evaluations of au7 thorized activities to determine methods for im8 proving the availability and quality of such ac9 tivities. 

10 ‘‘(2) ACTIVITIES OF CENTER FOR SUBSTANCE

11 ABUSE PREVENTION.—Of the amounts reserved 

12 under paragraph (1) for a fiscal year, the Secretary, 

13 acting through the Director of the Center for Sub14 stance Abuse Prevention, shall obligate 20 percent 

15 for carrying out paragraph (1)(C), section 1948(a) 

16 with respect to prevention activities, and section 

17 1945(g). 

18 ‘‘Subpart III—General Provisions 

19 ‘‘SEC. 1941. OPPORTUNITY FOR PUBLIC COMMENT ON 

20 STATE PLANS. 

21 ‘‘A funding agreement for a grant under section 1911 

22 or 1921 is that the State involved will make the plan re23 quired in section 1912, and the plan required in section 

24 1931, respectively, public within the State in such manner 

25 as to facilitate comment from any person (including any 


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1 Federal or other public agency) during the development 

2 of the plan (including any revisions) and after the submis3 sion of the plan to the Secretary. 

4 ‘‘SEC. 1942. REQUIREMENT OF REPORTS AND AUDITS BY 

5 STATES. 

6 ‘‘(a) REPORT.—A funding agreement for a grant 

7 under section 1911 or 1921 is that the State involved will 

8 submit to the Secretary an annual report in such form 

9 and containing such information as the Secretary deter10 mines (after consultation with the States) to be necessary 

11 for securing a record, including— 

12 ‘‘(1) a description of the purposes for which the 

13 grant received by the State for the preceding fiscal 

14 year under the program involved were expended and 

15 a description of the activities of the State under the 

16 program; 

17 ‘‘(2) a list of providers, and contact information 

18 for such providers, who are receiving funds under 

19 the program whether directly from the State or a 

20 third party (including another State, a local govern21 ment, or some other agent of the State including an 

22 administrative services organization or a managed 

23 care program); 

24 ‘‘(3) an evaluation of the progress being made 

25 towards meeting the goals and objectives of the 


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1 State plans required in sections 1912(b) and 

2 1931(a)(6)(A), an assessment as to whether the ac3 tivities described in such plans are helping to meet 

4 such goals and objectives, and any obstacles the 

5 State is encountering in meeting specific targets es6 tablished to achieve such goals; and 

7 ‘‘(4) information to enable the Secretary to de8 termine State compliance with all of the funding 

9 agreements in each grant. 

10 ‘‘(b) REVIEW, DETERMINATION, AND ENFORCE11 MENT.— 

12 ‘‘(1) REVIEW.—With respect to grants under 

13 sections 1911 and 1921, the Secretary shall review 

14 the annual reports submitted by the States under 

15 subsection (a). 

16 ‘‘(2) DETERMINATION.— 

17 ‘‘(A) IN GENERAL.—Based on the informa18 tion provided by a State in a report submitted 

19 under subsection (a), information obtained 

20 through monitoring visits, and any other public 

21 information made available, the Secretary shall 

22 evaluate the performance of the State in meet23 ing its goals and objectives, as established in 

24 the State plan under section 1912(b) and 

25 1931(b), respectively, for the year involved, and 


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1 make a determination as to whether the 

2 State— 

3 ‘‘(i) has met such goals and objec4 tives; 

5 ‘‘(ii) is making a serious effort to 

6 meet such goals and objectives but requires 

7 technical assistance; or 

8 ‘‘(iii) has failed to make a serious ef9 fort to meet such goals and objectives. 

10 ‘‘(B) TECHNICAL ASSISTANCE.—If the 

11 Secretary makes a determination under sub12 paragraph (A)(ii), the Secretary, in conjunction 

13 with the State, shall make an additional deter14 mination of what technical assistance is needed 

15 and either provide such assistance or advise the 

16 State on where such assistance may be ob17 tained. 

18 ‘‘(C) FAILURE OF EFFORT BY STATE.—If 

19 the Secretary makes a determination under 

20 subparagraph (A)(iii) with respect to a State 

21 for 3 consecutive years, the Secretary shall re22 quire the State to meet with the Secretary to 

23 develop a corrective action plan that includes 

24 the redirection of funds to meet State goals and 


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1 objectives, and that contains deadlines for State 

2 action. 

3 ‘‘(D) FAILURE TO COMPLY WITH CORREC4 TIVE ACTION PLAN.—If the Secretary deter5 mines that a State has failed to comply with a 

6 corrective action plan under subparagraph (C), 

7 the Secretary may suspend, terminate, or with8 hold funds in accordance with section 1945. 

9 ‘‘(E) NOTICE.—Prior to taking action 

10 under subparagraph (C) or (D), the Secretary 

11 shall provide the State with adequate notice and 

12 an opportunity for a hearing. 

13 ‘‘(c) AUDITS.—A funding agreement for a grant 

14 under section 1911 or 1921 is that the State will, with 

15 respect to the grant, comply with chapter 75 of title 31, 

16 United States Code. 

17 ‘‘(d) AVAILABILITY TO PUBLIC.—A funding agree18 ment for a grant under section 1911 or 1921 is that the 

19 State involved will— 

20 ‘‘(1) make copies of the reports and audits de21 scribed in this section available for public inspection 

22 within the State; and 

23 ‘‘(2) provide copies of the report under sub24 section (a), upon request, to any interested person 

25 (including any public agency). 


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1 ‘‘SEC. 1943. PATIENT RECORDS. 

2 ‘‘The Secretary may make a grant under section 

3 1911 or 1921 only if the State involved has in effect a 

4 system to protect from inappropriate disclosure patient 

5 records maintained by the State in connection with an ac6 tivity funded under the program involved or by any entity 

7 which is receiving amounts from the grant. 

8 ‘‘SEC. 1944. DISPOSITION OF CERTAIN FUNDS APPRO9 PRIATED FOR ALLOTMENTS. 

10 ‘‘(a) IN GENERAL.—Amounts described in subsection 

11 (b) and available for a fiscal year pursuant to section 1911 

12 or 1921, shall be allotted by the Secretary and paid to 

13 the States receiving a grant under the program involved, 

14 other than any State referred to in subsection (b) with 

15 respect to such program. Such amounts shall be allotted 

16 in a manner equivalent to the manner in which the allot17 ment under the program involved was determined. 

18 ‘‘(b) SPECIFICATION OF AMOUNTS.—The amounts 

19 referred to in subsection (a) are any amounts that— 

20 ‘‘(1) are not paid to States under the program 

21 involved as a result of— 

22 ‘‘(A) the failure of any State to submit an 

23 application in accordance with the program; 

24 ‘‘(B) the failure of any State to prepare 

25 such application in compliance with the pro26 gram; or 


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1 ‘‘(C) any State informing the Secretary 

2 that the State does not intend to expend the 

3 full amount of the allotment made to the State 

4 under the program; 

5 ‘‘(2) are terminated, repaid, or offset under sec6 tion 1945; 

7 ‘‘(3) in the case of the program established in 

8 section 1911, are available as a result of reductions 

9 in allotments under such section pursuant to section 

10 1915(b); or 

11 ‘‘(4) in the case of the program established in 

12 section 1921, are available as a result of reductions 

13 in allotments under such section pursuant to section 

14 1926 or 1929. 

15 ‘‘SEC. 1945. FAILURE TO COMPLY WITH AGREEMENTS. 

16 ‘‘(a) SUSPENSION OR TERMINATION OF PAY17 MENTS.—Subject to subsection (e), if the Secretary deter18 mines that a State has materially failed to comply with 

19 the agreements or other conditions required for the receipt 

20 of a grant under the program involved, the Secretary may 

21 in whole or in part suspend payments under the grant, 

22 terminate the grant for cause, or employ such other rem23 edies (including the remedies provided for in subsections 

24 (b) and (c)) as may be legally available and appropriate 

25 in the circumstances involved. 


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1 ‘‘(b) REPAYMENT OF PAYMENTS.— 

2 ‘‘(1) IN GENERAL.—Subject to subsection (e), 

3 the Secretary may require a State to repay with in4 terest any payments received by the State under sec5 tion 1911 or 1921 that the Secretary determines 

6 were not expended by the State in accordance with 

7 the agreements required under the program in8 volved. 

9 ‘‘(2) OFFSET AGAINST PAYMENTS.—If a State 

10 fails to make a repayment required in paragraph 

11 (1), the Secretary may offset the amount of the re12 payment against the amount of any payment due to 

13 be paid to the State under the program involved. 

14 ‘‘(c) WITHHOLDING OF PAYMENTS.— 

15 ‘‘(1) IN GENERAL.—Subject to subsections (e) 

16 and (g)(3), the Secretary may withhold payments 

17 due under section 1911 or 1921 if the Secretary de18 termines that the State involved is not expending 

19 amounts received under the program involved in ac20 cordance with the agreements required under the 

21 program. 

22 ‘‘(2) TERMINATION OF WITHHOLDING.—The 

23 Secretary shall cease withholding payments from a 

24 State under paragraph (1) if the Secretary deter25 mines that there are reasonable assurances that the 


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1 State will expend amounts received under the pro2 gram involved in accordance with the agreements re3 quired under the program. 

4 ‘‘(d) APPLICABILITY OF REMEDIES TO CERTAIN VIO5 LATIONS.— 

6 ‘‘(1) IN GENERAL.—With respect to agreements 

7 or other conditions for receiving a grant under the 

8 program involved, in the case of the failure of a 

9 State to maintain material compliance with a condi10 tion referred to in paragraph (2), the provisions for 

11 noncompliance with the condition that are provided 

12 in the section establishing the condition shall apply 

13 in lieu of subsections (a) through (c) of this section. 

14 ‘‘(2) RELEVANT CONDITIONS.—For purposes of 

15 paragraph (1): 

16 ‘‘(A) In the case of the program estab17 lished in section 1911, a condition referred to 

18 in this paragraph is the condition established in 

19 section 1915(b). 

20 ‘‘(B) In the case of the program estab21 lished in section 1921, a condition referred to 

22 in this paragraph is the condition established in 

23 section 1926 and the condition established in 

24 section 1929. 


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1 ‘‘(e) OPPORTUNITY FOR HEARING.—Before taking 

2 action against a State under any of subsections (a) 

3 through (c) (or under a section referred to in subsection 

4 (d)(2), as the case may be), the Secretary shall provide 

5 to the State involved adequate notice and an opportunity 

6 for a hearing. 

7 ‘‘(f) REQUIREMENT OF HEARING IN CERTAIN CIR8 CUMSTANCES.— 

9 ‘‘(1) IN GENERAL.—If the Secretary receives a 

10 complaint that a State has failed to maintain mate11 rial compliance with the agreements or other condi12 tions required for receiving a grant under the pro13 gram involved (including any condition referred to 

14 for purposes of subsection (d)), and there appears to 

15 be reasonable evidence to support the complaint, the 

16 Secretary shall promptly conduct a hearing with re17 spect to the complaint. 

18 ‘‘(2) FINDING OF MATERIAL NONCOMPLI19 ANCE.—If in a hearing under paragraph (1) the Sec20 retary finds that the State involved has failed to 

21 maintain material compliance with the agreement or 

22 other condition involved, the Secretary shall take 

23 such action under this section as may be appropriate 

24 to ensure that material compliance is so maintained, 


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1 or such action as may be required in a section re2 ferred to in subsection (d)(2), as the case may be. 

3 ‘‘(g) CERTAIN INVESTIGATIONS.— 

4 ‘‘(1) REQUIREMENT REGARDING SECRETARY.— 

5 The Secretary shall in fiscal year 1994 and each 

6 subsequent fiscal year conduct in not less than 10 

7 States investigations of the expenditure of grants re8 ceived by the States under section 1911 or 1921 in 

9 order to evaluate compliance with the agreements re10 quired under the program involved. 

11 ‘‘(2) PROVISION OF RECORDS ETC. UPON RE12 QUEST.—Each State receiving a grant under section 

13 1911 or 1921, and each entity receiving funds from 

14 the grant, shall make appropriate books, documents, 

15 papers, and records available to the Secretary or the 

16 Comptroller General, or any of their duly authorized 

17 representatives, for examination, copying, or me18 chanical reproduction on or off the premises of the 

19 appropriate entity upon a reasonable request there20 fore. 

21 ‘‘(3) LIMITATIONS ON AUTHORITY.—The Sec22 retary may not institute proceedings under sub23 section (c) unless the Secretary has conducted an in24 vestigation concerning whether the State has ex25 pended payments under the program involved in acVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00372 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 cordance with the agreements required under the 

2 program. Any such investigation shall be conducted 

3 within the State by qualified investigators. 

4 ‘‘SEC. 1946. PROHIBITIONS REGARDING RECEIPT OF 

5 FUNDS. 

6 ‘‘(a) ESTABLISHMENT.— 

7 ‘‘(1) CERTAIN FALSE STATEMENTS AND REP8 RESENTATIONS.—A person shall not knowingly and 

9 willfully make or cause to be made any false state10 ment or representation of a material fact in connec11 tion with the furnishing of items or services for 

12 which payments may be made by a State from a 

13 grant made to the State under section 1911 or 

14 1921. 

15 ‘‘(2) CONCEALING OR FAILING TO DISCLOSE

16 CERTAIN EVENTS.—A person with knowledge of the 

17 occurrence of any event affecting the initial or con18 tinued right of the person to receive any payments 

19 from a grant made to a State under section 1911 or 

20 1921 shall not conceal or fail to disclose any such 

21 event with an intent fraudulently to secure such pay22 ment either in a greater amount than is due or when 

23 no such amount is due. 

24 ‘‘(b) CRIMINAL PENALTY FOR VIOLATION OF PROHI25 BITION.—Any person who violates any prohibition estabVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00373 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 lished in subsection (a) shall for each violation be fined 

2 in accordance with title 18, United States Code, or impris3 oned for not more than 5 years, or both. 

4 ‘‘SEC. 1947. NONDISCRIMINATION. 

5 ‘‘(a) IN GENERAL.— 

6 ‘‘(1) RULE OF CONSTRUCTION REGARDING CER7 TAIN CIVIL RIGHTS LAWS.—For the purpose of ap8 plying the prohibitions against discrimination on the 

9 basis of age under the Age Discrimination Act of 

10 1975, on the basis of handicap under section 504 of 

11 the Rehabilitation Act of 1973, on the basis of sex 

12 under title IX of the Education Amendments of 

13 1972, or on the basis of race, color, or national ori14 gin under title VI of the Civil Rights Act of 1964, 

15 programs and activities funded in whole or in part 

16 with funds made available under section 1911 or 

17 1921 shall be considered to be programs and activi18 ties receiving Federal financial assistance. 

19 ‘‘(2) PROHIBITION.—No person shall on the 

20 ground of sex (including, in the case of a woman, on 

21 the ground that the woman is pregnant), or on the 

22 ground of religion, be excluded from participation in, 

23 be denied the benefits of, or be subjected to discrimi24 nation under, any program or activity funded in 


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1 whole or in part with funds made available under 

2 section 1911 or 1921. 

3 ‘‘(b) ENFORCEMENT.— 

4 ‘‘(1) REFERRALS TO ATTORNEY GENERAL

5 AFTER NOTICE.—Whenever the Secretary finds that 

6 a State, or an entity that has received a payment 

7 pursuant to section 1911 or 1921, has failed to com8 ply with a provision of law referred to in subsection 

9 (a)(1), with subsection (a)(2), or with an applicable 

10 regulation (including one prescribed to carry out 

11 subsection (a)(2)), the Secretary shall notify the 

12 chief executive officer of the State and shall request 

13 the chief executive officer to secure compliance. If 

14 within a reasonable period of time, not to exceed 60 

15 days, the chief executive officer fails or refuses to se16 cure compliance, the Secretary may— 

17 ‘‘(A) refer the matter to the Attorney Gen18 eral with a recommendation that an appropriate 

19 civil action be instituted; 

20 ‘‘(B) exercise the powers and functions 

21 provided by the Age Discrimination Act of 

22 1975, section 504 of the Rehabilitation Act of 

23 1973, title IX of the Education Amendments of 

24 1972, or title VI of the Civil Rights Act of 

25 1964, as may be applicable; or 


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1 ‘‘(C) take such other actions as may be au2 thorized by law. 

3 ‘‘(2) AUTHORITY OF ATTORNEY GENERAL.— 

4 When a matter is referred to the Attorney General 

5 pursuant to paragraph (1)(A), or whenever the At6 torney General has reason to believe that a State or 

7 an entity is engaged in a pattern or practice in viola8 tion of a provision of law referred to in subsection 

9 (a)(1) or in violation of subsection (a)(2), the Attor10 ney General may bring a civil action in any appro11 priate district court of the United States for such re12 lief as may be appropriate, including injunctive re13 lief. 

14 ‘‘SEC. 1948. TECHNICAL ASSISTANCE AND PROVISION OF 

15 SUPPLIES AND SERVICES IN LIEU OF GRANT 

16 FUNDS. 

17 ‘‘(a) TECHNICAL ASSISTANCE.—The Secretary shall, 

18 without charge to a State receiving a grant under section 

19 1911 or 1921, provide to the State (or to any public or 

20 nonprofit private entity within the State) technical assist21 ance with respect to the planning, development, and oper22 ation of any program or service carried out pursuant to 

23 the program involved. The Secretary may provide such 

24 technical assistance directly, through contract, or through 

25 grants. 


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1 ‘‘(b) PROVISION OF SUPPLIES AND SERVICES IN

2 LIEU OF GRANT FUNDS.— 

3 ‘‘(1) IN GENERAL.—Upon the request of a 

4 State receiving a grant under section 1911 or 1921, 

5 the Secretary may, subject to paragraph (2), provide 

6 supplies, equipment, and services for the purpose of 

7 aiding the State in carrying out the program in8 volved and, for such purpose, may detail to the State 

9 any officer or employee of the Department of Health 

10 and Human Services. 

11 ‘‘(2) CORRESPONDING REDUCTION IN PAY12 MENTS.—With respect to a request described in 

13 paragraph (1), the Secretary shall reduce the 

14 amount of payments under the program involved to 

15 the State by an amount equal to the costs of detail16 ing personnel and the fair market value of any sup17 plies, equipment, or services provided by the Sec18 retary. The Secretary shall, for the payment of ex19 penses incurred in complying with such request, ex20 pend the amounts withheld. 

21 ‘‘SEC. 1949. RULE OF CONSTRUCTION REGARDING DELEGA22 TION OF AUTHORITY TO STATES. 

23 ‘‘With respect to States receiving grants under sec24 tion 1911 or 1921, this part may not be construed to au25 thorize the Secretary to delegate to the States the primary 


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1 responsibility for interpreting the governing provisions of 

2 this part. 

3 ‘‘SEC. 1950. SOLICITATION OF VIEWS OF CERTAIN ENTITIES. 

4 ‘‘In carrying out this part, the Secretary, as appro5 priate, shall solicit the views of the States and other ap6 propriate entities. 

7 ‘‘SEC. 1951. AVAILABILITY TO STATES OF GRANT PAY8 MENTS. 

9 ‘‘Any amounts paid to a State for a fiscal year under 

10 section 1911 or 1921 shall be available for obligation and 

11 expenditure until the end of the fiscal year following the 

12 fiscal year for which the amounts were paid. 

13 ‘‘SEC. 1952. CONTINUATION OF CERTAIN PROGRAMS. 

14 ‘‘(a) IN GENERAL.—Of the amount allotted to the 

15 State of Hawaii under section 1911, and the amount allot16 ted to such State under section 1921, an amount equal 

17 to the proportion of Native Hawaiians residing in the 

18 State to the total population of the State shall be avail19 able, respectively, for carrying out the program involved 

20 for Native Hawaiians. 

21 ‘‘(b) EXPENDITURE OF AMOUNTS.—The amount 

22 made available under subsection (a) may be expended only 

23 through contracts entered into by the State of Hawaii with 

24 public and private nonprofit organizations to enable such 

25 organizations to plan, conduct, and administer comprehenVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00378 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 sive substance use disorder and treatment programs for 

2 the benefit of Native Hawaiians. In entering into contracts 

3 under this section, the State of Hawaii shall give pref4 erence to Native Hawaiian organizations and Native Ha5 waiian health centers. 

6 ‘‘(c) DEFINITIONS.—For the purposes of this sub7 section, the terms ‘Native Hawaiian’, ‘Native Hawaiian 

8 organization’, and ‘Native Hawaiian health center’ have 

9 the meaning given such terms in section 2308 of subtitle 

10 D of title II of the Anti-Drug Abuse Act of 1988. 

11 ‘‘SEC. 1953. DEFINITIONS. 

12 ‘‘(a) DEFINITIONS FOR SUBPART III.—For purposes 

13 of this subpart: 

14 ‘‘(1) The term ‘program involved’ means the 

15 program of grants established in section 1911 or 

16 1921, or both, as indicated by whether the State in17 volved is receiving or is applying to receive a grant 

18 under section 1911 or 1921, or both. 

19 ‘‘(2)(A) The term ‘funding agreement’, with re20 spect to a grant under section 1911, has the mean21 ing given such term in section 1919. 

22 ‘‘(B) The term ‘funding agreement’, with re23 spect to a grant under section 1921, has the mean24 ing given such term in section 1934. 


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1 ‘‘(b) DEFINITIONS FOR PART B.—For purposes of 

2 this part: 

3 ‘‘(1) The term ‘Comptroller General’ means the 

4 Comptroller General of the United States. 

5 ‘‘(2) The term ‘State’, except as provided in 

6 sections 1918(c)(5) and 1932(c)(5), means each of 

7 the several States, the District of Columbia, and 

8 each of the territories of the United States. 

9 ‘‘(3) The term ‘territories of the United States’ 

10 means each of the Commonwealth of Puerto Rico, 

11 American Samoa, Guam, the Commonwealth of the 

12 Northern Mariana Islands, the Virgin Islands, 

13 Palau, the Marshall Islands, and Micronesia. 

14 ‘‘(4) The term ‘interim services’, in the case of 

15 an individual in need of treatment for substance use 

16 disorders who has been denied admission to a pro17 gram of such treatment on the basis of the lack of 

18 the capacity of the program to admit the individual, 

19 means services for reducing the adverse health ef20 fects of such abuse, for promoting the health of the 

21 individual, and for reducing the risk of transmission 

22 of disease, which services are provided until the indi23 vidual is admitted to such a program. 


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1 ‘‘SEC. 1955. SERVICES FOR INDIVIDUALS WITH CO-OCCUR2 RING DISORDERS. 

3 ‘‘States may use funds available for treatment under 

4 sections 1911 and 1921 to treat persons with co-occurring 

5 substance use disorders and mental disorders as long as 

6 funds available under such sections are used for the pur7 poses for which they were authorized by law and can be 

8 tracked for accounting purposes. 

9 ‘‘SEC. 1956. PUBLIC HEALTH EMERGENCY DECLARATION. 

10 ‘‘In the case of a public health emergency as defined 

11 in section 319, the Administrator, on a State by State 

12 basis, may defer the application deadline and compliance 

13 with any other requirements of sections 521, 1911, 1921, 

14 and the Protection and Advocacy for Individuals with a 

15 Mental Illness Act. 

16 ‘‘PART C—CERTAIN PROGRAMS REGARDING 

17 MENTAL HEALTH AND SUBSTANCE USE DIS18 ORDERS 

19 ‘‘SEC. 1961. INTERIM MAINTENANCE TREATMENT. 

20 ‘‘(a) REQUIREMENT REGARDING SECRETARY.—Sub21 ject to the following subsections of this section, for the 

22 purpose of reducing the incidence of the transmission of 

23 HIV disease pursuant to the intravenous use of heroin or 

24 other morphine-like drugs, the Secretary, in establishing 

25 conditions for the use of methadone in public or nonprofit 


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1 private programs of treatment for dependence on such 

2 drugs, shall authorize such programs— 

3 ‘‘(1) to dispense methadone for treatment pur4 poses to individuals who— 

5 ‘‘(A) meet the conditions for admission to 

6 such programs that dispense methadone as part 

7 of comprehensive treatment for such depend8 ence; and 

9 ‘‘(B) are seeking admission to such pro10 grams that so dispense methadone, but as a re11 sult of the limited capacity of the programs, will 

12 not gain such admission until 14 or more days 

13 after seeking admission to the programs; and 

14 ‘‘(2) in dispensing methadone to such individ15 uals, to provide only minimum ancillary services dur16 ing the period in which the individuals are waiting 

17 for admission to programs of comprehensive treat18 ment. 

19 ‘‘(b) INAPPLICABILITY OF REQUIREMENT IN CER20 TAIN CIRCUMSTANCES.— 

21 ‘‘(1) IN GENERAL.—The requirement estab22 lished in subsection (a) for the Secretary does not 

23 apply if any or all of the following conditions are 

24 met: 


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1 ‘‘(A) The preponderance of scientific re2 search indicates that the risk of the trans3 mission of HIV disease pursuant to the inject4 ing abuse of drugs is minimal. 

5 ‘‘(B) The preponderance of scientific re6 search indicates that the medically supervised 

7 dispensing of methadone is not an effective 

8 method of reducing the extent of dependence on 

9 heroin and other morphine-like drugs. 

10 ‘‘(C) The preponderance of available data 

11 indicates that, of treatment programs that dis12 pense methadone as part of comprehensive 

13 treatment, a substantial majority admit all indi14 viduals seeking services to the programs not 

15 later than 14 days after the individuals seek ad16 mission to the programs. 

17 ‘‘(2) EVALUATION BY SECRETARY.—In evalu18 ating whether any or all of the conditions described 

19 in paragraph (1) have been met, the Secretary shall 

20 consult with the National Commission on Acquired 

21 Immune Deficiency Syndrome. 

22 ‘‘(c) CONDITIONS FOR OBTAINING AUTHORIZATION

23 FROM SECRETARY.— 

24 ‘‘(1) IN GENERAL.—In carrying out the require25 ment established in subsection (a), the Secretary 


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1 shall, after consultation with the National Commis2 sion on Acquired Immune Deficiency Syndrome, by 

3 regulation issue such conditions for treatment pro4 grams to obtain authorization from the Secretary to 

5 provide interim maintenance treatment as may be 

6 necessary to carry out the purpose described in such 

7 subsection. Such conditions shall include conditions 

8 for preventing the unauthorized use of methadone. 

9 ‘‘(2) COUNSELING ON HIV DISEASE.—The regu10 lations issued under paragraph (1) shall provide that 

11 an authorization described in such paragraph may 

12 not be issued to a treatment program unless the pro13 gram provides to recipients of the treatment coun14 seling on preventing exposure to and the trans15 mission of HIV disease. 

16 ‘‘(3) PERMISSION OF RELEVANT STATE AS CON17 DITION OF AUTHORIZATION.—The regulations issued 

18 under paragraph (1) shall provide that the Secretary 

19 may not provide an authorization described in such 

20 paragraph to any treatment program in a State un21 less the chief public health officer of the State has 

22 certified to the Secretary that— 

23 ‘‘(A) such officer does not object to the 

24 provision of such authorizations to treatment 

25 programs in the State; and 


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1 ‘‘(B) the provision of interim maintenance 

2 services in the State will not reduce the capac3 ity of comprehensive treatment programs in the 

4 State to admit individuals to the programs (rel5 ative to the date on which such officer so cer6 tifies). 

7 ‘‘(4) DATE CERTAIN FOR ISSUANCE OF REGU8 LATIONS; FAILURE OF SECRETARY.—The Secretary 

9 shall issue the final rule for purposes of the regula10 tions required in paragraph (1), and such rule shall 

11 be effective, not later than the expiration of the 180- 

12 day period beginning on July 10, 1992. If the Sec13 retary fails to meet the requirement of the preceding 

14 sentence, the proposed rule issued on March 2, 

15 1989, with respect to part 291 of title 21, Code of 

16 Federal Regulations (docket numbered 88N–0444; 

17 54 Fed. Reg. 8973 et seq.) is deemed to take effect 

18 as a final rule upon the expiration of such period, 

19 and the provisions of paragraph (3) of this sub20 section are deemed to be incorporated into such rule. 

21 ‘‘(d) DEFINITIONS.—For purposes of this section: 

22 ‘‘(1) The term ‘interim maintenance services’ 

23 means the provision of methadone in a treatment 

24 program under the circumstances described in para25 graphs (1) and (2) of subsection (a). 


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1 ‘‘(2) The term ‘HIV disease’ means infection 

2 with the etiologic agent for acquired immune defi3 ciency syndrome. 

4 ‘‘(3) The term ‘treatment program’ means a 

5 public or nonprofit private program of treatment for 

6 dependence on heroin or other morphine-like 

7 drugs.’’. 

8 (b) TECHNICAL AMENDMENTS.—Section 1955 of the 

9 Public Health Service Act (42 U.S.C. 300x–65), as added 

10 by section 3305 of Public Law 106–310 (114 Stat. 1212), 

11 is amended— 

12 (1) by redesignating such section as section 

13 1954; and 

14 (2) by transferring such section so as to appear 

15 after section 1953 (as so designated by the amend16 ment made by subsection (a)). 

17 SEC. 4. REPEAL. 

18 Section 330K of the Public Health Service Act (42 

19 U.S.C. 254c–16) is repealed. 

20 SEC. 5. AMENDMENTS TO THE PROTECTION AND ADVO21 CACY FOR INDIVIDUALS WITH MENTAL ILL22 NESS ACT. 

23 (a) DEFINITION OF FACILITIES.—Section 102(3) of 

24 the Protection and Advocacy for Individuals with Mental 

25 Illness Act (42 U.S.C. 10802(3)) is amended by striking 


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1 ‘‘community facilities’’ and inserting ‘‘residential or non2 residential community facilities’’. 

3 (b) SYSTEM REQUIREMENTS.—Section 105(a) of the 

4 Protection and Advocacy for Individuals with Mental Ill5 ness Act (42 U.S.C. 10805(a)) is amended— 

6 (1) in paragraph (1)(C)(ii), by striking the 

7 comma and inserting a semicolon; and 

8 (2) in paragraph (4)(A), by striking ‘‘who is a 

9 client of the system’’. 

10 (c) ALLOTMENTS.—Section 112(a) of the Protection 

11 and Advocacy for Individuals with Mental Illness Act (42 

12 U.S.C. 10822(a)) is amended— 

13 (1) in paragraph (1)— 

14 (A) in subparagraph (A), by inserting after 

15 ‘‘State’’ in clauses (i) and (ii) the following: 

16 ‘‘and the American Indian Consortium’’; and 

17 (B) in subparagraph (B)— 

18 (i) by inserting after ‘‘income of the 

19 State’’ the following: ‘‘or the American In20 dian Consortium’’; and 

21 (ii) by striking ‘‘if the State is Guam’’ 

22 and inserting ‘‘for the American Indian 

23 Consortium and the territories of Guam’’; 

24 and 


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1 (2) in paragraph (2)(B)(i), by striking ‘‘for 

2 American Samoa’’ and inserting ‘‘for the American 

3 Indian Consortium, American Samoa’’. 

4 (d) REGULATIONS.—Section 116(b) of the Protection 

5 and Advocacy for Individuals with Mental Illness Act (42 

6 U.S.C. 10826(b)) is amended by striking ‘‘enactment of 

7 this subsection’’ and inserting ‘‘enactment of the 

8 SAMHSA Modernization Act of 2010’’. 

9 (e) AUTHORIZATION OF APPROPRIATIONS.—Section 

10 117 of the Protection and Advocacy for Individuals with 

11 Mental Illness Act (42 U.S.C. 10827) is amended by strik12 ing ‘$19,500,000’’ and all that follows through the period 

13 and inserting ‘‘$37,000,000 for fiscal year 2011, and such 

14 sums as may be necessary for each of fiscal years 2012 

15 through 2015.’’. 

16 SEC. 6. STUDY OF THE DISTRIBUTION OF FUNDS UNDER 

17 THE SUBSTANCE ABUSE PREVENTION AND 

18 TREATMENT BLOCK GRANT AND THE COM19 MUNITY MENTAL HEALTH SERVICES BLOCK 

20 GRANT. 

21 (a) IN GENERAL.—The Secretary of Health and 

22 Human Services, acting through the Administrator of the 

23 Substance Abuse and Mental Health Services Administra24 tion, shall, directly or through a grant or contract, conduct 

25 a study to examine whether the funds under the substance 


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1 abuse prevention and treatment block grant and the com2 munity mental health services block grant under title XIX 

3 of the Public Health Service Act (42 U.S.C. 300w et seq.) 

4 are being distributed to States and territories according 

5 to need and to recommend changes in the distribution if 

6 necessary. Such study shall include— 

7 (1) an analysis of whether the distributions 

8 under such block grants accurately reflect the need 

9 for the services under the grants in such States and 

10 territories; 

11 (2) an examination of whether the indices used 

12 under the formulas for distribution of funds under 

13 such block grants are appropriate, and if not, alter14 natives recommended by the Secretary; 

15 (3) where recommendations are included under 

16 paragraph (2) for the use of different indices, a de17 scription of the variables and data sources that 

18 should be used to determine the indices; 

19 (4) an evaluation of the variables and data 

20 sources that are currently being used for each of the 

21 indices involved, and whether such variables and 

22 data sources accurately represent the need for serv23 ices, the cost of providing services, and the ability of 

24 the States to pay for such services; 


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1 (5) the impact that the minimum allotment pro2 visions under each such block grant have on each 

3 State’s final allotment and its effect, if any, on each 

4 State’s formula-based allotment; 

5 (6) recommendations for modifications to the 

6 minimum allotment provisions to ensure an appro7 priate distribution of funds; and 

8 (7) any other information that the Secretary 

9 determines appropriate. 

10 (b) REPORT.—Not later than 24 months after the 

11 date of enactment of this Act, the Secretary of Health and 

12 Human Services shall submit to the Committee on Health, 

13 Education, Labor, and Pensions of the Senate and the 

14 Committee on Energy and Commerce of the House of 

15 Representatives, a report containing the findings and rec16 ommendations of the study conducted under subsection 

17 (a). 

18 SEC. 7. TASK FORCE ON BEHAVIORAL AND MENTAL 

19 HEALTH IN MEDICAL EDUCATION. 

20 Part E of title VII of the Public Health Service Act 

21 (42 U.S.C. 294n et seq.) is amended by inserting after 

22 section 762 the following: 


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1 ‘‘SEC. 762A. TASK FORCE ON BEHAVIORAL AND MENTAL 

2 HEALTH IN MEDICAL EDUCATION. 

3 ‘‘(a) ESTABLISHMENT.—There is established the 

4 Task Force on Behavioral and Mental Health in Medical 

5 Education (in this section referred to as the ‘Task Force’). 

6 The Task Force— 

7 ‘‘(1) shall coordinate its activities with the ac8 tivities of the Council on Graduate Medical Edu9 cation established under section 762; and 

10 ‘‘(2) shall develop and publish not later than 1 

11 year after the date of the enactment of this section, 

12 and may periodically revise as appropriate there13 after, a comprehensive plan for the purpose of 

14 strengthening the capacity of graduates of accred15 ited schools of allopathic or osteopathic medicine to 

16 deliver integrated, comprehensive health care. 

17 ‘‘(b) PLAN CONTENTS.—The plan under subsection 

18 (a)(2) shall identify the specific behavioral and mental 

19 health education that should be— 

20 ‘‘(1) required for graduation from accredited 

21 schools of allopathic or osteopathic medicine; and 

22 ‘‘(2) integrated into medical curricula, con23 tinuing medical education, licensing examinations, 

24 and training for students and graduates of accred25 ited schools of allopathic or osteopathic medicine. 

26 ‘‘(c) MEMBERS.— 


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1 ‘‘(1) COMPOSITION; VOTING; CHAIR.—The Task 

2 Force shall be composed of the ex officio members 

3 specified in paragraph (2) and the members ap4 pointed under paragraph (3). Subject to paragraph 

5 (2)(B), all of the members of the Task Force shall 

6 be voting members. The Task Force shall elect a 

7 chair from among its voting members. 

8 ‘‘(2) EX OFFICIO MEMBERS.—The Task Force 

9 shall include the following ex officio members (or 

10 their designees): 

11 ‘‘(A) Each member serving on the Grad12 uate Medical Education Council pursuant to an 

13 appointment under paragraph (1), (2), or (3) of 

14 section 762(b). 

15 ‘‘(B) Each member serving on the Grad16 uate Medical Education Council pursuant to an 

17 appointment under paragraph (4), (5), or (6) of 

18 section 762(b). Any member serving on the 

19 Task Force under this subparagraph shall be a 

20 nonvoting member. 

21 ‘‘(C) The Administrator of the Substance 

22 Abuse and Mental Health Services Administra23 tion. 

24 ‘‘(D) The Deputy Director of the Office of 

25 National Drug Control Policy. 


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1 ‘‘(E) The Director of the National Insti2 tute on Drug Abuse. 

3 ‘‘(F) The Director of the National Insti4 tute on Mental Health. 

5 ‘‘(G) The Director of the National Insti6 tute on Alcohol Abuse and Alcoholism. 

7 ‘‘(3) APPOINTED MEMBERS.— 

8 ‘‘(A) IN GENERAL.—The Task Force shall 

9 include members to be appointed by the Sec10 retary (without regard to the civil service laws) 

11 who are not employees of the Federal Govern12 ment. Such members shall include the following: 

13 ‘‘(i) One mental health care consumer. 

14 ‘‘(ii) One individual in recovery from a 

15 behavioral health addiction (including any 

16 substance use disorder). 

17 ‘‘(iii) One individual who is a faculty 

18 member at an accredited program of train19 ing in mental health. 

20 ‘‘(iv) One individual who is a faculty 

21 member at an accredited program of train22 ing in behavioral health. 

23 ‘‘(v) One primary care physician spe24 cializing in internal medicine, family pracVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00393 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 tice, pediatrics, emergency medicine, or ob2 stetrics and gynecology. 

3 ‘‘(vi) Two allopathic or osteopathic 

4 physicians with experience in medical 

5 school curriculum or graduate medical edu6 cation. 

7 ‘‘(vii) One allopathic or osteopathic 

8 physician who spends a significant portion 

9 of his professional activity in direct patient 

10 care and is board certified in addiction 

11 medicine by the American Board of Addic12 tion Medicine. 

13 ‘‘(viii) One allopathic or osteopathic 

14 physician who spends a significant portion 

15 of his professional activity in direct patient 

16 care and is board certified in psychiatry by 

17 the American Board of Psychiatry and 

18 Neurology. 

19 ‘‘(ix) Four individuals selected from 

20 among individuals serving in the various 

21 fields charged with carrying out medical 

22 education and behavioral and mental 

23 health disorder services, including psychi24 atry, addiction medicine, psychology, social 

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1 riage and family therapy, pastoral coun2 seling, psychosocial rehabilitation, and sub3 stance use treatment counseling and recov4 ery coaching. 

5 ‘‘(x) One individual with demonstrated 

6 achievements in clinical or basic science re7 search relevant to mental health. 

8 ‘‘(xi) One individual with dem9 onstrated achievements in clinical or basic 

10 science research relevant to behavioral 

11 health disorders. 

12 ‘‘(xii) Two individuals, each from a 

13 separate nonprofit association representing 

14 accredited medical schools. 

15 ‘‘(xiii) Three individuals, each from a 

16 separate national, independent, nonprofit 

17 organization charged with developing na18 tional medical licensing examinations and 

19 assessments for health professionals in os20 teopathic or allopathic medicine. 

21 ‘‘(B) OTHER SELECTION CRITERIA.—In 

22 appointing members of the Task Force under 

23 this paragraph, the Secretary shall ensure— 

24 ‘‘(i) the inclusion of both urban and 

25 rural members; 


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1 ‘‘(ii) a range of members from a vari2 ety of practice settings and having exper3 tise in prevention and treatment across the 

4 lifespan; 

5 ‘‘(iii) adequate representation of ra6 cial, ethnic, religious, and economic diver7 sity; and 

8 ‘‘(iv) an equal distribution of the 

9 members appointed under subparagraph 

10 (A)(ix) between those specializing in men11 tal health services and those specializing in 

12 behavioral health (including substance use 

13 disorder services). 

14 ‘‘(C) TERMS.— 

15 ‘‘(i) IN GENERAL.—Subject to sub16 paragraph (D)(ii), each member of the 

17 Task Force under this paragraph shall be 

18 appointed for a term of 4 years. 

19 ‘‘(ii) VACANCIES.—Any member of the 

20 Task Force appointed to fill a vacancy oc21 curring before the expiration of the term 

22 for which the member’s predecessor was 

23 appointed shall be appointed only for the 

24 remainder of that term. A member may 


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1 serve after the expiration of that member’s 

2 term until a successor has taken office. 

3 ‘‘(D) INITIAL MEMBERS.— 

4 ‘‘(i) APPOINTMENT.—The Secretary 

5 shall appoint the initial members of the 

6 Task Force under this paragraph not less 

7 than 90 days after the date of the enact8 ment of this section. 

9 ‘‘(ii) TERMS.—As designated by the 

10 Secretary at the time of appointment, of 

11 the initial members of the Task Force 

under this paragraph, 1 12 ⁄4 shall be appointed for terms of 1 year, 1 13 ⁄4 shall be appointed for terms of 2 years, 1 14 ⁄4 shall be 

appointed for terms of 3 years, and 1 15 ⁄4

16 shall be appointed for terms of 4 years. 

17 ‘‘(d) STAFF.—The Secretary shall provide the Task 

18 Force with such professional and clerical staff, such infor19 mation, and the services of such consultants as may be 

20 necessary to assist the Task Force in carrying out effec21 tively its functions under this section. 

22 ‘‘(e) COMPENSATION.— 

23 ‘‘(1) RATES OF COMPENSATION.—To the extent 

24 or in the amounts made available in advance in ap25 propriations Acts, and except as provided in paraVerDate Mar 15 2010 20:19 Jun 07, 2010 Jkt 089200 PO 00000 Frm 00397 Fmt 6652 Sfmt 6201 E:\BILLS\H5466.IH H5466

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1 graph (2), members of the Task Force shall each be 

2 entitled to receive the daily equivalent of the annual 

3 rate of basic pay for grade GS–15 of the General 

4 Schedule for each day (including travel time) during 

5 which they are engaged in the actual performance of 

6 duties vested in the Task Force. 

7 ‘‘(2) PROHIBITION AGAINST COMPENSATION OF

8 FEDERAL EMPLOYEES.—Members of the Task Force 

9 who are officers or employees of the Federal Govern10 ment shall not receive additional pay, allowances, or 

11 benefits by reason of their service on the Task 

12 Force. 

13 ‘‘(f) MEETINGS.—The Task Force shall conduct at 

14 least 3 meetings each year. 

15 ‘‘(g) REPORTING.— 

16 ‘‘(1) BY TASK FORCE.—On an annual basis, the 

17 Task Force shall submit to the Secretary and make 

18 publicly available a report on the plan under sub19 section (a)(2) and its implementation. Each such re20 port shall include— 

21 ‘‘(A) a description of current and future 

22 needs pertaining to behavioral and mental 

23 health workforce, education, and training; 


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1 ‘‘(B) an identification of goals, outcome 

2 measures, and a time frame for addressing such 

3 needs; 

4 ‘‘(C) recommendations on the specific be5 havioral and mental health education compo6 nents identified in the plan developed under 

7 subsection (a)(2); and 

8 ‘‘(D) an evaluation of the extent to which 

9 the goals and recommendations in the plan de10 veloped under subsection (a)(2) (including the 

11 goals and recommendations described in sub12 paragraphs (B) and (C)) have been met. 

13 ‘‘(2) BY SECRETARY.—On an annual basis, the 

14 Secretary shall submit a report to the Congress on 

15 the activities of the Task Force, the plan under sub16 section (a)(2), and the plan’s implementation. 

17 ‘‘(h) ASSISTANCE.—The Task Force shall collaborate 

18 with private sector coalitions to facilitate and implement 

19 the Task Force’s recommendations in the plan under sub20 section (a)(2). 

21 ‘‘(i) DEFINITION.—In this section, any reference to 

22 behavioral health includes substance use health. 

23 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—To 

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1 priated such sums as may be necessary for each of fiscal 

2 years 2011 through 2016. 

3 ‘‘(k) TERMINATION.—The Task Force shall termi4 nate at the end of fiscal year 2016.’’. 

5 SEC. 8. COUNCIL ON INTEGRATION OF HEALTH CARE EDU6 CATION. 

7 (a) ESTABLISHMENT AND RESPONSIBILITIES OF

8 COUNCIL.— 

9 (1) ESTABLISHMENT.—There is established in 

10 the Office of the Secretary the Council on Integra11 tion of Health Care Education. 

12 (2) RECOMMENDATIONS.—The Council shall de13 velop and publish not later than 1 year after the 

14 date of the enactment of this Act, and may periodi15 cally revise as appropriate thereafter, recommenda16 tions for the purpose of strengthening the capacity 

17 of health care professionals and behavioral health 

18 providers to deliver integrated, comprehensive health 

19 care. The recommendations shall identify— 

20 (A) the core competencies to be required of 

21 each type of health care professional and behav22 ioral health provider with respect to mental 

23 health and substance use prevention and treat24 ment services in order to carry out their respec25 tive scope of practice; 


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1 (B) the appropriate methods for incor2 porating such competencies into the curricula of 

3 institutions of higher education, and of con4 tinuing education, for health care professionals 

5 and behavioral health providers; 

6 (C) the appropriate methods for incor7 porating such competencies into the licensure 

8 and certification requirements for health care 

9 professionals and behavioral health providers; 

10 and 

11 (D) the appropriate methods for incor12 porating such competencies into the accredita13 tion process for institutions of higher education 

14 providing terminal education for health care 

15 professionals and behavioral health providers. 

16 (3) REPORTING.— 

17 (A) BY THE COUNCIL.—Not later than 1 

18 year after the date of the enactment of this Act, 

19 and annually thereafter, the Council shall sub20 mit to the Secretary and the appropriate com21 mittees of the Congress, and to the Council on 

22 Graduate Medical Education when appropriate, 

23 and make publicly available, a report on the 

24 recommendations under paragraph (2) and the 


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1 implementation of such recommendations. Each 

2 such report shall include— 

3 (i) a description of current and future 

4 needs related to the successful integration 

5 core competencies for mental health and 

6 substance use disorders into health care 

7 professional and behavioral health provider 

8 education and education curricula beyond 

9 medical education; 

10 (ii) an identification of goals, outcome 

11 measures, and timeframes for addressing 

12 the needs described in clause (i); 

13 (iii) a detailed plan for implementing 

14 the recommendations under paragraph (2); 

15 and 

16 (iv) an evaluation of the extent to 

17 which such plan has been implemented. 

18 (B) BY THE SECRETARY.—Not later than 

19 1 year after the date of the enactment of this 

20 Act, and annually thereafter, the Secretary 

21 shall submit a report to the Congress on the ac22 tivities of the Council. 

23 (4) MEMBERS.— 

24 (A) COMPOSITION; VOTING; CHAIR.—The 

25 Council shall be composed of the ex officio 


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1 members specified in subparagraph (B) and the 

2 members appointed under subparagraph (C). 

3 All of the members of the Council shall be vot4 ing members. The Council shall elect a chair 

5 from among its members. 

6 (B) EX OFFICIO MEMBERS.—The Council 

7 shall include the following ex officio members 

8 (or their designees)— 

9 (i) the Secretary; 

10 (ii) the Administrator of the Health 

11 Resources and Services Administration; 

12 (iii) the Administrator of the Centers 

13 for Medicare & Medicaid Services; 

14 (iv) the Administrator of the Sub15 stance Abuse and Mental Health Services 

16 Administration; and 

17 (v) the Director of the Office of Na18 tional Drug Control Policy. 

19 (C) APPOINTED MEMBERS.— 

20 (i) IN GENERAL.—The Council shall 

21 include members to be appointed by the 

22 Secretary (in consultation with the other 

23 ex officio members of the Council and 

24 without regard to the civil service laws) 

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1 ernment. The Secretary shall appoint a 

2 sufficient number of members under this 

3 clause to ensure that the Council is com4 posed of not less than 20 members, includ5 ing both ex officio members under sub6 paragraph (B) and members appointed 

7 under this subparagraph. 

8 (ii) OTHER SELECTION CRITERIA.—In 

9 appointing members of the Council under 

10 this subparagraph, the Secretary shall en11 sure— 

12 (I) inclusion of both urban and 

13 rural members; 

14 (II) adequate representation of 

15 men and women; 

16 (III) a range of members from a 

17 variety of practice settings and having 

18 expertise in prevention and treatment 

19 across the lifespan; 

20 (IV) adequate representation of 

21 racial, ethnic, religious, and economic 

22 diversity; 

23 (V) an equal distribution of the 

24 members appointed under clause (i) 

25 between those specializing in mental 


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1 health services and those specializing 

2 in substance use disorders; 

3 (VI) diverse representation from 

4 addition and psychiatry specialty sec5 tors; 

6 (VII) diverse representation of 

7 allopathic and osteopathic physicians; 

8 (VIII) adequate representation of 

9 health care professionals and behav10 ioral health providers who provide di11 rect patient care to individuals with 

12 co-occurring mental health or sub13 stance use disorders and physical 

14 health conditions; 

15 (IX) adequate representation of 

16 health care and behavioral health (in17 cluding substance use) faculty who 

18 have demonstrated expertise in cur19 riculum development; and 

20 (X) inclusion of a health or be21 havioral health (including substance 

22 use) consumer. 

23 (iii) TERMS.— 

24 (I) IN GENERAL.—Subject to 

25 clause (iv)(II), each member of the 


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1 Council under this subparagraph shall 

2 be appointed for a term of 4 years. 

3 (II) VACANCIES.—Any member 

4 of the Council appointed to fill a va5 cancy occurring before the expiration 

6 of the term for which the member’s 

7 predecessor was appointed shall be ap8 pointed only for the remainder of that 

9 term. A member may serve after the 

10 expiration of that member’s term until 

11 a successor has taken office. 

12 (iv) INITIAL MEMBERS.— 

13 (I) APPOINTMENT.—The Sec14 retary shall appoint the initial mem15 bers of the Council under this sub16 paragraph not less than 90 days after 

17 the date of the enactment of this Act. 

18 (II) TERMS.—As designated by 

19 the Secretary at the time of appoint20 ment, of the initial members of the 

Council under this subparagraph, 1 21 ⁄4

22 shall be appointed for terms of 1 year, 

1 23 ⁄4 shall be appointed for terms of 2 

years, 1 24 ⁄4 shall be appointed for terms 


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of 3 years, and 1 1 ⁄4 shall be appointed 

2 for terms of 4 years. 

3 (5) STAFF.—The Secretary shall provide the 

4 Council with such professional and clerical staff, 

5 such information, and the services of such consult6 ants as may be necessary to assist the Council in 

7 carrying out effectively its functions under this sub8 section. 

9 (6) ADMINISTRATION.— 

10 (A) TRAVEL EXPENSES.—Members shall 

11 receive travel expenses, including per diem in 

12 lieu of subsistence, in accordance with sections 

13 5702 and 5703 of title 5, United States Code, 

14 while away from their homes or regular places 

15 of business in performance of services for the 

16 Council. 

17 (B) OTHER RESOURCES.—The Council 

18 shall have reasonable access to materials, re19 sources, statistical data, and other information 

20 such Council determines to be necessary to 

21 carry out its duties from agencies of the execu22 tive and legislative branches of the Federal 

23 Government. The chair of the Council shall 

24 make requests for such access in writing when 

25 necessary. 


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1 (C) PROHIBITION AGAINST COMPENSATION

2 OF FEDERAL EMPLOYEES.—Members of the 

3 Council who are officers or employees of the 

4 Federal Government shall not receive additional 

5 pay, allowances, or benefits by reason of their 

6 service on the Council. 

7 (7) MEETINGS.—The Council shall conduct at 

8 least 3 meetings each year. 

9 (8) AUTHORIZATION OF APPROPRIATIONS.—To 

10 carry out this subsection, there are authorized to be 

11 appropriated such sums as may be necessary for 

12 each of fiscal years 2011 through 2016. 

13 (b) IMPLEMENTATION OF RECOMMENDATIONS OF

14 THE COUNCIL.— 

15 (1) HEALTH CARE AND BEHAVIORAL HEALTH

16 WORKFORCE CONTINUING EDUCATION.— 

17 (A) IN GENERAL.—Beginning 1 year after 

18 submission of the first report of the Council 

19 under subsection (a)(3)(A), the Secretary may 

20 make grants, contracts, or cooperative agree21 ments to public or private nonprofit entities for 

22 the purpose of implementing the recommenda23 tions of the Council on continuing education for 

24 health care professionals and behavioral health 

25 providers. 


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1 (B) ELIGIBILITY.—To receive a grant, 

2 contract, or cooperative agreement under this 

3 paragraph, a public or private nonprofit entity 

4 shall demonstrate expertise in providing con5 tinuing education for health care professionals 

6 and behavioral health providers. 

7 (C) PRIORITY.—In awarding grants, con8 tracts, and cooperative agreements under this 

9 paragraph, the Secretary shall give priority to 

10 entities that propose to implement continuing 

11 education— 

12 (i) in interdisciplinary settings; or 

13 (ii) in collaboration with a diverse rep14 resentation of health care professionals 

15 and behavioral health providers who have 

16 no direct affiliation with the receiving enti17 ty as determined by the Secretary. 

18 (D) GEOGRAPHIC DISTRIBUTION.—The 

19 Secretary shall ensure that grants, contracts, 

20 and cooperative agreements under this para21 graph are awarded to entities throughout the 

22 United States to ensure the availability of con23 tinuing education in mental health and sub24 stance abuse prevention and treatment services. 


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1 (E) DURATION OF AWARDS.—The period 

2 of a grant, contract, or cooperative agreement 

3 under this paragraph shall not exceed 3 years. 

4 (F) AUTHORIZATION OF APPROPRIA5 TIONS.—There are authorized to be appro6 priated $5,000,000 for fiscal year 2012 and 

7 such sums as may be necessary for each of fis8 cal years 2013 through 2016. 

9 (2) HEALTH CARE AND BEHAVIORAL HEALTH

10 WORKFORCE EDUCATION CURRICULA.— 

11 (A) IN GENERAL.—The Secretary shall 

12 make grants, contracts, or cooperative agree13 ments to public or nonprofit private institutions 

14 of higher education for the purpose of imple15 menting the recommendations of the Council on 

16 education curricula for health care professionals 

17 and behavioral health providers. 

18 (B) PRIORITY.—In awarding grants, con19 tracts, and cooperative agreements under this 

20 paragraph, the Secretary shall give priority to 

21 applicants that demonstrate willingness— 

22 (i) to integrate the recommendations 

23 of the Council on curricula across aca24 demic disciplines; 


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1 (ii) to coordinate the use of Federal 

2 and non-Federal resources for purposes of 

3 such integration; or 

4 (iii) to incorporate other evidence5 based recommendations that further the 

6 integration of behavioral health in health 

7 care. 

8 (C) GEOGRAPHIC DISTRIBUTION.—The 

9 Secretary shall ensure that grants, contracts, 

10 and cooperative agreements under this para11 graph are awarded to institutions of higher edu12 cation throughout the United States to ensure 

13 the availability and improvement of education 

14 curricula for health care professionals and be15 havioral health providers. 

16 (D) DURATION OF AWARDS.—The period 

17 of a grant, contract, or cooperative agreement 

18 under this paragraph shall not exceed 3 years. 

19 (E) AUTHORIZATION OF APPROPRIA20 TIONS.—There are authorized to be appro21 priated $5,000,000 for fiscal year 2012 and 

22 such sums as may be necessary for each of fis23 cal years 2013 through 2016 

24 (c) DEFINITIONS.—In this section: 


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1 (1) BEHAVIORAL HEALTH PROVIDER.—The 

2 term ‘‘behavioral health provider’’— 

3 (A) means an individual who provides clin4 ical care (in accordance with applicable State 

5 law) specializing in the diagnosis or treatment 

6 of behavioral health, including such an indi7 vidual specializing in substance use, addiction, 

8 and dependence disorders; and 

9 (B) includes a psychiatrist, nurse practi10 tioner (as defined in section 1861(aa)(5)(A) of 

11 the Social Security Act), physician assistant (as 

12 defined in section 1861(aa)(5)(A) of such Act), 

13 clinical psychologist (as used in section 1861(ii) 

14 of such Act), clinical social worker (as defined 

15 in section 1861(hh) of such Act), psychiatric 

16 nurse, licensed professional counselor, marriage 

17 and family therapist, pastoral counselor, psy18 chosocial rehabilitation specialist, and any other 

19 individual determined to be appropriate by the 

20 Secretary. 

21 (2) COUNCIL.—The term ‘‘Council’’ means the 

22 Council on Integration of Health Care Education. 

23 (3) HEALTH CARE PROFESSIONAL.—The term 

24 ‘‘health care professional’’— 


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1 (A) means an individual who provides clin2 ical health care (in accordance with applicable 

3 State law) other than a behavioral health pro4 vider; and 

5 (B) includes (other than a behavioral 

6 health provider) a physician (as defined in sec7 tion 1861(r) of the Social Security Act), nurse 

8 practitioner (as defined in section 

9 1861(aa)(5)(A) of the Social Security Act), 

10 physician assistant (as defined in section 

11 1861(aa)(5)(A) of the Social Security Act), 

12 clinical nurse specialist (as defined in section 

13 1861(aa)(5)(B) of the Social Security Act), cer14 tified nurse-midwife (as defined in section 

15 1861(gg) of the Social Security Act), and any 

16 other individual determined to be appropriate 

17 by the Secretary. 

18 (4) INSTITUTION OF HIGHER EDUCATION.—The 

19 term ‘‘institution of higher education’’ has the same 

20 meaning given such term in section 101 of the High21 er Education Act of 1965 (20 U.S.C. 1001). 

22 (5) SECRETARY.—The term ‘‘Secretary’’ means 

23 the Secretary of Health and Human Services. 

Æ 


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