I
104TH CONGRESS
1ST SESSION
H. R. 2207
To provide for substance abuse and mental health performance partnerships,
and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
AUGUST 4, 1995
Mr. DINGELL (for himself and Mr. WAXMAN) (both by request) introduced the
following bill; which was referred to the Committee on Commerce
A BILL
To provide for substance abuse and mental health
performance partnerships, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE AND REFERENCES IN ACT.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Substance Abuse and Mental Health Performance Part-
nership Act of 1995’’.
(b) REFERENCES IN ACT.—The amendments in this
Act apply to the Public Health Service Act unless other-
wise specifically stated.
HR 2207 IH
‘‘(2) increasing development of systems of inte-
grated comprehensive community based services for
adults with serious mental illness and children with
a serious emotional disturbance.
‘‘(b) PERFORMANCE PARTNERSHIP OBJECTIVES.—
‘‘(1) The Secretary, in consultation with the
States, local governments, Indian tribes, and other
interested parties designated by the Secretary (in-
cluding consumers and relatives of consumers), shall
specify by the end of September 1996 (and from
time to time revise, as needed)—
‘‘(A) a list of performance partnership ob-
jectives to carry out the goals of this subpart,
and
‘‘(B) a core set of not more than five of
those objectives that address mental health
problems of national significance.
‘‘(2) Each performance partnership objective
shall include—
‘‘(A) a performance indicator;
‘‘(B) the specific population being ad-
dressed;
‘‘(C) a quantifiable performance target;
and
HR 2207 IH
‘‘(D) a date by which the target level is to
be achieved.
‘‘(3) In specifying the performance partnership
objectives, the Secretary shall be guided by the fol-
lowing principles—
‘‘(A) objectives should be closely related to
the goals of this subpart, and be viewed as im-
portant by and understandable to State policy-
makers and the general public;
‘‘(B) actions taken under the partnership
agreement should be expected to have an im-
pact on the objective;
‘‘(C) measurable progress in achieving the
objective should be expected over the period of
the grant;
‘‘(D) objectives should be result-oriented,
including a mix of outcome, process and capac-
ity measures, and, if an objective measures
process or capacity, it should be demonstrably
linked to the achievement of a health outcome;
and
‘‘(E) data to track the objective should, to
the extent practicable, be comparable for all
grant recipients, meet reasonable statistical
standards for quality, and be available in a
HR 2207 IH
timely fashion, at appropriate periodicity, and
at reasonable cost.
‘‘SEC. 1913. STATE PERFORMANCE PARTNERSHIP PRO-
POSAL.
‘‘(a) IN GENERAL.—In order to be eligible to receive
a grant under this subpart, a State shall propose to the
Secretary a performance partnership in accordance with
the provisions of this section.
‘‘(b) ELEMENTS RELATED TO PERFORMANCE OB-
JECTIVES.—The State proposal under this section shall
contain—
‘‘(1) a list on one or more objectives (derived
from the performance partnership objectives speci-
fied under section 1911(b)) toward which the State
will work and a performance target for each objec-
tive which the State will seek to achieve by the end
of the partnership period;
‘‘(2) a rationale for the State’s selection of its
objectives, including its performance targets, and
timeframes;
‘‘(3) a statement of the State’s strategies for
achieving the objectives over the course of the grant
period;
‘‘(4) a statement of the estimate amount to be
expended to carry out each strategy; and
HR 2207 IH
‘‘(5) an assurance that the State will report an-
nually on all core performance objectives specified
under section 1911(b)(1)(B) (regardless of whether
it is working toward those objectives) and the spe-
cific objectives toward which the State will work
under the performance partnership.
A State may select an objective that is not a specified per-
formance partnership objective under section 1911 if it
demonstrates to the Secretary that the objective relates
to a significant mental health problem in the State that
would not otherwise be addressed appropriately (and that
a suitable performance indicator exists to measure
progress toward the objective).
‘‘SEC. 1913. FEDERAL-STATE PERFORMANCE PARTNERSHIP.
‘‘(a) NEGOTIATIONS
CONCERNING
STATE
PRO-
POSAL.—
‘‘(1) A State submitting a proposed perform-
ance partnership and the Secretary shall make all
reasonable efforts to agree on a performance part-
nership pursuant to which the State shall expend the
grant provided under this subpart.
‘‘(2) In the negotiations concerning the State’s
proposal, the Secretary shall consider the extent to
which the State’s proposed objectives, performance
targets, timeframes, and strategies are likely to ad-
HR 2207 IH
dress appropriately the most significant mental
health problems (as measured by applicable indica-
tors) within the State, including the mental health
problems of vulnerable populations (such as home-
less individuals and children with a serious emo-
tional disturbance).
‘‘(b) PARTNERSHIP PERIOD.—The Secretary, in con-
sultation with the State, shall set the duration of the part-
nership with the State under this subpart. Initial and sub-
sequent partnership periods shall be not less than three
nor more than five years, except that the Secretary may
agree to a partnership period of less than three years
where a State demonstrates to the Secretary’s satisfaction
that such shorter period is appropriate.
‘‘(c) ASSESSMENT AND ADJUSTMENT.—
‘‘(1) THE SECRETARY
SHALL
ASSESS
ANNU-
ALLY.—
‘‘(A) the progress achieved nationally to-
ward each of the objectives in the core set of
performance partnership objectives; and
‘‘(B) in consultation with each State, the
State’s progress toward each objective agreed
upon in the performance partnership under this
subpart.
HR 2207 IH
The Secretary shall make assessments publicly avail-
able.
‘‘(2) The Secretary and a State may at any
time in the course of a performance partnership re-
negotiate, and revise by mutual agreement, the ele-
ments of the partnership in light of new information
or changed circumstances (including information or
changes identified during assessments under para-
graph (1)).
‘‘(d) GRANTS TO STATES; USE OF FUNDS.—
‘‘(1) A grant shall be made to each State which
has reached agreement with the Secretary on a per-
formance partnership under this subpart, and is car-
rying out activities in accordance with the terms of
such partnership, in an amount equal to its allot-
ment under section 1918, for each fiscal year for
which the partnership is in effect.
‘‘(2) Funds paid to a State from a grant de-
scribed in paragraph (1) may be used only for the
purpose of carrying out the partnership developed
under this section (including related data collection,
evaluation, planning, administration, and edu-
cational activities), except that a State may transfer
up to 10 percent of its grant to its allotment under
subpart II.’’.
HR 2207 IH
(c) ADDITIONAL GENERAL PROVISIONS CONCERNING
PARTNERSHIPS.—
(1) Subsection (a) of section 1917 is relocated
and redesignated as subsection (c) of section 1912,
as added by subsection (b) of this section, and is
amended—
(A) in the matter preceding paragraph (2),
to read as follows:
‘‘(c) ADDITIONAL ELEMENTS.—A State proposal is
in accordance with this subsection if—’’;
(B) by striking ‘‘application’’ throughout
and substituting ‘‘proposal’’;
(C) in paragraph (3), by inserting ‘‘pro-
posed performance partnership and’’ before
‘‘agreements’’;
(D) in paragraph (7), by striking ‘‘includ-
ing the plan under section 1912(a))’’; and
(E) by striking paragraph (5) and redesig-
nating paragraphs (2) through (4), (6), and (7)
as paragraphs (1) through (5).
(2) Section 1917(b) is—
(A) amended by striking ‘‘section 1911’’
and inserting ‘‘this subpart’’, and
HR 2207 IH
(B) relocated and redesignated as sub-
section (e) of section 1913, as added by sub-
section (b) of this section.
(3) The heading of section 1917 is repealed.
(d) CONFORMING AMENDMENTS.—
(1) The heading to subpart I of part B of title
XIX is amended by striking ‘‘Block’’ and inserting
‘‘Performance Partnership’’.
(2) Sections 1914(a), 1915, 1916, 1918, and
1919(2) are each amended by striking ‘‘section
1911’’ each place it occurs and inserting ‘‘this sub-
part’’.
(3) Section 1914(b)(1) is amended by striking
‘‘plans’’ each place it occurs and inserting ‘‘perform-
ance partnerships’’.
(4) Sections 1915(a) and 1941 are each amend-
ed by striking ‘‘plan’’ each place is occurs and in-
serting ‘‘performance partnership’’.
(5) The heading to section 1915(a) is amended
by striking ‘‘PLAN’’ and inserting ‘‘PERFORMANCE
PARTNERSHIPS’’.
(6) The heading to section 1941 is amended by
striking 
‘‘PLANS’’ 
and 
inserting 
‘‘PARTNER-
SHIPS’’.
HR 2207 IH
(7) Section 1944(b)(3) is amended by striking
‘‘1912(d) or’’.
(8) Section 1945(d)(2)(A) is amended by strik-
ing ‘‘the condition established in section 1912(d)
and’’.
(9) Subpart III of part B of title XIX is
amended throughout by striking ‘‘section 1911’’ and
inserting ‘‘subpart I’’.
(10) Section 520(b) is amended—
(A) by striking paragraph (5), and
(B) 
by 
renumbering 
paragraphs 
(6)
through (14) as (5) through (13).
SEC. 102. REVIEW BY PLANNING COUNCIL OF STATE’S RE-
PORT.
Section 1915(a)(1) is amended by inserting ‘‘(and the
State’s report under section 1942(a) concerning the pre-
ceding fiscal year)’’ after ‘‘to the grant’’.
SEC. 103. STATE OPPORTUNITY TO CORRECT OR MITIGATE
FAILURE TO MAINTAIN EFFORT.
Section 1915(b)(3)(A) is amended by striking the
second sentence and adding the following: ‘‘If the Sec-
retary determines that a State has failed to maintain such
compliance, the Secretary may permit the State, within
one year (or less) after notification, to correct or mitigate
the noncompliance. If the State does not carry out a cor-
HR 2207 IH
rection or mitigation as specified by the Secretary (or if
the Secretary decided it was not appropriate to provide
that opportunity), the Secretary shall reduce the amount
of the grant under this subpart for the State for the cur-
rent fiscal year by an amount equal to the amount con-
stituting such failure. That reduction shall be applied first
to the amounts for administrative expenses under section
1916(b).’’.
SEC. 104. FUNDING FOR ORGANIZATIONS THAT ARE FOR–
PROFIT.
Section 1916(a) is amended—
(1) by adding ‘‘or’’ at the end of paragraph (3),
(2) by striking ‘‘; or’’ at the end of paragraph
(4) and adding a period, and
(3) by striking paragraph (5).
SEC. 105. MINIMUM AMOUNT FOR ALLOTMENTS.
(a) IN GENERAL.—Section 1918(b) is amended to
read as follows:
‘‘(b) MINIMUM ALLOTMENTS.—For each fiscal year,
the amount of the allotment of a State shall be at least
equal to the amount the State received for fiscal year 1995
under this subpart and former part C of title V (but this
minimum shall be proportionately reduced to the extent
that the appropriation under this subpart for a fiscal year
HR 2207 IH
is less than the sum of the appropriations under this sub-
part and former part C of title V for fiscal year 1995).’’.
(b) 
CONFORMING
AMENDMENT.—Section
1918(c)(2)(C) is amended to read as follows:
‘‘(C) the amount determined under sub-
section (b).’’.
SEC. 106. APPROPRIATION AUTHORIZATIONS.
Section 
1920(a) 
is 
amended 
by 
striking
‘‘$450,000,000’’ and all that follows and inserting
‘‘$305,000,000 for fiscal year 1996, and such sums as
may be necessary for each of the four succeeding fiscal
years.’’.
SEC. 107. DATA COLLECTION, TECHNICAL ASSISTANCE,
EVALUATIONS, 
INCENTIVE 
GRANTS, 
AND
FUNDING FOR INDIAN TRIBES.
(a) RESERVED FUNDS.—Section 1920(b) is amended
to read as follows:
‘‘(b) RESERVED FUNDS.—
‘‘(1) DATA
COLLECTION, TECHNICAL
ASSIST-
ANCE, AND PROGRAM EVALUATIONS.—The Secretary
shall reserve 5 percent of the amounts appropriated
for a fiscal year under subsection (a)—
‘‘(A) to carry out sections 505 (providing
for data collection) and 1948(a) (providing for
HR 2207 IH
technical assistance to States) with respect to
mental health, and
‘‘(B) to conduct evaluations concerning
programs supported under this subpart.
The Secretary may carry out activities funded pur-
suant to this paragraph directly, or through grants,
contracts, or cooperative agreements.
‘‘(2) INCENTIVE GRANTS.—The Secretary may
reserve up to 10 percent of the amounts appro-
priated for a fiscal year under subsection (a) to
make payments to States that the Secretary has de-
termined demonstrate high or improved performance
towards achieving their targets. In making payments
under the preceding sentence the Secretary shall
take into account the comparable difficulty of a
State’s objectives and performance targets.
‘‘(3) FUNDING FOR INDIAN TRIBES.—The Sec-
retary shall reserve 3 percent of the amounts appro-
priated for a fiscal year under subsection (a) to
make payments to Indian tribes and tribal organiza-
tions to carry out the goals of this subpart.’’.
(b) DATA COLLECTION AUTHORITY.—Section 505(a)
is amended—
(1) by striking ‘‘and’’ at the end of paragraph
(1),
HR 2207 IH
(2) by striking the period at the end of para-
graph (2) and inserting ‘‘; and’’, and
(3) by adding at the end the following:
‘‘(3) other factors as needed to carry out part
B of title XIX.
The Secretary may conduct activities under the preceding
sentence directly, or through grants, contracts, or coopera-
tive agreements.’’.
(c) CONFORMING AMENDMENT.—Section 1948(a) is
amended by striking ‘‘through contract, or through
grants’’ and inserting ‘‘or through grants, contracts, or
cooperative agreements’’.
SEC. 108. REPEAL OF GRANT PROGRAM FOR TRANSITION
FROM HOMELESSNESS.
Part C of title V is repealed.
SEC. 109. MENTAL HEALTH SERVICES AND TRAINING DEM-
ONSTRATION PROJECTS.
(a) GENERAL DEMONSTRATION AUTHORITY.—Sec-
tion 520A is amended to read as follows:
‘‘MENTAL HEALTH SERVICES AND TRAINING
DEMONSTRATION PROJECTS
‘‘SEC. 520A. (a) IN GENERAL.—The Secretary may
make grants to, and enter into contracts and cooperative
agreements with, States, local governments, Indian tribes,
and other public and private entities for mental health pre-
vention, treatment, and training demonstration projects
HR 2207 IH
(and may establish financial matching, maintenance of ef-
fort, or non-supplementation requirements for any or all
projects). A specific project may receive funding under
this section for no more than three years.
‘‘(b) FOCUS OF PROJECTS.—Projects will be chosen
based on practical service needs and current policy ques-
tions as determined by the Secretary in consultation with
the States, local governments, Indian tribes, consumers,
and relatives of consumers. Projects shall be designed for
the development of timely, relevant, and replicable results
of immediate use to service providers and officials who de-
velop policy.
‘‘(c) EVALUATION.—The Secretary shall evaluate
each project carried out under subsection (a) and shall dis-
seminate to appropriate public and private entities infor-
mation on effective projects.’’.
(b) REPEAL OF AUTHORITIES FOR DEMONSTRATION
PROJECTS FOR INDIVIDUALS WITH POSITIVE HIV TEST
RESULTS.—Section 520B is repealed.
(c) CONFORMING AMENDMENTS.—
(1) Section 520(b)(6) (as renumbered by sec-
tion 101(d)(8) of this Act) is amended by striking
‘‘sections 520A’’ and all that follows and inserting
‘‘section 520A’’.
HR 2207 IH
(2) Section 612 of the Stewart B. McKinney
Homeless Assistance Act is repealed.
SEC. 110. PROTECTION AND ADVOCACY FOR MENTALLY ILL
INDIVIDUALS.
(a) APPROPRIATION AUTHORIZATIONS.—Section 117
of the Protection and Advocacy for Mentally Ill Individuals
Act of 1986 is amended—
(1) by striking ‘‘and’’ after ‘‘1992,’’, and
(2) by inserting before the period the following: ‘‘,
$22,000,000 for fiscal year 1996, and such sums as may
be necessary for each of the four succeeding fiscal years’’.
(b) ADJUSTMENT TO HOLD-HARMLESS.—
(1) Section 112(a)(2) of the Protection and Ad-
vocacy for Mentally Ill Individuals Act of 1986 is
amended to read as follows:
‘‘(2)(A) The minimum amount of the allotment of an
eligible system shall be the product (rounded to the near-
est 100 dollars) of the appropriate base amount specified
in subparagraph (B) and the factor specified in subpara-
graph (C).
‘‘(B) For purposes of subparagraph (A), the appro-
priate base amount is—
‘‘(i) for American Samoa, Guam, the Marshall
Islands, the Federated States of Micronesia, the
Commonwealth of the Northern Mariana Islands,
HR 2207 IH
the Republic of Palau, and the Virgin Islands,
$139,300, and
‘‘(ii) for any other State, $260,000.
‘‘(C) For purposes of subparagraph (A), the factor
is the ratio of the appropriation under section 117 for the
fiscal year for which the allotment is made to that appro-
priation for fiscal year 1995.’’.
(2)(A) Section 112(a) of that Act is amended
by striking paragraph (3).
(B) Section 112(a)(1)(B) of that Act is amend-
ed by striking ‘‘Trust Territory of the Pacific Is-
lands’’ and inserting ‘‘Marshall Islands, the Fed-
erated States of Micronesia, the Republic of Palau’’.
SEC. 111. COMPREHENSIVE COMMUNITY SERVICES FOR
CHILDREN WITH A SERIOUS EMOTIONAL DIS-
TURBANCE.
(a) 
APPROPRIATION
AUTHORIZATIONS.—Section
565(f)(1) is amended—
(1) by striking ‘‘and’’ after ‘‘1993,’’, and
(2) by inserting before the period the following:
‘‘, $60,000,000 for fiscal year 1996, and such sums
as may be necessary for each of the four succeeding
fiscal years’’.
(b) FLEXIBILITY FOR INDIAN TRIBES AND TERRI-
TORIES.—Section 562(c) is amended by adding at the end
HR 2207 IH
the following: ‘‘The Secretary may waive one or more of
the requirements of the preceding sentence (for a public
entity that is an Indian tribe or tribal organization, or
American Samoa, Guam, the Marshall Islands, the Fed-
erated States of Micronesia, the Commonwealth of the
Northern Mariana Islands, the Republic of Palau, or the
Virgin Islands) if the Secretary finds, after peer review,
that the system of care is family-centered and uses the
least restrictive environment that is clinically appro-
priate.’’.
SEC. 112. NONDISCHARGEABILITY IN BANKRUPTCY OF PAY-
BACK 
FOR 
MENTAL 
HEALTH 
CLINICAL
TRAINEESHIPS.
(a) GENERAL RULE.—Section 303(d) is amended by
adding at the end the following:
‘‘(6) Any obligation of an individual under paragraph
(3) may be released by a discharge in bankruptcy under
title 11, United States Code, only if the discharge is grant-
ed after the expiration of the seven-year period beginning
on the first date that payment under that paragraph is
required, and only if the Bankruptcy Court finds that the
nondischarge of the obligation would be unconscionable.’’.
(b) CONFORMING AMENDMENTS
TO BANKRUPTCY
CODE.—
HR 2207 IH
(1) Section 523(a) of title 11, United States
Code, is amended—
(A) by striking ‘‘or’’ at the end of para-
graph (11),
(B) by adding ‘‘or’’ at the end of para-
graph (12), and
(C) by adding at the end the following:
‘‘(13) that under provisions of the Public
Health Service Act is not to be discharged.’’.
(2) Section 1328(a)(2) of title 11, United
States Code, is amended by striking ‘‘or (8)’’ and in-
serting ‘‘, (8), or (13)’’.
TITLE II—SUBSTANCE ABUSE
SEC. 201. REPLACEMENT OF STATE PLAN PROGRAM WITH
PERFORMANCE PARTNERSHIPS.
(a) ELIMINATION OF STATE PLAN PROGRAM RE-
QUIREMENTS.—Subpart II of part B of title XIX is
amended—
(1) by striking section 1921 (concerning for-
mula grants to States),
(2) by redesignating section 1922 as section
1923A, and
(3) by striking section 1923 (concerning intra-
venous substance abuse programs).
HR 2207 IH
(b) PERFORMANCE PARTNERSHIP FRAMEWORK.—
Subpart II of part B of title XIX is further amended by
inserting after the subpart heading the following new sec-
tions:
‘‘SEC. 1921. PERFORMANCE PARTNERSHIP GOALS AND OB-
JECTIVES.
‘‘(a) GOALS.—The goals of this subpart are for the
States and the Federal Government, working together in
a partnership—
‘‘(1) to reduce the incidence and prevalence of
substance abuse and dependence;
‘‘(2) to improve access to and availability of ap-
propriate prevention and treatment programs for
targeted populations;
‘‘(3) to enhance the effectiveness of substance
abuse prevention and treatment programs; and
‘‘(4) to reduce the community and personal
health risks for substance abuse.
‘‘(b) PERFORMANCE PARTNERSHIP OBJECTIVES.—
‘‘(1) The Secretary, in consultation with the
States, local governments, Indian tribes, and other
interested parties designated by the Secretary (in-
cluding consumers and relatives of consumers), shall
specify by the end of September 1996 (and from
time to time revise, as needed)—
HR 2207 IH
‘‘(A) a list of performance partnership ob-
jectives to carry out the goals of this subpart,
and
‘‘(B) a core set of not more than five of
those objectives that address substance abuse
problems of national significance.
‘‘(2) Each performance partnership objective
shall include—
‘‘(A) a performance indicator;
‘‘(B) the specific population being ad-
dressed;
‘‘(C) a quantifiable performance target;
and
‘‘(D) a date by which the target level is to
be achieved.
‘‘(3) In specifying the performance partnership
objectives, the Secretary shall consider the goals,
priorities, and objectives of the National Drug Con-
trol Strategy and be guided by the following prin-
ciples—
‘‘(A) objectives should be closely related to
the goals of this subpart, and be viewed as im-
portant by and understandable to State policy-
makers and the general public;
HR 2207 IH
‘‘(B) actions taken under the partnership
agreement should be expected to have an im-
pact on the objective;
‘‘(C) measurable progress in achieving the
objective should be expected over the period of
the grant;
‘‘(D) objectives should be results-oriented,
including a mix of outcome, process and capac-
ity measurers, and, if an objective measures
process or capacity, it should be demonstrably
linked to the achievement of a health outcome;
and
‘‘(E) data to track the objective should, to
the extent practicable, be comparable for all
grant recipients, meet reasonable statistical
standards for quality, and be available in a
timely fashion, at appropriate periodicity, and
at reasonable cost.
‘‘SEC. 1922. STATE PERFORMANCE PARTNERSHIP PRO-
POSAL.
‘‘(a) IN GENERAL.—In order to be eligible to receive
a grant under this subpart, a State shall propose to the
Secretary a performance partnership in accordance with
the provisions of this section.
HR 2207 IH
‘‘(b) ELEMENTS RELATED TO PERFORMANCE OB-
JECTIVES.—The State proposal under this section shall
contain—
‘‘(1) a list of one or more objectives (derived
from the performance partnership objectives speci-
fied under section 1921(b)) toward which the State
will work and a performance target for each objec-
tive which the State will seek to achieve by the end
of the partnership period;
‘‘(2) a rationale for the State’s selection of its
objectives, including its performance targets, and
timeframes;
‘‘(3) a statement of the State’s strategies for
achieving the objectives over the course of the grant
period;
‘‘(4) a statement of the estimated amount to be
expended to carry out each strategy; and
‘‘(5) an assurance that the State will report an-
nually on all core performance objectives specified
under section 1921(b)(1)(B) (regardless of whether
it is working toward those objectives) and the spe-
cific objectives toward which the State will work
under the performance partnership.
A State may select an objective that is not a specified per-
formance partnership objective under section 1921 if it
HR 2207 IH
demonstrates to the Secretary that the objective relates
to a significant health problem related to substance abuse
in the State that would not otherwise be addressed appro-
priately (and that a suitable performance indicator exists
to measure progress toward the objective).
‘‘SEC. 1923. FEDERAL-STATE PERFORMANCE PARTNERSHIP.
‘‘(a) NEGOTIATIONS
CONCERNING
STATE
PRO-
POSAL.—
‘‘(1) A State submitting a proposed perform-
ance partnership and the Secretary shall make all
reasonable efforts to agree on a performance part-
nership pursuant to which the State shall expend the
grant provided under this subpart.
‘‘(2) In the negotiations concerning the State’s
proposal, the Secretary shall consider the extent to
which the State’s proposed objectives, performance
targets, timeframes, and strategies are likely to ad-
dress appropriately the most significant health prob-
lems associated with substance abuse (as measured
by applicable indicators) within the State, including
the health problems associated with substance abuse
of vulnerable populations (such as pregnant women
and women with children).
‘‘(b) PARTNERSHIP PERIOD.—The Secretary, in con-
sultation with the State, shall set the duration of the part-
HR 2207 IH
nership with the State under this subpart. Initial and sub-
sequent partnership periods shall be not less than three
nor more than five years, except that the Secretary may
agree to a partnership period of less than three years
where a State demonstrates to the Secretary’s satisfaction
that such shorter period is appropriate.
‘‘(c) ASSESSMENT AND ADJUSTMENT.—
‘‘(1) THE
SECRETARY
SHALL
ASSESS
ANNU-
ALLY—
‘‘(A) the progress achieved nationally to-
ward each of the objectives in the core set of
performance partnership objectives; and
‘‘(B) in consultation with each State, the
State’s progress toward each objective agreed
upon in the performance partnership under this
subpart.
The Secretary shall make assessments publicly avail-
able.
‘‘(2) REVISION
OF PERFORMANCE PARTNER-
SHIPS.—The Secretary and a State may at any time
in the course of a performance partnership renego-
tiate, and revise by mutual agreement, the elements
of the partnership in light of new information or
changed circumstances (including information or
HR 2207 IH
changes identified during assessments under para-
graph (1)).
‘‘(d) GRANTS TO STATES; USE OF FUNDS.—
‘‘(1) A grant shall be made to each State which
has reached agreement with the Secretary on a per-
formance partnership under this subpart, and is car-
rying out activities in accordance with the terms of
such partnership, in an amount equal to its allot-
ment under section 1933, for each fiscal year in
which the partnership is in effect.
‘‘(2) Funds paid to a State from a grant de-
scribed in paragraph (1) may be used only for the
purpose of carrying out the partnership developed
under this section (including related data collection,
evaluation, planning, administration, and edu-
cational activities), except that a State may transfer
up to 10 percent of its grant to its allotment under
subpart I.’’.
(c) ADDITIONAL GENERAL PROVISIONS CONCERNING
PARTNERSHIPS.—
(1) Section 1932 is amended by striking ‘‘sec-
tion 1921’’ each place it occurs and inserting ‘‘this
subpart’’.
(2) Subsection (a) of section 1932 is relocated
and redesignated as subsection (c) of section 1922,
HR 2207 IH
as added by subsection (b) of this section, and is
amended—
(A) in the matter preceding paragraph (2),
to read as follows:
‘‘(c) ADDITIONAL ELEMENTS.—A State proposal is
in accordance with this subsection if—’’;
(B) by striking ‘‘application’’ throughout
and substituting ‘‘proposal’’;
(C) in paragraph (3), by inserting ‘‘pro-
posed performance partnership and’’ before
‘‘agreements’’;
(D) in paragraph (7), by striking ‘‘includ-
ing the plan under paragraph (6))’’; and
(E) by striking paragraphs (5) and (6) and
redesignating paragraphs (2) through (4) and
(7) as paragraphs (1) through (4).
(3) Section 1932(c) is relocated and redesig-
nated as subsection (e) of section 1923, as added by
subsection (b) of this section.
(4) The remainder of section 1932 is repealed.
(d) CONFORMING AMENDMENTS.—
(1) The heading to subpart II of part B of title
XIX is amended by striking ‘‘Block’’ and inserting
‘‘Performance Partnership’’.
HR 2207 IH
(2) Sections 1924, 1926, 1928, 1930, 1931,
1933, and 1934(2) are each amended by striking
‘‘section 1921’’ each place it occurs and inserting
‘‘this subpart’’.
(3) Subpart III of part B of title XIX is
amended throughout by striking ‘‘section 1921’’ and
inserting ‘‘subpart II’’.
SEC. 202. REPEALS, REDESIGNATIONS, AND CONFORMING
AMENDMENTS.
(a) SUBSTANCE ABUSE AND TUBERCULOSIS.—Sec-
tion 1924 is amended—
(1) in the heading, by striking ‘‘TUBER-
CULOSIS AND’’;
(2) by striking subsection (a);
(3) in subsection (c)—
(A) in the heading, by striking ‘‘AGREE-
MENTS’’ and inserting ‘‘PARTNERSHIPS’’, and
(B) in paragraph (1), by striking ‘‘Agree-
ments’’ and inserting ‘‘Partnerships’’; and
(4) by redesignating subsections (b) through (e)
as subsections (a) through (d).
(b) GROUP HOMES FOR RECOVERING SUBSTANCE
ABUSERS.—
(1) Section 1925 is repealed.
(2) Section 507(b) is amended—
HR 2207 IH
(A) in paragraph (11), by striking ‘‘includ-
ing the effect of living in housing provided by
programs established under section 1925,’’,
(B) in paragraph (12), by striking ‘‘para-
graph (11)’’ and inserting ‘‘paragraph (9)’’,
(C) by striking paragraphs (1) and (5),
and
(D) by renumbering paragraphs (2), (3),
(4), (6), (7), (8), (9), (10), (11) and (12) as
(1), (2), (3), (4), (5), (6), (7), (8), (9), and
(10), respectively.
(c) CERTAIN ALLOCATIONS.—Section 1923A (as re-
designated by section 201(a)) is further redesignated and
relocated as section 1925, and is amended—
(1) in the matter in subsection (b) preceding
paragraph (1), by striking ‘‘section 1921’’ and in-
serting ‘‘this subpart’’,
(2) by striking subsections (a) (concerning allo-
cations regarding alcohol and other drugs) and (c)
(concerning allocations regarding women);
(3) in the heading, by striking ‘‘CERTAIN AL-
LOCATIONS’’ and inserting 
ALLOCATION
RE-
GARDING PRIMARY PREVENTION PROGRAMS’’;
and
HR 2207 IH
(4) by striking the subsection designation ‘‘(b)’’
and the heading that follows.
(d) 
TREATMENT
SERVICES
FOR
PREGNANT
WOMEN.—
(1) Section 1927 is repealed.
(2) 
CONFORMING
AMENDMENT.—Section
1934(6) is repealed.
(e) ADDITIONAL AGREEMENTS.—Section 1928 is
amended—
(1) by striking subsections (a) (concerning
treatment referral process), (b) (concerning continu-
ing education), and (d) (concerning waivers);
(2) in the heading, by striking ‘‘ADDITIONAL
AGREEMENTS’’ and inserting ‘‘COORDINATION
OF VARIOUS ACTIVITIES AND SERVICES’’; and
(3) by striking the subsection designation ‘‘(c)’’
and the heading that follows.
(f) STATEWIDE ASSESSMENT OF NEEDS.—Section
1929 is repealed.
SEC. 203. HIGHER THRESHOLD FOR REQUIREMENT CON-
CERNING 
HUMAN 
IMMUNODEFICIENCY
VIRUS.
Section 1924(b)(2) is amended by striking ‘‘10’’
and inserting ‘‘15’’.
HR 2207 IH
SEC. 204. STATE OPPORTUNITY TO CORRECT OR MITIGATE
FAILURE TO MAINTAIN EFFORT.
Section 1930(c)(1) is amended by striking the second
sentence and adding the following: ‘‘If the Secretary deter-
mines that a State has failed to maintain such compliance,
the Secretary may permit the State, within one year (or
less) after notification, to correct or mitigate the non-
compliance. If the State does not carry out a correction
or mitigation as specified by the Secretary (or if the Sec-
retary decided it was not appropriate to provide that op-
portunity), the Secretary shall reduce the amount of the
grant under this subpart for the State for the current fis-
cal year by an amount equal to the amount constituting
such failure. That reduction shall be applied first to the
amounts for administrative expenses under section
1931(a)(2).’’.
SEC. 205. FUNDING FOR ORGANIZATIONS THAT ARE FOR-
PROFIT.
Section 1931(a)(1) is amended—
(1) by adding ‘‘or’’ at the end of subparagraph
(D); and
(2) by striking subparagraph (E).
SEC. 206. APPROPRIATION AUTHORIZATIONS.
Section 
1935(a) 
is 
amended 
by 
striking
‘‘$1,500,000,000’’ and all that follows and inserting
‘‘$1,294,000,000 for fiscal year 1996, and such sums as
HR 2207 IH
may be necessary for each of the four succeeding fiscal
years.’’.
SEC. 207. DATA COLLECTION, TECHNICAL ASSISTANCE,
EVALUATIONS, 
INCENTIVE 
GRANTS, 
AND
FUNDING FOR INDIAN TRIBES.
Section 1935(b) is amended to read as follows:
‘‘(b) RESERVED FUNDS.—
‘‘(1) DATA
COLLECTION, TECHNICAL
ASSIST-
ANCE, AND PROGRAM EVALUATIONS.—
‘‘(A) The Secretary shall reserve 5 percent
of the amounts appropriated for a fiscal year
under subsection (a)—
‘‘(i) to carry out sections 505 (provid-
ing for data collection) and 1948(a) (pro-
viding for technical assistance to States)
with respect to substance abuse;
‘‘(ii) to carry out section 515(d) (pro-
viding for a substance abuse prevention
data base); and
‘‘(iii) to conduct evaluations concern-
ing programs supported under this sub-
part.
The Secretary may carry out activities funded
pursuant to this paragraph directly, or through
grants, contracts, or cooperative agreements.
HR 2207 IH
‘‘(B) Of the amounts reserved under sub-
paragraph (A) for a fiscal year, 20 percent shall
be used for activities related to prevention.
‘‘(2) INCENTIVE GRANTS.—The Secretary may
reserve up to 10 percent of the amounts appro-
priated for a fiscal year under subsection (a) to
make payments to States that the Secretary has de-
termined demonstrate high or improved performance
toward achieving their targets. In making payments
under the preceding sentence the Secretary shall
take into account the comparable difficulty of a
State’s objectives and performance targets.
‘‘(3) FUNDING FOR INDIAN TRIBES.—The Sec-
retary shall reserve 3 percent of the amounts appro-
priated for a fiscal year under subsection (a) to
make payments to Indian tribes and tribal organiza-
tions to carry out the goals of this subpart.’’.
SEC. 208. SUBSTANCE ABUSE PREVENTION, TREATMENT,
AND TRAINING DEMONSTRATION PROJECTS.
(a) GENERAL DEMONSTRATION AUTHORITY.—Sec-
tion 506 is amended to read as follows:
‘‘SUBSTANCE ABUSE PREVENTION, TREATMENT, AND
TRAINING DEMONSTRATION PROJECTS
‘‘SEC. 506. (a) IN GENERAL.—The Secretary may
make grants to, and enter into contracts and cooperative
agreements with, States, local governments, Indian tribes,
HR 2207 IH
and other public and private entities for substance abuse
prevention, 
treatment, 
and 
training 
demonstration
projects (and may establish financial matching, mainte-
nance of effort, or non-supplantation requirements for any
or all projects). A specific project may receive funding
under this section for no more than three years.
‘‘(b) FOCUS OF PROJECTS.—Projects will be chosen
based on practical service needs and currant policy ques-
tions as determined by the Secretary in consultation with
the States, local governments, Indian tribes, consumers,
and relatives of consumers. Projects shall be designed for
the development of timely, relevant, and replicable results
of immediate use to service providers and officials who de-
velop policy. Projects should consider the goals, priorities,
and objectives of the National Drug Control Strategy.
‘‘(c) EVALUATION.—The Secretary shall evaluate
each project carried out under subsection (a) and shall dis-
seminate to appropriate public and private entities infor-
mation on effective projects.’’.
(b) REPEAL OF REDUNDANT AUTHORITIES.—
(1) Sections 508, 509, 510, 511, 512,
515(b)(5), 516, 517, 518, part F of title V, and sub-
part I of part C of title XIX are repealed.
HR 2207 IH
(2) Section 515(b) is further amended by re-
numbering paragraphs (6) through (10) as (5)
through (9).
(3) Part C of title XIX is further amended—
(A) by striking the heading to subpart
II, and
(B) by striking ‘‘CERTAIN PROGRAMS
REGARDING SUBSTANCE ABUSE’’ in the
heading to the part and inserting ‘‘TREAT-
MENT OF NARCOTICS DEPENDENCE’’.
SEC. 209. STATE SUBSTANCE ABUSE PREVENTION AND
TREATMENT PLANNING COUNCIL.
Subpart II of part B of title XIX is further amended
by inserting after section 1926 the following:
‘‘SEC. 1927. STATE SUBSTANCE ABUSE PREVENTION AND
TREATMENT PLANNING COUNCIL.
‘‘(a) IN GENERAL.—A funding agreement for a grant
under this subpart is that the State involved will establish
and maintain a State substance abuse prevention and
treatment planning council in accordance with the condi-
tions described in this section.
‘‘(b) DUTIES.—A condition under subsection (a) for
a council is that the duties of the council are—
‘‘(1) to review performance partnerships and re-
lated reports provided to the council by the State in-
HR 2207 IH
volved and to submit to the State any recommenda-
tions of the council for modifications,
‘‘(2) to serve as an advocate for individuals suf-
fering from substance abuse, and
‘‘(3) to monitor, review, and evaluate, not less
than once each year, the allocation and adequacy of
substance abuse prevention and treatment services
within the State.
‘‘(c) MEMBERSHIP.—
‘‘(1) IN
GENERAL.—A condition under sub-
section (a) for a council is that the council be com-
posed of residents of the State, including representa-
tives of—
‘‘(A) the principal State agencies with re-
spect to—
‘‘(i) substance abuse prevention and
treatment, education, vocational rehabilita-
tion, criminal justice, housing, and social
services, and
‘‘(ii) the development of the plan sub-
mitted pursuant to title XIX of the Social
Security Act,
‘‘(B) public and private entities concerned
with the need, planning, operation, funding, and
HR 2207 IH
use of substance abuse prevention and treat-
ment services and related support services,
‘‘(C) individuals who are receiving (or have
received) substance abuse prevention or treat-
ment services, and
‘‘(D) the families of such individuals.
‘‘(2) LIMITATION ON STATE EMPLOYEES AND
PROVIDERS.—A condition under subsection (a) for a
council is that not less than 50 percent of the mem-
bers of the council are individuals who are not State
employees or providers of substance abuse preven-
tion or treatment services.
‘‘(d) REVIEW OF STATE PERFORMANCE PARTNER-
SHIP BY PLANNING COUNCIL.—The Secretary may make
a grant under this subpart only if—
‘‘(1) the performance partnership submitted
under this subpart with respect to the grant (and
the State’s report under section 1942(a) concerning
the preceding fiscal year) has been reviewed by the
council, and
‘‘(2) the State submits to the Secretary any
recommendations received by the State from the
council for modifications to the performance partner-
ship (without regard to whether the State has made
the recommended modifications).’’.
HR 2207 IH
SEC. 210. REPEAL OF OBSOLETE PROVISIONS CONCERNING
SUBSTANCE ABUSE ALLOCATIONS.
(a) IN GENERAL—Section 1933 is amended—
(1) by striking subsection (b);
(2) in subsection (c)(2)—
(A) by adding ‘‘and’’ at the end of sub-
paragraph (A);
(B) by striking ‘‘; and’’ at the end of sub-
paragraph (B) and adding a period; and
(C) by striking subparagraph (C); and
(3) by redesignating subsections (c) and (d) as
(b) and (c), respectively.
(b) CONFORMING AMENDMENT.—Section 1992(c) (as
redesignated by section 201(c)(2) of this Act) is amended
by striking ‘‘section 1933(c)(2)(B)’’ and inserting ‘‘section
1933(b)(2)(B)’’.
SEC. 211. REPEAL OF OBSOLETE ADDICT REFERRAL PROVI-
SIONS.
(a) REPEAL OF OBSOLETE PUBLIC HEALTH SERV-
ICE ACT AUTHORITIES.—Part E of title III is repealed.
(b) REPEAL OF OBSOLETE NARA AUTHORITIES.—
Titles III and IV of the Narcotic Addict Rehabilitation
Act of 1966 are repealed.
(c) REPEAL
OF OBSOLETE TITLE 28 AUTHORI-
TIES.—
HR 2207 IH
(1) Chapter 175 of title 28, United States
Code, is repealed.
(2) The table of contents to part VI of title 28,
United States Code, is amended by striking the ma-
terial related to chapter 175.
TITLE III—GENERAL
SEC. 301. REPORTING BY STATES ON PERFORMANCE.
Section 1942(a) is amended—
(1) by striking ‘‘and’’ at the end of paragraph
(1),
(2) by striking the period at the end of para-
graph (2) and inserting ‘‘; and’’, and
(3) by adding at the end the following:
‘‘(3) the performance of the State in relation to
the objectives specified or agreed upon under section
1911(b)(1)(B) and 1913, or section 1921(b)(1)(B)
and 1923, as applicable.’’.
SEC. 302. ELIMINATION OF STATE PEER REVIEW REQUIRE-
MENT.
Section 1943(a) is amended—
(1) by striking paragraph (1), and
(2) by renumbering paragraphs (2) and (3) as
(1) and (2), respectively.
HR 2207 IH
SEC. 303. ON SITE PERFORMANCE REVIEWS.
Section 1945(g)(1) is amended by striking ‘‘in fiscal
year 1994’’ and all that follows and inserting ‘‘, not more
frequently than every three nor less frequently than every
five years, conduct an on-site performance review of a
State’s activities supported under this part.’’.
SEC. 304. ADDITIONAL YEAR FOR OBLIGATION BY STATE.
Section 1952(a) is amended by striking everything
after ‘‘available for obligation’’ and inserting ‘‘and expend-
iture until the end of the fiscal year following the fiscal
year for which the amounts were paid.’’.
SEC. 305. DEFINITIONS.
Section 1954(b) is amended by striking paragraph
(4) and inserting the following:
‘‘(4) The term ‘performance indicator’ means a
quantifiable characteristic used as a measurement.
‘‘(5) The term ‘performance target’ means a
numerical value sought to be achieved within a spec-
ified period of time.’’.
SEC. 306. APPROPRIATION AUTHORIZATIONS FOR DEM-
ONSTRATION PROGRAMS.
Part A of title V is amended by adding after section
506 the following:
HR 2207 IH
‘‘APPROPRIATION AUTHORIZATIONS FOR DEMONSTRATION
PROJECTS
‘‘SEC. 506A. For the purpose of carrying out sections
506 and 520A there are authorized to be appropriated
$506,000,000 for fiscal year 1996, $483,000,000 for fis-
cal year 1997, $300,000,000 for fiscal year 1998, and
such sums as may be necessary for each of the two suc-
ceeding fiscal years.’’.
SEC. 307. HEADINGS.
(a) HEADING TO TITLE XIX.—The heading to title
XIX is amended by striking ‘‘BLOCK’’ and inserting
‘‘PERFORMANCE PARTNERSHIP’’.
(b) HEADING TO PART B OF TITLE XIX.—The head-
ing to part B of title XIX is amended by striking
‘‘BLOCK’’ and inserting ‘‘PERFORMANCE PARTNERSHIP’’.
SEC. 308. REGULATIONS.
Section 1949 is amended to read as follows:
‘‘SEC. 1949. REGULATIONS.
‘‘The Secretary shall prescribe regulations as needed
to carry out this part.’’.
SEC. 309. EFFECTIVE DATES AND TRANSITIONAL PROVI-
SIONS.
(a) APPROPRIATION AUTHORIZATIONS
AND DEM-
ONSTRATIONS.—
HR 2207 IH
(1) The amendments made by sections 105,
106, 108, 109, 110, 111, 206, 208, and 306 of this
Act apply to periods beginning after fiscal year
1995.
(2) A project that receives support for fiscal
year 1996, 1997, or 1998 under section 506 or
520A of the Public Health Service Act (as amended
by section 109(a) or 208(a) of this Act, respec-
tively), and that previously received support under
title V of the Public Health Service Act for fiscal
year 1995, shall be subject to the requirements to
which that project was subject for fiscal year 1995
unless the Secretary of Health and Human Services
determines otherwise.
(b) STATE OPPORTUNITY TO CORRECT OR MITIGATE
FAILURE
TO
MAINTAIN
EFFORT.—The amendments
made by sections 103 and 204 apply to failures occurring
after fiscal year 1994.
(c) REPEAL OF PENALTY PROVISION FOR FAILURE
TO IMPLEMENT COMPLETELY, AND OF OBSOLETE PROVI-
SIONS.—The repeal of section 1912(d) of the Public
Health Service Act by section 101(a) of this Act, and the
amendments enacted by sections 210 and 211 of this Act,
are effective upon enactment.
HR 2207 IH
(d) EFFECTIVE DATE FOR NONDISCHARGEABILITY
IN BANKRUPTCY.—The amendment made by section
112(a) applies to bankruptcy proceedings in which a dis-
charge has not been granted before 31 days after the date
of enactment of this Act.
(e) 
FUNDING
FOR
INDIAN
TRIBES.—Sections
1920(b)(3) and 1935(b)(3) of the Public Health Service
Act (as amended and enacted by sections 107(a) and 207,
respectively, of this Act) apply to fiscal years after fiscal
year 1996.
(f) PERFORMANCE PARTNERSHIP
AND RELATED
PROVISIONS.—
(1) The amendments made by the preceding
sections of this Act (other than the amendments list-
ed in the preceding subsections of this section) apply
to activities related to grants for periods after fiscal
year 1996, except that the amendments apply with
respect to a State (for either of the grant programs
affected by those amendments), if earlier, on the ef-
fective date of a performance partnership under such
program.
(2) The Secretary of Health and Human Serv-
ices may select a list of prototype performance part-
nership objectives and a core set of those objectives
on which all States should report (as provided in
HR 2207 IH
section 1911 or 1921 of the Public Health Service
Act, as amended by sections 101(a) and 201(a), re-
spectively, of this Act, but without consultation with
other parties). The amendments made by the preced-
ing sections of this Act (other than the amendments
listed in the preceding subsections of this section),
in conjunction with the first sentence of this para-
graph, apply (until the time applicable under para-
graph (1) of this subsection with respect to a State
(for either of the grant programs affected by those
amendments) at such time as the Secretary of
Health and Human Services and the State may
agree.
(3) In the case of the initial partnership pro-
posal by a State under paragraph (2) of this sub-
section, or under subpart I or II of part B of title
XIX of the Public Health Service Act—
(A) if the Secretary of Health and Human
Services and a State reach agreement on or be-
fore March 31 of a fiscal year, the performance
partnership shall take effect, at State option, as
of the beginning of such fiscal year or of the
succeeding fiscal year; and
(B) if such agreement is reached after
March 31 of a fiscal year, the performance
HR 2207 IH
partnership shall take effect as of the beginning
of the succeeding fiscal year.
(4) The requirements of part C of title V of the
Public Health Service Act (as in effect on the day
before the date of enactment of this Act) shall con-
tinue to apply (until the time applicable under para-
graph (1) or (2) of this subsection), with respect to
a State, to that portion of a grant to the State for
a fiscal year under subpart I of part B of title XIX
of that Act that bears the same relationship to the
entire grant as the amount granted to the State for
fiscal year 1995 under part C of title V of that Act
bore to the amount granted to the State for fiscal
year 1995 under part C of title V and subpart I of
part B of title XIX of that Act.
Æ
HR 2207 IH——2
HR 2207 IH——3
HR 2207 IH——4