150 
(e) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$1,000,000 for each of fiscal years 2017 through 2021. 
SEC. 514. BEHAVIORAL HEALTH CRISIS SYSTEMS. 
(a) DEFINITIONS.—For purposes of this section, the 
following definitions shall apply: 
(1) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means a State, political subdivision of a State, 
or nonprofit private entity. 
(2) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(3) STATE.—The term ‘‘State’’ means each 
State of the United States, the District of Columbia, 
each commonwealth, territory or possession of the 
United States, and each federally recognized Indian 
tribe. 
(b) ESTABLISHMENT OF GRANT PROGRAM.— 
(1) ESTABLISHMENT.—The Secretary shall es-
tablish a program to award grants to eligible entities 
to establish and implement a system for preventing 
and de-escalating behavioral health crises. 
(2) USE OF FUNDS.— 
(A) IN GENERAL.—Grants under this sec-
tion may be used to carry out programs that— 
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(i) expand early intervention and 
treatment services to improve access to be-
havioral health crisis assistance and ad-
dress unmet behavioral health care needs; 
(ii) expand the continuum of services 
to address crisis prevention, crisis interven-
tion, and crisis stabilization; and 
(iii) reduce unnecessary hospitaliza-
tions by appropriately utilizing community- 
based services and improving access to 
timely behavioral health crisis assistance. 
(B) AUTHORIZED
ACTIVITIES.—The pro-
grams described in subparagraph (A) may in-
clude activities such as: 
(i) Mobile support or crisis support 
centers that provide field-based behavioral 
health assistance to individuals with men-
tal health or substance use disorders and 
links such individuals in crisis to appro-
priate services. 
(ii) School and community-based early 
intervention and prevention programs that 
provide mobile response, screening and as-
sessment, training and education, and 
peer-based and family services. 
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(iii) Mental health crisis intervention 
and response training for law enforcement 
officers to increase officers’ understanding 
and recognition of mental illnesses as well 
as increase their awareness of health care 
services available to individuals in crisis. 
(3) APPLICATION.—To be considered for a 
grant under this section, an eligible entity shall sub-
mit an application to the Secretary at such time, in 
such manner, and containing such information as 
the Secretary may require. At minimum, such appli-
cation shall include a description of— 
(A) the activities to be funded with the 
grant; 
(B) community needs; 
(C) the population to be served; and 
(D) the interaction between the activities 
described in subparagraph (A) and public sys-
tems of health and mental health care, law en-
forcement, social services, and related assist-
ance programs. 
(4) SELECTING AMONG APPLICANTS.— 
(A) IN GENERAL.—Grants shall be award-
ed to eligible entities on a competitive basis. 
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(B) SELECTION CRITERIA.—The Secretary 
shall evaluate applicants based on such criteria 
as the Secretary determines to be appropriate, 
including the ability of an applicant to carry 
out the activities described in paragraph (2). 
(5) REPORTS.— 
(A) ANNUAL REPORTS.— 
(i) ELIGIBLE ENTITIES.—As a condi-
tion of receiving a grant under this section, 
an eligible entity shall agree to submit a 
report to the Secretary, on an annual 
basis, describing the activities carried out 
with the grant and assessing the effective-
ness of such activities. 
(ii) 
SECRETARY.—The 
Secretary 
shall, on an annual basis, and using the re-
ports received under clause (i), report to 
Congress on the overall impact and effec-
tiveness of the grant program under this 
section. 
(B) FINAL REPORT.—Not later than Janu-
ary 15, 2021, the Secretary shall submit to 
Congress a final report that includes rec-
ommendations with respect to the feasibility 
and advisability of extending or expanding the 
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grant program. The report shall also provide an 
assessment of which systems and system ele-
ments proved most effective. 
(6) COLLECTION
OF
DATA.—The Secretary 
shall collect data on the grant program to determine 
its effectiveness in reducing the social impact of 
mental health crises and the feasibility and advis-
ability of extending the grant program. 
(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$10,000,000 for each of fiscal years 2017 through 2021. 
SEC. 515. MENTAL HEALTH IN SCHOOLS. 
(a) TECHNICAL AMENDMENTS.—The second part G 
(relating to services provided through religious organiza-
tions) of title V of the Public Health Service Act (42 
U.S.C. 290kk et seq.) is amended— 
(1) by redesignating such part as part J; and 
(2) by redesignating sections 581 through 584 
as sections 596 through 596C, respectively. 
(b) SCHOOL-BASED MENTAL HEALTH AND CHIL-
DREN AND VIOLENCE.—Section 581 of the Public Health 
Service Act (42 U.S.C. 290hh) is amended to read as fol-
lows: 
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‘‘SEC. 581. SCHOOL-BASED MENTAL HEALTH AND CHIL-
DREN AND VIOLENCE. 
‘‘(a) IN GENERAL.—The Secretary, in collaboration 
with the Secretary of Education and in consultation with 
the Attorney General, shall, directly or through grants, 
contracts, or cooperative agreements awarded to public en-
tities and local education agencies, assist local commu-
nities and schools in applying a public health approach 
to mental health services both in schools and in the com-
munity. Such approach should provide comprehensive age 
appropriate services and supports, be linguistically and 
culturally appropriate, be trauma-informed, and incor-
porate age appropriate strategies of positive behavioral 
interventions and supports. A comprehensive school men-
tal health program funded under this section shall assist 
children in dealing with trauma and violence. 
‘‘(b) ACTIVITIES.—Under the program under sub-
section (a), the Secretary may— 
‘‘(1) provide financial support to enable local 
communities to implement a comprehensive cul-
turally and linguistically appropriate, trauma-in-
formed, and age-appropriate, school mental health 
program that incorporates positive behavioral inter-
ventions, client treatment, and supports to foster the 
health and development of children; 
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‘‘(2) provide technical assistance to local com-
munities with respect to the development of pro-
grams described in paragraph (1); 
‘‘(3) provide assistance to local communities in 
the development of policies to address child and ado-
lescent trauma and mental health issues and violence 
when and if it occurs; 
‘‘(4) facilitate community partnerships among 
families, students, law enforcement agencies, edu-
cation systems, mental health and substance use dis-
order service systems, family-based mental health 
service systems, welfare agencies, health care service 
systems (including physicians), faith-based pro-
grams, trauma networks, and other community- 
based systems; and 
‘‘(5) establish mechanisms for children and ado-
lescents to report incidents of violence or plans by 
other children, adolescents, or adults to commit vio-
lence. 
‘‘(c) REQUIREMENTS.— 
‘‘(1) IN GENERAL.—To be eligible for a grant, 
contract, or cooperative agreement under subsection 
(a), an entity shall— 
‘‘(A) be a partnership between a local edu-
cation agency and at least one community pro-
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gram or agency that is involved in mental 
health; and 
‘‘(B) submit an application, that is en-
dorsed by all members of the partnership, that 
contains the assurances described in paragraph 
(2). 
‘‘(2) REQUIRED ASSURANCES.—An application 
under paragraph (1) shall contain assurances as fol-
lows: 
‘‘(A) That the applicant will ensure that, 
in carrying out activities under this section, the 
local educational agency involved will enter into 
a memorandum of understanding— 
‘‘(i) with, at least one, public or pri-
vate mental health entity, health care enti-
ty, law enforcement or juvenile justice enti-
ty, child welfare agency, family-based men-
tal health entity, family or family organiza-
tion, trauma network, or other community- 
based entity; and 
‘‘(ii) that clearly states— 
‘‘(I) the responsibilities of each 
partner with respect to the activities 
to be carried out; 
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‘‘(II) how each such partner will 
be accountable for carrying out such 
responsibilities; and 
‘‘(III) the amount of non-Federal 
funding or in-kind contributions that 
each such partner will contribute in 
order to sustain the program. 
‘‘(B) That the comprehensive school-based 
mental health program carried out under this 
section supports the flexible use of funds to ad-
dress— 
‘‘(i) the promotion of the social, emo-
tional, and behavioral health of all students 
in an environment that is conducive to 
learning; 
‘‘(ii) the reduction in the likelihood of 
at risk students developing social, emo-
tional, behavioral health problems, or sub-
stance use disorders; 
‘‘(iii) the early identification of social, 
emotional, behavioral problems, or sub-
stance use disorders and the provision of 
early intervention services; 
‘‘(iv) the treatment or referral for 
treatment of students with existing social, 
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emotional, behavioral health problems, or 
substance use disorders; and 
‘‘(v) the development and implementa-
tion of programs to assist children in deal-
ing with trauma and violence. 
‘‘(C) That the comprehensive school-based 
mental health program carried out under this 
section will provide for in-service training of all 
school personnel, including ancillary staff and 
volunteers, in— 
‘‘(i) the techniques and supports need-
ed to identify early children with trauma 
histories and children with, or at risk of, 
mental illness; 
‘‘(ii) the use of referral mechanisms 
that effectively link such children to appro-
priate treatment and intervention services 
in the school and in the community and to 
follow-up when services are not available; 
‘‘(iii) strategies that promote a school- 
wide positive environment; 
‘‘(iv) strategies for promoting the so-
cial, emotional, mental, and behavioral 
health of all students; and 
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‘‘(v) strategies to increase the knowl-
edge and skills of school and community 
leaders about the impact of trauma and vi-
olence and on the application of a public 
health approach to comprehensive school- 
based mental health programs. 
‘‘(D) That the comprehensive school-based 
mental health program carried out under this 
section will include comprehensive training for 
parents, siblings, and other family members of 
children with mental health disorders, and for 
concerned members of the community in— 
‘‘(i) the techniques and supports need-
ed to identify early children with trauma 
histories, and children with, or at risk of, 
mental illness; 
‘‘(ii) the use of referral mechanisms 
that effectively link such children to appro-
priate treatment and intervention services 
in the school and in the community and 
follow-up when such services are not avail-
able; and 
‘‘(iii) strategies that promote a school- 
wide positive environment. 
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‘‘(E) That the comprehensive school-based 
mental health program carried out under this 
section will demonstrate the measures to be 
taken to sustain the program after funding 
under this section terminates. 
‘‘(F) That the local education agency part-
nership involved is supported by the State edu-
cational and mental health system to ensure 
that the sustainability of the programs is estab-
lished after funding under this section termi-
nates. 
‘‘(G) That the comprehensive school-based 
mental health program carried out under this 
section will be based on trauma-informed and 
evidence-based practices. 
‘‘(H) That the comprehensive school-based 
mental health program carried out under this 
section will be coordinated with early inter-
vening activities carried out under the Individ-
uals with Disabilities Education Act. 
‘‘(I) That the comprehensive school-based 
mental health program carried out under this 
section will be trauma-informed and culturally 
and linguistically appropriate. 
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‘‘(J) That the comprehensive school-based 
mental health program carried out under this 
section will include a broad needs assessment of 
youth who drop out of school due to policies of 
‘zero tolerance’ with respect to drugs, alcohol, 
or weapons and an inability to obtain appro-
priate services. 
‘‘(K) That the mental health services pro-
vided through the comprehensive school-based 
mental health program carried out under this 
section will be provided by qualified mental and 
behavioral health professionals who are certified 
or licensed by the State involved and practicing 
within their area of expertise. 
‘‘(3) COORDINATOR.—Any entity that is a 
member of a partnership described in paragraph 
(1)(A) may serve as the coordinator of funding and 
activities under the grant if all members of the part-
nership agree. 
‘‘(4) COMPLIANCE
WITH
HIPAA.—A grantee 
under this section shall be deemed to be a covered 
entity for purposes of compliance with the regula-
tions promulgated under section 264(c) of the 
Health Insurance Portability and Accountability Act 
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of 1996 with respect to any patient records devel-
oped through activities under the grant. 
‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary 
shall ensure that grants, contracts, or cooperative agree-
ments under subsection (a) will be distributed equitably 
among the regions of the country and among urban and 
rural areas. 
‘‘(e) DURATION
OF AWARDS.—With respect to a 
grant, contract, or cooperative agreement under sub-
section (a), the period during which payments under such 
an award will be made to the recipient shall be 5 years. 
An entity may receive only one award under this section, 
except that an entity that is providing services and sup-
ports on a regional basis may receive additional funding 
after the expiration of the preceding grant period. 
‘‘(f) EVALUATION AND MEASURES OF OUTCOMES.— 
‘‘(1) DEVELOPMENT
OF
PROCESS.—The Ad-
ministrator shall develop a fiscally appropriate proc-
ess for evaluating activities carried out under this 
section. Such process shall include— 
‘‘(A) the development of guidelines for the 
submission of program data by grant, contract, 
or cooperative agreement recipients; 
‘‘(B) the development of measures of out-
comes (in accordance with paragraph (2)) to be 
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applied by such recipients in evaluating pro-
grams carried out under this section; and 
‘‘(C) the submission of annual reports by 
such recipients concerning the effectiveness of 
programs carried out under this section. 
‘‘(2) MEASURES OF OUTCOMES.— 
‘‘(A) IN
GENERAL.—The Administrator 
shall develop measures of outcomes to be ap-
plied by recipients of assistance under this sec-
tion, and the Administrator, in evaluating the 
effectiveness of programs carried out under this 
section. Such measures shall include student 
and family measures as provided for in sub-
paragraph (B) and local educational measures 
as provided for under subparagraph (C). 
‘‘(B) STUDENT AND FAMILY MEASURES OF 
OUTCOMES.—The measures of outcomes devel-
oped under paragraph (1)(B) relating to stu-
dents and families shall, with respect to activi-
ties carried out under a program under this 
section, at a minimum include provisions to 
evaluate whether the program is effective in— 
‘‘(i) increasing social and emotional 
competency; 
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‘‘(ii) increasing academic competency 
(as defined by the Secretary); 
‘‘(iii) reducing disruptive and aggres-
sive behaviors; 
‘‘(iv) improving child functioning; 
‘‘(v) reducing substance use disorders; 
‘‘(vi) reducing suspensions, truancy, 
expulsions and violence; 
‘‘(vii) increasing graduation rates (as 
defined in section 1111(b)(2)(C)(vi) of the 
Elementary and Secondary Education Act 
of 1965); and 
‘‘(viii) improving access to care for 
mental health disorders. 
‘‘(C) LOCAL EDUCATIONAL OUTCOMES.— 
The outcome measures developed under para-
graph (1)(B) relating to local educational sys-
tems shall, with respect to activities carried out 
under a program under this section, at a min-
imum include provisions to evaluate— 
‘‘(i) the effectiveness of comprehensive 
school mental health programs established 
under this section; 
‘‘(ii) the effectiveness of formal part-
nership linkages among child and family 
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serving institutions, community support 
systems, and the educational system; 
‘‘(iii) the progress made in sustaining 
the program once funding under the grant 
has expired; 
‘‘(iv) the effectiveness of training and 
professional development programs for all 
school personnel that incorporate indica-
tors that measure cultural and linguistic 
competencies under the program in a man-
ner that incorporates appropriate cultural 
and linguistic training; 
‘‘(v) the improvement in perception of 
a safe and supportive learning environment 
among school staff, students, and parents; 
‘‘(vi) the improvement in case-finding 
of students in need of more intensive serv-
ices and referral of identified students to 
early intervention and clinical services; 
‘‘(vii) the improvement in the imme-
diate availability of clinical assessment and 
treatment services within the context of 
the local community to students posing a 
danger to themselves or others; 
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‘‘(viii) the increased successful matric-
ulation to postsecondary school; and 
‘‘(ix) reduced referrals to juvenile jus-
tice. 
‘‘(3) SUBMISSION OF ANNUAL DATA.—An entity 
that receives a grant, contract, or cooperative agree-
ment under this section shall annually submit to the 
Administrator a report that includes data to evalu-
ate the success of the program carried out by the en-
tity based on whether such program is achieving the 
purposes of the program. Such reports shall utilize 
the measures of outcomes under paragraph (2) in a 
reasonable manner to demonstrate the progress of 
the program in achieving such purposes. 
‘‘(4) EVALUATION BY ADMINISTRATOR.—Based 
on the data submitted under paragraph (3), the Ad-
ministrator shall annually submit to Congress a re-
port concerning the results and effectiveness of the 
programs carried out with assistance received under 
this section. 
‘‘(5) LIMITATION.—A grantee shall use not to 
exceed 10 percent of amounts received under a grant 
under this section to carry out evaluation activities 
under this subsection. 
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‘‘(g) INFORMATION
AND
EDUCATION.—The Sec-
retary shall establish comprehensive information and edu-
cation programs to disseminate the findings of the knowl-
edge development and application under this section to the 
general public and to health care professionals. 
‘‘(h) AMOUNT OF GRANTS AND AUTHORIZATION OF 
APPROPRIATIONS.— 
‘‘(1) AMOUNT OF GRANTS.—A grant under this 
section shall be in an amount that is not more than 
$1,000,000 for each of fiscal years 2017 through 
2021. The Secretary shall determine the amount of 
each such grant based on the population of children 
up to age 21 of the area to be served under the 
grant. 
‘‘(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this section, $20,000,000 for each of fiscal years 
2017 through 2021.’’. 
(c) CONFORMING AMENDMENT.—Part G of title V of 
the Public Health Service Act (42 U.S.C. 290hh et seq.), 
as amended by this section, is further amended by striking 
the part heading and inserting the following: 
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‘‘PART G—SCHOOL-BASED MENTAL HEALTH’’. 
SEC. 516. EXAMINING MENTAL HEALTH CARE FOR CHIL-
DREN. 
(a) IN GENERAL.—Not later than one year after the 
date of enactment of this Act, the Comptroller General 
of the United States shall conduct an independent evalua-
tion, and submit to the Committee on Health, Education, 
Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives, 
a report concerning the utilization of mental health serv-
ices for children, including the usage of psychotropic medi-
cations. 
(b) CONTENT.—The report submitted under sub-
section (a) shall review and assess— 
(1) the ways in which children access mental 
health care, including information on whether chil-
dren are screened and treated by primary care or 
specialty physicians or other health care providers, 
what types of referrals for additional care are rec-
ommended, and any barriers to accessing this care; 
(2) the extent to which children prescribed psy-
chotropic medications in the United States face bar-
riers to more comprehensive or other mental health 
services, interventions, and treatments; 
(3) the extent to which children are prescribed 
psychotropic medications in the United States in-
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cluding the frequency of concurrent medication 
usage; and 
(4) the tools, assessments, and medications that 
are available and used to diagnose and treat children 
with mental health disorders. 
SEC. 517. REPORTING COMPLIANCE STUDY. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall enter into an arrangement with the 
Institute of Medicine of the National Academies (or, if the 
Institute declines, another appropriate entity) under 
which, not later than 2 years after the date of enactment 
of this Act, the Institute will submit to the appropriate 
committees of Congress a report that evaluates the com-
bined paperwork burden of— 
(1) community mental health centers meeting 
the criteria specified in section 1913(c) of the Public 
Health Service Act (42 U.S.C. 300x–2), including 
such centers meeting such criteria as in effect on the 
day before the date of enactment of this Act; and 
(2) federally qualified community mental health 
clinics certified pursuant to section 223 of the Pro-
tecting Access to Medicare Act of 2014 (Public Law 
113–93), as amended by section 505. 
(b) SCOPE.—In preparing the report under sub-
section (a), the Institute of Medicine (or, if applicable, 
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other appropriate entity) shall examine licensing, certifi-
cation, service definitions, claims payment, billing codes, 
and financial auditing requirements used by the Office of 
Management and Budget, the Centers for Medicare & 
Medicaid Services, the Health Resources and Services Ad-
ministration, the Substance Abuse and Mental Health 
Services Administration, the Office of the Inspector Gen-
eral of the Department of Health and Human Services, 
State Medicaid agencies, State departments of health, 
State departments of education, and State and local juve-
nile justice, social service agencies, and private insurers 
to— 
(1) establish an estimate of the combined na-
tionwide cost of complying with such requirements, 
in terms of both administrative funding and staff 
time; 
(2) establish an estimate of the per capita cost 
to each center or clinic described in subparagraph 
(A) or (B) of paragraph (1) to comply with such re-
quirements, in terms of both administrative funding 
and staff time; and 
(3) make administrative and statutory rec-
ommendations to Congress (which recommendations 
may include a uniform methodology) to reduce the 
paperwork burden experienced by centers and clinics 
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described in subparagraph (A) or (B) of paragraph 
(1). 
SEC. 518. STRENGTHENING CONNECTIONS TO COMMUNITY 
CARE DEMONSTRATION GRANT PROGRAM. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Substance Abuse and 
Mental Health Services Administration, shall establish a 
demonstration grant program to award grants to eligible 
entities to help to connect incarcerated and recently re-
leased individuals with mental illness or substance use dis-
orders with community-based treatment providers and 
coverage opportunities upon release from a corrections fa-
cility. 
(b) DESIGN.—The demonstration grant program 
under this section shall be designed to ensure that incar-
cerated and recently released individuals with mental ill-
ness or substance use disorders have the information and 
help they need to connect to community-based care and 
coverage upon release from a corrections facility. 
(c) RECIPIENTS.—To be eligible to receive a grant 
under this section, an entity shall be a State Medicaid 
agency, State mental health agency, State substance abuse 
agency, county, city, nonprofit community-based organiza-
tion, or any other entity the Secretary deems appropriate. 
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(d) APPLICATION REQUIREMENT.—To seek an award 
under this section, an applicant shall provide a plan detail-
ing the applicant’s strategy for carrying out the program 
to be funded through the award. 
(e) SPECIAL CONSIDERATIONS.—In awarding grants 
under this section, the Secretary may consider— 
(1) the number of individuals or correctional fa-
cilities proposed to be served; and 
(2) the potential for replicability of the model 
proposed. 
(f) REPORTS.— 
(1) ANNUAL REPORTS.—As a condition of re-
ceiving a grant under this section, an eligible entity 
shall agree to submit a report to the Secretary, on 
an annual basis, describing the activities carried out 
with the grant and assessing the effectiveness of 
such activities. Such information shall include— 
(A) the number of individuals served with 
mental illness, serious mental illness, substance 
use disorders, or co-occurring mental health 
and substance use disorders; 
(B) the number of connections completed 
between individuals and community-based pro-
viders; 
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(C) the number of connections completed 
between individuals and community-based cov-
erage; and 
(D) any other information required by the 
Secretary. 
(2) SECRETARY.—The Secretary shall, on an 
annual basis, and using the reports received under 
paragraph (1), report to Congress on the overall im-
pact and effectiveness of the grant program under 
this section. 
(3) FINAL REPORT.—Not later than January 
15, 2020, the Secretary shall submit to Congress a 
final report that includes recommendations with re-
spect to the feasibility and advisability of extending 
or expanding the grant program under this section. 
The report shall also provide an assessment of which 
programs and program elements proved most effec-
tive. 
(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated to 
carry out this section $5,000,000 for each of fiscal years 
2017 through 2021. 
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SEC. 519. ASSERTIVE COMMUNITY TREATMENT GRANT 
PROGRAM FOR INDIVIDUALS WITH SERIOUS 
MENTAL ILLNESS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Substance Abuse and 
Mental Health Services Administration, shall award 
grants to eligible entities— 
(1) to establish assertive community treatment 
programs for individuals with serious mental illness; 
or 
(2) to maintain or expand such programs. 
(b) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under this section, an entity shall be a State, county, 
city, tribes, tribal organizations, mental health system, 
health care facility, or any other entity the Secretary 
deems appropriate. 
(c) SPECIAL CONSIDERATION.—In selecting among 
applicants for a grant under this section, the Secretary 
may give special consideration to the potential of the appli-
cant’s program to reduce hospitalization, homelessness, in-
carceration, and interaction with the criminal justice sys-
tem while improving the health and social outcomes of the 
patient. 
(d) ADDITIONAL ACTIVITIES.—The Secretary shall— 
(1) at the conclusion of each fiscal year, submit 
a report to the appropriate congressional committees 
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on the grant program under this section, including 
an evaluation of— 
(A) cost savings and public health out-
comes such as mortality, suicide, substance 
abuse, hospitalization, and use of services; 
(B) rates of incarceration of patients; 
(C) rates of homelessness among patients; 
and 
(D) patient and family satisfaction with 
program participation; and 
(2) provide appropriate information, training, 
and technical assistance to grant recipients under 
this section to help such recipients to establish, 
maintain, or expand their assertive community treat-
ment programs. 
(e) AUTHORIZATION OF APPROPRIATIONS.— 
(1) IN GENERAL.—To carry out this section, 
there is authorized to be appropriated $20,000,000 
for each of fiscal years 2017 through 2021. 
(2) USE OF CERTAIN FUNDS.—Of the funds ap-
propriated to carry out this section in any fiscal 
year, no more than 5 percent shall be available to 
the Secretary for carrying out subsection (d). 
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SEC. 520. IMPROVING MENTAL AND BEHAVIORAL HEALTH 
ON COLLEGE CAMPUSES. 
Title V of the Public Health Service Act (42 U.S.C. 
290aa et seq.) is amended by inserting after section 
520E–3, as added by section 111 of this Act, the fol-
lowing: 
‘‘SEC. 520E–4. GRANTS TO IMPROVE MENTAL AND BEHAV-
IORAL HEALTH ON COLLEGE CAMPUSES. 
‘‘(a) PURPOSE.—It is the purpose of this section, 
with respect to college and university settings, to— 
‘‘(1) increase access to mental and behavioral 
health services; 
‘‘(2) foster and improve the prevention of men-
tal and behavioral health disorders, and the pro-
motion of mental health wellness; 
‘‘(3) improve the identification and treatment 
for students at risk; 
‘‘(4) improve collaboration and the development 
of appropriate levels of mental and behavioral health 
care; 
‘‘(5) reduce the stigma for students with mental 
health disorders and enhance their access to mental 
health services; and 
‘‘(6) improve the efficacy of outreach efforts. 
‘‘(b) GRANTS.—The Secretary, acting through the 
Administrator and in consultation with the Secretary of 
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Education, shall award competitive grants to eligible enti-
ties to improve mental and behavioral health services and 
outreach on college and university campuses. 
‘‘(c) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (b), an entity shall— 
‘‘(1) be an institution of higher education (as 
defined in section 101 of the Higher Education Act 
of 1965 (20 U.S.C. 1001)); and 
‘‘(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require, including 
the information required under subsection (d). 
‘‘(d) APPLICATION.—An application for a grant 
under this section shall include— 
‘‘(1) a description of the population to be tar-
geted by the program carried out under the grant, 
the particular mental and behavioral health needs of 
the students involved; 
‘‘(2) a description of the Federal, State, local, 
private, and institutional resources available for 
meeting the needs of such students at the time the 
application is submitted; 
‘‘(3) an outline of the objectives of the program 
carried out under the grant; 
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‘‘(4) a description of activities, services, and 
training to be provided under the program, including 
planned outreach strategies to reach students not 
currently seeking services; 
‘‘(5) a plan to seek input from community men-
tal health providers, when available, community 
groups, and other public and private entities in car-
rying out the program; 
‘‘(6) a plan, when applicable, to meet the spe-
cific mental and behavioral health needs of veterans 
attending institutions of higher education; 
‘‘(7) a description of the methods to be used to 
evaluate the outcomes and effectiveness of the pro-
gram; and 
‘‘(8) an assurance that grant funds will be used 
to supplement, and not supplant, any other Federal, 
State, or local funds available to carry out activities 
of the type carried out under the grant. 
‘‘(e) 
SPECIAL
CONSIDERATIONS.—In 
awarding 
grants under this section, the Secretary shall give special 
consideration to applications that describe programs to be 
carried out under the grant that— 
‘‘(1) demonstrate the greatest need for new or 
additional mental and behavioral health services, in 
part by providing information on current ratios of 
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students to mental and behavioral health profes-
sionals; 
‘‘(2) propose effective approaches for initiating 
or expanding campus services and supports using 
evidence-based practices; 
‘‘(3) target traditionally underserved popu-
lations and populations most at risk; 
‘‘(4) where possible, demonstrate an awareness 
of, and a willingness to, coordinate with a commu-
nity mental health center or other mental health re-
source in the community, to support screening and 
referral of students requiring intensive services; 
‘‘(5) identify how the college or university will 
address psychiatric emergencies, including how in-
formation will be communicated with families or 
other appropriate parties; 
‘‘(6) propose innovative practices that will im-
prove efficiencies in clinical care, broaden collabora-
tions with primary care, or improve prevention pro-
grams; and 
‘‘(7) demonstrate the greatest potential for rep-
lication and dissemination. 
‘‘(f) USE OF FUNDS.—Amounts received under a 
grant under this section may be used to— 
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‘‘(1) provide mental and behavioral health serv-
ices to students, including prevention, promotion of 
mental health, voluntary screening, early interven-
tion, voluntary assessment, voluntary treatment, 
management, and education services relating to the 
mental and behavioral health of students; 
‘‘(2) conduct research through a counseling or 
health center at the institution of higher education 
involved regarding improving the mental and behav-
ioral health of college and university students 
through clinical services, outreach, prevention, or 
academic success; 
‘‘(3) provide outreach services to notify stu-
dents about the existence of mental and behavioral 
health services; 
‘‘(4) educate students, families, faculty, staff, 
and communities to increase awareness of mental 
health issues; 
‘‘(5) support student groups on campus that 
engage in activities to educate students, including 
activities to reduce stigma surrounding mental and 
behavioral disorders, and promote mental health 
wellness; 
‘‘(6) employ appropriately trained staff; 
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‘‘(7) provide training to students, faculty, and 
staff to respond effectively to students with mental 
and behavioral health issues; 
‘‘(8) expand mental health training through in-
ternship, post-doctorate, and residency programs; 
‘‘(9) develop and support evidence-based and 
emerging best practices, including a focus on cul-
turally and linguistically appropriate best practices; 
and 
‘‘(10) evaluate and disseminate best practices to 
other colleges and universities. 
‘‘(g) DURATION OF GRANTS.—A grant under this 
section shall be awarded for a period not to exceed 3 years. 
‘‘(h) EVALUATION AND REPORTING.— 
‘‘(1) EVALUATION.—Not later than 18 months 
after the date on which a grant is received under 
this section, the eligible entity involved shall submit 
to the Secretary the results of an evaluation to be 
conducted by the entity (or by another party under 
contract with the entity) concerning the effectiveness 
of the activities carried out under the grant and 
plans for the sustainability of such efforts. 
‘‘(2) REPORT.—Not later than 2 years after the 
date of enactment of this section, the Secretary shall 
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submit to the appropriate committees of Congress a 
report concerning the results of— 
‘‘(A) the evaluations conducted under 
paragraph (1); and 
‘‘(B) an evaluation conducted by the Sec-
retary to analyze the effectiveness and efficacy 
of the activities conducted with grants under 
this section. 
‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to grantees in carrying out 
this section. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated $15,000,000 for each 
of fiscal years 2017 through 2021.’’. 
SEC. 521. INCLUSION OF OCCUPATIONAL THERAPISTS IN 
NATIONAL HEALTH SERVICE CORPS PRO-
GRAM. 
(a) INCLUSION OF OCCUPATIONAL THERAPISTS.— 
Section 331(a)(3)(E)(i) of the Public Health Service Act 
(42 U.S.C. 254d(a)(3)(E)(i)) is amended by inserting 
‘‘subject to section 521(b)(2) of the Comprehensive Be-
havioral Health Reform and Recovery Act of 2016, occu-
pational therapists,’’ after ‘‘psychiatric nurse specialists,’’. 
(b) EFFECTIVE DATE; CONTINGENT IMPLEMENTA-
TION.— 
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(1) EFFECTIVE DATE.—Subject to paragraph 
(2), the amendment made by subsection (a) shall 
apply beginning on October 1, 2016. 
(2) 
CONTINGENT
IMPLEMENTATION.—The 
amendment made by subsection (a) shall apply with 
respect to obligations entered into for a fiscal year 
after fiscal year 2016 only if the total amount made 
available for the purpose of carrying out subparts II 
and III of part D of title III of the Public Health 
Service Act (42 U.S.C. 254d et seq.) for such fiscal 
year is greater than the total amount made available 
for such purpose for fiscal year 2016. 
TITLE VI—IMPROVING MENTAL 
HEALTH RESEARCH AND CO-
ORDINATION 
SEC. 601. INCREASE IN FUNDING FOR CERTAIN RESEARCH. 
Section 402A(a) of the Public Health Service Act (42 
U.S.C. 282a(a)) is amended by adding at the end the fol-
lowing: 
‘‘(3) FUNDING FOR THE BRAIN INITIATIVE AT 
THE NATIONAL INSTITUTE OF MENTAL HEALTH.— 
‘‘(A) FUNDING.—In addition to amounts 
made available pursuant to paragraphs (1) and 
(2), there are authorized to be appropriated to 
the National Institute of Mental Health for the 
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purpose described in subparagraph (B)(ii) 
$40,000,000 for each of fiscal years 2017 
through 2021. 
‘‘(B) PURPOSES.—Amounts appropriated 
pursuant to subparagraph (A) shall be used ex-
clusively for the purpose of conducting or sup-
porting— 
‘‘(i) research on the determinants of 
self- and other directed-violence in mental 
illness, including studies directed at the 
causes of such violence and at intervention 
to reduce the risk of self harm, suicide, 
and interpersonal violence; or 
‘‘(ii) brain research through the Brain 
Research through Advancing Innovative 
Neurotechnologies Initiative.’’. 
TITLE 
VII—BEHAVIORAL 
HEALTH INFORMATION TECH-
NOLOGY 
SEC. 701. EXTENSION OF HEALTH INFORMATION TECH-
NOLOGY ASSISTANCE FOR BEHAVIORAL AND 
MENTAL HEALTH AND SUBSTANCE ABUSE. 
Section 3000(3) of the Public Health Service Act (42 
U.S.C. 300jj(3)) is amended by inserting before ‘‘and any 
other category’’ the following: ‘‘behavioral and mental 
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health 
professionals 
(as 
defined 
in 
section 
331(a)(3)(E)(i)), a substance abuse professional, a psy-
chiatric hospital (as defined in section 1861(f) of the So-
cial Security Act), a community mental health center 
meeting the criteria specified in section 1913(c), a residen-
tial or outpatient mental health or substance use treat-
ment facility,’’. 
SEC. 702. EXTENSION OF ELIGIBILITY FOR MEDICARE AND 
MEDICAID 
HEALTH 
INFORMATION 
TECH-
NOLOGY IMPLEMENTATION ASSISTANCE. 
(a) PAYMENT INCENTIVES FOR ELIGIBLE PROFES-
SIONALS UNDER MEDICARE.—Section 1848 of the Social 
Security Act (42 U.S.C. 1395w–4) is amended— 
(1) in subsection (a)(7)— 
(A) in subparagraph (E), by adding at the 
end the following new clause: 
‘‘(iv) ADDITIONAL ELIGIBLE PROFES-
SIONAL.—The term ‘additional eligible pro-
fessional’ means a clinical psychologist pro-
viding qualified psychologist services (as 
defined in section 1861(ii)).’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(F) APPLICATION TO ADDITIONAL ELIGI-
BLE
PROFESSIONALS.—The Secretary shall 
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apply the provisions of this paragraph with re-
spect to an additional eligible professional in 
the same manner as such provisions apply to an 
eligible professional, except in applying sub-
paragraph (A)— 
‘‘(i) in clause (i), the reference to 
2015 shall be deemed a reference to 2020; 
‘‘(ii) in clause (ii), the references to 
2015, 2016, and 2017 shall be deemed ref-
erences to 2020, 2021, and 2022, respec-
tively; and 
‘‘(iii) in clause (iii), the reference to 
2018 shall be deemed a reference to 
2023.’’; and 
(2) in subsection (o)— 
(A) in paragraph (5), by adding at the end 
the following new subparagraph: 
‘‘(D) 
ADDITIONAL
ELIGIBLE
PROFES-
SIONAL.—The term ‘additional eligible profes-
sional’ means a clinical psychologist providing 
qualified psychologist services (as defined in 
section 1861(ii)).’’; and 
(B) by adding at the end the following new 
paragraph: 
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‘‘(6) APPLICATION
TO
ADDITIONAL
ELIGIBLE 
PROFESSIONALS.—The Secretary shall apply the 
provisions of this subsection with respect to an addi-
tional eligible professional in the same manner as 
such provisions apply to an eligible professional, ex-
cept in applying— 
‘‘(A) paragraph (1)(A)(ii), the reference to 
2016 shall be deemed a reference to 2021; 
‘‘(B) paragraph (1)(B)(ii), the references 
to 2011 and 2012 shall be deemed references to 
2016 and 2017, respectively; 
‘‘(C) paragraph (1)(B)(iii), the references 
to 2013 shall be deemed references to 2018; 
‘‘(D) paragraph (1)(B)(v), the references 
to 2014 shall be deemed references to 2019; 
and 
‘‘(E) paragraph (1)(E), the reference to 
2011 shall be deemed a reference to 2016.’’. 
(b) ELIGIBLE HOSPITALS.—Section 1886 of the So-
cial Security Act (42 U.S.C. 1395ww) is amended— 
(1) in subsection (b)(3)(B)(ix), by adding at the 
end the following new subclause: 
‘‘(V) The Secretary shall apply 
the provisions of this subsection with 
respect to an additional eligible hos-
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pital 
(as 
defined 
in 
subsection 
(n)(6)(C)) in the same manner as 
such provisions apply to an eligible 
hospital, except in applying— 
‘‘(aa) subclause (I), the ref-
erences to 2015, 2016, and 2017 
shall be deemed references to 
2020, 2021, and 2022, respec-
tively; and 
‘‘(bb) subclause (III), the 
reference 
to 
2015 
shall 
be 
deemed a reference to 2020.’’; 
and 
(2) in subsection (n)— 
(A) in paragraph (6), by adding at the end 
the following new subparagraph: 
‘‘(C) ADDITIONAL ELIGIBLE HOSPITAL.— 
The term ‘additional eligible hospital’ means an 
inpatient hospital that is a psychiatric hospital 
(as defined in section 1861(f)).’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(7) APPLICATION
TO
ADDITIONAL
ELIGIBLE 
HOSPITALS.—The Secretary shall apply the provi-
sions of this subsection with respect to an additional 
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eligible hospital in the same manner as such provi-
sions apply to an eligible hospital, except in apply-
ing— 
‘‘(A) paragraph (2)(E)(ii), the references 
to 2013 and 2015 shall be deemed references to 
2018 and 2020, respectively; and 
‘‘(B) paragraph (2)(G)(i), the reference to 
2011 shall be deemed a reference to 2016.’’. 
(c) MEDICAID PROVIDERS.—Section 1903(t) of the 
Social Security Act (42 U.S.C. 1396b(t)) is amended— 
(1) in paragraph (2)(B)— 
(A) in clause (i), by striking ‘‘, or’’ at the 
end and inserting a semicolon; 
(B) in clause (ii), by striking the period at 
the end and inserting a semicolon; and 
(C) by inserting after clause (ii) the fol-
lowing new clauses: 
‘‘(iii) a public hospital that is principally a 
psychiatric hospital (as defined in section 
1861(f)); 
‘‘(iv) a private hospital that is principally 
a psychiatric hospital (as defined in section 
1861(f)) and that has at least 10 percent of its 
patient volume (as estimated in accordance with 
a methodology established by the Secretary) at-
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tributable to individuals receiving medical as-
sistance under this title; 
‘‘(v) a community mental health center 
meeting the criteria specified in section 1913(c) 
of the Public Health Service Act; or 
‘‘(vi) a residential or outpatient mental 
health or substance use treatment facility 
that— 
‘‘(I) is accredited by the Joint Com-
mission on Accreditation of Healthcare Or-
ganizations, the Commission on Accredita-
tion of Rehabilitation Facilities, the Coun-
cil on Accreditation, or any other national 
accrediting agency recognized by the Sec-
retary; and 
‘‘(II) has at least 10 percent of its pa-
tient volume (as estimated in accordance 
with a methodology established by the Sec-
retary) attributable to individuals receiving 
medical assistance under this title.’’; and 
(2) in paragraph (3)(B)— 
(A) in clause (iv), by striking ‘‘; and’’ at 
the end and inserting a semicolon; 
(B) in clause (v), by striking the period at 
the end and inserting ‘‘; and’’; and 
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(C) by adding at the end the following new 
clause: 
‘‘(vi) clinical psychologist providing quali-
fied psychologist services (as defined in section 
1861(ii)), if such clinical psychologist is prac-
ticing in an outpatient clinic that— 
‘‘(I) is led by a clinical psychologist; 
and 
‘‘(II) is not otherwise receiving pay-
ment under paragraph (1) as a Medicaid 
provider described in paragraph (2)(B).’’. 
(d) MEDICARE ADVANTAGE ORGANIZATIONS.—Sec-
tion 1853 of the Social Security Act (42 U.S.C. 1395w– 
23) is amended— 
(1) in subsection (l)— 
(A) in paragraph (1)— 
(i) by inserting ‘‘or additional eligible 
professionals (as described in paragraph 
(9))’’ after ‘‘paragraph (2)’’; and 
(ii) by inserting ‘‘and additional eligi-
ble professionals’’ before ‘‘under such sec-
tions’’; 
(B) in paragraph (3)(B)— 
(i) in clause (i) in the matter pre-
ceding subclause (I), by inserting ‘‘or an 
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additional eligible professional described in 
paragraph (9)’’ after ‘‘paragraph (2)’’; and 
(ii) in clause (ii)— 
(I) in the matter preceding sub-
clause (I), by inserting ‘‘or an addi-
tional eligible professional described in 
paragraph 
(9)’’ 
after 
‘‘paragraph 
(2)’’; and 
(II) in subclause (I), by inserting 
‘‘or an additional eligible professional, 
respectively,’’ after ‘‘eligible profes-
sional’’; 
(C) in paragraph (3)(C), by inserting ‘‘and 
additional eligible professionals’’ after ‘‘all eligi-
ble professionals’’; 
(D) in paragraph (4)(D), by adding at the 
end the following new sentence: ‘‘In the case 
that a qualifying MA organization attests that 
not all additional eligible professionals of the 
organization are meaningful EHR users with 
respect to an applicable year, the Secretary 
shall apply the payment adjustment under this 
paragraph based on the proportion of all such 
additional eligible professionals of the organiza-
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194 
tion that are not meaningful EHR users for 
such year.’’; 
(E) in paragraph (6)(A), by inserting 
‘‘and, as applicable, each additional eligible pro-
fessional described in paragraph (9)’’ after 
‘‘paragraph (2)’’; 
(F) in paragraph (6)(B), by inserting 
‘‘and, as applicable, each additional eligible hos-
pital described in paragraph (9)’’ after ‘‘sub-
section (m)(1)’’; 
(G) in paragraph (7)(A), by inserting 
‘‘and, as applicable, additional eligible profes-
sionals’’ after ‘‘eligible professionals’’; 
(H) in paragraph (7)(B), by inserting 
‘‘and, as applicable, additional eligible profes-
sionals’’ after ‘‘eligible professionals’’; 
(I) in paragraph (8)(B), by inserting ‘‘and 
additional eligible professionals described in 
paragraph (9)’’ after ‘‘paragraph (2)’’; and 
(J) by adding at the end the following new 
paragraph: 
‘‘(9) ADDITIONAL ELIGIBLE PROFESSIONAL DE-
SCRIBED.—With respect to a qualifying MA organi-
zation, an additional eligible professional described 
in this paragraph is an additional eligible profes-
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sional (as defined for purposes of section 1848(o)) 
who— 
‘‘(A)(i) is employed by the organization; or 
‘‘(ii)(I) is employed by, or is a partner of, 
an entity that through contract with the organi-
zation furnishes at least 80 percent of the enti-
ty’s Medicare patient care services to enrollees 
of such organization; and 
‘‘(II) furnishes at least 80 percent of the 
professional services of the additional eligible 
professional covered under this title to enrollees 
of the organization; and 
‘‘(B) furnishes, on average, at least 20 
hours per week of patient care services.’’; and 
(2) in subsection (m)— 
(A) in paragraph (1)— 
(i) by inserting ‘‘or additional eligible 
hospitals (as described in paragraph (7))’’ 
after ‘‘paragraph (2)’’; and 
(ii) by inserting ‘‘and additional eligi-
ble hospitals’’ before ‘‘under such sec-
tions’’; 
(B) in paragraph (3)(A)(i), by inserting 
‘‘or additional eligible hospital’’ after ‘‘eligible 
hospital’’; 
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(C) in paragraph (3)(A)(ii), by inserting 
‘‘or an additional eligible hospital’’ after ‘‘eligi-
ble hospital’’ in each place it occurs; 
(D) in paragraph (3)(B)— 
(i) in clause (i), by inserting ‘‘or an 
additional eligible hospital described in 
paragraph (7)’’ after ‘‘paragraph (2)’’; and 
(ii) in clause (ii)— 
(I) in the matter preceding sub-
clause (I), by inserting ‘‘or an addi-
tional eligible hospital described in 
paragraph 
(7)’’ 
after 
‘‘paragraph 
(2)’’; and 
(II) in subclause (I), by inserting 
‘‘or an additional eligible hospital, re-
spectively,’’ after ‘‘eligible hospital’’; 
(E) in paragraph (4)(A), by inserting ‘‘or 
one or more additional eligible hospitals (as de-
fined in section 1886(n)), as appropriate,’’ after 
‘‘section 1886(n)(6)(A))’’; 
(F) in paragraph (4)(D), by adding at the 
end the following new sentence: ‘‘In the case 
that a qualifying MA organization attests that 
not all additional eligible hospitals of the orga-
nization are meaningful EHR users with re-
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and serves individuals enrolled under an MA plan of-
fered by such organization.’’. 
TITLE VIII—MAKING PARITY 
WORK 
SEC. 801. STRENGTHENING PARITY IN MENTAL HEALTH 
AND SUBSTANCE USE DISORDER BENEFITS. 
(a) 
PUBLIC
HEALTH
SERVICE
ACT.—Section 
2726(a) of the Public Health Service Act (42 U.S.C. 
300gg–26(a)) is amended by adding at the end the fol-
lowing new paragraphs: 
‘‘(6) DISCLOSURE
AND
ENFORCEMENT
RE-
QUIREMENTS.— 
‘‘(A) DISCLOSURE REQUIREMENTS.— 
‘‘(i) REGULATIONS.—Not later than 
December 31, 2016, the Secretary, in co-
operation with the Secretaries of Labor 
and the Treasury, as appropriate, shall 
issue additional regulations for carrying 
out this section, including an explanation 
of documents that must be disclosed by 
plans and issuers, the process governing 
such disclosures by plans and issuers, and 
analyses that must be conducted by plans 
and issuers by a group health plan or 
health insurance issuer offering health in-
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surance coverage in the group or individual 
market in order for such plan or issuer to 
demonstrate compliance with the provisions 
of this section. 
‘‘(ii) DISCLOSURE REQUIREMENTS.— 
Documents required to be disclosed by a 
group health plan or health insurance 
issuer offering health insurance coverage in 
the group or individual market under 
clause (i) shall include an annual report 
that details the specific analyses performed 
to ensure compliance of such plan or cov-
erage with the law and regulations. At a 
minimum, with respect to the application 
of non-quantitative treatment limitations 
(in this paragraph referred to as NQTLs) 
to benefits under the plan or coverage, 
such report shall— 
‘‘(I) identify the specific factors 
the plan or coverage used in per-
forming its NQTL analysis; 
‘‘(II) identify and define the spe-
cific evidentiary standards relied on to 
evaluate the factors; 
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‘‘(III) describe how the evi-
dentiary standards are applied to each 
service category for mental health, 
substance use disorders, medical bene-
fits, and surgical benefits; 
‘‘(IV) disclose the results of the 
analyses of the specific evidentiary 
standards in each service category; 
and 
‘‘(V) disclose the specific findings 
of the plan or coverage in each service 
category and the conclusions reached 
with respect to whether the processes, 
strategies, evidentiary standards, or 
other factors used in applying the 
NQTL to mental health or substance 
use disorder benefits are comparable 
to, and applied no more stringently 
than, the processes, strategies, evi-
dentiary standards, or other factors 
used in applying the limitation with 
respect to medical and surgical bene-
fits in the same classification. 
‘‘(iii) GUIDANCE.—The Secretary, in 
cooperation with the Secretaries of Labor 
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and the Treasury, as appropriate, shall 
issue guidance to group health plans and 
health insurance issuers offering health in-
surance coverage in the group or individual 
markets on how to satisfy the requirements 
of this section with respect to making in-
formation available to current and poten-
tial participants and beneficiaries. Such in-
formation shall include certificate of cov-
erage documents and instruments under 
which the plan or coverage involved is ad-
ministered and operated that specify, in-
clude, or refer to procedures, formulas, and 
methodologies applied to determine a par-
ticipant or beneficiary’s benefit under the 
plan or coverage, regardless of whether 
such information is contained in a docu-
ment designated as the ‘plan document’. 
Such guidance shall include a disclosure of 
how the plan or coverage involved has pro-
vided that processes, strategies, evidentiary 
standards, and other factors used in apply-
ing the NQTL to mental health or sub-
stance use disorder benefits are com-
parable to, and applied no more stringently 
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than, the processes, strategies, evidentiary 
standards, or other factors used in apply-
ing the limitation with respect to medical 
and surgical benefits in the same classi-
fication. 
‘‘(iv) DEFINITIONS.—In this para-
graph and paragraph (7), the terms ‘non- 
quantitative treatment limitations’, ‘com-
parable to’, and ‘applied no more strin-
gently than’ have the meanings given such 
terms in sections 146 and 147 of title 45, 
Code of Federal Regulations (or any suc-
cessor regulation). 
‘‘(B) ENFORCEMENT.— 
‘‘(i) PROCESS FOR COMPLAINTS.—The 
Secretary, in cooperation with the Secre-
taries of Labor and the Treasury, as ap-
propriate, shall, with respect to group 
health plans and health insurance issuers 
offering health insurance coverage in the 
group or individual market, issue guidance 
to clarify the process and timeline for cur-
rent and potential participants and bene-
ficiaries (and authorized representatives 
and health care providers of such partici-
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203 
pants and beneficiaries) with respect to 
such plans and coverage to file formal 
complaints of such plans or issuers being 
in violation of this section, including guid-
ance, by plan type, on the relevant State, 
regional, and national offices with which 
such complaints should be filed. 
‘‘(ii) AUTHORITY
FOR
PUBLIC
EN-
FORCEMENT.—The Secretary, in consulta-
tion with the Secretaries of Labor and the 
Treasury, shall make available to the pub-
lic on the Consumer Parity Portal website 
established under paragraph (7) de-identi-
fied information on audits and investiga-
tions of group health plans and health in-
surance issuers conducted under this sec-
tion. 
‘‘(iii) AUDITS.— 
‘‘(I) RANDOMIZED AUDITS.—The 
Secretary in cooperation with the Sec-
retaries of Labor and the Treasury, is 
authorized to conduct randomized au-
dits of group health plans and health 
insurance issuers offering health in-
surance coverage in the group or indi-
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204 
vidual market to determine compli-
ance with this section. Such audits 
shall be conducted on no fewer than 
twelve plans and issuers per plan 
year. Information from such audits 
shall be made plainly available on the 
Consumer Parity Portal website es-
tablished under paragraph (7). 
‘‘(II) ADDITIONAL
AUDITS.—In 
the case of a group health plan or 
health insurance issuer offering health 
insurance coverage in the group or in-
dividual market with respect to which 
any claim has been filed during a plan 
year, the Secretary may audit the 
books and records of such plan or 
issuer to determine compliance with 
this section. Information detailing the 
results of the audit shall be made 
available on the Consumer Parity Por-
tal website established under para-
graph (7). 
‘‘(iv) DENIAL RATES.—The Secretary 
shall collect information on the rates of 
and reasons for denial by group health 
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plans and health insurance issuers offering 
health insurance coverage in the group or 
individual market of claims for outpatient 
and inpatient mental health and substance 
use disorder services compared to the rates 
of and reasons for denial of claims for 
medical and surgical services. For the first 
plan year beginning at least two years 
after the date of the enactment of this 
paragraph and each subsequent plan year, 
the Secretary shall submit to the Com-
mittee on Energy and Commerce of the 
House of Representatives and the Com-
mittee on Health, Education, Labor, and 
Pensions of the Senate, and make plainly 
available on the Consumer Parity Portal 
website under paragraph (7), the informa-
tion collected under the previous sentence 
with respect to the previous plan year. 
‘‘(7) CONSUMER
PARITY
PORTAL
WEBSITE.— 
The Secretary, in consultation with the Secretaries 
of Labor and the Treasury, shall establish a one- 
stop Internet website portal for— 
‘‘(A) submitting complaints and violations 
relating to this section, section 712 of the Em-
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206 
ployee Retirement Income Security Act of 1974, 
and section 9812 of the Internal Revenue Code 
of 1986; and 
‘‘(B) for each of such Secretaries to submit 
information in order to provide such informa-
tion to health care consumers pursuant to para-
graph (6), section 712(a)(6) of the Employee 
Retirement Income Security Act of 1974, and 
section 9812(a)(6) of the Internal Revenue 
Code of 1986. 
Such portal shall have the ability to take basic infor-
mation related to the complaint, including name, 
contact information, and brief narrative, and trans-
mit such information in a timely fashion to the ap-
propriate State or Federal enforcement agency. Once 
the consumer information is submitted, such portal 
shall provide the consumer with contact information 
for the appropriate enforcement agency to follow-up 
on the complaint.’’. 
(b) EMPLOYEE RETIREMENT INCOME SECURITY ACT 
OF 1974.—Section 712(a) of the Employee Retirement In-
come Security Act of 1974 (29 U.S.C. 1185a(a)) is 
amended by adding at the end the following new para-
graph: 
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‘‘(6) DISCLOSURE
AND
ENFORCEMENT
RE-
QUIREMENTS.— 
‘‘(A) DISCLOSURE REQUIREMENTS.— 
‘‘(i) REGULATIONS.—Not later than 
December 31, 2016, the Secretary, in co-
operation with the Secretaries of Health 
and Human Services and the Treasury, as 
appropriate, shall issue additional regula-
tions for carrying out this section, includ-
ing an explanation of documents that must 
be disclosed by plans and issuers, the proc-
ess governing such disclosures by plans 
and issuers, and analyses that must be 
conducted by plans and issuers by a group 
health plan (or health insurance coverage 
offered in connection with such a plan) in 
order for such plan or issuer to dem-
onstrate compliance with the provisions of 
this section. 
‘‘(ii) DISCLOSURE REQUIREMENTS.— 
Documents required to be disclosed by a 
group health plan (or health insurance cov-
erage offered in connection with such a 
plan) under clause (i) shall include an an-
nual report that details the specific anal-
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208 
yses performed to ensure compliance of 
such plan or coverage with the law or regu-
lations. At a minimum, with respect to the 
application of non-quantitative treatment 
limitations (in this paragraph referred to 
as NQTLs) to benefits under the plan or 
coverage, such report shall— 
‘‘(I) identify the specific factors 
the plan or coverage used in per-
forming its NQTL analysis; 
‘‘(II) identify and define the spe-
cific evidentiary standards relied on to 
evaluate the factors; 
‘‘(III) describe how the evi-
dentiary standards are applied to each 
service category for mental health, 
substance use disorders, medical bene-
fits, and surgical benefits; 
‘‘(IV) disclose the results of the 
analyses of the specific evidentiary 
standards in each service category; 
and 
‘‘(V) disclose the specific findings 
of the plan or coverage in each service 
category and the conclusions reached 
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209 
with respect to whether the processes, 
strategies, evidentiary standards, or 
other factors used in applying the 
NQTL to mental health or substance 
use disorder benefits are comparable 
to, and applied no more stringently 
than, the processes, strategies, evi-
dentiary standards, or other factors 
used in applying the limitation with 
respect to medical and surgical bene-
fits in the same classification. 
‘‘(iii) GUIDANCE.—The Secretary, in 
cooperation with the Secretaries of Health 
and Human Services and the Treasury, as 
appropriate, shall issue guidance to group 
health plans (and health insurance cov-
erage offered in connection with such a 
plan) on how to satisfy the requirements of 
this section with respect to making infor-
mation available to current and potential 
participants and beneficiaries. Such infor-
mation shall include certificate of coverage 
documents and instruments under which 
the plan or coverage involved is adminis-
tered and operated that specify, include, or 
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210 
refer to procedures, formulas, and meth-
odologies applied to determine a partici-
pant or beneficiary’s benefit under the plan 
or coverage, regardless of whether such in-
formation is contained in a document des-
ignated as the ‘plan document’. Such guid-
ance shall include a disclosure of how the 
plan or coverage involved has provided that 
processes, strategies, evidentiary stand-
ards, and other factors used in applying 
the NQTL to mental health or substance 
use disorder benefits are comparable to, 
and applied no more stringently than, the 
processes, strategies, evidentiary stand-
ards, or other factors used in applying the 
limitation with respect to medical and sur-
gical benefits in the same classification. 
‘‘(iv) DEFINITIONS.—In this para-
graph, the terms ‘non-quantitative treat-
ment limitations’, ‘comparable to’, and ‘ap-
plied no more stringently than’ have the 
meanings given such terms in sections 146 
and 147 of title 45, Code of Federal Regu-
lations (or any successor regulation). 
‘‘(B) ENFORCEMENT.— 
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211 
‘‘(i) PROCESS FOR COMPLAINTS.—The 
Secretary, in cooperation with the Secre-
taries of Health and Human Services and 
the Treasury, as appropriate, shall, with 
respect to group health plans (and health 
insurance coverage offered in connection 
with such a plan), issue guidance to clarify 
the process and timeline for current and 
potential participants and beneficiaries 
(and authorized representatives and health 
care providers of such participants and 
beneficiaries) with respect to such plans 
(and coverage) to file formal complaints of 
such plans (or coverage) being in violation 
of this section, including guidance, by plan 
type, on the relevant State, regional, and 
national offices with which such complaints 
should be filed. 
‘‘(ii) AUTHORITY
FOR
PUBLIC
EN-
FORCEMENT.—The Secretary, in consulta-
tion with the Secretaries of Labor and the 
Treasury, shall make available to the pub-
lic on the Consumer Parity Portal website 
established under section 2726(a)(7) of the 
Public Health Service Act de-identified in-
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212 
formation on audits and investigations of 
group health plans (and health insurance 
coverage offered in connection with such a 
plan) conducted under this section. 
‘‘(iii) AUDITS.— 
‘‘(I) RANDOMIZED AUDITS.—The 
Secretary in cooperation with the Sec-
retaries of Health and Human Serv-
ices and the Treasury, is authorized 
to conduct randomized audits of 
group health plans (and health insur-
ance coverage offered in connection 
with such a plan) to determine com-
pliance with this section. Such audits 
shall be conducted on no fewer than 
twelve plans and coverage per plan 
year. Information from such audits 
shall be made plainly available on the 
Consumer Parity Portal website es-
tablished under section 2726(a)(7) of 
the Public Health Service Act. 
‘‘(II) ADDITIONAL
AUDITS.—In 
the case of a group health plan (or 
health insurance coverage offered in 
connection with such a plan) with re-
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213 
spect to which any claim has been 
filed during a plan year, the Secretary 
may audit the books and records of 
such plan (or coverage) to determine 
compliance with this section. Informa-
tion detailing the results of the audit 
shall be made available on the Con-
sumer Parity Portal website estab-
lished under section 2726(a)(7) of the 
Public Health Service Act. 
‘‘(iv) DENIAL RATES.—The Secretary 
shall collect information on the rates of 
and reasons for denial by group health 
plans (and health insurance coverage of-
fered in connection with such a plan) of 
claims for outpatient and inpatient mental 
health and substance use disorder services 
compared to the rates of and reasons for 
denial of claims for medical and surgical 
services. For the first plan year beginning 
at least two years after the date of the en-
actment of this paragraph and each subse-
quent plan year, the Secretary shall submit 
to the Committee on Energy and Com-
merce of the House of Representatives and 
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214 
the Committee on Health, Education, 
Labor, and Pensions of the Senate, and 
make plainly available on the Consumer 
Parity 
Portal 
website 
under 
section 
2726(a)(7) of the Public Health Service 
Act, the information collected under the 
previous sentence with respect to the pre-
vious plan year.’’. 
(c) INTERNAL REVENUE CODE OF 1986.—Section 
9812(a) of the Internal Revenue Code of 1986 is amended 
by adding at the end the following new paragraph: 
‘‘(6) DISCLOSURE
AND
ENFORCEMENT
RE-
QUIREMENTS.— 
‘‘(A) DISCLOSURE REQUIREMENTS.— 
‘‘(i) REGULATIONS.—Not later than 
December 31, 2016, the Secretary, in co-
operation with the Secretaries of Health 
and Human Services and Labor, as appro-
priate, shall issue additional regulations for 
carrying out this section, including an ex-
planation of documents that must be dis-
closed by plans and issuers, the process 
governing such disclosures by plans and 
issuers, and analyses that must be con-
ducted by plans and issuers by a group 
VerDate Sep 11 2014 
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215 
health plan in order for such plan to dem-
onstrate compliance with the provisions of 
this section. 
‘‘(ii) DISCLOSURE REQUIREMENTS.— 
Documents required to be disclosed by a 
group health plan under clause (i) shall in-
clude an annual report that details the spe-
cific analyses performed to ensure compli-
ance of such plan with the law and regula-
tions. At a minimum, with respect to the 
application of non-quantitative treatment 
limitations (in this paragraph referred to 
as NQTLs) to benefits under the plan or 
coverage, such report shall— 
‘‘(I) identify the specific factors 
the plan or coverage used in per-
forming its NQTL analysis; 
‘‘(II) identify and define the spe-
cific evidentiary standards relied on to 
evaluate the factors; 
‘‘(III) describe how the evi-
dentiary standards are applied to each 
service category for mental health, 
substance use disorders, medical bene-
fits, and surgical benefits; 
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216 
‘‘(IV) disclose the results of the 
analyses of the specific evidentiary 
standards in each service category; 
and 
‘‘(V) disclose the specific findings 
of the plan in each service category 
and the conclusions reached with re-
spect to whether the processes, strate-
gies, evidentiary standards, or other 
factors used in applying the NQTL to 
mental health or substance use dis-
order benefits are comparable to, and 
applied no more stringently than, the 
processes, 
strategies, 
evidentiary 
standards, or other factors used in ap-
plying the limitation with respect to 
medical and surgical benefits in the 
same classification. 
‘‘(iii) GUIDANCE.—The Secretary, in 
cooperation with the Secretaries of Health 
and Human Services and Labor, as appro-
priate, shall issue guidance to group health 
plans on how to satisfy the requirements of 
this section with respect to making infor-
mation available to current and potential 
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217 
participants and beneficiaries. Such infor-
mation shall include certificate of coverage 
documents and instruments under which 
the plan involved is administered and oper-
ated that specify, include, or refer to pro-
cedures, formulas, and methodologies ap-
plied to determine a participant or bene-
ficiary’s benefit under the plan, regardless 
of whether such information is contained 
in a document designated as the ‘plan doc-
ument’. Such guidance shall include a dis-
closure of how the plan involved has pro-
vided that processes, strategies, evidentiary 
standards, and other factors used in apply-
ing the NQTL to mental health or sub-
stance use disorder benefits are com-
parable to, and applied no more stringently 
than, the processes, strategies, evidentiary 
standards, or other factors used in apply-
ing the limitation with respect to medical 
and surgical benefits in the same classi-
fication. 
‘‘(iv) DEFINITIONS.—In this para-
graph, the terms ‘non-quantitative treat-
ment limitations’, ‘comparable to’, and ‘ap-
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plied no more stringently than’ have the 
meanings given such terms in sections 146 
and 147 of title 45, Code of Federal Regu-
lations (or any successor regulation). 
‘‘(B) ENFORCEMENT.— 
‘‘(i) PROCESS FOR COMPLAINTS.—The 
Secretary, in cooperation with the Secre-
taries of Health and Human Services and 
Labor, as appropriate, shall, with respect 
to group health plans, issue guidance to 
clarify the process and timeline for current 
and potential participants and beneficiaries 
(and authorized representatives and health 
care providers of such participants and 
beneficiaries) with respect to such plans 
(and coverage) to file formal complaints of 
such plans being in violation of this sec-
tion, including guidance, by plan type, on 
the relevant State, regional, and national 
offices with which such complaints should 
be filed. 
‘‘(ii) AUTHORITY
FOR
PUBLIC
EN-
FORCEMENT.—The Secretary, in consulta-
tion with the Secretaries of Labor and the 
Treasury, shall make available to the pub-
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lic on the Consumer Parity Portal website 
established under section 2726(a)(7) of the 
Public Health Service Act de-identified in-
formation on audits and investigations of 
group health plans conducted under this 
section. 
‘‘(iii) AUDITS.— 
‘‘(I) RANDOMIZED AUDITS.—The 
Secretary in cooperation with the Sec-
retaries of Health and Human Serv-
ices and Labor, is authorized to con-
duct randomized audits of group 
health plans to determine compliance 
with this section. Such audits shall be 
conducted on no fewer than twelve 
plans per plan year. Information from 
such audits shall be made plainly 
available on the Consumer Parity Por-
tal website established under section 
2726(a)(7) of the Public Health Serv-
ice Act. 
‘‘(II) ADDITIONAL
AUDITS.—In 
the case of a group health plan with 
respect to which any claim has been 
filed during a plan year, the Secretary 
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may audit the books and records of 
such plan to determine compliance 
with this section. Information detail-
ing the results of the audit shall be 
made available on the Consumer Par-
ity Portal website established under 
section 2726(a)(7) of the Public 
Health Service Act. 
‘‘(iv) DENIAL RATES.—The Secretary 
shall collect information on the rates of 
and reasons for denial by group health 
plans of claims for outpatient and inpa-
tient mental health and substance use dis-
order services compared to the rates of and 
reasons for denial of claims for medical 
and surgical services. For the first plan 
year beginning at least two years after the 
date of the enactment of this paragraph 
and each subsequent plan year, the Sec-
retary shall submit to the Committee on 
Energy and Commerce of the House of 
Representatives and the Committee on 
Health, Education, Labor, and Pensions of 
the Senate, and make plainly available on 
the Consumer Parity Portal website under 
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section 2726(a)(7) of the Public Health 
Service Act, the information collected 
under the previous sentence with respect to 
the previous plan year.’’. 
(d) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated $2,000,000 for each of fis-
cal years 2017 through 2021 to carry out this section, in-
cluding the amendments made by this section. 
SEC. 802. REPORT ON INVESTIGATIONS REGARDING PAR-
ITY IN MENTAL HEALTH AND SUBSTANCE 
USE DISORDER BENEFITS. 
(a) IN GENERAL.—Not later than one year after the 
date of the enactment of this Act, and annually thereafter, 
the Administrator of the Centers for Medicare & Medicaid 
Services, in collaboration with the Assistant Secretary of 
Labor of the Employee Benefits Security Administration 
and the Secretary of the Treasury shall submit to the Con-
gress a report— 
(1) identifying Federal investigations conducted 
or completed during the preceding 12-month period 
regarding compliance with parity in mental health, 
substance use disorder benefits, including benefits 
provided to persons with mental illness, including se-
rious mental illness, and substance use disorders 
under the Paul Wellstone and Pete Domenici Mental 
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Health Parity and Addiction Equity Act of 2008 
(subtitle B of title V of division C of Public Law 
110–343); and 
(2) summarizing the results of such investiga-
tions. 
(b) CONTENTS.—Subject to paragraph (3), each re-
port under paragraph (1) shall include the following infor-
mation: 
(1) The number of investigations opened and 
closed during the covered reporting period. 
(2) The benefit classification or classifications 
examined by each investigation. 
(3) The subject matter or subject matters of 
each investigation, including quantitative and non-
quantitative treatment limitations. 
(4) A summary of the basis of the final decision 
rendered for each investigation. 
(c) LIMITATION.—Individually identifiable informa-
tion shall be excluded from reports under paragraph (1) 
consistent with Federal privacy protections. 
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SEC. 803. GAO STUDY ON PREVENTING DISCRIMINATORY 
COVERAGE LIMITATIONS FOR INDIVIDUALS 
WITH SERIOUS MENTAL ILLNESS AND SUB-
STANCE USE DISORDERS. 
Not later than one year after the date of the enact-
ment of this Act, the Comptroller General of the United 
States shall submit to Congress a report describing the 
evidence regarding the extent to which private health in-
surance plans have nonquantitative treatment limits for 
mental health, substance use disorder, and other health 
services. The report shall also assess the Departments of 
Health and Human Services, Labor, and the Treasury’s 
oversight of private health insurance plans and Medicaid 
managed care plans under section 1903 of the Social Se-
curity Act (42 U.S.C. 1396b), compliance with the Paul 
Wellstone and Pete Domenici Mental Health Parity and 
Addiction Equity Act of 2008 (subtitle B of title V of divi-
sion C of Public Law 110–343) (as amended by Public 
Law 111–148) (in this section referred to as the ‘‘law’’), 
including— 
(1) how the responsible Federal departments 
and agencies ensure that plans comply with the law, 
including how the plans apply nonquantitative treat-
ment limitations and medical necessity criteria to be-
havioral health services compared to medical or sur-
gical services; and 
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(2) how proper enforcement, education, and co-
ordination activities within responsible Federal de-
partments and agencies can be used to ensure full 
compliance with the law, including educational ac-
tivities directed to State insurance commissioners. 
SEC. 804. REPORT TO CONGRESS ON FEDERAL ASSISTANCE 
TO 
STATE 
INSURANCE 
REGULATORS 
RE-
GARDING 
MENTAL 
HEALTH 
PARITY 
EN-
FORCEMENT. 
Not later than one year after the date of enactment 
of this Act, the Secretary of Health and Human Services 
shall submit to Congress a report detailing— 
(1) the ways in which State governments and 
State insurance regulators are either empowered or 
required to enforce the Paul Wellstone and Pete 
Domenici Mental Health Parity and Addiction Eq-
uity Act of 2008 (subtitle B of title V of division C 
of Public Law 110–343); 
(2) their capability to carry out these enforce-
ment powers or requirements; and 
(3) any technical assistance to State govern-
ment and State insurance regulators that has been 
communicated by the Department of Health and 
Human Services. 
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TITLE IX—SUBSTANCE ABUSE 
Subtitle A—Prevention 
SEC. 901. PRACTITIONER EDUCATION. 
(a) EDUCATION REQUIREMENTS.— 
(1) REGISTRATION
CONSIDERATION.—Section 
303(f) of the Controlled Substances Act (21 U.S.C. 
823(f)) is amended by inserting after paragraph (5) 
the following: 
‘‘(6) The applicant’s compliance with the train-
ing requirements described in subsection (g)(3) dur-
ing any previous period in which the applicant has 
been subject to such training requirements.’’. 
(2) TRAINING REQUIREMENTS.—Section 303(g) 
of the Controlled Substances Act (21 U.S.C. 823(g)) 
is amended by adding at the end the following: 
‘‘(3)(A) To be registered to prescribe or otherwise 
dispense opioids for the treatment of pain, or pain man-
agement, a practitioner described in paragraph (1) shall 
comply with the 12-hour training requirement of subpara-
graph (B) at least once during each 3-year period. 
‘‘(B) The training requirement of this subparagraph 
is that the practitioner has completed not less than 12 
hours of training (through classroom situations, seminars 
at professional society meetings, electronic communica-
tions, or otherwise) with respect to— 
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‘‘(i) the treatment and management of opioid- 
dependent patients; 
‘‘(ii) pain management treatment guidelines; 
and 
‘‘(iii) early detection of opioid addiction, includ-
ing through such methods as Screening, Brief Inter-
vention, and Referral to Treatment (SBIRT), 
that is provided by the American Society of Addiction 
Medicine, the American Academy of Addiction Psychiatry, 
the American Medical Association, the American Osteo-
pathic Association, the American Psychiatric Association, 
the American Academy of Pain Management, the Amer-
ican Pain Society, the American Academy of Pain Medi-
cine, the American Board of Pain Medicine, the American 
Society of Interventional Pain Physicians, or any other or-
ganization that the Secretary determines is appropriate 
for purposes of this subparagraph.’’. 
(b) FUNDING.—The Drug Enforcement Administra-
tion shall fund the enforcement of the requirements speci-
fied in section 303(g)(3) of the Controlled Substances Act 
(as added by subsection (a)) through the use of a portion 
of the licensing fees paid by controlled substance pre-
scribers under the Controlled Substances Act (21 U.S.C. 
801 et seq.). 
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(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$1,000,000 for each of fiscal years 2017 through 2021. 
SEC. 902. CO-PRESCRIBING OPIOID OVERDOSE REVERSAL 
DRUGS GRANT PROGRAM. 
(a) ESTABLISHMENT.— 
(1) IN GENERAL.—Not later than six months 
after the date of the enactment of this Act, the Sec-
retary of Health and Human Services shall estab-
lish, in accordance with this section, a four-year co- 
prescribing opioid overdose reversal drugs grant pro-
gram (in this title referred to as the ‘‘grant pro-
gram’’) under which the Secretary shall provide not 
more than a total of 12 grants to eligible entities to 
carry out the activities described in subsection (c). 
(2) ELIGIBLE ENTITY.—For purposes of this 
section, the term ‘‘eligible entity’’ means a federally 
qualified health center (as defined in section 
1861(aa) of the Social Security Act (42 U.S.C. 
1395x(aa))), an opioid treatment program under 
part 8 of title 42, Code of Federal Regulations, or 
section 303(g) of the Controlled Substances Act (21 
U.S.C. 823(g)), a program approved by a State sub-
stance abuse agency, or any other entity that the 
Secretary deems appropriate. 
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(3) CO-PRESCRIBING.—For purposes of this 
title, the term ‘‘co-prescribing’’ means, with respect 
to an opioid overdose reversal drug, the practice of 
prescribing such drug in conjunction with an opioid 
prescription for patients at an elevated risk of over-
dose, or in conjunction with an opioid agonist ap-
proved under section 505 of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 355) for the 
treatment of opioid abuse disorders, or in other cir-
cumstances in which a provider identifies a patient 
at an elevated risk for an intentional or uninten-
tional drug overdose from heroin or prescription 
opioid therapies. For purposes of the previous sen-
tence, a patient may be at an elevated risk of over-
dose if the patient meets the criteria under the exist-
ing co-prescribing guidelines that the Secretary 
deems appropriate, such as the criteria provided in 
the Opioid Overdose Toolkit published by the Sub-
stance Abuse and Mental Health Services Adminis-
tration. 
(b) APPLICATION.—To be eligible to receive a grant 
under this section, an eligible entity shall submit to the 
Secretary of Health and Human Services, in such form 
and manner as specified by the Secretary, an application 
that describes— 
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(1) the extent to which the area to which the 
entity will furnish services through use of the grant 
is experiencing significant morbidity and mortality 
caused by opioid abuse; 
(2) the criteria that will be used to identify eli-
gible patients to participate in such program; and 
(3) how such program will work to try to iden-
tify State, local, or private funding to continue the 
program after expiration of the grant. 
(c) USE OF FUNDS.—An eligible entity receiving a 
grant under this section may use the grant for any of the 
following activities: 
(1) To establish a program for co-prescribing 
opioid overdose reversal drugs, such as naloxone. 
(2) To train and provide resources for health 
care providers and pharmacists on the co-prescribing 
of opioid overdose reversal drugs. 
(3) To establish mechanisms and processes, 
consistent with applicable Federal and State privacy 
rules, for tracking patients participating in the pro-
gram described in paragraph (1) and the health out-
comes of such patients. 
(4) To purchase opioid overdose reversal drugs 
for distribution under the program described in 
paragraph (1). 
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(5) To offset the co-pays and other cost sharing 
associated with opioid overdose reversal drugs to en-
sure that cost is not a limiting factor for eligible pa-
tients. 
(6) To conduct community outreach, in con-
junction with community-based organizations, de-
signed to raise awareness of co-prescribing practices, 
and the availability of opioid overdose reversal 
drugs. 
(7) To establish protocols to connect patients 
who have experienced a drug overdose with appro-
priate treatment, including medication assisted 
treatment and appropriate counseling and behavioral 
therapies. 
(d) EVALUATIONS BY RECIPIENTS.—As a condition 
of receipt of a grant under this section, an eligible entity 
shall, for each year for which the grant is received, submit 
to the Secretary of Health and Human Services informa-
tion on appropriate outcome measures specified by the 
Secretary to assess the outcomes of the program funded 
by the grant, including— 
(1) the number of prescribers trained; 
(2) the number of prescribers who have co-pre-
scribed an opioid overdose reversal drugs to at least 
one patient; 
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(3) the total number of prescriptions written for 
opioid overdose reversal drugs; 
(4) the percentage of patients at elevated risk 
who received a prescription for an opioid overdose 
reversal drug; 
(5) the number of patients reporting use of an 
opioid overdose reversal drug; and 
(6) any other outcome measures that the Sec-
retary deems appropriate. 
(e) REPORTS BY SECRETARY.—For each year of the 
grant program under this section, the Secretary of Health 
and Human Services shall submit to the appropriate com-
mittees of the House of Representatives and of the Senate 
a report aggregating the information received from the 
grant recipients for such year under subsection (d) and 
evaluating the outcomes achieved by the programs funded 
by grants made under this section. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section and 
section 903 $4,000,000 for each of fiscal years 2017 
through 2021. 
SEC. 903. OPIOID OVERDOSE REVERSAL CO-PRESCRIBING 
GUIDELINES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a grant program under 
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which the Secretary shall award grants to eligible State 
entities to develop opioid overdose reversal co-prescribing 
guidelines. 
(b) ELIGIBLE STATE ENTITIES.—For purposes of 
subsection (a), eligible State entities are State depart-
ments of health in conjunction with State medical boards; 
city, county, and local health departments; and community 
stakeholder groups involved in reducing opioid overdose 
deaths. 
(c) ADMINISTRATIVE PROVISIONS.— 
(1) GRANT
AMOUNTS.—A grant made under 
this section may not be for more than $200,000 per 
grant. 
(2) 
PRIORITIZATION.—In 
awarding 
grants 
under this section, the Secretary shall give priority 
to eligible State entities which propose to base their 
guidelines on existing guidelines on co-prescribing to 
speed enactment, including guidelines of— 
(A) the Department of Veterans Affairs; 
(B) nationwide medical societies, such as 
the American Society of Addiction Medicine or 
American Medical Association; and 
(C) the Centers for Disease Control and 
Prevention. 
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SEC. 904. SURVEILLANCE CAPACITY BUILDING. 
(a) PROGRAM
AUTHORIZED.—The Secretary of 
Health and Human Services, acting through the Director 
of the Centers for Disease Control and Prevention, shall 
award cooperative agreements or grants to eligible entities 
to improve fatal and nonfatal drug overdose surveillance 
and reporting capabilities, including— 
(1) providing training to improve identification 
of drug overdose as the cause of death by coroners 
and medical examiners; 
(2) establishing, in cooperation with the Na-
tional Poison Data System, coroners, and medical 
examiners, a comprehensive national program for 
surveillance of, and reporting to an electronic data-
base on, drug overdose deaths in the United States; 
and 
(3) establishing, in cooperation with the Na-
tional Poison Data System, a comprehensive na-
tional program for surveillance of, and reporting to 
an electronic database on, fatal and nonfatal drug 
overdose occurrences, including epidemiological and 
toxicologic analysis and trends. 
(b) ELIGIBLE ENTITY.—To be eligible to receive a 
grant or cooperative agreement under this section, an enti-
ty shall be— 
(1) a State, local, or tribal government; or 
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(2) the National Poison Data System working 
in conjunction with a State, local, or tribal govern-
ment. 
(c) APPLICATION.— 
(1) IN GENERAL.—An eligible entity desiring a 
grant or cooperative agreement under this section 
shall submit to the Secretary an application at such 
time, in such manner, and containing such informa-
tion as the Secretary may require. 
(2) CONTENTS.—An application described in 
paragraph (1) shall include— 
(A) a description of the activities to be 
funded through the grant or cooperative agree-
ment; and 
(B) evidence that the eligible entity has the 
capacity to carry out such activities. 
(d) REPORT.—As a condition of receipt of a grant 
or cooperative agreement under this section, an eligible en-
tity shall agree to prepare and submit, not later than 90 
days after the end of the grant or cooperative agreement 
period, a report to the Secretary describing the results of 
the activities supported through the grant or cooperative 
agreement. 
(e) NATIONAL POISON DATA SYSTEM.—In this sec-
tion, the term ‘‘National Poison Data System’’ means the 
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system operated by the American Association of Poison 
Control Centers, in partnership with the Centers for Dis-
ease Control and Prevention, for real-time local, State, 
and national electronic reporting, and the corresponding 
database network. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$5,000,000 for each of the fiscal years 2017 through 
2021. 
Subtitle B—Crisis 
SEC. 921. GRANTS TO SUPPORT SYRINGE EXCHANGE PRO-
GRAMS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services may award grants to State, local, and 
tribal governments and community organizations to sup-
port syringe exchange programs. 
(b) USE OF FUNDS.—Grants under subsection (a) 
may be used to support carrying out syringe exchange pro-
grams, including through— 
(1) providing outreach, counseling, health edu-
cation, case management, syringe disposal, and 
other services as determined appropriate by the Sec-
retary of Health and Human Services; and 
(2) providing technical assistance, including 
training and capacity building, to assist the develop-
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ment and implementation of syringe exchange pro-
grams. 
(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated $15,000,000 for each of fis-
cal years 2017 through 2021 to carry out this section, of 
which— 
(1) at least 15 percent shall be for syringe ex-
change programs that have been in operation for 
less than 3 years; and 
(2) 5 percent shall be for technical assistance 
under subsection (b)(2). 
SEC. 922. GRANT PROGRAM TO REDUCE DRUG OVERDOSE 
DEATHS. 
(a) PROGRAM
AUTHORIZED.—The Secretary of 
Health and Human Services, acting through the Adminis-
trator of the Substance Abuse and Mental Health Services 
Administration, shall award grants or enter into coopera-
tive agreements with eligible entities to enable the eligible 
entities to reduce deaths occurring from overdoses of 
drugs. 
(b) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant or cooperative agreement under this section, an enti-
ty shall be a partnership between any of the following: a 
State, local, or tribal government, a correctional institu-
tion, a law enforcement agency, a community agency, a 
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professional organization in the field of poison control and 
surveillance, or a private nonprofit organization. 
(c) APPLICATION.— 
(1) IN GENERAL.—An eligible entity desiring a 
grant or cooperative agreement under this section 
shall submit to the Secretary of Health and Human 
Services an application at such time, in such man-
ner, and containing such information as the Sec-
retary may require. 
(2) CONTENTS.—An application under para-
graph (1) shall include— 
(A) a description of the activities to be 
funded through the grant or cooperative agree-
ment; and 
(B) evidence that the eligible entity has the 
capacity to carry out such activities. 
(d) PRIORITY.—In entering into grants and coopera-
tive agreements under subsection (a), the Secretary of 
Health and Human Services shall give priority to eligible 
entities that— 
(1) include a public health agency or commu-
nity-based organization; and 
(2) have expertise in preventing deaths occur-
ring from overdoses of drugs in populations at high 
risk of such deaths. 
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(e) ELIGIBLE ACTIVITIES.—As a condition of receipt 
of a grant or cooperative agreement under this section, 
an eligible entity shall agree to use the grant or coopera-
tive agreement to do each of the following: 
(1) Purchase and distribute the drug naloxone 
or a similarly effective medication. 
(2) Carry out one or more of the following ac-
tivities: 
(A) Educating prescribers and pharmacists 
about overdose prevention and naloxone pre-
scription, or prescriptions of a similarly effec-
tive medication. 
(B) Training first responders, other indi-
viduals in a position to respond to an overdose, 
and law enforcement and corrections officials on 
the effective response to individuals who have 
overdosed on drugs. Training pursuant to this 
subparagraph may include any activity that is 
educational, instructional, or consultative in na-
ture, and may include volunteer training, 
awareness building exercises, outreach to indi-
viduals who are at risk of a drug overdose, and 
distribution of educational materials. 
(C) Implementing and enhancing programs 
to provide overdose prevention, recognition, 
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treatment, and response to individuals in need 
of such services. 
(D) Educating the public and providing 
outreach to the public about overdose preven-
tion and naloxone prescriptions, or prescriptions 
of other similarly effective medications. 
(f) COORDINATING CENTER.— 
(1) ESTABLISHMENT.—The Secretary of Health 
and Human Services shall establish and provide for 
the operation of a coordinating center responsible 
for— 
(A) collecting, compiling, and dissemi-
nating data on the programs and activities 
under this section, including tracking and eval-
uating the distribution and use of naloxone and 
other similarly effective medication; 
(B) evaluating such data and, based on 
such evaluation, developing best practices for 
preventing 
deaths 
occurring 
from 
drug 
overdoses; 
(C) making such best practices specific to 
the type of community involved; 
(D) coordinating and harmonizing data 
collection measures; 
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(E) evaluating the effects of the program 
on overdose rates; and 
(F) education and outreach to the public 
about overdose prevention and prescription of 
naloxone and other similarly effective medica-
tion. 
(2) REPORTS TO CENTER.—As a condition on 
receipt of a grant or cooperative agreement under 
this section, an eligible entity shall agree to prepare 
and submit, not later than 90 days after the end of 
the award period, a report to such coordinating cen-
ter and the Secretary of Health and Human Services 
describing the results of the activities supported 
through the grant or cooperative agreement. 
(g) DURATION.—The period of a grant or cooperative 
agreement under this section shall be 4 years. 
(h) DEFINITION.—In this part, the term ‘‘drug’’— 
(1) means a drug, as defined in section 201 of 
the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 321); and 
(2) includes controlled substances, as defined in 
section 102 of the Controlled Substances Act (21 
U.S.C. 802). 
(i) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated $20,000,000 to carry out 
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this section for each of the fiscal years 2017 through 
2021. 
Subtitle C—Treatment 
SEC. 931. EXPANSION OF PATIENT LIMITS UNDER WAIVER. 
Section 303(g)(2)(B) of the Controlled Substances 
Act (21 U.S.C. 823(g)(2)(B)) is amended— 
(1) in clause (i), by striking ‘‘physician’’ and in-
serting ‘‘practitioner’’; 
(2) in clause (iii)— 
(A) by striking ‘‘30’’ and inserting ‘‘100’’; 
and 
(B) by striking ‘‘, unless, not sooner’’ and 
all that follows through the end and inserting a 
period; and 
(3) by inserting at the end the following new 
clause: 
‘‘(iv) Not earlier than 1 year after the date 
on which a qualifying practitioner obtained an 
initial waiver pursuant to clause (iii), the quali-
fying practitioner may submit a second notifica-
tion to the Secretary of the need and intent of 
the qualifying practitioner to treat an unlimited 
number of patients, if the qualifying practi-
tioner— 
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‘‘(I)(aa) satisfies the requirements of 
item (aa), (bb), (cc), or (dd) of subpara-
graph (G)(ii)(I); and 
‘‘(bb) agrees to fully participate in the 
Prescription Drug Monitoring Program of 
the State in which the qualifying practi-
tioner is licensed, pursuant to applicable 
State guidelines; or 
‘‘(II)(aa) satisfies the requirements of 
item (ee), (ff), or (gg) of subparagraph 
(G)(ii)(I); 
‘‘(bb) agrees to fully participate in the 
Prescription Drug Monitoring Program of 
the State in which the qualifying practi-
tioner is licensed, pursuant to applicable 
State guidelines; 
‘‘(cc) practices in a qualified practice 
setting; and 
‘‘(dd) has completed not less than 24 
hours of training (through classroom situa-
tions, seminars at professional society 
meetings, electronic communications, or 
otherwise) with respect to the treatment 
and management of opiate-dependent pa-
tients for substance use disorders provided 
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by the American Society of Addiction Med-
icine, the American Academy of Addiction 
Psychiatry, the American Medical Associa-
tion, the American Osteopathic Associa-
tion, the American Psychiatric Association, 
or any other organization that the Sec-
retary determines is appropriate for pur-
poses of this subclause.’’. 
SEC. 932. DEFINITIONS. 
Section 303(g)(2)(G) of the Controlled Substances 
Act (21 U.S.C. 823(g)(2)(G)) is amended— 
(1) by striking clause (ii) and inserting the fol-
lowing: 
‘‘(ii) The term ‘qualifying practitioner’ 
means the following: 
‘‘(I) A physician who is licensed under 
State law and who meets 1 or more of the 
following conditions: 
‘‘(aa) The physician holds a 
board certification in addiction psychi-
atry from the American Board of 
Medical Specialties. 
‘‘(bb) The physician holds an ad-
diction certification from the Amer-
ican Society of Addiction Medicine. 
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‘‘(cc) The physician holds a 
board certification in addiction medi-
cine from the American Osteopathic 
Association. 
‘‘(dd) The physician holds a 
board certification from the American 
Board of Addiction Medicine. 
‘‘(ee) The physician has com-
pleted not less than 8 hours of train-
ing (through classroom situations, 
seminar at professional society meet-
ings, electronic communications, or 
otherwise) with respect to the treat-
ment and management of opiate-de-
pendent patients for substance use 
disorders provided by the American 
Society of Addiction Medicine, the 
American Academy of Addiction Psy-
chiatry, the American Medical Asso-
ciation, the American Osteopathic As-
sociation, the American Psychiatric 
Association, or any other organization 
that the Secretary determines is ap-
propriate for purposes of this sub-
clause. 
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‘‘(ff) The physician has partici-
pated as an investigator in 1 or more 
clinical trials leading to the approval 
of a narcotic drug in schedule III, IV, 
or V for maintenance or detoxification 
treatment, as demonstrated by a 
statement submitted to the Secretary 
by this sponsor of such approved 
drug. 
‘‘(gg) The physician has such 
other training or experience as the 
Secretary determines will demonstrate 
the ability of the physician to treat 
and manage opiate-dependent pa-
tients. 
‘‘(II) A nurse practitioner or physi-
cian assistant who is licensed under State 
law and meets all of the following condi-
tions: 
‘‘(aa) The nurse practitioner or 
physician assistant is licensed under 
State law to prescribe schedule III, 
IV, or V medications for pain. 
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‘‘(bb) The nurse practitioner or 
physician assistant satisfies 1 or more 
of the following: 
‘‘(AA) Has completed not 
fewer than 24 hours of training 
(through 
classroom 
situations, 
seminar at professional society 
meetings, electronic communica-
tions, or otherwise) with respect 
to the treatment and manage-
ment of opiate-dependent pa-
tients for substance use disorders 
provided by the American Society 
of Addiction Medicine, the Amer-
ican Academy of Addiction Psy-
chiatry, the American Medical 
Association, the American Osteo-
pathic Association, the American 
Psychiatric Association, or any 
other organization that the Sec-
retary determines is appropriate 
for purposes of this subclause. 
‘‘(BB) Has such other train-
ing or experience as the Sec-
retary 
determines 
will 
dem-
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onstrate the ability of the nurse 
practitioner or physician assist-
ant to treat and manage opiate- 
dependent patients. 
‘‘(cc) The nurse practitioner or 
physician assistant practices within 
the scope of their State license, in-
cluding compliance with any super-
vision or collaboration requirements 
under State law. 
‘‘(dd) The nurse practitioner or 
physician assistant practice in a quali-
fied practice setting.’’; and 
(2) by adding at the end the following: 
‘‘(iii) The term ‘qualified practice setting’ 
means 1 or more of the following treatment set-
tings: 
‘‘(I) A National Committee for Qual-
ity Assurance-recognized Patient-Centered 
Medical Home or Patient-Centered Spe-
cialty Practice. 
‘‘(II) A Centers for Medicaid & Medi-
care Services-recognized Accountable Care 
Organization. 
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‘‘(III) A clinical facility administered 
by the Department of Veterans Affairs, 
Department of Defense, or Indian Health 
Service. 
‘‘(IV) A Behavioral Health Home ac-
credited by the Joint Commission. 
‘‘(V) A Federally-qualified health cen-
ter (as defined in section 1905(l)(2)(B) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396d(l)(2)(B))) or a Federally-qualified 
health center look-alike. 
‘‘(VI) A Substance Abuse and Mental 
Health Services-certified Opioid Treatment 
Program. 
‘‘(VII) A clinical program of a State 
or Federal jail, prison, or other facility 
where individuals are incarcerated. 
‘‘(VIII) A clinic that demonstrates 
compliance with the Model Policy on 
DATA 2000 and Treatment of Opioid Ad-
diction in the Medical Office issued by the 
Federation of State Medical Boards. 
‘‘(IX) A treatment setting that is part 
of an Accreditation Council for Graduate 
Medical Education, American Association 
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of Colleges of Osteopathic Medicine, or 
American Osteopathic Association-accred-
ited residency or fellowship training pro-
gram. 
‘‘(X) Any other practice setting ap-
proved by a State regulatory board, State 
substance abuse agency, or State Medicaid 
Plan to provide addiction treatment serv-
ices. 
‘‘(XI) Any other practice setting ap-
proved by the Secretary.’’. 
SEC. 933. EVALUATION BY ASSISTANT SECRETARY FOR 
PLANNING AND EVALUATION. 
Two years after the date on which the first notifica-
tion under clause (iv) of section 303(g)(2)(B) of the Con-
trolled Substances Act (21 U.S.C. 823(g)(2)(B)), as added 
by section 931, is received by the Secretary of Health and 
Human Services, the Assistant Secretary for Planning and 
Evaluation shall initiate an evaluation of the effectiveness 
of the amendments made by sections 301 and 302, which 
shall include an evaluation of— 
(1) any changes in the availability and use of 
medication-assisted treatment for opioid addiction; 
(2) the quality of medication-assisted treatment 
programs; 
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(3) the integration of medication-assisted treat-
ment with routine healthcare services; 
(4) diversion of opioid addiction treatment 
medication; 
(5) changes in State or local policies and legis-
lation relating to opioid addiction treatment; 
(6) the use of nurse practitioners and physician 
assistants who prescribe opioid addiction medication; 
(7) the use of Prescription Drug Monitoring 
Programs by waived practitioners to maximize safety 
of patient care and prevent diversion of opioid addic-
tion medication; 
(8) the findings of the Drug Enforcement Ad-
ministration inspections of waived practitioners, in-
cluding the frequency with which the Drug Enforce-
ment Administration finds no documentation of ac-
cess to behavioral health services; and 
(9) the effectiveness of cross-agency collabora-
tion between the Department of Health and Human 
Services and the Drug Enforcement Administration 
for expanding effective opioid addiction treatment. 
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