I 
114TH CONGRESS 
2D SESSION 
H. R. 5327 
To reauthorize and improve programs related to mental health and substance 
use disorders. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 25, 2016 
Ms. KUSTER (for herself and Mr. MOONEY of West Virginia) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To reauthorize and improve programs related to mental 
health and substance use disorders. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Mental Health Aware-
ness and Improvement Act of 2016’’. 
SEC. 2. GARRETT LEE SMITH MEMORIAL ACT REAUTHOR-
IZATION. 
(a) SUICIDE PREVENTION TECHNICAL ASSISTANCE 
CENTER.—Section 520C of the Public Health Service Act 
(42 U.S.C. 290bb–34) is amended— 
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(1) in the section heading, by striking the sec-
tion heading and inserting ‘‘SUICIDE PREVENTION 
TECHNICAL ASSISTANCE CENTER.’’; 
(2) in subsection (a), by striking ‘‘and in con-
sultation with’’ and all that follows through the pe-
riod at the end of paragraph (2) and inserting ‘‘shall 
establish a research, training, and technical assist-
ance resource center to provide appropriate informa-
tion, training, and technical assistance to States, po-
litical subdivisions of States, federally recognized In-
dian tribes, tribal organizations, institutions of high-
er education, public organizations, or private non-
profit organizations regarding the prevention of sui-
cide among all ages, particularly among groups that 
are at high risk for suicide.’’; 
(3) by striking subsections (b) and (c); 
(4) by redesignating subsection (d) as sub-
section (b); 
(5) in subsection (b), as so redesignated— 
(A) by striking the subsection heading and 
inserting ‘‘RESPONSIBILITIES
OF
THE
CEN-
TER.’’; 
(B) in the matter preceding paragraph (1), 
by striking ‘‘The additional research’’ and all 
that follows through ‘‘nonprofit organizations 
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for’’ and inserting ‘‘The center established 
under subsection (a) shall conduct activities for 
the purpose of’’; 
(C) by striking ‘‘youth suicide’’ each place 
such term appears and inserting ‘‘suicide’’; 
(D) in paragraph (1)— 
(i) by striking ‘‘the development or 
continuation of’’ and inserting ‘‘developing 
and continuing’’; and 
(ii) by inserting ‘‘for all ages, particu-
larly among groups that are at high risk 
for suicide’’ before the semicolon at the 
end; 
(E) in paragraph (2), by inserting ‘‘for all 
ages, particularly among groups that are at 
high risk for suicide’’ before the semicolon at 
the end; 
(F) in paragraph (3), by inserting ‘‘and 
tribal’’ after ‘‘statewide’’; 
(G) in paragraph (5), by inserting ‘‘and 
prevention’’ after ‘‘intervention’’; 
(H) in paragraph (8), by striking ‘‘in 
youth’’; 
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(I) in paragraph (9), by striking ‘‘and be-
havioral health’’ and inserting ‘‘health and sub-
stance use disorder’’; and 
(J) in paragraph (10), by inserting ‘‘con-
ducting’’ before ‘‘other’’; and 
(6) by striking subsection (e) and inserting the 
following: 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $6,000,000 for each of fiscal years 
2016 through 2020. 
‘‘(d) ANNUAL REPORT.—Not later than 2 years after 
the date of enactment of this subsection, the Secretary 
shall submit to Congress a report on the activities carried 
out by the center established under subsection (a) during 
the year involved, including the potential impacts of such 
activities, and the States, organizations, and institutions 
that have worked with the center.’’. 
(b) YOUTH SUICIDE EARLY INTERVENTION
AND 
PREVENTION STRATEGIES.—Section 520E of the Public 
Health Service Act (42 U.S.C. 290bb–36) is amended— 
(1) in paragraph (1) of subsection (a) and in 
subsection (c), by striking ‘‘substance abuse’’ each 
place such term appears and inserting ‘‘substance 
use disorder’’; 
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(2) in subsection (b)(2)— 
(A) by striking ‘‘each State is awarded 
only 1 grant or cooperative agreement under 
this section’’ and inserting ‘‘a State does not 
receive more than 1 grant or cooperative agree-
ment under this section at any 1 time’’; and 
(B) by striking ‘‘been awarded’’ and insert-
ing ‘‘received’’; 
(3) in subsection (g)(2), by striking ‘‘2 years 
after the date of enactment of this section,’’ and in-
sert ‘‘2 years after the date of enactment of the 
Mental Health Awareness and Improvement Act of 
2015,’’; and 
(4) by striking subsection (m) and inserting the 
following: 
‘‘(m) AUTHORIZATION
OF APPROPRIATIONS.—For 
the purpose of carrying out this section, there are author-
ized to be appropriated $30,000,000 for each of fiscal 
years 2016 through 2020.’’. 
(c) MENTAL HEALTH AND SUBSTANCE USE DIS-
ORDER SERVICES.—Section 520E–2 of the Public Health 
Service Act (42 U.S.C. 290bb–36b) is amended— 
(1) in the section heading, by striking ‘‘AND 
BEHAVIORAL HEALTH’’ and inserting ‘‘HEALTH 
AND SUBSTANCE USE DISORDER’’; 
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(2) in subsection (a)— 
(A) by striking ‘‘Services,’’ and inserting 
‘‘Services and’’; 
(B) by striking ‘‘and behavioral health 
problems’’ and inserting ‘‘health or substance 
use disorders’’; and 
(C) by striking ‘‘substance abuse’’ and in-
serting ‘‘substance use disorders’’; 
(3) in subsection (b)— 
(A) in the matter preceding paragraph (1), 
by striking ‘‘for—’’ and inserting ‘‘for one or 
more of the following:’’; and 
(B) by striking paragraphs (1) through (6) 
and inserting the following: 
‘‘(1) Educating students, families, faculty, and 
staff to increase awareness of mental health and 
substance use disorders. 
‘‘(2) The operation of hotlines. 
‘‘(3) Preparing informational material. 
‘‘(4) Providing outreach services to notify stu-
dents about available mental health and substance 
use disorder services. 
‘‘(5) Administering voluntary mental health and 
substance use disorder screenings and assessments. 
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‘‘(6) Supporting the training of students, fac-
ulty, and staff to respond effectively to students with 
mental health and substance use disorders. 
‘‘(7) Creating a network infrastructure to link 
colleges and universities with health care providers 
who treat mental health and substance use dis-
orders.’’; 
(4) in subsection (c)(5), by striking ‘‘substance 
abuse’’ and inserting ‘‘substance use disorder’’; 
(5) in subsection (d)— 
(A) in the matter preceding paragraph (1), 
by striking ‘‘An institution of higher education 
desiring a grant under this section’’ and insert-
ing ‘‘To be eligible to receive a grant under this 
section, an institution of higher education’’; 
(B) in paragraph (1)— 
(i) 
by 
striking 
‘‘and 
behavioral 
health’’ and inserting ‘‘health and sub-
stance use disorder’’; and 
(ii) by inserting ‘‘, including veterans 
whenever possible and appropriate,’’ after 
‘‘students’’; and 
(C) in paragraph (2), by inserting ‘‘, which 
may include, as appropriate and in accordance 
with subsection (b)(7), a plan to seek input 
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from relevant stakeholders in the community, 
including appropriate public and private enti-
ties, in order to carry out the program under 
the grant’’ before the period at the end; 
(6) in subsection (e)(1), by striking ‘‘and behav-
ioral health problems’’ and inserting ‘‘health and 
substance use disorders’’; 
(7) in subsection (f)(2)— 
(A) by striking ‘‘and behavioral health’’ 
and inserting ‘‘health and substance use dis-
order’’; and 
(B) by striking ‘‘suicide and substance 
abuse’’ and inserting ‘‘suicide and substance 
use disorders’’; and 
(8) in subsection (h), by striking ‘‘$5,000,000 
for fiscal year 2005’’ and all that follows through 
the period at the end and inserting ‘‘$6,500,000 for 
each of fiscal years 2016 through 2020.’’. 
SEC. 3. MENTAL HEALTH AWARENESS TRAINING GRANTS. 
Section 520J of the Public Health Service Act (42 
U.S.C. 290bb–41) is amended— 
(1) in the section heading, by inserting ‘‘MEN-
TAL HEALTH AWARENESS’’ before ‘‘TRAINING’’; 
and 
(2) in subsection (b)— 
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period at the end and inserting ‘‘$15,000,000 
for each of fiscal years 2016 through 2020.’’. 
SEC. 4. CHILDREN’S RECOVERY FROM TRAUMA. 
Section 582 of the Public Health Service Act (42 
U.S.C. 290hh–1) is amended— 
(1) in subsection (a), by striking ‘‘developing 
programs’’ and all that follows through the period at 
the end and inserting ‘‘developing and maintaining 
programs that provide for— 
‘‘(1) the continued operation of the National 
Child Traumatic Stress Initiative (referred to in this 
section as the ‘NCTSI’), which includes a coopera-
tive agreement with a coordinating center, that fo-
cuses on the mental, behavioral, and biological as-
pects of psychological trauma response, prevention 
of the long-term consequences of child trauma, and 
early intervention services and treatment to address 
the long-term consequences of child trauma; and 
‘‘(2) the development of knowledge with regard 
to evidence-based practices for identifying and treat-
ing mental, behavioral, and biological disorders of 
children and youth resulting from witnessing or ex-
periencing a traumatic event.’’; 
(2) in subsection (b)— 
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(A) by striking ‘‘subsection (a) related’’ 
and inserting ‘‘subsection (a)(2) (related’’; 
(B) by striking ‘‘treating disorders associ-
ated with psychological trauma’’ and inserting 
‘‘treating mental, behavioral, and biological dis-
orders associated with psychological trauma)’’; 
and 
(C) by striking ‘‘mental health agencies 
and programs that have established clinical and 
basic research’’ and inserting ‘‘universities, hos-
pitals, mental health agencies, and other pro-
grams that have established clinical expertise 
and research’’; 
(3) by redesignating subsections (c) through (g) 
as subsections (g) through (k), respectively; 
(4) by inserting after subsection (b), the fol-
lowing: 
‘‘(c) CHILD OUTCOME DATA.—The NCTSI coordi-
nating center shall collect, analyze, and report NCTSI- 
wide child treatment process and outcome data regarding 
the early identification and delivery of evidence-based 
treatment and services for children and families served by 
the NCTSI grantees. 
‘‘(d) TRAINING.—The NCTSI coordinating center 
shall facilitate the coordination of training initiatives in 
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evidence-based and trauma-informed treatments, interven-
tions, and practices offered to NCTSI grantees, providers, 
and partners. 
‘‘(e) DISSEMINATION
AND COLLABORATION.—The 
NCTSI coordinating center shall, as appropriate, collabo-
rate with— 
‘‘(1) the Secretary, in the dissemination of evi-
dence-based and trauma-informed interventions, 
treatments, products, and other resources to appro-
priate stakeholders; and 
‘‘(2) appropriate agencies that conduct or fund 
research within the Department of Health and 
Human Services, for purposes of sharing NCTSI ex-
pertise, evaluation data, and other activities, as ap-
propriate. 
‘‘(f) REVIEW.—The Secretary shall, consistent with 
the peer review process, ensure that NCTSI applications 
are reviewed by appropriate experts in the field as part 
of a consensus review process. The Secretary shall include 
review criteria related to expertise and experience in child 
trauma and evidence-based practices.’’; 
(5) in subsection (g) (as so redesignated), by 
striking ‘‘with respect to centers of excellence are 
distributed equitably among the regions of the coun-
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try’’ and inserting ‘‘are distributed equitably among 
the regions of the United States’’; 
(6) in subsection (i) (as so redesignated), by 
striking ‘‘recipient may not exceed 5 years’’ and in-
serting ‘‘recipient shall not be less than 4 years, but 
shall not exceed 5 years’’; and 
(7) in subsection (j) (as so redesignated), by 
striking ‘‘$50,000,000’’ and all that follows through 
‘‘2006’’ and inserting ‘‘$46,000,000 for each of fis-
cal years 2016 through 2020’’. 
SEC. 5. ASSESSING BARRIERS TO BEHAVIORAL HEALTH IN-
TEGRATION. 
(a) IN GENERAL.—Not later than 2 years after the 
date of enactment of this Act, the Comptroller General 
of the United States shall submit a report to the Com-
mittee on Health, Education, Labor, and Pensions of the 
Senate and the Committee on Energy and Commerce of 
the House of Representatives concerning Federal require-
ments that impact access to treatment of mental health 
and substance use disorders related to integration with 
primary care, administrative and regulatory issues, quality 
measurement and accountability, and data sharing. 
(b) CONTENTS.—The report submitted under sub-
section (a) shall include the following: 
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(1) An evaluation of the administrative or regu-
latory burden on behavioral health care providers. 
(2) The identification of outcome and quality 
measures relevant to integrated health care, evalua-
tion of the data collection burden on behavioral 
health care providers, and any alternative methods 
for evaluation. 
(3) An analysis of the degree to which elec-
tronic data standards, including interoperability and 
meaningful use includes behavioral health measures, 
and an analysis of strategies to address barriers to 
health information exchange posed by part 2 of title 
42, Code of Federal Regulations. 
(4) An analysis of the degree to which Federal 
rules and regulations for behavioral and physical 
health care are aligned, including recommendations 
to address any identified barriers. 
(5) An analysis of the challenges to behavioral 
health and primary care integration faced by pro-
viders in rural areas. 
SEC. 6. INCREASING EDUCATION AND AWARENESS OF 
TREATMENTS FOR OPIOID USE DISORDERS. 
(a) IN GENERAL.—In order to improve the quality 
of care delivery and treatment outcomes among patients 
with opioid use disorders, the Secretary of Health and 
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