388 
‘‘(C) to the extent practicable, educate pro-
viders about health information exchanges (or 
other relevant platforms) that employ some or all 
of the capabilities described in paragraph (1). 
‘‘(3) REQUIREMENTS.—In carrying out para-
graph (1), the Secretary, in coordination with the Of-
fice for Civil Rights, shall issue guidance to health in-
formation exchanges related to best practices to ensure 
that the electronic health information provided to pa-
tients is— 
‘‘(A) private and secure; 
‘‘(B) accurate; 
‘‘(C) verifiable; and 
‘‘(D) where a patient’s authorization to ex-
change information is required by law, easily ex-
changed pursuant to such authorization. 
‘‘(4) RULE OF CONSTRUCTION.—Nothing in this 
subsection shall be construed to preempt State laws 
applicable to patient consent for the access of infor-
mation through a health information exchange (or 
other relevant platform) that provide protections to 
patients that are greater than the protections other-
wise provided for under applicable Federal law. 
‘‘(d) EFFORTS TO PROMOTE ACCESS TO HEALTH IN-
FORMATION.—The National Coordinator and the Office for
389 
Civil Rights of the Department of Health and Human Serv-
ices shall jointly promote patient access to health informa-
tion in a manner that would ensure that such information 
is available in a form convenient for the patient, in a rea-
sonable manner, without burdening the health care provider 
involved. 
‘‘(e) ACCESSIBILITY OF PATIENT RECORDS.— 
‘‘(1) ACCESSIBILITY AND UPDATING OF INFORMA-
TION.— 
‘‘(A) IN GENERAL.—The Secretary, in con-
sultation with the National Coordinator, shall 
promote policies that ensure that a patient’s elec-
tronic health information is accessible to that 
patient and the patient’s designees, in a manner 
that facilitates communication with the patient’s 
health care providers and other individuals, in-
cluding researchers, consistent with such pa-
tient’s consent. 
‘‘(B) UPDATING EDUCATION ON ACCESSING 
AND EXCHANGING PERSONAL HEALTH INFORMA-
TION.—To promote awareness that an individual 
has a right of access to inspect, obtain a copy of, 
and transmit to a third party a copy of such in-
dividual’s protected health information pursuant 
to the Health Information Portability and Ac-
390 
countability Act, Privacy Rule (subpart E of 
part 164 of title 45, Code of Federal Regula-
tions), the Director of the Office for Civil Rights, 
in consultation with the National Coordinator, 
shall assist individuals and health care providers 
in understanding a patient’s rights to access and 
protect personal health information under the 
Health Insurance Portability and Accountability 
Act of 1996 (Public Law 104–191), including 
providing best practices for requesting personal 
health information in a computable format, in-
cluding using patient portals or third-party ap-
plications and common cases when a provider is 
permitted to exchange and provide access to 
health information.’’. 
‘‘(2) CERTIFYING USABILITY FOR PATIENTS.—In 
carrying out certification programs under section 
3001(c)(5), the National Coordinator may require 
that— 
‘‘(A) the certification criteria support— 
‘‘(i) patient access to their electronic 
health information, including in a single 
longitudinal format that is easy to under-
stand, secure, and may be updated auto-
matically;
391 
‘‘(ii) the patient’s ability to electroni-
cally communicate patient-reported infor-
mation (such as family history and medical 
history); and 
‘‘(iii) patient access to their personal 
electronic health information for research at 
the option of the patient; and 
‘‘(B) the HIT Advisory Committee develop 
and prioritize standards, implementation speci-
fications, and certification criteria required to 
help support patient access to electronic health 
information, patient usability, and support for 
technologies that offer patients access to their 
electronic health information in a single, longi-
tudinal format that is easy to understand, se-
cure, and may be updated automatically.’’. 
(b) ACCESS TO INFORMATION IN AN ELECTRONIC FOR-
MAT.—Section 13405(e) of the Health Information Tech-
nology for Economic and Clinical Health Act (42 U.S.C. 
17935) is amended— 
(1) in paragraph (1), by striking ‘‘and’’ at the 
end; 
(2) by redesignating paragraph (2) as para-
graph (3); and
392 
(3) by inserting after paragraph (1), the fol-
lowing: 
‘‘(2) if the individual makes a request to a busi-
ness associate for access to, or a copy of, protected 
health information about the individual, or if an in-
dividual makes a request to a business associate to 
grant such access to, or transmit such copy directly 
to, a person or entity designated by the individual, a 
business associate may provide the individual with 
such access or copy, which may be in an electronic 
form, or grant or transmit such access or copy to such 
person or entity designated by the individual; and’’. 
SEC. 4007. GAO STUDY ON PATIENT MATCHING. 
(a) IN GENERAL.—Not later than 1 year after the date 
of enactment of this Act, the Comptroller General of the 
United States shall conduct a study to— 
(1) review the policies and activities of the Office 
of the National Coordinator for Health Information 
Technology and other relevant stakeholders, which 
may include standards development organizations, ex-
perts in the technical aspects of health information 
technology, health information technology developers, 
providers of health services, health care suppliers, 
health care payers, health care quality organizations, 
States, health information technology policy experts,
393 
and other appropriate entities, to ensure appropriate 
patient matching to protect patient privacy and secu-
rity with respect to electronic health records and the 
exchange of electronic health information; and 
(2) survey ongoing efforts related to the policies 
and activities described in paragraph (1) and the ef-
fectiveness of such efforts occurring in the private sec-
tor. 
(b) AREAS OF CONCENTRATION.—In conducting the 
study under subsection (a), the Comptroller General shall— 
(1) evaluate current methods used in certified 
electronic health records for patient matching based 
on performance related to factors such as— 
(A) the privacy of patient information; 
(B) the security of patient information; 
(C) improving matching rates; 
(D) reducing matching errors; and 
(E) reducing duplicate records; and 
(2) determine whether the Office of the National 
Coordinator for Health Information Technology could 
improve patient matching by taking steps includ-
ing— 
(A) defining additional data elements to as-
sist in patient data matching;
394 
(B) agreeing on a required minimum set of 
elements that need to be collected and exchanged; 
(C) requiring electronic health records to 
have the ability to make certain fields required 
and use specific standards; and 
(D) other options recommended by the rel-
evant stakeholders consulted pursuant to sub-
section (a). 
(c) REPORT.—Not later than 2 years after the date of 
enactment of this Act, the Comptroller General shall submit 
to the appropriate committees of Congress a report con-
cerning the findings of the study conducted under subsection 
(a). 
SEC. 4008. GAO STUDY ON PATIENT ACCESS TO HEALTH IN-
FORMATION. 
(a) STUDY.— 
(1) IN GENERAL.—The Comptroller General of 
the United States (referred to in this section as the 
‘‘Comptroller General’’) shall build on prior Govern-
ment Accountability Office studies and other lit-
erature review and conduct a study to review patient 
access to their own protected health information, in-
cluding barriers to such patient access and complica-
tions or difficulties providers experience in providing 
access to patients. In conducting such study, the
395 
Comptroller General shall consider the increase in 
adoption of health information technology and the in-
creasing prevalence of protected health information 
that is maintained electronically. 
(2) AREAS OF CONCENTRATION.—In conducting 
the review under paragraph (1), the Comptroller Gen-
eral shall consider— 
(A) instances when covered entities charge 
individuals, including patients, third parties, 
and health care providers, for record requests, in-
cluding records that are requested in an elec-
tronic format; 
(B) examples of the amounts and types of 
fees charged to individuals for record requests, 
including instances when the record is requested 
to be transmitted to a third party; 
(C) the extent to which covered entities are 
unable to provide the access requested by individ-
uals in the form and format requested by the in-
dividual, including examples of such instances; 
(D) instances in which third parties may 
request protected health information through pa-
tients’ individual right of access, including in-
stances where such requests may be used to cir-
396 
cumvent appropriate fees that may be charged to 
third parties; 
(E) opportunities that permit covered enti-
ties to charge appropriate fees to third parties 
for patient records while providing patients with 
access to their protected health information at 
low or no cost; 
(F) the ability of providers to distinguish 
between requests originating from an individual 
that require limitation to a cost-based fee and re-
quests originating from third parties that may 
not be limited to cost-based fees; and 
(G) other circumstances that may inhibit 
the ability of providers to provide patients with 
access to their records, and the ability of patients 
to gain access to their records. 
(b) REPORT.—Not later than 18 months after the date 
of enactment of this Act, the Comptroller General shall sub-
mit a report to Congress on the findings of the study con-
ducted under subsection (a). 
SEC. 4009. IMPROVING MEDICARE LOCAL COVERAGE DE-
TERMINATIONS. 
(a) IN GENERAL.—Section 1862(l)(5) of the Social Se-
curity Act (42 U.S.C. 1395y(l)(5)) is amended by adding 
at the end the following new subparagraph:
397 
‘‘(D) LOCAL COVERAGE DETERMINATIONS.— 
The Secretary shall require each Medicare ad-
ministrative contractor that develops a local cov-
erage determination to make available on the 
Internet website of such contractor and on the 
Medicare Internet website, at least 45 days before 
the effective date of such determination, the fol-
lowing information: 
‘‘(i) Such determination in its en-
tirety. 
‘‘(ii) Where and when the proposed de-
termination was first made public. 
‘‘(iii) Hyperlinks to the proposed deter-
mination and a response to comments sub-
mitted to the contractor with respect to such 
proposed determination. 
‘‘(iv) A summary of evidence that was 
considered by the contractor during the de-
velopment of such determination and a list 
of the sources of such evidence. 
‘‘(v) An explanation of the rationale 
that supports such determination.’’. 
(b) EFFECTIVE DATE.—The amendment made by sub-
section (a) shall apply with respect to local coverage deter-
398 
minations that are proposed or revised on or after the date 
that is 180 days after the date of enactment of this Act. 
SEC. 4010. MEDICARE PHARMACEUTICAL AND TECHNOLOGY 
OMBUDSMAN. 
Section 1808 of the Social Security Act (42 U.S.C. 
1395b–9) is amended by adding at the end the following 
new subsection: 
‘‘(d) PHARMACEUTICAL AND TECHNOLOGY OMBUDS-
MAN.— 
‘‘(1) IN GENERAL.—Not later than 12 months 
after the date of enactment of this paragraph, the Sec-
retary shall provide for a pharmaceutical and tech-
nology ombudsman within the Centers for Medicare & 
Medicaid Services who shall receive and respond to 
complaints, grievances, and requests that— 
‘‘(A) are from entities that manufacture 
pharmaceutical, biotechnology, medical device, or 
diagnostic products that are covered or for which 
coverage is being sought under this title; and 
‘‘(B) are with respect to coverage, coding, or 
payment under this title for such products. 
‘‘(2) APPLICATION.—The second sentence of sub-
section (c)(2) shall apply to the ombudsman under 
subparagraph (A) in the same manner as such sen-
399 
tence applies to the Medicare Beneficiary Ombuds-
man under subsection (c).’’. 
SEC. 4011. MEDICARE SITE-OF-SERVICE PRICE TRANS-
PARENCY. 
Section 1834 of the Social Security Act (42 U.S.C. 
1395m) is amended by adding at the end the following new 
subsection: 
‘‘(t) SITE-OF-SERVICE PRICE TRANSPARENCY.— 
‘‘(1) IN GENERAL.—In order to facilitate price 
transparency with respect to items and services for 
which payment may be made either to a hospital out-
patient department or to an ambulatory surgical cen-
ter under this title, the Secretary shall, for 2018 and 
each year thereafter, make available to the public via 
a searchable Internet website, with respect to an ap-
propriate number of such items and services— 
‘‘(A) the estimated payment amount for the 
item or service under the outpatient department 
fee schedule under subsection (t) of section 1833 
and the ambulatory surgical center payment sys-
tem under subsection (i) of such section; and 
‘‘(B) the estimated amount of beneficiary li-
ability applicable to the item or service. 
‘‘(2) CALCULATION OF ESTIMATED BENEFICIARY 
LIABILITY.—For purposes of paragraph (1)(B), the es-
400 
timated amount of beneficiary liability, with respect 
to an item or service, is the amount for such item or 
service for which an individual who does not have 
coverage under a Medicare supplemental policy cer-
tified under section 1882 or any other supplemental 
insurance coverage is responsible. 
‘‘(3) IMPLEMENTATION.—In carrying out this 
subsection, the Secretary— 
‘‘(A) shall include in the notice described in 
section 1804(a) a notification of the availability 
of the estimated amounts made available under 
paragraph (1); and 
‘‘(B) may utilize mechanisms in existence 
on the date of enactment of this subsection, such 
as the portion of the Internet website of the Cen-
ters for Medicare & Medicaid Services on which 
information comparing physician performance is 
posted (commonly referred to as the Physician 
Compare Internet website), to make available 
such estimated amounts under such paragraph. 
‘‘(4) FUNDING.—For purposes of implementing 
this subsection, the Secretary shall provide for the 
transfer, from the Federal Supplementary Medical In-
surance Trust Fund under section 1841 to the Centers 
for Medicare & Medicaid Services Program Manage-
401 
ment Account, of $6,000,000 for fiscal year 2017, to 
remain available until expended.’’. 
SEC. 4012. TELEHEALTH SERVICES IN MEDICARE. 
(a) PROVISION OF INFORMATION BY CENTERS FOR 
MEDICARE & MEDICAID SERVICES.—Not later than 1 year 
after the date of enactment of this Act, the Administrator 
of the Centers for Medicare & Medicaid Services shall pro-
vide to the committees of jurisdiction of the House of Rep-
resentatives and the Senate information on the following: 
(1) The populations of Medicare beneficiaries, 
such as those who are dually eligible for the Medicare 
program under title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.) and the Medicaid program 
under title XIX of such Act (42 U.S.C. 1396 et seq.) 
and those with chronic conditions, whose care may be 
improved most in terms of quality and efficiency by 
the expansion, in a manner that meets or exceeds the 
existing in-person standard of care under the Medi-
care program under such title XVIII, of telehealth 
services under section 1834(m)(4) of such Act (42 
U.S.C. 1395m(m)(4)). 
(2) Activities by the Center for Medicare and 
Medicaid Innovation which examine the use of tele-
health services in models, projects, or initiatives fund-
402 
ed through section 1115A of such Act (42 U.S.C. 
1315a). 
(3) The types of high-volume services (and re-
lated diagnoses) under such title XVIII which might 
be suitable to be furnished using telehealth. 
(4) Barriers that might prevent the expansion of 
telehealth services under section 1834(m)(4) of the So-
cial Security Act (42 U.S.C. 1395m(m)(4)) beyond 
such services that are in effect as of the date of enact-
ment of this Act. 
(b) PROVISION OF INFORMATION BY MEDPAC.—Not 
later than March 15, 2018, the Medicare Payment Advisory 
Commission established under section 1805 of the Social Se-
curity Act (42 U.S.C. 1395b–6) shall, using quantitative 
and qualitative research methods, provide information to 
the committees of jurisdiction of the House of Representa-
tives and the Senate that identifies— 
(1) the telehealth services for which payment can 
be made, as of the date of enactment of this Act, 
under the fee-for-service program under parts A and 
B of title XVIII of such Act; 
(2) the telehealth services for which payment can 
be made, as of such date, under private health insur-
ance plans; and
403 
(3) with respect to services identified under 
paragraph (2) but not under paragraph (1), ways in 
which payment for such services might be incor-
porated into such fee-for-service program (including 
any recommendations for ways to accomplish this in-
corporation). 
(c) SENSE OF CONGRESS.—It is the sense of Congress 
that— 
(1) eligible originating sites should be expanded 
beyond those originating sites described in section 
1834(m)(4)(C) of the Social Security Act (42 U.S.C. 
1395m(m)(4)(C)); and 
(2) any expansion of telehealth services under the 
Medicare program under title XVIII of such Act 
should— 
(A) recognize that telemedicine is the deliv-
ery of safe, effective, quality health care services, 
by a health care provider, using technology as 
the mode of care delivery; 
(B) meet or exceed the conditions of cov-
erage and payment with respect to the Medicare 
program if the service was furnished in person, 
including standards of care, unless specifically 
addressed in subsequent legislation; and
404 
(C) involve clinically appropriate means to 
furnish such services. 
TITLE V—SAVINGS 
SEC. 5001. SAVINGS IN THE MEDICARE IMPROVEMENT 
FUND. 
Section 1898(b)(1) of the Social Security Act (42 
U.S.C. 1395iii(b)(1)), as amended by section 704(h) of the 
Comprehensive Addiction and Recovery Act of 2016, is 
amended by striking ‘‘$140,000,000’’ and inserting 
‘‘$270,000,000’’. 
SEC. 5002. MEDICAID REIMBURSEMENT TO STATES FOR DU-
RABLE MEDICAL EQUIPMENT. 
Section 1903(i)(27) of the Social Security Act (42 
U.S.C. 1396b(i)(27)) is amended by striking ‘‘January 1, 
2019’’ and inserting ‘‘January 1, 2018’’. 
SEC. 5003. PENALTIES FOR VIOLATIONS OF GRANTS, CON-
TRACTS, AND OTHER AGREEMENTS. 
(a) IN GENERAL.—Section 1128A of the Social Secu-
rity Act (42 U.S.C. 1320a–7a) is amended by adding at 
the end the following new subsections: 
‘‘(o) Any person (including an organization, agency, 
or other entity, but excluding a program beneficiary, as de-
fined in subsection (q)(4)) that, with respect to a grant, 
contract, or other agreement for which the Secretary pro-
vides funding—
405 
‘‘(1) knowingly presents or causes to be presented 
a specified claim (as defined in subsection (r)) under 
such grant, contract, or other agreement that the per-
son knows or should know is false or fraudulent; 
‘‘(2) knowingly makes, uses, or causes to be made 
or used any false statement, omission, or misrepresen-
tation of a material fact in any application, pro-
posal, bid, progress report, or other document that is 
required to be submitted in order to directly or indi-
rectly receive or retain funds provided in whole or in 
part by such Secretary pursuant to such grant, con-
tract, or other agreement; 
‘‘(3) knowingly makes, uses, or causes to be made 
or used, a false record or statement material to a false 
or fraudulent specified claim under such grant, con-
tract, or other agreement; 
‘‘(4) knowingly makes, uses, or causes to be made 
or used, a false record or statement material to an ob-
ligation (as defined in subsection (s)) to pay or trans-
mit funds or property to such Secretary with respect 
to such grant, contract, or other agreement, or know-
ingly conceals or knowingly and improperly avoids or 
decreases an obligation to pay or transmit funds or 
property to such Secretary with respect to such grant, 
contract, or other agreement; or
406 
‘‘(5) fails to grant timely access, upon reasonable 
request (as defined by such Secretary in regulations), 
to the Inspector General of the Department, for the 
purpose of audits, investigations, evaluations, or other 
statutory functions of such Inspector General in mat-
ters involving such grants, contracts, or other agree-
ments; 
shall be subject, in addition to any other penalties that may 
be prescribed by law, to a civil money penalty in cases 
under paragraph (1), of not more than $10,000 for each 
specified claim; in cases under paragraph (2), not more 
than $50,000 for each false statement, omission, or mis-
representation of a material fact; in cases under paragraph 
(3), not more than $50,000 for each false record or state-
ment; in cases under paragraph (4), not more than $50,000 
for each false record or statement or $10,000 for each day 
that the person knowingly conceals or knowingly and im-
properly avoids or decreases an obligation to pay; or in 
cases under paragraph (5), not more than $15,000 for each 
day of the failure described in such paragraph. In addition, 
in cases under paragraphs (1) and (3), such a person shall 
be subject to an assessment of not more than 3 times the 
amount claimed in the specified claim described in such 
paragraph in lieu of damages sustained by the United 
States or a specified State agency because of such specified
407 
claim, and in cases under paragraphs (2) and (4), such 
a person shall be subject to an assessment of not more than 
3 times the total amount of the funds described in para-
graph (2) or (4), respectively (or, in the case of an obliga-
tion to transmit property to the Secretary described in 
paragraph (4), of the value of the property described in such 
paragraph) in lieu of damages sustained by the United 
States or a specified State agency because of such case. In 
addition, the Secretary may make a determination in the 
same proceeding to exclude the person from participation 
in the Federal health care programs (as defined in section 
1128B(f)(1)) and to direct the appropriate State agency to 
exclude the person from participation in any State health 
care program. 
‘‘(p) The provisions of subsections (c), (d), (g), and (h) 
shall apply to a civil money penalty or assessment under 
subsection (o) in the same manner as such provisions apply 
to a penalty, assessment, or proceeding under subsection 
(a). In applying subsection (d), each reference to a claim 
under such subsection shall be treated as including a ref-
erence to a specified claim (as defined in subsection (r)). 
‘‘(q) For purposes of this subsection and subsections 
(o) and (p): 
‘‘(1) The term ‘Department’ means the Depart-
ment of Health and Human Services.
408 
‘‘(2) The term ‘material’ means having a natural 
tendency to influence, or be capable of influencing, the 
payment or receipt of money or property. 
‘‘(3) The term ‘other agreement’ includes a coop-
erative agreement, scholarship, fellowship, loan, sub-
sidy, payment for a specified use, donation agree-
ment, award, or subaward (regardless of whether one 
or more of the persons entering into the agreement is 
a contractor or subcontractor). 
‘‘(4) The term ‘program beneficiary’ means, in 
the case of a grant, contract, or other agreement de-
signed to accomplish the objective of awarding or oth-
erwise furnishing benefits or assistance to individuals 
and for which the Secretary provides funding, an in-
dividual who applies for, or who receives, such bene-
fits or assistance from such grant, contract, or other 
agreement. Such term does not include, with respect 
to such grant, contract, or other agreement, an officer, 
employee, or agent of a person or entity that receives 
such grant or that enters into such contract or other 
agreement. 
‘‘(5) The term ‘recipient’ includes a subrecipient 
or subcontractor. 
‘‘(6) The term ‘specified State agency’ means an 
agency of a State government established or des-
409 
ignated to administer or supervise the administration 
of a grant, contract, or other agreement funded in 
whole or in part by the Secretary. 
‘‘(r) For purposes of this section, the term ‘specified 
claim’ means any application, request, or demand under 
a grant, contract, or other agreement for money or property, 
whether or not the United States or a specified State agency 
has title to the money or property, that is not a claim (as 
defined in subsection (i)(2)) and that— 
‘‘(1) is presented or caused to be presented to an 
officer, employee, or agent of the Department or agen-
cy thereof, or of any specified State agency; or 
‘‘(2) is made to a contractor, grantee, or any 
other recipient if the money or property is to be spent 
or used on the Department’s behalf or to advance a 
Department program or interest, and if the Depart-
ment— 
‘‘(A) provides or has provided any portion 
of the money or property requested or demanded; 
or 
‘‘(B) will reimburse such contractor, grant-
ee, or other recipient for any portion of the 
money or property which is requested or de-
manded.
410 
‘‘(s) For purposes of subsection (o), the term ‘obliga-
tion’ means an established duty, whether or not fixed, aris-
ing from an express or implied contractual, grantor-grant-
ee, or licensor-licensee relationship, for a fee-based or simi-
lar relationship, from statute or regulation, or from the re-
tention of any overpayment.’’. 
(b) CONFORMING AMENDMENTS.—Section 1128A of the 
Social Security Act (42 U.S.C. 1320a–7a) is amended— 
(1) in subsection (e), by inserting ‘‘or specified 
claim’’ after ‘‘claim’’ in the first sentence; and 
(2) in subsection (f)— 
(A) in the matter preceding paragraph 
(1)— 
(i) by inserting ‘‘or specified claim (as 
defined in subsection (r))’’ after ‘‘district 
where the claim’’; and 
(ii) by inserting ‘‘(or, with respect to a 
person described in subsection (o), the per-
son)’’ after ‘‘claimant’’; and 
(B) in the matter following paragraph (4), 
by inserting ‘‘(or, in the case of a penalty or as-
sessment under subsection (o), by a specified 
State agency (as defined in subsection (q)(6)),’’ 
after ‘‘or a State agency’’.
411 
SEC. 
5004. 
REDUCING 
OVERPAYMENTS 
OF 
INFUSION 
DRUGS. 
(a) TREATMENT
OF INFUSION DRUGS FURNISHED 
THROUGH
DURABLE
MEDICAL
EQUIPMENT.—Section 
1842(o)(1) of the Social Security Act (42 U.S.C. 
1395u(o)(1)) is amended— 
(1) in subparagraph (C), by inserting ‘‘(and in-
cluding a drug or biological described in subpara-
graph (D)(i) furnished on or after January 1, 2017)’’ 
after ‘‘2005’’; and 
(2) in subparagraph (D)— 
(A) by striking ‘‘infusion drugs’’ and insert-
ing ‘‘infusion drugs or biologicals’’ each place it 
appears; and 
(B) in clause (i)— 
(i) by striking ‘‘2004’’ and inserting 
‘‘2004, and before January 1, 2017’’; and 
(ii) by striking ‘‘for such drug’’. 
(b) NONINCLUSION OF DME INFUSION DRUGS UNDER 
DME COMPETITIVE ACQUISITION PROGRAMS.— 
(1) IN GENERAL.—Section 1847(a)(2)(A) of the 
Social Security Act (42 U.S.C. 1395w–3(a)(2)(A)) is 
amended— 
(A) by striking ‘‘and excluding’’ and insert-
ing ‘‘, excluding’’; and
412 
(B) by inserting before the period at the end 
the following: ‘‘, and excluding drugs and 
biologicals described in section 1842(o)(1)(D)’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
1842(o)(1)(D)(ii) of the Social Security Act (42 
U.S.C. 1395u(o)(1)(D)(ii)) is amended by striking 
‘‘2007’’ and inserting ‘‘2007, and before the date of 
the enactment of the 21st Century Cures Act.’’. 
SEC. 5005. INCREASING OVERSIGHT OF TERMINATION OF 
MEDICAID PROVIDERS. 
(a) INCREASED OVERSIGHT AND REPORTING.— 
(1) STATE REPORTING REQUIREMENTS.—Section 
1902(kk) of the Social Security Act (42 U.S.C. 
1396a(kk)) is amended— 
(A) by redesignating paragraph (8) as 
paragraph (9); and 
(B) by inserting after paragraph (7) the fol-
lowing new paragraph: 
‘‘(8) PROVIDER TERMINATIONS.— 
‘‘(A) IN GENERAL.—Beginning on July 1, 
2018, in the case of a notification under sub-
section (a)(41) with respect to a termination for 
a reason specified in section 455.101 of title 42, 
Code of Federal Regulations (as in effect on No-
vember 1, 2015) or for any other reason specified
413 
by the Secretary, of the participation of a pro-
vider of services or any other person under the 
State plan (or under a waiver of the plan), the 
State, not later than 30 days after the effective 
date of such termination, submits to the Sec-
retary with respect to any such provider or per-
son, as appropriate— 
‘‘(i) the name of such provider or per-
son; 
‘‘(ii) the provider type of such provider 
or person; 
‘‘(iii) the specialty of such provider’s 
or person’s practice; 
‘‘(iv) the date of birth, Social Security 
number, national provider identifier (if ap-
plicable), Federal taxpayer identification 
number, and the State license or certifi-
cation number of such provider or person (if 
applicable); 
‘‘(v) the reason for the termination; 
‘‘(vi) a copy of the notice of termi-
nation sent to the provider or person; 
‘‘(vii) the date on which such termi-
nation is effective, as specified in the notice; 
and
414 
‘‘(viii) any other information required 
by the Secretary. 
‘‘(B) EFFECTIVE DATE DEFINED.—For pur-
poses of this paragraph, the term ‘effective date’ 
means, with respect to a termination described 
in subparagraph (A), the later of— 
‘‘(i) the date on which such termi-
nation is effective, as specified in the notice 
of such termination; or 
‘‘(ii) the date on which all appeal 
rights applicable to such termination have 
been exhausted or the timeline for any such 
appeal has expired.’’. 
(2) CONTRACT
REQUIREMENT
FOR
MANAGED 
CARE ENTITIES.—Section 1932(d) of the Social Secu-
rity Act (42 U.S.C. 1396u–2(d)) is amended by add-
ing at the end the following new paragraph: 
‘‘(5) CONTRACT
REQUIREMENT
FOR
MANAGED 
CARE ENTITIES.—With respect to any contract with a 
managed care entity under section 1903(m) or 
1905(t)(3) (as applicable), no later than July 1, 2018, 
such contract shall include a provision that providers 
of services or persons terminated (as described in sec-
tion 1902(kk)(8)) from participation under this title, 
title XVIII, or title XXI shall be terminated from par-
415 
ticipating under this title as a provider in any net-
work of such entity that serves individuals eligible to 
receive medical assistance under this title.’’. 
(3) TERMINATION
NOTIFICATION
DATABASE.— 
Section 1902 of the Social Security Act (42 U.S.C. 
1396a) is amended by adding at the end the following 
new subsection: 
‘‘(ll) TERMINATION NOTIFICATION DATABASE.—In the 
case of a provider of services or any other person whose 
participation under this title or title XXI is terminated (as 
described in subsection (kk)(8)), the Secretary shall, not 
later than 30 days after the date on which the Secretary 
is notified of such termination under subsection (a)(41) (as 
applicable), review such termination and, if the Secretary 
determines appropriate, include such termination in any 
database or similar system developed pursuant to section 
6401(b)(2) of the Patient Protection and Affordable Care 
Act (42 U.S.C. 1395cc note; Public Law 111–148).’’. 
(4) NO FEDERAL FUNDS FOR ITEMS AND SERV-
ICES FURNISHED BY TERMINATED PROVIDERS.—Sec-
tion 1903 of the Social Security Act (42 U.S.C. 
1396b) is amended— 
(A) in subsection (i)(2)—
416 
(i) in subparagraph (A), by striking 
the comma at the end and inserting a semi-
colon; 
(ii) in subparagraph (B), by striking 
‘‘or’’ at the end; and 
(iii) by adding at the end the following 
new subparagraph: 
‘‘(D) beginning on July 1, 2018, under the 
plan by any provider of services or person whose 
participation in the State plan is terminated (as 
described in section 1902(kk)(8)) after the date 
that is 60 days after the date on which such ter-
mination is included in the database or other 
system under section 1902(ll); or’’; and 
(B) in subsection (m), by inserting after 
paragraph (2) the following new paragraph: 
‘‘(3) No payment shall be made under this title to a 
State with respect to expenditures incurred by the State for 
payment for services provided by a managed care entity 
(as defined under section 1932(a)(1)) under the State plan 
under this title (or under a waiver of the plan) unless the 
State— 
‘‘(A) beginning on July 1, 2018, has a contract 
with such entity that complies with the requirement 
specified in section 1932(d)(5); and
417 
‘‘(B) beginning on January 1, 2018, complies 
with 
the 
requirement 
specified 
in 
section 
1932(d)(6)(A).’’. 
(5) DEVELOPMENT OF UNIFORM TERMINOLOGY 
FOR
REASONS
FOR
PROVIDER
TERMINATION.—Not 
later than July 1, 2017, the Secretary of Health and 
Human Services shall, in consultation with the heads 
of State agencies administering State Medicaid plans 
(or waivers of such plans), issue regulations estab-
lishing uniform terminology to be used with respect to 
specifying reasons under subparagraph (A)(v) of 
paragraph (8) of section 1902(kk) of the Social Secu-
rity Act (42 U.S.C. 1396a(kk)), as added by para-
graph (1), for the termination (as described in such 
paragraph (8)) of the participation of certain pro-
viders in the Medicaid program under title XIX of 
such Act or the Children’s Health Insurance Program 
under title XXI of such Act. 
(6) 
CONFORMING
AMENDMENT.—Section 
1902(a)(41) of the Social Security Act (42 U.S.C. 
1396a(a)(41)) is amended by striking ‘‘provide that 
whenever’’ and inserting ‘‘provide, in accordance with 
subsection (kk)(8) (as applicable), that whenever’’. 
(b) INCREASING AVAILABILITY
OF MEDICAID PRO-
VIDER INFORMATION.—
418 
(1) 
FFS 
PROVIDER
ENROLLMENT.—Section 
1902(a) of the Social Security Act (42 U.S.C. 
1396a(a)) is amended by inserting after paragraph 
(77) the following new paragraph: 
‘‘(78) provide that, not later than January 1, 
2017, in the case of a State that pursuant to its State 
plan or waiver of the plan for medical assistance 
pays for medical assistance on a fee-for-service basis, 
the State shall require each provider furnishing items 
and services to, or ordering, prescribing, referring, or 
certifying eligibility for, services for individuals eligi-
ble to receive medical assistance under such plan to 
enroll with the State agency and provide to the State 
agency the provider’s identifying information, includ-
ing the name, specialty, date of birth, Social Security 
number, national provider identifier (if applicable), 
Federal taxpayer identification number, and the 
State license or certification number of the provider 
(if applicable);’’. 
(2) MANAGED CARE PROVIDER ENROLLMENT.— 
Section 1932(d) of the Social Security Act (42 U.S.C. 
1396u–2(d)), as amended by subsection (a)(2), is 
amended by adding at the end the following new 
paragraph:
419 
‘‘(6) ENROLLMENT
OF
PARTICIPATING
PRO-
VIDERS.— 
‘‘(A) IN
GENERAL.—Beginning not later 
than January 1, 2018, a State shall require that, 
in order to participate as a provider in the net-
work of a managed care entity that provides 
services to, or orders, prescribes, refers, or cer-
tifies eligibility for services for, individuals who 
are eligible for medical assistance under the 
State plan under this title (or under a waiver of 
the plan) and who are enrolled with the entity, 
the provider is enrolled consistent with section 
1902(kk) with the State agency administering 
the State plan under this title. Such enrollment 
shall include providing to the State agency the 
provider’s identifying information, including the 
name, specialty, date of birth, Social Security 
number, national provider identifier, Federal 
taxpayer identification number, and the State li-
cense or certification number of the provider. 
‘‘(B) RULE OF CONSTRUCTION.—Nothing in 
subparagraph (A) shall be construed as requiring 
a provider described in such subparagraph to 
provide services to individuals who are not en-
420 
rolled with a managed care entity under this 
title.’’. 
(c) COORDINATION WITH CHIP.— 
(1) IN GENERAL.—Section 2107(e)(1) of the So-
cial Security Act (42 U.S.C. 1397gg(e)(1)) is amend-
ed— 
(A) by redesignating subparagraphs (B), 
(C), (D), (E), (F), (G), (H), (I), (J), (K), (L), 
(M), (N), and (O) as subparagraphs (D), (E), 
(F), (G), (H), (I), (J), (K), (M), (N), (O), (P), 
(Q), and (R), respectively; 
(B) by inserting after subparagraph (A) the 
following new subparagraphs: 
‘‘(B) Section 1902(a)(39) (relating to termi-
nation of participation of certain providers). 
‘‘(C) Section 1902(a)(78) (relating to enroll-
ment of providers participating in State plans 
providing medical assistance on a fee-for-service 
basis).’’; 
(C) by inserting after subparagraph (K) (as 
redesignated by subparagraph (A)) the following 
new subparagraph: 
‘‘(L) Section 1903(m)(3) (relating to limi-
tation on payment with respect to managed 
care).’’; and
421 
(D) in subparagraph (P) (as redesignated 
by subparagraph (A)), by striking ‘‘(a)(2)(C) 
and (h)’’ and inserting ‘‘(a)(2)(C) (relating to 
Indian enrollment), (d)(5) (relating to contract 
requirement for managed care entities), (d)(6) 
(relating to enrollment of providers participating 
with a managed care entity), and (h) (relating 
to special rules with respect to Indian enrollees, 
Indian health care providers, and Indian man-
aged care entities)’’. 
(2) EXCLUDING FROM MEDICAID PROVIDERS EX-
CLUDED FROM CHIP.—Section 1902(a)(39) of the So-
cial Security Act (42 U.S.C. 1396a(a)(39)) is amend-
ed by striking ‘‘title XVIII or any other State plan 
under this title’’ and inserting ‘‘title XVIII, any other 
State plan under this title (or waiver of the plan), or 
any State child health plan under title XXI (or waiv-
er of the plan) and such termination is included by 
the Secretary in any database or similar system de-
veloped pursuant to section 6401(b)(2) of the Patient 
Protection and Affordable Care Act’’. 
(d) RULE OF CONSTRUCTION.—Nothing in this section 
shall be construed as changing or limiting the appeal rights 
of providers or the process for appeals of States under the 
Social Security Act.
422 
(e) OIG REPORT.—Not later than March 31, 2020, the 
Inspector General of the Department of Health and Human 
Services shall submit to Congress a report on the implemen-
tation of the amendments made by this section. Such report 
shall include the following: 
(1) An assessment of the extent to which pro-
viders who are included under subsection (ll) of sec-
tion 1902 of the Social Security Act (42 U.S.C. 
1396a) (as added by subsection (a)(3)) in the data-
base or similar system referred to in such subsection 
are terminated (as described in paragraph (8) of sub-
section (kk) of such section, as added by subsection 
(a)(1)) from participation in all State plans under 
title XIX of such Act (or waivers of such plans). 
(2) Information on the amount of Federal finan-
cial participation paid to States under section 1903 
of such Act in violation of the limitation on such pay-
ment specified in subparagraph (D) of subsection 
(i)(2) of such section and paragraph (3) of subsection 
(m) of such section, as added by subsection (a)(4). 
(3) An assessment of the extent to which con-
tracts with managed care entities under title XIX of 
such Act comply with the requirement specified in 
paragraph (5) of section 1932(d) of such Act, as 
added by subsection (a)(2).
423 
(4) An assessment of the extent to which pro-
viders have been enrolled under section 1902(a)(78) or 
1932(d)(6)(A) of such Act (42 U.S.C. 1396a(a)(78), 
1396u–2(d)(6)(A)) with State agencies administering 
State plans under title XIX of such Act (or waivers 
of such plans). 
SEC. 5006. REQUIRING PUBLICATION OF FEE-FOR-SERVICE 
PROVIDER DIRECTORY. 
(a) IN GENERAL.—Section 1902(a) of the Social Secu-
rity Act (42 U.S.C. 1396a(a)) is amended— 
(1) in paragraph (81), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (82), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (82) the fol-
lowing new paragraph: 
‘‘(83) provide that, not later than January 1, 
2017, in the case of a State plan (or waiver of the 
plan) that provides medical assistance on a fee-for- 
service basis or through a primary care case-manage-
ment system described in section 1915(b)(1) (other 
than a primary care case management entity (as de-
fined by the Secretary)), the State shall publish (and 
update on at least an annual basis) on the public 
website of the State agency administering the State
424 
plan, a directory of the physicians described in sub-
section (mm) and, at State option, other providers de-
scribed in such subsection that— 
‘‘(A) includes— 
‘‘(i) with respect to each such physi-
cian or provider— 
‘‘(I) the name of the physician or 
provider; 
‘‘(II) the specialty of the physi-
cian or provider; 
‘‘(III) the address at which the 
physician or provider provides services; 
and 
‘‘(IV) the telephone number of the 
physician or provider; and 
‘‘(ii) with respect to any such physi-
cian or provider participating in such a 
primary care case-management system, in-
formation regarding— 
‘‘(I) whether the physician or pro-
vider is accepting as new patients in-
dividuals who receive medical assist-
ance under this title; and 
‘‘(II) the physician’s or provider’s 
cultural and linguistic capabilities, in-
425 
cluding the languages spoken by the 
physician or provider or by the skilled 
medical interpreter providing interpre-
tation services at the physician’s or 
provider’s office; and 
‘‘(B) may include, at State option, with re-
spect to each such physician or provider— 
‘‘(i) the Internet website of such physi-
cian or provider; or 
‘‘(ii) whether the physician or provider 
is accepting as new patients individuals 
who receive medical assistance under this 
title.’’. 
(b) DIRECTORY
PHYSICIAN
OR
PROVIDER
DE-
SCRIBED.—Section 1902 of the Social Security Act (42 
U.S.C. 1396a), as amended by section 5005(a)(3), is further 
amended by adding at the end the following new subsection: 
‘‘(mm) DIRECTORY PHYSICIAN
OR PROVIDER DE-
SCRIBED.—A physician or provider described in this sub-
section is— 
‘‘(1) in the case of a physician or provider of a 
provider type for which the State agency, as a condi-
tion on receiving payment for items and services fur-
nished by the physician or provider to individuals el-
igible to receive medical assistance under the State
426 
plan, requires the enrollment of the physician or pro-
vider with the State agency, a physician or a pro-
vider that— 
‘‘(A) is enrolled with the agency as of the 
date on which the directory is published or up-
dated (as applicable) under subsection (a)(83); 
and 
‘‘(B) received payment under the State plan 
in the 12-month period preceding such date; and 
‘‘(2) in the case of a physician or provider of a 
provider type for which the State agency does not re-
quire such enrollment, a physician or provider that 
received payment under the State plan (or a waiver 
of the plan) in the 12-month period preceding the 
date on which the directory is published or updated 
(as applicable) under subsection (a)(83).’’. 
(c) RULE OF CONSTRUCTION.— 
(1) IN GENERAL.—The amendment made by sub-
section (a) shall not be construed to apply in the case 
of a State (as defined for purposes of title XIX of the 
Social Security Act) in which all the individuals en-
rolled in the State plan under such title (or under a 
waiver of such plan), other than individuals described 
in paragraph (2), are enrolled with a medicaid man-
aged care organization (as defined in section
427 
1903(m)(1)(A) 
of 
such 
Act 
(42 
U.S.C. 
1396b(m)(1)(A))), including prepaid inpatient health 
plans and prepaid ambulatory health plans (as de-
fined by the Secretary of Health and Human Serv-
ices). 
(2) INDIVIDUALS
DESCRIBED.—An individual 
described in this paragraph is an individual who is 
an Indian (as defined in section 4 of the Indian 
Health Care Improvement Act (25 U.S.C. 1603)) or 
an Alaska Native. 
(d) EXCEPTION FOR STATE LEGISLATION.—In the case 
of a State plan under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.), which the Secretary of Health and 
Human Services determines requires State legislation in 
order for the respective plan to meet one or more additional 
requirements imposed by amendments made by this section, 
the respective plan shall not be regarded as failing to com-
ply with the requirements of such title solely on the basis 
of its failure to meet such an additional requirement before 
the first day of the first calendar quarter beginning after 
the close of the first regular session of the State legislature 
that begins after the date of enactment of this Act. For pur-
poses of the previous sentence, in the case of a State that 
has a 2-year legislative session, each year of the session shall
428 
be considered to be a separate regular session of the State 
legislature. 
SEC. 5007. FAIRNESS IN MEDICAID SUPPLEMENTAL NEEDS 
TRUSTS. 
(a) IN GENERAL.—Section 1917(d)(4)(A) of the Social 
Security Act (42 U.S.C. 1396p(d)(4)(A)) is amended by in-
serting ‘‘the individual,’’ after ‘‘for the benefit of such indi-
vidual by’’. 
(b) EFFECTIVE DATE.—The amendment made by sub-
section (a) shall apply to trusts established on or after the 
date of the enactment of this Act. 
SEC. 5008. ELIMINATING FEDERAL FINANCIAL PARTICIPA-
TION 
WITH 
RESPECT 
TO 
EXPENDITURES 
UNDER MEDICAID FOR AGENTS USED FOR 
COSMETIC PURPOSES OR HAIR GROWTH. 
(a) IN GENERAL.—Section 1903(i)(21) of the Social 
Security Act (42 U.S.C. 1396b(i)(21)) is amended by in-
serting ‘‘section 1927(d)(2)(C) (relating to drugs when used 
for cosmetic purposes or hair growth), except where medi-
cally necessary, and’’ after ‘‘drugs described in’’. 
(b) EFFECTIVE DATE.—The amendment made by sub-
section (a) shall apply with respect to calendar quarters 
beginning on or after the date of the enactment of this Act.
429 
SEC. 5009. AMENDMENT TO THE PREVENTION AND PUBLIC 
HEALTH FUND. 
Section 4002(b) of the Patient Protection and Afford-
able Care Act (42 U.S.C. 300u–11(b)) is amended— 
(1) 
in 
paragraph 
(3), 
by 
striking 
‘‘$1,250,000,000’’ and inserting ‘‘$900,000,000’’; 
(2) 
in 
paragraph 
(4), 
by 
striking 
‘‘$1,500,000,000’’ and inserting ‘‘$1,000,000,000’’; 
and 
(3) by striking paragraph (5) and inserting the 
following: 
‘‘(5) for fiscal year 2022, $1,500,000,000; 
‘‘(6) for fiscal year 2023, $1,000,000,000; 
‘‘(7) for fiscal year 2024, $1,700,000,000; and 
‘‘(8) for fiscal year 2025 and each fiscal year 
thereafter, $2,000,000,000.’’. 
SEC. 5010. STRATEGIC PETROLEUM RESERVE DRAWDOWN. 
(a) DRAWDOWN AND SALE.— 
(1) IN GENERAL.—Notwithstanding section 161 
of the Energy Policy and Conservation Act (42 U.S.C. 
6241), except as provided in subsections (b) and (c), 
the Secretary of Energy shall drawdown and sell from 
the Strategic Petroleum Reserve— 
(A) 10,000,000 barrels of crude oil during 
fiscal year 2017;
430 
(B) 9,000,000 barrels of crude oil during 
fiscal year 2018; and 
(C) 6,000,000 barrels of crude oil during 
fiscal year 2019. 
(2) DEPOSIT
OF
AMOUNTS
RECEIVED
FROM 
SALE.—Amounts received from a sale under para-
graph (1) shall be deposited in the general fund of the 
Treasury during the fiscal year in which the sale oc-
curs. 
(b) EMERGENCY PROTECTION.—The Secretary shall 
not draw down and sell crude oil under this section in 
quantities that would limit the authority to sell petroleum 
products under section 161(h) of the Energy Policy and 
Conservation Act (42 U.S.C. 6241(h)) in the full quantity 
authorized by that subsection. 
(c) STRATEGIC
PETROLEUM
DRAWDOWN
LIMITA-
TIONS.—Subparagraphs (C) and (D) of section 161(h)(2) 
of the Energy Policy and Conservation Act (42 U.S.C. 
6241(h)(2)(C) and (D)) are both amended by striking 
‘‘500,000,000’’ and inserting ‘‘450,000,000’’. 
SEC. 5011. RESCISSION OF PORTION OF ACA TERRITORY 
FUNDING. 
Of the unobligated amounts available under section 
1323(c)(1) of the Patient Protection and Affordable Care
432 
‘‘(B) with respect to whom a plan prescribing 
the type, amount, and duration of infusion therapy 
services that are to be furnished such individual has 
been established by a physician (as defined in sub-
section (r)(1)) and is periodically reviewed by a phy-
sician (as so defined) in coordination with the fur-
nishing of home infusion drugs (as defined in para-
graph (3)(C)) under part B. 
‘‘(2) The items and services described in this para-
graph are the following: 
‘‘(A) Professional services, including nursing 
services, furnished in accordance with the plan. 
‘‘(B) Training and education (not otherwise 
paid for as durable medical equipment (as defined in 
subsection (n)), remote monitoring, and monitoring 
services for the provision of home infusion therapy 
and home infusion drugs furnished by a qualified 
home infusion therapy supplier. 
‘‘(3) For purposes of this subsection: 
‘‘(A) The term ‘applicable provider’ means— 
‘‘(i) a physician; 
‘‘(ii) a nurse practitioner; and 
‘‘(iii) a physician assistant.
433 
‘‘(B) The term ‘home’ means a place of residence 
used as the home of an individual (as defined for pur-
poses of subsection (n)). 
‘‘(C) The term ‘home infusion drug’ means a 
parenteral drug or biological administered intra-
venously, or subcutaneously for an administration pe-
riod of 15 minutes or more, in the home of an indi-
vidual through a pump that is an item of durable 
medical equipment (as defined in subsection (n)). 
Such term does not include the following: 
‘‘(i) Insulin pump systems. 
‘‘(ii) A self-administered drug or biological 
on a self-administered drug exclusion list. 
‘‘(D)(i) The term ‘qualified home infusion ther-
apy supplier’ means a pharmacy, physician, or other 
provider of services or supplier licensed by the State 
in which the pharmacy, physician, or provider or 
services or supplier furnishes items or services and 
that— 
‘‘(I) furnishes infusion therapy to individ-
uals with acute or chronic conditions requiring 
administration of home infusion drugs; 
‘‘(II) ensures the safe and effective provision 
and administration of home infusion therapy on 
a 7-day-a-week, 24-hour-a-day basis;
434 
‘‘(III) is accredited by an organization des-
ignated by the Secretary pursuant to section 
1834(u)(5); and 
‘‘(IV) meets such other requirements as the 
Secretary determines appropriate, taking into 
account the standards of care for home infusion 
therapy established by Medicare Advantage plans 
under part C and in the private sector. 
‘‘(ii) A qualified home infusion therapy supplier 
may subcontract with a pharmacy, physician, pro-
vider of services, or supplier to meet the requirements 
of this subparagraph.’’. 
(b) PAYMENT
AND RELATED REQUIREMENTS
FOR 
HOME INFUSION THERAPY.—Section 1834 of the Social Se-
curity Act (42 U.S.C. 1395m), as amended by section 4011, 
is further amended by adding at the end the following new 
subsection: 
‘‘(u) PAYMENT AND RELATED REQUIREMENTS FOR 
HOME INFUSION THERAPY.— 
‘‘(1) PAYMENT.— 
‘‘(A) SINGLE PAYMENT.— 
‘‘(i) IN
GENERAL.—Subject to clause 
(iii) and subparagraphs (B) and (C), the 
Secretary shall implement a payment sys-
tem under which a single payment is made
435 
under this title to a qualified home infusion 
therapy supplier for items and services de-
scribed in subparagraphs (A) and (B) of 
section 1861(iii)(2)) furnished by a quali-
fied home infusion therapy supplier (as de-
fined in section 1861(iii)(3)(D)) in coordi-
nation with the furnishing of home infusion 
drugs (as defined in section 1861(iii)(3)(C)) 
under this part. 
‘‘(ii) UNIT
OF
SINGLE
PAYMENT.—A 
unit of single payment under the payment 
system implemented under this subpara-
graph is for each infusion drug administra-
tion calendar day in the individual’s home. 
The Secretary shall, as appropriate, estab-
lish single payment amounts for types of in-
fusion therapy, including to take into ac-
count variation in utilization of nursing 
services by therapy type. 
‘‘(iii) LIMITATION.—The single pay-
ment amount determined under this sub-
paragraph after application of subpara-
graph (B) and paragraph (3) shall not ex-
ceed the amount determined under the fee 
schedule under section 1848 for infusion
436 
therapy services furnished in a calendar 
day if furnished in a physician office set-
ting, except such single payment shall not 
reflect more than 5 hours of infusion for a 
particular therapy in a calendar day. 
‘‘(B) REQUIRED ADJUSTMENTS.—The Sec-
retary shall adjust the single payment amount 
determined under subparagraph (A) for home in-
fusion therapy services under section 1861(iii)(1) 
to reflect other factors such as— 
‘‘(i) a geographic wage index and other 
costs that may vary by region; and 
‘‘(ii) patient acuity and complexity of 
drug administration. 
‘‘(C) DISCRETIONARY ADJUSTMENTS.— 
‘‘(i) IN
GENERAL.—Subject to clause 
(ii), the Secretary may adjust the single 
payment amount determined under sub-
paragraph (A) (after application of sub-
paragraph (B)) to reflect outlier situations 
and other factors as the Secretary deter-
mines appropriate. 
‘‘(ii) REQUIREMENT OF BUDGET NEU-
TRALITY.—Any adjustment under this sub-
437 
paragraph shall be made in a budget neu-
tral manner. 
‘‘(2) CONSIDERATIONS.—In developing the pay-
ment system under this subsection, the Secretary may 
consider the costs of furnishing infusion therapy in 
the home, consult with home infusion therapy sup-
pliers, consider payment amounts for similar items 
and services under this part and part A, and consider 
payment amounts established by Medicare Advantage 
plans under part C and in the private insurance 
market for home infusion therapy (including average 
per treatment day payment amounts by type of home 
infusion therapy). 
‘‘(3) ANNUAL UPDATES.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the Secretary shall update the single 
payment amount under this subsection from year 
to year beginning in 2022 by increasing the sin-
gle payment amount from the prior year by the 
percentage increase in the Consumer Price Index 
for all urban consumers (United States city av-
erage) for the 12-month period ending with June 
of the preceding year. 
‘‘(B) ADJUSTMENT.—For each year, the 
Secretary shall reduce the percentage increase de-
438 
scribed in subparagraph (A) by the productivity 
adjustment 
described 
in 
section 
1886(b)(3)(B)(xi)(II). The application of the pre-
ceding sentence may result in a percentage being 
less than 0.0 for a year, and may result in pay-
ment being less than such payment rates for the 
preceding year. 
‘‘(4) AUTHORITY TO APPLY PRIOR AUTHORIZA-
TION.—The Secretary may, as determined appro-
priate by the Secretary, apply prior authorization for 
home 
infusion 
therapy 
services 
under 
section 
1861(iii)(1). 
‘‘(5) ACCREDITATION OF QUALIFIED HOME INFU-
SION THERAPY SUPPLIERS.— 
‘‘(A) FACTORS
FOR
DESIGNATION
OF
AC-
CREDITATION
ORGANIZATIONS.—The Secretary 
shall consider the following factors in desig-
nating accreditation organizations under sub-
paragraph (B) and in reviewing and modifying 
the list of accreditation organizations designated 
pursuant to subparagraph (C): 
‘‘(i) The ability of the organization to 
conduct timely reviews of accreditation ap-
plications.
439 
‘‘(ii) The ability of the organization to 
take into account the capacities of suppliers 
located in a rural area (as defined in sec-
tion 1886(d)(2)(D)). 
‘‘(iii) Whether the organization has es-
tablished reasonable fees to be charged to 
suppliers applying for accreditation. 
‘‘(iv) Such other factors as the Sec-
retary determines appropriate. 
‘‘(B) DESIGNATION.—Not later than Janu-
ary 1, 2021, the Secretary shall designate orga-
nizations to accredit suppliers furnishing home 
infusion therapy. The list of accreditation orga-
nizations so designated may be modified pursu-
ant to subparagraph (C). 
‘‘(C) REVIEW AND MODIFICATION OF LIST 
OF ACCREDITATION ORGANIZATIONS.— 
‘‘(i) IN GENERAL.—The Secretary shall 
review the list of accreditation organiza-
tions designated under subparagraph (B) 
taking into account the factors under sub-
paragraph (A). Taking into account the re-
sults of such review, the Secretary may, by 
regulation, modify the list of accreditation
440 
organizations designated under subpara-
graph (B). 
‘‘(ii) SPECIAL RULE FOR ACCREDITA-
TIONS DONE PRIOR TO REMOVAL FROM LIST 
OF DESIGNATED ACCREDITATION ORGANIZA-
TIONS.—In the case where the Secretary re-
moves an organization from the list of ac-
creditation organizations designated under 
subparagraph (B), any supplier that is ac-
credited by the organization during the pe-
riod beginning on the date on which the or-
ganization is designated as an accreditation 
organization under subparagraph (B) and 
ending on the date on which the organiza-
tion is removed from such list shall be con-
sidered to have been accredited by an orga-
nization designated by the Secretary under 
subparagraph (B) for the remaining period 
such accreditation is in effect. 
‘‘(D) RULE
FOR
ACCREDITATIONS
MADE 
PRIOR TO DESIGNATION.—In the case of a sup-
plier that is accredited before January 1, 2021, 
by an accreditation organization designated by 
the Secretary under subparagraph (B) as of Jan-
uary 1, 2019, such supplier shall be considered
441 
to have been accredited by an organization des-
ignated by the Secretary under such paragraph 
as of January 1, 2023, for the remaining period 
such accreditation is in effect. 
‘‘(6) NOTIFICATION OF INFUSION THERAPY OP-
TIONS AVAILABLE PRIOR TO FURNISHING HOME INFU-
SION THERAPY.—Prior to the furnishing of home in-
fusion therapy to an individual, the physician who 
establishes the plan described in section 1861(iii)(1) 
for the individual shall provide notification (in a 
form, manner, and frequency determined appropriate 
by the Secretary) of the options available (such as 
home, physician’s office, hospital outpatient depart-
ment) for the furnishing of infusion therapy under 
this part.’’. 
(c) CONFORMING AMENDMENTS.— 
(1) PAYMENT REFERENCE.—Section 1833(a)(1) 
of the Social Security Act (42 U.S.C. 1395l(a)(1)) is 
amended— 
(A) by striking ‘‘and’’ before ‘‘(AA)’’; and 
(B) by inserting before the semicolon at the 
end the following: ‘‘, and (BB) with respect to 
home infusion therapy, the amount paid shall be 
an amount equal to 80 percent of the lesser of the
442 
actual charge for the services or the amount de-
termined under section 1834(u)’’. 
(2) DIRECT PAYMENT.—The first sentence of sec-
tion 1842(b)(6) of the Social Security Act (42 U.S.C. 
1395u(b)(6)) is amended— 
(A) by striking ‘‘and’’ before ‘‘(H)’’; and 
(B) by inserting before the period at the end 
the following: ‘‘, and (I) in the case of home in-
fusion therapy, payment shall be made to the 
qualified home infusion therapy supplier’’. 
(3) EXCLUSION
FROM
HOME
HEALTH
SERV-
ICES.—Section 1861(m) of the Social Security Act 
(42 U.S.C. 1395x(m)) is amended, in the first sen-
tence, by inserting the following before the period at 
the end: ‘‘and home infusion therapy (as defined in 
subsection (iii)(i))’’. 
(d) EFFECTIVE DATE.—The amendments made by this 
section shall apply to items and services furnished on or 
after January 1, 2021. 
DIVISION B—HELPING FAMILIES 
IN MENTAL HEALTH CRISIS 
SEC. 6000. SHORT TITLE. 
This division may be cited as the ‘‘Helping Families 
in Mental Health Crisis Reform Act of 2016’’.
443 
TITLE 
VI—STRENGTHENING 
LEADERSHIP AND ACCOUNT-
ABILITY 
Subtitle A—Leadership 
SEC. 6001. ASSISTANT SECRETARY FOR MENTAL HEALTH 
AND SUBSTANCE USE. 
(a) ASSISTANT SECRETARY.—Section 501(c) of the 
Public Health Service Act (42 U.S.C. 290aa(c)) is amended 
to read as follows: 
‘‘(c) ASSISTANT SECRETARY AND DEPUTY ASSISTANT 
SECRETARY.— 
‘‘(1) ASSISTANT SECRETARY.—The Administra-
tion shall be headed by an official to be known as the 
Assistant Secretary for Mental Health and Substance 
Use (hereinafter in this title referred to as the ‘Assist-
ant Secretary’) who shall be appointed by the Presi-
dent, by and with the advice and consent of the Sen-
ate. 
‘‘(2) DEPUTY ASSISTANT SECRETARY.—The As-
sistant Secretary, with the approval of the Secretary, 
may appoint a Deputy Assistant Secretary and may 
employ and prescribe the functions of such officers 
and employees, including attorneys, as are necessary 
to administer the activities to be carried out through 
the Administration.’’.
444 
(b) TRANSFER OF AUTHORITIES.—The Secretary of 
Health and Human Services shall delegate to the Assistant 
Secretary for Mental Health and Substance Use all duties 
and authorities that— 
(1) as of the day before the date of enactment of 
this Act, were vested in the Administrator of the Sub-
stance Abuse and Mental Health Services Administra-
tion; and 
(2) are not terminated by this Act. 
(c) CONFORMING AMENDMENTS.—Title V of the Public 
Health Service Act (42 U.S.C. 290aa et seq.), as amended 
by the previous provisions of this section, is further amend-
ed— 
(1) by striking ‘‘Administrator of the Substance 
Abuse and Mental Health Services Administration’’ 
each place it appears and inserting ‘‘Assistant Sec-
retary for Mental Health and Substance Use’’; and 
(2) by striking ‘‘Administrator’’ or ‘‘ADMINIS-
TRATOR’’ each place it appears (including in any 
headings) and inserting ‘‘Assistant Secretary’’ or 
‘‘ASSISTANT SECRETARY’’, respectively, except where 
the term ‘‘Administrator’’ appears— 
(A) in each of subsections (e) and (f) of sec-
tion 501 of such Act (42 U.S.C. 290aa), includ-
446 
SEC. 6002. STRENGTHENING THE LEADERSHIP OF THE SUB-
STANCE ABUSE AND MENTAL HEALTH SERV-
ICES ADMINISTRATION. 
Section 501 of the Public Health Service Act (42 
U.S.C. 290aa), as amended by section 6001, is further 
amended— 
(1) in subsection (b)— 
(A) in the subsection heading, by striking 
‘‘AGENCIES’’ and inserting ‘‘CENTERS’’; and 
(B) in the matter preceding paragraph (1), 
by striking ‘‘entities’’ and inserting ‘‘Centers’’; 
(2) in subsection (d)— 
(A) in paragraph (1)— 
(i) by striking ‘‘agencies’’ each place 
the term appears and inserting ‘‘Centers’’; 
and 
(ii) by striking ‘‘such agency’’ and in-
serting ‘‘such Center’’; 
(B) in paragraph (2)— 
(i) by striking ‘‘agencies’’ and insert-
ing ‘‘Centers’’; 
(ii) by striking ‘‘with respect to sub-
stance abuse’’ and inserting ‘‘with respect to 
substance use disorders’’; and
447 
(iii) by striking ‘‘and individuals who 
are substance abusers’’ and inserting ‘‘and 
individuals with substance use disorders’’; 
(C) in paragraph (5), by striking ‘‘sub-
stance abuse’’ and inserting ‘‘substance use dis-
order’’; 
(D) in paragraph (6)— 
(i) by striking ‘‘the Centers for Disease 
Control’’ and inserting ‘‘the Centers for Dis-
ease Control and Prevention,’’; 
(ii) by striking ‘‘Administration de-
velop’’ and inserting ‘‘Administration, de-
velop’’; 
(iii) by striking ‘‘HIV or tuberculosis 
among substance abusers and individuals 
with mental illness’’ and inserting ‘‘HIV, 
hepatitis, tuberculosis, and other commu-
nicable diseases among individuals with 
mental or substance use disorders,’’; and 
(iv) by striking ‘‘illnesses’’ at the end 
and inserting ‘‘diseases or disorders’’; 
(E) in paragraph (7), by striking ‘‘abuse 
utilizing anti-addiction medications, including 
methadone’’ and inserting ‘‘use disorders, includ-
ing services that utilize drugs or devices ap-
448 
proved or cleared by the Food and Drug Admin-
istration for the treatment of substance use dis-
orders’’; 
(F) in paragraph (8)— 
(i) by striking ‘‘Agency for Health 
Care Policy Research’’ and inserting ‘‘Agen-
cy for Healthcare Research and Quality’’; 
and 
(ii) by striking ‘‘treatment and preven-
tion’’ and inserting ‘‘prevention and treat-
ment’’; 
(G) in paragraph (9)— 
(i) by inserting ‘‘and maintenance’’ 
after ‘‘development’’; 
(ii) by striking ‘‘Agency for Health 
Care Policy Research’’ and inserting ‘‘Agen-
cy for Healthcare Research and Quality’’; 
and 
(iii) by striking ‘‘treatment and pre-
vention services’’ and inserting ‘‘prevention, 
treatment, and recovery support services 
and are appropriately incorporated into 
programs carried out by the Administra-
tion’’;
449 
(H) in paragraph (10), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; 
(I) by striking paragraph (11) and insert-
ing the following: 
‘‘(11) work with relevant agencies of the Depart-
ment of Health and Human Services on integrating 
mental health promotion and substance use disorder 
prevention with general health promotion and disease 
prevention and integrating mental and substance use 
disorders treatment services with physical health 
treatment services;’’; 
(J) in paragraph (13)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘this title, assure 
that’’ and inserting ‘‘this title or part B of 
title XIX, or grant programs otherwise 
funded by the Administration’’; 
(ii) in subparagraph (A)— 
(I) by inserting ‘‘require that’’ be-
fore ‘‘all grants’’; and 
(II) by striking ‘‘and’’ at the end; 
(iii) by redesignating subparagraph 
(B) as subparagraph (C); 
(iv) by inserting after subparagraph 
(A) the following:
450 
‘‘(B) ensure that the director of each Center 
of the Administration consistently documents the 
application of criteria when awarding grants 
and the ongoing oversight of grantees after such 
grants are awarded;’’; 
(v) in subparagraph (C), as so redesig-
nated— 
(I) by inserting ‘‘require that’’ be-
fore ‘‘all grants’’; and 
(II) in clause (ii), by inserting 
‘‘and’’ after the semicolon at the end; 
and 
(vi) by adding at the end the following: 
‘‘(D) inform a State when any funds are 
awarded through such a grant to any entity 
within such State;’’; 
(K) in paragraph (16), by striking ‘‘abuse 
and mental health information’’ and inserting 
‘‘use disorder information, including evidence- 
based and promising best practices for preven-
tion, treatment, and recovery support services for 
individuals with mental and substance use dis-
orders,’’; 
(L) in paragraph (17)—
451 
(i) by striking ‘‘substance abuse’’ and 
inserting ‘‘substance use disorder’’; and 
(ii) by striking ‘‘and’’ at the end; 
(M) in paragraph (18), by striking the pe-
riod and inserting a semicolon; and 
(N) by adding at the end the following: 
‘‘(19) consult with State, local, and tribal gov-
ernments, nongovernmental entities, and individuals 
with mental illness, particularly adults with a serious 
mental illness, children with a serious emotional dis-
turbance, and the family members of such adults and 
children, with respect to improving community-based 
and other mental health services; 
‘‘(20) collaborate with the Secretary of Defense 
and the Secretary of Veterans Affairs to improve the 
provision of mental and substance use disorder serv-
ices provided by the Department of Defense and the 
Department of Veterans Affairs to members of the 
Armed Forces, veterans, and the family members of 
such members and veterans, including through the 
provision of services using the telehealth capabilities 
of the Department of Defense and the Department of 
Veterans Affairs; 
‘‘(21) collaborate with the heads of relevant Fed-
eral agencies and departments, States, communities,
452 
and nongovernmental experts to improve mental and 
substance use disorders services for chronically home-
less individuals, including by designing strategies to 
provide such services in supportive housing; 
‘‘(22) work with States and other stakeholders to 
develop and support activities to recruit and retain 
a workforce addressing mental and substance use dis-
orders; 
‘‘(23) collaborate with the Attorney General and 
representatives of the criminal justice system to im-
prove mental and substance use disorders services for 
individuals who have been arrested or incarcerated; 
‘‘(24) after providing an opportunity for public 
input, set standards for grant programs under this 
title for mental and substance use disorders services 
and prevention programs, which standards may ad-
dress— 
‘‘(A) the capacity of the grantee to imple-
ment the award; 
‘‘(B) requirements for the description of the 
program implementation approach; 
‘‘(C) the extent to which the grant plan sub-
mitted by the grantee as part of its application 
must explain how the grantee will reach the pop-
ulation of focus and provide a statement of need,
453 
which may include information on how the 
grantee will increase access to services and a de-
scription of measurable objectives for improving 
outcomes; 
‘‘(D) the extent to which the grantee must 
collect and report on required performance meas-
ures; and 
‘‘(E) the extent to which the grantee is pro-
posing to use evidence-based practices; and 
‘‘(25) advance, through existing programs, the 
use of performance metrics, including those based on 
the recommendations on performance metrics from the 
Assistant Secretary for Planning and Evaluation 
under section 6021(d) of the Helping Families in 
Mental Health Crisis Reform Act of 2016.’’; and 
(3) in subsection (m), by adding at the end the 
following: 
‘‘(4) EMERGENCY
RESPONSE.—Amounts made 
available for carrying out this subsection shall remain 
available through the end of the fiscal year following 
the fiscal year for which such amounts are appro-
priated.’’.
454 
SEC. 6003. CHIEF MEDICAL OFFICER. 
Section 501 of the Public Health Service Act (42 
U.S.C. 290aa), as amended by sections 6001 and 6002, is 
further amended— 
(1) by redesignating subsections (g) through (j) 
and subsections (k) through (o) as subsections (h) 
through (k) and subsections (m) through (q), respec-
tively; 
(2) in subsection (e)(3)(C), by striking ‘‘sub-
section (k)’’ and inserting ‘‘subsection (m)’’; 
(3) in subsection (f)(2)(C)(iii), by striking ‘‘sub-
section (k)’’ and inserting ‘‘subsection (m)’’; and 
(4) by inserting after subsection (f) the following: 
‘‘(g) CHIEF MEDICAL OFFICER.— 
‘‘(1) IN
GENERAL.—The Assistant Secretary, 
with the approval of the Secretary, shall appoint a 
Chief Medical Officer to serve within the Administra-
tion. 
‘‘(2) ELIGIBLE CANDIDATES.—The Assistant Sec-
retary shall select the Chief Medical Officer from 
among individuals who— 
‘‘(A) have a doctoral degree in medicine or 
osteopathic medicine; 
‘‘(B) have experience in the provision of 
mental or substance use disorder services;
455 
‘‘(C) have experience working with mental 
or substance use disorder programs; 
‘‘(D) have an understanding of biological, 
psychosocial, and pharmaceutical treatments of 
mental or substance use disorders; and 
‘‘(E) are licensed to practice medicine in 
one or more States. 
‘‘(3) DUTIES.—The Chief Medical Officer shall— 
‘‘(A) serve as a liaison between the Admin-
istration and providers of mental and substance 
use disorders prevention, treatment, and recovery 
services; 
‘‘(B) assist the Assistant Secretary in the 
evaluation, organization, integration, and co-
ordination of programs operated by the Adminis-
tration; 
‘‘(C) promote evidence-based and promising 
best practices, including culturally and linguis-
tically appropriate practices, as appropriate, for 
the prevention and treatment of, and recovery 
from, mental and substance use disorders, in-
cluding serious mental illness and serious emo-
tional disturbances; 
‘‘(D) participate in regular strategic plan-
ning with the Administration;
456 
‘‘(E) coordinate with the Assistant Sec-
retary for Planning and Evaluation to assess the 
use of performance metrics to evaluate activities 
within the Administration related to mental and 
substance use disorders; and 
‘‘(F) coordinate with the Assistant Sec-
retary to ensure mental and substance use dis-
orders grant programs within the Administra-
tion consistently utilize appropriate performance 
metrics and evaluation designs.’’. 
SEC. 6004. IMPROVING THE QUALITY OF BEHAVIORAL 
HEALTH PROGRAMS. 
Section 505 of the Public Health Service Act (42 
U.S.C. 290aa–4), as amended by section 6001(c), is amend-
ed— 
(1) by striking the section designation and head-
ing and inserting the following: 
‘‘SEC. 505. CENTER FOR BEHAVIORAL HEALTH STATISTICS 
AND QUALITY.’’; 
(2) by redesignating subsections (a) through (d) 
as subsections (b) through (e), respectively; 
(3) before subsection (b), as redesignated by 
paragraph (2), by inserting the following: 
‘‘(a) IN GENERAL.—The Assistant Secretary shall 
maintain within the Administration a Center for Behav-
457 
ioral Health Statistics and Quality (in this section referred 
to as the ‘Center’). The Center shall be headed by a Director 
(in this section referred to as the ‘Director’) appointed by 
the Secretary from among individuals with extensive expe-
rience and academic qualifications in research and analysis 
in behavioral health care or related fields.’’; 
(4) in subsection (b), as redesignated by para-
graph (2)— 
(A) by redesignating paragraphs (1) and 
(2) as subparagraphs (A) and (B), respectively; 
(B) by striking ‘‘The Secretary, acting’’ and 
all that follows through ‘‘year on—’’ and insert-
ing ‘‘The Director shall— 
‘‘(1) coordinate the Administration’s integrated 
data strategy, including by collecting data each year 
on—’’; 
(C) in the subparagraph (B), as redesig-
nated by subparagraph (A), by striking ‘‘Assist-
ant Secretary’’ and inserting ‘‘Director’’; and 
(D) by adding at the end the following new 
paragraphs: 
‘‘(2) provide statistical and analytical support 
for activities of the Administration;
458 
‘‘(3) recommend a core set of performance 
metrics to evaluate activities supported by the Admin-
istration; and 
‘‘(4) coordinate with the Assistant Secretary, the 
Assistant Secretary for Planning and Evaluation, 
and the Chief Medical Officer appointed under section 
501(g), as appropriate, to improve the quality of serv-
ices provided by programs of the Administration and 
the evaluation of activities carried out by the Admin-
istration.’’. 
(5) in subsection (c), as so redesignated— 
(A) by striking ‘‘With respect to the activi-
ties’’ and inserting ‘‘MENTAL HEALTH.—With 
respect to the activities’’; 
(B) by striking ‘‘Assistant Secretary’’ each 
place it appears and inserting ‘‘Director’’; and 
(C) by striking ‘‘subsection (a)’’ and insert-
ing ‘‘subsection (b)(1)’’; 
(6) in subsection (d), as so redesignated— 
(A) by striking the subsection designation 
and all that follows through ‘‘With respect to the 
activities’’ and inserting the following: 
‘‘(d) SUBSTANCE ABUSE.— 
‘‘(1) IN GENERAL.—With respect to the activi-
ties’’;
459 
(B) in paragraph (1)— 
(i) in the matter before subparagraph 
(A)— 
(I) by striking ‘‘subsection (a)’’ 
and inserting ‘‘subsection (b)(1)’’; and 
(II) by striking ‘‘Assistant Sec-
retary’’ each place it appears and in-
serting ‘‘Director’’; and 
(ii) in subparagraph (B), by inserting 
‘‘in coordination with the Centers for Dis-
ease Control and Prevention’’ before the 
semicolon at the end; and 
(C) in paragraph (2), by striking ‘‘ANNUAL 
SURVEYS’’ and inserting ‘‘ANNUAL
SURVEYS; 
PUBLIC
AVAILABILITY
OF
DATA.—Annual sur-
veys’’; and 
(7) in subsection (e), as so redesignated— 
(A) by striking ‘‘After consultation’’ and in-
serting ‘‘CONSULTATION.—After consultation’’; 
and 
(B) by striking ‘‘Assistant Secretary shall 
develop’’ and inserting ‘‘Assistant Secretary shall 
use existing standards and best practices to de-
velop’’.
460 
SEC. 6005. STRATEGIC PLAN. 
Section 501 of the Public Health Service Act (42 
U.S.C. 290aa), as amended by sections 6001 through 6003, 
is further amended by inserting after subsection (k), as re-
designated by section 6003, the following: 
‘‘(l) STRATEGIC PLAN.— 
‘‘(1) IN GENERAL.—Not later than September 30, 
2018, and every 4 years thereafter, the Assistant Sec-
retary shall develop and carry out a strategic plan in 
accordance with this subsection for the planning and 
operation of activities carried out by the Administra-
tion, including evidence-based programs. 
‘‘(2) COORDINATION.—In developing and car-
rying out the strategic plan under this subsection, the 
Assistant Secretary shall take into consideration the 
findings and recommendations of the Assistant Sec-
retary for Planning and Evaluation under section 
6021(d) of the Helping Families in Mental Health 
Crisis Reform Act of 2016 and the report of the Inter-
departmental Serious Mental Illness Coordinating 
Committee under section 6031 of such Act. 
‘‘(3) PUBLICATION
OF
PLAN.—Not later than 
September 30, 2018, and every 4 years thereafter, the 
Assistant Secretary shall— 
‘‘(A) submit the strategic plan developed 
under paragraph (1) to the Committee on En-
461 
ergy and Commerce and the Committee on Ap-
propriations of the House of Representatives and 
the Committee on Health, Education, Labor, and 
Pensions and the Committee on Appropriations 
of the Senate; and 
‘‘(B) post such plan on the Internet website 
of the Administration. 
‘‘(4) CONTENTS.—The strategic plan developed 
under paragraph (1) shall— 
‘‘(A) identify strategic priorities, goals, and 
measurable objectives for mental and substance 
use disorders activities and programs operated 
and supported by the Administration, including 
priorities to prevent or eliminate the burden of 
mental and substance use disorders; 
‘‘(B) identify ways to improve the quality 
of services for individuals with mental and sub-
stance use disorders, and to reduce homelessness, 
arrest, incarceration, violence, including self-di-
rected violence, and unnecessary hospitalization 
of individuals with a mental or substance use 
disorder, including adults with a serious mental 
illness or children with a serious emotional dis-
turbance;
462 
‘‘(C) ensure that programs provide, as ap-
propriate, access to effective and evidence-based 
prevention, diagnosis, intervention, treatment, 
and recovery services, including culturally and 
linguistically appropriate services, as appro-
priate, for individuals with a mental or sub-
stance use disorder; 
‘‘(D) identify opportunities to collaborate 
with the Health Resources and Services Adminis-
tration to develop or improve— 
‘‘(i) initiatives to encourage individ-
uals to pursue careers (especially in rural 
and underserved areas and with rural and 
underserved populations) as psychiatrists, 
including child and adolescent psychiatrists, 
psychologists, 
psychiatric 
nurse 
practi-
tioners, physician assistants, clinical social 
workers, certified peer support specialists, 
licensed professional counselors, or other li-
censed or certified mental health or sub-
stance use disorder professionals, including 
such professionals specializing in the diag-
nosis, evaluation, or treatment of adults 
with a serious mental illness or children 
with a serious emotional disturbance; and
463 
‘‘(ii) a strategy to improve the recruit-
ment, training, and retention of a workforce 
for the treatment of individuals with mental 
or substance use disorders, or co-occurring 
disorders; 
‘‘(E) identify opportunities to improve col-
laboration with States, local governments, com-
munities, and Indian tribes and tribal organiza-
tions (as such terms are defined in section 4 of 
the Indian Self-Determination and Education 
Assistance Act); and 
‘‘(F) specify a strategy to disseminate evi-
dence-based and promising best practices related 
to prevention, diagnosis, early intervention, 
treatment, and recovery services related to men-
tal illness, particularly for adults with a serious 
mental illness and children with a serious emo-
tional disturbance, and for individuals with a 
substance use disorder.’’. 
SEC. 6006. BIENNIAL REPORT CONCERNING ACTIVITIES 
AND PROGRESS. 
(a) IN GENERAL.—Section 501 of the Public Health 
Service Act (42 U.S.C. 290aa), as so amended, is further 
amended by amending subsection (m), as redesignated by 
section 6003, to read as follows:
464 
‘‘(m) BIENNIAL REPORT CONCERNING ACTIVITIES AND 
PROGRESS.—Not later than September 30, 2020, and every 
2 years thereafter, the Assistant Secretary shall prepare and 
submit to the Committee on Energy and Commerce and the 
Committee on Appropriations of the House of Representa-
tives and the Committee on Health, Education, Labor, and 
Pensions and the Committee on Appropriations of the Sen-
ate, and post on the Internet website of the Administration, 
a report containing at a minimum— 
‘‘(1) a review of activities conducted or sup-
ported by the Administration, including progress to-
ward strategic priorities, goals, and objectives identi-
fied in the strategic plan developed under subsection 
(l); 
‘‘(2) an assessment of programs and activities 
carried out by the Assistant Secretary, including the 
extent to which programs and activities under this 
title and part B of title XIX meet identified goals and 
performance measures developed for the respective 
programs and activities; 
‘‘(3) a description of the progress made in ad-
dressing gaps in mental and substance use disorders 
prevention, treatment, and recovery services and im-
proving outcomes by the Administration, including
465 
with respect to serious mental illnesses, serious emo-
tional disturbances, and co-occurring disorders; 
‘‘(4) a description of the manner in which the 
Administration coordinates and partners with other 
Federal agencies and departments related to mental 
and substance use disorders, including activities re-
lated to— 
‘‘(A) the implementation and dissemination 
of research findings into improved programs, in-
cluding with respect to how advances in serious 
mental illness and serious emotional disturbance 
research have been incorporated into programs; 
‘‘(B) the recruitment, training, and reten-
tion of a mental and substance use disorders 
workforce; 
‘‘(C) the integration of mental disorder serv-
ices, substance use disorder services, and physical 
health services; 
‘‘(D) homelessness; and 
‘‘(E) veterans; 
‘‘(5) a description of the manner in which the 
Administration promotes coordination by grantees 
under this title, and part B of title XIX, with State 
or local agencies; and
466 
‘‘(6) a description of the activities carried out 
under section 501A(e), with respect to mental and 
substance use disorders, including— 
‘‘(A) the number and a description of 
grants awarded; 
‘‘(B) the total amount of funding for grants 
awarded; 
‘‘(C) a description of the activities sup-
ported through such grants, including outcomes 
of programs supported; and 
‘‘(D) information on how the National Men-
tal Health and Substance Use Policy Laboratory 
is consulting with the Assistant Secretary for 
Planning and Evaluation and collaborating with 
the Center for Substance Abuse Treatment, the 
Center for Substance Abuse Prevention, the Cen-
ter for Behavioral Health Statistics and Quality, 
and the Center for Mental Health Services to 
carry out such activities; and 
‘‘(7) recommendations made by the Assistant 
Secretary for Planning and Evaluation under section 
6021 of the Helping Families in Mental Health Crisis 
Reform Act of 2016 to improve programs within the 
Administration, and actions taken in response to such
467 
recommendations to improve programs within the Ad-
ministration. 
The Assistant Secretary may meet reporting requirements 
established under this title by providing the contents of such 
reports as an addendum to the biennial report established 
under this subsection, notwithstanding the timeline of other 
reporting requirements in this title. Nothing in this sub-
section shall be construed to alter the content requirements 
of such reports or authorize the Assistant Secretary to alter 
the timeline of any such reports to be less frequent than 
biennially, unless as specified in this title.’’. 
(b) CONFORMING AMENDMENT.—Section 508(p) of the 
Public Health Service Act (42 U.S.C. 290bb–1(p)) is 
amended by striking ‘‘section 501(k)’’ and inserting ‘‘sec-
tion 501(m)’’. 
SEC. 
6007. 
AUTHORITIES 
OF 
CENTERS 
FOR 
MENTAL 
HEALTH SERVICES, SUBSTANCE ABUSE PRE-
VENTION, AND SUBSTANCE ABUSE TREAT-
MENT. 
(a) CENTER FOR MENTAL HEALTH SERVICES.—Sec-
tion 520(b) of the Public Health Service Act (42 U.S.C. 
290bb–31(b)) is amended— 
(1) by redesignating paragraphs (3) through (15) 
as paragraphs (4) through (16), respectively;
468 
(2) by inserting after paragraph (2) the fol-
lowing: 
‘‘(3) collaborate with the Director of the National 
Institute of Mental Health and the Chief Medical Of-
ficer, appointed under section 501(g), to ensure that, 
as appropriate, programs related to the prevention 
and treatment of mental illness and the promotion of 
mental health and recovery support are carried out in 
a manner that reflects the best available science and 
evidence-based practices, including culturally and lin-
guistically appropriate services, as appropriate;’’; 
(3) in paragraph (5), as so redesignated, by in-
serting ‘‘, including through programs that reduce 
risk and promote resiliency’’ before the semicolon; 
(4) in paragraph (6), as so redesignated, by in-
serting ‘‘in collaboration with the Director of the Na-
tional Institute of Mental Health,’’ before ‘‘develop’’; 
(5) in paragraph (8), as so redesignated, by in-
serting ‘‘, increase meaningful participation of indi-
viduals with mental illness in programs and activi-
ties of the Administration,’’ before ‘‘and protect the 
legal’’; 
(6) in paragraph (10), as so redesignated, by 
striking ‘‘professional and paraprofessional personnel
469 
pursuant to section 303’’ and inserting ‘‘health para-
professional personnel and health professionals’’; 
(7) in paragraph (11), as so redesignated, by in-
serting ‘‘and tele-mental health’’ after ‘‘rural mental 
health’’; 
(8) in paragraph (12), as so redesignated, by 
striking ‘‘establish a clearinghouse for mental health 
information to assure the widespread dissemination of 
such information’’ and inserting ‘‘disseminate mental 
health information, including evidence-based prac-
tices,’’; 
(9) in paragraph (15), as so redesignated, by 
striking ‘‘and’’ at the end; 
(10) in paragraph (16), as so redesignated, by 
striking the period and inserting ‘‘; and’’; and 
(11) by adding at the end the following: 
‘‘(17) ensure the consistent documentation of the 
application of criteria when awarding grants and the 
ongoing oversight of grantees after such grants are 
awarded.’’. 
(b) DIRECTOR
OF
THE CENTER
FOR SUBSTANCE 
ABUSE PREVENTION.—Section 515 of the Public Health 
Service Act (42 U.S.C. 290bb–21) is amended— 
(1) in the section heading, by striking ‘‘OFFICE’’ 
and inserting ‘‘CENTER’’;
470 
(2) in subsection (a)— 
(A) by striking ‘‘an Office’’ and inserting 
‘‘a Center’’; and 
(B) by striking ‘‘The Office’’ and inserting 
‘‘The Prevention Center’’; and 
(3) in subsection (b)— 
(A) in paragraph (1), by inserting ‘‘through 
the reduction of risk and the promotion of resil-
iency’’ before the semicolon; 
(B) 
by 
redesignating 
paragraphs 
(3) 
through (11) as paragraphs (4) through (12), re-
spectively; 
(C) by inserting after paragraph (2) the fol-
lowing: 
‘‘(3) collaborate with the Director of the National 
Institute on Drug Abuse, the Director of the National 
Institute on Alcohol Abuse and Alcoholism, and States 
to promote the study of substance abuse prevention 
and the dissemination and implementation of re-
search findings that will improve the delivery and ef-
fectiveness of substance abuse prevention activities;’’; 
(D) in paragraph (4), as so redesignated, by 
striking ‘‘literature on the adverse effects of co-
caine free base (known as crack)’’ and inserting 
‘‘educational information on the effects of drugs
472 
(H) in paragraph (11), as so redesignated, 
by striking ‘‘and’’ after the semicolon; 
(I) in paragraph (12), as so redesignated, 
by striking the period and inserting a semicolon; 
and 
(J) by adding at the end the following: 
‘‘(13) ensure the consistent documentation of the 
application of criteria when awarding grants and the 
ongoing oversight of grantees after such grants are 
awarded; and 
‘‘(14) assist and support States in preventing il-
licit drug use, including emerging illicit drug use 
issues.’’. 
(c) DIRECTOR
OF
THE CENTER
FOR SUBSTANCE 
ABUSE TREATMENT.—Section 507 of the Public Health 
Service Act (42 U.S.C. 290bb) is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘treatment of substance 
abuse’’ and inserting ‘‘treatment of substance use 
disorders’’; and 
(B) by striking ‘‘abuse treatment systems’’ 
and inserting ‘‘use disorder treatment systems’’; 
and 
(2) in subsection (b)—
473 
(A) in paragraph (1), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; 
(B) in paragraph (3), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; 
(C) in paragraph (4), by striking ‘‘individ-
uals who abuse drugs’’ and inserting ‘‘individ-
uals who illicitly use drugs’’; 
(D) in paragraph (9), by striking ‘‘carried 
out by the Director’’; 
(E) by striking paragraph (10); 
(F) by redesignating paragraphs (11) 
through (14) as paragraphs (10) through (13), 
respectively; 
(G) in paragraph (12), as so redesignated, 
by striking ‘‘; and’’ and inserting a semicolon; 
and 
(H) by striking paragraph (13), as so redes-
ignated, and inserting the following: 
‘‘(13) ensure the consistent documentation of the 
application of criteria when awarding grants and the 
ongoing oversight of grantees after such grants are 
awarded; and 
‘‘(14) work with States, providers, and individ-
uals in recovery, and their families, to promote the
474 
expansion of recovery support services and systems of 
care oriented toward recovery.’’. 
SEC. 6008. ADVISORY COUNCILS. 
Section 502(b) of the Public Health Service Act (42 
U.S.C. 290aa–1(b)) is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (E), by striking ‘‘and’’ 
after the semicolon; 
(B) by redesignating subparagraph (F) as 
subparagraph (J); and 
(C) by inserting after subparagraph (E), 
the following: 
‘‘(F) the Chief Medical Officer, appointed 
under section 501(g); 
‘‘(G) the Director of the National Institute 
of Mental Health for the advisory councils ap-
pointed 
under 
subsections 
(a)(1)(A) 
and 
(a)(1)(D); 
‘‘(H) the Director of the National Institute 
on Drug Abuse for the advisory councils ap-
pointed under subsections (a)(1)(A), (a)(1)(B), 
and (a)(1)(C); 
‘‘(I) the Director of the National Institute 
on Alcohol Abuse and Alcoholism for the advi-
475 
sory 
councils 
appointed 
under 
subsections 
(a)(1)(A), (a)(1)(B), and (a)(1)(C); and’’; and 
(2) in paragraph (3), by adding at the end the 
following: 
‘‘(C) Not less than half of the members of 
the advisory council appointed under subsection 
(a)(1)(D)— 
‘‘(i) shall— 
‘‘(I) have a medical degree; 
‘‘(II) have a doctoral degree in 
psychology; or 
‘‘(III) have an advanced degree in 
nursing or social work from an accred-
ited graduate school or be a certified 
physician assistant; and 
‘‘(ii) shall specialize in the mental 
health field. 
‘‘(D) Not less than half of the members of 
the advisory councils appointed under sub-
sections (a)(1)(B) and (a)(1)(C)— 
‘‘(i) shall— 
‘‘(I) have a medical degree; 
‘‘(II) have a doctoral degree; or 
‘‘(III) have an advanced degree in 
nursing, public health, behavioral or
476 
social sciences, or social work from an 
accredited graduate school or be a cer-
tified physician assistant; and 
‘‘(ii) shall have experience in the provi-
sion of substance use disorder services or the 
development and implementation of pro-
grams to prevent substance misuse.’’. 
SEC. 6009. PEER REVIEW. 
Section 504(b) of the Public Health Service Act (42 
U.S.C. 290aa–3(b)) is amended by adding at the end the 
following: ‘‘In the case of any such peer review group that 
is reviewing a grant, cooperative agreement, or contract re-
lated to mental illness treatment, not less than half of the 
members of such peer review group shall be licensed and 
experienced professionals in the prevention, diagnosis, or 
treatment of, or recovery from, mental illness or co-occur-
ring mental illness and substance use disorders and have 
a medical degree, a doctoral degree in psychology, or an 
advanced degree in nursing or social work from an accred-
ited program, and the Secretary, in consultation with the 
Assistant Secretary, shall, to the extent possible, ensure such 
peer review groups include broad geographic representation, 
including both urban and rural representatives.’’.
477 
Subtitle B—Oversight and 
Accountability 
SEC. 6021. IMPROVING OVERSIGHT OF MENTAL AND SUB-
STANCE 
USE 
DISORDERS 
PROGRAMS 
THROUGH THE ASSISTANT SECRETARY FOR 
PLANNING AND EVALUATION. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Assistant Secretary for 
Planning and Evaluation, shall ensure efficient and effec-
tive planning and evaluation of mental and substance use 
disorders prevention and treatment programs and related 
activities. 
(b) EVALUATION STRATEGY.—In carrying out sub-
section (a), the Assistant Secretary for Planning and Eval-
uation shall, not later than 180 days after the date of enact-
ment of this Act, develop a strategy for conducting ongoing 
evaluations that identifies priority programs to be evalu-
ated by the Assistant Secretary for Planning and Evalua-
tion and priority programs to be evaluated by other rel-
evant offices and agencies within the Department of Health 
and Human Services. The strategy shall— 
(1) include a plan for evaluating programs re-
lated to mental and substance use disorders, including 
co-occurring disorders, across agencies, as appro-
priate, including programs related to—
478 
(A) prevention, intervention, treatment, and 
recovery support services, including such services 
for adults with a serious mental illness or chil-
dren with a serious emotional disturbance; 
(B) the reduction of homelessness and incar-
ceration among individuals with a mental or 
substance use disorder; and 
(C) public health and health services; and 
(2) include a plan for assessing the use of per-
formance metrics to evaluate activities carried out by 
entities receiving grants, contracts, or cooperative 
agreements related to mental and substance use dis-
orders prevention and treatment services under title V 
or title XIX of the Public Health Service Act (42 
U.S.C. 290aa et seq.; 42 U.S.C. 300w et seq.). 
(c) CONSULTATION.—In carrying out this section, the 
Assistant Secretary for Planning and Evaluation shall con-
sult, as appropriate, with the Assistant Secretary for Men-
tal Health and Substance Use, the Chief Medical Officer 
of the Substance Abuse and Mental Health Services Admin-
istration appointed under section 501(g) of the Public 
Health Service Act (42 U.S.C. 290aa(g)), as amended by 
section 6003, the Behavioral Health Coordinating Council 
of the Department of Health and Human Services, other 
agencies within the Department of Health and Human
479 
Services, and other relevant Federal departments and agen-
cies. 
(d) RECOMMENDATIONS.—In carrying out this section, 
the Assistant Secretary for Planning and Evaluation shall 
provide recommendations to the Secretary of Health and 
Human Services, the Assistant Secretary for Mental Health 
and Substance Use, and the Congress on improving the 
quality of prevention and treatment programs and activi-
ties related to mental and substance use disorders, including 
recommendations for the use of performance metrics. The 
Assistant Secretary for Mental Health and Substance Use 
shall include such recommendations in the biennial report 
required by subsection 501(m) of the Public Health Service 
Act, as redesignated by section 6003 of this Act. 
SEC. 6022. REPORTING FOR PROTECTION AND ADVOCACY 
ORGANIZATIONS. 
(a) PUBLIC
AVAILABILITY
OF
REPORTS.—Section 
105(a)(7) of the Protection and Advocacy for Individuals 
with Mental Illness Act (42 U.S.C. 10805(a)(7)) is amended 
by striking ‘‘is located a report’’ and inserting ‘‘is located, 
and make publicly available, a report’’. 
(b) DETAILED ACCOUNTING.—Section 114(a) of the 
Protection and Advocacy for Individuals with Mental Ill-
ness Act (42 U.S.C. 10824(a)) is amended—
480 
(1) in paragraph (3), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (4), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(5) using data from the existing required an-
nual program progress reports submitted by each sys-
tem funded under this title, a detailed accounting for 
each 
such 
system 
of 
how 
funds 
are 
spent, 
disaggregated according to whether the funds were re-
ceived from the Federal Government, the State govern-
ment, a local government, or a private entity.’’. 
SEC. 6023. GAO STUDY. 
(a) IN GENERAL.—Not later than 18 months after the 
date of enactment of this Act, the Comptroller General of 
the United States, in consultation with the Secretary of 
Health and Human Services and the Assistant Secretary 
for Mental Health and Substance Use, shall conduct an 
independent evaluation, and 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, on programs funded by allot-
ments made under title I of the Protection and Advocacy 
for Individuals with Mental Illness Act (42 U.S.C. 10801 
et seq.).
481 
(b) CONTENTS.—The report and evaluation required 
under subsection (a) shall include— 
(1) a review of the programs described in such 
subsection that are carried out by State agencies and 
such programs that are carried out by private, non-
profit organizations; and 
(2) a review of the compliance of the programs 
described in subsection (a) with statutory and regu-
latory responsibilities, such as— 
(A) responsibilities relating to family en-
gagement; 
(B) responsibilities relating to the grievance 
procedure for clients or prospective clients of the 
system to assure that individuals with mental 
illness have full access to the services of the sys-
tem, for individuals who have received or are re-
ceiving mental health services, and for family 
members of such individuals with mental illness, 
or representatives of such individuals or family 
members, to assure that the eligible system is op-
erating in compliance with the provisions of the 
Protection and Advocacy for Individuals with 
Mental Illness Act, as required to be established 
by section 105(a)(9) of such Act (42 U.S.C. 
10805(a)(9));
482 
(C) investigation of alleged abuse and ne-
glect of persons with mental illness; 
(D) availability of adequate medical and 
behavioral health treatment; 
(E) denial of rights for persons with mental 
illness; and 
(F) compliance with the Federal prohibition 
on lobbying. 
Subtitle C—Interdepartmental Seri-
ous Mental Illness Coordinating 
Committee 
SEC. 6031. INTERDEPARTMENTAL SERIOUS MENTAL ILL-
NESS COORDINATING COMMITTEE. 
(a) ESTABLISHMENT.— 
(1) IN GENERAL.—Not later than 3 months after 
the date of enactment of this Act, the Secretary of 
Health and Human Services, or the designee of the 
Secretary, shall establish a committee to be known as 
the Interdepartmental Serious Mental Illness Coordi-
nating Committee (in this section referred to as the 
‘‘Committee’’). 
(2) FEDERAL ADVISORY COMMITTEE ACT.—Ex-
cept as provided in this section, the provisions of the 
Federal Advisory Committee Act (5 U.S.C. App.) 
shall apply to the Committee.
483 
(b) MEETINGS.—The Committee shall meet not fewer 
than 2 times each year. 
(c) RESPONSIBILITIES.—Not later than 1 year after 
the date of enactment of this Act, and 5 years after such 
date of enactment, the Committee shall submit to Congress 
and any other relevant Federal department or agency a re-
port including— 
(1) a summary of advances in serious mental ill-
ness and serious emotional disturbance research re-
lated to the prevention of, diagnosis of, intervention 
in, and treatment and recovery of serious mental ill-
nesses, serious emotional disturbances, and advances 
in access to services and support for adults with a se-
rious mental illness or children with a serious emo-
tional disturbance; 
(2) an evaluation of the effect Federal programs 
related to serious mental illness have on public health, 
including public health outcomes such as— 
(A) rates of suicide, suicide attempts, inci-
dence and prevalence of serious mental illnesses, 
serious emotional disturbances, and substance 
use disorders, overdose, overdose deaths, emer-
gency hospitalizations, emergency room board-
ing, preventable emergency room visits, inter-
484 
action with the criminal justice system, home-
lessness, and unemployment; 
(B) increased rates of employment and en-
rollment in educational and vocational pro-
grams; 
(C) quality of mental and substance use dis-
orders treatment services; or 
(D) any other criteria as may be deter-
mined by the Secretary; and 
(3) specific recommendations for actions that 
agencies can take to better coordinate the administra-
tion of mental health services for adults with a serious 
mental illness or children with a serious emotional 
disturbance. 
(d) COMMITTEE EXTENSION.—Upon the submission of 
the second report under subsection (c), the Secretary shall 
submit a recommendation to Congress on whether to extend 
the operation of the Committee. 
(e) MEMBERSHIP.— 
(1) FEDERAL MEMBERS.—The Committee shall 
be composed of the following Federal representatives, 
or the designees of such representatives— 
(A) the Secretary of Health and Human 
Services, who shall serve as the Chair of the 
Committee;
485 
(B) the Assistant Secretary for Mental 
Health and Substance Use; 
(C) the Attorney General; 
(D) the Secretary of Veterans Affairs; 
(E) the Secretary of Defense; 
(F) the Secretary of Housing and Urban 
Development; 
(G) the Secretary of Education; 
(H) the Secretary of Labor; 
(I) the Administrator of the Centers for 
Medicare & Medicaid Services; and 
(J) the Commissioner of Social Security. 
(2) NON-FEDERAL
MEMBERS.—The Committee 
shall also include not less than 14 non-Federal public 
members appointed by the Secretary of Health and 
Human Services, of which— 
(A) at least 2 members shall be an indi-
vidual who has received treatment for a diag-
nosis of a serious mental illness; 
(B) at least 1 member shall be a parent or 
legal guardian of an adult with a history of a 
serious mental illness or a child with a history 
of a serious emotional disturbance; 
(C) at least 1 member shall be a representa-
tive of a leading research, advocacy, or service
486 
organization for adults with a serious mental ill-
ness; 
(D) at least 2 members shall be— 
(i) a licensed psychiatrist with experi-
ence in treating serious mental illnesses; 
(ii) a licensed psychologist with experi-
ence in treating serious mental illnesses or 
serious emotional disturbances; 
(iii) a licensed clinical social worker 
with experience treating serious mental ill-
nesses or serious emotional disturbances; or 
(iv) a licensed psychiatric nurse, nurse 
practitioner, or physician assistant with ex-
perience in treating serious mental illnesses 
or serious emotional disturbances; 
(E) at least 1 member shall be a licensed 
mental health professional with a specialty in 
treating children and adolescents with a serious 
emotional disturbance; 
(F) at least 1 member shall be a mental 
health professional who has research or clinical 
mental health experience in working with mi-
norities; 
(G) at least 1 member shall be a mental 
health professional who has research or clinical
487 
mental health experience in working with medi-
cally underserved populations; 
(H) at least 1 member shall be a State cer-
tified mental health peer support specialist; 
(I) at least 1 member shall be a judge with 
experience in adjudicating cases related to crimi-
nal justice or serious mental illness; 
(J) at least 1 member shall be a law en-
forcement officer or corrections officer with exten-
sive experience in interfacing with adults with a 
serious mental illness, children with a serious 
emotional disturbance, or individuals in a men-
tal health crisis; and 
(K) at least 1 member shall have experience 
providing services for homeless individuals and 
working with adults with a serious mental ill-
ness, children with a serious emotional disturb-
ance, or individuals in a mental health crisis. 
(3) TERMS.—A member of the Committee ap-
pointed under subsection (e)(2) shall serve for a term 
of 3 years, and may be reappointed for 1 or more ad-
ditional 3-year terms. Any member appointed to fill 
a vacancy for an unexpired term shall be appointed 
for the remainder of such term. A member may serve
488 
after the expiration of the member’s term until a suc-
cessor has been appointed. 
(f) WORKING GROUPS.—In carrying out its functions, 
the Committee may establish working groups. Such working 
groups shall be composed of Committee members, or their 
designees, and may hold such meetings as are necessary. 
(g) SUNSET.—The Committee shall terminate on the 
date that is 6 years after the date on which the Committee 
is established under subsection (a)(1). 
TITLE VII—ENSURING MENTAL 
AND 
SUBSTANCE 
USE 
DIS-
ORDERS 
PREVENTION, 
TREATMENT, AND RECOVERY 
PROGRAMS KEEP PACE WITH 
SCIENCE AND TECHNOLOGY 
SEC. 7001. ENCOURAGING INNOVATION AND EVIDENCE- 
BASED PROGRAMS. 
Title V of the Public Health Service Act (42 U.S.C. 
290aa et seq.) is amended by inserting after section 501 
(42 U.S.C. 290aa) the following: 
‘‘SEC. 501A. NATIONAL MENTAL HEALTH AND SUBSTANCE 
USE POLICY LABORATORY. 
‘‘(a) IN GENERAL.—There shall be established within 
the Administration a National Mental Health and Sub-
489 
stance Use Policy Laboratory (referred to in this section 
as the ‘Laboratory’). 
‘‘(b) RESPONSIBILITIES.—The Laboratory shall— 
‘‘(1) continue to carry out the authorities and 
activities that were in effect for the Office of Policy, 
Planning, and Innovation as such Office existed prior 
to the date of enactment of the Helping Families in 
Mental Health Crisis Reform Act of 2016; 
‘‘(2) identify, coordinate, and facilitate the im-
plementation of policy changes likely to have a sig-
nificant effect on mental health, mental illness, recov-
ery supports, and the prevention and treatment of 
substance use disorder services; 
‘‘(3) work with the Center for Behavioral Health 
Statistics and Quality to collect, as appropriate, in-
formation from grantees under programs operated by 
the Administration in order to evaluate and dissemi-
nate information on evidence-based practices, includ-
ing culturally and linguistically appropriate services, 
as appropriate, and service delivery models; 
‘‘(4) provide leadership in identifying and co-
ordinating policies and programs, including evidence- 
based programs, related to mental and substance use 
disorders;
490 
‘‘(5) periodically review programs and activities 
operated by the Administration relating to the diag-
nosis or prevention of, treatment for, and recovery 
from, mental and substance use disorders to— 
‘‘(A) identify any such programs or activi-
ties that are duplicative; 
‘‘(B) identify any such programs or activi-
ties that are not evidence-based, effective, or effi-
cient; and 
‘‘(C) formulate recommendations for coordi-
nating, eliminating, or improving programs or 
activities identified under subparagraph (A) or 
(B) and merging such programs or activities 
into other successful programs or activities; and 
‘‘(6) carry out other activities as deemed nec-
essary to continue to encourage innovation and dis-
seminate evidence-based programs and practices. 
‘‘(c) EVIDENCE-BASED PRACTICES AND SERVICE DE-
LIVERY MODELS.— 
‘‘(1) IN GENERAL.—In carrying out subsection 
(b)(3), the Laboratory— 
‘‘(A) may give preference to models that im-
prove— 
‘‘(i) the coordination between mental 
health and physical health providers;
491 
‘‘(ii) the coordination among such pro-
viders and the justice and corrections sys-
tem; and 
‘‘(iii) the cost effectiveness, quality, ef-
fectiveness, and efficiency of health care 
services furnished to adults with a serious 
mental illness, children with a serious emo-
tional disturbance, or individuals in a men-
tal health crisis; and 
‘‘(B) may include clinical protocols and 
practices that address the needs of individuals 
with early serious mental illness. 
‘‘(2) CONSULTATION.—In carrying out this sec-
tion, the Laboratory shall consult with— 
‘‘(A) the Chief Medical Officer appointed 
under section 501(g); 
‘‘(B) representatives of the National Insti-
tute of Mental Health, the National Institute on 
Drug Abuse, and the National Institute on Alco-
hol Abuse and Alcoholism, on an ongoing basis; 
‘‘(C) other appropriate Federal agencies; 
‘‘(D) clinical and analytical experts with 
expertise in psychiatric medical care and clin-
ical psychological care, health care management,
492 
education, corrections health care, and mental 
health court systems, as appropriate; and 
‘‘(E) other individuals and agencies as de-
termined appropriate by the Assistant Secretary. 
‘‘(d) DEADLINE FOR BEGINNING IMPLEMENTATION.— 
The Laboratory shall begin implementation of this section 
not later than January 1, 2018. 
‘‘(e) PROMOTING INNOVATION.— 
‘‘(1) IN GENERAL.—The Assistant Secretary, in 
coordination with the Laboratory, may award grants 
to States, local governments, Indian tribes or tribal 
organizations (as such terms are defined in section 4 
of the Indian Self-Determination and Education As-
sistance Act), educational institutions, and nonprofit 
organizations to develop evidence-based interventions, 
including culturally and linguistically appropriate 
services, as appropriate, for— 
‘‘(A) evaluating a model that has been sci-
entifically demonstrated to show promise, but 
would benefit from further applied development, 
for— 
‘‘(i) enhancing the prevention, diag-
nosis, intervention, and treatment of, and 
recovery from, mental illness, serious emo-
493 
tional disturbances, substance use disorders, 
and co-occurring illness or disorders; or 
‘‘(ii) integrating or coordinating phys-
ical health services and mental and sub-
stance use disorders services; and 
‘‘(B) expanding, replicating, or scaling evi-
dence-based programs across a wider area to en-
hance effective screening, early diagnosis, inter-
vention, and treatment with respect to mental 
illness, serious mental illness, serious emotional 
disturbances, and substance use disorders, pri-
marily by— 
‘‘(i) applying such evidence-based pro-
grams to the delivery of care, including by 
training staff in effective evidence-based 
treatments; or 
‘‘(ii) integrating such evidence-based 
programs into models of care across special-
ties and jurisdictions. 
‘‘(2) CONSULTATION.—In awarding grants under 
this subsection, the Assistant Secretary shall, as ap-
propriate, consult with the Chief Medical Officer, ap-
pointed under section 501(g), the advisory councils 
described in section 502, the National Institute of 
Mental Health, the National Institute on Drug Abuse,
494 
and the National Institute on Alcohol Abuse and Al-
coholism, as appropriate. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated— 
‘‘(A) to carry out paragraph (1)(A), 
$7,000,000 for the period of fiscal years 2018 
through 2020; and 
‘‘(B) to carry out paragraph (1)(B), 
$7,000,000 for the period of fiscal years 2018 
through 2020.’’. 
SEC. 7002. PROMOTING ACCESS TO INFORMATION ON EVI-
DENCE-BASED PROGRAMS AND PRACTICES. 
Part D of title V of the Public Health Service Act (42 
U.S.C. 290dd et seq.) is amended by inserting after section 
543 of such Act (42 U.S.C. 290dd–2) the following: 
‘‘SEC. 543A. PROMOTING ACCESS TO INFORMATION ON EVI-
DENCE-BASED PROGRAMS AND PRACTICES. 
‘‘(a) IN GENERAL.—The Assistant Secretary shall, as 
appropriate, improve access to reliable and valid informa-
tion on evidence-based programs and practices, including 
information on the strength of evidence associated with such 
programs and practices, related to mental and substance 
use disorders for States, local communities, nonprofit enti-
ties, and other stakeholders, by posting on the Internet 
website of the Administration information on evidence-
495 
based programs and practices that have been reviewed by 
the Assistant Secretary in accordance with the requirements 
of this section. 
‘‘(b) APPLICATIONS.— 
‘‘(1) APPLICATION
PERIOD.—In carrying out 
subsection (a), the Assistant Secretary may establish 
a period for the submission of applications for evi-
dence-based programs and practices to be posted pub-
licly in accordance with subsection (a). 
‘‘(2) NOTICE.—In establishing the application 
period under paragraph (1), the Assistant Secretary 
shall provide for the public notice of such application 
period in the Federal Register. Such notice may so-
licit applications for evidence-based programs and 
practices to address gaps in information identified by 
the Assistant Secretary, the National Mental Health 
and Substance Use Policy Laboratory established 
under section 501A, or the Assistant Secretary for 
Planning and Evaluation, including pursuant to the 
evaluation and recommendations under section 6021 
of the Helping Families in Mental Health Crisis Re-
form Act of 2016 or priorities identified in the stra-
tegic plan under section 501(l). 
‘‘(c) REQUIREMENTS.—The Assistant Secretary may 
establish minimum requirements for the applications sub-
496 
mitted under subsection (b), including applications related 
to the submission of research and evaluation. 
‘‘(d) REVIEW AND RATING.— 
‘‘(1) IN
GENERAL.—The Assistant Secretary 
shall review applications prior to public posting in 
accordance with subsection (a), and may prioritize 
the review of applications for evidence-based pro-
grams and practices that are related to topics in-
cluded in the notice provided under subsection (b)(2). 
‘‘(2) SYSTEM.—In carrying out paragraph (1), 
the Assistant Secretary may utilize a rating and re-
view system, which may include information on the 
strength of evidence associated with the evidence-based 
programs and practices and a rating of the methodo-
logical rigor of the research supporting the applica-
tions. 
‘‘(3) PUBLIC ACCESS TO METRICS AND RATING.— 
The Assistant Secretary shall make the metrics used 
to evaluate applications under this section, and any 
resulting ratings of such applications, publicly avail-
able.’’. 
SEC. 7003. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL 
AND NATIONAL SIGNIFICANCE. 
Section 520A of the Public Health Service Act (42 
U.S.C. 290bb–32) is amended—
497 
(1) in subsection (a)— 
(A) in paragraph (4), by inserting before 
the period ‘‘, which may include technical assist-
ance centers’’; and 
(B) in the flush sentence following para-
graph (4)— 
(i) by inserting ‘‘, contracts,’’ before 
‘‘or cooperative agreements’’; and 
(ii) by striking ‘‘Indian tribes and 
tribal organizations’’ and inserting ‘‘Indian 
tribes or tribal organizations (as such terms 
are defined in section 4 of the Indian Self- 
Determination and Education Assistance 
Act), health facilities, or programs operated 
by or in accordance with a contract or 
grant with the Indian Health Service, or’’; 
and 
(2) by amending subsection (f) to read as follows: 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section 
$394,550,000 for each of fiscal years 2018 through 2022.’’.
498 
SEC. 7004. PRIORITY SUBSTANCE USE DISORDER TREAT-
MENT NEEDS OF REGIONAL AND NATIONAL 
SIGNIFICANCE. 
Section 509 of the Public Health Service Act (42 
U.S.C. 290bb–2) is amended— 
(1) in subsection (a)— 
(A) in the matter preceding paragraph (1), 
by striking ‘‘abuse’’ and inserting ‘‘use dis-
order’’; 
(B) in paragraph (3), by inserting before 
the period ‘‘that permit States, local govern-
ments, communities, and Indian tribes and trib-
al organizations (as the terms ‘Indian tribes’ 
and ‘tribal organizations’ are defined in section 
4 of the Indian Self-Determination and Edu-
cation Assistance Act) to focus on emerging 
trends in substance abuse and co-occurrence of 
substance use disorders with mental illness or 
other conditions’’; and 
(C) in the flush sentence following para-
graph (3)— 
(i) by inserting ‘‘, contracts,’’ before 
‘‘or cooperative agreements’’; and 
(ii) by striking ‘‘Indian tribes and 
tribal organizations,’’ and inserting ‘‘In-
dian tribes or tribal organizations (as such
499 
terms are defined in section 4 of the Indian 
Self-Determination and Education Assist-
ance Act), health facilities, or programs op-
erated by or in accordance with a contract 
or grant with the Indian Health Service, 
or’’; 
(2) in subsection (b)— 
(A) in paragraph (1), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; and 
(B) in paragraph (2), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; 
(3) in subsection (e), by striking ‘‘abuse’’ and in-
serting ‘‘use disorder’’; and 
(4) in subsection (f), by striking ‘‘$300,000,000’’ 
and all that follows through the period and inserting 
‘‘$333,806,000 for each of fiscal years 2018 through 
2022.’’. 
SEC. 7005. PRIORITY SUBSTANCE USE DISORDER PREVEN-
TION NEEDS OF REGIONAL AND NATIONAL 
SIGNIFICANCE. 
Section 516 of the Public Health Service Act (42 
U.S.C. 290bb–22) is amended— 
(1) in the section heading, by striking ‘‘ABUSE’’ 
and inserting ‘‘USE DISORDER’’; 
(2) in subsection (a)—
500 
(A) in the matter preceding paragraph (1), 
by striking ‘‘abuse’’ and inserting ‘‘use dis-
order’’; 
(B) in paragraph (3), by inserting before 
the period ‘‘, including such programs that focus 
on emerging drug abuse issues’’; and 
(C) in the flush sentence following para-
graph (3)— 
(i) by inserting ‘‘, contracts,’’ before 
‘‘or cooperative agreements’’; and 
(ii) by striking ‘‘Indian tribes and 
tribal organizations,’’ and inserting ‘‘In-
dian tribes or tribal organizations (as such 
terms are defined in section 4 of the Indian 
Self-Determination and Education Assist-
ance Act), health facilities, or programs op-
erated by or in accordance with a contract 
or grant with the Indian Health Service,’’; 
(3) in subsection (b)— 
(A) in paragraph (1), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; and 
(B) in paragraph (2)— 
(i) in subparagraph (A), by striking ‘‘; 
and’’ at the end and inserting ‘‘;’’; 
(ii) in subparagraph (B)—
501 
(I) by striking ‘‘abuse’’ and in-
serting ‘‘use disorder’’; and 
(II) by striking the period and in-
serting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(C) substance use disorder prevention 
among high-risk groups.’’; 
(4) in subsection (e), by striking ‘‘abuse’’ and in-
serting ‘‘use disorder’’; and 
(5) in subsection (f), by striking ‘‘$300,000,000’’ 
and all that follows through the period and inserting 
‘‘$211,148,000 for each of fiscal years 2018 through 
2022.’’. 
TITLE VIII—SUPPORTING STATE 
PREVENTION ACTIVITIES AND 
RESPONSES 
TO 
MENTAL 
HEALTH AND SUBSTANCE USE 
DISORDER NEEDS 
SEC. 8001. COMMUNITY MENTAL HEALTH SERVICES BLOCK 
GRANT. 
(a) FORMULA GRANTS.—Section 1911(b) of the Public 
Health Service Act (42 U.S.C. 300x(b)) is amended— 
(1) by redesignating paragraphs (1) through (3) 
as paragraphs (2) through (4), respectively; and
502 
(2) by inserting before paragraph (2) (as so re-
designated) the following: 
‘‘(1) providing community mental health services 
for adults with a serious mental illness and children 
with a serious emotional disturbance as defined in ac-
cordance with section 1912(c);’’. 
(b) STATE PLAN.—Section 1912(b) of the Public 
Health Service Act (42 U.S.C. 300x–1(b)) is amended— 
(1) in paragraph (3), by redesignating subpara-
graphs (A) through (C) as clauses (i) through (iii), re-
spectively, and realigning the margins accordingly; 
(2) by redesignating paragraphs (1) through (5) 
as subparagraphs (A) through (E), respectively, and 
realigning the margins accordingly; 
(3) in the matter preceding subparagraph (A) 
(as so redesignated), by striking ‘‘With respect to’’ 
and all that follows through ‘‘are as follows:’’ and in-
serting ‘‘In accordance with subsection (a), a State 
shall submit to the Secretary a plan every two years 
that, at a minimum, includes each of the following:’’; 
(4) by inserting before subparagraph (A) (as so 
redesignated) the following: 
‘‘(1) SYSTEM
OF
CARE.—A description of the 
State’s system of care that contains the following:’’;
503 
(5) by striking subparagraph (A) (as so redesig-
nated) and inserting the following: 
‘‘(A) COMPREHENSIVE
COMMUNITY-BASED 
HEALTH SYSTEMS.—The plan shall— 
‘‘(i) identify the single State agency to 
be responsible for the administration of the 
program under the grant, including any 
third party who administers mental health 
services and is responsible for complying 
with the requirements of this part with re-
spect to the grant; 
‘‘(ii) provide for an organized commu-
nity-based system of care for individuals 
with mental illness, and describe available 
services and resources in a comprehensive 
system of care, including services for indi-
viduals with co-occurring disorders; 
‘‘(iii) include a description of the man-
ner in which the State and local entities 
will coordinate services to maximize the ef-
ficiency, effectiveness, quality, and cost-ef-
fectiveness of services and programs to 
produce the best possible outcomes (includ-
ing health services, rehabilitation services, 
employment services, housing services, edu-
504 
cational services, substance use disorder 
services, legal services, law enforcement serv-
ices, social services, child welfare services, 
medical and dental care services, and other 
support services to be provided with Fed-
eral, State, and local public and private re-
sources) with other agencies to enable indi-
viduals receiving services to function outside 
of inpatient or residential institutions, to 
the maximum extent of their capabilities, 
including services to be provided by local 
school systems under the Individuals with 
Disabilities Education Act; 
‘‘(iv) include a description of how the 
State promotes evidence-based practices, in-
cluding those evidence-based programs that 
address the needs of individuals with early 
serious mental illness regardless of the age 
of the individual at onset, provide com-
prehensive individualized treatment, or in-
tegrate mental and physical health services; 
‘‘(v) include a description of case man-
agement services; 
‘‘(vi) include a description of activities 
that seek to engage adults with a serious
505 
mental illness or children with a serious 
emotional disturbance and their caregivers 
where appropriate in making health care 
decisions, including activities that enhance 
communication among individuals, fami-
lies, caregivers, and treatment providers; 
and 
‘‘(vii) as appropriate to, and reflective 
of, the uses the State proposes for the block 
grant funds, include— 
‘‘(I) a description of the activities 
intended to reduce hospitalizations and 
hospital stays using the block grant 
funds; 
‘‘(II) a description of the activi-
ties intended to reduce incidents of sui-
cide using the block grant funds; 
‘‘(III) a description of how the 
State integrates mental health and pri-
mary care using the block grant funds, 
which may include providing, in the 
case of individuals with co-occurring 
mental and substance use disorders, 
both mental and substance use dis-
orders services in primary care settings
506 
or arrangements to provide primary 
and specialty care services in commu-
nity-based mental and substance use 
disorders settings; and 
‘‘(IV) a description of recovery 
and recovery support services for 
adults with a serious mental illness 
and children with a serious emotional 
disturbance.’’; 
(6) in subparagraph (B) (as so redesignated)— 
(A) by striking ‘‘The plan contains’’ and 
inserting ‘‘The plan shall contain’’; and 
(B) by striking ‘‘presents quantitative tar-
gets to be achieved in the implementation of the 
system described in paragraph (1)’’ and insert-
ing ‘‘present quantitative targets and outcome 
measures for programs and services provided 
under this subpart’’; 
(7) in subparagraph (C) (as so redesignated)— 
(A) by striking ‘‘serious emotional disturb-
ance’’ in the matter preceding clause (i) (as so 
redesignated) and all that follows through ‘‘sub-
stance abuse services’’ in clause (i) (as so redes-
ignated) and inserting the following: ‘‘a serious 
emotional disturbance (as defined pursuant to
507 
subsection (c)), the plan shall provide for a sys-
tem of integrated social services, educational 
services, child welfare services, juvenile justice 
services, law enforcement services, and substance 
use disorder services’’; 
(B) by striking ‘‘Education Act);’’ and in-
serting ‘‘Education Act).’’; and 
(C) by striking clauses (ii) and (iii) (as so 
redesignated); 
(8) in subparagraph (D) (as so redesignated), by 
striking ‘‘plan describes’’ and inserting ‘‘plan shall 
describe’’; 
(9) in subparagraph (E) (as so redesignated)— 
(A) in the subparagraph heading by strik-
ing ‘‘SYSTEMS’’ and inserting ‘‘SERVICES’’; 
(B) in the first sentence, by striking ‘‘plan 
describes’’ and all that follows through ‘‘and pro-
vides for’’ and inserting ‘‘plan shall describe the 
financial resources available, the existing mental 
health workforce, and the workforce trained in 
treating individuals with co-occurring mental 
and substance use disorders, and shall provide 
for’’; and 
(C) in the second sentence—
508 
(i) by striking ‘‘further describes’’ and 
inserting ‘‘shall further describe’’; and 
(ii) by striking ‘‘involved.’’ and insert-
ing ‘‘involved, and the manner in which the 
State intends to comply with each of the 
funding agreements in this subpart and 
subpart III.’’; 
(10) by striking the flush matter at the end; and 
(11) by adding at the end the following: 
‘‘(2) GOALS
AND
OBJECTIVES.—The establish-
ment of goals and objectives for the period of the plan, 
including targets and milestones that are intended to 
be met, and the activities that will be undertaken to 
achieve those targets.’’. 
(c) EARLY SERIOUS MENTAL ILLNESS.—Section 1920 
of the Public Health Service Act (42 U.S.C. 300x–9) is 
amended by adding at the end the following: 
‘‘(c) EARLY SERIOUS MENTAL ILLNESS.— 
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), a State shall expend not less than 10 per-
cent of the amount the State receives for carrying out 
this section for each fiscal year to support evidence- 
based programs that address the needs of individuals 
with early serious mental illness, including psychotic
509 
disorders, regardless of the age of the individual at 
onset. 
‘‘(2) STATE FLEXIBILITY.—In lieu of expending 
10 percent of the amount the State receives under this 
section for a fiscal year as required under paragraph 
(1), a State may elect to expend not less than 20 per-
cent of such amount by the end of such succeeding fis-
cal year.’’. 
(d) ADDITIONAL PROVISIONS.—Section 1915(b) of the 
Public Health Service Act (42 U.S.C. 300x–4(b)) is amend-
ed— 
(1) in paragraph (3)— 
(A) by striking ‘‘The Secretary’’ and insert-
ing the following: 
‘‘(A) IN GENERAL.—The Secretary’’; 
(B) by striking ‘‘paragraph (1) if’’ and in-
serting ‘‘paragraph (1) in whole or in part if’’; 
(C) by striking ‘‘State justify the waiver.’’ 
and inserting ‘‘State in the fiscal year involved 
or in the previous fiscal year justify the waiver’’; 
and 
(D) by adding at the end the following: 
‘‘(B) DATE CERTAIN FOR ACTION UPON RE-
QUEST.—The Secretary shall approve or deny a 
request for a waiver under this paragraph not
510 
later than 120 days after the date on which the 
request is made. 
‘‘(C) APPLICABILITY OF WAIVER.—A waiver 
provided by the Secretary under this paragraph 
shall be applicable only to the fiscal year in-
volved.’’; and 
(2) in paragraph (4)— 
(A) in subparagraph (A)— 
(i) by inserting after the subparagraph 
designation the following: ‘‘IN GENERAL.— 
’’; 
(ii) by striking ‘‘In making a grant’’ 
and inserting the following: 
‘‘(i) DETERMINATION.—In making a 
grant’’; and 
(iii) by inserting at the end the fol-
lowing: 
‘‘(ii) ALTERNATIVE.—A State that has 
failed to comply with paragraph (1) and 
would otherwise be subject to a reduction in 
the State’s allotment under section 1911 
may, upon request by the State, in lieu of 
having the amount of the allotment under 
section 1911 for the State reduced for the 
fiscal year of the grant, agree to comply
511 
with a negotiated agreement that is ap-
proved by the Secretary and carried out in 
accordance with guidelines issued by the 
Secretary. If a State fails to enter into or 
comply with a negotiated agreement, the 
Secretary may take action under this para-
graph or the terms of the negotiated agree-
ment.’’; and 
(B) in subparagraph (B)— 
(i) by inserting after the subparagraph 
designation the following: ‘‘SUBMISSION OF 
INFORMATION TO THE SECRETARY.—’’; and 
(ii) by striking ‘‘subparagraph (A)’’ 
and inserting ‘‘subparagraph (A)(i)’’. 
(e) APPLICATION FOR GRANT.—Section 1917(a) of the 
Public Health Service Act (42 U.S.C. 300x–6(a)) is amend-
ed— 
(1) in paragraph (1), by striking ‘‘1941’’ and in-
serting ‘‘1942(a)’’; and 
(2) 
in 
paragraph 
(5), 
by 
striking 
‘‘1915(b)(3)(B)’’ and inserting ‘‘1915(b)’’. 
(f) FUNDING.—Section 1920 of the Public Health Serv-
ice Act (42 U.S.C. 300x–9) is amended— 
(1) in subsection (a)—
512 
(A) by striking ‘‘section 505’’ and inserting 
‘‘section 505(c)’’; and 
(B) by striking ‘‘$450,000,000’’ and all that 
follows 
through 
the 
period 
and 
inserting 
‘‘$532,571,000 for each of fiscal years 2018 
through 2022.’’; and 
(2) in subsection (b)(2) by striking ‘‘sections 505 
and’’ and inserting ‘‘sections 505(c) and’’. 
SEC. 8002. SUBSTANCE ABUSE PREVENTION AND TREAT-
MENT BLOCK GRANT. 
(a) FORMULA GRANTS.—Section 1921(b) of the Public 
Health Service Act (42 U.S.C. 300x–21(b)) is amended— 
(1) by inserting ‘‘carrying out the plan developed 
in accordance with section 1932(b) and for’’ after ‘‘for 
the purpose of’’; and 
(2) by striking ‘‘abuse’’ and inserting ‘‘use dis-
orders’’. 
(b) OUTREACH TO PERSONS WHO INJECT DRUGS.— 
Section 1923(b) of the Public Health Service Act (42 U.S.C. 
300x–23(b)) is amended— 
(1) in the subsection heading, by striking ‘‘RE-
GARDING INTRAVENOUS SUBSTANCE ABUSE’’ and in-
serting ‘‘TO PERSONS WHO INJECT DRUGS’’; and 
(2) by striking ‘‘for intravenous drug abuse’’ and 
inserting ‘‘for persons who inject drugs’’.
513 
(c) REQUIREMENTS REGARDING TUBERCULOSIS AND 
HUMAN IMMUNODEFICIENCY VIRUS.—Section 1924 of the 
Public Health Service Act (42 U.S.C. 300x–24) is amend-
ed— 
(1) in subsection (a)(1)— 
(A) in the matter preceding subparagraph 
(A), by striking ‘‘substance abuse’’ and inserting 
‘‘substance use disorders’’; and 
(B) in subparagraph (A), by striking ‘‘such 
abuse’’ and inserting ‘‘such disorders’’; 
(2) in subsection (b)— 
(A) in paragraph (1)(A), by striking ‘‘sub-
stance abuse’’ and inserting ‘‘substance use dis-
orders’’; 
(B) in paragraph (2), by inserting ‘‘and 
Prevention’’ after ‘‘Disease Control’’; 
(C) in paragraph (3)— 
(i) in the paragraph heading, by strik-
ing ‘‘ABUSE’’ and inserting ‘‘USE
DIS-
ORDERS’’; and 
(ii) by striking ‘‘substance abuse’’ and 
inserting ‘‘substance use disorders’’; and 
(D) in paragraph (6)(B), by striking ‘‘sub-
stance abuse’’ and inserting ‘‘substance use dis-
orders’’;
514 
(3) by striking subsection (d); and 
(4) by redesignating subsection (e) as subsection 
(d). 
(d) GROUP HOMES.—Section 1925 of the Public 
Health Service Act (42 U.S.C. 300x–25) is amended— 
(1) in the section heading, by striking ‘‘RECOV-
ERING
SUBSTANCE
ABUSERS’’ and inserting 
‘‘PERSONS
IN
RECOVERY
FROM
SUBSTANCE 
USE DISORDERS’’; and 
(2) in subsection (a), in the matter preceding 
paragraph (1), by striking ‘‘recovering substance 
abusers’’ and inserting ‘‘persons in recovery from sub-
stance use disorders’’. 
(e) ADDITIONAL AGREEMENTS.—Section 1928 of the 
Public Health Service Act (42 U.S.C. 300x–28) is amend-
ed— 
(1) in subsection (a), by striking ‘‘(relative to 
fiscal year 1992)’’; 
(2) by striking subsection (b) and inserting the 
following: 
‘‘(b) 
PROFESSIONAL
DEVELOPMENT.—A 
funding 
agreement for a grant under section 1921 is that the State 
involved will ensure that prevention, treatment, and recov-
ery personnel operating in the State’s substance use dis-
order prevention, treatment, and recovery systems have an
515 
opportunity to receive training, on an ongoing basis, con-
cerning— 
‘‘(1) recent trends in substance use disorders in 
the State; 
‘‘(2) improved methods and evidence-based prac-
tices for providing substance use disorder prevention 
and treatment services; 
‘‘(3) performance-based accountability; 
‘‘(4) data collection and reporting requirements; 
and 
‘‘(5) any other matters that would serve to fur-
ther improve the delivery of substance use disorder 
prevention and treatment services within the State.’’; 
and 
(3) in subsection (d)(1), by striking ‘‘substance 
abuse’’ and inserting ‘‘substance use disorders’’. 
(f) REPEAL.—Section 1929 of the Public Health Serv-
ice Act (42 U.S.C. 300x–29) is repealed. 
(g) MAINTENANCE OF EFFORT.—Section 1930 of the 
Public Health Service Act (42 U.S.C. 300x–30) is amend-
ed— 
(1) in subsection (c)(1), by striking ‘‘in the State 
justify the waiver’’ and inserting ‘‘exist in the State, 
or any part of the State, to justify the waiver’’; and
516 
(2) in subsection (d), by inserting at the end the 
following: 
‘‘(3) ALTERNATIVE.—A State that has failed to 
comply with this section and would otherwise be sub-
ject to a reduction in the State’s allotment under sec-
tion 1921, may, upon request by the State, in lieu of 
having the State’s allotment under section 1921 re-
duced, agree to comply with a negotiated agreement 
that is approved by the Secretary and carried out in 
accordance with guidelines issued by the Secretary. If 
a State fails to enter into or comply with a negotiated 
agreement, the Secretary may take action under this 
paragraph or the terms of the negotiated agreement.’’. 
(h) 
RESTRICTIONS
ON
EXPENDITURES.—Section 
1931(b)(1) of the Public Health Service Act (42 U.S.C. 
300x–31(b)(1)) is amended by striking ‘‘substance abuse’’ 
and inserting ‘‘substance use disorders’’. 
(i) APPLICATION.—Section 1932 of the Public Health 
Service Act (42 U.S.C. 300x–32) is amended— 
(1) in subsection (a)— 
(A) in the matter preceding paragraph (1), 
by striking ‘‘subsections (c) and (d)(2)’’ and in-
serting ‘‘subsection (c)’’; and
517 
(B) in paragraph (5), by striking ‘‘the in-
formation required in section 1929, the informa-
tion required in section 1930(c)(2), and’’; 
(2) in subsection (b)— 
(A) by striking paragraph (1) and inserting 
the following: 
‘‘(1) IN GENERAL.—In order for a State to be in 
compliance with subsection (a)(6), the State shall sub-
mit to the Secretary a plan that, at a minimum, in-
cludes the following: 
‘‘(A) A description of the State’s system of 
care that— 
‘‘(i) identifies the single State agency 
responsible for the administration of the 
program, including any third party who 
administers substance use disorder services 
and is responsible for complying with the 
requirements of the grant; 
‘‘(ii) provides information on the need 
for substance use disorder prevention and 
treatment services in the State, including 
estimates on the number of individuals who 
need treatment, who are pregnant women, 
women with dependent children, individuals 
with a co-occurring mental health and sub-
518 
stance use disorder, persons who inject 
drugs, and persons who are experiencing 
homelessness; 
‘‘(iii) provides aggregate information 
on the number of individuals in treatment 
within the State, including the number of 
such individuals who are pregnant women, 
women with dependent children, individuals 
with a co-occurring mental health and sub-
stance use disorder, persons who inject 
drugs, and persons who are experiencing 
homelessness; 
‘‘(iv) provides a description of the sys-
tem that is available to provide services by 
modality, including the provision of recov-
ery support services; 
‘‘(v) provides a description of the 
State’s comprehensive statewide prevention 
efforts, including the number of individuals 
being served in the system, target popu-
lations, and priority needs, and provides a 
description of the amount of funds from the 
prevention set-aside expended on primary 
prevention;
519 
‘‘(vi) provides a description of the fi-
nancial resources available; 
‘‘(vii) describes the existing substance 
use disorders workforce and workforce 
trained in treating co-occurring substance 
use and mental disorders; 
‘‘(viii) includes a description of how 
the State promotes evidence-based practices; 
and 
‘‘(ix) describes how the State integrates 
substance use disorder services and primary 
health care, which in the case of those indi-
viduals with co-occurring mental health and 
substance use disorders may include pro-
viding both mental health and substance use 
disorder services in primary care settings or 
providing primary and specialty care serv-
ices in community-based mental health and 
substance use disorder service settings. 
‘‘(B) The establishment of goals and objec-
tives for the period of the plan, including targets 
and milestones that are intended to be met, and 
the activities that will be undertaken to achieve 
those targets.
520 
‘‘(C) A description of how the State will 
comply with each funding agreement for a grant 
under section 1921 that is applicable to the 
State, including a description of the manner in 
which the State intends to expend grant funds.’’; 
and 
(B) in paragraph (2)— 
(i) in the paragraph heading, by strik-
ing ‘‘AUTHORITY OF SECRETARY REGARDING 
MODIFICATIONS’’ and inserting ‘‘MODIFICA-
TIONS’’; 
(ii) by striking ‘‘As a condition’’ and 
inserting the following: 
‘‘(A) AUTHORITY
OF
SECRETARY.—As a 
condition;’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(B) STATE
REQUEST
FOR
MODIFICA-
TION.—If the State determines that a modifica-
tion to such plan is necessary, the State may re-
quest the Secretary to approve the modification. 
Any such modification shall be in accordance 
with paragraph (1) and section 1941.’’; and
521 
(C) in paragraph (3), by inserting, ‘‘, in-
cluding any modification under paragraph (2)’’ 
after ‘‘subsection (a)(6)’’; and 
(3) in subsection (e)(2), by striking ‘‘section 
1922(c)’’ and inserting ‘‘section 1922(b)’’. 
(j) DEFINITIONS.—Section 1934 of the Public Health 
Service Act (42 U.S.C. 300x–34) is amended— 
(1) in paragraph (3), by striking ‘‘substance 
abuse’’ and inserting ‘‘substance use disorders’’; and 
(2) in paragraph (7), by striking ‘‘substance 
abuse’’ and inserting ‘‘substance use disorders’’. 
(k) FUNDING.—Section 1935 of the Public Health 
Service Act (42 U.S.C. 300x–35) is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘section 505’’ and inserting 
‘‘section 505(d)’’; and 
(B) by striking ‘‘$2,000,000,000 for fiscal 
year 2001, and such sums as may be necessary 
for each of the fiscal years 2002 and 2003’’ and 
inserting ‘‘$1,858,079,000 for each of fiscal years 
2018 through 2022.’’; and 
(2) in subsection (b)(1)(B) by striking ‘‘sections 
505 and’’ and inserting ‘‘sections 505(d) and’’.
522 
SEC. 8003. ADDITIONAL PROVISIONS RELATED TO THE 
BLOCK GRANTS. 
Subpart III of part B of title XIX of the Public Health 
Service Act (42 U.S.C. 300x–51 et seq.) is amended— 
(1) in section 1943(a)(3) (42 U.S.C. 300x– 
53(a)(3)), by striking ‘‘section 505’’ and inserting 
‘‘subsections (c) and (d) of section 505’’; 
(2) in section 1953(b) (42 U.S.C. 300x–63(b)), 
by striking ‘‘substance abuse’’ and inserting ‘‘sub-
stance use disorder’’; and 
(3) by adding at the end the following: 
‘‘SEC. 1957. PUBLIC HEALTH EMERGENCIES. 
‘‘In the case of a public health emergency (as deter-
mined under section 319), the Secretary, on a State by 
State basis, may, as the circumstances of the emergency rea-
sonably require and for the period of the emergency, grant 
an extension, or waive application deadlines or compliance 
with any other requirement, of a grant authorized under 
section 521, 1911, or 1921 or an allotment authorized under 
Public Law 99–319 (42 U.S.C. 10801 et seq.). 
‘‘SEC. 1958. JOINT APPLICATIONS. 
‘‘The Secretary, acting through the Assistant Secretary 
for Mental Health and Substance Use, shall permit a joint 
application to be submitted for grants under subpart I and 
subpart II upon the request of a State. Such application 
may be jointly reviewed and approved by the Secretary
523 
with respect to such subparts, consistent with the purposes 
and authorized activities of each such grant program. A 
State submitting such a joint application shall otherwise 
meet the requirements with respect to each such subpart.’’. 
SEC. 8004. STUDY OF DISTRIBUTION OF FUNDS UNDER THE 
SUBSTANCE ABUSE PREVENTION AND TREAT-
MENT BLOCK GRANT AND THE COMMUNITY 
MENTAL HEALTH SERVICES BLOCK GRANT. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Assistant Secretary for 
Mental Health and Substance Use, shall through a grant 
or contract, or through an agreement with a third party, 
conduct a study on the formulas for distribution of funds 
under the substance abuse prevention and treatment block 
grant, and the community mental health services block 
grant, under part B of title XIX of the Public Health Serv-
ice Act (42 U.S.C. 300x et seq.) and recommend changes 
if necessary. Such study shall include— 
(1) an analysis of whether the distributions 
under such block grants accurately reflect the need for 
the services under the grants in the States; 
(2) an examination of whether the indices used 
under the formulas for distribution of funds under 
such block grants are appropriate, and if not, alter-
natives recommended by the Secretary;
524 
(3) where recommendations are included under 
paragraph (2) for the use of different indices, a de-
scription of the variables and data sources that should 
be used to determine the indices; 
(4) an evaluation of the variables and data 
sources that are being used for each of the indices in-
volved, and whether such variables and data sources 
accurately represent the need for services, the cost of 
providing services, and the ability of the States to 
pay for such services; 
(5) the effect that the minimum allotment re-
quirements for each such block grant have on each 
State’s final allotment and the effect of such require-
ments, if any, on each State’s formula-based allot-
ment; 
(6) recommendations for modifications to the 
minimum allotment provisions to ensure an appro-
priate distribution of funds; and 
(7) any other information that the Secretary de-
termines appropriate. 
(b) REPORT.—Not later than 2 years after the date 
of enactment of this Act, the Secretary of Health and 
Human Services shall submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the Com-
mittee on Energy and Commerce of the House of Represent-
525 
atives, a report containing the findings and recommenda-
tions of the study conducted under subsection (a) and the 
study conducted under section 9004(g). 
TITLE IX—PROMOTING ACCESS 
TO 
MENTAL 
HEALTH 
AND 
SUBSTANCE USE DISORDER 
CARE 
Subtitle A—Helping Individuals 
and Families 
SEC. 9001. GRANTS FOR TREATMENT AND RECOVERY FOR 
HOMELESS INDIVIDUALS. 
Section 506 of the Public Health Service Act (42 
U.S.C. 290aa–5) is amended— 
(1) in subsection (a), by striking ‘‘substance 
abuse’’ and inserting ‘‘substance use disorder’’; 
(2) in subsection (b)— 
(A) in paragraphs (1) and (3), by striking 
‘‘substance abuse’’ each place the term appears 
and inserting ‘‘substance use disorder’’; and 
(B) in paragraph (4), by striking ‘‘sub-
stance abuse’’ and inserting ‘‘a substance use 
disorder’’; 
(3) in subsection (c)—
526 
(A) in paragraph (1), by striking ‘‘sub-
stance abuse disorder’’ and inserting ‘‘substance 
use disorder’’; and 
(B) in paragraph (2)— 
(i) in subparagraph (A), by striking 
‘‘substance abuse’’ and inserting ‘‘a sub-
stance use disorder’’; and 
(ii) in subparagraph (B), by striking 
‘‘substance abuse’’ and inserting ‘‘substance 
use disorder’’; and 
(4) in subsection (e), by striking ‘‘, $50,000,000 
for fiscal year 2001, and such sums as may be nec-
essary for each of the fiscal years 2002 and 2003’’ 
and inserting ‘‘$41,304,000 for each of fiscal years 
2018 through 2022’’. 
SEC. 9002. GRANTS FOR JAIL DIVERSION PROGRAMS. 
Section 520G of the Public Health Service Act (42 
U.S.C. 290bb–38) is amended— 
(1) by striking ‘‘substance abuse’’ each place such 
term appears and inserting ‘‘substance use disorder’’; 
(2) in subsection (a)— 
(A) by striking ‘‘Indian tribes, and tribal 
organizations’’ and inserting ‘‘and Indian tribes 
and tribal organizations (as the terms ‘Indian 
tribes’ and ‘tribal organizations’ are defined in
527 
section 4 of the Indian Self-Determination and 
Education Assistance Act)’’; and 
(B) by inserting ‘‘or a health facility or 
program operated by or in accordance with a 
contract or grant with the Indian Health Serv-
ice,’’ after ‘‘entities,’’; 
(3) in subsection (c)(2)(A)(i), by striking ‘‘the 
best known’’ and inserting ‘‘evidence-based’’; 
(4) by redesignating subsections (d) through (i) 
as subsections (e) through (j), respectively; 
(5) by inserting after subsection (c) the fol-
lowing: 
‘‘(d) SPECIAL
CONSIDERATION
REGARDING
VET-
ERANS.—In awarding grants under subsection (a), the Sec-
retary shall, as appropriate, give special consideration to 
entities proposing to use grant funding to support jail di-
version services for veterans.’’; 
(6) in subsection (e), as so redesignated— 
(A) in paragraph (3), by striking ‘‘; and’’ 
and inserting a semicolon; 
(B) in paragraph (4), by striking the period 
and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(5) develop programs to divert individuals 
prior to booking or arrest.’’; and
528 
(7) in subsection (j), as so redesignated, by strik-
ing ‘‘$10,000,000 for fiscal year 2001, and such sums 
as may be necessary for fiscal years 2002 through 
2003’’ and inserting ‘‘$4,269,000 for each of fiscal 
years 2018 through 2022’’. 
SEC. 9003. PROMOTING INTEGRATION OF PRIMARY AND BE-
HAVIORAL HEALTH CARE. 
Section 520K of the Public Health Service Act (42 
U.S.C. 290bb–42) is amended to read as follows: 
‘‘SEC. 520K. INTEGRATION INCENTIVE GRANTS AND COOP-
ERATIVE AGREEMENTS. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible enti-
ty’ means a State, or other appropriate State agency, 
in collaboration with 1 or more qualified community 
programs as described in section 1913(b)(1) or 1 or 
more community health centers as described in section 
330. 
‘‘(2) INTEGRATED CARE.—The term ‘integrated 
care’ means collaborative models or practices offering 
mental and physical health services, which may in-
clude practices that share the same space in the same 
facility. 
‘‘(3) SPECIAL POPULATION.—The term ‘special 
population’ means—
529 
‘‘(A) adults with a mental illness who have 
co-occurring physical health conditions or chron-
ic diseases; 
‘‘(B) adults with a serious mental illness 
who have co-occurring physical health conditions 
or chronic diseases; 
‘‘(C) children and adolescents with a serious 
emotional disturbance with co-occurring physical 
health conditions or chronic diseases; or 
‘‘(D) individuals with a substance use dis-
order. 
‘‘(b) GRANTS AND COOPERATIVE AGREEMENTS.— 
‘‘(1) IN GENERAL.—The Secretary may award 
grants and cooperative agreements to eligible entities 
to support the improvement of integrated care for pri-
mary care and behavioral health care in accordance 
with paragraph (2). 
‘‘(2) PURPOSES.—A grant or cooperative agree-
ment awarded under this section shall be designed 
to— 
‘‘(A) promote full integration and collabora-
tion in clinical practices between primary and 
behavioral health care; 
‘‘(B) support the improvement of integrated 
care models for primary care and behavioral
530 
health care to improve the overall wellness and 
physical health status of adults with a serious 
mental illness or children with a serious emo-
tional disturbance; and 
‘‘(C) promote integrated care services re-
lated to screening, diagnosis, prevention, and 
treatment of mental and substance use disorders, 
and co-occurring physical health conditions and 
chronic diseases. 
‘‘(c) APPLICATIONS.— 
‘‘(1) IN GENERAL.—An eligible entity seeking a 
grant or cooperative agreement under this section 
shall submit an application to the Secretary at such 
time, in such manner, and accompanied by such in-
formation as the Secretary may require, including the 
contents described in paragraph (2). 
‘‘(2) CONTENTS.—The contents described in this 
paragraph are— 
‘‘(A) a description of a plan to achieve fully 
collaborative agreements to provide services to 
special populations; 
‘‘(B) a document that summarizes the poli-
cies, if any, that serve as barriers to the provi-
sion of integrated care, and the specific steps, if
531 
applicable, that will be taken to address such 
barriers; 
‘‘(C) a description of partnerships or other 
arrangements with local health care providers to 
provide services to special populations; 
‘‘(D) an agreement and plan to report to 
the Secretary performance measures necessary to 
evaluate patient outcomes and facilitate evalua-
tions across participating projects; and 
‘‘(E) a plan for sustainability beyond the 
grant or cooperative agreement period under sub-
section (e). 
‘‘(d) 
GRANT
AND
COOPERATIVE
AGREEMENT 
AMOUNTS.— 
‘‘(1) TARGET AMOUNT.—The target amount that 
an eligible entity may receive for a year through a 
grant or cooperative agreement under this section 
shall be $2,000,000. 
‘‘(2) ADJUSTMENT PERMITTED.—The Secretary, 
taking into consideration the quality of the applica-
tion and the number of eligible entities that received 
grants under this section prior to the date of enact-
ment of the Helping Families in Mental Health Cri-
sis Reform Act of 2016, may adjust the target amount
532 
that an eligible entity may receive for a year through 
a grant or cooperative agreement under this section. 
‘‘(3) LIMITATION.—An eligible entity receiving 
funding under this section may not allocate more 
than 10 percent of funds awarded under this section 
to administrative functions, and the remaining 
amounts shall be allocated to health facilities that 
provide integrated care. 
‘‘(e) DURATION.—A grant or cooperative agreement 
under this section shall be for a period not to exceed 5 years. 
‘‘(f) REPORT ON PROGRAM OUTCOMES.—An eligible 
entity receiving a grant or cooperative agreement under this 
section shall submit an annual report to the Secretary that 
includes— 
‘‘(1) the progress made to reduce barriers to inte-
grated care as described in the entity’s application 
under subsection (c); and 
‘‘(2) a description of functional outcomes of spe-
cial populations, including— 
‘‘(A) with respect to adults with a serious 
mental illness, participation in supportive hous-
ing or independent living programs, attendance 
in social and rehabilitative programs, participa-
tion in job training opportunities, satisfactory 
performance in work settings, attendance at
533 
scheduled medical and mental health appoint-
ments, and compliance with prescribed medica-
tion regimes; 
‘‘(B) with respect to individuals with co-oc-
curring mental illness and physical health condi-
tions and chronic diseases, attendance at sched-
uled medical and mental health appointments, 
compliance with prescribed medication regimes, 
and participation in learning opportunities re-
lated to improved health and lifestyle practices; 
and 
‘‘(C) with respect to children and adoles-
cents with a serious emotional disturbance who 
have co-occurring physical health conditions and 
chronic diseases, attendance at scheduled medical 
and mental health appointments, compliance 
with prescribed medication regimes, and partici-
pation in learning opportunities at school and 
extracurricular activities. 
‘‘(g) TECHNICAL ASSISTANCE FOR PRIMARY-BEHAV-
IORAL HEALTH CARE INTEGRATION.— 
‘‘(1) IN GENERAL.—The Secretary may provide 
appropriate information, training, and technical as-
sistance to eligible entities that receive a grant or co-
operative agreement under this section, in order to
534 
help such entities meet the requirements of this sec-
tion, including assistance with— 
‘‘(A) development and selection of integrated 
care models; 
‘‘(B) dissemination of evidence-based inter-
ventions in integrated care; 
‘‘(C) establishment of organizational prac-
tices to support operational and administrative 
success; and 
‘‘(D) other activities, as the Secretary deter-
mines appropriate. 
‘‘(2) ADDITIONAL DISSEMINATION OF TECHNICAL 
INFORMATION.—The information and resources pro-
vided by the Secretary under paragraph (1) shall, as 
appropriate, be made available to States, political 
subdivisions of States, Indian tribes or tribal organi-
zations (as defined in section 4 of the Indian Self-De-
termination and Education Assistance Act), out-
patient mental health and addiction treatment cen-
ters, community mental health centers that meet the 
criteria under section 1913(c), certified community 
behavioral health clinics described in section 223 of 
the Protecting Access to Medicare Act of 2014, pri-
mary care organizations such as Federally qualified 
health centers or rural health clinics as defined in sec-
535 
tion 1861(aa) of the Social Security Act, other com-
munity-based organizations, or other entities engag-
ing in integrated care activities, as the Secretary de-
termines appropriate. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$51,878,000 for each of fiscal years 2018 through 2022.’’. 
SEC. 9004. PROJECTS FOR ASSISTANCE IN TRANSITION 
FROM HOMELESSNESS. 
(a) FORMULA GRANTS TO STATES.—Section 521 of the 
Public Health Service Act (42 U.S.C. 290cc–21) is amended 
by striking ‘‘1991 through 1994’’ and inserting ‘‘2018 
through 2022’’. 
(b) PURPOSE OF GRANTS.—Section 522 of the Public 
Health Service Act (42 U.S.C. 290cc–22) is amended— 
(1) in subsection (a)(1)(B), by striking ‘‘sub-
stance abuse’’ and inserting ‘‘a substance use dis-
order’’; 
(2) in subsection (b)(6), by striking ‘‘substance 
abuse’’ and inserting ‘‘substance use disorder’’; 
(3) in subsection (c), by striking ‘‘substance 
abuse’’ and inserting ‘‘a substance use disorder’’; 
(4) in subsection (e)—
536 
(A) in paragraph (1), by striking ‘‘sub-
stance abuse’’ and inserting ‘‘a substance use 
disorder’’; and 
(B) in paragraph (2), by striking ‘‘sub-
stance abuse’’ and inserting ‘‘substance use dis-
order’’; 
(5) by striking subsection (g) and redesignating 
subsections (h) and (i) as (g) and (h), accordingly; 
and 
(6) in subsection (g), as redesignated by para-
graph (5), by striking ‘‘substance abuse’’ each place 
such term appears and inserting ‘‘substance use dis-
order’’. 
(c) DESCRIPTION OF INTENDED EXPENDITURES OF 
GRANT.—Section 527 of the Public Health Service Act (42 
U.S.C. 290cc–27) is amended by striking ‘‘substance abuse’’ 
each place such term appears and inserting ‘‘substance use 
disorder’’. 
(d) TECHNICAL ASSISTANCE.—Section 530 of the Pub-
lic Health Service Act (42 U.S.C. 290cc–30) is amended 
by striking ‘‘through the National Institute of Mental 
Health, the National Institute of Alcohol Abuse and Alco-
holism, and the National Institute on Drug Abuse’’ and in-
serting ‘‘acting through the Assistant Secretary’’.
537 
(e) DEFINITIONS.—Section 534(4) of the Public Health 
Service Act (42 U.S.C. 290cc–34(4)) is amended to read as 
follows: 
‘‘(4) SUBSTANCE USE DISORDER SERVICES.—The 
term ‘substance use disorder services’ has the meaning 
given the term ‘substance abuse services’ in section 
330(h)(5)(C).’’. 
(f) FUNDING.—Section 535(a) of the Public Health 
Service Act (42 U.S.C. 290cc–35(a)) is amended by striking 
‘‘$75,000,000 for each of the fiscal years 2001 through 
2003’’ and inserting ‘‘$64,635,000 for each of fiscal years 
2018 through 2022’’. 
(g) STUDY CONCERNING FORMULA.— 
(1) IN GENERAL.—Not later than 2 years after 
the date of enactment of this Act, the Assistant Sec-
retary for Mental Health and Substance Use (referred 
to in this section as the ‘‘Assistant Secretary’’) shall 
conduct a study concerning the formula used under 
section 524 of the Public Health Service Act (42 
U.S.C. 290cc–24) for making allotments to States 
under section 521 of such Act (42 U.S.C. 290cc–21). 
Such study shall include an evaluation of quality in-
dicators of need for purposes of revising the formula 
for determining the amount of each allotment for the 
fiscal years following the submission of the study.
538 
(2) 
REPORT.—In 
accordance 
with 
section 
8004(b), the Assistant Secretary shall submit to the 
committees of Congress described in such section a re-
port concerning the results of the study conducted 
under paragraph (1). 
SEC. 9005. NATIONAL SUICIDE PREVENTION LIFELINE PRO-
GRAM. 
Subpart 3 of part B of title V of the Public Health 
Service Act (42 U.S.C. 290bb–31 et seq.) is amended by in-
serting after section 520E–2 (42 U.S.C. 290bb–36b) the fol-
lowing: 
‘‘SEC. 520E–3. NATIONAL SUICIDE PREVENTION LIFELINE 
PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Assistant Secretary, shall maintain the National Suicide 
Prevention Lifeline program (referred to in this section as 
the ‘program’), authorized under section 520A and in effect 
prior to the date of enactment of the Helping Families in 
Mental Health Crisis Reform Act of 2016. 
‘‘(b) ACTIVITIES.—In maintaining the program, the 
activities of the Secretary shall include— 
‘‘(1) coordinating a network of crisis centers 
across the United States for providing suicide preven-
tion and crisis intervention services to individuals 
seeking help at any time, day or night;
539 
‘‘(2) maintaining a suicide prevention hotline to 
link callers to local emergency, mental health, and so-
cial services resources; and 
‘‘(3) consulting with the Secretary of Veterans 
Affairs to ensure that veterans calling the suicide pre-
vention hotline have access to a specialized veterans’ 
suicide prevention hotline. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$7,198,000 for each of fiscal years 2018 through 2022.’’. 
SEC. 9006. CONNECTING INDIVIDUALS AND FAMILIES WITH 
CARE. 
Subpart 3 of part B of title V of the Public Health 
Service Act (42 U.S.C. 290bb–31 et seq.), as amended by 
section 9005, is further amended by inserting after section 
520E–3 the following: 
‘‘SEC. 520E–4. TREATMENT REFERRAL ROUTING SERVICE. 
‘‘(a) IN GENERAL.—The Secretary, acting through the 
Assistant Secretary, shall maintain the National Treatment 
Referral Routing Service (referred to in this section as the 
‘Routing Service’) to assist individuals and families in lo-
cating mental and substance use disorders treatment pro-
viders.
540 
‘‘(b) ACTIVITIES OF THE SECRETARY.—To maintain 
the Routing Service, the activities of the Assistant Secretary 
shall include administering— 
‘‘(1) a nationwide, telephone number providing 
year-round access to information that is updated on 
a regular basis regarding local behavioral health pro-
viders and community-based organizations in a man-
ner that is confidential, without requiring individuals 
to identify themselves, is in languages that include at 
least English and Spanish, and is at no cost to the 
individual using the Routing Service; and 
‘‘(2) an Internet website to provide a searchable, 
online treatment services locator of behavioral health 
treatment providers and community-based organiza-
tions, which shall include information on the name, 
location, contact information, and basic services pro-
vided by such providers and organizations. 
‘‘(c) REMOVING PRACTITIONER CONTACT INFORMA-
TION.—In the event that the Internet website described in 
subsection (b)(2) contains information on any qualified 
practitioner that is certified to prescribe medication for 
opioid dependency under section 303(g)(2)(B) of the Con-
trolled Substances Act, the Assistant Secretary— 
‘‘(1) shall provide an opportunity to such practi-
tioner to have the contact information of the practi-
541 
tioner removed from the website at the request of the 
practitioner; and 
‘‘(2) may evaluate other methods to periodically 
update the information displayed on such website. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to prevent the Assistant Secretary 
from using any unobligated amounts otherwise made avail-
able to the Administration to maintain the Routing Serv-
ice.’’. 
SEC. 9007. STRENGTHENING COMMUNITY CRISIS RESPONSE 
SYSTEMS. 
Section 520F of the Public Health Service Act (42 
U.S.C. 290bb–37) is amended to read as follows: 
‘‘SEC. 520F. STRENGTHENING COMMUNITY CRISIS RE-
SPONSE SYSTEMS. 
‘‘(a) IN GENERAL.—The Secretary shall award com-
petitive grants to— 
‘‘(1) State and local governments and Indian 
tribes and tribal organizations, to enhance commu-
nity-based crisis response systems; or 
‘‘(2) States to develop, maintain, or enhance a 
database of beds at inpatient psychiatric facilities, 
crisis stabilization units, and residential community 
mental health and residential substance use disorder 
treatment facilities, for adults with a serious mental
542 
illness, children with a serious emotional disturbance, 
or individuals with a substance use disorder. 
‘‘(b) APPLICATIONS.— 
‘‘(1) IN
GENERAL.—To receive a grant under 
subsection (a), an entity shall submit to the Secretary 
an application, at such time, in such manner, and 
containing such information as the Secretary may re-
quire. 
‘‘(2) 
COMMUNITY-BASED
CRISIS
RESPONSE 
PLAN.—An application for a grant under subsection 
(a)(1) shall include a plan for— 
‘‘(A) promoting integration and coordina-
tion between local public and private entities en-
gaged in crisis response, including first respond-
ers, emergency health care providers, primary 
care providers, law enforcement, court systems, 
health care payers, social service providers, and 
behavioral health providers; 
‘‘(B) developing memoranda of under-
standing with public and private entities to im-
plement crisis response services; 
‘‘(C) addressing gaps in community re-
sources for crisis intervention and prevention; 
and
543 
‘‘(D) developing models for minimizing hos-
pital readmissions, including through appro-
priate discharge planning. 
‘‘(3) BEDS DATABASE PLAN.—An application for 
a grant under subsection (a)(2) shall include a plan 
for developing, maintaining, or enhancing a real- 
time, Internet-based bed database to collect, aggregate, 
and display information about beds in inpatient psy-
chiatric facilities and crisis stabilization units, and 
residential community mental health and residential 
substance use disorder treatment facilities to facilitate 
the identification and designation of facilities for the 
temporary treatment of individuals in mental or sub-
stance use disorder crisis. 
‘‘(c) DATABASE REQUIREMENTS.—A bed database de-
scribed in this section is a database that— 
‘‘(1) includes information on inpatient psy-
chiatric facilities, crisis stabilization units, and resi-
dential community mental health and residential sub-
stance use disorder facilities in the State involved, in-
cluding contact information for the facility or unit; 
‘‘(2) provides real-time information about the 
number of beds available at each facility or unit and, 
for each available bed, the type of patient that may 
be admitted, the level of security provided, and any
544 
other information that may be necessary to allow for 
the proper identification of appropriate facilities for 
treatment of individuals in mental or substance use 
disorder crisis; and 
‘‘(3) enables searches of the database to identify 
available beds that are appropriate for the treatment 
of individuals in mental or substance use disorder 
crisis. 
‘‘(d) EVALUATION.—An entity receiving a grant under 
subsection (a)(1) shall submit to the Secretary, at such time, 
in such manner, and containing such information as the 
Secretary may reasonably require, a report, including an 
evaluation of the effect of such grant on— 
‘‘(1) local crisis response services and measures 
for individuals receiving crisis planning and early 
intervention supports; 
‘‘(2) individuals reporting improved functional 
outcomes; and 
‘‘(3) individuals receiving regular followup care 
following a crisis. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are 
authorized to be appropriated to carry out this section, 
$12,500,000 for the period of fiscal years 2018 through 
2022.’’.
545 
SEC. 9008. 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), as amended by section 6001, is fur-
ther amended— 
(1) in the section heading, by striking ‘‘YOUTH 
INTERAGENCY
RESEARCH, 
TRAINING, 
AND 
TECHNICAL ASSISTANCE CENTERS’’ and insert-
ing ‘‘SUICIDE PREVENTION TECHNICAL ASSIST-
ANCE CENTER’’; 
(2) in subsection (a), by striking ‘‘acting through 
the Assistant Secretary for Mental Health and Sub-
stance Use’’ and all that follows through the period at 
the end of paragraph (2) and inserting ‘‘acting 
through the Assistant Secretary, shall establish a re-
search, training, and technical assistance resource 
center to provide appropriate information, training, 
and technical assistance to States, political subdivi-
sions of States, federally recognized Indian tribes, 
tribal organizations, institutions of higher education, 
public organizations, or private nonprofit organiza-
tions regarding the prevention of suicide among all 
ages, particularly among groups that are at a high 
risk for suicide.’’; 
(3) by striking subsections (b) and (c);
546 
(4) by redesignating subsection (d) as subsection 
(b); 
(5) in subsection (b), as so redesignated— 
(A) in the subsection heading, by striking 
‘‘ADDITIONAL CENTER’’ and inserting ‘‘RESPON-
SIBILITIES OF THE CENTER’’; 
(B) in the matter preceding paragraph (1), 
by striking ‘‘The additional research’’ and all 
that follows through ‘‘nonprofit organizations 
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 a 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 a 
high risk for suicide’’ before the semicolon at the 
end;
547 
(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’’; 
(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 $5,988,000 for each of fiscal years 2018 
through 2022. 
‘‘(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 effects of such activi-
ties, and the States, organizations, and institutions that 
have worked with the center.’’.
548 
(b) YOUTH SUICIDE EARLY INTERVENTION AND PRE-
VENTION 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’’; 
(2) in subsection (b)— 
(A) in paragraph (2)— 
(i) by striking ‘‘ensure that each State 
is awarded only 1 grant or cooperative 
agreement under this section’’ and inserting 
‘‘ensure that a State does not receive more 
than 1 grant or cooperative agreement 
under this section at any 1 time’’; and 
(ii) by striking ‘‘been awarded’’ and 
inserting ‘‘received’’; and 
(B) by adding after paragraph (2) the fol-
lowing: 
‘‘(3) 
CONSIDERATION.—In 
awarding 
grants 
under this section, the Secretary shall take into con-
sideration the extent of the need of the applicant, in-
cluding the incidence and prevalence of suicide in the 
State and among the populations of focus, including 
rates of suicide determined by the Centers for Disease
549 
Control and Prevention for the State or population of 
focus.’’; 
(3) in subsection (g)(2), by striking ‘‘2 years 
after the date of enactment of this section,’’ and insert 
‘‘2 years after the date of enactment of Helping Fam-
ilies in Mental Health Crisis Reform Act of 2016,’’; 
and 
(4) by striking subsection (m) and inserting the 
following: 
‘‘(m) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $30,000,000 for each of fiscal years 2018 
through 2022.’’. 
SEC. 9009. ADULT SUICIDE PREVENTION. 
Subpart 3 of part B of title V of the Public Health 
Service Act (42 U.S.C. 290bb–31 et seq.) is amended by 
adding at the end the following: 
‘‘SEC. 520L. ADULT SUICIDE PREVENTION. 
‘‘(a) GRANTS.— 
‘‘(1) IN
GENERAL.—The Assistant Secretary 
shall award grants to eligible entities described in 
paragraph (2) to implement suicide prevention and 
intervention programs, for individuals who are 25 
years of age or older, that are designed to raise 
awareness of suicide, establish referral processes, and
550 
improve care and outcomes for such individuals who 
are at risk of suicide. 
‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re-
ceive a grant under this section, an entity shall be a 
community-based primary care or behavioral health 
care setting, an emergency department, a State men-
tal health agency (or State health agency with mental 
or behavioral health functions), public health agency, 
a territory of the United States, or an Indian tribe 
or tribal organization (as the terms ‘Indian tribe’ and 
‘tribal organization’ are defined in section 4 of the 
Indian Self-Determination and Education Assistance 
Act). 
‘‘(3) USE
OF
FUNDS.—The grants awarded 
under paragraph (1) shall be used to implement pro-
grams, in accordance with such paragraph, that in-
clude one or more of the following components: 
‘‘(A) Screening for suicide risk, suicide 
intervention services, and services for referral for 
treatment for individuals at risk for suicide. 
‘‘(B) Implementing evidence-based practices 
to provide treatment for individuals at risk for 
suicide, including appropriate followup services. 
‘‘(C) Raising awareness and reducing stig-
ma of suicide.
551 
‘‘(b) EVALUATIONS AND TECHNICAL ASSISTANCE.— 
The Assistant Secretary shall— 
‘‘(1) evaluate the activities supported by grants 
awarded under subsection (a), and disseminate, as 
appropriate, the findings from the evaluation; and 
‘‘(2) provide appropriate information, training, 
and technical assistance, as appropriate, to eligible 
entities that receive a grant under this section, in 
order to help such entities to meet the requirements of 
this section, including assistance with selection and 
implementation of evidence-based interventions and 
frameworks to prevent suicide. 
‘‘(c) DURATION.—A grant under this section shall be 
for a period of not more than 5 years. 
‘‘(d) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$30,000,000 for the period of fiscal years 2018 through 
2022.’’. 
SEC. 
9010. 
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
552 
(2) in subsection (b)— 
(A) in the subsection heading, by striking 
‘‘ILLNESS’’ and inserting ‘‘HEALTH’’; 
(B) in paragraph (1), by inserting ‘‘vet-
erans, law enforcement, and other categories of 
individuals, as determined by the Secretary,’’ 
after ‘‘emergency services personnel’’; 
(C) in paragraph (5)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘to’’ and inserting 
‘‘for evidence-based programs that provide 
training and education in accordance with 
paragraph (1) on matters including’’; and 
(ii) by striking subparagraphs (A) 
through (C) and inserting the following: 
‘‘(A) recognizing the signs and symptoms of 
mental illness; and 
‘‘(B)(i) resources available in the commu-
nity for individuals with a mental illness and 
other relevant resources; or 
‘‘(ii) safely de-escalating crisis situations 
involving individuals with a mental illness.’’; 
and 
(D) in paragraph (7), by striking ‘‘, 
$25,000,000’’ and all that follows through the pe-
553 
riod at the end and inserting ‘‘$14,693,000 for 
each of fiscal years 2018 through 2022.’’. 
SEC. 9011. SENSE OF CONGRESS ON PRIORITIZING AMER-
ICAN INDIANS AND ALASKA NATIVE YOUTH 
WITHIN SUICIDE PREVENTION PROGRAMS. 
(a) FINDINGS.—The Congress finds as follows: 
(1) Suicide is the eighth leading cause of death 
among American Indians and Alaska Natives across 
all ages. 
(2) Among American Indians and Alaska Na-
tives who are 10 to 34 years of age, suicide is the sec-
ond leading cause of death. 
(3) The suicide rate among American Indian 
and Alaska Native adolescents and young adults ages 
15 to 34 (17.9 per 100,000) is approximately 1.3 
times higher than the national average for that age 
group (13.3 per 100,000). 
(b) SENSE OF CONGRESS.—It is the sense of Congress 
that the Secretary of Health and Human Services, in car-
rying out suicide prevention and intervention programs, 
should prioritize programs and activities for populations 
with disproportionately high rates of suicide, such as Amer-
ican Indians and Alaska Natives.
554 
SEC. 
9012. 
EVIDENCE-BASED 
PRACTICES 
FOR 
OLDER 
ADULTS. 
Section 520A(e) of the Public Health Service Act (42 
U.S.C. 290bb–32(e)) is amended by adding at the end the 
following: 
‘‘(3) GERIATRIC MENTAL DISORDERS.—The Sec-
retary shall, as appropriate, provide technical assist-
ance to grantees regarding evidence-based practices 
for the prevention and treatment of geriatric mental 
disorders and co-occurring mental health and sub-
stance use disorders among geriatric populations, as 
well as disseminate information about such evidence- 
based practices to States and nongrantees throughout 
the United States.’’. 
SEC. 9013. NATIONAL VIOLENT DEATH REPORTING SYSTEM. 
The Secretary of Health and Human Services, acting 
through the Director of the Centers for Disease Control and 
Prevention, is encouraged to improve, particularly through 
the inclusion of additional States, the National Violent 
Death Reporting System as authorized by title III of the 
Public Health Service Act (42 U.S.C. 241 et seq.). Partici-
pation in the system by the States shall be voluntary. 
SEC. 9014. ASSISTED OUTPATIENT TREATMENT. 
Section 224 of the Protecting Access to Medicare Act 
of 2014 (42 U.S.C. 290aa note) is amended—
555 
(1) in subsection (e), by striking ‘‘and 2018,’’ 
and inserting ‘‘2018, 2019, 2020, 2021, and 2022,’’; 
and 
(2) in subsection (g)— 
(A) in paragraph (1), by striking ‘‘2018’’ 
and inserting ‘‘2022’’; and 
(B) in paragraph (2), by striking ‘‘is au-
thorized to be appropriated to carry out this sec-
tion $15,000,000 for each of fiscal years 2015 
through 2018’’ and inserting ‘‘are authorized to 
be appropriated to carry out this section 
$15,000,000 for each of fiscal years 2015 through 
2017, 
$20,000,000 
for 
fiscal 
year 
2018, 
$19,000,000 for each of fiscal years 2019 and 
2020, and $18,000,000 for each of fiscal years 
2021 and 2022’’. 
SEC. 9015. ASSERTIVE COMMUNITY TREATMENT GRANT 
PROGRAM. 
Part B of title V of the Public Health Service Act (42 
U.S.C. 290bb et seq.), as amended by section 9009, is further 
amended by adding at the end the following: 
‘‘SEC. 520M. ASSERTIVE COMMUNITY TREATMENT GRANT 
PROGRAM. 
‘‘(a) IN GENERAL.—The Assistant Secretary shall 
award grants to eligible entities—
556 
‘‘(1) to establish assertive community treatment 
programs for adults with a 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, political 
subdivision of a State, Indian tribe or tribal organization 
(as such terms are defined in section 4 of the Indian Self- 
Determination and Education Assistance Act), mental 
health system, health care facility, or any other entity the 
Assistant Secretary deems appropriate. 
‘‘(c) SPECIAL CONSIDERATION.—In selecting among 
applicants for a grant under this section, the Assistant Sec-
retary may give special consideration to the potential of 
the applicant’s program to reduce hospitalization, homeless-
ness, and involvement with the criminal justice system 
while improving the health and social outcomes of the pa-
tient. 
‘‘(d) ADDITIONAL ACTIVITIES.—The Assistant Sec-
retary shall— 
‘‘(1) not later than the end of fiscal year 2021, 
submit a report to the appropriate congressional com-
mittees on the grant program under this section, in-
cluding an evaluation of—
557 
‘‘(A) any cost savings and public health 
outcomes such as mortality, suicide, substance 
use disorders, hospitalization, and use of services; 
‘‘(B) rates of involvement with the criminal 
justice system 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 treatment pro-
grams. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there is authorized to be appropriated $5,000,000 for 
the period of fiscal years 2018 through 2022. 
‘‘(2) USE OF CERTAIN FUNDS.—Of the funds ap-
propriated to carry out this section in any fiscal 
year, not more than 5 percent shall be available to the 
Assistant Secretary for carrying out subsection (d).’’.
558 
SEC. 9016. SOBER TRUTH ON PREVENTING UNDERAGE 
DRINKING REAUTHORIZATION. 
Section 519B of the Public Health Service Act (42 
U.S.C. 290bb–25b) is amended— 
(1) in subsection (c)(3), by striking ‘‘fiscal year 
2007’’ and all that follows through the period at the 
end and inserting ‘‘each of the fiscal years 2018 
through 2022.’’; 
(2) in subsection (d)(4), by striking ‘‘fiscal year 
2007’’ and all that follows through the period at the 
end and inserting ‘‘each of the fiscal years 2018 
through 2022.’’; 
(3) in subsection (e)(1)(I), by striking ‘‘fiscal 
year 2007’’ and all that follows through the period at 
the end and inserting ‘‘each of the fiscal years 2018 
through 2022.’’; 
(4) in subsection (f)(2), by striking ‘‘$6,000,000 
for fiscal year 2007’’ and all that follows through the 
period at the end and inserting ‘‘$3,000,000 for each 
of the fiscal years 2018 through 2022’’; and 
(5) by adding at the end the following new sub-
section: 
‘‘(g) REDUCING
UNDERAGE
DRINKING
THROUGH 
SCREENING AND BRIEF INTERVENTION.— 
‘‘(1) GRANTS TO PEDIATRIC HEALTH CARE PRO-
VIDERS TO REDUCE UNDERAGE DRINKING.—The As-
559 
sistant Secretary may make grants to eligible entities 
to increase implementation of practices for reducing 
the prevalence of alcohol use among individuals under 
the age of 21, including college students. 
‘‘(2) PURPOSES.—Grants under this subsection 
shall be made to improve— 
‘‘(A) screening children and adolescents for 
alcohol use; 
‘‘(B) offering brief interventions to children 
and adolescents to discourage such use; 
‘‘(C) educating parents about the dangers 
of, and methods of discouraging, such use; 
‘‘(D) diagnosing and treating alcohol use 
disorders; and 
‘‘(E) referring patients, when necessary, to 
other appropriate care. 
‘‘(3) USE
OF
FUNDS.—An entity receiving a 
grant under this subsection may use such funding for 
the purposes identified in paragraph (2) by— 
‘‘(A) providing training to health care pro-
viders; 
‘‘(B) disseminating best practices, including 
culturally and linguistically appropriate best 
practices, as appropriate, and developing and 
distributing materials; and
560 
‘‘(C) supporting other activities, as deter-
mined appropriate by the Assistant Secretary. 
‘‘(4) APPLICATION.—To be eligible to receive a 
grant under this subsection, an entity shall submit an 
application to the Assistant Secretary at such time, 
and in such manner, and accompanied by such infor-
mation as the Assistant Secretary may require. Each 
application shall include— 
‘‘(A) a description of the entity; 
‘‘(B) a description of activities to be com-
pleted; 
‘‘(C) a description of how the services speci-
fied in paragraphs (2) and (3) will be carried 
out and the qualifications for providing such 
services; and 
‘‘(D) a timeline for the completion of such 
activities. 
‘‘(5) DEFINITIONS.—For the purpose of this sub-
section: 
‘‘(A) 
BRIEF
INTERVENTION.—The 
term 
‘brief intervention’ means, after screening a pa-
tient, providing the patient with brief advice 
and other brief motivational enhancement tech-
niques designed to increase the insight of the pa-
tient regarding the patient’s alcohol use, and any
561 
realized or potential consequences of such use, to 
effect the desired related behavioral change. 
‘‘(B) CHILDREN
AND
ADOLESCENTS.—The 
term ‘children and adolescents’ means any per-
son under 21 years of age. 
‘‘(C) ELIGIBLE ENTITY.—The term ‘eligible 
entity’ means an entity consisting of pediatric 
health care providers and that is qualified to 
support or provide the activities identified in 
paragraph (2). 
‘‘(D) 
PEDIATRIC
HEALTH
CARE
PRO-
VIDER.—The term ‘pediatric health care pro-
vider’ means a provider of primary health care 
to individuals under the age of 21 years. 
‘‘(E) SCREENING.—The term ‘screening’ 
means using validated patient interview tech-
niques to identify and assess the existence and 
extent of alcohol use in a patient.’’. 
SEC. 9017. CENTER AND PROGRAM REPEALS. 
Part B of title V of the Public Health Service Act (42 
U.S.C. 290bb et seq.) is amended by striking section 506B 
(42 U.S.C. 290aa–5b), the second section 514 (42 U.S.C. 
290bb–9) relating to methamphetamine and amphetamine 
treatment initiatives, and each of sections 514A, 517, 519A, 
519C, 519E, 520B, 520D, and 520H (42 U.S.C. 290bb–8,
562 
290bb–23, 290bb–25a, 290bb–25c, 290bb–25e, 290bb–33, 
290bb–35, and 290bb–39). 
Subtitle B—Strengthening the 
Health Care Workforce 
SEC. 9021. MENTAL AND BEHAVIORAL HEALTH EDUCATION 
AND TRAINING GRANTS. 
Section 756 of the Public Health Service Act (42 
U.S.C. 294e–1) is amended— 
(1) in subsection (a)— 
(A) in the matter preceding paragraph (1), 
by striking ‘‘of higher education’’; and 
(B) by striking paragraphs (1) through (4) 
and inserting the following: 
‘‘(1) accredited institutions of higher education 
or accredited professional training programs that are 
establishing or expanding internships or other field 
placement programs in mental health in psychiatry, 
psychology, school psychology, behavioral pediatrics, 
psychiatric nursing (which may include master’s and 
doctoral level programs), social work, school social 
work, substance use disorder prevention and treat-
ment, marriage and family therapy, occupational 
therapy, school counseling, or professional counseling, 
including such programs with a focus on child and 
adolescent mental health and transitional-age youth;
563 
‘‘(2) accredited doctoral, internship, and post- 
doctoral residency programs of health service psy-
chology (including clinical psychology, counseling, 
and school psychology) for the development and im-
plementation of interdisciplinary training of psy-
chology graduate students for providing behavioral 
health services, including substance use disorder pre-
vention and treatment services, as well as the develop-
ment of faculty in health service psychology; 
‘‘(3) accredited master’s and doctoral degree pro-
grams of social work for the development and imple-
mentation of interdisciplinary training of social work 
graduate students for providing behavioral health 
services, including substance use disorder prevention 
and treatment services, and the development of faculty 
in social work; and 
‘‘(4) State-licensed mental health nonprofit and 
for-profit organizations to enable such organizations 
to pay for programs for preservice or in-service train-
ing in a behavioral health-related paraprofessional 
field with preference for preservice or in-service train-
ing of paraprofessional child and adolescent mental 
health workers.’’; 
(2) in subsection (b)— 
(A) by striking paragraph (5);
564 
(B) 
by 
redesignating 
paragraphs 
(1) 
through (4) as paragraphs (2) through (5), re-
spectively; 
(C) by inserting before paragraph (2), as so 
redesignated, the following: 
‘‘(1) an ability to recruit and place the students 
described in subsection (a) in areas with a high need 
and high demand population;’’; 
(D) in paragraph (3), as so redesignated, by 
striking ‘‘subsection (a)’’ and inserting ‘‘para-
graph (2), especially individuals with mental 
disorder symptoms or diagnoses, particularly 
children and adolescents, and transitional-age 
youth’’; 
(E) in paragraph (4), as so redesignated, by 
striking ‘‘;’’ and inserting ‘‘; and’’; and 
(F) in paragraph (5), as so redesignated, by 
striking ‘‘; and’’ and inserting a period; 
(3) in subsection (c), by striking ‘‘authorized 
under subsection (a)(1)’’ and inserting ‘‘awarded 
under paragraphs (2) and (3) of subsection (a)’’; 
(4) by amending subsection (d) to read as fol-
lows: 
‘‘(d) PRIORITY.—In selecting grant recipients under 
this section, the Secretary shall give priority to—
565 
‘‘(1) programs that have demonstrated the abil-
ity to train psychology, psychiatry, and social work 
professionals to work in integrated care settings for 
purposes of recipients under paragraphs (1), (2), and 
(3) of subsection (a); and 
‘‘(2) programs for paraprofessionals that empha-
size the role of the family and the lived experience of 
the consumer and family-paraprofessional partner-
ships for purposes of recipients under subsection 
(a)(4).’’; and 
(5) by striking subsection (e) and inserting the 
following: 
‘‘(e) REPORT TO CONGRESS.—Not later than 4 years 
after the date of enactment of the Helping Families in Men-
tal Health Crisis Reform Act of 2016, the Secretary shall 
include in the biennial report submitted to Congress under 
section 501(m) an assessment on the effectiveness of the 
grants under this section in— 
‘‘(1) providing graduate students support for ex-
periential training (internship or field placement); 
‘‘(2) recruiting students interested in behavioral 
health practice; 
‘‘(3) recruiting students in accordance with sub-
section (b)(1);
566 
‘‘(4) developing and implementing interprofes-
sional training and integration within primary care; 
‘‘(5) developing and implementing accredited 
field placements and internships; and 
‘‘(6) collecting data on the number of students 
trained in behavioral health care and the number of 
available accredited internships and field placements. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For each 
of fiscal years 2018 through 2022, there are authorized to 
be appropriated to carry out this section $50,000,000, to 
be allocated as follows: 
‘‘(1) For grants described in subsection (a)(1), 
$15,000,000. 
‘‘(2) For grants described in subsection (a)(2), 
$15,000,000. 
‘‘(3) For grants described in subsection (a)(3), 
$10,000,000. 
‘‘(4) For grants described in subsection (a)(4), 
$10,000,000.’’. 
SEC. 9022. STRENGTHENING THE MENTAL AND SUBSTANCE 
USE DISORDERS WORKFORCE. 
Part D of title VII of the Public Health Service Act 
(42 U.S.C. 294 et seq.) is amended by adding at the end 
the following:
567 
‘‘SEC. 760. TRAINING DEMONSTRATION PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary shall establish a 
training demonstration program to award grants to eligible 
entities to support— 
‘‘(1) training for medical residents and fellows to 
practice psychiatry and addiction medicine in under-
served, community-based settings that integrate pri-
mary care with mental and substance use disorders 
prevention and treatment services; 
‘‘(2) training for nurse practitioners, physician 
assistants, health service psychologists, and social 
workers to provide mental and substance use disorders 
services in underserved community-based settings that 
integrate primary care and mental and substance use 
disorders services; and 
‘‘(3) establishing, maintaining, or improving 
academic units or programs that— 
‘‘(A) provide training for students or fac-
ulty, including through clinical experiences and 
research, to improve the ability to be able to rec-
ognize, diagnose, and treat mental and substance 
use disorders, with a special focus on addiction; 
or 
‘‘(B) develop evidence-based practices or rec-
ommendations for the design of the units or pro-
568 
grams described in subparagraph (A), including 
curriculum content standards. 
‘‘(b) ACTIVITIES.— 
‘‘(1) TRAINING FOR RESIDENTS AND FELLOWS.— 
A recipient of a grant under subsection (a)(1)— 
‘‘(A) shall use the grant funds— 
‘‘(i)(I) to plan, develop, and operate a 
training program for medical psychiatry 
residents and fellows in addiction medicine 
practicing in eligible entities described in 
subsection (c)(1); or 
‘‘(II) to train new psychiatric residents 
and fellows in addiction medicine to pro-
vide and expand access to integrated mental 
and substance use disorders services; and 
‘‘(ii) to provide at least 1 training 
track that is— 
‘‘(I) a virtual training track that 
includes an in-person rotation at a 
teaching health center or in a commu-
nity-based setting, followed by a vir-
tual rotation in which the resident or 
fellow continues to support the care of 
patients at the teaching health center 
or in the community-based setting
569 
through the use of health information 
technology and, as appropriate, tele-
health services; 
‘‘(II) an in-person training track 
that includes a rotation, during which 
the resident or fellow practices at a 
teaching health center or in a commu-
nity-based setting; or 
‘‘(III) an in-person training track 
that includes a rotation during which 
the resident practices in a community- 
based setting that specializes in the 
treatment of infants, children, adoles-
cents, or pregnant or postpartum 
women; and 
‘‘(B) may use the grant funds to provide 
additional support for the administration of the 
program or to meet the costs of projects to estab-
lish, maintain, or improve faculty development, 
or departments, divisions, or other units nec-
essary to implement such training. 
‘‘(2) TRAINING FOR OTHER PROVIDERS.—A re-
cipient of a grant under subsection (a)(2)— 
‘‘(A) shall use the grant funds to plan, de-
velop, or operate a training program to provide
570 
mental and substance use disorders services in 
underserved, community-based settings, as ap-
propriate, that integrate primary care and men-
tal and substance use disorders prevention and 
treatment services; and 
‘‘(B) may use the grant funds to provide 
additional support for the administration of the 
program or to meet the costs of projects to estab-
lish, maintain, or improve faculty development, 
or departments, divisions, or other units nec-
essary to implement such program. 
‘‘(3) ACADEMIC UNITS OR PROGRAMS.—A recipi-
ent of a grant under subsection (a)(3) shall enter into 
a partnership with organizations such as an edu-
cation accrediting organization (such as the Liaison 
Committee on Medical Education, the Accreditation 
Council for Graduate Medical Education, the Com-
mission on Osteopathic College Accreditation, the Ac-
creditation Commission for Education in Nursing, 
the Commission on Collegiate Nursing Education, the 
Accreditation Council for Pharmacy Education, the 
Council on Social Work Education, American Psycho-
logical Association Commission on Accreditation, or 
the Accreditation Review Commission on Education
571 
for the Physician Assistant) to carry out activities 
under subsection (a)(3). 
‘‘(c) ELIGIBLE ENTITIES.— 
‘‘(1) TRAINING FOR RESIDENTS AND FELLOWS.— 
To be eligible to receive a grant under subsection 
(a)(1), an entity shall— 
‘‘(A) be a consortium consisting of— 
‘‘(i) at least one teaching health center; 
and 
‘‘(ii) the sponsoring institution (or 
parent institution of the sponsoring institu-
tion) of— 
‘‘(I) a psychiatry residency pro-
gram that is accredited by the Accredi-
tation Council of Graduate Medical 
Education (or the parent institution of 
such a program); or 
‘‘(II) a fellowship in addiction 
medicine, as determined appropriate 
by the Secretary; or 
‘‘(B) be an entity described in subpara-
graph (A)(ii) that provides opportunities for 
residents or fellows to train in community-based 
settings that integrate primary care with mental
572 
and substance use disorders prevention and 
treatment services. 
‘‘(2) TRAINING FOR OTHER PROVIDERS.—To be 
eligible to receive a grant under subsection (a)(2), an 
entity shall be— 
‘‘(A) a teaching health center (as defined in 
section 749A(f)); 
‘‘(B) a Federally qualified health center (as 
defined in section 1905(l)(2)(B) of the Social Se-
curity Act); 
‘‘(C) a community mental health center (as 
defined in section 1861(ff)(3)(B) of the Social 
Security Act); 
‘‘(D) a rural health clinic (as defined in 
section 1861(aa) of the Social Security Act); 
‘‘(E) a health center operated by the Indian 
Health Service, an Indian tribe, a tribal organi-
zation, or an urban Indian organization (as de-
fined in section 4 of the Indian Health Care Im-
provement Act); or 
‘‘(F) an entity with a demonstrated record 
of success in providing training for nurse practi-
tioners, physician assistants, health service psy-
chologists, and social workers.
573 
‘‘(3) ACADEMIC UNITS OR PROGRAMS.—To be eli-
gible to receive a grant under subsection (a)(3), an 
entity shall be a school of medicine or osteopathic 
medicine, a nursing school, a physician assistant 
training program, a school of pharmacy, a school of 
social work, an accredited public or nonprofit private 
hospital, an accredited medical residency program, or 
a public or private nonprofit entity which the Sec-
retary has determined is capable of carrying out such 
grant. 
‘‘(d) PRIORITY.— 
‘‘(1) IN GENERAL.—In awarding grants under 
subsection (a)(1) or (a)(2), the Secretary shall give 
priority to eligible entities that— 
‘‘(A) demonstrate sufficient size, scope, and 
capacity to undertake the requisite training of 
an appropriate number of psychiatric residents, 
fellows, nurse practitioners, physician assistants, 
or social workers in addiction medicine per year 
to meet the needs of the area served; 
‘‘(B) demonstrate experience in training 
providers to practice team-based care that inte-
grates mental and substance use disorder preven-
tion and treatment services with primary care 
in community-based settings;
574 
‘‘(C) demonstrate experience in using health 
information technology and, as appropriate, tele-
health to support— 
‘‘(i) the delivery of mental and sub-
stance use disorders services at the eligible 
entities described in subsections (c)(1) and 
(c)(2); and 
‘‘(ii) community health centers in inte-
grating primary care and mental and sub-
stance use disorders treatment; or 
‘‘(D) have the capacity to expand access to 
mental and substance use disorders services in 
areas with demonstrated need, as determined by 
the Secretary, such as tribal, rural, or other un-
derserved communities. 
‘‘(2) 
ACADEMIC
UNITS
OR
PROGRAMS.—In 
awarding grants under subsection (a)(3), the Sec-
retary shall give priority to eligible entities that— 
‘‘(A) have a record of training the greatest 
percentage of mental and substance use disorders 
providers who enter and remain in these fields or 
who enter and remain in settings with inte-
grated primary care and mental and substance 
use disorder prevention and treatment services;
575 
‘‘(B) have a record of training individuals 
who are from underrepresented minority groups, 
including native populations, or from a rural or 
disadvantaged background; 
‘‘(C) provide training in the care of vulner-
able populations such as infants, children, ado-
lescents, pregnant and postpartum women, older 
adults, homeless individuals, victims of abuse or 
trauma, individuals with disabilities, and other 
groups as defined by the Secretary; 
‘‘(D) teach trainees the skills to provide 
interprofessional, integrated care through col-
laboration among health professionals; or 
‘‘(E) provide training in cultural com-
petency and health literacy. 
‘‘(e) DURATION.—Grants awarded under this section 
shall be for a minimum of 5 years. 
‘‘(f) STUDY AND REPORT.— 
‘‘(1) STUDY.— 
‘‘(A) IN GENERAL.—The Secretary, acting 
through the Administrator of the Health Re-
sources and Services Administration, shall con-
duct a study on the results of the demonstration 
program under this section.
576 
‘‘(B) DATA SUBMISSION.—Not later than 90 
days after the completion of the first year of the 
training program and each subsequent year that 
the program is in effect, each recipient of a grant 
under subsection (a) shall submit to the Sec-
retary such data as the Secretary may require 
for analysis for the report described in para-
graph (2). 
‘‘(2) REPORT TO CONGRESS.—Not later than 1 
year after receipt of the data described in paragraph 
(1)(B), the Secretary shall submit to Congress a re-
port that includes— 
‘‘(A) an analysis of the effect of the dem-
onstration program under this section on the 
quality, quantity, and distribution of mental 
and substance use disorders services; 
‘‘(B) an analysis of the effect of the dem-
onstration program on the prevalence of un-
treated mental and substance use disorders in the 
surrounding communities of health centers par-
ticipating in the demonstration; and 
‘‘(C) recommendations on whether the dem-
onstration program should be expanded.