An Act to extend through fiscal year 1974 certain expiring appropriations authorizations in the Public Health Service Act, the Community Mental Health Centers Act, and the Developmental Disabilities Services and Facilities Construction Act, and for other purposes.
PL 93-282 (S.1125), enacted 05/14/1974

88 STAT. ] 
PUBLIC LAW 93-282-MAY 14, 1974 
125 
"(1) if the applicant is a practitioner who is determined by 
the Secretary to be qualified (under standards established by the 
Secretary) to engage in the treatment with respect to which 
registration is sought; 
"(2) if the Attorney General determines that the applicant 
will comply with standards established by the Attorney General 
respecting (A) security of stocks of narcotic drugs for such treat-
ment, and (B) the maintenance of records (in accordance with 
section 307) on such drugs; and 
21 use 827. 
" (3) if the Secretary determines that the applicant will comply 
with standards established by the Secretary (after consultation 
w^ith the Attorney General) respecting the quantities of narcotic 
drugs which may be provided for unsupervised use by individuals 
in such treatment.". 
SEC. 4. (a) Section 304(a) of the Controlled Substances Act (21 
suspension or 
U.S.C. 824(a)) is amended by adding after and below paragraph (3) '•e^°'=^tion. 
the following: "A registration pursuant to section 303(g) to dispense 
21 use 823. 
a narcotic drug for maintenance treatment or detoxification treatment 
may be suspended or revoked by the Attorney General upon a findinij 
that the registrant has failed to complv with any standard referred to 
in section 303(g)." 
(b) Section 304(d) of such Act is amended (1) by inserting after 
the first sentence the following: "A failure to comply with a standard 
referred to in section 303(g) may be treated under this subsection as 
grounds for immediate suspension of a registration granted under 
such section."; and (2) by striking out "Such suspension" and insert-
ing in lieu thereof "A suspension under this subsection". 
SEC. 5. Section 307(c) (1) (A) of the Controlled Substances Act (21 
U.S.C. 827(c) (1) (A)) is amended to read as follows: 
"(1) (A) with respect to any narcotic controlled substance in 
schedule II, III, IV, or V, to the prescribing or administering of 
such substance by a practitioner in the lawful course of his pro-
fessional practice unless such substance was prescribed or admin-
istered in the course of maintenance treatment or detoxification 
treatment of an individual; or". 
Approved May 14, 1974. 
Public Law 93-282 
AN ACT 
j^gy j4^ 1974 
To extend through fiscal year 1974 certain expiring appropriations authorizations 
i^^'^^25] 
in the Public Health Service Act, the Community Mental Health Centers Act, 
and the Developmental Disabilities Services and Facilities Construction Act, 
and for other purposes. 
Be it enacted hy the Senate and House of Representatives 
of the 
United States of America in Conqress assembled. 
AicohoUsm and 
alcohol abuse 
programs. 
TITLE I—FEDERAL ASSISTANCE FOR STATE AND LOCAL 
Appropriations 
authorizations, 
ALCOHOLISM AND ALCOHOL ABUSE PROGRAMS 
extension. 
note. 
126 
PUBLIC LAW 93-282-MAY 14, 1974 
[88 STAT. 
PART A—SHORT TITLE; FINDINGS AND PURPOSE 
SHORT TITLE 
Comprehensive 
SEC. 101. This title may be cited as the "Comprehensive Alcohol 
and°Ai'iotoUsm 
Abusc and Alcoholism Prevention, Treatment, and Rehabilitation Act 
Prevention, Treat- Amendments of 1974". 
ment, and Reha-
bilitation Act 
Amendments of 
FINDINGS AND PURPOSE 
1974. 
nole."^*^ ^^^^ 
S^*^- -'•^^- (^) "^^^ Comprehensive Alcohol Abuse and Alcoholism 
42USC 4551 
Prevention, Treatment, and Rehabilitation Act of 1970 is amended by 
adding after section 1 the following new section: 
" F I N D I N G S AND PURPOSE 
42 use 4541. 
"SEC. 2. (a) The Congress finds that— 
"(1) alcohol is one of the most dangerous drugs and the drug 
most frequently abused in the United States; 
"(2) of the Nation's estimated ninety-five million drinkers, at 
least nine million, or 7 per centum of the adult population, are 
alcohol abusers and alcoholics; 
"(3) problem drinking costs the national economy at least 
$15,000,000,000 annually m lost working time, medical and pub-
lic assistance expenditures, and police and court costs; 
"(4) alcohol abuse is found with increasing frequency among 
persons who are multiple-drug abusers and among former heroin 
users who are being treated in methadone maintenance programs; 
" (5) alcohol abuse is being discovered among growing numbers 
of youth; and 
"(6) alcoholism is an illness requiring treatment and rehabili-
tation through the assistance of a broad range of community 
health and social services, and with the cooperation of law 
enforcement agencies. 
"(b) It is the policy of the United States and the purpose of this 
Act to (1) approach alcohol abuse and alcoholism from a comprehen-
sive community care standpoint, and (2) meet the problems of alcohol 
abuse and alcoholism not only through Federal assistance to the 
States but also through direct Federal assistance to community-based 
programs meeting the urgent needs of special populations and develop-
ing methods for diverting problem drinkers from criminal justice 
systems into prevention and treatment programs.". 
42 use 4542. 
(b) The Congress declares that, in addition to the programs under 
the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treat-
ment, and Rehabilitation Act of 1970, programs under other Federal 
laws which provide Federal or federally assisted research, prevention, 
treatment, or rehabilitation in the fields of health and social services 
should be appropriately utilized to help eradicate alcohol abuse and 
alcoholism as a major problem. 
42 use 4571. 
88 STAT. ] 
PUBLIC LAW 93-282-MAY 14, 1974 
127 
PART B—GRANTS TO STATES 
PROGRAM E X T E N S I O N 
SEC. 105. (a) Section 301 of the Comprehensive Alcohol Abuse and 
Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 
is amended by inserting immediately after "for each of the next two 
fiscal years" the following: ", $80,000,000 for the fiscal year ending 
June 30, 1975, and $80,000,000 for the fiscal year ending June 30, 
1976,". 
(b) The section heading for such section is amended to read as 
follows: 
" A U T H O R I Z A T I O N FOR FORMULA GRANTS". 
PROGRAM IMPROVEMENTS 
SEC. 106. (a) (1) Section 302 of such Act is amended by adding at 
42 use 4572. 
the end thereof the following new subsection: 
"(d) On the request of any State, the Secretary is authorized to 
arrange for the assignment of officers and employees of the Depart-
ment or provide equipment or supplies in lieu of a portion of the 
allotment of such State. The allotment may be reduced by the fair 
market value of any equipment or supplies furnished to such State and 
by the amount of the pay, allowances, traveling expenses, and any 
other costs in connection with the detail of an officer or employee to 
the State. The amount by which such payments are so reduced shall 
be available for payment of such costs (including the costs of such 
equipment and supplies) by the Secretary, but shall for purposes of 
determining the allotment under section 302(a), be deemed to have 
been paid to the State.". 
(2) Section 302(b) of such Act is amended (A) by striking out in 
the first sentence "so allotted to a State" and inserting in lieu thereof 
"allotted to a State in a fiscal year"; and (B) by striking out in the 
second sentence "for a fiscal year" and inserting in lieu thereof "in 
a fiscal year". 
(b) Section 303(a) of such Act is amended— 
42 use 4573. 
(1) by striking out in paragraph (3) "or groups" and insert-
ing in lieu thereof ", of groups to be served with attention to 
assuring representation of minority and poverty groups"; 
(2) by striking out "and" at the end of paragraph (9); 
(3) by redesignating paragraph (10) as paragraph (11); and 
(4) by adding after 
paragraph 
(9) 
the following 
new 
paragraph: 
"(10) set forth, in accordance with criteria to be set by the 
Secretary, standards (including enforcement procedures and pen-
alties) for (A) construction and licensing of public and private 
treatment facilities, and (B) for other community services or 
resources available to assist individuals to meet problems result-
ing from alcohol abuse; and". 
UNIFORM ALCOHOLISM AND INTOXICATION TREATMENT ACT 
SEC. 107. Part A of title I I I of such Act is amended by adding 
^2 use 4571. 
at the end thereof the following new section: 
128 
PUBLIC LAW 93-282-MAY 14, 1974 
[88 STAT. 
42 use 4574. 
Applications. 
Treatment pro-
grams, acceptance 
standards. 
SPECIAL GRANTS FOR IMPLEMENTATION OF THE UNIFORM ALCOHOLISM 
AND INTOXICATION TREATMENT ACT 
"SEC. 304. (a) To assist States which have adopted the basic provi-
sions of the Uniform Alcoholism and Intoxication Treatment Act 
(hereinafter in this section referred to as the 'Uniform Act') to utilize 
fully the protections of the Uniform Act in their efforts to approach 
alcohol abuse and alcoholism from a community care standpoint, the 
Secretary, acting through the Institute, shall, during the period begin-
ning July 1, 1974, and ending June 30, 1977, make grants to such 
States for the implementation of the Uniform Act. A grant under this 
section to any State may only be made for that State's costs (as 
determined in accordance with regulations which the Secretary shall 
promulgate not later than July 1,1974) in implementing the Uniform 
Act for a period which does not exceed one year from the first day of 
the first month for which the grant is made. No State may receive more 
than three grants under this section. 
" (b) No grant may be made under this section unless an application 
therefor has been submitted to, and approved by, the Secretary. Such 
application shall be in such form, submitted in such manner, and 
contain such information as the Secretary shall by regulation pre-
scribe. The Secretary may not approve an application of a State under 
this section unless he determines the following: 
"(1) The State and each of its political subdivisions are com-
mitted to the concept of care for alcoholism and alcohol abuse 
through community health and social service agencies, and, in 
accordance with the purposes of sections 1 and 19 of the Uniform 
Act, have repealed those portions of their criminal statutes and 
ordinances under which drunkenness is the gravamen of a petty 
criminal offense, such as loitering, vagrancy, or disturbing the 
peace. 
"(2) The laws of the State respecting acceptance of individuals 
into alcoholism and intoxication treatment programs are in 
accordance with the following standards of acceptance of individ-
uals for such treatment (contained in section 10 of the Uniform 
Act): 
" (A) A patient shall, if possible, be treated on a voluntary 
rather than an involuntary basis. 
"(B) A patient shall be initially assigned or transferred 
to outpatient or intermediate treatment, unless he is found 
to require inpatient treatment. 
"(C) A person shall not be denied treatment solely because 
he has withdrawn from treatment against medical advice on 
a prior occasion or because he has relapsed after earlier treat-
ment. 
"(D) An individualized treatment plan shall be prepared 
and maintained on a current basis for each patient. 
"(E) Provision shall be made for a continuum of coordi-
nated treatment services so that a person who leaves a facil-
ity or a form of treatment will have available and utilize 
other appropriate treatment. 
"(3) The laws of the State respecting involuntary commit-
ment of alcoholics are consistent with the provisions of section 14 
of the Uniform Act which protect individual rights. 
"(4) The application of the State contains such assurances as 
the Secretary may require to carry out the purposes of this section. 
For purposes of subsection (a), the term 'basic provisions of the Uni-
form Alcoholism and Intoxication Treatment Act' shall not in the 
88 STAT. ] 
PUBLIC LAW 93-282-MAY 14, 1974 
129 
case of a State which has a State plan approved under section 303 
"
^
^ use 4573. 
include any provision of the Uniform Act respecting the organization 
of such State's treatment programs (as defined in the Uniform Act) 
which are inconsistent with the requirements of such State plan. 
"(c) The amount of any grant under this section to any State for 
any fiscal year may not exceed the sum of $100,000 and an amount equal 
to 10 per centum of the allotment of such State for such fiscal year un-
der section 302 of this Act. Payments under grants under this section 
^2 use 4572. 
may be made in advance or by way of reimbursement, and at such 
intervals and on such conditions, as the Secretary finds necessary. 
"(d) For the purpose of making payments under grants imder this 
Appropriation, 
section, there are authorized to be appropriated $13,000,000/^or the 
fiscal year ending June 30, 1975, and for each of the next two fiscal 
years.". 
CONFORMING 
AMENDMENT 
SEC. 108. The heading for part A of title I I I of such Act is amended 
by striking out "FORMULA GRANTS" and inserting in lieu thereof 
"GRANTS TO STATES". 
PART C—PROJECT GRANTS AND CONTRACTS 
GRANTS AND CONTRACTS FOR PREVENTION AND TREATMENT PROJECTS 
SEC. 111. Section 311 of the Comprehensive Alcohol Abuse and 
Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 is 
^2 use 4577. 
amended to read as follows: 
" G R A N T S A N D CONTRACTS FOR T H E PREVENTION AND TREATMENT OF 
ALCOHOL ABUSE AND 
ALCOHOLISM 
"SEO. 311. (a) The Secretary, acting through the Institute, may 
make grants to public and nonprofit private entities and may enter into 
contracts with public and private entities and with individuals— 
" (1) to conduct demonstration, service, and evaluation projects, 
" (2) to provide education and training, 
"(3) to provide programs and services in cooperation with 
schools, courts, penal institutions, and other public agencies, and 
"(4) to provide counseling and education activities on an indi-
vidual or community basis, 
for the prevention and treatment of alcohol abuse and alcoholism and 
for the rehabilitation of alcohol abusers and alcoholics. 
"(b) Projects and programs for which grants and contracts are 
made under this section shall (1) whenever possible, be community 
based, seek to insure care of good quality in general community care 
facilities and under health insurance plans, and be integrated with, 
and provide for the active participation of, a wide range of public and 
nongovernmental agencies, organizations, institutions, and individ-
uals; and (2) where appropriate utilize existing community resources 
(including community mental health centers). 
"(c) (1) In administering this section, the Secretary shall require 
coordination of all applications for projects and programs in a State. 
"(2) Each applicant from within a State, upon filing its application 
with the Secretary for a grant or contract under this section, shall 
submit a copy of its application for review by the State agency desig-
nated under section 303 of this Act, if such designation has been made. 
Such State agency shall be given not more than thirty days from the 
date of receipt of the application to submit to the Secretary, in writ-
ing, an evaluation of the project or program set forth in the applica-
130 
PUBLIC LAW 93-282-MAY 14, 1974 
[88 STAT. 
tion. Such evaluation shall include comments on the relationship of 
the project to other projects and programs pending and approved 
and to the State comprehensive plan for treatment and prevention of 
42 use 4573. 
alcohol abusc and alcoholism under section 303. The State shall furnish 
the applicant a copy of any such evaluation. 
"(3) Approval of any application for a grant or contract by the 
Secretary, including the earmarking of financial assistance for a pro-
gram or project, may be granted only if the application substantially 
meets a set of criteria established by the Secretary that— 
" (A) provides that the projects and programs for which assist-
ance under this section is sought will be substantially administered 
by or under the supervision of the applicant; 
"(B) provides for such methods of administration £ts are neces-
sary for the proper and efficient operation of such programs and 
projects; 
"(C) provides for such fiscal control and fund accounting pro-
cedures as may be necessary to assure proper disbursement of and 
accounting for Federal funds paid to the applicant; and 
"(D) provides reasonable assurance that Federal funds made 
available under this section for any period will be so used as to 
supplement and increase, to the extent feasible and practical, the 
level of State, local, and other non-Federal funds that would in 
the absence of such Federal funds be made available for the 
projects and programs described in this section, and will in no 
event supplant such State, local, and other non-Federal funds. 
Appropriation. 
^^ (d) To make payments under grants and contracts under this 
section, there are authorized to be appropriated $80,000,000 for the 
fiscal year ending June 30, 1975, and $95,000,000 for the fiscal year 
ending June 30,1976.". 
PART D—^ADMISSION TO HOSPITALS; CONFIDENTIALITY or KECORDS 
HOSPITAL A D M I S S I O N S 
42 use 4581, 
SEC. 121. (a) Section 321 of the Comprehensive Alcohol Abuse and 
Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 is 
amended to read as follows: 
"ADMISSION or ALCOHOL ABUSERS AND ALCOHOLICS TO PRIVATE AND PUBLIC 
HOSPITALS 
"SEC. 321. (a) Alcohol abusers and alcoholics who are suffering from 
medical conditions shall not be discriminated against in admission or 
treatment, solely because of their alcohol abuse or alcoholism, by any 
private or public general hospital which receives support in any form 
from any program supported in whole or in part by funds appropri-
ated to any Federal department or agency. 
Regulations. 
"(b)(1) The Sccretaiy is authorized to make regulations for the 
enforcement of the policy of subsection (a) with respect to the admis-
sion and treatment of alcohol abusers and alcoholics in hospitals which 
receive support of any kind from any program administered by the 
Secretary. Such regulations shall include procedures for determining 
(after opportunity for a hearing if requested) if a violation of sub-
section (a) has occurred, notification of failure to comply with such 
subsection, and opportunity for a violator to. comply with such sub-
section. If the Secretary determines that a hospital subject to such 
regulations has violated subsection (a) and such violation continues 
after an opportunity has been afforded for compliance, the Secretary 
88 STAT. ] 
PUBLIC LAW 93-282-MAY 14, 1974 
131 
may suspend or revoke, after opportunity for a hearing, all or part of 
any support of any kind received by such hospital from any program 
administered by the Secretary. The Secretary may consult with the 
officials responsible for the administration of any other Federal pro-
gram from which such hospital receives support of any kind, with 
respect to the suspension or revocation of such other Federal support 
for such hospital. 
"(2) The Administrator of Veterans' Affairs, through the Chief 
^^g^i^tions. 
Medical Director, shall, to the maximum feasible extent consistent 
with their responsibilities under title 38, United States Code, prescribe ^^^ ^^^ ^°^ ®
' 
regulations making applicable the regulations prescribed by the Sec-
retary under paragraph (1) of this subsection to the provision of hos-
pital care, nursing home care, domiciliary care, and medical services 
under such title 38 to veterans suffering from alcohol abuse or alcohol-
ism. In prescribing and implementing regulations pursuant to this 
paragraph, the Administrator shall, from time to time, consult with 
the Secretary in order to achieve the maximum possible coordination 
of the regulations, and the implementation thereof, which they each 
prescribe.". 
(b) The Administrator of Veterans' Affairs shall submit to the 
Report, submit-
appropriate committees of the House of Representatives and the Sen- slonai'^commul 
ate a full report (1) on the regulations (including guidelines, policies, tees. 
and procedures thereunder) he has prescribed pursuant to section ^^il^^'^ "^^^^ 
321(b) (2) of the Comprehensive Alcohol Abuse and Alcoholism Pre-
vention, Treatment, and Rehabilitation Act of 1970, (2) explaining 
Ante, p. uo. 
the bases for any inconsistency between such regulations and regula-
tions of the Secretary under section 321(b) (1) of such Act, (3) on the 
extent, substance, and results of his consultations with the Secretary 
respecting the prescribing and implementation of the Administrator's 
regulations, and (4) containing such recommendations for legislation 
and administrative actions as he determines are necessary and desir-
able. The Administrator shall submit such report not later than sixty 
days after the effective date of the regulations prescribed by the Sec-
retary under such section 321(b)(1), and shall timely publish such ^J^"''i\''|*f°" j " 
report in the Federal Register. 
Federal Registe 
CONFIDENTIALITY 
SEC. 122. (a) Section 333 of such Act is amended to read as follows: 
42 use 4582. 
"CONFIDENTIALITY OF KECORDS 
"SEC. 333. (a) Records of the identity, diagnosis, prognosis, or 
treatment of any patient which are maintained in connection with 
the performance of any program or activity relating to alcoholism or 
alcohol abuse education, training, treatment, rehabilitation, or 
research, which is conducted, regulated, or directly or indirectly 
assisted by any department or agency of the United States shall, except 
as provided in subsection (e), be confidential and be disclosed only 
for the purposes and under the circumstances expressly authorized 
under subsection (b) of this section. 
"(b)(1) The content of any record referred to in subsection (a) 
Disclosure. 
may be disclosed in accordance with the prior written consent of the 
patient with respect to whom such record is maintained, but only to 
such extent, under such circumstances, and for such purposes as may 
be allowed under regulations prescribed pursuant to subsection (g). 
"(2) Whether or not the patient, with respect to whom any given 
record referred to in subsection (a) of this section is maintained, gives 
132 
PUBLIC LAW 93-282-MAY 14, 1974 
[88 STAT. 
his written consent, the content of such record may be disclosed as 
follows: 
"(A) To medical personnel to the extent necessary to meet a 
bona fide medical emergency. 
"(B) To qualified personnel for the purpose of conducting 
scientific research, management audits, financial audits,, or pro-
gram evaluation, but such personnel may not identify, directly 
or indirectly, any individual patient in any report of such research, 
audit, or evaluation, or otherwise disclose patient identities in any 
manner. 
"(C) If authorized by an appropriate order of a court of com-
petent jurisdiction granf^ed after application showing good cause 
therefor. Iniassessing good cause the court shall weigh the public 
interest and the need for disclosure against the injury to the 
patient, to the physician-patient relationship, and to the treatment 
services. Upon the granting of such order, the court, in determin-
ing the extent to which any disclosure of all or any part of any 
record is necessary, shall impose appropriate safeguards against 
unauthorized disclosure. 
"(c) Except as authorized by a court order granted under subsec-
tion (b) (2) (C) of this section, no record referred to in subsection (a) 
may be used to initiate or substantiate any criminal charges against 
a patient or to conduct any investigation of a patient. 
"(d) The prohibitions of this section continue to apply to records 
concerning any individual who has been a patient, irrespective of 
whether or when he ceases to be a patient. 
"(e) The prohibitions of this section do not apply to any interchange 
of records— 
"(1) within the Armed Forces or within those components of 
the Veterans' Administration furnishing health care to veter-
ans, or 
" (2) between such components and the Armed Forces. 
Penalty. 
"^f^ Any pcTSon wlio violatcs any provision of this section or any 
regulation issued pursuant to this section shall be fined not more 
than $500 in the case of a first offense, and not more than $5,000 in 
the case of each subsequent offense. 
Regulations. 
"(g) Except as provided in subsection (h) of this section, the 
Secretary shall prescribe regulations to carry out the purposes of this 
section. These regulations may contain such definitions, and may pro-
vide for such safeguards and procedures, including procedures and 
criteria for the issuance and scope of orders under subsection (b) (2) 
(C), as in the judgment of the Secretary are necessary or proper to 
effectuate the purposes of this section, to prevent circumvention or 
evasion thereof, or to facilitate compliance therewith. 
"(h) The Administrator of Veterans' Affairs, through the Chief 
Medical Director, shall, to the maximum feasible extent consistent 
with their responsibilities under title 38, United States Code, prescribe 
regulations making applicable the regulations prescribed by the Sec-
retary under subsection (g) of this section to records maintained in 
connection with the provision of hospital care, nursing home care, 
domiciliary care, and medical services under such title 38 to veterans 
suffering from alcohol abuse or alcoholism. In prescribing and im-
plementing regulations pursuant to this subsection, the Administrator 
shall, from time to time, consult with the Secretary in order to achieve 
the maximum possible coordination of the regulations, and the imple-
mentation thereof, which they each prescribe.". 
(b) Section 303(a) of the Public Health Service Act (42 U.S.C. 
242a (a)) is amended by striking out "the use and effect of drugs" and 
38 u s e 101 et 
seq. 
88 STAT. ] 
PUBLIC LAW 93-282-IVlAY 14, 1974 
133 
inserting in lieu thereof "mental health, including research on the use 
and effect of alcohol and other psychoactive drugs,". 
(c) The Administrator of Veterans' Affairs shall submit to the 
Report to con-
appropriate committees of the House of Representatives and the Senate mutee s?^ 
a full report (1) on the regulations (including guidelines, policies, and 
42 use 4582 
procedures thereunder) he has prescribed pursuant to section 333(h) 
of the Comprehensive Alcohol Abuse and Alcoholism Prevention, 
Treatment, and Rehabilitation Act of 1970, (2) explaining the basis 
Ante, p. isi. 
for any inconsistency between such regulations and regulations of the 
Secretary under section 333(g) of such Act, (3) on the extent, sub-
stance, and results of his consultations with the Secretary respecting 
the prescribing and implementation of the Administrator's regulations, 
and (4) containing such recommendations for legislation and admin-
istrative actions as he determines are necessary and desirable. The 
Administrator shall submit such report not later than sixty days 
after the effective date of the regulations prescribed by the Secretary 
under such section 333(g), and shall timely publish such report in the 
Publication in 
Federal Register. 
^^'^"^^ Register. 
PART E—INTERAGENCY COMMITTEE 
INTERAGENCY COMMITTEE 
SEC. 131. Title I of the Comprehensive Alcohol Abuse and Alcohol-
ism Prevention, Treatment, and Rehabilitation Act of 1970 is 
42 use 4551. 
amended by adding at the end the following: 
"INTERAGENCY COMMITT^EE ON FEDERAL ACTIVITIES FOR ALCOHOL ABUSE 
AND ALCOHOLISM 
"SEC. 103. (a) The Secretary shall establish an Interagency Com- 
Establishment. 
mittee on Federal Activities for Alcohol Abuse and Alcoholism (here-
inafter in this section referred to as the 'Committee'). The Committee 
shall (1) evaluate the adequacy and technical soundness of all Federal 
programs and activities which relate to alcoholism and alcohol abuse 
and provide for the comunication and exchange of information neces-
sary to maintain the coordination and effectiveness of such programs 
and activities, and (2) seek to coordinate efforts undertaken to deal 
with alcohol abuse and alcoholism in carrying out Federal health, wel-
fare, rehabilitation, highway safety, law enforcement, and economic 
opportunity laws. 
"(b) The Secretary or the Director of the National Institute on 
Membership. 
Alcohol Abuse and Alcoholism (or the Director's designee) shall serve 
as Chairman of the Committee, the membership of which shall include 
(1) appropriate scientific, medical, or technical representation from the 
Department of Transportation, the Department of Justice, the Depart-
ment of Defense, the Veterans' Administration, and such other Federal 
agencies and offices (including appropriate agencies and offices of the 
Department of Health, Education, and Welfare) as the Secretary 
determines administer programs directly affecting alcoholism and 
alcohol abuse, and (2) five individuals from the general public 
appointed by the Secretary from individuals who by virtue of their 
training or experience are particularly qualified to participate in the 
performance of the Committee's functions. The Committee shall meet 
at the call of the Chairman, but not less often than four times a year. 
"(c) Each appointed member of the Committee shall be appointed 
Term. 
for a term of four years, except that— 
" (1) any member appointed to fill a vacancy occurring prior to 
the expiration of the term for which his predecessor was appointed 
shall be appointed for the remainder of such term; and 
note 
134 
PUBLIC LAW 93-282-MAY 14, 1974 
[88 STAT. 
"(2) of the members first appointed, two shall be appointed 
for a term of four years, two shall be appointed for a term of three 
years, and one shall be appointed for a term of one year, as desig-
nated by the Secretary at the time of apj)ointment. 
Appointed members may serve after the expiration of their terms until 
their successors have taken office. 
Compensation. 
"(d) Appointed members of the Committee shall receive for each 
day they are engaged in the performance of the functions of the Com-
mittee compensation at rates not to exceed the daily equivalent of the 
5 use 5332 
annual rate in effect for grade GS-18 of the General Schedule, includ-
ing traveltime; and all members, while so serving away from their 
homes or regular places of business, may be allowed travel expenses, 
including per diem in lieu of subsistence, in the same manner as such 
expenses are authorized by section 5703 of title 5, United States Code, 
for persons in the Government servicie employed intermittently. 
"(e) The Secretary shall make available to the Committee such 
staff, information, and other assistance as it may require to carry out 
its activities effectively.". 
TITLE II—ADMINISTKATION AND COOKDINATION OF 
THE 
NATIONAL INSTITUTE 
OF MENTAL 
HEALTH, 
T H E NATIONAL INSTITUTE ON ALCOHOL ABUSE AND 
ALCOHOLISM, AND T H E NATIONAL INSTITUTE 
ON 
DKUG ABUSE 
ALCOHOL, DRUG ABUSE, AND MENTAL HEALTH ADMINISTRATION 
Establishment. 
gEC. 201. (a) The Secretary of Health, Education, and Welfare 
4
2 use 3511. 
QY^QII establish, in the Department of Health, Education, and Wel-
fare, the Alcohol, Drug Abuse, and Mental Health Administration 
(hereinafter in this section referred to as the "Administration"). 
The Administration shall be headed by an Administrator appointed 
by the President, by and with the advice and consent of the Senate. 
The Administrator, with the approval of the Secretary, may appoint 
a Deputy Administrator 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 Adminis-
tration. 
(b) The Secretary, acting through the Administration, shall super-
vise the functions of the National Institute of Mental Health, the 
National Institute on Alcohol Abuse and Alcoholism, and the National 
Institute on Drug Abuse in order to assure that (1) the programs 
carried out through each such Institute receive appropriate and equi-
table support, and (2) there is cooperation among the Institutes in 
the implementation of such programs. 
National Panel 
(c) The Secretary of Health, Education, and Welfare shall estab-
ThuseT^nd "'"^ 
lish ^. National Panel on A.lcohol, Drug Abuse, and Mental Health 
Mental'Health. 
(hereinafter in this subsection referred to as the "panel") to advise, 
consult with, and make recommendations to the Secretary concerning 
the activities to be carried out through the Administration. The panel 
shall consist of three members appointed by the Secretary as follows: 
One member shall be appointed from the public members of the 
National Advisory Mental Health Council established under section 
217 of the Public Health Service Act, one member shall be appointed 
from the public members of the National Advisory Council on Alcohol 
Abuse and Alcoholism established under such section, and one member 
shall be appointed from the public members of the National Advisory 
Council on Drug Abuse established under such section. 
Establishment. 
42 use 218. 
88 STAT. ] 
PUBLIC LAW 93-282-MAY 14, 1974 
135 
NATIONAL INSTITUTE OF MENTAL HEALTH 
SEC. 202. Title IV of the Public Health Service Act is amended by 
redesignating part G as part H, by redesignating section 454 as sec-
tion 461, and by inserting after part F the following new part: 
"PART G—NATIONAL INSTITUTE OF MENTAL HEALTH 
42 use 2S9l. 
42 use 289i. 
ESTABLISHMENT OF INSTITUTE 
"SEC. 455. (a) There is established the National Institute of Mental 
Health (hereinafter in this part referred to as the 'Institute') to admin-
ister the programs and authorities of the Secretary with respect to 
mental health. The Secretary, acting through the Institute, shall, in 
carrying out the purposes of sections 301 and 303 of this Act and the 
Mental Eetardation Facilities and Community Mental Health Centers 
Construction Act of 1963 (other than part C of title II) with respect 
to mental illness, develop and conduct comprehensive health, educa-
tion, training, research, and planning programs for the prevention and 
treatment of mental illness and for the rehabilitation of the mentally 
ill. The Secretary shall carry out through the Institute the admin-
istrative and financial management, policy development and planning, 
evaluation, and public information functions which are required for 
the implementation of such programs and authorities. 
"(b) (1) The Institute shall be under the direction of a Director 
who shall be appointed by the Secretary. 
"(2) The Director, with the approval of the Secretary, may employ 
and prescribe the functions of such officers and employees, including 
attorneys, as are necessary to administer the programs and authorities 
to be carried out through the Institute. 
"(c) The programs to be carried out through the Institute shall be 
administered so as to encourage the broadest possible participation 
of professionals and paraprofessionals in the fields of medicine, sci-
ence, the social sciences, and other related disciplines." 
42 use 289k-l. 
42 use 241, 
242a. 
42 use 2661 
note. 
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM 
SEC. 203. (a) Section 101 of the Comprehensive Alcohol Abuse and 
Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 is 
amended to read as follows: 
42 use 4551, 
"ESTABLISHMENT OF THE INSTITUTE 
"SEC. 101. (a) There is established the National Institute on Alcohol 
Abuse and Alcoholism (hereafter in this Act referred to as the 'Insti-
tute') to administer the programs and authorities assigned to the 
Secretary of Health, Education, and Welfare (hereafter in this Act 
referred to as the 'Secretary') by this Act and part C of the Com-
munity Mental Health Centers Act. The Secretary, acting through 
the Institute, shall, in carrying out the purposes of sections 301 and 
303 of the Public Health Service Act with respect to alcohol abuse and 
alcoholism, develop and conduct comprehensive health, education, 
training, research, and planning programs for the prevention and 
treatment of alcohol abuse and alcoholism and for the rehabilitation 
of alcohol abusers and alcoholics. The Secretary shall carry out 
through the Institute the administrative and financial management, 
policy development and planning, evaluation, and public information 
functions which are required for the implementation of such programs 
and authorities. 
42 use 2688e. 
136 
PUBLIC LAW 93-282-MAY 14, 1974 
[88 STAT. 
" (b) (1) The Institute shall be under the direction of a Director who 
shall be appointed by the Secretary. 
"(2) The Director, with the approval of the Secretary, may employ 
and prescribe the functions of such oiScers and employees, including 
attorneys, as are necessary to administer the programs to be carried 
out through the Institute. 
"(c) The programs to be carried out through the Institute shall 
be administered so as to encourage the broadest possible participation 
of professionals and paraprofessionals in the fields of medicine, sci-
ence, the social sciences, and other related disciplines." 
42 use 4552. 
(b) (1) Scctlou 102(2) of such Act is amended by inserting "and 
every three years thereafter" after "Act". 
(2) (A) Section 102 of such Act is amended by striking out "and" 
at the end of paragraph (3), by striking the period at the end of para-
graph (4) and inserting in lieu thereof "; and", and by adding after 
paragraph (4) the following: 
Report to 
"(5) submit to Congress on or before the end of each calendar 
Congress, 
^^^^ ^ report on the extent to which other Federal programs and 
departments are concerned and dealing effectively with the prob-
lems of alcohol abuse and alcoholism. 
Before submitting a report under paragraph (5), the Secretary shall 
give each department and agency of the Government which (or a pro-
gram of which) is referred to in the report he proposes to submit 
under such paragraph an opportunity to comment on the proposed 
report; and the Secretary shall include in the report submitted to 
Congress under such paragraph the comments received by him from 
any such department or agency within 30 days from the date the pro-
posed report was submitted to such department or agency.". 
Submittal date. 
(B) The first report to be submitted by the Secretary of Health, 
^
4
2 use 4552 
Educatiou, and Welfare under section 102(5) of the Comprehensive 
Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabili-
^"p''^- 
tation Act of 1970 shall be submitted not later than December 31, 
1974. 
NATIONAL INSTITUTE ON DRUG ABUSE 
SEC. 204. Subsections (a) and (b) of section 501 of the Drug Abuse 
21 use 1191. 
Office and Treatment Act of 1972 are amended to read as follows: 
"(a) There is established the National Institute on Drug Abuse 
(hereinafter in this section referred to as the 'Institute') to administer 
the programs and authorities of the Secretary of Health, Education, 
and Welfare (hereinafter in this section referred to as the 'Secretary') 
with respect to drug abuse prevention functions. The Secretary, act-
ing through the Institute, shall, in carrying out the purposes of sec-
/^2 usc^ 241. 
tions 301, 302, and 303 of the Public Health Service Act with respect 
to drug abuse, develop and conduct comprehensive health, education, 
training, research, and planning programs for the prevention and 
treatment of drug abuse and for the rehabilitation of drug abusers. 
The Secretary shall carry out through the Institute the administrative 
and financial rnanagement, policy development and planning, evalua-
tion, and public information functions which are required for the 
implementation of such programs and authorities. 
" (b) (1) The Institute shall be under the direction of a Director who 
shall be appointed by the Secretary. 
"(2) The Director, with the approval of the Secretary, maj employ 
and prescribe the functions of such officers and employees, including 
attorneys, as are necessary to administer the programs and authorities 
to be carried out through the Institute.". 
note 
242, 242a. 
88 STAT. ] 
PUBLIC LAW 93-282-MAY 14, 1974 
137 
TITLE III—TECHNICAL AND CONFOKMING 
AMENDMENTS 
SEC. 301. Section 5108 (c) of title 5, United States Code, is amended— 
(1) by striking out the period at the end of paragraph (10) (B) 
and inserting in lieu thereof a semicolon; 
(2) by redesignating the paragraph (10) relating to the Law 
Enforcement Assistance Administration as paragraph (11) and 
by striking out the period at the end of that paragraph and 
inserting in lieu thereof a semicolon; 
(3) by redesignating the paragraph (10) relating to the Chief 
Judge of the United States Tax Court as paragraph (12) and by 
striking out "and" at the end of that paragraph; 
(4) by redesignating the paragraph (11) relating to the Chair-
man of the Equal Employment Opportunity Commission as para-
graph (13) and by striking out the period at the end of that 
paragraph and inserting in lieu thereof "; and"; and 
(5) by adding at the end thereof the following new paragraph: 
"(14) the Secretary of Health, Education, and Welfare, subject 
to the standards and procedures prescribed by this chapter, may 
place a total of eleven positions in the National Institute on 
Alcohol Abuse and Alcoholism in GS-16, 17, and 18.". 
SEC. 302. Section 247 of the Community Mental Health Centers Act 
R^p^ai-
(42 U.S.C. 2688J-2) is repealed. 
SEC. 303. (a) Section 408 of the Drug Abuse Office and Treatment 
Act of 1972 (21 U.S.C. 1175) is amended to read as follows: 
"§ 408. Confidentiality of patient records 
"(a) Records of the identity, diagnosis, prognosis, or treatment of 
any patient which are maintained in connection with the performance 
of any drug abuse prevention function conducted, regulated, or 
directly or indirectly assisted by any department or agency of the 
United States shall, except as provided in subsection (e), be confi-
dential and be disclosed only for the purposes and under the circum-
stances expressly authorized under subsection (b) of this section. 
" (b) (1) The content of any record referred to in subsection (a) may 
be disclosed in accordance with the prior written consent of the patient 
with respect to whom such record is maintained, but only to such 
extent, under such circumstances, and for such purposes as may be 
allowed under regulations prescribed pursuant to subsection (g). 
"(2) Whether or not the patient, with respect to whom any given 
record referred to in subsection (a) of this section is maintained, 
gives his written consent, the content of such record may be disclosed 
as follows: 
"(A) To medical personnel to the extent necessary to meet a 
bona fide medical emergency. 
"(B) To qualified personnel for the purpose of conducting 
scientific research, management audits, financial audits, or pro-
gram evaluation, but such personnel may not identify, directly or 
indirectly, any individual patient in any report of such research, 
audit, or evaluation, or otherwise disclose patient identities in 
any maniier. 
"(C) If authorized by an appropriate order of a court of com-
petent jurisdiction granted after application showing good cause 
therefor. In assessing good cause the court shall weigh the public 
interest and the need for disclosure against the injury to the 
patient, to the physician-patient relationship, and to the treat-
ment services. Upon the granting of such order, the court, in deter-
138 
PUBLIC LAW 93-282-MAY 14, 1974 
[88 STAT. 
mining the extent to which any disclosure of all or any part of 
any record is necessary, shall impose appropriate safeguards 
against unauthorized disclosure. 
"(c) Except as authorized by a court order granted under subsection 
(b) (2) (C) of this section, no record referred to in subsection (a) may 
be used to initiate or substantiate any criminal charges against a 
patient or to conduct any investigation of a patient. 
"(d) The prohibitions of this section continue to aj)ply to records 
concerning any individual who has been a patient, irrespective of 
whether or when he ceases to be a patient. 
"(e) The prohibitions of this section do not apply to any interchange 
of records— 
"(1) within the Armed Forces or within those components of 
the Veterans' Administration furnishing health care to veterans, 
or 
" (2) between such components and the Armed Forces. 
Penalties. 
''(f) Xny persou who violates any provision of this section or any 
regulation issued pursuant to this section shall be fined not more than 
$500 in the case of a first offense, and not more than $5,000 in the case 
of each subsequent offense. 
Regulations. 
" (g) The Dircctor of the Special Action Office for Drug Abuse Pre-
vention, after consultation with the Administrator of Veterans' Affairs 
and the heads of other Federal departments and agencies substantially 
affected thereby, shall prescribe regulations to carry out the purposes 
of this section. These regulations may contain such definitions, and may 
provide for such safeguards and procedures, including procedures and 
criteria for the issuance and scope of orders under subsection (b) (2) 
(C), as in the judgment of the Director are necessary or proper to 
effectuate the purposes of this section, to prevent circumvention or 
evasion thereof, or to facilitate compliance therewith.". 
(b) (1) Effective on the date specified in section 104 of the Drug 
Abuse Office and Treatment Act of 1972 (21 U.S.C. 1104), the first sen-
Ante. p. 137. 
^^^^,^ ^f sectiou 408(g) of that Act (21 U.S.C. 1175) is amended by 
striking "Director of the Special Action Office for Drug Abuse Pre-
vention" and inserting in lieu thereof "Secretary of Health, Educa-
tion, and Welfare", and the second sentence of such section is amended 
by striking "Director" and inserting "Secretary" in lieu thereof. 
(2) Effective on the date specified in paragraph (1) of this sub-
section, section 408 of such Act is further amended by— 
(A) striking out "The" and inserting in lieu thereof "Except 
as provided in subsection (h) of this section, the" in the first 
sentence of subsection (g) of such section; and 
(B) adding at the end of such section the following new sub-
section : 
"(h) The Administrator of Veterans' Affairs, through the Chief 
Medical Director, shall, to the maximum feasible extent consistent with 
38 use 101 e^ 
their responsibilities under title 38, United States Code, prescribe 
regulations making applicable the regulations established by the Sec-
retary under subsection (g) of this section to records maintained in 
connection with the provision of hospital care, nursing home care, 
domiciliary care, and medical services under such title 38 to veterans 
suffering from drug abuse. In prescribing and implementing regula-
tions pursuant to this subsection, the Administrator shall, from time 
to time, consult with the Secretary in order to achieve the maximum 
possible coordination of the regulations, and the implementation 
thereof, which they each prescribe.". 
seq 
88 STAT. ] 
PUBLIC LAW 93-283-MAY 14, 1974 
139 
(c) The Administrator of Veterans' Affairs shall submit to the ^^^^°^^ \° ""^^ 
appropriate committees of the House of Representatives and the Sen- m'ltt^esr^ '^°"' 
ate a full report (1) on the regulations (including guidelines, policies, 
21 use 1175 
and procedures thereunder) he has prescribed pursuant to section 
408(h) of the Drug Abuse Office and Treatment Act of 1972, (2) 
Ante, p. 138. 
explaining the bases for any inconsistency between such regulations 
and the regulations of the Secretary of Health, Education, and Wel-
fare under section 408(g) of that Act, (3) on the extent, substance, 
^nte, p. 137. 
and results of his consultations with the Secretary respecting the pre-
scribing and implementation of the Administrator's regulations, and 
(4) containing such recommendations for legislation and administra-
tive actions as he determines are necessary and desirable. The Admin- ^^^^^'^%^'^°'}j^[' 
istrator shall submit such report not later than sixty days after the 
" °'° 
°"'° " 
effective date of the regulations prescribed by the Secretary under such 
section 408(g), and shall timely publish such report in the Federal 
Register. 
(d) Any regulation under or with respect to section 408 of the Drug 
Abuse Office and Treatment Act of 1972 (21 U.S.C. 1175) issued by 
the Director of the Special Action Office for Drug Abuse Prevention 
prior to the date specified in section 104 of that Act (21 U.S.C. 1104), 
whether before or after the enactment of this Act, shall remain in 
effect until revoked or amended by the Director or the Secretary of 
Health, Education, and Welfare, as the case may be. 
Approved May 14, 1974. 
Public Law 93-283 
AN ACT 
May 14, 1974 
To amend certain laws affecting the Coast Guard. 
[H. R. 9293] 
Federal Register. 
21 use 1175 
note. 
Be it enacted hy the Seriate and House of Representatives 
of the 
United States of America in Congress assembled., That title 14, United 
States Code, is amended as follows: 
(1) Section 83 is amended by inserting the words "in or adjacent 
to the waters subject to the jurisdiction of the United States, its 
territories or possessions, or the Trust Territory of the Pacific Islands, 
or on the high seas if that person, or public body, or instrumentality 
is subject to the jurisdiction of the United States," between the word 
"navigation" and the word "without" in the first sentence thereof. 
(2) Section 85 is amended— 
(A) by deleting the words "on fixed structures" from the 
catchline; 
(B) by inserting the words "and floating" between the word 
"fixed" and the word "structures" in the first sentence thereof; 
(C) by deleting the word "navigable" between the word "over" 
and the word "waters" and by inserting the words "subject to the 
jurisdiction" between the word "waters" and the words "of the 
United States"; and 
(D) by adding the following words at the end of the first sen-
tence thereof: "and in the high seas for structures owned or 
operated by persons subject to the jurisdiction of the United 
States". 
(3) Section 86 is amended by deleting the word "any" preceding 
the words "navigable waters" and substituting therefor the word 
"the" and by inserting the words "or waters above the continental 
shelf" between the words "navigable waters" and the words "of the 
United States" in the first sentence thereof. 
Coast Guard.