The 21 st Century Cures Act ( P.L. 114-255 ) was signed into law on December 13, 2016, by President Barack Obama. On N ovember 30, 2016, the House passed an amendment to the Senate amendment to H.R. 34 , the 21 st Century Cures Act, on a vote of 392 to 26. The bill was then sent to the Senate, where it was considered and passed, with only minor technical modification, on December 7, 2016, on a vote of 94 to 5. The law consists of three divisions: Division A—21 st Century Cures; Division B—Helping Families in Mental Health Crisis; and Division C—Increasing Choice, Access, and Quality in Health Care for Americans. CRS has published a series of reports on this law, one on each division. This report provides information on Division B of the law. Enactment of Division B is the culmination of a multiyear congressional effort dating back at least to December 2013, when the Helping Families in Mental Health Crisis Act of 2013 ( H.R. 3717 in the 113 th Congress) was introduced. In the 113 th Congress, H.R. 3717 did not have a Senate companion (although other mental health bills were introduced in both chambers). In the 114 th Congress, the Helping Families in Mental Health Crisis Act of 2015 ( H.R. 2646 ) was introduced in June 2015. It gained a Senate companion in August 2015, with the introduction of the Mental Health Reform Act of 2015 ( S. 1945 ). The more recent Mental Health Reform Act of 2016 ( S. 2680 ), introduced in March 2016, includes elements of the earlier S. 1945 ; the Mental Health Awareness and Improvement Act of 2015 ( S. 1893 ), which passed the Senate in December 2015; and other bills that were smaller in scope. The bulk of Division B represents a compromise between the Helping Families in Mental Health Crisis Act of 2015 ( H.R. 2646 RFS) and the Mental Health Reform Act of 2016 ( S. 2680 RS). Within the final title of Division B (Title XVI), Subtitle A represents a version of the Mental Health and Safe Communities Act of 2015 ( H.R. 3722 , S. 2002 ), and Subtitle B represents a version of the Comprehensive Justice and Mental Health Act of 2015 ( H.R. 1854 , S. 993 ). This report provides a brief summary of each provision of the Helping Families in Mental Health Crisis Act (Division B of P.L. 114-255 ), by title and subtitle. Within each title (or subtitle), major provisions are organized by topic. In some cases, each topic corresponds with a section in the act. In other cases, multiple sections address the same topic or one section addresses multiple topics. Throughout this report, clarity takes priority over consistency. For example, some summaries are more detailed than others where such detail is necessary to highlight important changes. Technical edits to redesignating sections, subsections, paragraphs, et cetera are generally not noted. Edits to clarify meaning or replace outdated terminology are not provided in detail. For example, provisions throughout Division B replace the term "substance abuse" with the term "substance use disorder." See below for a list of which CRS author covers which topics. The Appendix provides a list of abbreviations used throughout this report. Division B begins before Title VI with the short title (Section 6000), "Helping Families in Mental Health Crisis Reform Act of 2016." Subtitle A makes changes to the leadership, organization, and responsibilities of the Substance Abuse and Mental Health Services Administration (SAMHSA), the agency within the Department of Health and Human Services (HHS) that has primary responsibility for increasing access to community-based services to prevent and treat mental disorders and substance use disorders. Subtitle A (Sections 6001 and 6002) replaces the position of SAMHSA Administrator with a newly established Assistant Secretary for Mental Health and Substance Use (ASMHSU), to be appointed by the President and subject to Senate confirmation (as was the case with the Administrator). It expands (and otherwise revises) the list of responsibilities to be carried out by the HHS Secretary, acting through the newly established ASMHSU (formerly the Administrator). For example, the revised list of responsibilities requires collaboration with other federal agencies, including the Secretaries of Defense and Veterans Affairs, and the Attorney General. Subtitle A (Sections 6005 and 6006) requires the ASMHSU to develop and carry out a strategic plan, with specified contents, by the end of FY2018 and every four years thereafter. It changes the required contents of a biennial report concerning activities and progress; the ASMHSU must prepare the report, with specified contents, by the end of FY2020 and every two years thereafter. Both the strategic plan and the report on programs and activities must be submitted to specified congressional committees and posted on the agency website. Subtitle A (Section 6003) establishes a new position of Chief Medical Officer, to be selected by the ASMHSU from among physicians with relevant experience, knowledge, and licensure. It specifies the duties of SAMHSA's Chief Medical Officer. Subtitle A (Section 6007) modifies the authorities for SAMHSA's Center for Mental Health Services, Center for Substance Abuse Prevention, and Center for Substance Abuse Treatment. Changes include increased requirements for collaboration (e.g., with relevant institutes of the National Institutes of Health [NIH]). Each center was, and remains, permanently authorized. Subtitle A (Section 6004) also provides permanent statutory authority for SAMHSA's Center for Behavioral Health Statistics and Quality (which was not previously authorized explicitly in statute) and specifies the responsibilities of its Director. Subtitle A (Sections 6008 and 6009) changes the membership requirements for SAMHSA's advisory councils and peer review groups. It includes the newly established Chief Medical Officer and the Directors of relevant NIH institutes as ex officio members of each advisory council. It requires that not less than half of appointed members of the advisory council for each of three centers—the Center for Mental Health Services, the Center for Substance Abuse Prevention, and the Center for Substance Abuse Treatment—shall have relevant clinical experience and training (i.e., a medical degree, a doctoral degree in psychology, or other specified advanced degree or certification). It also requires that not less than half of any peer review group reviewing a grant, contract, or cooperative agreement related to mental illness treatment shall have relevant experience and training, as specified. It requires the HHS Secretary, in consultation with the ASMHSU, to ensure broad geographic representation on peer review groups (to the extent possible). Subtitle A (Section 6002) provides that funds made available for emergency response grants under Public Health Service Act (PHSA) Section 501 shall remain available through the end of the fiscal year following the fiscal year for which such amounts are appropriated, and makes numerous technical edits, such as updating terminology (e.g., replacing "illnesses" with "diseases or disorders"). Subtitle B creates new planning and evaluation requirements, changes reporting and accounting requirements for state-designated protection and advocacy systems, and requires a report by the Comptroller General on programs funded by SAMHSA's Protection and Advocacy for Individuals with Mental Illness (PAIMI) grants. Planning and Evaluation Subtitle B (Section 6021) requires the HHS Secretary, acting through the HHS Assistant Secretary for Planning and Evaluation (ASPE), to ensure efficient and effective planning and evaluation of programs and activities for the prevention and treatment of mental disorders and substance use disorders. It requires the ASPE, not later than 180 days after enactment, to develop an evaluation strategy that identifies priority programs for evaluation. It specifies some contents of the evaluation strategy, requires consultation with others inside and outside HHS, and requires the ASPE to make recommendations to Congress and the HHS Secretary on improving the quality of relevant programs and activities. The Protection and Advocacy for Individuals with Mental Illness Act of 1986 (PAIMI Act, P.L. 99-319 , as amended) authorizes formula grants to state-designated protection and advocacy systems mandated to protect individuals with mental illness residing in care or treatment facilities from abuse, neglect, and violations of their civil rights. The PAIMI Act requires each protection and advocacy system to prepare an annual report on the system's activities, accomplishments, and expenditures and to transmit the report to the HHS Secretary and the head of the state mental health agency. It also requires the HHS Secretary to provide a biennial report to the President, Congress, and the National Council on Disability describing the goals and outcomes of specified programs for individuals with disabilities; it requires the Secretary to include in each such report a separate statement containing specified information. Subtitle B (Section 6022) requires each protection and advocacy system to make the annual report publicly available, in addition to transmitting the report to the Secretary and the head of the state mental health agency. It also specifies inclusion of additional information in the separate statement in the HHS Secretary's biennial report. The separate statement must contain "a detailed accounting" of the protection and advocacy system's spending, broken down by funding source: federal government, state government, local government, or a private entity. Subtitle B (Section 6023) requires the Comptroller General, not later than 18 months after the date of enactment, to submit a report to specified congressional committees on programs funded by PAIMI grants. It requires the Comptroller General to consult with the HHS Secretary and the ASMHSU in conducting the evaluation, and it specifies the contents of the report.