[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4435 Introduced in House (IH)]
<DOC>
114th CONGRESS
2d Session
H. R. 4435
To improve access to mental health and substance use disorder
prevention, treatment, crisis, and recovery services.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 2, 2016
Mr. Gene Green of Texas (for himself, Ms. DeGette, Mr. Kennedy, Ms.
Matsui, Mr. Tonko, and Mr. Loebsack) introduced the following bill;
which was referred to the Committee on Energy and Commerce, and in
addition to the Committees on the Judiciary, Ways and Means, Education
and the Workforce, and Natural Resources, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To improve access to mental health and substance use disorder
prevention, treatment, crisis, and recovery services.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Comprehensive
Behavioral Health Reform and Recovery Act of 2016''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--STRENGTHENING AND INVESTING IN SAMHSA PROGRAMS
Sec. 101. Assistant Secretary for Mental Health and Substance Use
Disorders.
Sec. 102. Office of Chief Medical Officer.
Sec. 103. Independent audit of SAMHSA.
Sec. 104. Center for Behavioral Health Statistics and Quality.
Sec. 105. Innovation grants.
Sec. 106. Demonstration grants.
Sec. 107. Early intervention and treatment in childhood.
Sec. 108. Block grants.
Sec. 109. Children's recovery from trauma.
Sec. 110. Garrett Lee Smith Memorial Act reauthorization.
Sec. 111. National Suicide Prevention Lifeline Program.
Sec. 112. Adult suicide prevention.
Sec. 113. Peer review and advisory councils.
Sec. 114. Adult trauma.
Sec. 115. Reducing the stigma of serious mental illness.
Sec. 116. Report on mental health and substance abuse treatment in the
States.
Sec. 117. Mental health first aid training grants.
Sec. 118. Acute care bed registry grant for States.
Sec. 119. Older adult mental health grants.
TITLE II--INTERAGENCY SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE
Sec. 201. Interagency Serious Mental Illness Coordinating Committee.
TITLE III--COMMUNICATIONS BETWEEN INDIVIDUALS, FAMILIES, AND PROVIDERS
Sec. 301. Clarification of circumstances under which disclosure of
protected health information of mental
illness patients is permitted.
Sec. 302. Development and dissemination of model training programs.
Sec. 303. Modernizing privacy protections.
Sec. 304. Improving communication with individuals, families, and
providers.
TITLE IV--IMPROVING MEDICAID AND MEDICARE MENTAL HEALTH SERVICES
Subtitle A--Medicaid Provisions
Sec. 401. Enhanced Medicaid coverage relating to certain mental health
services.
Sec. 402. Extension and expansion of demonstration programs to improve
community mental health services.
Sec. 403. Terms for extension and expansion of Medicaid emergency
psychiatric demonstration project.
Sec. 404. Community-based mental health services Medicaid option for
children in or at risk of psychiatric
residential treatment.
Sec. 405. Expansion of CMMI authority to support major mental illness
projects in Medicaid.
Sec. 406. Medicaid data and reporting.
Sec. 407. At-risk youth Medicaid protection.
Subtitle B--Medicare Provisions
Sec. 411. Elimination of 190-day lifetime limit on coverage of
inpatient psychiatric hospital services
under Medicare.
Sec. 412. Modifications to Medicare discharge planning requirements.
Subtitle C--Provisions Related to Medicaid and Medicare
Sec. 421. Reports on Medicaid and Medicare part D formulary and appeals
practices with respect to coverage of
mental health drugs.
TITLE V--STRENGTHENING THE BEHAVIORAL HEALTH WORKFORCE AND IMPROVING
ACCESS TO CARE
Sec. 501. Nationwide workforce strategy.
Sec. 502. Report on best practices for peer-support specialist
programs, training, and certification.
Sec. 503. Advisory Council on Graduate Medical Education.
Sec. 504. Telepsychiatry and primary care provider training grant
program.
Sec. 505. Liability protections for health care professional volunteers
at community health centers and federally
qualified community behavioral health
clinics.
Sec. 506. Minority Fellowship Program.
Sec. 507. National Health Service Corps.
Sec. 508. SAMHSA grant program for development and implementation of
curricula for continuing education on
serious mental illness.
Sec. 509. Peer professional workforce development grant program.
Sec. 510. Demonstration grant program to recruit, train, and
professionally support psychiatric
physicians in Indian health programs.
Sec. 511. Education and training on eating disorders for health
professionals.
Sec. 512. Primary and behavioral health care integration grant
programs.
Sec. 513. Health professions competencies to address racial, ethnic,
sexual, and gender minority behavioral
health disparities.
Sec. 514. Behavioral health crisis systems.
Sec. 515. Mental health in schools.
Sec. 516. Examining mental health care for children.
Sec. 517. Reporting compliance study.
Sec. 518. Strengthening connections to community care demonstration
grant program.
Sec. 519. Assertive community treatment grant program for individuals
with serious mental illness.
Sec. 520. Improving mental and behavioral health on college campuses.
Sec. 521. Inclusion of occupational therapists in National Health
Service Corps program.
TITLE VI--IMPROVING MENTAL HEALTH RESEARCH AND COORDINATION
Sec. 601. Increase in funding for certain research.
TITLE VII--BEHAVIORAL HEALTH INFORMATION TECHNOLOGY
Sec. 701. Extension of health information technology assistance for
behavioral and mental health and substance
abuse.
Sec. 702. Extension of eligibility for Medicare and Medicaid health
information technology implementation
assistance.
TITLE VIII--MAKING PARITY WORK
Sec. 801. Strengthening parity in mental health and substance use
disorder benefits.
Sec. 802. Report on investigations regarding parity in mental health
and substance use disorder benefits.
Sec. 803. GAO study on preventing discriminatory coverage limitations
for individuals with serious mental illness
and substance use disorders.
Sec. 804. Report to Congress on Federal assistance to State insurance
regulators regarding mental health parity
enforcement.
TITLE IX--SUBSTANCE ABUSE
Subtitle A--Prevention
Sec. 901. Practitioner education.
Sec. 902. Co-prescribing opioid overdose reversal drugs grant program.
Sec. 903. Opioid overdose reversal co-prescribing guidelines.
Sec. 904. Surveillance capacity building.
Subtitle B--Crisis
Sec. 921. Grants to support syringe exchange programs.
Sec. 922. Grant program to reduce drug overdose deaths.
Subtitle C--Treatment
Sec. 931. Expansion of patient limits under waiver.
Sec. 932. Definitions.
Sec. 933. Evaluation by assistant Secretary for planning and
evaluation.
Sec. 934. Reauthorization of residential treatment programs for
pregnant and postpartum women.
Sec. 935. Pilot program grants for State substance abuse agencies.
Sec. 936. Evidence-based opioid and heroin treatment and interventions
demonstration.
Sec. 937. Adolescent treatment and recovery services demonstration
grant program.
Sec. 938. Study on treatment infrastructure.
Sec. 939. Substance use disorder professional loan repayment program.
Subtitle D--Recovery
Sec. 951. National youth recovery initiative.
Sec. 952. Grants to enhance and expand recovery support services.
TITLE I--STRENGTHENING AND INVESTING IN SAMHSA PROGRAMS
SEC. 101. ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE USE
DISORDERS.
(a) In General.--Section 501 of the Public Health Service Act (42
U.S.C. 290aa) is amended--
(1) in subsection (c)(1), by adding at the end the
following: ``The Administrator shall be selected from
individuals who have appropriate education and experience. The
Administrator shall also be the Assistant Secretary for Mental
Health and Substance Abuse.'';
(2) in subsection (d)--
(A) by striking ``The Secretary'' and all that
follows through ``(1) supervise the functions'' and
inserting the following:
``(1) Secretary's authorities.--The Secretary, acting
through the Administrator, shall--
``(A) supervise the functions'';
(B) by moving the indentation of each of paragraphs
(2) through (18) 2 ems to the right and redesignating
such paragraphs as subparagraphs (B) through (R),
respectively; and
(3) by adding at the end the following:
``(2) Assistant secretary's authorities.--The Assistant
Secretary for Mental Health and Substance Abuse shall--
``(A) serve as the effective and visible advocate
for individuals with, or at risk for, mental illness
and substance use disorders within the Department of
Health and Human Services and with other departments,
agencies, and instrumentalities of the Federal
Government;
``(B) assist the Secretary in all matters
pertaining to issues that impact the prevention,
treatment, and recovery of individuals with mental
illness or substance use disorders;
``(C) coordinate Federal programs and activities
related to promoting mental health and preventing
substance abuse;
``(D) coordinate activities with Federal entities
to implement and build awareness of programs providing
benefits affecting individuals with mental illness or
substance use disorders;
``(E) promote and coordinate research, treatment,
and services across departments, agencies,
organizations, and individuals with respect to
prevention, treatment, and recovery support research
and programs for individuals with, or at risk for,
substance use disorders or mental illness;
``(F) coordinate functions within the Department of
Health and Human Services--
``(i) to improve the treatment of, and
related services to, individuals with substance
use disorders or mental illness;
``(ii) to improve substance misuse and
abuse prevention and mental health promotion
services;
``(iii) to ensure access to effective,
evidence-based treatment for individuals with
mental illnesses and individuals with a
substance use disorder;
``(iv) to ensure that grant programs of the
Department adhere to scientific standards for
individuals with mental illness or substance
use disorders; and
``(v) to support the development and
implementation of initiatives to encourage
individuals to pursue careers (especially in
underserved areas and populations) as
psychiatrists, psychologists, psychiatric nurse
practitioners, clinical social workers,
physician assistants, peer support specialists,
and other licensed or certified mental health
and substance abuse professionals;
``(G) within the Department of Health and Human
Services, coordinate all programs and activities
relating to--
``(i) the prevention of, and treatment and
recovery for, mental health or substance use
disorders; or
``(ii) the reduction of homelessness among
individuals with mental illness or substance
use disorders;
``(H) across the Federal Government, in conjunction
with the Interagency Serious Mental Illness
Coordinating Committee under section 501A--
``(i) review all programs and activities
relating to the prevention of, or treatment or
rehabilitation for, mental illness or substance
use disorders;
``(ii) identify any such programs and
activities that are duplicative;
``(iii) identify any such programs and
activities that are not evidence-based,
effective, or efficient; and
``(iv) formulate recommendations for
expanding, coordinating, eliminating, and
improving programs and activities identified
pursuant to subparagraph (B) or (C) and merging
such programs and activities into other,
successful programs and activities; and
``(I) identify evidence-based best practices across
the Federal Government for treatment and services for
those with mental health and substance use disorders by
reviewing practices for efficiency, effectiveness,
quality, coordination, and cost effectiveness.''.
(b) Prioritization of Integration of Services, Early Diagnosis,
Intervention, and Workforce Development.--In carrying out the duties
described in section 501(d)(2) of the Public Health Service Act, as
added by subsection (a), the Assistant Secretary shall prioritize--
(1) the integration of mental health, substance use, and
physical health services for the purpose of diagnosing,
preventing, treating, or providing rehabilitation for mental
illness or substance use disorders, including any such services
provided through the justice system (including departments of
correction) or other entities other than the Department of
Health and Human Services;
(2) crisis intervention for, early diagnosis and
intervention services for the prevention of, and treatment and
rehabilitation for, serious mental illness, serious emotional
disturbance, or substance use disorders; and
(3) workforce development for--
(A) appropriate treatment of serious mental
illness, serious emotional disturbance, or substance
use disorders; and
(B) research activities that advance scientific and
clinical understandings of these disorders, including
the development and implementation of a continuing
nationwide strategy to increase the psychiatric
workforce with psychiatrists, child and adolescent
psychiatrists, psychologists, psychiatric nurse
practitioners, clinical social workers, peer support
specialists, and other licensed or certified mental
health or substance abuse professionals.
(c) Requirements and Restrictions on Authority To Award Grants.--In
awarding any grant or financial assistance, the Administrator of the
Substance Abuse and Mental Health Services Administration, and any
agency or official within such Administration, shall comply with the
following:
(1) Any program to be funded shall be demonstrated--
(A) in the case of an ongoing program, to be
effective; and
(B) in the case of a new program, to have the
prospect of being effective.
(2) The programs and activities to be funded shall, as
appropriate, use evidence-based best practices or emerging
evidence-based practices that are translational and can be
expanded or replicated to other States, local communities,
agencies, tribes, or through the Medicaid program under title
XIX of the Social Security Act.
(3) An application for the grant or financial assistance
shall include, as applicable, a scientific justification based
on previously demonstrated models, the number of individuals to
be served, the population to be targeted, what objective
outcomes measures will be used, and details on how the program
or activity to be funded can be replicated and by whom.
(4) Applicants shall be evaluated and selected through a
blind, peer-review process by individuals with expertise
appropriate to the grant or other financial assistance, such as
health care providers with professional experience in mental
health or substance abuse research or treatment.
(5) The Secretary shall adopt a policy that ensures that
any member of a peer review group does not have a conflict of
interest with respect to any program or grant to be reviewed.
(6) Award recipients may be periodically reviewed and
audited at the discretion of the Inspector General of the
Department of Health and Human Services or the Comptroller
General of the United States to ensure that--
(A) the best scientific method for both services
and data collection is being followed; and
(B) Federal funds are being used as required by the
conditions of the award.
(7) Award recipients that fail an audit or fail to provide
information pursuant to an audit shall have their awards
terminated or shall be placed on a corrective action plan to
address the issues raised in the audit findings.
(d) Definition.--In this Act, except as inconsistent with the
provisions of this Act, the term ``Assistant Secretary'' means the
Assistant Secretary for Mental Health and Substance Use Disorders.
SEC. 102. OFFICE OF CHIEF MEDICAL OFFICER.
(a) In General.--Section 501 of the Public Health Service Act (42
U.S.C. 290aa) is amended--
(1) by redesignating subsections (g) through (o) as
subsections (h) through (p), respectively; and
(2) by inserting after subsection (f) the following:
``(g) Chief Medical Office.--The Administrator shall establish
within the Administration a Chief Medical Office, to be headed by a
Chief Medical Officer, who shall be a psychiatrist. The Chief Medical
Office shall be staffed by mental health and substance abuse
providers.''.
(b) Conforming Changes.--Title V of the Public Health Service Act
(42 U.S.C. 290aa et seq.) is amended--
(1) in subsections (e)(3)(C) and (f)(2)(C)(iii) of section
501, by striking ``subsection (k)'' and inserting ``subsection
(l)''; and
(2) in section 508(p), by striking ``501(k)'' and inserting
``501(l)''.
SEC. 103. INDEPENDENT AUDIT OF SAMHSA.
(a) In General.--The Secretary shall enter into an contract or
cooperative agreement with an external, independent entity to conduct a
full assessment and review of the Substance Abuse and Mental Health
Services Administration (in this section referred to as ``SAMHSA'').
(b) Report.--The contract or cooperative agreement under subsection
(a) shall require that, not later than 18 months after the date of
enactment of this Act, the external, independent entity will submit to
the Committee on Energy and Commerce of the House of Representatives
and the Committee on Health, Education, Labor, and Pensions of the
Senate a report on the findings and conclusion of the assessment and
review.
(c) Topics.--The assessment and review conducted pursuant to
subsection (a), and the report submitted pursuant to subsection (b),
shall address each of the following:
(1) Whether the mission of SAMHSA is appropriate.
(2) Whether the program authority of SAMHSA is appropriate.
(3) Whether SAMHSA has adequate staffing, including
technical expertise, to fulfill its mission.
(4) Whether SAMHSA is funded appropriately.
(5) The efficacy of the programs funded by SAMHSA.
(6) Whether funding is being spent in a way that
effectively supports and promotes the authorities vested by
section 501(d) of the Public Health Service Act, as amended by
section 101 of this Act.
(7) Whether SAMHSA's focus on recovery is appropriate.
(8) Additional steps SAMHSA can take to fulfill its charge
of leading public health efforts to advance the behavioral
health of the Nation and reduce the impact of substance abuse
and mental illness on the Nation's communities.
(9) Whether standards for SAMHSA's grant programs are
effective.
(10) Whether standards for SAMHSA's appointment of peer-
review panels to evaluate grant applications is appropriate.
(11) How SAMHSA serves individuals with mental illness,
serious mental illness, serious emotional disturbance, or
substance use disorders, and individuals with co-occurring
conditions.
SEC. 104. CENTER FOR BEHAVIORAL HEALTH STATISTICS AND QUALITY.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.)
is amended--
(1) in section 501(b) (42 U.S.C. 290aa(b)), by adding at
the end the following:
``(4) The Center for Behavioral Health Statistics and
Quality.'';
(2) in section 502(a)(1) (42 U.S.C. 290aa-1(a)(1))--
(A) in subparagraph (C), by striking ``and'' at the
end;
(B) in subparagraph (D), by striking the period at
the end and inserting ``and''; and
(C) by inserting after subparagraph (D) the
following:
``(E) the Center for Behavioral Health Statistics
and Quality.''; and
(3) in part B (42 U.S.C. 290bb et seq.) by adding at the
end the following new subpart:
``Subpart 4--Center for Behavioral Health Statistics and Quality
``SEC. 520L. CENTER FOR BEHAVIORAL HEALTH STATISTICS AND QUALITY.
``(a) Establishment.--There is established in the Administration a
Center for Behavioral 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 experience and academic
qualifications in research and analysis in behavioral health care or
related fields.
``(b) Duties.--The Director of the Center shall--
``(1) coordinate the Administration's integrated data
strategy by coordinating--
``(A) surveillance and data collection (including
that authorized by section 505);
``(B) evaluation;
``(C) statistical and analytic support;
``(D) service systems research; and
``(E) performance and quality information systems;
``(2) maintain operation of the National Registry of
Evidence-Based Programs and Practices to provide for the
evaluation and dissemination to the Administration of the
evidence-based practices and services delivery models of
grantees and other interested parties;
``(3) recommend a core set of measurement standards for
grant programs administered by the Administration; and
``(4) lead evaluation efforts for the grant programs,
contracts, and collaborative agreements of the Administration.
``(c) Biannual Report to Congress.--Not later than 2 years after
the date of enactment of this section, and every 2 years thereafter,
the Director of the Center shall submit to Congress a report on the
quality of services furnished through grant programs of the
Administration, including applicable measures of outcomes for
individuals and public outcomes such as--
``(1) the number of patients screened positive for
unhealthy alcohol use who receive brief counseling as
appropriate; the number of patients screened positive for
tobacco use and receiving smoking cessation interventions; the
number of patients with a new diagnosis of major depressive
episode who are assessed for suicide risk; the number of
patients screened positive for clinical depression with a
documented follow-up plan; and the number of patients with a
documented pain assessment that have a follow-up treatment plan
when pain is present; and satisfaction with care;
``(2) the incidence and prevalence of substance use and
mental disorders; the number of suicide attempts and suicide
completions; overdoses seen in emergency rooms resulting from
alcohol and drug use; emergency room boarding; overdose deaths;
emergency psychiatric hospitalizations; new criminal justice
involvement while in treatment; stable housing; and rates of
involvement in employment, education, and training; and
``(3) such other measures for outcomes of services as the
Director may determine.
``(d) Staffing Composition.--The staff of the Center may include
individuals with advanced degrees and field expertise as well as
clinical and research experience in mental and substance use disorders
such as--
``(1) professionals with clinical and research expertise in
the prevention and treatment of, and recovery from, substance
use and mental disorders;
``(2) professionals with training and expertise in
statistics or research and survey design and methodologies; and
``(3) other related fields in the social and behavioral
sciences, as specified by relevant position descriptions.
``(e) Grants and Contracts.--In carrying out the duties established
in subsection (b), the Director may make grants to and enter into
contracts and cooperative agreements with public and nonprofit private
entities.
``(f) Definition.--In this section, the term `emergency room
boarding' means the practice of admitting patients to an emergency
department and holding such patients in the department until inpatient
psychiatric beds become available.''.
SEC. 105. INNOVATION GRANTS.
(a) In General.--The Assistant Secretary, acting through the
Substance Abuse and Mental Health Services Administration, shall award
grants to State and local governments, tribes and tribal organizations,
educational institutions, and nonprofit organizations for expanding a
model that has been scientifically demonstrated to show promise, but
would benefit from further applied research, for--
(1) enhancing the screening, diagnosis, and treatment of
mental illness and serious mental illness; or
(2) integrating or coordinating physical, mental health,
and substance use services.
(b) Duration.--A grant under this section shall be for a period of
not less than 3 years and not more than 5 years.
(c) Limitations.--Of the amounts made available for carrying out
this section for a fiscal year, not less than one-third shall be
awarded for screening, diagnosis, treatment, or services, as described
in subsection (a), for individuals (or subpopulations of individuals)
who are below the age of 18 when activities funded through the grant
award are initiated.
(d) Guidelines.--As a condition on receipt of an award under this
section, an applicant shall agree to adhere to any requirements or
guidelines issued by the Secretary on research designs and data
collection.
(e) Termination.--The Secretary may terminate any award under this
section upon a determination that--
(1) the recipient is not providing information requested by
the Secretary in connection with the award; or
(2) there is a clear failure in the effectiveness of the
recipient's programs or activities funded through the award.
(f) Reporting.--As a condition on receipt of an award under this
section, an applicant shall agree--
(1) to report to the Secretary the results of programs and
activities funded through the award; and
(2) to include in such reporting any relevant data
requested by the Secretary.
(g) Authorization of Appropriations.--For the purpose of providing
grants under this section, there is authorized to be appropriated
$40,000,000 for each of fiscal years 2017 through 2021.
SEC. 106. DEMONSTRATION GRANTS.
(a) Grants.--The Secretary of Health and Human Services (in this
section referred to as the ``Secretary''), acting through the Substance
Abuse and Mental Health Services Administration, shall award grants to
States, counties, local governments, tribes and tribal organizations,
educational institutions, and private nonprofit organizations for the
expansion, replication, or scaling of evidence-based programs across a
wider area to enhance effective screening, early diagnosis,
intervention, and treatment with respect to mental illness, serious
mental illness, and serious emotional disturbance, primarily by--
(1) applied delivery of care, including training staff in
effective evidence-based treatment; and
(2) integrating models of care across specialties and
jurisdictions.
(b) Duration.--A grant under this section shall be for a period of
not less than 3 years and not more than 5 years.
(c) Limitations.--Of the amounts made available for carrying out
this section for a fiscal year--
(1) not less than half shall be awarded for screening,
diagnosis, intervention, and treatment, as described in
subsection (a), for individuals (or subpopulations of
individuals) who are below the age of 26 when activities funded
through the grant award are initiated;
(2) no amounts shall be made available for any program or
project that is not evidence-based;
(3) no amounts shall be made available for primary
prevention; and
(4) no amounts shall be made available solely for the
purpose of expanding facilities or increasing staff at an
existing program, although funds may be so used by an existing
program if such an expansion or increase is needed to support
the implementation of a new program under this section.
(d) Termination.--The Secretary may terminate any award under this
section upon a determination that--
(1) the recipient is not providing information requested by
the Secretary in connection with the award; or
(2) there is a clear failure in the effectiveness of the
recipient's programs or activities funded through the award.
(e) Reporting.--As a condition on receipt of an award under this
section, an applicant shall agree--
(1) to report to the Secretary the results of programs and
activities funded through the award; and
(2) to include in such reporting any relevant data
requested by the Secretary.
(f) Authorization of Appropriations.--For the purpose of providing
grants under this section, there is authorized to be appropriated
$80,000,000 for each of fiscal years 2017 through 2021.
SEC. 107. EARLY INTERVENTION AND TREATMENT IN CHILDHOOD.
(a) Grants.--The Secretary of Health and Human Services (in this
Act referred to as the ``Secretary''), acting through the Substance
Abuse and Mental Health Services Administration, shall--
(1) award grants to eligible entities to initiate and
undertake, for eligible children, early childhood intervention
and treatment programs, and specialized preschool and
elementary school programs, with the goal of preventing chronic
and serious mental illness and serious emotional disturbance;
(2) award grants to not more than 3 eligible entities for
studying the longitudinal outcomes of programs funded under
paragraph (1) on eligible children who were treated 5 or more
years prior to the enactment of this Act; and
(3) ensure that programs and activities funded through
grants under this subsection are based on a sound scientific
model that shows evidence and promise and can be replicated in
other settings.
(b) Eligible Entities and Children.--In this section:
(1) Eligible entity.--The term ``eligible entity'' means a
nonprofit institution that--
(A) is accredited by State mental health,
education, or human services agencies, as applicable,
for the treatment or education of children from 0 to 12
years of age; and
(B) provides services that include early childhood
intervention and specialized preschool and elementary
school programs focused on children whose primary need
is a social or emotional disability (in addition to any
learning disability).
(2) Eligible child.--The term ``eligible child'' means a
child who is at least 0 years old and not more than 12 years
old--
(A) whose primary need is a social and emotional
disability (in addition to any learning disability);
(B) who is at risk of developing serious mental
illness and/or may show early signs of mental illness;
and
(C) who could benefit from early childhood
intervention and specialized preschool or elementary
school programs with the goal of preventing or treating
chronic and serious mental illness.
(c) Application.--An eligible entity seeking a grant under
subsection (a) shall submit to the Secretary an application at such
time, in such manner, and containing such information as the Secretary
may require.
(d) Use of Funds for Early Childhood Intervention and Treatment
Programs.--An eligible entity shall use amounts awarded under a grant
under subsection (a)(1) to carry out the following activities:
(1) Deliver (or facilitate) for eligible children treatment
and education, early childhood intervention, and specialized
preschool and elementary school programs, including the
provision of medically based child care and early education
services.
(2) Treat and educate eligible children, including startup,
curricula development, operating and capital needs, staff and
equipment, assessment and intervention services, administration
and medication requirements, enrollment costs, collaboration
with primary care providers and psychiatrists, other related
services to meet emergency needs of children, and communication
with families and medical professionals concerning the
children.
(3) Develop and implement other strategies to address
identified treatment and educational needs of eligible children
that have reliable and valid evaluation modalities built into
assess outcomes based on sound scientific metrics.
(e) Use of Funds for Longitudinal Study.--In conducting a study on
longitudinal outcomes through a grant under subsection (a)(2), an
eligible entity shall include an analysis of--
(1) the individuals treated and educated;
(2) the success of such treatment and education in--
(A) avoiding the onset of serious emotional
disturbance and serious mental illness; or
(B) the preparation of such children for the care
and management of serious emotional disturbance and
serious mental illness;
(3) any evidence-based best practices generally applicable
as a result of such treatment and educational techniques used
with such children; and
(4) the ability of programs to be replicated as a best
practice model of intervention.
(f) Requirements.--In carrying out this section, the Secretary
shall ensure that each entity receiving a grant under subsection (a)
maintains a written agreement with the Secretary, and provides regular
written reports, as required by the Secretary, regarding the quality,
efficiency, and effectiveness of intervention and treatment for
eligible children preventing or treating the development and onset of
serious mental illness or serious emotional disturbance.
(g) Amount of Awards.--
(1) Amounts for early childhood intervention and treatment
programs.--The amount of an award to an eligible entity under
subsection (a)(1) shall be not more than $600,000 per fiscal
year.
(2) Amounts for longitudinal study.--The total amount of an
award to an eligible entity under subsection (a)(2) (for one or
more fiscal years) shall be not less than $1,000,000 and not
greater than $2,000,000.
(h) Project Terms.--The period of a grant--
(1) for awards under subsection (a)(1), shall be not less
than 3 fiscal years and not more than 5 fiscal years; and
(2) for awards under subsection (a)(2), shall be not more
than 5 fiscal years.
(i) Matching Funds.--The Secretary may not award a grant under this
section to an eligible entity unless the eligible entity agrees, with
respect to the costs to be incurred by the eligible entity in carrying
out the activities described in subparagraph (D), to make available
non-Federal contributions (in cash or in kind) toward such costs in an
amount equal to not less than 10 percent of Federal funds provided in
the grant.
(j) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $5,000,000 for each of fiscal
years 2017 through 2021.
SEC. 108. BLOCK GRANTS.
(a) Best Practices in Clinical Care Models.--Section 1920 of the
Public Health Service Act (42 U.S.C. 300x-9) is amended by adding at
the end the following:
``(c) Best Practices in Clinical Care Models.--The Substance Abuse
and Mental Health Services Administration, acting in collaboration with
the Director of the National Institute of Mental Health, shall require
States to obligate at least 5 percent of the amounts appropriated for a
fiscal year under subsection (a) to support evidence-based programs
that address the needs of individuals with early serious mental illness
or serious emotional disturbance, including psychotic disorders,
regardless of the age of individual onset. Such models shall translate
evidence-based interventions and best available science into systems of
care, such as through models such as--
``(1) the Recovery After an Initial Schizophrenia Episode
research project of the National Institute of Mental Health;
and
``(2) the North American Prodrome Longitudinal Study.''.
(b) Additional Program Requirements.--
(1) Integrated services.--Subsection (b)(1) of section 1912
of the Public Health Service Act (42 U.S.C. 300x-1(b)(1)) is
amended--
(A) by striking ``The plan provides'' and
inserting:
``(A) The plan provides'';
(B) in subparagraph (A), as inserted by paragraph
(1), in the second sentence, by striking ``health and
mental health services'' and inserting ``integrated
physical and mental health services'';
(C) in such subparagraph (A), by striking ``The
plan shall include'' through the period at the end and
inserting ``The plan shall integrate and coordinate
services to maximize the efficiency, effectiveness,
quality, coordination, and cost effectiveness of those
services and programs to produce the best possible
outcomes for those with serious mental illness or
serious emotional disturbance.''; and
(D) by adding at the end the following new
subparagraph:
``(B) The plan shall include a separate description
of case management services and provide for activities
leading to improved outcomes, such as reduction of
rates of suicides, suicide attempts, substance abuse,
overdose deaths, emergency hospitalizations,
incarceration, crimes, arrest, victimization,
homelessness, joblessness, medication nonadherence, and
education and vocational programs drop outs. The plan
must also include a detailed list of services available
for individuals with serious mental illness or serious
emotional disturbance in each county or county
equivalent.
``(C) The plan shall include a separate description
of active programs that seek to engage individuals with
serious mental illness in proactively making their own
health care decisions and enhancing communication among
themselves, their families, and their treatment
providers by allowing for early intervention by
reducing legal proceedings related to involuntary
treatment. Such programs may include services that help
develop psychiatric advanced directives.''.
(2) Data collection system.--Subsection (b)(2) of section
1912 of the Public Health Service Act (42 U.S.C. 300x-1(b)(2))
is amended--
(A) by striking ``The plan contains an estimate
of'' and inserting the following: ``The plan contains--
``(A) an estimate of'';
(B) in subparagraph (A), as inserted by paragraph
(1), by inserting ``, such as reductions in
homelessness, emergency hospitalization, incarceration,
and unemployment'' after ``targets'';
(C) in such subparagraph, by striking the period at
the end and inserting ``; and''; and
(D) by adding at the end the following new
subparagraph:
``(B) an agreement by the State to report to the
Secretary such data as may be required by the Secretary
concerning--
``(i) comprehensive community mental health
services in the State; and
``(ii) public health outcomes for persons
with serious mental illness or serious
emotional disturbance in the State, such as
rates of suicides, suicide attempts, substance
abuse, overdose deaths, emergency
hospitalizations, incarceration, crimes,
arrest, victimization, homelessness,
joblessness, medication nonadherence, and
education and vocational programs drop outs.''.
(3) Implementation of plan.--Subsection (d)(1) of section
1912 of the Public Health Service Act (42 U.S.C. 300x-1(d)(1))
is amended--
(A) by striking ``Except as provided'' and
inserting:
``(A) Except as provided''; and
(B) by adding at the end the following new
subparagraph:
``(B) For individuals receiving treatment through
funds awarded under a grant under section 1911, a State
shall include in the State plan for the first year
beginning after the date of the enactment of this
subparagraph and each subsequent year, a de-
individualized report, containing information that is
de-identified, on the services provided to those
individuals, including--
``(i) outcomes and the overall cost of such
treatment provided; and
``(ii) county or county equivalent level
data on such population, such as overall costs
and raw number data on rates of involuntary
commitment orders, suicides, suicide attempts,
substance abuse, overdose deaths, emergency
hospitalizations, incarceration, crimes,
arrest, victimization, homelessness,
joblessness, medication nonadherence, and
education and vocational programs drop outs.''.
(c) Incentives for State-Based Outcome Measures.--Section 1920 of
the Public Health Service Act (42 U.S.C. 300x-9) is amended by adding
at the end the following:
``(c) Incentives for State-Based Outcome Measures.--
``(1) In general.--In addition to the amounts made
available under subsection (a) for each fiscal year, the
Secretary shall provide to each State that meets the conditions
under paragraph (2) by the end of the first quarter of the
subsequent fiscal year, an equally divided share of the funding
under paragraph (3).
``(2) Conditions.--The Secretary shall define the
conditions under which a State is eligible to receive the
additional amount under paragraph (1).
``(3) Authorization of appropriations.--For purposes of
this subsection, there is authorized to be appropriated
$25,000,000 for each of fiscal years 2017 through 2021. Any
amounts made available under paragraph (1) shall be in addition
to the State's block grant allocation.''.
(d) Evidence-Based Services Delivery Models.--Section 1912 of the
Public Health Service Act (42 U.S.C. 300x-1) is amended by adding at
the end the following new subsection:
``(e) Expansion of Models.--
``(1) In general.--Taking into account the results of
evaluations of block grant programs, the Secretary may, as part
of the program of block grants under this subpart, provide for
expanded use across the Nation of evidence-based service
delivery models by providers funded under such block grants, so
long as--
``(A) the Secretary determines that such expansion
will--
``(i) result in more effective use of funds
under such block grants without reducing the
quality of care; or
``(ii) improve the quality of patient care
without significantly increasing spending;
``(B) the Secretary determines that such expansion
would improve the quality of patient care; and
``(C) the Secretary determines that the change
will--
``(i) significantly reduce severity and
duration of symptoms of mental illness;
``(ii) reduce rates of suicide, suicide
attempts, substance abuse, overdose, emergency
hospitalizations, emergency room boarding,
incarceration, crime, arrest, victimization,
homelessness, or joblessness; or
``(iii) significantly improve the quality
of patient care and mental health crisis
outcomes without significantly increasing
spending.
``(2) Definition.--In this subsection, the term `emergency
room boarding' means the practice of admitting patients to an
emergency department and holding them in the department until
inpatient psychiatric beds become available.''.
(e) Period for Expenditure of Grant Funds.--Section 1913 of the
Public Health Service Act (42 U.S.C. 300x-2), as amended, is further
amended by adding at the end the following:
``(d) Period for Expenditure of Grant Funds.--In implementing a
plan submitted under section 1912(a), a State receiving grant funds
under section 1911 may make such funds available to providers of
services described in subsection (b) for the provision of services
without fiscal year limitation, so long as any carryover is spent
within 3 years of the year in which the funding was provided.''.
(f) Active Outreach and Engagement.--Section 1915 of the Public
Health Service Act (42 U.S.C. 300x-4) is amended by adding at the end
of the following:
``(c) Active Outreach and Engagement to Persons With Serious Mental
Illness.--
``(1) In general.--A funding agreement for a grant under
section 1911 is that the State involved has in effect active
programs that seek to engage individuals with serious mental
illness in comprehensive services in order to avert relapse,
repeated hospitalizations, arrest, incarceration, suicide, and
to provide the individuals with the opportunity to live in the
least restrictive setting, through a comprehensive program of
evidence-based and culturally relevant assertive outreach and
engagement services focusing on individuals who are homeless,
have co-occurring disorders, are at risk for incarceration or
re-incarceration, or have a history of treatment failure,
including repeated hospitalizations or emergency room usage.
``(2) Evidence-based assertive outreach and engagement
services.--
``(A) SAMHSA.--The Administrator of the Substance
Abuse and Mental Health Services Administration, in
cooperation with the Director of the National Institute
of Mental Health, shall develop--
``(i) a list of evidence-based culturally
and linguistically relevant assertive outreach
and engagement services; and
``(ii) criteria to be used to assess the
scope and effectiveness of the approaches taken
by such services, such as the ability to
provide same-day appointments for emergent
situations.
``(B) Types of assertive outreach and engagement
services.--For purposes of paragraph (1), appropriate
programs of evidence-based assertive outreach and
engagement services may include peer support programs;
the Wellness Recovery Action Plan, Assertive Community
Treatment, and Forensic Assertive Community Treatment
of the Substance Abuse and Mental Health Services
Administration; appropriate supportive housing programs
incorporating a Housing First model; and intensive,
evidence-based approaches to early intervention in
psychosis, such as the Recovery After an Initial
Schizophrenia Episode model of the National Institute
of Mental Health and the Specialized Treatment Early in
Psychosis program.''.
SEC. 109. CHILDREN'S RECOVERY FROM TRAUMA.
Section 582 of the Public Health Service Act (42 U.S.C. 290hh-1) is
amended--
(1) in subsection (a), by striking ``developing programs''
and all that follows through the period at the end and
inserting ``developing and maintaining programs that provide
for--
``(1) the continued operation of the National Child
Traumatic Stress Initiative (referred to in this section as the
`NCTSI'), which includes a coordinating center, that focuses on
the mental, behavioral, and biological aspects of psychological
trauma response, prevention of the long-term consequences of
child trauma, and early intervention services and treatment to
address the long-term consequences of child trauma; and
``(2) the development of knowledge with regard to evidence-
based practices for identifying and treating mental,
behavioral, and biological disorders of children and youth
resulting from witnessing or experiencing a traumatic event.'';
(2) in subsection (b)--
(A) by striking ``subsection (a) related'' and
inserting ``subsection (a)(2) (related'';
(B) by striking ``treating disorders associated
with psychological trauma'' and inserting ``treating
mental, behavioral, and biological disorders associated
with psychological trauma)''; and
(C) by striking ``mental health agencies and
programs that have established clinical and basic
research'' and inserting ``universities, hospitals,
mental health agencies, and other programs that have
established clinical expertise and research'';
(3) by redesignating subsections (c) through (g) as
subsections (g) through (k), respectively;
(4) by inserting after subsection (b), the following:
``(c) Child Outcome Data.--The NCTSI coordinating center shall
collect, analyze, and report NCTSI-wide child treatment process and
outcome data regarding the early identification and delivery of
evidence-based treatment and services for children and families served
by the NCTSI grantees.
``(d) Training.--The NCTSI coordinating center shall facilitate the
coordination of training initiatives in evidence-based and trauma-
informed treatments, interventions, and practices offered to NCTSI
grantees, providers, and partners.
``(e) Dissemination and Collaboration.--The NCTSI coordinating
center shall, as appropriate, collaborate with--
``(1) the Secretary, in the dissemination of evidence-based
and trauma-informed interventions, treatments, products, and
other resources to appropriate stakeholders; and
``(2) appropriate agencies that conduct or fund research
within the Department of Health and Human Services, for
purposes of sharing NCTSI expertise, evaluation data, and other
activities, as appropriate.
``(f) Review.--The Secretary shall, consistent with the peer review
process, ensure that NCTSI applications are reviewed by appropriate
experts in the field as part of a consensus review process. The
Secretary shall include review criteria related to expertise and
experience in child trauma and evidence-based practices.'';
(5) in subsection (g) (as so redesignated), by striking
``with respect to centers of excellence are distributed
equitably among the regions of the country'' and inserting
``are distributed equitably among the regions of the United
States'';
(6) in subsection (i) (as so redesignated), by striking
``recipient may not exceed 5 years'' and inserting ``recipient
shall not be less than 4 years, but shall not exceed 5 years'';
and
(7) in subsection (j) (as so redesignated), by striking
``$50,000,000'' and all that follows through ``2006'' and
inserting ``$47,000,000 for each of fiscal years 2017 through
2021''.
SEC. 110. GARRETT LEE SMITH MEMORIAL ACT REAUTHORIZATION.
(a) Interagency Research, Training, and Technical Assistance
Centers.--Section 520C of the Public Health Service Act (42 U.S.C.
290bb-34) is amended--
(1) in subsection (d)--
(A) in paragraph (1), by striking ``youth suicide
early intervention and prevention strategies'' and
inserting ``suicide early intervention and prevention
strategies for all ages, particularly for youth'';
(B) in paragraph (2), by striking ``youth suicide
early intervention and prevention strategies'' and
inserting ``suicide early intervention and prevention
strategies for all ages, particularly for youth'';
(C) in paragraph (3)--
(i) by striking ``youth''; and
(ii) by inserting before the semicolon the
following: ``for all ages, particularly for
youth'';
(D) in paragraph (4), by striking ``youth suicide''
and inserting ``suicide for all ages, particularly
among youth'';
(E) in paragraph (5), by striking ``youth suicide
early intervention techniques and technology'' and
inserting ``suicide early intervention techniques and
technology for all ages, particularly for youth'';
(F) in paragraph (7)--
(i) by striking ``youth''; and
(ii) by inserting ``for all ages,
particularly for youth,'' after ``strategies'';
and
(G) in paragraph (8)--
(i) by striking ``youth suicide'' each
place that such appears and inserting
``suicide''; and
(ii) by striking ``in youth'' and inserting
``among all ages, particularly among youth'';
and
(2) by amending subsection (e) to read as follows:
``(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there is authorized to be appropriated $5,988,000 for
each of fiscal years 2017 through 2021.''.
(b) Youth Suicide Early Intervention and Prevention Strategies.--
Section 520E of the Public Health Service Act (42 U.S.C. 290bb-36) is
amended--
(1) in subsection (b), by striking paragraph (2) and
inserting the following:
``(2) Limitation.--In carrying out this section, the
Secretary shall ensure that a State does not receive more than
one grant or cooperative agreement under this section at any
one time. For purposes of the preceding sentences, a State
shall be considered to have received a grant or cooperative
agreement if the eligible entity involved is the State or an
entity designated by the State under paragraph (1)(B). Nothing
in this paragraph shall be construed to apply to entities
described in paragraph (1)(C).''; and
(2) by striking subsection (m) and inserting the following:
``(m) Authorization of Appropriations.--For the purpose of carrying
out this section, there is authorized to be appropriated $35,427,000
for each of fiscal years 2017 through 2021.''.
(c) Mental and Behavioral Health Services on Campus.--Section 520E-
2(h) of the Public Health Service Act (42 U.S.C. 290bb-36b(h)) is
amended by striking ``$5,000,000 for fiscal year 2005'' and all that
follows through the period and inserting ``$6,488,000 for each of
fiscal years 2017 through 2021.''.
SEC. 111. NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.
Subpart 3 of part B of title V of the Public Health Service Act is
amended by inserting after section 520E-2 of such Act (42 U.S.C. 290bb-
36b), as amended, the following:
``SEC. 520E-3. NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.
``(a) In General.--The Secretary shall maintain the National
Suicide Prevention Lifeline program, including by--
``(1) coordinating a network of crisis centers across the
United States for providing suicide prevention and crisis
intervention services to individuals seeking help at any time,
day or night;
``(2) maintaining a suicide prevention hotline to link
callers to local emergency, mental health, and social services
resources; and
``(3) consulting with the Secretary of Veterans Affairs to
ensure that veterans calling the suicide prevention hotline
have access to a specialized veterans' suicide prevention
hotline.
``(b) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $8,000,000 for each of fiscal
years 2017 through 2021.''.
SEC. 112. ADULT SUICIDE PREVENTION.
(a) Grants.--
(1) Authority.--The Administrator of the Substance Abuse
and Mental Health Services Administration (referred to in this
section as the ``Administrator'') may award grants to eligible
entities in order to implement suicide prevention efforts
amongst adults 25 and older.
(2) Purpose.--The grant program under this section shall be
designed to raise suicide awareness, establish referral
processes, and improve clinical care practice standards for
treating suicide ideation, plans, and attempts among adults.
(3) Recipients.--To be eligible to receive a grant under
this section, an entity shall be a community-based primary care
or behavioral health care setting, an emergency department, a
State mental health agency, an Indian tribe, a tribal
organization, or any other entity the Administrator deems
appropriate.
(4) Nature of activities.--The grants awarded under
paragraph (1) shall be used to implement programs that--
(A) screen for suicide risk in adults and provide
intervention and referral to treatment;
(B) implement evidence-based practices to treat
individuals who are at suicide risk, including
appropriate follow-up services; and
(C) raise awareness, reduce stigma, and foster open
dialog about suicide prevention.
(b) Additional Activities.--The Administrator shall--
(1) evaluate the activities supported by grants awarded
under subsection (a) in order to further the Nation's
understanding of effective interventions to prevent suicide in
adults;
(2) disseminate the findings from the evaluation as the
Administrator considers appropriate; and
(3) provide appropriate information, training, and
technical assistance 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--
(A) selection and implementation of evidence-based
interventions and frameworks to prevent suicide, such
as the Zero Suicide framework; and
(B) other activities as the Administrator
determines appropriate.
(c) Duration.--A grant under this section shall be for a period of
not more than 5 years.
(d) Authorization of Appropriations.--
(1) In general.--There is authorized to be appropriated to
carry out this section $15,000,000 for each of fiscal years
2017 through 2021.
(2) Use of certain funds.--Of the funds appropriated to
carry out this section in any fiscal year, the lesser of 5
percent of such funds or $500,000 shall be available to the
Administrator for purposes of carrying out subsection (b).
SEC. 113. PEER REVIEW AND ADVISORY COUNCILS.
(a) In General.--Section 501 of the Public Health Service Act (42
U.S.C. 290aa) is amended--
(1) in subsection (i), as redesignated by section 102, by
inserting at the end the following: ``For any such peer-review
group reviewing a proposal or grant related to the treatment of
mental illness, no fewer than half of the members of the group
shall be experienced mental health providers.''; and
(2) in subsection (m), as redesignated by section 102--
(A) in paragraph (2), by striking ``and'' at the
end; and
(B) in paragraph (3), by striking the period at the
end and inserting ``; and''.
(b) Advisory Councils.--Paragraph (3) of section 502(b) of the
Public Health Service Act (42 U.S.C. 290aa-1(b)) is amended by adding
at the end the following:
``(C) No fewer than one-third of the members of an
advisory council for the Center for Mental Health
Services shall be mental health care providers with--
``(i) experience in mental health research
or treatment; and
``(ii) expertise in the fields on which
they are advising.
``(D) The Secretary shall adopt a policy that
ensures members of advisory councils do not have
conflicts of interest with any program or grant about
which the members are to advise.''.
(c) Peer Review.--Section 504 of the Public Health Service Act (42
U.S.C. 290aa-3) is amended--
(1) by adding at the end of subsection (b) the following:
``At least half of the members of any peer-review group
established under subsection (a) that pertains to the treatment
of mental illness shall be licensed and experienced mental
health professionals.''; and
(2) by adding at the end the following:
``(e) Scientific Controls and Standards.--Peer review under this
section shall ensure that any research concerning an intervention is
based on scientific evidence indicating whether the intervention
reduces symptoms, improves medical or behavioral outcomes, or improves
social functioning.''.
SEC. 114. ADULT TRAUMA.
(a) Grants.--
(1) Authority.--The Administrator of the Substance Abuse
and Mental Health Services Administration (referred to in this
section as the ``Administrator'') may award grants to eligible
entities in order to implement trauma-informed care in primary
care and public health settings.
(2) Purpose.--The grant program under this section shall be
designed to facilitate and evaluate the impact of appropriate
trauma screening and responses in primary care settings in
order to further advance the Nation's understanding of the need
for addressing trauma in nonbehavioral health settings.
(3) Recipients.--To be eligible to receive a grant under
this section, an entity shall be a community-based, primary
care setting, an academic research setting in conjunction with
primary care settings, or any other entity the Administrator
deems appropriate.
(4) Nature of activities.--The grants awarded under
paragraph (1) shall be used to implement programs that--
(A) screen for trauma in adults, provide
intervention and referral to treatment, and provide
follow-up services, as appropriate; and
(B) engage and involve trauma survivors, people
receiving services, and family members receiving
services in program design.
(5) Practitioners.--As a condition on receipt of a grant
under paragraph (1), an entity shall agree that practitioners
used to carry out any program through the grant will be trained
in interventions that, as described in ``SAMHSA's Concept of
Trauma and Guidance for a Trauma-Informed Approach'', are--
(A) based on the best available empirical evidence
and science;
(B) culturally appropriate; and
(C) reflecting principles of a trauma-informed
approach.
(b) Additional Activities.--The Director shall--
(1) evaluate the activities supported by grants awarded
under subsection (a) in order to further the Nation's
understanding of the need for, and complexity of, addressing
trauma in nonbehavioral health settings;
(2) disseminate the findings from the evaluation as the
Administrator considers appropriate;
(3) provide appropriate information, training, and
technical assistance 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--
(A) selection and implementation of culturally
appropriate, evidence-based interventions that reflect
the principles of trauma-informed approach;
(B) incorporating principles of peer support and
trauma-informed care in hiring, supervision, and staff
evaluation;
(C) establishment of organizational practices and
policies to support trauma-informed approaches to care;
and
(D) other activities as the Administrator
determines appropriate.
(c) Duration.--A grant under this section shall be for a period of
not more than 5 years.
(d) Authorization of Appropriations.--
(1) In general.--There is authorized to be appropriated to
carry out this section $3,000,000 for each of fiscal years 2017
through 2021.
(2) Use of certain funds.--Of the funds appropriated to
carry out this section in any fiscal year, the lesser of 5
percent of such funds or $500,000 shall be available to the
Director for purposes of carrying out subsection (b).
SEC. 115. REDUCING THE STIGMA OF SERIOUS MENTAL ILLNESS.
(a) In General.--The Secretary of Health and Human Services and the
Secretary of Education shall organize a national awareness campaign
involving public health organizations, advocacy groups for persons with
serious mental illness or serious emotional disturbance, and social
media companies to assist secondary school students and postsecondary
students in--
(1) reducing the stigma associated with serious mental
illness and serious emotional disturbance;
(2) understanding how to assist an individual who is
demonstrating signs of a serious mental illness or serious
emotional disturbance; and
(3) understanding the importance of seeking treatment from
a physician, clinical psychologist, psychiatric nurse
practitioner, or licensed mental health professional when a
student believes the student may be suffering from a serious
mental illness, serious emotional disturbance, or behavioral
health disorder.
(b) Data Collection.--The Secretary of Health and Human Services
shall evaluate the program under subsection (a) on public health to
determine whether the program has made an impact on public health, such
as reducing mortality rates of persons with serious mental illness or
serious emotional disturbance, the prevalence of serious mental illness
and serious emotional disturbance, physician and clinical psychological
visits, and emergency room visits for psychiatric services.
(c) Secondary School Defined.--For purposes of this section, the
term ``secondary school'' has the meaning given the term in section
9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C.
7801).
(d) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $1,000,000 for each of fiscal
years 2017 through 2021.
SEC. 116. REPORT ON MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT IN THE
STATES.
(a) In General.--Not later than 18 months after the date of
enactment of this Act, and not less than every 2 years thereafter, the
Secretary of Health and Human Services shall submit to the Congress and
make available to the public a report on mental health and substance
use treatment in the States, including the following:
(1) A detailed report on how Federal mental health and
substance use treatment funds are used in each State including:
(A) The numbers of individuals with mental illness,
serious mental illness, serious emotional disturbance,
substance use disorders, or co-occurring disorders who
are served with Federal funds.
(B) The types of programs made available to
individuals with mental illness, serious mental
illness, substance use disorders, or co-occurring
disorders.
(2) A summary of best practice models in the States
highlighting programs that are cost effective, provide
evidence-based care, increase access to care, integrate
physical, psychiatric, psychological, and behavioral medicine,
and improve outcomes for individuals with mental illness or
substance use disorders.
(3) A statistical report of outcome measures in each State,
for individuals with mental illness, serious mental illness,
substance use disorders, and co-occurring disorders, such as--
(A) rates of suicide, suicide attempts, substance
abuse, overdose, overdose deaths, health outcomes,
emergency psychiatric hospitalizations, and emergency
room boarding; and
(B) arrests, incarcerations, victimization,
homelessness, joblessness, employment, and enrollment
in educational or vocational programs.
(b) Definition.--In this subsection, the term ``emergency room
boarding'' means the practice of admitting patients to an emergency
department and holding them in the department until inpatient
psychiatric beds become available.
SEC. 117. MENTAL HEALTH FIRST AID TRAINING GRANTS.
Section 520J of the Public Health Service Act (42 U.S.C. 290bb-41)
is amended to read as follows:
``SEC. 520J. MENTAL HEALTH FIRST AID TRAINING GRANTS.
``(a) Grants.--The Secretary, acting through the Administrator,
shall award grants to States, political subdivisions of States, Indian
tribes, tribal organizations, and nonprofit private entities to
initiate and sustain mental health first aid training programs.
``(b) Program Requirements.--
``(1) In general.--To be eligible for funding under
subsection (a), a mental health first aid training program
shall--
``(A) be designed to train individuals in the
categories listed in paragraph (2) to accomplish the
objectives described in paragraph (3);
``(B) ensure that training is conducted by trainers
that are properly licensed and credentialed by
nonprofit entities as designated by the Secretary; and
``(C) include--
``(i) at a minimum--
``(I) a core live training course
for individuals in the categories
listed in paragraph (2) on the skills,
resources, and knowledge to assist
individuals in crisis to connect with
appropriate local mental health care
services;
``(II) training on mental health
resources, including the location of
community mental health centers
described in section 1913(c), in the
State and local community; and
``(III) training on action plans
and protocols for referral to such
resources; and
``(ii) where feasible, continuing education
and updated training for individuals in the
categories listed in paragraph (2).
``(2) Categories of individuals to be trained.--The
categories of individuals listed in this paragraph are the
following:
``(A) Emergency services personnel and other first
responders.
``(B) Police officers and other law enforcement
personnel.
``(C) Teachers and school administrators.
``(D) Human resources professionals.
``(E) Faith community leaders.
``(F) Nurses and other primary care personnel.
``(G) Students enrolled in an elementary school, a
secondary school, or an institution of higher
education.
``(H) The parents of students described in
subparagraph (G).
``(I) Veterans.
``(J) Other individuals, audiences or training
populations as determined appropriate by the Secretary.
``(3) Objectives of training.--To be eligible for funding
under subsection (a), a mental health first aid training
program shall be designed to train individuals in the
categories listed in paragraph (2) to accomplish each of the
following objectives (as appropriate for the individuals to be
trained, taking into consideration their age):
``(A) Safe de-escalation of crisis situations.
``(B) Recognition of the signs and symptoms of
mental illness, including such common psychiatric
conditions as schizophrenia, bipolar disorder, major
clinical depression, and anxiety disorders.
``(C) Timely referral to mental health services in
the early stages of developing mental disorders in
order to--
``(i) avoid more costly subsequent
behavioral health care; and
``(ii) enhance the effectiveness of mental
health services.
``(c) Distribution of Awards.--In awarding grants under this
section, the Secretary shall--
``(1) ensure that grants are equitably distributed among
the geographical regions of the United States; and
``(2) pay particular attention to the mental health
training needs of populations and target audiences residing in
rural areas.
``(d) Application.--A State, political subdivision of a State,
Indian tribe, tribal organization, or nonprofit private entity that
desires a grant under this section shall submit an application to the
Secretary at such time, in such manner, and containing such information
as the Secretary may require, including a plan for the rigorous
evaluation of activities that are carried out with funds received under
such grant.
``(e) Evaluation.--A State, political subdivision of a State,
Indian tribe, tribal organization, or nonprofit private entity that
receives a grant under this section shall prepare and submit an
evaluation to the Secretary at such time, in such manner, and
containing such information as the Secretary may reasonably require,
including an evaluation of activities carried out with funds received
under such grant and a process and outcome evaluation.
``(f) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $20,000,000 for each of fiscal
years 2017 through 2021.''.
SEC. 118. ACUTE CARE BED REGISTRY GRANT FOR STATES.
(a) In General.--The Secretary of Health and Human Services, acting
through the Administrator of the Substance Abuse and Mental Health
Services Administration, shall award grants to State mental health
agencies to develop and administer, or maintain an existing, real-time
Internet-based bed registry described in subsection (b), to collect,
aggregate, and display information about available beds in public and
private inpatient psychiatric facilities and public and private
residential crisis stabilization units, and residential community
mental health and residential substance abuse treatment facilities to
facilitate the identification and designation of facilities for the
temporary treatment of individuals in psychiatric or substance abuse
crisis.
(b) Registry Requirements.--A bed registry described in this
subsection is a registry that--
(1) includes descriptive information for every public and
private inpatient psychiatric facility, every public and
private residential crisis stabilization unit, and residential
community mental health and residential substance abuse
facility in the State involved, including 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 other information that may be necessary to
allow for the proper identification of appropriate facilities
for treatment of individuals in psychiatric or substance abuse
crisis; and
(3) allows employees and designees of community mental
health and substance abuse service providers, employees of
inpatient psychiatric facilities, public and private
residential crisis stabilization units, or residential
substance abuse treatment facilities, and health care providers
working in an emergency room of a hospital or clinic or other
facility rendering emergency medical care to perform searches
of the registry to identify available beds that are appropriate
for the treatment of individuals in psychiatric crisis or
substance abuse crisis.
(c) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $15,000,000 for each of fiscal
years 2017 through 2021.
SEC. 119. OLDER ADULT MENTAL HEALTH GRANTS.
(a) In General.--The Secretary of Health and Human Services, acting
through the Director of the Center for Mental Health Services, shall
award grants, contracts, or cooperative agreements to public and
private nonprofit entities for projects that address the mental health
needs of older adults, including programs to--
(1) support the establishment and maintenance of
interdisciplinary geriatric mental health specialist outreach
teams in community settings where older adults reside or
receive social services, in order to provide screening,
referrals, and evidence-based intervention and treatment
services, including services provided by licensed mental health
professionals;
(2) develop and implement older adult suicide early
intervention and prevention strategies in 1 or more settings
that serve seniors, and collect and analyze data on older adult
suicide early intervention and prevention services for purposes
of monitoring, research, and policy development; and
(3) otherwise improve the mental health of older adults, as
determined by the Secretary.
(b) Considerations in Awarding Grants.--In awarding grants under
this section, the Secretary, to the extent feasible, shall ensure
that--
(1) projects are funded in a variety of geographic areas,
including urban and rural areas;
(2) a variety of populations, including racial and ethnic
minorities and low-income populations, are served by projects
funded under this section; and
(3) older adult suicide intervention and prevention
programs are targeted towards areas with high older adult
suicide rates.
(c) Application.--To be eligible to receive a grant under this
section, a public or private nonprofit entity shall--
(1) submit an application to the Secretary (in such form,
containing such information, and at such time as the Secretary
may specify);
(2) agree to report to the Secretary standardized clinical
and behavioral data or other performance data necessary to
evaluate patient or program outcomes and to facilitate
evaluations across participating projects; and
(3) demonstrate how such applicant will collaborate with
other State and local public and private nonprofit
organizations.
(d) Duration.--A project may receive funding under a grant under
this section for a period of up to 3 years, and such funding may be
extended for a period of 2 additional years, at the discretion of the
Secretary.
(e) Supplement, Not Supplant.--Funds made available under this
section shall be used to supplement, and not supplant, other Federal,
State, or local funds available to an entity to carry out activities
described in this section.
(f) Report.--Grantees under this section shall, beginning with the
end of the second year of the grant, submit yearly reports to the
Secretary on the activities of the grantee in support of the grant and
the latest performance data. Such reports shall contain recommendations
as how to replicate the project funded through the grant.
(g) Definitions.--In this section, the term ``older adult'' has the
meaning given the term ``older individual'' in section 102 of the Older
Americans Act of 1965 (42 U.S.C. 3002).
(h) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $5,000,000 for each of fiscal
years 2017 through 2021.
TITLE II--INTERAGENCY SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE
SEC. 201. INTERAGENCY SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE.
Title V of the Public Health Service Act, as amended by section
101, is further amended by inserting after section 501 of such Act the
following:
``SEC. 501A. INTERAGENCY SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE.
``(a) Establishment.--The Assistant Secretary for Mental Health and
Substance Use Disorders (in this section referred to as the `Assistant
Secretary') shall establish a committee, to be known as the Interagency
Serious Mental Illness Coordinating Committee (in this section referred
to as the `Committee'), to assist the Assistant Secretary in carrying
out the Assistant Secretary's duties.
``(b) Responsibilities.--The Committee, in coordination with the
Assistant Secretary, shall--
``(1) develop and annually update a summary of advances in
serious mental illness research related to causes, prevention,
treatment, early screening, diagnosis or rule out,
intervention, and access to services and supports for
individuals with serious mental illness;
``(2) monitor Federal activities with respect to serious
mental illness;
``(3) make recommendations to the Assistant Secretary
regarding any appropriate changes to such activities, including
recommendations with respect to the strategic plan developed
under paragraph (5);
``(4) make recommendations to the Assistant Secretary
regarding public participation in decisions relating to serious
mental illness;
``(5) develop and update every 5 years a strategic plan for
the conduct and support of programs and services to assist
individuals with serious mental illness, including--
``(A) a summary of the advances in serious mental
illness research developed under paragraph (1);
``(B) a list of the Federal programs and activities
identified under paragraph (2);
``(C) an analysis of the efficiency, effectiveness,
quality, coordination, and cost-effectiveness of
Federal programs and activities relating to the
prevention, diagnosis, treatment, or rehabilitation of
serious mental illness, including an accounting of the
costs of such programs and activities with
administrative costs disaggregated from the costs of
services and care; and
``(D) a plan with recommendations--
``(i) for the coordination and improvement
of Federal programs and activities related to
serious mental illness, including budgetary
requirements;
``(ii) for improving outcomes for
individuals with a serious mental illness
including appropriate benchmarks to measure
progress on achieving improvements;
``(iii) for the mental health workforce;
``(iv) to disseminate relevant information
developed by the coordinating committee to the
public, health care providers, social service
providers, public health officials, courts, law
enforcement, and other relevant groups;
``(v) to identify research needs, including
longitudinal studies of pediatric populations;
and
``(vi) for vulnerable and underserved
populations, including pediatric populations,
geriatric populations, and racial, ethnic,
sexual, and gender minorities; and
``(6) submit to the Congress such strategic plan and any
updates to such plan.
``(c) Membership.--
``(1) In general.--The Committee shall be composed of--
``(A) the Assistant Secretary for Mental Health and
Substance Use Disorders (or the Assistant Secretary's
designee), who shall serve as the Chair of the
Committee;
``(B) the Director of the National Institute of
Mental Health (or the Director's designee);
``(C) the Attorney General of the United States (or
the Attorney General's designee);
``(D) the Director of the Centers for Disease
Control and Prevention (or the Director's designee);
``(E) the Director of the National Institutes of
Health (or the Director's designee);
``(F) the Director of the Indian Health Service;
``(G) a member of the United States Interagency
Council on Homelessness;
``(H) the Administrator of the Centers for Medicare
& Medicaid Service (or the Administrator's designee);
``(I) the Secretary of Defense (or the Secretary's
designee);
``(J) the Secretary of Education (or the
Secretary's designee);
``(K) the Secretary of Labor (or the Secretary's
designee);
``(L) the Secretary of Veterans Affairs (or the
Secretary's designee);
``(M) the Commissioner of the Social Security
Administration (or the Commissioner's designee); and
``(N) the additional members appointed under
paragraph (2).
``(2) Additional members.--Not fewer than 20 members of the
Committee, or \1/3\ of the total membership of the Committee,
whichever is greater, shall be composed of non-Federal public
members to be appointed by the Assistant Secretary, of which--
``(A) at least five such members shall be an
individual in recovery from a diagnosis of serious
mental illness who has benefited from medical treatment
under the care of a licensed mental health
professional;
``(B) at least three such members shall be a parent
or legal guardian of an individual with a history of
serious mental illness, including at least one of whom
is the parent or legal guardian of a child who has
either attempted suicide or is incarcerated for a crime
committed while experiencing a serious mental illness
or serious emotional disturbance;
``(C) at least one such member shall be a
representative of a leading research, advocacy, and
service organization for individuals with serious
mental illness;
``(D) at least one such member shall be--
``(i) a licensed psychiatrist with
experience treating serious mental illness; or
``(ii) a licensed clinical psychologist
with experience treating serious mental
illness;
``(E) at least one member shall be a licensed
mental health counselor or psychotherapist;
``(F) at least one member shall be a licensed
clinical social worker;
``(G) at least one member shall be a licensed
psychiatric nurse or nurse practitioner;
``(H) at least one member shall be a mental health
professional with a significant focus in his or her
practice working with children and adolescents;
``(I) at least one member shall be a mental health
professional who spends a significant concentration of
his or her professional time or leadership practicing
community mental health;
``(J) at least one member shall be a mental health
professional with substantial experience working with
mentally ill individuals who have a history of violence
or suicide;
``(K) at least one such member shall be a State
certified mental health peer specialist;
``(L) at least one member shall be a judge with
experience adjudicating cases related to criminal
justice and serious mental illness;
``(M) at least one member shall be a law
enforcement officer with extensive experience in
interfacing with psychiatric and psychological
disorders or individuals in mental health crisis; and
``(N) at least one member shall be a corrections
officer with extensive experience in interfacing with
psychiatric and psychological disorders or individuals
in mental health crisis.
``(d) Reports to Congress.--Not later than 2 years after the date
of enactment of this Act, and every 3 years thereafter, the Committee
shall submit a report to the Congress--
``(1) evaluating the impact of projects addressing priority
mental health needs of regional and national significance under
sections 501, 509, 516, and 520A including measurement of
public health outcomes such as--
``(A) reduced rates of suicide, suicide attempts,
substance abuse, overdose, overdose deaths, emergency
hospitalizations, emergency room boarding,
incarceration, crime, arrest, victimization,
homelessness, and joblessness;
``(B) increased rates of employment and enrollment
in educational and vocational programs; and
``(C) such other criteria as may be determined by
the Assistant Secretary;
``(2) formulating recommendations for the coordination and
improvement of Federal programs and activities that affect
individuals with serious mental illness;
``(3) identifying any such programs and activities that are
duplicative; and
``(4) summarizing all recommendations made, activities
carried out, and results achieved pursuant to the workforce
development strategy under section 501.
``(e) Administrative Support; Terms of Service; Other Provisions.--
The following provisions shall apply with respect to the Committee:
``(1) The Assistant Secretary shall provide such
administrative support to the Committee as may be necessary for
the Committee to carry out its responsibilities.
``(2) Members of the Committee appointed under subsection
(c)(2) shall serve for a term of 4 years, and may be
reappointed for one or more additional 4-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
after the expiration of the member's term until a successor has
taken office.
``(3) The Committee shall meet at the call of the chair or
upon the request of the Assistant Secretary. The Committee
shall meet not fewer than 2 times each year.
``(4) All meetings of the Committee shall be public and
shall include appropriate time periods for questions and
presentations by the public.
``(f) Subcommittees; Establishment and Membership.--In carrying out
its functions, the Committee may establish subcommittees and convene
workshops and conferences. Such subcommittees shall be composed of
Committee members and may hold such meetings as are necessary to enable
the subcommittees to carry out their duties.
``(g) Authorization of Appropriations.--There is authorized to be
appropriated $1,000,000 to carry out the staffing functions under
subsection (e)(1) for each of fiscal years 2017 through 2021.''.
TITLE III--COMMUNICATIONS BETWEEN INDIVIDUALS, FAMILIES, AND PROVIDERS
SEC. 301. CLARIFICATION OF CIRCUMSTANCES UNDER WHICH DISCLOSURE OF
PROTECTED HEALTH INFORMATION OF MENTAL ILLNESS PATIENTS
IS PERMITTED.
The HITECH Act (title XIII of division A of Public Law 111-5) is
amended by adding at the end of subtitle D of such Act (42 U.S.C. 17921
et seq.) the following:
``PART 3--IMPROVED PRIVACY AND SECURITY PROVISIONS FOR MENTAL ILLNESS
PATIENTS
``SEC. 13431. CLARIFICATION OF CIRCUMSTANCES UNDER WHICH DISCLOSURE OF
PROTECTED HEALTH INFORMATION IS PERMITTED.
``(a) In General.--Not later than one year after the date of
enactment of this section, the Secretary shall promulgate final
regulations clarifying the circumstances under which, consistent with
the standards governing the privacy and security of individually
identifiable health information promulgated by the Secretary under
sections 262(a) and 264 of the Health Insurance Portability and
Accountability Act of 1996, health care providers and covered entities
may disclose the protected health information of patients with a mental
illness, including for purposes of--
``(1) communicating with a patient's family, caregivers,
friends, or others involved in the patient's care, including
communication about treatments, side effects, risk factors, and
the availability of community resources;
``(2) communicating with family or caregivers when the
patient is an adult;
``(3) communicating with the parent or caregiver of a
patient who is a minor;
``(4) considering the patient's capacity to agree or object
to the sharing of their information;
``(5) communicating and sharing information with a
patient's family or caregivers when--
``(A) the patient consents; or
``(B) the patient does not consent, but the patient
lacks the capacity to agree or object and the
communication or sharing of information is in the
patient's best interest;
``(6) involving a patient's family members, friends, or
caregivers, or others involved in the patient's care in the
patient's care plan, including treatment and medication
adherence, in dealing with patient failures to adhere to
medication or other therapy;
``(7) listening to or receiving information from family
members or caregivers about their loved ones receiving mental
illness treatment;
``(8) communicating with family members, caregivers, law
enforcement, or others when the patient presents a serious and
imminent threat of harm to self or others; and
``(9) communicating to law enforcement and family members
or caregivers about the admission of a patient to receive care
at a facility or the release of a patient who was admitted to a
facility for an emergency psychiatric hold or involuntary
treatment.
``(b) Coordination.--The Secretary shall carry out this section in
coordination with the Director of the Office for Civil Rights within
the Department of Health and Human Services.
``(c) Consistency With Guidance.--The Secretary shall ensure that
the regulations under this section are consistent with the guidance
entitled `HIPAA Privacy Rule and Sharing Information Related to Mental
Health', issued by the Department of Health and Human Services on
February 20, 2014.''.
SEC. 302. DEVELOPMENT AND DISSEMINATION OF MODEL TRAINING PROGRAMS.
(a) Initial Programs and Materials.--Not later than one year after
promulgating final regulations under section 13431 of the HITECH Act,
as added by section 301, the Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall develop and
disseminate--
(1) a model program and materials for training health care
providers (including physicians, emergency medical personnel,
psychologists, counselors, therapists, behavioral health
facilities and clinics, care managers, and hospitals) regarding
the circumstances under which, consistent with the standards
governing the privacy and security of individually identifiable
health information promulgated by the Secretary under sections
262(a) and 264 of the Health Insurance Portability and
Accountability Act of 1996, the protected health information of
patients with a mental illness may be disclosed with and
without patient consent;
(2) a model program and materials for training lawyers and
others in the legal profession on such circumstances; and
(3) a model program and materials for training patients and
their families regarding their rights to protect and obtain
information under the standards specified in paragraph (1).
(b) Periodic Updates.--The Secretary shall--
(1) periodically review and update the model programs and
materials developed under subsection (a); and
(2) disseminate the updated model programs and materials.
(c) Contents.--The programs and materials developed under
subsection (a) shall address the guidance entitled ``HIPAA Privacy Rule
and Sharing Information Related to Mental Health'', issued by the
Department of Health and Human Services on February 20, 2014.
(d) Coordination.--The Secretary shall carry out this section in
coordination with the Director of the Office for Civil Rights within
the Department of Health and Human Services, the Administrator of the
Substance Abuse and Mental Health Services Administration, the
Administrator of the Health Resources and Services Administration, and
the heads of other relevant agencies within the Department of Health
and Human Services.
(e) Input of Certain Entities.--In developing the model programs
and materials required by subsections (a) and (b), the Secretary shall
solicit the input of relevant national, State, and local associations,
medical societies, and licensing boards.
(f) Funding.--There is authorized to be appropriated to carry out
this section $5,000,000 for fiscal year 2017 and $25,000,000 for the
period of fiscal years 2018 through 2023.
SEC. 303. MODERNIZING PRIVACY PROTECTIONS.
Not later than two years after the date of the enactment of this
Act, the Secretary of Health and Human Services shall issue a final
rule modernizing the privacy protections under section 543 of the
Public Health Service Act (42 U.S.C. 290dd-2).
SEC. 304. IMPROVING COMMUNICATION WITH INDIVIDUALS, FAMILIES, AND
PROVIDERS.
(a) Grants.--
(1) Authority.--The Secretary of Health and Human Services,
acting through the Administrator of the Substance Abuse and
Mental Health Services Administration, shall award grants to
eligible entities for the implementation of pilot programs
designed to enhance care and promote recovery by supporting
communication between individuals in treatment, their families,
providers, and other individuals involved in their care.
(2) Recipients.--To be eligible to receive a grant under
this section, an entity shall be a State, county, city, tribe,
tribal organization, institutions of higher education, public
organization, or private nonprofit organizations.
(3) Nature of activities.--The grants awarded under
paragraph (1) shall be used to implement evidence-based or
innovative programs, such as Adapted or Open Dialogue, that
enhance care and promote recovery by supporting communities
between individuals and those involved in their treatment,
care, and support.
(b) Additional Activities.--The Secretary shall--
(1) evaluate the activities supported by grants awarded
under subsection (a) in order to further the Nation's
understanding of effective communication strategies between
individuals with mental illness and their families and health
care providers;
(2) disseminate the findings from the evaluation as the
Secretary considers appropriate;
(3) make recommendations for scaling up successful models
across the country, including in publicly funded programs; and
(4) other activities as the Secretary determines
appropriate.
(c) Duration.--A grant under this section shall be for a period of
not more than 5 years.
(d) Authorization of Appropriations.--
(1) In general.--There is authorized to be appropriated to
carry out this section $2,000,000 for each of fiscal years 2017
through 2021.
(2) Use of certain funds.--Of the funds appropriated to
carry out this section in any fiscal year, no more than 5
percent shall be available to the Secretary for the purposes of
carrying out subsection (b).
TITLE IV--IMPROVING MEDICAID AND MEDICARE MENTAL HEALTH SERVICES
Subtitle A--Medicaid Provisions
SEC. 401. ENHANCED MEDICAID COVERAGE RELATING TO CERTAIN MENTAL HEALTH
SERVICES.
(a) Medicaid Coverage of Mental Health Services and Primary Care
Services Furnished on the Same Day.--Section 1902 of the Social
Security Act (42 U.S.C. 1396a) is amended--
(1) in subsection (a), by inserting after paragraph (77)
the following new paragraph:
``(78) in the case of a State that does not have in effect
(as of the date of the enactment of this paragraph) under its
State plan a payment methodology that allows for full
reimbursement of all same-day qualifying services through a
single payment, not prohibit payment under the plan for a
mental health service or primary care service furnished to an
individual at a community mental health center meeting the
criteria specified in section 1913(c) of the Public Health
Service Act or a federally qualified health center (as defined
in section 1861(aa)(3)) for which payment would otherwise be
payable under the plan, with respect to such individual, if
such service were not a same-day qualifying service (as defined
in subsection (ll));''; and
(2) by adding at the end the following new subsection:
``(ll) Same-Day Qualifying Services Defined.--For purposes of
subsection (a)(78), the term `same-day qualifying service' means--
``(1) a primary care service furnished to an individual by
a provider at a facility on the same day a mental health
service is furnished to such individual by such provider (or
another provider) at the facility; and
``(2) a mental health service furnished to an individual by
a provider at a facility on the same day a primary care service
is furnished to such individual by such provider (or another
provider) at the facility.''.
(b) Providing Full-Range of EPSDT Services to Children in IMDs.--
Section 1905(h) of the Social Security Act (42 U.S.C. 1396d(h)) is
amended by adding at the end the following new paragraph:
``(3) Such term includes the full-range of early and periodic
screening, diagnostic, and treatment services (as defined in subsection
(r)).''.
(c) Optional Limited Coverage of Inpatient Services Furnished in
Institutions for Mental Diseases.--Section 1903(m)(2) of the Social
Security Act (42 U.S.C. 1396b(m)(2)) is amended by adding at the end
the following new subparagraph:
``(I)(i) Notwithstanding the limitation specified in the
subdivision (B) following paragraph (29) of section 1905(a), beginning
on the date of the enactment of this subparagraph, a State may provide,
as part of the monthly capitated payment made by the State under this
title to a medicaid managed care organization or a prepaid inpatient
health plan (as defined in section 438.2 of title 42, Code of Federal
Regulations (or any successor regulation)), for payment for limited
inpatient psychiatric hospital services provided by such organization
or health plan, at the option of the individual receiving such
services, in lieu of services covered under the State plan during the
month for which the payment is made.
``(ii) In this subparagraph, the term `limited inpatient
psychiatric hospital services' means the services described in
subparagraphs (A) and (B) of section 1905(h)(1)--
``(I) that are furnished to individuals over 21 years of
age and under 65 years of age in an institution for mental
diseases (as defined in section 1905(i)) that is an inpatient
hospital facility or a sub-acute care facility providing crisis
residential services (as defined by the Secretary); and
``(II) for which the length of stay in such an institution
is for a short-term stay of not more than 15 days during the
month for which the capitated payment referred to in clause (i)
is made.''.
(d) Effective Date.--
(1) In general.--Subject to paragraph (2), the amendments
made by subsections (a) and (b) shall apply to items and
services furnished after the date of the enactment of this
section.
(2) Exception for state legislation.--In the case of a
State plan under title XIX of the Social Security Act, which
the Secretary of Health and Human Services determines requires
State legislation in order for the respective plan to meet any
requirement imposed by amendments made by subsections (a) and
(b), the respective plan shall not be regarded as failing to
comply 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
purposes of the previous sentence, in the case of a State that
has a 2-year legislative session, each year of the session
shall be considered to be a separate regular session of the
State legislature.
SEC. 402. EXTENSION AND EXPANSION OF DEMONSTRATION PROGRAMS TO IMPROVE
COMMUNITY MENTAL HEALTH SERVICES.
Paragraph (3) of section 223(d) of the Protecting Access to
Medicare Act of 2014 (Public Law 113-93; 128 Stat. 1077) is amended to
read as follows:
``(3) Number and length of demonstration programs.--
``(A) In general.--Except as provided in
subparagraphs (B) and (C), not more than 8 States shall
be selected for 2-year demonstration programs under
this subsection.
``(B) Three-year extension.--A State selected to
participate in the demonstration project under this
subsection shall, upon the request of the State, be
permitted to continue to participate in the
demonstration project for an additional 3-year period,
if the Secretary makes the determination specified in
subparagraph (D) with respect to the State. The
Secretary shall provide each such State with notice of
that determination.
``(C) Expansion to additional states.--
``(i) In general.--The Secretary may expand
the number of eligible States participating in
the demonstration project, if, with respect to
any such State, the Secretary makes the
determination specified in subparagraph (D).
The period of the participation of any such
eligible State in the demonstration project
shall end on December 31, 2022, regardless of
the date on which the State begins
participating in the demonstration project.
``(ii) Notification.--The Secretary shall
provide each State that applies to be added to
the demonstration project under this subsection
with notice of the determination under
subparagraph (D) and the standards used to make
such determination.
``(D) Determination.--The determination specified
in this subparagraph is that the Secretary determines
that, in the case of a request under subparagraph (B)
or an expansion of the demonstration project under
subparagraph (C)--
``(i) the continued participation of a
State in the demonstration project under this
subsection or an expansion of the project to
any additional State (as applicable) will
measurably improve access to, and participation
in, services described in subsection (a)(2)(D)
by individuals eligible for medical assistance
under the State Medicaid program; and
``(ii) any such State is in full compliance
with the reporting requirements under paragraph
(7) and any quality reporting requirements
established by the Secretary.''.
SEC. 403. TERMS FOR EXTENSION AND EXPANSION OF MEDICAID EMERGENCY
PSYCHIATRIC DEMONSTRATION PROJECT.
Section 2707(f)(4) of the Patient Protection and Affordable Care
Act (42 U.S.C. 1396a note; Public Law 111-148), as amended by section
2(c) of the Improving Access to Emergency Psychiatric Care Act (Public
Law 114-97), is amended by striking subparagraph (C).
SEC. 404. COMMUNITY-BASED MENTAL HEALTH SERVICES MEDICAID OPTION FOR
CHILDREN IN OR AT RISK OF PSYCHIATRIC RESIDENTIAL
TREATMENT.
Section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)) is
amended--
(1) in paragraph (1)--
(A) in the first sentence, by striking ``or a
nursing facility or intermediate care facility for the
mentally retarded'' and inserting ``, nursing facility,
intermediate care facility for the mentally retarded,
or psychiatric residential treatment facility''; and
(B) in the second sentence, by striking ``or
intermediate care facility for the mentally retarded''
and inserting ``intermediate care facility for the
mentally retarded, or psychiatric residential treatment
facility'';
(2) in paragraph (2)--
(A) in subparagraph (B)--
(i) in clause (i), by striking ``or
services in an intermediate care facility for
the mentally retarded'' and inserting
``services in an intermediate care facility for
the mentally retarded, or services in a
psychiatric residential treatment facility'';
and
(ii) in the matter following clause (iii),
by striking ``or services in an intermediate
care facility for the mentally retarded'' and
inserting ``services in an intermediate care
facility for the mentally retarded, or services
in a psychiatric residential treatment
facility''; and
(B) in subparagraph (C)--
(i) by striking ``or intermediate care
facility for the mentally retarded'' and
inserting ``intermediate care facility for the
mentally retarded, or psychiatric residential
treatment facility''; and
(ii) by striking ``or services in an
intermediate care facility for the mentally
retarded'' and inserting ``services in an
intermediate care facility for the mentally
retarded, or services in a psychiatric
residential treatment facility'';
(3) in paragraph (7)(A), by striking ``or intermediate care
facilities for the mentally retarded'' and inserting
``intermediate care facilities for the mentally retarded, or
psychiatric residential treatment facilities''; and
(4) by adding at the end the following new paragraph:
``(11) For purposes of this subsection, the term `psychiatric
residential treatment facility' has the meaning given such term in
section 483.352 of title 42, Code of Federal Regulations (or any
successor regulation).''.
SEC. 405. EXPANSION OF CMMI AUTHORITY TO SUPPORT MAJOR MENTAL ILLNESS
PROJECTS IN MEDICAID.
Section 1115A(b)(2)(B) of the Social Security Act (42 U.S.C.
1315a(b)(2)(B)) is amended by adding at the end the following new
clause:
``(xxv) Focusing primarily on title XIX,
preventing major mental illness and substance
use disorders and reducing the impact of long-
term mental illness and substance use disorders
among children, adolescents, pregnant women,
and adults through multi-level treatment
including but not limited to outreach, clinical
assessment and mental health services, and
supported education and employment.''.
SEC. 406. MEDICAID DATA AND REPORTING.
(a) Guidance on Reporting Medicaid Mental Health Screening and
Treatment for Youth.--The Secretary of Health and Human Services shall
develop guidance for the annual reporting by States of mental health
screening provided to children eligible for medical assistance for
early and periodic screening, diagnostic, and treatment services under
title XIX of the Social Security Act. Such guidance shall be provided
in the form of a modification of the CMS 416 Annual EPSDT Participation
Report in a manner so that the report includes information on the
number of children under 12 years of age, and the number of individuals
who are at least 12 years of age but not older than 21 years of age,
who receive mental health screening services, the number of such
children and individuals who are referred for mental health treatment,
and the number of such children and individuals who are receive
treatment for mental health conditions under such title.
(b) MACPAC.--Section 1900(b)(6) of the Social Security Act (42
U.S.C. 1396(b)(6)) is amended--
(1) by striking ``MACPAC shall consult'' and inserting the
following:
``(A) In general.--MACPAC shall consult''; and
(2) by adding at the end the following new subparagraph:
``(B) Review and reports regarding behavioral
health provider reimbursement.--
``(i) In general.--MACPAC shall survey
selected State Medicaid programs' behavioral
health provider reimbursement rates and
beneficiary utilization of behavioral health
services and shall submit an annual report to
Congress regarding such review.
``(ii) Required report information.--Each
such report regarding behavioral health
services shall include selected data relating
to--
``(I) beneficiary behavioral health
service encounters; and
``(II) the amount of Medicaid
behavioral health provider
reimbursement rates and the sources for
such rates.
``(iii) Data.--Notwithstanding any other
provision of law, the Secretary regularly shall
provide MACPAC with--
``(I) the most recent State reports
and most recent independent certified
audits submitted under section 1923(j);
``(II) cost reports submitted under
title XVIII; and
``(III) such other data as MACPAC
may request,
for purposes of conducting the reviews and
preparing and submitting the annual reports
required under this subparagraph.''.
SEC. 407. AT-RISK YOUTH MEDICAID PROTECTION.
(a) In General.--Section 1902 of the Social Security Act (42 U.S.C.
1396a), as amended by section 401, is further amended--
(1) in subsection (a)--
(A) by striking ``and'' at the end of paragraph
(80);
(B) by striking the period at the end of paragraph
(81) and inserting ``; and''; and
(C) by inserting after paragraph (81) the following
new paragraph:
``(82) provide that--
``(A) the State shall not terminate (but may
suspend) eligibility for medical assistance under a
State plan for an individual who is an eligible
juvenile (as defined in subsection (mm)(2)) because the
juvenile is an inmate of a public institution (as
defined in subsection (mm)(3));
``(B) the State shall automatically restore
eligibility for such medical assistance to such an
individual upon the individual's release from any such
public institution, unless (and until such date as)
there is a determination that the individual no longer
meets the eligibility requirements for such medical
assistance; and
``(C) the State shall process any application for
medical assistance submitted by, or on behalf of, a
juvenile who is an inmate of a public institution
notwithstanding that the juvenile is such an inmate.'';
and
(2) by adding at the end the following new subsection:
``(mm) Juvenile; Eligible Juvenile; Public Institution.--For
purposes of subsection (a)(82) and this subsection:
``(1) Juvenile.--The term `juvenile' means an individual
who is--
``(A) under 19 years of age (or such higher age as
the State has elected under section 475(8)(B)(iii)); or
``(B) is described in subsection (a)(10)(A)(i)(IX).
``(2) Eligible juvenile.--The term `eligible juvenile'
means a juvenile who is an inmate of a public institution and
was eligible for medical assistance under the State plan
immediately before becoming an inmate of such a public
institution or who becomes eligible for such medical assistance
while an inmate of a public institution.
``(3) Inmate of a public institution.--The term `inmate of
a public institution' has the meaning given such term for
purposes of applying the subdivision (A) following paragraph
(29) of section 1905(a), taking into account the exception in
such subdivision for a patient of a medical institution.''.
(b) No Change in Exclusion From Medical Assistance for Inmates of
Public Institutions.--Nothing in this section shall be construed as
changing the exclusion from medical assistance under the subdivision
(A) following paragraph (29) of section 1905(a) of the Social Security
Act (42 U.S.C. 1396d(a)), including any applicable restrictions on a
State submitting claims for Federal financial participation under title
XIX of such Act for such assistance.
(c) Effective Date.--
(1) In general.--Except as provided in paragraph (2), the
amendments made by subsection (a) shall apply to eligibility of
juveniles who become inmates of public institutions on or after
the date that is 1 year after the date of the enactment of this
Act.
(2) Rule for changes requiring state legislation.--In the
case of a State plan for medical assistance under title XIX of
the Social Security Act which the Secretary of Health and Human
Services determines requires State legislation (other than
legislation appropriating funds) in order for the plan to meet
the additional requirements imposed by the amendments made by
subsection (a), the State plan shall not be regarded as failing
to comply with the requirements of such title solely on the
basis of its failure to meet these additional requirements
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 the enactment of this
Act. For purposes of the previous sentence, in the case of a
State that has a 2-year legislative session, each year of such
session shall be deemed to be a separate regular session of the
State legislature.
Subtitle B--Medicare Provisions
SEC. 411. ELIMINATION OF 190-DAY LIFETIME LIMIT ON COVERAGE OF
INPATIENT PSYCHIATRIC HOSPITAL SERVICES UNDER MEDICARE.
Section 1812 of the Social Security Act (42 U.S.C. 1395d) is
amended--
(1) in subsection (b)--
(A) in paragraph (1), by adding ``or'' at the end;
(B) in paragraph (2), by striking ``; or'' at the
end and inserting a period; and
(C) by striking paragraph (3); and
(2) in subsection (c), by striking ``or in determining the
190-day limit under subsection (b)(3)''.
SEC. 412. MODIFICATIONS TO MEDICARE DISCHARGE PLANNING REQUIREMENTS.
Section 1861(ee) of the Social Security Act (42 U.S.C. 1395x(ee))
is amended--
(1) in paragraph (1), by inserting ``and, in the case of a
psychiatric hospital or a psychiatric unit (as described in the
matter following clause (v) of section 1886(d)(1)(B)), if it
also meets the guidelines and standards established by the
Secretary under paragraph (4)'' before the period at the end;
and
(2) by adding at the end the following new paragraph:
``(4) The Secretary shall develop guidelines and standards, in
addition to those developed under paragraph (2), for the discharge
planning process of a psychiatric hospital or a psychiatric unit (as
described in the matter following clause (v) of section 1886(d)(1)(B))
in order to ensure a timely and smooth transition to the most
appropriate type of and setting for posthospital or rehabilitative
care, taking into account variations in posthospital care access,
including mental health professional shortage areas designated by the
Health Resources and Services Administration. The Secretary shall issue
final regulations implementing such guidelines and standards not later
than 24 months after the date of the enactment of this paragraph. The
guidelines and standards shall include the following:
``(A) The hospital or unit must identify the types of
services needed upon discharge for the patients being treated
by the hospital or unit.
``(B) The hospital or unit must--
``(i) identify organizations that offer community
services to the community that is served by the
hospital or unit and the types of services provided by
the organizations; and
``(ii) make demonstrated efforts to establish
connections, relationships, and partnerships with such
organizations.
``(C) The hospital or unit must arrange (with the
participation of the patient and of any other individuals
selected by the patient for such purpose) for the development
and implementation of a discharge plan for the patient as part
of the patient's overall treatment plan from admission to
discharge. Such discharge plan shall meet the requirements
described in subparagraphs (G) and (H) of paragraph (2).
``(D) The hospital or unit shall coordinate with the
patient (or assist the patient with) the referral for
posthospital or rehabilitative care and as part of that
referral the hospital or unit shall include transmitting to the
receiving organization, in a timely manner, appropriate
information about the care furnished to the patient by the
hospital or unit and recommendations for posthospital or
rehabilitative care to be furnished to the patient by the
organization.''.
Subtitle C--Provisions Related to Medicaid and Medicare
SEC. 421. REPORTS ON MEDICAID AND MEDICARE PART D FORMULARY AND APPEALS
PRACTICES WITH RESPECT TO COVERAGE OF MENTAL HEALTH
DRUGS.
(a) Medicaid.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Comptroller General of the
United States shall submit to Congress a report that, with
respect to mental health drugs, describes the practices of the
State with respect to the following (for both such drugs
furnished on a fee-for-service basis and through Medicaid
managed care organizations):
(A) The establishment of formularies and preferred
drugs lists.
(B) The appeal of any coverage determination.
(2) Mental health drug defined.--In this section, the term
``mental health drug'' means a covered outpatient drug (as
defined in section 1927(k) of the Social Security Act (42
U.S.C. 1396r-8(k))) that--
(A) is approved or licensed under section 505 of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
355) or section 351 of the Public Health Service Act
(42 U.S.C. 262) to be used for the treatment of a
mental health disorder, including major depression,
bipolar (manic-depressive) disorder, panic disorder,
obsessive-compulsive disorder, schizophrenia, and
schizoaffective disorder; and
(B) is covered under the State plan under title XIX
of the Social Security Act (42 U.S.C. 1396 et seq.) (or
under a waiver of such plan).
(b) Medicare.--
(1) Study.--
(A) In general.--The Inspector General of the
Department of Health and Human Services shall conduct a
study that examines, with respect to the Medicare
program established under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.), the extent to
which Medicare part D appeals-related processes are
transparent, fair, effective, and in compliance with
existing statutory and regulatory requirements.
(B) Included elements of study.--The study required
under paragraph (1) shall include--
(i) an identification, with respect to a
two-year period beginning not earlier than
January 1, 2010, of--
(I) the number of grievances,
reconsiderations, and independent
reviews and appeals pursuant to
Medicare part D appeals-related
processes that were lodged, requested,
or otherwise filed during such period
by part D eligible individuals who were
enrolled in prescription drug plans
offered by PDP sponsors under part D of
title XVIII of the Social Security Act
(42 U.S.C. 1395 et seq.); and
(II) with respect to such
grievances, reconsiderations, and
independent reviews and appeals that
were so lodged, requested, or otherwise
filed during such period by such
individuals, the number of such
grievances, reconsiderations, and
independent reviews and appeals that
were decided in favor of such
individuals; and
(ii) an examination of the extent to which
Medicare part D appeals-related processes, with
respect to grievances, reconsiderations, and
independent reviews and appeals that relate to
benefits for psychiatric medications under such
part, are transparent, fair, effective, and in
compliance with existing statutory and
regulatory requirements.
(2) Report.--Not later than one year after the date of the
enactment of this Act, such Inspector General shall submit to
Congress a report on the results of the study described in
subsection (a), including the recommendations of such Inspector
General, if any, for improvements that can be made to Medicare
part D appeals-related processes.
(3) Definitions.--For purposes of this section:
(A) Medicare part d appeals-related processes.--The
term ``Medicare part D appeals-related processes''
means--
(i) grievance procedures provided by PDP
sponsors pursuant to subsection (f) of section
1860D-4 of the Social Security Act (42 U.S.C.
1395w-104);
(ii) reconsiderations provided by PDP
sponsors pursuant to subsection (g) of such
section; and
(iii) independent reviews and appeals to
which part D eligible individuals are entitled
under subsection (h) of such section.
(B) Part d terms.--The terms ``part D eligible
individual'', ``prescription drug plan'', and ``PDP
sponsor'' have the meanings given such terms by section
1840D-41 of the Social Security Act (42 U.S.C. 1395w-
151).
(c) Access to Treatments for Resistant Depression in the Medicare
and Medicaid Programs.--Not later than one year after the date of the
enactment of this Act, the Comptroller General of the United States
shall submit to Congress a report that reviews--
(1) access of available treatments for resistant depression
under the Medicare program under title XVIII of the Social
Security Act and the Medicaid program under title XIX of such
Act; and
(2) the length of time to adopt, and processes for the
adoption of, newly available treatment for resistant depression
for individuals entitled to benefits under part A of such title
XVIII or enrolled under part B of such title and for
individuals enrolled under a State plan under such title XIX.
TITLE V--STRENGTHENING THE BEHAVIORAL HEALTH WORKFORCE AND IMPROVING
ACCESS TO CARE
SEC. 501. NATIONWIDE WORKFORCE STRATEGY.
(a) In General.--Not later than one year after the date of
enactment of this Act, the Substance Abuse Mental Health and Services
Administration shall, submit to the Congress a report containing a
nationwide strategy to increase the culturally aware behavioral health
workforce and recruit professionals for the treatment of individuals
with mental illness and substance use disorders.
(b) Design.--The nationwide strategy shall be designed--
(1) to encourage and incentivize students enrolled in
accredited medical or osteopathic medical school to enter the
specialty of psychiatry;
(2) to promote greater research-oriented psychiatrist
residency training on evidence-based service delivery models
for individuals with serious mental illness or substance use
disorders;
(3) to promote appropriate Federal administrative and
fiscal mechanisms that support--
(A) evidence-based collaborative care models; and
(B) the necessary trained and culturally aware
preventionists, health care practitioners,
paraprofessionals, and peers;
(4) to increase access to child and adolescent psychiatric
services in order to promote early intervention for prevention
and mitigation of mental illness; and
(5) to identify populations and locations that are most
underserved by mental health and substance use professionals
and the most in need of psychiatrists (including child and
adolescent psychiatrists), psychologists, psychiatric nurse
practitioners, physician assistants, clinical social workers,
mental health counselors, substance abuse counselors, peer-
support specialists, recovery coaches, and other mental health
and substance use disorder professionals.
SEC. 502. REPORT ON BEST PRACTICES FOR PEER-SUPPORT SPECIALIST
PROGRAMS, TRAINING, AND CERTIFICATION.
(a) In General.--Not later than 2 years after the date of enactment
of this Act, the Secretary shall submit to the Congress and make
publicly available a report on best practices and professional
standards in States for--
(1) establishing and operating health care programs using
peer-support specialists; and
(2) training and certifying peer-support specialists.
(b) Peer-Support Specialist Defined.--In this subsection, the term
``peer-support specialist'' means an individual who--
(1) uses his or her lived experience of recovery from
mental illness or substance abuse, plus skills learned in
formal training, to facilitate support groups, and to work on a
one-on-one basis, with individuals with a serious mental
illness or a substance use disorder;
(2) has benefited or is benefiting from mental health or
substance use treatment services or supports;
(3) provides non-medical services; and
(4) performs services only within his or her area of
training, expertise, competence, or scope of practice.
(c) Contents.--The report under this section shall include
information on best practices and standards with regard to the
following:
(1) Hours of formal work or volunteer experience related to
mental health and substance use issues.
(2) Types of peer support specialists used by different
health care programs.
(3) Types of peer specialist exams required.
(4) Code of ethics.
(5) Additional training required prior to certification,
including in areas such as--
(A) ethics;
(B) scope of practice;
(C) crisis intervention;
(D) State confidentiality laws;
(E) Federal privacy protections, including under
the Health Insurance Portability and Accountability Act
of 1996; and
(F) other areas as determined by the Secretary.
(6) Requirements to explain what, where, when, and how to
accurately complete all required documentation activities.
(7) Required or recommended skill sets, such as knowledge
of--
(A) risk indicators, including individual
stressors, triggers, and indicators of escalating
symptoms;
(B) basic de-escalation techniques;
(C) basic suicide prevention concepts and
techniques;
(D) indicators that the consumer may be
experiencing abuse or neglect;
(E) stages of change or recovery;
(F) the typical process that should be followed to
access or participate in community mental health and
related services; and
(G) circumstances when it is appropriate to request
assistance from other professionals to help meet the
consumer's recovery goals.
(8) Requirements for continuing education.
SEC. 503. ADVISORY COUNCIL ON GRADUATE MEDICAL EDUCATION.
Section 762(b) of the Public Health Service Act (42 U.S.C. 294o(b))
is amended--
(1) by redesignating paragraphs (4) through (6) as
paragraphs (5) through (7), respectively; and
(2) by inserting after paragraph (3) the following:
``(4) the Assistant Secretary for Mental Health and
Substance Use Disorders;''.
SEC. 504. TELEPSYCHIATRY AND PRIMARY CARE PROVIDER TRAINING GRANT
PROGRAM.
(a) In General.--The Secretary of Health and Human Services shall
establish a grant program (in this subsection referred to as the
``grant program'') under which the Secretary shall award to 10 eligible
States (as described in subsection (e)) grants for carrying out all of
the purposes described in subsections (b), (c), and (d).
(b) Training Program for Certain Primary Care Providers.--For
purposes of subsection (a), the purpose described in this paragraph,
with respect to a grant awarded to a State under the grant program, is
for the State to establish a training program to train primary care
providers in--
(1) valid and reliable behavioral-health screening tools
for violence and suicide risk, early signs of serious mental
illness, and untreated substance abuse, including any
standardized behavioral-health screening tools that are
determined appropriate by the Secretary;
(2) implementing the use of behavioral-health screening
tools in their practices;
(3) establishment of recommended intervention and treatment
protocols for individuals in mental health crisis, especially
for individuals whose illness makes them less receptive to
mental health services; and
(4) implementing the evidence-based collaborative care
model of integrated medical-behavioral health care in their
practices.
(c) Payments for Mental Health Services Provided by Certain Primary
Care Providers.--
(1) In general.--For purposes of subsection (a), the
purpose described in this paragraph, with respect to a grant
awarded to a State under the grant program, is for the State to
provide, in accordance with this paragraph, in the case of a
primary care physician who participates in the training program
of the State establish pursuant to subsection (b), payments to
the primary care providers for services furnished by the
primary care providers.
(2) Considerations.--The Secretary, in determining the
structure, quality, and form of payment under paragraph (1)
shall seek to find innovative payment systems which may take
into account--
(A) the nature and quality of services rendered;
(B) the patients' health outcome;
(C) the geographical location where services were
provided;
(D) the acuteness of the patient's medical
condition;
(E) the duration of services provided;
(F) the feasibility of replicating the payment
model in other locations nationwide; and
(G) proper triage and enduring linkage to
appropriate treatment provider for subspecialty care in
child or forensic issues; family crisis intervention;
drug or alcohol rehabilitation; management of suicidal
or violent behavior risk, and treatment for serious
mental illness.
(d) Telehealth Services for Mental Health Disorders.--
(1) In general.--For purposes of subsection (a), the
purpose described in this paragraph, with respect to a grant
awarded to a State under the grant program, is for the State to
provide, in the case of an individual furnished items and
services by a primary care physician during an office visit,
for payment for a consultation provided by a psychiatrist or
psychologist to such primary care provider with respect to such
individual through the use of qualified telehealth technology
for the identification, diagnosis, mitigation, or treatment of
a mental health disorder if such consultation occurs not later
than the first business day that follows such visit.
(2) Qualified telehealth technology.--For purposes of
paragraph (1), the term ``qualified telehealth technology'',
with respect to the provision of items and services to a
patient by a health care provider, includes the use of
interactive audio, audio-only telephone conversation, video, or
other telecommunications technology by a health care provider
to deliver health care services within the scope of the
provider's practice including the use of electronic media for
consultation relating to the health care diagnosis or treatment
of the patient.
(e) Eligible State.--
(1) In general.--For purposes of this subsection, an
eligible State is a State that has submitted to the Secretary
an application under paragraph (2) and has been selected under
paragraph (4).
(2) Application.--A State seeking to participate in the
grant program under this subsection shall submit to the
Secretary, at such time and in such format as the Secretary
requires, an application that includes such information,
provisions, and assurances as the Secretary may require.
(3) Matching requirement.--The Secretary may not make a
grant under the grant program unless the State involved agrees,
with respect to the costs to be incurred by the State in
carrying out the purposes described in this subsection, to make
available non-Federal contributions (in cash or in kind) toward
such costs in an amount equal to not less than 20 percent of
Federal funds provided in the grant.
(4) Selection.--A State shall be determined eligible for
the grant program by the Secretary on a competitive basis among
States with applications meeting the requirements of paragraphs
(2) and (3). In selecting State applications for the grant
program, the Secretary shall seek to achieve an appropriate
national balance in the geographic distribution of grants
awarded under the grant program.
(f) Target Population.--In seeking a grant under this subsection, a
State shall demonstrate how the grant will improve care for individuals
with co-occurring behavioral health and physical health conditions,
vulnerable populations, socially isolated populations, rural
populations, and other populations who have limited access to qualified
mental health providers.
(g) Length of Grant Program.--The grant program under this
subsection shall be conducted for a period of 3 consecutive years.
(h) Public Availability of Findings and Conclusions.--Subject to
Federal privacy protections with respect to individually identifiable
information, the Secretary shall make the findings and conclusions
resulting from the grant program under this subsection available to the
public.
(i) Authorization of Appropriations.--Out of any funds in the
Treasury not otherwise appropriated, there is authorized to be
appropriated to carry out this subsection, $3,000,000 for each of the
fiscal years 2017 through 2021.
(j) Reports.--
(1) Reports.--For each fiscal year that grants are awarded
under this subsection, the Secretary shall conduct a study on
the results of the grants and submit to the Congress a report
on such results that includes the following:
(A) An evaluation of the grant program outcomes,
including a summary of activities carried out with the
grant and the results achieved through those
activities.
(B) Recommendations on how to improve access to
mental health services at grantee locations.
(C) An assessment of access to mental health
services under the program.
(D) An assessment of the impact of the
demonstration project on the costs of the full range of
mental health services (including inpatient, emergency
and ambulatory care).
(E) Recommendations on congressional action to
improve the grant.
(F) Recommendations to improve training of primary
care providers.
(2) Report.--Not later than December 31, 2018, the
Secretary shall submit to Congress and make available to the
public a report on the findings of the evaluation under
subparagraph (A) and also a policy outline on how Congress can
expand the grant program to the national level.
SEC. 505. LIABILITY PROTECTIONS FOR HEALTH CARE PROFESSIONAL VOLUNTEERS
AT COMMUNITY HEALTH CENTERS AND FEDERALLY QUALIFIED
COMMUNITY BEHAVIORAL HEALTH CLINICS.
Section 224 of the Public Health Service Act (42 U.S.C. 233) is
amended by adding at the end the following:
``(q)(1) In this subsection, the term `federally qualified
community behavioral health clinic' means--
``(A) a federally qualified community behavioral health
clinic with a certification in effect under section 223 of the
Protecting Access to Medicare Act of 2014; or
``(B) a community mental health center meeting the criteria
specified in section 1913(c) of this Act.
``(2) For purposes of this section, a health care professional
volunteer at an entity described in subsection (g)(4) or a federally
qualified community behavioral health clinic shall, in providing health
care services eligible for funding under section 330 or subpart I of
part B of title XIX to an individual, be deemed to be an employee of
the Public Health Service for a calendar year that begins during a
fiscal year for which a transfer was made under paragraph (5)(C). The
preceding sentence is subject to the provisions of this subsection.
``(3) In providing a health care service to an individual, a health
care professional shall for purposes of this subsection be considered
to be a health professional volunteer at an entity described in
subsection (g)(4) or at a federally qualified community behavioral
health clinic if the following conditions are met:
``(A) The service is provided to the individual at the
facilities of an entity described in subsection (g)(4), at a
federally qualified community behavioral health clinic, or
through offsite programs or events carried out by the center.
``(B) The center or entity is sponsoring the health care
professional volunteer pursuant to paragraph (4)(B).
``(C) The health care professional does not receive any
compensation for the service from the individual or from any
third-party payer (including reimbursement under any insurance
policy or health plan, or under any Federal or State health
benefits program), except that the health care professional may
receive repayment from the entity described in subsection
(g)(4) or the center for reasonable expenses incurred by the
health care professional in the provision of the service to the
individual.
``(D) Before the service is provided, the health care
professional or the center or entity described in subsection
(g)(4) posts a clear and conspicuous notice at the site where
the service is provided of the extent to which the legal
liability of the health care professional is limited pursuant
to this subsection.
``(E) At the time the service is provided, the health care
professional is licensed or certified in accordance with
applicable law regarding the provision of the service.
``(4) Subsection (g) (other than paragraphs (3) and (5)) and
subsections (h), (i), and (l) apply to a health care professional for
purposes of this subsection to the same extent and in the same manner
as such subsections apply to an officer, governing board member,
employee, or contractor of an entity described in subsection (g)(4),
subject to paragraph (5) and subject to the following:
``(A) The first sentence of paragraph (2) applies in lieu
of the first sentence of subsection (g)(1)(A).
``(B) With respect to an entity described in subsection
(g)(4) or a federally qualified community behavioral health
clinic, a health care professional is not a health professional
volunteer at such center unless the center sponsors the health
care professional. For purposes of this subsection, the center
shall be considered to be sponsoring the health care
professional if--
``(i) with respect to the health care professional,
the center submits to the Secretary an application
meeting the requirements of subsection (g)(1)(D); and
``(ii) the Secretary, pursuant to subsection
(g)(1)(E), determines that the health care professional
is deemed to be an employee of the Public Health
Service.
``(C) In the case of a health care professional who is
determined by the Secretary pursuant to subsection (g)(1)(E) to
be a health professional volunteer at such center, this
subsection applies to the health care professional (with
respect to services described in paragraph (2)) for any cause
of action arising from an act or omission of the health care
professional occurring on or after the date on which the
Secretary makes such determination.
``(D) Subsection (g)(1)(F) applies to a health professional
volunteer for purposes of this subsection only to the extent
that, in providing health services to an individual, each of
the conditions specified in paragraph (3) is met.
``(5)(A) Amounts in the fund established under subsection (k)(2)
shall be available for transfer under subparagraph (C) for purposes of
carrying out this subsection for health professional volunteers at
entities described in subsection (g)(4).
``(B) Not later than May 1 of each fiscal year, the Attorney
General, in consultation with the Secretary, shall submit to the
Congress a report providing an estimate of the amount of claims
(together with related fees and expenses of witnesses) that, by reason
of the acts or omissions of health care professional volunteers, will
be paid pursuant to this subsection during the calendar year that
begins in the following fiscal year. Subsection (k)(1)(B) applies to
the estimate under the preceding sentence regarding health care
professional volunteers to the same extent and in the same manner as
such subsection applies to the estimate under such subsection regarding
officers, governing board members, employees, and contractors of
entities described in subsection (g)(4).
``(C) Not later than December 31 of each fiscal year, the Secretary
shall transfer from the fund under subsection (k)(2) to the appropriate
accounts in the Treasury an amount equal to the estimate made under
subparagraph (B) for the calendar year beginning in such fiscal year,
subject to the extent of amounts in the fund.
``(6)(A) This subsection takes effect on October 1, 2017, except as
provided in subparagraph (B).
``(B) Effective on the date of the enactment of this subsection--
``(i) the Secretary may issue regulations for carrying out
this subsection, and the Secretary may accept and consider
applications submitted pursuant to paragraph (4)(B); and
``(ii) reports under paragraph (5)(B) may be submitted to
the Congress.''.
SEC. 506. MINORITY FELLOWSHIP PROGRAM.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.),
as amended, is further amended by adding at the end the following:
``PART K--MINORITY FELLOWSHIP PROGRAM
``SEC. 597. FELLOWSHIPS.
``(a) In General.--The Secretary shall maintain a program, to be
known as the Minority Fellowship Program, under which the Secretary
awards fellowships, which may include stipends, for the purposes of--
``(1) increasing behavioral health practitioners' knowledge
of issues related to prevention, treatment, and recovery
support for mental and substance use disorders among racial and
ethnic minority populations;
``(2) improving the quality of mental and substance use
disorder prevention and treatment delivered to ethnic
minorities; and
``(3) increasing the number of culturally competent
behavioral health professionals who teach, administer, conduct
services research, and provide direct mental health or
substance use services to underserved minority populations.
``(b) Training Covered.--The fellowships under subsection (a) shall
be for postbaccalaureate training (including for master's and doctoral
degrees) for mental health professionals, including in the fields of
psychiatry, nursing, social work, psychology, marriage and family
therapy, professional counseling, and substance use and addiction
counseling.
``(c) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $11,000,000 for fiscal year
2017, $14,000,000 for fiscal year 2018, $16,000,000 for fiscal year
2019, $18,000,000 for fiscal year 2020, and $20,000,000 for fiscal year
2021.''.
SEC. 507. NATIONAL HEALTH SERVICE CORPS.
(a) Definitions.--
(1) Primary health services.--Section 331(a)(3)(D) of the
Public Health Service Act (42 U.S.C. 254d(a)(3)) is amended by
inserting ``(including pediatric mental health subspecialty
services)'' after ``pediatrics''.
(2) Behavioral and mental health professionals.--Clause (i)
of section 331(a)(3)(E) of the Public Health Service Act (42
U.S.C. 254d(a)(3)(E)) is amended by inserting ``(and pediatric
subspecialists thereof)'' before the period at the end.
(b) Eligibility To Participate in Loan Repayment Program.--Section
338B(b)(1)(B) of the Public Health Service Act (42 U.S.C. 254l-
1(b)(1)(B)) is amended by inserting ``, including any physician child
and adolescent psychiatry residency or fellowship training program''
after ``be enrolled in an approved graduate training program in
medicine, osteopathic medicine, dentistry, behavioral and mental
health, or other health profession''.
SEC. 508. SAMHSA GRANT PROGRAM FOR DEVELOPMENT AND IMPLEMENTATION OF
CURRICULA FOR CONTINUING EDUCATION ON SERIOUS MENTAL
ILLNESS.
Title V of the Public Health Service Act is amended by inserting
after section 520I (42 U.S.C. 290bb-40) the following:
``SEC. 520I-1. CURRICULA FOR CONTINUING EDUCATION ON SERIOUS MENTAL
ILLNESS.
``(a) Grants.--The Secretary may award grants to eligible entities
for the development and implementation of curricula for providing
continuing education and training to health care professionals on
identifying, referring, and treating individuals with serious mental
illness or serious emotional disturbance.
``(b) Eligible Entities.--To be eligible to seek a grant under this
section, an entity shall be a public or nonprofit entity that--
``(1) provides continuing education or training to health
care professionals; or
``(2) applies for the grant in partnership with another
entity that provides such education and training.
``(c) Preference.--In awarding grants under this section, the
Secretary shall give preference to eligible entities proposing to
develop and implement curricula for providing continuing education and
training to--
``(1) health care professionals in primary care
specialties; or
``(2) health care professionals who are required, as a
condition of State licensure, to participate in continuing
education or training specific to mental health.
``(d) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $1,000,000 for each of fiscal
years 2017 through 2021.''.
SEC. 509. PEER PROFESSIONAL WORKFORCE DEVELOPMENT GRANT PROGRAM.
(a) In General.--For the purposes described in subsection (b), the
Secretary of Health and Human Services shall award grants to develop
and sustain behavioral health paraprofessional training and education
programs, including through tuition support.
(b) Purposes.--The purposes of grants under this section are--
(1) to increase the number of behavioral health
paraprofessionals, including trained peers, recovery coaches,
mental health and addiction specialists, prevention
specialists, and pre-masters-level addiction counselors; and
(2) to help communities develop the infrastructure to train
and certify peers as behavioral health paraprofessionals.
(c) Eligible Entities.--To be eligible to receive a grant under
this section, an entity shall be a community college or other entity
the Secretary deems appropriate.
(d) Geographic Distribution.--In awarding grants under this
section, the Secretary shall seek to achieve an appropriate national
balance in the geographic distribution of such awards.
(e) Special Consideration.--In awarding grants under this section,
the Secretary may give special consideration to proposed and existing
programs targeting peer professionals serving youth ages 16 to 25.
(f) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated to carry out this section
$5,000,000 for each of fiscal years 2017 through 2021.
SEC. 510. DEMONSTRATION GRANT PROGRAM TO RECRUIT, TRAIN, AND
PROFESSIONALLY SUPPORT PSYCHIATRIC PHYSICIANS IN INDIAN
HEALTH PROGRAMS.
(a) Establishment.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary''), in consultation with
the Director of the Indian Health Service and demonstration programs
established under section 123 of the Indian Health Care Improvement Act
(25 U.S.C. 1616p), shall award one 5-year grant to one eligible entity
to carry out a demonstration program (in this Act referred to as the
``Program'') under which the eligible entity shall carry out the
activities described in subsection (b).
(b) Activities To Be Carried Out by Recipient of Grant Under
Program.--Under the Program, the grant recipient shall--
(1) create a nationally replicable workforce model that
identifies and incorporates best practices for recruiting,
training, deploying, and professionally supporting Native
American and non-Native American psychiatric physicians to be
fully integrated into medical, mental, and behavioral health
systems in Indian health programs;
(2) recruit to participate in the Program Native American
and non-Native American psychiatric physicians who demonstrate
interest in providing specialty health care services (as
defined in section 313(a)(3) of the Indian Health Care
Improvement Act (25 U.S.C. 1638g(a)(3))) and primary care
services to American Indians and Alaska Natives;
(3) provide such psychiatric physicians participating in
the Program with not more than 1 year of supplemental clinical
and cultural competency training to enable such physicians to
provide such specialty health care services and primary care
services in Indian health programs;
(4) with respect to such psychiatric physicians who are
participating in the Program and trained under paragraph (3),
deploy such physicians to practice specialty care or primary
care in Indian health programs for a period of not less than 2
years and professionally support such physicians for such
period with respect to practicing such care in such programs;
and
(5) not later than 1 year after the last day of the 5-year
period for which the grant is awarded under subsection (a),
submit to the Secretary and to the appropriate committees of
Congress a report that shall include--
(A) the workforce model created under paragraph
(1);
(B) strategies for disseminating the workforce
model to other entities with the capability of adopting
it; and
(C) recommendations for the Secretary and Congress
with respect to supporting an effective and stable
psychiatric and mental health workforce that serves
American Indians and Alaska Natives.
(c) Eligible Entities.--
(1) Requirements.--To be eligible to receive the grant
under this section, an entity shall--
(A) submit to the Secretary an application at such
time, in such manner, and containing such information
as the Secretary may require;
(B) be a department of psychiatry within a medical
school in the United States that is accredited by the
Liaison Committee on Medical Education or a public or
private nonprofit entity affiliated with a medical
school in the United States that is accredited by the
Liaison Committee on Medical Education; and
(C) have in existence, as of the time of submission
of the application under subparagraph (A), a
relationship with Indian health programs in at least
two States with a demonstrated need for psychiatric
physicians and provide assurances that the grant will
be used to serve rural and non-rural American Indian
and Alaska Native populations in at least two States.
(2) Priority in selecting grant recipient.--In awarding the
grant under this section, the Secretary shall give priority to
an eligible entity that satisfies each of the following:
(A) Demonstrates sufficient infrastructure in size,
scope, and capacity to undertake the supplemental
clinical and cultural competency training of a minimum
of 5 psychiatric physicians, and to provide ongoing
professional support to psychiatric physicians during
the deployment period to an Indian health program.
(B) Demonstrates a record in successfully
recruiting, training, and deploying physicians who are
American Indians and Alaska Natives.
(C) Demonstrates the ability to establish a program
advisory board, which may be primarily composed of
representatives of federally recognized tribes, Alaska
Natives, and Indian health programs to be served by the
Program.
(d) Eligibility of Psychiatric Physicians To Participate in the
Program.--
(1) In general.--To be eligible to participate in the
Program, as described in subsection (b), a psychiatric
physician shall--
(A) be licensed or eligible for licensure to
practice in the State to which the physician is to be
deployed under subsection (b)(4); and
(B) demonstrate a commitment beyond the one year of
training described in subsection (b)(3) and two years
of deployment described in subsection (b)(4) to a
career as a specialty care physician or primary care
physician providing mental health services in Indian
health programs.
(2) Preference.--In selecting physicians to participate
under the Program, as described in subsection (b)(2), the grant
recipient shall give preference to physicians who are American
Indians and Alaska Natives.
(e) Loan Forgiveness.--Under the Program, any psychiatric physician
accepted to participate in the Program shall, notwithstanding the
provisions of subsection (b) of section 108 of the Indian Health Care
Improvement Act (25 U.S.C. 1616a) and upon acceptance into the Program,
be deemed eligible and enrolled to participate in the Indian Health
Service Loan Repayment Program under such section 108. Under such Loan
Repayment Program, the Secretary shall pay on behalf of the physician
for each year of deployment under the Program under this section up to
$35,000 for loans described in subsection (g)(1) of such section 108.
(f) Deferral of Certain Service.--The starting date of required
service of individuals in the National Health Service Corps Service
Program under title II of the Public Health Service Act (42 U.S.C. 202
et seq.) who are psychiatric physicians participating under the Program
under this section shall be deferred until the date that is 30 days
after the date of completion of the participation of such a physician
in the Program under this section.
(g) Definitions.--For purposes of this section:
(1) American indians and alaska natives.--The term
``American Indians and Alaska Natives'' has the meaning given
the term ``Indian'' in section 447.50(b)(1) of title 42, Code
of Federal Regulations, as in existence as of the date of the
enactment of this Act.
(2) Indian health program.--The term ``Indian health
program'' has the meaning given such term in section 104(12) of
the Indian Health Care Improvement Act (25 U.S.C. 1603(12)).
(3) Professionally support.--The term ``professionally
support'' means, with respect to psychiatric physicians
participating in the Program and deployed to practice specialty
care or primary care in Indian health programs, the provision
of compensation to such physicians for the provision of such
care during such deployment and may include the provision,
dissemination, or sharing of best practices, field training,
and other activities deemed appropriate by the recipient of the
grant under this section.
(4) Psychiatric physician.--The term ``psychiatric
physician'' means a medical doctor or doctor of osteopathy in
good standing who has successfully completed four-year
psychiatric residency training or who is enrolled in four-year
psychiatric residency training in a residency program
accredited by the Accreditation Council for Graduate Medical
Education.
(h) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $1,000,000 for each of the
fiscal years 2017 through 2021.
SEC. 511. EDUCATION AND TRAINING ON EATING DISORDERS FOR HEALTH
PROFESSIONALS.
(a) In General.--The Secretary of Health and Human Services, acting
through the Administrator of the Substance Abuse and Mental Health
Services Administration, shall award grants to eligible entities to
integrate training into existing curricula for primary care physicians,
other licensed or certified health and mental health professionals, and
public health professionals that may include--
(1) early intervention and identification of eating
disorders;
(2) types of treatment (including family-based treatment,
inpatient, residential, partial hospitalization programming,
intensive outpatient and outpatient);
(3) how to properly refer patients to treatment;
(4) steps to aid in the prevention of the development of
eating disordered behaviors; and
(5) how to treat individuals with eating disorders.
(b) Application.--An entity that desires a grant under this section
shall submit to the Secretary an application at such time, in such
manner, and containing such information as the Secretary may require,
including a plan for the use of funds that may be awarded and an
evaluation of the training that will be provided.
(c) Use of Funds.--An entity that receives a grant under this
section shall use the funds made available through such grant to--
(1) use a training program containing evidence-based
findings, promising emerging best practices, or recommendations
that pertain to the identification, early intervention,
prevention of the development of eating disordered behaviors,
and treatment of eating disorders to conduct educational
training and conferences, including Internet-based courses and
teleconferences, on--
(A) how to help prevent the development of eating
disordered behaviors, identify, intervene early, and
appropriately and adequately treat eating disordered
patients;
(B) how to identify individuals with eating
disorders, and those who are at risk for suffering from
eating disorders and, therefore, at risk for related
severe medical and mental health conditions;
(C) how to conduct a comprehensive assessment of
individual and familial health risk factors; and
(D) how to conduct a comprehensive assessment of a
treatment plan; and
(2) evaluate and report to the Secretary on the
effectiveness of the training provided by such entity in
increasing knowledge and changing attitudes and behaviors of
trainees.
(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $1,000,000 for each of the
fiscal years 2017 through 2021.
SEC. 512. PRIMARY AND BEHAVIORAL HEALTH CARE INTEGRATION GRANT
PROGRAMS.
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.
``(a) In General.--The Secretary shall establish a primary and
behavioral health care integration grant program. The Secretary may
award grants and cooperative agreements to eligible entities to expend
funds for improvements in integrated settings with integrated
practices.
``(b) Definitions.--In this section:
``(1) Integrated care.--The term `integrated care' means
full collaboration in merged or transformed practices offering
behavioral and physical health services within the same shared
practice space in the same facility, where the entity--
``(A) provides services in a shared space that
ensures services will be available and accessible
promptly and in a manner which preserves human dignity
and assures continuity of care;
``(B) ensures communication among the integrated
care team that is consistent and team-based;
``(C) ensures shared decisionmaking between
behavioral health and primary care providers;
``(D) provides evidence-based services in a mode of
service delivery appropriate for the target population;
``(E) employs staff who are multidisciplinary and
culturally and linguistically competent;
``(F) provides integrated services related to
screening, diagnosis, and treatment of mental illness
and substance use disorder and co-occurring primary
care conditions and chronic diseases; and
``(G) provides targeted case management, including
services to assist individuals gaining access to needed
medical, social, educational, and other services and
applying for income security, housing, employment, and
other benefits to which they may be entitled.
``(2) Integrated care team.--The term `integrated care
team' means a team that includes--
``(A) allopathic or osteopathic medical doctors,
such as a primary care physician and a psychiatrist;
``(B) licensed clinical behavioral health
professionals, such as psychologists or social workers;
``(C) a case manager; and
``(D) other members, such as psychiatric advanced
practice nurses, physician assistants, peer-support
specialists or other allied health professionals, such
as mental health counselors.
``(3) Special population.--The term `special population'
means--
``(A) adults with mental illnesses who have co-
occurring primary care conditions with chronic
diseases;
``(B) adults with serious mental illnesses who have
co-occurring primary care conditions with chronic
diseases;
``(C) children and adolescents with serious
emotional disturbances with co-occurring primary care
conditions and chronic diseases;
``(D) older adults with mental illness who have co-
occurring primary care conditions with chronic
conditions;
``(E) individuals with substance use disorder; or
``(F) individuals from populations for which there
is a significant disparity in the quality, outcomes,
cost, or use of mental health or substance use disorder
services or a significant disparity in access to such
services, as compared to the general population, such
as racial and ethnic minorities and rural populations.
``(c) Purpose.--The grant program under this section shall be
designed to lead to full collaboration between primary and behavioral
health in an integrated practice model to ensure that--
``(1) the overall wellness and physical health status of
individuals with serious mental illness or serious emotional
disturbance and co-occurring substance use disorders is
supported through integration of primary care into community
mental health centers meeting the criteria specified in section
1913(c) of the Social Security Act or certified community
behavioral health clinics described in section 223 of the
Protecting Access to Medicare Act of 2014; or
``(2) the mental health status of individuals with
significant co-occurring psychiatric and physical conditions
will be supported through integration of behavioral health into
primary care settings.
``(d) Eligible Entities.--To be eligible to receive a grant or
cooperative agreement under this section, an entity shall be a State
department of health, State mental health or addiction agency, State
Medicaid agency, or licensed health care provider or institution. The
Administrator may give preference to States that have existing
integrated care models, such as those authorized by section 1945 of the
Social Security Act.
``(e) Application.--An eligible entity desiring a grant or
cooperative agreement under this section shall submit an application to
the Administrator at such time, in such manner, and accompanied by such
information as the Administrator may require, including a description
of a plan to achieve fully collaborative agreements to provide services
to special populations and--
``(1) a document that summarizes the State-specific
policies that inhibit the provision of integrated care, and the
specific steps that will be taken to address such barriers,
such as through licensing and billing procedures; and
``(2) a plan to develop and share a de-identified patient
registry to track treatment implementation and clinical
outcomes to inform clinical interventions, patient education,
and engagement with merged or transformed integrated practices
in compliance with applicable national and State health
information privacy laws.
``(f) Grant Amounts.--The maximum annual grant amount under this
section shall be $2,000,000, of which not more than 10 percent may be
allocated to State administrative functions, and the remaining amounts
shall be allocated to health facilities that provide integrated care.
``(g) Duration.--A grant under this section shall be for a period
of 5 years.
``(h) Report on Program Outcomes.--An entity receiving a grant or
cooperative agreement under this section shall submit an annual report
to the Administrator that includes--
``(1) the progress to reduce barriers to integrated care,
including regulatory and billing barriers, as described in the
entity's application under subsection (d); and
``(2) a description of functional outcomes of special
populations, such as--
``(A) with respect to individuals with serious
mental illness, participation in supportive housing or
independent living programs, engagement in social or
education activities, participation in job training or
employment opportunities, attendance at scheduled
medical and mental health appointments, and compliance
with treatment plans;
``(B) with respect to individuals with co-occurring
mental illness and primary care conditions and chronic
diseases, attendance at scheduled medical and mental
health appointments, compliance with treatment plans,
and participation in learning opportunities related to
improved health and lifestyle practice; and
``(C) with respect to children and adolescents with
serious emotional disorders who have co-occurring
primary care conditions and chronic diseases,
attendance at scheduled medical and mental health
appointments, compliance with treatment plans, and
participation in learning opportunities at school and
extracurricular activities.
``(i) Technical Assistance Center for Primary-Behavioral Health
Care Integration.--
``(1) In general.--The Secretary shall establish a program
through which such Secretary shall provide appropriate
information, training, and technical assistance to eligible
entities that receive a grant or cooperative agreement under
this section, in order to help such entities to meet the
requirements of this section, including assistance with--
``(A) development and selection of integrated care
models;
``(B) dissemination of evidence-based interventions
in integrated care;
``(C) establishment of organizational practices to
support operational and administrative success; and
``(D) other activities, as the Secretary determines
appropriate.
``(2) Additional dissemination of technical information.--
The information and resources provided by the technical
assistance program established under paragraph (1) shall be
made available to States, political subdivisions of a State,
Indian tribes or tribal organizations (as defined in section 4
of the Indian Self-Determination and Education Assistance Act),
outpatient mental health and addiction treatment centers,
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, primary care organizations such as Federally
qualified health centers or rural health centers, other
community-based organizations, or other entities engaging in
integrated care activities, as the Secretary determines
appropriate.
``(j) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $50,000,000 for each of fiscal
years 2017 through 2021, of which $2,000,000 shall be available to the
technical assistance program under subsection (i).''.
SEC. 513. HEALTH PROFESSIONS COMPETENCIES TO ADDRESS RACIAL, ETHNIC,
SEXUAL, AND GENDER MINORITY BEHAVIORAL HEALTH
DISPARITIES.
(a) In General.--The Secretary of Health and Human Services shall
award grants to national organizations for the purpose of developing,
and disseminating to health professional educational programs,
curricula or core competencies addressing behavioral health disparities
among racial, ethnic, sexual, and gender minority groups.
(b) Use of Funds.--Organizations receiving funds under subsection
(a) shall use the funds to develop and disseminate curricula or core
competencies, as described in such subsection, for use in the training
of students in the professions of social work, psychology, psychiatry,
nursing, physician assistants, marriage and family therapy, mental
health counseling, substance abuse counseling, or other mental health
and substance use disorder providers that the Secretary deems
appropriate.
(c) Allowable Activities.--Organizations receiving funds under
subsection (a) may use the funds to engage in the following activities
related to the development and dissemination of curricula or core
competencies:
(1) Formation of committees or working groups comprised of
experts from accredited health professions schools to identify
core competencies relating to mental health disparities among
racial and ethnic minority groups.
(2) Planning of workshops in national fora to allow for
public input into the educational needs associated with mental
health disparities among racial and ethnic minority groups.
(3) Dissemination and promotion of the use of curricula or
core competencies in undergraduate and graduate health
professions training programs nationwide.
(d) Definitions.--In this section, the term ``racial and ethnic
minority group'' has the meaning given to such term in section 1707(g)
of the Public Health Service Act (42 U.S.C. 300u-6(g)).
(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $1,000,000 for each of fiscal
years 2017 through 2021.
SEC. 514. BEHAVIORAL HEALTH CRISIS SYSTEMS.
(a) Definitions.--For purposes of this section, the following
definitions shall apply:
(1) Eligible entity.--The term ``eligible entity'' means a
State, political subdivision of a State, or nonprofit private
entity.
(2) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(3) State.--The term ``State'' means each State of the
United States, the District of Columbia, each commonwealth,
territory or possession of the United States, and each
federally recognized Indian tribe.
(b) Establishment of Grant Program.--
(1) Establishment.--The Secretary shall establish a program
to award grants to eligible entities to establish and implement
a system for preventing and de-escalating behavioral health
crises.
(2) Use of funds.--
(A) In general.--Grants under this section may be
used to carry out programs that--
(i) expand early intervention and treatment
services to improve access to behavioral health
crisis assistance and address unmet behavioral
health care needs;
(ii) expand the continuum of services to
address crisis prevention, crisis intervention,
and crisis stabilization; and
(iii) reduce unnecessary hospitalizations
by appropriately utilizing community-based
services and improving access to timely
behavioral health crisis assistance.
(B) Authorized activities.--The programs described
in subparagraph (A) may include activities such as:
(i) Mobile support or crisis support
centers that provide field-based behavioral
health assistance to individuals with mental
health or substance use disorders and links
such individuals in crisis to appropriate
services.
(ii) School and community-based early
intervention and prevention programs that
provide mobile response, screening and
assessment, training and education, and peer-
based and family services.
(iii) Mental health crisis intervention and
response training for law enforcement officers
to increase officers' understanding and
recognition of mental illnesses as well as
increase their awareness of health care
services available to individuals in crisis.
(3) Application.--To be considered for a grant under this
section, an eligible entity shall submit an application to the
Secretary at such time, in such manner, and containing such
information as the Secretary may require. At minimum, such
application shall include a description of--
(A) the activities to be funded with the grant;
(B) community needs;
(C) the population to be served; and
(D) the interaction between the activities
described in subparagraph (A) and public systems of
health and mental health care, law enforcement, social
services, and related assistance programs.
(4) Selecting among applicants.--
(A) In general.--Grants shall be awarded to
eligible entities on a competitive basis.
(B) Selection criteria.--The Secretary shall
evaluate applicants based on such criteria as the
Secretary determines to be appropriate, including the
ability of an applicant to carry out the activities
described in paragraph (2).
(5) Reports.--
(A) Annual reports.--
(i) Eligible entities.--As a condition of
receiving a grant under this section, an
eligible entity shall agree to submit a report
to the Secretary, on an annual basis,
describing the activities carried out with the
grant and assessing the effectiveness of such
activities.
(ii) Secretary.--The Secretary shall, on an
annual basis, and using the reports received
under clause (i), report to Congress on the
overall impact and effectiveness of the grant
program under this section.
(B) Final report.--Not later than January 15, 2021,
the Secretary shall submit to Congress a final report
that includes recommendations with respect to the
feasibility and advisability of extending or expanding
the grant program. The report shall also provide an
assessment of which systems and system elements proved
most effective.
(6) Collection of data.--The Secretary shall collect data
on the grant program to determine its effectiveness in reducing
the social impact of mental health crises and the feasibility
and advisability of extending the grant program.
(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $10,000,000 for each of fiscal
years 2017 through 2021.
SEC. 515. MENTAL HEALTH IN SCHOOLS.
(a) Technical Amendments.--The second part G (relating to services
provided through religious organizations) of title V of the Public
Health Service Act (42 U.S.C. 290kk et seq.) is amended--
(1) by redesignating such part as part J; and
(2) by redesignating sections 581 through 584 as sections
596 through 596C, respectively.
(b) School-Based Mental Health and Children and Violence.--Section
581 of the Public Health Service Act (42 U.S.C. 290hh) is amended to
read as follows:
``SEC. 581. SCHOOL-BASED MENTAL HEALTH AND CHILDREN AND VIOLENCE.
``(a) In General.--The Secretary, in collaboration with the
Secretary of Education and in consultation with the Attorney General,
shall, directly or through grants, contracts, or cooperative agreements
awarded to public entities and local education agencies, assist local
communities and schools in applying a public health approach to mental
health services both in schools and in the community. Such approach
should provide comprehensive age appropriate services and supports, be
linguistically and culturally appropriate, be trauma-informed, and
incorporate age appropriate strategies of positive behavioral
interventions and supports. A comprehensive school mental health
program funded under this section shall assist children in dealing with
trauma and violence.
``(b) Activities.--Under the program under subsection (a), the
Secretary may--
``(1) provide financial support to enable local communities
to implement a comprehensive culturally and linguistically
appropriate, trauma-informed, and age-appropriate, school
mental health program that incorporates positive behavioral
interventions, client treatment, and supports to foster the
health and development of children;
``(2) provide technical assistance to local communities
with respect to the development of programs described in
paragraph (1);
``(3) provide assistance to local communities in the
development of policies to address child and adolescent trauma
and mental health issues and violence when and if it occurs;
``(4) facilitate community partnerships among families,
students, law enforcement agencies, education systems, mental
health and substance use disorder service systems, family-based
mental health service systems, welfare agencies, health care
service systems (including physicians), faith-based programs,
trauma networks, and other community-based systems; and
``(5) establish mechanisms for children and adolescents to
report incidents of violence or plans by other children,
adolescents, or adults to commit violence.
``(c) Requirements.--
``(1) In general.--To be eligible for a grant, contract, or
cooperative agreement under subsection (a), an entity shall--
``(A) be a partnership between a local education
agency and at least one community program or agency
that is involved in mental health; and
``(B) submit an application, that is endorsed by
all members of the partnership, that contains the
assurances described in paragraph (2).
``(2) Required assurances.--An application under paragraph
(1) shall contain assurances as follows:
``(A) That the applicant will ensure that, in
carrying out activities under this section, the local
educational agency involved will enter into a
memorandum of understanding--
``(i) with, at least one, public or private
mental health entity, health care entity, law
enforcement or juvenile justice entity, child
welfare agency, family-based mental health
entity, family or family organization, trauma
network, or other community-based entity; and
``(ii) that clearly states--
``(I) the responsibilities of each
partner with respect to the activities
to be carried out;
``(II) how each such partner will
be accountable for carrying out such
responsibilities; and
``(III) the amount of non-Federal
funding or in-kind contributions that
each such partner will contribute in
order to sustain the program.
``(B) That the comprehensive school-based mental
health program carried out under this section supports
the flexible use of funds to address--
``(i) the promotion of the social,
emotional, and behavioral health of all
students in an environment that is conducive to
learning;
``(ii) the reduction in the likelihood of
at risk students developing social, emotional,
behavioral health problems, or substance use
disorders;
``(iii) the early identification of social,
emotional, behavioral problems, or substance
use disorders and the provision of early
intervention services;
``(iv) the treatment or referral for
treatment of students with existing social,
emotional, behavioral health problems, or
substance use disorders; and
``(v) the development and implementation of
programs to assist children in dealing with
trauma and violence.
``(C) That the comprehensive school-based mental
health program carried out under this section will
provide for in-service training of all school
personnel, including ancillary staff and volunteers,
in--
``(i) the techniques and supports needed to
identify early children with trauma histories
and children with, or at risk of, mental
illness;
``(ii) the use of referral mechanisms that
effectively link such children to appropriate
treatment and intervention services in the
school and in the community and to follow-up
when services are not available;
``(iii) strategies that promote a school-
wide positive environment;
``(iv) strategies for promoting the social,
emotional, mental, and behavioral health of all
students; and
``(v) strategies to increase the knowledge
and skills of school and community leaders
about the impact of trauma and violence and on
the application of a public health approach to
comprehensive school-based mental health
programs.
``(D) That the comprehensive school-based mental
health program carried out under this section will
include comprehensive training for parents, siblings,
and other family members of children with mental health
disorders, and for concerned members of the community
in--
``(i) the techniques and supports needed to
identify early children with trauma histories,
and children with, or at risk of, mental
illness;
``(ii) the use of referral mechanisms that
effectively link such children to appropriate
treatment and intervention services in the
school and in the community and follow-up when
such services are not available; and
``(iii) strategies that promote a school-
wide positive environment.
``(E) That the comprehensive school-based mental
health program carried out under this section will
demonstrate the measures to be taken to sustain the
program after funding under this section terminates.
``(F) That the local education agency partnership
involved is supported by the State educational and
mental health system to ensure that the sustainability
of the programs is established after funding under this
section terminates.
``(G) That the comprehensive school-based mental
health program carried out under this section will be
based on trauma-informed and evidence-based practices.
``(H) That the comprehensive school-based mental
health program carried out under this section will be
coordinated with early intervening activities carried
out under the Individuals with Disabilities Education
Act.
``(I) That the comprehensive school-based mental
health program carried out under this section will be
trauma-informed and culturally and linguistically
appropriate.
``(J) That the comprehensive school-based mental
health program carried out under this section will
include a broad needs assessment of youth who drop out
of school due to policies of `zero tolerance' with
respect to drugs, alcohol, or weapons and an inability
to obtain appropriate services.
``(K) That the mental health services provided
through the comprehensive school-based mental health
program carried out under this section will be provided
by qualified mental and behavioral health professionals
who are certified or licensed by the State involved and
practicing within their area of expertise.
``(3) Coordinator.--Any entity that is a member of a
partnership described in paragraph (1)(A) may serve as the
coordinator of funding and activities under the grant if all
members of the partnership agree.
``(4) Compliance with hipaa.--A grantee under this section
shall be deemed to be a covered entity for purposes of
compliance with the regulations promulgated under section
264(c) of the Health Insurance Portability and Accountability
Act of 1996 with respect to any patient records developed
through activities under the grant.
``(d) Geographical Distribution.--The Secretary shall ensure that
grants, contracts, or cooperative agreements under subsection (a) will
be distributed equitably among the regions of the country and among
urban and rural areas.
``(e) Duration of Awards.--With respect to a grant, contract, or
cooperative agreement under subsection (a), the period during which
payments under such an award will be made to the recipient shall be 5
years. An entity may receive only one award under this section, except
that an entity that is providing services and supports on a regional
basis may receive additional funding after the expiration of the
preceding grant period.
``(f) Evaluation and Measures of Outcomes.--
``(1) Development of process.--The Administrator shall
develop a fiscally appropriate process for evaluating
activities carried out under this section. Such process shall
include--
``(A) the development of guidelines for the
submission of program data by grant, contract, or
cooperative agreement recipients;
``(B) the development of measures of outcomes (in
accordance with paragraph (2)) to be applied by such
recipients in evaluating programs carried out under
this section; and
``(C) the submission of annual reports by such
recipients concerning the effectiveness of programs
carried out under this section.
``(2) Measures of outcomes.--
``(A) In general.--The Administrator shall develop
measures of outcomes to be applied by recipients of
assistance under this section, and the Administrator,
in evaluating the effectiveness of programs carried out
under this section. Such measures shall include student
and family measures as provided for in subparagraph (B)
and local educational measures as provided for under
subparagraph (C).
``(B) Student and family measures of outcomes.--The
measures of outcomes developed under paragraph (1)(B)
relating to students and families shall, with respect
to activities carried out under a program under this
section, at a minimum include provisions to evaluate
whether the program is effective in--
``(i) increasing social and emotional
competency;
``(ii) increasing academic competency (as
defined by the Secretary);
``(iii) reducing disruptive and aggressive
behaviors;
``(iv) improving child functioning;
``(v) reducing substance use disorders;
``(vi) reducing suspensions, truancy,
expulsions and violence;
``(vii) increasing graduation rates (as
defined in section 1111(b)(2)(C)(vi) of the
Elementary and Secondary Education Act of
1965); and
``(viii) improving access to care for
mental health disorders.
``(C) Local educational outcomes.--The outcome
measures developed under paragraph (1)(B) relating to
local educational systems shall, with respect to
activities carried out under a program under this
section, at a minimum include provisions to evaluate--
``(i) the effectiveness of comprehensive
school mental health programs established under
this section;
``(ii) the effectiveness of formal
partnership linkages among child and family
serving institutions, community support
systems, and the educational system;
``(iii) the progress made in sustaining the
program once funding under the grant has
expired;
``(iv) the effectiveness of training and
professional development programs for all
school personnel that incorporate indicators
that measure cultural and linguistic
competencies under the program in a manner that
incorporates appropriate cultural and
linguistic training;
``(v) the improvement in perception of a
safe and supportive learning environment among
school staff, students, and parents;
``(vi) the improvement in case-finding of
students in need of more intensive services and
referral of identified students to early
intervention and clinical services;
``(vii) the improvement in the immediate
availability of clinical assessment and
treatment services within the context of the
local community to students posing a danger to
themselves or others;
``(viii) the increased successful
matriculation to postsecondary school; and
``(ix) reduced referrals to juvenile
justice.
``(3) Submission of annual data.--An entity that receives a
grant, contract, or cooperative agreement under this section
shall annually submit to the Administrator a report that
includes data to evaluate the success of the program carried
out by the entity based on whether such program is achieving
the purposes of the program. Such reports shall utilize the
measures of outcomes under paragraph (2) in a reasonable manner
to demonstrate the progress of the program in achieving such
purposes.
``(4) Evaluation by administrator.--Based on the data
submitted under paragraph (3), the Administrator shall annually
submit to Congress a report concerning the results and
effectiveness of the programs carried out with assistance
received under this section.
``(5) Limitation.--A grantee shall use not to exceed 10
percent of amounts received under a grant under this section to
carry out evaluation activities under this subsection.
``(g) Information and Education.--The Secretary shall establish
comprehensive information and education programs to disseminate the
findings of the knowledge development and application under this
section to the general public and to health care professionals.
``(h) Amount of Grants and Authorization of Appropriations.--
``(1) Amount of grants.--A grant under this section shall
be in an amount that is not more than $1,000,000 for each of
fiscal years 2017 through 2021. The Secretary shall determine
the amount of each such grant based on the population of
children up to age 21 of the area to be served under the grant.
``(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section, $20,000,000 for
each of fiscal years 2017 through 2021.''.
(c) Conforming Amendment.--Part G of title V of the Public Health
Service Act (42 U.S.C. 290hh et seq.), as amended by this section, is
further amended by striking the part heading and inserting the
following:
``PART G--SCHOOL-BASED MENTAL HEALTH''.
SEC. 516. EXAMINING MENTAL HEALTH CARE FOR CHILDREN.
(a) In General.--Not later than one year after the date of
enactment of this Act, the Comptroller General of the United States
shall conduct an independent evaluation, and submit to the Committee on
Health, Education, Labor, and Pensions of the Senate and the Committee
on Energy and Commerce of the House of Representatives, a report
concerning the utilization of mental health services for children,
including the usage of psychotropic medications.
(b) Content.--The report submitted under subsection (a) shall
review and assess--
(1) the ways in which children access mental health care,
including information on whether children are screened and
treated by primary care or specialty physicians or other health
care providers, what types of referrals for additional care are
recommended, and any barriers to accessing this care;
(2) the extent to which children prescribed psychotropic
medications in the United States face barriers to more
comprehensive or other mental health services, interventions,
and treatments;
(3) the extent to which children are prescribed
psychotropic medications in the United States including the
frequency of concurrent medication usage; and
(4) the tools, assessments, and medications that are
available and used to diagnose and treat children with mental
health disorders.
SEC. 517. REPORTING COMPLIANCE STUDY.
(a) In General.--The Secretary of Health and Human Services shall
enter into an arrangement with the Institute of Medicine of the
National Academies (or, if the Institute declines, another appropriate
entity) under which, not later than 2 years after the date of enactment
of this Act, the Institute will submit to the appropriate committees of
Congress a report that evaluates the combined paperwork burden of--
(1) community mental health centers meeting the criteria
specified in section 1913(c) of the Public Health Service Act
(42 U.S.C. 300x-2), including such centers meeting such
criteria as in effect on the day before the date of enactment
of this Act; and
(2) federally qualified community mental health clinics
certified pursuant to section 223 of the Protecting Access to
Medicare Act of 2014 (Public Law 113-93), as amended by section
505.
(b) Scope.--In preparing the report under subsection (a), the
Institute of Medicine (or, if applicable, other appropriate entity)
shall examine licensing, certification, service definitions, claims
payment, billing codes, and financial auditing requirements used by the
Office of Management and Budget, the Centers for Medicare & Medicaid
Services, the Health Resources and Services Administration, the
Substance Abuse and Mental Health Services Administration, the Office
of the Inspector General of the Department of Health and Human
Services, State Medicaid agencies, State departments of health, State
departments of education, and State and local juvenile justice, social
service agencies, and private insurers to--
(1) establish an estimate of the combined nationwide cost
of complying with such requirements, in terms of both
administrative funding and staff time;
(2) establish an estimate of the per capita cost to each
center or clinic described in subparagraph (A) or (B) of
paragraph (1) to comply with such requirements, in terms of
both administrative funding and staff time; and
(3) make administrative and statutory recommendations to
Congress (which recommendations may include a uniform
methodology) to reduce the paperwork burden experienced by
centers and clinics described in subparagraph (A) or (B) of
paragraph (1).
SEC. 518. STRENGTHENING CONNECTIONS TO COMMUNITY CARE DEMONSTRATION
GRANT PROGRAM.
(a) In General.--The Secretary of Health and Human Services, acting
through the Substance Abuse and Mental Health Services Administration,
shall establish a demonstration grant program to award grants to
eligible entities to help to connect incarcerated and recently released
individuals with mental illness or substance use disorders with
community-based treatment providers and coverage opportunities upon
release from a corrections facility.
(b) Design.--The demonstration grant program under this section
shall be designed to ensure that incarcerated and recently released
individuals with mental illness or substance use disorders have the
information and help they need to connect to community-based care and
coverage upon release from a corrections facility.
(c) Recipients.--To be eligible to receive a grant under this
section, an entity shall be a State Medicaid agency, State mental
health agency, State substance abuse agency, county, city, nonprofit
community-based organization, or any other entity the Secretary deems
appropriate.
(d) Application Requirement.--To seek an award under this section,
an applicant shall provide a plan detailing the applicant's strategy
for carrying out the program to be funded through the award.
(e) Special Considerations.--In awarding grants under this section,
the Secretary may consider--
(1) the number of individuals or correctional facilities
proposed to be served; and
(2) the potential for replicability of the model proposed.
(f) Reports.--
(1) Annual reports.--As a condition of receiving a grant
under this section, an eligible entity shall agree to submit a
report to the Secretary, on an annual basis, describing the
activities carried out with the grant and assessing the
effectiveness of such activities. Such information shall
include--
(A) the number of individuals served with mental
illness, serious mental illness, substance use
disorders, or co-occurring mental health and substance
use disorders;
(B) the number of connections completed between
individuals and community-based providers;
(C) the number of connections completed between
individuals and community-based coverage; and
(D) any other information required by the
Secretary.
(2) Secretary.--The Secretary shall, on an annual basis,
and using the reports received under paragraph (1), report to
Congress on the overall impact and effectiveness of the grant
program under this section.
(3) Final report.--Not later than January 15, 2020, the
Secretary shall submit to Congress a final report that includes
recommendations with respect to the feasibility and
advisability of extending or expanding the grant program under
this section. The report shall also provide an assessment of
which programs and program elements proved most effective.
(g) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated to carry out this section
$5,000,000 for each of fiscal years 2017 through 2021.
SEC. 519. ASSERTIVE COMMUNITY TREATMENT GRANT PROGRAM FOR INDIVIDUALS
WITH SERIOUS MENTAL ILLNESS.
(a) In General.--The Secretary of Health and Human Services, acting
through the Substance Abuse and Mental Health Services Administration,
shall award grants to eligible entities--
(1) to establish assertive community treatment programs for
individuals with serious mental illness; or
(2) to maintain or expand such programs.
(b) Eligible Entities.--To be eligible to receive a grant under
this section, an entity shall be a State, county, city, tribes, tribal
organizations, mental health system, health care facility, or any other
entity the Secretary deems appropriate.
(c) Special Consideration.--In selecting among applicants for a
grant under this section, the Secretary may give special consideration
to the potential of the applicant's program to reduce hospitalization,
homelessness, incarceration, and interaction with the criminal justice
system while improving the health and social outcomes of the patient.
(d) Additional Activities.--The Secretary shall--
(1) at the conclusion of each fiscal year, submit a report
to the appropriate congressional committees on the grant
program under this section, including an evaluation of--
(A) cost savings and public health outcomes such as
mortality, suicide, substance abuse, hospitalization,
and use of services;
(B) rates of incarceration of patients;
(C) rates of homelessness among patients; and
(D) patient and family satisfaction with program
participation; and
(2) provide appropriate information, training, and
technical assistance to grant recipients under this section to
help such recipients to establish, maintain, or expand their
assertive community treatment programs.
(e) Authorization of Appropriations.--
(1) In general.--To carry out this section, there is
authorized to be appropriated $20,000,000 for each of fiscal
years 2017 through 2021.
(2) Use of certain funds.--Of the funds appropriated to
carry out this section in any fiscal year, no more than 5
percent shall be available to the Secretary for carrying out
subsection (d).
SEC. 520. IMPROVING MENTAL AND BEHAVIORAL HEALTH ON COLLEGE CAMPUSES.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.)
is amended by inserting after section 520E-3, as added by section 111
of this Act, the following:
``SEC. 520E-4. GRANTS TO IMPROVE MENTAL AND BEHAVIORAL HEALTH ON
COLLEGE CAMPUSES.
``(a) Purpose.--It is the purpose of this section, with respect to
college and university settings, to--
``(1) increase access to mental and behavioral health
services;
``(2) foster and improve the prevention of mental and
behavioral health disorders, and the promotion of mental health
wellness;
``(3) improve the identification and treatment for students
at risk;
``(4) improve collaboration and the development of
appropriate levels of mental and behavioral health care;
``(5) reduce the stigma for students with mental health
disorders and enhance their access to mental health services;
and
``(6) improve the efficacy of outreach efforts.
``(b) Grants.--The Secretary, acting through the Administrator and
in consultation with the Secretary of Education, shall award
competitive grants to eligible entities to improve mental and
behavioral health services and outreach on college and university
campuses.
``(c) Eligibility.--To be eligible to receive a grant under
subsection (b), an entity shall--
``(1) be an institution of higher education (as defined in
section 101 of the Higher Education Act of 1965 (20 U.S.C.
1001)); and
``(2) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require, including the information required under
subsection (d).
``(d) Application.--An application for a grant under this section
shall include--
``(1) a description of the population to be targeted by the
program carried out under the grant, the particular mental and
behavioral health needs of the students involved;
``(2) a description of the Federal, State, local, private,
and institutional resources available for meeting the needs of
such students at the time the application is submitted;
``(3) an outline of the objectives of the program carried
out under the grant;
``(4) a description of activities, services, and training
to be provided under the program, including planned outreach
strategies to reach students not currently seeking services;
``(5) a plan to seek input from community mental health
providers, when available, community groups, and other public
and private entities in carrying out the program;
``(6) a plan, when applicable, to meet the specific mental
and behavioral health needs of veterans attending institutions
of higher education;
``(7) a description of the methods to be used to evaluate
the outcomes and effectiveness of the program; and
``(8) an assurance that grant funds will be used to
supplement, and not supplant, any other Federal, State, or
local funds available to carry out activities of the type
carried out under the grant.
``(e) Special Considerations.--In awarding grants under this
section, the Secretary shall give special consideration to applications
that describe programs to be carried out under the grant that--
``(1) demonstrate the greatest need for new or additional
mental and behavioral health services, in part by providing
information on current ratios of students to mental and
behavioral health professionals;
``(2) propose effective approaches for initiating or
expanding campus services and supports using evidence-based
practices;
``(3) target traditionally underserved populations and
populations most at risk;
``(4) where possible, demonstrate an awareness of, and a
willingness to, coordinate with a community mental health
center or other mental health resource in the community, to
support screening and referral of students requiring intensive
services;
``(5) identify how the college or university will address
psychiatric emergencies, including how information will be
communicated with families or other appropriate parties;
``(6) propose innovative practices that will improve
efficiencies in clinical care, broaden collaborations with
primary care, or improve prevention programs; and
``(7) demonstrate the greatest potential for replication
and dissemination.
``(f) Use of Funds.--Amounts received under a grant under this
section may be used to--
``(1) provide mental and behavioral health services to
students, including prevention, promotion of mental health,
voluntary screening, early intervention, voluntary assessment,
voluntary treatment, management, and education services
relating to the mental and behavioral health of students;
``(2) conduct research through a counseling or health
center at the institution of higher education involved
regarding improving the mental and behavioral health of college
and university students through clinical services, outreach,
prevention, or academic success;
``(3) provide outreach services to notify students about
the existence of mental and behavioral health services;
``(4) educate students, families, faculty, staff, and
communities to increase awareness of mental health issues;
``(5) support student groups on campus that engage in
activities to educate students, including activities to reduce
stigma surrounding mental and behavioral disorders, and promote
mental health wellness;
``(6) employ appropriately trained staff;
``(7) provide training to students, faculty, and staff to
respond effectively to students with mental and behavioral
health issues;
``(8) expand mental health training through internship,
post-doctorate, and residency programs;
``(9) develop and support evidence-based and emerging best
practices, including a focus on culturally and linguistically
appropriate best practices; and
``(10) evaluate and disseminate best practices to other
colleges and universities.
``(g) Duration of Grants.--A grant under this section shall be
awarded for a period not to exceed 3 years.
``(h) Evaluation and Reporting.--
``(1) Evaluation.--Not later than 18 months after the date
on which a grant is received under this section, the eligible
entity involved shall submit to the Secretary the results of an
evaluation to be conducted by the entity (or by another party
under contract with the entity) concerning the effectiveness of
the activities carried out under the grant and plans for the
sustainability of such efforts.
``(2) Report.--Not later than 2 years after the date of
enactment of this section, the Secretary shall submit to the
appropriate committees of Congress a report concerning the
results of--
``(A) the evaluations conducted under paragraph
(1); and
``(B) an evaluation conducted by the Secretary to
analyze the effectiveness and efficacy of the
activities conducted with grants under this section.
``(i) Technical Assistance.--The Secretary may provide technical
assistance to grantees in carrying out this section.
``(j) Authorization of Appropriations.--There are authorized to be
appropriated $15,000,000 for each of fiscal years 2017 through 2021.''.
SEC. 521. INCLUSION OF OCCUPATIONAL THERAPISTS IN NATIONAL HEALTH
SERVICE CORPS PROGRAM.
(a) Inclusion of Occupational Therapists.--Section 331(a)(3)(E)(i)
of the Public Health Service Act (42 U.S.C. 254d(a)(3)(E)(i)) is
amended by inserting ``subject to section 521(b)(2) of the
Comprehensive Behavioral Health Reform and Recovery Act of 2016,
occupational therapists,'' after ``psychiatric nurse specialists,''.
(b) Effective Date; Contingent Implementation.--
(1) Effective date.--Subject to paragraph (2), the
amendment made by subsection (a) shall apply beginning on
October 1, 2016.
(2) Contingent implementation.--The amendment made by
subsection (a) shall apply with respect to obligations entered
into for a fiscal year after fiscal year 2016 only if the total
amount made available for the purpose of carrying out subparts
II and III of part D of title III of the Public Health Service
Act (42 U.S.C. 254d et seq.) for such fiscal year is greater
than the total amount made available for such purpose for
fiscal year 2016.
TITLE VI--IMPROVING MENTAL HEALTH RESEARCH AND COORDINATION
SEC. 601. INCREASE IN FUNDING FOR CERTAIN RESEARCH.
Section 402A(a) of the Public Health Service Act (42 U.S.C.
282a(a)) is amended by adding at the end the following:
``(3) Funding for the brain initiative at the national
institute of mental health.--
``(A) Funding.--In addition to amounts made
available pursuant to paragraphs (1) and (2), there are
authorized to be appropriated to the National Institute
of Mental Health for the purpose described in
subparagraph (B)(ii) $40,000,000 for each of fiscal
years 2017 through 2021.
``(B) Purposes.--Amounts appropriated pursuant to
subparagraph (A) shall be used exclusively for the
purpose of conducting or supporting--
``(i) research on the determinants of self-
and other directed-violence in mental illness,
including studies directed at the causes of
such violence and at intervention to reduce the
risk of self harm, suicide, and interpersonal
violence; or
``(ii) brain research through the Brain
Research through Advancing Innovative
Neurotechnologies Initiative.''.
TITLE VII--BEHAVIORAL HEALTH INFORMATION TECHNOLOGY
SEC. 701. EXTENSION OF HEALTH INFORMATION TECHNOLOGY ASSISTANCE FOR
BEHAVIORAL AND MENTAL HEALTH AND SUBSTANCE ABUSE.
Section 3000(3) of the Public Health Service Act (42 U.S.C.
300jj(3)) is amended by inserting before ``and any other category'' the
following: ``behavioral and mental health professionals (as defined in
section 331(a)(3)(E)(i)), a substance abuse professional, a psychiatric
hospital (as defined in section 1861(f) of the Social Security Act), a
community mental health center meeting the criteria specified in
section 1913(c), a residential or outpatient mental health or substance
use treatment facility,''.
SEC. 702. EXTENSION OF ELIGIBILITY FOR MEDICARE AND MEDICAID HEALTH
INFORMATION TECHNOLOGY IMPLEMENTATION ASSISTANCE.
(a) Payment Incentives for Eligible Professionals Under Medicare.--
Section 1848 of the Social Security Act (42 U.S.C. 1395w-4) is
amended--
(1) in subsection (a)(7)--
(A) in subparagraph (E), by adding at the end the
following new clause:
``(iv) Additional eligible professional.--
The term `additional eligible professional'
means a clinical psychologist providing
qualified psychologist services (as defined in
section 1861(ii)).''; and
(B) by adding at the end the following new
subparagraph:
``(F) Application to additional eligible
professionals.--The Secretary shall apply the
provisions of this paragraph with respect to an
additional eligible professional in the same manner as
such provisions apply to an eligible professional,
except in applying subparagraph (A)--
``(i) in clause (i), the reference to 2015
shall be deemed a reference to 2020;
``(ii) in clause (ii), the references to
2015, 2016, and 2017 shall be deemed references
to 2020, 2021, and 2022, respectively; and
``(iii) in clause (iii), the reference to
2018 shall be deemed a reference to 2023.'';
and
(2) in subsection (o)--
(A) in paragraph (5), by adding at the end the
following new subparagraph:
``(D) Additional eligible professional.--The term
`additional eligible professional' means a clinical
psychologist providing qualified psychologist services
(as defined in section 1861(ii)).''; and
(B) by adding at the end the following new
paragraph:
``(6) Application to additional eligible professionals.--
The Secretary shall apply the provisions of this subsection
with respect to an additional eligible professional in the same
manner as such provisions apply to an eligible professional,
except in applying--
``(A) paragraph (1)(A)(ii), the reference to 2016
shall be deemed a reference to 2021;
``(B) paragraph (1)(B)(ii), the references to 2011
and 2012 shall be deemed references to 2016 and 2017,
respectively;
``(C) paragraph (1)(B)(iii), the references to 2013
shall be deemed references to 2018;
``(D) paragraph (1)(B)(v), the references to 2014
shall be deemed references to 2019; and
``(E) paragraph (1)(E), the reference to 2011 shall
be deemed a reference to 2016.''.
(b) Eligible Hospitals.--Section 1886 of the Social Security Act
(42 U.S.C. 1395ww) is amended--
(1) in subsection (b)(3)(B)(ix), by adding at the end the
following new subclause:
``(V) The Secretary shall apply the
provisions of this subsection with
respect to an additional eligible
hospital (as defined in subsection
(n)(6)(C)) in the same manner as such
provisions apply to an eligible
hospital, except in applying--
``(aa) subclause (I), the
references to 2015, 2016, and
2017 shall be deemed references
to 2020, 2021, and 2022,
respectively; and
``(bb) subclause (III), the
reference to 2015 shall be
deemed a reference to 2020.'';
and
(2) in subsection (n)--
(A) in paragraph (6), by adding at the end the
following new subparagraph:
``(C) Additional eligible hospital.--The term
`additional eligible hospital' means an inpatient
hospital that is a psychiatric hospital (as defined in
section 1861(f)).''; and
(B) by adding at the end the following new
paragraph:
``(7) Application to additional eligible hospitals.--The
Secretary shall apply the provisions of this subsection with
respect to an additional eligible hospital in the same manner
as such provisions apply to an eligible hospital, except in
applying--
``(A) paragraph (2)(E)(ii), the references to 2013
and 2015 shall be deemed references to 2018 and 2020,
respectively; and
``(B) paragraph (2)(G)(i), the reference to 2011
shall be deemed a reference to 2016.''.
(c) Medicaid Providers.--Section 1903(t) of the Social Security Act
(42 U.S.C. 1396b(t)) is amended--
(1) in paragraph (2)(B)--
(A) in clause (i), by striking ``, or'' at the end
and inserting a semicolon;
(B) in clause (ii), by striking the period at the
end and inserting a semicolon; and
(C) by inserting after clause (ii) the following
new clauses:
``(iii) a public hospital that is principally a
psychiatric hospital (as defined in section 1861(f));
``(iv) a private hospital that is principally a
psychiatric hospital (as defined in section 1861(f))
and that has at least 10 percent of its patient volume
(as estimated in accordance with a methodology
established by the Secretary) attributable to
individuals receiving medical assistance under this
title;
``(v) a community mental health center meeting the
criteria specified in section 1913(c) of the Public
Health Service Act; or
``(vi) a residential or outpatient mental health or
substance use treatment facility that--
``(I) is accredited by the Joint Commission
on Accreditation of Healthcare Organizations,
the Commission on Accreditation of
Rehabilitation Facilities, the Council on
Accreditation, or any other national
accrediting agency recognized by the Secretary;
and
``(II) has at least 10 percent of its
patient volume (as estimated in accordance with
a methodology established by the Secretary)
attributable to individuals receiving medical
assistance under this title.''; and
(2) in paragraph (3)(B)--
(A) in clause (iv), by striking ``; and'' at the
end and inserting a semicolon;
(B) in clause (v), by striking the period at the
end and inserting ``; and''; and
(C) by adding at the end the following new clause:
``(vi) clinical psychologist providing qualified
psychologist services (as defined in section 1861(ii)),
if such clinical psychologist is practicing in an
outpatient clinic that--
``(I) is led by a clinical psychologist;
and
``(II) is not otherwise receiving payment
under paragraph (1) as a Medicaid provider
described in paragraph (2)(B).''.
(d) Medicare Advantage Organizations.--Section 1853 of the Social
Security Act (42 U.S.C. 1395w-23) is amended--
(1) in subsection (l)--
(A) in paragraph (1)--
(i) by inserting ``or additional eligible
professionals (as described in paragraph (9))''
after ``paragraph (2)''; and
(ii) by inserting ``and additional eligible
professionals'' before ``under such sections'';
(B) in paragraph (3)(B)--
(i) in clause (i) in the matter preceding
subclause (I), by inserting ``or an additional
eligible professional described in paragraph
(9)'' after ``paragraph (2)''; and
(ii) in clause (ii)--
(I) in the matter preceding
subclause (I), by inserting ``or an
additional eligible professional
described in paragraph (9)'' after
``paragraph (2)''; and
(II) in subclause (I), by inserting
``or an additional eligible
professional, respectively,'' after
``eligible professional'';
(C) in paragraph (3)(C), by inserting ``and
additional eligible professionals'' after ``all
eligible professionals'';
(D) in paragraph (4)(D), by adding at the end the
following new sentence: ``In the case that a qualifying
MA organization attests that not all additional
eligible professionals of the organization are
meaningful EHR users with respect to an applicable
year, the Secretary shall apply the payment adjustment
under this paragraph based on the proportion of all
such additional eligible professionals of the
organization that are not meaningful EHR users for such
year.'';
(E) in paragraph (6)(A), by inserting ``and, as
applicable, each additional eligible professional
described in paragraph (9)'' after ``paragraph (2)'';
(F) in paragraph (6)(B), by inserting ``and, as
applicable, each additional eligible hospital described
in paragraph (9)'' after ``subsection (m)(1)'';
(G) in paragraph (7)(A), by inserting ``and, as
applicable, additional eligible professionals'' after
``eligible professionals'';
(H) in paragraph (7)(B), by inserting ``and, as
applicable, additional eligible professionals'' after
``eligible professionals'';
(I) in paragraph (8)(B), by inserting ``and
additional eligible professionals described in
paragraph (9)'' after ``paragraph (2)''; and
(J) by adding at the end the following new
paragraph:
``(9) Additional eligible professional described.--With
respect to a qualifying MA organization, an additional eligible
professional described in this paragraph is an additional
eligible professional (as defined for purposes of section
1848(o)) who--
``(A)(i) is employed by the organization; or
``(ii)(I) is employed by, or is a partner of, an
entity that through contract with the organization
furnishes at least 80 percent of the entity's Medicare
patient care services to enrollees of such
organization; and
``(II) furnishes at least 80 percent of the
professional services of the additional eligible
professional covered under this title to enrollees of
the organization; and
``(B) furnishes, on average, at least 20 hours per
week of patient care services.''; and
(2) in subsection (m)--
(A) in paragraph (1)--
(i) by inserting ``or additional eligible
hospitals (as described in paragraph (7))''
after ``paragraph (2)''; and
(ii) by inserting ``and additional eligible
hospitals'' before ``under such sections'';
(B) in paragraph (3)(A)(i), by inserting ``or
additional eligible hospital'' after ``eligible
hospital'';
(C) in paragraph (3)(A)(ii), by inserting ``or an
additional eligible hospital'' after ``eligible
hospital'' in each place it occurs;
(D) in paragraph (3)(B)--
(i) in clause (i), by inserting ``or an
additional eligible hospital described in
paragraph (7)'' after ``paragraph (2)''; and
(ii) in clause (ii)--
(I) in the matter preceding
subclause (I), by inserting ``or an
additional eligible hospital described
in paragraph (7)'' after ``paragraph
(2)''; and
(II) in subclause (I), by inserting
``or an additional eligible hospital,
respectively,'' after ``eligible
hospital'';
(E) in paragraph (4)(A), by inserting ``or one or
more additional eligible hospitals (as defined in
section 1886(n)), as appropriate,'' after ``section
1886(n)(6)(A))'';
(F) in paragraph (4)(D), by adding at the end the
following new sentence: ``In the case that a qualifying
MA organization attests that not all additional
eligible hospitals of the organization are meaningful
EHR users with respect to an applicable period, the
Secretary shall apply the payment adjustment under this
paragraph based on the methodology specified by the
Secretary, taking into account the proportion of such
additional eligible hospitals, or discharges from such
hospitals, that are not meaningful EHR users for such
period.'';
(G) in paragraph (5)(A), by inserting ``and, as
applicable, each additional eligible hospital described
in paragraph (7)'' after ``paragraph (2)'';
(H) in paragraph (5)(B), by inserting ``and
additional eligible hospitals, as applicable,'' after
``eligible hospitals'';
(I) in paragraph (6)(B), by inserting ``and
additional eligible hospitals described in paragraph
(7)'' after ``paragraph (2)''; and
(J) by adding at the end the following new
paragraph:
``(7) Additional eligible hospital described.--With respect
to a qualifying MA organization, an additional eligible
hospital described in this paragraph is an additional eligible
hospital (as defined in section 1886(n)(6)(C)) that is under
common corporate governance with such organization and serves
individuals enrolled under an MA plan offered by such
organization.''.
TITLE VIII--MAKING PARITY WORK
SEC. 801. STRENGTHENING PARITY IN MENTAL HEALTH AND SUBSTANCE USE
DISORDER BENEFITS.
(a) Public Health Service Act.--Section 2726(a) of the Public
Health Service Act (42 U.S.C. 300gg-26(a)) is amended by adding at the
end the following new paragraphs:
``(6) Disclosure and enforcement requirements.--
``(A) Disclosure requirements.--
``(i) Regulations.--Not later than December
31, 2016, the Secretary, in cooperation with
the Secretaries of Labor and the Treasury, as
appropriate, shall issue additional regulations
for carrying out this section, including an
explanation of documents that must be disclosed
by plans and issuers, the process governing
such disclosures by plans and issuers, and
analyses that must be conducted by plans and
issuers by a group health plan or health
insurance issuer offering health insurance
coverage in the group or individual market in
order for such plan or issuer to demonstrate
compliance with the provisions of this section.
``(ii) Disclosure requirements.--Documents
required to be disclosed by a group health plan
or health insurance issuer offering health
insurance coverage in the group or individual
market under clause (i) shall include an annual
report that details the specific analyses
performed to ensure compliance of such plan or
coverage with the law and regulations. At a
minimum, with respect to the application of
non-quantitative treatment limitations (in this
paragraph referred to as NQTLs) to benefits
under the plan or coverage, such report shall--
``(I) identify the specific factors
the plan or coverage used in performing
its NQTL analysis;
``(II) identify and define the
specific evidentiary standards relied
on to evaluate the factors;
``(III) describe how the
evidentiary standards are applied to
each service category for mental
health, substance use disorders,
medical benefits, and surgical
benefits;
``(IV) disclose the results of the
analyses of the specific evidentiary
standards in each service category; and
``(V) disclose the specific
findings of the plan or coverage in
each service category and the
conclusions reached with respect to
whether the processes, strategies,
evidentiary standards, or other factors
used in applying the NQTL to mental
health or substance use disorder
benefits are comparable to, and applied
no more stringently than, the
processes, strategies, evidentiary
standards, or other factors used in
applying the limitation with respect to
medical and surgical benefits in the
same classification.
``(iii) Guidance.--The Secretary, in
cooperation with the Secretaries of Labor and
the Treasury, as appropriate, shall issue
guidance to group health plans and health
insurance issuers offering health insurance
coverage in the group or individual markets on
how to satisfy the requirements of this section
with respect to making information available to
current and potential participants and
beneficiaries. Such information shall include
certificate of coverage documents and
instruments under which the plan or coverage
involved is administered and operated that
specify, include, or refer to procedures,
formulas, and methodologies applied to
determine a participant or beneficiary's
benefit under the plan or coverage, regardless
of whether such information is contained in a
document designated as the `plan document'.
Such guidance shall include a disclosure of how
the plan or coverage involved has provided that
processes, strategies, evidentiary standards,
and other factors used in applying the NQTL to
mental health or substance use disorder
benefits are comparable to, and applied no more
stringently than, the processes, strategies,
evidentiary standards, or other factors used in
applying the limitation with respect to medical
and surgical benefits in the same
classification.
``(iv) Definitions.--In this paragraph and
paragraph (7), the terms `non-quantitative
treatment limitations', `comparable to', and
`applied no more stringently than' have the
meanings given such terms in sections 146 and
147 of title 45, Code of Federal Regulations
(or any successor regulation).
``(B) Enforcement.--
``(i) Process for complaints.--The
Secretary, in cooperation with the Secretaries
of Labor and the Treasury, as appropriate,
shall, with respect to group health plans and
health insurance issuers offering health
insurance coverage in the group or individual
market, issue guidance to clarify the process
and timeline for current and potential
participants and beneficiaries (and authorized
representatives and health care providers of
such participants and beneficiaries) with
respect to such plans and coverage to file
formal complaints of such plans or issuers
being in violation of this section, including
guidance, by plan type, on the relevant State,
regional, and national offices with which such
complaints should be filed.
``(ii) Authority for public enforcement.--
The Secretary, in consultation with the
Secretaries of Labor and the Treasury, shall
make available to the public on the Consumer
Parity Portal website established under
paragraph (7) de-identified information on
audits and investigations of group health plans
and health insurance issuers conducted under
this section.
``(iii) Audits.--
``(I) Randomized audits.--The
Secretary in cooperation with the
Secretaries of Labor and the Treasury,
is authorized to conduct randomized
audits of group health plans and health
insurance issuers offering health
insurance coverage in the group or
individual market to determine
compliance with this section. Such
audits shall be conducted on no fewer
than twelve plans and issuers per plan
year. Information from such audits
shall be made plainly available on the
Consumer Parity Portal website
established under paragraph (7).
``(II) Additional audits.--In the
case of a group health plan or health
insurance issuer offering health
insurance coverage in the group or
individual market with respect to which
any claim has been filed during a plan
year, the Secretary may audit the books
and records of such plan or issuer to
determine compliance with this section.
Information detailing the results of
the audit shall be made available on
the Consumer Parity Portal website
established under paragraph (7).
``(iv) Denial rates.--The Secretary shall
collect information on the rates of and reasons
for denial by group health plans and health
insurance issuers offering health insurance
coverage in the group or individual market of
claims for outpatient and inpatient mental
health and substance use disorder services
compared to the rates of and reasons for denial
of claims for medical and surgical services.
For the first plan year beginning at least two
years after the date of the enactment of this
paragraph and each subsequent plan year, the
Secretary shall submit to the Committee on
Energy and Commerce of the House of
Representatives and the Committee on Health,
Education, Labor, and Pensions of the Senate,
and make plainly available on the Consumer
Parity Portal website under paragraph (7), the
information collected under the previous
sentence with respect to the previous plan
year.
``(7) Consumer parity portal website.--The Secretary, in
consultation with the Secretaries of Labor and the Treasury,
shall establish a one-stop Internet website portal for--
``(A) submitting complaints and violations relating
to this section, section 712 of the Employee Retirement
Income Security Act of 1974, and section 9812 of the
Internal Revenue Code of 1986; and
``(B) for each of such Secretaries to submit
information in order to provide such information to
health care consumers pursuant to paragraph (6),
section 712(a)(6) of the Employee Retirement Income
Security Act of 1974, and section 9812(a)(6) of the
Internal Revenue Code of 1986.
Such portal shall have the ability to take basic information
related to the complaint, including name, contact information,
and brief narrative, and transmit such information in a timely
fashion to the appropriate State or Federal enforcement agency.
Once the consumer information is submitted, such portal shall
provide the consumer with contact information for the
appropriate enforcement agency to follow-up on the
complaint.''.
(b) Employee Retirement Income Security Act of 1974.--Section
712(a) of the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1185a(a)) is amended by adding at the end the following new
paragraph:
``(6) Disclosure and enforcement requirements.--
``(A) Disclosure requirements.--
``(i) Regulations.--Not later than December
31, 2016, the Secretary, in cooperation with
the Secretaries of Health and Human Services
and the Treasury, as appropriate, shall issue
additional regulations for carrying out this
section, including an explanation of documents
that must be disclosed by plans and issuers,
the process governing such disclosures by plans
and issuers, and analyses that must be
conducted by plans and issuers by a group
health plan (or health insurance coverage
offered in connection with such a plan) in
order for such plan or issuer to demonstrate
compliance with the provisions of this section.
``(ii) Disclosure requirements.--Documents
required to be disclosed by a group health plan
(or health insurance coverage offered in
connection with such a plan) under clause (i)
shall include an annual report that details the
specific analyses performed to ensure
compliance of such plan or coverage with the
law or regulations. At a minimum, with respect
to the application of non-quantitative
treatment limitations (in this paragraph
referred to as NQTLs) to benefits under the
plan or coverage, such report shall--
``(I) identify the specific factors
the plan or coverage used in performing
its NQTL analysis;
``(II) identify and define the
specific evidentiary standards relied
on to evaluate the factors;
``(III) describe how the
evidentiary standards are applied to
each service category for mental
health, substance use disorders,
medical benefits, and surgical
benefits;
``(IV) disclose the results of the
analyses of the specific evidentiary
standards in each service category; and
``(V) disclose the specific
findings of the plan or coverage in
each service category and the
conclusions reached with respect to
whether the processes, strategies,
evidentiary standards, or other factors
used in applying the NQTL to mental
health or substance use disorder
benefits are comparable to, and applied
no more stringently than, the
processes, strategies, evidentiary
standards, or other factors used in
applying the limitation with respect to
medical and surgical benefits in the
same classification.
``(iii) Guidance.--The Secretary, in
cooperation with the Secretaries of Health and
Human Services and the Treasury, as
appropriate, shall issue guidance to group
health plans (and health insurance coverage
offered in connection with such a plan) on how
to satisfy the requirements of this section
with respect to making information available to
current and potential participants and
beneficiaries. Such information shall include
certificate of coverage documents and
instruments under which the plan or coverage
involved is administered and operated that
specify, include, or refer to procedures,
formulas, and methodologies applied to
determine a participant or beneficiary's
benefit under the plan or coverage, regardless
of whether such information is contained in a
document designated as the `plan document'.
Such guidance shall include a disclosure of how
the plan or coverage involved has provided that
processes, strategies, evidentiary standards,
and other factors used in applying the NQTL to
mental health or substance use disorder
benefits are comparable to, and applied no more
stringently than, the processes, strategies,
evidentiary standards, or other factors used in
applying the limitation with respect to medical
and surgical benefits in the same
classification.
``(iv) Definitions.--In this paragraph, the
terms `non-quantitative treatment limitations',
`comparable to', and `applied no more
stringently than' have the meanings given such
terms in sections 146 and 147 of title 45, Code
of Federal Regulations (or any successor
regulation).
``(B) Enforcement.--
``(i) Process for complaints.--The
Secretary, in cooperation with the Secretaries
of Health and Human Services and the Treasury,
as appropriate, shall, with respect to group
health plans (and health insurance coverage
offered in connection with such a plan), issue
guidance to clarify the process and timeline
for current and potential participants and
beneficiaries (and authorized representatives
and health care providers of such participants
and beneficiaries) with respect to such plans
(and coverage) to file formal complaints of
such plans (or coverage) being in violation of
this section, including guidance, by plan type,
on the relevant State, regional, and national
offices with which such complaints should be
filed.
``(ii) Authority for public enforcement.--
The Secretary, in consultation with the
Secretaries of Labor and the Treasury, shall
make available to the public on the Consumer
Parity Portal website established under section
2726(a)(7) of the Public Health Service Act de-
identified information on audits and
investigations of group health plans (and
health insurance coverage offered in connection
with such a plan) conducted under this section.
``(iii) Audits.--
``(I) Randomized audits.--The
Secretary in cooperation with the
Secretaries of Health and Human
Services and the Treasury, is
authorized to conduct randomized audits
of group health plans (and health
insurance coverage offered in
connection with such a plan) to
determine compliance with this section.
Such audits shall be conducted on no
fewer than twelve plans and coverage
per plan year. Information from such
audits shall be made plainly available
on the Consumer Parity Portal website
established under section 2726(a)(7) of
the Public Health Service Act.
``(II) Additional audits.--In the
case of a group health plan (or health
insurance coverage offered in
connection with such a plan) with
respect to which any claim has been
filed during a plan year, the Secretary
may audit the books and records of such
plan (or coverage) to determine
compliance with this section.
Information detailing the results of
the audit shall be made available on
the Consumer Parity Portal website
established under section 2726(a)(7) of
the Public Health Service Act.
``(iv) Denial rates.--The Secretary shall
collect information on the rates of and reasons
for denial by group health plans (and health
insurance coverage offered in connection with
such a plan) of claims for outpatient and
inpatient mental health and substance use
disorder services compared to the rates of and
reasons for denial of claims for medical and
surgical services. For the first plan year
beginning at least two years after the date of
the enactment of this paragraph and each
subsequent plan year, the Secretary shall
submit to the Committee on Energy and Commerce
of the House of Representatives and the
Committee on Health, Education, Labor, and
Pensions of the Senate, and make plainly
available on the Consumer Parity Portal website
under section 2726(a)(7) of the Public Health
Service Act, the information collected under
the previous sentence with respect to the
previous plan year.''.
(c) Internal Revenue Code of 1986.--Section 9812(a) of the Internal
Revenue Code of 1986 is amended by adding at the end the following new
paragraph:
``(6) Disclosure and enforcement requirements.--
``(A) Disclosure requirements.--
``(i) Regulations.--Not later than December
31, 2016, the Secretary, in cooperation with
the Secretaries of Health and Human Services
and Labor, as appropriate, shall issue
additional regulations for carrying out this
section, including an explanation of documents
that must be disclosed by plans and issuers,
the process governing such disclosures by plans
and issuers, and analyses that must be
conducted by plans and issuers by a group
health plan in order for such plan to
demonstrate compliance with the provisions of
this section.
``(ii) Disclosure requirements.--Documents
required to be disclosed by a group health plan
under clause (i) shall include an annual report
that details the specific analyses performed to
ensure compliance of such plan with the law and
regulations. At a minimum, with respect to the
application of non-quantitative treatment
limitations (in this paragraph referred to as
NQTLs) to benefits under the plan or coverage,
such report shall--
``(I) identify the specific factors
the plan or coverage used in performing
its NQTL analysis;
``(II) identify and define the
specific evidentiary standards relied
on to evaluate the factors;
``(III) describe how the
evidentiary standards are applied to
each service category for mental
health, substance use disorders,
medical benefits, and surgical
benefits;
``(IV) disclose the results of the
analyses of the specific evidentiary
standards in each service category; and
``(V) disclose the specific
findings of the plan in each service
category and the conclusions reached
with respect to whether the processes,
strategies, evidentiary standards, or
other factors used in applying the NQTL
to mental health or substance use
disorder benefits are comparable to,
and applied no more stringently than,
the processes, strategies, evidentiary
standards, or other factors used in
applying the limitation with respect to
medical and surgical benefits in the
same classification.
``(iii) Guidance.--The Secretary, in
cooperation with the Secretaries of Health and
Human Services and Labor, as appropriate, shall
issue guidance to group health plans on how to
satisfy the requirements of this section with
respect to making information available to
current and potential participants and
beneficiaries. Such information shall include
certificate of coverage documents and
instruments under which the plan involved is
administered and operated that specify,
include, or refer to procedures, formulas, and
methodologies applied to determine a
participant or beneficiary's benefit under the
plan, regardless of whether such information is
contained in a document designated as the `plan
document'. Such guidance shall include a
disclosure of how the plan involved has
provided that processes, strategies,
evidentiary standards, and other factors used
in applying the NQTL to mental health or
substance use disorder benefits are comparable
to, and applied no more stringently than, the
processes, strategies, evidentiary standards,
or other factors used in applying the
limitation with respect to medical and surgical
benefits in the same classification.
``(iv) Definitions.--In this paragraph, the
terms `non-quantitative treatment limitations',
`comparable to', and `applied no more
stringently than' have the meanings given such
terms in sections 146 and 147 of title 45, Code
of Federal Regulations (or any successor
regulation).
``(B) Enforcement.--
``(i) Process for complaints.--The
Secretary, in cooperation with the Secretaries
of Health and Human Services and Labor, as
appropriate, shall, with respect to group
health plans, issue guidance to clarify the
process and timeline for current and potential
participants and beneficiaries (and authorized
representatives and health care providers of
such participants and beneficiaries) with
respect to such plans (and coverage) to file
formal complaints of such plans being in
violation of this section, including guidance,
by plan type, on the relevant State, regional,
and national offices with which such complaints
should be filed.
``(ii) Authority for public enforcement.--
The Secretary, in consultation with the
Secretaries of Labor and the Treasury, shall
make available to the public on the Consumer
Parity Portal website established under section
2726(a)(7) of the Public Health Service Act de-
identified information on audits and
investigations of group health plans conducted
under this section.
``(iii) Audits.--
``(I) Randomized audits.--The
Secretary in cooperation with the
Secretaries of Health and Human
Services and Labor, is authorized to
conduct randomized audits of group
health plans to determine compliance
with this section. Such audits shall be
conducted on no fewer than twelve plans
per plan year. Information from such
audits shall be made plainly available
on the Consumer Parity Portal website
established under section 2726(a)(7) of
the Public Health Service Act.
``(II) Additional audits.--In the
case of a group health plan with
respect to which any claim has been
filed during a plan year, the Secretary
may audit the books and records of such
plan to determine compliance with this
section. Information detailing the
results of the audit shall be made
available on the Consumer Parity Portal
website established under section
2726(a)(7) of the Public Health Service
Act.
``(iv) Denial rates.--The Secretary shall
collect information on the rates of and reasons
for denial by group health plans of claims for
outpatient and inpatient mental health and
substance use disorder services compared to the
rates of and reasons for denial of claims for
medical and surgical services. For the first
plan year beginning at least two years after
the date of the enactment of this paragraph and
each subsequent plan year, the Secretary shall
submit to the Committee on Energy and Commerce
of the House of Representatives and the
Committee on Health, Education, Labor, and
Pensions of the Senate, and make plainly
available on the Consumer Parity Portal website
under section 2726(a)(7) of the Public Health
Service Act, the information collected under
the previous sentence with respect to the
previous plan year.''.
(d) Authorization of Appropriations.--There is authorized to be
appropriated $2,000,000 for each of fiscal years 2017 through 2021 to
carry out this section, including the amendments made by this section.
SEC. 802. REPORT ON INVESTIGATIONS REGARDING PARITY IN MENTAL HEALTH
AND SUBSTANCE USE DISORDER BENEFITS.
(a) In General.--Not later than one year after the date of the
enactment of this Act, and annually thereafter, the Administrator of
the Centers for Medicare & Medicaid Services, in collaboration with the
Assistant Secretary of Labor of the Employee Benefits Security
Administration and the Secretary of the Treasury shall submit to the
Congress a report--
(1) identifying Federal investigations conducted or
completed during the preceding 12-month period regarding
compliance with parity in mental health, substance use disorder
benefits, including benefits provided to persons with mental
illness, including serious mental illness, and substance use
disorders under the Paul Wellstone and Pete Domenici Mental
Health Parity and Addiction Equity Act of 2008 (subtitle B of
title V of division C of Public Law 110-343); and
(2) summarizing the results of such investigations.
(b) Contents.--Subject to paragraph (3), each report under
paragraph (1) shall include the following information:
(1) The number of investigations opened and closed during
the covered reporting period.
(2) The benefit classification or classifications examined
by each investigation.
(3) The subject matter or subject matters of each
investigation, including quantitative and nonquantitative
treatment limitations.
(4) A summary of the basis of the final decision rendered
for each investigation.
(c) Limitation.--Individually identifiable information shall be
excluded from reports under paragraph (1) consistent with Federal
privacy protections.
SEC. 803. GAO STUDY ON PREVENTING DISCRIMINATORY COVERAGE LIMITATIONS
FOR INDIVIDUALS WITH SERIOUS MENTAL ILLNESS AND SUBSTANCE
USE DISORDERS.
Not later than one year after the date of the enactment of this
Act, the Comptroller General of the United States shall submit to
Congress a report describing the evidence regarding the extent to which
private health insurance plans have nonquantitative treatment limits
for mental health, substance use disorder, and other health services.
The report shall also assess the Departments of Health and Human
Services, Labor, and the Treasury's oversight of private health
insurance plans and Medicaid managed care plans under section 1903 of
the Social Security Act (42 U.S.C. 1396b), compliance with the Paul
Wellstone and Pete Domenici Mental Health Parity and Addiction Equity
Act of 2008 (subtitle B of title V of division C of Public Law 110-343)
(as amended by Public Law 111-148) (in this section referred to as the
``law''), including--
(1) how the responsible Federal departments and agencies
ensure that plans comply with the law, including how the plans
apply nonquantitative treatment limitations and medical
necessity criteria to behavioral health services compared to
medical or surgical services; and
(2) how proper enforcement, education, and coordination
activities within responsible Federal departments and agencies
can be used to ensure full compliance with the law, including
educational activities directed to State insurance
commissioners.
SEC. 804. REPORT TO CONGRESS ON FEDERAL ASSISTANCE TO STATE INSURANCE
REGULATORS REGARDING MENTAL HEALTH PARITY ENFORCEMENT.
Not later than one year after the date of enactment of this Act,
the Secretary of Health and Human Services shall submit to Congress a
report detailing--
(1) the ways in which State governments and State insurance
regulators are either empowered or required to enforce the Paul
Wellstone and Pete Domenici Mental Health Parity and Addiction
Equity Act of 2008 (subtitle B of title V of division C of
Public Law 110-343);
(2) their capability to carry out these enforcement powers
or requirements; and
(3) any technical assistance to State government and State
insurance regulators that has been communicated by the
Department of Health and Human Services.
TITLE IX--SUBSTANCE ABUSE
Subtitle A--Prevention
SEC. 901. PRACTITIONER EDUCATION.
(a) Education Requirements.--
(1) Registration consideration.--Section 303(f) of the
Controlled Substances Act (21 U.S.C. 823(f)) is amended by
inserting after paragraph (5) the following:
``(6) The applicant's compliance with the training
requirements described in subsection (g)(3) during any previous
period in which the applicant has been subject to such training
requirements.''.
(2) Training requirements.--Section 303(g) of the
Controlled Substances Act (21 U.S.C. 823(g)) is amended by
adding at the end the following:
``(3)(A) To be registered to prescribe or otherwise dispense
opioids for the treatment of pain, or pain management, a practitioner
described in paragraph (1) shall comply with the 12-hour training
requirement of subparagraph (B) at least once during each 3-year
period.
``(B) The training requirement of this subparagraph is that the
practitioner has completed not less than 12 hours of training (through
classroom situations, seminars at professional society meetings,
electronic communications, or otherwise) with respect to--
``(i) the treatment and management of opioid-dependent
patients;
``(ii) pain management treatment guidelines; and
``(iii) early detection of opioid addiction, including
through such methods as Screening, Brief Intervention, and
Referral to Treatment (SBIRT),
that is provided by the American Society of Addiction Medicine, the
American Academy of Addiction Psychiatry, the American Medical
Association, the American Osteopathic Association, the American
Psychiatric Association, the American Academy of Pain Management, the
American Pain Society, the American Academy of Pain Medicine, the
American Board of Pain Medicine, the American Society of Interventional
Pain Physicians, or any other organization that the Secretary
determines is appropriate for purposes of this subparagraph.''.
(b) Funding.--The Drug Enforcement Administration shall fund the
enforcement of the requirements specified in section 303(g)(3) of the
Controlled Substances Act (as added by subsection (a)) through the use
of a portion of the licensing fees paid by controlled substance
prescribers under the Controlled Substances Act (21 U.S.C. 801 et
seq.).
(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $1,000,000 for each of fiscal
years 2017 through 2021.
SEC. 902. CO-PRESCRIBING OPIOID OVERDOSE REVERSAL DRUGS GRANT PROGRAM.
(a) Establishment.--
(1) In general.--Not later than six months after the date
of the enactment of this Act, the Secretary of Health and Human
Services shall establish, in accordance with this section, a
four-year co-prescribing opioid overdose reversal drugs grant
program (in this title referred to as the ``grant program'')
under which the Secretary shall provide not more than a total
of 12 grants to eligible entities to carry out the activities
described in subsection (c).
(2) Eligible entity.--For purposes of this section, the
term ``eligible entity'' means a federally qualified health
center (as defined in section 1861(aa) of the Social Security
Act (42 U.S.C. 1395x(aa))), an opioid treatment program under
part 8 of title 42, Code of Federal Regulations, or section
303(g) of the Controlled Substances Act (21 U.S.C. 823(g)), a
program approved by a State substance abuse agency, or any
other entity that the Secretary deems appropriate.
(3) Co-prescribing.--For purposes of this title, the term
``co-prescribing'' means, with respect to an opioid overdose
reversal drug, the practice of prescribing such drug in
conjunction with an opioid prescription for patients at an
elevated risk of overdose, or in conjunction with an opioid
agonist approved under section 505 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 355) for the treatment of opioid
abuse disorders, or in other circumstances in which a provider
identifies a patient at an elevated risk for an intentional or
unintentional drug overdose from heroin or prescription opioid
therapies. For purposes of the previous sentence, a patient may
be at an elevated risk of overdose if the patient meets the
criteria under the existing co-prescribing guidelines that the
Secretary deems appropriate, such as the criteria provided in
the Opioid Overdose Toolkit published by the Substance Abuse
and Mental Health Services Administration.
(b) Application.--To be eligible to receive a grant under this
section, an eligible entity shall submit to the Secretary of Health and
Human Services, in such form and manner as specified by the Secretary,
an application that describes--
(1) the extent to which the area to which the entity will
furnish services through use of the grant is experiencing
significant morbidity and mortality caused by opioid abuse;
(2) the criteria that will be used to identify eligible
patients to participate in such program; and
(3) how such program will work to try to identify State,
local, or private funding to continue the program after
expiration of the grant.
(c) Use of Funds.--An eligible entity receiving a grant under this
section may use the grant for any of the following activities:
(1) To establish a program for co-prescribing opioid
overdose reversal drugs, such as naloxone.
(2) To train and provide resources for health care
providers and pharmacists on the co-prescribing of opioid
overdose reversal drugs.
(3) To establish mechanisms and processes, consistent with
applicable Federal and State privacy rules, for tracking
patients participating in the program described in paragraph
(1) and the health outcomes of such patients.
(4) To purchase opioid overdose reversal drugs for
distribution under the program described in paragraph (1).
(5) To offset the co-pays and other cost sharing associated
with opioid overdose reversal drugs to ensure that cost is not
a limiting factor for eligible patients.
(6) To conduct community outreach, in conjunction with
community-based organizations, designed to raise awareness of
co-prescribing practices, and the availability of opioid
overdose reversal drugs.
(7) To establish protocols to connect patients who have
experienced a drug overdose with appropriate treatment,
including medication assisted treatment and appropriate
counseling and behavioral therapies.
(d) Evaluations by Recipients.--As a condition of receipt of a
grant under this section, an eligible entity shall, for each year for
which the grant is received, submit to the Secretary of Health and
Human Services information on appropriate outcome measures specified by
the Secretary to assess the outcomes of the program funded by the
grant, including--
(1) the number of prescribers trained;
(2) the number of prescribers who have co-prescribed an
opioid overdose reversal drugs to at least one patient;
(3) the total number of prescriptions written for opioid
overdose reversal drugs;
(4) the percentage of patients at elevated risk who
received a prescription for an opioid overdose reversal drug;
(5) the number of patients reporting use of an opioid
overdose reversal drug; and
(6) any other outcome measures that the Secretary deems
appropriate.
(e) Reports by Secretary.--For each year of the grant program under
this section, the Secretary of Health and Human Services shall submit
to the appropriate committees of the House of Representatives and of
the Senate a report aggregating the information received from the grant
recipients for such year under subsection (d) and evaluating the
outcomes achieved by the programs funded by grants made under this
section.
(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section and section 903 $4,000,000 for
each of fiscal years 2017 through 2021.
SEC. 903. OPIOID OVERDOSE REVERSAL CO-PRESCRIBING GUIDELINES.
(a) In General.--The Secretary of Health and Human Services shall
establish a grant program under which the Secretary shall award grants
to eligible State entities to develop opioid overdose reversal co-
prescribing guidelines.
(b) Eligible State Entities.--For purposes of subsection (a),
eligible State entities are State departments of health in conjunction
with State medical boards; city, county, and local health departments;
and community stakeholder groups involved in reducing opioid overdose
deaths.
(c) Administrative Provisions.--
(1) Grant amounts.--A grant made under this section may not
be for more than $200,000 per grant.
(2) Prioritization.--In awarding grants under this section,
the Secretary shall give priority to eligible State entities
which propose to base their guidelines on existing guidelines
on co-prescribing to speed enactment, including guidelines of--
(A) the Department of Veterans Affairs;
(B) nationwide medical societies, such as the
American Society of Addiction Medicine or American
Medical Association; and
(C) the Centers for Disease Control and Prevention.
SEC. 904. SURVEILLANCE CAPACITY BUILDING.
(a) Program Authorized.--The Secretary of Health and Human
Services, acting through the Director of the Centers for Disease
Control and Prevention, shall award cooperative agreements or grants to
eligible entities to improve fatal and nonfatal drug overdose
surveillance and reporting capabilities, including--
(1) providing training to improve identification of drug
overdose as the cause of death by coroners and medical
examiners;
(2) establishing, in cooperation with the National Poison
Data System, coroners, and medical examiners, a comprehensive
national program for surveillance of, and reporting to an
electronic database on, drug overdose deaths in the United
States; and
(3) establishing, in cooperation with the National Poison
Data System, a comprehensive national program for surveillance
of, and reporting to an electronic database on, fatal and
nonfatal drug overdose occurrences, including epidemiological
and toxicologic analysis and trends.
(b) Eligible Entity.--To be eligible to receive a grant or
cooperative agreement under this section, an entity shall be--
(1) a State, local, or tribal government; or
(2) the National Poison Data System working in conjunction
with a State, local, or tribal government.
(c) Application.--
(1) In general.--An eligible entity desiring a grant or
cooperative agreement under this section shall submit to the
Secretary an application at such time, in such manner, and
containing such information as the Secretary may require.
(2) Contents.--An application described in paragraph (1)
shall include--
(A) a description of the activities to be funded
through the grant or cooperative agreement; and
(B) evidence that the eligible entity has the
capacity to carry out such activities.
(d) Report.--As a condition of receipt of a grant or cooperative
agreement under this section, an eligible entity shall agree to prepare
and submit, not later than 90 days after the end of the grant or
cooperative agreement period, a report to the Secretary describing the
results of the activities supported through the grant or cooperative
agreement.
(e) National Poison Data System.--In this section, the term
``National Poison Data System'' means the system operated by the
American Association of Poison Control Centers, in partnership with the
Centers for Disease Control and Prevention, for real-time local, State,
and national electronic reporting, and the corresponding database
network.
(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $5,000,000 for each of the
fiscal years 2017 through 2021.
Subtitle B--Crisis
SEC. 921. GRANTS TO SUPPORT SYRINGE EXCHANGE PROGRAMS.
(a) In General.--The Secretary of Health and Human Services may
award grants to State, local, and tribal governments and community
organizations to support syringe exchange programs.
(b) Use of Funds.--Grants under subsection (a) may be used to
support carrying out syringe exchange programs, including through--
(1) providing outreach, counseling, health education, case
management, syringe disposal, and other services as determined
appropriate by the Secretary of Health and Human Services; and
(2) providing technical assistance, including training and
capacity building, to assist the development and implementation
of syringe exchange programs.
(c) Authorization of Appropriations.--There is authorized to be
appropriated $15,000,000 for each of fiscal years 2017 through 2021 to
carry out this section, of which--
(1) at least 15 percent shall be for syringe exchange
programs that have been in operation for less than 3 years; and
(2) 5 percent shall be for technical assistance under
subsection (b)(2).
SEC. 922. GRANT PROGRAM TO REDUCE DRUG OVERDOSE DEATHS.
(a) Program Authorized.--The Secretary of Health and Human
Services, acting through the Administrator of the Substance Abuse and
Mental Health Services Administration, shall award grants or enter into
cooperative agreements with eligible entities to enable the eligible
entities to reduce deaths occurring from overdoses of drugs.
(b) Eligible Entities.--To be eligible to receive a grant or
cooperative agreement under this section, an entity shall be a
partnership between any of the following: a State, local, or tribal
government, a correctional institution, a law enforcement agency, a
community agency, a professional organization in the field of poison
control and surveillance, or a private nonprofit organization.
(c) Application.--
(1) In general.--An eligible entity desiring a grant or
cooperative agreement under this section shall submit to the
Secretary of Health and Human Services an application at such
time, in such manner, and containing such information as the
Secretary may require.
(2) Contents.--An application under paragraph (1) shall
include--
(A) a description of the activities to be funded
through the grant or cooperative agreement; and
(B) evidence that the eligible entity has the
capacity to carry out such activities.
(d) Priority.--In entering into grants and cooperative agreements
under subsection (a), the Secretary of Health and Human Services shall
give priority to eligible entities that--
(1) include a public health agency or community-based
organization; and
(2) have expertise in preventing deaths occurring from
overdoses of drugs in populations at high risk of such deaths.
(e) Eligible Activities.--As a condition of receipt of a grant or
cooperative agreement under this section, an eligible entity shall
agree to use the grant or cooperative agreement to do each of the
following:
(1) Purchase and distribute the drug naloxone or a
similarly effective medication.
(2) Carry out one or more of the following activities:
(A) Educating prescribers and pharmacists about
overdose prevention and naloxone prescription, or
prescriptions of a similarly effective medication.
(B) Training first responders, other individuals in
a position to respond to an overdose, and law
enforcement and corrections officials on the effective
response to individuals who have overdosed on drugs.
Training pursuant to this subparagraph may include any
activity that is educational, instructional, or
consultative in nature, and may include volunteer
training, awareness building exercises, outreach to
individuals who are at risk of a drug overdose, and
distribution of educational materials.
(C) Implementing and enhancing programs to provide
overdose prevention, recognition, treatment, and
response to individuals in need of such services.
(D) Educating the public and providing outreach to
the public about overdose prevention and naloxone
prescriptions, or prescriptions of other similarly
effective medications.
(f) Coordinating Center.--
(1) Establishment.--The Secretary of Health and Human
Services shall establish and provide for the operation of a
coordinating center responsible for--
(A) collecting, compiling, and disseminating data
on the programs and activities under this section,
including tracking and evaluating the distribution and
use of naloxone and other similarly effective
medication;
(B) evaluating such data and, based on such
evaluation, developing best practices for preventing
deaths occurring from drug overdoses;
(C) making such best practices specific to the type
of community involved;
(D) coordinating and harmonizing data collection
measures;
(E) evaluating the effects of the program on
overdose rates; and
(F) education and outreach to the public about
overdose prevention and prescription of naloxone and
other similarly effective medication.
(2) Reports to center.--As a condition on receipt of a
grant or cooperative agreement under this section, an eligible
entity shall agree to prepare and submit, not later than 90
days after the end of the award period, a report to such
coordinating center and the Secretary of Health and Human
Services describing the results of the activities supported
through the grant or cooperative agreement.
(g) Duration.--The period of a grant or cooperative agreement under
this section shall be 4 years.
(h) Definition.--In this part, the term ``drug''--
(1) means a drug, as defined in section 201 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 321); and
(2) includes controlled substances, as defined in section
102 of the Controlled Substances Act (21 U.S.C. 802).
(i) Authorization of Appropriations.--There is authorized to be
appropriated $20,000,000 to carry out this section for each of the
fiscal years 2017 through 2021.
Subtitle C--Treatment
SEC. 931. EXPANSION OF PATIENT LIMITS UNDER WAIVER.
Section 303(g)(2)(B) of the Controlled Substances Act (21 U.S.C.
823(g)(2)(B)) is amended--
(1) in clause (i), by striking ``physician'' and inserting
``practitioner'';
(2) in clause (iii)--
(A) by striking ``30'' and inserting ``100''; and
(B) by striking ``, unless, not sooner'' and all
that follows through the end and inserting a period;
and
(3) by inserting at the end the following new clause:
``(iv) Not earlier than 1 year after the date on
which a qualifying practitioner obtained an initial
waiver pursuant to clause (iii), the qualifying
practitioner may submit a second notification to the
Secretary of the need and intent of the qualifying
practitioner to treat an unlimited number of patients,
if the qualifying practitioner--
``(I)(aa) satisfies the requirements of
item (aa), (bb), (cc), or (dd) of subparagraph
(G)(ii)(I); and
``(bb) agrees to fully participate in the
Prescription Drug Monitoring Program of the
State in which the qualifying practitioner is
licensed, pursuant to applicable State
guidelines; or
``(II)(aa) satisfies the requirements of
item (ee), (ff), or (gg) of subparagraph
(G)(ii)(I);
``(bb) agrees to fully participate in the
Prescription Drug Monitoring Program of the
State in which the qualifying practitioner is
licensed, pursuant to applicable State
guidelines;
``(cc) practices in a qualified practice
setting; and
``(dd) has completed not less than 24 hours
of training (through classroom situations,
seminars at professional society meetings,
electronic communications, or otherwise) with
respect to the treatment and management of
opiate-dependent patients for substance use
disorders provided by the American Society of
Addiction Medicine, the American Academy of
Addiction Psychiatry, the American Medical
Association, the American Osteopathic
Association, the American Psychiatric
Association, or any other organization that the
Secretary determines is appropriate for
purposes of this subclause.''.
SEC. 932. DEFINITIONS.
Section 303(g)(2)(G) of the Controlled Substances Act (21 U.S.C.
823(g)(2)(G)) is amended--
(1) by striking clause (ii) and inserting the following:
``(ii) The term `qualifying practitioner' means the
following:
``(I) A physician who is licensed under
State law and who meets 1 or more of the
following conditions:
``(aa) The physician holds a board
certification in addiction psychiatry
from the American Board of Medical
Specialties.
``(bb) The physician holds an
addiction certification from the
American Society of Addiction Medicine.
``(cc) The physician holds a board
certification in addiction medicine
from the American Osteopathic
Association.
``(dd) The physician holds a board
certification from the American Board
of Addiction Medicine.
``(ee) The physician has completed
not less than 8 hours of training
(through classroom situations, seminar
at professional society meetings,
electronic communications, or
otherwise) with respect to the
treatment and management of opiate-
dependent patients for substance use
disorders provided by the American
Society of Addiction Medicine, the
American Academy of Addiction
Psychiatry, the American Medical
Association, the American Osteopathic
Association, the American Psychiatric
Association, or any other organization
that the Secretary determines is
appropriate for purposes of this
subclause.
``(ff) The physician has
participated as an investigator in 1 or
more clinical trials leading to the
approval of a narcotic drug in schedule
III, IV, or V for maintenance or
detoxification treatment, as
demonstrated by a statement submitted
to the Secretary by this sponsor of
such approved drug.
``(gg) The physician has such other
training or experience as the Secretary
determines will demonstrate the ability
of the physician to treat and manage
opiate-dependent patients.
``(II) A nurse practitioner or physician
assistant who is licensed under State law and
meets all of the following conditions:
``(aa) The nurse practitioner or
physician assistant is licensed under
State law to prescribe schedule III,
IV, or V medications for pain.
``(bb) The nurse practitioner or
physician assistant satisfies 1 or more
of the following:
``(AA) Has completed not
fewer than 24 hours of training
(through classroom situations,
seminar at professional society
meetings, electronic
communications, or otherwise)
with respect to the treatment
and management of opiate-
dependent patients for
substance use disorders
provided by the American
Society of Addiction Medicine,
the American Academy of
Addiction Psychiatry, the
American Medical Association,
the American Osteopathic
Association, the American
Psychiatric Association, or any
other organization that the
Secretary determines is
appropriate for purposes of
this subclause.
``(BB) Has such other
training or experience as the
Secretary determines will
demonstrate the ability of the
nurse practitioner or physician
assistant to treat and manage
opiate-dependent patients.
``(cc) The nurse practitioner or
physician assistant practices within
the scope of their State license,
including compliance with any
supervision or collaboration
requirements under State law.
``(dd) The nurse practitioner or
physician assistant practice in a
qualified practice setting.''; and
(2) by adding at the end the following:
``(iii) The term `qualified practice setting' means
1 or more of the following treatment settings:
``(I) A National Committee for Quality
Assurance-recognized Patient-Centered Medical
Home or Patient-Centered Specialty Practice.
``(II) A Centers for Medicaid & Medicare
Services-recognized Accountable Care
Organization.
``(III) A clinical facility administered by
the Department of Veterans Affairs, Department
of Defense, or Indian Health Service.
``(IV) A Behavioral Health Home accredited
by the Joint Commission.
``(V) A Federally-qualified health center
(as defined in section 1905(l)(2)(B) of the
Social Security Act (42 U.S.C. 1396d(l)(2)(B)))
or a Federally-qualified health center look-
alike.
``(VI) A Substance Abuse and Mental Health
Services-certified Opioid Treatment Program.
``(VII) A clinical program of a State or
Federal jail, prison, or other facility where
individuals are incarcerated.
``(VIII) A clinic that demonstrates
compliance with the Model Policy on DATA 2000
and Treatment of Opioid Addiction in the
Medical Office issued by the Federation of
State Medical Boards.
``(IX) A treatment setting that is part of
an Accreditation Council for Graduate Medical
Education, American Association of Colleges of
Osteopathic Medicine, or American Osteopathic
Association-accredited residency or fellowship
training program.
``(X) Any other practice setting approved
by a State regulatory board, State substance
abuse agency, or State Medicaid Plan to provide
addiction treatment services.
``(XI) Any other practice setting approved
by the Secretary.''.
SEC. 933. EVALUATION BY ASSISTANT SECRETARY FOR PLANNING AND
EVALUATION.
Two years after the date on which the first notification under
clause (iv) of section 303(g)(2)(B) of the Controlled Substances Act
(21 U.S.C. 823(g)(2)(B)), as added by section 931, is received by the
Secretary of Health and Human Services, the Assistant Secretary for
Planning and Evaluation shall initiate an evaluation of the
effectiveness of the amendments made by sections 301 and 302, which
shall include an evaluation of--
(1) any changes in the availability and use of medication-
assisted treatment for opioid addiction;
(2) the quality of medication-assisted treatment programs;
(3) the integration of medication-assisted treatment with
routine healthcare services;
(4) diversion of opioid addiction treatment medication;
(5) changes in State or local policies and legislation
relating to opioid addiction treatment;
(6) the use of nurse practitioners and physician assistants
who prescribe opioid addiction medication;
(7) the use of Prescription Drug Monitoring Programs by
waived practitioners to maximize safety of patient care and
prevent diversion of opioid addiction medication;
(8) the findings of the Drug Enforcement Administration
inspections of waived practitioners, including the frequency
with which the Drug Enforcement Administration finds no
documentation of access to behavioral health services; and
(9) the effectiveness of cross-agency collaboration between
the Department of Health and Human Services and the Drug
Enforcement Administration for expanding effective opioid
addiction treatment.
SEC. 934. REAUTHORIZATION OF RESIDENTIAL TREATMENT PROGRAMS FOR
PREGNANT AND POSTPARTUM WOMEN.
Section 508 of the Public Health Service Act (42 U.S.C. 290bb-1) is
amended--
(1) in subsection (p), by inserting ``(other than
subsection (r))'' after ``section''; and
(2) in subsection (r), by striking ``such sums'' and all
that follows through ``2003'' and inserting ``$40,000,000 for
each of fiscal years 2017 through 2021''.
SEC. 935. PILOT PROGRAM GRANTS FOR STATE SUBSTANCE ABUSE AGENCIES.
(a) In General.--Section 508 of the Public Health Service Act (42
U.S.C. 290bb-1) is amended--
(1) by redesignating subsection (r), as amended by section
934, as subsection (s); and
(2) by inserting after subsection (q) the following new
subsection:
``(r) Pilot Program for State Substance Abuse Agencies.--
``(1) In general.--From amounts made available under
subsection (s), the Director of the Center for Substance Abuse
Treatment shall carry out a pilot program under which
competitive grants are made by the Director to State substance
abuse agencies to--
``(A) enhance flexibility in the use of funds
designed to support family-based services for pregnant
and postpartum women with a primary diagnosis of a
substance use disorder, including opioid use disorders;
``(B) help State substance abuse agencies address
identified gaps in services furnished to such women
along the continuum of care, including services
provided to women in non-residential based settings;
and
``(C) promote a coordinated, effective, and
efficient State system managed by State substance abuse
agencies by encouraging new approaches and models of
service delivery.
``(2) Requirements.--In carrying out the pilot program
under this subsection, the Director shall--
``(A) require State substance abuse agencies to
submit to the Director applications, in such form and
manner and containing such information as specified by
the Director, to be eligible to receive a grant under
the program;
``(B) identify, based on such submitted
applications, State substance abuse agencies that are
eligible for such grants;
``(C) require services proposed to be furnished
through such a grant to support family based treatment
and other services for pregnant and postpartum women
with a primary diagnosis of a substance use disorder,
including opioid use disorders;
``(D) not require that services furnished through
such a grant be provided solely to women that reside in
facilities;
``(E) not require that grant recipients under the
program make available through use of the grant all
services described in subsection (d); and
``(F) consider not applying requirements described
in paragraphs (1) and (2) of subsection (f) to
applicants, depending on the circumstances of the
applicant.
``(3) Required services.--
``(A) In general.--The Director shall specify a
minimum set of services required to be made available
to eligible women through a grant awarded under the
pilot program under this subsection. Such minimum set--
``(i) shall include requirements described
in subsection (c) and be based on the
recommendations submitted under subparagraph
(B); and
``(ii) may be selected from among the
services described in subsection (d) and
include other services as appropriate.
``(B) Stakeholder input.--The Director shall
convene and solicit recommendations from stakeholders,
including State substance abuse agencies, health care
providers, persons in recovery from substance abuse,
and other appropriate individuals, for the minimum set
of services described in subparagraph (A).
``(4) Duration.--The pilot program under this subsection
shall not exceed 5 years.
``(5) Evaluation and report to congress.--The Director of
the Center for Behavioral Health Statistics and Quality shall
fund an evaluation of the pilot program at the conclusion of
the first grant cycle funded by the pilot program. The Director
of the Center for Behavioral Health Statistics and Quality, in
coordination with the Director of the Center for Substance
Abuse Treatment shall submit to the relevant Committees of
jurisdiction of the House of Representatives and the Senate a
report on such evaluation. The report shall include at a
minimum outcomes information from the pilot program, including
any resulting reductions in the use of alcohol and other drugs;
engagement in treatment services; retention in the appropriate
level and duration of services; increased access to the use of
medications approved by the Food and Drug Administration for
the treatment of substance use disorders in combination with
counseling; and other appropriate measures.
``(6) State substance abuse agencies defined.--For purposes
of this subsection, the term `State substance abuse agency'
means, with respect to a State, the agency in such State that
manages the Substance Abuse Prevention and Treatment Block
Grant under part B of title XIX.''.
(b) Funding.--Subsection (s) of section 508 of the Public Health
Service Act (42 U.S.C. 290bb-1), as amended by section 934 and
redesignated by subsection (a), is further amended by adding at the end
the following new sentence: ``Of the amounts made available for a year
pursuant to the previous sentence to carry out this section, not more
than 25 percent of such amounts shall be made available for such year
to carry out subsection (r), other than paragraph (5) of such
subsection.''.
SEC. 936. EVIDENCE-BASED OPIOID AND HEROIN TREATMENT AND INTERVENTIONS
DEMONSTRATION.
Subpart 1 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb et seq.) is amended--
(1) by redesignating section 514 (42 U.S.C. 290bb-9), as
added by section 3632 of the Methamphetamine Anti-Proliferation
Act of 2000 (Public Law 106-310; 114 Stat. 1236), as section
514B; and
(2) by adding at the end the following:
``SEC. 514C. EVIDENCE-BASED OPIOID AND HEROIN TREATMENT AND
INTERVENTIONS DEMONSTRATION.
``(a) Grants.--
``(1) Authority to make grants.--The Director of the Center
for Substance Abuse Treatment (referred to in this section as
the `Director') shall award grants to State substance abuse
agencies, units of local government, nonprofit organizations,
and Indian tribes or tribal organizations (as defined in
section 4 of the Indian Health Care Improvement Act (25 U.S.C.
1603)) that have a high rate, or have had a rapid increase, in
the use of heroin or other opioids, in order to permit such
entities to expand activities, including an expansion in the
availability of medication assisted treatment, evidence-based
counseling, or behavioral therapies with respect to the
treatment of addiction in the specific geographical areas of
such entities where there is a rate or rapid increase in the
use of heroin or other opioids.
``(2) Recipients.--The entities receiving grants under
paragraph (1) shall be selected by the Director.
``(3) Nature of activities.--The grant funds awarded under
paragraph (1) shall be used for activities that are based on
reliable scientific evidence of efficacy in the treatment of
problems related to heroin or other opioids.
``(b) Geographic Distribution.--The Director shall ensure that
grants awarded under subsection (a) are distributed equitably among the
various regions of the Nation and among rural, urban, and suburban
areas that are affected by the use of heroin or other opioids.
``(c) Additional Activities.--The Director shall--
``(1) evaluate the activities supported by grants awarded
under subsection (a);
``(2) disseminate widely such significant information
derived from the evaluation as the Director considers
appropriate;
``(3) provide States, Indian tribes and tribal
organizations, and providers with technical assistance in
connection with the provision of treatment of problems related
to heroin and other opioids; and
``(4) fund only those applications that specifically
support recovery services as a critical component of the grant
program.
``(d) Definition.--The term `medication assisted treatment' means
the use, for problems relating to heroin and other opioids, of
medications approved by the Food and Drug Administration in combination
with counseling and behavioral therapies.
``(e) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated
to carry out this section $300,000,000 for each of fiscal years
2017 through 2021.
``(2) Use of certain funds.--Of the funds appropriated to
carry out this section in any fiscal year, not more than 5
percent of such funds shall be available to the Director for
purposes of carrying out subsection (c).''.
SEC. 937. ADOLESCENT TREATMENT AND RECOVERY SERVICES DEMONSTRATION
GRANT PROGRAM.
Subpart 1 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb et seq.), as amended by section 936, is further amended by
adding at the end the following:
``SEC. 514D. GRANTS TO IMPROVE ACCESS TO TREATMENT AND RECOVERY FOR
ADOLESCENTS.
``(a) In General.--The Secretary, acting through the Director of
the Center for Substance Abuse Treatment, shall award grants,
contracts, or cooperative agreements to eligible State substance abuse
agencies and other entities determined appropriate by the Director for
the purpose of increasing the capacity of substance use disorder
treatment and recovery services for adolescents.
``(b) Eligibility.--To be eligible to receive a grant, contract, or
cooperative agreement under subsection (a) an entity shall--
``(1) prepare and submit to the Director an application at
such time, in such manner, and contain such information as the
Director may require, including a plan for the evaluation of
any activities carried out with the funds provided under this
section;
``(2) ensure that all entities receiving support under the
grant, contract, or cooperative agreement comply with all
applicable State licensure or certification requirements
regarding the provision of the services involved; and
``(3) provide the Director with periodic evaluations of the
progress of the activities funded under this section and an
evaluation at the completion of such activities, as the
Director determines to be appropriate.
``(c) Priority.--In awarding grants, contracts, and cooperative
agreements under subsection (a), the Director shall give priority to
applicants who propose to fill a demonstrated geographic need for
adolescent specific residential treatment services.
``(d) Use of Funds.--Amounts awarded under grants, contracts, or
cooperative agreements under this section may be used to enable health
care providers or facilities that provide treatment and recovery
assistance for adolescents with a substance use disorder to provide the
following services:
``(1) Individualized patient centered care that is specific
to circumstances of the individual patient.
``(2) Clinically appropriate, trauma-informed, gender-
specific and age appropriate treatment services that are based
on reliable scientific evidence of efficacy in the treatment of
problems related to substance use disorders.
``(3) Clinically appropriate care to address treatment for
substance use and any co-occurring physical and mental health
disorders at the same location, and through access to primary
care services.
``(4) Coordination of treatment services with recovery and
other social support, including educational, vocational
training, assistance with the juvenile justice system, child
welfare, and mental health agencies.
``(5) Aftercare and long-term recovery support, including
peer support services.
``(e) Duration of Assistance.--Grants, contracts, and cooperative
agreements awarded under subsection (a) shall be for a period not to
exceed 5 years.
``(f) Additional Activities.--The Director shall--
``(1) collect and evaluate the activities carried out with
amount received under subsection (a);
``(2) disseminate widely such significant information
derived from the evaluation as the Secretary considers
appropriate; and
``(3) provide States, Indian tribes and tribal
organizations, and providers with technical assistance in
connection with the provision of treatment and recovery
services funded through this section to adolescents related to
the abuse of heroin and other opioids.
``(g) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated
to carry out this section, $25,000,000 for each of fiscal years
2017 through 2021.
``(2) Use of certain funds.--Of the funds appropriated to
carry out this section in any fiscal year, not more than 5
percent of such funds shall be available to the Director for
purposes of carrying out subsection (f).''.
SEC. 938. STUDY ON TREATMENT INFRASTRUCTURE.
Not later than 24 months after the date of enactment of this Act,
the Comptroller General of the United States shall initiate an
evaluation, and submit to Congress a report, of the inpatient and
outpatient treatment capacity, availability, and needs of the United
States, which shall include, to the extent data is available--
(1) the capacity of acute residential or inpatient
detoxification programs;
(2) the capacity of inpatient clinical stabilization
programs, transitional residential support services, and
residential rehabilitation programs;
(3) the capacity of demographic specific residential or
inpatient treatment programs, such as those designed for
pregnant women or adolescents;
(4) geographical differences of the availability of
residential and outpatient treatment and recovery options for
substance use disorders across the continuum of care;
(5) the availability of residential and outpatient
treatment programs that offer treatment options based on
reliable scientific evidence of efficacy for the treatment of
substance use disorders, including the use of Food and Drug
Administration-approved medicines and evidence-based
nonpharmacological therapies;
(6) the number of patients in residential and specialty
outpatient treatment services for substance use disorders; and
(7) an assessment of the need for residential and
outpatient treatment for substance use disorders across the
continuum of care.
SEC. 939. SUBSTANCE USE DISORDER PROFESSIONAL LOAN REPAYMENT PROGRAM.
Subpart 3 of part E of title VII of the Public Health Service Act
(42 U.S.C. 295f et seq.) is amended by adding at the end the following:
``SEC. 779. SUBSTANCE USE DISORDER PROFESSIONAL LOAN REPAYMENT PROGRAM.
``(a) Establishment.--The Secretary shall establish and carry out a
substance use disorder health professional loan repayment program under
which qualified health professionals agree to be employed full time for
a specified period (which shall be not less than 2 years) in providing
substance use disorder prevention and treatment services.
``(b) Program Administration.--Through the program established
under this section, the Secretary shall enter into contracts with
qualified health professionals under which--
``(1) a qualified health professional agrees to provide
substance use disorder prevention and treatment services with
respect to an area or population that (as determined by the
Secretary)--
``(A) has a shortage of such services (as defined
by the Secretary); and
``(B) has a sufficient population of individuals
with a substance use disorder to support the provision
of such services; and
``(2) the Secretary agrees to make payments on the
principal and interest of undergraduate, or graduate education
loans of the qualified health professional--
``(A) of not more than $35,000 for each year of
service described in paragraph (1); and
``(B) for not more than 3 years.
``(c) Qualified Health Professional Defined.--In this section, the
term `qualified health professional' means an individual who is (or
will be upon the completion of the individual's graduate education) a
psychiatrist, psychologist, nurse practitioner, physician assistant,
clinical social worker, substance abuse counselor, or other substance
use disorder health professional.
``(d) Priority.--In entering into agreements under this section,
the Secretary shall give priority to applicants who--
``(1) have familiarity with evidence-based methods and
culturally and linguistically competent health care services;
and
``(2) demonstrate financial need.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated $20,000,000 for each of fiscal years 2017 through 2021 to
carry out this section.''.
Subtitle D--Recovery
SEC. 951. NATIONAL YOUTH RECOVERY INITIATIVE.
(a) Definitions.--In this section:
(1) Eligible entity.--The term ``eligible entity'' means--
(A) a high school that has been accredited as a
recovery high school by the Association of Recovery
Schools;
(B) an accredited high school that is seeking to
establish or expand recovery support services;
(C) an institution of higher education;
(D) a recovery program at a nonprofit collegiate
institution; or
(E) a nonprofit organization.
(2) Institution of higher education.--The term
``institution of higher education'' has the meaning given the
term in section 101 of the Higher Education Act of 1965 (20
U.S.C. 1001).
(3) Recovery program.--The term ``recovery program''--
(A) means a program to help individuals who are
recovering from substance use disorders to initiate,
stabilize, and maintain healthy and productive lives in
the community; and
(B) includes peer-to-peer support and communal
activities to build recovery skills and supportive
social networks.
(b) Grants Authorized.--The Secretary of Health and Human Services,
acting through the Substance Abuse and Mental Health Services
Administration, in consultation with the Secretary of Education, may
award grants to eligible entities to enable the entities to--
(1) provide substance use recovery support services to
young people in high school and enrolled in institutions of
higher education;
(2) help build communities of support for young people in
recovery through a spectrum of activities such as counseling
and healthy and wellness-oriented social activities; and
(3) encourage initiatives designed to help young people
achieve and sustain recovery from substance use disorders.
(c) Use of Funds.--Grants awarded under subsection (b) may be used
for activities to develop, support, and maintain youth recovery support
services, including--
(1) the development and maintenance of a dedicated physical
space for recovery programs;
(2) dedicated staff for the provision of recovery programs;
(3) healthy and wellness-oriented social activities and
community engagement;
(4) establishment of recovery high schools;
(5) coordination of recovery programs with--
(A) substance use disorder treatment programs and
systems;
(B) providers of mental health services;
(C) primary care providers;
(D) the criminal justice system, including the
juvenile justice system;
(E) employers;
(F) housing services;
(G) child welfare services;
(H) institutions of secondary higher education and
institutions of higher education; and
(I) other programs or services related to the
welfare of an individual in recovery from a substance
use disorder;
(6) the development of peer-to-peer support programs or
services; and
(7) additional activities that help youths and young adults
to achieve recovery from substance use disorders.
(d) Technical Support.--The Secretary of Health and Human Services
shall provide technical support to recipients of grants under this
section.
(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $30,000,000 for each of fiscal
years 2017 through 2021.
SEC. 952. GRANTS TO ENHANCE AND EXPAND RECOVERY SUPPORT SERVICES.
Subpart 1 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb et seq.), as amended by sections 306 and 307, is further
amended by adding at the end the following:
``SEC. 514E. GRANTS TO ENHANCE AND EXPAND RECOVERY SUPPORT SERVICES.
``(a) In General.--The Secretary, acting through the Administrator
of the Substance Abuse and Mental Health Services Administration, shall
award grants to State substance abuse agencies and nonprofit
organizations to develop, expand, and enhance recovery support services
for individuals with substance use disorders.
``(b) Eligible Entities.--In the case of an applicant that is not a
State substance abuse agency, to be eligible to receive a grant under
this section, the entity shall--
``(1) prepare and submit to the Secretary an application at
such time, in such manner, and contain such information as the
Secretary may require, including a plan for the evaluation of
any activities carried out with the funds provided under this
section;
``(2) demonstrate the inclusion of individuals in recovery
from a substance use disorder in leadership levels or governing
bodies of the entity;
``(3) have as a primary mission the provision of long-term
recovery support for substance use disorders; and
``(4) be accredited by the Council on the Accreditation of
Peer Recovery Support Services or meet any applicable State
certification requirements regarding the provision of the
recovery services involved.
``(c) Use of Funds.--Amounts awarded under a grant under this
section shall be used to provide for the following activities:
``(1) Educating and mentoring that assists individuals and
families with substance use disorders in navigating systems of
care.
``(2) Peer recovery support services which include peer
coaching and mentoring.
``(3) Recovery-focused community education and outreach
programs, including training on the use of all forms of opioid
overdose antagonists used to counter the effects of an
overdose.
``(4) Training, mentoring, and education to develop and
enhance peer mentoring and coaching.
``(5) Programs aimed at identifying and reducing stigma and
discriminatory practices that serve as barriers to substance
use disorder recovery and treatment of these disorders.
``(6) Developing partnerships between networks that support
recovery and other community organizations and services,
including--
``(A) public and private substance use disorder
treatment programs and systems;
``(B) health care providers;
``(C) recovery-focused addiction and recovery
professionals;
``(D) faith-based organizations;
``(E) organizations focused on criminal justice
reform;
``(F) schools; and
``(G) social service agencies in the community,
including educational, juvenile justice, child welfare,
housing, and mental health agencies.
``(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $100,000,000 for each of fiscal
years 2017 through 2021.''.
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