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Title II — Strengthening and Investing in SAMHSA Programs

H.R. 4574 · 113th Congress · May 6, 2014 · Lineage

II Strengthening and Investing in SAMHSA Programs

Sec. 201 Community mental health services block grant reauthorization

Section 1920(a) of the Public Health Service Act (42 U.S.C. 300x–9(a)) is amended by striking “$450,000,000 for fiscal year 2001, and such sums as may be necessary for each of the fiscal years 2002 and 2003” and inserting “$483,744,000 for fiscal year 2015 and such sums as may be necessary for each of fiscal years 2016 through 2019”.

Sec. 202 Reporting requirements for block grants regarding mental health and substance use disorders

Section 1942 of the Public Health Service Act (42 U.S.C. 300x–52) is amended to read as follows:

“1942. Requirement of reports and audits by States

“(a) Annual report—A funding agreement for a grant under section 1911 is that—

“(1) the State involved will prepare and submit to the Secretary an annual report on the activities funded through the grant; and

“(2) each such report shall be prepared by, or in consultation with, the State agency responsible for community mental health programs and activities.

“(b) Standardized form; contents—In order to properly evaluate and to compare the performance of different States assisted under section 1911, reports under this section shall be in such standardized form and contain such information as the Secretary determines (after consultation with the States) to be necessary—

“(1) to secure an accurate description of the activities funded through the grant under section 1911;

“(2) to determine the extent to which funds were expended consistent with the State’s application transmitted under section 1917(a); and

“(3) to describe the extent to which the State has met the goals and objectives it set forth in its State plan under section 1912(b).

“(c) Minimum contents—Each report under this section shall, at a minimum, include the following information:

“(1)

“(A) The number of individuals served by the State under subpart I (by class of individuals).

“(B) The proportion of each class of such individuals which has health coverage.

“(C) The types of services (as defined by the Secretary) provided under subpart I to individuals within each such class.

“(D) The amounts spent under subpart I on each type of service (by class of individuals served).

“(2) Information on the status of mental health in the State, including information (by county and by racial and ethnic group) on each of the following:

“(A) The proportion of adolescents with serious emotional disturbances.

“(B) The proportion of adults with serious mental illness (including major depression).

“(C) The proportion of individuals with co-occurring mental health and substance use disorders.

“(D) The proportion of children and adolescents with mental health disorders who seek and receive treatment.

“(E) The proportion of adults with mental health disorders who seek and receive treatment.

“(F) The proportion of individuals with co-occurring mental health and substance use disorders who seek and receive treatment.

“(G) The proportion of homeless adults with mental health disorders who receive treatment.

“(H) The number of primary care facilities that provide mental health screening and treatment services onsite or by paid referral.

“(I) The number of primary care physician office visits that include mental health screening services.

“(J) The number of juvenile residential facilities that screen admissions for mental health disorders.

“(K) The number of deaths attributable to suicide.

“(3) Information on the number and type of health care practitioners licensed in the State and providing mental health-related services.

“(d) Availability of reports—The Secretary shall, upon request, provide a copy of any report under this section to any interested public agency.”

Sec. 203 Garrett Lee Smith Memorial Act reauthorization

(a)
Suicide prevention technical assistance center— Section 520C of the Public Health Service Act (42 U.S.C. 290bb–34) is amended—
(1)
in the section heading, by striking the section heading and inserting “Suicide prevention technical assistance center.”;
(2)
in subsection (a), by striking “and in consultation with” and all that follows through the period at the end of paragraph (2) and inserting “shall establish a research, training, and technical assistance resource center to provide appropriate information, training, and technical assistance to States, political subdivisions of States, federally recognized Indian tribes, tribal organizations, institutions of higher education, public organizations, or private nonprofit organizations regarding the prevention of suicide among all ages, particularly among groups that are at high risk for suicide.”;
(3)
by striking subsections (b) and (c);
(4)
by redesignating subsection (d) as subsection (b);
(5)
in subsection (b), as so redesignated—
(A)
by striking the subsection heading and inserting “Responsibilities of the center.”;
(B)
in the matter preceding paragraph (1), by striking “The additional research” and all that follows through “nonprofit organizations for” and inserting “The center established under subsection (a) shall conduct activities for the purpose of”;
(C)
by striking “youth suicide” each place such term appears and inserting “suicide”;
(D)
in paragraph (1)—
(i)
by striking “the development or continuation of” and inserting “developing and continuing”; and
(ii)
by inserting “for all ages, particularly among groups that are at high risk for suicide” before the semicolon at the end;
(E)
in paragraph (2), by inserting “for all ages, particularly among groups that are at high risk for suicide” before the semicolon at the end;
(F)
in paragraph (3), by inserting “and tribal” after “statewide”;
(G)
in paragraph (5), by inserting “and prevention” after “intervention”;
(H)
in paragraph (8), by striking “in youth”;
(I)
in paragraph (9), by striking “and behavioral health” and inserting “health and substance use disorder”; and
(J)
in paragraph (10), by inserting “conducting” before “other”; and
(6)
by striking subsection (e) and inserting the following:

“(c) Authorization of appropriations—For the purpose of carrying out this section, there are authorized to be appropriated $4,948,000 for each of fiscal years 2015 through 2019.”

(b)
Youth suicide early intervention and prevention strategies— Section 520E of the Public Health Service Act (42 U.S.C. 290bb–36) is amended—
(1)
in paragraph (1) of subsection (a) and in subsection (c), by striking “substance abuse” each place such term appears and inserting “substance use disorder”;
(2)
in subsection (b)(2)—
(A)
by striking “each State is awarded only 1 grant or cooperative agreement under this section” and inserting “a State does not receive more than 1 grant or cooperative agreement under this section at any 1 time”; and
(B)
by striking “been awarded” and inserting “received”; and
(3)
by striking subsection (m) and inserting the following:

“(m) Authorization of appropriations—For the purpose of carrying out this section, there are authorized to be appropriated $29,682,000 for each of fiscal years 2015 through 2019.”

(c)
Mental health and substance use disorder services— Section 520E–2 of the Public Health Service Act (42 U.S.C. 290bb–36b) is amended—
(1)
in the section heading, by striking “and behavioral health” and inserting “health and substance use disorder services”;
(2)
in subsection (a)—
(A)
by striking “Services,” and inserting “Services and”;
(B)
by striking “and behavioral health problems” and inserting “health or substance use disorders”; and
(C)
by striking “substance abuse” and inserting “substance use disorders”;
(3)
in subsection (b)—
(A)
in the matter preceding paragraph (1), by striking “for—” and inserting “for one or more of the following:”; and
(B)
by striking paragraphs (1) through (6) and inserting the following:

“(1) Educating students, families, faculty, and staff to increase awareness of mental health and substance use disorders.

“(2) The operation of hotlines.

“(3) Preparing informational material.

“(4) Providing outreach services to notify students about available mental health and substance use disorder services.

“(5) Administering voluntary mental health and substance use disorder screenings and assessments.

“(6) Supporting the training of students, faculty, and staff to respond effectively to students with mental health and substance use disorders.

“(7) Creating a network infrastructure to link colleges and universities with health care providers who treat mental health and substance use disorders.”

(4)
in subsection (c)(5), by striking “substance abuse” and inserting “substance use disorder”;
(5)
in subsection (d)—
(A)
in the matter preceding paragraph (1), by striking “An institution of higher education desiring a grant under this section” and inserting “To be eligible to receive a grant under this section, an institution of higher education”;
(B)
in paragraph (1)—
(i)
by striking “and behavioral health” and inserting “health and substance use disorder”; and
(ii)
by inserting “, including veterans whenever possible and appropriate,” after “students”; and
(C)
in paragraph (2), by inserting “, which may include, as appropriate and in accordance with subsection (b)(7), a plan to seek input from relevant stakeholders in the community, including appropriate public and private entities, in order to carry out the program under the grant” before the period at the end;
(6)
in subsection (e)(1), by striking “and behavioral health problems” and inserting “health and substance use disorders”;
(7)
in subsection (f)(2)—
(A)
by striking “and behavioral health” and inserting “health and substance use disorder”; and
(B)
by striking “suicide and substance abuse” and inserting “suicide and substance use disorders”; and
(8)
in subsection (h), by striking “$5,000,000 for fiscal year 2005” and all that follows through the period at the end and inserting “$4,858,000 for each of fiscal years 2015 through 2019.”.

Sec. 204 Priority mental health needs of regional and national significance reauthorization

Section 520A(f)(1) of the Public Health Service Act (42 U.S.C. 290bb–32(f)(1)) is amended by striking “$300,000,000 for fiscal year 2001, and such sums as may be necessary for each of the fiscal years 2002 and 2003” and inserting “$216,632,000 for fiscal year 2015 and such sums as may be necessary for each of fiscal years 2016 through 2019”.

Sec. 205 Grants for jail diversion programs reauthorization

Section 520G(i) of the Public Health Service Act (42 U.S.C. 290bb–38(i)) is amended by striking “$10,000,000 for fiscal year 2001, and such sums as may be necessary for fiscal years 2002 through 2003” and inserting “$4,280,000 for fiscal year 2015 and such sums as may be necessary for each of fiscal years 2016 through 2019”.

Sec. 206 Projects for assistance in transition from homelessness

Section 535(a) of the Public Health Service Act (42 U.S.C. 29cc–35(a)) is amended by striking “$75,000,000 for each of the fiscal years 2001 through 2003” and inserting “$64,800,000 for fiscal year 2015 and such sums as may be necessary for each of fiscal years 2016 through 2019”.

Sec. 207 Comprehensive community mental health services for children with serious emotional disturbances

Section 565 of the Public Health Service Act (42 U.S.C. 290ff–4) is amended—
(1)
in subsection (b)(1), by striking “receiving a grant under section 561(a)” and inserting “(irrespective of whether the public entity is in receipt of a grant under section 561(a))”;
(2)
in subsection (b)(1)(B), by striking “planning, development, and operation of systems of care pursuant to section 562” and inserting “planning, development, and operation of systems of care described in section 562”; and
(3)
in subsection (f)(1), by striking “$100,000,000 for fiscal year 2001, and such sums as may be necessary for each of the fiscal years 2002 and 2003” and inserting “$117,315,000 for fiscal year 2015 and such sums as may be necessary for each of fiscal years 2016 through 2019”.

Sec. 208 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 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; 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—The NCTSI coordinating center shall, as appropriate, collaborate with the Secretary in the dissemination of evidence-based and trauma-informed interventions, treatments, products and other resources to appropriate stakeholders.

“(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 “$45,714,000 for each of fiscal years 2015 through 2019”.

Sec. 209 Protection and advocacy for individuals with mental illness reauthorization

Section 117 of the Protection and Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10827) is amended by striking “$19,500,000 for fiscal year 1992, and such sums as may be necessary for each of the fiscal years 1993 through 2003” and inserting “$36,238,000 for fiscal year 2015 and such sums as may be necessary for each of fiscal years 2016 through 2019”.

Sec. 210 Mental health awareness training grants

Section 520J of the Public Health Service Act (42 U.S.C. 290bb–41) is amended—
(1)
in the section heading, by inserting “Mental health awareness” before “Training”; and
(2)
in subsection (b)—
(A)
in the subsection heading, by striking “illness” and inserting “health”;
(B)
in paragraph (1), by inserting “, and other categories of individuals listed in paragraph (2),” after “emergency services personnel”; and
(C)
by striking paragraph (2) and inserting the following:

“(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.”

(D)
in paragraph (5)—
(i)
in the matter preceding subparagraph (A), by striking “to” and inserting “for evidence-based programs for the purpose of”; and
(ii)
by striking subparagraphs (A) through (C) and inserting the following:

“(A) recognizing the signs and symptoms of mental illness; and

“(B)

“(i) providing education to personnel regarding resources available in the community for individuals with a mental illness and other relevant resources; or

“(ii) the safe de-escalation of crisis situations involving individuals with a mental illness.”

(E)
in paragraph (7), by striking “, $25,000,000” and all that follows through the period at the end and inserting “$20,000,000 for each of fiscal years 2014 through 2018”.

Sec. 211 National media campaign to reduce the stigma associated with mental illness

Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C. 290bb–31 et seq.) is amended by adding at the end the following new section:

“520L. National media campaign to reduce the stigma associated with mental illness

“(a) Scope of the campaign—The Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration, shall provide for the production, broadcasting, and evaluation of a national media public service campaign to reduce the stigma associated with mental illness. Such campaign shall seek to reach as wide and diverse an audience as possible and shall particularly target the population between the ages of 16 and 24 years of age.

“(b) Report—The Secretary shall provide a report to the Congress annually detailing—

“(1) the production, broadcasting, and evaluation of the campaign under subsection (a); and

“(2) the effectiveness of the campaign in reducing the stigma associated with mental illness, as measured using such methods as public attitude surveys and mental health services utilization statistics.

“(c) Consultation requirement—In carrying out this section, the Secretary shall ensure that mental health professionals and patient advocates are consulted in carrying out the media campaign under this section. The progress of this consultative process is to be covered in the report under subsection (b).

“(d) Authorization of appropriations—There are authorized to be appropriated to carry out this section, $10,000,000 for each of the fiscal years 2015 through 2019.”

Sec. 212 SAMHSA and HRSA integration of behavioral health services into primary care settings

Title V of the Public Health Service Act is amended by inserting after section 520K (42 U.S.C. 290bb–42) the following:

“520K–1. Awards for co-locating behavioral health services in primary care settings

“(a) Program authorized—The Secretary, acting through the Administrators of the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration, shall award grants, contracts, and cooperative agreements to eligible entities for the provision of coordinated and integrated behavioral health services and primary health care.

“(b) Eligible entities—To be eligible to seek a grant, contract, or cooperative agreement this section, an entity shall be a public or nonprofit entity.

“(c) Use of funds—An eligible entity receiving an award under this section shall use the award for the provision of coordinated and integrated behavioral health services and primary health care through—

“(1) the co-location of behavioral health services in primary care settings;

“(2) the use of care management services to facilitate coordination between behavioral health and primary care providers;

“(3) the use of information technology (such as telemedicine)—

“(A) to facilitate coordination between behavioral health and primary care providers; or

“(B) to expand the availability of behavioral health services; or

“(4) the provision of training and technical assistance to improve the delivery, effectiveness, and integration of behavioral health services into primary care settings.

“(d) Authorization of appropriations—To carry out this section—

“(1) there are authorized to be appropriated such sums as may be necessary for fiscal years 2015 through 2019; and

“(2) such sums as necessary are authorized to be transferred from the Substance Abuse and Mental Health Services Administration to the Health Resources and Services Administration.”

Sec. 213 Geriatric mental health disorders

Section 520A(e) of the Public Health Service Act (42 U.S.C. 290bb–32(e)) is amended by adding at the end the following:

“(3) Geriatric mental health disorders—The Secretary shall, as appropriate, provide technical assistance to grantees regarding evidence-based practices for the prevention and treatment of geriatric mental health disorders, as well as disseminate information about such evidence-based practices to States and nongrantees throughout the United States.”

Sec. 214 Assessing barriers to behavioral health integration

(a)
In general— Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall submit a report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives concerning Federal requirements that impact access to treatment of mental health and substance use disorders related to integration with primary care, administrative and regulatory issues, quality measurement and accountability, and data sharing.
(b)
Contents— The report submitted under subsection (a) shall include the following:
(1)
An evaluation of the administrative or regulatory burden on behavioral health care providers.
(2)
The identification of outcome and quality measures relevant to integrated health care, evaluation of the data collection burden on behavioral health care providers, and any alternative methods for evaluation.
(3)
An analysis of the degree to which electronic data standards, including interoperability and meaningful use includes behavioral health measures, and an analysis of strategies to address barriers to health information exchange posed by part 2 of title 42, Code of Federal Regulations.
(4)
An analysis of the degree to which Federal rules and regulations for behavioral and physical health care are aligned, including recommendations to address any identified barriers.

Sec. 215 Acute care bed registry grant for States

(a)
In general— The Secretary of Health and Human Services, acting through Administrator of the Substance Abuse and Mental Health Services Administration, shall award grants to State mental health agencies to develop and administer a Web-based acute psychiatric bed registry to collect, aggregate, and display information about available acute beds in public and private inpatient psychiatric facilities and public and private residential crisis stabilization units to facilitate the identification and designation of facilities for the temporary treatment of individuals in psychiatric crisis.
(b)
Registry requirements— An acute psychiatric bed registry funded under this section shall—
(1)
include descriptive information for every public and private inpatient psychiatric facility and every public and private residential crisis stabilization unit in the State involved, including contact information for the facility or unit;
(2)
provide 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 crisis; and
(3)
allow employees and designees of community mental health service providers, employees of inpatient psychiatric facilities or public and private residential crisis stabilization units, 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.
(c)
Authorization of appropriations— To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2015 through 2019.

Sec. 216 Awards for co-locating primary and specialty care in community-based mental health settings

Section 520K(f) of the Public Health Service Act (42 U.S.C. 290bb–42(f)) is amended by striking “$50,000,000 for fiscal year 2010 and such sums as may be necessary for each of fiscal years 2011 through 2014” and inserting “$50,000,000 for fiscal year 2015 and such sums as may be necessary for each of fiscal years 2016 through 2019”.

Sec. 217 Grants for the benefit of homeless individuals

Section 506(e) of the Public Health Service Act (42 U.S.C. 290aa–5(e)) is amended by striking “$50,000,000 for fiscal year 2001, and such sums as may be necessary for each of the fiscal years 2002 and 2003” and inserting “$____for fiscal year 2015 and such sums as may be necessary for each of fiscal years 2016 through 2019”.