Title V — Addiction and Treatment Services for Women, Families, and Veterans

114th Congress · Approved Jul 22, 2016 · 130 Stat. 695

TITLE V Addiction and Treatment Services for Women, Families, and Veterans

SEC. 501. Improving Treatment for Pregnant and Postpartum Women.

(a)

General Amendments to the Residential Treatment Program for Pregnant and Postpartum Women.— Section 508 of the Public Health Service Act (42 U.S.C. 290bb–1) is amended—

(1)

in subsection (a)—

(A)

in the matter preceding paragraph (1)—

(i)

by inserting “ (referred to in this section as the ‘Director’)” after “ Substance Abuse Treatment”;

(ii)

by striking “ grants, cooperative agreement,” and inserting “ grants, including the grants under subsection (r), cooperative agreements”; and

(iii)

by striking “ for substance abuse” and inserting “ for substance use disorders”; and

(B)

in paragraph (1), by inserting “ or receive outpatient treatment services from” after “ reside in”;

(2)

in subsection (b)(2), by inserting “ and her children” before the period at the end;

(3)

in subsection (c)—

(A)

in paragraph (1), by striking “ to the woman of the services” and inserting “ of services for the woman and her children”; and

(B)

in paragraph (2)—

(i)

in subparagraph (A), by striking “ substance abuse” and inserting “ substance use disorders”; and

(ii)

in subparagraph (B), by striking “ such abuse” and inserting “ such a disorder”;

(4)

in subsection (d)—

(A)

in paragraph (3)(A), by striking “ maternal substance abuse” and inserting “ a maternal substance use disorder”;

(B)

by amending paragraph (4) to read as follows:

“(4) Providing therapeutic, comprehensive child care for children during the periods in which the woman is engaged in therapy or in other necessary health and rehabilitative activities.”

(C)

in paragraphs (9), (10), and (11), by striking “ women” each place such term appears and inserting “ woman”;

(D)

in paragraph (9), by striking “ units” and inserting “ unit”; and

(E)

in paragraph (11)—

(i)

in subparagraph (A), by striking “ their children” and inserting “ any child of such woman”;

(ii)

in subparagraph (B), by striking “ ; and” and inserting a semicolon;

(iii)

in subparagraph (C), by striking the period and inserting “ ; and”; and

(iv)

by adding at the end the following:

“(D) family reunification with children in kinship or foster care arrangements, where safe and appropriate.”

(5)

in subsection (e)—

(A)

in paragraph (1)—

(i)

in the matter preceding subparagraph (A), by striking “ substance abuse” and inserting “ substance use disorders”; and

(ii)

in subparagraph (B), by striking “ substance abuse” and inserting “ substance use disorders”; and

(B)

in paragraph (2)—

(i)

by striking “ (A) Subject” and inserting the following:

“(A) In general.—Subject”

(ii)

in subparagraph (B)—

(I)

by striking “ (B)(i) In the case” and inserting the following:

“(B) Waiver of participation agreements.—

“(i) In general.—In the case”

; and

(II)

by striking “ (ii) A determination” and inserting the following:

“(ii) Donations.—A determination”

; and

(iii)

by striking “ (C) With respect” and inserting the following:

“(C) Nonapplication of certain requirements.—With respect”

(6)

in subsection (g)—

(A)

by striking “ who are engaging in substance abuse” and inserting “ who have a substance use disorder”; and

(B)

by striking “ such abuse” and inserting “ such disorder”;

(7)

in subsection (j)—

(A)

in the matter preceding paragraph (1), by striking “ to on” and inserting “ to or on”; and

(B)

in paragraph (3), by striking “ Office for” and inserting “ Office of”;

(8)

by amending subsection (m) to read as follows:

“(m) Allocation of Awards.—In making awards under subsection (a), the Director shall give priority to an applicant that agrees to use the award for a program serving an area that is a rural area, an area designated under section 332 by the Secretary as a health professional shortage area, or an area determined by the Director to have a shortage of family-based substance use disorder treatment options.”

; and

(9)

in subsection (q)—

(A)

in paragraph (3), by striking “ funding agreement under subsection (a)” and inserting “ funding agreement”; and

(B)

in paragraph (4), by striking “ substance abuse” and inserting “ a substance use disorder”.

(b)

Reauthorization of Program.— Section 508 of the Public Health Service Act (42 U.S.C. 290bb–1), as amended by subsection (a), is further amended—

(1)

in subsection (p), in the first sentence, 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 “ $16,900,000 for each of fiscal years 2017 through 2021”.

(c)

Pilot Program Grants for State Substance Abuse Agencies.—

(1)

In general.— Section 508 of the Public Health Service Act (42 U.S.C. 290bb–1), as amended by subsections (a) and (b), is further amended—

(A)

by redesignating subsection (r), as amended by subsection (b), as subsection (s); and

(B)

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—

“(A) to 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) to 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 nonresidential-based settings; and

“(C) to 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 the services described in subsection (d); and

“(F) consider not applying the requirements described in paragraphs (1) and (2) of subsection (f) to an applicant, 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 of services—

“(i) shall include the services 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.—

“(A) In general.—The Director of the Center for Behavioral Health Statistics and Quality shall evaluate the pilot program at the conclusion of the first grant cycle funded by the pilot program.

“(B) Report.—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 the evaluation under subparagraph (A). The report shall include, at a minimum—

“(i) outcomes information from the pilot program, including any resulting reductions in the use of alcohol and other drugs;

“(ii) engagement in treatment services;

“(iii) retention in the appropriate level and duration of services;

“(iv) 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

“(v) other appropriate measures.

“(C) Recommendation.—The report under subparagraph (B) shall include a recommendation by the Director of the Center for Substance Abuse Treatment as to whether the pilot program under this subsection should be extended.

“(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.”

(2)

Funding.— Subsection (s) of section 508 of the Public Health Service Act (42 U.S.C. 290bb–1), as amended by subsection (a) and redesignated by paragraph (1), is further amended by adding at the end the following new sentences: “ 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. Notwithstanding the preceding sentence, no funds shall be made available to carry out subsection (r) for a fiscal year unless the amount made available to carry out this section for such fiscal year is more than the amount made available to carry out this section for fiscal year 2016.”.

SEC. 502. Veterans Treatment Courts.

Section 2991 of the Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa) is amended—

(1)

by redesignating subsection (i) as subsection (j); and

(2)

by inserting after subsection (h) the following:

“(i) Assisting Veterans.—

“(1) Definitions.—In this subsection:

“(A) Peer-to-peer services or programs.—The term ‘peer-to-peer services or programs’ means services or programs that connect qualified veterans with other veterans for the purpose of providing support and mentorship to assist qualified veterans in obtaining treatment, recovery, stabilization, or rehabilitation.

“(B) Qualified veteran.—The term ‘qualified veteran’ means a preliminarily qualified offender who—

“(i) served on active duty in any branch of the Armed Forces, including the National Guard or Reserves; and

“(ii) was discharged or released from such service under conditions other than dishonorable, unless the reason for the dishonorable discharge was attributable to a substance abuse disorder.

“(C) Veterans treatment court program.—The term ‘veterans treatment court program’ means a court program involving collaboration among criminal justice, veterans, and mental health and substance abuse agencies that provides qualified veterans with—

“(i) intensive judicial supervision and case management, which may include random and frequent drug testing where appropriate;

“(ii) a full continuum of treatment services, including mental health services, substance abuse services, medical services, and services to address trauma;

“(iii) alternatives to incarceration; or

“(iv) other appropriate services, including housing, transportation, mentoring, employment, job training, education, or assistance in applying for and obtaining available benefits.

“(2) Veterans assistance program.—

“(A) In general.—The Attorney General, in consultation with the Secretary of Veterans Affairs, may award grants under this subsection to applicants to establish or expand—

“(i) veterans treatment court programs;

“(ii) peer-to-peer services or programs for qualified veterans;

“(iii) practices that identify and provide treatment, rehabilitation, legal, transitional, and other appropriate services to qualified veterans who have been incarcerated; or

“(iv) training programs to teach criminal justice, law enforcement, corrections, mental health, and substance abuse personnel how to identify and appropriately respond to incidents involving qualified veterans.

“(B) Priority.—In awarding grants under this subsection, the Attorney General shall give priority to applications that—

“(i) demonstrate collaboration between and joint investments by criminal justice, mental health, substance abuse, and veterans service agencies;

“(ii) promote effective strategies to identify and reduce the risk of harm to qualified veterans and public safety; and

“(iii) propose interventions with empirical support to improve outcomes for qualified veterans.”

SEC. 503. Infant Plan of Safe Care.

(a)

Best Practices for Development of Plans of Safe Care.— Section 103(b) of the Child Abuse Prevention and Treatment Act (42 U.S.C. 5104(b)) is amended—

(1)

by redesignating paragraphs (5) through (8) as paragraphs (6) through (9), respectively; and

(2)

by inserting after paragraph (4) the following:

“(5) maintain and disseminate information about the requirements of section 106(b)(2)(B)(iii) and best practices relating to the development of plans of safe care as described in such section for infants born and identified as being affected by substance abuse or withdrawal symptoms, or a Fetal Alcohol Spectrum Disorder;”

(b)

State Plans.— Section 106(b)(2)(B) of the Child Abuse Prevention and Treatment Act (42 U.S.C. 5106a(b)(2)(B)) is amended—

(1)

in clause (ii), by striking “ illegal substance abuse” and inserting “ substance abuse”; and

(2)

in clause (iii)—

(A)

by striking “ illegal substance abuse” and inserting “ substance abuse”; and

(B)

by inserting before the semicolon at the end the following:

“(I) addressing the health and substance use disorder treatment needs of the infant and affected family or caregiver; and

“(II) the development and implementation by the State of monitoring systems regarding the implementation of such plans to determine whether and in what manner local entities are providing, in accordance with State requirements, referrals to and delivery of appropriate services for the infant and affected family or caregiver”

(c)

Data Reports.—

(1)

In general.— Section 106(d) of the Child Abuse Prevention and Treatment Act (42 U.S.C. 5106a(d)) is amended by adding at the end of the following:

“(17) The number of infants—

“(A) identified under subsection (b)(2)(B)(ii);

“(B) for whom a plan of safe care was developed under subsection (b)(2)(B)(iii); and

“(C) for whom a referral was made for appropriate services, including services for the affected family or caregiver, under subsection (b)(2)(B)(iii).”

(2)

Redesignation.— Effective on May 29, 2017, section 106(d) of the Child Abuse Prevention and Treatment Act (42 U.S.C. 5106a(d)) is amended by redesignating paragraph (17) (as added by paragraph (1)) as paragraph (18).

(d)

Monitoring and Oversight.—

(1)

Amendment.— Title I of the Child Abuse Prevention and Treatment Act (42 U.S.C. 5101 et seq.) is amended by adding at the end the following:

“SEC. 114. MONITORING AND OVERSIGHT.

“The Secretary shall conduct monitoring to ensure that each State that receives a grant under section 106 is in compliance with the requirements of section 106(b), which—

“(1) shall—

“(A) be in addition to the review of the State plan upon its submission under section 106(b)(1)(A); and

“(B) include monitoring of State policies and procedures required under clauses (ii) and (iii) of section 106(b)(2)(B); and

“(2) may include—

“(A) a comparison of activities carried out by the State to comply with the requirements of section 106(b) with the State plan most recently approved under section 432 of the Social Security Act;

“(B) a review of information available on the website of the State relating to its compliance with the requirements of section 106(b);

“(C) site visits, as may be necessary to carry out such monitoring; and

“(D) a review of information available in the State’s Annual Progress and Services Report most recently submitted under section 1357.16 of title 45, Code of Federal Regulations (or successor regulations).”

(2)

Table of contents.— The table of contents in section 1(b) of the Child Abuse Prevention and Treatment Act (42 U.S.C. 5101 note) is amended by inserting after the item relating to section 113, the following:

“Sec. 114. Monitoring and oversight.”.

(e)

Rule of Construction.— Nothing in this section, or the amendments made by this section, shall be construed to authorize the Secretary of Health and Human Services or any other officer of the Federal Government to add new requirements to section 106(b) of the Child Abuse Prevention and Treatment Act (42 U.S.C. 5106a(b)), as amended by this section.

SEC. 504. Gao Report on Neonatal Abstinence Syndrome (nas).

(a)

In General.— Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Finance and the Committee on Health, Education, Labor, and Pensions of the Senate a report on neonatal abstinence syndrome (in this section referred to as “NAS”) in the United States.

(b)

Information To Be Included in Report.— Such report shall include information on the following:

(1)

The prevalence of NAS in the United States, including the proportion of children born in the United States with NAS who are eligible for medical assistance under State Medicaid programs under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) at birth, and the costs associated with coverage under such programs for treatment of infants with NAS.

(2)

The services for which coverage is available under State Medicaid programs for treatment of infants with NAS.

(3)

The settings (including inpatient, outpatient, hospital-based, and other settings) for the treatment of infants with NAS and the reimbursement methodologies and costs associated with such treatment in such settings.

(4)

The prevalence of utilization of various care settings under State Medicaid programs for treatment of infants with NAS and any Federal barriers to treating such infants under such programs, particularly in non-hospital-based settings.

(5)

What is known about best practices for treating infants with NAS.

(c)

Recommendations.— Such report also shall include such recommendations as the Comptroller General determines appropriate for improvements that will ensure access to treatment for infants with NAS under State Medicaid programs.

Title V — Addiction and Treatment Services for Women, Families, and Veterans