Restoring Hope for Mental Health and Well-Being Act of 2022
Summary
Part 1 of Report 117-364 of the 117th Congress, 2d Session, from the Committee on Energy and Commerce on H.R. 7666, the Restoring Hope for Mental Health and Well-Being Act of 2022, dated June 13, 2022 and submitted by Mr. Pallone. The text shown reproduces the bill with its changes marked, including a provision authorizing $29,605,000 for each of fiscal years 2023 through 2027, replacing 2018 through 2022. A section on an Evidence-Based Prescription Opioid and Heroin Treatment and Interventions Demonstration lets the Secretary award grants, contracts or cooperative agreements to State substance use disorder agencies, local governments, nonprofit organizations and Indian Tribes and Tribal organizations.
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Cite this document
“Restoring Hope for Mental Health and Well-Being Act of 2022.”
Original at www.govinfo.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/crpt-crpt-117hrpt364-crpt-117hrpt364-pt1/
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117TH CONGRESS REPT. 117–364
" HOUSE OF REPRESENTATIVES !
2d Session Part 1
RESTORING HOPE FOR MENTAL HEALTH
AND WELL-BEING ACT OF 2022
R E P O R T
OF THE
COMMITTEE ON ENERGY AND COMMERCE
TO ACCOMPANY H.R. 7666
JUNE 13, 2022.—Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
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RESTORING HOPE FOR MENTAL HEALTH AND WELL-BEING ACT OF
2022
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117TH CONGRESS REPT. 117–364
" HOUSE OF REPRESENTATIVES !
2d Session Part 1
RESTORING HOPE FOR MENTAL HEALTH
AND WELL-BEING ACT OF 2022
R E P O R T
OF THE
COMMITTEE ON ENERGY AND COMMERCE
TO ACCOMPANY H.R. 7666
JUNE 13, 2022.—Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
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U.S. GOVERNMENT PUBLISHING OFFICE
47–779 WASHINGTON : 2022
E:\Seals\Congress.#13
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117TH CONGRESS REPT. 117–364
" HOUSE OF REPRESENTATIVES !
2d Session Part 1
RESTORING HOPE FOR MENTAL HEALTH AND WELL-
BEING ACT OF 2022
JUNE 13, 2022.—Committed to the Committee of the Whole House on the State of
the Union and ordered to be printed
Mr. PALLONE, from the Committee on Energy and Commerce,
submitted the following
R E P O R T
[To accompany H.R. 7666]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 7666) to amend the Public Health Service Act to re-
authorize certain programs relating to mental health and sub-
stance use disorders, and for other purposes, having considered the
same, reports favorably thereon with an amendment and rec-
ommends that the bill as amended do pass.
CONTENTS
Page
I. Purpose and Summary ............................................................................... 42
II. Background and Need for the Legislation ................................................ 43
III. Committee Hearings ................................................................................... 49
IV. Committee Consideration ........................................................................... 49
V. Committee Votes ......................................................................................... 50
VI. Oversight Findings ...................................................................................... 56
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures 56
VIII. Federal Mandates Statement ..................................................................... 56
IX. Statement of General Performance Goals and Objectives ....................... 56
X. Duplication of Federal Programs ............................................................... 56
XI. Committee Cost Estimate ........................................................................... 56
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits ............... 56
XIII. Advisory Committee Statement ................................................................. 57
XIV. Applicability to Legislative Branch ........................................................... 57
XV. Section-by-Section Analysis of the Legislation ......................................... 57
XVI. Changes in Existing Law Made by the Bill, as Reported ........................ 66
XVII. Communications from Other Committees ................................................. 456
The amendment is as follows:
Strike all after the enacting clause and insert the following:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the ‘‘Restoring Hope for Mental
Health and Well-Being Act of 2022’’.
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(b) TABLE OF CONTENTS.—The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—MENTAL HEALTH AND CRISIS CARE NEEDS
Subtitle A—Crisis Care Services and 9–8–8 Implementation
Sec. 101. Behavioral Health Crisis Coordinating Office.
Sec. 102. Crisis response continuum of care.
Subtitle B—Into the Light for Maternal Mental Health and Substance Use Disorders
Sec. 111. Screening and treatment for maternal mental health and substance use disorders.
Sec. 112. Maternal mental health hotline.
Sec. 113. Task force on maternal mental health.
Subtitle C—Reaching Improved Mental Health Outcomes for Patients
Sec. 121. Innovation for mental health.
Sec. 122. Crisis care coordination.
Sec. 123. Treatment of serious mental illness.
Subtitle D—Anna Westin Legacy
Sec. 131. Maintaining education and training on eating disorders.
Subtitle E—Community Mental Health Services Block Grant Reauthorization
Sec. 141. Reauthorization of block grants for community mental health services.
Subtitle F—Peer-Supported Mental Health Services
Sec. 151. Peer-supported mental health services.
TITLE II—SUBSTANCE USE DISORDER PREVENTION, TREATMENT, AND RECOVERY SERVICES
Subtitle A—Native Behavioral Health Access Improvement
Sec. 201. Behavioral health and substance use disorder services for Native Americans.
Subtitle B—Summer Barrow Prevention, Treatment, and Recovery
Sec. 211. Grants for the benefit of homeless individuals.
Sec. 212. Priority substance abuse treatment needs of regional and national significance.
Sec. 213. Evidence-based prescription opioid and heroin treatment and interventions demonstration.
Sec. 214. Priority substance use disorder prevention needs of regional and national significance.
Sec. 215. Sober Truth on Preventing (STOP) Underage Drinking Reauthorization.
Sec. 216. Grants for jail diversion programs.
Sec. 217. Formula grants to States.
Sec. 218. Projects for Assistance in Transition From Homelessness.
Sec. 219. Grants for reducing overdose deaths.
Sec. 220. Opioid overdose reversal medication access and education grant programs.
Sec. 221. State demonstration grants for comprehensive opioid abuse response.
Sec. 222. Emergency department alternatives to opioids.
Subtitle C—Excellence in Recovery Housing
Sec. 231. Clarifying the role of SAMHSA in promoting the availability of high-quality recovery housing.
Sec. 232. Developing guidelines for States to promote the availability of high-quality recovery housing.
Sec. 233. Coordination of Federal activities to promote the availability of recovery housing.
Sec. 234. NAS study and report.
Sec. 235. Grants for States to promote the availability of recovery housing and services.
Sec. 236. Funding.
Sec. 237. Technical correction.
Subtitle D—Substance Use Prevention, Treatment, and Recovery Services Block Grant
Sec. 241. Eliminating stigmatizing language relating to substance use.
Sec. 242. Authorized activities.
Sec. 243. Requirements relating to certain infectious diseases and human immunodeficiency virus.
Sec. 244. State plan requirements.
Sec. 245. Updating certain language relating to Tribes.
Sec. 246. Block grants for substance use prevention, treatment, and recovery services.
Sec. 247. Requirement of reports and audits by States.
Sec. 248. Study on assessment for use in distribution of limited State resources.
Subtitle E—Timely Treatment for Opioid Use Disorder
Sec. 251. Study on exemptions for treatment of opioid use disorder through opioid treatment programs during
the COVID–19 public health emergency.
Sec. 252. Changes to Federal opioid treatment standards.
Subtitle F—Additional Provisions Relating to Addiction Treatment
Sec. 261. Prohibition.
Sec. 262. Eliminating additional requirements for dispensing narcotic drugs in schedule III, IV, and V for main-
tenance or detoxification treatment.
Sec. 263. Requiring prescribers of controlled substances to complete training.
TITLE III—ACCESS TO MENTAL HEALTH CARE AND COVERAGE
Subtitle A—Collaborate in an Orderly and Cohesive Manner
Sec. 301. Increasing uptake of the collaborative care model.
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Subtitle B—Helping Enable Access to Lifesaving Services
Sec. 311. Reauthorization and provision of certain programs to strengthen the health care workforce.
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Subtitle C—Eliminating the Opt-Out for Nonfederal Governmental Health Plans
Sec. 321. Eliminating the opt-out for nonfederal governmental health plans.
Subtitle D—Mental Health and Substance Use Disorder Parity Implementation
Sec. 331. Grants to support mental health and substance use disorder parity implementation.
TITLE IV—CHILDREN AND YOUTH
Subtitle A—Supporting Children’s Mental Health Care Access
Sec. 401. Pediatric mental health care access grants.
Sec. 402. Infant and early childhood mental health promotion, intervention, and treatment.
Subtitle B—Continuing Systems of Care for Children
Sec. 411. Comprehensive Community Mental Health Services for Children with Serious Emotional Disturb-
ances.
Sec. 412. Substance Use Disorder Treatment and Early Intervention Services for Children and Adolescents.
Subtitle C—Garrett Lee Smith Memorial Reauthorization
Sec. 421. Suicide prevention technical assistance center.
Sec. 422. Youth suicide early intervention and prevention strategies.
Sec. 423. Mental health and substance use disorder services for students in higher education.
Sec. 424. Mental and behavioral health outreach and education at institutions of higher education.
TITLE I—MENTAL HEALTH AND CRISIS CARE
NEEDS
Subtitle A—Crisis Care Services and 9–8–8
Implementation
SEC. 101. BEHAVIORAL HEALTH CRISIS COORDINATING OFFICE.
Part A of title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is
amended by adding at the end the following:
‘‘SEC. 506B. BEHAVIORAL HEALTH CRISIS COORDINATING OFFICE.
‘‘(a) IN GENERAL.—The Secretary shall establish, within the Substance Abuse and
Mental Health Services Administration, an office to coordinate work relating to be-
havioral health crisis care across the operating divisions and agencies of the Depart-
ment of Health and Human Services, including the Substance Abuse and Mental
Health Services Administration, the Centers for Medicare & Medicaid Services, and
the Health Resources and Services Administration, and external stakeholders.
‘‘(b) DUTY.—The office established under subsection (a) shall—
‘‘(1) convene Federal, State, Tribal, local, and private partners;
‘‘(2) launch and manage Federal workgroups charged with making rec-
ommendations regarding behavioral health crisis issues, including with respect
to health care best practices, workforce development, mental health disparities,
data collection, technology, program oversight, public awareness, and engage-
ment; and
‘‘(3) support technical assistance, data analysis, and evaluation functions in
order to assist States, localities, Territories, Tribes, and Tribal communities to
develop crisis care systems and establish nationwide best practices with the ob-
jective of expanding the capacity of, and access to, local crisis call centers, mo-
bile crisis care, crisis stabilization, psychiatric emergency services, and rapid
post-crisis follow-up care provided by—
‘‘(A) the National Suicide Prevention and Mental Health Crisis Hotline
and Response System;
‘‘(B) community mental health centers (as defined in section 1861(ff)(3)(B)
of the Social Security Act);
‘‘(C) certified community behavioral health clinics, as described in section
223 of the Protecting Access to Medicare Act of 2014; and
‘‘(D) other community mental health and substance use disorder pro-
viders.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated
to carry out this section $5,000,000 for each of fiscal years 2023 through 2027.’’.
SEC. 102. CRISIS RESPONSE CONTINUUM OF CARE.
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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:
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‘‘SEC. 520N. CRISIS RESPONSE CONTINUUM OF CARE.
‘‘(a) IN GENERAL.—The Secretary shall publish best practices for a crisis response
continuum of care for use by health care providers, crisis services administrators,
and crisis services providers in responding to individuals (including children and
adolescents) experiencing mental health crises, substance-related crises, and crises
arising from co-occurring disorders.
‘‘(b) BEST PRACTICES.—
‘‘(1) SCOPE OF BEST PRACTICES.—The best practices published under sub-
section (a) shall define—
‘‘(A) a minimum set of core crisis response services, as determined by the
Secretary, for each entity that furnishes such services, that—
‘‘(i) do not require prior authorization from an insurance provider or
group health plan nor a referral from a health care provider prior to
the delivery of services;
‘‘(ii) provide for serving all individuals regardless of age or ability to
pay;
‘‘(iii) provide for operating 24 hours a day, 7 days a week; and
‘‘(iv) provide for care and support through resources described in
paragraph (2)(A) until the individual has been stabilized or transferred
to the next level of crisis care; and
‘‘(B) psychiatric stabilization, including the point at which a case may be
closed for—
‘‘(i) individuals screened over the phone; and
‘‘(ii) individuals stabilized on the scene by mobile teams.
‘‘(2) IDENTIFICATION OF ESSENTIAL FUNCTIONS.—The best practices published
under subsection (a) shall identify the essential functions of each service in the
crisis response continuum, which shall include at least the following:
‘‘(A) Identification of resources for referral and enrollment in continuing
mental health, substance use, or other human services relevant for the indi-
vidual in crisis where necessary.
‘‘(B) Delineation of access and entry points to services within the crisis
response continuum.
‘‘(C) Development of protocols and agreements for the transfer and receipt
of individuals to and from other segments of the crisis response continuum
segments as needed, and from outside referrals including health care pro-
viders, first responders including law enforcement, paramedics, and fire-
fighters, education institutions, and community-based organizations.
‘‘(D) Description of the qualifications of crisis services staff, including
roles for physicians, licensed clinicians, case managers, and peers (in ac-
cordance with State licensing requirements or requirements applicable to
Tribal health professionals).
‘‘(E) The convening of collaborative meetings of crisis response service
providers, first responders including law enforcement, paramedics, and fire-
fighters, and community partners (including National Suicide Prevention
Lifeline or 9–8–8 call centers, 9–1–1 public service answering points, and
local mental health and substance use disorder treatment providers) oper-
ating in a common region for the discussion of case management, best prac-
tices, and general performance improvement.
‘‘(3) SERVICE CAPACITY AND QUALITY BEST PRACTICES.—The best practices
under subsection (a) shall include recommendations on—
‘‘(A) adequate volume of services to meet population need;
‘‘(B) appropriate timely response; and
‘‘(C) capacity to meet the needs of different patient populations that may
experience a mental health or substance use crisis, including children, fami-
lies, and all age groups, cultural and linguistic minorities, individuals with
co-occurring mental health and substance use disorders, individuals with
cognitive disabilities, individuals with developmental delays, and individ-
uals with chronic medical conditions and physical disabilities.
‘‘(4) IMPLEMENTATION TIMEFRAME.—The Secretary shall—
‘‘(A) not later than 1 year after the date of enactment of this section, pub-
lish and maintain the best practices required by subsection (a); and
‘‘(B) every two years thereafter, publish updates.
‘‘(5) DATA COLLECTION AND EVALUATIONS.—The Secretary, directly or through
grants, contracts, or interagency agreements, shall collect data and conduct
evaluations with respect to the provision of services and programs offered on
the crisis response continuum for purposes of assessing the extent to which the
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provision of such services and programs meet certain objectives and outcomes
measures as determined by the Secretary. Such objectives shall include—
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‘‘(A) a reduction in reliance on law enforcement response, as appropriate,
to individuals in crisis who would be more appropriately served by a mobile
crisis team capable of responding to mental health and substance-related
crises;
‘‘(B) a reduction in boarding or extended holding of patients in emergency
room facilities who require further psychiatric care, including care for sub-
stance use disorders;
‘‘(C) evidence of adequate access to crisis care centers and crisis bed serv-
ices; and
‘‘(D) evidence of adequate linkage to appropriate post-crisis care and lon-
gitudinal treatment for mental health or substance use disorder when rel-
evant.’’.
Subtitle B—Into the Light for Maternal Mental
Health and Substance Use Disorders
SEC. 111. SCREENING AND TREATMENT FOR MATERNAL MENTAL HEALTH AND SUBSTANCE
USE DISORDERS.
(a) IN GENERAL.—Section 317L–1 of the Public Health Service Act (42 U.S.C.
247b–13a) is amended—
(1) in the section heading, by striking ‘‘MATERNAL DEPRESSION’’ and inserting
‘‘MATERNAL MENTAL HEALTH AND SUBSTANCE USE DISORDERS’’; and
(2) in subsection (a)—
(A) by inserting ‘‘, Indian Tribes and Tribal organizations (as such terms
are defined in section 4 of the Indian Self-Determination and Education As-
sistance Act), and Urban Indian organizations (as such term is defined
under the Federally Recognized Indian Tribe List Act of 1994)’’ after
‘‘States’’; and
(B) by striking ‘‘for women who are pregnant, or who have given birth
within the preceding 12 months, for maternal depression’’ and inserting ‘‘for
women who are postpartum, pregnant, or have given birth within the pre-
ceding 12 months, for maternal mental health and substance use dis-
orders’’.
(b) APPLICATION.—Subsection (b) of section 317L–1 of the Public Health Service
Act (42 U.S.C. 247b–13a) is amended—
(1) by striking ‘‘a State shall submit’’ and inserting ‘‘an entity listed in sub-
section (a) shall submit’’; and
(2) in paragraphs (1) and (2), by striking ‘‘maternal depression’’ each place it
appears and inserting ‘‘maternal mental health and substance use disorders’’.
(c) PRIORITY.—Subsection (c) of section 317L–1 of the Public Health Service Act
(42 U.S.C. 247b–13a) is amended—
(1) by striking ‘‘may give priority to States proposing to improve or enhance
access to screening’’ and inserting the following: ‘‘shall give priority to entities
listed in subsection (a) that—
‘‘(1) are proposing to create, improve, or enhance screening, prevention, and
treatment’’;
(2) by striking ‘‘maternal depression’’ and inserting ‘‘maternal mental health
and substance use disorders’’;
(3) by striking the period at the end of paragraph (1), as so designated, and
inserting a semicolon; and
(4) by inserting after such paragraph (1) the following:
‘‘(2) are currently partnered with, or will partner with, a community-based or-
ganization to address maternal mental health and substance use disorders;
‘‘(3) are located in an area with high rates of adverse maternal health out-
comes or significant health, economic, racial, or ethnic disparities in maternal
health and substance use disorder outcomes; and
‘‘(4) operate in a health professional shortage area designated under section
332.’’.
(d) USE OF FUNDS.—Subsection (d) of section 317L–1 of the Public Health Service
Act (42 U.S.C. 247b–13a) is amended—
(1) in paragraph (1)—
(A) in subparagraph (A), by striking ‘‘to health care providers; and’’ and
inserting ‘‘on maternal mental health and substance use disorder screening,
brief intervention, treatment (as applicable for health care providers), and
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referrals for treatment to health care providers in the primary care setting
and nonclinical perinatal support workers;’’;
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(B) in subparagraph (B), by striking ‘‘to health care providers, including
information on maternal depression screening, treatment, and followup sup-
port services, and linkages to community-based resources; and’’ and insert-
ing ‘‘on maternal mental health and substance use disorder screening, brief
intervention, treatment (as applicable for health care providers) and refer-
rals for treatment, follow-up support services, and linkages to community-
based resources to health care providers in the primary care setting and
clinical perinatal support workers; and’’; and
(C) by adding at the end the following:
‘‘(C) enabling health care providers (such as obstetrician-gynecologists,
nurse practitioners, nurse midwives, pediatricians, psychiatrists, mental
and other behavioral health care providers, and adult primary care clini-
cians) to provide or receive real-time psychiatric consultation (in-person or
remotely), including through the use of technology-enabled collaborative
learning and capacity building models (as defined in section 330N), to aid
in the treatment of pregnant and postpartum women; and’’; and
(2) in paragraph (2)—
(A) by striking subparagraph (A) and redesignating subparagraphs (B)
and (C) as subparagraphs (A) and (B), respectively;
(B) in subparagraph (A), as redesignated, by striking ‘‘and’’ at the end;
(C) in subparagraph (B), as redesignated—
(i) by inserting ‘‘, including’’ before ‘‘for rural areas’’; and
(ii) by striking the period at the end and inserting a semicolon; and
(D) by inserting after subparagraph (B), as redesignated, the following:
‘‘(C) providing assistance to pregnant and postpartum women to receive
maternal mental health and substance use disorder treatment, including
patient consultation, care coordination, and navigation for such treatment;
‘‘(D) coordinating with maternal and child health programs of the Federal
Government and State, local, and Tribal governments, including child psy-
chiatric access programs;
‘‘(E) conducting public outreach and awareness regarding grants under
subsection (a);
‘‘(F) creating multistate consortia to carry out the activities required or
authorized under this subsection; and
‘‘(G) training health care providers in the primary care setting and non-
clinical perinatal support workers on trauma-informed care, culturally and
linguistically appropriate services, and best practices related to training to
improve the provision of maternal mental health and substance use dis-
order care for racial and ethnic minority populations, including with respect
to perceptions and biases that may affect the approach to, and provision of,
care.’’.
(e) ADDITIONAL PROVISIONS.—Section 317L–1 of the Public Health Service Act (42
U.S.C. 247b–13a) is amended—
(1) by redesignating subsection (e) as subsection (h); and
(2) by inserting after subsection (d) the following:
‘‘(e) TECHNICAL ASSISTANCE.—The Secretary shall provide technical assistance to
grantees and entities listed in subsection (a) for carrying out activities pursuant to
this section.
‘‘(f) DISSEMINATION OF BEST PRACTICES.—The Secretary, based on evaluation of
the activities funded pursuant to this section, shall identify and disseminate evi-
dence-based or evidence-informed best practices for screening, assessment, and
treatment services for maternal mental health and substance use disorders, includ-
ing culturally and linguistically appropriate services, for women during pregnancy
and 12 months following pregnancy.
‘‘(g) MATCHING REQUIREMENT.—The Federal share of the cost of the activities for
which a grant is made to an entity under subsection (a) shall not exceed 90 percent
of the total cost of such activities.’’.
(f) AUTHORIZATION OF APPROPRIATIONS.—Subsection (h) of section 317L–1 (42
U.S.C. 247b–13a) of the Public Health Service Act, as redesignated, is further
amended—
(1) by striking ‘‘$5,000,000’’ and inserting ‘‘$24,000,000’’; and
(2) by striking ‘‘2018 through 2022’’ and inserting ‘‘2023 through 2027’’.
SEC. 112. MATERNAL MENTAL HEALTH HOTLINE.
Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is
amended by adding at the end the following:
‘‘SEC. 399V–7. MATERNAL MENTAL HEALTH HOTLINE.
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‘‘(a) IN GENERAL.—The Secretary shall maintain, directly or by grant or contract,
a national hotline to provide emotional support, information, brief intervention, and
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mental health and substance use disorder resources to pregnant and postpartum
women at risk of, or affected by, maternal mental health and substance use dis-
orders, and to their families or household members.
‘‘(b) REQUIREMENTS FOR HOTLINE.—The hotline under subsection (a) shall—
‘‘(1) be a 24/7 real-time hotline;
‘‘(2) provide voice and text support;
‘‘(3) be staffed by certified peer specialists, licensed health care professionals,
or licensed mental health professionals who are trained on—
‘‘(A) maternal mental health and substance use disorder prevention, iden-
tification, and intervention; and
‘‘(B) providing culturally and linguistically appropriate support; and
‘‘(4) provide maternal mental health and substance use disorder assistance
and referral services to meet the needs of underserved populations, individuals
with disabilities, and family and household members of pregnant or postpartum
women at risk of experiencing maternal mental health and substance use dis-
orders.
‘‘(c) ADDITIONAL REQUIREMENTS.—In maintaining the hotline under subsection (a),
the Secretary shall—
‘‘(1) consult with the Domestic Violence Hotline, National Suicide Prevention
Lifeline, and Veterans Crisis Line to ensure that pregnant and postpartum
women are connected in real-time to the appropriate specialized hotline service,
when applicable;
‘‘(2) conduct a public awareness campaign for the hotline; and
‘‘(3) consult with Federal departments and agencies, including the Centers of
Excellence of the Substance Abuse and Mental Health Services Administration
and the Department of Veterans Affairs, to increase awareness regarding the
hotline.
‘‘(d) ANNUAL REPORT.—The Secretary shall submit an annual report to the Con-
gress on the hotline under subsection (a) and implementation of this section, includ-
ing—
‘‘(1) an evaluation of the effectiveness of activities conducted or supported
under subsection (a);
‘‘(2) a directory of entities or organizations to which staff maintaining the hot-
line funded under this section may make referrals; and
‘‘(3) such additional information as the Secretary determines appropriate.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there are au-
thorized to be appropriated $10,000,000 for each of fiscal years 2023 through 2027.’’.
SEC. 113. TASK FORCE ON MATERNAL MENTAL HEALTH.
Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is
amended by inserting after section 317L–1 (42 U.S.C. 247b–13a) the following:
‘‘SEC. 317L–2. TASK FORCE ON MATERNAL MENTAL HEALTH.
‘‘(a) ESTABLISHMENT.—Not later than 180 days after the date of enactment of the
Restoring Hope for the Mental Health and Well-Being Act of 2022, the Secretary,
for purposes of identifying, evaluating, and making recommendations to coordinate
and improve Federal responses to maternal mental health conditions, shall—
‘‘(1) establish a task force to be known as the Task Force on Maternal Mental
Health (in this section referred to as the ‘Task Force’); or
‘‘(2) incorporate the duties, public meetings, and reports specified in sub-
sections (c) through (f) into existing Federal policy forums, including the Mater-
nal Health Interagency Policy Committee and the Maternal Health Working
Group, as appropriate.
‘‘(b) MEMBERSHIP.—
‘‘(1) COMPOSITION.—The Task Force shall be composed of—
‘‘(A) the Federal members under paragraph (2); and
‘‘(B) the non-Federal members under paragraph (3).
‘‘(2) FEDERAL MEMBERS.—The Federal members of the Task Force shall con-
sist of the following heads of Federal departments and agencies (or their des-
ignees):
‘‘(A) The Assistant Secretary for Health of the Department of Health and
Human Services, who shall serve as Chair.
‘‘(B) The Assistant Secretary for Planning and Evaluation of the Depart-
ment of Health and Human Services.
‘‘(C) The Assistant Secretary of the Administration for Children and Fam-
ilies.
‘‘(D) The Director of the Centers for Disease Control and Prevention.
‘‘(E) The Administrator of the Centers for Medicare & Medicaid Services.
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‘‘(F) The Administrator of the Health Resources and Services Administra-
tion.
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‘‘(G) The Director of the Indian Health Service.
‘‘(H) The Assistant Secretary for Mental Health and Substance Use.
‘‘(I) Such other Federal departments and agencies as the Secretary deter-
mines appropriate that serve individuals with maternal mental health con-
ditions.
‘‘(3) NON-FEDERAL MEMBERS.—The non-Federal members of the Task Force
shall—
‘‘(A) compose not more than one-half, and not less than one-third, of the
total membership of the Task Force;
‘‘(B) be appointed by the Secretary; and
‘‘(C) include—
‘‘(i) representatives of medical societies with expertise in maternal or
mental health;
‘‘(ii) representatives of nonprofit organizations with expertise in ma-
ternal or mental health;
‘‘(iii) relevant industry representatives; and
‘‘(iv) other representatives, as appropriate.
‘‘(4) DEADLINE FOR DESIGNATING DESIGNEES.—If the Assistant Secretary for
Health, or the head of a Federal department or agency serving as a member
of the Task Force under paragraph (2), chooses to be represented on the Task
Force by a designee, the Assistant Secretary or department or agency head shall
designate such designee not later than 90 days after the date of the enactment
of this section.
‘‘(c) DUTIES.—The Task Force shall—
‘‘(1) prepare and regularly update a report that analyzes and evaluates the
state of national maternal mental health policy and programs at the Federal,
State, and local levels, and identifies best practices with respect to maternal
mental health policy, including—
‘‘(A) a set of evidence-based, evidence-informed, and promising practices
with respect to—
‘‘(i) prevention strategies for individuals at risk of experiencing a ma-
ternal mental health condition, including strategies and recommenda-
tions to address health inequities;
‘‘(ii) the identification, screening, diagnosis, intervention, and treat-
ment of individuals and families affected by a maternal mental health
condition;
‘‘(iii) the expeditious referral to, and implementation of, practices and
supports that prevent and mitigate the effects of a maternal mental
health condition, including strategies and recommendations to elimi-
nate the racial and ethnic disparities that exist in maternal mental
health; and
‘‘(iv) community-based or multigenerational practices that support in-
dividuals and families affected by a maternal mental health condition;
and
‘‘(B) Federal and State programs and activities to prevent, screen, diag-
nose, intervene, and treat maternal mental health conditions;
‘‘(2) develop and regularly update a national strategy for maternal mental
health, taking into consideration the findings of the report under paragraph (1),
on how the Task Force and Federal departments and agencies represented on
the Task Force may prioritize options for, and may implement a coordinated ap-
proach to, addressing maternal mental health conditions, including by—
‘‘(A) increasing prevention, screening, diagnosis, intervention, treatment,
and access to care, including clinical and nonclinical care such as peer-sup-
port and community health workers, through the public and private sectors;
‘‘(B) providing support for pregnant or postpartum individuals who are at
risk for or experiencing a maternal mental health condition, and their fami-
lies, as appropriate;
‘‘(C) reducing racial, ethnic, geographic, and other health disparities for
prevention, diagnosis, intervention, treatment, and access to care;
‘‘(D) identifying options for modifying, strengthening, and coordinating
Federal programs and activities, such as the Medicaid program under title
XIX of the Social Security Act and the State Children’s Health Insurance
Program under title XXI of such Act, including existing infant and mater-
nity programs, in order to increase research, prevention, identification,
intervention, and treatment with respect to maternal mental health; and
‘‘(E) planning, data sharing, and communication within and across Fed-
eral departments, agencies, offices, and programs;
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‘‘(3) solicit public comments from stakeholders for the report under paragraph
(1) and the national strategy under paragraph (2), including comments from
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frontline service providers, mental health professionals, researchers, experts in
maternal mental health, institutions of higher education, public health agencies
(including maternal and child health programs), and industry representatives,
in order to inform the activities and reports of the Task Force; and
‘‘(4) disaggregate any data collected under this section by race, ethnicity, geo-
graphical location, age, marital status, socioeconomic level, and other factors, as
the Secretary determines appropriate.
‘‘(d) MEETINGS.—The Task Force shall—
‘‘(1) meet not less than two times each year; and
‘‘(2) convene public meetings, as appropriate, to fulfill its duties under this
section.
‘‘(e) REPORTS TO PUBLIC AND FEDERAL LEADERS.—The Task Force shall make pub-
licly available and submit to the heads of relevant Federal departments and agen-
cies, the Committee on Energy and Commerce of the House of Representatives, the
Committee on Health, Education, Labor, and Pensions of the Senate, and other rel-
evant congressional committees, the following:
‘‘(1) Not later than 1 year after the first meeting of the Task Force, an initial
report under subsection (c)(1).
‘‘(2) Not later than 2 years after the first meeting of the Task Force, an initial
national strategy under subsection (c)(2).
‘‘(3) Each year thereafter—
‘‘(A) an updated report under subsection (c)(1);
‘‘(B) an updated national strategy under subsection (c)(2); or
‘‘(C) if no update is made under subsection (c)(1) or (c)(2), a report sum-
marizing the activities of the Task Force.
‘‘(f) REPORTS TO GOVERNORS.—Upon finalizing the initial national strategy under
subsection (c)(2), and upon making relevant updates to such strategy, the Task
Force shall submit a report to the Governors of all States describing opportunities
for local- and State-level partnerships identified under subsection (c)(2)(D).
‘‘(g) SUNSET.—The Task Force shall terminate on September 30, 2027.
‘‘(h) NONDUPLICATION OF FEDERAL EFFORTS.—The Secretary may relieve the Task
Force, in carrying out subsections (c) through (f), from responsibility for carrying out
such activities as may be specified by the Secretary as duplicative with other activi-
ties carried out by the Department of Health and Human Services.’’.
Subtitle C—Reaching Improved Mental Health
Outcomes for Patients
SEC. 121. INNOVATION FOR MENTAL HEALTH.
(a) NATIONAL MENTAL HEALTH AND SUBSTANCE USE POLICY LABORATORY.—Sec-
tion 501A of the Public Health Service Act (42 U.S.C. 290aa–0) is amended—
(1) in subsection (e)(1), by striking ‘‘Indian tribes or tribal organizations’’ and
inserting ‘‘Indian Tribes or Tribal organizations’’;
(2) by striking subsection (e)(3); and
(3) by adding at the end the following:
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is au-
thorized to be appropriated $10,000,000 for each of fiscal years 2023 through 2027.’’.
(b) INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE.—
(1) IN GENERAL.—Part A of title V of the Public Health Service Act (42 U.S.C.
290aa et seq.) is amended by inserting after section 501A (42 U.S.C. 290aa–0)
the following:
‘‘SEC. 501B. INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE.
‘‘(a) ESTABLISHMENT.—
‘‘(1) IN GENERAL.—The Secretary of Health and Human Services, or the des-
ignee of the Secretary, shall establish a committee to be known as the Inter-
departmental Serious Mental Illness Coordinating Committee (in this section
referred to as the ‘Committee’).
‘‘(2) FEDERAL ADVISORY COMMITTEE ACT.—Except as provided in this section,
the provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall
apply to the Committee.
‘‘(b) MEETINGS.—The Committee shall meet not fewer than 2 times each year.
‘‘(c) RESPONSIBILITIES.—The Committee shall submit, on a biannual basis, to Con-
gress and any other relevant Federal department or agency a report including—
‘‘(1) a summary of advances in serious mental illness and serious emotional
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disturbance research related to the prevention of, diagnosis of, intervention in,
and treatment and recovery of serious mental illnesses, serious emotional dis-
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turbances, and advances in access to services and support for adults with a seri-
ous mental illness or children with a serious emotional disturbance;
‘‘(2) an evaluation of the effect Federal programs related to serious mental ill-
ness have on public health, including public health outcomes such as—
‘‘(A) rates of suicide, suicide attempts, incidence and prevalence of serious
mental illnesses, serious emotional disturbances, and substance use dis-
orders, overdose, overdose deaths, emergency hospitalizations, emergency
room boarding, preventable emergency room visits, interaction with the
criminal justice system, homelessness, and unemployment;
‘‘(B) increased rates of employment and enrollment in educational and vo-
cational programs;
‘‘(C) quality of mental and substance use disorders treatment services; or
‘‘(D) any other criteria as may be determined by the Secretary; and
‘‘(3) specific recommendations for actions that agencies can take to better co-
ordinate the administration of mental health services for adults with a serious
mental illness or children with a serious emotional disturbance.
‘‘(d) MEMBERSHIP.—
‘‘(1) FEDERAL MEMBERS.—The Committee shall be composed of the following
Federal representatives, or the designees of such representatives—
‘‘(A) the Secretary of Health and Human Services, who shall serve as the
Chair of the Committee;
‘‘(B) the Assistant Secretary for Mental Health and Substance Use;
‘‘(C) the Attorney General;
‘‘(D) the Secretary of Veterans Affairs;
‘‘(E) the Secretary of Defense;
‘‘(F) the Secretary of Housing and Urban Development;
‘‘(G) the Secretary of Education;
‘‘(H) the Secretary of Labor;
‘‘(I) the Administrator of the Centers for Medicare & Medicaid Services;
and
‘‘(J) the Commissioner of Social Security.
‘‘(2) NON-FEDERAL MEMBERS.—The Committee shall also include not less than
14 non-Federal public members appointed by the Secretary of Health and
Human Services, of which—
‘‘(A) at least 2 members shall be an individual who has received treat-
ment for a diagnosis of a serious mental illness;
‘‘(B) at least 1 member shall be a parent or legal guardian of an adult
with a history of a serious mental illness or a child with a history of a seri-
ous emotional disturbance;
‘‘(C) at least 1 member shall be a representative of a leading research,
advocacy, or service organization for adults with a serious mental illness;
‘‘(D) at least 2 members shall be—
‘‘(i) a licensed psychiatrist with experience in treating serious mental
illnesses;
‘‘(ii) a licensed psychologist with experience in treating serious men-
tal illnesses or serious emotional disturbances;
‘‘(iii) a licensed clinical social worker with experience treating serious
mental illnesses or serious emotional disturbances; or
‘‘(iv) a licensed psychiatric nurse, nurse practitioner, or physician as-
sistant with experience in treating serious mental illnesses or serious
emotional disturbances;
‘‘(E) at least 1 member shall be a licensed mental health professional with
a specialty in treating children and adolescents with a serious emotional
disturbance;
‘‘(F) at least 1 member shall be a mental health professional who has re-
search or clinical mental health experience in working with minorities;
‘‘(G) at least 1 member shall be a mental health professional who has re-
search or clinical mental health experience in working with medically un-
derserved populations;
‘‘(H) at least 1 member shall be a State certified mental health peer sup-
port specialist;
‘‘(I) at least 1 member shall be a judge with experience in adjudicating
cases related to criminal justice or serious mental illness;
‘‘(J) at least 1 member shall be a law enforcement officer or corrections
officer with extensive experience in interfacing with adults with a serious
mental illness, children with a serious emotional disturbance, or individuals
in a mental health crisis; and
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‘‘(K) at least 1 member shall have experience providing services for home-
less individuals and working with adults with a serious mental illness, chil-
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dren with a serious emotional disturbance, or individuals in a mental
health crisis.
‘‘(3) TERMS.—A member of the Committee appointed under paragraph (2)
shall serve for a term of 3 years, and may be reappointed for 1 or more addi-
tional 3-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 been appointed.
‘‘(e) WORKING GROUPS.—In carrying out its functions, the Committee may estab-
lish working groups. Such working groups shall be composed of Committee mem-
bers, or their designees, and may hold such meetings as are necessary.
‘‘(f) SUNSET.—The Committee shall terminate on September 30, 2027.’’.
(2) CONFORMING AMENDMENTS.—
(A) Section 501(l)(2) of the Public Health Service Act (42 U.S.C.
290aa(l)(2)) is amended by striking ‘‘section 6031 of such Act’’ and inserting
‘‘section 501B of this Act’’.
(B) Section 6031 of the Helping Families in Mental Health Crisis Reform
Act of 2016 (Division B of Public Law 114–255) is repealed (and by con-
forming the item relating to such section in the table of contents in section
1(b)).
(c) PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL SIGNIFI-
CANCE.—Section 520A of the Public Health Service Act (42 U.S.C. 290bb–32) is
amended—
(1) in subsection (a), by striking ‘‘Indian tribes or tribal organizations’’ and
inserting ‘‘Indian Tribes or Tribal organizations’’; and
(2) in subsection (f), by striking ‘‘$394,550,000 for each of fiscal years 2018
through 2022’’ and inserting ‘‘$599,036,000 for each of fiscal years 2023 through
2027’’.
SEC. 122. CRISIS CARE COORDINATION.
(a) STRENGTHENING COMMUNITY CRISIS RESPONSE SYSTEMS.—Section 520F of the
Public Health Service Act (42 U.S.C. 290bb–37) is amended to read as follows:
‘‘SEC. 520F. MENTAL HEALTH CRISIS RESPONSE PARTNERSHIP PILOT PROGRAM.
‘‘(a) IN GENERAL.—The Secretary shall establish a pilot program under which the
Secretary will award competitive grants to States, localities, territories, Indian
Tribes, and Tribal organizations to establish new, or enhance existing, mobile crisis
response teams that divert the response for mental health and substance use crises
from law enforcement to mobile crisis teams, as described in subsection (b).
‘‘(b) MOBILE CRISIS TEAMS DESCRIBED.—A mobile crisis team described in this
subsection is a team of individuals—
‘‘(1) that is available to respond to individuals in crisis and provide immediate
stabilization, referrals to community-based mental health and substance use
disorder services and supports, and triage to a higher level of care if medically
necessary;
‘‘(2) which may include licensed counselors, clinical social workers, physicians,
paramedics, crisis workers, peer support specialists, or other qualified individ-
uals; and
‘‘(3) which may provide support to divert behavioral health crisis calls from
the 9–1–1 system to the 9–8–8 system.
‘‘(c) PRIORITY.—In awarding grants under this section, the Secretary shall
prioritize applications which account for the specific needs of the communities to be
served, including children and families, veterans, rural and underserved popu-
lations, and other groups at increased risk of death from suicide or overdose.
‘‘(d) REPORT.—
‘‘(1) INITIAL REPORT.—Not later than September 30, 2024, the Secretary shall
submit to Congress a report on steps taken by the entities specified in sub-
section (a) as of such date of enactment to strengthen the partnerships among
mental health providers, substance use disorder treatment providers, primary
care physicians, mental health and substance use crisis teams, paramedics, law
enforcement officers, and other first responders.
‘‘(2) PROGRESS REPORTS.—Not later than one year after the date on which the
first grant is awarded to carry out this section, and for each year thereafter,
the Secretary shall submit to Congress a report on the grants made during the
year covered by the report, which shall include—
‘‘(A) impact data on the teams and people served by such programs, in-
cluding demographic information of individuals served, volume, and types
of service utilization;
‘‘(B) outcomes of the number of linkages to community-based resources,
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short-term crisis receiving and stabilization facilities, and diversion from
law enforcement or hospital emergency department settings;
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‘‘(C) data consistent with the State block grant requirements for contin-
uous evaluation and quality improvement, and other relevant data as deter-
mined by the Secretary; and
‘‘(D) the Secretary’s recommendations and best practices for—
‘‘(i) States and localities providing mobile crisis response and sta-
bilization services for youth and adults; and
‘‘(ii) improvements to the program established under this section.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated
to carry out this section, $10,000,000 for each of fiscal years 2023 through 2027.’’.
(b) MENTAL HEALTH AWARENESS TRAINING GRANTS.—
(1) IN GENERAL.—Section 520J(b) of the Public Health Service Act (42 U.S.C.
290bb–41(b)) is amended—
(A) in paragraph (1), by striking ‘‘Indian tribes, tribal organizations’’ and
inserting ‘‘Indian Tribes, Tribal organizations’’;
(B) in paragraph (4), by striking ‘‘Indian tribe, tribal organization’’ and
inserting ‘‘Indian Tribe, Tribal organization’’;
(C) in paragraph (5)—
(i) by striking ‘‘Indian tribe, tribal organization’’ and inserting ‘‘In-
dian Tribe, Tribal organization’’;
(ii) in subparagraph (A), by striking ‘‘and’’ at the end;
(iii) in subparagraph (B)(ii), by striking the period at the end and in-
serting ‘‘; and’’; and
(iv) by adding at the end the following:
‘‘(C) suicide intervention and prevention, including recognizing warning
signs and how to refer someone for help.’’;
(D) in paragraph (6), by striking ‘‘Indian tribe, tribal organization’’ and
inserting ‘‘Indian Tribe, Tribal organization’’; and
(E) in paragraph (7), by striking ‘‘$14,693,000 for each of fiscal years 2018
through 2022’’ and inserting ‘‘$24,963,000 for each of fiscal years 2023
through 2027’’.
(2) TECHNICAL CORRECTIONS.—Section 520J(b) of the Public Health Service
Act (42 U.S.C. 290bb–41(b)) is amended—
(A) in the heading of paragraph (2), by striking ‘‘EMERGENCY SERVICES
PERSONNEL’’ and inserting ‘‘EMERGENCY SERVICES PERSONNEL’’; and
(B) in the heading of paragraph (3), by striking ‘‘DISTRIBUTION OF
AWARDS’’ and inserting ‘‘DISTRIBUTION OF AWARDS’’.
(c) ADULT SUICIDE PREVENTION.—Section 520L of the Public Health Service Act
(42 U.S.C. 290bb–43) is amended—
(1) in subsection (a)—
(A) in paragraph (2)—
(i) by striking ‘‘Indian tribe’’ each place it appears and inserting ‘‘In-
dian Tribe’’; and
(ii) by striking ‘‘tribal organization’’ each place it appears and insert-
ing ‘‘Tribal organization’’; and
(B) by amending paragraph (3)(C) to read as follows:
‘‘(C) Raising awareness of suicide prevention resources, promoting help
seeking among those at risk for suicide.’’; and
(2) in subsection (d), by striking ‘‘$30,000,000 for the period of fiscal years
2018 through 2022’’ and inserting ‘‘$30,000,000 for each of fiscal years 2023
through 2027’’.
SEC. 123. TREATMENT OF SERIOUS MENTAL ILLNESS.
(a) ASSERTIVE COMMUNITY TREATMENT GRANT PROGRAM.—
(1) TECHNICAL AMENDMENT.—Section 520M(b) of the Public Health Service
Act (42 U.S.C. 290bb–44(b)) is amended by striking ‘‘Indian tribe or tribal orga-
nization’’ and inserting ‘‘Indian Tribe or Tribal organization’’.
(2) REPORT TO CONGRESS.—Section 520M(d)(1) of the Public Health Service
Act (42 U.S.C. 290bb–44(d)(1)) is amended by striking ‘‘not later than the end
of fiscal year 2021’’ and inserting ‘‘not later than the end of fiscal year 2026’’.
(3) AUTHORIZATION OF APPROPRIATIONS.—Section 520M(e)(1) of the Public
Health Service Act (42 U.S.C. 290bb–44(d)(1)) is amended by striking
‘‘$5,000,000 for the period of fiscal years 2018 through 2022’’ and inserting
‘‘$9,000,000 for each of fiscal years 2023 through 2027’’.
(b) ASSISTED OUTPATIENT TREATMENT.—Section 224 of the Protecting Access to
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Medicare Act of 2014 (42 U.S.C. 290aa note) is amended to read as follows:
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‘‘SEC. 224. ASSISTED OUTPATIENT TREATMENT GRANT PROGRAM FOR INDIVIDUALS WITH SE-
RIOUS MENTAL ILLNESS.
‘‘(a) IN GENERAL.—The Secretary shall carry out a program to award grants to
eligible entities for assisted outpatient treatment programs for individuals with seri-
ous mental illness.
‘‘(b) CONSULTATION.—The Secretary shall carry out this section in consultation
with the Director of the National Institute of Mental Health, the Attorney General
of the United States, the Administrator of the Administration for Community Liv-
ing, and the Assistant Secretary for Mental Health and Substance Use.
‘‘(c) SELECTING AMONG APPLICANTS.—In awarding grants under this section, the
Secretary—
‘‘(1) may give preference to applicants that have not previously implemented
an assisted outpatient treatment program; and
‘‘(2) shall evaluate applicants based on their potential to reduce hospitaliza-
tion, homelessness, incarceration, and interaction with the criminal justice sys-
tem while improving the health and social outcomes of the patient.
‘‘(d) PROGRAM REQUIREMENTS.—An assisted outpatient treatment program funded
with a grant awarded under this section shall include—
‘‘(1) evaluating the medical and social needs of the patients who are partici-
pating in the program;
‘‘(2) preparing and executing treatment plans for such patients that—
‘‘(A) include criteria for completion of court-ordered treatment if applica-
ble; and
‘‘(B) provide for monitoring of the patient’s compliance with the treatment
plan, including compliance with medication and other treatment regimens;
‘‘(3) providing for case management services that support the treatment plan;
‘‘(4) ensuring appropriate referrals to medical and social services providers;
‘‘(5) evaluating the process for implementing the program to ensure consist-
ency with the patient’s needs and State law; and
‘‘(6) measuring treatment outcomes, including health and social outcomes
such as rates of incarceration, health care utilization, and homelessness.
‘‘(e) REPORT.—Not later than the end of fiscal year 2027, the Secretary shall sub-
mit a report to the appropriate congressional committees on the grant program
under this section. Such report shall include an evaluation of the following:
‘‘(1) Cost savings and public health outcomes such as mortality, suicide, sub-
stance abuse, hospitalization, and use of services.
‘‘(2) Rates of incarceration of patients.
‘‘(3) Rates of homelessness of patients.
‘‘(4) Patient and family satisfaction with program participation.
‘‘(5) Demographic information regarding participation of those served by the
grant compared to demographic information in the population of the grant re-
cipient.
‘‘(f) DEFINITIONS.—In this section:
‘‘(1) The term ‘assisted outpatient treatment’ means medically prescribed
mental health treatment that a patient receives while living in a community
under the terms of a law authorizing a State or local civil court to order such
treatment.
‘‘(2) The term ‘eligible entity’ means a county, city, mental health system,
mental health court, or any other entity with authority under the law of the
State in which the entity is located to implement, monitor, and oversee an as-
sisted outpatient treatment program.
‘‘(g) FUNDING.—
‘‘(1) AMOUNT OF GRANTS.—
‘‘(A) MAXIMUM AMOUNT.—The amount of a grant under this section shall
not exceed $1,000,000 for any fiscal year.
‘‘(B) DETERMINATION.—Subject to subparagraph (A), the Secretary shall
determine the amount of each grant under this section based on the popu-
lation of the area to be served through the grant and an estimate of the
number of patients to be served.
‘‘(2) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appro-
priated to carry out this section $22,000,000 for each of fiscal years 2023
through 2027.’’.
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Subtitle D—Anna Westin Legacy
SEC. 131. MAINTAINING EDUCATION AND TRAINING ON EATING DISORDERS.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C. 290bb–
31 et seq.), as amended by section 102, is further amended by adding at the end
the following:
‘‘SEC. 520O. CENTER OF EXCELLENCE FOR EATING DISORDERS FOR EDUCATION AND TRAIN-
ING ON EATING DISORDERS.
‘‘(a) IN GENERAL.—The Secretary, acting through the Assistant Secretary, shall
maintain, by competitive grant or contract, a Center of Excellence for Eating Dis-
orders (referred to in this section as the ‘Center’) to improve the identification of,
interventions for, and treatment of eating disorders in a manner that is develop-
mentally, culturally, and linguistically appropriate.
‘‘(b) SUBGRANTS AND SUBCONTRACTS.—The Center shall coordinate and implement
the activities under subsection (c), in whole or in part, by awarding competitive sub-
grants or subcontracts—
‘‘(1) across geographical regions; and
‘‘(2) in a manner that is not duplicative.
‘‘(c) ACTIVITIES.—The Center—
‘‘(1) shall—
‘‘(A) provide training and technical assistance for—
‘‘(i) primary care and behavioral health care providers to carry out
screening, brief intervention, and referral to treatment for individuals
experiencing, or at risk for, eating disorders; and
‘‘(ii) nonclinical community support workers to identify and support
individuals with, or at disproportionate risk for, eating disorders;
‘‘(B) develop and provide training materials to health care providers, in-
cluding primary care and behavioral health care providers, in the effective
treatment and ongoing support of individuals with eating disorders, includ-
ing children and marginalized populations at disproportionate risk for eat-
ing disorders;
‘‘(C) provide collaboration and coordination to other centers of excellence,
technical assistance centers, and psychiatric consultation lines of the Sub-
stance Abuse and Mental Health Services Administration and the Health
Resources and Services Administration on the identification, effective treat-
ment, and ongoing support of individuals with eating disorders; and
‘‘(D) coordinate with the Director of the Centers for Disease Control and
Prevention and the Administrator of the Health Resources and Services Ad-
ministration to disseminate training to primary care and behavioral health
care providers; and
‘‘(2) may—
‘‘(A) coordinate with electronic health record systems for the integration
of protocols pertaining to screening, brief intervention, and referral to treat-
ment for individuals experiencing, or at risk for, eating disorders;
‘‘(B) develop and provide training materials to health care providers, in-
cluding primary care and behavioral health care providers, in the effective
treatment and ongoing support for members of the Armed Forces and vet-
erans experiencing, or at risk for, eating disorders; and
‘‘(C) consult with the Secretary of Defense and the Secretary of Veterans
Affairs on prevention, identification, intervention for, and treatment of eat-
ing disorders.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is au-
thorized to be appropriated $1,000,000 for each of fiscal years 2023 through 2027.’’.
Subtitle E—Community Mental Health Services
Block Grant Reauthorization
SEC. 141. REAUTHORIZATION OF BLOCK GRANTS FOR COMMUNITY MENTAL HEALTH SERV-
ICES.
(a) FUNDING.—Section 1920(a) of the Public Health Service Act (42 U.S.C. 300x–
9(a)) is amended by striking ‘‘$532,571,000 for each of fiscal years 2018 through
2022’’ and inserting ‘‘$857,571,000 for each of fiscal years 2023 through 2027’’.
(b) SET-ASIDE FOR EVIDENCE-BASED CRISIS CARE SERVICES.—Section 1920 of the
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Public Health Service Act (42 U.S.C. 300x–9) is amended by adding at the end the
following:
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‘‘(d) CRISIS CARE.—
‘‘(1) IN GENERAL.—Except as provided in paragraph (3), a State shall expend
at least 5 percent of the amount the State receives pursuant to section 1911
for each fiscal year to support evidenced-based programs that address the crisis
care needs of—
‘‘(A) individuals, including children and adolescents, experiencing mental
health crises, substance-related crises, or crises arising from co-occurring
disorders; and
‘‘(B) persons with intellectual and developmental disabilities.
‘‘(2) CORE ELEMENTS.—At the discretion of the single State agency responsible
for the administration of the program of the State under a grant under section
1911, funds expended pursuant to paragraph (1) may be used to fund some or
all of the core crisis care service components, delivered according to evidence-
based principles, including the following:
‘‘(A) Crisis call centers.
‘‘(B) 24/7 mobile crisis services.
‘‘(C) Crisis stabilization programs offering acute care or subacute care in
a hospital or appropriately licensed facility, as determined by the Substance
Abuse and Mental Health Services Administration, with referrals to inpa-
tient or outpatient care.
‘‘(3) STATE FLEXIBILITY.—In lieu of expending 5 percent of the amount the
State receives pursuant to section 1911 for a fiscal year to support evidence-
based programs as required by paragraph (1), a State may elect to expend not
less than 10 percent of such amount to support such programs by the end of
two consecutive fiscal years.
‘‘(4) RULE OF CONSTRUCTION.—With respect to funds expended pursuant to
the set-aside in paragraph (1), section 1912(b)(1)(A)(vi) shall not apply.’’.
(c) EARLY INTERVENTION.—
(1) STATE PLAN OPTION.—Section 1912(b)(1)(A)(vii) of the Public Health Serv-
ice Act (42 U.S.C. 300x–1(b)(1)(A)(vii)) is amended—
(A) in subclause (III), by striking ‘‘and’’ at the end;
(B) in subclause (IV), by striking the period at the end and inserting ‘‘;
and’’; and
(C) by adding at the end the following:
‘‘(V) a description of any evidence-based early intervention strat-
egies and programs the State provides to prevent, delay, or reduce
the severity and onset of mental illness and behavioral problems,
including for children and adolescents, irrespective of experiencing
a serious mental illness or serious emotional disturbance, as de-
fined under subsection (c)(1).’’.
(2) ALLOCATION ALLOWANCE; REPORTS.—Section 1920 of the Public Health
Service Act (42 U.S.C. 300x–9), as amended by subsection (c), is further amend-
ed by adding at the end the following:
‘‘(e) EARLY INTERVENTION SERVICES.—In the case of a State with a State plan that
provides for strategies and programs specified in section 1912(b)(1)(A)(vii)(VI), such
State may expend not more than 5 percent of the amount of the allotment of the
State pursuant to a funding agreement under section 1911 for each fiscal year to
support such strategies and programs.
‘‘(f) REPORTS TO CONGRESS.—Not later than September 30, 2025, and biennially
thereafter, the Secretary shall provide a report to the Congress on the crisis care
and early intervention strategies and programs pursued by States pursuant to sub-
sections (d) and (e). Each such report shall include—
‘‘(1) a description of the each State’s crisis care and early intervention activi-
ties;
‘‘(2) the population served, including information on demographics, including
age;
‘‘(3) the outcomes of such activities, including—
‘‘(A) how such activities reduced hospitalizations and hospital stays;
‘‘(B) how such activities reduced incidents of suicidal ideation and behav-
iors; and
‘‘(C) how such activities reduced the severity of onset of serious mental
illness and serious emotional disturbance; and
‘‘(4) any other relevant information the Secretary deems necessary.’’.
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Subtitle F—Peer-Supported Mental Health
Services
SEC. 151. PEER-SUPPORTED MENTAL HEALTH SERVICES.
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 inserting after section 520G (42 U.S.C. 290bb—38) the
following:
‘‘SEC. 520H. PEER-SUPPORTED MENTAL HEALTH SERVICES.
‘‘(a) GRANTS AUTHORIZED.—The Secretary, acting through the Director of the Cen-
ter for Mental Health Services, shall award grants to eligible entities to enable such
entities to develop, expand, and enhance access to mental health peer-delivered
services.
‘‘(b) USE OF FUNDS.—Grants awarded under subsection (a) shall be used to de-
velop, expand, and enhance national, statewide, or community-focused programs, in-
cluding virtual peer-support services and infrastructure, including by—
‘‘(1) carrying out workforce development, recruitment, and retention activities,
to train, recruit, and retain peer-support providers;
‘‘(2) building connections between mental health treatment programs, includ-
ing between community organizations and peer-support networks, including vir-
tual peer-support networks, and with other mental health support services;
‘‘(3) reducing stigma associated with mental health disorders;
‘‘(4) expanding and improving virtual peer mental health support services, in-
cluding adoption of technologies to expand access to virtual peer mental health
support services, including by acquiring—
‘‘(A) appropriate physical hardware for such virtual services;
‘‘(B) software and programs to efficiently run peer-support services vir-
tually; and
‘‘(C) other technology for establishing virtual waiting rooms and virtual
video platforms for meetings; and
‘‘(5) conducting research on issues relating to mental illness and the impact
peer-support has on resiliency, including identifying—
‘‘(A) the signs of mental illness;
‘‘(B) the resources available to individuals with mental illness and to
their families; and
‘‘(C) the resources available to help support individuals living with men-
tal illness.
‘‘(c) SPECIAL CONSIDERATION.—In carrying out this section, the Secretary shall
give special consideration to the unique needs of rural areas.
‘‘(d) DEFINITION.—In this section, the term ‘eligible entity’ means—
‘‘(1) a nonprofit consumer-run organization that—
‘‘(A) is principally governed by people living with a mental health condi-
tion; and
‘‘(B) mobilizes resources within and outside of the mental health commu-
nity, which may include through peer-support networks, to increase the
prevalence and quality of long-term wellness of individuals living with a
mental health condition, including those with a co-occurring substance use
disorder; or
‘‘(2) a Federally recognized Tribe, Tribal organization, Urban Indian organiza-
tion, or consortium of Tribes or Tribal organizations.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated
to carry out this section $13,000,000 for each of fiscal years 2023 through 2027.’’.
TITLE II—SUBSTANCE USE DISORDER PRE-
VENTION, TREATMENT, AND RECOVERY
SERVICES
Subtitle A—Native Behavioral Health Access
Improvement
SEC. 201. BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER SERVICES FOR NATIVE
AMERICANS.
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Section 506A of the Public Health Service Act (42 U.S.C. 290aa–5a) is amended
to read as follows:
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‘‘SEC. 506A. BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER SERVICES FOR NATIVE
AMERICANS.
‘‘(a) DEFINITIONS.—In this section:
‘‘(1) The term ‘eligible entity’ means an Indian Tribe, a Tribal organization,
an Urban Indian organization, and a Native Hawaiian health organization.
‘‘(2) The terms ‘Indian Tribe’, ‘Tribal organization’, and ‘Urban Indian organi-
zation’ have the meanings given to the terms ‘Indian tribe’, ‘tribal organization’,
and ‘Urban Indian organization’ in section 4 of the Indian Health Care Improve-
ment Act.
‘‘(3) The term ‘Native Hawaiian health organization’ means ‘Papa Ola Lokahi’
as defined in section 12 of the Native Hawaiian Health Care Improvement Act.
‘‘(b) FORMULA FUNDS.—
‘‘(1) IN GENERAL.—The Secretary, in consultation with the Director of the In-
dian Health Service, as appropriate, shall award funds to eligible entities, in
amounts determined pursuant to the formula described in paragraph (2), to be
used by the eligible entity to provide culturally appropriate mental health and
substance use disorder prevention, treatment, and recovery services to Amer-
ican Indians, Alaska Natives, and Native Hawaiians.
‘‘(2) FORMULA.—The Secretary, using the process described in subsection (d),
shall develop a formula to determine the amount of an award under paragraph
(1). Such formula shall take into account the populations of eligible entities
whose rates of overdose deaths or suicide are substantially higher relative to
the populations of other Indian Tribes, Tribal organizations, Urban Indian orga-
nizations, or Native Hawaiian health organizations, as applicable.
‘‘(c) TECHNICAL ASSISTANCE AND PROGRAM EVALUATION.—
‘‘(1) IN GENERAL.—The Secretary shall—
‘‘(A) provide technical assistance to applicants and awardees under this
section; and
‘‘(B) collect and evaluate information on the program carried out under
this section.
‘‘(2) CONSULTATION ON EVALUATION MEASURES, AND DATA SUBMISSION AND RE-
PORTING REQUIREMENTS.—The Secretary shall, using the process described in
subsection (d), develop evaluation measures and data submission and reporting
requirements for purposes of the collection and evaluation of information.
‘‘(3) DATA SUBMISSION AND REPORTING.—As a condition on receipt of funds
under this section, an applicant shall agree to submit data and reports in a
timely manner consistent with the evaluation measures and data submission
and reporting requirements developed under subsection (d).
‘‘(d) REGULATIONS.—
‘‘(1) PROMULGATION.—Not later than 180 days after the date of enactment of
the Restoring Hope for Mental Health and Well-Being Act of 2022, the Sec-
retary shall initiate procedures under subchapter III of chapter 5 of title 5,
United States Code, to negotiate and promulgate such regulations as are nec-
essary to carry out this section, including development of the funding formula
described in subsection (b) and the program evaluation and reporting require-
ments under subsection (c).
‘‘(2) PUBLICATION.—Not later than 18 months after the date of enactment of
the Restoring Hope for Mental Health and Well-Being Act of 2022, the Sec-
retary shall publish in the Federal Register proposed regulations to implement
this section.
‘‘(3) COMMITTEE.—A negotiated rulemaking committee established pursuant
to section 565 of title 5, United States Code, to carry out this subsection shall
have as its members only representatives of the Federal Government, Tribal
Governments, and Urban Indian organizations. For purposes of such rule-
making, the Indian Health Service shall be the lead agency for the Department.
‘‘(4) ADAPTATION OF PROCEDURES.—In carrying out this subsection, the Sec-
retary shall adapt any negotiated rulemaking procedures to the unique context
of the government-to-government relationship between the United States and
Indian Tribes.
‘‘(5) EFFECT.—The lack of promulgated regulations under this subsection shall
not limit the effect or implementation of this section.
‘‘(e) APPLICATION.—An entity desiring an award under subsection (b) shall submit
an application to the Secretary at such time, in such manner, and accompanied by
such information as the Secretary may reasonably require.
‘‘(f) REPORT.—Not later than 3 years after the date of the enactment of the Restor-
ing Hope for Mental Health and Well-Being Act of 2022, and annually thereafter,
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the Secretary shall prepare and submit, to the Committee on Health, Education,
Labor, and Pensions of the Senate, and the Committee on Energy and Commerce
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18
of the House of Representatives, a report describing the services provided pursuant
to this section.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appro-
priated to carry out this section, $40,000,000 for each of fiscal years 2023 through
2027.’’.
Subtitle B—Summer Barrow Prevention,
Treatment, and Recovery
SEC. 211. 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 ‘‘2018 through 2022’’ and inserting ‘‘2023 through 2027’’.
SEC. 212. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS OF REGIONAL AND NATIONAL
SIGNIFICANCE.
Section 509 of the Public Health Service Act (42 U.S.C. 290bb–2) is amended—
(1) in the section heading, by striking ‘‘ABUSE’’ and inserting ‘‘USE DISORDER’’;
(2) in subsection (a)—
(A) by striking ‘‘tribes and tribal organizations (as the terms ‘Indian
tribes’ and ‘tribal organizations’ are defined’’ and inserting ‘‘Tribes and
Tribal organizations (as such terms are defined’’; and
(B) in paragraph (3), by striking ‘‘in substance abuse’’;
(3) in subsection (b), in the subsection heading, by striking ‘‘ABUSE’’ and in-
serting ‘‘USE DISORDER’’; and
(4) in subsection (f), by striking ‘‘$333,806,000 for each of fiscal years 2018
through 2022’’ and inserting ‘‘$521,517,000 for each of fiscal years 2023 through
2027’’.
SEC. 213. EVIDENCE-BASED PRESCRIPTION OPIOID AND HEROIN TREATMENT AND INTERVEN-
TIONS DEMONSTRATION.
Section 514B of the Public Health Service Act (42 U.S.C. 290bb–10) is amended—
(1) in subsection (a)(1)—
(A) by striking ‘‘substance abuse’’ and inserting ‘‘substance use disorder’’;
(B) by striking ‘‘tribes and tribal organizations’’ and inserting ‘‘Tribes and
Tribal organizations’’; and
(C) by striking ‘‘addiction’’ and inserting ‘‘substance use disorders’’;
(2) in subsection (e)(3), by striking ‘‘tribes and tribal organizations’’ and in-
serting ‘‘Tribes and Tribal organizations’’; and
(3) in subsection (f), by striking ‘‘2017 through 2021’’ and inserting ‘‘2023
through 2027’’.
SEC. 214. PRIORITY SUBSTANCE USE DISORDER PREVENTION NEEDS OF REGIONAL AND NA-
TIONAL SIGNIFICANCE.
Section 516 of the Public Health Service Act (42 U.S.C. 290bb–22) is amended—
(1) in subsection (a)—
(A) in paragraph (3), by striking ‘‘abuse’’ and inserting ‘‘use’’; and
(B) in the matter following paragraph (3), by striking ‘‘tribes or tribal or-
ganizations’’ and inserting ‘‘Tribes or Tribal organizations’’;
(2) in subsection (b), in the subsection heading, by striking ‘‘ABUSE’’ and in-
serting ‘‘USE DISORDER’’; and
(3) in subsection (f), by striking ‘‘$211,148,000 for each of fiscal years 2018
through 2022’’ and inserting ‘‘$218,219,000 for each of fiscal years 2023 through
2027’’.
SEC. 215. SOBER TRUTH ON PREVENTING (STOP) UNDERAGE DRINKING REAUTHORIZATION.
Section 519B of the Public Health Service Act (42 U.S.C. 290bb–25b) is amend-
ed—
(1) by amending subsection (a) to read as follows:
‘‘(a) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘alcohol beverage industry’ means the brewers, vintners, dis-
tillers, importers, distributors, and retail or online outlets that sell or serve
beer, wine, and distilled spirits.
‘‘(2) The term ‘school-based prevention’ means programs, which are institu-
tionalized, and run by staff members or school-designated persons or organiza-
tions in any grade of school, kindergarten through 12th grade.
‘‘(3) The term ‘youth’ means persons under the age of 21.’’; and
(2) by striking subsections (c) through (g) and inserting the following:
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‘‘(c) INTERAGENCY COORDINATING COMMITTEE; ANNUAL REPORT ON STATE UNDER-
AGE DRINKING PREVENTION AND ENFORCEMENT ACTIVITIES.—
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‘‘(1) INTERAGENCY COORDINATING COMMITTEE ON THE PREVENTION OF UNDER-
AGE DRINKING.—
‘‘(A) IN GENERAL.—The Secretary, in collaboration with the Federal offi-
cials specified in subparagraph (B), shall continue to support and enhance
the efforts of the interagency coordinating committee, that began operating
in 2004, focusing on underage drinking (referred to in this subsection as the
‘Committee’).
‘‘(B) OTHER AGENCIES.—The officials referred to in subparagraph (A) are
the Secretary of Education, the Attorney General, the Secretary of Trans-
portation, the Secretary of the Treasury, the Secretary of Defense, the Sur-
geon General, the Director of the Centers for Disease Control and Preven-
tion, the Director of the National Institute on Alcohol Abuse and Alco-
holism, the Assistant Secretary for Mental Health and Substance Use, the
Director of the National Institute on Drug Abuse, the Assistant Secretary
for Children and Families, the Director of the Office of National Drug Con-
trol Policy, the Administrator of the National Highway Traffic Safety Ad-
ministration, the Administrator of the Office of Juvenile Justice and Delin-
quency Prevention, the Chairman of the Federal Trade Commission, and
such other Federal officials as the Secretary of Health and Human Services
determines to be appropriate.
‘‘(C) CHAIR.—The Secretary of Health and Human Services shall serve as
the chair of the Committee.
‘‘(D) DUTIES.—The Committee shall guide policy and program develop-
ment across the Federal Government with respect to underage drinking,
provided, however, that nothing in this section shall be construed as trans-
ferring regulatory or program authority from an Agency to the Coordinating
Committee.
‘‘(E) CONSULTATIONS.—The Committee shall actively seek the input of
and shall consult with all appropriate and interested parties, including
States, public health research and interest groups, foundations, and alcohol
beverage industry trade associations and companies.
‘‘(F) ANNUAL REPORT.—
‘‘(i) IN GENERAL.—The Secretary, on behalf of the Committee, shall
annually submit to the Congress a report that summarizes—
‘‘(I) all programs and policies of Federal agencies designed to pre-
vent and reduce underage drinking, focusing particularly on pro-
grams and policies that support the adoption and enforcement of
State policies designed to prevent and reduce underage drinking as
specified in paragraph (2);
‘‘(II) the extent of progress in preventing and reducing underage
drinking at State and national levels;
‘‘(III) data that the Secretary shall collect with respect to the in-
formation specified in clause (ii); and
‘‘(IV) such other information regarding underage drinking as the
Secretary determines to be appropriate.
‘‘(ii) CERTAIN INFORMATION.—The report under clause (i) shall include
information on the following:
‘‘(I) Patterns and consequences of underage drinking as reported
in research and surveys such as, but not limited to, Monitoring the
Future, Youth Risk Behavior Surveillance System, the National
Survey on Drug Use and Health, and the Fatality Analysis Report-
ing System.
‘‘(II) Measures of the availability of alcohol from commercial and
non-commercial sources to underage populations.
‘‘(III) Measures of the exposure of underage populations to mes-
sages regarding alcohol in advertising, social media, and the enter-
tainment media.
‘‘(IV) Surveillance data, including information on the onset and
prevalence of underage drinking, consumption patterns, beverage
preferences, prevalence of drinking among students at institutions
of higher education, correlations between adult and youth drinking,
and the means of underage access, including trends over time for
these surveillance data. The Secretary shall develop a plan to im-
prove the collection, measurement, and consistency of reporting
Federal underage alcohol data.
‘‘(V) Any additional findings resulting from research conducted or
supported under subsection (f).
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‘‘(VI) Evidence-based best practices to prevent and reduce under-
age drinking including a review of the research literature related
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to State laws, regulations, and policies designed to prevent and re-
duce underage drinking, as described in paragraph (2)(B)(i).
‘‘(2) ANNUAL REPORT ON STATE UNDERAGE DRINKING PREVENTION AND EN-
FORCEMENT ACTIVITIES.—
‘‘(A) IN GENERAL.—The Secretary shall, with input and collaboration from
other appropriate Federal agencies, States, Indian Tribes, territories, and
public health, consumer, and alcohol beverage industry groups, annually
issue a report on each State’s performance in enacting, enforcing, and cre-
ating laws, regulations, and policies to prevent or reduce underage drinking
based on an assessment of best practices developed pursuant to paragraph
(1)(F)(ii)(VI) and subparagraph (B)(i). For purposes of this paragraph, each
such report, with respect to a year, shall be referred to as the ‘State Re-
port’. Each State Report shall be designed as a resource tool for Federal
agencies assisting States in the their underage drinking prevention efforts,
State public health and law enforcement agencies, State and local policy-
makers, and underage drinking prevention coalitions including those receiv-
ing grants pursuant to subsection (e).
‘‘(B) STATE PERFORMANCE MEASURES.—
‘‘(i) IN GENERAL.—The Secretary shall develop, in consultation with
the Committee, a set of measures to be used in preparing the State Re-
port on best practices as they relate to State laws, regulations, policies,
and enforcement practices.
‘‘(ii) STATE REPORT CONTENT.—The State Report shall include updates
on State laws, regulations, and policies included in previous reports to
Congress, including with respect to the following:
‘‘(I) Whether or not the State has comprehensive anti-underage
drinking laws such as for the illegal sale, purchase, attempt to pur-
chase, consumption, or possession of alcohol; illegal use of fraudu-
lent ID; illegal furnishing or obtaining of alcohol for an individual
under 21 years; the degree of strictness of the penalties for such
offenses; and the prevalence of the enforcement of each of these in-
fractions.
‘‘(II) Whether or not the State has comprehensive liability stat-
utes pertaining to underage access to alcohol such as dram shop,
social host, and house party laws, and the prevalence of enforce-
ment of each of these laws.
‘‘(III) Whether or not the State encourages and conducts com-
prehensive enforcement efforts to prevent underage access to alco-
hol at retail outlets, such as random compliance checks and shoul-
der tap programs, and the number of compliance checks within al-
cohol retail outlets measured against the number of total alcohol
retail outlets in each State, and the result of such checks.
‘‘(IV) Whether or not the State encourages training on the proper
selling and serving of alcohol for all sellers and servers of alcohol
as a condition of employment.
‘‘(V) Whether or not the State has policies and regulations with
regard to direct sales to consumers and home delivery of alcoholic
beverages.
‘‘(VI) Whether or not the State has programs or laws to deter
adults from purchasing alcohol for minors; and the number of
adults targeted by these programs.
‘‘(VII) Whether or not the State has enacted graduated drivers li-
censes and the extent of those provisions.
‘‘(iii) ADDITIONAL CATEGORIES.—In addition to the updates on State
laws, regulations, and policies listed in clause (ii), the Secretary shall
consider the following:
‘‘(I) Whether or not States have adopted laws, regulations, and
policies that deter underage alcohol use, as described in ‘The Sur-
geon General’s Call to Action to Prevent and Reduce Underage
Drinking’ issued in 2007 and ‘Facing Addiction in America: The
Surgeon General’s Report on Alcohol, Drugs and Health’ issued in
2016, including restrictions on low-price, high-volume drink spe-
cials, and wholesaler pricing provisions.
‘‘(II) Whether or not States have adopted laws, regulations, and
policies designed to reduce alcohol advertising messages attractive
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to youth and youth exposure to alcohol advertising and marketing
in measured and unmeasured media and digital and social media.
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‘‘(III) Whether or not States have laws and policies that promote
underage drinking prevention policy development by local jurisdic-
tions.
‘‘(IV) Whether or not States have adopted laws, regulations, and
policies to restrict youth access to alcoholic beverages that may
pose special risks to youth, including but not limited to alcoholic
mists, gelatins, freezer pops, premixed caffeinated alcoholic bev-
erages, and flavored malt beverages.
‘‘(V) Whether or not States have adopted uniform best practices
protocols for conducting compliance checks and shoulder tap pro-
grams.
‘‘(VI) Whether or not States have adopted uniform best practices
penalty protocols for violations of laws prohibiting retail licensees
from selling or furnishing of alcohol to minors.
‘‘(iv) UNIFORM DATA SYSTEM.—For performance measures related to
enforcement of underage drinking laws as specified in clauses (ii) and
(iii), the Secretary shall develop and test a uniform data system for re-
porting State enforcement data, including the development of a pilot
program for this purpose. The pilot program shall include procedures
for collecting enforcement data from both State and local law enforce-
ment jurisdictions.
‘‘(3) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appro-
priated to carry out this subsection $1,000,000 for each of fiscal years 2023
through 2027.
‘‘(d) NATIONAL MEDIA CAMPAIGN TO PREVENT UNDERAGE DRINKING.—
‘‘(1) IN GENERAL.—The Secretary, in consultation with the National Highway
Traffic Safety Administration, shall develop an intensive, multifaceted, adult-
oriented national media campaign to reduce underage drinking by influencing
attitudes regarding underage drinking, increasing the willingness of adults to
take actions to reduce underage drinking, and encouraging public policy
changes known to decrease underage drinking rates.
‘‘(2) PURPOSE.—The purpose of the national media campaign described in this
section shall be to achieve the following objectives:
‘‘(A) Instill a broad societal commitment to reduce underage drinking.
‘‘(B) Increase specific actions by adults that are meant to discourage or
inhibit underage drinking.
‘‘(C) Decrease adult conduct that tends to facilitate or condone underage
drinking.
‘‘(3) COMPONENTS.—When implementing the national media campaign de-
scribed in this section, the Secretary shall—
‘‘(A) educate the public about the public health and safety benefits of evi-
dence-based policies to reduce underage drinking, including minimum legal
drinking age laws, and build public and parental support for and coopera-
tion with enforcement of such policies;
‘‘(B) educate the public about the negative consequences of underage
drinking;
‘‘(C) promote specific actions by adults that are meant to discourage or
inhibit underage drinking, including positive behavior modeling, general pa-
rental monitoring, and consistent and appropriate discipline;
‘‘(D) discourage adult conduct that tends to facilitate underage drinking,
including the hosting of underage parties with alcohol and the purchasing
of alcoholic beverages on behalf of underage youth;
‘‘(E) establish collaborative relationships with local and national organiza-
tions and institutions to further the goals of the campaign and assure that
the messages of the campaign are disseminated from a variety of sources;
‘‘(F) conduct the campaign through multi-media sources; and
‘‘(G) conduct the campaign with regard to changing demographics and
cultural and linguistic factors.
‘‘(4) CONSULTATION REQUIREMENT.—In developing and implementing the na-
tional media campaign described in this section, the Secretary shall consult rec-
ommendations for reducing underage drinking published by the National Acad-
emy of Sciences and the Surgeon General. The Secretary shall also consult with
interested parties including medical, public health, and consumer and parent
groups, law enforcement, institutions of higher education, community organiza-
tions and coalitions, and other stakeholders supportive of the goals of the cam-
paign.
‘‘(5) ANNUAL REPORT.—The Secretary shall produce an annual report on the
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progress of the development or implementation of the media campaign de-
scribed in this subsection, including expenses and projected costs, and, as such
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22
information is available, report on the effectiveness of such campaign in affect-
ing adult attitudes toward underage drinking and adult willingness to take ac-
tions to decrease underage drinking.
‘‘(6) RESEARCH ON YOUTH-ORIENTED CAMPAIGN.—The Secretary may, based on
the availability of funds, conduct research on the potential success of a youth-
oriented national media campaign to reduce underage drinking. The Secretary
shall report any such results to Congress with policy recommendations on es-
tablishing such a campaign.
‘‘(7) ADMINISTRATION.—The Secretary may enter into a subcontract with an-
other Federal agency to delegate the authority for execution and administration
of the adult-oriented national media campaign.
‘‘(8) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appro-
priated to carry out this section $2,500,000 for each of fiscal years 2023 through
2027.
‘‘(e) COMMUNITY-BASED COALITION ENHANCEMENT GRANTS TO PREVENT UNDER-
AGE DRINKING.—
‘‘(1) AUTHORIZATION OF PROGRAM.—The Assistant Secretary for Mental Health
and Substance Use, in consultation with the Director of the Office of National
Drug Control Policy, shall award enhancement grants to eligible entities to de-
sign, implement, evaluate, and disseminate comprehensive strategies to maxi-
mize the effectiveness of community-wide approaches to preventing and reduc-
ing underage drinking. This subsection is subject to the availability of appro-
priations.
‘‘(2) PURPOSES.—The purposes of this subsection are to—
‘‘(A) prevent and reduce alcohol use among youth in communities
throughout the United States;
‘‘(B) strengthen collaboration among communities, the Federal Govern-
ment, Tribal Governments, and State and local governments;
‘‘(C) enhance intergovernmental cooperation and coordination on the issue
of alcohol use among youth;
‘‘(D) serve as a catalyst for increased citizen participation and greater col-
laboration among all sectors and organizations of a community that first
demonstrates a long-term commitment to reducing alcohol use among
youth;
‘‘(E) implement state-of-the-art science-based strategies to prevent and re-
duce underage drinking by changing local conditions in communities; and
‘‘(F) enhance, not supplant, effective local community initiatives for pre-
venting and reducing alcohol use among youth.
‘‘(3) APPLICATION.—An eligible entity desiring an enhancement grant under
this subsection shall submit an application to the Assistant Secretary at such
time, and in such manner, and accompanied by such information and assur-
ances, as the Assistant Secretary may require. Each application shall include—
‘‘(A) a complete description of the entity’s current underage alcohol use
prevention initiatives and how the grant will appropriately enhance the
focus on underage drinking issues; or
‘‘(B) a complete description of the entity’s current initiatives, and how it
will use this grant to enhance those initiatives by adding a focus on under-
age drinking prevention.
‘‘(4) USES OF FUNDS.—Each eligible entity that receives a grant under this
subsection shall use the grant funds to carry out the activities described in such
entity’s application submitted pursuant to paragraph (3) and obtain specialized
training and technical assistance by the entity funded under section 4 of Public
Law 107–82, as amended (21 U.S.C. 1521 note). Grants under this subsection
shall not exceed $60,000 per year and may not exceed four years.
‘‘(5) SUPPLEMENT NOT SUPPLANT.—Grant funds provided under this subsection
shall be used to supplement, not supplant, Federal and non-Federal funds avail-
able for carrying out the activities described in this subsection.
‘‘(6) EVALUATION.—Grants under this subsection shall be subject to the same
evaluation requirements and procedures as the evaluation requirements and
procedures imposed on recipients of drug-free community grants.
‘‘(7) DEFINITIONS.—For purposes of this subsection, the term ‘eligible entity’
means an organization that is currently receiving or has received grant funds
under the Drug-Free Communities Act of 1997.
‘‘(8) ADMINISTRATIVE EXPENSES.—Not more than 6 percent of a grant under
this subsection may be expended for administrative expenses.
‘‘(9) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appro-
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priated to carry out this subsection $11,500,000 for each of fiscal years 2023
through 2027.
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‘‘(f) GRANTS TO PROFESSIONAL PEDIATRIC PROVIDER ORGANIZATIONS TO REDUCE
UNDERAGE DRINKING THROUGH SCREENING AND BRIEF INTERVENTIONS.—
‘‘(1) IN GENERAL.—The Secretary, acting through the Assistant Secretary for
Mental Health and Substance Use, shall make one or more grants to profes-
sional pediatric provider organizations to increase among the members of such
organizations effective practices to reduce the prevalence of alcohol use among
individuals under the age of 21, including college students.
‘‘(2) PURPOSES.—Grants under this subsection shall be made to promote the
practices of—
‘‘(A) screening adolescents for alcohol use;
‘‘(B) offering brief interventions to adolescents to discourage such use;
‘‘(C) educating parents about the dangers of and methods of discouraging
such use;
‘‘(D) diagnosing and treating alcohol use disorders; and
‘‘(E) referring patients, when necessary, to other appropriate care.
‘‘(3) USE OF FUNDS.—A professional pediatric provider organization receiving
a grant under this section may use the grant funding to promote the practices
specified in paragraph (2) among its members by—
‘‘(A) providing training to health care providers;
‘‘(B) disseminating best practices, including culturally and linguistically
appropriate best practices, and developing, printing, and distributing mate-
rials; and
‘‘(C) supporting other activities approved by the Assistant Secretary.
‘‘(4) APPLICATION.—To be eligible to receive a grant under this subsection, a
professional pediatric provider organization shall submit an application to the
Assistant Secretary at such time, and in such manner, and accompanied by
such information and assurances as the Secretary may require. Each applica-
tion shall include—
‘‘(A) a description of the pediatric provider organization;
‘‘(B) a description of the activities to be completed that will promote the
practices specified in paragraph (2);
‘‘(C) a description of the organization’s qualifications for performing such
practices; and
‘‘(D) a timeline for the completion of such activities.
‘‘(5) DEFINITIONS.—For the purpose of this subsection:
‘‘(A) BRIEF INTERVENTION.—The term ‘brief intervention’ means, after
screening a patient, providing the patient with brief advice and other brief
motivational enhancement techniques designed to increase the insight of
the patient regarding the patient’s alcohol use, and any realized or poten-
tial consequences of such use to effect the desired related behavioral
change.
‘‘(B) ADOLESCENTS.—The term ‘adolescents’ means individuals under 21
years of age.
‘‘(C) PROFESSIONAL PEDIATRIC PROVIDER ORGANIZATION.—The term ‘profes-
sional pediatric provider organization’ means an organization or association
that—
‘‘(i) consists of or represents pediatric health care providers; and
‘‘(ii) is qualified to promote the practices specified in paragraph (2).
‘‘(D) SCREENING.—The term ‘screening’ means using validated patient
interview techniques to identify and assess the existence and extent of alco-
hol use in a patient.
‘‘(6) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appro-
priated to carry out this subsection $3,000,000 for each of fiscal years 2023
through 2027.
‘‘(g) DATA COLLECTION AND RESEARCH.—
‘‘(1) ADDITIONAL RESEARCH ON UNDERAGE DRINKING.—
‘‘(A) IN GENERAL.—The Secretary shall, subject to the availability of ap-
propriations, collect data, and conduct or support research that is not dupli-
cative of research currently being conducted or supported by the Depart-
ment of Health and Human Services, on underage drinking, with respect
to the following:
‘‘(i) Improve data collection in support of evaluation of the effective-
ness of comprehensive community-based programs or strategies and
statewide systems to prevent and reduce underage drinking, across the
underage years from early childhood to age 21, such as programs fund-
ed and implemented by governmental entities, public health interest
groups and foundations, and alcohol beverage companies and trade as-
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sociations, through the development of models of State-level epidemio-
logical surveillance of underage drinking by funding in States or large
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24
metropolitan areas new epidemiologists focused on excessive drinking
including underage alcohol use.
‘‘(ii) Obtain and report more precise information than is currently col-
lected on the scope of the underage drinking problem and patterns of
underage alcohol consumption, including improved knowledge about the
problem and progress in preventing, reducing, and treating underage
drinking, as well as information on the rate of exposure of youth to ad-
vertising and other media messages encouraging and discouraging alco-
hol consumption.
‘‘(iii) Synthesize, expand on, and widely disseminate existing research
on effective strategies for reducing underage drinking, including
translational research, and make this research easily accessible to the
general public.
‘‘(iv) Improve and conduct public health surveillance on alcohol use
and alcohol-related conditions in States by increasing the use of sur-
veys, such as the Behavioral Risk Factor Surveillance System, to mon-
itor binge and excessive drinking and related harms among individuals
who are at least 18 years of age, but not more than 20 years of age,
including harm caused to self or others as a result of alcohol use that
is not duplicative of research currently being conducted or supported by
the Department of Health and Human Services.
‘‘(B) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be ap-
propriated to carry out this paragraph $5,000,000 for each of fiscal years
2023 through 2027.
‘‘(2) NATIONAL ACADEMY OF SCIENCES STUDY.—
‘‘(A) IN GENERAL.—Not later than 12 months after the enactment of the
Restoring Hope for Mental Health and Well-Being Act of 2022, the Sec-
retary shall—
‘‘(i) contract with the National Academy of Sciences to study develop-
ments in research on underage drinking and the public policy implica-
tions of these developments; and
‘‘(ii) report to the Congress on the results of such review.
‘‘(B) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be ap-
propriated to carry out this paragraph $500,000 for fiscal year 2023.’’.
SEC. 216. GRANTS FOR JAIL DIVERSION PROGRAMS.
Section 520G of the Public Health Service Act (42 U.S.C. 290bb–38) is amended—
(1) in subsection (a)—
(A) by striking ‘‘up to 125’’; and
(B) by striking ‘‘tribes and tribal organizations’’ and inserting ‘‘Tribes and
Tribal organizations’’;
(2) in subsection (b)(2), by striking ‘‘tribes, and tribal organizations’’ and in-
serting ‘‘Tribes, and Tribal organizations’’;
(3) in subsection (c)—
(A) in paragraph (1), by striking ‘‘tribe or tribal organization’’ and insert-
ing ‘‘Tribe or Tribal organization, health facility or program described in
subsection (a), or public or nonprofit entity referred to in subsection (a)’’;
and
(B) in paragraph (2)(A)(iii), by striking ‘‘tribe, or tribal organization’’ and
inserting ‘‘Tribe, or Tribal organization’’;
(4) in subsection (e)—
(A) in the matter preceding paragraph (1), by striking ‘‘tribe, or tribal or-
ganization’’ and inserting ‘‘Tribe, or Tribal organization’’; and
(B) in paragraph (5), by striking ‘‘or arrest’’ and inserting ‘‘, arrest, or re-
lease’’;
(5) in subsection (f), by striking ‘‘tribe, or tribal organization’’ each place it
appears and inserting ‘‘Tribe, or Tribal organization’’;
(6) in subsection (h), by striking ‘‘tribe, or tribal organization’’ and inserting
‘‘Tribe, or Tribal organization’’; and
(7) in subsection (j), by striking ‘‘$4,269,000 for each of fiscal years 2018
through 2022’’ and inserting ‘‘$14,000,000 for each of fiscal years 2023 through
2027’’.
SEC. 217. FORMULA GRANTS TO STATES.
Section 521 of the Public Health Service Act (42 U.S.C. 290cc–21) is amended by
striking ‘‘2018 through 2022’’ and inserting ‘‘2023 through 2027’’.
SEC. 218. PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS.
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Section 535(a) of the Public Health Service Act (42 U.S.C. 290cc–35(a)) is amend-
ed by striking ‘‘2018 through 2022’’ and inserting ‘‘2023 through 2027’’.
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25
SEC. 219. GRANTS FOR REDUCING OVERDOSE DEATHS.
(a) GRANTS.—
(1) REPEAL OF MAXIMUM GRANT AMOUNT.—Paragraph (2) of section 544(a) of
the Public Health Service Act (42 U.S.C. 290dd–3(a)) is hereby repealed.
(2) ELIGIBLE ENTITY; SUBGRANTS.—Section 544(a) of the Public Health Service
Act (42 U.S.C. 290dd–3(a)) is amended by striking paragraph (3) and inserting
the following:
‘‘(2) ELIGIBLE ENTITY.—For purposes of this section, the term ‘eligible entity’
means a State, Territory, locality, Indian Tribe (as defined in the Federally Rec-
ognized Indian Tribe List Act of 1994), Tribal organization, or Urban Indian or-
ganization (as those terms are defined in section 4 of the Indian Health Care
Improvement Act).
‘‘(3) SUBGRANTS.—For the purposes for which a grant is awarded under this
section, the eligible entity receiving the grant may award subgrants to a Feder-
ally qualified health center (as defined in section 1861(aa) of the Social Security
Act), an opioid treatment program (as defined in section 8.2 of title 42, Code
of Federal Regulations (or any successor regulations)), any practitioner dis-
pensing narcotic drugs pursuant to section 303(g) of the Controlled Substances
Act, or any nonprofit organization that the Secretary deems appropriate.’’.
(3) PRESCRIBING.—Section 544(a)(4) of the Public Health Service Act (42
U.S.C. 290dd–3(a)(4)) is amended—
(A) in subparagraph (A), by inserting ‘‘, including patients prescribed
with both an opioid and a benzodiazepine’’ before the semicolon at the end;
and
(B) in subparagraph (D), by striking ‘‘drug overdose’’ and inserting ‘‘sub-
stance overdose’’.
(4) USE OF FUNDS.—Paragraph (5) of section 544(c) of the Public Health Serv-
ice Act (42 U.S.C. 290dd–3(c)) is amended to read as follows:
‘‘(5) To establish protocols to connect patients who have experienced an over-
dose with appropriate treatment, including overdose reversal medications, medi-
cation assisted treatment, and appropriate counseling and behavioral thera-
pies.’’.
(5) IMPROVING ACCESS TO OVERDOSE TREATMENT.—Section 544 of the Public
Health Service Act (42 U.S.C. 290dd–3) is amended—
(A) by redesignating subsections (d) through (f) as subsections (e) through
(g), respectively;
(B) in subsection (f), as so redesignated, by striking ‘‘subsection (d)’’ and
inserting ‘‘subsection (e)’’; and
(C) by inserting after subsection (c) the following:
‘‘(d) IMPROVING ACCESS TO OVERDOSE TREATMENT.—
‘‘(1) INFORMATION ON BEST PRACTICES.—
‘‘(A) HEALTH AND HUMAN SERVICES.—The Secretary of Health and Human
Services may provide information to States, localities, Indian Tribes, Tribal
organizations, and Urban Indian organizations on best practices for pre-
scribing or co-prescribing a drug or device approved, cleared, or otherwise
authorized under the Federal Food, Drug, and Cosmetic Act for emergency
treatment of known or suspected opioid overdose, including for patients re-
ceiving chronic opioid therapy and patients being treated for opioid use dis-
orders.
‘‘(B) DEFENSE.—The Secretary of Defense may provide information to pre-
scribers within Department of Defense medical facilities on best practices
for prescribing or co-prescribing a drug or device approved, cleared, or oth-
erwise authorized under the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected opioid overdose, including for
patients receiving chronic opioid therapy and patients being treated for
opioid use disorders.
‘‘(C) VETERANS AFFAIRS.—The Secretary of Veterans Affairs may provide
information to prescribers within Department of Veterans Affairs medical
facilities on best practices for prescribing or co-prescribing a drug or device
approved, cleared, or otherwise authorized under the Federal Food, Drug,
and Cosmetic Act for emergency treatment of known or suspected opioid
overdose, including for patients receiving chronic opioid therapy and pa-
tients being treated for opioid use disorders.
‘‘(2) RULE OF CONSTRUCTION.—Nothing in this subsection shall be construed
as establishing or contributing to a medical standard of care.’’.
(6) AUTHORIZATION OF APPROPRIATIONS.—Section 544(g) of the Public Health
Service Act (42 U.S.C. 290dd–3), as redesignated, is amended by striking ‘‘fiscal
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years 2017 through 2021’’ and inserting ‘‘fiscal years 2023 through 2027’’.
(7) TECHNICAL AMENDMENTS.—
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(A) Section 544 of the Public Health Service Act (42 U.S.C. 290dd–3), as
amended, is further amended by striking ‘‘approved or cleared’’ each place
it appears and inserting ‘‘approved, cleared, or otherwise authorized’’.
(B) Section 107 of the Comprehensive Addiction and Recovery Act of 2016
(Public Law 114–198) is amended by striking subsection (b).
SEC. 220. OPIOID OVERDOSE REVERSAL MEDICATION ACCESS AND EDUCATION GRANT PRO-
GRAMS.
(a) GRANTS.—Section 545 of the Public Health Service Act (42 U.S.C. 290ee) is
amended—
(1) in the section heading, by striking ‘‘ACCESS AND EDUCATION GRANT PRO-
GRAMS’’ and inserting ‘‘ACCESS, EDUCATION, AND CO-PRESCRIBING GRANT PRO-
GRAMS’’;
(2) in the heading of subsection (a), by striking ‘‘GRANTS TO STATES’’ and in-
serting ‘‘GRANTS’’;
(3) in subsection (a), by striking ‘‘shall make grants to States’’ and inserting
‘‘shall make grants to States, localities, Indian Tribes (as defined by the Feder-
ally Recognized Indian Tribe List Act of 1994), Tribal organizations, and Urban
Indian organizations (as those terms are defined in section 4 of the Indian
Health Care Improvement Act)’’;
(4) in subsection (a)(1), by striking ‘‘implement strategies for pharmacists to
dispense a drug or device’’ and inserting ‘‘implement strategies that increase ac-
cess to drugs or devices’’;
(5) by redesignating paragraphs (3) and (4) as paragraphs (4) and (5), respec-
tively; and
(6) by inserting after paragraph (2) the following:
‘‘(3) encourage health care providers to co-prescribe, as appropriate, drugs or
devices approved, cleared, or otherwise authorized under the Federal Food,
Drug, and Cosmetic Act for emergency treatment of known or suspected opioid
overdose;’’.
(b) GRANT PERIOD.—Section 545(d)(2) of the Public Health Service Act (42 U.S.C.
290ee(d)(2)) is amended by striking ‘‘3 years’’ and inserting ‘‘5 years’’.
(c) LIMITATION.—Paragraph (3) of section 545(d) of the Public Health Service Act
(42 U.S.C. 290ee(d)) is amended to read as follows:
‘‘(3) LIMITATIONS.—A State may—
‘‘(A) use not more than 10 percent of a grant under this section for edu-
cating the public pursuant to subsection (a)(5); and
‘‘(B) use not less than 20 percent of a grant under this section to offset
cost-sharing for distribution and dispensing of drugs or devices approved,
cleared, or otherwise authorized under the Federal Food, Drug, and Cos-
metic Act for emergency treatment of known or suspected opioid overdose.’’.
(d) AUTHORIZATION OF APPROPRIATIONS.—Section 545(h)(1) of the Public Health
Service Act, is amended by striking ‘‘fiscal years 2017 through 2019’’ and inserting
‘‘fiscal years 2023 through 2027’’.
(e) TECHNICAL AMENDMENT.—Section 545 of the Public Health Service Act (42
U.S.C. 290ee), as amended, is further amended by striking ‘‘approved or cleared’’
each place it appears and inserting ‘‘approved, cleared, or otherwise authorized’’.
SEC. 221. STATE DEMONSTRATION GRANTS FOR COMPREHENSIVE OPIOID ABUSE RESPONSE.
Section 548 of the Public Health Service Act (42 U.S.C. 290ee–3) is amended—
(1) in the section heading, by striking ‘‘ABUSE’’ and inserting ‘‘USE DISORDER’’;
(2) in subsection (b)—
(A) in the subsection heading, by striking ‘‘ABUSE’’ and inserting ‘‘USE
DISORDER’’;
(B) in paragraph (1), by striking ‘‘abuse’’ and inserting ‘‘use disorder’’;
(C) in paragraph (2)—
(i) in the matter preceding subparagraph (A), by striking ‘‘abuse’’ and
inserting ‘‘use disorder’’;
(ii) in subparagraph (A), by striking ‘‘opioid use, treatment, and ad-
diction recovery’’ and inserting ‘‘opioid use disorders, and treatment for,
and recovery from opioid use disorders’’;
(iii) in subparagraph (C), by striking ‘‘addiction’’ each place it appears
and inserting ‘‘use disorder’’;
(iv) by amending subparagraph (D) to read as follows:
‘‘(D) developing, implementing, and expanding efforts to prevent overdose
death from opioid or other prescription medication use disorders; and’’; and
(v) in subparagraph (E), by striking ‘‘abuse’’ and inserting ‘‘use dis-
orders’’; and
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(D) in paragraph (4), by striking ‘‘abuse’’ each place it appears and insert-
ing ‘‘use disorders’’; and
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(3) by striking ‘‘2017 through 2021’’ and inserting ‘‘2023 through 2027’’.
SEC. 222. EMERGENCY DEPARTMENT ALTERNATIVES TO OPIOIDS.
Section 7091 of the SUPPORT for Patients and Communities Act (Public Law
115–271) is amended—
(1) in the section heading, by striking ‘‘DEMONSTRATION’’ (and by conforming
the item relating to such section in the table of contents in section 1(b));
(2) in subsection (a)—
(A) by amending the subsection heading to read as follows: ‘‘GRANT PRO-
GRAM’’; and
(B) in paragraph (1), by striking ‘‘demonstration’’;
(3) in subsection (b), in the subsection heading, by striking ‘‘DEMONSTRATION’’;
(4) in subsection (d)(4), by striking ‘‘tribal’’ and inserting ‘‘Tribal’’;
(5) in subsection (f), by striking ‘‘Not later than 1 year after completion of the
demonstration program under this section, the Secretary shall submit a report
to the Congress on the results of the demonstration program’’ and inserting
‘‘Not later than the end of each of fiscal years 2024 and 2027, the Secretary
shall submit to the Congress a report on the results of the program’’; and
(6) in subsection (g), by striking ‘‘2019 through 2021’’ and inserting ‘‘2023
through 2027’’.
Subtitle C—Excellence in Recovery Housing
SEC. 231. CLARIFYING THE ROLE OF SAMHSA IN PROMOTING THE AVAILABILITY OF HIGH-
QUALITY RECOVERY HOUSING.
Section 501(d) of the Public Health Service Act (42 U.S.C. 290aa) is amended—
(1) in paragraph (24)(E), by striking ‘‘and’’ at the end;
(2) in paragraph (25), by striking the period at the end and inserting ‘‘; and’’;
and
(3) by adding at the end the following:
‘‘(26) collaborate with national accrediting entities, reputable providers, orga-
nizations or individuals with established expertise in delivery of recovery hous-
ing services, States, Federal agencies (including the Department of Health and
Human Services, the Department of Housing and Urban Development, and the
agencies listed in section 550(e)(2)(B)), and other relevant stakeholders, to pro-
mote the availability of high-quality recovery housing and services for individ-
uals with a substance use disorder.’’.
SEC. 232. DEVELOPING GUIDELINES FOR STATES TO PROMOTE THE AVAILABILITY OF HIGH-
QUALITY RECOVERY HOUSING.
Section 550(a) of the Public Health Service Act (42 U.S.C. 290ee–5(a)) (relating
to national recovery housing best practices) is amended—
(1) by amending paragraph (1) to read as follows:
‘‘(1) IN GENERAL.—The Secretary, in consultation with the individuals and en-
tities specified in paragraph (2), shall build on existing best practices and pre-
viously developed guidelines to develop and periodically update consensus-based
best practices, which may include model laws for implementing suggested min-
imum standards for operating, and promoting the availability of, high-quality
recovery housing.’’;
(2) in paragraph (2)—
(A) by striking subparagraphs (A) and (B) and inserting the following:
‘‘(A) Officials representing the agencies described in subsection (e)(2).’’;
and
(B) by redesignating subparagraphs (C) through (G) as subparagraphs (B)
through (F), respectively; and
(3) by adding at the end the following:
‘‘(3) AVAILABILITY.—The best practices referred to in paragraph (1) shall be—
‘‘(A) made publicly available; and
‘‘(B) published on the public website of the Substance Abuse and Mental
Health Services Administration.
‘‘(4) EXCLUSION OF GUIDELINE ON TREATMENT SERVICES.—In developing the
guidelines under paragraph (1), the Secretary may not include any guidelines
with respect to substance use disorder treatment services.’’.
SEC. 233. COORDINATION OF FEDERAL ACTIVITIES TO PROMOTE THE AVAILABILITY OF RE-
COVERY HOUSING.
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Section 550 of the Public Health Service Act (42 U.S.C. 290ee–5) (relating to na-
tional recovery housing best practices) is amended—
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28
(1) by redesignating subsections (e), (f), and (g) as subsections (g), (h), and (i),
respectively; and
(2) by inserting after subsection (d) the following:
‘‘(e) COORDINATION OF FEDERAL ACTIVITIES TO PROMOTE THE AVAILABILITY OF
HOUSING FOR INDIVIDUALS EXPERIENCING HOMELESSNESS, INDIVIDUALS WITH A
MENTAL ILLNESS, AND INDIVIDUALS WITH A SUBSTANCE USE DISORDER.—
‘‘(1) IN GENERAL.—The Secretary, acting through the Assistant Secretary, and
the Secretary of Housing and Urban Development shall convene an interagency
working group for the following purposes:
‘‘(A) To increase collaboration, cooperation, and consultation among the
Department of Health and Human Services, the Department of Housing
and Urban Development, and the Federal agencies listed in paragraph
(2)(B), with respect to promoting the availability of housing, including re-
covery housing, for individuals experiencing homelessness, individuals with
mental illnesses, and individuals with substance use disorder.
‘‘(B) To align the efforts of such agencies and avoid duplication of such
efforts by such agencies.
‘‘(C) To develop objectives, priorities, and a long-term plan for supporting
State, Tribal, and local efforts with respect to the operation of recovery
housing that is consistent with the best practices developed under this sec-
tion.
‘‘(D) To coordinate enforcement of fair housing practices, as appropriate,
among Federal and State agencies.
‘‘(E) To coordinate data collection on the quality of recovery housing.
‘‘(2) COMPOSITION.—The interagency working group under paragraph (1) shall
be composed of—
‘‘(A) the Secretary, acting through the Assistant Secretary, and the Sec-
retary of Housing and Urban Development, who shall serve as the co-
chairs; and
‘‘(B) representatives of each of the following Federal agencies:
‘‘(i) The Centers for Medicare & Medicaid Services.
‘‘(ii) The Substance Abuse and Mental Health Services Administra-
tion.
‘‘(iii) The Health Resources and Services Administration.
‘‘(iv) The Office of Inspector General.
‘‘(v) The Indian Health Service.
‘‘(vi) The Department of Agriculture.
‘‘(vii) The Department of Justice.
‘‘(viii) The Office of National Drug Control Policy.
‘‘(ix) The Bureau of Indian Affairs.
‘‘(x) The Department of Labor.
‘‘(xi) The Department of Veterans Affairs.
‘‘(xii) Any other Federal agency as the co-chairs determine appro-
priate.
‘‘(3) MEETINGS.—The working group shall meet on a quarterly basis.
‘‘(4) REPORTS TO CONGRESS.—Not later than 4 years after the date of the en-
actment of this section, the working group shall submit to the Committee on
Energy and Commerce, the Committee on Ways and Means, the Committee on
Agriculture, and the Committee on Financial Services of the House of Rep-
resentatives and the Committee on Health, Education, Labor, and Pensions, the
Committee on Agriculture, Nutrition, and Forestry, and the Committee on Fi-
nance of the Senate a report describing the work of the working group and any
recommendations of the working group to improve Federal, State, and local co-
ordination with respect to recovery housing and other housing resources and op-
erations for individuals experiencing homelessness, individuals with a mental
illness, and individuals with a substance use disorder.’’.
SEC. 234. NAS STUDY AND REPORT.
(a) IN GENERAL.—Not later than 60 days after the date of enactment of this Act,
the Secretary of Health and Human Services, acting through the Assistant Sec-
retary for Mental Health and Substance Use shall—
(1) contract with the National Academies of Sciences, Engineering, and Medi-
cine—
(A) to study the quality and effectiveness of recovery housing in the
United States and whether the availability of such housing meets demand;
and
(B) to identify recommendations to promote the availability of high-qual-
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ity recovery housing; and
(2) report to the Congress on the results of such review.
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(b) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section there is author-
ized to be appropriated $1,500,000 for fiscal year 2023.
SEC. 235. GRANTS FOR STATES TO PROMOTE THE AVAILABILITY OF RECOVERY HOUSING AND
SERVICES.
Section 550 of the Public Health Service Act (42 U.S.C. 290ee–5) (relating to na-
tional recovery housing best practices), as amended by sections 232 and 233, is fur-
ther amended by inserting after subsection (e) (as inserted by section 233) the fol-
lowing:
‘‘(f) GRANTS FOR IMPLEMENTING NATIONAL RECOVERY HOUSING BEST PRACTICES.—
‘‘(1) IN GENERAL.—The Secretary shall award grants to States (and political
subdivisions thereof), Tribes, and territories—
‘‘(A) for the provision of technical assistance to implement the guidelines
and recommendations developed under subsection (a); and
‘‘(B) to promote—
‘‘(i) the availability of recovery housing for individuals with a sub-
stance use disorder; and
‘‘(ii) the maintenance of recovery housing in accordance with best
practices developed under this section.
‘‘(2) STATE PROMOTION PLANS.—Not later than 90 days after receipt of a grant
under paragraph (1), and every 2 years thereafter, each State (or political sub-
divisions thereof,) Tribe, or territory receiving a grant under paragraph (1) shall
submit to the Secretary, and publish on a publicly accessible internet website
of the State (or political subdivisions thereof), Tribe, or territory—
‘‘(A) the plan of the State (or political subdivisions thereof), Tribe, or ter-
ritory, with respect to the promotion of recovery housing for individuals
with a substance use disorder located within the jurisdiction of such State
(or political subdivisions thereof), Tribe, or territory; and
‘‘(B) a description of how such plan is consistent with the best practices
developed under this section.’’.
SEC. 236. FUNDING.
Subsection (i) of section 550 of the Public Health Service Act (42 U.S.C. 290ee–
5) (relating to national recovery housing best practices), as redesignated by section
233, is amended by striking ‘‘$3,000,000 for the period of fiscal years 2019 through
2021’’ and inserting ‘‘$5,000,000 for the period of fiscal years 2023 through 2027’’.
SEC. 237. TECHNICAL CORRECTION.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended—
(1) by redesignating section 550 (relating to Sobriety Treatment and Recovery
Teams) (42 U.S.C. 290ee–10), as added by section 8214 of Public Law 115–271,
as section 550A; and
(2) by moving such section so it appears after section 550 (relating to national
recovery housing best practices).
Subtitle D—Substance Use Prevention, Treatment,
and Recovery Services Block Grant
SEC. 241. ELIMINATING STIGMATIZING LANGUAGE RELATING TO SUBSTANCE USE.
(a) BLOCK GRANTS FOR PREVENTION AND TREATMENT OF SUBSTANCE USE.—Part
B of title XIX of the Public Health Service Act (42 U.S.C. 300x et seq.) is amended—
(1) in the part heading, by striking ‘‘SUBSTANCE ABUSE’’ and inserting ‘‘SUB-
STANCE USE’’;
(2) in subpart II, by amending the subpart heading to read as follows: ‘‘Block
Grants for Substance Use Prevention, Treatment, and Recovery Serv-
ices’’;
(3) in section 1922(a) (42 U.S.C. 300x–22(a))—
(A) in paragraph (1), in the matter preceding subparagraph (A), by strik-
ing ‘‘substance abuse’’ and inserting ‘‘substance use disorders’’; and
(B) by striking ‘‘such abuse’’ each place it appears in paragraphs (1) and
(2) and inserting ‘‘such disorders’’;
(4) in section 1923 (42 U.S.C. 300x–23)—
(A) in the section heading, by striking ‘‘SUBSTANCE ABUSE’’ and inserting
‘‘SUBSTANCE USE’’; and
(B) in subsection (a), by striking ‘‘drug abuse’’ and inserting ‘‘substance
use disorders’’;
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(5) in section 1925(a)(1) (42 U.S.C. 300x–25(a)(1)), by striking ‘‘alcohol or drug
abuse’’ and inserting ‘‘alcohol or other substance use disorders’’;
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30
(6) in section 1926(b)(2)(B) (42 U.S.C. 300x–26(b)(2)(B)), by striking ‘‘sub-
stance abuse’’;
(7) in section 1931(b)(2) (42 U.S.C. 300x–31(b)(2)), by striking ‘‘substance
abuse’’ and inserting ‘‘substance use disorders’’;
(8) in section 1933(d)(1) (42 U.S.C. 300x–33(d)), in the matter following sub-
paragraph (B), by striking ‘‘abuse of alcohol and other drugs’’ and inserting ‘‘use
of substances’’;
(9) by amending paragraph (4) of section 1934 (42 U.S.C. 300x–34) to read
as follows:
‘‘(4) The term ‘substance use disorder’ means the recurrent use of alcohol or
other drugs that causes clinically significant impairment.’’;
(10) in section 1935 (42 U.S.C. 300x–35)—
(A) in subsection (a), by striking ‘‘substance abuse’’ and inserting ‘‘sub-
stance use disorders’’; and
(B) in subsection (b)(1), by striking ‘‘substance abuse’’ each place it ap-
pears and inserting ‘‘substance use disorders’’;
(11) in section 1949 (42 U.S.C. 300x–59), by striking ‘‘substance abuse’’ each
place it appears in subsections (a) and (d) and inserting ‘‘substance use dis-
orders’’;
(12) in section 1954(b)(4) (42 U.S.C. 300x–64(b)(4))—
(A) by striking ‘‘substance abuse’’ and inserting ‘‘substance use disorders’’;
and
(B) by striking ‘‘such abuse’’ and inserting ‘‘such disorders’’;
(13) in section 1955 (42 U.S.C. 300x–65), by striking ‘‘substance abuse’’ each
place it appears and inserting ‘‘substance use disorder’’; and
(14) in section 1956 (42 U.S.C. 300x–66), by striking ‘‘substance abuse’’ and
inserting ‘‘substance use disorders’’.
(b) CERTAIN PROGRAMS REGARDING MENTAL HEALTH AND SUBSTANCE ABUSE.—
Part C of title XIX of the Public Health Service Act (42 U.S.C. 300y et seq.) is
amended—
(1) in the part heading, by striking ‘‘SUBSTANCE ABUSE’’ and inserting ‘‘SUB-
STANCE USE’’;
(2) in section 1971 (42 U.S.C. 300y), by striking ‘‘substance abuse’’ each place
it appears in subsections (a), (b), and (f) and inserting ‘‘substance use’’; and
(3) in section 1976 (42 U.S.C. 300y–11), by striking ‘‘intravenous abuse’’ each
place it appears and inserting ‘‘intravenous use’’.
SEC. 242. AUTHORIZED ACTIVITIES.
Section 1921(b) of the Public Health Service Act (42 U.S.C. 300x–21(b)) is amend-
ed by striking ‘‘prevent and treat substance use disorders’’ and inserting ‘‘prevent,
treat, and provide recovery support services for substance use disorders’’.
SEC. 243. REQUIREMENTS RELATING TO CERTAIN INFECTIOUS DISEASES AND HUMAN IM-
MUNODEFICIENCY VIRUS.
Section 1924 of the Public Health Service Act (42 U.S.C. 300x–24) is amended—
(1) in the section heading, by striking ‘‘TUBERCULOSIS AND HUMAN IMMUNO-
DEFICIENCY VIRUS’’ and inserting ‘‘TUBERCULOSIS, VIRAL HEPATITIS, AND
HUMAN IMMUNODEFICIENCY VIRUS’’;
(2) by amending subsection (a)(2) to read as follows:
‘‘(2) DESIGNATED STATES.—
‘‘(A) FISCAL YEARS THROUGH FISCAL YEAR 2024.—For purposes of this sub-
section, through September 30, 2024, a State described in this paragraph
is any State whose rate of cases of acquired immune deficiency syndrome
is 10 or more such cases per 100,000 individuals (as indicated by the num-
ber of such cases reported to and confirmed by the Director of the Centers
for Disease Control and Prevention for the most recent calendar year for
which such data are available).
‘‘(B) FISCAL YEAR 2025 AND SUCCEEDING FISCAL YEARS.—
‘‘(i) IN GENERAL.—Beginning with fiscal year 2025, for purposes of
this subsection, a State described in this paragraph is any State whose
rate of cases of human immunodeficiency virus is 10 or more such cases
per 100,000 individuals (as indicated by the number of such cases
newly reported to and confirmed by the Director of the Centers for Dis-
ease Control and Prevention for the most recent calendar year for
which such data are available).
‘‘(ii) CONTINUATION OF DESIGNATED STATE STATUS.—In the case of a
State whose rate of cases of human immunodeficiency virus falls below
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the threshold specified in clause (i) for a calendar year, such State
shall, notwithstanding clause (i), continue to be described in this para-
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31
graph unless the rate of cases falls below such threshold for three con-
secutive calendar years.’’.
(3) by redesignating subsections (c) and (d) as subsections (d) and (e), respec-
tively; and
(4) by inserting after subsection (b) the following:
‘‘(c) VIRAL HEPATITIS.—
‘‘(1) IN GENERAL.—A funding agreement for a grant under section 1921 is that
the State involved will require that any entity receiving amounts from the grant
for operating a program of treatment for substance use disorders—
‘‘(A) will, directly or through arrangements with other public or nonprofit
private entities, routinely make available viral hepatitis services to each in-
dividual receiving treatment for such disorders; and
‘‘(B) in the case of an individual in need of such treatment who is denied
admission to the program on the basis of the lack of the capacity of the pro-
gram to admit the individual, will refer the individual to another provider
of viral hepatitis services.
‘‘(2) VIRAL HEPATITIS SERVICES.—For purposes of paragraph (1), the term
‘viral hepatitis services’, with respect to an individual, means—
‘‘(A) screening the individual for viral hepatitis; and
‘‘(B) referring the individual to a provider whose practice includes viral
hepatitis vaccination and treatment.’’.
SEC. 244. STATE PLAN REQUIREMENTS.
Section 1932(b)(1)(A) of the Public Health Service Act (42 U.S.C. 300x–32(b)(1)(A))
is amended—
(1) by redesignating clauses (vi) through (ix) as clauses (vii) through (x), re-
spectively; and
(2) by inserting after clause (v) the following:
‘‘(vi) provides a description of—
‘‘(I) the State’s comprehensive statewide recovery support serv-
ices activities, including the number of individuals being served,
target populations, and priority needs; and
‘‘(II) the amount of funds received under this subpart expended
on recovery support services, disaggregated by the amount ex-
pended for type of service activity;’’.
SEC. 245. UPDATING CERTAIN LANGUAGE RELATING TO TRIBES.
Section 1933(d) of the Public Health Service Act (42 U.S.C. 300x–33(d)) is amend-
ed—
(1) in paragraph (1)—
(A) in subparagraph (A)—
(i) by striking ‘‘of an Indian tribe or tribal organization’’ and inserting
‘‘of an Indian Tribe or Tribal organization’’; and
(ii) by striking ‘‘such tribe’’ and inserting ‘‘such Tribe’’;
(B) in subparagraph (B)—
(i) by striking ‘‘tribe or tribal organization’’ and inserting ‘‘Tribe or
Tribal organization’’; and
(ii) by striking ‘‘Secretary under this’’ and inserting ‘‘Secretary under
this subpart’’; and
(C) in the matter following subparagraph (B), by striking ‘‘tribe or tribal
organization’’ and inserting ‘‘Tribe or Tribal organization’’;
(2) by amending paragraph (2) to read as follows:
‘‘(2) INDIAN TRIBE OR TRIBAL ORGANIZATION AS GRANTEE.—The amount re-
served by the Secretary on the basis of a determination under this subsection
shall be granted to the Indian Tribe or Tribal organization serving the individ-
uals for whom such a determination has been made.’’;
(3) in paragraph (3), by striking ‘‘tribe or tribal organization’’ and inserting
‘‘Tribe or Tribal organization’’; and
(4) in paragraph (4)—
(A) in the paragraph heading, by striking ‘‘DEFINITION’’ and inserting
‘‘DEFINITIONS’’; and
(B) by striking ‘‘The terms’’ and all that follows through ‘‘given such
terms’’ and inserting the following: ‘‘The terms ‘Indian Tribe’ and ‘Tribal or-
ganization’ have the meanings given the terms ‘Indian tribe’ and ‘tribal or-
ganization’ ’’.
SEC. 246. BLOCK GRANTS FOR SUBSTANCE USE PREVENTION, TREATMENT, AND RECOVERY
SERVICES.
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(a) IN GENERAL.—Section 1935(a) of the Public Health Service Act (42 U.S.C.
300x–35(a)), as amended by section 241, is further amended by striking ‘‘appro-
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32
priated’’ and all that follows through ‘‘2022..’’ and inserting the following: ‘‘appro-
priated $1,908,079,000 for each of fiscal years 2023 through 2027.’’.
(b) TECHNICAL CORRECTIONS.—Section 1935(b)(1)(B) of the Public Health Service
Act (42 U.S.C. 300x–35(b)(1)(B)) is amended by striking ‘‘the collection of data in
this paragraph is’’.
SEC. 247. REQUIREMENT OF REPORTS AND AUDITS BY STATES.
Section 1942(a) of the Public Health Service Act (42 U.S.C. 300x–52(a)) is amend-
ed—
(1) in paragraph (1), by striking ‘‘and’’ at the end;
(2) in paragraph (2), by striking the period at the end and inserting ‘‘; and’’;
and
(3) by adding at the end the following:
‘‘(3) the amount provided to each recipient in the previous fiscal year.’’.
SEC. 248. STUDY ON ASSESSMENT FOR USE IN DISTRIBUTION OF LIMITED STATE RESOURCES.
(a) IN GENERAL.—The Secretary of Health and Human Services, acting through
the Assistant Secretary for Mental Health and Substance Use (in this section re-
ferred to as the ‘‘Secretary’’), shall, in consultation with States and other local enti-
ties providing prevention, treatment, or recovery support services related to sub-
stance use, conduct a study to develop a model needs assessment process for States
to consider to help determine how best to allocate block grant funding received
under subpart II of part B of title XIX of the Public Health Service Act (42 U.S.C.
300x–21) to provide services to substance use disorder prevention, treatment, and
recovery support. The study shall include cost estimates with each model needs as-
sessment process.
(b) REPORT.—Not later than 2 years after the date of the enactment of this Act,
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 a report on the results of the study conducted under paragraph (1).
Subtitle E—Timely Treatment for Opioid Use
Disorder
SEC. 251. STUDY ON EXEMPTIONS FOR TREATMENT OF OPIOID USE DISORDER THROUGH
OPIOID TREATMENT PROGRAMS DURING THE COVID–19 PUBLIC HEALTH EMER-
GENCY.
(a) STUDY.—The Assistant Secretary for Mental Health and Substance Use shall
conduct a study, in consultation with patients and other stakeholders, on activities
carried out pursuant to exemptions granted—
(1) to a State (including the District of Columbia or any territory of the
United States) or an opioid treatment program;
(2) pursuant to section 8.11(h) of title 42, Code of Federal Regulations; and
(3) during the period—
(A) beginning on the declaration of the public health emergency for the
COVID–19 pandemic under section 319 of the Public Health Service Act (42
U.S.C. 247d); and
(B) ending on the earlier of—
(i) the termination of such public health emergency, including exten-
sions thereof pursuant to such section 319; and
(ii) the end of calendar year 2022.
(b) PRIVACY.—The section does not authorize the disclosure by the Department of
Health and Human Services of individually identifiable information about patients.
(c) FEEDBACK.—In conducting the study under subsection (a), the Assistant Sec-
retary for Mental Health and Substance Use shall gather feedback from the States
and opioid treatment programs on their experiences in implementing exemptions de-
scribed in subsection (a).
(d) REPORT.—Not later than 180 days after the end of the period described in sub-
section (a)(3)(B), and subject to subsection (c), the Assistant Secretary for Mental
Health and Substance Use shall publish a report on the results of the study under
this section.
SEC. 252. CHANGES TO FEDERAL OPIOID TREATMENT STANDARDS.
(a) MOBILE MEDICATION UNITS.—Section 302(e) of the Controlled Substances Act
(21 U.S.C. 822(e)) is amended by adding at the end the following:
‘‘(3) Notwithstanding paragraph (1), a registrant that is dispensing pursuant to
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section 303(g) narcotic drugs to individuals for maintenance treatment or detoxifica-
tion treatment shall not be required to have a separate registration to incorporate
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33
one or more mobile medication units into the registrant’s practice to dispense such
narcotics at locations other than the registrant’s principal place of business or pro-
fessional practice described in paragraph (1), so long as the registrant meets such
standards for operation of a mobile medication unit as the Attorney General may
establish.’’.
(b) REVISE OPIOID TREATMENT PROGRAM ADMISSION CRITERIA TO ELIMINATE RE-
QUIREMENT THAT PATIENTS HAVE AN OPIOID USE DISORDER FOR AT LEAST 1 YEAR.—
Not later than 18 months after the date of enactment of this Act, the Secretary of
Health and Human Services shall revise section 8.12(e)(1) of title 42, Code of Fed-
eral Regulations (or successor regulations), to eliminate the requirement that an
opioid treatment program only admit an individual for treatment under the program
if the individual has been addicted to opioids for at least 1 year before being so ad-
mitted for treatment.
(c) FINAL REGULATION ON PERIODS FOR TAKE-HOME SUPPLY REQUIREMENTS.—
(1) IN GENERAL.—Not later than 18 months after the date of enactment of this
Act, the Secretary of Health and Human Services shall promulgate a final regu-
lation amending paragraphs (i)(3)(i) through (i)(3)(vi) of section 8.12 of title 42,
Code of Federal Regulations, as appropriate based on the findings of the study
under section 251 of this Act.
(2) CRITERIA.—The regulation under paragraph (1) shall establish relevant
criteria for the medical director or an appropriately licensed practitioner of an
opioid treatment program, to determine whether a patient is stable and may
qualify for unsupervised use, which criteria may allow for consideration of each
of the following:
(A) Whether the benefits of providing unsupervised doses to a patient
outweigh the risks.
(B) The patient’s demonstrated adherence to their treatment plan.
(C) The patient’s history of negative toxicology tests.
(D) Whether there is an absence of serious behavioral problems.
(E) The patient’s stability in living arrangements and social relationships.
(F) Whether there is an absence of substance misuse-related behaviors.
(G) Whether there is an absence of recent diversion activity.
(H) Whether there is an assurance that the medication can be safely
stored by the patient.
(I) Any other criterion the Secretary of Health and Human Services de-
termines appropriate.
(3) PROHIBITED SOLE CONSIDERATION.—The regulation under paragraph (1)
shall prohibit the medical director of an opioid treatment program from consid-
ering, as the sole consideration in determining whether a patient is sufficiently
responsible in handling opioid drugs for unsupervised use, whether the patient
has an absence of recent misuse of drugs (whether narcotic or nonnarcotic), in-
cluding alcohol.
Subtitle F—Additional Provisions Relating to
Addiction Treatment
SEC. 261. PROHIBITION.
Notwithstanding any provision of this Act and the amendments made by this Act,
no funds made available to carry out this Act or any amendment made by this Act
shall be used to purchase, procure, or distribute pipes or cylindrical objects intended
to be used to smoke or inhale illegal scheduled substances.
SEC. 262. ELIMINATING ADDITIONAL REQUIREMENTS FOR DISPENSING NARCOTIC DRUGS IN
SCHEDULE III, IV, AND V FOR MAINTENANCE OR DETOXIFICATION TREATMENT.
(a) IN GENERAL.—Section 303(g) of the Controlled Substances Act (21 U.S.C.
823(g)) is amended—
(1) by striking paragraph (2);
(2) by striking ‘‘(g)(1) Except as provided in paragraph (2), practitioners who
dispense narcotic drugs to individuals for maintenance treatment or detoxifica-
tion treatment’’ and inserting ‘‘(g) Practitioners who dispense narcotic drugs
(other than narcotic drugs in schedule III, IV, or V) to individuals for mainte-
nance treatment or detoxification treatment’’;
(3) by redesignating subparagraphs (A), (B), and (C) as paragraphs (1), (2),
and (3), respectively; and
(4) in paragraph (2), as so redesignated—
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(A) by striking ‘‘(i) security of stocks’’ and inserting ‘‘(A) security of
stocks’’; and
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34
(B) by striking ‘‘(ii) the maintenance of records’’ and inserting ‘‘(B) the
maintenance of records’’.
(b) CONFORMING CHANGES.—
(1) Subsections (a) and (d)(1) of section 304 of the Controlled Substances Act
(21 U.S.C. 824) are each amended by striking ‘‘303(g)(1)’’ each place it appears
and inserting ‘‘303(g)’’.
(2) Section 309A(a)(2) of the Controlled Substances Act (21 U.S.C. 829a) is
amended—
(A) in the matter preceding subparagraph (A), by striking ‘‘the controlled
substance is to be administered for the purpose of maintenance or detoxi-
fication treatment under section 303(g)(2)’’ and inserting ‘‘the controlled
substance is a narcotic drug in schedule III, IV, or V to be administered
for the purpose of maintenance or detoxification treatment’’; and
(B) by striking ‘‘and—’’ and all that follows through ‘‘is to be administered
by injection or implantation;’’ and inserting ‘‘and is to be administered by
injection or implantation;’’.
(3) Section 520E–4(c) of the Public Health Service Act (42 U.S.C. 290bb–
36d(c)) is amended by striking ‘‘information on any qualified practitioner that
is certified to prescribe medication for opioid dependency under section
303(g)(2)(B) of the Controlled Substances Act’’ and inserting ‘‘information on
any practitioner who prescribes narcotic drugs in schedule III, IV, or V of sec-
tion 202 of the Controlled Substances Act for the purpose of maintenance or de-
toxification treatment’’.
(4) Section 544(a)(3) of the Public Health Service Act (42 U.S.C. 290dd–3), as
added by section 219(a)(2), is amended by striking ‘‘any practitioner dispensing
narcotic drugs pursuant to section 303(g) of the Controlled Substances Act’’ and
inserting ‘‘any practitioner dispensing narcotic drugs for the purpose of mainte-
nance or detoxification treatment’’.
(5) Section 1833(bb)(3)(B) of the Social Security Act (42 U.S.C. 1395l(bb)(3)(B))
is amended by striking ‘‘first receives a waiver under section 303(g) of the Con-
trolled Substances Act on or after January 1, 2019’’ and inserting ‘‘first begins
prescribing narcotic drugs in schedule III, IV, or V of section 202 of the Con-
trolled Substances Act for the purpose of maintenance or detoxification treat-
ment on or after January 1, 2021’’.
(6) Section 1834(o)(3)(C)(ii) of the Social Security Act (42 U.S.C.
1395m(o)(3)(C)(ii)) is amended by striking ‘‘first receives a waiver under section
303(g) of the Controlled Substances Act on or after January 1, 2019’’ and insert-
ing ‘‘first begins prescribing narcotic drugs in schedule III, IV, or V of section
202 of the Controlled Substances Act for the purpose of maintenance or detoxi-
fication treatment on or after January 1, 2021’’.
(7) Section 1866F(c)(3) of the Social Security Act (42 U.S.C. 1395cc–6(c)(3)) is
amended—
(A) in subparagraph (A), by adding ‘‘and’’ at the end;
(B) in subparagraph (B), by striking ‘‘; and’’ and inserting a period; and
(C) by striking subparagraph (C).
(8) Section 1903(aa)(2)(C) of the Social Security Act (42 U.S.C.
1396b(aa)(2)(C)) is amended—
(A) in clause (i), by adding ‘‘and’’ at the end;
(B) by striking clause (ii); and
(C) by redesignating clause (iii) as clause (ii).
SEC. 263. REQUIRING PRESCRIBERS OF CONTROLLED SUBSTANCES TO COMPLETE TRAINING.
Section 303 of the Controlled Substances Act (21 U.S.C. 823) is amended by add-
ing at the end the following:
‘‘(l) REQUIRED TRAINING FOR PRESCRIBERS.—
‘‘(1) TRAINING REQUIRED.—As a condition on registration under this section to
dispense controlled substances in schedule II, III, IV, or V, the Attorney Gen-
eral shall require any qualified practitioner, beginning with the first applicable
registration for the practitioner, to meet the following:
‘‘(A) If the practitioner is a physician, the practitioner meets one or more
of the following conditions:
‘‘(i) The physician holds a board certification in addiction psychiatry
or addiction medicine from the American Board of Medical Specialties.
‘‘(ii) The physician holds a board certification from the American
Board of Addiction Medicine.
‘‘(iii) The physician holds a board certification in addiction medicine
from the American Osteopathic Association.
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‘‘(iv) The physician has, with respect to the treatment and manage-
ment of patients with opioid or other substance use disorders, com-
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pleted not less than 8 hours of training (through classroom situations,
seminars at professional society meetings, electronic communications,
or otherwise) that is provided by—
‘‘(I) the American Society of Addiction Medicine, the American
Academy of Addiction Psychiatry, the American Medical Associa-
tion, the American Osteopathic Association, the American Psy-
chiatric Association, or any other organization accredited by the
Accreditation Council for Continuing Medical Education (commonly
known as the ‘ACCME’);
‘‘(II) any organization accredited by a State medical society
accreditor that is recognized by the ACCME;
‘‘(III) any organization accredited by the American Osteopathic
Association to provide continuing medical education; or
‘‘(IV) any organization approved by the Assistant Secretary for
Mental Health and Substance Abuse or the ACCME.
‘‘(v) The physician graduated in good standing from an accredited
school of allopathic medicine or osteopathic medicine in the United
States during the 5-year period immediately preceding the date on
which the physician first registers or renews under this section and has
successfully completed a comprehensive allopathic or osteopathic medi-
cine curriculum or accredited medical residency that included not less
than 8 hours of training on treating and managing patients with opioid
and other substance use disorders, including the appropriate clinical
use of all drugs approved by the Food and Drug Administration for the
treatment of a substance use disorder.
‘‘(B) If the practitioner is not a physician, the practitioner meets one or
more of the following conditions:
‘‘(i) The practitioner has completed not fewer than 8 hours of training
with respect to the treatment and management of patients with opioid
or other substance use disorders (through classroom situations, semi-
nars at professional society meetings, electronic communications, or
otherwise) provided by the American Society of Addiction Medicine, the
American Academy of Addiction Psychiatry, the American Medical As-
sociation, the American Osteopathic Association, the American Nurses
Credentialing Center, the American Psychiatric Association, the Amer-
ican Association of Nurse Practitioners, the American Academy of Phy-
sician Associates, or any other organization approved or accredited by
the Assistant Secretary for Mental Health and Substance Abuse or the
or the Accreditation Council for Continuing Medical Education.
‘‘(ii) The practitioner has graduated in good standing from an accred-
ited physician assistant school or accredited school of advanced practice
nursing in the United States during the 5-year period immediately pre-
ceding the date on which the practitioner first registers or renews
under this section and has successfully completed a comprehensive
physician assistant or advanced practice nursing curriculum that in-
cluded not fewer than 8 hours of training on treating and managing pa-
tients with opioid and other substance use disorders, including the ap-
propriate clinical use of all drugs approved by the Food and Drug Ad-
ministration for the treatment of a substance use disorder.
‘‘(2) ONE-TIME TRAINING.—The Attorney General shall not require any quali-
fied practitioner to complete the training described in clause (iv) or (v) of para-
graph (1)(A) or clause (i) or (ii) of paragraph (1)(B) more than once.
‘‘(3) RULE OF CONSTRUCTION.—Nothing in this subsection shall be construed
to preclude the use, by a qualified practitioner, of training received pursuant
to this subsection to satisfy registration requirements of a State or for some
other lawful purpose.
‘‘(4) DEFINITIONS.—In this section:
‘‘(A) FIRST APPLICABLE REGISTRATION.—The term ‘first applicable registra-
tion’ means the first registration or renewal of registration by a qualified
practitioner under this section that occurs on or after the date that is 180
days after the date of enactment of the Restoring Hope for Mental Health
and Well-Being Act of 2022.
‘‘(B) QUALIFIED PRACTITIONER.—In this subsection, the term ‘qualified
practitioner’ means a practitioner who—
‘‘(i) is licensed under State law to prescribe controlled substances;
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and
‘‘(ii) is not solely a veterinarian.’’.
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TITLE III—ACCESS TO MENTAL HEALTH CARE
AND COVERAGE
Subtitle A—Collaborate in an Orderly and
Cohesive Manner
SEC. 301. INCREASING UPTAKE OF THE COLLABORATIVE CARE MODEL.
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 AND COOPERATIVE AGREEMENTS.
‘‘(a) DEFINITIONS.—In this section:
‘‘(1) COLLABORATIVE CARE MODEL.—The term ‘collaborative care model’ means
the evidence-based, integrated behavioral health service delivery method that
includes—
‘‘(A) care directed by the primary care team;
‘‘(B) structured care management;
‘‘(C) regular assessments of clinical status using developmentally appro-
priate, validated tools; and
‘‘(D) modification of treatment as appropriate.
‘‘(2) ELIGIBLE ENTITY.—The term ‘eligible entity’ means a State, or an appro-
priate State agency, in collaboration with—
‘‘(A) 1 or more qualified community programs as described in section
1913(b)(1);
‘‘(B) 1 or more health centers (as defined in section 330(a)), a rural health
clinic (as defined in section 1961(aa) of the Social Security Act), or a Feder-
ally qualified health center (as defined in such section); or
‘‘(C) 1 or more primary health care practices.
‘‘(3) INTEGRATED CARE; BIDIRECTIONAL INTEGRATED CARE.—
‘‘(A) The term ‘integrated care’ means models or practices for coordinating
and jointly delivering behavioral and physical health services, which may
include practices that share the same space in the same facility.
‘‘(B) The term ‘bidirectional integrated care’ means the integration of be-
havioral health care and specialty physical health care, as well as the inte-
gration of primary and physical health care with specialty behavioral
health settings, including within primary health care settings.
‘‘(4) PRIMARY HEALTH CARE PROVIDER.—The term ‘primary health care pro-
vider’ means a provider who—
‘‘(A) provides health services related to family medicine, internal medi-
cine, pediatrics, obstetrics, gynecology, or geriatrics; or
‘‘(B) is a doctor of medicine or osteopathy, physician assistant, or nurse
practitioner, who is licensed to practice medicine by the State in which such
physician, assistant, or practitioner primarily practices, including within
primary health care settings.
‘‘(5) PRIMARY HEALTH CARE PRACTICE.—The term ‘primary health care prac-
tice’ means a medical practice of primary health care providers, including a
practice within a larger health care system.
‘‘(6) SPECIAL POPULATION.—The term ‘special population’, for an eligible entity
that is collaborating with an entity described in subparagraph (A) or (B) of
paragraph (3), means—
‘‘(A) adults with a serious mental illness who have a co-occurring physical
health condition or chronic disease;
‘‘(B) children and adolescents with a mental illness who have a co-occur-
ring physical health condition or chronic disease;
‘‘(C) individuals with a substance use disorder; or
‘‘(D) individuals with a mental illness who have a co-occurring substance
use disorder.
‘‘(b) GRANTS AND COOPERATIVE AGREEMENTS.—
‘‘(1) IN GENERAL.—The Secretary may award grants and cooperative agree-
ments to eligible entities to support the improvement of integrated care for
physical and behavioral health care in accordance with paragraph (2).
‘‘(2) USE OF FUNDS.—A grant or cooperative agreement awarded under this
section shall be used—
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‘‘(A) in the case of an eligible entity that is collaborating with an entity
described in subparagraph (A) or (B) of subsection (a)(2)—
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‘‘(i) to promote full integration and collaboration in clinical practices
between physical and behavioral health care for special populations in-
cluding each population listed in subsection (a)(7);
‘‘(ii) to support the improvement of integrated care models for phys-
ical and behavioral health care to improve the overall wellness and
physical health status of—
‘‘(I) adults with a serious mental illness or children with a seri-
ous emotional disturbance; and
‘‘(II) individuals with a substance use disorder; and
‘‘(iii) to promote bidirectional integrated care services including
screening, diagnosis, prevention, treatment, and recovery of mental and
substance use disorders, and co-occurring physical health conditions
and chronic diseases; and
‘‘(B) in the case of an eligible entity that is collaborating with a primary
health care practice, to support the uptake of the collaborative care model,
including by—
‘‘(i) hiring staff;
‘‘(ii) identifying and formalizing contractual relationships with other
health care providers, including providers who will function as psy-
chiatric consultants and behavioral health care managers in providing
behavioral health integration services through the collaborative care
model;
‘‘(iii) purchasing or upgrading software and other resources needed to
appropriately provide behavioral health integration services through
the collaborative care model, including resources needed to establish a
patient registry and implement measurement-based care; and
‘‘(iv) for such other purposes as the Secretary determines to be nec-
essary.
‘‘(c) APPLICATIONS.—
‘‘(1) IN GENERAL.—An eligible entity that is collaborating with an entity de-
scribed in subparagraph (A) or (B) of subsection (a)(2) seeking a grant or cooper-
ative agreement under subsection (b)(2)(A) shall submit an application to the
Secretary at such time, in such manner, and accompanied by such information
as the Secretary may require, including the contents described in paragraph (2).
‘‘(2) CONTENTS.—Any such application of an eligible entity described in sub-
paragraph (A) or (B) of subsection (a)(2) shall include—
‘‘(A) a description of a plan to achieve fully collaborative agreements to
provide bidirectional integrated care to special populations;
‘‘(B) a document that summarizes the policies, if any, that are barriers
to the provision of integrated care, and the specific steps, if applicable, that
will be taken to address such barriers;
‘‘(C) a description of partnerships or other arrangements with local health
care providers to provide services to special populations;
‘‘(D) an agreement and plan to report to the Secretary performance meas-
ures necessary to evaluate patient outcomes and facilitate evaluations
across participating projects;
‘‘(E) a description of how validated rating scales will be implemented to
support the improvement of patient outcomes using measurement-based
care, including those related to depression screening, patient follow-up, and
symptom remission; and
‘‘(F) a plan for sustainability beyond the grant or cooperative agreement
period under subsection (e).
‘‘(3) COLLABORATIVE CARE MODEL GRANTS.—An eligible entity that is collabo-
rating with a primary health care practice seeking a grant pursuant to sub-
section (b)(2)(B) shall submit an application to the Secretary at such time, in
such manner, and accompanied by such information as the Secretary may re-
quire.
‘‘(d) GRANT AND COOPERATIVE AGREEMENT AMOUNTS.—
‘‘(1) TARGET AMOUNT.—The target amount that an eligible entity may receive
for a year through a grant or cooperative agreement under this section shall
be—
‘‘(A) $2,000,000 for an eligible entity described in subparagraph (A) or (B)
of subsection (a)(2); or
‘‘(B) $100,000 or less for an eligible entity described in subparagraph (C)
of subsection (a)(2).
‘‘(2) ADJUSTMENT PERMITTED.—The Secretary, taking into consideration the
quality of an eligible entity’s application and the number of eligible entities that
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received grants under this section prior to the date of enactment of the Restor-
ing Hope for Mental Health and Well-Being Act of 2022, may adjust the target
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38
amount that an eligible entity may receive for a year through a grant or cooper-
ative agreement under this section.
‘‘(3) LIMITATION.—An eligible entity that is collaborating with an entity de-
scribed in subparagraph (A) or (B) of subsection (a)(2) receiving funding under
this section—
‘‘(A) may not allocate more than 20 percent of the funds awarded to such
eligible entity under this section to administrative functions; and
‘‘(B) shall allocate the remainder of such funding to health facilities that
provide integrated care.
‘‘(e) DURATION.—A grant or cooperative agreement under this section shall be for
a period not to exceed 5 years.
‘‘(f) REPORT ON PROGRAM OUTCOMES.—An eligible entity receiving a grant or coop-
erative agreement under this section—
‘‘(1) that is collaborating with an entity described in subparagraph (A) or (B)
of subsection (a)(2) shall submit an annual report to the Secretary that in-
cludes—
‘‘(A) the progress made to reduce barriers to integrated care as described
in the entity’s application under subsection (c); and
‘‘(B) a description of outcomes with respect to each special population list-
ed in subsection (a)(7), including outcomes related to education, employ-
ment, and housing; or
‘‘(2) that is collaborating with a primary health care practice shall submit an
annual report to the Secretary that includes—
‘‘(A) the progress made to improve access;
‘‘(B) the progress made to improve patient outcomes; and
‘‘(C) the progress made to reduce referrals to specialty care.
‘‘(g) TECHNICAL ASSISTANCE FOR PRIMARY-BEHAVIORAL HEALTH CARE INTEGRA-
TION.—
‘‘(1) CERTAIN RECIPIENTS.—The Secretary may provide appropriate informa-
tion, training, and technical assistance to eligible entities that are collaborating
with an entity described in subparagraph (A) or (B) of subsection (a)(2) that re-
ceive a grant or cooperative agreement under this section, in order to help such
entities 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) COLLABORATIVE CARE MODEL RECIPIENTS.—The Secretary shall provide
appropriate information, training, and technical assistance to eligible entities
that are collaborating with primary health care practices that receive funds
under this section to help such entities implement the collaborative care model,
including—
‘‘(A) developing financial models and budgets for implementing and main-
taining a collaborative care model, based on practice size;
‘‘(B) developing staffing models for essential staff roles;
‘‘(C) providing strategic advice to assist practices seeking to utilize other
clinicians for additional psychotherapeutic interventions;
‘‘(D) providing information technology expertise to assist with building
the collaborative care model into electronic health records, including assist-
ance with care manager tools, patient registry, ongoing patient monitoring,
and patient records;
‘‘(E) training support for all key staff and operational consultation to de-
velop practice workflows;
‘‘(F) establishing methods to ensure the sharing of best practices and
operational knowledge among primary health care physicians and primary
health care practices that provide behavioral health integration services
through the collaborative care model; and
‘‘(G) providing guidance and instruction to primary health care physicians
and primary health care practices on developing and maintaining relation-
ships with community-based mental health and substance use disorder fa-
cilities for referral and treatment of patients whose clinical presentation or
diagnosis is best suited for treatment at such facilities.
‘‘(3) ADDITIONAL DISSEMINATION OF TECHNICAL INFORMATION.—In addition to
providing the assistance described in paragraphs (1) and (2) to recipients of a
grant or cooperative agreement under this section, the Secretary may also pro-
vide such assistance to other States and political subdivisions of States, Indian
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Tribes and Tribal organizations (as defined under the Federally Recognized In-
dian Tribe List Act of 1994), outpatient mental health and addiction treatment
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39
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 clinics as defined in
section 1861(aa) of the Social Security Act, primary health care practices, other
community-based organizations, and other entities engaging in integrated care
activities, as the Secretary determines appropriate.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there is au-
thorized to be appropriated $60,000,000 for each of fiscal years 2023 through 2027.’’.
Subtitle B—Helping Enable Access to Lifesaving
Services
SEC. 311. REAUTHORIZATION AND PROVISION OF CERTAIN PROGRAMS TO STRENGTHEN THE
HEALTH CARE WORKFORCE.
(a) LIABILITY PROTECTIONS FOR HEALTH PROFESSIONAL VOLUNTEERS.—Section
224(q)(6) of the Public Health Service Act (42 U.S.C. 233(q)(6)) is amended by strik-
ing ‘‘October 1, 2022’’ and inserting ‘‘October 1, 2027’’.
(b) MINORITY FELLOWSHIPS IN CRISIS CARE MANAGEMENT.—Section 597(b) of the
Public Health Service Act (42 U.S.C. 290ll(b)) is amended by striking ‘‘in the fields
of psychiatry,’’ and inserting ‘‘in the fields of crisis care management, psychiatry,’’.
(c) MENTAL AND BEHAVIORAL HEALTH EDUCATION AND TRAINING GRANTS.—Section
756 of the Public Health Service Act (42 U.S.C. 294e–1) is amended—
(1) in subsection (a)(1), by inserting ‘‘(which may include master’s and doc-
toral level programs)’’ after ‘‘occupational therapy’’; and
(2) in subsection (f), by striking ‘‘For each of fiscal years 2019 through 2023’’
and inserting ‘‘For each of fiscal years 2023 through 2027’’.
(d) TRAINING DEMONSTRATION PROGRAM.—Section 760(g) of the Public Health
Service Act (42 U.S.C. 294k(g)) is amended by inserting ‘‘and $31,700,000 for each
of fiscal years 2023 through 2027’’ before the period at the end.
Subtitle C—Eliminating the Opt-Out for
Nonfederal Governmental Health Plans
SEC. 321. ELIMINATING THE OPT-OUT FOR NONFEDERAL GOVERNMENTAL HEALTH PLANS.
Section 2722(a)(2) of the Public Health Service Act (42 U.S.C. 300gg–21(a)(2)) is
amended by adding at the end the following new subparagraph:
‘‘(F) SUNSET OF ELECTION OPTION.—
‘‘(i) IN GENERAL.—Notwithstanding the preceding provisions of this
paragraph—
‘‘(I) no election described in subparagraph (A) with respect to sec-
tion 2726 may be made on or after the date of the enactment of
this subparagraph; and
‘‘(II) except as provided in clause (ii), no such election with re-
spect to section 2726 expiring on or after the date that is 180 days
after the date of such enactment may be renewed.
‘‘(ii) EXCEPTION FOR CERTAIN COLLECTIVELY BARGAINED PLANS.—Not-
withstanding clause (i)(II), a plan described in subparagraph (B)(ii)
that is subject to multiple agreements described in such subparagraph
of varying lengths and that has an election described in subparagraph
(A) with respect to section 2726 in effect as of the date of the enact-
ment of this subparagraph that expires on or after the date that is 180
days after the date of such enactment may extend such election until
the date on which the term of the last such agreement expires.’’.
Subtitle D—Mental Health and Substance Use
Disorder Parity Implementation
SEC. 331. GRANTS TO SUPPORT MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY IM-
PLEMENTATION.
(a) IN GENERAL.—Section 2794(c) of the Public Health Service Act (42 U.S.C.
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300gg–94(c)) (as added by section 1003 of the Patient Protection and Affordable
Care Act (Public Law 111–148)) is amended by adding at the end the following:
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40
‘‘(3) PARITY IMPLEMENTATION.—
‘‘(A) IN GENERAL.—Beginning during the first fiscal year that begins after
the date of enactment of this paragraph, the Secretary shall, out of funds
made available pursuant to subparagraph (C), award grants to eligible
States to enforce and ensure compliance with the mental health and sub-
stance use disorder parity provisions of section 2726.
‘‘(B) ELIGIBLE STATE.—A State shall be eligible for a grant awarded under
this paragraph only if such State—
‘‘(i) submits to the Secretary an application for such grant at such
time, in such manner, and containing such information as specified by
the Secretary; and
‘‘(ii) agrees to request and review from health insurance issuers offer-
ing group or individual health insurance coverage the comparative
analyses and other information required of such health insurance
issuers under subsection (a)(8)(A) of section 2726 relating to the design
and application of nonquantitative treatment limitations imposed on
mental health or substance use disorder benefits.
‘‘(C) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be ap-
propriated $10,000,000 for each of the first five fiscal years beginning after
the date of the enactment of this paragraph, to remain available until ex-
pended, for purposes of awarding grants under subparagraph (A).’’.
(b) TECHNICAL AMENDMENT.—Section 2794 of the Public Health Service Act (42
U.S.C. 300gg–95), as added by section 6603 of the Patient Protection and Affordable
Care Act (Public Law 111–148) is redesignated as section 2795.
TITLE IV—CHILDREN AND YOUTH
Subtitle A—Supporting Children’s Mental Health
Care Access
SEC. 401. PEDIATRIC MENTAL HEALTH CARE ACCESS GRANTS.
Section 330M of the Public Health Service Act (42 U.S.C. 254c–19) is amended—
(1) in the section enumerator, by striking ‘‘330M’’ and inserting ‘‘330M.’’;
(2) in subsection (a)—
(A) by striking ‘‘Indian tribes and tribal organizations’’ and inserting ‘‘In-
dian Tribes and Tribal organizations’’; and
(B) by inserting ‘‘or, in the case of a State that does not submit an appli-
cation, a nonprofit entity that has the support of the State’’ after ‘‘450b))’’;
(3) in subsection (b)—
(A) in paragraph (1)—
(i) in subparagraph (G), by inserting ‘‘developmental-behavioral pedi-
atricians,’’ after ‘‘adolescent psychiatrists,’’;
(ii) in subparagraph (H), by striking ‘‘; and’’ at the end and inserting
a semicolon;
(iii) by redesignating subparagraph (I) as subparagraph (J); and
(iv) by inserting after subparagraph (H) the following:
‘‘(I) maintain an up-to-date list of community-based supports for children
with mental health problems; and’’;
(B) by redesignating paragraph (2) as paragraph (4);
(C) by inserting after paragraph (1) the following:
‘‘(2) SUPPORT TO SCHOOLS AND EMERGENCY DEPARTMENTS.—In addition to the
activities required by paragraph (1), a pediatric mental health care telehealth
access program referred to in subsection (a), with respect to which a grant
under such subsection may be used, may provide support to schools and emer-
gency departments.
‘‘(3) PRIORITY.—In awarding grants under this section, the Secretary shall
give priority to applicants proposing to—
‘‘(A) continue existing programs that meet the requirements of paragraph
(1);
‘‘(B) establish a pediatric mental health care telehealth access program
in the jurisdiction of a State, Territory, Indian Tribe, or Tribal organization
that does not yet have such a program; or
‘‘(C) expand a pediatric mental health care telehealth access program to
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include one or more new sites of care, such as a school or emergency de-
partment.’’; and
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(D) in paragraph (4), as redesignated by subparagraph (B), by inserting
‘‘Such a team may include a developmental-behavioral pediatrician.’’ after
‘‘mental health counselor.’’;
(4) in subsections (c), (d), and (f), by striking ‘‘Indian tribe, or tribal organiza-
tion’’ each place it appears and inserting ‘‘Indian Tribe, Tribal organization, or
nonprofit entity’’; and
(5) by striking subsection (g) and inserting the following:
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall award grants or contracts to
one or more eligible entities (as defined by the Secretary) for the purposes of pro-
viding technical assistance and evaluation support to grantees under subsection (a).
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there are au-
thorized to be appropriated—
‘‘(1) $14,000,000 for each of fiscal years 2023 through 2025; and
‘‘(2) $30,000,000 for each of fiscal years 2026 through 2027.’’.
SEC. 402. INFANT AND EARLY CHILDHOOD MENTAL HEALTH PROMOTION, INTERVENTION,
AND TREATMENT.
Section 399Z–2(f) of the Public Health Service Act (42 U.S.C. 280h–6(f)) is amend-
ed by striking ‘‘$20,000,000 for the period of fiscal years 2018 through 2022’’ and
inserting ‘‘$50,000,000 for the period of fiscal years 2023 through 2027’’.
Subtitle B—Continuing Systems of Care for
Children
SEC. 411. COMPREHENSIVE COMMUNITY MENTAL HEALTH SERVICES FOR CHILDREN WITH
SERIOUS EMOTIONAL DISTURBANCES.
(a) DEFINITION OF FAMILY.—Section 565(d)(2)(B) of the Public Health Service Act
(42 U.S.C. 290ff–4(d)(2)(B)) is amended by striking ‘‘as appropriate regarding mental
health services for the child, the parents of the child (biological or adoptive, as the
case may be) and any foster parents of the child’’ and inserting ‘‘as appropriate re-
garding mental health services for the child and the parents or kinship caregivers
of the child’’.
(b) AUTHORIZATION OF APPROPRIATIONS.—Paragraph (1) of section 565(f) of the
Public Health Service Act (42 U.S.C. 290ff–4(f)) is amended—
(1) by moving the margin of such paragraph 2 ems to the right; and
(2) by striking ‘‘$119,026,000 for each of fiscal years 2018 through 2022’’ and
inserting ‘‘$125,000,000 for each of fiscal years 2023 through 2027’’.
SEC. 412. SUBSTANCE USE DISORDER TREATMENT AND EARLY INTERVENTION SERVICES FOR
CHILDREN AND ADOLESCENTS.
Section 514 of the Public Health Service Act (42 U.S.C. 290bb–7) is amended—
(1) in subsection (a), by striking ‘‘Indian tribes or tribal organizations’’ and
inserting ‘‘Indian Tribes or Tribal organizations’’; and
(2) in subsection (f), by striking ‘‘2018 through 2022’’ and inserting ‘‘2023
through 2027’’.
Subtitle C—Garrett Lee Smith Memorial
Reauthorization
SEC. 421. SUICIDE PREVENTION TECHNICAL ASSISTANCE CENTER.
(a) TECHNICAL AMENDMENT.—Section 520C of the Public Health Service Act (42
U.S.C. 290bb–34) is amended—
(1) by striking ‘‘tribes’’ and inserting ‘‘Tribes’’; and
(2) by striking ‘‘tribal’’ each place it appears and inserting ‘‘Tribal’’.
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 520C(c) of the Public Health
Service Act (42 U.S.C. 290bb–34(c)) is amended by striking ‘‘$5,988,000 for each of
fiscal years 2018 through 2022’’ and inserting ‘‘$9,000,000 for each of fiscal years
2023 through 2027’’.
(c) ANNUAL REPORT.—Section 520C(d) of the Public Health Service Act (42 U.S.C.
290bb–34(d)) is amended by striking ‘‘Not later than 2 years after the date of enact-
ment of this subsection’’ and inserting ‘‘Not later than 2 years after the date of en-
actment of the Restoring Hope for Mental Health and Well-Being Act of 2022’’.
SEC. 422. YOUTH SUICIDE EARLY INTERVENTION AND PREVENTION STRATEGIES.
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Section 520E of the Public Health Service Act (42 U.S.C. 290bb–36) is amended—
(1) by striking ‘‘tribe’’ and inserting ‘‘Tribe’’;
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(2) by striking ‘‘tribal’’ each place it appears and inserting ‘‘Tribal’’;
(3) in subsection (a)(1), by inserting ‘‘pediatric health programs,’’ after ‘‘foster
care systems,’’;
(4) by amending subsection (b)(1)(B) to read as follows:
‘‘(B) a public organization or private nonprofit organization designated by
a State or Indian Tribe (as defined under the Federally Recognized Indian
Tribe List Act of 1994) to develop or direct the State-sponsored statewide
or Tribal youth suicide early intervention and prevention strategy; or’’;
(5) in subsection (c)—
(A) in paragraph (1), by inserting ‘‘pediatric health programs,’’ after ‘‘fos-
ter care systems,’’;
(B) in paragraph (7), by inserting ‘‘pediatric health programs,’’ after ‘‘fos-
ter care systems,’’;
(C) in paragraph (9), by inserting ‘‘pediatric health programs,’’ after ‘‘edu-
cational institutions,’’;
(D) in paragraph (13), by striking ‘‘and’’ at the end;
(E) in paragraph (14), by striking the period at the end and inserting ‘‘;
and’’; and
(F) by adding at the end the following:
‘‘(15) provide to parents, legal guardians, and family members of youth, sup-
plies to securely store means commonly used in suicide, if applicable, within the
household.’’;
(6) in subsection (d)—
(A) in the heading, by striking ‘‘DIRECT SERVICES’’ and inserting ‘‘SUICIDE
PREVENTION ACTIVITIES’’; and
(B) by striking ‘‘direct services, of which not less than 5 percent shall be
used for activities authorized under subsection (a)(3)’’ and inserting ‘‘suicide
prevention activities’’;
(7) in subsection (e)(3)(A), by inserting ‘‘and Department of Education’’ after
‘‘Department of Health and Human Services’’;
(8) in subsection (g)—
(A) in paragraph (1), by striking ‘‘18’’ and inserting ‘‘24’’; and
(B) in paragraph (2), by striking ‘‘2 years after the date of enactment of
Helping Families in Mental Health Crisis Reform Act of 2016’’ and insert-
ing ‘‘3 years after December 31, 2022’’;
(9) in subsection (l)(4), by striking ‘‘between 10 and 24 years of age’’ and in-
serting ‘‘up to 24 years of age’’; and
(10) in subsection (m), by striking ‘‘$30,000,000 for each of fiscal years 2018
through 2022’’ and inserting ‘‘$40,000,000 for each of fiscal years 2023 through
2027’’.
SEC. 423. MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES FOR STUDENTS IN
HIGHER EDUCATION.
Section 520E–2 of the Public Health Service Act (42 U.S.C. 290bb–36b) is amend-
ed—
(1) in the heading, by striking ‘‘ON CAMPUS’’ and inserting ‘‘FOR STUDENTS
IN HIGHER EDUCATION’’; and
(2) in subsection (i), by striking ‘‘2018 through 2022’’ and inserting ‘‘2023
through 2027’’.
SEC. 424. MENTAL AND BEHAVIORAL HEALTH OUTREACH AND EDUCATION AT INSTITUTIONS
OF HIGHER EDUCATION.
Section 549 of the Public Health Service Act (42 U.S.C. 290ee–4) is amended—
(1) in the heading, by striking ‘‘ON COLLEGE CAMPUSES’’ and inserting ‘‘AT
INSTITUTIONS OF HIGHER EDUCATION’’;
(2) in subsection (c)(2), by inserting ‘‘, including minority-serving institutions
as described in section 371(a) of the Higher Education Act of 1965 (20 U.S.C.
1067q) and community colleges’’ after ‘‘higher education’’; and
(3) in subsection (f), by striking ‘‘2018 through 2022’’ and inserting ‘‘2023
through 2027’’.
I. PURPOSE AND SUMMARY
H.R. 7666, the ‘‘Restoring Hope for Mental Health and Well-
Being Act of 2022,’’ amends the Public Health Service Act to reau-
thorize and establish certain mental health and substance use dis-
order programs at the Substance Abuse and Mental Health Serv-
ices Administration (SAMHSA) and the Health Resources and
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Services Administration (HRSA) through fiscal year 2027, for the
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43
purposes of improving Americans’ mental health and addressing
substance use disorders. H.R. 7666 includes provisions to support
crisis care and other mental health services for a range of popu-
lations, as well as substance use disorder prevention, treatment,
and recovery support services. The legislation provides increased
support for youth suicide prevention, maternal mental health, and
jail diversion programs. Further, the bill includes provisions to as-
sist in addiction and overdose prevention and treatment, including
expanded access to medication-assisted treatment and provider
training. H.R. 7666 also facilitates further integration of mental
health and primary care services, bolsters the mental health care
workforce, applies mental health parity requirements to self-fund-
ed, non-governmental plans, and supports enforcement of mental
health parity requirements.
II. BACKGROUND AND NEED FOR LEGISLATION
Americans have been in the midst of a mental health and sub-
stance use disorder crisis predating the emergence of the
coronavirus disease of 2019 (COVID–19). Increased social isolation
and stress caused by the pandemic further exacerbated these chal-
lenges,1 with American adults reporting elevated levels of mental
illness (AMI) including anxiety, depression, and suicidal ideation.2
Children and teens have also experienced major increases in ad-
verse mental health symptoms.3 Among youth ages 10 and older,
the national suicide rate increased by more than 25 percent since
1999, nearly doubling in some states.4 In addition, one out of five
women will experience maternal mental health conditions, such as
depression, anxiety, or substance use disorder, during pregnancy or
the first year following childbirth.5 Suicide and substance use dis-
order are some of the leading causes of death in the first year
postpartum.6
The state of substance use disorders in the United States has fol-
lowed a similar upward trajectory in recent years. Nearly 108,000
people died due to drug overdose in 2021, a record-breaking num-
ber that followed a 30 percent increase in the rate of overdose
deaths from 2019 to 2020.7 Additionally, substance use disorders
frequently co-occur with mental health disorders, such as anxiety
1 Kaiser Family Foundation, The implications of COVID–19 for mental health and substance
use (Feb. 10, 2021).
2 Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, Mental
Health, Substance Use, and Suicidal Ideation During the COVID–19 Pandemic—United States,
June 24–30, 2020 (Aug. 14, 2020).
3 Surgeon General, Protecting Youth Mental Health: The U.S. Surgeon General’s Advisory (Dec.
7, 2021).
4 Centers for Disease Control and Prevention, Supplementary Table. Trends in Suicide Rates
among Persons ≥ 10 Years of Age, by State and Sex, National Vital Statistics System, 1999–2016
(June 8, 2018) (https://stacks.cdc.gov/view/cdc/53785).
5 Obstetrics & Gynecology, ACOG Committee Opinion No. 757, Screening for Perinatal Depres-
sion (journals.lww.com/greenjournal/Fulltext/2018/11000/ACOG_Committee_Opinion_No_757_
Screening_for.42.aspx); Fawcett, et. al, The Prevalence of Anxiety Disorders During Pregnancy
and the Postpartum Period, J. Clin Psychiatry (July 23, 2019) (pubmed.ncbi.nlm.nih.gov/
31347796/).
6 See Pregnancy-Related Deaths; Data from 14 U.S. Maternal Mortality Review Committees,
2008–2017 (www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/MMR-Data-
Brief_2019-h.pdf).
7 Centers for Disease Control and Prevention, Vital Statistics Rapid Release (www.cdc.gov/
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nchs/nvss/vsrr/drug-overdose-data.htm) (accessed June 6, 2022); Overdose Deaths Continue Ris-
ing, With Fentanyl and Meth Key Culprits, New York Times (May 11, 2022).
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44
and depression.8 Nearly 50 percent of individuals who develop a
mental health disorder will also experience a substance use dis-
order, and vice versa.9
Despite high rates of mental health conditions and substance use
disorders, access to treatment and services remains limited. In
2020, for instance, only 1.4 percent of individuals who were classi-
fied as in need of substance use treatment, and just 46.2 percent
of adults with any mental illness, received treatment.10 Major bar-
riers to treatment include the shortage of mental health profes-
sionals which affects one-third of Americans.11 The treatment bur-
den of mental illnesses is particularly acute among those who expe-
rience disability due to serious mental illness (SMI). SMI is defined
as a mental, behavioral, or emotional disorder resulting in serious
functional impairment, which substantially interferes with or lim-
its one or more major life activities.12 Those living with SMI—in-
cluding bipolar disorder, schizophrenia, and severe depression—are
jailed more than 2 million times each year, often for misdemeanor
crimes.13 The U.S. criminal justice system has witnessed dramatic
increases in its mentally ill population during the past years, with
decreasing numbers of psychiatric beds being identified as one of
the major causes.14 One-third of the total homeless population con-
sists of individuals with untreated SMI, with the rates being even
higher in homeless women and individuals who are chronically
homeless.15
H.R. 7666 reauthorizes 35 SAMHSA and HRSA grant programs
that provide critical support for mental health and substance use
disorder activities at a time when increased services for these con-
ditions are needed more than ever. These programs were estab-
lished or most recently reauthorized through the 21st Century
Cures Act,16 the Comprehensive Addiction and Recovery Act,17 or
the Substance Use-Disorder Prevention that Promotes Opioid Re-
covery and Treatment (SUPPORT) for Patients and Communities
Act,18 in efforts to curb rising rates of mental health conditions and
substance use disorders.
Collectively, through funding to states, territories, Tribes, Tribal
organizations, community-based and consumer-led organizations,
and a range of providers, these programs—including the respective
8 National Institute on Drug Abuse, Common Comorbidities with Substance Use Disorders Re-
search Report (April 2020).
9 Id.
10 Substance Abuse and Mental Health Services Administration. Key substance use and mental
health indicators in the United States: Results from the 2020 National Survey on Drug Use and
Health, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental
Health Services Administration (June 1, 2022).
11 USA FACTS, Over one-third of Americans live in areas lacking mental health professionals
(June 9, 2021) (https://usafacts.org/articles/over-one-third-of-americans-live-in-areas-lacking-
mental-health-professionals/); U.S. Department of Labor, U.S. Departments of Labor, Health and
Human Services, Treasury Issue 2022 Mental Health Parity and Addiction Equity Act Report to
Congress (June 1, 2022).
12 National Institute of Mental Health, Mental Illness (www.nimh.nih.gov/health/statistics/
mental-illness) (accessed June 8, 2022).
13 The Pew Charitable Trusts, Project: Mental Health and Justice Partnerships
(www.pewtrusts.org/en/projects/mental-health-and-justice-partnerships) (accessed June 8, 2022).
14 Y. Nina Gao, Relationship Between Psychiatric Inpatient Beds and Jail Populations in the
United States, Journal of Psychiatric Practice (Jan. 21, 2021).
15 Treatment Advocacy Center Office of Research & Public Affairs, Serious Mental Illness and
Homelessness (Sept. 2016) (https://www.treatmentadvocacycenter.org/storage/documents/
backgrounders/smi-and-homelessness.pdf).
16 Pub. L. 114–255.
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17 Pub. L. 114–198.
18 Pub. L. 115–271.
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Community Mental Health Services Block Grants and the Sub-
stance Use Disorder Treatment and Recovery Services Block
Grants—target communities and populations at increased need for
mental health support or services and substance use disorder pre-
vention, treatment, or recovery support services—such as for chil-
dren and adolescents, college students, pregnant or postpartum
women, people of color, Veterans, those experiencing homelessness,
those facing or at risk of incarceration, and rural communities.
In addition, to respond to the urgent mental health crisis care
needs of Americans, and in preparation of the 9–8–8 National Sui-
cide Prevention Lifeline dialing code launch in July 2022, H.R.
7666 establishes the SAMHSA Behavioral Health Crisis Coordi-
nating Office to convene partners and provide technical assistance
to enhance access to crisis care. Further, the bill requires the Sec-
retary of Health and Human Services (HHS) to publish best prac-
tices for a crisis response continuum of care, and replaces the reau-
thorization of the Community Crisis Response Systems Grants with
a Mental Health Crisis Response Partnership Pilot Program.
To address the rising maternal mental health and substance use
disorder needs across the country, H.R. 7666 establishes a national
hotline to provide information, interventions, and resources to preg-
nant and postpartum women at risk of, or affected by, maternal
mental health and substance use disorders, and establishes a task
force to make recommendations to coordinate and inform a national
strategy to improve Federal and State responses to maternal men-
tal health conditions.
Further, as nearly 29 million Americans have had or will have
an eating disorder at some point in their lives,19 the bill meets an
ongoing specific mental health disorder need and establishes an au-
thorization for the SAMHSA National Center of Excellence for Eat-
ing Disorders. It also authorizes grants to consumer-led nonprofits
and Tribal entities to provide peer-supported mental health serv-
ices, including virtual peer support.
H.R. 7666 also rises to meet the needs of young Americans dis-
proportionately impacted by mental health challenges and sub-
stance use disorders. Prior to the COVID–19 pandemic, mental
health crises experienced by adolescents were already on the rise,
with 13.2 percent of American children between the ages of three
and 17 experiencing a current, diagnosed mental or behavioral
health condition from 2018 to 2019.20 In addition, suicide rates for
Americans ages 10 to 24 has jumped nearly 60 percent between
2007 and 2018.21 These trends were exacerbated by the pandemic,
so much so that on December 7, 2021, the Surgeon General issued
an advisory on the impact that COVID–19 has had on the ongoing
children’s mental health crisis.22 The bill takes numerous steps
aimed to address youth mental health, including: reauthorizing
19 Deloitte Access Economic. The Social and Economic Cost of Eating Disorders in the United
States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Dis-
orders and the Academy for Eating Disorders (June 2020).
20 Health Resources and Services Administration, Mental and Behavioral Health, NSCH Data
Brief (Oct. 2020) (mchb.hrsa.gov/sites/default/files/mchb/data-research/nsch-data-brief-2019-men-
tal-bh.pdf)
21 Centers for Disease Control and Prevention, National Vital Statistics Reports, Volume 69,
Number 11: State Suicide Rates Among Adolescents and Young Adults Aged 10–24: United
States, 2000–2018 (Sept. 11, 2020) (www.cdc.gov/nchs/data/nvsr/nvsr69/nvsr-69-11-508.pdf).
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22 Department of Health and Human Services, U.S. Surgeon General Issues Advisory on Youth
Mental Health Crisis Further Exposed by COVID–19 Pandemic (Dec. 7, 2021) (press release).
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HRSA’s Pediatric Mental Health Care Access grant program, which
promotes behavioral health integration into pediatric primary care
by supporting pediatric mental health care telehealth access pro-
grams in states, and SAMHSA’s Infant and Early Childhood Men-
tal Health Grant Program, which helps to improve outcomes for
children from birth to age 12 by developing, maintaining, or en-
hancing mental health promotion, intervention, and treatment
services. The bill further supports continuing mental health and
substance use disorder systems of care for children through the
five-year reauthorization of the Comprehensive Community Mental
Health Services for Children with Serious Emotional Disturbances
Grants and the Enhancement and Expansion of Treatment and Re-
covery Services for Adolescents, Transitional Aged Youth, and their
Families—known as the Youth and Family TREE Grants.
Many of the millions of older adolescents and young adults living
with a mental or substance use disorder may not realize they have
one or know how to seek help.23 H.R. 7666 further supports youth
and young adults across the country through the reauthorization of
the Garrett Lee Smith Memorial Act programs including the Sui-
cide Prevention Resource Center, the State and Tribal Youth Sui-
cide Prevention and Early Intervention Grants Program, the Men-
tal Health Youth Suicide Prevention Campus Grants, and the Men-
tal and Behavioral Health Public Outreach and Education at Insti-
tutions of Higher Education program.
In addition, H.R. 7666 reauthorizes the Sober Truth on Preven-
tion Underage Drinking Programs, supporting a national media
campaign, community-based coalition enhancement grants, and
grants for pediatric provider screening and brief interventions as
well as data collection and research to prevent and address under-
age drinking at a time when alcohol remains the most widely used
substance among America’s young people.24 The bill reauthorizes a
range of other substance- or intervention-specific programs, such as
the grants for reducing overdose deaths and the emergency depart-
ment alternatives to opioids grant program. Further, the bill re-
quires that the Secretary of HHS, acting through the SAMHSA As-
sistant Secretary, collaborate with federal agencies and stake-
holders to update, disseminate and promote through grants high-
quality recovery housing best practices.
The climbing rate of Americans experiencing mental health con-
ditions is projected to put a strain on the mental and behavioral
health workforce—according to HRSA’s Bureau of Health Work-
force, a majority of states will experience shortages of licensed
mental health counselors by 2030.25 In addition, as of March 2021,
about 122 million Americans were living in areas experiencing
mental health professional shortages.26 H.R. 7666 includes a num-
ber of programs to bolster mental and behavioral health workforce
capacity, including Liability Protections for Health Professional
23 Substance Abuse and Mental Health Services Administration, Mental Illness and Substance
Use in Young Adults (www.samhsa.gov.young-adults) (accessed June 7, 2022).
24 National Institutes of Health, Underage Drinking (www.niaaa.nih.gov/publications/bro-
chures-and-fact-sheets/underage-drinking) (accessed June 7, 2022).
25 Health Resources and Services Administration, Behavioral Health Workforce Projections,
2017–2030 (bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/bh-workforce-
projections-fact-sheet.pdf) (accessed June 7, 2022).
26 U.S. News and World Report, Many States Face Shortage of Mental Health Providers (June
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10, 2021) (www.usnews.com/news/best-states/articles/2021-06-10/northeastern-states-have-few-
est-mental-health-provider-shortages).
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47
Volunteers, Mental and Behavioral Health Education and Training
Grants (including updates to the education reference for occupa-
tional therapist), the Training Demonstration Program, and expan-
sion of the Integration Incentive Grants and Cooperative Agree-
ments to increase uptake of the collaborate care model.
Even with access to mental health and substance use disorder
prevention, treatment, and care, consumers with health care cov-
erage face numerous challenges accessing mental health and sub-
stance disorder benefits provided by their health insurance plans.27
The Paul Wellstone and Pete Domenici Mental Health Parity and
Addiction Equity Act of 2008 (MHPAEA) requires parity between
mental health and substance use disorder benefits and medical/sur-
gical benefits of health plans.28 The MHPAEA prohibits coverage
requirements for mental health and substance disorder benefits
from being more restrictive than those for medical/surgical benefits,
and prevents health insurance plans that provide mental health or
substance use disorder benefits from imposing less favorable finan-
cial requirements and treatment limitations on those benefits than
on medical/surgical benefits. However, some health insurance plans
fail to comply with parity requirements of the MHPAEA, and as a
result, consumers face more coverage limitations for behavioral
health services than for medical/surgical benefits.29 A recent report
by the Departments of HHS, Treasury, and Labor found that some
health plans and health insurance issuers are failing to deliver par-
ity for mental health and substance use disorder benefits to those
they cover.30 H.R. 7666 authorizes funding to assist States to en-
force and ensure compliance with mental health parity, and re-
quires self-funded, non-federal governmental plans to comply with
mental health parity requirements.
It is estimated that more than 2 million people in the United
States have an opioid use disorder (OUD), a chronic brain disease
caused by prolonged use of opioids, such as fentanyl, oxycodone,
and heroin.31 There are three FDA-approved medications used to
treat OUD, methadone, buprenorphine, and extended-release
naltrexone; these medications reduce cravings and reduce the risk
future use, which greatly reduces the risk of fatal overdose.32 How-
ever, access to these medications is not widely available to those
who may benefit the most, and there are disparities in access
across different populations.33 The bill includes provisions that re-
duce regulatory barriers, enhance provider education, and increase
access to medication-assisted treatment for OUD.
Scientific literature shows that regulatory and administrative
burdens create barriers to accessing treatment for OUD. For exam-
ple, methadone is only accessible through specialty treatment fa-
cilities known as opioid treatment programs (OTPs). OTPs are
strictly regulated by the Drug Enforcement Administration (DEA)
27 Government Accountability Office, Mental Health Care: Consumers with Coverage Face Ac-
cess Challenges (Mar. 30, 2022).
28 Pub. L. 110–343.
29 Id; Department of Treasury, Realizing Parity, Reducing Stigma, and Raising Awareness: In-
creasing Access to Mental Health and Substance Use Disorder Coverage (2022) www.dol.gov/
sites/dolgov/files/EBSA/laws-and-regulations/laws/mental-health-parity/report-to-congress-2022-
realizing-parity-reducing-stigma-and-raising-awareness.pdf (Report to Congress).
30 Id.
31 National Academy of Sciences, Engineering, and Science (NASEM), Consensus Study Re-
port: Medications for Opioid Use Disorder Save Lives (2019) (https://bit.ly/2NJnNXQ).
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32
33 Id.
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and SAMHSA.34 Limits to how, where, and when patients can ac-
cess OUD treatment limits uptake of life-saving medications.35
During the public health emergency declared to respond to the
COVID–19 pandemic, regulatory flexibilities were provided to
OTPs and practitioners seeking to dispense medications to treat
OUD. In 2020, SAMHSA implemented regulatory flexibilities for
take-home-methadone doses; preliminary studies show that metha-
done uptake among patients with OUD nearly doubled and was not
associated with negative health outcomes, such as increased fatal
drug overdoses.36,37 Provisions in this bill allow OTPs to operate
mobile medication units to dispense methadone without a separate
DEA registration; eliminate the requirement that patients have
OUD for one year before becoming eligible for admission into an
OTP; direct SAMHSA to study the regulatory flexibilities exercised
during the COVID–19 pandemic and submit a report to Congress
with their findings; and requires SAMHSA to develop criteria and
update regulations for OTPs to dispense take-home methadone
doses.
Buprenorphine can be prescribed in office-based settings by pro-
viders who apply for a special DEA waiver, known as the ‘‘X Waiv-
er.’’ 38 It is estimated that one in ten medical providers hold these
waivers and many do not prescribe at the allotted cap due to per-
ceptions of regulatory complexity.39 Further, studies show that lack
of provider education about medication-assisted treatment for OUD
compounds stigma and leads to reduced patient access.40 Inte-
grating OUD treatment education into mainstream health systems
and reducing regulatory barriers is likely to increase provider
knowledge and patient access.41 During the COVID–19 pandemic,
SAMHSA has also allowed practitioners to treat up to 30 patients
with buprenorphine for OUD without a separate DEA registration,
citing it as an important first step in decreasing barriers to treat-
ment.42
The legislation eliminates the requirement for health practi-
tioners to apply for the ‘‘X-waiver’’ in order to prescribe
buprenorphine. It further requires health practitioners to meet a
one-time, eight-hour training requirement on treating and identi-
fying patients with substance use disorders as a condition of receiv-
ing or renewing a DEA registration to dispense controlled sub-
stances.
34 42 CFR 8.12.
35 Id.
36 Substance Abuse and Mental Health Services Administration, SAMHSA Extends the Metha-
done Take-Home Flexibility for One Year While Working Toward a Permanent Solution (2021)
(www.samhsa.gov/newsroom/press-announcements/202111181000).
37 American Journal of Drug and Alcohol Abuse, The impact of relaxation of methadone take-
home protocols on treatment outcomes in the COVID–19 era (Nov. 2021)
(pubmed.ncbi.nlm.nih.gov/34670453/).
38 End Substance Use Disorder, Federal barriers to prescribing buprenorphine (the X-Waiver)
(www.endsud.org/mat-act-federal-barriers/#mat-act).
39 Id.
40 National Academy of Sciences, Engineering, and Science, Consensus Study Report: Medica-
tions for Opioid Use Disorder Save Lives (2019) (https://nap.nationalacademies.org/catalog/25310/
medications-for-opioid-use-disorder-save-lives).
41 Id.
42 Substance Abuse and Mental Health Services Administration, FAQs About the New
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Buprenorphine Practice Guidelines (2021) (www.samhsa.gov/medication-assisted-treatment/be-
come-buprenorphine-waivered-practitioner/new-practice-guidelines-faqs).
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III. COMMITTEE HEARINGS
For the purposes of section 3(c) of rule XIII of the Rules of the
House of Representatives, the following hearing was used to de-
velop or consider H.R. 7666:
The Subcommittee on Health held a legislative hearing on April
5, 2022, entitled ‘‘Communities in Need: Legislation to Support
Mental Health and Well-Being.’’ The Subcommittee received testi-
mony from the following witnesses:
Panel I:
• Miriam E. Delphin-Rittmon, Ph.D., Assistant Secretary for
Mental Health and Substance Use, Substance Abuse and Men-
tal Health Services Administration; and
• Carole Johnson, M.A., Administrator, Health Resources
and Services Administration.
Panel II:
• Rebecca W. Brendel, M.D., J.D., President-Elect, American
Psychiatric Association;
• Sandy L. Chung, M.D., F.A.A.P., F.A.C.H.E., President-
Elect, American Academy of Pediatrics;
• Steven Adelsheim, M.D., Clinical Professor of Psychiatry
and Director, Stanford Center for Youth Mental Health and
Wellbeing, Stanford University School of Medicine, Stanford
Children’s Health;
• Debra Pinals, M.D., Medical Director, Behavioral Health
and Forensic Programs, Michigan Department of Health and
Human Services, On behalf of the National Association of State
Mental Health Program Directors;
• Cassandra Price, M.B.A., Director, Office of Addictive Dis-
eases, Georgia Department of Behavioral Health and Develop-
mental Disabilities, On behalf of the National Association of
State Alcohol and Drug Abuse Directors; and
• LeVail W. Smith, C.P.S.S., Peer Support Specialist In-
structor and Mentor.
IV. COMMITTEE CONSIDERATION
H.R. 7666, the ‘‘Restoring Hope for Mental Health and Well-
Being Act of 2022,’’ was introduced on May 6, 2022, by Representa-
tives Pallone (D–NJ) and Rodgers (R–WA) and referred to the Com-
mittee on Energy and Commerce. Subsequently, on May 9, 2022,
the bill was referred to the Subcommittee on Health.
On May 11, 2022, the Subcommittee on Health met in open
markup session, pursuant to notice, to consider H.R. 7666 and five
other bills. During consideration of the bill, no amendments were
offered. Upon conclusion of consideration of the bill, the Sub-
committee on Health agreed to report the bill favorably to the full
Committee, without amendment, by a roll call vote of 32 yeas to
zero nays.
On May 18, 2022, the full Committee met in open markup ses-
sion, pursuant to notice, to consider H.R. 7666 and five other bills.
An amendment in the nature of a substitute (AINS), offered by
Representative Pallone, was agreed to by a voice vote. An amend-
ment to the AINS, offered by Representative Tonko (D–NY), was
agreed to by a roll call vote of 45 yeas to 10 nays. An amendment
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to the Tonko amendment to the AINS, offered by Representative
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50
Burgess (R–TX), was withdrawn. An amendment to the AINS, of-
fered by Representative Trahan (D–MA), was agreed to by a roll
call vote of 46 yeas to 8 nays. An amendment to the AINS, offered
by Representative Upton (R–MI), was agreed to by a roll call vote
of 55 yeas to one nay. An amendment to the AINS, offered by Rep-
resentative Cárdenas (D–CA), was agreed to by a roll call vote of
31 yeas to 24 nays. An amendment to the bill, offered by Rep-
resentative Curtis (R–UT), was withdrawn. Upon conclusion of con-
sideration of the bill, the full Committee agreed to a motion on
final passage offered by Representative Pallone, Chairman of the
Committee, to order H.R. 7666 reported favorably to the House,
amended, by a voice vote.
V. COMMITTEE VOTES
Clause 3(b) of rule XIII of the Rules of the House of Representa-
tives requires the Committee to list each record vote on the motion
to report legislation and amendments thereto. The Committee ad-
vises that there were five record votes taken on H.R. 7666. The mo-
tion on final passage of the bill ordering H.R. 7666 favorably re-
ported to the House, amended, was approved by a voice vote. The
following are the record votes taken during Committee consider-
ation, including the names of those members voting for and
against:
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Q!:ommittee on <!Enrrgp anb Q!:ommerce
117th Congress
Subcommittee on Health
(ratio: 19-15)
ROLL CALL VOTE #2
Bill: H.R. 7666, the "Restoring Hope for Mental Health and Well-Being Act of2022"
Motion: A motion by Ms. Eshoo of California to order H.R. 7666 transmitted favorably to
the full Committee, amended (Final Passage).
Disposition: AGREED TO by a roll call vote of 32 yeas to O nays
REPRESENTATIVE YEAS N A Y S ~ ~
Ms. Eshoo X Mr. Guthrie X
Mr. Butterfield Mr. Upton X
Ms. Matsui X Mr. Burgess X
Ms. Castor X Mr. Griffith X
Mr. Sarbanes X Mr. Bilirakis X
Mr. Welch X Mr. Long X
Mr. Schrader X Mr. Bucshon X
Mr. Cardenas X Mr. Mullin X
Mr. Ruiz X Mr. Hudson X
Mrs. Dingell X Mr. Carter X
Ms. Kuster X Mr. Dunn X
Ms. Kelly Mr. Curtis X
Ms. Barragan X Mr. Crenshaw X
Ms. Blunt Rochester X Mr. Joyce X
Ms. Craig X Mrs. Rodgers X
Ms. Schrier X
Ms. Trahan X
Ms. Fletcher X
Mr. Pallone X
05/11/22
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52
(i[ommitter on Qf'ncrl!1' anb (i[ommme
117" Congress
Full Committee
(ratio: 32-26)
ROLL CALL VOTE # 120
Bill: H.R. 7666, the "Restoring Hope for Mental Health and Well-Being Act of2022"
Amendment: An amendment (H7666-SCD-AMD_0l) to the AINS by Mr. Tonko of New York,
No. Ia
Disposition: AGREED TO by a roll call vote of 45 yeas to IO nays
REPRESENTATIVE YEAS NAYS PRESENT REPRESENTATIVE YEAS NAYS PRESENT
Mr. Pallone X Mrs. Rodgers X
Mr. Rush Mr. Upton X
Ms. Eshoo X Mr. Burgess X
Ms. DeGette X Mr. Scalise
Mr. Doyle X Mr. Latta X
Ms. Schakowsky X Mr. Guthrie X
Mr. Butterfield X Mr. McKinley X
Ms. Matsui X Mr. Kinzinger
Ms. Castor X Mr. Griffith X
Mr. Sarbanes X Mr. Bilirakis X
Mr. McNemey X Mr. Johnson X
Mr. Welch X Mr. Long X
Mr. Tonko X Mr. Bucshon X
Ms. Clarke X Mr. Mullin X
Mr. Schrader X Mr. Hudson X
Mr. Cardenas X Mr. Walberg X
Mr.Ruiz X Mr. Carter X
Mr. Peters X Mr. Duncan X
Mrs. Dingell X Mr. Palmer X
Mr. Veasey X Mr. Dunn X
Ms. Kuster X Mr. Curtis X
Ms. Kelly X Ms. Lesko X
Ms. Barragan X Mr. Pence X
Mr. McEachin X Mr. Crenshaw X
Ms. Blunt Rochester X Mr. Joyce X
Mr. Soto X Mr. Armstrong X
Mr. O'Halleran X
Ms. Rice X
Ms. Craig X
Ms. Schrier X
Ms. Trahan X
Ms. Fletcher X
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53
QCommittee on Qfn,r~p anb QCommme
117"' Congress
Full Committee
(rado: 32-26)
ROLL CALL VOTE#l2I
Bill: H.R. 7666, the "Restoring Hope for Mental Health and Well-Being Act of2022"
Amendment: An amendment (H7666-SCD-AMD_ 02) to the AINS by Ms. Trahan of
Massachusetts, No. 1b
Disposition: AGREED TO by a roll call vote of 46 yeas to 8 nays
YEAS NAYS PRESENT REPRESENTATlVE YEAS NAYS PRESENT
~e X Mrs. Rodgers X
Mr. Rush Mr. Upton X
Ms. Eshoo X Mr. Burgess X
Ms. DeGette X Mr. Scalise
Mr. Doyle X Mr. Latta X
Ms. Schakowsky X Mr. Guthrie X
Mr. Butterfield Mr. McKinley X
Ms. Matsui X Mr. Kinzinger
Ms. Castor X Mr. Griffith X
Mr. Sarbanes X Mr. Bilirakis X
Mr. McNemey X Mr. Johnson X
Mr. Welch X Mr. Long X
Mr. Tonko X Mr. Bucshon X
Ms. Clarke X Mr.Mullin X
Mr. Schrader X Mr. Hudson X
Mr. Cardenas X Mr. Walberg X
Mr.Ruiz X Mr. Carter X
Mr. Peters X Mr. Duncan X
Mrs. Dingell X Mr. Palmer X
Mr. Veasey X Mr. Dunn X
Ms. Kuster X Mr. Curtis X
Ms. Kelly X Ms. Lesko X
Ms. Barragan X Mr. Pence X
Mr. McEachin X Mr. Crenshaw X
Ms. Blunt Rochester X Mr. Joyce X
Mr. Soto X Mr. Armstrong X
Mr. O'Halleran X
Ms. Rice X
Ms. Craig X
Ms. Schrier X
Ms. Trahan X
Ms. Fletcher X
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54
IICommitt,e on Q.:nergp anh IICommme
117 th Congress
Full Committee
(ratio: 32-26)
ROLL CALL VOTE# I 22
Bill: H.R. 7666, the "Restoring Hope for Mental Health and Well-Being Act of2022"
Amendment: An amendment (H7666-FCD-AMD_ 01) to the AINS by Mr. Upton of Michigan,
No. le
Disposition: AGREED TO by a roll call vote of 55 yeas to I nay
REPRESENTATIVE YEAS NAYS PRESENT REPRESENTATIVE YEAS NAYS PRESENT
Mr. Pallone X Mrs. Rodgers X
Mr. Rush X Mr. Upton X
Ms. Eshoo X Mr. Burgess X
Ms. DeGette X Mr. Scalise
Mr. Doyle X Mr. Latta X
Ms. Schakowsky X Mr. Guthrie X
Mr. Butterfield X Mr. McKinley X
Ms. Matsui X Mr. Kinzinger
Ms. Castor X Mr. Griffith X
Mr. Sarbanes X Mr. Bilirakis X
Mr. McNemey X Mr. Johnson X
Mr. Welch X Mr. Long X
Mr. Tonko X Mr. Bucshon X
Ms. Clarke X Mr. Mullin X
Mr. Schrader X Mr. Hudson X
Mr. Cardenas X Mr. Walberg X
Mr.Ruiz X Mr. Carter X
Mr. Peters X Mr. Duncan X
Mrs. Dingell X Mr. Palmer X
Mr. Veasey X Mr. Dunn X
Ms. Kuster X Mr. Curtis X
Ms.Kelly X Ms. Lesko X
Ms. Barrag.in X Mr. Pence X
Mr. McEachin X Mr. Crenshaw X
Ms. Blunt Rochester X Mr. Joyce X
Mr. Soto X Mr. Armstrong X
Mr. O'Halleran X
Ms. Rice X
Ms. Craig X
Ms. Schrier X
Ms. Trahan X
Ms. Fletcher X
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55
(!Committee on <energp anb (!Commerce
117'" Congress
Full Committee
(ratio: 32-26)
ROLL CALL VOTE# 123
Bill: H.R. 7666, the "Restoring Hope for Mental Health and Well-Being Act of2022"
Amendment: An amendment (H7666-FC-AMD 01) to the AINS by Mr. Cardenas of
California, No. l d -
Disposition: AGREED TO by a roll call vote of3 l yeas to 24 nays
ESENTATIVE YEAS NAYS PRESENT REPRESENTATIVE YEAS NAYS PRESENT
Mr. Pallone X Mrs. Rodgers X
Mr. Rush X Mr. Upton X
Ms. Eshoo X Mr. Burgess X
Ms. DeGette X Mr. Scalise
Mr. Doyle X Mr.Latta X
Ms. Schakowsky X Mr. Guthrie X
Mr. Butterfield X Mr. McKinley X
Ms. Matsui X Mr. Kinzinger
Ms. Castor X Mr. Griffith X
Mr. Sarbanes X Mr. Bilirakis X
Mr. McNerney X Mr. Johnson X
Mr. Welch X Mr. Long X
Mr. Tonko X Mr. Bucshon X
Ms. Clarke X Mr.Mullin X
Mr. Schrader X Mr. Hudson X
Mr. Cardenas X Mr. Walberg X
Mr.Ruiz X Mr. Carter X
Mr. Peters X Mr. Duncan X
Mrs. Dingell X Mr. Palmer X
Mr. Veasey X Mr. Dunn X
Ms. Kuster X Mr. Curtis X
Ms. Kelly X Ms. Lesko X
Ms. Barragan Mr. Pence X
Mr. McEachin X Mr. Crenshaw X
Ms. Blunt Rochester X Mr. Joyce X
Mr. Soto X Mr. Armstrong X
Mr. O'Halleran X
Ms. Rice X
Ms. Craig X
Ms. Schrier X
Ms. Trahan X
Ms. Fletcher X
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VI. OVERSIGHT FINDINGS
Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) of rule
X of the Rules of the House of Representatives, the oversight find-
ings and recommendations of the Committee are reflected in the
descriptive portion of the report.
VII. NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX
EXPENDITURES
Pursuant to 3(c)(2) of rule XIII of the Rules of the House of Rep-
resentatives, the Committee adopts as its own the estimate of new
budget authority, entitlement authority, or tax expenditures or rev-
enues contained in the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
The Committee has requested but not received from the Director
of the Congressional Budget Office a statement as to whether this
bill contains any new budget authority, spending authority, credit
authority, or an increase or decrease in revenues or tax expendi-
tures.
VIII. FEDERAL MANDATES STATEMENT
The Committee adopts as its own the estimate of Federal man-
dates prepared by the Director of the Congressional Budget Office
pursuant to section 423 of the Unfunded Mandates Reform Act.
IX. STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
Pursuant to clause 3(c)(4) of rule XIII, the general performance
goal or objective of this legislation is to amend the Public Health
Service Act to reauthorize certain programs relating to mental
health and substance use disorders to support the mental health of
Americans.
X. DUPLICATION OF FEDERAL PROGRAMS
Pursuant to clause 3(c)(5) of rule XIII, no provision of H.R. 7666
is known to be duplicative of another Federal program, including
any program that was included in a report to Congress pursuant
to section 21 of Public Law 111–139 or the most recent Catalog of
Federal Domestic Assistance.
XI. COMMITTEE COST ESTIMATE
Pursuant to clause 3(d)(1) of rule XIII, the Committee adopts as
its own the cost estimate prepared by the Director of the Congres-
sional Budget Office pursuant to section 402 of the Congressional
Budget Act of 1974.
XII. EARMARKS, LIMITED TAX BENEFITS, AND LIMITED TARIFF
BENEFITS
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the Committee
finds that H.R. 7666 contains no earmarks, limited tax benefits, or
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XIII. ADVISORY COMMITTEE STATEMENT
No advisory committee within the meaning of section 5(b) of the
Federal Advisory Committee Act was created by this legislation.
XIV. APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that the legislation does not relate to the
terms and conditions of employment or access to public services or
accommodations within the meaning of section 102(b)(3) of the Con-
gressional Accountability Act.
XV. SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION
Section. 1. Short title; Table of contents
Section 1 designates that the short title may be cited as the ‘‘Re-
storing Hope for Mental Health and Well-Being Act of 2022.’’
TITLE I: MENTAL HEALTH AND CRISIS CARE NEEDS
SUBTITLE A—CRISIS CARE SERVICES AND 9–8–8 IMPLEMENTATION
Sec. 101. Behavioral Health Crisis Coordinating Office
Section 101 establishes the Behavioral Health Crisis Coordi-
nating Office within the Substance Abuse and Mental Health Serv-
ices Administration (SAMHSA) to convene partners and provide
technical assistance to enhance access to crisis care, authorized at
$5 million annually for fiscal years 2023 through 2027.
Sec. 102. Crisis response continuum of care
Section 102 requires the Secretary of HHS to publish best prac-
tices for a crisis response continuum of care not later than one year
after the date of enactment for use by health care providers, crisis
services administrators, and crisis services providers.
SUBTITLE B—INTO THE LIGHT FOR MATERNAL MENTAL HEALTH AND
SUBSTANCE USE DISORDERS
Sec. 111. Screening and treatment for maternal mental health and
substance use disorders
Section 111 reauthorizes section 317L–1 of the Public Health
Service Act (PHSA) to award Screening and Treatment for Mater-
nal Mental Health and Substance Use Disorders grants to states
to establish, improve, or maintain programs for screening, assess-
ment, and treatment services for women who are postpartum, preg-
nant, or have given birth within the preceding 12 months, for ma-
ternal mental health and substance use disorders. The grants are
authorized at $24 million annually for fiscal years 2023 through
2027.
Sec. 112. Maternal mental health hotline
Section 112 establishes a national hotline to provide information,
brief intervention, and mental health and substance use disorder
resources to pregnant and postpartum women at risk of, or affected
by, maternal mental health and substance use disorders, and au-
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thorizes $10 million annually for fiscal years 2023 through 2027.
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Sec. 113. Task force on maternal mental health
Section 113 establishes a task force to make recommendations to
coordinate and inform a national strategy to improve federal and
state responses to maternal mental health conditions and requires
a report to Congress and to governors and state leaders two years
after the first meeting of the task force.
SUBTITLE C—REACHING IMPROVED MENTAL HEALTH OUTCOMES FOR
PATIENTS
Sec. 121. Innovation for mental health
Section 121 replaces the unfunded Community Crisis Response
Systems Grants authorization with an authorization of $10 million
annually for fiscal years 2023 through 2027 for the establishment
of a Mental Health Crisis Response Partnership Pilot Program.
Sec. 122. Crisis care coordination
Section 122 reauthorizes five additional SAMHSA programs to
address mental health needs, provide crisis response care, and pre-
vent suicide among adults for fiscal years 2023 through 2027, in-
cluding: National Mental Health and Substance Abuse Policy Lab-
oratory, authorized at $10 million for each fiscal year; Interdepart-
mental Serious Mental Illness Coordinating Committee; Mental
Health Needs Priority Regions of National Significance (PRNS), au-
thorized at $599.036 million for each fiscal year; Mental Health
Awareness Training (MHAT) Grants, authorized at $24.963 million
for each fiscal year; and Adult Suicide Prevention, authorized at
$30 million for each fiscal year.
Sec. 123. Treatment of serious mental illness
Section 123 reauthorizes two programs for the treatment of seri-
ous mental illness, the Assertive Community Treatment Grants,
authorized at $9 million for each fiscal year for fiscal years 2023
through 2027 and the Assisted Outpatient Treatment Grant Pro-
gram for Individuals with Serious Mental Illness, authorized at $22
million for each fiscal year for the same period.
SUBTITLE D—ANNA WESTIN LEGACY
Sec. 131. Maintaining education and training on eating disorders
Section 131 establishes an authorization for the SAMHSA Na-
tional Center of Excellence for Eating Disorders at $1 million annu-
ally for fiscal years 2023 through 2027 to award competitive sub-
grants or subcontracts for the development and provision of train-
ing and technical assistance to primary and behavioral health pro-
viders and non-clinical community support workers as well as col-
laboration and coordination with SAMHSA, the Centers for Disease
Control and Prevention, and the Health Resources and Services
Administration (HRSA) on the identification, effective treatment,
and ongoing support of individuals with eating disorders.
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SUBTITLE E—COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT
REAUTHORIZATION
Sec. 141. Reauthorization of block grants for community mental
health services
Section 141 reauthorizes the Community Mental Health Services
Block Grants for states, territories, Tribes, and Tribal organiza-
tions to support community mental health services for adults with
serious mental illness and children with serious emotional disturb-
ance and to support the collection of performance and outcome
data. This section also requires that five percent of the funds
granted be used for crisis-care services and allows for up to five
percent of funds for early intervention activities. This section au-
thorizes $857.571 million annually for fiscal years 2023 through
2027.
SUBTITLE F—PEER-SUPPORTED MENTAL HEALTH SERVICES
Sec. 151. Peer-supported mental health services
Section 151 authorizes $13 million annually for fiscal years 2023
through 2027 for grants to consumer-led nonprofits, Tribes and
Tribal organizations, Urban Indian organizations, or Tribal consor-
tium to provide peer-supported mental health services, including
virtual peer support.
TITLE II: SUBSTANCE USE DISORDER PREVENTION, TREATMENT, AND
RECOVERY SERVICES
SUBTITLE A—NATIVE BEHAVIORAL HEALTH ACCESS IMPROVEMENT
Sec. 201. Behavioral health and substance use disorder services for
Native Americans
Section 201 reauthorizes the Alcohol and Drug Prevention or
Treatment Services for Indians and Native Alaskans Grant Pro-
gram to provide culturally appropriate mental health and sub-
stance use disorder prevention, treatment, and recovery services to
American Indians, Alaska Natives, and Native Hawaiians. This
section requires the convening of a negotiated rulemaking com-
mittee composed of representatives of the federal government, Trib-
al Governments, and Urban Indian Organizations to establish a
funding formula and program evaluation standards. This section
authorizes $40 million annually for fiscal years 2023 through 2027.
SUBTITLE B—SUMMER BARROW PREVENTION, TREATMENT, AND
RECOVERY
Sec. 211. Grants for the benefit of homeless individuals
Section 211 reauthorizes formula grants for the benefit of home-
less individuals, administered through SAMHSA, authorized at
$41.304 million for each fiscal year for fiscal years 2023 through
2027.
Sec. 212. Priority substance abuse treatment needs of regional and
national significance
Section 212 reauthorizes the SAMHSA Substance Use Disorder
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Treatment Programs of Regional and National Significance
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(PRNS), authorized at $521.517 million for each fiscal year for fis-
cal years 2023 through 2027.
Sec. 213. Evidence-based prescription opioid and heroin treatment
and interventions demonstration
Section 213 reauthorizes the Prescription Opioid and Heroin
Treatment and Interventions Demonstration Grants, administered
by SAMHSA, authorized at $25 million for each fiscal year for fis-
cal years 2023 through 2027.
Sec. 214. Priority substance use disorder prevention needs of re-
gional and national significance
Section 214 reauthorizes the SAMHSA Substance Use Disorder
Prevention PRNS, authorized at $218.219 million for each fiscal
year for fiscal years 2023 through 2027.
Sec. 215. Sober Truth on Preventing (STOP) Underage Drinking Re-
authorization
Section 215 reauthorizes programs to reduce underage drinking,
including requiring an annual report, a national media campaign,
extending Community-based Coalition Enhancement Grants to Pre-
vent Underage Drinking, Pediatric Provider Screening and Brief
Intervention Grants, and data collection and research, collectively
authorized at $23 million for each fiscal year for fiscal years 2023
through 2027. This section also requires a National Academy of
Sciences review and report to Congress authorized at $500,000 for
fiscal year 2023.
Sec. 216. Grants for jail diversion programs
Section 216 reauthorizes the SAMHSA Jail Diversion Program
and Grants, authorized at $14 million each fiscal year for fiscal
years 2023 through 2027.
Sec. 217. Formula grants to States
Section 217 authorizes formula grants to states from fiscal years
2023 through 2027.
Sec. 218. Projects for Assistance in Transition From Homelessness
Section 218 reauthorizes SAMHSA’s Projects for Assistance in
Transition from Homelessness Program, authorized at $64.635 mil-
lion each fiscal year for fiscal years 2023 through 2027.
Sec. 219. Grants for reducing overdose deaths
Section 219 reauthorizes SAMHSA grants for reducing overdose
deaths, including supporting the development of strategic opioid
crisis response plans, authorized at $5 million each fiscal year for
fiscal years 2023 through 2027.
Sec. 220. Opioid overdose reversal medication access and education
grant programs
Section 220 reauthorizes Opioid Overdose Reversal Medication
Access, Education, and Co-prescribing Grants, requiring health
care practitioners to prescribe an opioid reversal drug when pre-
scribing an opioid for certain patients, authorized at $5 million
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each fiscal year for fiscal years 2023 through 2027.
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Sec. 221. State demonstration grants for comprehensive opioid
abuse response
Section 221 reauthorizes SAMHSA grants for State and Local In-
tegrated Comprehensive Opioid Use Disorder Response, authorized
at $5 million each fiscal year for fiscal years 2023 through 2027.
Sec. 222. Emergency department alternatives to opioids
Section 222 reauthorizes Emergency Department Alternatives to
Opioids Demonstration Grants, authorized at $10 million each fis-
cal year for fiscal years 2023 through 2027.
SUBTITLE C—EXCELLENCE IN RECOVERY HOUSING
Sec. 231. Clarifying the role of SAMHSA in promoting the avail-
ability of high-quality recovery housing
Section 231 requires the Secretary, acting through the SAMHSA
Assistant Secretary, to collaborate with federal agencies and rel-
evant stakeholders to promote the availability of high-quality re-
covery housing and services for individuals with substance use dis-
order.
Sec. 232. Developing guidelines for States to promote the avail-
ability of high-quality recovery housing
Section 232 requires the Secretary to develop and periodically
update consensus based best practices for operating, and promoting
the availability of, high-quality recovery housing.
Sec. 233. Coordination of Federal activities to promote the avail-
ability of recovery housing
Section 233 requires the Secretary, acting through the SAMHSA
Assistant Secretary, and the Secretary of Housing and Urban De-
velopment, to convene an interagency working group and report to
Congress on its activities to increase federal collaboration and co-
ordination, develop a long-term plan to support state, Tribal, and
local efforts to operate recovery housing consistent with best prac-
tices, and coordinate fair housing practices and data collection on
the quality of recovery housing.
Sec. 234. NAS study and report
Section 234 requires the Secretary, acting through the Assistant
Secretary for Mental Health and Substance Use, to contract with
the National Academy of Sciences, Engineering, and Medicine to
study the quality and effectiveness of recovery housing in the
United States and identify recommendations, and to report to Con-
gress the results of the review. This section authorizes $1.5 million
for fiscal year 2023.
Sec. 235. Grants for States to promote the availability of recovery
housing and services
Section 235 permits SAMHSA to provide grants to states, Tribes,
and territories for technical assistance to promote and maintain re-
covery housing according to best practices and to develop related
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state promotion plans.
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Sec. 236. Funding
Section 236 reauthorizes $5 million for the period of fiscal years
2023 through 2027 for the activities described in sections 231
through 235.
Sec. 237. Technical correction
Section 237 makes technical conforming corrections to the Public
Health Services Act (PHSA).
SUBTITLE D—SUBSTANCE USE PREVENTION, TREATMENT, AND
RECOVERY SERVICES BLOCK GRANT
Sec. 241. Eliminating stigmatizing language relating to substance
use
Section 241 renames SAMHSA’s Substance Abuse Prevention
and Treatment Block Grant as the ‘‘Substance Use Prevention,
Treatment, and Recovery Services Block Grant,’’ and replaces ‘‘sub-
stance abuse’’ with ‘‘substance use’’ throughout the program.
Sec. 242. Authorized activities
Section 242 is expanded to specify that providing recovery sup-
port services is an authorized activity under the block grant use of
funds.
Sec. 243. Requirements relating to certain infectious diseases and
human immunodeficiency virus
Section 243 updates the basis by which states are designated as
required to provide HIV related services based on HIV case rate
rather than AIDS case rate effective fiscal year 2025. This section
also requires states receiving block grant funds to provide viral
hepatitis screening and referrals to providers whose practice in-
cludes viral hepatitis vaccination and treatment.
Sec. 244. State plan requirements
Section 233 requires that states’ plans describe the recovery sup-
port service activities supported by block grant funds, including the
number of individuals served, target populations, priority needs,
and the amount of funds allocated to recovery support service
disaggregated by type of activity.
Sec. 245. Updating certain language relating to Tribes
Section 245 updates statutory language to recognize Tribes and
Tribal organizations as proper nouns.
Sec. 246. Block grants for substance use prevention, treatment, and
recovery services
Section 246 authorizes the Substance Use Prevention, Treat-
ment, and Recovery Services Block Grants at $1.908 billion annu-
ally for fiscal years 2023 through 2027. The section also makes a
technical correction to the PHSA.
Sec. 247. Requirement of reports and audits by States
Section 247 requires states’ report to include the amount of funds
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provided to each grant recipient the previous fiscal year.
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Sec. 248. Study on assessment for use in distribution of limited
State resources
Section 248 requires the Secretary to conduct a study to develop
a model needs assessment process for states.
SUBTITLE E—TIMELY TREATMENT FOR OPIOID USE DISORDER
Sec. 251. Study on exemptions for treatment of opioid use disorder
through opioid treatment programs during the COVID–19 pub-
lic health emergency
Section 251 requires the Assistant Secretary for Mental Health
and Substance Use to conduct a study and report within 180 days
on the impact of treatment flexibilities allowed during the pan-
demic on an OTP’s effectiveness and safety.
Sec. 252. Changes to Federal opioid treatment standards
Section 252 changes the federal opioid treatment standards to
allow an OTP to operate one or more mobile units to dispense
medications at locations other than the registrant’s principal place
of business or professional practice under the same registration.
Previously, each mobile unit had to be separately registered. This
section eliminates the requirement that an individual be addicted
to opioids for at least one year before being admitted for treatment
by an OTP. This section also requires the Secretary to establish cri-
teria for OTP to allow certain patients to receive take home medi-
cations.
SUBTITLE F—ADDITIONAL PROVISIONS RELATING TO ADDICTION
TREATMENT
Sec. 261. Prohibition
Section 261 prohibits funds authorized or amended by this Act
from being used to purchase, procure, or distribute pipes or cylin-
drical objects intended to be used to smoke or inhale illegal sched-
ule substances.
Sec. 262. Eliminating additional requirements for dispensing nar-
cotic drugs in schedule III, IV, and V for maintenance or detoxi-
fication treatment
Section 262 eliminates the requirement for registered health care
practitioners to apply for a separate waiver through the Drug En-
forcement Administration to dispense certain narcotic drugs (e.g.,
buprenorphine) for maintenance or detoxification treatment.
Sec. 263. Requiring prescribers of controlled substances to complete
training
Section 263 requires health care providers, as a condition of re-
ceiving or renewing a registration to prescribe controlled sub-
stances, to meet a one-time eight-hour training requirement on
treating patients with substance use disorders.
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TITLE III: ACCESS TO MENTAL HEALTH CARE AND COVERAGE
SUBTITLE A—COLLABORATE IN AN ORDERLY AND COHESIVE MANNER
Sec. 301. Increasing uptake of the collaborative care model
Section 301 reauthorizes a program that allows HHS to award
grants to states that partner with a community program, a health
center, a Federally Qualified Health Center or rural health clinic,
or a primary health care physician practice to implement and
evaluate specified models of care that integrate behavioral health
and primary care services. Recipients who provide care to medically
underserved populations and in areas where the prevalence of be-
havioral health conditions exceeds the national average are given
priority for these grants. This section establishes incentive pay-
ments for recipients that use appropriate billing codes and quality
measures for behavioral health services as well as grants for na-
tional and regional organizations that provide technical assistance
to improve integration. This section authorizes $60 million annu-
ally for fiscal years 2023 through 2027.
SUBTITLE B—HELPING ENABLE ACCESS TO LIFESAVING SERVICES
Sec. 311. Reauthorization and provision of certain programs to
strengthen the health care workforce
Section 311 reauthorizes multiple programs to support and
strengthen the health care workforce, including Liability Protec-
tions for Health Professional Volunteers, reauthorized through Oc-
tober 1, 2027; Mental and Behavioral Health Education and Train-
ing Grants including updates to the education reference for occupa-
tional therapist, reauthorized at $50 million for fiscal years 2023
through 2027; and the Training Demonstration Program, reauthor-
ized at $37.1 million annually for fiscal years 2023 through 2027.
This section updates the Minority Fellowship Program to include
those ‘‘in the fields of crisis care management.’’
SUBTITLE C—ELIMINATING THE OPT-OUT FOR NONFEDERAL
GOVERNMENTAL HEALTH PLANS
Sec. 321. Eliminating the opt-out for nonfederal governmental
health plans
Section 321 requires self-funded, non-federal governmental plans
to comply with mental health parity requirements starting six
months after the date of enactment or longer contingent on the
terms of the plan agreement.
SUBTITLE D—MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY
IMPLEMENTATION
Sec. 331. Grants to support mental health and substance use dis-
order parity implementation
Section 331 authorizes $10 million annually for fiscal years 2023
through 2027 for grants to states to enforce and ensure compliance
with mental health parity.
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TITLE IV: CHILDREN AND YOUTH
SUBTITLE A—SUPPORTING CHILDREN’S MENTAL HEALTH CARE ACCESS
Sec. 401. Pediatric mental health care access grants
Section 401 reauthorizes HRSA’s Pediatric Mental Health Care
Access grant program that promotes behavioral health integration
into pediatric primary care by supporting pediatric mental health
care telehealth access programs in states at $14 million annually
for fiscal years 2023 through 2025 and $30 million annually for fis-
cal years 2026 through 2027.
Sec. 402. Infant and early childhood mental health promotion,
intervention, and treatment
Section 402 reauthorizes SAMHSA’s Infant and Early Childhood
Mental Health Grant Program, which is intended to improve out-
comes for children from birth to age 12 by developing, maintaining,
or enhancing mental health promotion, intervention, and treatment
services at $50 million for the period of fiscal years 2023 through
2027.
SUBTITLE B—CONTINUING SYSTEMS OF CARE FOR CHILDREN
Sec. 411. Comprehensive Community Mental Health Services for
Children with Serious Emotional Disturbances
Section 411 reauthorizes the Comprehensive Community Mental
Health Services for Children with Serious Emotional Disturbances
Grants, maintaining the existing program structure with the excep-
tion of redefining ‘‘parents or kinship caregivers,’’ authorized at
$125 million annually for fiscal years 2023 through 2027.
Sec. 412. Substance Use Disorder Treatment and Early Intervention
Services for Children and Adolescents
Section 412 reauthorizes the Enhancement and Expansion of
Treatment and Recovery Services for Adolescents, Transitional
Aged Youth, and their Families (Youth and Family TREE) Grants
at $29.605 million annually for fiscal years 2023 through 2027.
SUBTITLE C—GARRETT LEE SMITH MEMORIAL REAUTHORIZATION
Sec. 421. Suicide prevention technical assistance center
Section 421 reauthorizes the Suicide Prevention Resource Center
at $9 million annually for fiscal years 2023 through 2027.
Sec. 422. Youth suicide early intervention and prevention strategies
Section 422 reauthorizes the State and Tribal Youth Suicide Pre-
vention and Early Intervention Grants Program at $40 million an-
nually for fiscal years 2023 through 2027 and provides the allow-
able use of funds for supplies to securely store commonly used
means of suicide within a household.
Sec. 423. Mental health and substance use disorder services for stu-
dents in higher education
Section 423 reauthorizes the Mental Health Youth Suicide Pre-
vention Campus Grants at $7 million for each fiscal year for fiscal
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Sec. 424. Mental and behavioral health outreach and education at
institutions of higher education
Section 424 reauthorizes and renames the Mental and Behav-
ioral Health Public Outreach and Education at Institutions of
Higher Education program at $1 million for fiscal years 2023
through 2027 and specifies that representatives from minority-serv-
ing institutions and community colleges be included on the pro-
gram’s working group.
XVI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED
In compliance with clause 3(e) of rule XIII of the Rules of the
House of Representatives, changes in existing law made by the bill,
as reported, are shown as follows (existing law proposed to be omit-
ted is enclosed in black brackets, new matter is printed in italics,
and existing law in which no change is proposed is shown in
roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE II—ADMINISTRATION AND MISCELLANEOUS
PROVISIONS
PART A—ADMINISTRATION
* * * * * * *
DEFENSE OF CERTAIN MALPRACTICE AND NEGLIGENCE SUITS
SEC. 224. (a) The remedy against the United States provided by
sections 1346(b) and 2672 of title 28, or by alternative benefits pro-
vided by the United States where the availability of such benefits
precludes a remedy under section 1346(b) of title 28, for damage for
personal injury, including death, resulting from the performance of
medical, surgical, dental, or related functions, including the con-
duct of clinical studies or investigation, by any commissioned offi-
cer or employee of the Public Health Service while acting within
the scope of his office or employment, shall be exclusive of any
other civil action or proceeding by reason of the same subject-mat-
ter against the officer or employee (or his estate) whose act or
omission gave rise to the claim.
(b) The Attorney General shall defend any civil action or pro-
ceeding brought in any court against any person referred to in sub-
section (a) of this section (or his estate) for any such damage or in-
jury. Any such person against whom such civil action or proceeding
is brought shall deliver within such time after date of service or
knowledge of service as determined by the Attorney General, all
process served upon him or an attested true copy thereof to his im-
mediate superior or to whomever was designated by the Secretary
to receive such papers and such persons shall promptly furnish
copies of the pleading and process therein to the United States at-
torney for the district embracing the place wherein the proceeding
is brought, to the Attorney General, and to the Secretary.
(c) Upon a certification by the Attorney General that the defend-
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incident out of which the suit arose, any such civil action or pro-
ceeding commenced in a State court shall be removed without bond
at any time before trial by the Attorney General to the district
court of the United States of the district and division embracing
the place wherein it is pending and the proceeding deemed a tort
action brought against the United States under the provisions of
title 28 and all references thereto. Should a United States district
court determine on a hearing on a motion to remand held before
a trial on the merit that the case so removed is one in which a rem-
edy by suit within the meaning of subsection (a) of this section is
not available against the United States, the case shall be remanded
to the State Court: Provided, That where such a remedy is pre-
cluded because of the availability of a remedy through proceedings
for compensation or other benefits from the United States as pro-
vided by any other law, the case shall be dismissed, but in the
event the running of any limitation of time for commencing, or fil-
ing an application or claim in, such proceedings for compensation
or other benefits shall be deemed to have been suspended during
the pendency of the civil action or proceeding under this section.
(d) The Attorney General may compromise or settle any claim as-
serted in such civil action or proceeding in the manner provided in
section 2677 of title 28 and with the same effect.
(e) For purposes of this section, the provisions of section 2680(h)
of title 28 shall not apply to assault or battery arising out of neg-
ligence in the performance of medical, surgical, dental, or related
functions, including the conduct of clinical studies or investigations.
(f) The Secretary or his designee may, to the extent that he
deems appropriate, hold harmless or provide liability insurance for
any officer or employee of the Public Health Service for damage for
personal injury, including death, negligently caused by such officer
or employee while acting within the scope of his office or employ-
ment and as a result of the performance of medical, surgical, den-
tal, or related functions, including the conduct of clinical studies or
investigations, if such employee is assigned to a foreign country or
detailed to a State or political subdivision thereof or to a non-profit
institution, and if the circumstances are such as are likely to pre-
clude the remedies of third persons against the United States de-
scribed in section 2679(b) of title 28, for such damage or injury.
(g)(1)(A) For purposes of this section and subject to the approval
by the Secretary of an application under subparagraph (D), an enti-
ty described in paragraph (4), and any officer, governing board
member, or employee of such an entity, and any contractor of such
an entity who is a physician or other licensed or certified health
care practitioner (subject to paragraph (5)), shall 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
subsection (k)(3) (subject to paragraph (3)). The remedy against the
United States for an entity described in paragraph (4) and any offi-
cer, governing board member, employee, or contractor (subject to
paragraph (5)) of such an entity who is deemed to be an employee
of the Public Health Service pursuant to this paragraph shall be
exclusive of any other civil action or proceeding to the same extent
as the remedy against the United States is exclusive pursuant to
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(B) The deeming of any entity or officer, governing board mem-
ber, employee, or contractor of the entity to be an employee of the
Public Health Service for purposes of this section shall apply with
respect to services provided—
(i) to all patients of the entity, and
(ii) subject to subparagraph (C), to individuals who are not
patients of the entity.
(C) Subparagraph (B)(ii) applies to services provided to individ-
uals who are not patients of an entity if the Secretary determines,
after reviewing an application submitted under subparagraph (D),
that the provision of the services to such individuals—
(i) benefits patients of the entity and general populations
that could be served by the entity through community-wide
intervention efforts within the communities served by such en-
tity;
(ii) facilitates the provision of services to patients of the enti-
ty; or
(iii) are otherwise required under an employment contract
(or similar arrangement) between the entity and an officer,
governing board member, employee, or contractor of the entity.
(D) The Secretary may not under subparagraph (A) deem an en-
tity or an officer, governing board member, employee, or contractor
of the entity to be an employee of the Public Health Service for
purposes of this section, and may not apply such deeming to serv-
ices described in subparagraph (B)(ii), unless the entity has sub-
mitted an application for such deeming to the Secretary in such
form and such manner as the Secretary shall prescribe. The appli-
cation shall contain detailed information, along with supporting
documentation, to verify that the entity, and the officer, governing
board member, employee, or contractor of the entity, as the case
may be, meets the requirements of subparagraphs (B) and (C) of
this paragraph and that the entity meets the requirements of para-
graphs (1) through (4) of subsection (h).
(E) The Secretary shall make a determination of whether an en-
tity or an officer, governing board member, employee, or contractor
of the entity is deemed to be an employee of the Public Health
Service for purposes of this section within 30 days after the receipt
of an application under subparagraph (D). The determination of the
Secretary that an entity or an officer, governing board member,
employee, or contractor of the entity is deemed to be an employee
of the Public Health Service for purposes of this section shall apply
for the period specified by the Secretary under subparagraph (A).
(F) Once the Secretary makes a determination that an entity or
an officer, governing board member, employee, or contractor of an
entity is deemed to be an employee of the Public Health Service for
purposes of this section, the determination shall be final and bind-
ing upon the Secretary and the Attorney General and other parties
to any civil action or proceeding. Except as provided in subsection
(i), the Secretary and the Attorney General may not determine that
the provision of services which are the subject of such a determina-
tion are not covered under this section.
(G) In the case of an entity described in paragraph (4) that has
not submitted an application under subparagraph (D):
(i) The Secretary may not consider the entity in making esti-
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mates under subsection (k)(1).
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(ii) This section does not affect any authority of the entity to
purchase medical malpractice liability insurance coverage with
Federal funds provided to the entity under section 329, 330, or
340A.
(H) In the case of an entity described in paragraph (4) for which
an application under subparagraph (D) is in effect, the entity may,
through notifying the Secretary in writing, elect to terminate the
applicability of this subsection to the entity. With respect to such
election by the entity:
(i) The election is effective upon the expiration of the 30-day
period beginning on the date on which the entity submits such
notification.
(ii) Upon taking effect, the election terminates the applica-
bility of this subsection to the entity and each officer, gov-
erning board member, employee, and contractor of the entity.
(iii) Upon the effective date for the election, clauses (i) and
(ii) of subparagraph (G) apply to the entity to the same extent
and in the same manner as such clauses apply to an entity
that has not submitted an application under subparagraph (D).
(iv) If after making the election the entity submits an appli-
cation under subparagraph (D), the election does not preclude
the Secretary from approving the application (and thereby re-
storing the applicability of this subsection to the entity and
each officer, governing board member, employee, and con-
tractor of the entity, subject to the provisions of this subsection
and the subsequent provisions of this section.
(2) If, with respect to an entity or person deemed to be an em-
ployee for purposes of paragraph (1), a cause of action is instituted
against the United States pursuant to this section, any claim of the
entity or person for benefits under an insurance policy with respect
to medical malpractice relating to such cause of action shall be sub-
rogated to the United States.
(3) This subsection shall apply with respect to a cause of action
arising from an act or omission which occurs on or after January
1, 1993.
(4) An entity described in this paragraph is a public or non-profit
private entity receiving Federal funds under section 330.
(5) For purposes of paragraph (1), an individual may be consid-
ered a contractor of an entity described in paragraph (4) only if—
(A) the individual normally performs on average at least
321⁄2 hours of service per week for the entity for the period of
the contract; or
(B) in the case of an individual who normally performs an
average of less than 321⁄2 hours of services per week for the en-
tity for the period of the contract, the individual is a licensed
or certified provider of services in the fields of family practice,
general internal medicine, general pediatrics, or obstetrics and
gynecology.
(h) The Secretary may not approve an application under sub-
section (g)(1)(D) unless the Secretary determines that the entity—
(1) has implemented appropriate policies and procedures to
reduce the risk of malpractice and the risk of lawsuits arising
out of any health or health-related functions performed by the
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(2) has reviewed and verified the professional credentials,
references, claims history, fitness, professional review organi-
zation findings, and license status of its physicians and other
licensed or certified health care practitioners, and, where nec-
essary, has obtained the permission from these individuals to
gain access to this information;
(3) has no history of claims having been filed against the
United States as a result of the application of this section to
the entity or its officers, employees, or contractors as provided
for under this section, or, if such a history exists, has fully co-
operated with the Attorney General in defending against any
such claims and either has taken, or will take, any necessary
corrective steps to assure against such claims in the future;
and
(4) will fully cooperate with the Attorney General in pro-
viding information relating to an estimate described under sub-
section (k).
(i)(1) Notwithstanding subsection (g)(1), the Attorney General, in
consultation with the Secretary, may on the record determine, after
notice and opportunity for a full and fair hearing, that an indi-
vidual physician or other licensed or certified health care practi-
tioner who is an officer, employee, or contractor of an entity de-
scribed in subsection (g)(4) shall not be deemed to be an employee
of the Public Health Service for purposes of this section, if treating
such individual as such an employee would expose the Government
to an unreasonably high degree of risk of loss because such indi-
vidual—
(A) does not comply with the policies and procedures that the
entity has implemented pursuant to subsection (h)(1);
(B) has a history of claims filed against him or her as pro-
vided for under this section that is outside the norm for li-
censed or certified health care practitioners within the same
specialty;
(C) refused to reasonably cooperate with the Attorney Gen-
eral in defending against any such claim;
(D) provided false information relevant to the individual’s
performance of his or her duties to the Secretary, the Attorney
General, or an applicant for or recipient of funds under this
Act; or
(E) was the subject of disciplinary action taken by a State
medical licensing authority or a State or national professional
society.
(2) A final determination by the Attorney General under this
subsection that an individual physician or other licensed or cer-
tified health care professional shall not be deemed to be an em-
ployee of the Public Health Service shall be effective upon receipt
by the entity employing such individual of notice of such deter-
mination, and shall apply only to acts or omissions occurring after
the date such notice is received.
(j) In the case of a health care provider who is an officer, em-
ployee, or contractor of an entity described in subsection (g)(4), sec-
tion 335(e) shall apply with respect to the provider to the same ex-
tent and in the same manner as such section applies to any mem-
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(k)(1)(A) For each fiscal year, the Attorney General, in consulta-
tion with the Secretary, shall estimate by the beginning of the year
the amount of all claims which are expected to arise under this sec-
tion (together with related fees and expenses of witnesses) for
which payment is expected to be made in accordance with section
1346 and chapter 171 of title 28, United States Code, from the acts
or omissions, during the calendar year that begins during that fis-
cal year, of entities described in subsection (g)(4) and of officers,
employees, or contractors (subject to subsection (g)(5)) of such enti-
ties.
(B) The estimate under subparagraph (A) shall take into ac-
count—
(i) the value and frequency of all claims for damage for per-
sonal injury, including death, resulting from the performance
of medical, surgical, dental, or related functions by entities de-
scribed in subsection (g)(4) or by officers, employees, or con-
tractors (subject to subsection (g)(5)) of such entities who are
deemed to be employees of the Public Health Service under
subsection (g)(1) that, during the preceding 5-year period, are
filed under this section or, with respect to years occurring be-
fore this subsection takes effect, are filed against persons other
than the United States,
(ii) the amounts paid during that 5-year period on all claims
described in clause (i), regardless of when such claims were
filed, adjusted to reflect payments which would not be per-
mitted under section 1346 and chapter 171 of title 28, United
States Code, and
(iii) amounts in the fund established under paragraph (2) but
unspent from prior fiscal years.
(2) Subject to appropriations, for each fiscal year, the Secretary
shall establish a fund of an amount equal to the amount estimated
under paragraph (1) that is attributable to entities receiving funds
under each of the grant programs described in paragraph (4) of
subsection (g), but not to exceed a total of $10,000,000 for each
such fiscal year. Appropriations for purposes of this paragraph
shall be made separate from appropriations made for purposes of
sections 329, 330 and 340A.
(3) In order for payments to be made for judgments against the
United States (together with related fees and expenses of wit-
nesses) pursuant to this section arising from the acts or omissions
of entities described in subsection (g)(4) and of officers, employees,
or contractors (subject to subsection (g)(5)) of such entities, the
total amount contained within the fund established by the Sec-
retary under paragraph (2) for a fiscal year shall be transferred not
later than the December 31 that occurs during the fiscal year to
the appropriate accounts in the Treasury.
(l)(1) If a civil action or proceeding is filed in a State court
against any entity described in subsection (g)(4) or any officer, gov-
erning board member, employee, or any contractor of such an enti-
ty for damages described in subsection (a), the Attorney General,
within 15 days after being notified of such filing, shall make an ap-
pearance in such court and advise such court as to whether the
Secretary has determined under subsections (g) and (h), that such
entity, officer, governing board member, employee, or contractor of
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for purposes of this section with respect to the actions or omissions
that are the subject of such civil action or proceeding. Such advice
shall be deemed to satisfy the provisions of subsection (c) that the
Attorney General certify that an entity, officer, governing board
member, employee, or contractor of the entity was acting within
the scope of their employment or responsibility.
(2) If the Attorney General fails to appear in State court within
the time period prescribed under paragraph (1), upon petition of
any entity or officer, governing board member, employee, or con-
tractor of the entity named, the civil action or proceeding shall be
removed to the appropriate United States district court. The civil
action or proceeding shall be stayed in such court until such court
conducts a hearing, and makes a determination, as to the appro-
priate forum or procedure for the assertion of the claim for dam-
ages described in subsection (a) and issues an order consistent with
such determination.
(m)(1) An entity or officer, governing board member, employee, or
contractor of an entity described in subsection (g)(1) shall, for pur-
poses of this section, be deemed to be an employee of the Public
Health Service with respect to services provided to individuals who
are enrollees of a managed care plan if the entity contracts with
such managed care plan for the provision of services.
(2) Each managed care plan which enters into a contract with an
entity described in subsection (g)(4) shall deem the entity and any
officer, governing board member, employee, or contractor of the en-
tity as meeting whatever malpractice coverage requirements such
plan may require of contracting providers for a calendar year if
such entity or officer, governing board member, employee, or con-
tractor of the entity has been deemed to be an employee of the Pub-
lic Health Service for purposes of this section for such calendar
year. Any plan which is found by the Secretary on the record, after
notice and an opportunity for a full and fair hearing, to have vio-
lated this subsection shall upon such finding cease, for a period to
be determined by the Secretary, to receive and to be eligible to re-
ceive any Federal funds under titles XVIII or XIX of the Social Se-
curity Act.
(3) For purposes of this subsection, the term ‘‘managed care plan’’
shall mean health maintenance organizations and similar entities
that contract at-risk with payors for the provision of health services
or plan enrollees and which contract with providers (such as enti-
ties described in subsection (g)(4)) for the delivery of such services
to plan enrollees.
(n)(1) Not later than one year after the date of the enactment of
the Federally Supported Health Centers Assistance Act of 1995,
the Comptroller General of the United States shall submit to the
Congress a report on the following:
(A) The medical malpractice liability claims experience of en-
tities that have been deemed to be employees for purposes of
this section.
(B) The risk exposure of such entities.
(C) The value of private sector risk-management services,
and the value of risk-management services and procedures re-
quired as a condition of receiving a grant under section 329,
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(D) A comparison of the costs and the benefits to taxpayers
of maintaining medical malpractice liability coverage for such
entities pursuant to this section, taking into account—
(i) a comparison of the costs of premiums paid by such
entities for private medical malpractice liability insurance
with the cost of coverage pursuant to this section; and
(ii) an analysis of whether the cost of premiums for pri-
vate medical malpractice liability insurance coverage is
consistent with the liability claims experience of such enti-
ties.
(2) The report under paragraph (1) shall include the following:
(A) A comparison of—
(i) an estimate of the aggregate amounts that such enti-
ties (together with the officers, governing board members,
employees, and contractors of such entities who have been
deemed to be employees for purposes of this section) would
have directly or indirectly paid in premiums to obtain
medical malpractice liability insurance coverage if this sec-
tion were not in effect; with
(ii) the aggregate amounts by which the grants received
by such entities under this Act were reduced pursuant to
subsection (k)(2).
(B) A comparison of—
(i) an estimate of the amount of privately offered such
insurance that such entities (together with the officers,
governing board members, employees, and contractors of
such entities who have been deemed to be employees for
purposes of this section) purchased during the three-year
period beginning on January 1, 1993; with
(ii) an estimate of the amount of such insurance that
such entities (together with the officers, governing board
members, employees, and contractors of such entities who
have been deemed to be employees for purposes of this sec-
tion) will purchase after the date of the enactment of the
Federally Supported Health Centers Assistance Act of
1995.
(C) An estimate of the medical malpractice liability loss his-
tory of such entities for the 10-year period preceding October
1, 1996, including but not limited to the following:
(i) Claims that have been paid and that are estimated to
be paid, and legal expenses to handle such claims that
have been paid and that are estimated to be paid, by the
Federal Government pursuant to deeming entities as em-
ployees for purposes of this section.
(ii) Claims that have been paid and that are estimated
to be paid, and legal expenses to handle such claims that
have been paid and that are estimated to be paid, by pri-
vate medical malpractice liability insurance.
(D) An analysis of whether the cost of premiums for private
medical malpractice liability insurance coverage is consistent
with the liability claims experience of entities that have been
deemed as employees for purposes of this section.
(3) In preparing the report under paragraph (1), the Comptroller
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entities with expertise on the matters with which the report is con-
cerned.
(o)(1) For purposes of this section, a free clinic health profes-
sional shall in providing a qualifying health service to an indi-
vidual, or an officer, governing board member, employee, or con-
tractor of a free clinic shall in providing services for the free clinic,
be deemed to be an employee of the Public Health Service for a cal-
endar year that begins during a fiscal year for which a transfer
was made under paragraph (6)(D). The preceding sentence is sub-
ject to the provisions of this subsection.
(2) In providing a health service to an individual, a health care
practitioner shall for purposes of this subsection be considered to
be a free clinic health professional if the following conditions are
met:
(A) The service is provided to the individual at a free clinic,
or through offsite programs or events carried out by the free
clinic.
(B) The free clinic is sponsoring the health care practitioner
pursuant to paragraph (5)(C).
(C) The service is a qualifying health service (as defined in
paragraph (4)).
(D) Neither the health care practitioner nor the free clinic re-
ceives any compensation for the service from the individual or
from any third-party payor (including reimbursement under
any insurance policy or health plan, or under any Federal or
State health benefits program). With respect to compliance
with such condition:
(i) The health care practitioner may receive repayment
from the free clinic for reasonable expenses incurred by
the health care practitioner in the provision of the service
to the individual.
(ii) The free clinic may accept voluntary donations for
the provision of the service by the health care practitioner
to the individual.
(E) Before the service is provided, the health care practi-
tioner or the free clinic provides written notice to the indi-
vidual of the extent to which the legal liability of the health
care practitioner is limited pursuant to this subsection (or in
the case of an emergency, the written notice is provided to the
individual as soon after the emergency as is practicable). If the
individual is a minor or is otherwise legally incompetent, the
condition under this subparagraph is that the written notice be
provided to a legal guardian or other person with legal respon-
sibility for the care of the individual.
(F) At the time the service is provided, the health care prac-
titioner is licensed or certified in accordance with applicable
law regarding the provision of the service.
(3)(A) For purposes of this subsection, the term ‘‘free clinic’’
means a health care facility operated by a nonprofit private entity
meeting the following requirements:
(i) The entity does not, in providing health services through
the facility, accept reimbursement from any third-party payor
(including reimbursement under any insurance policy or health
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plan, or under any Federal or State health benefits program).
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(ii) The entity, in providing health services through the facil-
ity, either does not impose charges on the individuals to whom
the services are provided, or imposes a charge according to the
ability of the individual involved to pay the charge.
(iii) The entity is licensed or certified in accordance with ap-
plicable law regarding the provision of health services.
(B) With respect to compliance with the conditions under sub-
paragraph (A), the entity involved may accept voluntary donations
for the provision of services.
(4) For purposes of this subsection, the term ‘‘qualifying health
service’’ means any medical assistance required or authorized to be
provided in the program under title XIX of the Social Security Act,
without regard to whether the medical assistance is included in the
plan submitted under such program by the State in which the
health care practitioner involved provides the medical assistance.
References in the preceding sentence to such program shall as ap-
plicable be considered to be references to any successor to such pro-
gram.
(5) Subsection (g) (other than paragraphs (3) through (5)) and
subsections (h), (i), and (l) apply to a health care practitioner 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 sub-
section (g)(4), subject to paragraph (6) and subject to the following:
(A) The first sentence of paragraph (1) applies in lieu of the
first sentence of subsection (g)(1)(A).
(B) This subsection may not be construed as deeming any
free clinic to be an employee of the Public Health Service for
purposes of this section.
(C) With respect to a free clinic, a health care practitioner
is not a free clinic health professional unless the free clinic
sponsors the health care practitioner. For purposes of this sub-
section, the free clinic shall be considered to be sponsoring the
health care practitioner if—
(i) with respect to the health care practitioner, the free
clinic submits to the Secretary an application meeting the
requirements of subsection (g)(1)(D); and
(ii) the Secretary, pursuant to subsection (g)(1)(E), deter-
mines that the health care practitioner is deemed to be an
employee of the Public Health Service.
(D) In the case of a health care practitioner who is deter-
mined by the Secretary pursuant to subsection (g)(1)(E) to be
a free clinic health professional, this subsection applies to the
health care practitioner (with respect to the free clinic spon-
soring the health care practitioner pursuant to subparagraph
(C)) for any cause of action arising from an act or omission of
the health care practitioner occurring on or after the date on
which the Secretary makes such determination.
(E) Subsection (g)(1)(F) applies to a health care practitioner
for purposes of this subsection only to the extent that, in pro-
viding health services to an individual, each of the conditions
specified in paragraph (2) is met.
(6)(A) For purposes of making payments for judgments against
the United States (together with related fees and expenses of wit-
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nesses) pursuant to this section arising from the acts or omissions
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of free clinic health professionals, there is authorized to be appro-
priated $10,000,000 for each fiscal year.
(B) The Secretary shall establish a fund for purposes of this sub-
section. Each fiscal year amounts appropriated under subpara-
graph (A) shall be deposited in such fund.
(C) Not later than May 1 of each fiscal year, the Attorney Gen-
eral, in consultation with the Secretary, shall submit to the Con-
gress a report providing an estimate of the amount of claims (to-
gether with related fees and expenses of witnesses) that, by reason
of the acts or omissions of free clinic health professionals, will be
paid pursuant to this section during the calendar year that begins
in the following fiscal year. Subsection (k)(1)(B) applies to the esti-
mate under the preceding sentence regarding free clinic health pro-
fessionals to the same extent and in the same manner as such sub-
section applies to the estimate under such subsection regarding of-
ficers, governing board members, employees, and contractors of en-
tities described in subsection (g)(4).
(D) Not later than December 31 of each fiscal year, the Secretary
shall transfer from the fund under subparagraph (B) to the appro-
priate accounts in the Treasury an amount equal to the estimate
made under subparagraph (C) for the calendar year beginning in
such fiscal year, subject to the extent of amounts in the fund.
(7)(A) This subsection takes effect on the date of the enactment
of the first appropriations Act that makes an appropriation under
paragraph (6)(A), except as provided in subparagraph (B)(i).
(B)(i) Effective on the date of the enactment of the Health Insur-
ance Portability and Accountability Act of 1996—
(I) the Secretary may issue regulations for carrying out this
subsection, and the Secretary may accept and consider applica-
tions submitted pursuant to paragraph (5)(C); and
(II) reports under paragraph (6)(C) may be submitted to the
Congress.
(ii) For the first fiscal year for which an appropriation is made
under subparagraph (A) of paragraph (6), if an estimate under sub-
paragraph (C) of such paragraph has not been made for the cal-
endar year beginning in such fiscal year, the transfer under sub-
paragraph (D) of such paragraph shall be made notwithstanding
the lack of the estimate, and the transfer shall be made in an
amount equal to the amount of such appropriation.
(p) ADMINISTRATION OF SMALLPOX COUNTERMEASURES BY HEALTH
PROFESSIONALS.—
(1) IN GENERAL.—For purposes of this section, and subject to
other provisions of this subsection, a covered person shall be
deemed to be an employee of the Public Health Service with
respect to liability arising out of administration of a covered
countermeasure against smallpox to an individual during the
effective period of a declaration by the Secretary under para-
graph (2)(A).
(2) DECLARATION BY SECRETARY CONCERNING COUNTER-
MEASURE AGAINST SMALLPOX.—
(A) AUTHORITY TO ISSUE DECLARATION.—
(i) IN GENERAL.—The Secretary may issue a declara-
tion, pursuant to this paragraph, concluding that an
actual or potential bioterrorist incident or other actual
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or potential public health emergency makes advisable
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the administration of a covered countermeasure to a
category or categories of individuals.
(ii) COVERED COUNTERMEASURE.—The Secretary
shall specify in such declaration the substance or sub-
stances that shall be considered covered counter-
measures (as defined in paragraph (7)(A)) for purposes
of administration to individuals during the effective
period of the declaration.
(iii) EFFECTIVE PERIOD.—The Secretary shall specify
in such declaration the beginning and ending dates of
the effective period of the declaration, and may subse-
quently amend such declaration to shorten or extend
such effective period, provided that the new closing
date is after the date when the declaration is amend-
ed.
(iv) PUBLICATION.—The Secretary shall promptly
publish each such declaration and amendment in the
Federal Register.
(B) LIABILITY OF UNITED STATES ONLY FOR ADMINISTRA-
TIONS WITHIN SCOPE OF DECLARATION.—Except as provided
in paragraph (5)(B)(ii), the United States shall be liable
under this subsection with respect to a claim arising out
of the administration of a covered countermeasure to an
individual only if—
(i) the countermeasure was administered by a quali-
fied person, for a purpose stated in paragraph (7)(A)(i),
and during the effective period of a declaration by the
Secretary under subparagraph (A) with respect to such
countermeasure; and
(ii)(I) the individual was within a category of indi-
viduals covered by the declaration; or
(II) the qualified person administering the counter-
measure had reasonable grounds to believe that such
individual was within such category.
(C) PRESUMPTION OF ADMINISTRATION WITHIN SCOPE OF
DECLARATION IN CASE OF ACCIDENTAL VACCINIA INOCULA-
TION.—
(i) IN GENERAL.—If vaccinia vaccine is a covered
countermeasure specified in a declaration under sub-
paragraph (A), and an individual to whom the vaccinia
vaccine is not administered contracts vaccinia, then,
under the circumstances specified in clause (ii), the in-
dividual—
(I) shall be rebuttably presumed to have con-
tracted vaccinia from an individual to whom such
vaccine was administered as provided by clauses
(i) and (ii) of subparagraph (B); and
(II) shall (unless such presumption is rebutted)
be deemed for purposes of this subsection to be an
individual to whom a covered countermeasure was
administered by a qualified person in accordance
with the terms of such declaration and as de-
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(ii) CIRCUMSTANCES IN WHICH PRESUMPTION AP-
PLIES.—The presumption and deeming stated in clause
(i) shall apply if—
(I) the individual contracts vaccinia during the
effective period of a declaration under subpara-
graph (A) or by the date 30 days after the close of
such period; or
(II) the individual has resided with, or has had
contact with, an individual to whom such vaccine
was administered as provided by clauses (i) and
(ii) of subparagraph (B) and contracts vaccinia
after such date.
(D) ACTS AND OMISSIONS DEEMED TO BE WITHIN SCOPE OF
EMPLOYMENT.—
(i) IN GENERAL.—In the case of a claim arising out
of alleged transmission of vaccinia from an individual
described in clause (ii), acts or omissions by such indi-
vidual shall be deemed to have been taken within the
scope of such individual’s office or employment for pur-
poses of—
(I) subsection (a); and
(II) section 1346(b) and chapter 171 of title 28,
United States Code.
(ii) INDIVIDUALS TO WHOM DEEMING APPLIES.—An in-
dividual is described by this clause if—
(I) vaccinia vaccine was administered to such in-
dividual as provided by subparagraph (B); and
(II) such individual was within a category of in-
dividuals covered by a declaration under subpara-
graph (A)(i).
(3) EXHAUSTION; EXCLUSIVITY; OFFSET.—
(A) EXHAUSTION.—
(i) IN GENERAL.—A person may not bring a claim
under this subsection unless such person has ex-
hausted such remedies as are available under part C
of this title, except that if the Secretary fails to make
a final determination on a request for benefits or com-
pensation filed in accordance with the requirements of
such part within 240 days after such request was filed,
the individual may seek any remedy that may be
available under this section.
(ii) TOLLING OF STATUTE OF LIMITATIONS.—The time
limit for filing a claim under this subsection, or for fil-
ing an action based on such claim, shall be tolled dur-
ing the pendency of a request for benefits or com-
pensation under part C of this title.
(iii) CONSTRUCTION.—This subsection shall not be
construed as superseding or otherwise affecting the
application of a requirement, under chapter 171 of
title 28, United States Code, to exhaust administrative
remedies.
(B) EXCLUSIVITY.—The remedy provided by subsection
(a) shall be exclusive of any other civil action or proceeding
for any claim or suit this subsection encompasses, except
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for a proceeding under part C of this title.
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(C) OFFSET.—The value of all compensation and benefits
provided under part C of this title for an incident or series
of incidents shall be offset against the amount of an
award, compromise, or settlement of money damages in a
claim or suit under this subsection based on the same inci-
dent or series of incidents.
(4) CERTIFICATION OF ACTION BY ATTORNEY GENERAL.—Sub-
section (c) applies to actions under this subsection, subject to
the following provisions:
(A) NATURE OF CERTIFICATION.—The certification by the
Attorney General that is the basis for deeming an action
or proceeding to be against the United States, and for re-
moving an action or proceeding from a State court, is a
certification that the action or proceeding is against a cov-
ered person and is based upon a claim alleging personal
injury or death arising out of the administration of a cov-
ered countermeasure.
(B) CERTIFICATION OF ATTORNEY GENERAL CONCLUSIVE.—
The certification of the Attorney General of the facts speci-
fied in subparagraph (A) shall conclusively establish such
facts for purposes of jurisdiction pursuant to this sub-
section.
(5) COVERED PERSON TO COOPERATE WITH UNITED STATES.—
(A) IN GENERAL.—A covered person shall cooperate with
the United States in the processing and defense of a claim
or action under this subsection based upon alleged acts or
omissions of such person.
(B) CONSEQUENCES OF FAILURE TO COOPERATE.—Upon
the motion of the United States or any other party and
upon finding that such person has failed to so cooperate—
(i) the court shall substitute such person as the
party defendant in place of the United States and,
upon motion, shall remand any such suit to the court
in which it was instituted if it appears that the court
lacks subject matter jurisdiction;
(ii) the United States shall not be liable based on
the acts or omissions of such person; and
(iii) the Attorney General shall not be obligated to
defend such action.
(6) RECOURSE AGAINST COVERED PERSON IN CASE OF GROSS
MISCONDUCT OR CONTRACT VIOLATION.—
(A) IN GENERAL.—Should payment be made by the
United States to any claimant bringing a claim under this
subsection, either by way of administrative determination,
settlement, or court judgment, the United States shall
have, notwithstanding any provision of State law, the right
to recover for that portion of the damages so awarded or
paid, as well as interest and any costs of litigation, result-
ing from the failure of any covered person to carry out any
obligation or responsibility assumed by such person under
a contract with the United States or from any grossly neg-
ligent, reckless, or illegal conduct or willful misconduct on
the part of such person.
(B) VENUE.—The United States may maintain an action
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under this paragraph against such person in the district
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court of the United States in which such person resides or
has its principal place of business.
(7) DEFINITIONS.—As used in this subsection, terms have the
following meanings:
(A) COVERED COUNTERMEASURE.—The term ‘‘covered
countermeasure’’ or ‘‘covered countermeasure against
smallpox’’, means a substance that is—
(i)(I) used to prevent or treat smallpox (including
the vaccinia or another vaccine); or
(II) used to control or treat the adverse effects
of vaccinia inoculation or of administration of an-
other covered countermeasure; and
(ii) specified in a declaration under paragraph (2).
(B) COVERED PERSON.—The term ‘‘covered person’’, when
used with respect to the administration of a covered coun-
termeasure, means a person who is—
(i) a manufacturer or distributor of such counter-
measure;
(ii) a health care entity under whose auspices—
(I) such countermeasure was administered;
(II) a determination was made as to whether, or
under what circumstances, an individual should
receive a covered countermeasure;
(III) the immediate site of administration on the
body of a covered countermeasure was monitored,
managed, or cared for; or
(IV) an evaluation was made of whether the ad-
ministration of a countermeasure was effective;
(iii) a qualified person who administered such coun-
termeasure;
(iv) a State, a political subdivision of a State, or an
agency or official of a State or of such a political sub-
division, if such State, subdivision, agency, or official
has established requirements, provided policy guid-
ance, supplied technical or scientific advice or assist-
ance, or otherwise supervised or administered a pro-
gram with respect to administration of such counter-
measures;
(v) in the case of a claim arising out of alleged trans-
mission of vaccinia from an individual—
(I) the individual who allegedly transmitted the
vaccinia, if vaccinia vaccine was administered to
such individual as provided by paragraph (2)(B)
and such individual was within a category of indi-
viduals covered by a declaration under paragraph
(2)(A)(i); or
(II) an entity that employs an individual de-
scribed by clause (I) or where such individual has
privileges or is otherwise authorized to provide
health care;
(vi) an official, agent, or employee of a person de-
scribed in clause (i), (ii), (iii), or (iv);
(vii) a contractor of, or a volunteer working for, a
person described in clause (i), (ii), or (iv), if the con-
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tractor or volunteer performs a function for which a
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person described in clause (i), (ii), or (iv) is a covered
person; or
(viii) an individual who has privileges or is other-
wise authorized to provide health care under the aus-
pices of an entity described in clause (ii) or (v)(II).
(C) QUALIFIED PERSON.—The term ‘‘qualified person’’,
when used with respect to the administration of a covered
countermeasure, means a licensed health professional or
other individual who—
(i) is authorized to administer such countermeasure
under the law of the State in which the counter-
measure was administered; or
(ii) is otherwise authorized by the Secretary to ad-
minister such countermeasure.
(D) ARISING OUT OF ADMINISTRATION OF A COVERED
COUNTERMEASURE.—The term ‘‘arising out of administra-
tion of a covered countermeasure’’, when used with respect
to a claim or liability, includes a claim or liability arising
out of—
(i) determining whether, or under what conditions,
an individual should receive a covered counter-
measure;
(ii) obtaining informed consent of an individual to
the administration of a covered countermeasure;
(iii) monitoring, management, or care of an imme-
diate site of administration on the body of a covered
countermeasure, or evaluation of whether the adminis-
tration of the countermeasure has been effective; or
(iv) transmission of vaccinia virus by an individual
to whom vaccinia vaccine was administered as pro-
vided by paragraph (2)(B).
(q)(1) For purposes of this section, a health professional volunteer
at a deemed entity described in subsection (g)(4) shall, in providing
a health professional service eligible for funding under section 330
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 (4)(C). The preceding
sentence is subject to the provisions of this subsection.
(2) In providing a health service to an individual, a health care
practitioner shall for purposes of this subsection be considered to
be a health professional volunteer at an entity described in sub-
section (g)(4) 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), or through offsite
programs or events carried out by the entity.
(B) The entity is sponsoring the health care practitioner pur-
suant to paragraph (3)(B).
(C) The health care practitioner does not receive any com-
pensation for the service from the individual, the entity de-
scribed in subsection (g)(4), or 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 practitioner may receive repayment from
the entity described in subsection (g)(4) for reasonable ex-
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penses incurred by the health care practitioner in the provision
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of the service to the individual, which may include travel ex-
penses to or from the site of services.
(D) Before the service is provided, the health care practi-
tioner or the 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
practitioner is limited pursuant to this subsection.
(E) At the time the service is provided, the health care prac-
titioner is licensed or certified in accordance with applicable
Federal and State laws regarding the provision of the service.
(F) At the time the service is provided, the entity described
in subsection (g)(4) maintains relevant documentation certi-
fying that the health care practitioner meets the requirements
of this subsection.
(3) Subsection (g) (other than paragraphs (3) and (5)) and sub-
sections (h), (i), and (l) apply to a health care practitioner for pur-
poses of this subsection to the same extent and in the same man-
ner as such subsections apply to an officer, governing board mem-
ber, employee, or contractor of an entity described in subsection
(g)(4), subject to paragraph (4), and subject to the following:
(A) The first sentence of paragraph (1) applies in lieu of the
first sentence of subsection (g)(1)(A).
(B) With respect to an entity described in subsection (g)(4),
a health care practitioner is not a health professional volunteer
at such entity unless the entity sponsors the health care prac-
titioner. For purposes of this subsection, the entity shall be
considered to be sponsoring the health care practitioner if—
(i) with respect to the health care practitioner, the entity
submits to the Secretary an application meeting the re-
quirements of subsection (g)(1)(D); and
(ii) the Secretary, pursuant to subsection (g)(1)(E), deter-
mines that the health care practitioner is deemed to be an
employee of the Public Health Service.
(C) In the case of a health care practitioner who is deter-
mined by the Secretary pursuant to subsection (g)(1)(E) to be
a health professional volunteer at such entity, this subsection
applies to the health care practitioner (with respect to services
performed on behalf of the entity sponsoring the health care
practitioner pursuant to subparagraph (B)) for any cause of ac-
tion arising from an act or omission of the health care practi-
tioner occurring on or after the date on which the Secretary
makes such determination.
(D) Subsection (g)(1)(F) applies to a health care practitioner
for purposes of this subsection only to the extent that, in pro-
viding health services to an individual, each of the conditions
specified in paragraph (2) is met.
(4)(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.
(B)(i) Not later than May 1 of each fiscal year, the Attorney Gen-
eral, in consultation with the Secretary, shall submit to the Con-
gress a report providing an estimate of the amount of claims (to-
gether with related fees and expenses of witnesses) that, by reason
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of the acts or omissions of health professional volunteers, will be
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paid pursuant to this section during the calendar year that begins
in the following fiscal year.
(ii) Subsection (k)(1)(B) applies to the estimate under clause (i)
regarding health 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, em-
ployees, and contractors of entities described in subsection (g)(4).
(iii) The report shall include a summary of the data relied upon
for the estimate in clause (i), including the number of claims filed
and paid from the previous calendar year.
(C) Not later than December 31 of each fiscal year, the Secretary
shall transfer from the fund under subsection (k)(2) to the appro-
priate 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.
(5)(A) This subsection shall take effect on October 1, 2017, except
as provided in subparagraph (B) and paragraph (6).
(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 applica-
tions submitted pursuant to paragraph (3)(B); and
(ii) reports under paragraph (4)(B) may be submitted to Con-
gress.
(6) Beginning on øOctober 1, 2022¿ October 1, 2027, this sub-
section shall cease to have any force or effect.
* * * * * * *
TITLE III—GENERAL POWERS AND DUTIES OF PUBLIC
HEALTH SERVICE
* * * * * * *
PART B—FEDERAL-STATE COOPERATION
* * * * * * *
SEC. 317L–1. SCREENING AND TREATMENT FOR øMATERNAL DEPRES-
SION¿ MATERNAL MENTAL HEALTH AND SUBSTANCE USE
DISORDERS.
(a) GRANTS.—The Secretary shall make grants to States, Indian
Tribes and Tribal organizations (as such terms are defined in sec-
tion 4 of the Indian Self-Determination and Education Assistance
Act), and Urban Indian organizations (as such term is defined
under the Federally Recognized Indian Tribe List Act of 1994) to es-
tablish, improve, or maintain programs for screening, assessment,
and treatment services, including culturally and linguistically ap-
propriate services, as appropriate, øfor women who are pregnant,
or who have given birth within the preceding 12 months, for mater-
nal depression¿ for women who are postpartum, pregnant, or have
given birth within the preceding 12 months, for maternal mental
health and substance use disorders.
(b) APPLICATION.—To seek a grant under this section, øa State
shall submit¿ an entity listed in subsection (a) shall submit an ap-
plication to the Secretary at such time, in such manner, and con-
taining such information as the Secretary may require. At a min-
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imum, any such application shall include explanations of—
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(1) how a program, or programs, will increase the percentage
of women screened and treated, as appropriate, for ømaternal
depression¿ maternal mental health and substance use dis-
orders in 1 or more communities; and
(2) how a program, or programs, if expanded, would increase
access to screening and treatment services for ømaternal de-
pression¿ maternal mental health and substance use disorders.
(c) PRIORITY.—In awarding grants under this section, the Sec-
retary ømay give priority to States proposing to improve or en-
hance access to screening¿ shall give priority to entities listed in
subsection (a) that—
(1) are proposing to create, improve, or enhance screening,
prevention, and treatment services for ømaternal depression¿
maternal mental health and substance use disorders in primary
care settingsø.¿;
(2) are currently partnered with, or will partner with, a com-
munity-based organization to address maternal mental health
and substance use disorders;
(3) are located in an area with high rates of adverse maternal
health outcomes or significant health, economic, racial, or eth-
nic disparities in maternal health and substance use disorder
outcomes; and
(4) operate in a health professional shortage area designated
under section 332.
(d) USE OF FUNDS.—The activities eligible for funding through a
grant under subsection (a)—
(1) shall include—
(A) providing appropriate training øto health care pro-
viders; and¿ on maternal mental health and substance use
disorder screening, brief intervention, treatment (as appli-
cable for health care providers), and referrals for treatment
to health care providers in the primary care setting and
nonclinical perinatal support workers;
(B) providing information øto health care providers, in-
cluding information on maternal depression screening,
treatment, and followup support services, and linkages to
community-based resources; and¿ on maternal mental
health and substance use disorder screening, brief interven-
tion, treatment (as applicable for health care providers)
and referrals for treatment, follow-up support services, and
linkages to community-based resources to health care pro-
viders in the primary care setting and clinical perinatal
support workers; and
(C) enabling health care providers (such as obstetrician-
gynecologists, nurse practitioners, nurse midwives, pediatri-
cians, psychiatrists, mental and other behavioral health
care providers, and adult primary care clinicians) to pro-
vide or receive real-time psychiatric consultation (in-person
or remotely), including through the use of technology-en-
abled collaborative learning and capacity building models
(as defined in section 330N), to aid in the treatment of
pregnant and postpartum women; and
(2) may include—
ø(A) enabling health care providers (including obstetri-
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health care providers, and adult primary care clinicians) to
provide or receive real-time psychiatric consultation (in-
person or remotely) to aid in the treatment of pregnant
and parenting women;¿
ø(B)¿ (A) establishing linkages with and among commu-
nity-based resources, including mental health resources,
primary care resources, and support groups; øand¿
ø(C)¿ (B) utilizing telehealth services, including for rural
areas and medically underserved areas (as defined in sec-
tion 330I(a))ø.¿;
(C) providing assistance to pregnant and postpartum
women to receive maternal mental health and substance
use disorder treatment, including patient consultation, care
coordination, and navigation for such treatment;
(D) coordinating with maternal and child health pro-
grams of the Federal Government and State, local, and
Tribal governments, including child psychiatric access pro-
grams;
(E) conducting public outreach and awareness regarding
grants under subsection (a);
(F) creating multistate consortia to carry out the activi-
ties required or authorized under this subsection; and
(G) training health care providers in the primary care
setting and nonclinical perinatal support workers on trau-
ma-informed care, culturally and linguistically appropriate
services, and best practices related to training to improve
the provision of maternal mental health and substance use
disorder care for racial and ethnic minority populations,
including with respect to perceptions and biases that may
affect the approach to, and provision of, care.
(e) TECHNICAL ASSISTANCE.—The Secretary shall provide tech-
nical assistance to grantees and entities listed in subsection (a) for
carrying out activities pursuant to this section.
(f) DISSEMINATION OF BEST PRACTICES.—The Secretary, based on
evaluation of the activities funded pursuant to this section, shall
identify and disseminate evidence-based or evidence-informed best
practices for screening, assessment, and treatment services for ma-
ternal mental health and substance use disorders, including cul-
turally and linguistically appropriate services, for women during
pregnancy and 12 months following pregnancy.
(g) MATCHING REQUIREMENT.—The Federal share of the cost of
the activities for which a grant is made to an entity under sub-
section (a) shall not exceed 90 percent of the total cost of such activi-
ties.
ø(e)¿ (h) AUTHORIZATION OF APPROPRIATIONS.—To carry out this
section, there are authorized to be appropriated ø$5,000,000¿
$24,000,000 for each of fiscal years ø2018 through 2022¿ 2023
through 2027.
SEC. 317L–2. TASK FORCE ON MATERNAL MENTAL HEALTH.
(a) ESTABLISHMENT.—Not later than 180 days after the date of
enactment of the Restoring Hope for the Mental Health and Well-
Being Act of 2022, the Secretary, for purposes of identifying, evalu-
ating, and making recommendations to coordinate and improve
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Federal responses to maternal mental health conditions, shall—
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(1) establish a task force to be known as the Task Force on
Maternal Mental Health (in this section referred to as the ‘‘Task
Force’’); or
(2) incorporate the duties, public meetings, and reports speci-
fied in subsections (c) through (f) into existing Federal policy fo-
rums, including the Maternal Health Interagency Policy Com-
mittee and the Maternal Health Working Group, as appro-
priate.
(b) MEMBERSHIP.—
(1) COMPOSITION.—The Task Force shall be composed of—
(A) the Federal members under paragraph (2); and
(B) the non-Federal members under paragraph (3).
(2) FEDERAL MEMBERS.—The Federal members of the Task
Force shall consist of the following heads of Federal depart-
ments and agencies (or their designees):
(A) The Assistant Secretary for Health of the Department
of Health and Human Services, who shall serve as Chair.
(B) The Assistant Secretary for Planning and Evaluation
of the Department of Health and Human Services.
(C) The Assistant Secretary of the Administration for
Children and Families.
(D) The Director of the Centers for Disease Control and
Prevention.
(E) The Administrator of the Centers for Medicare &
Medicaid Services.
(F) The Administrator of the Health Resources and Serv-
ices Administration.
(G) The Director of the Indian Health Service.
(H) The Assistant Secretary for Mental Health and Sub-
stance Use.
(I) Such other Federal departments and agencies as the
Secretary determines appropriate that serve individuals
with maternal mental health conditions.
(3) NON-FEDERAL MEMBERS.—The non-Federal members of
the Task Force shall—
(A) compose not more than one-half, and not less than
one-third, of the total membership of the Task Force;
(B) be appointed by the Secretary; and
(C) include—
(i) representatives of medical societies with expertise
in maternal or mental health;
(ii) representatives of nonprofit organizations with
expertise in maternal or mental health;
(iii) relevant industry representatives; and
(iv) other representatives, as appropriate.
(4) DEADLINE FOR DESIGNATING DESIGNEES.—If the Assistant
Secretary for Health, or the head of a Federal department or
agency serving as a member of the Task Force under paragraph
(2), chooses to be represented on the Task Force by a designee,
the Assistant Secretary or department or agency head shall des-
ignate such designee not later than 90 days after the date of the
enactment of this section.
(c) DUTIES.—The Task Force shall—
(1) prepare and regularly update a report that analyzes and
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and programs at the Federal, State, and local levels, and iden-
tifies best practices with respect to maternal mental health pol-
icy, including—
(A) a set of evidence-based, evidence-informed, and prom-
ising practices with respect to—
(i) prevention strategies for individuals at risk of ex-
periencing a maternal mental health condition, includ-
ing strategies and recommendations to address health
inequities;
(ii) the identification, screening, diagnosis, interven-
tion, and treatment of individuals and families affected
by a maternal mental health condition;
(iii) the expeditious referral to, and implementation
of, practices and supports that prevent and mitigate
the effects of a maternal mental health condition, in-
cluding strategies and recommendations to eliminate
the racial and ethnic disparities that exist in maternal
mental health; and
(iv) community-based or multigenerational practices
that support individuals and families affected by a ma-
ternal mental health condition; and
(B) Federal and State programs and activities to prevent,
screen, diagnose, intervene, and treat maternal mental
health conditions;
(2) develop and regularly update a national strategy for ma-
ternal mental health, taking into consideration the findings of
the report under paragraph (1), on how the Task Force and
Federal departments and agencies represented on the Task
Force may prioritize options for, and may implement a coordi-
nated approach to, addressing maternal mental health condi-
tions, including by—
(A) increasing prevention, screening, diagnosis, interven-
tion, treatment, and access to care, including clinical and
nonclinical care such as peer-support and community
health workers, through the public and private sectors;
(B) providing support for pregnant or postpartum indi-
viduals who are at risk for or experiencing a maternal men-
tal health condition, and their families, as appropriate;
(C) reducing racial, ethnic, geographic, and other health
disparities for prevention, diagnosis, intervention, treat-
ment, and access to care;
(D) identifying options for modifying, strengthening, and
coordinating Federal programs and activities, such as the
Medicaid program under title XIX of the Social Security
Act and the State Children’s Health Insurance Program
under title XXI of such Act, including existing infant and
maternity programs, in order to increase research, preven-
tion, identification, intervention, and treatment with re-
spect to maternal mental health; and
(E) planning, data sharing, and communication within
and across Federal departments, agencies, offices, and pro-
grams;
(3) solicit public comments from stakeholders for the report
under paragraph (1) and the national strategy under para-
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mental health professionals, researchers, experts in maternal
mental health, institutions of higher education, public health
agencies (including maternal and child health programs), and
industry representatives, in order to inform the activities and
reports of the Task Force; and
(4) disaggregate any data collected under this section by race,
ethnicity, geographical location, age, marital status, socio-
economic level, and other factors, as the Secretary determines
appropriate.
(d) MEETINGS.—The Task Force shall—
(1) meet not less than two times each year; and
(2) convene public meetings, as appropriate, to fulfill its du-
ties under this section.
(e) REPORTS TO PUBLIC AND FEDERAL LEADERS.—The Task Force
shall make publicly available and submit to the heads of relevant
Federal departments and agencies, the Committee on Energy and
Commerce of the House of Representatives, the Committee on
Health, Education, Labor, and Pensions of the Senate, and other
relevant congressional committees, the following:
(1) Not later than 1 year after the first meeting of the Task
Force, an initial report under subsection (c)(1).
(2) Not later than 2 years after the first meeting of the Task
Force, an initial national strategy under subsection (c)(2).
(3) Each year thereafter—
(A) an updated report under subsection (c)(1);
(B) an updated national strategy under subsection (c)(2);
or
(C) if no update is made under subsection (c)(1) or (c)(2),
a report summarizing the activities of the Task Force.
(f) REPORTS TO GOVERNORS.—Upon finalizing the initial national
strategy under subsection (c)(2), and upon making relevant updates
to such strategy, the Task Force shall submit a report to the Gov-
ernors of all States describing opportunities for local- and State-
level partnerships identified under subsection (c)(2)(D).
(g) SUNSET.—The Task Force shall terminate on September 30,
2027.
(h) NONDUPLICATION OF FEDERAL EFFORTS.—The Secretary may
relieve the Task Force, in carrying out subsections (c) through (f),
from responsibility for carrying out such activities as may be speci-
fied by the Secretary as duplicative with other activities carried out
by the Department of Health and Human Services.
* * * * * * *
PART D—PRIMARY HEALTH CARE
Subpart I—Health Centers
* * * * * * *
SEC. 330M. PEDIATRIC MENTAL HEALTH CARE ACCESS GRANTS.
(a) IN GENERAL.—The Secretary, acting through the Adminis-
trator of the Health Resources and Services Administration and in
coordination with other relevant Federal agencies, shall award
grants to States, political subdivisions of States, and øIndian tribes
and tribal organizations¿ Indian Tribes and Tribal organizations
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4 of the Indian Self-Determination and Education Assistance Act
(25 U.S.C. 450b)) or, in the case of a State that does not submit an
application, a nonprofit entity that has the support of the State to
promote behavioral health integration in pediatric primary care
by—
(1) supporting the development of statewide or regional pedi-
atric mental health care telehealth access programs; and
(2) supporting the improvement of existing statewide or re-
gional pediatric mental health care telehealth access programs.
(b) PROGRAM REQUIREMENTS.—
(1) IN GENERAL.—A pediatric mental health care telehealth
access program referred to in subsection (a), with respect to
which a grant under such subsection may be used, shall—
(A) be a statewide or regional network of pediatric men-
tal health teams that provide support to pediatric primary
care sites as an integrated team;
(B) support and further develop organized State or re-
gional networks of pediatric mental health teams to pro-
vide consultative support to pediatric primary care sites;
(C) conduct an assessment of critical behavioral con-
sultation needs among pediatric providers and such pro-
viders’ preferred mechanisms for receiving consultation,
training, and technical assistance;
(D) develop an online database and communication
mechanisms, including telehealth, to facilitate consultation
support to pediatric practices;
(E) provide rapid statewide or regional clinical telephone
or telehealth consultations when requested between the
pediatric mental health teams and pediatric primary care
providers;
(F) conduct training and provide technical assistance to
pediatric primary care providers to support the early iden-
tification, diagnosis, treatment, and referral of children
with behavioral health conditions;
(G) provide information to pediatric providers about, and
assist pediatric providers in accessing, pediatric mental
health care providers, including child and adolescent psy-
chiatrists, developmental-behavioral pediatricians, and li-
censed mental health professionals, such as psychologists,
social workers, or mental health counselors and in sched-
uling and conducting technical assistance;
(H) assist with referrals to specialty care and community
or behavioral health resourcesø; and¿;
(I) maintain an up-to-date list of community-based sup-
ports for children with mental health problems; and
ø(I)¿ (J) establish mechanisms for measuring and moni-
toring increased access to pediatric mental health care
services by pediatric primary care providers and expanded
capacity of pediatric primary care providers to identify,
treat, and refer children with mental health problems.
(2) SUPPORT TO SCHOOLS AND EMERGENCY DEPARTMENTS.—In
addition to the activities required by paragraph (1), a pediatric
mental health care telehealth access program referred to in sub-
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may be used, may provide support to schools and emergency de-
partments.
(3) PRIORITY.—In awarding grants under this section, the
Secretary shall give priority to applicants proposing to—
(A) continue existing programs that meet the require-
ments of paragraph (1);
(B) establish a pediatric mental health care telehealth ac-
cess program in the jurisdiction of a State, Territory, In-
dian Tribe, or Tribal organization that does not yet have
such a program; or
(C) expand a pediatric mental health care telehealth ac-
cess program to include one or more new sites of care, such
as a school or emergency department.
ø(2)¿ (4) PEDIATRIC MENTAL HEALTH TEAMS.—In this sub-
section, the term ‘‘pediatric mental health team’’ means a team
consisting of at least one case coordinator, at least one child
and adolescent psychiatrist, and at least one licensed clinical
mental health professional, such as a psychologist, social work-
er, or mental health counselor. Such a team may include a de-
velopmental-behavioral pediatrician. Such a team may be re-
gionally based.
(c) APPLICATION.—A State, political subdivision of a State, øIn-
dian tribe, or tribal organization¿ Indian Tribe, Tribal organiza-
tion, or nonprofit entity seeking a grant under this section shall
submit an application to the Secretary at such time, in such man-
ner, and containing such information as the Secretary may require,
including a plan for the comprehensive evaluation of activities that
are carried out with funds received under such grant.
(d) EVALUATION.—A State, political subdivision of a State, øIn-
dian tribe, or tribal organization¿ Indian Tribe, Tribal organiza-
tion, or nonprofit entity that receives a grant under this section
shall prepare and submit an evaluation of activities that are car-
ried out with funds received under such grant to the Secretary at
such time, in such manner, and containing such information as the
Secretary may reasonably require, including a process and outcome
evaluation.
(e) ACCESS TO BROADBAND.—In administering grants under this
section, the Secretary may coordinate with other agencies to ensure
that funding opportunities are available to support access to reli-
able, high-speed Internet for providers.
(f) MATCHING REQUIREMENT.—The Secretary may not award a
grant under this section unless the State, political subdivision of a
State, øIndian tribe, or tribal organization¿ Indian Tribe, Tribal or-
ganization, or nonprofit entity involved agrees, with respect to the
costs to be incurred by the State, political subdivision of a State,
øIndian tribe, or tribal organization¿ Indian Tribe, Tribal organi-
zation, or nonprofit entity in carrying out the purpose described in
this section, to make available non-Federal contributions (in cash
or in kind) toward such costs in an amount that is not less than
20 percent of Federal funds provided in the grant.
ø(g) AUTHORIZATION OF APPROPRIATIONS.—To carry out this sec-
tion, there are authorized to be appropriated, $9,000,000 for the pe-
riod of fiscal years 2018 through 2022.¿
(g) TECHNICAL ASSISTANCE.—The Secretary shall award grants or
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retary) for the purposes of providing technical assistance and eval-
uation support to grantees under subsection (a).
(h) AUTHORIZATION OF APPROPRIATIONS.—To carry out this sec-
tion, there are authorized to be appropriated—
(1) $14,000,000 for each of fiscal years 2023 through 2025;
and
(2) $30,000,000 for each of fiscal years 2026 through 2027.
* * * * * * *
PART P—ADDITIONAL PROGRAMS
* * * * * * *
SEC. 399V–7. MATERNAL MENTAL HEALTH HOTLINE.
(a) IN GENERAL.—The Secretary shall maintain, directly or by
grant or contract, a national hotline to provide emotional support,
information, brief intervention, and mental health and substance
use disorder resources to pregnant and postpartum women at risk
of, or affected by, maternal mental health and substance use dis-
orders, and to their families or household members.
(b) REQUIREMENTS FOR HOTLINE.—The hotline under subsection
(a) shall—
(1) be a 24/7 real-time hotline;
(2) provide voice and text support;
(3) be staffed by certified peer specialists, licensed health care
professionals, or licensed mental health professionals who are
trained on—
(A) maternal mental health and substance use disorder
prevention, identification, and intervention; and
(B) providing culturally and linguistically appropriate
support; and
(4) provide maternal mental health and substance use dis-
order assistance and referral services to meet the needs of un-
derserved populations, individuals with disabilities, and family
and household members of pregnant or postpartum women at
risk of experiencing maternal mental health and substance use
disorders.
(c) ADDITIONAL REQUIREMENTS.—In maintaining the hotline
under subsection (a), the Secretary shall—
(1) consult with the Domestic Violence Hotline, National Sui-
cide Prevention Lifeline, and Veterans Crisis Line to ensure
that pregnant and postpartum women are connected in real-
time to the appropriate specialized hotline service, when appli-
cable;
(2) conduct a public awareness campaign for the hotline; and
(3) consult with Federal departments and agencies, including
the Centers of Excellence of the Substance Abuse and Mental
Health Services Administration and the Department of Veterans
Affairs, to increase awareness regarding the hotline.
(d) ANNUAL REPORT.—The Secretary shall submit an annual re-
port to the Congress on the hotline under subsection (a) and imple-
mentation of this section, including—
(1) an evaluation of the effectiveness of activities conducted or
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(2) a directory of entities or organizations to which staff
maintaining the hotline funded under this section may make re-
ferrals; and
(3) such additional information as the Secretary determines
appropriate.
(e) AUTHORIZATION OF APPROPRIATIONS.—To carry out this sec-
tion, there are authorized to be appropriated $10,000,000 for each
of fiscal years 2023 through 2027.
PART Q—PROGRAMS TO IMPROVE THE
HEALTH OF CHILDREN
* * * * * * *
SEC. 399Z–2. INFANT AND EARLY CHILDHOOD MENTAL HEALTH PRO-
MOTION, INTERVENTION, AND TREATMENT.
(a) GRANTS.—The Secretary shall—
(1) award grants to eligible entities to develop, maintain, or
enhance infant and early childhood mental health promotion,
intervention, and treatment programs, including—
(A) programs for infants and children at significant risk
of developing, showing early signs of, or having been diag-
nosed with mental illness, including a serious emotional
disturbance; and
(B) multigenerational therapy and other services that
support the caregiving relationship; and
(2) ensure that programs funded through grants under this
section are evidence-informed or evidence-based models, prac-
tices, and methods that are, as appropriate, culturally and lin-
guistically appropriate, and can be replicated in other appro-
priate settings.
(b) ELIGIBLE CHILDREN AND ENTITIES.—In this section:
(1) ELIGIBLE CHILD.—The term ‘‘eligible child’’ means a child
from birth to not more than 12 years of age who—
(A) is at risk for, shows early signs of, or has been diag-
nosed with a mental illness, including a serious emotional
disturbance; and
(B) may benefit from infant and early childhood inter-
vention or treatment programs or specialized preschool or
elementary school programs that are evidence-based or
that have been scientifically demonstrated to show promise
but would benefit from further applied development.
(2) ELIGIBLE ENTITY.—The term ‘‘eligible entity’’ means a
human services agency or nonprofit institution that—
(A) employs licensed mental health professionals who
have specialized training and experience in infant and
early childhood mental health assessment, diagnosis, and
treatment, or is accredited or approved by the appropriate
State agency, as applicable, to provide for children from in-
fancy to 12 years of age mental health promotion, inter-
vention, or treatment services; and
(B) provides services or programs described in subsection
(a) that are evidence-based or that have been scientifically
demonstrated to show promise but would benefit from fur-
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(c) APPLICATION.—An eligible entity seeking a grant under sub-
section (a) shall submit to the Secretary an application at such
time, in such manner, and containing such information as the Sec-
retary may require.
(d) USE OF FUNDS FOR EARLY INTERVENTION AND TREATMENT
PROGRAMS.—An eligible entity may use amounts awarded under a
grant under subsection (a)(1) to carry out the following:
(1) Provide age-appropriate mental health promotion and
early intervention services or mental illness treatment serv-
ices, which may include specialized programs, for eligible chil-
dren at significant risk of developing, showing early signs of,
or having been diagnosed with a mental illness, including a se-
rious emotional disturbance. Such services may include social
and behavioral services as well as multigenerational therapy
and other services that support the caregiving relationship.
(2) Provide training for health care professionals with exper-
tise in infant and early childhood mental health care with re-
spect to appropriate and relevant integration with other dis-
ciplines such as primary care clinicians, early intervention spe-
cialists, child welfare staff, home visitors, early care and edu-
cation providers, and others who work with young children and
families.
(3) Provide mental health consultation to personnel of early
care and education programs (including licensed or regulated
center-based and home-based child care, home visiting, pre-
school special education, and early intervention programs) who
work with children and families.
(4) Provide training for mental health clinicians in infant
and early childhood in promising and evidence-based practices
and models for infant and early childhood mental health treat-
ment and early intervention, including with regard to practices
for identifying and treating mental illness and behavioral dis-
orders of infants and children resulting from exposure or re-
peated exposure to adverse childhood experiences or childhood
trauma.
(5) Provide age-appropriate assessment, diagnostic, and
intervention services for eligible children, including early men-
tal health promotion, intervention, and treatment services.
(e) 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 enti-
ty in carrying out the activities described in subsection (d), to make
available non-Federal contributions (in cash or in kind) toward
such costs in an amount that is not less than 10 percent of the
total amount of Federal funds provided in the grant.
(f) AUTHORIZATION OF APPROPRIATIONS.—To carry out this sec-
tion, there are authorized to be appropriated ø$20,000,000 for the
period of fiscal years 2018 through 2022¿ $50,000,000 for the pe-
riod of fiscal years 2023 through 2027.
* * * * * * *
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TITLE V—SUBSTANCE ABUSE AND MENTAL HEALTH
SERVICES ADMINISTRATION
PART A—ORGANIZATION AND GENERAL AUTHORITIES
SEC. 501. SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMIN-
ISTRATION.
(a) ESTABLISHMENT.—The Substance Abuse and Mental Health
Services Administration (hereafter referred to in this title as the
‘‘Administration’’) is an agency of the Service.
(b) CENTERS.—The following Centers are agencies of the Admin-
istration:
(1) The Center for Substance Abuse Treatment.
(2) The Center for Substance Abuse Prevention.
(3) The Center for Mental Health Services.
(c) ASSISTANT SECRETARY AND DEPUTY ASSISTANT SECRETARY.—
(1) ASSISTANT SECRETARY.—The Administration shall be
headed by an official to be known as the Assistant Secretary
for Mental Health and Substance Use (hereinafter in this title
referred to as the ‘‘Assistant Secretary’’) who shall be ap-
pointed by the President, by and with the advice and consent
of the Senate.
(2) DEPUTY ASSISTANT SECRETARY.—The Assistant Secretary,
with the approval of the Secretary, may appoint a Deputy As-
sistant Secretary and may employ and prescribe the functions
of such officers and employees, including attorneys, as are nec-
essary to administer the activities to be carried out through
the Administration.
(d) AUTHORITIES.—The Secretary, acting through the Assistant
Secretary, shall—
(1) supervise the functions of the Centers of the Administra-
tion in order to assure that the programs carried out through
each such Center receive appropriate and equitable support
and that there is cooperation among the Centers in the imple-
mentation of such programs;
(2) establish and implement, through the respective Centers,
a comprehensive program to improve the provision of treat-
ment and related services to individuals with respect to sub-
stance use disorders and mental illness and to improve preven-
tion services, promote mental health and protect the legal
rights of individuals with mental illnesses and individuals with
substance use disorders;
(3) carry out the administrative and financial management,
policy development and planning, evaluation, knowledge dis-
semination, and public information functions that are required
for the implementation of this title;
(4) assure that the Administration conduct and coordinate
demonstration projects, evaluations, and service system assess-
ments and other activities necessary to improve the avail-
ability and quality of treatment, prevention and related serv-
ices;
(5) support activities that will improve the provision of treat-
ment, prevention and related services, including the develop-
ment of national mental health and substance use disorder
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goals and model programs;
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(6) in cooperation with the National Institutes of Health, the
Centers for Disease Control and Prevention, and the Health
Resources and Services Administration, develop educational
materials and intervention strategies to reduce the risks of
HIV, hepatitis, tuberculosis, and other communicable diseases
among individuals with mental or substance use disorders, and
to develop appropriate mental health services for individuals
with such diseases or disorders;
(7) coordinate Federal policy with respect to the provision of
treatment services for substance use disorders, including serv-
ices that utilize drugs or devices approved or cleared by the
Food and Drug Administration for the treatment of substance
use disorders;
(8) conduct programs, and assure the coordination of such
programs with activities of the National Institutes of Health
and the Agency for Healthcare Research and Quality, as appro-
priate, to evaluate the process, outcomes and community im-
pact of prevention and treatment services and systems of care
in order to identify the manner in which such services can
most effectively be provided;
(9) collaborate with the Director of the National Institutes of
Health in the development and maintenance of a system by
which the relevant research findings of the National Institute
on Drug Abuse, the National Institute on Alcohol Abuse and
Alcoholism, the National Institute of Mental Health, and, as
appropriate, the Agency for Healthcare Research and Quality
are disseminated to service providers in a manner designed to
improve the delivery and effectiveness of prevention, treat-
ment, and recovery support services and are appropriately in-
corporated into programs carried out by the Administration;
(10) encourage public and private entities that provide
health insurance to provide benefits for substance use disorder
and mental health services;
(11) work with relevant agencies of the Department of
Health and Human Services on integrating mental health pro-
motion and substance use disorder prevention with general
health promotion and disease prevention and integrating men-
tal and substance use disorders treatment services with phys-
ical health treatment services;
(12) monitor compliance by hospitals and other facilities with
the requirements of sections 542 and 543;
(13) with respect to grant programs authorized under this
title or part B of title XIX, or grant programs otherwise funded
by the Administration—
(A) require that all grants that are awarded for the pro-
vision of services are subject to performance and outcome
evaluations;
(B) ensure that the director of each Center of the Admin-
istration consistently documents the application of criteria
when awarding grants and the ongoing oversight of grant-
ees after such grants are awarded;
(C) require that all grants that are awarded to entities
other than States are awarded only after the State in
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which the entity intends to provide services—
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(i) is notified of the pendency of the grant applica-
tion; and
(ii) is afforded an opportunity to comment on the
merits of the application; and
(D) inform a State when any funds are awarded through
such a grant to any entity within such State;
(14) assure that services provided with amounts appro-
priated under this title are provided bilingually, if appropriate;
(15) improve coordination among prevention programs, treat-
ment facilities and nonhealth care systems such as employers,
labor unions, and schools, and encourage the adoption of em-
ployee assistance programs and student assistance programs;
(16) maintain a clearinghouse for substance use disorder in-
formation, including evidence-based and promising best prac-
tices for prevention, treatment, and recovery support services
for individuals with mental and substance use disorders, to as-
sure the widespread dissemination of such information to
States, political subdivisions, educational agencies and institu-
tions, treatment providers, and the general public;
(17) in collaboration with the National Institute on Aging,
and in consultation with the National Institute on Drug Abuse,
the National Institute on Alcohol Abuse and Alcoholism and
the National Institute of Mental Health, as appropriate, pro-
mote and evaluate substance use disorder services for older
Americans in need of such services, and mental health services
for older Americans who are seriously mentally ill;
(18) promote the coordination of service programs conducted
by other departments, agencies, organizations and individuals
that are or may be related to the problems of individuals suf-
fering from mental illness or substance abuse, including liai-
sons with the Social Security Administration, Centers for
Medicare & Medicaid Services, and other programs of the De-
partment, as well as liaisons with the Department of Edu-
cation, Department of Justice, and other Federal Departments
and offices, as appropriate;
(19) consult with State, local, and tribal governments, non-
governmental entities, and individuals with mental illness,
particularly adults with a serious mental illness, children with
a serious emotional disturbance, and the family members of
such adults and children, with respect to improving commu-
nity-based and other mental health services;
(20) collaborate with the Secretary of Defense and the Sec-
retary of Veterans Affairs to improve the provision of mental
and substance use disorder services provided by the Depart-
ment of Defense and the Department of Veterans Affairs to
members of the Armed Forces, veterans, and the family mem-
bers of such members and veterans, including through the pro-
vision of services using the telehealth capabilities of the De-
partment of Defense and the Department of Veterans Affairs;
(21) collaborate with the heads of relevant Federal agencies
and departments, States, communities, and nongovernmental
experts to improve mental and substance use disorders services
for chronically homeless individuals, including by designing
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strategies to provide such services in supportive housing;
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(22) work with States and other stakeholders to develop and
support activities to recruit and retain a workforce addressing
mental and substance use disorders;
(23) collaborate with the Attorney General and representa-
tives of the criminal justice system to improve mental and sub-
stance use disorders services for individuals who have been ar-
rested or incarcerated;
(24) after providing an opportunity for public input, set
standards for grant programs under this title for mental and
substance use disorders services and prevention programs,
which standards may address—
(A) the capacity of the grantee to implement the award;
(B) requirements for the description of the program im-
plementation approach;
(C) the extent to which the grant plan submitted by the
grantee as part of its application must explain how the
grantee will reach the population of focus and provide a
statement of need, which may include information on how
the grantee will increase access to services and a descrip-
tion of measurable objectives for improving outcomes;
(D) the extent to which the grantee must collect and re-
port on required performance measures; and
(E) the extent to which the grantee is proposing to use
evidence-based practices; øand¿
(25) advance, through existing programs, the use of perform-
ance metrics, including those based on the recommendations
on performance metrics from the Assistant Secretary for Plan-
ning and Evaluation under section 6021(d) of the Helping Fam-
ilies in Mental Health Crisis Reform Act of 2016ø.¿; and
(26) collaborate with national accrediting entities, reputable
providers, organizations or individuals with established exper-
tise in delivery of recovery housing services, States, Federal
agencies (including the Department of Health and Human Serv-
ices, the Department of Housing and Urban Development, and
the agencies listed in section 550(e)(2)(B)), and other relevant
stakeholders, to promote the availability of high-quality recov-
ery housing and services for individuals with a substance use
disorder.
(e) ASSOCIATE ADMINISTRATOR FOR ALCOHOL PREVENTION AND
TREATMENT POLICY.—
(1) IN GENERAL.—There may be in the Administration an As-
sociate Administrator for Alcohol Prevention and Treatment
Policy to whom the Assistant Secretary may delegate the func-
tions of promoting, monitoring, and evaluating service pro-
grams for the prevention and treatment of alcoholism and alco-
hol abuse within the Center for Substance Abuse Prevention,
the Center for Substance Abuse Treatment and the Center for
Mental Health Services, and coordinating such programs
among the Centers, and among the Centers and other public
and private entities. The Associate Administrator also may en-
sure that alcohol prevention, education, and policy strategies
are integrated into all programs of the Centers that address
substance abuse prevention, education, and policy, and that
the Center for Substance Abuse Prevention addresses the
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Healthy People 2010 goals and the National Dietary Guide-
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lines of the Department of Health and Human Services and
the Department of Agriculture related to alcohol consumption.
(2) PLAN.—
(A) The Assistant Secretary, acting through the Asso-
ciate Administrator for Alcohol Prevention and Treatment
Policy, shall develop, and periodically review and as appro-
priate revise, a plan for programs and policies to treat and
prevent alcoholism and alcohol abuse. The plan shall be
developed (and reviewed and revised) in collaboration with
the Directors of the Centers of the Administration and in
consultation with members of other Federal agencies and
public and private entities.
(B) Not later than 1 year after the date of the enactment
of the ADAMHA Reorganization Act, the Assistant Sec-
retary shall submit to the Congress the first plan devel-
oped under subparagraph (A).
(3) REPORT.—
(A) Not less than once during each 2 years, the Assistant
Secretary, acting through the Associate Administrator for
Alcohol Prevention and Treatment Policy, shall prepare a
report describing the alcoholism and alcohol abuse preven-
tion and treatment programs undertaken by the Adminis-
tration and its agencies, and the report shall include a de-
tailed statement of the expenditures made for the activi-
ties reported on and the personnel used in connection with
such activities.
(B) Each report under subparagraph (A) shall include a
description of any revisions in the plan under paragraph
(2) made during the preceding 2 years.
(C) Each report under subparagraph (A) shall be sub-
mitted to the Assistant Secretary for inclusion in the bien-
nial report under subsection (m).
(f) ASSOCIATE ADMINISTRATOR FOR WOMEN’S SERVICES.—
(1) APPOINTMENT.—The Assistant Secretary, with the ap-
proval of the Secretary, shall appoint an Associate Adminis-
trator for Women’s Services who shall report directly to the As-
sistant Secretary.
(2) DUTIES.—The Associate Administrator appointed under
paragraph (1) shall—
(A) establish a committee to be known as the Coordi-
nating Committee for Women’s Services (hereafter in this
subparagraph referred to as the ‘‘Coordinating Com-
mittee’’), which shall be composed of the Directors of the
agencies of the Administration (or the designees of the Di-
rectors);
(B) acting through the Coordinating Committee, with re-
spect to women’s substance abuse and mental health serv-
ices—
(i) identify the need for such services, and make an
estimate each fiscal year of the funds needed to ade-
quately support the services;
(ii) identify needs regarding the coordination of serv-
ices;
(iii) encourage the agencies of the Administration to
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support such services; and
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(iv) assure that the unique needs of minority
women, including Native American, Hispanic, African-
American and Asian women, are recognized and ad-
dressed within the activities of the Administration;
and
(C) establish an advisory committee to be known as the
Advisory Committee for Women’s Services, which shall be
composed of not more than 10 individuals, a majority of
whom shall be women, who are not officers or employees
of the Federal Government, to be appointed by the Assist-
ant Secretary from among physicians, practitioners, treat-
ment providers, and other health professionals, whose clin-
ical practice, specialization, or professional expertise in-
cludes a significant focus on women’s substance abuse and
mental health conditions, that shall—
(i) advise the Associate Administrator on appro-
priate activities to be undertaken by the agencies of
the Administration with respect to women’s substance
abuse and mental health services, including services
which require a multidisciplinary approach;
(ii) collect and review data, including information
provided by the Secretary (including the material re-
ferred to in paragraph (3)), and report biannually to
the Assistant Secretary regarding the extent to which
women are represented among senior personnel, and
make recommendations regarding improvement in the
participation of women in the workforce of the Admin-
istration; and
(iii) prepare, for inclusion in the biennial report re-
quired pursuant to subsection (m), a description of ac-
tivities of the Committee, including findings made by
the Committee regarding—
(I) the extent of expenditures made for women’s
substance abuse and mental health services by
the agencies of the Administration; and
(II) the estimated level of funding needed for
substance abuse and mental health services to
meet the needs of women;
(D) improve the collection of data on women’s health
by—
(i) reviewing the current data at the Administration
to determine its uniformity and applicability;
(ii) developing standards for all programs funded by
the Administration so that data are, to the extent
practicable, collected and reported using common re-
porting formats, linkages and definitions; and
(iii) reporting to the Assistant Secretary a plan for
incorporating the standards developed under clause
(ii) in all Administration programs and a plan to as-
sure that the data so collected are accessible to health
professionals, providers, researchers, and members of
the public; and
(E) shall establish, maintain, and operate a program to
provide information on women’s substance abuse and men-
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tal health services.
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(3) STUDY.—
(A) The Secretary, acting through the Assistant Sec-
retary for Personnel, shall conduct a study to evaluate the
extent to which women are represented among senior per-
sonnel at the Administration.
(B) Not later than 90 days after the date of the enact-
ment of the ADAMHA Reorganization Act, the Assistant
Secretary for Personnel shall provide the Advisory Com-
mittee for Women’s Services with a study plan, including
the methodology of the study and any sampling frames.
Not later than 180 days after such date of enactment, the
Assistant Secretary shall prepare and submit directly to
the Advisory Committee a report concerning the results of
the study conducted under subparagraph (A).
(C) The Secretary shall prepare and provide to the Advi-
sory Committee for Women’s Services any additional data
as requested.
(4) OFFICE.—Nothing in this subsection shall be construed to
preclude the Secretary from establishing within the Substance
Abuse and Mental Health Administration an Office of Women’s
Health.
(5) DEFINITION.—For purposes of this subsection, the term
‘‘women’s substance abuse and mental health conditions’’, with
respect to women of all age, ethnic, and racial groups, means
all aspects of substance abuse and mental illness—
(A) unique to or more prevalent among women; or
(B) with respect to which there have been insufficient
services involving women or insufficient data.
(g) CHIEF MEDICAL OFFICER.—
(1) IN GENERAL.—The Assistant Secretary, with the approval
of the Secretary, shall appoint a Chief Medical Officer to serve
within the Administration.
(2) ELIGIBLE CANDIDATES.—The Assistant Secretary shall se-
lect the Chief Medical Officer from among individuals who—
(A) have a doctoral degree in medicine or osteopathic
medicine;
(B) have experience in the provision of mental or sub-
stance use disorder services;
(C) have experience working with mental or substance
use disorder programs;
(D) have an understanding of biological, psychosocial,
and pharmaceutical treatments of mental or substance use
disorders; and
(E) are licensed to practice medicine in one or more
States.
(3) DUTIES.—The Chief Medical Officer shall—
(A) serve as a liaison between the Administration and
providers of mental and substance use disorders preven-
tion, treatment, and recovery services;
(B) assist the Assistant Secretary in the evaluation, or-
ganization, integration, and coordination of programs oper-
ated by the Administration;
(C) promote evidence-based and promising best prac-
tices, including culturally and linguistically appropriate
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practices, as appropriate, for the prevention and treatment
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of, and recovery from, mental and substance use disorders,
including serious mental illness and serious emotional dis-
turbances;
(D) participate in regular strategic planning with the
Administration;
(E) coordinate with the Assistant Secretary for Planning
and Evaluation to assess the use of performance metrics to
evaluate activities within the Administration related to
mental and substance use disorders; and
(F) coordinate with the Assistant Secretary to ensure
mental and substance use disorders grant programs within
the Administration consistently utilize appropriate per-
formance metrics and evaluation designs.
(h) SERVICES OF EXPERTS.—
(1) IN GENERAL.—The Assistant Secretary may obtain (in ac-
cordance with section 3109 of title 5, United States Code, but
without regard to the limitation in such section on the number
of days or the period of service) the services of not more than
20 experts or consultants who have professional qualifications.
Such experts and consultants shall be obtained for the Admin-
istration and for each of its agencies.
(2) COMPENSATION AND EXPENSES.—
(A) Experts and consultants whose services are obtained
under paragraph (1) shall be paid or reimbursed for their
expenses associated with traveling to and from their as-
signment location in accordance with sections 5724,
5724a(a), 5724a(c), and 5726(c) of title 5, United States
Code.
(B) Expenses specified in subparagraph (A) may not be
allowed in connection with the assignment of an expert or
consultant whose services are obtained under paragraph
(1), unless and until the expert or consultant agrees in
writing to complete the entire period of assignment or one
year, whichever is shorter, unless separated or reassigned
for reasons beyond the control of the expert or consultant
that are acceptable to the Secretary. If the expert or con-
sultant violates the agreement, the money spent by the
United States for the expenses specified in subparagraph
(A) is recoverable from the expert or consultant as a debt
of the United States. The Secretary may waive in whole or
in part a right of recovery under this subparagraph.
(i) PEER REVIEW GROUPS.—The Assistant Secretary shall, with-
out regard to the provisions of title 5, United States Code, gov-
erning appointments in the competitive service, and without regard
to the provisions of chapter 51 and subchapter III of chapter 53 of
such title, relating to classification and General Schedule pay rates,
establish such peer review groups and program advisory commit-
tees as are needed to carry out the requirements of this title and
appoint and pay members of such groups, except that officers and
employees of the United States shall not receive additional com-
pensation for services as members of such groups. The Federal Ad-
visory Committee Act shall not apply to the duration of a peer re-
view group appointed under this subsection.
(j) VOLUNTARY SERVICES.—The Assistant Secretary may accept
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voluntary and uncompensated services.
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(k) ADMINISTRATION.—The Assistant Secretary shall ensure that
programs and activities assigned under this title to the Administra-
tion are fully administered by the respective Centers to which such
programs and activities are assigned.
(l) STRATEGIC PLAN.—
(1) IN GENERAL.—Not later than September 30, 2018, and
every 4 years thereafter, the Assistant Secretary shall develop
and carry out a strategic plan in accordance with this sub-
section for the planning and operation of activities carried out
by the Administration, including evidence-based programs.
(2) COORDINATION.—In developing and carrying out the stra-
tegic plan under this subsection, the Assistant Secretary shall
take into consideration the findings and recommendations of
the Assistant Secretary for Planning and Evaluation under sec-
tion 6021(d) of the Helping Families in Mental Health Crisis
Reform Act of 2016 and the report of the Interdepartmental
Serious Mental Illness Coordinating Committee under øsection
6031 of such Act¿ section 501B of this Act.
(3) PUBLICATION OF PLAN.—Not later than September 30,
2018, and every 4 years thereafter, the Assistant Secretary
shall—
(A) submit the strategic plan developed under paragraph
(1) to the Committee on Energy and Commerce and the
Committee on Appropriations of the House of Representa-
tives and the Committee on Health, Education, Labor, and
Pensions and the Committee on Appropriations of the Sen-
ate; and
(B) post such plan on the Internet website of the Admin-
istration.
(4) CONTENTS.—The strategic plan developed under para-
graph (1) shall—
(A) identify strategic priorities, goals, and measurable
objectives for mental and substance use disorders activities
and programs operated and supported by the Administra-
tion, including priorities to prevent or eliminate the bur-
den of mental and substance use disorders;
(B) identify ways to improve the quality of services for
individuals with mental and substance use disorders, and
to reduce homelessness, arrest, incarceration, violence, in-
cluding self-directed violence, and unnecessary hospitaliza-
tion of individuals with a mental or substance use dis-
order, including adults with a serious mental illness or
children with a serious emotional disturbance;
(C) ensure that programs provide, as appropriate, access
to effective and evidence-based prevention, diagnosis,
intervention, treatment, and recovery services, including
culturally and linguistically appropriate services, as appro-
priate, for individuals with a mental or substance use dis-
order;
(D) identify opportunities to collaborate with the Health
Resources and Services Administration to develop or im-
prove—
(i) initiatives to encourage individuals to pursue ca-
reers (especially in rural and underserved areas and
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with rural and underserved populations) as psychia-
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trists, including child and adolescent psychiatrists,
psychologists, psychiatric nurse practitioners, physi-
cian assistants, clinical social workers, certified peer
support specialists, licensed professional counselors, or
other licensed or certified mental health or substance
use disorder professionals, including such profes-
sionals specializing in the diagnosis, evaluation, or
treatment of adults with a serious mental illness or
children with a serious emotional disturbance; and
(ii) a strategy to improve the recruitment, training,
and retention of a workforce for the treatment of indi-
viduals with mental or substance use disorders, or co-
occurring disorders;
(E) identify opportunities to improve collaboration with
States, local governments, communities, and Indian tribes
and tribal organizations (as such terms are defined in sec-
tion 4 of the Indian Self-Determination and Education As-
sistance Act); and
(F) specify a strategy to disseminate evidence-based and
promising best practices related to prevention, diagnosis,
early intervention, treatment, and recovery services re-
lated to mental illness, particularly for adults with a seri-
ous mental illness and children with a serious emotional
disturbance, and for individuals with a substance use dis-
order.
(m) BIENNIAL REPORT CONCERNING ACTIVITIES AND PROGRESS.—
Not later than September 30, 2020, and every 2 years thereafter,
the Assistant Secretary shall prepare and submit to the Committee
on Energy and Commerce and the Committee on Appropriations of
the House of Representatives and the Committee on Health, Edu-
cation, Labor, and Pensions and the Committee on Appropriations
of the Senate, and post on the Internet website of the Administra-
tion, a report containing at a minimum—
(1) a review of activities conducted or supported by the Ad-
ministration, including progress toward strategic priorities,
goals, and objectives identified in the strategic plan developed
under subsection (l);
(2) an assessment of programs and activities carried out by
the Assistant Secretary, including the extent to which pro-
grams and activities under this title and part B of title XIX
meet identified goals and performance measures developed for
the respective programs and activities;
(3) a description of the progress made in addressing gaps in
mental and substance use disorders prevention, treatment, and
recovery services and improving outcomes by the Administra-
tion, including with respect to serious mental illnesses, serious
emotional disturbances, and co-occurring disorders;
(4) a description of the manner in which the Administration
coordinates and partners with other Federal agencies and de-
partments related to mental and substance use disorders, in-
cluding activities related to—
(A) the implementation and dissemination of research
findings into improved programs, including with respect to
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how advances in serious mental illness and serious emo-
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tional disturbance research have been incorporated into
programs;
(B) the recruitment, training, and retention of a mental
and substance use disorders workforce;
(C) the integration of mental disorder services, sub-
stance use disorder services, and physical health services;
(D) homelessness; and
(E) veterans;
(5) a description of the manner in which the Administration
promotes coordination by grantees under this title, and part B
of title XIX, with State or local agencies; and
(6) a description of the activities carried out under section
501A(e), with respect to mental and substance use disorders,
including—
(A) the number and a description of grants awarded;
(B) the total amount of funding for grants awarded;
(C) a description of the activities supported through such
grants, including outcomes of programs supported; and
(D) information on how the National Mental Health and
Substance Use Policy Laboratory is consulting with the As-
sistant Secretary for Planning and Evaluation and collabo-
rating with the Center for Substance Abuse Treatment,
the Center for Substance Abuse Prevention, the Center for
Behavioral Health Statistics and Quality, and the Center
for Mental Health Services to carry out such activities; and
(7) recommendations made by the Assistant Secretary for
Planning and Evaluation under section 6021 of the Helping
Families in Mental Health Crisis Reform Act of 2016 to im-
prove programs within the Administration, and actions taken
in response to such recommendations to improve programs
within the Administration.
The Assistant Secretary may meet reporting requirements estab-
lished under this title by providing the contents of such reports as
an addendum to the biennial report established under this sub-
section, notwithstanding the timeline of other reporting require-
ments in this title. Nothing in this subsection shall be construed
to alter the content requirements of such reports or authorize the
Assistant Secretary to alter the timeline of any such reports to be
less frequent than biennially, unless as specified in this title.
(n) APPLICATIONS FOR GRANTS AND CONTRACTS.—With respect to
awards of grants, cooperative agreements, and contracts under this
title, the Assistant Secretary, or the Director of the Center in-
volved, as the case may be, may not make such an award unless—
(1) an application for the award is submitted to the official
involved;
(2) with respect to carrying out the purpose for which the
award is to be provided, the application provides assurances of
compliance satisfactory to such official; and
(3) the application is otherwise in such form, is made in such
manner, and contains such agreements, assurances, and infor-
mation as the official determines to be necessary to carry out
the purpose for which the award is to be provided.
(o) EMERGENCY RESPONSE.—
(1) IN GENERAL.—Notwithstanding section 504 and except as
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provided in paragraph (2), the Secretary may use not to exceed
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2.5 percent of all amounts appropriated under this title for a
fiscal year to make noncompetitive grants, contracts or cooper-
ative agreements to public entities to enable such entities to
address emergency substance abuse or mental health needs in
local communities.
(2) EXCEPTIONS.—Amounts appropriated under part C shall
not be subject to paragraph (1).
(3) EMERGENCIES.—The Secretary shall establish criteria for
determining that a substance abuse or mental health emer-
gency exists and publish such criteria in the Federal Register
prior to providing funds under this subsection.
(4) EMERGENCY RESPONSE.—Amounts made available for car-
rying out this subsection shall remain available through the
end of the fiscal year following the fiscal year for which such
amounts are appropriated.
(p) LIMITATION ON THE USE OF CERTAIN INFORMATION.—No infor-
mation, if an establishment or person supplying the information or
described in it is identifiable, obtained in the course of activities
undertaken or supported under section 505 may be used for any
purpose other than the purpose for which it was supplied unless
such establishment or person has consented (as determined under
regulations of the Secretary) to its use for such other purpose. Such
information may not be published or released in other form if the
person who supplied the information or who is described in it is
identifiable unless such person has consented (as determined under
regulations of the Secretary) to its publication or release in other
form.
(q) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of pro-
viding grants, cooperative agreements, and contracts under this
section, there are authorized to be appropriated $25,000,000 for fis-
cal year 2001, and such sums as may be necessary for each of the
fiscal years 2002 and 2003.
SEC. 501A. NATIONAL MENTAL HEALTH AND SUBSTANCE USE POLICY
LABORATORY.
(a) IN GENERAL.—There shall be established within the Adminis-
tration a National Mental Health and Substance Use Policy Lab-
oratory (referred to in this section as the ‘‘Laboratory’’).
(b) RESPONSIBILITIES.—The Laboratory shall—
(1) continue to carry out the authorities and activities that
were in effect for the Office of Policy, Planning, and Innovation
as such Office existed prior to the date of enactment of the
Helping Families in Mental Health Crisis Reform Act of 2016;
(2) identify, coordinate, and facilitate the implementation of
policy changes likely to have a significant effect on mental
health, mental illness, recovery supports, and the prevention
and treatment of substance use disorder services;
(3) work with the Center for Behavioral Health Statistics
and Quality to collect, as appropriate, information from grant-
ees under programs operated by the Administration in order to
evaluate and disseminate information on evidence-based prac-
tices, including culturally and linguistically appropriate serv-
ices, as appropriate, and service delivery models;
(4) provide leadership in identifying and coordinating policies
and programs, including evidence-based programs, related to
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mental and substance use disorders;
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(5) periodically review programs and activities operated by
the Administration relating to the diagnosis or prevention of,
treatment for, and recovery from, mental and substance use
disorders to—
(A) identify any such programs or activities that are du-
plicative;
(B) identify any such programs or activities that are not
evidence-based, effective, or efficient; and
(C) formulate recommendations for coordinating, elimi-
nating, or improving programs or activities identified
under subparagraph (A) or (B) and merging such programs
or activities into other successful programs or activities;
(6) issue and periodically update information for entities ap-
plying for grants or cooperative agreements from the Sub-
stance Abuse and Mental Health Services Administration in
order to—
(A) encourage the implementation and replication of evi-
dence-based practices; and
(B) provide technical assistance to applicants for fund-
ing, including with respect to justifications for such pro-
grams and activities; and
(7) carry out other activities as deemed necessary to continue
to encourage innovation and disseminate evidence-based pro-
grams and practices.
(c) EVIDENCE-BASED PRACTICES AND SERVICE DELIVERY MOD-
ELS.—
(1) IN GENERAL.—In carrying out subsection (b)(3), the Lab-
oratory—
(A) may give preference to models that improve—
(i) the coordination between mental health and
physical health providers;
(ii) the coordination among such providers and the
justice and corrections system; and
(iii) the cost effectiveness, quality, effectiveness, and
efficiency of health care services furnished to adults
with a serious mental illness, children with a serious
emotional disturbance, or individuals in a mental
health crisis; and
(B) may include clinical protocols and practices that ad-
dress the needs of individuals with early serious mental
illness.
(2) CONSULTATION.—In carrying out this section, the Labora-
tory shall consult with—
(A) the Chief Medical Officer appointed under section
501(g);
(B) representatives of the National Institute of Mental
Health, the National Institute on Drug Abuse, and the Na-
tional Institute on Alcohol Abuse and Alcoholism, on an
ongoing basis;
(C) other appropriate Federal agencies;
(D) clinical and analytical experts with expertise in psy-
chiatric medical care and clinical psychological care, health
care management, education, corrections health care, and
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mental health court systems, as appropriate; and
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(E) other individuals and agencies as determined appro-
priate by the Assistant Secretary.
(d) DEADLINE FOR BEGINNING IMPLEMENTATION.—The Laboratory
shall begin implementation of this section not later than January
1, 2018.
(e) PROMOTING INNOVATION.—
(1) IN GENERAL.—The Assistant Secretary, in coordination
with the Laboratory, may award grants to States, local govern-
ments, øIndian tribes or tribal organizations¿ Indian Tribes or
Tribal organizations (as such terms are defined in section 4 of
the Indian Self-Determination and Education Assistance Act),
educational institutions, and nonprofit organizations to develop
evidence-based interventions, including culturally and linguis-
tically appropriate services, as appropriate, for—
(A) evaluating a model that has been scientifically dem-
onstrated to show promise, but would benefit from further
applied development, for—
(i) enhancing the prevention, diagnosis, intervention,
and treatment of, and recovery from, mental illness,
serious emotional disturbances, substance use dis-
orders, and co-occurring illness or disorders; or
(ii) integrating or coordinating physical health serv-
ices and mental and substance use disorders services;
and
(B) expanding, replicating, or scaling evidence-based pro-
grams across a wider area to enhance effective screening,
early diagnosis, intervention, and treatment with respect
to mental illness, serious mental illness, serious emotional
disturbances, and substance use disorders, primarily by—
(i) applying such evidence-based programs to the de-
livery of care, including by training staff in effective
evidence-based treatments; or
(ii) integrating such evidence-based programs into
models of care across specialties and jurisdictions.
(2) CONSULTATION.—In awarding grants under this sub-
section, the Assistant Secretary shall, as appropriate, consult
with the Chief Medical Officer, appointed under section 501(g),
the advisory councils described in section 502, the National In-
stitute of Mental Health, the National Institute on Drug
Abuse, and the National Institute on Alcohol Abuse and Alco-
holism, as appropriate.
ø(3) AUTHORIZATION OF APPROPRIATIONS.—There are author-
ized to be appropriated—
ø(A) to carry out paragraph (1)(A), $7,000,000 for the pe-
riod of fiscal years 2018 through 2020; and
ø(B) to carry out paragraph (1)(B), $7,000,000 for the pe-
riod of fiscal years 2018 through 2020.¿
(f) AUTHORIZATION OF APPROPRIATIONS.—To carry out this sec-
tion, there is authorized to be appropriated $10,000,000 for each of
fiscal years 2023 through 2027.
SEC. 501B. INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS COORDI-
NATING COMMITTEE.
(a) ESTABLISHMENT.—
(1) IN GENERAL.—The Secretary of Health and Human Serv-
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ices, or the designee of the Secretary, shall establish a com-
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mittee to be known as the Interdepartmental Serious Mental Ill-
ness Coordinating Committee (in this section referred to as the
‘‘Committee’’).
(2) FEDERAL ADVISORY COMMITTEE ACT.—Except as provided
in this section, the provisions of the Federal Advisory Com-
mittee Act (5 U.S.C. App.) shall apply to the Committee.
(b) MEETINGS.—The Committee shall meet not fewer than 2 times
each year.
(c) RESPONSIBILITIES.—The Committee shall submit, on a bian-
nual basis, to Congress and any other relevant Federal department
or agency a report including—
(1) a summary of advances in serious mental illness and seri-
ous emotional disturbance research related to the prevention of,
diagnosis of, intervention in, and treatment and recovery of se-
rious mental illnesses, serious emotional disturbances, and ad-
vances in access to services and support for adults with a seri-
ous mental illness or children with a serious emotional disturb-
ance;
(2) an evaluation of the effect Federal programs related to se-
rious mental illness have on public health, including public
health outcomes such as—
(A) rates of suicide, suicide attempts, incidence and prev-
alence of serious mental illnesses, serious emotional dis-
turbances, and substance use disorders, overdose, overdose
deaths, emergency hospitalizations, emergency room board-
ing, preventable emergency room visits, interaction with the
criminal justice system, homelessness, and unemployment;
(B) increased rates of employment and enrollment in edu-
cational and vocational programs;
(C) quality of mental and substance use disorders treat-
ment services; or
(D) any other criteria as may be determined by the Sec-
retary; and
(3) specific recommendations for actions that agencies can
take to better coordinate the administration of mental health
services for adults with a serious mental illness or children
with a serious emotional disturbance.
(d) MEMBERSHIP.—
(1) FEDERAL MEMBERS.—The Committee shall be composed of
the following Federal representatives, or the designees of such
representatives—
(A) the Secretary of Health and Human Services, who
shall serve as the Chair of the Committee;
(B) the Assistant Secretary for Mental Health and Sub-
stance Use;
(C) the Attorney General;
(D) the Secretary of Veterans Affairs;
(E) the Secretary of Defense;
(F) the Secretary of Housing and Urban Development;
(G) the Secretary of Education;
(H) the Secretary of Labor;
(I) the Administrator of the Centers for Medicare & Med-
icaid Services; and
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(J) the Commissioner of Social Security.
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(2) NON-FEDERAL MEMBERS.—The Committee shall also in-
clude not less than 14 non-Federal public members appointed
by the Secretary of Health and Human Services, of which—
(A) at least 2 members shall be an individual who has
received treatment for a diagnosis of a serious mental ill-
ness;
(B) at least 1 member shall be a parent or legal guardian
of an adult with a history of a serious mental illness or a
child with a history of a serious emotional disturbance;
(C) at least 1 member shall be a representative of a lead-
ing research, advocacy, or service organization for adults
with a serious mental illness;
(D) at least 2 members shall be—
(i) a licensed psychiatrist with experience in treating
serious mental illnesses;
(ii) a licensed psychologist with experience in treating
serious mental illnesses or serious emotional disturb-
ances;
(iii) a licensed clinical social worker with experience
treating serious mental illnesses or serious emotional
disturbances; or
(iv) a licensed psychiatric nurse, nurse practitioner,
or physician assistant with experience in treating seri-
ous mental illnesses or serious emotional disturbances;
(E) at least 1 member shall be a licensed mental health
professional with a specialty in treating children and ado-
lescents with a serious emotional disturbance;
(F) at least 1 member shall be a mental health profes-
sional who has research or clinical mental health experi-
ence in working with minorities;
(G) at least 1 member shall be a mental health profes-
sional who has research or clinical mental health experi-
ence in working with medically underserved populations;
(H) at least 1 member shall be a State certified mental
health peer support specialist;
(I) at least 1 member shall be a judge with experience in
adjudicating cases related to criminal justice or serious
mental illness;
(J) at least 1 member shall be a law enforcement officer
or corrections officer with extensive experience in inter-
facing with adults with a serious mental illness, children
with a serious emotional disturbance, or individuals in a
mental health crisis; and
(K) at least 1 member shall have experience providing
services for homeless individuals and working with adults
with a serious mental illness, children with a serious emo-
tional disturbance, or individuals in a mental health crisis.
(3) TERMS.—A member of the Committee appointed under
paragraph (2) shall serve for a term of 3 years, and may be re-
appointed for 1 or more additional 3-year terms. Any member
appointed to fill a vacancy for an unexpired term shall be ap-
pointed for the remainder of such term. A member may serve
after the expiration of the member’s term until a successor has
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(e) WORKING GROUPS.—In carrying out its functions, the Com-
mittee may establish working groups. Such working groups shall be
composed of Committee members, or their designees, and may hold
such meetings as are necessary.
(f) SUNSET.—The Committee shall terminate on September 30,
2027.
* * * * * * *
SEC. 506. GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.
(a) IN GENERAL.—The Secretary shall award grants, contracts
and cooperative agreements to community-based public and private
nonprofit entities for the purposes of providing mental health and
substance use disorder services for homeless individuals. In car-
rying out this section, the Secretary shall consult with the Inter-
agency Council on the Homeless, established under section 201 of
the Stewart B. McKinney Homeless Assistance Act (42 U.S.C.
11311).
(b) PREFERENCES.—In awarding grants, contracts, and coopera-
tive agreements under subsection (a), the Secretary shall give a
preference to—
(1) entities that provide integrated primary health, sub-
stance use disorder, and mental health services to homeless in-
dividuals;
(2) entities that demonstrate effectiveness in serving run-
away, homeless, and street youth;
(3) entities that have experience in providing substance use
disorder and mental health services to homeless individuals;
(4) entities that demonstrate experience in providing housing
for individuals in treatment for or in recovery from mental ill-
ness or a substance use disorder; and
(5) entities that demonstrate effectiveness in serving home-
less veterans.
(c) SERVICES FOR CERTAIN INDIVIDUALS.—In awarding grants,
contracts, and cooperative agreements under subsection (a), the
Secretary shall not—
(1) prohibit the provision of services under such subsection
to homeless individuals who are suffering from a substance use
disorder and are not suffering from a mental health disorder;
and
(2) make payments under subsection (a) to any entity that
has a policy of—
(A) excluding individuals from mental health services
due to the existence or suspicion of a substance use dis-
order; or
(B) has a policy of excluding individuals from substance
use disorder services due to the existence or suspicion of
mental illness.
(d) TERM OF THE AWARDS.—No entity may receive a grant, con-
tract, or cooperative agreement under subsection (a) for more than
5 years.
(e) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to
be appropriated to carry out this section$41,304,000 for each of fis-
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cal years ø2018 through 2022¿ 2023 through 2027.
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øSEC. 506A. ALCOHOL AND DRUG PREVENTION OR TREATMENT SERV-
ICES FOR INDIANS AND NATIVE ALASKANS.
ø(a) IN GENERAL.—The Secretary shall award grants, contracts,
or cooperative agreements to public and private nonprofit entities,
including Native Alaskan entities and Indian tribes and tribal or-
ganizations, for the purpose of providing alcohol and drug preven-
tion or treatment services for Indians and Native Alaskans.
ø(b) PRIORITY.—In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall give priority
to applicants that—
ø(1) propose to provide alcohol and drug prevention or treat-
ment services on reservations;
ø(2) propose to employ culturally-appropriate approaches, as
determined by the Secretary, in providing such services; and
ø(3) have provided prevention or treatment services to Na-
tive Alaskan entities and Indian tribes and tribal organizations
for at least 1 year prior to applying for a grant under this sec-
tion.
ø(c) DURATION.—The Secretary shall award grants, contracts, or
cooperative agreements under subsection (a) for a period not to ex-
ceed 5 years.
ø(d) APPLICATION.—An entity desiring a grant, contract, or coop-
erative agreement under subsection (a) shall submit an application
to the Secretary at such time, in such manner, and accompanied
by such information as the Secretary may reasonably require.
ø(e) EVALUATION.—An entity that receives a grant, contract, or
cooperative agreement under subsection (a) shall submit, in the ap-
plication for such grant, a plan for the evaluation of any project un-
dertaken with funds provided under this section. Such entity shall
provide the Secretary with periodic evaluations of the progress of
such project and such evaluation at the completion of such project
as the Secretary determines to be appropriate. The final evaluation
submitted by such entity shall include a recommendation as to
whether such project shall continue.
ø(f) REPORT.—Not later than 3 years after the date of the enact-
ment of this section and annually thereafter, the Secretary shall
prepare and submit, to the Committee on Health, Education,
Labor, and Pensions of the Senate, a report describing the services
provided pursuant to this section.
ø(g) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section, $15,000,000 for fiscal
year 2001, and such sums as may be necessary for fiscal years 2002
and 2003.¿
SEC. 506A. BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER
SERVICES FOR NATIVE AMERICANS.
(a) DEFINITIONS.—In this section:
(1) The term ‘‘eligible entity’’ means an Indian Tribe, a Tribal
organization, an Urban Indian organization, and a Native Ha-
waiian health organization.
(2) The terms ‘‘Indian Tribe’’, ‘‘Tribal organization’’, and
‘‘Urban Indian organization’’ have the meanings given to the
terms ‘‘Indian tribe’’, ‘‘tribal organization’’, and ‘‘Urban Indian
organization’’ in section 4 of the Indian Health Care Improve-
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ment Act.
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(3) The term ‘‘Native Hawaiian health organization’’ means
‘‘Papa Ola Lokahi’’ as defined in section 12 of the Native Ha-
waiian Health Care Improvement Act.
(b) FORMULA FUNDS.—
(1) IN GENERAL.—The Secretary, in consultation with the Di-
rector of the Indian Health Service, as appropriate, shall award
funds to eligible entities, in amounts determined pursuant to
the formula described in paragraph (2), to be used by the eligi-
ble entity to provide culturally appropriate mental health and
substance use disorder prevention, treatment, and recovery serv-
ices to American Indians, Alaska Natives, and Native Hawai-
ians.
(2) FORMULA.—The Secretary, using the process described in
subsection (d), shall develop a formula to determine the amount
of an award under paragraph (1). Such formula shall take into
account the populations of eligible entities whose rates of over-
dose deaths or suicide are substantially higher relative to the
populations of other Indian Tribes, Tribal organizations, Urban
Indian organizations, or Native Hawaiian health organizations,
as applicable.
(c) TECHNICAL ASSISTANCE AND PROGRAM EVALUATION.—
(1) IN GENERAL.—The Secretary shall—
(A) provide technical assistance to applicants and award-
ees under this section; and
(B) collect and evaluate information on the program car-
ried out under this section.
(2) CONSULTATION ON EVALUATION MEASURES, AND DATA SUB-
MISSION AND REPORTING REQUIREMENTS.—The Secretary shall,
using the process described in subsection (d), develop evaluation
measures and data submission and reporting requirements for
purposes of the collection and evaluation of information.
(3) DATA SUBMISSION AND REPORTING.—As a condition on re-
ceipt of funds under this section, an applicant shall agree to
submit data and reports in a timely manner consistent with the
evaluation measures and data submission and reporting re-
quirements developed under subsection (d).
(d) REGULATIONS.—
(1) PROMULGATION.—Not later than 180 days after the date
of enactment of the Restoring Hope for Mental Health and Well-
Being Act of 2022, the Secretary shall initiate procedures under
subchapter III of chapter 5 of title 5, United States Code, to ne-
gotiate and promulgate such regulations as are necessary to
carry out this section, including development of the funding for-
mula described in subsection (b) and the program evaluation
and reporting requirements under subsection (c).
(2) PUBLICATION.—Not later than 18 months after the date of
enactment of the Restoring Hope for Mental Health and Well-
Being Act of 2022, the Secretary shall publish in the Federal
Register proposed regulations to implement this section.
(3) COMMITTEE.—A negotiated rulemaking committee estab-
lished pursuant to section 565 of title 5, United States Code, to
carry out this subsection shall have as its members only rep-
resentatives of the Federal Government, Tribal Governments,
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and Urban Indian organizations. For purposes of such rule-
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making, the Indian Health Service shall be the lead agency for
the Department.
(4) ADAPTATION OF PROCEDURES.—In carrying out this sub-
section, the Secretary shall adapt any negotiated rulemaking
procedures to the unique context of the government-to-govern-
ment relationship between the United States and Indian Tribes.
(5) EFFECT.—The lack of promulgated regulations under this
subsection shall not limit the effect or implementation of this
section.
(e) APPLICATION.—An entity desiring an award under subsection
(b) shall submit an application to the Secretary at such time, in
such manner, and accompanied by such information as the Sec-
retary may reasonably require.
(f) REPORT.—Not later than 3 years after the date of the enact-
ment of the Restoring Hope for Mental Health and Well-Being Act
of 2022, and annually thereafter, the Secretary shall prepare and
submit, to the Committee on Health, Education, Labor, and Pen-
sions of the Senate, and the Committee on Energy and Commerce
of the House of Representatives, a report describing the services pro-
vided pursuant to this section.
(g) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to
be appropriated to carry out this section, $40,000,000 for each of fis-
cal years 2023 through 2027.
SEC. 506B. BEHAVIORAL HEALTH CRISIS COORDINATING OFFICE.
(a) IN GENERAL.—The Secretary shall establish, within the Sub-
stance Abuse and Mental Health Services Administration, an office
to coordinate work relating to behavioral health crisis care across
the operating divisions and agencies of the Department of Health
and Human Services, including the Substance Abuse and Mental
Health Services Administration, the Centers for Medicare & Med-
icaid Services, and the Health Resources and Services Administra-
tion, and external stakeholders.
(b) DUTY.—The office established under subsection (a) shall—
(1) convene Federal, State, Tribal, local, and private partners;
(2) launch and manage Federal workgroups charged with
making recommendations regarding behavioral health crisis
issues, including with respect to health care best practices,
workforce development, mental health disparities, data collec-
tion, technology, program oversight, public awareness, and en-
gagement; and
(3) support technical assistance, data analysis, and evalua-
tion functions in order to assist States, localities, Territories,
Tribes, and Tribal communities to develop crisis care systems
and establish nationwide best practices with the objective of ex-
panding the capacity of, and access to, local crisis call centers,
mobile crisis care, crisis stabilization, psychiatric emergency
services, and rapid post-crisis follow-up care provided by—
(A) the National Suicide Prevention and Mental Health
Crisis Hotline and Response System;
(B) community mental health centers (as defined in sec-
tion 1861(ff)(3)(B) of the Social Security Act);
(C) certified community behavioral health clinics, as de-
scribed in section 223 of the Protecting Access to Medicare
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Act of 2014; and
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(D) other community mental health and substance use
disorder providers.
(c) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to
be appropriated to carry out this section $5,000,000 for each of fis-
cal years 2023 through 2027.
PART B—CENTERS AND PROGRAMS
Subpart 1—Center for Substance Abuse Treatment
* * * * * * *
SEC. 509. PRIORITY SUBSTANCE øABUSE¿ USE DISORDER TREATMENT
NEEDS OF REGIONAL AND NATIONAL SIGNIFICANCE.
(a) PROJECTS.—The Secretary shall address priority substance
use disorder treatment needs of regional and national significance
(as determined under subsection (b)) through the provision of or
through assistance for—
(1) knowledge development and application projects for treat-
ment and rehabilitation and the conduct or support of evalua-
tions of such projects;
(2) training and technical assistance; and
(3) targeted capacity response programs that permit States,
local governments, communities, and Indian øtribes and tribal
organizations (as the terms ‘‘Indian tribes’’ and ‘‘tribal organi-
zations’’ are defined¿ Tribes and Tribal organizations (as such
terms are defined in section 4 of the Indian Self-Determination
and Education Assistance Act) to focus on emerging trends øin
substance abuse¿ and co-occurrence of substance use disorders
with mental illness or other conditions.
The Secretary may carry out the activities described in this section
directly or through grants, contracts, or cooperative agreements
with States, political subdivisions of States, Indian tribes or tribal
organizations (as such terms are defined in section 4 of the Indian
Self-Determination and Education Assistance Act), health facilities,
or programs operated by or in accordance with a contract or grant
with the Indian Health Service, or other public or nonprofit private
entities.
(b) PRIORITY SUBSTANCE øABUSE¿ USE DISORDER TREATMENT
NEEDS.—
(1) IN GENERAL.—Priority substance use disorder treatment
needs of regional and national significance shall be determined
by the Secretary after consultation with States and other inter-
ested groups. The Secretary shall meet with the States and in-
terested groups on an annual basis to discuss program prior-
ities.
(2) SPECIAL CONSIDERATION.—In developing program prior-
ities under paragraph (1), the Secretary shall give special con-
sideration to promoting the integration of substance use dis-
order treatment services into primary health care systems.
(c) REQUIREMENTS.—
(1) IN GENERAL.—Recipients of grants, contracts, or coopera-
tive agreements under this section shall comply with informa-
tion and application requirements determined appropriate by
the Secretary.
(2) DURATION OF AWARD.—With respect to a grant, contract,
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or cooperative agreement awarded under this section, the pe-
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riod during which payments under such award are made to the
recipient may not exceed 5 years.
(3) MATCHING FUNDS.—The Secretary may, for projects car-
ried out under subsection (a), require that entities that apply
for grants, contracts, or cooperative agreements under that
project provide non-Federal matching funds, as determined ap-
propriate by the Secretary, to ensure the institutional commit-
ment of the entity to the projects funded under the grant, con-
tract, or cooperative agreement. Such non-Federal matching
funds may be provided directly or through donations from pub-
lic or private entities and may be in cash or in kind, fairly
evaluated, including plant, equipment, or services.
(4) MAINTENANCE OF EFFORT.—With respect to activities for
which a grant, contract, or cooperative agreement is awarded
under this section, the Secretary may require that recipients
for specific projects under subsection (a) agree to maintain ex-
penditures of non-Federal amounts for such activities at a level
that is not less than the level of such expenditures maintained
by the entity for the fiscal year preceding the fiscal year for
which the entity receives such a grant, contract, or cooperative
agreement.
(d) EVALUATION.—The Secretary shall evaluate each project car-
ried out under subsection (a)(1) and shall disseminate the findings
with respect to each such evaluation to appropriate public and pri-
vate entities.
(e) INFORMATION AND EDUCATION.—The Secretary shall establish
comprehensive information and education programs to disseminate
and apply the findings of the knowledge development and applica-
tion, training and technical assistance programs, and targeted ca-
pacity response programs under this section to the general public,
to health professionals and other interested groups. The Secretary
shall make every effort to provide linkages between the findings of
supported projects and State agencies responsible for carrying out
substance use disorder prevention and treatment programs.
(f) AUTHORIZATION OF APPROPRIATION.—There are authorized to
be appropriated to carry out this section, ø$333,806,000 for each of
fiscal years 2018 through 2022¿ $521,517,000 for each of fiscal
years 2023 through 2027.
* * * * * * *
SEC. 514. SUBSTANCE USE DISORDER TREATMENT AND EARLY INTER-
VENTION SERVICES FOR CHILDREN, ADOLESCENTS, AND
YOUNG ADULTS.
(a) IN GENERAL.—The Secretary shall award grants, contracts, or
cooperative agreements to public and private nonprofit entities, in-
cluding øIndian tribes or tribal organizations¿ Indian Tribes or
Tribal organizations (as such terms are defined in section 4 of the
Indian Self-Determination and Education Assistance Act), or health
facilities or programs operated by or in accordance with a contract
or grant with the Indian Health Service, for the purpose of—
(1) providing early identification and services to meet the
needs of children, adolescents, and young adults who are at
risk of substance use disorders;
(2) providing substance use disorder treatment services for
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children, adolescents, and young adults, includingchildren, ado-
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lescents, and young adults with co-occurring mental illness and
substance use disorders; and
(3) providing assistance to pregnant women, and parenting
women, with substance use disorders, in obtaining treatment
services, linking mothers to community resources to support
independent family lives, and staying in recovery so that chil-
dren are in safe, stable home environments and receive appro-
priate health care services.
(b) PRIORITY.—In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall give priority
to applicants who propose to—
(1) apply evidence-based and cost-effective methods;
(2) coordinate the provision of services with other social serv-
ice agencies in the community, including educational, juvenile
justice, child welfare, substance abuse, and mental health
agencies;
(3) provide a continuum of integrated treatment services, in-
cluding case management, for children, adolescents, and young
adults with substance use disorders, including children, adoles-
cents, and young adults with co-occurring mental illness and
substance use disorders, and their families;
(4) provide treatment that is gender-specific and culturally
appropriate;
(5) involve and work with families of children, adolescents,
and young adults receiving services; and
(6) provide aftercare services for children, adolescents, and
young adults and their families after completion of treatment.
(c) DURATION OF GRANTS.—The Secretary shall award grants,
contracts, or cooperative agreements under subsection (a) for peri-
ods not to exceed 5 fiscal years.
(d) APPLICATION.—An entity desiring a grant, contract, or cooper-
ative agreement under subsection (a) shall submit an application to
the Secretary at such time, in such manner, and accompanied by
such information as the Secretary may reasonably require.
(e) EVALUATION.—An entity that receives a grant, contract, or co-
operative agreement under subsection (a) shall submit, in the ap-
plication for such grant, contract, or cooperative agreement, a plan
for the evaluation of any project undertaken with funds provided
under this section. Such entity shall provide the Secretary with
periodic evaluations of the progress of such project and such eval-
uation at the completion of such project as the Secretary deter-
mines to be appropriate.
(f) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to
be appropriated to carry out this section, $29,605,000 for each of
fiscal years ø2018 through 2022¿ 2023 through 2027.
SEC. 514B. EVIDENCE-BASED PRESCRIPTION OPIOID AND HEROIN
TREATMENT AND INTERVENTIONS DEMONSTRATION.
(a) GRANTS TO EXPAND ACCESS.—
(1) AUTHORITY TO AWARD GRANTS.—The Secretary shall
award grants, contracts, or cooperative agreements to State
øsubstance abuse¿ substance use disorder agencies, units of
local government, nonprofit organizations, and Indian øtribes
and tribal organizations¿ Tribes and Tribal organizations (as
defined in section 4 of the Indian Self-Determination and Edu-
dlhill on DSK120RN23PROD with HEARING
cation Assistance Act) that have a high rate, or have had a
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