[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2207 Introduced in House (IH)]

  1st Session
                                H. R. 2207

     To provide for substance abuse and mental health performance 
                 partnerships, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 4, 1995

 Mr. Dingell (for himself and Mr. Waxman) (both by request) introduced 
  the following bill; which was referred to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
     To provide for substance abuse and mental health performance 
                 partnerships, and for other purposes.
    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE AND REFERENCES IN ACT.

    (a) Short Title.--This Act may be cited as the ``Substance Abuse 
and Mental Health Performance Partnership Act of 1995''.
    (b) References in Act.--The amendments in this Act apply to the 
Public Health Service Act unless otherwise specifically stated.

                         TITLE I--MENTAL HEALTH

SEC. 101. REPLACEMENT OF STATE PLAN PROGRAM WITH PERFORMANCE 
              PARTNERSHIPS.

    (a) Elimination of State Plan Program Requirements.--Subpart I of 
part B of title XIX is amended by striking sections 1911 (concerning 
formula grants to States), 1912 (concerning State plans for community 
mental health services), and 1913 (concerning services for children and 
community programs).
    (b) Performance Partnership Framework.--Subpart I of part B of 
title XIX is further amended by inserting after the subpart heading the 
following new sections:

``SEC. 1911. PERFORMANCE PARTNERSHIP GOALS AND OBJECTIVES.

    ``(a) Goals.--The goals of this subpart are for the States and the 
Federal Government, working together in a partnership, to improve the 
quality of life of adults with serious mental illness and children with 
a serious emotional disturbance, and to improve the overall mental 
health of the Nation, by--
            ``(1) promoting access to comprehensive community mental 
        health services for adults with serious mental illness and 
        children with a serious emotional disturbance; and
            ``(2) increasing development of systems of integrated 
        comprehensive community based services for adults with serious 
        mental illness and children with a serious emotional 
        disturbance.
    ``(b) Performance Partnership Objectives.--
            ``(1) The Secretary, in consultation with the States, local 
        governments, Indian tribes, and other interested parties 
        designated by the Secretary (including consumers and relatives 
        of consumers), shall specify by the end of September 1996 (and 
        from time to time revise, as needed)--
                    ``(A) a list of performance partnership objectives 
                to carry out the goals of this subpart, and
                    ``(B) a core set of not more than five of those 
                objectives that address mental health problems of 
                national significance.
            ``(2) Each performance partnership objective shall 
        include--
                    ``(A) a performance indicator;
                    ``(B) the specific population being addressed;
                    ``(C) a quantifiable performance target; and
                    ``(D) a date by which the target level is to be 
                achieved.
            ``(3) In specifying the performance partnership objectives, 
        the Secretary shall be guided by the following principles--
                    ``(A) objectives should be closely related to the 
                goals of this subpart, and be viewed as important by 
                and understandable to State policymakers and the 
                general public;
                    ``(B) actions taken under the partnership agreement 
                should be expected to have an impact on the objective;
                    ``(C) measurable progress in achieving the 
                objective should be expected over the period of the 
                grant;
                    ``(D) objectives should be result-oriented, 
                including a mix of outcome, process and capacity 
                measures, and, if an objective measures process or 
                capacity, it should be demonstrably linked to the 
                achievement of a health outcome; and
                    ``(E) data to track the objective should, to the 
                extent practicable, be comparable for all grant 
                recipients, meet reasonable statistical standards for 
                quality, and be available in a timely fashion, at 
                appropriate periodicity, and at reasonable cost.

``SEC. 1913. STATE PERFORMANCE PARTNERSHIP PROPOSAL.

    ``(a) In General.--In order to be eligible to receive a grant under 
this subpart, a State shall propose to the Secretary a performance 
partnership in accordance with the provisions of this section.
    ``(b) Elements Related to Performance Objectives.--The State 
proposal under this section shall contain--
            ``(1) a list on one or more objectives (derived from the 
        performance partnership objectives specified under section 
        1911(b)) toward which the State will work and a performance 
        target for each objective which the State will seek to achieve 
        by the end of the partnership period;
            ``(2) a rationale for the State's selection of its 
        objectives, including its performance targets, and timeframes;
            ``(3) a statement of the State's strategies for achieving 
        the objectives over the course of the grant period;
            ``(4) a statement of the estimate amount to be expended to 
        carry out each strategy; and
            ``(5) an assurance that the State will report annually on 
        all core performance objectives specified under section 
        1911(b)(1)(B) (regardless of whether it is working toward those 
        objectives) and the specific objectives toward which the State 
        will work under the performance partnership.
A State may select an objective that is not a specified performance 
partnership objective under section 1911 if it demonstrates to the 
Secretary that the objective relates to a significant mental health 
problem in the State that would not otherwise be addressed 
appropriately (and that a suitable performance indicator exists to 
measure progress toward the objective).

``SEC. 1913. FEDERAL-STATE PERFORMANCE PARTNERSHIP.

    ``(a) Negotiations Concerning State Proposal.--
            ``(1) A State submitting a proposed performance partnership 
        and the Secretary shall make all reasonable efforts to agree on 
        a performance partnership pursuant to which the State shall 
        expend the grant provided under this subpart.
            ``(2) In the negotiations concerning the State's proposal, 
        the Secretary shall consider the extent to which the State's 
        proposed objectives, performance targets, timeframes, and 
        strategies are likely to address appropriately the most 
        significant mental health problems (as measured by applicable 
        indicators) within the State, including the mental health 
        problems of vulnerable populations (such as homeless 
        individuals and children with a serious emotional disturbance).
    ``(b) Partnership Period.--The Secretary, in consultation with the 
State, shall set the duration of the partnership with the State under 
this subpart. Initial and subsequent partnership periods shall be not 
less than three nor more than five years, except that the Secretary may 
agree to a partnership period of less than three years where a State 
demonstrates to the Secretary's satisfaction that such shorter period 
is appropriate.
    ``(c) Assessment and Adjustment.--
            ``(1) The Secretary shall assess annually.--
                    ``(A) the progress achieved nationally toward each 
                of the objectives in the core set of performance 
                partnership objectives; and
                    ``(B) in consultation with each State, the State's 
                progress toward each objective agreed upon in the 
                performance partnership under this subpart.
        The Secretary shall make assessments publicly available.
            ``(2) The Secretary and a State may at any time in the 
        course of a performance partnership renegotiate, and revise by 
        mutual agreement, the elements of the partnership in light of 
        new information or changed circumstances (including information 
        or changes identified during assessments under paragraph (1)).
    ``(d) Grants to States; Use of Funds.--
            ``(1) A grant shall be made to each State which has reached 
        agreement with the Secretary on a performance partnership under 
        this subpart, and is carrying out activities in accordance with 
        the terms of such partnership, in an amount equal to its 
        allotment under section 1918, for each fiscal year for which 
        the partnership is in effect.
            ``(2) Funds paid to a State from a grant described in 
        paragraph (1) may be used only for the purpose of carrying out 
        the partnership developed under this section (including related 
        data collection, evaluation, planning, administration, and 
        educational activities), except that a State may transfer up to 
        10 percent of its grant to its allotment under subpart II.''.
    (c) Additional General Provisions Concerning Partnerships.--
            (1) Subsection (a) of section 1917 is relocated and 
        redesignated as subsection (c) of section 1912, as added by 
        subsection (b) of this section, and is amended--
                    (A) in the matter preceding paragraph (2), to read 
                as follows:
    ``(c) Additional Elements.--A State proposal is in accordance with 
this subsection if--'';
                    (B) by striking ``application'' throughout and 
                substituting ``proposal'';
                    (C) in paragraph (3), by inserting ``proposed 
                performance partnership and'' before ``agreements'';
                    (D) in paragraph (7), by striking ``including the 
                plan under section 1912(a))''; and
                    (E) by striking paragraph (5) and redesignating 
                paragraphs (2) through (4), (6), and (7) as paragraphs 
                (1) through (5).
            (2) Section 1917(b) is--
                    (A) amended by striking ``section 1911'' and 
                inserting ``this subpart'', and
                    (B) relocated and redesignated as subsection (e) of 
                section 1913, as added by subsection (b) of this 
                section.
            (3) The heading of section 1917 is repealed.
    (d) Conforming Amendments.--
            (1) The heading to subpart I of part B of title XIX is 
        amended by striking ``Block'' and inserting ``Performance 
        Partnership''.
            (2) Sections 1914(a), 1915, 1916, 1918, and 1919(2) are 
        each amended by striking ``section 1911'' each place it occurs 
        and inserting ``this subpart''.
            (3) Section 1914(b)(1) is amended by striking ``plans'' 
        each place it occurs and inserting ``performance 
        partnerships''.
            (4) Sections 1915(a) and 1941 are each amended by striking 
        ``plan'' each place is occurs and inserting ``performance 
        partnership''.
            (5) The heading to section 1915(a) is amended by striking 
        ``Plan'' and inserting ``Performance Partnerships''.
            (6) The heading to section 1941 is amended by striking 
        ``plans'' and inserting ``partnerships''.
            (7) Section 1944(b)(3) is amended by striking ``1912(d) 
        or''.
            (8) Section 1945(d)(2)(A) is amended by striking ``the 
        condition established in section 1912(d) and''.
            (9) Subpart III of part B of title XIX is amended 
        throughout by striking ``section 1911'' and inserting ``subpart 
        I''.
            (10) Section 520(b) is amended--
                    (A) by striking paragraph (5), and
                    (B) by renumbering paragraphs (6) through (14) as 
                (5) through (13).
SEC. 102. REVIEW BY PLANNING COUNCIL OF STATE'S REPORT.

    Section 1915(a)(1) is amended by inserting ``(and the State's 
report under section 1942(a) concerning the preceding fiscal year)'' 
after ``to the grant''.

SEC. 103. STATE OPPORTUNITY TO CORRECT OR MITIGATE FAILURE TO MAINTAIN 
              EFFORT.

    Section 1915(b)(3)(A) is amended by striking the second sentence 
and adding the following: ``If the Secretary determines that a State 
has failed to maintain such compliance, the Secretary may permit the 
State, within one year (or less) after notification, to correct or 
mitigate the noncompliance. If the State does not carry out a 
correction or mitigation as specified by the Secretary (or if the 
Secretary decided it was not appropriate to provide that opportunity), 
the Secretary shall reduce the amount of the grant under this subpart 
for the State for the current fiscal year by an amount equal to the 
amount constituting such failure. That reduction shall be applied first 
to the amounts for administrative expenses under section 1916(b).''.

SEC. 104. FUNDING FOR ORGANIZATIONS THAT ARE FOR-PROFIT.

    Section 1916(a) is amended--
            (1) by adding ``or'' at the end of paragraph (3),
            (2) by striking ``; or'' at the end of paragraph (4) and 
        adding a period, and
            (3) by striking paragraph (5).

SEC. 105. MINIMUM AMOUNT FOR ALLOTMENTS.

    (a) In General.--Section 1918(b) is amended to read as follows:
    ``(b) Minimum Allotments.--For each fiscal year, the amount of the 
allotment of a State shall be at least equal to the amount the State 
received for fiscal year 1995 under this subpart and former part C of 
title V (but this minimum shall be proportionately reduced to the 
extent that the appropriation under this subpart for a fiscal year is 
less than the sum of the appropriations under this subpart and former 
part C of title V for fiscal year 1995).''.
    (b) Conforming Amendment.--Section 1918(c)(2)(C) is amended to read 
as follows:
                    ``(C) the amount determined under subsection 
                (b).''.

SEC. 106. APPROPRIATION AUTHORIZATIONS.

    Section 1920(a) is amended by striking ``$450,000,000'' and all 
that follows and inserting ``$305,000,000 for fiscal year 1996, and 
such sums as may be necessary for each of the four succeeding fiscal 
years.''.

SEC. 107. DATA COLLECTION, TECHNICAL ASSISTANCE, EVALUATIONS, INCENTIVE 
              GRANTS, AND FUNDING FOR INDIAN TRIBES.

    (a) Reserved Funds.--Section 1920(b) is amended to read as follows:
    ``(b) Reserved Funds.--
            ``(1) Data collection, technical assistance, and program 
        evaluations.--The Secretary shall reserve 5 percent of the 
        amounts appropriated for a fiscal year under subsection (a)--
                    ``(A) to carry out sections 505 (providing for data 
                collection) and 1948(a) (providing for technical 
                assistance to States) with respect to mental health, 
                and
                    ``(B) to conduct evaluations concerning programs 
                supported under this subpart.
        The Secretary may carry out activities funded pursuant to this 
        paragraph directly, or through grants, contracts, or 
        cooperative agreements.
            ``(2) Incentive grants.--The Secretary may reserve up to 10 
        percent of the amounts appropriated for a fiscal year under 
        subsection (a) to make payments to States that the Secretary 
        has determined demonstrate high or improved performance towards 
        achieving their targets. In making payments under the preceding 
        sentence the Secretary shall take into account the comparable 
        difficulty of a State's objectives and performance targets.
            ``(3) Funding for indian tribes.--The Secretary shall 
        reserve 3 percent of the amounts appropriated for a fiscal year 
        under subsection (a) to make payments to Indian tribes and 
        tribal organizations to carry out the goals of this subpart.''.
    (b) Data Collection Authority.--Section 505(a) is amended--
            (1) by striking ``and'' at the end of paragraph (1),
            (2) by striking the period at the end of paragraph (2) and 
        inserting ``; and'', and
            (3) by adding at the end the following:
            ``(3) other factors as needed to carry out part B of title 
        XIX.
The Secretary may conduct activities under the preceding sentence 
directly, or through grants, contracts, or cooperative agreements.''.
    (c) Conforming Amendment.--Section 1948(a) is amended by striking 
``through contract, or through grants'' and inserting ``or through 
grants, contracts, or cooperative agreements''.

SEC. 108. REPEAL OF GRANT PROGRAM FOR TRANSITION FROM HOMELESSNESS.

    Part C of title V is repealed.

SEC. 109. MENTAL HEALTH SERVICES AND TRAINING DEMONSTRATION PROJECTS.

    (a) General Demonstration Authority.--Section 520A is amended to 
read as follows:

      ``mental health services and training demonstration projects

    ``Sec. 520A. (a) In General.--The Secretary may make grants to, and 
enter into contracts and cooperative agreements with, States, local 
governments, Indian tribes, and other public and private entities for 
mental health prevention, treatment, and training demonstration 
projects (and may establish financial matching, maintenance of effort, 
or non-supplementation requirements for any or all projects). A 
specific project may receive funding under this section for no more 
than three years.
    ``(b) Focus of Projects.--Projects will be chosen based on 
practical service needs and current policy questions as determined by 
the Secretary in consultation with the States, local governments, 
Indian tribes, consumers, and relatives of consumers. Projects shall be 
designed for the development of timely, relevant, and replicable 
results of immediate use to service providers and officials who develop 
policy.
    ``(c) Evaluation.--The Secretary shall evaluate each project 
carried out under subsection (a) and shall disseminate to appropriate 
public and private entities information on effective projects.''.
    (b) Repeal of Authorities for Demonstration Projects for 
Individuals With Positive HIV Test Results.--Section 520B is repealed.
    (c) Conforming Amendments.--
            (1) Section 520(b)(6) (as renumbered by section 101(d)(8) 
        of this Act) is amended by striking ``sections 520A'' and all 
        that follows and inserting ``section 520A''.
            (2) Section 612 of the Stewart B. McKinney Homeless 
        Assistance Act is repealed.

SEC. 110. PROTECTION AND ADVOCACY FOR MENTALLY ILL INDIVIDUALS.

    (a) Appropriation Authorizations.--Section 117 of the Protection 
and Advocacy for Mentally Ill Individuals Act of 1986 is amended--
            (1) by striking ``and'' after ``1992,'', and
    (2) by inserting before the period the following: ``, $22,000,000 
for fiscal year 1996, and such sums as may be necessary for each of the 
four succeeding fiscal years''.
    (b) Adjustment to Hold-Harmless.--
            (1) Section 112(a)(2) of the Protection and Advocacy for 
        Mentally Ill Individuals Act of 1986 is amended to read as 
        follows:
    ``(2)(A) The minimum amount of the allotment of an eligible system 
shall be the product (rounded to the nearest 100 dollars) of the 
appropriate base amount specified in subparagraph (B) and the factor 
specified in subparagraph (C).
    ``(B) For purposes of subparagraph (A), the appropriate base amount 
is--
            ``(i) for American Samoa, Guam, the Marshall Islands, the 
        Federated States of Micronesia, the Commonwealth of the 
        Northern Mariana Islands, the Republic of Palau, and the Virgin 
        Islands, $139,300, and
            ``(ii) for any other State, $260,000.
    ``(C) For purposes of subparagraph (A), the factor is the ratio of 
the appropriation under section 117 for the fiscal year for which the 
allotment is made to that appropriation for fiscal year 1995.''.
            (2)(A) Section 112(a) of that Act is amended by striking 
        paragraph (3).
            (B) Section 112(a)(1)(B) of that Act is amended by striking 
        ``Trust Territory of the Pacific Islands'' and inserting 
        ``Marshall Islands, the Federated States of Micronesia, the 
        Republic of Palau''.

SEC. 111. COMPREHENSIVE COMMUNITY SERVICES FOR CHILDREN WITH A SERIOUS 
              EMOTIONAL DISTURBANCE.

    (a) Appropriation Authorizations.--Section 565(f)(1) is amended--
            (1) by striking ``and'' after ``1993,'', and
            (2) by inserting before the period the following: ``, 
        $60,000,000 for fiscal year 1996, and such sums as may be 
        necessary for each of the four succeeding fiscal years''.
    (b) Flexibility for Indian Tribes and Territories.--Section 562(c) 
is amended by adding at the end the following: ``The Secretary may 
waive one or more of the requirements of the preceding sentence (for a 
public entity that is an Indian tribe or tribal organization, or 
American Samoa, Guam, the Marshall Islands, the Federated States of 
Micronesia, the Commonwealth of the Northern Mariana Islands, the 
Republic of Palau, or the Virgin Islands) if the Secretary finds, after 
peer review, that the system of care is family-centered and uses the 
least restrictive environment that is clinically appropriate.''.

SEC. 112. NONDISCHARGEABILITY IN BANKRUPTCY OF PAYBACK FOR MENTAL 
              HEALTH CLINICAL TRAINEESHIPS.

    (a) General Rule.--Section 303(d) is amended by adding at the end 
the following:
    ``(6) Any obligation of an individual under paragraph (3) may be 
released by a discharge in bankruptcy under title 11, United States 
Code, only if the discharge is granted after the expiration of the 
seven-year period beginning on the first date that payment under that 
paragraph is required, and only if the Bankruptcy Court finds that the 
nondischarge of the obligation would be unconscionable.''.
    (b) Conforming Amendments to Bankruptcy Code.--
            (1) Section 523(a) of title 11, United States Code, is 
        amended--
                    (A) by striking ``or'' at the end of paragraph 
                (11),
                    (B) by adding ``or'' at the end of paragraph (12), 
                and
                    (C) by adding at the end the following:
            ``(13) that under provisions of the Public Health Service 
        Act is not to be discharged.''.
            (2) Section 1328(a)(2) of title 11, United States Code, is 
        amended by striking ``or (8)'' and inserting ``, (8), or 
        (13)''.

                       TITLE II--SUBSTANCE ABUSE

SEC. 201. REPLACEMENT OF STATE PLAN PROGRAM WITH PERFORMANCE 
              PARTNERSHIPS.

    (a) Elimination of State Plan Program Requirements.--Subpart II of 
part B of title XIX is amended--
            (1) by striking section 1921 (concerning formula grants to 
        States),
            (2) by redesignating section 1922 as section 1923A, and
            (3) by striking section 1923 (concerning intravenous 
        substance abuse programs).
    (b) Performance Partnership Framework.--Subpart II of part B of 
title XIX is further amended by inserting after the subpart heading the 
following new sections:

``SEC. 1921. PERFORMANCE PARTNERSHIP GOALS AND OBJECTIVES.

    ``(a) Goals.--The goals of this subpart are for the States and the 
Federal Government, working together in a partnership--
            ``(1) to reduce the incidence and prevalence of substance 
        abuse and dependence;
            ``(2) to improve access to and availability of appropriate 
        prevention and treatment programs for targeted populations;
            ``(3) to enhance the effectiveness of substance abuse 
        prevention and treatment programs; and
            ``(4) to reduce the community and personal health risks for 
        substance abuse.
    ``(b) Performance Partnership Objectives.--
            ``(1) The Secretary, in consultation with the States, local 
        governments, Indian tribes, and other interested parties 
        designated by the Secretary (including consumers and relatives 
        of consumers), shall specify by the end of September 1996 (and 
        from time to time revise, as needed)--
                    ``(A) a list of performance partnership objectives 
                to carry out the goals of this subpart, and
                    ``(B) a core set of not more than five of those 
                objectives that address substance abuse problems of 
                national significance.
            ``(2) Each performance partnership objective shall 
        include--
                    ``(A) a performance indicator;
                    ``(B) the specific population being addressed;
                    ``(C) a quantifiable performance target; and
                    ``(D) a date by which the target level is to be 
                achieved.
            ``(3) In specifying the performance partnership objectives, 
        the Secretary shall consider the goals, priorities, and 
        objectives of the National Drug Control Strategy and be guided 
        by the following principles--
                    ``(A) objectives should be closely related to the 
                goals of this subpart, and be viewed as important by 
                and understandable to State policymakers and the 
                general public;
                    ``(B) actions taken under the partnership agreement 
                should be expected to have an impact on the objective;
                    ``(C) measurable progress in achieving the 
                objective should be expected over the period of the 
                grant;
                    ``(D) objectives should be results-oriented, 
                including a mix of outcome, process and capacity 
                measurers, and, if an objective measures process or 
                capacity, it should be demonstrably linked to the 
                achievement of a health outcome; and
                    ``(E) data to track the objective should, to the 
                extent practicable, be comparable for all grant 
                recipients, meet reasonable statistical standards for 
                quality, and be available in a timely fashion, at 
                appropriate periodicity, and at reasonable cost.

``SEC. 1922. STATE PERFORMANCE PARTNERSHIP PROPOSAL.

    ``(a) In General.--In order to be eligible to receive a grant under 
this subpart, a State shall propose to the Secretary a performance 
partnership in accordance with the provisions of this section.
    ``(b) Elements Related to Performance Objectives.--The State 
proposal under this section shall contain--
            ``(1) a list of one or more objectives (derived from the 
        performance partnership objectives specified under section 
        1921(b)) toward which the State will work and a performance 
        target for each objective which the State will seek to achieve 
        by the end of the partnership period;
            ``(2) a rationale for the State's selection of its 
        objectives, including its performance targets, and timeframes;
            ``(3) a statement of the State's strategies for achieving 
        the objectives over the course of the grant period;
            ``(4) a statement of the estimated amount to be expended to 
        carry out each strategy; and
            ``(5) an assurance that the State will report annually on 
        all core performance objectives specified under section 
        1921(b)(1)(B) (regardless of whether it is working toward
         those objectives) and the specific objectives toward which the 
State will work under the performance partnership.
A State may select an objective that is not a specified performance 
partnership objective under section 1921 if it demonstrates to the 
Secretary that the objective relates to a significant health problem 
related to substance abuse in the State that would not otherwise be 
addressed appropriately (and that a suitable performance indicator 
exists to measure progress toward the objective).

``SEC. 1923. FEDERAL-STATE PERFORMANCE PARTNERSHIP.

    ``(a) Negotiations Concerning State Proposal.--
            ``(1) A State submitting a proposed performance partnership 
        and the Secretary shall make all reasonable efforts to agree on 
        a performance partnership pursuant to which the State shall 
        expend the grant provided under this subpart.
            ``(2) In the negotiations concerning the State's proposal, 
        the Secretary shall consider the extent to which the State's 
        proposed objectives, performance targets, timeframes, and 
        strategies are likely to address appropriately the most 
        significant health problems associated with substance abuse (as 
        measured by applicable indicators) within the State, including 
        the health problems associated with substance abuse of 
        vulnerable populations (such as pregnant women and women with 
        children).
    ``(b) Partnership Period.--The Secretary, in consultation with the 
State, shall set the duration of the partnership with the State under 
this subpart. Initial and subsequent partnership periods shall be not 
less than three nor more than five years, except that the Secretary may 
agree to a partnership period of less than three years where a State 
demonstrates to the Secretary's satisfaction that such shorter period 
is appropriate.
    ``(c) Assessment and Adjustment.--
            ``(1) The secretary shall assess annually--
                    ``(A) the progress achieved nationally toward each 
                of the objectives in the core set of performance 
                partnership objectives; and
                    ``(B) in consultation with each State, the State's 
                progress toward each objective agreed upon in the 
                performance partnership under this subpart.
        The Secretary shall make assessments publicly available.
            ``(2) Revision of Performance Partnerships.--The Secretary 
        and a State may at any time in the course of a performance 
        partnership renegotiate, and revise by mutual agreement, the 
        elements of the partnership in light of new information or 
        changed circumstances (including information or changes 
        identified during assessments under paragraph (1)).
    ``(d) Grants to States; Use of Funds.--
            ``(1) A grant shall be made to each State which has reached 
        agreement with the Secretary on a performance partnership under 
        this subpart, and is carrying out activities in accordance with 
        the terms of such partnership, in an amount equal to its 
        allotment under section 1933, for each fiscal year in which the 
        partnership is in effect.
            ``(2) Funds paid to a State from a grant described in 
        paragraph (1) may be used only for the purpose of carrying out 
        the partnership developed under this section (including related 
        data collection, evaluation, planning, administration, and 
        educational activities), except that a State may transfer up to 
        10 percent of its grant to its allotment under subpart I.''.
    (c) Additional General Provisions Concerning Partnerships.--
            (1) Section 1932 is amended by striking ``section 1921'' 
        each place it occurs and inserting ``this subpart''.
            (2) Subsection (a) of section 1932 is relocated and 
        redesignated as subsection (c) of section 1922, as added by 
        subsection (b) of this section, and is amended--
                    (A) in the matter preceding paragraph (2), to read 
                as follows:
    ``(c) Additional Elements.--A State proposal is in accordance with 
this subsection if--'';
                    (B) by striking ``application'' throughout and 
                substituting ``proposal'';
                    (C) in paragraph (3), by inserting ``proposed 
                performance partnership and'' before ``agreements'';
                    (D) in paragraph (7), by striking ``including the 
                plan under paragraph (6))''; and
                    (E) by striking paragraphs (5) and (6) and 
                redesignating paragraphs (2) through (4) and (7) as 
                paragraphs (1) through (4).
            (3) Section 1932(c) is relocated and redesignated as 
        subsection (e) of section 1923, as added by subsection (b) of 
        this section.
            (4) The remainder of section 1932 is repealed.
    (d) Conforming Amendments.--
            (1) The heading to subpart II of part B of title XIX is 
        amended by striking ``Block'' and inserting ``Performance 
        Partnership''.
            (2) Sections 1924, 1926, 1928, 1930, 1931, 1933, and 
        1934(2) are each amended by striking ``section 1921'' each 
        place it occurs and inserting ``this subpart''.
            (3) Subpart III of part B of title XIX is amended 
        throughout by striking ``section 1921'' and inserting ``subpart 
        II''.

SEC. 202. REPEALS, REDESIGNATIONS, AND CONFORMING AMENDMENTS.

    (a) Substance Abuse and Tuberculosis.--Section 1924 is amended--
            (1) in the heading, by striking ``tuberculosis and'';
            (2) by striking subsection (a);
            (3) in subsection (c)--
                    (A) in the heading, by striking ``agreements'' and 
                inserting ``partnerships'', and
                    (B) in paragraph (1), by striking ``Agreements'' 
                and inserting ``Partnerships''; and
            (4) by redesignating subsections (b) through (e) as 
        subsections (a) through (d).
    (b) Group Homes for Recovering Substance Abusers.--
            (1) Section 1925 is repealed.
            (2) Section 507(b) is amended--
                    (A) in paragraph (11), by striking ``including the 
                effect of living in housing provided by programs 
                established under section 1925,'',
                    (B) in paragraph (12), by striking ``paragraph 
                (11)'' and inserting ``paragraph (9)'',
                    (C) by striking paragraphs (1) and (5), and
                    (D) by renumbering paragraphs (2), (3), (4), (6), 
                (7), (8), (9), (10), (11) and (12) as (1), (2), (3), 
                (4), (5), (6), (7), (8), (9), and (10), respectively.
    (c) Certain Allocations.--Section 1923A (as redesignated by section 
201(a)) is further redesignated and relocated as section 1925, and is 
amended--
            (1) in the matter in subsection (b) preceding paragraph 
        (1), by striking ``section 1921'' and inserting ``this 
        subpart'',
            (2) by striking subsections (a) (concerning allocations 
        regarding alcohol and other drugs) and (c) (concerning 
        allocations regarding women);
            (3) in the heading, by striking ``certain allocations'' and 
        inserting allocation regarding primary prevention programs''; 
        and
            (4) by striking the subsection designation ``(b)'' and the 
        heading that follows.
    (d) Treatment Services for Pregnant Women.--
            (1) Section 1927 is repealed.
            (2) Conforming amendment.--Section 1934(6) is repealed.
    (e) Additional Agreements.--Section 1928 is amended--
            (1) by striking subsections (a) (concerning treatment 
        referral process), (b) (concerning continuing education), and 
        (d) (concerning waivers);
            (2) in the heading, by striking ``additional agreements'' 
        and inserting ``coordination of various activities and 
        services''; and
            (3) by striking the subsection designation ``(c)'' and the 
        heading that follows.
    (f) Statewide Assessment of Needs.--Section 1929 is repealed.

SEC. 203. HIGHER THRESHOLD FOR REQUIREMENT CONCERNING HUMAN 
              IMMUNODEFICIENCY VIRUS.

            Section 1924(b)(2) is amended by striking ``10'' and 
        inserting ``15''.

SEC. 204. STATE OPPORTUNITY TO CORRECT OR MITIGATE FAILURE TO MAINTAIN 
              EFFORT.

    Section 1930(c)(1) is amended by striking the second sentence and 
adding the following: ``If the Secretary determines that a State has 
failed to maintain such compliance, the Secretary may permit the State, 
within one year (or less) after notification, to correct or mitigate 
the noncompliance. If the State does not carry out a correction or 
mitigation as specified by the Secretary (or if the Secretary decided 
it was not appropriate to provide that opportunity), the Secretary 
shall reduce the amount of the grant under this subpart for the State 
for the current fiscal year by an amount equal to the amount 
constituting such failure. That reduction shall be applied first to the 
amounts for administrative expenses under section 1931(a)(2).''.

SEC. 205. FUNDING FOR ORGANIZATIONS THAT ARE FOR-PROFIT.

    Section 1931(a)(1) is amended--
            (1) by adding ``or'' at the end of subparagraph (D); and
            (2) by striking subparagraph (E).

SEC. 206. APPROPRIATION AUTHORIZATIONS.

    Section 1935(a) is amended by striking ``$1,500,000,000'' and all 
that follows and inserting ``$1,294,000,000 for fiscal year 1996, and 
such sums as may be necessary for each of the four succeeding fiscal 
years.''.

SEC. 207. DATA COLLECTION, TECHNICAL ASSISTANCE, EVALUATIONS, INCENTIVE 
              GRANTS, AND FUNDING FOR INDIAN TRIBES.

    Section 1935(b) is amended to read as follows:
    ``(b) Reserved Funds.--
            ``(1) Data collection, technical assistance, and program 
        evaluations.--
                    ``(A) The Secretary shall reserve 5 percent of the 
                amounts appropriated for a fiscal year under subsection 
                (a)--
                            ``(i) to carry out sections 505 (providing 
                        for data collection) and 1948(a) (providing for 
                        technical assistance to States) with respect to 
                        substance abuse;
                            ``(ii) to carry out section 515(d) 
                        (providing for a substance abuse prevention 
                        data base); and
                            ``(iii) to conduct evaluations concerning 
                        programs supported under this subpart.
                The Secretary may carry out activities funded pursuant 
                to this paragraph directly, or through grants, 
                contracts, or cooperative agreements.
                    ``(B) Of the amounts reserved under subparagraph 
                (A) for a fiscal year, 20 percent shall be used for 
                activities related to prevention.
            ``(2) Incentive grants.--The Secretary may reserve up to 10 
        percent of the amounts appropriated for a fiscal year under 
        subsection (a) to make payments to States that the Secretary 
        has determined demonstrate high or improved performance toward 
        achieving their targets. In making payments under the preceding 
        sentence the Secretary shall take into account the comparable 
        difficulty of a State's objectives and performance targets.
            ``(3) Funding for indian tribes.--The Secretary shall 
        reserve 3 percent of the amounts appropriated for a fiscal year 
        under subsection (a) to make payments to Indian tribes and 
        tribal organizations to carry out the goals of this subpart.''.
SEC. 208. SUBSTANCE ABUSE PREVENTION, TREATMENT, AND TRAINING 
              DEMONSTRATION PROJECTS.

    (a) General Demonstration Authority.--Section 506 is amended to 
read as follows:

  ``substance abuse prevention, treatment, and training demonstration 
                                projects

    ``Sec. 506. (a) In General.--The Secretary may make grants to, and 
enter into contracts and cooperative agreements with, States, local 
governments, Indian tribes, and other public and private entities for 
substance abuse prevention, treatment, and training demonstration 
projects (and may establish financial matching, maintenance of effort, 
or non-supplantation requirements for any or all projects). A specific 
project may receive funding under this section for no more than three 
years.
    ``(b) Focus of Projects.--Projects will be chosen based on 
practical service needs and currant policy questions as determined by 
the Secretary in consultation with the States, local governments, 
Indian tribes, consumers, and relatives of consumers. Projects shall be 
designed for the development of timely, relevant, and replicable 
results of immediate use to service providers and officials who develop 
policy. Projects should consider the goals, priorities, and objectives 
of the National Drug Control Strategy.
    ``(c) Evaluation.--The Secretary shall evaluate each project 
carried out under subsection (a) and shall disseminate to appropriate 
public and private entities information on effective projects.''.
    (b) Repeal of Redundant Authorities.--
            (1) Sections 508, 509, 510, 511, 512, 515(b)(5), 516, 517, 
        518, part F of title V, and subpart I of part C of title XIX 
        are repealed.
            (2) Section 515(b) is further amended by renumbering 
        paragraphs (6) through (10) as (5) through (9).
            (3) Part C of title XIX is further amended--
                            (A) by striking the heading to subpart II, 
                        and
                            (B) by striking ``Certain Programs 
                        Regarding Substance Abuse'' in the heading to 
                        the part and inserting ``Treatment of Narcotics 
                        Dependence''.

SEC. 209. STATE SUBSTANCE ABUSE PREVENTION AND TREATMENT PLANNING 
              COUNCIL.

    Subpart II of part B of title XIX is further amended by inserting 
after section 1926 the following:

``SEC. 1927. STATE SUBSTANCE ABUSE PREVENTION AND TREATMENT PLANNING 
              COUNCIL.

    ``(a) In General.--A funding agreement for a grant under this 
subpart is that the State involved will establish and maintain a State 
substance abuse prevention and treatment planning council in accordance 
with the conditions described in this section.
    ``(b) Duties.--A condition under subsection (a) for a council is 
that the duties of the council are--
            ``(1) to review performance partnerships and related 
        reports provided to the council by the State involved and to 
        submit to the State any recommendations of the council for 
        modifications,
            ``(2) to serve as an advocate for individuals suffering 
        from substance abuse, and
            ``(3) to monitor, review, and evaluate, not less than once 
        each year, the allocation and adequacy of substance abuse 
        prevention and treatment services within the State.
    ``(c) Membership.--
            ``(1) In general.--A condition under subsection (a) for a 
        council is that the council be composed of residents of the 
        State, including representatives of--
                    ``(A) the principal State agencies with respect 
                to--
                            ``(i) substance abuse prevention and 
                        treatment, education, vocational 
                        rehabilitation, criminal justice, housing, and 
                        social services, and
                            ``(ii) the development of the plan 
                        submitted pursuant to title XIX of the Social 
                        Security Act,
                    ``(B) public and private entities concerned with 
                the need, planning, operation, funding, and use of 
                substance abuse prevention and treatment services and 
                related support services,
                    ``(C) individuals who are receiving (or have 
                received) substance abuse prevention or treatment 
                services, and
                    ``(D) the families of such individuals.
            ``(2) Limitation on state employees and providers.--A 
        condition under subsection (a) for a council is that not less 
        than 50 percent of the members of the council are individuals 
        who are not State employees or providers of substance abuse 
        prevention or treatment services.
    ``(d) Review of State Performance Partnership by Planning 
Council.--The Secretary may make a grant under this subpart only if--
            ``(1) the performance partnership submitted under this 
        subpart with respect to the grant (and the State's report under 
        section 1942(a) concerning the preceding fiscal year) has been 
        reviewed by the council, and
            ``(2) the State submits to the Secretary any 
        recommendations received by the State from the council for 
        modifications to the performance partnership (without regard to 
        whether the State has made the recommended modifications).''.

SEC. 210. REPEAL OF OBSOLETE PROVISIONS CONCERNING SUBSTANCE ABUSE 
              ALLOCATIONS.

    (a) In General--Section 1933 is amended--
            (1) by striking subsection (b);
            (2) in subsection (c)(2)--
                    (A) by adding ``and'' at the end of subparagraph 
                (A);
                    (B) by striking ``; and'' at the end of 
                subparagraph (B) and adding a period; and
                    (C) by striking subparagraph (C); and
            (3) by redesignating subsections (c) and (d) as (b) and 
        (c), respectively.
    (b) Conforming Amendment.--Section 1992(c) (as redesignated by 
section 201(c)(2) of this Act) is amended by striking ``section 
1933(c)(2)(B)'' and inserting ``section 1933(b)(2)(B)''.

SEC. 211. REPEAL OF OBSOLETE ADDICT REFERRAL PROVISIONS.

    (a) Repeal of Obsolete Public Health Service Act Authorities.--Part 
E of title III is repealed.
    (b) Repeal of Obsolete NARA Authorities.--Titles III and IV of the 
Narcotic Addict Rehabilitation Act of 1966 are repealed.
    (c) Repeal of Obsolete Title 28 Authorities.--
            (1) Chapter 175 of title 28, United States Code, is 
        repealed.
            (2) The table of contents to part VI of title 28, United 
        States Code, is amended by striking the material related to 
        chapter 175.

                           TITLE III--GENERAL

SEC. 301. REPORTING BY STATES ON PERFORMANCE.

    Section 1942(a) is amended--
            (1) by striking ``and'' at the end of paragraph (1),
            (2) by striking the period at the end of paragraph (2) and 
        inserting ``; and'', and
            (3) by adding at the end the following:
            ``(3) the performance of the State in relation to the 
        objectives specified or agreed upon under section 1911(b)(1)(B) 
        and 1913, or section 1921(b)(1)(B) and 1923, as applicable.''.

SEC. 302. ELIMINATION OF STATE PEER REVIEW REQUIREMENT.

    Section 1943(a) is amended--
            (1) by striking paragraph (1), and
            (2) by renumbering paragraphs (2) and (3) as (1) and (2), 
        respectively.

SEC. 303. ON SITE PERFORMANCE REVIEWS.

    Section 1945(g)(1) is amended by striking ``in fiscal year 1994'' 
and all that follows and inserting ``, not more frequently than every 
three nor less frequently than every five years, conduct an on-site 
performance review of a State's activities supported under this 
part.''.

SEC. 304. ADDITIONAL YEAR FOR OBLIGATION BY STATE.

    Section 1952(a) is amended by striking everything after ``available 
for obligation'' and inserting ``and expenditure until the end of the 
fiscal year following the fiscal year for which the amounts were 
paid.''.

SEC. 305. DEFINITIONS.

    Section 1954(b) is amended by striking paragraph (4) and inserting 
the following:
            ``(4) The term `performance indicator' means a quantifiable 
        characteristic used as a measurement.
            ``(5) The term `performance target' means a numerical value 
        sought to be achieved within a specified period of time.''.

SEC. 306. APPROPRIATION AUTHORIZATIONS FOR DEMONSTRATION PROGRAMS.

    Part A of title V is amended by adding after section 506 the 
following:
       ``appropriation authorizations for demonstration projects

    ``Sec. 506A. For the purpose of carrying out sections 506 and 520A 
there are authorized to be appropriated $506,000,000 for fiscal year 
1996, $483,000,000 for fiscal year 1997, $300,000,000 for fiscal year 
1998, and such sums as may be necessary for each of the two succeeding 
fiscal years.''.

SEC. 307. HEADINGS.

    (a) Heading to Title XIX.--The heading to title XIX is amended by 
striking ``BLOCK'' and inserting ``PERFORMANCE PARTNERSHIP''.
    (b) Heading to Part B of Title XIX.--The heading to part B of title 
XIX is amended by striking ``Block'' and inserting ``Performance 
Partnership''.

SEC. 308. REGULATIONS.

    Section 1949 is amended to read as follows:

``SEC. 1949. REGULATIONS.

    ``The Secretary shall prescribe regulations as needed to carry out 
this part.''.

SEC. 309. EFFECTIVE DATES AND TRANSITIONAL PROVISIONS.

    (a) Appropriation Authorizations and Demonstrations.--
            (1) The amendments made by sections 105, 106, 108, 109, 
        110, 111, 206, 208, and 306 of this Act apply to periods 
        beginning after fiscal year 1995.
            (2) A project that receives support for fiscal year 1996, 
        1997, or 1998 under section 506 or 520A of the Public Health 
        Service Act (as amended by section 109(a) or 208(a) of this 
        Act, respectively), and that previously received support under 
        title V of the Public Health Service Act for fiscal year 1995, 
        shall be subject to the requirements to which that project was 
        subject for fiscal year 1995 unless the Secretary of Health and 
        Human Services determines otherwise.
    (b) State Opportunity To Correct or Mitigate Failure To Maintain 
Effort.--The amendments made by sections 103 and 204 apply to failures 
occurring after fiscal year 1994.
    (c) Repeal of Penalty Provision for Failure To Implement 
Completely, and of Obsolete Provisions.--The repeal of section 1912(d) 
of the Public Health Service Act by section 101(a) of this Act, and the 
amendments enacted by sections 210 and 211 of this Act, are effective 
upon enactment.
    (d) Effective Date for Nondischargeability in Bankruptcy.--The 
amendment made by section 112(a) applies to bankruptcy proceedings in 
which a discharge has not been granted before 31 days after the date of 
enactment of this Act.
    (e) Funding for Indian Tribes.--Sections 1920(b)(3) and 1935(b)(3) 
of the Public Health Service Act (as amended and enacted by sections 
107(a) and 207, respectively, of this Act) apply to fiscal years after 
fiscal year 1996.
    (f) Performance Partnership and Related Provisions.--
            (1) The amendments made by the preceding sections of this 
        Act (other than the amendments listed in the preceding 
        subsections of this section) apply to activities related to 
        grants for periods after fiscal year 1996, except that the 
        amendments apply with respect to a State (for either of the 
        grant programs affected by those amendments), if earlier, on 
        the effective date of a performance partnership under such 
        program.
            (2) The Secretary of Health and Human Services may select a 
        list of prototype performance partnership objectives and a core 
        set of those objectives on which all States should report (as 
        provided in section 1911 or 1921 of the Public Health Service 
        Act, as amended by sections 101(a) and 201(a), respectively, of 
        this Act, but without consultation with other parties). The 
        amendments made by the preceding sections of this Act (other 
        than the amendments listed in the preceding subsections of this 
        section), in conjunction with the first sentence of this 
        paragraph, apply (until the time applicable under paragraph (1) 
        of this subsection with respect to a State (for either of the 
        grant programs affected by those amendments) at such time as 
        the Secretary of Health and Human Services and the State may 
        agree.
            (3) In the case of the initial partnership proposal by a 
        State under paragraph (2) of this subsection, or under subpart 
        I or II of part B of title XIX of the Public Health Service 
        Act--
                    (A) if the Secretary of Health and Human Services 
                and a State reach agreement on or before March 31 of a 
                fiscal year, the performance partnership shall take 
                effect, at State option, as of the beginning of such 
                fiscal year or of the succeeding fiscal year; and
                    (B) if such agreement is reached after March 31 of 
                a fiscal year, the performance partnership shall take 
                effect as of the beginning of the succeeding fiscal 
                year.
            (4) The requirements of part C of title V of the Public 
        Health Service Act (as in effect on the day before the date of 
        enactment of this Act) shall continue to apply (until the time 
        applicable under paragraph (1) or (2) of this subsection), with 
        respect to a State, to that portion of a grant to the State for 
        a fiscal year under subpart I of part B of title XIX of that 
        Act that bears the same relationship to the entire grant as the 
        amount granted to the State for fiscal year 1995 under part C 
        of title V of that Act bore to the amount granted to the State 
        for fiscal year 1995 under part C of title V and subpart I of 
        part B of title XIX of that Act.
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